Feeling Grubered Lately? Obamacare Death Spiral Update

Oh, dear! Not only are the big insurers cutting and running. Now we're seeing healthcare providers fronting the cost of Odumbocare premiums for their sick patients so they can bill more than they would under Medicare or Medicaid. What other nasty surprises lurk within the perverse, cost-escalating incentives created by this disastrous 10,585-page gruberizing clusterfuck?

Obama's legacy!


ObamaCare Death Spiral Update

Increasingly, the only customers for ObamaCare policies are those who are already sick.

By Holman W. Jenkins, Jr.
Updated Aug. 5, 2016 6:27 p.m. ET

It’s hard to exaggerate the alchemy of distortions that are turning ObamaCare into such a pending disaster that big insurers like Aetna, Anthem, Humana and UnitedHealth Group, once supporters, can’t cut back their participation fast enough.

ObamaCare was always going to be a questionable deal for taxpayers if the only people who signed up were poorer people whose premiums were largely paid by taxpayers. That was fine as far as insurers were concerned. They can make a profit even if taxpayers are the only ones paying.

For insurers, the problem lies elsewhere: ObamaCare policies have proved so unattractive that even customers eligible for subsidies are turning away unless they also happen to be seriously or chronically ill. That’s because deductibles and copays keep going up with each successive renewal period. For a family of four on a bronze plan, the deductible is now above $11,000. This is the equivalent, in the case of routine illness or injury, of not being insured at all.

And the problem only gets worse as insurers, to stem their losses, keep hiking premiums, copays and deductibles. With each turn of the wheel, ObamaCare becomes an insurance program that appeals only to those who already know they face large health-care costs.

From Day One, defenders of the Affordable Care Act pooh-poohed the “death spiral” predictions that sober analysts, being realistic about the law’s incentives, voiced. Yet the outcome was always implicit in the program’s design. The death spiral would have been a non-birth spiral if ObamaCare hadn’t originally offered direct, temporary subsidies to insurers to offset their losses. ObamaCare wouldn’t be with us today if insurers weren’t hanging on in quiet expectation that Washington somehow will come up with more funding to keep the jalopy going. Indeed, even as Aetna, one of ObamaCare’s biggest cheerleaders, was throwing in the towel this week on plans to expand its ObamaCare exchange business, its chief, Mark Bertolini, was full of ideas for how taxpayer money could be used to make the business profitable.

There are rational ways to subsidize health insurance for the needy (and stop subsidizing the non-needy). There are rational ways to compensate insurers for taking on the uninsurable, i.e., those with pre-existing conditions.

All this could have been done without loosing perverse and uncontainable incentives of the sort that already make U.S. health care so problematic. Alas, non-Rube Goldberg is not Congress’s métier.

So we come to last month’s reductio ad absurdum. In a lawsuit, UnitedHealth Group, the country’s biggest health insurer, charges that American Renal Associates, one of the biggest providers of kidney treatment, supplied charitable “donations” to pay for ObamaCare policies (average annual premium $4,800) so patients could patronize American Renal’s dialysis treatment (average annual cost $100,000).

What’s more, United claims many of these patients, for which American Renal billed $4,000 per session, were eligible for Medicare or Medicaid, which pays less than $300 per session.

OK, modulate your outrage for the fact that American Renal vehemently denies the allegations—and for the fact that Medicare and Medicaid keep themselves afloat partly by underpaying for services like dialysis, knowing providers will make up the difference by charging higher prices to private customers.

State and federal regulators increasingly face this problem and are in a deep quandary. After all, ObamaCare is supposed to cover those with pre-existing conditions, and hospitals and other providers have every incentive to sign up their sickest patients for ObamaCare to make sure they get paid. How can anyone complain about charity?

All this cost shifting and gaming of our payment systems is inevitable because long-term U.S. policies have created a customer, i.e. patient, at the point of sale who has little skin in the game financially once insurance kicks in. The same patient also tends to be relatively passive on the question of whether care is medically necessary when someone else is paying.

During the 2008 campaign, President Obama stated a deceptively insightful vision of health-care reform: If health insurance were a good deal, nobody would have to be forced to buy it. He was specifically rejecting, of course, Hillary Clinton’s proposed individual mandate (which he would later adopt). But his original concept was a good one. By now, nobody who has paid attention fails to grasp all the ways our system rewards providers for delivering excessive care at excessive and uncompetitive cost.

Many Democrats, it’s no secret, see these perversities as a feature and not a bug—bringing closer the day when Washington will take charge of health care entirely. It’s their article of faith, impervious to experience, that the solution to government screwing up health care is to give government more power over health care.

http://www.wsj.com/articles/obamacar...ate-1470436014

SNICK!

Oh, dear! Not only are the big insurers cutting and running. Now we're seeing healthcare providers fronting the cost of Odumbocare premiums for their sick patients so they can bill more than they would under Medicare or Medicaid. What other nasty surprises lurk within the perverse, cost-escalating incentives created by this disastrous 10,585-page gruberizing clusterfuck?

Obama's legacy!


ObamaCare Death Spiral Update

Increasingly, the only customers for ObamaCare policies are those who are already sick.

By Holman W. Jenkins, Jr.
Updated Aug. 5, 2016 6:27 p.m. ET

It’s hard to exaggerate the alchemy of distortions that are turning ObamaCare into such a pending disaster that big insurers like Aetna, Anthem, Humana and UnitedHealth Group, once supporters, can’t cut back their participation fast enough.

ObamaCare was always going to be a questionable deal for taxpayers if the only people who signed up were poorer people whose premiums were largely paid by taxpayers. That was fine as far as insurers were concerned. They can make a profit even if taxpayers are the only ones paying.

For insurers, the problem lies elsewhere: ObamaCare policies have proved so unattractive that even customers eligible for subsidies are turning away unless they also happen to be seriously or chronically ill. That’s because deductibles and copays keep going up with each successive renewal period. For a family of four on a bronze plan, the deductible is now above $11,000. This is the equivalent, in the case of routine illness or injury, of not being insured at all.

And the problem only gets worse as insurers, to stem their losses, keep hiking premiums, copays and deductibles. With each turn of the wheel, ObamaCare becomes an insurance program that appeals only to those who already know they face large health-care costs.

From Day One, defenders of the Affordable Care Act pooh-poohed the “death spiral” predictions that sober analysts, being realistic about the law’s incentives, voiced. Yet the outcome was always implicit in the program’s design. The death spiral would have been a non-birth spiral if ObamaCare hadn’t originally offered direct, temporary subsidies to insurers to offset their losses. ObamaCare wouldn’t be with us today if insurers weren’t hanging on in quiet expectation that Washington somehow will come up with more funding to keep the jalopy going. Indeed, even as Aetna, one of ObamaCare’s biggest cheerleaders, was throwing in the towel this week on plans to expand its ObamaCare exchange business, its chief, Mark Bertolini, was full of ideas for how taxpayer money could be used to make the business profitable.

There are rational ways to subsidize health insurance for the needy (and stop subsidizing the non-needy). There are rational ways to compensate insurers for taking on the uninsurable, i.e., those with pre-existing conditions.

All this could have been done without loosing perverse and uncontainable incentives of the sort that already make U.S. health care so problematic. Alas, non-Rube Goldberg is not Congress’s métier.

So we come to last month’s reductio ad absurdum. In a lawsuit, UnitedHealth Group, the country’s biggest health insurer, charges that American Renal Associates, one of the biggest providers of kidney treatment, supplied charitable “donations” to pay for ObamaCare policies (average annual premium $4,800) so patients could patronize American Renal’s dialysis treatment (average annual cost $100,000).

What’s more, United claims many of these patients, for which American Renal billed $4,000 per session, were eligible for Medicare or Medicaid, which pays less than $300 per session.

OK, modulate your outrage for the fact that American Renal vehemently denies the allegations—and for the fact that Medicare and Medicaid keep themselves afloat partly by underpaying for services like dialysis, knowing providers will make up the difference by charging higher prices to private customers.

State and federal regulators increasingly face this problem and are in a deep quandary. After all, ObamaCare is supposed to cover those with pre-existing conditions, and hospitals and other providers have every incentive to sign up their sickest patients for ObamaCare to make sure they get paid. How can anyone complain about charity?

All this cost shifting and gaming of our payment systems is inevitable because long-term U.S. policies have created a customer, i.e. patient, at the point of sale who has little skin in the game financially once insurance kicks in. The same patient also tends to be relatively passive on the question of whether care is medically necessary when someone else is paying.

During the 2008 campaign, President Obama stated a deceptively insightful vision of health-care reform: If health insurance were a good deal, nobody would have to be forced to buy it. He was specifically rejecting, of course, Hillary Clinton’s proposed individual mandate (which he would later adopt). But his original concept was a good one. By now, nobody who has paid attention fails to grasp all the ways our system rewards providers for delivering excessive care at excessive and uncompetitive cost.

Many Democrats, it’s no secret, see these perversities as a feature and not a bug—bringing closer the day when Washington will take charge of health care entirely. It’s their article of faith, impervious to experience, that the solution to government screwing up health care is to give government more power over health care.

http://www.wsj.com/articles/obamacar...ate-1470436014 Originally Posted by lustylad

No insurance company is going to make a profit if a majority of the risk they take on is negative. This paragraph from above explains it all. What you have is sick people who know they are sick buying the health insurance. Not enough low risk people are buying the insurance. This creates a negative risk pool and lost profit for the insurance company in the individual market.
From the link.

And the problem only gets worse as insurers, to stem their losses, keep hiking premiums, copays and deductibles. With each turn of the wheel, ObamaCare becomes an insurance program that appeals only to those who already know they face large health-care costs.

If low risk people don't buy the insurance to balance out the risk pools, then the individual market won't work. The risk corridors (bailouts for insurance companies that lost) are only in effect for one more year. All of the health insurance companies that are losing money in the individual market will eventually get out of the individual market. Then the government will take over the individual market. The health insurance companies will just sell group plans to companies with more than 100 employees and stop selling plans to individuals. What you had in the individual market before the ACA was health insurance companies not selling insurance to people with pre-existing conditions (already sick) to maximize their profits.

All of the health insurance companies... will eventually get out of the individual market. Then the government will take over the individual market. Originally Posted by flghtr65

So that was the plan all along, right? You admit Odumbocare was deliberately designed from the get-go to slide into a death spiral and self-destruct, allowing Jonathan Gruber and the rest of its architects to step in afterwards and say the solution to the government fucking up your health care is - to give the government MORE control over your health care!

So what's your timetable for the government to take over the Group insurance market after it is done fucking up the individual market?

So that was the plan all along, right? You admit Odumbocare was deliberately designed from the get-go to slide into a death spiral and self-destruct, allowing Jonathan Gruber and the rest of its architects to step in afterwards and say the solution to the government fucking up your health care is - to give the government MORE control over your health care!

So what's your timetable for the government to take over the Group insurance market after it is done fucking up the individual market? Originally Posted by lustylad

That was the original plan, and the increasingly powerful liberal hold is such that they may just admit it.

They knew it would fail, and they hoped it would lead to single payer.

Once they take over healthcare and pack the Supreme Court, it is over for Amerika.

That is why we need to dump Trump and get a good candidate who can beat Hillary.

So that was the plan all along, right? Originally Posted by lustylad

Yes.

One reason why they kept kicking the can down the road for the "start"!

They had to underwrite it with taxpayers' dollars to keep it afloat long enough to drive the insurers out of the market with their ridiculous regs and demands.... along with skyrocketing premiums. They didn't give a rat's ass about the 11 to 50 million folks without health insurance ... otherwise they would have just added them to medicaid and let them be happy .... along with the rest of us!

0zombie King fucking us hard! We don't like it, we fight back with a TRUMP CARD! Some may not like it, they can suck air!

http://www.benefit-revolution.com/20...nlawfully.html

Obama Administration Unlawfully Reimbursed Health Insurers, Judge Rules
House Republicans win challenge, but judge stays ruling pending the government's appeal.

From Zoe Tillman writing at The National Law Journal:
The Obama administration unlawfully paid billions of dollars to insurance providers under the Affordable Care Act without a funding appropriation from Congress, a federal district judge in Washington ruled.

The insurance subsidies were designed to offset discounts that insurers were required to give eligible lower-income Americans [making less than 250% of the Federal Poverty Level] under the health care reform law. U.S. District Judge Rosemary Collyer said federal agencies could not fund the subsidies through another section of the health care law that allocated money for tax credits.

“Paying out Section 1402 reimbursements without an appropriation thus violates the Constitution,” Collyer wrote. “Congress authorized reduced cost sharing but did not appropriate monies for it, in the FY 2014 budget or since. Congress is the only source for such an appropriation, and no public money can be spent without one." ...

0zombie King fucking us hard! We don't like it, we fight back with a TRUMP CARD! Some may not like it, they can suck air!

http://www.benefit-revolution.com/20...nlawfully.html Originally Posted by IIFFOFRDB

It's not Obaminable's money ....

.... $400 million here ... a $500 million there .....

He'll let someone else pick up the tab ... just stick it on the taxpayers' credit card and make him look good .....

.. how many have you known like that?

So that was the plan all along, right? You admit Odumbocare was deliberately designed from the get-go to slide into a death spiral and self-destruct, allowing Jonathan Gruber and the rest of its architects to step in afterwards and say the solution to the government fucking up your health care is - to give the government MORE control over your health care!

So what's your timetable for the government to take over the Group insurance market after it is done fucking up the individual market? Originally Posted by lustylad

If it was designed to deliberately fail, they (the government) would not have gone to the supreme court to get the individual mandate passed. The health insurance companies had to have two things before they would agree to attempt to sell health insurance polices to people who were already sick in the individual market. They had to have the individual mandate passed for a chance to have balanced risk pools in all markets (states, counties where the health insurance companies decide to market) and two the risk corridors (bailouts) for four years. The health insurance companies wanted at least 4 years to see if the risk pools could become stabilized. The year 2017 is the last year for the risk corridors. At that time the health insurance companies will have to decide if they want to take the risk in the individual market without getting help from the government if they lose doing business on the government exchanges (individual market).

The risk pools in the group insurance market are stable and highly profitable for the health insurance companies. The reason is for a company of lets say 20,000 people 19,000 of them will be healthy and low risk. They won't be submitting claims. For the 1,000 that become sick, their claims will paid for by the premiums of the low risk. Eighty percent of the population is covered by group (employer based) health insurance. I don't see the government replacing that. The health insurance companies certainly do not want to. Premiums are reasonable because the risk pools are relatively low risk, unlike the individual market where there is a lot of high risk(sick people) trying to purchase health insurance. All policies in all markets have the 10 minimum benefits, except for the grandfather policies that were retained( that eventually goes away, if it hasn't already).

Facts are completely foreign to you, aren't they, Fluffy? But keep spewing what you're told. It's funny. In a sad sort of way.

If it was designed to deliberately fail, they (the government) would not have gone to the supreme court to get the individual mandate passed. The health insurance companies had to have two things before they would agree to attempt to sell health insurance polices to people who were already sick in the individual market. They had to have the individual mandate passed for a chance to have balanced risk pools in all markets (states, counties where the health insurance companies decide to market) and two the risk corridors (bailouts) for four years. The health insurance companies wanted at least 4 years to see if the risk pools could become stabilized. The year 2017 is the last year for the risk corridors. At that time the health insurance companies will have to decide if they want to take the risk in the individual market without getting help from the government if they lose doing business on the government exchanges (individual market).

The risk pools in the group insurance market are stable and highly profitable for the health insurance companies. The reason is for a company of lets say 20,000 people 19,000 of them will be healthy and low risk. They won't be submitting claims. For the 1,000 that become sick, their claims will paid for by the premiums of the low risk. Eighty percent of the population is covered by group (employer based) health insurance. I don't see the government replacing that. The health insurance companies certainly do not want to. Premiums are reasonable because the risk pools are relatively low risk, unlike the individual market where there is a lot of high risk(sick people) trying to purchase health insurance. All policies in all markets have the 10 minimum benefits, except for the grandfather policies that were retained( that eventually goes away, if it hasn't already). Originally Posted by flghtr65

Hahahaha................What a Fucking Duckling.


Jim

Another day, another bumphazi fest. It's on you, LLiarMan. ENTIRELY on you.

Notably, we've now got LLiarMan's personal bunghole cleaner bumping. He obviously hasn't figured out why he's doing it, but maybe it came to him during one of his "head movies."

The point is that ASSup is an ASShole. Yup. We got it.