uuummmm... as guerilla pointed out, 20% of $500 is more than 50% of $100. Also, they can always change it latter. The trick in a negotiation is the make the other side *think* they won.
They don't give a shit about pre-existing conditions so long as everyone has to take them on, the costs is just passed on to their user base.
OK, I will admit that in general Insurance companies will get more customers as a number from what they had before because of the new insurance pool.
Take a look at the following conditions though:
1. 80% of what the end customer pays has to go to paying claim CPTs.
2. They have to accept anyone willing to pay for insurance, regardless of their health status.
3. They have to compete to get to the new pool
4. The new pool is generally of low quality business (low incomes, pre-existings). The exception is young people, these people will end up bearing costs. Which is how insurance pools are supposed to work.
Also no one has addressed the end result, that effectively more people will end up joining the insurance pool and paying in at least some amount and start getting needed and recommended care.
Do you know how why the costs are so high for medical care? Lets address that. I have a sanitized SQL DB sitting here with 280 medical centers around the country with around 2000 doctors/providers and all of their claims from the start of this year.
Here are some stats:
Self-Pay (read uninsured) billed amounts are approximately
600% of the
allowed amount for matching CPTs. This means that most care providers are charging their self pay patients
6 TIMES what they accept as a payment for a particular charge from an insurance company or medicare. Individuals have almost NO leverage to dispute the bill.
THIS IS WHY ADVIL IS $60 A PILL AT HOSPITALS.
Lets look at buying power/leverage on costs, the payors with the highest calculated market leverage (aka highest negative standard deviations from the arithmetic average of (CPT code - Allowed amounts) both contractual and claim based for that code) are:
Medicaid - around 0.4 dev from mean
Medicare - same as medicaid but little higher
UHC (united health) - 0.18 for CA, their biggest market
Cigna - even lower for most states
Aetna - Northeast has less than 0.1 std dev
That means Medicare and Medicaid are the most effective cost controllers for any given CPT, with the private payors controlling costs very closely to how big their collective pools are.
This is exactly what I mean by the ACA being good for the economy, it pushes more people into insurance plans and those who can't afford it on to medicaid/care or subsidies. It increases the market power/leverage of the companies and the individuals themselves to demand lower costs.
That in turn puts pressure on the care providers to deliver at lower costs because they get paid much lower amounts. You don't have people like Liam's mom going bankrupt as much and putting other negative unseen externalities into the market (she can't work or defaults on the debt, which lowers the revenue of the financial institution that lent it etc.).
Tons of image macros about me being economically illiterate but no counterexamples, no one has given me a solid reasoned argument for why the ACA is economically detrimental past "premiums will go up for some" to "but the gubmint maaaaan".
Like I said, in general a free market works well, but for a product that cannot be effectively shopped for at the point of delivery, cannot be evaluated for quality without a 2nd or 3rd party and isn't paid for by the purchaser directly is NOT going to solve to the pareto optimal distribution of said resource. Literally no one can tell me why that is not the case, I would love to hear it and would even love more to be wrong and learn something I didn't know about econ or a theory that is truly novel.
