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.