David Harlow hosts this week's on-air analysis of the most recent Health Wonk Review. Tune in at 1:00PM (Eastern) for the livestream, or listen in later for the recorded version.
Selasa, 10 Mei 2016
Self-awareness & PPACA
It's no surprise that the so-called "Marketplace" is a disaster. Whether it's missing enrollment goals or drastically underestimating claims, there've been very few positives.
But this article may have inadvertently summarized all that's truly wrong:
"In fact, the exchanges are quickly turning into toxic pools of surprisingly expensive patients who seek coverage when they need treatment and then drop out."
It's only a "surprise" to folks who blindingly and uncritically accepted that removing underwriting from insurance was always going to result in a disproportionate population of sickly folks. The only "surprise" here is that anyone truly believed otherwise, specifically after its chief architectspecifically admitted bragged about it..
Self-awareness: how does it work‽
[Hat Tip: Ʀєfùsєηíκ]
But this article may have inadvertently summarized all that's truly wrong:
"In fact, the exchanges are quickly turning into toxic pools of surprisingly expensive patients who seek coverage when they need treatment and then drop out."
It's only a "surprise" to folks who blindingly and uncritically accepted that removing underwriting from insurance was always going to result in a disproportionate population of sickly folks. The only "surprise" here is that anyone truly believed otherwise, specifically after its chief architect
Self-awareness: how does it work‽
[Hat Tip: Ʀєfùsєηíκ]
Senin, 09 Mei 2016
More Tar Heel State Blues [UPDATED]
It's apparently not enough that North Carolina's Blue Cross franchise has been taking major poundings; it now appears that the reverberations are affecting providers in an even more direct way:
"[T]he many medical practices and clinics not getting paid by the insurance giant. Some of them are on the brink of shutting down."
When you have a virtual monopoly in terms of insurance coverage, and you stop paying the bills (whether by design or not) then providers are left holding the bag. After all, their creditors don't care a whit about whether or not Blue Cross has computer and/or personnel issues. They want to be paid.
Now.
And it's not just "the little guys." One major surgicenter is on the hook for over three quarters of a million dollars, with no end in sight.
Me thinks it's going to get uglier still.
UPDATE: It occurs to me that, ultimately, these providerscan will just go back to the patients themselves for the missing funds. Granted: blood, turnip, some assembly required. But even a few shekels may make the difference between staying open and shutting down.
[Hat Tip: FoIB Jeff M]
"[T]he many medical practices and clinics not getting paid by the insurance giant. Some of them are on the brink of shutting down."
When you have a virtual monopoly in terms of insurance coverage, and you stop paying the bills (whether by design or not) then providers are left holding the bag. After all, their creditors don't care a whit about whether or not Blue Cross has computer and/or personnel issues. They want to be paid.
Now.
And it's not just "the little guys." One major surgicenter is on the hook for over three quarters of a million dollars, with no end in sight.
Me thinks it's going to get uglier still.
UPDATE: It occurs to me that, ultimately, these providers
[Hat Tip: FoIB Jeff M]
DIAM '16: Week 2 Factoids
As Disability Insurance Awareness Month continues to roll out, the Council for Disability Awareness points out that:
- Less than 20 percent of millennials have more than $5,000 in emergency savings.
- College-educated millennials face the highest student loan burden of any generation – according to Edvisors, the average 2015 graduate faced a whopping $35,000 of debt.
- In a recent CDA study, 40 percent of millennials said they would consider disability insurance if they knew more about it.
- In that same study, more than a third of millennials said they couldn’t last three months without their income.
What's perhaps even scarier is that this is far from limited to millenials:
"47 percent of Americans "can’t pay for an unexpected $400 expense through savings or credit cards, without selling something or borrowing money."
That's a minor fender bender or medical procedure, let alone a major wreck or cancer. And if you can't pay for that, where are the groceries and rent coming from?
Something to think about.
"47 percent of Americans "can’t pay for an unexpected $400 expense through savings or credit cards, without selling something or borrowing money."
That's a minor fender bender or medical procedure, let alone a major wreck or cancer. And if you can't pay for that, where are the groceries and rent coming from?
Something to think about.
Jumat, 06 Mei 2016
Buh-Bye, Bronze!
First they came for HSA plans. Now it appears that the Rocket Surgeons behind the ObamaTax are about to drive out the most affordable least expensive (outside of Cat plans, which are available only to relatively few) plan design left:
"Insurers -- who might not be allowed the huge rate increases they need to stay solvent --- are looking to save money by eliminating so-called Bronze-level plans."
Briefly, those 3000% rate reductions were always a lie; carriers keep having to come back for ever greater rate increases to offset significant losses. Folks who choose Bronze level plans are looking to minimize their premiums, banking on avoiding substantial losses that would diminish those savings with higher out-of-pocket costs.
But this presents a problem to the carriers:
"In order to achieve solvency, the ObamaCare exchanges require 40% of their customers to be young and healthy enough to pay large sums over time into the markets without taking out much in benefits."
The problem is that there's no evidence that this goal has been met, and ample evidence that it hasn't:
"As of December 2015, only 28% of enrollees were between the ages 18-34"
Missed it by that much!
Losing Bronze tier plans means even fewer choices, and thus more expense. It's almost as if the whole process was doomed from the start.
Hunh.
[Hat Tip: Rich Weinstein]
"Insurers -- who might not be allowed the huge rate increases they need to stay solvent --- are looking to save money by eliminating so-called Bronze-level plans."
Briefly, those 3000% rate reductions were always a lie; carriers keep having to come back for ever greater rate increases to offset significant losses. Folks who choose Bronze level plans are looking to minimize their premiums, banking on avoiding substantial losses that would diminish those savings with higher out-of-pocket costs.
But this presents a problem to the carriers:
"In order to achieve solvency, the ObamaCare exchanges require 40% of their customers to be young and healthy enough to pay large sums over time into the markets without taking out much in benefits."
The problem is that there's no evidence that this goal has been met, and ample evidence that it hasn't:
"As of December 2015, only 28% of enrollees were between the ages 18-34"
Missed it by that much!
Losing Bronze tier plans means even fewer choices, and thus more expense. It's almost as if the whole process was doomed from the start.
Hunh.
[Hat Tip: Rich Weinstein]
DIAM '16: Real Life
I've always discounted the 'value' of group (aka employer provided) life and disability insurance. Typically, these are designed not to be there when you need it. No, I don't mean that they won't pay off on a claim, but rather that they're typically not actually in force at claim time (eg new job, unemployed or retired, etc). The challenge has always been that this is a judgement call; that is, I had no way to objectively quantify it.
Until now, that is, and at least for the disability portion:
I've been working on a case for a well-compensated local exec, whose paycheck renders her eligible for up to $12,500 a month benefit. She already owns a $5,000 per month policy on her own, and her employer-paid group disability plan provides an additional $7,500 to that.
Those playing along at home will notice that this seems to indicate that my client can't buy any more on her own: $12,500 less the $5,000 private plan and the $7,500 group cover equals zero.
But a funny thing happened:
It turns out that the two carriers I contacted about this case both offered an additional $4,000 a month benefit. Which tells me that they've discounted the group plan by almost 50%. So at least in this instance, I can put a quantifiable value on that group coverage.
Interesting, no?
Until now, that is, and at least for the disability portion:
I've been working on a case for a well-compensated local exec, whose paycheck renders her eligible for up to $12,500 a month benefit. She already owns a $5,000 per month policy on her own, and her employer-paid group disability plan provides an additional $7,500 to that.
Those playing along at home will notice that this seems to indicate that my client can't buy any more on her own: $12,500 less the $5,000 private plan and the $7,500 group cover equals zero.
But a funny thing happened:
It turns out that the two carriers I contacted about this case both offered an additional $4,000 a month benefit. Which tells me that they've discounted the group plan by almost 50%. So at least in this instance, I can put a quantifiable value on that group coverage.
Interesting, no?
Kamis, 05 Mei 2016
Two Fine(s)!
■ Several months ago, we noted that MetLife was having some "issues" with the Feds about how they're (potentially) "too big to fail."
Well that was then, and this is now, and now is really painful for the erstwhile insurance behemoth:
"MetLife’s securities sales unit today was fined $20 million and ordered to reimburse $5 million to customers for wrongdoing related to sales of replacement variable annuities from 2009 to 2014."
Ouch!
Variable annuities often get a bad rap, but they're also fairly sophisticated instruments (as opposed to fixed products), which means extra-strength due diligence in their sale.
As Met is (painfully) learning.
■ FoIB Jeff M has been indispensable in keeping us apprised of the travails of the Tar Heel State's Blues, and today offers this update:
"North Carolina's insurance commissioner says he expects to issue big fines against Blue Cross and Blue Shield for technology problems that have resulted in insurance coverage and payment problems for thousands of customers."
And by "big fines" they apparently mean "millions of dollars," which certainly qualifies as "big," even by Blue Cross standards.
That's gonna leave a mark.
Well that was then, and this is now, and now is really painful for the erstwhile insurance behemoth:
"MetLife’s securities sales unit today was fined $20 million and ordered to reimburse $5 million to customers for wrongdoing related to sales of replacement variable annuities from 2009 to 2014."
Ouch!
Variable annuities often get a bad rap, but they're also fairly sophisticated instruments (as opposed to fixed products), which means extra-strength due diligence in their sale.
As Met is (painfully) learning.
■ FoIB Jeff M has been indispensable in keeping us apprised of the travails of the Tar Heel State's Blues, and today offers this update:
"North Carolina's insurance commissioner says he expects to issue big fines against Blue Cross and Blue Shield for technology problems that have resulted in insurance coverage and payment problems for thousands of customers."
And by "big fines" they apparently mean "millions of dollars," which certainly qualifies as "big," even by Blue Cross standards.
That's gonna leave a mark.
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