‘WASHINGTON — Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they are determined to see that the requests are scaled back.
Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives.
The Oregon insurance commissioner, Laura N. Cali, has just approved 2016 rate increases for companies that cover more than 220,000 people. Moda Health Plan, which has the largest enrollment in the state, received a 25 percent increase, and the second-largest plan, Lifewise, received a 33 percent increase.
Jesse Ellis O’Brien, a health advocate at the Oregon State Public Interest Research Group, said: “Rate increases will be bigger in 2016 than they have been for years and years and will have a profound effect on consumers here. Some may start wondering if insurance is affordable or if it’s worth the money.”’ - Health Insurance Companies Seek Big Rate Increases for 2016, New York Times, 07/03/2015
Link to the complete article appears below:
http://www.nytimes.com/2015/07/04/us/health-insurance-companies-seek-big-rate-increases-for-2016.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0
"Have you ever wondered why the largest companies almost never criticize the Affordable Care Act? That may be because they are getting a deal that the rest of us aren’t getting.
The mandate to provide health insurance to employees kicks in for large employers on January 1st and applies to smaller companies the following year. Surprisingly, firms that are large enough to self-insure (and pay employees’ medical expenses directly) can satisfy the mandate without covering hospitalization. They can also avoid paying for mental health care, the services of specialist doctors and even emergency room visits.
In a nutshell, the largest firms can offer the skimpiest plans.
Perhaps aware of the embarrassing implications of these loopholes, the Obama administration made an election eve announcement that there would be limits on the ability of firms to exploit them going forward. On Election Day, a Treasury Department notice alerted employers that any health plans not already finalized will have to cover hospitalization and doctor services—but not other benefits that are required of small-employer plans and plans purchased by individuals.
The timing of these announcements suggests that the administration wanted absolutely no media attention for them. Who is going to pore over changes to Obamacare technicalities when exciting election results are coming in? There are two issues here that the administration doesn’t want discussed: Why does the law have a huge gaping loophole for the largest companies? And how is the Obama administration able (once again) to re-write the law without any act of Congress?
If you work for a self-insured company and have an above-average income, you probably don’t have much to worry about. Employers are going to provide higher-income employees reasonably good health insurance in the future, just as they have in the past. But if your income is below-average, you could end up with worse coverage than you had before." - Obamacare’s Gift to Big Business: The Largest Firms Can Offer the Skimpiest Health Plans, The Independent Institute, 11/25/2014
Link to the entire article appears below:
http://www.independent.org/newsroom/article.asp?id=5224
‘“What makes Obamacare so unique, and therefore so politically toxic for those who passed it, is that they did it on a straight party line. That has never occurred in American history – something of this social importance, something so sweeping to be done on a purely party-line basis,” Krauthammer said.’
‘That ACA lacked bipartisan support from the start has made it a “terrible liability” for Democrats, Krauthammer said. Liberals will be “tagged as the cause of everything that goes wrong,” he said, whether or not the legislation caused the issue.
He added that he thinks the law oversteps its bounds, and that issues of the uninsured and insufficient plans should have been dealt with “as a discrete issue.” Instead, the ACA has attempted to entirely reform the health care system, leading to what Krauthammer contended are unnecessary additions to the law with “ripple effects” that may negatively affect millions.
“As a result, politically I think it’s quite likely that the Republicans will win the Senate, and I think it gives them a leg up, probably a slight advantage if you had to put down a bet today for the 2016 election,” Krauthammer said.’
He said the reform will be short-lived to due to its overambitious nature: “The likelihood that Obamacare will survive [to be] anything like what it looks like now or what it was intended to [look like] I think is rather small. I do think Obamacare is such a clumsy beast that it will simply expire … and then the country’s going to have a true choice between a single-payer system … [and] a free-market system.”
Krauthammer said ACA supporters used the issue of the uninsured “as an excuse for, or as leverage to, revolutionize everything in the health care system. He said Democrats have used a “combination of hype and partisanship” to make Republicans seem “hard-hearted,” particularly on stem cell research early in the George W. Bush presidency.
“The hype was that stem cell research, or what was known as regenerative medicine, was just a step away from relieving the suffering of millions. And the partisanship was the notion that with Republicans in office, conservatives … [who were] attached to the past and anti-science … were holding this back.”
This notion, Krauthammer noted, fits with caricatures of conservatism, such as “people who love to throw orphans into the snow. Especially in winter.”’ - Krauthammer: Obamacare is a 'clumsy beast', Cornell Chronicle, 04/17/2014
Link to the entire article appears below:
http://www.news.cornell.edu/stories/2014/04/krauthammer-obamacare-clumsy-beast
“Last week, I wrote about an article in the Los Angeles Times, on a then-as-yet unpublished report from the RAND Corporation. The report indicated that only one-third of Obamacare’s purported 7.1 million exchange sign-ups were from the previously uninsured. But Noam Levey, the author of the Times article, didn’t disclose RAND’s actual findings as to the actual number of previously uninsured exchange enrollees. Well, now we know why. RAND published the full report yesterday; it indicates that Obamacare’s exchanges only enrolled 1.4 million previously uninsured individuals.
That 1.4 million is out of a total of 3.9 million exchange enrollees overall. That is to say, a little over a third of enrollees—36 percent—were previously uninsured. RAND’s figures don’t take into account the last few weeks of the Obamacare open enrollment period, and they contain a substantial margin of error, due to the study’s small sample size. (RAND surveyed 2,425 individuals aged 18 to 64; the 1.4 million figure has a margin of error of 700,000, meaning that there is a 95 percent probability that the actual number is between 700,000 and 2.1 million previously uninsured enrollees.)
If you assume that 80 percent of signer-uppers will eventually pay their premiums, the true number of previously uninsured exchange enrollees is likely closer to 2 million. That’s far from what the Congressional Budget Office has projected; the CBO estimated that 80 to 90 percent of the first-year enrollees would come from the previously uninsured population. Instead, it appears to be more like 24 to 36 percent.
Because the RAND survey is quite small—a comparable survey by the U.S. Census Bureau surveys around 250,000 individuals—its results aren’t as reliable. But the RAND authors, Katherine Grace Carman and Christine Eibner, perform a useful service, because they break out how people of varying insurance statuses in 2013 fared in 2014. For example, of the 40.7 million people they consider to have been uninsured in 2013, RAND can break out the fraction of those who gained insurance via the exchanges, via Medicaid, via employer-sponsored insurance, et al.
RAND finds that, overall, 9.3 million more U.S. residents have health insurance in 2014 relative to 2013. That figure has a margin of error of 3.5 million. But that’s not the interesting part. The interesting part is that 8.2 million of that comes from growth in employer-sponsored insurance. Labor force participation has been steadily declining, especially among younger individuals, which would seemingly make this result unlikely. Other surveys from ADP and Aon Hewitt have found that employer-sponsored coverage among the young has been flat to down.” - RAND Comes Clean: Obamacare's Exchanges Enrolled Only 1.4 Million Previously Uninsured Individuals, Forbes, 04/09/2014
Link to the entire article appears below:
http://www.forbes.com/sites/theapothecary/2014/04/09/rand-comes-clean-obamacares-exchanges-enrolled-only-1-4-million-previously-uninsured-individuals/?partner=yahootix
‘One in three Americans who lack health coverage plan to remain uninsured, citing cost as their chief obstacle, according to Bankrate's latest Health Insurance Pulse survey.
Fewer than a third (30 percent) of the uninsured realize that federal tax credits available through the new Obamacare health exchanges can make health insurance affordable to lower-income individuals and families.
In a telephone survey of uninsured adults drawn from a nationally representative sample of more than 3,000 Americans, one-third (34 percent) said they intend to continue without health coverage. When asked why, 41 percent said health insurance is too expensive, 17 percent cited opposition to the Affordable Care Act, and 13 percent said they're healthy and don't need coverage.
Just over half (56 percent) of the uninsured said they plan to obtain health coverage.
If a late January Pulse survey demonstrated how familiar the overall population is with health reform penalties and deadlines that won't affect most Americans, this first Bankrate.com survey directed specifically at uninsured adults suggests that efforts to reach those most in need of affordable coverage may have fallen short.
"It's hard to generalize, but for some of these folks, it's a case of, 'I'm in pretty good health, I don't think about these things, I know I can't afford it now,'" says Michael Morrisey, professor of health economics at the University of Alabama at Birmingham School of Public Health. "I think it's just rolling past them, and they're not giving it a whole lot of attention." ‘ - Many uninsured still unaware about Obamacare, bankrate.com, 03/17/2014
Link to the entire article appears below:
http://www.bankrate.com/finance/insurance/health-insurance-poll-0314.aspx?ic_id=Top_Financial News Center_link_1
Update: Uninsured: Obamacare Is Unaffordable, American Spectator
http://spectator.org/articles/58149/uninsured-obamacare-unaffordable
“House Republicans floated the idea Friday of demanding that the White House agree to end programs designed to assist insurance companies selling policies as part of the new health-care law in exchange for raising the debt ceiling for one year, according to a GOP lawmaker and senior leadership aides.”
“Under one scenario discussed Friday morning at the House GOP's annual policy retreat held on Maryland's Eastern shore, Republicans would agree to extend the debt limit for one year, but demand that there be "no bailouts for insurance companies under Obamacare," the lawmaker and aides said. House Majority Leader Eric I. Cantor (R-Va.) and House Budget Committee Chairman Paul Ryan (R-Wis.) described to colleagues how this scenario could play out and conservative lawmakers in the room seemed supportive of the idea, including Rep. Michele Bachmann (R-Minn.), who spoke up in support and offered to help whip up support for the plan among Republicans.”
“Concerns about a so-called "Obamacare bailout" have emerged in recent days, especially on conservative op-ed pages. The term is generally used to describe three programs in the health-care law — two temporary and one permanent — that make it less financially risky for health insurance plans to sell on the new exchanges. The term also is sometimes used to refer to one specific program in the health-care law known as "risk corridors" that limit both the amount of money that a health insurance plan can make and lose during the first three years it is sold on the new health-care exchanges established by the law.” - House Republicans might propose canceling ‘Obamacare bailouts’ to raise debt limit, Washington Post, 01/31/2014
Link to the entire article appears below:
http://www.washingtonpost.com/blogs/post-politics/wp/2014/01/31/house-republicans-might-propose-canceling-obamacare-bailouts-to-raise-debt-limit/
In the book, The Basic Bond Book, which is a book for general contractors and sub-contractors to help them understand surety, the book opens with a definition of insurance. The definition is displayed to contrast insurance with the definition of surety which are two different concepts. The comparison of definitions is also displayed to end confusion between the two products. The confusion occurs because insurers offer both insurance and surety products. Being that James and Jane Goodfellow are more familiar with insurance, it follows that people will confuse surety with insurance due to the base issuer of both products.
The definition of insurance offered is as follows:
“Insurance is a two-risk party transfer mechanism whereby one party pays to have another protect it from certain well-defined risks. In purely theoretical terms, insurance is a pool created by a large number of people exposed to a common risk. Each member of the pool contributes to it and any members who suffer loss as a result of the risk assumed may be compensated for that loss by the pool. The contribution to the pool is determined by an actuarial study of probability of loss. The probability factor determines how much will be charged to pay losses while still leaving the pool solvent.” (1)
One of many basic problems with ACA/Obamacare is that its proponents have based the viability of ACA on one half of the definition of insurance. That is, the “large pool” and/or law of large numbers; is one of the mantra of ACA proponents. Implicitly and explicitly they claim that a large pool of insured’s becomes self solving regarding coverage/price. The second half of the definition is discarded: “The contribution to the pool is determined by an actuarial study of probability of loss. The probability factor determines how much will be charged to pay losses while still leaving the pool solvent.”
As with all chairs with four legs, all legs support the chair. One can not discard a leg or two and expect the chair to function properly or to deliver its intended utility. So it is too with insurance. Discarding the probability of loss and consequently charging premium based on individual exposure units based upon probability of loss, is to create nitwit insurance.
Can you suddenly insure a burning house? Insurance would not be the mechanism. Fire trucks serve better. The insurance premium, if it was possible insurance could be written (which it is not), would be exactly equal to the loss sustained, plus some. If the fire causes $50,000 of loss, then the premium is $50,000 plus the price of insuring a standard exposure unit and claims administration expense.
Can you suddenly insure a burning home and non-burning homes would remain with their current premium? No. Why? The $50,000 loss, if it in fact it could be insured during a current/present fire, would require the $50,000 loss be spread across the non-burning homes as an increased price. The only way for the non-burning homes to remain with their current premium would be to charge the burning home $50,000 plus the premium associated with a standard exposure unit and claims administration expense.
Moreover, if one’s mantra is “large pool” then one needs to go one step further in insurance theory regarding an expanded definition of insurance. The theory of large numbers aka “large pool” demands the pool be populated by homogeneous exposure units, e.g. vehicles, commercial buildings, health of people, life of people, etc. Once the homogenous exposure unit is identified an average exposure unit is determined with above or below average exposure units existing in comparison to the average unit. The “actuarial study of probability of loss” is applied to average exposure, above average and below average exposure units arriving at price that varies based on the probability of loss.
The homogenous exposure unit is only “homogenous” in a very broad sense. Within the broad swath of homogeneous exists differing risk criteria. For example, regarding the homogeneous exposure unit “commercial building” one might find a commercial building built in 2004 with superior construction, a sprinkler system, central fire and burglar systems. Another homogenous exposure unit within “commercial building” might be a commercial building built in 1978, with no updates since time of construction, of frame construction, with no sprinklers nor central fire and burglar systems.
The two commercial buildings have different probability of loss. Hence price differs to insure. If one’s mantra is “large pool”, then one would want to charge differing rates given the above discussion. However, if one merely figures “large pool” is all one needs, then: Superior construction and the price inherent with such construction, safety measures such as sprinkler systems, central fire and burglar systems and the price inherent with such systems and finally age of construction are all tossed aside.
When one tosses aside differences in probability of loss, then the exposure units have disincentives to lower probability of loss. Further, any prior value associated with reducing the probability of loss is destroyed. One arrives at a price that, in the short-run becomes cross subsided and in the long-run a price exists with zero incentive to lower probability of loss.
Returning to the mantra of ACA proponents regarding “large pool” and/or law of large numbers: Is “large pool” an insurance concept -or- is “large pool” a politico collective action concept? Stated alternatively, was an insurance concept/term merely borrowed with no intention of deploying “insurance”? Is the intention to charge the many, for the few with no insurance mechanism intended? Is "insurance" politically-purposely used as a substitute term for "scheme"? Was the greater intention, to camouflage as it were, politico focused benefit/politico dispersed price [scheme], as a happy little insurance plan with a happy little insurance web site?
Notes:
(1) The Basic Bond Book, second edition, 2001, The Associated General Contractors of America, John J. Curtin Jr., page 1.
“New York, January 23, 2014 -- Moody's changed the outlook for US health insurers to negative from stable, as implementation of the Affordable Care Act (ACA) continues to create uncertainty for the industry, says Moody's Investors Service in its new industry outlook "US Healthcare Insurers: Outlook Changed to Negative from Stable."
The ACA—signed into law in March 2010—seeks to increase affordability of health insurance and expand both public and private insurance coverage through a number of mechanisms including exchanges, mandates and subsidies.
"While we've had industry risks from regulatory changes on our radar for a while, the ongoing unstable and evolving environment is a key factor for our outlook change," said Stephen Zaharuk, a Moody's Senior Vice President and author of the report. "The past few months have seen new regulations and announcements that impose operational changes well after product and pricing decisions were finalized."
Uncertainty over the demographics of those enrolling in individual products through the exchanges is a key factor in Moody's outlook change, says the rating agency. Enrollment statistics show that only 24% of enrollees so far are aged 18-34, a critical group in ensuring that lower claim costs subsidize the higher claim costs of less healthy, older individuals. This is well short of the original 40% target based on the proportion of eligible people in this cohort, says Moody's.” - Moody's: Uncertain healthcare landscape leads to negative outlook for US health insurers, Global Credit Research - 23 Jan 2014, moodys.com
Link to the entire report appears below:
https://www.moodys.com/research/Moodys-Uncertain-healthcare-landscape-leads-to-negative-outlook-for-US--PR_291141
“WASHINGTON – Insurers have raised concerns that too few young people are signing up for heath insurance through the ObamaCare exchanges after newly released statistics showed that less than a quarter of people who have enrolled are between the ages of 18 and 34.
According to the numbers released Monday by the U.S. Department of Health and Human Services, only 24 percent – or 489,460 – of the 2.2 million people who signed up for ACA were in the coveted 18-to-34 age range. That means the government has hit only 18 percent of its stated goal of registering 2.7 million adults in the 18-to-34 age range.
Experts have predicted that the program will need roughly 40 percent of enrollees to be in that prime demographic in order to be fiscally solvent. Adults ages 55 to 64 made up 33 percent of the total number of Americans who signed up, the largest group represented in the data.” - Insurers raise cost concerns after ObamaCare demographic data released, foxnews.com, 01/14/2014
Link to the entire article appears below:
http://www.foxnews.com/politics/2014/01/14/numbers-key-obamacare-demographic-group-come-in-well-below-estimates/
‘Amid the holiday season craziness, The Washington Post published an in-depth account of how a subsidiary of Canadian IT giant CGI Group won the contract to lead the design and testing of the HealthCare.gov website.
The article debunked rumors that cronyism motivated the Centers for Medicare and Medicaid Services’ (CMS) September 2011 decision to award CGI Federal the $93.7 million contract. Instead, the Post found that the main culprit was CMS, which by its own admission “dropped the ball” on evaluating the company’s background.
Specifically, what CMS contracting officials overlooked and/or downplayed was that more than 100 of CGI’s employees came from Virginia-based IT company American Management Systems (AMS), which CGI acquired in 2004. According to the Post, AMS had mishandled at least 20 government IT projects, including one particularly well-publicized fiasco involving the Federal Retirement Thrift Investment Board’s $36 million overhaul of its recordkeeping system.
AMS’s questionable past performance on government contracts should have set off alarms in 2007, when CMS awarded CGI and 15 other companies an umbrella contract allowing them to bid on future CMS projects. In fact, a former CMS official told the Post that AMS’s track record “could well have knocked [CGI Federal] out of the competition, and probably should have.”’
‘The part of the Post story that really rankled the Project On Government Oversight is contained in this passage:
While it is unclear whether agency officials examined the AMS track record, former CMS officials said it probably would not have made much difference, because past performance has long been an overlooked component of federal contracting.’
- HealthCare.gov Debacle Reveals Flaws in Contractor Screening, pogo.org, 01/03/2013
Link to the entire article appears below:
http://www.pogo.org/blog/2014/01/healthcaregov-debacle-revelas-flaws-in-contractor-screening.html
H/T: Crony Chronicles
'Disgraced federal bureaucrats don't seem to resign these days. They certainly aren't fired -- and even when they are, they appeal and are reinstated. No, they "retire," and make off with a raft of taxpayer-funded benefits accrued over years of "public service." As Ms. Snyder prepares to step aside to spend more time with her family or whatever, her boss is singing her praises:
CMS administrator Marilyn Tavenner noted in an email that Snyder was set to leave CMS at the end of 2012 but stayed on at Tavenner’s request to help with “the challenges facing CMS in 2013.” “While the agency is losing a key member of its leadership team, we should celebrate Michelle’s dedication to a mission that provides vital health care services to tens of millions of our fellow Americans through the Medicare and Medicaid programs,” Tavenner said. Snyder is the second top CMS official to leave since the website’s rocky rollout. Tony Trenkle, who served as the agency’s chief information officer, retired in November.
A job well done, Michelle. Bravo. And what did that job entail? According to the New York Times, "her official biography says that Ms. Snyder was responsible for “standing up new programs and activities required by the Affordable Care Act." And who among us wouldn't "celebrate" her job performance? Aside from the millions who struggled to log on to the broken website she oversaw, and plugged sensitive data into a compromised website, that is. Mary Katharine Ham quips, "Botch the roll-out of the president’s legacy law so badly that you end up with three million fewer insured people than when we started, and you get to retire, announce it over a holiday weekend, and grab that juicy pension for 41 years of mediocre-to-disastrous public service." ' - Shhh: Embattled Obamacare Official Quietly 'Retires', townhall.com, 12/31/2013
Link to entire article appears below:
http://townhall.com/tipsheet/guybenson/2013/12/31/shhh-embattled-obamacare-official-quietly-retires-n1770213?utm_source=thdailypm&utm_medium=email&utm_campaign=nl_pm
‘WASHINGTON (Reuters) - President Barack Obama's healthcare law could have a "meltdown" and make it difficult for his Democratic Party to keep control of the U.S. Senate next year if ongoing problems with the program are not resolved, a Democratic senator said on Sunday.
Senator Joe Manchin of West Virginia, who has urged delaying a penalty for people who do not enroll for health insurance in 2014 under the law, told CNN that a transitional year was needed for the complex healthcare program, commonly known as Obamacare, to work.
"If it's so much more expensive than what we anticipated and if the coverage is not as good as what we had, you've got a complete meltdown at that time," Manchin told CNN's "State of the Union" program.
"It falls of its own weight, if basically the cost becomes more than we can absorb, absolutely."‘
‘Manchin said Senate Democrats who are up for re-election next year are "feeling the weight" of the program's woes and could have trouble keeping their majority in the chamber.’
‘"It needs to turn around," Manchin said of Obamacare. "I'm not going to say that I think we will lose it (the Senate). It's going to be extremely challenging. We have some very good people who are truly there, I believe, for the right reason. They're going to be challenged for the wrong reason."‘ - Democratic senator says Obamacare could have 'meltdown,' hurt party, 12/22/2013, Yahoo.com
Link to the entire article appears below:
http://news.yahoo.com/democratic-senator-says-obamacare-could-39-meltdown-39-172125028.html
Observation: If one reads the article then reflects upon its content, one comes away with a second, alternate impression. How so? Manchin is basically stating that Obamacare's intention was not insurance. Rather, Obamacare's intention was/is a political constituency building exercise with other people's money. The political constituency building exercise is backfiring and hence a liability to those depending on the political constituency building exercise, to in fact, build constituency. The backfire is: This particular political constituency building exercise is building constituency for competing politicos.
The Scheme
Imagine government G, through a series of highly regulated insurers of the same government G, heavily advertises a new taxpayer subsidized insurance plan, independent of underwriting criteria (all comers), and such plan receives only a tepid response attracting less than 400,000 applicants. (1) (2) (3)
The plan is very difficult to apply for and application for such plan does not guarantee the plan was issued. Hence one must spend hours, if not days, applying for coverage and once what appears to be a successful application is finally submitted one must follow up by correspondence and phone calls to assure the application was accepted. Even then many applications can not be found or where transmitted with errors.
Meanwhile, government G, through a series of third party administrators has been maintaining a high risk plan of 101,000 insured‘s. Government G's published intention (known-known) is to end the high risk plan with an inordinately high loss ratio and dump the high risk plan into the aforementioned heavily advertised, taxpayer subsidized, independent of underwriting criteria plan that is difficult to apply for and determine issued-bound coverage. (4) (5)
Since the plan is very difficult to apply for yet has no underwriting criteria, the vast majority of those applying, those that would take enormous amounts of time to apply and follow up to make sure coverage adhered, are likely those that would benefit from the non-underwriting criteria plan. Stated alternatively, the subject of the insurance at hand, given the non-underwriting aspect, strongly attracts those wanting the insurance subject at hand, due to the non-underwriting aspect.
Does the above sound familiar? Please note that the above description is not of insurance, rather it is a description of a scheme known as Obamacare. As Thomas Sowell has noted many times: Not everything called insurance is insurance.
Nicolaus Copernicus, They Are Not
If one examines Obamacare’s latest enrollment figures one finds about 1.2 million applicants with 800,000 going into Medicaid and 400,000 going into subsidized private insurance (note that 1.2 million applicants does not indicate 1.2 million insured as no one appears to be able determine coverage adhesion). The 400,000 subsidized private insured’s are very likely made up of, in large portion, of those desperate for coverage and the despair leading to a grand incentive to take advantage of non-underwriting criteria and hence spending hours if not days applying for coverage and doing all the follow up to make sure coverage is effective. (6)
Rewinding a few years one finds that the Affordable Care Act (ACA) authorized a “Risk Pool” that covered applicants with pre-existing conditions. Approximately 101,000 remain in this pool. Further, state run risk pools that have existed longer than ACA have approximately 235,000 members. Meaning the 336,000 risk pool members will be added to the 400,000 non-underwritten applicants described above on or before 01/31/2014. (7) (8)
Hence the scheme has 400,000 members who’s make-up is likely an inordinate amount of chronically ill which in turn is combined with 336,000 chronically ill to produce a 736,000 anti-selection case that likely rivals or even surpasses anti-selection in another non-insurance insurance scheme known as Flood Insurance.
Upon Further Review
Consider for a moment that the ACA risk pool had to begin turning away applicants the first week in March, 2013 as the plan was going bankrupt as the $5 billion of taxpayer money (subsidy) used to initiate the pool and the premiums paid by members of the pool were not enough money to offset the claims of the pool. Hence any new applicants could not be accepted as current premiums paid by members plus the $5 billion of taxpayer money was calculated to exhaust by 01/01/2014 which met the criteria for dumping the pool into Obamacare. (9)
Insurance (Scheme) Death Spiral
The premiums paid, including taxpayer subsidy, will not sustain a 736,000 member plan that is likely made up of the chronically ill to a very large degree. Historical insurance plan results predict that losses will easily exceed premium causing a major premium adjustment upward. The upward premium adjustment will cause many healthy insured’s to find the plan too costly and they will drop out. As the healthy drop out one ends with an ever increasing concentration of the chronically ill. Round after round of premium increases occur until, theoretically, premium paid equals benefit derived. However, the premium equals benefit point is never reached as the plan implodes prior to that point as even the chronically ill find the plan too costly. (10)
But The Group Will Become Larger and That Will Solve the Problem
Nay, nay! The law of large numbers is only one criteria within legal reserve insurance. The oft mentioned mantra of “pooling the risk”, and all problems are solved, is a misnomer.
A pool of homogeneous exposure units spread across a wide geographic area, subject to underwriting criteria, with risks priced according to potential loss, with future losses fully reserved, is a totally different concept than some fuzzy panacea of: “pooling the risk”.
Furthermore, the accumulation of the group into the future, if indeed it does accumulate; each and every new applicant, healthy or chronic, is faced with the original price driver as mentioned above, as well as, the future price driver of risks not subject to underwriting criteria, with risks not priced according to potential loss. Stated alternatively, cross subsidy exits in that each applicant is either a subsidizer or a subsidized.
It becomes a fiction that at price subsidized (Ps), that all can insure off one another at price Ps. Price does not function as a signal nor rationing agent, price merely becomes a political price (a price based upon politics, not economics).
Moreover, the younger, who are more healthy and less wealthy, cross subsidize the more wealthy and less healthy in regards to base premium, beyond the non-priced-risk phenomena and price subsidized fiction (Ps). Therefore the more healthy and less wealthy produce an additional subsidy for the benefit of the more wealthy and less healthy, which is directly related to price having become based upon politics, not economics.
Notes:
(1) New Enrollment Figures Show Obamacare is Not on Track, breitbart.com, 12/11/2013
http://www.breitbart.com/InstaBlog/2013/12/11/New-Enrollment-Figures-Show-Obamacare-is-Not-on-Track
(2) Obamacare’s Medicaid enrollment crowding out private plans, Daily Caller, 10/29/2013
http://dailycaller.com/2013/10/29/obamacares-medicaid-enrollment-crowding-out-private-plans/
(3) 70% of ObamaCare Enrollees Are In Medicaid, breitbart.com, 12/11/2013
http://www.breitbart.com/Big-Government/2013/12/11/70-of-ObamaCare-Enrollees-Are-For-Medicaid
(4) Health insurance and high-risk pools, health insurance.org, 12/12/2013
http://www.healthinsurance.org/risk_pools/
(5) High Risk Insurance Pool Enrollees Losing Coverage Because of Obamacare, 11/19/2013
http://insurancenewsnet.com/oarticle/2013/11/20/high-risk-insurance-pool-enrollees-losing-coverage-because-of-obamacare-a-424373.html#.UrbiHml3t1s
(6) Economist: ‘Triple Whammy' Could Send Obamacare Exchanges Into ‘Death Spiral’ - cnsnews.com, 10/21/2013
http://www.cnsnews.com/news/article/barbara-hollingsworth/economist-triple-whammy-could-send-obamacare-exchanges-death
(7) Funds run low for health insurance in state ‘high-risk pools’, Washington Post, 02/16/2013
http://www.washingtonpost.com/national/health-science/2013/02/15/cb9d56ac-779c-11e2-8f84-3e4b513b1a13_story.html?hpid=z1
(8) Obama administration extends state high-risk pools through January, Washington Post, 12/12/2013
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/12/12/obama-administration-extends-state-high-risk-pools-through-january/
(9) Funds run low for health insurance in state ‘high-risk pools’, Washington Post, 02/16/2013
http://www.washingtonpost.com/national/health-science/2013/02/15/cb9d56ac-779c-11e2-8f84-3e4b513b1a13_story.html?hpid=z1
(10) Economist: ‘Triple Whammy' Could Send Obamacare Exchanges Into ‘Death Spiral’ - cnsnews.com, 10/21/2013
http://www.cnsnews.com/news/article/barbara-hollingsworth/economist-triple-whammy-could-send-obamacare-exchanges-death
"WASHINGTON – The House Oversight and Government Reform Committee today released a new staff report on the Obama Administration’s Navigator and Assister program in conjunction with today’s field hearing in Dallas, Texas. The report explains how the Administration’s serious mismanagement of these outreach programs exposes Americans to fraud and poses a threat to the safety of consumers’ personal information.
The Navigator program was created by ObamaCare as an outreach program to encourage and facilitate enrollment in health insurance exchanges. The Assister program was created by the Administration with dubious legal authority as a way around ObamaCare’s clear statutory prohibition on using federal exchange establishment funds on Navigators.
Months before the launch of ObamaCare on October 1, the Oversight Committee initiated an investigation into potential problems with the Navigator and Assister program. The Committee released a preliminary staff report in September that highlighted the significant risks for fraud, abuse, and misinformation due to the lack of background checks, inadequate training standards, and weak Administration oversight plan for Navigators and Assisters.
The new report makes clear that U.S. Department of Health and Human Services (HHS) officials lacked a contingency plan for the Navigator and Assister program after HealthCare.gov failed, leaving consumers open to the risk of identity theft due to confusion surrounding enrollment for health exchanges."
Link to the entire Congressional report appears below:
http://oversight.house.gov/release/oversight-report-obamacare-navigator-program-reveals-mismanagement-lax-oversight/
"Americans remain unhappy with the health care law: Majorities say they wish it had never passed, would vote to repeal it if they could, and think implementation should be delayed until the kinks are worked out. At the same time, a shrinking majority believes the law will survive.
That’s according to a year-end Fox News poll released Wednesday.
Click here for the poll results.
The number of voters who want implementation of the law delayed continues to grow. The new poll shows 67 percent think it should be postponed a year “until more details are ironed out.” That’s up four percentage points since last month -- and up 10 points since October.
Those favoring a delay also now include a majority of Democrats: 54 percent support delaying implementation. That’s up 10 points from 44 percent last month.
Overall, by a 54-38 percent margin, people wish the health care law had never passed and the 2009 system were still in place.
Similarly, 53 percent would vote to repeal the law if given the chance, while 41 percent would keep it.
Republicans (86 percent repeal) are 14 points more likely to want the health care law repealed than Democrats are to want to keep it (72 percent keep).
About one Democrat in five would vote to repeal the law (22 percent).
Sixty-one percent of voters believe the Obama administration knew ahead of time that not everyone would be able to keep their doctor. What’s more, almost everyone says it’s important to them to be able to choose their doctor (82 percent “very” and 13 percent “somewhat” important)." - Fox News Poll: 67 percent say delay Obamacare, 53 percent would vote to repeal it, foxnews.com, 12/18/2013
Link to the entire article appears below:
http://www.foxnews.com/politics/2013/12/18/fox-news-poll-67-percent-say-delay-obamacare-53-would-vote-to-repeal-it/?intcmp=latestnews
"During a White House meeting called to brief America's largest tech companies today about government overreach in electronic surveillance, President Barack Obama changed the subject – angering some meeting participants by shifting gears to address the failed launch of healthcare.gov.
'That wasn't what we came for,' a vice-president of a company whose CEO attended told MailOnline. 'We really didn't care for a PR pitch about how the administration is trying to salvage its internal health care tech nightmare.'
One executive said that meeting participants were dead-set against straying from the principal focus of the meeting – the uncomfortable and legally untenable position they are in when the National Security Agency demands access to their digital records.
The White House said in advance that the meeting would include a discussion of healthcare.gov, but the company executive said the only subject that mattered to the participants was the NSA.
'He basically hijacked the meeting,' the executive said. 'We all told the White House that we were only there to talk about what the NSA was up to and how it affects us.'
Yet Obama, according to insiders, repeatedly peppered the discussion with reassuring words about how the Affordable Care Act's marquee website was well on its way to becoming functional.
The change was so noticeable that an AFP/Getty photographer assigned to cover the event noted in a photo caption only that Obama was there to 'meet with executives from leading tech companies to discuss progress with healthcare.gov.'
One executive of a company represented at the meeting told The Guardian that a change of focus 'is not going to happen. We are there to talk about the NSA.' " - Obama 'hijacks' tech executive meeting to make 'PR pitch' on Obamacare website fix instead of dealing with NSA surveillance, dailymail.com, 12/17/2013
Link to the entire article appears below:
http://www.dailymail.co.uk/news/article-2525447/Obama-hijacks-tech-executive-meeting-changes-subject-NSA-surveillance-healthcare-gov-fixes.html
'Many in New York’s professional and cultural elite have long supported President Obama’s health care plan. But now, to their surprise, thousands of writers, opera singers, music teachers, photographers, doctors, lawyers and others are learning that their health insurance plans are being canceled and they may have to pay more to get comparable coverage, if they can find it.
They are part of an unusual, informal health insurance system that has developed in New York, in which independent practitioners were able to get lower insurance rates through group plans, typically set up by their professional associations or chambers of commerce. That allowed them to avoid the sky-high rates in New York’s individual insurance market, historically among the most expensive in the country.
But under the Affordable Care Act, they will be treated as individuals, responsible for their own insurance policies. For many of them, that is likely to mean they will no longer have access to a wide network of doctors and a range of plans tailored to their needs. And many of them are finding that if they want to keep their premiums from rising, they will have to accept higher deductible and co-pay costs or inferior coverage.
“I couldn’t sleep because of it,” said Barbara Meinwald, a solo practitioner lawyer in Manhattan.
Ms. Meinwald, 61, has been paying $10,000 a year for her insurance through the New York City Bar. A broker told her that a new temporary plan with fewer doctors would cost $5,000 more, after factoring in the cost of her medications.
Ms. Meinwald also looked on the state’s health insurance exchange. But she said she found that those plans did not have a good choice of doctors, and that it was hard to even find out who the doctors were, and which hospitals were covered. “It’s like you’re blindfolded and you’re told that you have to buy something,” she said.
The people affected include not just writers, artists, doctors and the like, but also independent tradespeople, like home builders or carpenters, who work on their own.' - With Affordable Care Act, Canceled Policies for New York Professionals, NYT, 12/13/2013
Link to entire article appears below:
http://mobile.nytimes.com/2013/12/14/nyregion/with-affordable-care-act-canceled-policies-for-new-york-professionals.html?smid=pl-share
"New Coke was introduced to the marketplace on April 23, 1985. On that same date, old Coke was removed from the marketplace. On July 10, 1985, the old Coke product was returned to the marketplace. It only took 78 days for the people at Coca Cola to recognize and admit that they had made a huge mistake. Obamacare will be 78 days old on Tuesday, December 17, 2013. There is a message here." - Obamacare and New Coke, Ken Adler, Townhall.com, 12/16/2013
Link to the entire article appears below:
http://townhall.com/columnists/hankadler/2013/12/16/obamacare-and-new-coke-n1762840
