The Geniuses Behind ObamaCare©

Noted rocket surgeon and ObamaCare© advocate Rep Hank "Geophysicist" Johnson (D-GA) puts us some knowledge:



Get that? "“My fear is that the whole island will become so overly populated that it will tip over and capsize.”

And this is the kind of scary-smart DC-insider who will be determining your health care.

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Heading for the Exits

Some states have learned when they put the squeeze on insurance carriers in an attempt to appear "consumer friendly," the carriers simply pick up their ball and bat and go home.

Lately we have heard a lot of saber rattling over premium rate increases. In fact, Obama and the clan used this as their drum beat to drive the vote on health insurance reform.

That, plus some heavy bribery in a vote buying scheme.

But I digress . . .

It seems the state of Massaconfusitts is following in the path of HHS Sebelius in trying to brow beat health insurance companies into submission over requested rate hikes.

Insurance Commissioner Joseph Murphy said he had disapproved 235 of 274 proposed rate increases because they included "excessive increases and rates unreasonable relative to the benefits provided."

Some of us know where this is headed.

If the carriers don't get what they need they will simply withdraw from the market. This happened with homeowners insurance in Florida. It happened in northern states when the DOI imposed suppressive underwriting rules combined with rate restrictions on health insurance.

Murphy's decision covered all 19 of the plan increases proposed by Blue Cross Blue Shield of Massachusetts, 63 of the 64 plan increases proposed by the Blue Cross HMO, all 47 proposed by Fallon Community Health Plan and all 36 proposed by Tufts Health Plan. The 33 plans offered by three out-of-state, for-profit insurers — Aetna, ConnectiCare and United HealthCare — all were approved. Each does relatively little business in Massachusetts.

There are some curious oddities in that quote.

Note that all requests for rate increases by FOR PROFIT insurers were granted.

Note also that they do "relatively little business" in MA.

I can speculate as to why it happened this way but I will let our readers form their own opinions.

Reading further this appears to be almost certainly political grandstanding and has no basis in sound principles of risk management and accounting.

If the denial stands one has to wonder where Massachutians will get their mandatory health insurance. It certainly won't be from the carriers who had their rate adjustments denied.

Smaller cars, fewer health insurance options, Poppa Washington.

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Hey AMA: How's That "Hope and Change" Workin' Out for Ya?

Today's the day:

"Doctors slated to have their Medicare reimbursements cut 21 percent on April 1 got a reprieve from the Centers for Medicare and Medicaid Services, which is delaying lowered payments until after Congress reconvenes ... The agency ...has ordered that claims submitted on or after April 1 be held for an added 10 days before being paid."

Still counting on that "doc fix?"

How's this instead?

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"Care" vs "Control"

As we've previously noted, ObamaCare© is most decidedly not about health care; rather, it is explicitly about increased government control of our lives. And now, a new addition to our pantheon of right-wing, fascist hate-mongers, the inestimable Dr Howard Dean making the case as only he can:



[Hat Tip: Big Government]

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Under the ObamaScope©: An InsureBlog Exclusive [UPDATED]

Many (most?) folks don't know that, although Medicare and Medicaid are enabled at the Federal level, they are funded and implemented at the state level. That's why, for example, Sen Nelson's "CornHustler" deal was so valuable: by insulating his state from increasing Medicaid obligations, he really "brought home the bacon."

And so it is with the majority of ObamaCare©: that which the Feds have wrought, the various States must implement. Because of relationships we've cultivated over the five years of InsureBlog's existence, we have obtained a copy of the directives that Secretary Shecantbeserious, et al has sent out explaining how each state must make ObamaCare© a "reality."

Over the next few weeks, we will be presenting selected initiatives from that directive, and offering our commentary on their efficacy and implications.

Let's start with an easy one:

"Sec. 2711. No lifetime or annual limits. As amended by Section 10101, prohibits plans from establishing lifetime limits, and annual limits beginning in 2014, on the dollar value of benefits. Prior to 2014, plans may only establish restricted annual limits as defined by the Secretary of Health and Human Services (HHS), ensuring access to needed services with minimal impact on premiums."

Now that would seem to be rather innocuous, no? We've discussed the issue of lifetime caps before, and the anxiety that they can cause folks suffering from (for example) a chronic illness.

The problem is that insurance is a risk management tool; that is, once a carrier has assessed the risk and issued a policy, it has essentially given the insured a $2 or $5 or $10 million unsecured line of credit for health care. That's a lot of money. And as we saw with Fannie and Freddie, unrestricted access to credit is not, in fact, a "good thing;" it's a way to quickly bankrupt an institution (or agency). Removing the lifetime cap may not seem like a big deal, but how does a carrier price the risk when the risk itself is a complete unknown?

One way, of course, will be to increase premiums. Substantially. Another is to offer policies with internal caps on specific items. I could find nothing in "the regs" which precluded this. So one could have a plan with "unlimited lifetime benefits," yet annual maximums or limits on specific conditions or types of expenses.

A real "win-win," right?

UPDATED: As Bob notes in the comments, and as I've confirmed with "inside sources," the price increase to "lift the cap" is estimated at about 2%. So it is possible to "price the risk," and it isn't (at first blush) a major increase.

On the other hand, "2% here, and 2% there, and pretty soon you're talking some real dollars." The problem becomes one of "mission creep:" just how many of these 2% "hits" will we pile on policies until they become prohibitively expensive?

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Health Wonk Review: "Special Edition"

Over at the Healthcare Technology News blog, Rich Elmore hosts this week's collection of wonky and informative posts on health care.

Right-brainers will find Joel Ohman's handy "Change Chart" most helpful in navigating the what and when of ObamaCare©.

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