Tag Archives: insurance

Health Insurance Rates Are Going Up Next Year, But It’s Nothing to Panic Over

by LazaroWorley Posted on March 30, 2014

Mother Jones

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The LA Times has a piece today about the next battleground for Obamacare: rate increases for 2015. The warnings are already coming thick and fast:

WellPoint Inc., parent of California’s leading health insurer in the exchange, Anthem Blue Cross, has already predicted “double-digit-plus” rate increases on Obamacare policies across much of the country.

…. Health insurers aren’t wasting any time sizing up what patients are costing them now and what that will mean for 2015 rates. Hunkered down in conference rooms, insurance actuaries are parsing prescriptions, doctor visits and hospital stays for clues about how expensive these new patients may be. By May, insurance companies must file next year’s rates with California’s state-run exchange so negotiations can begin.

I hope everyone manages to restrain their Obamacare hysteria over this. Here in California, we’ve played this game annually for years. Health insurers in the individual market propose wild increases in their premiums—10 percent, 20 percent, sometimes even 30 percent—and then dial them back a bit after consumer outrage blankets the media and the Department of Insurance pushes back. But even then, we routinely end up with double-digit increases. Just for background, here are the average annual rate increases requested by a few of California’s biggest insurers over the last three years:

Anthem Blue Cross: 10.7%
Aetna: 12.1%
Blue Shield: 15.4%
HealthNet: 12.0%

And this doesn’t include changes in deductibles or out-of-pocket maximums. Add those in, and the annual proposed increases are probably in the range of 15-20 percent. Obamacare, of course, limits both those things, which means that in the future insurance companies will have to put everything into rate hikes instead of spreading the increases around to make them harder to add up.

Bottom line: if we end up seeing double-digit rate increases, it will be business as usual. Insurance companies will all blame it on Obamacare because that’s a convenient thing to do, but the truth is that we probably would have seen exactly the same thing even if Barack Obama had never been born. So let’s all keep our feet on the ground when the inevitable huge rate increase requests start flowing in. It’s mostly an insurance company thing and a healthcare thing, not an Obamacare thing.

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Health Insurance Rates Are Going Up Next Year, But It’s Nothing to Panic Over

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Hostage Taking Is Back!

by AntonVaughan Posted on March 14, 2014

Mother Jones

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Last month I passed along the news that, in a break with recent tradition, Congress might actually do something useful and pass a permanent fix to Medicare’s Sustainable Growth Rate, a well-meaning policy that turned out not to be sustainable at all when its formula started calling for actual cuts in payments to doctors. Every year Congress addresses this by passing a one-year “doc fix,” but recently a bipartisan effort finally came together to pass a permanent modification. Hooray!

But now it turns out that congressional Republicans enjoy the tradition of dysfunctional government too much to give it up. Sahil Kapur reports that hostage-taking is back:

House Republicans expect to vote this Friday on legislation that would risk steep, destabilizing Medicare cuts at the end of the month unless Democrats agree to a five-year delay of Obamacare’s individual mandate.

It mirrors some of the brinkmanship in the government shutdown fight last fall in that the GOP is using a must-pass bill as a vehicle to chop the Affordable Care Act. Democratic leaders have repeatedly rejected proposals to tinker with the mandate to buy insurance and have warned Republicans not to tie a physician payment fix to their partisan quest to unravel Obamacare.

Insurance companies oppose this. Doctors oppose this. The CBO says it would be a disaster. It obviously has no chance of passing. But it looks like Republicans are going right up to the brink once again. I guess that once you’ve tasted the thrill of threatening to shoot a hostage, nothing else quite compares.

Besides, there’s a midterm election coming up. Have I mentioned that before?

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Hostage Taking Is Back!

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Here’s What We Can Learn About Health Care From the Mortgage Crisis

by ColemanKrauss Posted on February 4, 2014

Mother Jones

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This story first appeared on the TomDispatch website.

Health care isn’t the first boon that President Obama tried to give us through a public-private partnership. When he took office, more than 25% of US home mortgages were underwater—meaning that people owed more on their houses than they could get if they tried to sell them. The president offered those homeowners debt relief through banks. Now he’s offering health care through insurance companies.

In both cases, the administration shied away from direct government aid. Instead, it subsidized private companies to serve the people. To get your government-subsidized mortgage modification, you applied at your bank; to get your government-mandated health coverage, you buy private insurance.

Let a Hundred Middlemen Bloom

In other countries with national health plans, a variety of independent health care providers—hospitals, doctors, and clinics, among others—deliver medical care, while the government doles out the compensation. They let a hundred healthcare providers bloom, but there’s only a single payer. If the US moved to single-payer healthcare, however, what would happen to the private health insurance business?

In the 1990s, the conservative Heritage Foundation floated the idea of extending health coverage to more Americans via government exchanges or “connectors” that would funnel individual buyers to competing, for-profit health insurance companies. In other words, let a hundred middlemen bloom.

On the face of it, such a plan would seem expensive, since it means supporting two bureaucracies, one of which would be obliged to take profits for investors. Meanwhile, doctors would still have the expense of trying to collect from multiple insurers with reasons to stall. But the Heritage plan had one great advantage. Since Harry Truman, American presidents have tried unsuccessfully to get us national health care. The exchange system, however awkward it might be, pacified the insurance companies which had previously spent millions of dollars to defeat other plans for “socialized medicine.” With the support of those companies for a program that not only kept them in the picture, but also promised to deliver millions of new, subsidized customers to them, Obama gave us a national healthcare law.

The danger is that it essentially makes insurance companies our medical receptionists, a profit-making face that greets sick people whenever they try to use their government healthcare. That gives private companies a lot of power to make the government look bad.

That’s why it’s important to understand how banks used Obama’s mortgage subsidy program to sabotage debt relief and discredit government. If we grasp how they pulled that off, we may be able to protect the present health plan and someday even get genuine single-payer healthcare out of it. So here’s the story.

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Here’s What We Can Learn About Health Care From the Mortgage Crisis

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Note to GOP: Don’t Reveal Your Fiendish Plan to Destroy Obamacare Until the Last Reel

by muistenam Posted on January 22, 2014

Mother Jones

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One of the reasons that insurers aren’t too worried about the low signup rate for Obamacare is that it’s early days. They figure things will work out eventually, and in the meantime they’re protected from serious losses during the first three years by a provision of the bill called “risk corridors.” The details aren’t too important here. In a nutshell, if it turns out that an insurer has seriously miscalculated the cost of its coverage on the exchanges—perhaps because too few people have signed up—the federal government will reimburse them for part of their losses.

This is all very wonky stuff designed to smooth the transition to Obamacare. You’re only reading about it now because a little while back some bright spark decided that if you called this an “Obamacare bailout” it might turn into a big campaign issue. Maybe Republicans could even get it repealed, which in turn would make life so hard for insurers that they’d drop out of Obamacare entirely! Bwa-ha-ha!

But their plan isn’t going anywhere, and Dave Weigel thinks it’s partly because conservatives have acted too much like a stock villain from a James Bond movie:

I mention Bond villainy for a reason. What’s the mistake that Goldfinger and Blofeld and 006 et al constantly make? They explain the plot while there’s still time for 007 to stop it. Conservative groups from FreedomWorks to Heritage Action have rallied behind Rubio’s bill and a companion House bill, and obviously the hope is that a “no bailout” bill would gather momentum in the Senate and make life difficult for red state Democrats. But Congress just passed an omnibus funding bill that takes care of things for the rest of the year. A good chance to pressure the Senate on Obamacare — slotting the “no bailout” language in the House bill — has been lost. Even a scheme backed by Krauthammer, Ponnuru, and Cannon, all well-respected on the right, failed to gain traction in a Congress that’s been chastened by the shutdown, and is more fearful of causing a crisis to gut Obamacare.

Neither Democrats nor the insurance industry were ever going to be fooled by any of this, but by making it clear that the real goal of repealing risk corridors is to cripple Obamacare completely, proponents lost even the slim chance they had to get a hearing from the press and from independents. They might take another crack at making this a big issue when the debt ceiling comes up, but it probably won’t get them anywhere. Their tea party allies will be thrilled, but everyone else will see it as yet another in a long, tired string of contrived outrages designed to kill Obamacare. Time to move on, folks.

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Note to GOP: Don’t Reveal Your Fiendish Plan to Destroy Obamacare Until the Last Reel

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Surprise! Lots of People Are Saving Money Thanks to Obamacare.

by Louise6qy Posted on December 18, 2013

Mother Jones

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Today brings ever more stories of rate shock from people signing up for Obamacare:

Sue Spanke of Missoula, Mont., was highly displeased this fall when she learned her health insurance had been canceled….After angrily calling her state auditor’s office, Spanke, a self-employed artist in her 50s, found she was eligible for a federal subsidy. Her new insurance will cover her for a mere $30 to $40 a month with a deductible of only $500. She had been paying $350 a month for a Blue Cross policy with a $5,000 deductible. “I went from a horrible policy that didn’t cover anything, that was breaking me, to the best policy at the best price I’ve had since I was in my 20s,” she said.

….In Lancaster, Pa., Lori Lapman, 58, learned her health plan was being canceled in September—by October things were looking up. Per The Sunday News: “Sitting at a laptop with a certified health law helper, Lapman went to HealthCare.gov, found it running smoothly, and bought a subsidized Highmark plan that allows her to keep her doctors while saving her money. Her canceled plan cost her $520 a month. Her new coverage? Only $111.73.”

….In a letter to the editor in The Santa Maria Times, Allan Pacela told the story of how after his wife lost her insurance this fall, she found much better coverage under Obamacare. The couple is now saving $8,000 per year for a “much better plan.”

There’s more at the link, and all from doing a quick Nexis search of newspapers across the country. Just imagine what we might find out with a little bit of old-school shoe-leather reporting.

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Surprise! Lots of People Are Saving Money Thanks to Obamacare.

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Obamacare Will Prevent Millions of People From Being Gouged by Hospitals

by AngelikaSantacr Posted on December 8, 2013

Mother Jones

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When President Obama said that if you like your health insurance, you can keep it, he was clearly taking some liberties with the strict truth.1But as Ezra Klein points out this weekend, the reason he pressed this point so hard is that Americans have an understandable fear of losing their health insurance. And why not? You can lose it if you lose your job. Or if you lose access to Medicaid. Or if your insurance company decides to effectively eliminate your plan by jacking up its price. And that’s not even counting the millions of people who don’t have health coverage in the first place.

So, yes, it’s true that Obama was wrong when he guaranteed that every single person could keep their current plan if they wanted to:

What Obamacare comes pretty close to guaranteeing, though, is that everyone who needs health insurance, or who wants health insurance, can get it.

It guarantees that if you lose the plan you liked — perhaps because you were fired from your job, or because you left your job to start a new business, or because your income made you ineligible for Medicaid — you’ll have a choice of new plans you can purchase, you’ll know that no insurer can turn you away, and you’ll be able to get financial help if you need it. In states that accept the Medicaid expansion, it guarantees that anyone who makes less than 133 percent of poverty can get fully subsidized insurance.

Health insurance isn’t such a fraught topic in countries such as Canada and France because people don’t live in constant fear of losing their ability to get routine medical care. A decade from now, that will be true in the U.S., too. But it’s not true yet, and paradoxically, that’s one reason health reform is so difficult. The status quo has left people rightly fearful, and when people are afraid, change is even scarier.

Yep. I want to add one more point to this that doesn’t get as much attention as it deserves: Hospitals routinely charge uninsured patients rates that are 3-4x higher than those paid by insured patients. A heart attack that gets billed—profitably!—to Blue Cross at $50,000, can end up costing you $200,000 if you’re unlucky enough to suffer that heart attack while you’re uninsured. Think about that: for decades, the health care industry has deliberately taken ruthless advantage of the very people who are the weakest and most vulnerable—those who are poor or unemployed—and seems to think that this is a perfectly decent and moral way to conduct business.

It’s not. It’s shameless and obscene. It’s like kicking a beggar and stealing his coat just because you know the cops will never do anything about it.

This is something that Obamacare goes a long way toward fixing. If you’re covered by private insurance through an exchange, you’re not just protected against catastrophic illness. You’re also protected against being charged outrageous rates for non-catastrophic problems—broken legs, asthma attacks, etc.—just because hospitals have the brute power to do so.

Because of Obamacare, you no longer have to fear being shut out of the insurance market. But that’s not all. You no longer have to fear being gouged and possibly bankrupted because you’ve been shut out of the insurance market. Access to reasonable rates2 is one of the key benefits that Obamacare delivers to millions, and it deserves more attention.

1Though, let’s be honest, not that big a liberty. The vast, vast majority of people will see little or no change in their coverage thanks to Obamacare, and of the ones who will, most will be able to buy similar or better coverage at a lower price. The problem of rate shock isn’t an invented one, but it is a much exaggerated one.

2Reasonable by American standards, anyway.

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Obamacare Will Prevent Millions of People From Being Gouged by Hospitals

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Republicans Refuse to Cover the Poor, Then Complain that Obamacare Isn’t Covering the Poor

by HiramWhittell Posted on November 21, 2013

Mother Jones

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The New York Times has gotten hold of the “House Republican Playbook” on Obamacare, and I have to admit that it brought back warm memories. It’s just like the launch kits I used to produce for our sales force whenever we came out with a new product, and I have to say that it looks very professional. For Eric Cantor’s sake, I hope his sales force pays more attention to it than my sales force used to pay to mine.

In any case, it’s all pretty predictable stuff: Obamacare is an abomination; people are losing their insurance; small companies are being ruined; etc. etc. But I have to say that this is my favorite talking point:

Needless to say, this is primarily because Republicans governors have refused to implement Obamacare’s Medicaid expansion, even though it’s 100 percent paid for at first and 90 percent paid for forever. These governors literally prefer to have their state’s residents pay taxes and get nothing in return rather than give so much as an extra dime to poor people who need health care. It’s truly hard to fathom what kind of human being is callous enough to do this, but apparently there are a bunch of them in the Republican Party.

And then, just to add a cherry of chutzpah on top of this ice cream sundae of spitefulness, they crow about how Obamacare isn’t covering as many people as Obama hoped it would. You really have to marvel.

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Republicans Refuse to Cover the Poor, Then Complain that Obamacare Isn’t Covering the Poor

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Why Are American Doctors Paid So Damn Much?

by pa98grv Posted on November 20, 2013

Mother Jones

Conservatives have picked up today on a Kaiser Health News piece reporting on doctor complaints that insurers plan to pay them less for Obamacare patients than for other patients:

Insurance officials acknowledge they have reduced rates in some plans, saying they are under enormous pressure to keep premiums affordable. They say physicians will make up for the lower pay by seeing more patients, since the plans tend to have smaller networks of doctors. But many primary care doctors say they barely have time to take care of the patients they have now.

Matt Yglesias is unsympathetic. He says American doctors are very well paid and should quit griping: “If we ever reach the point where American doctors have been squeezed so badly that they start fleeing north of the border to get higher pay in Canada, then we’ve squeezed too hard. Until that happens, forget about it.”

That’s pretty cold. But if you really want to know what’s going on, take a gander at the chart below. It’s from the OECD, so it includes all of the world’s relatively rich countries:

That’s damn peculiar, isn’t it? If Econ 101 is to be believed, higher pay should produce more doctors. And yet, even though the United States pays doctors far more than any other country on the globe, we’re in the bottom third. We have more doctors per capita than poorish countries like Mexico and Poland, but far fewer than Belgium and Britain and Germany—all of which pay doctors considerably less than we do here. So what’s going on?

As Matt says, the basic answer is that U.S. doctors operate as a cartel. They artificially limit their own ranks, which drives up their compensation:

What we really ought to be doing is working to further pressure the incomes of doctors through supply-side reforms. That means letting nurse-practitioners treat patients without kicking a slice upstairs to an M.D., letting more doctors immigrate to the United States, and it means opening more medical schools. Common sense says that since the population both grows and ages over time, there should be more people admitted to medical school today than were thirty years ago. But that’s not the case. Instead we produce roughly the same number of new doctors, admissions standards have gotten tougher, and doctors have become scarcer.

This is yet another reason not to shed too many tears for doctors. They’ve basically brought this on themselves. If the market were allowed to produce as many doctors as there’s demand for, they’d already be getting paid less. Right now they’re enjoying the substantial rents that come from squeezing their own supply, and they’ve fought like lemmings for decades to keep it that way. You can hardly blame them for that, but there’s no reason the rest of us should put up with it. It’s time to fight back.

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Why Are American Doctors Paid So Damn Much?

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Obamacare Has a Few Months Left to Start Working, And It Probably Won’t Get an Extension

by PiperASZcygvte Posted on November 13, 2013

Mother Jones

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I’ve been avoiding speculation about the Obamacare website for the past week or two because, really, there hasn’t been much concrete information to base anything on. The whole exercise feels like the ultimate in bloggish wankery. There’s no real news out there, and spending time either defending Obama or ripping him apart is kind of pointless. Why not just wait and see how things turn out?

Because we’re all humans, that’s why. We don’t need to speculate endlessly about the big Denver-KC showdown on Sunday night either. We could just wait and see who actually wins. But speculation is fun.

That said, concrete information is finally starting to trickle out, and it’s grim. Healthcare.gov has signed up only about 40,000 people so far, compared to early estimates of several hundred thousand.1 That’s pretty effing bad. Still, we all know the website is a horror show, so this isn’t a huge surprise. It just confirms that the website is, indeed, a horror show.

Today, though, we learn that, contrary to President Obama’s promise a couple of weeks ago, the horror show isn’t likely to get fixed by the end of November:

Software problems with the federal online health insurance marketplace, especially in handling high volumes, are proving so stubborn that the system is unlikely to work fully by the end of the month as the White House has promised, according to an official with knowledge of the project.

The insurance exchange is balking when more than 20,000 to 30,000 people attempt to use it at the same time — about half its intended capacity, said the official, who spoke on the condition of anonymity to disclose internal information. And CGI Federal, the main contractor that built the site, has succeeded in repairing only about six of every 10 of the defects it has addressed so far.

….This inside view of the halting nature of HealthCare.gov repairs is emerging as the insurance industry is working behind the scenes on contingency plans, in case the site continues to have problems….The need for what the official called a “divide-and-conquer strategy” for enrollment puts more emphasis on alternative methods for buying health plans. These methods include federal call centers and insurance companies that sell policies directly to customers — paths that are hobbled for now by some of the same technical problems affecting the federal Web site.

And this is all coming on top of screaming from middle-class individual insurance buyers—the kind of people Congress actually cares about—that their rates are going up considerably thanks to Obamacare. Senate Democrats might be able to stand fast against this pressure if the program was actually working smoothly, but the combination of voter anger and technical disaster is wearing them down. At this point, they might very well acquiesce to some kind of Republican “fix” that, we can be sure, will be very precisely calculated to do maximum damage to the goals of Obamacare. That would add disaster on top of disaster.

Sabotage works. But it works a lot better when the bridge is teetering in the first place. I still don’t know that I can think of anything very insightful to say about any of this, but it’s certainly a low point for Obama’s presidency—and the polls are finally catching up to that. I know it’s melodramatic to say this, but his presidency really does depend on the next few months. I sure hope everyone in the administration is taking this as seriously as they should.

1This sentence originally said the early estimate was 500,000 signups, but that was for both state and federal exchanges. There was no separate estimate just for the federal exchange. However, since the federal exchange covers more than half the population, it’s reasonable to figure that early hopes were for something on the order of 300,000 signups.

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Obamacare Has a Few Months Left to Start Working, And It Probably Won’t Get an Extension

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Will Sandy’s Lessons Fade as a Sleepy Atlantic Storm Season Ends?

by Myrna Posted on October 28, 2013

An extraordinarily quiet Atlantic hurricane season follows an epic storm surge, raising questions about disaster forgetfulness. Taken from: Will Sandy’s Lessons Fade as a Sleepy Atlantic Storm Season Ends? ; ;Related ArticlesDot Earth Blog: Will Sandy’s Lessons Fade as a Sleepy Atlantic Storm Season Ends?Updates on America’s Persistent Air and Water Pollution ChallengesA Tonic for Computer Hell: Getting Lost in the Woods ;

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Will Sandy’s Lessons Fade as a Sleepy Atlantic Storm Season Ends?

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