Happy Birthday to Obamacare

The first anniversary of Obamacrap is just a few days away, so we are jumping the gun a bit. I hope the folks in DC don't mind.

We took our cue from Kaiser Health News, so don't think it is our fault for suffering the shame of premature emasculation.

A quick read of their news shows how you view the law depends on whether your ox is being gored or not.

a coalition of conservative groups is hosting a pizza party in the Capitol Visitor Center Monday to hash out their opposition to the law

Probably a healthy veggie pizza.

The Senate Budget Committee will take a look at some policies to save money on Tuesday, including proposals that would turn part of Medicare into a voucher program and redefine Washington's relationship with the states under Medicaid.

Redefine Washington's role. Somehow I don't think it means less interference from the feds.

The House Oversight and Government Reform Health Subcommittee will take a closer look at waivers under the health care reform law on Tuesday, examining how the Obama administration has used them for some employers. The waivers — temporary changes for states, employers, or companies in the year-old law — have become a political flash point, with Republicans using them to argue that the law is not working and should be repealed

This is total nonsense. Increase the pace of waiver approval and before you know it, no one will be subject to Obamacrap.

A handful of House Democrats are backing a resolution that would require all members of Congress to disclose whether they receive health insurance through the Federal Employees Health Benefits Program. A number of high-profile Democrats, including Sen. Charles Schumer of New York, and progressive groups have routinely hammered House Republicans for accepting government health benefits while opposing the reform law

How about this? Kill benefits for all Congress critters. No taxpayer funded health insurance for any of them and make them buy from one of the online vending machines. That will give them an idea of what kind of problem they have created for their subjects.

Of course any parent knows what follows the first birthday.

The terrible two's . . .

Rocky Weighs In

For those not directly affected by some of the constraints of Obamacrap, the letters MLR mean nothing to you. But one of the provisions of Obamacrap is a requirement that health insurance carriers meet certain guidelines for medical loss ratio's (MLR).

In simple terms, the carrier must pay out at least $0.80 of every dollar taken in for individual health insurance and $0.85 of every dollar for insured group health plans. The payout must be for claims including reserves.

If they do not meet these goals they must essentially declare a dividend and refund the difference in the $0.80/$0.85 to policyholders.

The brainiacs in Washington thought this would reduce premiums and make health insurance more affordable.

Truth is, this crunch has resulted in a few carriers throwing in the towel (and at least one in Maine that threatened to leave) meaning LESS competition in certain markets.

Less competition = higher premiums.

All the carriers I know have laid off home office and field staff as well as cutting compensation to agents by 50% or more.

Some may see this as a good thing, as long as you don't consider the downside of layoffs. More people out of work and collecting unemployment plus fewer workers to answer policyholder questions. In other words, if you call, expect to be on hold for a while before a human answers and when you do get someone don't expect them to spend more than 3 minutes addressing your issue.

As for agents, many have already left the industry which is not altogether bad since some never should have been here any way. Those that stay can no longer spend time helping clients the way they once did since they are earning half what they did last year.

All this leads to an article in a trade publication about MLR and industry representatives trying to get some relief. The National Association of Health Underwriters (NAHU) is trying to growsome testicles after getting on the Obamacrap bus and supporting this mess all the way until it became law.

Then, just like Nancy Pelosi, they finally read the law and found out what was in it and they did not like what they saw.

So where does Rocky come in?

Sen. Jay Rockefeller has decided to fight any effort to modify Obamacrap where it pertains to MLR calculations. According to him, while he "recognizes the valuable work of agents" he fails to see the other side of MLR.

“I cannot support a proposal that would allow agents, brokers and health insurance companies to retain the estimated $1 billion in benefits that American consumers will receive next year thanks to the health care reform law,” Rockefeller says.

I have no idea where he got this figure. Probably like all other numbers from Washington he pulled them out of his butt.

Even if the savings is a billion it is not being returned in the form of lower premiums. Rather, it is resulting in less customer service, tougher underwriting which makes it more difficult for people to obtain individual health insurance and higher (not lower) rates.

“I am encouraged by the fact that the new law is prompting many health insurance companies that were not meeting these targets to conduct a long-overdue review of their business operations and make changes that will result in higher-quality care and lower premiums for their customers,” Rockefeller says.

What is his standard for "higher quality care"?

Surely he knows that health insurance is not the same as health care. With reduced staff, policyholders are actually getting a lower quality of care from a customer service perspective.

One side effect of reduced commissions is carriers are seeing more direct business (applications that do not originate from brokers) as well as agent directed business that has not been pre-qualified. The result is higher rejected applications, some as high as 50%, and more business issue that is "not taken".

That is an industry term which means the policy was approved but the offer was not accepted since it was different from what the applicant expected.

Direct business is more costly to underwrite and service than agent directed business. It also has a tendency to lapse, usually within 6 months vs. agent business that has a 2 - 3 year life expectancy. (Some of my clients have been on the same plan for 5 years or more).

All of this was easy to predict, along with higher premiums. It doesn't take a rocket surgeon to figure out if you require carriers to provide more benefits, tell them they cannot deny coverage to children, regardless of their medical condition, and set strict guidelines for claim payout the result would not match the campaign promises of lower premiums and more accessibility to health insurance.

The Obamacrap bus is headed straight for a cliff and everyone in the country is along for a very short and disastrous ride.

Smaller cars, bigger health insurance, Poppa Washington.

If it walks like a duck...

It's probably not Gilbert Gottfired....er, uh, Gottfried.

Some of the more annoying TV commercials are from the the Aflac folks, known for their worksite marketing of specialty disability, critical illness and other policies. Apparently, the former rocket-surgeon-turned-washed-up comedian thought it would be a good idea to "tweet" a series of tasteless jokes about the earthquake/tsunami and its aftermath.

According to the WSJ, "70% to 75% of Aflac’s earnings come from Japan."

Ooops.

I Want My Adult Basic

When the state of Pennsylvania ran out of money for a low income, subsidized health insurance plan with limited benefits, they closed the offering.

Seems folks in PA weren't happy, so they did the all American thing.

They sued.

Three people who were covered by a state-run health care plan for lower-income adults that stopped being funded two weeks ago sued Monday to force Pennsylvania to re-establish the program.

The lawsuit filed in Commonwealth Court alleges that money set aside for the plan, called adultBasic, was unlawfully diverted to other purposes, and is directly responsible for the plan's end on Feb. 28. The suit, filed by Sheryl Sears of McKeesport, Ronald Guiney of Butler and Florence Spanos of Pittsburgh, also seeks a class-action order. More than 41,000 were covered under adultBasic.

Times are hard and money doesn't grow on tree's . . . except in Washington. The rest of us need money in the bank.

AdultBasic began in 2002 as a basic health insurance program for low-income working adults who weren't poor enough to qualify for Medicaid and weren't old enough to qualify for Medicare. It didn't cover dental needs or prescription drugs, but it covered the cost of major surgeries and is considered better coverage than Special Care.

In 2005, the state's Blue Cross/Blue Shield insurers, which were under scrutiny from then-Gov. Ed Rendell's administration for the size of their surpluses, agreed to help finance adultBasic for six years, ending Dec. 31, 2010.

The program was financed on the backs of taxpayers, tobacco users and insurance companies (including their policyholders).

Obviously that wasn't enough.

As harsh as this may sound, at some point adults need to accept personal responsibility for their decisions. Jobs are hard to come by but there is always a reward for hard work and a sense of industry.

Your Tax Dollars at "Work"

I'm tempted to say that only at an (alleged) institute of higher learning would one expect to find actual money spent on a study titled:

"Use of $4 Drug Programs Could Save Society Billions of Dollars, Says Pitt Graduate School of Public Health Study"

But of course, we've seen plenty of such examples in the halls of government, so I'll just mention that this came in email from the above referenced "elite" institution. The release, which arrived early yesterday afternoon, very explicitly warned "EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, MARCH 14."

We aim to please.

All Ides on Grand Rounds

Amy Tenderich presents an Ides of March themed Grand Rounds. This week's edition is notable not only for its attractive layout, but the helpful context she provides for each entry.

Question of the Day

Obamacare is almost an exact duplicate of the model for health insurance used in Maine, except without the individual mandate.

Maine prohibits health insurance companies from denying coverage based on pre-existing medical conditions.

Maine requires (both) health insurance carriers to use a community rating model.

Maine has some of the highest rates in the country for individual health insurance.

Given all this, why does Maine want to opt out of Obamacrap, and why were they granted a waiver?