The Final Solution

Health insurance carriers are tallying the results from their first full year as purveyors of Obamacare and it isn't pretty. Losses are in the tens of millions of dollars and no relief in sight.

Carriers have filed preliminary rates for 2016. Increases are in the 20 - 50% range.

Not pretty.

But have no fear. HHS Secretary Burwell has a solution to avert the losses.

Lower premiums and make up the losses on volume.

Secretary of Health and Human Services Sylvia Mathews Burwell argued Thursday that premium hikes floated by health insurance companies this week will likely end up being lower once they are finalized. - The Hill

Either Ms Burwell is looney or she thinks we are.

Thursday ObamaTax News (Oy)

■ First up, FoIB Jeff M tips us to this breaking news lie:

"Blue Cross and Blue Shield of North Carolina requested a 25.7 percent increase to premium rates ...  the N.C. Department of Insurance must approve the request ... apply only to ACA plans, meaning those purchased largely through the federally facilitated marketplace"

Why is this a lie? Because we were explicitly promised 3000% rate decreases.

Let's unpack this a bit farther: these plans affect only those bought On-Exchange, meaning that most (if not all) of them will be subsidized (why else risk the 404Care.gov security black hole?). Higher premiums mean higher subsidies, and thus higher taxes for the rest of us.

Gee, thanks!

On and, by the way?

In late-breaking "news," looks like most other Tar Heel State insureds will get to share in the joy noted above:

"Most state residents will see their health insurance costs rise next year under proposed pricing plans from insurers offering health coverage."

You're welcome!

■ Next up, Green Mountain State citizens may have dodged the aforementioned 404Care.gov bullet, but they'd be wrong:

"The online insurance marketplace that Vermont built to enroll people in private coverage under the law had extensive technical failures ...  even though its residents’ subsidies appear safe for now, Vermont stands as a cautionary tale."

As readers may recall, the current SCOTUS subsidy cases are about states (like North Carolina) that outsourced their marketplace efforts to the Feds. Since Vermont went the DIY route, their citizens' subsidies should be safe (for the nonce). Still, state leaders had hoped to springboard into single-payer, and now see those plans crumbling.

Gee, darn.

■ And finally (but by no means least): you know all those folks touting the recent "success" of Open Enrollment v2.0? You know, the one where they (allegedly) enrolled an additional 10 million suckers folks on ObamaPlans?

Well, aside from the fact that they repeatedly (and conveniently) fail to disclose how many of those folks had been previously insured and then lost their old plans, the results themselves are, in fact, a bitter disappointment:

"A little bit of math shows that sign-ups in 2015 came in 22% below the CBO's earlier forecast."

Ooops.

So it seems that - quelle surprise! - O'Care proponents not only moved the goalpoats, they also failed to score.

Oh well: lose some, lose some.

Health Wonk Review: Hello Summer!

Our good friend Louise Norris hosts this week's collection of interesting and thought-provoking posts on health care wonkery.

Come for Roy Poses fisking of the JEJM, stay for Jaan Siderow's excellent advice on planning for the future.

The Lighter Side of Health Care

Our own Kelley B has written about the new ICD-10 codes that providers use for billing purposes. Not everyone, though, is as up to speed as she is:

MVNHS© Doubles Down

It's been a while since we last checked in with Britain's Much Vaunted National Health System©, and it's, um ... heartening to see that they haven't lost their touch. On the one hand:

"Elderly people are being denied life-saving operations because of age discrimination within the [MVNHS©] ... New data reveal for the first time that across large areas of the country, almost no patients above the age of 75 are receiving surgery for breast cancer or routine operations"

Now, we were assured two years ago that the (infamous) Liverpool Pathway was no more. And yet, here we are:

"Last October, the Government introduced age discrimination laws which mean patients should not be denied procedures on grounds of age ... [but] Prof Norman Williams, said the scale of the differences was “extremely worrying,” raising suspicions that some parts of the NHS were operating covert blanket bans against procedures on age grounds."

That is, while the practice is technically illegal, it is at least tacitly  approved for use by the rocket surgeons who provide care to seasoned citizens. On the other hand, maybe seniors just need to pony up a bit of coin:

"Hospitals are letting patients jump NHS queues for knee and hip replacement surgery if they pay for the operations themselves."

Actually, this isn't exactly breaking any new ground. Early last year, we reported on the case of Grandma Stanton, an elderly subject of the Crown, who was denied life-saving chemo and was forced to sell her house to pay for it. She would probably have appreciated knowing that simply greasing the correct palms might have saved her home - and her life.

As it is, "[p]atients are being charged up to £14,000 for some procedures – almost treble the cost to the Health Service – leading to accusations that hospitals are ripping off the sick." So the Brit's do, in fact, have in place a tiered health care system favoring those with the cash to pay for that care. In fact, there's quite the little cottage industry amongst the various MVNHS© "trusts" (hospitals) to attract such patients:

"[M]ore than 40 trusts are promising patients they can have the ops in as little as a week – if they can afford it."

Seems like a promising candidate for GroupOn, no?

Preview of Coming Attractions

How much MORE will your Obamacare health insurance cost in 2016? We bring you a preview of coming attractions by clicking here.

Click the link.

Select "Search ACA compliant products"

Pick your state, carrier and effective date (1/1/16 suggested).

Read them and weep.

These are filed rates, not yet approved. Some rates may change if SCOTUS rules against subsidies paid for plans purchased through federal exchanges.

Monday Morning Spindle-clearing

In no particular order:

■ Our thoughts and prayers go out to the Biden family on the loss of Beau to brain cancer. The fight against this terrible disease is still on-going, but help may soon be on the way to save other families from experiencing this kind of loss:

"MD Anderson researchers identify protein with therapeutic potential for brain cancer ...  FGL2 protein is a crucial immune-suppressive factor in glioblastoma multiforme (GBM) cancer. As such, blocking FGL2 may promote GBM patients’ enhanced survival."

Still early days, but promising.

■ Courtesy of FoIB Holly R, we learn that "44% of Covered California customers report difficulty paying premiums." Of course, this must be a lie, since the President explicitly promised that rates would decrease by 3000%.

So there.

■ Regular readers know that part of that Medical Loss Ratios are a grab-bag of admin costs which carriers must use to determine whether or not they're paying out enough in claims. One controversial such expense has been agent compensation (fees and/or commissions). The Center for Consumer Information & Insurance Oversight (CCIIO) has recently clarified when that comp may not be excluded from carriers' MLR calculations (Spoiler Alert: pretty much always). Look for lower commissions and fewer agents (that's NOT a good thing, by the way).