Shot:
Chaser:
Single-Payer Healthcare System Projected to Send Colorado Off a Financial Cliff
[Hat Tip: FoIB Holly R]
Single-Payer Healthcare System Projected to Send Colorado Off a Financial Cliff
[Hat Tip: FoIB Holly R]
Wednesday, August 10, 2016
Arizona Central Strikes Out
How can Arizona Central newspaper, part of USA Today, call themselves journalists? Their #Obamacare fluff piece alerts the readers that premiums will rise as health insurance carriers leave the Arizona market.
No kidding.
They even have the gall to reference a report that has nothing to do with reality in Arizona.
Nine percent? How about 19% to 122%?
Rates filed with the Arizona Dept of Insurance have been reviewed and (presumably) approved. Note that some of the "final" rates are higher than the carriers requested.
How do you like those apples?
Shame on you Arizona Central. You should have your press pass revoked.
Five insurance companies that had offered coverage in the Affordable Care Act marketplace have told state regulators that they will opt out or scale back coverage when the next open season for Affordable Care Act coverage begins Nov. 1.
There will still be coverage, but with fewer providers, experts say costs will likely go up “much higher in 2017 than they had in the past couple of years.”- AZ CentralCosts will likely go up.
No kidding.
They even have the gall to reference a report that has nothing to do with reality in Arizona.
A national estimate by the Kaiser Family Foundation predicts that premiums for one of the lower-costs plans could rise as much as 9 percent next year, compared to 2 percent this year. In Arizona, those higher premiums could hit more than 100,000 people.
Nine percent? How about 19% to 122%?
Rates filed with the Arizona Dept of Insurance have been reviewed and (presumably) approved. Note that some of the "final" rates are higher than the carriers requested.
How do you like those apples?
Shame on you Arizona Central. You should have your press pass revoked.
Tuesday, August 9, 2016
And now for something completely different: Gaming edition
Our friends at Fat Dragon Games have partnered with Bundle of Holding to offer some incredible discounts on industry-leading FDG terrain sets! Part of your payment will be donated to Doctors Without Borders as well, so get some awesome terrain for your game at an amazingly low price, and help a wonderful charity, too!
Death of a Salesman
After more than 40 years in the health insurance industry, I never thought this day would come. The advice offered based on years of experience and hearing almost everything under the sun from (literally) thousands of clients is now going silent.
#Obamacare has replaced insurance agents with "navigators" who have been given a week of training, mostly on how to use their computer to find health insurance plans and rates. These reps are nothing more than faceless voices at the other end of an 800 number.
Because they are unlicensed, and nameless, they are not accountable for the advice they give.
Got a problem? Who did you talk to? Tamika? Tamika who?
It really doesn't matter because whoever you talked to before, and the one you are talking to now, really doesn't care about your problem. Why? Because there is no accountability.
Mary Jennings is (was) a health insurance broker in Connecticut. Mary is 29 and has held an insurance license for 2 years. She is approved to help people find health insurance on the Connecticut insurance exchange, Access Health CT.
Her two year career is about to end, thanks to Obamacare.
Most of the health insurance agents I know have completely left the insurance business or shifted to other areas like Medicare. Working with folks age 65 and up who are entering Medicare is where my focus has been since 2011. Two years ago I completely abandoned the under 65 health insurance market and suggested my clients get used to dealing with healthcare.gov.
No one is happy with that decision but for me, health insurance is not a hobby. It is my paycheck.
According to the CT Mirror article, 40% of those who bought health insurance on the CT exchange did so with the help of agents.
What happens in 2017 when there are no agents to offer advice and guidance? No doubt they will still buy insurance if for no other reason than the fact the government has told them they must buy insurance or else .....
But who will they turn to when they have a complaint or question? Will Tamika still be there or will they talk to someone who was asking if you want fries with your order the week before?
Obamacare has brought about the death of a salesman and that is truly a loss that cannot be replaced.
#Obamacare has replaced insurance agents with "navigators" who have been given a week of training, mostly on how to use their computer to find health insurance plans and rates. These reps are nothing more than faceless voices at the other end of an 800 number.
Because they are unlicensed, and nameless, they are not accountable for the advice they give.
Got a problem? Who did you talk to? Tamika? Tamika who?
It really doesn't matter because whoever you talked to before, and the one you are talking to now, really doesn't care about your problem. Why? Because there is no accountability.
Mary Jennings is (was) a health insurance broker in Connecticut. Mary is 29 and has held an insurance license for 2 years. She is approved to help people find health insurance on the Connecticut insurance exchange, Access Health CT.
Her two year career is about to end, thanks to Obamacare.
Jennings is one of more than 250 brokers certified to help customers navigate the state exchange, Access Health CT, and find the plan that best fits their needs. But next year, she said, she won’t be helping customers anymore if the health insurers on the exchange decide to eliminate the already-low commissions they pay to brokers like her.
As state regulators consider rate proposals for next year, both of the carriers set to remain on Connecticut's exchange – Anthem and ConnectiCare – could eliminate their commissions for brokers in 2017, creating uncertainty as brokers and customers plan for the coming year. Anthem said earlier this year it would eliminate broker commissions while ConnectiCare has yet to decide. - CT MirrorConnecticut is not the only state where agent commissions have been cut to zero. Carriers have been decreasing commissions for the last 3 years with major cuts in the last 18 months.
Most of the health insurance agents I know have completely left the insurance business or shifted to other areas like Medicare. Working with folks age 65 and up who are entering Medicare is where my focus has been since 2011. Two years ago I completely abandoned the under 65 health insurance market and suggested my clients get used to dealing with healthcare.gov.
No one is happy with that decision but for me, health insurance is not a hobby. It is my paycheck.
According to the CT Mirror article, 40% of those who bought health insurance on the CT exchange did so with the help of agents.
What happens in 2017 when there are no agents to offer advice and guidance? No doubt they will still buy insurance if for no other reason than the fact the government has told them they must buy insurance or else .....
But who will they turn to when they have a complaint or question? Will Tamika still be there or will they talk to someone who was asking if you want fries with your order the week before?
Obamacare has brought about the death of a salesman and that is truly a loss that cannot be replaced.
Reverse Robin Hood: Obamacare's Transitional Reinsurance Program
Written in Obamacare, transitional reinsurance is a fee disguised as a levy on insurance companies that is passed through to all consumers. It is a temporary program that cost each covered person a set annual dollar amount. In 2014 every insured person was charged $63. This reduced to $44 in 2015 and is set for $27 in 2016.All group plans - self funded and fully insured - as well as individual plans pay this fee. But, the only ones who benefit from the fee are insurers who have high claimants in Obamacare compliant individual plans.
The original design assumed consumers would pay $12 Billion in 2014, $8 Billion in 2015 and projects for $6 Billion in 2016. $10 Billion would pay off insurance companies who incurred loses and $2 Billion would go to the U.S. Treasury to reduce debt. In 2015 there would be $6 Billion to pay off insurers and another $2 Billion for the U.S. Treasury. For this year there would be $4 Billion to fund insurance company losses and $1 Billion to the Treasury.
The way that insurers would get money back was based on a formula for large claims. The government determined a base dollar amount and a cap they would pay for claims an insurance company incurred. There was also a coinsurance percentage associated with it. The original floor for claims was set at $60,000 ($75,000 in 2015 and $90,000 in 2016)
with a cap of $250,000. The coinsurance was set for 80% in 2014 and 50% in 2015.
Here's an example of how the program should have worked. Assume an insurer has a large claim of $210,000. They pay the first $60,000. The remaining $150,000 would be split with the insurer paying $30,000 (20%) and the government paying the insurer $120,000 of money you paid into the reinsurance program. Once all of the claims were paid out the remainder would go as a payment to the U.S. Treasury for debt reduction.
The outcome is much different. Like most government programs, this one over-promised and is under-delivering.
First, the actual collection numbers were $9.7 Billion in 2014 and $6.5 Billion in 2015 - more than 20% lower than projected. While this is an important development, it is what the Obama administration did next that really cheats you as a taxpayer.
Insurers only requested payments of $7.9 Billion for 2014. At a coinsurance rate of 80% the amount that HHS should have distributed was $6.3 Billion. This would have left $3.4 Billion and resulted in the U.S. Treasury receiving their $2 Billion contribution and allowed the program to carry over $1.4 Billion.
What happened? The Obama administration chose to "change" the law in final regulations. They lowered the floor (attachment point) to $45,000, down from $60,000. Then, instead of a coinsurance rate of 80% they upped the ante to 100%. Doing so gave insurers an additional $1.6 Billion in payments leaving $1.7 Billion which one would assume would be a payment to the Treasury. Except they didn't. They took the full $1.7 Billion and rolled it into the 2015 program leaving the U.S. Treasury with nothing.
Which brings us to now.
CMS recently released the 2015 payments and data. The first interesting point was the increase in payment requests. The requests totaled $14.3 Billion. Yet HHS estimates on reinsurance payments projected it would go down as the years go forward. They believed that the first year would be the worst and then the market would correct itself. Obviously that's not happening and it appears that it is getting worse. The collections total $6.5 Billion. Taking the current $6.5 billion and adding the $1.7 Billion that rolled over gives HHS a cool $8.1 Billion to play with for this year.
At a coinsurance rate 50% on $14.3 Billion in requests the CMS should be paying out $7.1 Billion and give the Treasury $1 Billion. But of course they didn't. Instead they upped the coinsurance rate to 55.1% and paid out $7.8 Billion. The remaining amount of roughly $500 Million is going to the Treasury.
The first two years is proof that there is no method to the Obama administration's madness. They simply do what they want regardless of their responsibility to follow the rules of a law they championed.
The Obama administration lied and stole from you the taxpayer. All for the benefit of the insurance companies - who were supposed to be the ones paying the tab.
(ED NOTE: Image above is a summary of Transitional Reinsurance Program before and after)
Monday, August 8, 2016
Aetna Does Self-Funding
Patrick's had a couple recent posts on "alternative arrangements" such as MEWAs and self-funded plans (here and here), and I thought I'd throw in my 2¢ on the matter.
[ed: click here for a more detailed explanation of self-funding under the ACA]
Recently, Aetna's been pushing its version pretty hard, with emails like this:
"Are your clients looking for more options? Think bigger with Aetna Funding Advantage ... Aetna Funding Advantage plans are self-funded, which means they aren’t subject to all of the same rules as an ACA plan. And, they could help save your clients as much as 24%*."
That little * is to alert one to the fact that YMMV.
Be that as it may, it's pretty interesting that carriers are finally developing these products for the small group market (although they're literally 10 years late to the game). One presumes that this is simply recognition that there really is a market for these products, as employers struggle to stay afloat while offering (and helping pay for) group health plans.
And speaking of which, they didn't just scale down a large group product, but apparently built one specifically for smaller companies. From their online toolkit:
"Aetna Funding Advantage [is] similar to the self-funded plans traditionally offered to larger companies, but designed with smaller clients in mind."
They even have a helpful video to help explain the benefits and process of self-funding for smaller groups.
Very cool.
[ed: click here for a more detailed explanation of self-funding under the ACA]
Recently, Aetna's been pushing its version pretty hard, with emails like this:
"Are your clients looking for more options? Think bigger with Aetna Funding Advantage ... Aetna Funding Advantage plans are self-funded, which means they aren’t subject to all of the same rules as an ACA plan. And, they could help save your clients as much as 24%*."
That little * is to alert one to the fact that YMMV.
Be that as it may, it's pretty interesting that carriers are finally developing these products for the small group market (although they're literally 10 years late to the game). One presumes that this is simply recognition that there really is a market for these products, as employers struggle to stay afloat while offering (and helping pay for) group health plans.
And speaking of which, they didn't just scale down a large group product, but apparently built one specifically for smaller companies. From their online toolkit:
"Aetna Funding Advantage [is] similar to the self-funded plans traditionally offered to larger companies, but designed with smaller clients in mind."
They even have a helpful video to help explain the benefits and process of self-funding for smaller groups.
Very cool.
Medicaid Expansion Woes
Jonathon Gruber and his band of merry men and women at CMS keep finding new surprises in the cost and true impact of #Obamacare.
Recently we discovered that the man credited with counting on the stupidity of the American voter underestimated the popularity of the free health care program known as Medicaid. Instead of 12 million new Medicaid enrollees we have 15 million.
No big deal. As they say in DC, a million here, a million there, before you know it you have some serious numbers.
Now it seems that not only have Medicaid ranks expanded like my waistline during the holiday season, but these folks are costing more than anticipated.
Consider that the Transcontinental Railroad covered 1776 miles. Constructed between 1863 and 1869 the two rail lines met at Promontory Point, Utah. While many facts contribute to the story, one that amazes me is that the teams started at two different points and met in the middle. One team started in California while the other in Iowa. Yet they managed to meet at a precise point.
So if two teams of laborers can travel that much distance and hit their mark with precision, why can't the high paid goofballs in DC make accurate predictions of how much #ObamacareFail is supposed to cost?
Recently we discovered that the man credited with counting on the stupidity of the American voter underestimated the popularity of the free health care program known as Medicaid. Instead of 12 million new Medicaid enrollees we have 15 million.
No big deal. As they say in DC, a million here, a million there, before you know it you have some serious numbers.
Now it seems that not only have Medicaid ranks expanded like my waistline during the holiday season, but these folks are costing more than anticipated.
The Department of Health and Human Services just "found that the ACA's Medicaid expansion enrollees cost an average of $6,366 in (fiscal) 2015--49 percent higher than the $4,281 amount that the agency projected in last year's report." - Maciver InstituteHow can they miss by that much?
Consider that the Transcontinental Railroad covered 1776 miles. Constructed between 1863 and 1869 the two rail lines met at Promontory Point, Utah. While many facts contribute to the story, one that amazes me is that the teams started at two different points and met in the middle. One team started in California while the other in Iowa. Yet they managed to meet at a precise point.
So if two teams of laborers can travel that much distance and hit their mark with precision, why can't the high paid goofballs in DC make accurate predictions of how much #ObamacareFail is supposed to cost?
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