Tag Archives: Obamacare

Obamacare bailouts prove that the law is flawed and lousy, by Diana Furchtgott-Roth

Marco Rubio may be leading a charge that Republicans are not 100 percent useless (“may” is used because one can never be certain about anything politicians do or say). From a guest post by Diana Furchtgott-Roth at theburningplatform.com:

This week, as part of the reconciliation bill, Congress may vote on bailing out health-insurance companies losing money from their participation in the Affordable Care Act exchanges. With an $18 trillion national debt, Congress should stand firm and say no to the bailouts.

Sen. Marco Rubio is leading the fight against the bailouts. In a letter to congressional leaders, he wrote: “The reason these health-insurance companies are enduring a financial loss is that ObamaCare is a disastrous law. It broke the promise to lower health-insurance premiums and allow Americans to keep their health care. Now the very architects of this law are attempting to place taxpayers on the hook.”

Last year Rubio limited the bailout of the insurance companies with the ObamaCare Bailout Prevention Act. Some of the provisions were included in last year’s spending bill. The result of the measure was that, in October, the Department of Health and Human Services transferred $362 million to the losing insurance companies, rather than the $2.9 billion that they requested. That’s $2.5 billion more for taxpayers.

The Health Insurance Association of America, under the leadership of Karen Ignagni, lobbied heavily in favor of the Affordable Care Act. Insurance companies shouldn’t get government money now that their bet is going the wrong way.

Insurance companies thought they would have a captive market of young, healthy people who would be forced to sign up for expensive policies with the threat of penalties. But it was a cynical scheme. The premiums from young people, who do not use much health care because they are rarely sick, would be used to pay for the care of the old and the chronically ill. The Affordable Care Act was structured so that younger, healthy Americans would pay for everyone else, even though the young have higher unemployment rates, less disposable income, more student loans and fewer assets.

Little did these insurance companies know that enrollment would fall far short of predictions. Enrollment in the exchanges is estimated by Health and Human Services Secretary Sylvia Burwell to be 10 million in 2016, compared with 22 million predicted by the Congressional Budget Office in May 2013. Insurance companies are not getting enough premiums to cover the costs of treating enrollees.

The problem is that the Affordable Care Act is simply unsustainable, as I predicted in December 2009. It mandates a generous, comprehensive plan that is also expensive. Young, healthy people do not want to sign up because the premiums are far higher than their health-care costs. They rightly do not see why they have to buy a plan with pediatric dental care if they have no children, and mental-health and drug-abuse coverage if they do not need it. Many would buy a simple plan, covering major catastrophic expenses, but such plans are not allowed to be sold on the exchanges. People who are signing up for Obamacare are not the young. They are sicker than average and have chronic health conditions that make them more expensive to insure.

Insurance companies were relying on payments from the federal government to constrain their losses as part of a device known as “risk corridors.” Risk corridors allow the government to bear a portion of the costs if they become too high. Section 1342 of the Affordable Care Act states that the secretary of HHS can reimburse insurance companies if the costs of covering sick people exceed the premiums received. However, the act did not provide an appropriation for these funds. In order for risk-corridor funds to be distributed, Congress has to appropriate them.

Some legislation that includes risk corridors includes an appropriation. For instance, payments for losses under the Medicare Part D plan come from a permanent appropriation from the Medicare Prescription Drug Account. However, the ACA did not include such an appropriation.

Both the Congressional Research Service and the U.S. Government Accountability Office have ruled that a congressional appropriation is required before federal agencies can make risk-corridor payments for losses incurred under the Affordable Care Act.

Enter Rubio, who has figured out that the best way to get rid of the Affordable Care Act is simply to prevent Congress from appropriating the money to pay insurance companies’ losses. If the companies are not reimbursed, they will withdraw from the exchanges. Companies estimate that they will need $2.9 billion next year to stay in business, and they cannot manage without the government subsidy.

To continue reading: Obamacare bailouts prove that the law is flawed and lousy

A new taxpayer bailout to cover up ObamaCare’s failure? by Betsy McCaughey

From Betsy McCaughey at nypost.com:
How dare the Obama administration bail out insurance companies with our money in order to hide ObamaCare’s failures. Thursday, just hours after giant insurer UnitedHealthcare said it’s losing money selling ObamaCare plans and will likely exit the health exchanges next year, the Obama administration quietly promised to bail out insurers for their losses — using your money.

Nearly all insurers are bleeding red ink trying to sell the unworkable plans. Without a bailout, more insurers will abandon ObamaCare, pushing it closer to its demise. A bailout would benefit insurers and the Democratic Party, which is desperate to cover up the health law’s failure. Ironically Democrats (including Hillary Clinton and Bernie Sanders) bad-mouth bank bailouts but are all for insurance-company bailouts. Truth is, it’s a ripoff for taxpayers, who shouldn’t have to pay for this sleazy coverup.

The pressure is building on Republicans in Congress. Industry groups like the American Health Insurance Plans and giant insurers are joining with the Obama folks to lobby ferociously for a bailout.

UnitedHealthcare’s Thursday bombshell rattled investors, health-plan subscribers and ObamaCare partisans. The insurer currently covers more than half a million ObamaCare plan subscribers in 23 states, including New York, New Jersey and Connecticut.

The insurer announced losses of $425 million on ObamaCare plans, and CEO Stephen Hemsley said, “We cannot sustain these losses,” and “we saw no indication of anything actually improving.”

To continue reading: A New Taxpayer Bailout to Cover Up Obamacare’s Failure?

This Obamacare News Is One of the Law’s Worst Omens to Date, by David Zeiler

The wheels are falling off Obamacare…as predicted. From David Zeiler at moneymorning.com:

UnitedHealth Group Inc. (NYSE: UNH) CEO Stephen J. Hemsley unleashed a bombshell of Obamacare news when he announced that his firm is considering a 2017 exit from the exchanges created by the Affordable Care Act (ACA).

“We are evaluating the viability of the insurance exchange product category for us and will determine during the first half of 2016 the extent to which we can continue to serve the public exchange markets in 2017,” Hemsley said in a Thursday morning conference call. UnitedHealth added that it would cut back on the marketing of its ACA plans.

UnitedHealth is the largest health insurer in the United States. For 2016, it offers Obamacare plans in 35 states and serves half a million customers.

In revising its 2015 earnings outlook downward from $6.25-$6.35 to $6.00, UnitedHealth blamed “pressure” of $425 million, or $0.26 a share, on losses from its Obamacare-related business.

“We cannot sustain these losses,” Hemsley told analysts on a conference call. “We can’t really subsidize a marketplace that doesn’t appear at the moment to be sustaining itself.”

This devastating Obamacare news confirmed suspicion that the major insurers aren’t doing well with their ACA plans and eventually could follow UnitedHealth’s lead in abandoning the exchanges.

To continue reading: Obamacare News Is One of the Law’s Worst Omens to Date

Research Explains Why the Obamacare Marketplace is Slowly Failing, by Devon Herrick

From Devon Herrick at healthblog.ncpa.org:

With great fanfare, the U.S. Department of Health and Human Services issued a press release in mid-October estimating enrollment in the Obamacare Marketplace (i.e. the exchange) at 10 million by the end of 2016. HHS Secretary Burwell said, “We believe 10 million is a strong and realistic goal.”

Before you burst out with excitement, keep in mind enrollment for 2015 is estimated at 9.1 million. As recently as March 2015, estimates by the Congressional Budget Office (CBO) projected 21 million would sign up in 2016. Enrollment is only about half what the CBO originally estimated and is likely to gradually decline into what actuaries sometimes refer to as an adverse selection death spiral.

In a nutshell, Obamacare exchange plans are premised on the idea that young healthy people would be overcharged to help pay for older, less healthy enrollees – who would otherwise find their coverage unaffordable if charged premiums based on their health risk. In theory, sliding-scale subsidies would make premiums affordable for moderate-income families, while the law would force healthy, wealthier families to subsidize the poor and those in poor health. The only problem: people know when they are getting a bad deal and resist in any way they can!

This was tried once before in the 1990s. At the time, states passed perverse regulations to force insurers to accept all applicants — including people in poor health — at rates reflecting average health in a community rather than individual health status. What happened was young people (who already had lower demand for health insurance because they were healthy) were charged too much and abandoned the market. As healthy people dropped out, sicker people remained in the insurance market. As this progressed, the risk pool of enrollees that remained became increasingly costly to ensure. Premiums increased in response to higher costs of the remaining enrollees, prompting an new round of healthier enrollees to drop out.

To continue reading: Research Explains Why Obamacare is Failing

UnitedHealth May Quit Obamacare in Blow to Health Law, by Zachary Tracer

Obamacare, as predicted by SLL and a multitude of other critics, is falling apart. From Zachary Tracer at bloomberg.com:

Largest insurer lost hundreds of millions of dollars on plans
Retreat calls into question Obamacare exchanges, analyst says

The biggest U.S. health insurer is considering pulling out of Obamacare as it loses hundreds of millions of dollars on the program, casting a pall over President Barack Obama’s signature domestic policy achievement.

UnitedHealth Group Inc. has scaled back marketing efforts for plans sold to individuals this year and may quit the business entirely in 2017. It’s an abrupt shift from October, when the health insurer said it was planning to sell coverage through the Affordable Care Act in 11 more states next year, bringing its total to 34. The company also cut its 2015 earnings forecast.

While millions of Americans have gained coverage under Obamacare since new government-run marketplaces for the plans opened in late 2013, in UnitedHealth’s case they haven’t been the most profitable. Customers the company has added have tended to use more medical care. UnitedHealth also said today that some people are signing up for coverage, getting care and then dropping their policies.

“We cannot sustain these losses,” Chief Executive Officer Stephen Hemsley told analysts on a conference call. “We can’t really subsidize a marketplace that doesn’t appear at the moment to be sustaining itself.”

UnitedHealth said it expects as much as $500 million in losses on the Obamacare plans in 2016. The insurer will record $275 million of the costs in the fourth quarter. United also said Thursday it’s booking $350 million in losses tied to the 2015 performance of its ACA plans.

To continue reading: UnitedHealth May Quit Obamacare

Meet The Family That Just Spent Half Its Annual Income Paying For Obamacare, by Tyler Durden

From Tyler Durden at zerohedge.com:

Not a week passes without some incremental revelation showing precisely what happens when Congress passes a bill just to see what’s in it.

Well, since the passage of the Affordable Care Act, also known as the Obamacare tax, we have watched in horror as shocker after shocker are revealed.

Some examples: [link to original articles for below links]

• In Latest Obamacare Fiasco, Most Low-Income Workers Can’t Afford “Affordable Care Act”
• The Stunning “Explanation” An Insurance Company Just Used To Boost Health Premiums By 60%
• Your Health Insurance Premiums Are About To Go Through The Roof -The Stunning Reason Why
• Obama Promised Healthcare Premiums Would Fall $2,500 Per Family; They Have Climbed $4,865
• Largest Health Insurer On Colorado Exchange Abruptly Collapses
• Co-Op Insurers Across America Are Collapsing, And Now There Is Fraud
• “$19,000 Premiums, Up 4x Since Passage”: The ‘Crippling Effect’ Of Obamacare On The Middle Class

Now we can add one more thing that “was in it”: soaring deductibles, which give the fake impression of contained, low all-in costs… until one actually needs expensive medial help (and these days there is no other kind).

The latest expose against Obamacare comes not from its usual nemesis, but the hard-left NYT, suggesting that even the ideological supporters of Obama’s “crowning achievement” are losing faith. To wit:

Obama administration officials, urging people to sign up for health insurance under the Affordable Care Act, have trumpeted the low premiums available on the law’s new marketplaces.

But for many consumers, the sticker shock is coming not on the front end, when they purchase the plans, but on the back end when they get sick: sky-high deductibles that are leaving some newly insured feeling nearly as vulnerable as they were before they had coverage.

“The deductible, $3,000 a year, makes it impossible to actually go to the doctor,” said David R. Reines, 60, of Jefferson Township, N.J., a former hardware salesman with chronic knee pain. “We have insurance, but can’t afford to use it.”

In many states, more than half the plans offered for sale through HealthCare.gov, the federal online marketplace, have a deductible of $3,000 or more, a New York Times review has found. Those deductibles are causing concern among Democrats — and some Republican detractors of the health law, who once pushed high-deductible health plans in the belief that consumers would be more cost-conscious if they had more of a financial stake or skin in the game.

“We could not afford the deductible,” said Kevin Fanning, 59, who lives in North Texas, near Wichita Falls. “Basically I was paying for insurance I could not afford to use.” He dropped his policy.

In other words, Obamacare’s “affordable care” is affordable, as long as one doesn’t actually have to use it!

To continue reading: Meet The Family That Just Spent Half Its Annual Income on Obamacare

Image

Don’t Worry, from The Burning Platform

Unaffordable Care Act Third Open Enrollment Nothing to Celebrate, by Devon Herrick

This year’s price increases for Obamacare insurance policies make a bitter joke of Obama’s assurances that costs would go down under his fiasco-prone scheme. From Devon Harrick at healthblog.ncpa.org:

The third Obamacare Open Enrollment period began November 1st. As a result, many families are faced with a tough choice: purchase coverage they cannot afford with few tangible benefits, or pay an equally unaffordable penalty and hope they do not become sick. The Internal Revenue Service determined that 7.5 million individuals opted to pay the penalty rather than purchase health coverage in 2014, far more than originally projected. The penalty for going without coverage in 2014 was only $95 or one percent of income, whichever was greater. Yet the tax year data found the average penalty paid was double the minimum. This suggests it wasn’t the poor who were going without coverage; the poorest individuals either qualified for generous subsidies, Medicaid or got an exemption from the penalty. Many of those who paid the penalty were likely individuals who did not qualify for subsidies and could not afford Obamacare coverage due to the costly mandates. To make matters worse, the costs are rising fast.

According to data from the Kaiser Family Foundation, premiums for coverage in Alaska, Colorado, Hawaii, Idaho, Minnesota, Montana, Oklahoma and Tennessee, for example, will rise by about one-third in 2016. Rates in Arizona, Delaware, Nebraska, North Carolina, Oregon, South Dakota and West Virginia will increase by 20 percent to 25 percent. Residents in Iowa, Kansas, Louisiana, Nevada, North Dakota, South Carolina and Utah will see increases of above 10 percent or more.

No one will escape these rising costs. Americans with employee health plans also experience rising premiums when insurers are forced to sell bloated policies in unprofitable markets. Individuals who forego insurance and chose to pay the penalty will face a greater fine. In 2015, the penalty more than doubled from 2014; in 2016, it will increase yet again. Those failing to obtain health coverage in 2016 will face a penalty of $695 or 2.5 percent of income, whichever is higher.

Americans were led to believe the Affordable Care Act would save the average family about $2,500 per year. That dubious claim was actually just a sound bite with no basis in fact. Unfortunately, in a health reform debate about complicated insurance regulations, a simple assertion that families would save a couple hundred bucks a month resonated more than wonky counterarguments about adverse selection, moral hazard and rising deficits. The Obama Administration would ultimately be proved wrong about cost savings; it recently acknowledged that the “Affordable Care Act” is not affordable for many individuals. An “I told you so” may be in order, but it hardly makes people saddled with high insurance premiums feel any better.

To continue reading: Unaffordable Care Act Nothing to Celebrate

Your Health Insurance Premiums Are About To Go Through The Roof -The Stunning Reason Why, by Tyler Durden

From Tyler Durden at zerohedge.com:

After years of delays and failed launches, Obamacare has finally taken hold, and with it the economic and financial implications from this mandatory tax are finally being felt.

We have extensively covered how Obama’s Affordable Care Act will end up being a failure, observing both the economic implications in “In Latest Obamacare Fiasco, Most Low-Income Workers Can’t Afford “Affordable Care Act” as well as its operational shortcomings in “Obamacare Is A Disaster: Co-Op Insurers Across America Are Collapsing, And Now There Is Fraud”, paradoxically even as Obamacare – a tax – was according to the BEA the single biggest contributor to GDP growth in the third quarter.

Of course, the most obvious reason why Obamacare will have a dire impact the economy is also very simple: soaring healthcare premiums, also covered before…

… which incidentally also explain why all those touted “gas savings” failed to materialize in discretionary spending behavior: all of the “saved” money went to cover rising health insurance costs.

None of this should come as a surprise.

What should, however, is that according to a very unexpected twist healthcare premiums are about to soar so much in the coming months that the shocking increases of the past year will seem like a walk in the park.

The reason for this comes courtesy of a new report from the WSJ which explains something few if any had expected: corporate insurers are scrambling to profit from Obamacare!

Yes, we know: Obamacare was written by the health insurance companies, and it was supposed to benefit them first and foremost as US households struggled to catch up to what most rational observers had said would be surging premiums. And, on the top line, it did just that: “under the ACA, insurers have seen an influx of new membership in individual plans and in Medicaid plans they administer for the government, expanding the industry’s total U.S. revenue to $743 billion in 2014, the year the law’s biggest changes took effect, from $641 billion the year before, according to a new analysis by consulting firm McKinsey & Co.”

So far so good, and just as expected – incidentally, that 16% increase in industry revenue comes right out of your pocket, dear U.S. reader with the blessings of the US Supreme Court of course.

But where it gets fascinating is that while the surge in the top-line was expected, what comes as close to a black swan as possible, is what happens below the revenue line on the insurers’ income statement.

The stunning finding comes from a new analysis by McKinsey which notes that much of that revenue growth has been unprofitable! Health insurers lost a total of $2.5 billion, or on average $163 per consumer enrolled, in the individual market in 2014, McKinsey found. A number are also expecting to lose money on their marketplace business for 2015.

To continue reading: Your Health Insurance Premiums Are About To Go Through The Roof

Obamacare Is A Disaster: Co-Op Insurers Across America Are Collapsing, And Now There Is Fraud, by Tyler Durden

It would be nice to say that SLL’s prediction that Obamacare would be a disaster demonstrated extraordinary insight, but virtually every SLL reader probably made the same prediction. It goes the other way; you had to be a pretty dim bulb not to see it coming. From Tyler Durden at zerohedge.com:

Two weeks ago we reported that in what at the time was still a rather isolated incident, Colorado’s largest nonprofit health insurer (aka co-op), Colorado HealthOP is abruptly shutting down, forcing 80,000 Coloradans to find a new insurer for 2016.

At the time, we said that the health insurer had been decertified by the Division of Insurance as an eligible insurance company because the cooperative relied on federal support, and federal authorities announced last month they wouldn’t be able to pay most of what they owed in a program designed to help health insurance co-ops get established.

In other words, one of the 24 co-ops funded with Federal dollars and created to give more policyholders control over their insurers – especially those who wished to stay away from various corporate offerings, had failed simply because the government was unable to subsidize it: the same government that spends $35 billion in global economic “aid” but can’t support its most important welfare program.

Fast forward to today, when we learn that another co-op, this time New York’s Health Republic Insurance – the largest of the nonprofit cooperatives created under the Affordable Care Act – is not only shuttering, but was engaging in fraud.

The fate of Health Republic Insurance was first revealed a month ago when the WSJ reported it would shut down after suffering massive losses “in the latest sign of the financial pressures facing many insurers that participated in the law’s new marketplaces.”

The insurer lost about $52.7 million in the first six months of this year, on top of a $77.5 million loss in 2014, according to regulatory filings. The move to wind down its operations was made jointly by officials from the federal Centers for Medicare & Medicaid Services; New York’s state insurance exchange, known as New York State of Health; and the New York State Department of Financial Services.

In a statement, Health Republic said it was “deeply disappointed” by the outcome, and pointed to “challenges placed on us by the structure of the CO-OP program.”

Health Republic has about 215,000 members, with about half holding individual plans and half under small-business coverage, a spokesman for the insurer said.
Today we learn that not only was this largest Co-op insolvent, it had also committed fraud. According to Politico, the collapsing insurance company that is creating headaches for hundreds of thousands of New Yorkers, misled state and federal officials about its finances, and will not be able to remain in business through the end of the year as originally hoped.

Because incompetence is one thing, but corruption: now that’s real government work, right there.

To continue reading: Obamacare Is A Disaster