Posted in Access to healthcare, Affordable Care Act (ObamaCare), Community Underwriting, Crony Capitalism, DC & Related Shenanigans, Economic Issues, Employee Benefits, Free-Market, Government Regulations, Health Insurance, Healthcare financing, Individual Market, Individual ObamaCare Market, Insurance subsidies, Medical Costs, News From Washington, Patient Choice, Policy Issues, State-Run Insurance Exchanges, Uncategorized

Judge strikes down association health plan rule as ACA runaround

New York state and the special interests who want to maintain the ACA-dependent grip on the market are at it again.

Using a similarly contorted legal and regulatory logic that went into the design and subsequent SCOTUS justification for the ACA, a Federal District Court in District of Columbia (Judge John C. Bates) has ruled to block the Labor Department’s final rule on the implementation of Association Health Plans as an “end-run” around the ACA.

So let’s all pretend it all worked out just peachy, as the flimsy arguments made by the Plaintiffs suggest, and remove yet another financial tool which might help small businesses and individuals obtain affordable, more portable coverage!

Ostensibly and officially, the goal of the ACA was to expand affordable health insurance coverage.  Yet it has, arguably and predictably, expanded the Health Insurance Industrial complex by propping it up with tax-payer subsidized funds and making insurance MORE expensive.

And who cautions against the new AHP final Labor Department rules?  Who else but the American Health Insurance Plans (AHIP).

 “…we remain concerned that broadly expanding the use of AHPs may lead to higher premiums for consumers who depend on the individual or small group market for their coverage.  Ultimately, the rule could result in fewer insured Americans and may put consumers at greater risk of fraudulent actors entering this market.”

Really? Higher premiums? Compared to what?

In the ACA individual market insurance exchanges, single coverage premiums (unsubsidized) increased by 62% and family coverage premiums increased by 75% just since implementation of ObamaCare!

The financial life support of the community rating standards in the ACA Individual Market was contingent on a “Young-Healthy” participation rate of roughly 40%. It never happened as predicted, thus the skyrocketing premiums in the Individual Market.

The only concern of opponents of AHPs and other market reforms is to ensure that our healthcare dollars keep flowing through the channels they control.

Source: Judge strikes down association health plan rule as ACA runaround

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Individual ObamaCare Market, Medical Costs, Patient Choice, Patient-centered Care, Policy Issues, State-Run Insurance Exchanges, Subsidies, Uncategorized

California’s Public Option Would Not Rescue Obamacare | Health Policy Blog | NCPA.org

The wheels are falling off Obamacare in California. UnitedHealth Care, the nation’s largest health insurer, only participated in the state’s exchange, Covered California, for one year before deciding to bail out. Participants are much older and sicker than the Administration or health insurers expected. So, premiums are spiraling up, beyond people’s ability to pay.

Covered California is already responsible for a significant taxpayer-funded cash flow. Currently, only a very small share is borne by the state. That will change if a public option relieves beneficiaries of their sky-high premiums. Last March (after the dust had settled on Obamacare’s third open season), Covered California had just under one million policies in force, covering almost 1.4 million enrollees. Total annual 2016 premiums would amount to $6.8 billion.

However, nine of ten enrollees pay significantly discounted premiums, because the insurers who write the policies receive significant tax credits to induce them to participate. Only $2.4 billion of the estimated total 2016 premium will have been paid by enrollees. Fully $4.4 billion will have been funded by federal taxpayers. So, if the public option eliminates enrollees’ responsibility to pay premium, state taxpayers would be on the hook for $2.4 billion.

But wait, there’s more! The U.S. Department of Health & Human Services estimatesthere are 313,000 Californians who are eligible for subsidized health insurance in Covered California, but chose to buy unsubsidized individual policies outside the exchange. It is not clear why they forgo the subsidies. Perhaps they want access to more doctors and hospitals than are available in Covered California’s infamously narrow networks. If they were freed from the responsibility of paying for any part of their premium in Covered California, surely many would get onboard.

If they are similar to the current enrollees, they would add almost half a billion dollars to the state taxpayers’ tab…

(A version of this Health Alert was published by the Orange County Register.) Dave Jones, California’s Insurance Commissioner, has lifted a page from Hillary

Source: California’s Public Option Would Not Rescue Obamacare | Health Policy Blog | NCPA.org

Posted in Access to healthcare, advance-pricing, Affordable Care Act (ObamaCare), Consumer-Driven Health Care, Deductibles, Defined Contribution Benefit Plans, Direct-Pay Medicine, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Federal Exchanges, Free-Market, Government Spending, Health Insurance, Health Reimbursement Arrangement (HRA), Health Savings Accounts (HSA's), Healthcare financing, Independent Physicians, Individual Mandate, Individual Market, Individual ObamaCare Market, Individual Underwriting Standards, Insurance subsidies, Liberty, Medicaid, medical inflation, Patient Choice, Patient-centered Care, Policy Issues, Pre-existing Conditions, Price Tansparency, Private Exchanges, Quality, Reforming Medicaid, Self-Insured Companies, Self-Insured Plans, State-Run Insurance Exchanges, Subsidies, Tax Policy, Uncategorized, Uninsured

All the Problems plaguing ObamaCare are Solved by These 12 Bold Ideas

The Sessions – Cassidy bill:

Source: Summary | Goodman Institute for Public Policy Research

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, government incompetence, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Individual Mandate, Individual Market, Individual ObamaCare Market, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, medical inflation, Policy Issues, Reforming Medicaid, State-Run Insurance Exchanges, Subsidies, Uncategorized

Single-Rural Heath Care: Obamacare Insurers Retreat, Leaving Only One ACA Insurer In Some Areas – Matt Vespa

Monopoly?

Obamacare has been disastrous for health insurers, like UnitedHealth Group, billions have been wasted on state exchanges, which are hanging by a thread, and the law’s enrollment projections (calculated by the CBO three years ago) were off by 24 million for 2016. Now, more Americans are opting to pay the penalty and remain uninsured because it makes more sense for their finances. No wonder why this law is unpopular. Oh, and did I mention that premiums are projected to rise (again) this year. Given the expensive nature of the Obamacare market, some insurers are dropping like flies, giving Americans in some rural areas just one choice when it comes to their health care. Of course, some folks are worried about monopoly dynamics

Source: Single-Rural Heath Care: Obamacare Insurers Retreat, Leaving Only One ACA Insurer In Some Areas – Matt Vespa

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relations, Doctor-Patient Relationship, Independent Physicians, Medical Costs, out-of-pocket costs, Patient Choice, Patient-centered Care, Price Tansparency, State-Run Insurance Exchanges, Subsidies, Third-Party Free Practices, Uncategorized, Uninsured

It Was the Best of Days and the Worst of Days | Jeffrey Gold | LinkedIn

Jeff Gold
Jeff Gold, MD

 

Last Wednesday, January 6 2016, was a day I will not forget any time soon. It was a day that showed me the worst of our healthcare system but also the best. The week prior, a new patient enrolled with

Source: It Was the Best of Days and the Worst of Days | Jeffrey Gold | LinkedIn

Posted in Affordable Care Act (ObamaCare), Economic Issues, Employer Mandate, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Government Regulations, Health Insurance, Individual Mandate, Individual Underwriting Standards, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, Patient Choice, Policy Issues, Reforming Medicaid, Rule of Law, State-Run Insurance Exchanges, Subsidies, Tax Policy

Defending Public Policy: What’s in a Name? | Robert Nelson, MD | LinkedIn

Robert Nelson, MD
Robert Nelson Publisher & Editor, The Sovereign Patient

Let’s pretend a non-partisan, unelected committee had drafted a health reform plan to be reviewed and debated by the people of each state and then voted on with a simple up or down vote. If a minimum of 38 states passed it, then it would become the law of the land. Let’s assume this health reform plan contained the following characteristics:

Read the entire article via Defending Public Policy: What’s in a Name? | Robert Nelson, MD | LinkedIn.

Posted in Affordable Care Act (ObamaCare), Economic Issues, Federal Exchanges, Health Insurance, Insurance subsidies, Medical Costs, Policy Issues, Rule of Law, State-Run Insurance Exchanges, Subsidies, U.S. Constitution

King vs Burwell: Even Wrong-Headed Decisions Can Have an Upside | Robert Nelson, MD | LinkedIn

The Supreme Court’s ruling in King vs Burwell has some parallels to PPACA in general and the subsequent ruling 5D3_0034on the individual mandate “penalty vs tax” issue in 2012, in the way in which it may influence policy decisions downstream.  In the case of the 2012 ruling, Judge Roberts really provided us with two legal choices: obtain the kind of coverage the government deems appropriate OR pay penalty (I mean tax).  

The K v B ruling, albeit another judicially illogical head-scratcher from Chief Justice Roberts, does not create any political emergencies or policy conundrums which could lead to the adoption of hasty “remedies”; remedies that would even be harder to undo when they miss their mark.  For this small positive, those of us that favor Insurance market-friendly public policy alternatives to PPACA can be grateful.  

via King vs Burwell: Even Wrong-Headed Decisions Can Have an Upside | Robert Nelson, MD | LinkedIn.

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Federal Exchanges, Health Insurance, Insurance subsidies, State-Run Insurance Exchanges, Subsidies

SCOTUS Rulings: a twitter poll would be quicker and just as meaningful | Robert Nelson, MD | LinkedIn

5D3_0034
Robert Nelson, MD

As noted by Justice Antonin Scalia in a scathing dissent, the Court rules that the term “established by the State,” which appears seven times in the statute, can also mean “not established by the State.”

For those of us opposed to the economic catastrophe that is PPACA, this ruling may be a blessing in disguise.  More tomorrow on the intended and unintended consequences of the SCOTUS ruling.

But for starters, here is something to think about. We now know (per Gruber and many others) the portion of the law that ties subsidies to formation of State Exchange was intentional and DEFINITELY NOT an oversight as Judge Roberts as other apologists for PPACA would have us believe – leaving him “no choice” but to intervene in order to prevent chaos…. as if there was no other financial option besides the subsidies as prescribed and ineptly administered by the ObamaCare mandate.

via SCOTUS Rulings: a twitter poll would be quicker and just as meaningful | Robert Nelson, MD | LinkedIn.