Daily Archives: June 22, 2013

Young People Boycott Obamacare?

 Young People Should Say No to Obamacare | National Review Online.



Indeed, the law will require four out of five young Americans to pay more than they otherwise would for health coverage — yet another form of generational theft from young to old that ought to sour young people on government “help.”

What happens if the young invincibles don’t sign up?

If young people boycott Obamacare, the law of adverse selection kicks in. Too few young people in an insurance pool means fewer healthy people to subsidize the sicker people. Costs and premiums will rise more than expected, which will lead to fewer young people signing up and costs going up even more. In insurance jargon, it’s called a death spiral.

… and a young person’s decision process?

Grace-Marie Turner, head of the free-market Galen Institute, has looked at a typical young person’s decision tree on Obamacare. If someone is 27 years old, single, and making $34,000 a year, he will have to fork over more than $300 a month for a basic health-care package — that’s 50 percent more than he is likely paying now. Obamacare would send him a check for $20 a month through its subsidy program, but he or she will still wind up paying some $1,000 a year of after-tax income for basic health insurance. That’s a lot for someone with a decent job who is trying to save money for a house or to start a family.

Depending on the plan, the premium amount mentioned above seems high. That is about the maximum someone with that income could pay for a Silver plan.

The article also mischaracterizes the guaranteed issue portion of Obamacare:

And whether they are slackers, students, or software engineers, young people are smart enough to figure out that they can easily wait to sign up for coverage until after they get sick. Obamacare requires every insurance company to take anyone on as a customer regardless of any pre-existing conditions.

This is NOT, I repeat NOT true. OK, wanted to get your attention. Yes, Obamacare is guaranteed issue, but plans are only issued during open enrollment. The first years open enrollment is extended so it lasts from October 1st 2013 to March 31st 2014. In future years open enrollment will be from October 1st to sometime in December. Now this is very important:


Be careful out there.


Obamacare Causing Nearly Half Of Small Businesses To Freeze Hiring:

Obamacare Causing Nearly Half Of Small Businesses To Freeze Hiring: Poll.

Small business owners’ fear of the effect of the new health-care reform law on their bottom line is prompting many to hold off on hiring and even to shed jobs in some cases, a recent poll found.

“We were startled because we know that employers were concerned about the Affordable Care Act and the effects it would have on their business, but we didn’t realize the extent they were concerned, or that the businesses were being proactive to make sure the effects of the ACA actually were minimized,” said attorney Steven Friedman of Littler Mendelson. His firm, which specializes in employment law, commissioned the Gallup poll. (emphasis added – Ed)

Really? Attorney Steven Friedman needs to venture out into the real world a little more often.

Forty-one percent of the businesses surveyed have frozen hiring because of the health-care law known as Obamacare. And almost one-fifth—19 percent— answered “yes” when asked if they had “reduced the number of employees you have in your business as a specific result of the Affordable Care Act.”

So if you’re looking for a job, on average a small business isn’t a great place to start.


“If there is an exchange I’m sure there will be the Blues.”

Says Ana Gupte, an insurance stocky analyst for Dowling & Parners.

Blue Cross-Blue Shield Bets Big On Obamacare Exchanges – Kaiser Health News.

At a closed White House meeting in April, President Barack Obama told corporate insurance bosses “we’re all in this together” on implementing his signature health law. But some insurance companies seem to be more in than others.

At least five Blue Cross and Blue Shield executives sat at the table of about a dozen CEOs with the president, according to those knowledgeable about the session, first reported by the New York Times. Just as significant is who wasn’t there: chiefs of the country’s biggest and third-biggest health insurers, UnitedHealth Group and Aetna.

The article goes on to discuss issues concerning the insurers including the inability to properly understand the risk pool of the actual participants that will sign up.


Carriers submitting plans for the Colorado individual marketplace

There are 10 carriers that have submitted plans for the Colorado health exchange for the individual market. They are:

  1. All Savers Insurance Company (A United HealthOne company)
  2. Cigna Health and Life Insurance Company
  3. Colorado Choice Health Plans (San Luis Valley HMO?)
  4. Denver Health Medical Plans
  5. HMO Colorado (Anthem)
  6. Humana Health Plan
  7. Humana Insurance Company
  8. Kaiser Foundation Health Plan
  9. New Health Ventures
  10. Rocky Mountain HMO

Big problem: Shortage of primary care doctors

A looming shortage of primary care doctors appears to be a nationwide problem. These cases showed up in my RSS feed, I’m sure I could find links for almost every state.


Minn. Faces Shortage Of Primary Care Doctors

Primary care physicians are more readily available in Minnesota than most of the country, but experts say the state faces a looming shortage and only partly because of the federal health care overhaul that will extend coverage to around 300,000 uninsured residents.

Utah faces shortage of primary care doctors

Utah has a shortage of doctors that practice family medicine, and that shortage could be compounded next year as millions of newly insured patients around the country gain coverage under the health care law.

Shortage Of Primary Care Doctors In Florida

There is a severe shortage of doctors in much of Florida. According to the state Department of Health, 16 mostly small and rural counties have fewer than seven active physicians per 10,000 residents. That compares to 22 active physicians per 10,000 residents in the United States. The state estimates it would take at least 753 primary care physicians to eliminate those shortages.


Obamacare exacerbates primary care physician shortage

Obamacare: Will it worsen Missouri’s doctor shortage? – CSMonitor.com.

“A lot of folks say that politics is the biggest threat to Obamacare or the Affordable Care Act. I think the second biggest threat is the lack of primary care providers to serve the folks who are going to gain access to coverage,” said Joe Pierle, CEO of the Missouri Primary Care Association that represents community health centers. “We can give everybody health insurance, but if they can’t get in to a doctor, especially in rural Missouri, then we’re really not making much progress.”

I don’t believe this is simply a Missouri problem. How do you create more primary care physicians? Higher pay, better working conditions and more respect.

What are the odds of that?


Additional Colorado exchange pricing from CCHI

The Colorado Consumer Health Initiative (CCHI) has done some analysis of Colorado exchange pricing filed with the state. Their dressed up conclusion in my opinion…

“Colorado consumers will be pleased they will have a enough health insurance plans from among which to choose, without being overwhelmed by too many choices – it looks like Goldilocks, just right,” said Dede de Percin, executive director of the Colorado Consumer Health Initiative. “Despite doomsday predictions, the state is not seeing ‘rate shock’, so many of the choices will be more affordable, especially with the subsidies.”

Here are some examples of pricing for “one Silver plan” from each of the 10 insurers…


Denver Individual Plans

  • 27 year old: $207 to $373 per month
  • 40-year old: $253 to $454 per month

Denver Family Plan (2 parents age 40, children under 18)

  • $756 to $1,360 per month

Durango Individual Plans

  • 27-year old: $207 to $504 per month
  • 40-year old: $253 to $615 per month

Durango Family Plan (2 parents age 40, children under 18)

  •  $756 to $1,840 per month

Fort Collins Individual Plans

  • 27-year old: $197 to $406 per month
  • 40-year old: $240 to $495 per month

Fort Collins Family Plan (2 parents age 40, children under 18)

  • $718 to $1,481 per month


Having sold numerous health policies in Colorado, I can assure you this most DEFINITELY WILL BE sticker shock. That said, of course many will be eligible for subsidies to defray the cost. Let’s hear it from CCHI:

Most consumers will not pay these prices since low and middle-income Connect for Health Colorado marketplace consumers will be eligible for advanced premium tax credits based on income.  For example, a 40-year old earning $29,000 a year, paying a premium of $350 per month would be eligible for a subsidy of up to $154 per month and would contribute $196 per month for his or her health plan.

Subsidies are not reduced in a straight line fashion as your income increases. If you are closer to 400% of the Federal Poverty Level (FPL) the amount of subsidy you will receive is substantially reduced. View a FPL spreadsheet vs. number of family members here.


Connect for Health Colorado hints at upcoming pricing for health coverage

In this June 7th posting on the Connect for Health Colorado, Patty Fontneau, Executive Director and Chief Executive Officer provides indications of the pricing filed with the department of insurance…

I wanted to provide an update in response to questions we received about how much health plans will cost when our health insurance marketplace opens in October. The Division of Insurance posted information about preliminary filings and the Colorado Consumer Health Initiative conducted an analysis of those filings. We’re also analyzing the preliminary filings and are encouraged to see a broad range of costs. These monthly costs will be further lowered for many Coloradans by new financial assistance (tax credits) available only through Connect for Health Colorado.

Preliminary filings from health insurance carriers show that monthly premiums for a 21-year-old living in Denver from the majority of carriers will range from $146 to $234 for bronze plans and from $192 to $279 for silver plans, before cost-reductions based on income. Monthly premiums for a 40-year-old living in Denver from the majority of carriers will range from $186 to $299 for bronze plans and from $245 to $357 for silver plans. Bronze plans are the group of health plans for which the carrier will, on average, cover about 60 percent of health care costs and the consumer will pay for about 40 percent of costs. With silver plans the customer will pay less of the average overall health care costs (closer to 30%), but will pay more each month in premium. Connect for Health Colorado also expects to offer health plans at lower and higher costs and with other cost-sharing levels. The health plans are new and include a comprehensive set of benefits, including doctor visits, hospitalizations, maternity care, emergency room care and prescriptions.(emphasis and italics added)

We’re also seeing strong competition among carriers. Preliminary filings show that 10 carriers requested approval to provide about 150 health plans for individuals and families through Connect for Health Colorado. They include All Savers Insurance Company (part of UnitedHealthcare), Anthem Blue Cross and Blue Shield, Cigna, Colorado Choice, Colorado HealthOP, Denver Health, Humana, Kaiser Permanente, New Health Ventures and Rocky Mountain Health Plans. Six carriers – Anthem, Colorado Choice, Colorado HealthOP, Kaiser Permanente, Rocky Mountain Health Plans and See Change – requested approval to provide nearly 100 health plans to small employers through our marketplace.

What we’re seeing so far is good news for Colorado consumers. Starting in October, they will be able shop through Connect for Health Colorado and choose from many health insurance carriers at competitive rates. Nearly a half-million Coloradans will be eligible for further cost reductions to make health insurance more affordable.

Please keep in mind that all of this information is preliminary and may change based on review by the Colorado Division of Insurance. The Division of Insurance regulates insurance companies in the state and has started their standard review of the carrier filings. The review and final determination of plans and rates is expected to be completed in late July. Final details about premiums and the types and number of health plans will be known after that. We’ll continue to keep you updated.

I’m not so sure what the good news is. The pricing is not particularly great compared to what’s presently available. I suppose the good news is many will qualify for a subsidy to reduce the cost. What I don’t see is pricing that will attract the “young invinceables” but the exchange has their marketing efforts up and running.