johde
DIS Veteran
- Joined
- Jul 27, 2002
- Messages
- 3,817
Right now the only winners are the insurance companies who have put some pretty pathetic offerings onto the healthcare exchange. Unfortunately, the ACA does fall short since it is full of partisan compromises.
In some cases it's the insurance companies but in other cases it's the state legislatures. I know in California, New York, and probably some others, the state decided what a platinum, gold, silver, and bronze plan would look like. So different insurance companies are only competing on price and network.
In other states, the insurance companies decided on the plans. In either case, the plans need to meet the actuarial guidelines established under the ACA. IE. Bronze plans for supposed to pay 60% of expected medical costs, silver 70%, gold 80%, and platinum 90%. There are also requirement regarding maximum out of pocket spending. For 2014, I think the maximum in network OOP is $6350.