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Still Sensible

(2,870 posts)
Wed Aug 18, 2021, 08:30 PM Aug 2021

Why shouldn't health insurers demand a higher premium

for adults that refuse to be vaccinated. Maybe they are just waiting for full FDA before pulling that trigger... but make no mistake, there will be immediate bills filed by repug neanderthals to prohibit that.

But here's the thing. The whole insurance industry is based on mitigating risk, so those who willfully put themselves at greater risk should face a higher premium IMO. Of course there are certain mitigating conditions that would need to be factored in if those conditions make some unable to have the shot. JMHO

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Why shouldn't health insurers demand a higher premium (Original Post) Still Sensible Aug 2021 OP
"The whole insurance industry is based on mitigating risk" -- I disagree. Pobeka Aug 2021 #1
My employer requires me to affirm I don't smoke else... VarryOn Aug 2021 #2
Neither of those are permitted reasons for a surcharge. Ms. Toad Aug 2021 #8
OK. Thanks. That makes sense.... VarryOn Aug 2021 #11
Yeah but where does it stop? luv2fly Aug 2021 #3
Not everyone has insurance leftstreet Aug 2021 #4
No, it won't solve the problem, but Still Sensible Aug 2021 #6
The cheapest option is to triage them out. roamer65 Aug 2021 #5
If Jeebus (or his spokesman) told them to not vaccinate... Thunderbeast Aug 2021 #10
Because the ACA prohibits it. Ms. Toad Aug 2021 #7
Thanks for that. It would seem to me that insurance companies Still Sensible Aug 2021 #9
I support this 100% LetMyPeopleVote Aug 2021 #12

Pobeka

(4,999 posts)
1. "The whole insurance industry is based on mitigating risk" -- I disagree.
Wed Aug 18, 2021, 08:35 PM
Aug 2021

The industry is based on making a profit.

They can do that with or without separate groups for vaxed/unvaxed.

Ultimately, I wish they would just offer a discount for being vaxed, rather than a premium increase for being unvaxed. This may be a legitimate loophole through the ACA? I am not sure about that at all...

 

VarryOn

(2,343 posts)
2. My employer requires me to affirm I don't smoke else...
Wed Aug 18, 2021, 08:35 PM
Aug 2021

I'm subject to a higher premium. Charging unvaccinated seems fair. I'd ding overweight people, too.

Ms. Toad

(33,785 posts)
8. Neither of those are permitted reasons for a surcharge.
Wed Aug 18, 2021, 10:39 PM
Aug 2021

Smoking is the only health/behavior-based reason for a surcharge, and the surcharge is capped at 1.5 x the premium for non-smokers.

 

VarryOn

(2,343 posts)
11. OK. Thanks. That makes sense....
Wed Aug 18, 2021, 11:12 PM
Aug 2021

StilI, I would be OK with those who are not taking health seriously being penalized .

luv2fly

(2,474 posts)
3. Yeah but where does it stop?
Wed Aug 18, 2021, 08:44 PM
Aug 2021

I get what you're saying but people engage in all sorts of unsafe behaviors. How does someone decide which ones cost more to be insured and which ones don't?

leftstreet

(36,050 posts)
4. Not everyone has insurance
Wed Aug 18, 2021, 09:01 PM
Aug 2021

There are uninsured, Medicare and Medicaid recipients, etc

Singling out premium-payers won't solve the vax problem

Still Sensible

(2,870 posts)
6. No, it won't solve the problem, but
Wed Aug 18, 2021, 10:28 PM
Aug 2021

I would argue that, until recently, the overwhelming financial burden has largely been on Medicare and Medicaid. That is because, early on, COVID was much more deadly to the older population and it seemed disproportionately in non-elderly populations of people that were low income.

Now that the Delta variant is seemingly more contagious and apparently more deadly, I expect the health insurance industry will be asking for relief soon.

roamer65

(36,736 posts)
5. The cheapest option is to triage them out.
Wed Aug 18, 2021, 09:24 PM
Aug 2021

Food, water, cot over in that tent in the parking lot or parking structure.

Thunderbeast

(3,338 posts)
10. If Jeebus (or his spokesman) told them to not vaccinate...
Wed Aug 18, 2021, 11:01 PM
Aug 2021

Send them to church. Lay them out on a pew.

Call them the control group.

Ms. Toad

(33,785 posts)
7. Because the ACA prohibits it.
Wed Aug 18, 2021, 10:38 PM
Aug 2021

Does no one remember one of the main premises of the ACA? Insurance companies which were free to set premiums as they deemed fit made anyone with a chronic health condition uninsurable. My daughter, with a condition that has a minimum of $200,000/year in billed expenses, was uninsurable, unable to stay in school full time after she reached the age 18 (a condition to remain on our insurance) and unable to work at a job that provided health insurance, was uninsurable. The ACA is the only way she has access to a means to pay for her health care.

Under the ACA, to avoid making people uninsurable, there are only 5 reasons to vary premiums: smoking, age, geography, single v family, and plan type.

Specific health conditions, or behavior (other than smoking) are not valid bases for charging one person higher premiums than another.

To change that, you would need to amend the ACA - which has been in litigation since it was enacted more than a decade ago. Anyone attempting to amend it to punish people based on health condition will earn my undying wrath.

Still Sensible

(2,870 posts)
9. Thanks for that. It would seem to me that insurance companies
Wed Aug 18, 2021, 10:42 PM
Aug 2021

either need to find a way to incentivize or get some bill moving. Based on the current data, they are about to be overwhelmed by the volume of hospitalizations not otherwise covered by the government.

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