As we've mentioned before, more than a few folks who were initially eligible for ObamaPlan premium subsidies subsequently become ineligible, with predictable consequences:
"Consider the case of Erica Cherington that bought an Obamacrack plan for 2014 and only paid $89 monthly because her low income entitled her to a $284 per month taxpayer funded subsidy.Then she got a new job that paid more. As a result she had to pay back $600 of her subsidy"
But that was then, and this is now:
"Only 52 percent had to repay a portion of government subsidy during last year’s tax season, compared to 60 percent this year ... three out of five customers who received advanced tax credits to help them buy private plans on Obamacare’s web-based exchanges must pay a portion back to the IRS"
That's because they mis-estimated [ed: is that even a word, Henry?] their 2015 income ... Of course they did: whose Ouija board has a $ sign? Sheesh!
And what, you may be wondering, was the average ding for this little "problem?" Well, how about $579? Of course, as we've pointed out numerous times, this represents one - maybe two at the outside - month's premium. Why not roll the dice; after all, the next Open Enrollment is only a few months away...
[Hat Tip: Rich Weinstein]
Courtesy of FoIB Holly R, we learn that making health care more convenient doesn't necessarily make it any less expensive. "Bending the cost curve down" has become the Holy Grail, but as we've seen over and over this just doesn't happen in a vacuum (or at all).Or put in more relevant terms:"Rand researcher Dr. Ateev Mehrotra said a minute clinic is to healthcare what an iPhone is to email.
“Because it’s so convenient for me to check my email on my iPhone, I check it a lot. Way more than I may need to,” he said."Of course, checking your email really doesn't cost anything above the monthly Verizon (or whichever) charge; very different from the per visit charge (reasonable as it may be) at the Wally World Minit Clinic. And thus over-utilization rears its ugly head:"[T]hanks to the rise of all these clinics, folks with a cold, the flu or a sore throat are getting care instead of staying home.""So what?" you may ask, it's their choice, and their dollars. Ah, not so fast, grasshoppa: there's always a cost: over-utilization means higher insurance rates, for one thing. And even if one accesses that clinic without insurance. there's a societal cost as that provider is no longer available to care for a more sickly patient.As I mentioned to Holly, this reminds me of a favorite saying:You can have it good.
You can have it fast.
You can have it cheap.
Pick any 2.
Open Enrollment v3.0 is fading quickly from the rearview, which means that you'll need to come up with a valid reason to trigger a Special Open Enrollment for the opportunity to buy an (overpriced, underperforming) ObamaPlan.
And by the way, the rules are the same whether you buy it on or off the 404Care.gov site.
As we noted earlier this year (3rd item), the bureauweanies in DC are tightening up the rules for those triggers, primarily because folks have figured out how to effectively game the system by using them. Carriers have been losing their shirts on these plans (awww!), and they really needed the Feds to step in and save themselves from...themselves.
So, said Capital City rocket surgeons have released new guidance on what does - and doesn't - constitute a Special Open Enrollment window. Frankly, I think it's about time, but one wonders why it took them so long to figure this out.
[Hat Tip: MMO]
At first glance, this concept appears to have some merit:
"Mothers of children with fatal defects will have the option to give birth. Once the infant has been declared stillborn, doctors will remove its organs. They will then be used to save the lives of other children who are currently being placed on 7,000-strong waiting list"
After all, if the baby isn't itself viable, and could save the lives of others who may be, that's potentially a good thing, no?
The problem is, the Much Vaunted National Health System© hasn't shown itself to be particularly concerned with ethics, which leads folks to (justifiably) call into question the rationale behind this effort, not to mention the motivations of those tasked with implementing it.
This in particular raises moral hackles:
"Amid a chronic shortage of donated organs, mums will be 'supported' to have the baby at nine months so that the child's vital organs can be taken for transplant"
Law of supply and demand seems particularly tempting here; so who makes the call as to whether this or that baby is the viable one, and which is to be sacrificed? After all, these are the folks responsible for the (notorious) Liverpool Pathway.
Thus far, this is only in the "proposal" stage.
Thus far.
[Hat Tip: Co-blogger Mike F]
Remember when The ObamaTax was going to "bend the cost curve down?"
Good times, good times.
[Hat Tip: A M Best]
Note well how the various age cohorts are clustered: very heavily skewed towards the more claims-prone older ages, very few in the crucial (ie low claims) 25-and-under crowd.
Think that's a problem?
Yup.
[Hat Tip: A M Best]
■ As we've noted, the issue of agent compensation (commissions) for writing new Obamaplans has become quite the issue. More than a few carriers have decided to stop paying agents, and thus staunch the flow of claims dollars pouring out the door. Kentucky has put carriers on notice that in the Blue Grass State such practices are a no-no.
Thanks to FoIB David Williams, we learn that California is considering outlawing this practice, and for the very reason we've long put forth:
"California’s health exchange may require its health plans to pay sales commissions to insurance agents to keep insurers from shunning the sickest and costliest patients."
Of course, by next year it may be a moot point.
■ Next, SoIB Gail S tips us to the latest in the struggle to find lost life insurance policies:
"Smaller insurers balk at searching databases to check if policyholders have died; ‘It wasn’t priced in’"
Which is true, of course, but belies two other more pressing issues: the fact that it's the insured's responsibility to make sure his or her beneficiaries know about any policies and, two, even if they *could* afford to track down who's currently at room temp, there's no effective means to do so. As we reported almost 4 years ago:
"[T]he SSA has itself acknowledged, the DMF [Death Master File] is itself rife with potential errors and misinformation"
Oh, I'm sure they'll get right on that.
■ Finally, longtime FoIB Jeff M alerts us that North Carolina Blue Cross/Shield's woes aren't going away any time soon:
"Blue Cross and Blue Shield of North Carolina finished 2015 with just $500,000 in net profit, due largely to losses associated with Affordable Care Act plans."
But that's only part of the picture:
"Reserves" are the insurance company's "cushion" against future claims [Correction: as Mike points out in the comments, it would be more accurate to say that reserves are amounts held back from current premiums to pay for certain past claims, not future claims]. It's important that they be sufficient to handle not only anticipated claims (which follow generally predictable trends) but unexpected ones as well (say a major listeria outbreak). Jeff points out this little nugget on that article:
"The insurer reported having 3.2 months of reserves, a measure of how long it could operate if it did not collect any more in revenue, down from 3.6 months at the beginning of 2015"
Seems a little light, no?
While it may not be a surprise to those who've been paying attention, the overall response to the "benefits" of The ObamaTax have been, in a word, meh:
Poll: Only 15 percent say they have benefited from ObamaCare
Which is interesting, no? After all, the stated premise in the first place was that roughly 15% of us were (at any given time) uninsured. On the other hand, over a quarter of us feel harmed by the train wreck.
But here's what's interesting to me: over half of the respondents claim that they've been personally unaffected by it. So by the "glass half full" metric, it seems that a (bare) majority don't see any great benefit, but neither have they (personally) felt a terrible loss from it.
Yet.
But then, the (so-called) Cadillac Tax has been pushed back (again); since most folks get their health insurance through employer-sponsored plans, it'll be interesting to see if (how?) these numbers begin to move.
[Hat Tip: FoIB Sam B]
