Tag: "insurance"

Employer-Based Health Insurance: “Job Lock” Is Not the Problem, “Insurance Lock” Is

Over at The Incidental Economist, Austin Frakt is publishing an interesting series on “job lock“. This is the idea that, because most of us get our health benefits from our employers, we are “locked” into jobs we don’t like because they offer benefits which we do like (or need).

678We get our health benefits from our employer because they are non-taxable. If employees bought health insurance on our own, we would pay premiums with after-tax dollars. Given this government discrimination, the idea of job lock makes sense: If we got our homes from our employers we would surely hesitate to switch jobs, which would result in forced eviction from the current home to a new one.

But while there may be some job lock due to employer-based benefits, the problem has become way overblown in public discourse, with politicians like Nancy Pelosi claiming that ObamaCare would free the masses to pursue artistic dreams, free of wage slavery.

ObamaCare to Increase Disruption and Discontinuity of Care for Low-Income Americans

A new Health Affairs study:

  • PiStock_000004347437XSmallre-ObamaCare, approximately half of low-income adults might have experienced a change of circumstances that caused churn between Medicaid and private coverage each year.
  • Higher-income states and states that had more generous Medicaid eligibility criteria for nonelderly adults before the ACA experienced more churning.
  • Under ObamaCare, more than 40 percent of adults likely to enroll in Medicaid or subsidized exchange coverage would experience a change in eligibility within twelve months.

Why is this important? Because people who are eligible for Medicaid are not allowed to get private, subsidized insurance in the exchange and vice versa.

Milliman: Insurance Exchange Plans Shifting Costs from the Healthy to the Chronically Ill

Actuarial studies of plans sold through health insurance marketplaces in some states found that many make consumers responsible for as much as 50 percent of the price of specialty drugs, which can cost $8,000 or more a month…

Researchers also say the higher rates help insurers bankroll low monthly premiums to attract healthy young enrollees…

Obamacare caps those expenses at $6,350 for individuals and $12,700 for families. But patient advocates say the spike in cost-sharing means chronically ill people could reach those caps quickly, in some cases within the first months of coverage. (Reuters)

Premiums Soar Because of ObamaCare Regulations

health-insurance-costs-600x400_304Premiums for 2014 individual plans sold by eHealth, the nation’s largest private insurance exchange, have spiked by more than a third since coverage requirements under the Patient Protection and Affordable Care Act took effect. For family plans, the increase is more than 50%, the Mountain View, Calif., company reports. The average monthly premium for individual coverage purchased through the company’s website was $274. That was up from an average monthly premium of $197 for individual plans that did not have to adhere to new coverage requirements under the ACA. For family coverage, the average monthly premium for 2014 plans sold through eHealth was $663 a month, compared to $426 for non-ACA compliant plans. (Modern Healthcare)

Megan McCarthy Enrolls in ObamaCare

After an hour on the phone, most of which was hold time, a call center employee had entered the several pages of information (names, dates of birth, addresses, etc.) into an application on her computer twice without success. She suggested that it might be something to do with the fact that our street address has the word “North” in it, which could confused the system if it wasn’t entered to exactly match the records they had received. (So was it N? Or North? Or NORTH? So many options!) We consulted the company benefits office, which advised us to enter everything in all capital letters…

404-error-obamacareThree hours after beginning my second attempt, I succeeded, or so I thought. DC Health Link congratulated me on my enrollment and I thought a health insurance card would be making its way to my door soon…Once again, that assumption was incorrect. When we hadn’t gotten any information on our new health insurance plans by February 3, I called our new insurance company and see what was up. They said they had no record of our enrollment…

Eventually my family got a letter that did confirm our enrollment. While the letter confirmed that we had enrolled in something, it did not explain why our insurance company didn’t know who we were three days into the month our coverage was supposed to start. (More)

Can Employers Pay Workers to go Into the Exchange?

employer coverage 300Put yourself in the position of an employer that’s looking to save money on the health coverage you offer your workers. Wouldn’t it be great if your costliest employees declined that coverage and instead bought insurance on an exchange?

Heck, you’d be willing to pay your sickest employees to refuse coverage. On average, your share of a family’s health plan comes to almost $12,000. Your costliest employees are even more expensive to cover. What if you offered those employees a $6,000 bump in wages if they declined coverage? You’d still come out ahead — and, now that the ACA is up and running, your employees might be better off, too. They could buy comparable health insurance through an exchange and, if the tax credits are rich enough, even pocket some of the $6,000. You win, your employees win. Only the federal government, which pays for the tax credits, loses.

More from Nicholas Bagley at the Incidental Economist.

How Many People Really Have Bought Insurance in the Exchange?

Bob Laszewski:

bildeMy informal survey can’t be too precise, but I can say with pretty good confidence that based upon the drop-outs so far, about 20% of the 3.1 million people the administration has said have enrolled through January are not going to stick. That means the real number is closer to about 2.5 million.

Some of this attrition is due to people not paying their bill because they decided not to buy after all. Some to people signing-up twice and just paying once — Healthcare.gov can’t handle duplicate enrollments! Some of it may be due to people wanting coverage but they never got their invoice in all of the January administrative mess. Until the dust settles we really won’t know.

How many are newly insured verses re-enrolling?

In an earlier post I told you that published reports that put the number of reenrollments at about two-thirds of the ObamaCare exchange enrollments sounded about right given my own discussions with carriers. Two weeks later I haven’t heard anything to change that assessment.

ACO Savings Meager (And They May Not Be Real)

CMS is touting savings in its Accountable Care Organization pilot programs. But it’s not answering questions, and the reason is apparently because the real story is not good. Kaiser Health News reports:

[According to David Muhlestein of the consulting firm Leavitt Partners] today’s news is actually “a net negative.” That’s because the savings, when averaged over the approximately 1.6 million lives covered by those ACOs, were only about $80 per person for the year, or a little less than 1 percent of spending.

“It’s not insignificant, but it’s not what you’d consider a huge success,” Muhlestein said. He adds that it’s unclear whether the savings covered the cost of the ACOs’ initial investment in information technology, nurse care coordinators, and any other upfront costs to become an ACO.

How Insurance Agents Feel About ObamaCare Exchanges

In Minnesota, the exchange is called MNsure:

  • mnsure-dot-org-ss_mainEleven percent of agents indicate they are convinced MNsure will eventually work, and be a benefit to clients, while 13 percent are hopeful it will eventually work.

  • Nearly 60 percent express disbelief it will ever work well, but expect to keep trying.
  • More than 19 percent have given up trying.
  • More than 47 percent urge professional insurance agent associations to focus on making sure a competitive, private marketplace exists outside of MNsure.
  • Yet 27 percent urge their associations to work with MNsure while protecting the private, non-MNsure marketplace.
  • Twenty-two percent ask their associations to support a complete MNsure overhaul, or work against MNsure.

Survey by Dave Racer.

Who’s Signing Up?

ACA-enrollment-by-age-group

Source: Avik Roy.