85 percent of ObamaCare ‘inconsistencies’ can’t be fixed

[RobDownSouth]

Been a while since I have been here....funny how downsouth never changes.

Just so you know, he is, well, to put it nicely, not much into truth telling.

As far as my insurance goes....which for some reason he believes it to be insurance that was not real....let me give you actual numbers.

$350/month for complete family coverage. Deductible (catastrophic) was $6500. The limit on our insurance...I have no idea as we apparently never hit it. Of course, this was never hitting it with my husband dealing with and the dying from brain cancer after 2.5 years. This was not hitting it even though he was taking chemo which costs $15,000 each treatment....and he had those weekly for 3 months.

So we went from that (sub-par insurance...according to downsouth) to Obamacare's off of the basic Bronze plan.....$950/month (as we dot not qualify for a tax payer supported subsidy), $10,000/year deductible which means we would be out of pocket over $20,000 BEFORE Obamacare even reared it's ugly head).

We went with a Christian Cost Sharing option. $380/month. No limit lifetime.

So no matter what the non-speaking truth person tries to sell as "reality"....those are the actual numbers we have had to deal with.

It's true that my position doesn't change...unlike the "facts" associated with your ever-changing harangue about health insurance.

Subsidies kick in to ensure that families never pay more than 9.5% of their income for health insurance.

You claim that you were quoted a bronze level health insurance policy at a cost of $950 per month. Since you also claimed you didn't qualify for a subsidy, this would mean that your household income is at least $120,000 per year.

I tried running your family situation through the Kaiser premium calculator, , but your $950 doesn't make sense. Most bronze level coverage tops out at $800 per month for a family. A silver level plan covers much more with substantially less deductible.

At this point, I think you got a single high priced premium quote and failed to shop it.

I will agree with you once again that you did in fact lose your previous gold-plated policy, but would point out once again that you profited (via your artificially low premiums) for many years at the expense of other sicker families who were denied coverage.

If in fact you did have an all-encompassing policy with no lifetime cap at the bargain basement rate of $350 per month (which is questionable at best, given your long history here of not telling the complete truth), consider yourself fortunate.

I would point out that now you are smugly claiming insurance paid for everything during your previous husband's battle with cancer, but not so long ago you were whining quite often about how his medical condition left your family destitute.

So my question to you is, which story was true? Did your old insurance "pay for everything"? Or did it leave you broke as you previously claimed?

 

[julybaby04]

It's true that my position doesn't change...unlike the "facts" associated with your ever-changing harangue about health insurance.

Subsidies kick in to ensure that families never pay more than 9.5% of their income for health insurance.

You claim that you were quoted a bronze level health insurance policy at a cost of $950 per month. Since you also claimed you didn't qualify for a subsidy, this would mean that your household income is at least $120,000 per year.

I tried running your family situation through the Kaiser premium calculator, , but your $950 doesn't make sense. Most bronze level coverage tops out at $800 per month for a family. A silver level plan covers much more with substantially less deductible.

At this point, I think you got a single high priced premium quote and failed to shop it.

I will agree with you once again that you did in fact lose your previous gold-plated policy, but would point out once again that you profited (via your artificially low premiums) for many years at the expense of other sicker families who were denied coverage.

If in fact you did have an all-encompassing policy with no lifetime cap at the bargain basement rate of $350 per month (which is questionable at best, given your long history here of not telling the complete truth), consider yourself fortunate.

I would point out that now you are smugly claiming insurance paid for everything during your previous husband's battle with cancer, but not so long ago you were whining quite often about how his medical condition left your family destitute.

So my question to you is, which story was true? Did your old insurance "pay for everything"? Or did it leave you broke as you previously claimed?

Going to directly answer you as it is Christmas..

I don't recall saying my husband's medical condition left us destitute. I have mentioned that it was expensive....I believe you must have assumed that it left us destitute. We did hit the limit for those three years, 2 of those years we hit it by the end of January. We had to pay the deductibles, the catastrophic deductibles and that was fine. We were able to do it, but we were definitely not wealthy.

As far as the Obamacare thing, we started a small business. There was a minimum level of income that had to be reached to receive a subsidy. In our first year, as with most business, we had a loss simply because of start up costs. If we met that threshold, we could get a subsidy. Without it, on the Bronze plan, in our state, it was $950 with $10K deductible.....and these were the numbers given to us by our insurance agent.

We had great insurance. Yes, perhaps, low premiums. But, now, we could not afford even the basic insurance. So, that was the reason why we went with Cost Sharing.

If Obamacare works for you, then you are blessed. We were unable to afford it, so other solutions were needed.

 

[toubab]

"After Multiple Enrollment Failures, Hawaii Dumps State Obamacare Exchange"

http://townhall.com/tipsheet/katiep...aii-dumps-federal-obamacare-exchange-n2009538

"Last week Americans For Tax Reform released new information showing that during Hawaii's special Obamacare enrollment period, zero people enrolled. The total state cost for the exchange sits at more than $200 million.

While Hawaii enrolled zero individuals and is the worst performing state, it is not alone. Vermont signed up only 97 households, while Rhode Island enrolled just 25 households.

Hawaii’s dismal performance should not be surprising. The website cost taxpayers $205 million but could only enroll 8,592 individuals in year one. Cost to taxpayers per enroll: $23,899.

The state legislature recently rejected a $28 million bailout for the website meaning that a contingency plan to dismantle the exchange and migrate to the federal exchange will be implemented immediately. Unfortunately, taxpayers are not off the hook yet as it is expected that moving to the federally run healthcare.gov will cost $30 million.

Now, due to a lack of enrollment and a failed website, Hawaii has scrapped the state based exchange altogether and will be moving to the federal Obamacare system.

Hawaii is taking its troubled ObamaCare insurance exchange off life support, the governor’s office announced Friday, the latest addition to a growing number of state exchanges forced to close after operations became unsustainable.

The once-highly praised Hawaii Health Connector has been “unable to generate sufficient revenues to sustain operations,” Gov. David Ige’s office said in a statement. The federal Centers for Medicaid and Medicare Services (CMS) informed the exchange last week that federal funds were no longer available to support long-term operations.

“The state is working with the Connector and CMS to determine what functions can be transitioned to state oversight to ensure compliance with the Affordable Care Act (ACA) by the next Open Enrollment in November 2015,” Ige said.

Oops.

I wonder if the Obama administration will accuse blue Hawaii of playing politics or attempting to sabotage President Obama's signature health care law by scrapping the state based exchange. After all, that's what the White House said about Republican governors to refused to implement state exchanges in the first place.

Hawaii's decision to scrap the exchange comes just ahead of the Supreme Court decision in King v. Burwell, the case surrounding whether federal subsides taken by people in states without state based exchanges are legal."

 

[toubab]

Big premium increase requests show volatility in health care market

http://www.startribune.com/big-prem...w-volatility-in-health-care-market/306436431/

"Hike requests come after insurers lost $300M on policies for individuals."

"Big premium increases that Minnesota insurers proposed last week reflect losses they’ve been taking in a part of the market targeted by the federal health law.

Insurers say they collectively lost more than $300 million on policies for individuals who buy coverage on their own last year because subscribers had more costly health problems than expected.

Higher rates on that coverage would help close the gap, though the size of the increases will attract attention amid scrutiny of the effects of the Affordable Care Act. If regulators were to approve the full amounts, average premiums would increase by more than 50 percent for about 179,000 people, and by more than 10 percent for another 60,000.

Insurers say they are making adjustments now that they have more experience under the health care law, which will cover a chunk of first-year losses.

“This just shows the volatility that we’re experiencing in the first few years of the Affordable Care Act,” said Lynn Blewett, a health policy expert at the University of Minnesota. “Eventually, it will work itself out into a more stable market.”

Observers say the proposed increases are driven largely by factors that are unique to the individual market, and don’t point to similar jumps for employer groups and government programs that cover roughly 90 percent of Minnesotans.

But the individual market, which includes the state’s MNsure exchange, grew by about 53 percent last year to about 292,138 people, according to the Minnesota Council of Health Plans. Low rates that some people initially found on MNsure have already started to go away.

Golden Valley-based PreferredOne made a big splash in 2014 during the first year of the exchange, but had to pull out of MNsure for 2015 after low rates proved unsustainable. The company increased premiums by an average of 63 percent for 2015, prompting thousands of subscribers to take their business elsewhere.

With the federal information released last week, other Minnesota insurers signaled they need to boost premiums, too.

“They didn’t do a good job of estimating health care costs for that population in the individual market,” said Roger Feldman, a health insurance expert at the University of Minnesota. The hope, Feldman said, is that the increases for 2016 reflect a one-time correction.

Blue Cross and Blue Shield of Minnesota, which is the largest insurer in the individual market, announced proposed average increases of 54 percent and 55 percent for policies that collectively cover about 179,000 people.

Blue Cross says it lost $135 million in the individual market during 2014 — a figure that would be significantly higher without financial safety nets for insurers that are built into the health law."

"Health law supporters say they’re disappointed by the rate requests, but argue insurers remain profitable overall and have large financial reserves.

“It is important that we have public scrutiny — and expert scrutiny — over those claims about losses, and those proposed increases, because they will weigh very heavily on enrollees,” said Sarah Greenfield of TakeAction Minnesota, a St. Paul-based consumer group that backs changes under the Affordable Care Act.

But Peter Nelson with the Center of the American Experiment said he believes state regulators pushed too hard to keep rates low in 2014, setting the stage for “rate shock” in the new filings.

“Insurers clearly need to raise rates,” said Nelson, whose group supports free-market changes in health care. “It’s clear that they are losing substantial amounts of money, and that is not sustainable.”"

 

[toubab]

Licking Wounds, Insurers Accelerate Moves To Limit Health-Law Enrollment

http://khn.org/news/licking-wounds-insurers-accelerate-moves-to-limit-health-law-enrollment/

"Stung by losses under the federal health law, major insurers are seeking to sharply limit how policies are sold to individuals in ways that consumer advocates say seem to discriminate against the sickest and could hold down future enrollment.

In recent days Anthem, Aetna and Cigna, all among the top five health insurers, told brokers they will stop paying them sales commissions to sign up most customers who qualify for new coverage outside the normal enrollment period, according to the companies and broker documents.

The health law allows people who lose other coverage, families with new children and others in certain circumstances to buy insurance after enrollment season ends. In most states the deadline for 2016 coverage was Jan. 31.

Last year, these “special enrollment” clients were much more expensive than expected because lax enforcement allowed many who didn’t qualify to sign up, insurers said. Nearly a million special-enrollment customers selected plans in the first half of 2015, half of them after losing previous coverage.

In addition, Cigna and Humana, another big health insurer, have ceased paying brokers to sell many higher-benefit “gold” marketplace plans for individuals and families while continuing to pay commissions on more-profitable, lower-benefit “bronze” plans, according to documents and interviews.

Gold plans typically enroll sicker members than do less comprehensive policies, say insurance experts. As of June, more than 695,000 people had enrolled in gold plans.

Those who want to buy individual and family plans can still do so directly through the Affordable Care Act’s online marketplaces or via navigators working for nonprofit groups.

But the retreat from broker sales, which includes last year’s decision by No. 1 carrier UnitedHealthcare to suspend almost any commissions for such business, erodes a pillar of the health law: that insurers must sell to all customers no matter how sick, consumer advocates say.

By inducing brokers to avoid high-cost members — whether in gold plans or special enrollment — the moves limit access to coverage and discriminate against those with greater medical needs, said Timothy Jost, a law professor at Washington and Lee University and an authority on the health law.

“The only explanation I can see for them doing this is risk avoidance — and that is discriminatory marketing and not permitted,” he said. “When people wonder why we’re not getting millions more enrollees in Affordable Care Act health plans, one reason is, the carriers are discouraging it.”

The insurance industry says it is not discriminating but adjusting to market realities including higher-than-expected medical claims and the failure of a government risk-adjustment program called “risk corridors” to cover much of that cost."