Tag: "health policy"

How Much Did ObamaCare Increase Your Premiums? A New County-By-County Calculator

The Manhattan Institute has published an interactive map that shows ObamaCare’s effect on premiums for individual health insurance in almost every U.S. county. On average, premiums have increased by 49 percent. However, there is huge variance:

Among men, the county with the greatest increase in insurance prices from 2013 to 2014 was Buchanan County, Missouri, about 45 miles north of Kansas City: 271 percent. Among women, the “winner” was Goodhue County, Minnesota, about an hour southwest of Minneapolis: 200 percent. Overall, the counties of Nevada, North Carolina, Minnesota, and Arkansas haven experienced the largest rate hikes under the law. (Avik Roy, Forbes)

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Reflections on Risk Adjustment, Reinsurance, and Risk Corridors in ObamaCare

fgdfgOn Wednesday, June 18, 2014, I had the pleasure of testifying at the House of Representatives’ Committee on Oversight and Government Reform’s Subcommittee on Economic Growth, Job Creation, and Regulatory Affairs. The subcommittee held a hearing it called “Poised to Profit: How ObamaCare Helps Insurance Companies Even If It Fails Patients.”

Much of my testimony was drawn from content in this blog. What struck me was the minority’s emphasis that these provisions, which protect insurers from losing money in ObamaCare, are designed to motivate insurers to offer coverage to sick people.

It is a well-worn talking point of ObamaCare’s supporters that insurers can no longer charge higher premiums or deny coverage to applicants who are expected to have higher health costs, or exclude coverage for pre-existing conditions. Obviously, no insurer will seek to cover these people just because the government wants it to. The market has to be structured to achieve that objective.

The Sickest Low-Income Patients Will Pay the Most under ObamaCare

Follprescription-bottleowing up a February study, which showed that people needing drugs on the highest formulary tier will pay much higher out-of-pocket costs than other ObamaCare enrollees, consultants at Avalere have released another study, which shows that the low-income ObamaCare enrollees will suffer this effect even more than middle-class ones.

A formulary is a list of drugs that a health plan covers. It can be divided into up to four tiers. Drugs on the lowest tier (usually generic medicines) cost the least out of pocket, while those on the highest tier cost the most. However, those on the highest tier are the most expensive, and often indicated for those suffering the worst diseases.

Hits and Misses

woman-with-childA commonly used drug can protect fertility in women undergoing chemotherapy.

Shocker! Bernie Sanders, the only socialist in the U.S. Senate, wants to fix the VA by privatizing the provider network.

Are health insurers lobbying to extend the risk-corridor “bailout” beyond three years?

Thousands of Georgia doctors lack medical-malpractice liability insurance.

Californians complaining to state regulators about ObamaCare plans: Can’t get ID cards, few providers in networks.

Study: Half a Million More Uninsured by 2019, Four Million More by 2025

A new study by Professor Steve Parente and Professor Michael Ramlet estimates that the number of uninsured will increase under ObamaCare, from 36.5 million in 2015 to 40.5 million in 2025. It further estimates that the average cost of an ObamaCare Silver plan will increase by over $4,000 in five years.

Nationally, we estimate an initial decrease in the uninsured with greater use of the private health insurance subsidies, but over time health plan prices are likely to increase faster than the value of the insurance subsidy. As a result of the declining purchasing power of the insurance subsidy, the implementation of the qualified health plan requirements and the end of the reinsurance and risk corridor programs we estimate a significant reduction in the private insurance market in 2017 with steady declines continuing for the rest of the decade. The Medicaid population is estimated to grow substantially in 2015 as more individuals are enrolled in states who have chosen to expand the program. Medicaid enrollment is estimated to slow down to between 2% to 3% each year from 2016 to 2024.

I guess they had not heard the President’s declaration that the debate over ObamaCare is over.

Primary-Care Physicians Earn Only 20 Percent of What They Charge

If $180,000.00 is 20% of the total reimbursement, then a PCP brings in $900,000.00 a year. Therein lays the misconception that doctors are overpaid, but remember: the doctor does not pocket that total. At a patient load of 7,200 patients that is $125.00 for a 15 minute appointment. This is great pay. But remember also that 80% of that total goes to pay the staff salaries and benefits, rent, utilities, as well as such government mandated programs like Electronic Medical Records and all other costs needed to keep a business running. (The InsureBlog)

Over Half of Workers Would Have to Borrow Money to Pay for Unexpected Medical Costs

AFLAC has just published its fourth annual survey of employees and business leaders about health benefits. Overall, the responses show how poorly our system of prepaid healthcare (inaccurately labelled “health insurance”) protects workers from the costs of catastrophic illness. Highlights include:

  • 53 percent of workers would have to borrow from their 401(k)s and/or use a credit card to cover costs associated with an unexpected serious illness or accident;
  • 49 percent have less than $1,000 to pay for out of pocket expenses associated with a serious illness or accident, and 27 percent have less than $500;
  • 42 percent say they are not at all or not very prepared to pay out-of-pocket expenses associated with a serious illness or injury.

Health Insurers Continue To Grow Under ObamaCare

Although health insurers’ profit margins shrank a little in 2013, enrollment amongst the largest for-profit insurers jumped by eight million over 2012, according to a new analysis by Mark Farrah Associates. The report concludes that “leaders in the health insurance sector have good reason to remain optimistic”.

Although all major insurers succeeded in enrolling members in the new ObamaCare health insurance exchanges, this is still a small fraction of their business.

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Latest IRS Rule Outlaws Decades-Old Benefits, But Will Not Stop Employers Dumping Workers into ObamaCare’s Broken Exchanges

The New York Times‘ Robert Pear has covered an IRS rule that he interprets as barring employers from dumping workers into ObamaCare health insurance exchanges. Although this is the goal of the IRS rule, it is unlikely to have a significant effect on employers’ executing such changes.

Pear’s article covers a Q&A just released by the IRS that summarizes a decision it made back in September (Notice 2013-54). That notice laid down rules for Health Reimbursement Accounts (HRAs), Flexible Spending Accounts (FSAs), and Employer Payment Plans (EPPs). Employers have made pre-tax contributions to these plans for many years.

The notice clarifies that HRAs and FSAs must be “integrated” with employers’ group health plans to count towards ObamaCare’s minimum essential coverage. EPPs are a little known method for employers to contribute non-taxable dollars to workers’ premiums for individual insurance, and were defined by the IRS way back in 1961. Unfortunately, I can find no estimate of how many workers have such arrangements, although one expert source suggests they are “not as common” as HRAs and FSAs. My contacts confirm that benefits advisors have also proposed to employers that they fund HRAs and FSAs for workers, as long as those workers have individual policies. The contributions don’t necessarily fund premiums directly, but the money is considered fungible by workers who pay premiums out of their wages.

How Many Signed Up for ObamaCare? Time to Bury That Story

health-insuranceThe most transparent administration in history has decided to discontinue the monthly Affordable Care Act enrollment reports now that open enrollment is closed.

But while the official open enrollment period is closed, that doesn’t mean that activity on the health insurance exchanges has shut down. People who have experienced a “qualifying life event” — getting a job, having a baby or moving to another state, among others — are still eligible to enroll in an exchange policy.

Meanwhile, other people will be exiting the system — they will get a job that has benefits, marry someone with benefits, or just stop making their payments and go without insurance.

And, of course, voters need to know these numbers in order to evaluate the signature legislative achievement of this administration and the many members of Congress who will be standing for re-election come November.

(Megan McArdle, Bloomberg View)