Skip to comments.Top insurer warns that Obamacare enrollment mix worse than expected [Humana, Medicare Advantage]
Posted on 01/10/2014 11:34:48 PM PST by Cincinatus' Wife
Humana Inc., the nation's fourth-largest health insurer by market share, warned Thursday that the risk pool of applicants for insurance through President Obama's health care law would be worse than previously expected.
Ever since the botched rollout of the health care law's exchanges in October, the policy community has been eager to know more about the mix of individuals signing up for insurance through the law.
Because the law forces insurers to cover those with pre-existing conditions, insurers need to attract a critical mass of young and healthy individuals with lower medical costs into the exchanges to offset the cost. But the Obama administration has yet to release demographic data on those who have picked a plan through the exchanges.
But in a filing with the Securities and Exchange Commission, Humana disclosed to investors, "as a result of the December 2013 federal and state regulatory changes allowing certain individuals to remain in their previously existing off-exchange health plans, the Company now expects the risk mix of members enrolling through the health insurance exchanges to be more adverse than previously expected."
The regulatory change Humana is referring to is the "administrative fix" announced by the Obama administration aimed at allowing individuals to remain enrolled in their current plans, which had been cancelled as a result of requirements imposed by the law. Obama announced the "fix" after a storm of criticism over his broken promise that anybody who liked their plan could keep it. Insurers had been depending on those with cancelled plans (who tend to be healthier) to end up obtaining insurance through exchanges.
Humana said that the company was "evaluating" the financial effects of the changes, but at this time, did not adjust their earnings forecast for 2014.
In the same filing, Humana said cuts to Medicare Advantage payments to private insurers made by the health care law would be steeper than expected, triggering changes to benefits.
"The Company expects to continue its standard process of seeking alternatives to minimize the disruption to Medicare beneficiaries this level of rate decline may cause," the filing read. "Such alternatives include clinical management programs, operating cost efficiencies, benefit changes, market exits and other operating strategies. In the interim, the Company also expects to continue its efforts to educate CMS, the Administration and Congress on the adverse impact such rate pressures have upon Medicare beneficiaries."
The Florida special election to replace Bill Young for one. [note typo in article - Paragraph #4 where "Jolly" is misidentified as "Peters"] Obamacare has the race fluctuating and Alan West playing a big role in the surge of Mark Bircher.
In other words, higher premiums for the responsible people.
Humana says Obamacare enrollee mix 'worse than expected' ".......Just about everything the administration has done with Obamacare so far encourages the old and sick to sign up while making it easy for the young and healthy to avoid buying insurance. What did they expect?
Health insurer Humana Inc said on Thursday that it projected its enrollment mix in private plans through the exchanges created by President Barack Obama's healthcare law will be, "more adverse than previously expected."
Humana attributed the enrollment trend to regulatory changes allowing people to remain in previously existing plans not sold on the exchanges. Obama proposed allowing insurers to keep selling plans that did not comply with the Affordable Care Act after political fallout that he was not keeping his promise that people can keep insurance plans if they like them.
Humana released its projections in a U.S. securities filing ahead of meetings next week with investors and analysts. Despite the negative projections about the exchange enrollment, Humana backed its 2014 earnings forecast of $7.25 to $7.75 per share.
The company, one of the largest providers of Medicare plans for the elderly, expected higher membership gains in its Medicare Advantage and Medicare prescription drug plans in 2014, following the enrollment period for Medicare.
No wonder we haven't heard squat from the administration about the breakdown between sick and healthy enrollees. For them, no news means that the bad news doesn't exist. Eventually, they'll get around to giving us the numbers - probably late, Friday afternoon on Super Bowl weekend......."
The reality is this. July and August will come this year, with the new 2015 rates to be published. Everyone will get this in the mail, and go berserk because it’s another twenty to forty percent more than this year, and this year was already a hefty jump up. Most everyone thought the rates would stabilize and at least stay the same for two or three years.
By September....questions will arise by the public. The news media will be in a tight position. Bad news, pointed questions, and an election period in November. What can they say or avoid saying?
But here’s the kicker. You wake up in January of 2015, and realize that you are now paying around $950 a month for family insurance, and you still have a $6000 a year deductible. So it’s roughly eighteen thousand dollars that you need to lay out possibly for health costs. What idiot will accept that? You could buy a car every single year for that. In ten years, you could buy a decent property in most rural areas of America, with a shed, barn, and twenty acres.
If you ask me....it gets bad late in 2014, but really negative by the spring of 2015 as folks wake up and realize cost never stopped spiraling upward.
Go back and look at the Roosevelt era of the 1930s and all the mistakes he made. Things look awful familiar.
Can we say “BAILOUT?”
In all seriousness, old farts have a patriotic duty to sign up for Obamacare just to wreck the economics. If young people need to sign up to make it work, old people need to sign up to make it fail.
People will panic - Obama-Reid will step in and call for Single Payer [total government control].
Any calls by the GOP to repeal Obamacare [and use common sense solutions to right this ship] will be slammed in the state media as attacking American’s and leaving them without healthcare.
I’ve been paying on average $15k/year for the last 10 years, and it’s extremely difficult. And of course there are the deductibles you mentioned.
The regime has destabilized the health insurance industry, while sticking its finger in the eye of those who’ve paid dearly to support it.
Few can appreciate the reality of what you’re foretelling.
And they will fail completely, because while that may have been their original aim, the completely inept handling of the "Affordable Healthcare Act" has most Americans wanting the federal government out of health care, not more involved. They had their chance, they blew it. They made themselves the one thing you never want to be in politics: a national joke.
My thoughts exactly, JennysCool.
Humana said that the company was “evaluating” the financial effects of the changes, but at this time did not adjust their earnings forecast for 2014 “because we’re waiting to see how big the bail out will be.”
The economy is causing crime rates to go up. That means homeowner’s and auto insurance rates will be going up, too. Food and other goods have and will continue to go up. It’s gonna’ get badder and badder. (I know that’s not a word.)
So the geniuses at Humana and the other insurers actually thought that Obumbles and his coven of university Leftiists would be able to take over the medical care of 300,000,000 Americans? I doubt it.
What they liked was the guarantee that the stupid U.S. taxpayers would bail them out if it failed. This is the part of ObamaCare that Republicans ought to repeal. If Democrats vote No, they are voting for government bailouts for Big Insurance...not something you want on your voting record in Democrat precincts.
When this repeal passes, the insurers won’t be supporting this disaster,
MD Gov Martin O'Mally- Maryland's plans for healthcare dictates and cuts [full read best]:
Jan 11, 2014: "......Under the new model, our hospitals have committed to achieving significant quality improvements, including reductions in readmission rates and hospital-acquired-conditions rates. We will limit the growth in hospital spending per capita, including inpatient and outpatient care, to the rate of growth in the state's economy. We will also control annual Medicare per capita hospital spending growth to a rate lower than the national annual per capita growth rate. Not only will this new system keep people healthier, it is expected to save the federal government at least $330 million in Medicare spending over the next five years.
The new model will complement a number of steps Maryland has taken in recent years to transition our health care system to better support health and wellness. We have built an electronic platform for medical records, which now connects hospitals across our state and serves as a common system for alerting doctors when their patients are in the emergency room, querying prescription databases to identify people abusing pain medications and generating maps of preventable disease and costs. We're also developing an innovative approach that links community health outreach and planning to primary care. And we have created Health Enterprise Zones to address persistent health disparities in five targeted areas across the state.
When the dust from today's political battles has settled, our nation will still need a health care system that works. Maryland intends to be a model for a system that prevents sickness, promotes wellness and reduces overall costs." -
More likely, what the geniuses at Humana, et al understood was an implicit threat: If you guys don't go along with this scheme, we will destroy you.
Remember the budget “compromise” that Paul Ryan and John Boehner just passed?
That funds ObamaCare for two years, and part of that funding can be used to subsidize insurance companies.
No doubt the GOP leadership will wail and shriek and beat their anguish drums, but when Obama demands the money, House Republicans will vote yes and give it to him.
In other words the death spiral....this number when it comes out will cause those red state dems to flee in mass..
Single-payer is the only ‘trick’ left in this bag of solutions. I agree.
But then, you have to establish cost thresholds for every single procedure. Does anyone really believe that if some gov’t agency dictates a process will cost no more than $550...that the hospital or doctor will just stand there and agree, when the normal expectation is $740.
It’d take five years, but almost every doctor, clinic and hospital would go to a two-star program and offer the same marginal services that you’d find in Bolivia. The only way that you’d get better services? Pay cash to the hospital.
Single-payer in America would be a short-lived solution that gets us out of the Affordable Healthcare Act. Once we realized what marginal care was about and how a government guy dictating our health resources doesn’t work....we’d voice concerns over this.
What’s left? Go back to square one? That’s the comedy of this whole mess. The more you try to fix something...the less capable it is in the end. That’s reality.
And what would happen if they vote no and don't give it to him?
The entire health insurance industry turns turtle and goes under is what.
Whereupon, there is no choice: single payer becomes the only solution.
Be careful what you wish for...
“Humana Inc., the nation’s fourth-largest health insurer by market share, warned Thursday that the risk pool of applicants for insurance through President Obama’s health care law would be worse than previously expected. “
One of the Federal Work Camp’s contractors warned that the boxcars body count tally, into the Extortion-Care Concentration Camp, would be worse than previously expected.
The theme should be to damn the government and its overbearing size. It should be, how do $600 toilet seats translate to copayments? It should be that everything the government takes on, other than world war, turns into sh¡t!
So, the thing to do is not to cut the US down to size, as has been Obama’s foreign policy, but to cut the USG down to size!
Consider how it's worked in Canada and the UK. Admittedly, your average Canuck or Limey is not the equal of a red-blooded American. But Americans elected Barack Obama twice. So, I'm not ready to trust American Exceptionalism on this issue.
Single payer must never be allowed to be tried.
RE: “A system that prevents sickness, promotes wellness and reduces overall costs.”
This is such a scam.
We are basically talking about a once a year appointment where a nurse will take your vitals.
Then, you will have a 15 minute chat with a doctor you have never met before who will counsel you about weight, smoking, diet, exercise, in other words, the same things your Mom and Dad talked to you about when you were a little kid.
If you actually have symptoms of a potential disease, you will need to make a new appointment (probably a month or more in the future) and come back for a real examination!
The number of people who will be diagnosed at an early cost saving stage of some disease will be ridiculously small.
And, 95% of the people who feel healthy will never schedule a “prevention” appointment at all.
What I'm saying is that the same Republicans who plan to ride ObamaCare to victory in November will cement it firmly in place BEFORE we have the election.
The GOP is going to do NOTHING to stop it!
“And they will fail completely, “
Enough people are dumb enough to believe the new lies they’ll tell. “It’s going to be free to you. We’ll make those evil rich people pay.” Thirty-eight percent of the populace still supports him. If the government spent $600 million dollars on advertising suicide vacations half of those people would sign up.
I know this will become more invasive and you will be required to meet health goals, or else.
I have also been pointing our for some time exactly what Humana said: while it is true that the healthier or younger insurees were supposed to subsidize the sicker or older ones, in reality even this isn’t workable. While older insureds may pay less for their plans, the benefits have been severely reduced by everything from a reduction in covered procedures to a huge rise in the deductibles and out of pocket expenses. This is going to be devastating to Medicare Advantage subscribers.
So in other words, no one benefits from Obamacare.
Except Big Government control.
Oh my, health goals, or else.
Please, God, let me wake up from this Marxist tyrannical nightmare!
It should be obvious to the most causal observer that this was an intentional failure. The powers that be will ignore the people’s wishes about Obomacare just as they have ignored our wishes on everything else. It is single payer time and was designed to be from the start. Get used to it Comrade.
Also, the “Silver Plan” pays subsidies for deductibles and co-pays, and it also caps total out-of-pocket costs each year at a much lower level.
The “Silver Plan” is essentially open to the lower income groups and will be paid for, in theory, by the unsubsidized higher income groups.
Like this in the UK
130,000 elderly patients killed every year by death pathway, claims leading UK doctor
by Thaddeus Baklinski Thu Jun 21, 2012 10:02 EST Tags: euthanasia, patrick pullicino, uk
LONDON, June 21, 2012 (LifeSiteNews.com) - An eminent British doctor told a meeting of the Royal Society of Medicine in London that every year 130,000 elderly patients that die while under the care of the National Health Service (NHS) have been effectively euthanized by being put on the controversial Liverpool Care Pathway (LCP), a protocol for care of the terminally ill that he described as a death pathway.
3.2 million think there is no point saving for old age as it will be swallowed by care bills" More than three million middle aged and retired people have effectively given up saving for their old age believing there is no point because it will only be taken away to pay for care, research shows.
Britains biggest charity working with elderly people warned that the Governments long-awaited overhaul of the care system, currently before Parliament, will fail if large numbers of people simply abandon saving for later life.
Age UK said that the new system, which will cap the amount people have to pay for care in their lifetime, relies on people being able to make a contribution to the cost and could be thrown into crisis if too many people turn their back on saving.
The system, based on the recommendations of a landmark Commission chaired by the economist Andrew Dilnot, is due to come into force in just over two years time.
It will introduce a theoretical £72,000 cap on the amount anyone has to pay for their care in their lifetime, overhaul the system of assessing whether people are frail enough to need care and prevent those who do have to pay having to sell their home.........."
There was another thread today about a feeble-minded dude who won the lottery to the tune of $500/week for life. With the help of "friends", he figured out how to convert his winnings into a lump-sum payout of 403,288 minus tax withholding. As you might guess, he managed to blow more than half the payment before a judge intervened. But, since he was a ward of the state all along, he's now in danger of losing the rest!
It all has to do with income (unless you’re among the privileged few, such as government officials and members of certain unions) and I think this was just another one of Obama’s ways of punishing people for succeeding. Obamacare is a backdoor to “income equality,” so that even people who do work and do achieve a reasonable standard of living now find this “excessive” income taken away from them and redistributed, while at the same time finding that even though they are paying more, their expenditure is buying them less, they are getting fewer benefits and their care will soon be no better than that of the average Medicaid clinic patient. Instant equality!
Of course, this does not touch the more equal animals at the top (the pigs in the WH, for example).
Sensible conservatives assumed that people who profit even from overpriced insurance with weak coverage would buy it, while those who stand to lose money but are needed to subsidize others would choose not to obey FedGov. Apparently, to some moron in the newsroom, this is "unexpected".
The federal Affordable Care Act, also known as Obamacare, excludes undocumented immigrants from being able to purchase health care through the new marketplaces states created for selling insurance. After the federal health care program is completely rolled out, experts predict that 3 million to 4 million people in California -- many of them undocumented immigrants -- will not have health care.
Some California counties offer health care to undocumented immigrants, but access varies around the state. Lara aims to make health insurance available statewide, but has not yet announced exactly how the goal would be achieved. Neither a bill number nor a cost estimate were available Friday.................
Bad news all the way around. The downward health care spiral is on.
And they will fail completely, because while that may have been their original aim, the completely inept handling of the “Affordable Healthcare Act” has most Americans wanting the federal government out of health care, not more involved. They had their chance, they blew it. They made themselves the one thing you never want to be in politics: a national joke.
Thanks for your post. It is correct on every point.
I would hope you are correct, but I suspect the Marxists in control of the US government will employ whatever amount of force and deceit is required to get to their goal. They will use the IRS, the HHS, the DOJ and whatever else they have to motivate compliance and punish opposition. Those who speak up will be targeted and silenced. Those who play along will be rewarded. It is going to take blood in the streets and mass civil disobedience to change their course IMO.
That would be interesting. According to this, Humana has profits of about $7.50 per share. Insurance companies have the smart math guys and gals, the actuaries. Long run, they'll do just fine.
Which is the reason that the feds will NOT release any valid numbers regarding the sign ups.
This is now 11 days since the end of the year, and if the computer programs still can't give accurate information...
Check comment #3 excerpt [then note the following - the rest of the story].
......”Note that Humana still projects strong growth despite the bad Obamacare numbers. They know that if things are really bad, they’ll get a government bailout - courtesy of the taxpayer.
A sickening thought considering their previous support for Obamacare.”
In defense of the insurance companies: No insurance companies would have participated in Obamacare if they thought it was likely to be a financial disaster for them. In order to get the insurance industry on board Obama needed to cover their potential loses.
Evaluating risks is what insurance companies do. They know what its like to play ball with the government.
One of the other points that people have to remember is that insurance had been heavily regulated by the federal government for years before Obamacare came along. That, of course, was one of the reasons the industry was not working as well as it might have to begin with.
So when the Feds announced they simply wanted to take over the insurance industry entirely (because that’s what’s happening), the companies just shrugged and went along. They knew that they’d make sufficient money because anything the government controls becomes a money-pit and is just another boondoggle that enriches somebody somewhere, and at the same time, they knew resistance was futile because the government would simply crush them.
Mmmmmmm....sounds more like the mistakes by Nicolai and Elena Ceaușescu.
Or maybe Juan and Evita's screw-ups?