Obamacare. Is it working?

[rushmc 23]

Quote

UnitedHealth Group announced last week that it was looking to end its participation in the UnAffordable Care Act, ObamaCare, during 2017. As America’s largest third-party payer for health insurance, UnitedHealth’s warning sent a message that is unmistakable — ObamaCare, as predicted, is failing.

Specifically, UnitedHealth Group’s report noted that the firm “is evaluating the viability of the insurance exchange product segment and will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.” The mammoth insurer covers half a million ObamaCare subscribers in 23 states.

The shock of the insurers is feigned. They worked tirelessly to lobby, market and “educate” about the government-run health insurance program. Only in a business model written around the financial backing of the U.S. government would such disastrous and laughable projections be utilized. Charge all the same premiums regardless of age, health status or use of services with the hope that enough young, healthy participants would pay for the more chronically ill.

Remember, ObamaCare’s early promises included, “If you like your doctor/plan, you can keep your plan.” The pretense that health providers and institutions would flock willingly to participate in a program that had indicated its reimbursement for services rendered were around Medicaid rates. What does that mean?

If you are a health provider treating two identical patients with the exact same ailment receiving identical care, one patient having private insurance and the second Medicaid, your reimbursement from the government for services rendered is about 56% of that which you will receive for treating a privately insured patient. Put another way, there are price caps in place for Medicaid patients with about 56 cents paid on a dollar of services provided.

Further, because most of the ACA exchange plans created to cover the uninsured have extremely high co-pays, physicians have changed their payment structure from fee-for-service to fee-paid-in-full-before service. Anecdotally, the “Silver” government-approved plan has a $2,500 deductible before your insurance pays one penny. Wasn’t each family supposed to save at least $2,500 on premiums or did they get their numbers confused?

ObamaCare is proving to be the predicted failure that every Republican who refused to support the legislation knew it would be — leaving only Democrats to support its massive government expansion. It’s also exposing those expecting financial benefits from the newly insured —insurance companies and hospitals. They parroted Democrat talking points about the health care system in order to curry favor in the imminent legislation. But they’re now wanting a government bailout to cover massive losses created by the monster they helped make.

The UnitedHealth Group report put into public view the $425 million the company projected to lose in its fourth quarter due to its ObamaCare offerings. The timing was impeccable — just as national headlines have featured the closure and mismanagement of the health care cooperatives in various states that are defaulting on government-guaranteed loans, as well as continued skyrocketing premiums.

Supposedly, says ObamaCare, losses incurred by participating insurers could be recouped up to 80% of that total through “risk-corridor payments.” But it seems losses are being reimbursed at just under 13% for 2014 and Marilyn Tavenner, CEO of the trade group America’s Health Insurance Plans, is demanding change for her members.

Irony of ironies, the voice demanding the Obama administration keep its promises is none other than the former administrator of the Centers for Medicare and Medicaid Services that “rolled out” Healthcare.gov. Yep, the top lobbyist for the insurers was once the one in charge of the failed program.

According to the consulting giant, McKinsey & Company, the troubles of UnitedHealth Group are echoes of troubles of other insurers that have “lost billions selling Obamacare plans in 2014, and the losses are mounting again this year.”

USA Today chronicled Tavenner’s demands: “When health plans cannot rely on the government to meet its obligations, individuals and families are harmed as a result. The administration must act to ensure this program works as intended and consumers are protected.”

Despite a provision inserted into a 2014 spending bill by Republicans that would limit insurance bailouts for losses to come only from these risk pools, the Department of Health and Human Services is now claiming it’s the “obligation” of the government to do just as the insurance lobbyist says — cover their losses.

Your tax dollars are now being demanded by the very same special interests who spent millions to lobby for this destruction of our health system through government control. Exactly how much do insurers want for their losses?

For 2014 alone, insurance companies with ObamaCare plans have requested $2.87 billion in government payments through the risk corridor program. The problem? You see, HHS only collected $362 million, which returned only 12.6% of what these insurance companies say that they are owed.

Let’s just sum this up: Insurers and hospitals, you wanted this pig in a poke, you got this pig and a poke so take your losses and either eat them or declare the obvious — ObamaCare has failed.

From "The Patriot Post"

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[normiss 763]

"From "The Patriot Post"

Nothing to see here, I'll move along.

[billvon 2,898]

>Obamacare. Is it working?

Yes. 17 million more people are now insured - which was the goal (more insurance coverage for Americans.)

The insurance companies aren't making as much money? Too bad, so sad. The goal of Obamacare was not to make them rich.

[rushmc 23]

billvon

>Obamacare. Is it working?

Yes. 17 million more people are now insured - which was the goal (more insurance coverage for Americans.)

The insurance companies aren't making as much money? Too bad, so sad. The goal of Obamacare was not to make them rich.

this post will be interesting to look at in another 6 months

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[headoverheels 330]

I'm curious as to the amount the ACA reimburses (about same as Medicaid, according to your post) vs. the amount that Medicare pays. I use a doctor/practice that doesn't accept ACA coverage, but the great majority of their practice is old folks on Medicare.

[tkhayes 327]

certainly not working the way that it should or could. I predicted this from the beginning anyway. It will fail because we are simply forcing people to buy insurance they cannot afford. Not enough regulation of the actual prices or the controls to keep costs in check.

People that could not get insurance before are thrilled I am sure - they are the happy ones. I always have had insurance but quickly becoming unaffordable.

The solution is and always was, a public option paid for by tax dollars, universal or single payer, a public/private system or several possible variations of that.

You can blame the left, the liberals, the democrats all you want, but even if the Republicans got in with majority house, senate and presidency, they have absolutley ZERO solution to control costs and will fail just as equally. And the idea fo the 'free market' is bullshit when talking about health care.

We do not, nor have we ever delivered health care in this country. we only deliver health insurance. The greatest system in the world but only if you can afford it. If you cannot, you are still fucked.

As an employer we are actively loojking into bringing subsidized insurance to our employees. COMPLETELY unaffordable, whether we buy it or they do.

It will all be replaced with a public system, eventually. The USA just has to try every other possible option (and fail) first.

[normiss 763]

Our coverage for the 2 of us went up $440 for the year.
Out of pocket went down a couple thou, monthly contribution by my employer went up, as required by law.
I've been fortunate over the course of my career by having a great job with a top employer (most of them anyway), so they've always offered good coverage.

[rushmc 23]

the plan was for it to fail

and there are other options

and the only ones that will work with NOT include government controls

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[jclalor 12]

The fact is, most people don't have the slightest idea what obamacare is.

Example:

Being a nurse in Califlornia, it's mandatory if you work in a hospital to get a flu shot. It's required by the Ca department of health. Usually, my works lags in buying the vaccine until mid-November, past the ideal time to be vaccinated.

I got my flu shot earlier at my local drugstore, for free, as required by the ACA. I tried telling countless coworkers that this was available with our medical insurance. Every time I explained obamacare required it, all I got was blank stares and shaking heads saying they didn't have obamacare. I tried telling this to the person in charge with making sure every employee had their flu shot. Again just a blank look.

[rushmc 23]

jclalor

The fact is, most people don't have the slightest idea what obamacare is.

Example:

Being a nurse in Califlornia, it's mandatory if you work in a hospital to get a flu shot. It's required by the Ca department of health. Usually, my works lags in buying the vaccine until mid-November, past the ideal time to be vaccinated.

I got my flu shot earlier at my local drugstore, for free, as required by the ACA. I tried telling countless coworkers that this was available with our medical insurance. Every time I explained obamacare required it, all I got was blank stares and shaking heads saying they didn't have obamacare. I tried telling this to the person in charge with making sure every employee had their flu shot. Again just a blank look.

to extend your point
We are still learning things about ACA

many of them are not good

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[ryoder 1,590]

headoverheels

I'm curious as to the amount the ACA reimburses (about same as Medicaid, according to your post) vs. the amount that Medicare pays. I use a doctor/practice that doesn't accept ACA coverage, but the great majority of their practice is old folks on Medicare.

This does not add up.
"ACA" is not an insurance policy.
It is a program to get people on insurance.
The policies are issued by private insurance companies.
Payments are still negotiated between insurance companies and providers.
So does your provider not accept people insured by insurance companies?

"There are only three things of value: younger women, faster airplanes, and bigger crocodiles" - Arthur Jones.

[Bolas 5]

ryoder

***
I'm curious as to the amount the ACA reimburses (about same as Medicaid, according to your post) vs. the amount that Medicare pays. I use a doctor/practice that doesn't accept ACA coverage, but the great majority of their practice is old folks on Medicare.

This does not add up.
"ACA" is not an insurance policy.
It is a program to get people on insurance.
The policies are issued by private insurance companies.
Payments are still negotiated between insurance companies and providers.
So does your provider not accept people insured by insurance companies?

Some places just don't deal directly with insurance companies. They charge the person, the person pays, then the person submits the claim to their insurance company for reimbursement.

Stupidity if left untreated is self-correcting
If ya can't be good, look good, if that fails, make 'em laugh.

[tkhayes 327]

Perhaps you could expand on the solution you propose might work because it is nowhere to be found in the right wing charters and doctrines

[JohnnyMarko 1]

tkhayes

It will fail because we are simply forcing people to buy insurance they cannot afford. Not enough regulation of the actual prices or the controls to keep costs in check.

Can confirm. My plan through the Colorado Exchange keeps going up and up, and the crazy premiums + high out of pocket actually keeps me from going to the doctor if I need to.

I said it in another thread, but Colorado is going to vote on a single payer system next year. I haven't read enough about how it will work or the numbers or how it will effect my costs, so I'm not for or against it yet.

[mirage62 0]

As I've stated before. My company pays 100% of our employee health care. Unfortunately the cost keep going up - a lot. It's a small group - 33. We have some health issues in the group. I believe in companies providing health insurance. It is seen as a big benefit to most of my employees but not surprisingly the younger employees would rather have the cash, they can go into the Obama care system and get a better policy than ours for less money BUT the catch is they wouldn't. Most would pay the fine and go without. For the first time ever I have a part time employee who cannot be on our health care. She's interesting. She is estimating her income at (most likely) lower than it will be and getting a nice credit on her insurance. As I understand it she will have to have it adjusted after the first year and she will lose some of the credit. In the end I don't know the right system other than we took a good system but pricey and put in a more expensive system that worse (IMO) but we did cover 17 million more people. If you believe that they 17 million people deserve health care no matter what than I guess your happy.

Kevin Keenan is my hero, a double FUP, he does so much with so little

[rushmc 23]

tkhayes

Perhaps you could expand on the solution you propose might work because it is nowhere to be found in the right wing charters and doctrines

actually plans have been brought up

Portable health plans

the ability for carriers to sell products across state lines

HC savings plans

Remove as much gov regulation as you can


It does not surprise me you have not seen or heard of any of these as the Clinton super PAC media will not talk about them

and there are other ideas too

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[headoverheels 330]

ryoder

***
I'm curious as to the amount the ACA reimburses (about same as Medicaid, according to your post) vs. the amount that Medicare pays. I use a doctor/practice that doesn't accept ACA coverage, but the great majority of their practice is old folks on Medicare.

This does not add up.
"ACA" is not an insurance policy.
It is a program to get people on insurance.
The policies are issued by private insurance companies.
Payments are still negotiated between insurance companies and providers.
So does your provider not accept people insured by insurance companies?

I've used to at least 5 medical providers in the past year who either had a sign at the front desk saying that they do not accept insurance obtained through the state ACA exchange, or who said that when I called to make an appointment, or both. Others may have had that policy, but I didn't notice, since I have insurance through my employer.

[headoverheels 330]

rushmc

the ability for carriers to sell products across state lines

What is the case for this reducing costs? I guess I can imagine it in low-population states that may have less "competetion," but I don't see what improvement it would have in states like CA or TX.

[headoverheels 330]

United Healthcare is an additional provider in California, starting in 2016. The total number is going from 10 insurers to 12. Insurance rates for Covered California plans are going up an average of 4% for 2016, after going up an average of 1% in 2015.

[tkhayes 327]

Quote

the ability for carriers to sell products across state lines

HC savings plans

Remove as much gov regulation as you can

none of these have anything that controls the costs, therefore the costs will continue to rise as the hospitals, doctors, lawyers are still being fed by the syetm and have nothing to stop it from going up.

It is pure delusion to think that just because I can buy a policy in Georgia rather than Florida that somehow it will be cheaper. the people in either state have exactly the same issues, the same cost structures the same everything pretty much.

What in this plan stops people from being served in emergency rooms and the bill being put onto the insured? what stops doctors and hospitals from continuously raising their fees? What stops frivilous lawsuits (or non-friviolous ones from bankruptcy)?

All of these are just a few of the factors that are causing the upward spiral of costs.

There is NOTHING in there to control costs, therefore the costs will continue to rise.

And BTW, i do not follow the super pacs to get my news or information.....I actually do the homewrok and the research.

please try again. give me an example where the cost of health care will actually be reduced if I can buy a policy in another state. Do I have to travel to that state to get coverage? Do I get a choice in doctors? Does the open market still allow doctors to lose their licenses for malpractice or does the free market really mean FREE market, meaning any doctor can hang out a chingle to get the lowest price? Are you advocating absolutely ZERO regulation of helath care across the board? I mean I am sure we can open ahospital that will do surgeries for $20/pop, but you might have to allow doctors who get mail-order degrees to operate.

[Croc 0]

tkhayes

It will all be replaced with a public system, eventually. The USA just has to try every other possible option (and fail) first.

Agreed. This lack of affordable health insurance is one of the biggest deterrents for entrepreneurship in the US. I'm a tradesman. Forty years I'd have been self employed. Today most tradesmen are working for someone who started when he was young and went without insurance. It is becoming nearly impossible to start out that way now.

"Here's a good specimen of my own wisdom. Something is so, except when it isn't so."

Charles Fort, commenting on the many contradictions of astronomy

[jclalor 12]

Quote

rushmc

***Perhaps you could expand on the solution you propose might work because it is nowhere to be found in the right wing charters and doctrines

actually plans have been brought up

Portable health plans

the ability for carriers to sell products across state lines

HC savings plans

Remove as much gov regulation as you can


It does not surprise me you have not seen or heard of any of these as the Clinton super PAC media will not talk about them

and there are other ideas too

Remove as much government regulation as you can?

Do you think that the government should license medical doctors or should the free market dictate who practices?

[kallend 1,935]

JohnnyMarko

***It will fail because we are simply forcing people to buy insurance they cannot afford. Not enough regulation of the actual prices or the controls to keep costs in check.

Can confirm. My plan through the Colorado Exchange keeps going up and up, and the crazy premiums + high out of pocket actually keeps me from going to the doctor if I need to.

I said it in another thread, but Colorado is going to vote on a single payer system next year. I haven't read enough about how it will work or the numbers or how it will effect my costs, so I'm not for or against it yet.


My premiums have gone up year after year since long before the ACA became law. It's not a new phenomenon.

...

The only sure way to survive a canopy collision is not to have one.

[cvfd1399 0]

But now they have an excuse for the increase most people can't challenge, and a governemnt who isn't stopping their bullshit. They created that part of the mess.

[JohnnyMarko 1]

kallend

******It will fail because we are simply forcing people to buy insurance they cannot afford. Not enough regulation of the actual prices or the controls to keep costs in check.

Can confirm. My plan through the Colorado Exchange keeps going up and up, and the crazy premiums + high out of pocket actually keeps me from going to the doctor if I need to.

I said it in another thread, but Colorado is going to vote on a single payer system next year. I haven't read enough about how it will work or the numbers or how it will effect my costs, so I'm not for or against it yet.


My premiums have gone up year after year since long before the ACA became law. It's not a new phenomenon.

$158.26 to $173.25 a month is a big jump for someone in my financial situation. For a shit plan I don't see why I need to pay and extra $15 a month this coming year.