Aetna Does Self-Funding

Patrick's had a couple recent posts on "alternative arrangements" such as MEWAs and self-funded plans (here and here), and I thought I'd throw in my 2¢ on the matter.

[ed: click here for a more detailed explanation of self-funding under the ACA]

Recently, Aetna's been pushing its version pretty hard, with emails like this:

"Are your clients looking for more options? Think bigger with Aetna Funding Advantage ... Aetna Funding Advantage plans are self-funded, which means they aren’t subject to all of the same rules as an ACA plan. And, they could help save your clients as much as 24%*."

That little * is to alert one to the fact that YMMV.

Be that as it may, it's pretty interesting that carriers are finally developing these products for the small group market (although they're literally 10 years late to the game). One presumes that this is simply recognition that there really is a market for these products, as employers struggle to stay afloat while offering (and helping pay for) group health plans.

And speaking of which, they didn't just scale down a large group product, but apparently built one specifically for smaller companies. From their online toolkit:

"Aetna Funding Advantage [is] similar to the self-funded plans traditionally offered to larger companies, but designed with smaller clients in mind."

They even have a helpful video to help explain the benefits and process of self-funding for smaller groups.

Very cool.

Medicaid Expansion Woes

Jonathon Gruber and his band of merry men and women at CMS keep finding new surprises in the cost and true impact of #Obamacare.

Recently we discovered that the man credited with counting on the stupidity of the American voter underestimated the popularity of the free health care program known as Medicaid. Instead of 12 million new Medicaid enrollees we have 15 million.

No big deal. As they say in DC, a million here, a million there, before you know it you have some serious numbers.

Now it seems that not only have Medicaid ranks expanded like my waistline during the holiday season, but these folks are costing more than anticipated.

The Department of Health and Human Services just "found that the ACA's Medicaid expansion enrollees cost an average of $6,366 in (fiscal) 2015--49 percent higher than the $4,281 amount that the agency projected in last year's report." - Maciver Institute

How can they miss by that much?

Consider that the Transcontinental Railroad covered 1776 miles. Constructed between 1863 and 1869 the two rail lines met at Promontory Point, Utah. While many facts contribute to the story, one that amazes me is that the teams started at two different points and met in the middle. One team started in California while the other in Iowa. Yet they managed to meet at a precise point.

So if two teams of laborers can travel that much distance and hit their mark with precision, why can't the high paid goofballs in DC make accurate predictions of how much #ObamacareFail is supposed to cost?

Empire State Skyrockets

Those 3000% rate decreases keep on comin':

"The Cuomo administration on Friday announced that health insurance rates on the individual market would increase by a weighted average of 16.6 percent ... Rates in the small group market will increase by a weighted average of 8.3 percent"

That individual plan hike, by the way, represents "the largest individual market hike since the [Un]Affordable Care Act began"

It's what happens when regulators try to impose caps on rates for years on end, until (eventually) the lid comes off.

It's simple physics, really.

ObamaCare #Fail?

The headline is inviting:

"ObamaCare Is Failing Exactly The Way Critics Said It Would"

And for those that are focused on the (long since broken) promises of "if you like your plan" and "3000% rate decreases" there's no small measure of satisfaction seeing "Aetna's decision to abandon its ObamaCare expansion plans" and "UnitedHealth Group's decision to leave most ObamaCare markets" and the like.

One of the great lies touted by ObamaCare supporters is that 20 million previously uninsured folks now have coverage. The lie of omission is that it fails to take into account all the folks that have lost (and who are about to lose) their coverage, and those who can't afford to use the coverage they now have.

But I would argue that these are all very tangible ObamaCare successess if one understands that the entire point of the exercise was to usher in Single Payer (ie Government-run) health care. You know, to be run by the same competent, friendly, prompt folks who run the DMV and IRS.

You're welcome.

[Hat Tip: Holly R]

Welcome to Walmart, ObamaCare-style

Via email from The Rocket Surgeons in DC©:

"Last year during Open Enrollment 2016, agents and brokers enrolled consumers in Marketplace plans at a variety of retail locations, including Walmart stores across the country. The opportunity to be in Walmart stores will be available again this year during Open Enrollment for 2017"

Can't wait.

From the agent's perspective, this may make some sense: Walmart provides the overhead (literally and figuratively) and the foot traffic. And since ObamaPlans are guaranteed issue, there's no field underwriting problem. From Walmart's point of view, it's space they already own, and having agents on-site may be a draw, bringing in folks looking for more than just a policy.

From the government's viewpoint it's also win-win: there's zero cost to HHS, and the potential for signing up additional victims insureds.

If you're a licensed agent who's completed the 2017 Marketplace training and would like more info just click here.

Oh, and please pick me up a pack of paper towels. Thanks!

The Obamacare Cheese and Meat Plate

Obamacare promised us government cheese.

New customers would get huge subsidies for insurance from the government which would give insurers millions of new paying customers. Customers would be able to keep their plans and doctors and insurers would be protected from excessive losses. The best part of all, Obamacare won't add "one dime" to the federal deficit.

Obamacare delivered us unicorn meat. 

Customers are receiving huge subsidies but premiums are rising. Many "would be" customers are still have trouble affording insurance. They can't keep their plans and in many cases they aren't able to keep their doctors either. It's been a nightmare for insurers too. They haven't been able to avoid excessive losses, even with the beloved 3 R's trying to help. The worst part of all, not one dime turned in to billions increasing the deficit.

From the Mailbag: Rules for Thee, Not for Me

Reader Brian J offers some interesting insights into the double standard between those who toil in government and ourselves:

On a related topic about this failure of taxpayer-subsidized health insurance (i.e., Obamacare), I’m surprised that no one has brought up the fact that everyone in the U.S. who is employed by the federal government – from the President, Congress, Supreme Court, and all-related branches, all the way down to the local federal civil-service worker – has affordable taxpayer-subsidized health insurance;  everyone who is employed by State governments, County governments, local governments, defense contractors, anyone retired from any of those afore-mentioned levels of government/contractors, and every company (that offers health insurance) doing any type of work for any level of government, all have taxpayer-subsidized health insurance.  (Not to mention tens of millions of more people covered under Medicare, Medicaid, etc.)

With all these employers/entities – with their grand total of many scores of millions of covered employees – providing affordable taxpayer-subsidized health insurance, how is the individual person/small business owner to seek out -- in what’s left of our so-called “free market” -- affordable health insurance coverage on his/her own?

How, indeed?

Thanks, Brian!