The Promise of Obamacare

About that Union label...

Back in the Spring, we noted that "some unions leaders have grown frustrated and angry about what they say are unexpected consequences of the [ObamaTax]."

Unexpected. Heh.

Fast forward a few months, and we learn that this anger and frustration has brought forth this result:

"[T]he 40,000 members of the International Longshore and Warehouse Union (ILWU) announced that they have formally ended their association with the AFL-CIO, one of the nation's largest private sector unions. The Longshoremen cited Obamacare" as one of the two primary rationales (the other being immigration "reform" which, perhaps not coincidentally, will heavily impact the train-wreck, as well).

Never say die, though, exclaims HHS Secretary Shecantbeserious, and out come the big guns:

"[A]ccording to a report from InsideHealthPolicy, the Obama administration is considering offering insurance subsidies—intended for the uninsured—to labor union members who already have employer-sponsored coverage."

As the indispensable Avik Roy points out, folks covered under their employer's group plan aren't eligible for subsidies (although I would add that, technically, no one in states with Federally-run Exchanges are, either, but that hasn't stopped Ms Kathleen from handing them out willy-nilly).

The upshot is that funds that were earmarked for those previously unemployed will now be diverted to the more favored constituency (union members). Seems fair, no?

And it what is certainly "coincidental," grocery behemoth Krogers is following the UPS route [ed: very funny] and cutting off health bennies to its employees' spouses. But remember, "if you like your plan, you can keep your plan."

Or not.

HHS wants you to meet Lupita

 
 [In case you missed it, HHS also wants you to meet Howard]

Lupita and her nine year old daughter are uninsured. She works at a dental office as a dental assistant. She scrapes by every month trying to earn a few extra dollars by staying late just to make sure she and her daughter "have enough" at the end of the month. According to her story over at hhs.gov, she is really looking forward to the value Obamacare will bring to she and her daughter.

According to the Bureau of Labor Statistics, the average income for a dental assistant is $33,470. Assuming she is making this amount, the cost for her to purchase insurance through the marketplace Exchange would equate to 5.41% of her income or $2,294 per year. While that will clearly be less than the full premium, for Lupita to make up the $191 of monthly income she will have to pick up an additional 140+ hours of work per year just to come close to breakeven.

There is an alternative: continue to go bare and only have to pay a tax; I mean "shared responsibility payment" of roughly $240.

Interesting Life Underwriting news

Little did I realize when I recently posted about a client that I was on the bleeding edge of a potential revolution in life insurance underwriting. But that seems to be the case, as "new research by Timetric [shows that] three key technological developments have had a substantial impact on life insurance underwriting: automation, social media and big data."

[ed: gotta love "Big Data." Brent Spiner must be jealous]

Two items caught my eye:

First, that social media seems to be playing a larger role in detecting insurance fraud (we tend to see this more in the disability and workers comp fields, of course). But it strikes me as a little creepy that underwriters access FaceBook, Twitter and the like as part of their process. On the one hand, this makes sense: you checked "non-smoker," but there you are, tagged at a party, with a joint or a Marlboro. On the other hand, it seems to me that this comes awfully close to cyber-stalking. One supposes that the message is to be careful regarding your on-line presence.

The second is the idea of "Big Data." As we've seen from the recent NSA scandal(s), the idea that you have any real data privacy is quaint. Unlike Facebook posts, though, there's little you can do to control what's in your "file." And of course, to the extent that the privacy notice you signed allows, most of that info is legally accessible by the folks who are, after all, potentially on the hook for major dollars.

Brave new world, indeed.

Cavalcade of Risk #191: Call for submissions

Julie Ferguson hosts next week's Cav. Entries are due by Monday (the 2nd).

To submit your risk-related post, just click here to email it.

You'll need to provide:

■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post

PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like). And please only submit if you are willing to link back to the carnival if your submission is accepted.

Open wide and say...Yikes!

One of the "core" elements of the train wreck's Essential Health Benefits mandate is the requirement to provide pediatric dental benefits.

FoIB Jeremy from Assurant Employee Benefits has some news about how that's going to play out in real life. As with so many aspects of the ObamaTax, there's little guidance from Capital City as to what's going to actually be enforced come January. It appears that large groups (ie over 50 employees) probably won't have to make any changes to their plans to remain in compliance.

Small groups, though, will see "pediatric dental EHB services embedded in their medical plan...but those will generally be only dental services for the pediatric population (under age 19)." [ellipses in original]

But what are these services? In general, they'll mirror current coverage available with the SCHIP program, with perhaps some broader coverage available for additional screenings.

But the truly scary part is what's going to happen to the cost of orthodontia.

Hunh?!

One of the key "features" of the dental benefit is coverage for "medically necessary orthodontia." But FoIB Fred of Companion Life wonders, since "a definition of medically necessary orthodontia has not been yet established, it is unclear" how many ortho claims will fall in that category?

It's perfectly clear how many such claims will fall under that rubric: 100% of them. Count on it. And, as we have seen in, for example, the higher education, when the government subsidizes something, its cost always skyrockets.

Sounds like the brace-fitters, at least, have reason to rejoice.

Oscar-care

Need health insurance? Think transparency. Think lower health care costs. Think lower health

insurance premiums. Think Oscar-care. 

Oscar-care is a start-up health insurance company making their debut on the New York health insurance exchange in a few weeks.

Oscar will have one plan in each of the ACAs metal-tiered categories, and additional plan options for the Bronze and Silver tiers. Although Oscar will have some of the familiar pillars of the health care industry like co-pays and deductibles for in-person visits, it introduces new elements like free telemedicine, free generic drugs and online price comparisons. Oscar health insurance will pioneer “a consumer experience, not a processor of claims,” explained Nazemi, with the goal of simply guiding individuals through the complex health system in an integrative and safe way.

Forbes

This is a great idea. Color me skeptical, but if it delivers anywhere close to the promise, Oscar should run for public office.

New York mayor comes to mind . . .

For frequent conditions or issues, patients will be able to find treatments right on the website and have 24/7 access to a physician through their unique partnership with the telemedicine company, TeleDoc. Additionally, the creators claim there will be no need to discuss prescription refills in-person with an expensive physician when a user can have “one-click refills” through a health records feed that resembles a Twitter timeline.

Oscar will also offer services at many hospitals and retail locations such as New York CVS CareMark. The partnership that Oscar and CVS have is so strong that CVS is building sites for Oscar. 

One concern to me is, HIPAA privacy. Just how secure is this?

The founders of Oscar claim that consumers will have access to a doctor by phone within 20 minutes of a request, with no co-pay. Perhaps the concept is not revolutionary, but if it works, the behavioral changes associated with seeking care could be seismic. Currently, not many patients log onto insurance carrier webpages before seeing a doctor, unless they are seeing if the doctor is in-network. Oscar, however, wants patients to start their care with the insurer, not just use it for payment submission.

Someone put a lot of thought into this.