Tag Archives: Health Insurance

Obamacare’s California Insurance Premiums Are Soaring – This Is Fact

By Peter Ferrara, Contributor

The great American experiment in democracy is currently failing. In proof of that, I give you Exhibit A: We cannot even agree on the basic fact of whether health insurance premiums are rising or falling under Obamacare. Note, this is not a matter even of opinion. It is a matter of simple fact, right or wrong. But if we can’t agree on what the basic facts are, we cannot analyze Obamacare, or even discuss it intelligently. 

The problem began with contentious California bureaucrats running the California Obamacare Exchange, named Covered California. They released the rates that insurance companies bid to sell the required insurance to individual purchasers on the California Obamacare Exchange. See if you can immediately spot the dishonest fallacy in the key summary statement in the Covered California press release: “The rates submitted to Covered California for the 2014 individual market ranged from 2 percent above to 29 percent below the 2013 average premium for small employer plans in California’s most populous regions.”

This is like a California Chevy dealer in a year when the price of new Chevys has soared, issuing a press release that says, “The prices for new Chevy autos and trucks this year ranged from 2 percent above to 29 percent below the average price this year for new Cadillac autos and trucks in California’s most populous regions.”

Actually, it is worse even than that. Because the Covered California press release compared the prices of individual insurance to the prices for small business insurance, it is more like a Chevy dealer press release that says, “The prices for new Chevy autos and trucks this year ranged from 2 percent above to 29 percent below the average price this year for new small buses and dump trucks.”

But that misstatement of the basic facts is all it took for media organs of Leftist so-called Progressivism to crank up the celebratory pipes. Peter Lee, Executive Director of the Covered California Exchange kicked off the dishonest, misleading rhetoric, proclaiming regarding the newly announced rates, “This is a home run for consumers in every region of California.” He reached that conclusion by comparing Yankee Stadium home runs to Lambeau Field touchdowns.

Next up to bat at the free throw line was logic arsonist Paul Krugman, whose writing always makes you feel like the First Amendment was a mistake. On the basis of the data comparing apples to Orangutans, he concluded that “the real Obamacare shock will be one of unexpected success,” explaining that the ultimate result of Obamacare will be “millions of Americans will suddenly gain health coverage, and millions more will feel much more secure knowing that such coverage is available if they lose their jobs or suffer other misfortunes. Only a relative handful of people will be hurt at all.”

He overlooks the equal millions of Americans that will suddenly not get health coverage under “universal” Obamacare, the millions more who will choose not to get health insurance “secure knowing that such coverage is available” if they get sick later, the tens of millions who will lose their employer provided health insurance, regardless of whether they like that coverage or not, the millions more who will lose their full time jobs for part time jobs with lower incomes and no benefits, becoming truly middle class in the Obama/Krugman era, where middle class is just another word for declining real incomes, and the millions more who will be denied access to the best health practitioners and facilities, and to the new, innovative, health care breakthroughs that were never financed, under the restrictive Obamacare choices allowed by the social justice of “progressive,” political health care.

Krugman reveals his true “Progressivism,” saying the end result will be that “the sheer meanspiritedness of the Obamacare opponents will become ever more obvious,” argument collapsing into sheer name calling being the hallmark of a truly “progressive” discussion.

The simplest and most direct discussion of the issue, failing to grasp any relevant distinctions at all, was provided by my fellow Forbes contributor Rick Ungar, who reported in one of his columns, echoing of course Krugman, “Upon reviewing the data, I was indeed shocked by the proposed premium rates, but not in the way you might expect. The jolt that I was experiencing was not the result of out-of-control premium costs but the shock of rates far lower than what I expected – even at the lowest end of the age scale.” Either Ungar failed to understand the distinction between Chevys and Cadillacs, or between the family Chevy and a bus, or he decided that the truly progressive course was to play along with the California bureaucrat misrepresentation, rather than disclose the fallacy to his readers. Apple or Orange, Rick?

But Ungar went on to explain, “what we are now seeing in states like California is that the desire on the part of the health insurance companies to increase market share – thanks to the large influx of customers as a result of Obamacare – is driving prices downward.” We will see about that large influx of customers. Personally, I am not buying an Obamacare policy until I am sick, and I am already well over 40 years old. And I don’t expect to be paying any penalty for that decision either.

It took Avik Roy to explain the real story in his column, also at Forbes. He examined health insurance policies currently offered on the unofficial, private sector, non-political ehealthinsurance exchange and concluded, “Obamacare, in fact, will increase individual-market premiums by as much as 146 percent.”

“[F]or the typical 25 year old male non-smoking Californian,” Roy added, “Obamacare will drive premiums up by between 100 and 123 percent.” For a 40 year old male non-smoker” Obamacare will increase individual-market premiums by an average of 116 percent.” Roy summarized, “For both 25-year-olds and 40-year-olds, then, Californians under Obamacare who buy insurance for themselves will see their insurance premiums double.” That is a conservative understatement of his actual results.

But Ungar responded in his next column, objecting to Roy’s methodology with Alinskyite ridicule: “my first reaction was to laugh. eHealthinsurance.com? Seriously?” Ungar’s complaint was that Roy’s comparisons were based on so-called “teaser rates” on the eHealthinsurance website, explaining “I mean, you don’t have to be a healthcare policy expert to know that websites like eHealthinsurance.com always flash low rates in front of you—prices that maybe one person in a thousand might actually hope to achieve—to tickle the interest of a potential customer.” That “knowledge” is based on what?

Ungar continued, “It’s not that the flashing low prices are necessarily false as there is always going to be someone who can qualify for the exceptionally low rate.” But “have you ever suffered a migraine headache? If you have, be prepared for a substantial increase over the teaser price stated on a website like eHealthinsurance.com. Ever experience a summer of hay fever? Your rate will skyrocket as a result. Did you have acne as a teenager? Uh-oh…price is going up.”

Next Page »

Source: FULL ARTICLE at Forbes Latest

States Rejecting Medicaid Expansion Face Fallout

By The Associated Press

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Danny Johnston/APArkansas House Majority Leader Rep. Bruce Westerman signals his intention to speak against a Medicaid funding bill in the House chamber at the Arkansas state Capitol in Little Rock, Ark.

By RICARDO ALONSO-ZALDIVAR

WASHINGTON — Rejecting the Medicaid expansion in the federal health care law could have unexpected consequences for states where Republican lawmakers remain steadfastly opposed to what they scorn as “Obamacare.”

It could mean exposing businesses to Internal Revenue Service penalties and leaving low-income citizens unable to afford coverage even as legal immigrants get financial aid for their premiums. For the poorest people, it could virtually guarantee that they will remain uninsured and dependent on the emergency room at local hospitals that already face federal cutbacks.

Concern about such consequences helped forge a deal in Arkansas last week. The Republican-controlled Legislature endorsed a plan by Democratic Gov. Mike Beebe to accept additional Medicaid money under the federal law, but to use the new dollars to buy private insurance for eligible residents.

One of the main arguments for the private option was that it would help businesses avoid tax penalties.

The Obama administration hasn’t signed off on the Arkansas deal, and it’s unclear how many other states will use it as a model. But it reflects a pragmatic streak in American politics that’s still the exception in the polarized health care debate.

“The biggest lesson out of Arkansas is not so much the exact structure of what they are doing,” said Alan Weil, executive director of the nonpartisan National Academy for State Health Policy. “Part of it is just a message of creativity, that they can look at it and say, ‘How can we do this in a way that works for us?'”

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About half the nearly 30 million uninsured people expected to gain coverage under President Barack Obama‘s health care overhaul would do so through Medicaid. Its expansion would cover low-income people making up to 138 percent of the federal poverty level, about $15,860 for an individual.

Middle-class people who don’t have coverage at their jobs will be able to purchase private insurance in new state markets, helped by new federal tax credits. The big push to sign up the uninsured starts this fall, and coverage takes effect Jan. 1.

As originally written, the Affordable Care Act required states to accept the Medicaid expansion as a condition of staying in the program. Last summer’s Supreme Court decision gave each state the right to decide. While that pleased many governors, it also created complications by opening the door to unintended consequences.

So far, 20 mostly blue states, plus the District of Columbia, have accepted the expansion.

Thirteen GOP-led states have declined. They say Medicaid already is too costly, and they don’t trust Washington to keep its promise of generous funding for

From: http://www.dailyfinance.com/2013/04/22/medicaid-expansion/

Health-Care Overhaul Seen Driving Claims' Costs Up 32%

By The Associated Press

healthcare overhaul costs obamacare medical claims

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J. Scott Applewhite/AP President Obama signs the health-care bill into law in this March 2010 photo. A new study suggests medical-claims costs for individual policy holders will jump an average 32 percent.

By RICARDO ALONSO-ZALDIVAR

WASHINGTON — A new study finds that insurance companies will have to pay out an average of 32 percent more for medical claims under President Barack Obama‘s health-care overhaul.

What does that mean for you? It could increase premiums for at least some Americans. If you are uninsured, or you buy your policy directly from an insurance company, you should pay attention.

But if you have an employer plan, like most workers and their families, odds are you don’t have much to worry about. The estimates from the Society of Actuaries could turn into a political headache for the Obama administration at a time when much of the country remains skeptical of the Affordable Care Act.

The administration is questioning the study, saying it doesn’t give a full picture — and costs will go down. Actuaries are financial risk professionals who conduct long-range cost estimates for pension plans, insurance companies and government programs.

The study says claims costs will go up largely because sicker people will join the insurance pool. That’s because the law forbids insurers from turning down those with pre-existing medical problems, effective Jan. 1. Everyone gets sick sooner or later, but sicker people also use more health care services.

“Claims cost is the most important driver of health care premiums,” said Kristi Bohn, an actuary who worked on the study. Spending on sicker people and other high-cost groups will overwhelm an influx of younger, healthier people into the program, said the report.

The Obama administration challenged the design of the study, saying it focused only on one piece of the puzzle and ignored cost relief strategies in the law, such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick.

The study also doesn’t take into account the potential price-cutting effect of competition in new state insurance markets that will go live Oct. 1, administration officials said.

At a White House briefing Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can’t be compared to the comprehensive coverage available under the law. “Some of these folks have very high catastrophic plans that don’t pay for anything unless you get hit by a bus,” she said. “They’re really mortgage protection, not health insurance.”

Sebelius said the picture on premiums won’t start coming into focus until insurers submit their bids. Those results may not be publicly known until late summer.

‘Double-Digit’ Increases

Another striking finding of the report was …read more
Source: FULL ARTICLE at DailyFinance

Student Who Battled Insurance Company Over Cancer Coverage Dies

By Bruce Watson

Poop Strong  Arijit Guha

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Courtesy Arijit Guha

On Friday, 32-year old graduate student Arijit Guha died of colon cancer. Guha came to national attention in 2012 through “Poopstrong,” his website and Twitter account, which documented his ongoing battle with cancer — and with Aetna, his insurance company.

In 2011, Guha was diagnosed with Stage IV colon cancer and immediately began to undergo treatment. Unfortunately, his health insurance, which he purchased through his university, placed a $300,000 lifetime cap on his policy. When he reached that limit, Guha found himself caught in a life-or-death battle with Aetna — and in a desperate struggle to raise the money he needed for treatment.

Through “Poopstrong,” Guha told about his fight with Aetna. The story, which highlighted some of the flaws of the public health system, quickly drew attention. Eventually, following a face-to-face Twitter exchange, the company’s CEO, Mark T. Bertolini, agreed to cover the student’s bills. Within months, Guha’s health had improved enough for him to go off chemotherapy. Last fall, however, his cancer returned and his health quickly deteriorated.

On January 1, 2014, Obamacare’s spending cap and pre-existing conditions provisions will be enacted, effectively making it illegal for companies like Aetna to refuse coverage to patients like Guha.

Below is a reprint of our original story on Arijit Guha.

There’s nothing new about using social media to battle big businesses: For years, the media has trumpeted stories of angry customers who voiced their gripes on social networks, often with great results. Recently, however, an Arizona cancer patient went to unusual lengths in his social media campaign, using Twitter and Facebook to engage the CEO of one of America’s biggest insurance companies in a dialog about America’s health care system — and his own troubles within it.

In the end, he emerged victorious: His insurance company, which had previously denied him coverage for his expensive treatments, agreed to pay the bills.

In February 2011, Arijit Guha, a 30-year-old graduate student at Arizona State University, returned from a trip to India with a recurring pain in his abdomen. Convinced that he had picked up “a stomach bug,” he went to the hospital, where he underwent extensive tests. The ultimate diagnosis: Stage IV colon cancer, which had spread to his gall bladder, lymph nodes and abdominal lining.

Courtesy of Arijit GuhaA Brief Respite

Luckily, Guha was insured: When he enrolled at Arizona State, he signed up for the university’s health insurance program, which was underwritten by Aetna (AET) — in fact, he paid extra to sign his wife up for coverage, too. But less than a year into his battle with cancer, Aetna let him know that he was going to have to …read more
Source: FULL ARTICLE at DailyFinance

Employers Caught Off Guard by 'Unfair' Health-Care Fee

By David Schepp

employers health care fee

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Getty Images

Employers are bracing for big fees next year for insuring their employees. The fee, equal to $63 for each employee, is a little-noticed requirement of the Patient Protection and Affordable Care Act that became law in 2010. The fee goes to create a $25 billion fund for insurance companies to offset the cost of covering patients with high medical bills.

As The Wall Street Journal reports, the fee will hit most large employers, and they’re fighting back. The requirement unfair, they say, because it subsidizes individually purchased plans that won’t cover their workers. Companies including Boeing Co. (BA) and a union health plan covering retirees of General Motors (GM) Ford Motor Co. (F) and Chrysler, among other groups, have asked federal regulators to exclude or shield their insurance recipients from the fee.

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The fee goes into affect next year and applies to medical plans covering millions of Americans. It applies to employers who self insure as well as private plans sold by insurers. As the Journal notes, the fee will be smaller in 2015 and 2016, but amounts for those years have yet to be determined.

Few noticed the fee when the act passed three years ago. Employers have spent recent months trying to peel it back, the Journal reports, but final regulations published Monday in the Federal Register left it largely intact.

You can read more about the controversy and learn what insurers are saying in the full story (subscription required).

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Source: FULL ARTICLE at DailyFinance

Could Slowing Health Care Costs Save Medicare?

By Dan Caplinger

Medicaid

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Among all the budget concerns facing the U.S., few pose as big a threat to the government‘s balance sheet as our growing health care bill. The rise in health care costs has significantly outpaced both inflation and economic growth for decades, leading to increasingly dire projections about Medicare’s long-term solvency in recent years.

Yet even as policymakers debate about ways to shore up Medicare, some promising trends suggest the government program may get a new lease on life.

Although the Medicare program’s trustees’ report says the program will remain solvent until 2024, its projections are based on assumptions that haven’t been borne out in the past.
For instance, Congress has traditionally kept reimbursement-rate cuts from taking effect, with the latest reversal overriding what would have been a 31 percent cut effective Jan. 1.

With Medicare’s expansion to include prescription-drug coverage, the program has become exposed to a new set of health costs. And as the Baby Boom generation gradually reaches Medicare age, it’ll be tougher than ever to keep costs in line.

Cutting Back

Yet past predictions about financial trouble haven’t resulted in Medicare’s failure. Back in 1997, the Medicare Trustees‘ report set 2001 as the program’s insolvency date. But shortly thereafter, a new law was passed that cut back on the expansion of health care expenditures, extending Medicare’s viability for years.

And recently, we’ve started to see a favorable trend arise: Growth in health care spending has slowed to its lowest level in 50 years.

According to the newest data from Centers for Medicare and Medicaid Services, health-related spending rose 3.9 percent in 2011. That was the first time in more than 10 years that it rose more slowly than the overall economy grew.

What’s less clear is whether spending growth will stay subdued.

Can the Good Times Last?

Some economists believe that the slow recovery from the deep recession of 2008 and 2009 has forced many would-be patients to forgo necessary medical care due to job loss and the loss of insurance coverage. As the Washington Post reported, the number of Americans covered by private insurance fell by 8 million from 2005 to 2011 even as Medicare enrollment soared 12 million over the same period, and many of those formerly covered by employer-provided health insurance fell back on Medicaid.

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Since government programs tend to pay less than private insurance for health care, a reversal of the trend away from private insurance — as the Affordable Care Act envisions — could send costs growing more quickly again.

Others, though, point to spending trends among hospitals and other health-care institutions. Knowing that reimbursement rates will be held in check, these institutions are reining in their own costs to stay profitable, suggesting that slower growth in spending could be more lasting.

What to Watch For

Projections aside, the …read more
Source: FULL ARTICLE at DailyFinance