On one side is the Obama administration, which is preparing to carry out the president’s landmark health care reform law. It sees success directly linked to his legacy.
The group insurance rates are expected to increase between 13 and 30 percent, but it is the increase for individual health insurance that could skyrocket.
“We have heard from various insurance carriers on the individual market rates could go anyplace from 60 to 120 percent higher than the current market,” Steven Roper with Roper Insurance said.
The initial rate filings have been submitted and I’ll post a link to instructions to look at rates later. Without looking at them, I don’t believe individual Colorado Health insurance rates will rise as much as the article suggests. My reasoning is the CO Dept of Ins (DORA) has been leading the charge in implementing many of the mandates early such as maternity care and gender neutral pricing (to spread maternity out across the rate base requires gender neutral pricing). We’ll find out soon enough.
Another issue to keep in mind is that some companies are restructuring their individual insurance policies such that they will not “renew” until Dec 2014. This will allow you to keep your present plan as long as possible (assuming you don’t have a Grandfathered plan). These companies are Cigna, United HealthOne and Assurant Health.
Why? Because your policy doesn’t meet the Essential Health Benefit standards, which include the following at a minimum:
- Ambulatory patient services, such as doctor’s visits and outpatient services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
The changes don’t seem to square with one of the president’s promises: “If you like your health care plan, you’ll be able to keep your health care plan.” (emphasis added)
And if you’re just hearing about this, you need to speak with your journalism friends…
This is also a classic case of the media making sure they are on the record reporting something, but only doing so after it is too late to hurt their big government agenda. The media wanted ObamaCare to pass, so the media refused to do any kind of reporting like this when it might have derailed the legislation before it became law.
Four years after passage, though, the Associated Press decides to pretend they are real reporters. The same thing is going to happen if this new immigration reform package passes. Five years from now the AP will report, “Border Not Closed as Promised.” This is what happens when the government and media are both liars and become one.
The closer of this AP piece is especially hilarious. We are assured that those who lose their insurance “won’t object once they realize that the new coverage they will get is better than current bare-bones plans.”
Well, the plans may be a good deal if you qualify for a substantial subsidy and may not if you don’t. The pricing isn’t clear yet. Some states are showing what on the surface appear to be “reasonable” pricing, however these are primarily states (California, Washington, Vermont) that already have very expensive health coverage due to (excessive) government mandates.
Dr. Michael Ciampi, Portland, ME: South Portland doctor stops accepting insurance, posts prices online — Portland — Bangor Daily News — BDN Maine.
Dr. Michael Ciampi took a step this spring that many of his fellow physicians would describe as radical.
The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.
The change took effect April 1.
Dr. Ryan Neuhofel, Lawrence, KS: The Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care
Dr. Ryan Neuhofel, 31, offers a rare glimpse at what it would be like to go to the doctor without massive government interference in health care. Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that’s as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn’t accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat’s milk.
and we also have Dr. Lisa Davidson in Denver, CO:
Dr. Lisa Davidson had 8 years of frustration while running a successful traditional practice in Denver, Colorado. She had 6,000 patients when she decided to stop taking insurance and adopt the same business model as Neuhofel. Her patient list has dropped to about 2,000. She used to spend about 15 minutes with each patient and now it’s more like 45 minutes. “We’re on track to make more money and take better care of our patients,” says Davidson. “It’s a win-win all around.”
Here is the driving issue:
Under Obamacare, more and more doctors are becoming employees of large hospitals, where there will be more control over how they practice medicine. Hoover Institution Senior Fellow Dr. Scott Atlas fears this will cause a brain drain in medicine. “Really smart people want autonomy, and when you take that away it’s naive to think you’re going to get really bright people becoming doctors,” says Atlas. “The best doctors could excel at any profession, so why go into medicine if they won’t have the opportunity to be their best?”
and talk about cost savings…
When she was operating a traditional practice, Davidson witnessed firsthand how our “payment plans for routine expenses” drive up prices and block innovation. She recalls that one insurance company paid $118 for a routine PSA test. Now that her patients pay the bill directly the cost is $18. Insurance used to pay $128 for a bag of IV fluid. Now Davidson doesn’t bother passing on the cost of IV bags because they run $1.50 each.
I sell health insurance, so why would I be for doctors not taking insurance? Having insurance to cover day to day expenses makes no sense. That is not insurance, it is prepayment. What Obamacare does is play Robin Hood with premiums (i.e. subsidies) to tax one group so the other can afford it. That’s not insurance either. Thankfully, at least some doctors are revolting against the insurance & obamacare bureaucracies and cutting costs at the same time. Now THAT is Patient Protection and Affordable Care. Unfortunately the name has already been taken.
I am for insurance to cover major unexpected expenses. That’s what it’s for.
In southern Los Angeles County, for example, Health Net is charging $242 a month for one of its plans. Blue Shield is charging $287 and Kaiser Permanente $325 for the same coverage.
For the first time, consumers are in a position to make an informed decision about health insurance. They can opt for the lowest-priced plan or they can factor in other considerations, such as personal convenience.
Here’s the best example of the comparision shopping that I’ve seen:
Comparison shopping for health insurance isn’t a revolutionary idea. You can already go to websites such as eHealthInsurance.com to sample what’s available. But that’s kind of like going to a department store to shop for shoes.
There may be plenty of choices at a Macy’s or a Nordstrom, and prices may vary, but it’s hard to know which ones are best. Different pairs of shoes might offer different features, or different workmanship, or come from different parts of the world.
The beauty of the insurance exchanges is that they’ll make all participating insurance plans equal. So when one plan is offered at a particular tier — Platinum, Gold, Silver or Bronze — for significantly less than another, you’ll know you’re getting a better deal, not sacrificing quality for price.
And insurers, at last, will compete by offering the best coverage at the lowest price, rather than trying to sell you as little coverage as possible for the highest price, which is how the market is currently structured.
I take some exception to the last paragraph. With the MLR (minimum loss ratio) insurers are already operating under, they cannot charge random prices. Another item that people may not realize is a bronze plan from one insurer is not exactly the same as a bronze plan from another. What they have in common is from an actuarial perspective they both will, on average, pay 60% of the medical expenses of the plan members.
When she was 32, Wendy Drabick opened her own IT and accounting consulting business and started paying health insurance premiums for herself and her family, now a hefty $1,100 every month. That’s about $10,000 more each year than she’d be paying if she worked for a large employer who paid most of the premium. Drabick isn’t complaining, but she would like to know if her premium will go up under the Affordable Care Act (ACA, also known as Obamacare), and if so, how much. Nearly all Americans will need to have coverage, many through state marketplaces, beginning January 1, 2014.
The article doesn’t directly mention two issues that will have a direct effect on the cost of one’s coverage:
- A person’s age. The older one is, the greater the self employed person will benefit from the 3:1 maximum difference in premiums between young and old
- Income. Subsidy eligibility determines how much you will actually have to to pay.
Some labor unions that enthusiastically backed President Barack Obama’s health care overhaul are now frustrated and angry, fearful that it will jeopardize benefits for millions of their members.
Union leaders warn that unless the problem is fixed, there could be consequences for Democrats facing re-election next year.
“It makes an untruth out of what the president said _ that if you like your insurance, you could keep it,” said Joe Hansen, president of the United Food and Commercial Workers International Union. “That is not going to be true for millions of workers now.”
Color me skeptical on the consequences for Democrats. I suppose there could be from lack of enthusiasm but that’s as far as I can imagine it going.
As always, Sarah Kliff has the details. The California exchange will have 13 insurance options, and the heavy competition appears to be driving down prices. The most affordable silver-level plan is charging $276-a-month. The second-most affordable plan is charging $294. And all this is before subsidies. Someone making twice the poverty line, say, will only pay $104-a-month.
Sparer plans are even cheaper. A young person buying the cheapest “bronze”-level plan will pay $172 — and that, again, is before any subsidies.
I just don’t get the compeition argument but the post goes on to give an example…
The way this competition can drive down rates is already evident in Oregon. There, one insurer came in with monthly premium costs in the $169 range, while other insurers asked to charge more than $400. But then, seeing what their competitors were charging, two insurers came back to the state’s regulators and asked if they could refile at lower rates. Otherwise, they wouldn’t be competitive in the exchange. The Obama administration was ecstatic to see this: It’s exactly what they’re hoping will happen across the country.
The unfolding will continue over the coming months…
Mid-level “silver plan” coverage could cost less than $250 per month for a 40-year-old male in some markets, but the average premium rate for the cheapest silver-level plan in a market will be about $300 per month, and the rate for the third cheapest silver plan will be $335, according to a guide to the exchange menu plan rates and a related Covered California presentation.
Some prominent health insurers, including industry giant UnitedHealth Group Inc., are not participating in California’s new state-run health insurance market, possibly limiting the number of choices for millions of consumers.
The cost of a family policy, then, doesn’t say anything about whether a worker would be eligible for federal subsidies. The important number is how much it would cost Ricchuiti, or others, to buy an individual plan. If that number is more than 9.5 percent of household income, then it would likely mean eligibility for tax credits on the exchange.
This gets to the second part of Ricchuiti’s question: If he is eligible for tax credits, “can I only access them if I sign up for a health exchange plan?” This, fortunately, is a much simpler question to answer: Yes, the tax credits must be used on the new, government-run marketplaces.
The family subsidy eligiblity situation can be complicated but in general, if the primary breadwinner is covered by a group plan, the odds of subsidy eligiblity decrease.
I don’t 100% buy the insurance company not offering coverage claim since that issue goes away in about 7 months. Certainly the data may help insurance companies price their product correctly.
Do not, do not share information unless it is necessary.
Months after the president’s reelection, a variety of unions are publicly balking at how the administration plans to implement the landmark law. They warn that unless there are changes, the results could be catastrophic.
They seem to have an issue with the “you can keep your plan if you like it” theme…
In a new op-ed published in The Hill, UFCW President Joe Hansen homed in on the president’s speech at the 2009 AFL-CIO convention. Obama at the time said union members could keep their insurance under the law, but Hansen writes “that the president’s statement to labor in 2009 is simply not true for millions of workers.” (emphasis added)
You drink the kool-aid, you reap the consequences. The Unions and “Big Pharma” should get together and have a “Obamacare finally caught up with us” party.
News you can use: Feds post PCIP regs | LifeHealthPro.
Effective June 15th:
The federal PCIP program run by the U.S. Department of Health and Human Services (HHS) will set most reimbursement levels at just 100 percent of the Medicare reimbursement rates, officials said in a new interim final rule that is set to appear in the Federal Register May 22.
In situations in which federal PCIP managers cannot use Medicare provider reimbursement rates to set rates, PCIP managers will pay either 50 percent of billed charges or an amount set using a “relative value scale pricing methodology,” officials said.
The new payment rules will not apply to prescription drugs, organ transplants, dialysis services or durable medical equipment.
Why is this happening?
The managers of the PCIP program have to take emergency steps to cut reimbursement costs, because Congress allocated only $5 billion for the program, the money is running out, PCIP already has done everything else it can think of to cut costs, and Congress seems to be unwilling to provide any more funding, officials said in the preamble to the rule.
Once again, why is this happening?
Because the Federal Government knows absolutely nothing about running an insurance company or the concept of “adverse selection”. This program was vastly undersubscribed compared to expectations yet it obviously ran substantially over budget.
The Obama administration says the Affordable Care Act will provide cheaper health insurance for millions of Americans.
But some people, particularly young men who aren’t insured through their employers, could see their premiums go up once coverage in the state-based insurance exchanges begins in January.
How will premiums most likely change?
Taken together, men ages 25 to 36 could see rate increases greater than 50%, according to Milliman’s O’Connor, but women of the same age will only see their premiums creep up 4%. Meanwhile, men age 60 to 64 could see their premiums drop by 12%.
The big question is…
At this point, everyone — including the insurers — is just guessing at what premiums should be. That makes next year a giant experiment. Will younger, healthier people purchase coverage, or will they skip it and simply pay the fine? Next year, the fine starts at $95 per adult — a rate likely to be cheaper than any individual plan available on the state exchanges. (emphasis added)
Imagine a giant experiment depending on young healthy men participating in the health insurance risk pool. That’s not a recipe for sleeping well at night for Obamacare supporters.