Tag: "insurance"

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.

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.

Millionaires on Medicaid

billsGot a house worth $802,000, lots of savings and a nice car? You might still qualify for benefits… In fact, 15% of elderly individuals in the middle-income quintile, 8% in the upper-middle quintile, and 5% in the top quintile receive Medicaid benefits…

[S]tate governments are mandated by law to pursue the estates of wealthy residents to recoup the costs incurred by their use of long-term care programs. Yet the most recent study by Health and Human Services found that most states recoup less than 2% of total long-term care spending. Four states — Alaska, Georgia, Michigan and Texas — even reported no reimbursements whatsoever. (WSJ)

Fascinating Question

shutterstock_141533524-750x420Can an employer pay chronically ill workers to leave the company health plan and get insurance somewhere else? That’s a question some business owners are asking, now that no one can be turned away from individual health plans under ObamaCare. The potential loophole in the Affordable Care Act could threaten the viability of ObamaCare marketplaces if they get the most expensive-to-insure workers while companies keep healthier employees on their own plans. Some mid-sized companies that self-insure — that is, they pay the cost of employees’ medical claims directly — are at least talking about the idea. (BusinessWeek)

Private Exchanges: Getting Ready For Individual Health Insurance to be The Standard

Professor John H. Cochrane of the University of Chicago had an op-ed in The Wall Street Journal on December 25, in which he gave a brief description of (among other things) a market in which individuals buy their own health insurance — and not from an ObamaCare exchange.

privateAccording to Professor Cochrane: “…we should transition to fully individual-based health insurance.” This is the Holy Grail of free-market reformers, and likely unattainable as long as ObamaCare’s political opponents are unwilling to take the risk of a reform that can be twisted as “taking away” employer-based benefits. (Although, as I have described in a previous post, the task would not be impossible if free-market reformers improved our communications skills.)

In Professor Cochrane’s approach, each individual would buy health insurance that actually combines two policies. The first would cover the beneficiary for catastrophic illness and accidents this year. The second, called health-status insurance, is insurance against being underwritten again in future years.

Insurance Turning Out To Be Unaffordable

More than half of the counties in 34 states using the federal health insurance exchange lack even a bronze plan that’s affordable — by the government’s own definition — for 40-year-old couples who make just a little too much for financial assistance, a USA Today analysis shows…

stethoscope-squeezing-moneyMore than a third don’t offer an affordable plan in the four tiers of coverage known as bronze, silver, gold or platinum for people buying individual plans who are 50 or older and ineligible for subsidies.

Those making more than 400% of the federal poverty limit — $47,780 for an individual or $61,496 for a couple — are ineligible for subsidies to buy insurance.

The USA Today analysis looked at whether premiums for the least expensive plan in any of the metal levels was more than 8% of household income. That’s similar to the affordability test used by the federal government to determine whether premiums are so expensive consumers aren’t required to buy plans under the Affordable Care Act. (USA Today)

Mandela: Father of MSAs

Nelson-MandelaAbout the time that Nelson Mandela became South Africa’s president, there was wholesale deregulation of the country’s market for health insurance. As a result, virtually every major form of insurance that existed in the United States at the time competed on a level playing field in the South African market: PPOs, HMOs, MSA plans, etc. In fact, U.S. companies were involved in many of these ventures.

In a short period of time, Medical Savings Account plans became the most popular, capturing more than 50 percent of the market. However, as Shaun Matisonn explained in an NCPA study, there were no restrictions on the design of MSA plans like there were in the U.S. Whereas our plans are required to have an across-the-board deductible, in South Africa insurers were free to creatively use the accounts to create special programs for the chronically ill and to create economic incentives only in those areas and for those services where patience choice is appropriate and desirable.

This market, by the way, directly affects only about 20 percent of the population ― since everyone else tends to rely on free health care system. Like similar systems in other countries, government-provided care is characterized by limited resources and rationing by waiting.

You Can’t Make An Omelet Without Breaking…

Ah, yes. The poor eggs. MoveOn says the sacrifice is worth it. From their latest petition:

Why are we so fixated on 4 million insured people who may lose their current and mostly sub-standard health insurance policies and ignoring the fact that 48 million people who have never had health insurance will finally be able to buy health insurance?

The 4 million insured have had the ability to purchase insurance all along. Now, due to circumstances beyond their control, including the greed of insurance companies, they could potentially lose their current policy. But they still have the option to get another plan.

The 48 million people that have never had coverage would not be able to get any health insurance coverage if it were not for the Affordable Care Act. End of story!

Ouch. Too bad we didn’t hear that until after election day.