Gaming O'Care in the news

Co-blogger Patrick has written quite a bit about the challenges that carriers face regarding the overly generous 90 day grace period enjoyed by folks who buy their ObamaPlans on the Exchange.

Now, some 4 years since they first opened for business on that platform, carriers are beginning to realize just how dangerous that game of chicken has been.

For them:

"They are using [health insurance] until they need it and then when they don't need it, they get rid of it"

That's Patrick, as quoted in this morning's US News online edition, where he and FoIB Louise Norris share some interesting, disturbing insights.

Recommended.

Hey Senator Rubio, Give Credit Where It's Due

Obamacare supporters need to stop giving Marco Rubio credit for the splinter he wedged into Obamacare's fingertip. The splinter is the language Rubio inserted into the 2014 CRomnibus that made Obamacare risk corridor payments budget neutral.

When Obamacare passed, the risk corridor provision - which is a temporary program - was written with very vague language. The program existed but didn't specify where funding was coming from. Theoretically it was going to come from a combination of the profitable insurers and the federal government sending payments to insurers who suffered losses.

Because there was a chance of government funding, the GOP called out risk corridors as a bailout for insurers. To combat the political gamesmanship, the Obama Administration pushed a narrative that the program would pay for itself and pointed to an April 2014 CBO document stating the budget neutrality position.

Based on the CBO numbers, Senator Rubio's risk corridor language shouldn't have been an issue. But like many CBO reports, the actual results are a far cry from their rosy projections. In 2014, risk corridors paid out roughly 13% of what they were supposed to. CMS just released preliminary data for 2015 and have made it clear that they will have another shortfall this year. All of this is resulting in pundits and politicians calling the GOP the devil or heroes.

Unfortunately they've got it all wrong. Marco Rubio inserting language into a budget amendment didn't make the legislation pass. That would come from all of the brains in DC who vote on the bills. It also comes from a Presidential signature making the bill become a law.

In CRomnibus, its not about what Rubio did. It's about the bipartisan approval (57 Democrats in the house and 25 Democrats in the senate) that voted in favor of the bill. And let's not forget President Obama who signed it into law.

These are the elected officials who put risk corridors in jeopardy. They are the ones who should be given credit.

Sorry Marco.

MVNHS© vs Autism

If you, or a loved one, is on the autism scale, you need to be very afraid of ObamaCare's ultimate goal of Single Payer.

Why is that, you ask?

Here's why:

"The euthanasia of Nancy Fitzmaurice, a severely disabled child who was not dying, has made international waves ... Nancy’s mother had requested that her daughter be killed and was granted approval by the British legal system."

As we've mentioned before, "who pays the piper calls the tune." And while this may the most egregious example of that we've seen, even by the standards of the Much Vaunted National Health System©, it's absolutely how Single Payer works, how it has to work. And of course, little Nancy's only advocate was the one who petitioned for this outcome.

When an unelected, unaccountable Star Chamber is given free rein to make these kinds of life-and-death decisions, and when the cost of life becomes the value of it, well, that's what we're headed for here.

Now, some would argue that this isn't about the MVNHS©, per se; that it's about the British legal system. And they'd be right - up to a point. That point is that regardless of the agency which murdered this little girl, it was the state that ordered it done.

Be careful what you wish for.

[Hat Tip: C. C. Pecknold]

Bad News and Good News, Enrollment edition

As we've noted previously, the Marketplace seems to have a problem keeping out the riff-raff:

"[F]ederal watchdog office did set up 10 phony insurance coverage accounts with no pushback from those overseeing the applications."

That was a year ago, and we're happy to report that there's been a 50% improvement in those numbers:

"Investigators got coverage approval for 15 out of 15 fake people this year"

Okay, I suppose that depends on one's definition of "improvement."

The GAO was apparently unable to make premium payments for three of these "people," which I suppose is reason for celebration, although where those funds would have come from (and where they did originate for the 80% of those who successfully ponied up) remains a mystery.

On the gripping hand, I am pleased to report that none of these "insureds" racked up more than $10,000 in medical expenses.

That we're aware of.

Hit the Reset Button

Six years after the passage of Obamacare. Two years into the full Obamacare version. What happened?

Where to begin?

Became law without a single Republican vote. Barely survived Supreme Court challenge by a 5 - 4 decision. Several health insurance carriers dropped out of the market before the official January, 2014 rollout. Failed $600 million website that still isn't secure and is semi-functional. Health insurance carrier losses in the millions and most of the few remaining carriers are considering dropping out of Obamacare for 2017. Every health insurance co-op created by Obamacare has either failed or is failing.

By almost every measure, Obamacare is a complete failure.

So what does Mr. Lame Duck do?

Obama dropped by a meeting with Secretary of Health and Human Services Sylvia Burwell and 13 health insurance CEOs, including the CEOs of Humana and Cigna, to emphasize the need to work together on the ACA's public marketplaces. 

In addition to the meeting, Obama sent a letter to the CEO of every health insurance company participating in the exchanges asking for help improving them. - Business Insider

The horses are out of the barn. Time to hit the reset button.

"And since the remaining uninsured are disproportionately younger and healthier, signing them up improves the risk pool and consequently the affordability of coverage for all enrollees.

After 6 years of telling carriers how they got everything wrong he now wants their help to fix his mess.

Open enrollment for the 2017 year starts in 6 weeks. This gives "Hail Mary" an entirely new meaning.

#ObamacareFail

Garden State Breaking: Another one bites the dust

Oops:

"The [New Jersey] state Department of Banking and Insurance moved Monday to take over Health Republic — known as a consumer-operated and –oriented, or COOP, plan — because of its “hazardous financial condition.”

As with Ohio's own InHealth, and most of the other Co-Ops, the numbers just didn't add up. and the carrier has been forced to fold.

Just in time for Open Enrollment v4.0.

And the timing couldn't be better (for certain values of "better"): when this happens, policyholders are generally eligible for a Special Open Enrollment. Which means they'll be looking for new plans over the coming weeks, and then new new ones a few weeks later. Oh, and looking at three - yes three - deductibles to be met in a year's time.

Yippee!

If You Like Your Plan: Part #4,287

One of the most pernicious claims made by President Obama (and his surrogates) has been the promise that "if you like your current insurance, you can keep it." No rational person ever actually bought that, but it made a great sound-bite (or 3,000). As we all know, with each passing year we're been offered fewer and fewer choices, and very few people have been able to actually keep their plans.

Folks in the Tar Heel State have even fewer choices coming up in November:

"Most in N.C. will have one Obamacare option in 2017"

And to no one's real surprise, that carrier is ... Blue Cross/Blue Shield. Yes, that Blue Cross:

"The N.C. Department of Insurance announced Monday it will broaden its investigation into Blue Cross and Blue Shield of North Carolina, citing “disagreements” with the insurer."

Looks like that particular endeavor is about to hit the trash bin of history.

[Hat Tip: FoIB Jeff M]