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Monday, July 11, 2011

Monday LinkFest

As is so often the case, these are items of interest which don't seem to merit their own, dedicated post. Still, we'd hate to miss mentioning them:

■ Buckeyes Buck BambiCare©?

Maybe so:

"More than 540,000 voters in the state have signed petitions in favor of a ballot initiative to amend Ohio’s state constitution to directly conflict with Obamacare’s individual mandate."

Assuming those half-a-million-plus signatures prove valid (and sufficient), there's a good chance that we'll see this on the ballot in a few months. The initiative is doubly-interesting: in addition to contesting the (Evil) Individual Mandate, it's worded to prevent the state from passing its own version of the federal train-wreck. Not that there's any great rush to do so: just check out our last item (below).

One of the major "accomplishments" of ObamaCare© is to move more folks off of their own private (and group) health plans and onto Medicaid. Whether or not that's such a great idea economically is, of course, a matter of great debate. What's not so debatable, though, may be whether or not it's good for our physical health:

"[S]tudies that show big mortality impacts from being uninsured show even bigger mortality impacts from being on Medicare and Medicaid, even after controlling for age and income: you are more likely to die if you are on government insurance than if you have no insurance at all." [emphasis added]

Ooops!

Clunkers and Insurance

Government Motors has added a new "service;" in addition to selling, servicing and financing your new car purchase, they'll even throw in free insurance:

"To spur sales, General Motors is offering a year's worth of car insurance along with any new GM car purchased in the states of Washington or Oregon ... The insurance ... includes both liability and physical damage coverage."

I'm reminded of an old saying.

Slow and Easy Does It (Not)

Whether or not Ohio voters are successful in blocking implementation of ObamaCare© here, at least one piece is facing an uphill battle in at least a few of the other 57 states:

"State insurance exchanges are not being set up fast enough to meet the 2014 deadline set by the healthcare law ... a number of state legislatures are at risk of handing over the central component of the reform effort to the federal government."

If your state hasn't set up its version of the notorious Exchange by '14, HHS Secretary Shecantbeserious is set to do so, like it or not. How that would play against any state-specific law barring such a move I'll leave to the lawyers to ponder.

Passages

[7/16/11: Sandy passed away last evening. She will be missed.]

Best selling author Gail Sheehy wrote a book several years ago titled "Passages". The book discusses the changes in life as we move from one stage to the next.

We start as a child, grow through the teen and young adult years and so forth. Along the way we have family issues to deal with, career changes and the loss of loved ones.

One person has graced our lives on a public forum for several years now. Sandy is a testament to a life fulfilled. In spite of adversity in many areas of her life she has proved to be a conqueror.

The last 3 years or so she has been courageously battling cancer. It started out as breast cancer then later returned and invaded several organs.

Throughout all this she has remained positive and inspiring to all who have come to know her. She has an infectious sense of humor, so much so, that her screen name is 1character, and she is truly a character.

Sandy agreed to share her story with IB readers a few years ago. While her post has not been updated until now, it just seems appropriate at this time.

Last week 1character notified her cyber friends that she was entering hospice. I dare say no one who read her post was able to keep from getting choked up. The dialogue that followed shows just how much she is loved, and how much she will be missed.

Someone suggested making donations in her honor to her favorite charity. We are glad to provide a link for those who want to contribute.

This link goes to Capital Caring, the Hospice that took such good care of our friend Sandy. If you're so inclined, please make your donation "In Honor Memory of ... Sandy Tucker." We've started the ball rolling with a donation of $36 from InsureBlog on her behalf. Please feel free to one-up that.

You may not know Sandy, but you probably know someone like her. IB readers have been generous in the past andLink we feel this is no different.

Sunday, July 10, 2011

PCIP by the Numbers

The well intentioned but poorly designed PCIP program is in poor health. Pre-existing Condition Insurance Plan (PCIP) is a bridge plan for those who cannot obtain health insurance in traditional markets (including risk pools or HIPAA conversion).

The precept is simple. If you have a medical condition that precludes you from obtaining medically underwritten health insurance and have been uninsured (for any reason) for at least 6 months, welcome to PCIP.

PCIP is guaranteed issue, regardless of your health. Not only will you be issued a policy but it will cover all your pre-existing medical conditions and their treatment.

A virtual health insurance panacea.

But the same folks that gave us Cash for Clunkers and sold 700,000 cars in 6 weeks can just barely get 20,000 folks into a health insurance plan designed just for them and this is after a year of sales pitches.

Even the recent 40% drop in premiums designed to lure in new participants appears to be sluggish.

But how well is PCIP working from a financial perspective?

I decided to ask that same of the folks at Google by entering a query for "PCIP loss reports". The first one that came up as a PDF from the state of Washington.

Here are some excerpts:

Total member months through April were 1085

"the receivable for unbilled HHS reimbursements is $4.2 M. This
amount represents an offset of liabilities, including IBNR, which will be invoiced and funded by HHS before the end of the program"


"As of April 2011 YTD, total operating expenses are $340 K and HHS Reimbursement is $6.6 M."

"For April 2011 YTD, administrative expenses are $95 K or 17.2% favorable to budget (cash basis)."

"As of May 2011, membership is at 50.1% of projected year-end enrollment. Actual YTD claims PMPM is $3,574 as compared to $5,180 budgeted claims PMPM. As illustrated in the program summary, the current 2011 allotment of funds is projected
to deplete in August of 2011."

"As of April 2011, projections indicated that PCIP-WA will use up 75% of the original federally allotted funds by August 2012."

(If you go further in to the report you find that premiums are not supporting the program. Without the heavy subsidy by HHS the program would have failed long ago.)

2011 YTD premiums are $803,278 vs YTD claims of $3,408,946 medical plus $558,981 Rx.

HHS (taxpayer) reimbursements of $3,379,891 are needed to keep the program afloat for 263 participants.

For Sept 2010 through Dec 2010 they received $251,511 in premiums vs $1,005,816 in claims.

The program is not even a year old and already running a deficit if not for the taxpayer subsidy and these numbers are on fewer than 300 people who are getting a bargain.


Friday, July 8, 2011

ObamaCare©: Another Victim's Tale

As previously noted (here and here), very few weeks go by without at least one of us having to help a client deal with the consequences of ObamaCare©. This time, it's an old friend of mine whose family is quickly exhausting their COBRA coverage, and who need to find a place to land once it's gone later this summer.

Fred and Ethel are in their early 50's, and both have health issues serious enough to earn them declines in the open market. Their 13 year old daughter, in perfectly good health, is ineligible for her own plan because neither Mom nor Dad are insurable.

Or is she?

Bob recently pointed out two potential plans that might work: the first is a Short Term Medical, the other is a quasi-limited benefit plan. Both are from the same carrier, which has apparently decided that it will continue to offer child-only plans in these configurations.

So what's my beef?

First, the Short Term Medical plan is, well, only good for a short term (6 months at a time, to a maximum of two years in Ohio). And, it excludes coverage for pre-existing conditions (including those that develop during a previous STM's term). On the other hand, it's inexpensive and it does provide some coverage.

The other plan, which we'll call HA, may cover pre-existing conditions (depending on whether they were disclosed and underwritten), and doesn't have a built-in time limit. It's basically a limited benefit plan with some additional bells and whistles. It, too, is relatively inexpensive.

Fred and Ethel, though, are basically SOL: once COBRA runs out, their only real option is a (so-called) HIPAA Plan. This is expensive, mediocre coverage, but it does cover pre-existing conditions. Another option might have been the richer benefits and lower premiums of the ObamaPool©, but they're ineligible for that because they actually played by the rules and made the responsible decision to remain insured.

Oh, Brave New System.

Grand Rounds: "It's Up To Us" edition (Here at IB!)

Next Tuesday, InsureBlog hosts Grand Rounds, the prestigious compendium of the best the medblogosphere has to offer.

Also: a great way to learn about blogs you've never heard of (but should get to know).

Our theme will be "Personal Responsibility" - only posts that address this issue will be included (BUT: feel free to reach back into your archives - any relevant 2011 post will do). Submissions MUST be received no later than Sunday (7/10/11) to be considered.

Potential contributors can submit their entries to insureblog (at) mail (dot) com, and please include the following:

■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post

Thanks!

Cavalcade of Risk #135: Call for submissions

NotWithStanding blog hosts next week's CavRisk. Entries are due by Monday (the 11th).

NB: We're now using this submission tool: The BC WorkAround

Once there, you'll be asked to provide:

■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post ("Remarks")

At the bottom of the form, you'll see a drop-down menu; simply select "Cavalcade of Risk" then press "Submit" and you're good to go.

And PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).

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