Posted on 08/11/2016 10:45:56 AM PDT by Red Badger
The next president could be dealing with an ObamaCare insurer meltdown in his or her very first month.
The incoming administration will take office just as the latest ObamaCare enrollment tally comes in, delivering a potentially crucial verdict about the still-shaky healthcare marketplaces.
The fourth ObamaCare signup period begins about one week before Election Day, and it will end about one week before inauguration on Jan. 20. After mounting complaints from big insurers about losing money this year, the results could serve as a kind of judgment day for ObamaCare, experts say.
“The next open enrollment period is key,” said Larry Levitt, senior vice president of the Kaiser Family Foundation.
The Obama administration has struggled for several years to bring young, healthy people into the marketplaces, which is needed to offset the medical costs of older and sicker customers.
These problems are coming to light this year, as insurers get their first full look at ObamaCare customer data. Some, like UnitedHealth Group, say they’ve seen enough and are already vowing to leave the exchanges.
Levitt and other experts warn that if the numbers don’t improve this year, more insurers could bolt. That would deal a major blow to marketplace competition while also driving up rates and keeping even more people out of the exchanges.
Already, many insurers this year are proposing substantial rate hikes with the hopes of making up for higher recent medical costs. The average premium increase next year is about 9 percent, according to an analysis of 17 cities by the Kaiser Family Foundation. But some hikes are far higher: Blue Cross Blue Shield has proposed increases of 40 percent in Alabama and 60 percent in Texas.
Levitt said the premium hikes could be “just be a one-time market correction” in the still-new marketplace. But if insurers continue to lose money, it could be a sign of bigger problems.
Republican nominee Donald Trump has vowed to undo ObamaCare, but it could be a tough test for Hillary Clinton, President Obama's potential Democratic successor.
Clinton has already laid out plans to help boost enrollment by making coverage more affordable for people who are still priced out of ObamaCare.
Like Obama, she vowed to invest in advertising and in-person outreach to help more people enroll. Clinton would also increase ObamaCare subsidies so that customers spend no more than 8.5 percent of their income on premiums — down from 9.5 percent under current law.
She has also proposed a tax credit of up to $5,000 per family specifically to offset rising out-of-pocket costs — a side effect of cheaper plans offered under ObamaCare.
But other experts say the problems could lie deeper and that it would take a major shift in ObamaCare’s customer base to offset those massive medical costs.
Insurers have fretted for years about lower-than-expected enrollment through ObamaCare.
Last year, more than 11 million people bought coverage through the exchanges. While that figure beat the Obama administration’s expectations for 2016, it’s a huge drop from the Congressional Budget Office’s initial projections that 21 million would be enrolled by that time.
Now, several high-profile insurers are raising new concerns about the healthcare law’s mix of customers and questioning whether their companies can keep selling ObamaCare plans.
Part of those concerns stem from distrust of the Obama administration after its key marketplace stabilization program — known as risk corridors — was too cash-strapped to pay back the insurers. In the first two years of the healthcare law, more insurers than expected have ended up with balance sheets in the red. As a result, the risk corridor pool was left with only about $1 to cover every $10 in claims.
But those risk corridor payments, as well as from a similar program called reinsurance, have played a major role in controlling costs for insurers.
A recent study by the nonprofit Commonwealth Fund found that medical claims were only 2 percent higher than insurers projected, after taking into account the reinsurance payments.
In some corners, though, insurer complaints are seen as fresh evidence that ObamaCare marketplaces are on the brink.
In the last month, two major insurers — Aetna and Anthem — both reversed course on their plans to expand in the marketplace. Now, all five of the nation’s largest insurers say they are losing money on the exchanges.
“From a policy point of view, we’re basically seeing the exchanges unravel,” said Michael Abrams, a healthcare strategist with Numerof & Associates who consults for insurers including UnitedHealth Group.
“More than anything else, it’s a serious symbolic blow to ObamaCare,” he said.
The two companies’ abrupt decisions to pull back from ObamaCare have baffled healthcare experts. Both Aetna and Anthem had previously been optimistic about the marketplace, unlike UnitedHealth, which had been cautious from the start.
As recently as this spring, Anthem said it was “well-positioned” to stay in the marketplace, and Aetna said it was in a “very good place."
None of the top five companies — which also include UnitedHealth, Cigna and Humana — had been major players in the ObamaCare marketplace and are unlikely to cause sudden rate hikes for most customers. They’re also unlikely to have a major effect on competition next year, though some people could see rate hikes in the local markets where the carriers are exiting.
Some experts say the insurers’ moves this year could be part of a strategy to drive more changes to the marketplace over time.
“I’ve been dealing with insurance companies for many years, and it is often the case that insurance companies say, ‘Gee, things are horrible, business is horrible, we’re going to pull out,” said Leighton Wu, a professor of health policy at George Washington University.
“Some of it is a posturing thing, this is what companies do,” added Wu, who also sits on the board of the D.C. Health Exchange.
"Some insurers will say, ‘We’re unhappy, we’d like to get paid better.’”
Yep, a mere way station to Single Payer.
I wish that idiot John Roberts would have understood that.
Trump is the only one who can handle it and turn things around. Period.
John Roberts was TOLD how to rule..or else.
Democrats demand health not car, home insurance paid by your boss, because they are lying frauds.
Trump slander.
Trump does not believe in Govt healthcare. All his employees get private insurance. Another Trump slander.
As BO’B found just after his first election win, those Tsunamis can be devastating. This next one will just happen to be on America’s soil rather than Japan’s.
The TSUNAMI will be named TRUMP and it will wash the countryside to rid the trash from every corner of our hallowed halls, our communities. TRUMP TRUMP TRUMP!!!!!
The time is now TRUMP TIME and the church bells are ringing, calling for the faithful to do the right thing. Make AMERICA Good Again.
You missed my point entirely. And spare me your boiler plate response that does not address the issue. We already have the other programs for the poor and the veterans, the issues there are mismanagement. But there are people out there that have no money and are too lazy to fill out a simple form. The governments of every state along with the federal government have made it mandatory that these people have to be taken care of when they show up to the emergency room. If the hospital cannot collect from the patent then they have to eat that cost. This is one of the big reasons that those of us that do pay have to pay so much. This is what Trump is trying to address, if you are going to mandate that a hospital treat someone, then you should be on the hook for the bill, not the hospital.
Have no fear! Senator Cruz will be a leader in the upper chamber and assist President Trump in overhauling our health care system!
Or on the other hand, looking to a 2020 campaign with an "I told you so!" message, he just might be the turd in the punchbowl and let Trump fail miserably.
ObamaCare is melting down as I type, but the state controlled media will not report on it. Same story with the homeless.
5.56mm
“I believe in market-driven healthcare.”
I do as well.
We have Christian Healthshare and pay $325 a month for $500 deductible with unlimited payout.
We used it once and actually were only $390 out of pocket for a $7,900 procedure.
We were quoted $1,000 a month for a $10,000 deductible from Obamacare. If we were on Obamacare we would have been out $7,900 plus $1,000 a month.
This is a proof that government is wasteful and private industry is far more efficient.
Best!
“if you are going to mandate that a hospital treat someone, then you should be on the hook for the bill, not the hospital”
Payment could often be made at Medicare rates from Social Security accounts.
Tax refunds and Earned Income/Child Care Credits could be withheld and certain deductions (dependents, mortgage interest) barred until the Social Security account debit is fully reversed.
Earned Income (and Child Care) Credits could be placed in Medical Savings Accounts.
High-priced drugs might be required under federal law to be sold by hospitals on a consignment basis. The drug company would bill the patient (getting a clot-buster), so the hospital’s finances wouldn’t be hurt if a $5,000/dose drug wasn’t paid for by a patient.
“America’s healthcare system from a free market model”
There hasn’t been a relatively free market in healthcare for over 100 years.
“Replace it with MARKET-BASED reforms (get the government out of health care business)”
Article I Section 8
“The Congress shall have Power .... To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries;”
That’s where the government gets the power to issue patents that allow drugs to be expensive.
“And To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers”
And that’s why the government is in the health care business via the PPACA to deal with the natural inclination of health insurers to refuse to sell insurance to people that need to have expensive drugs.
This is what Trump is trying to address, if you are going to mandate that a hospital treat someone, then you should be on the hook for the bill, not the hospital.
Point taken. And it sent me back to Trump's website, which provides details on his healthcare reform, and it all sounds good.
Also aren’t there elements of the law that were delayed until after the election that kick in in 2017? Don’t now recall what they were but I remember reading aboUT them.
Probably.............
“If Trump is president, the MSM will blame Trump for it all.....”
No, they’ll blame Bush. They won’t start blaming Trump until after he’s gone. And if he should not get elected, they’ll still blame Trump, or Bush, Reagan, Or Lincoln, or...........
red
Repeal and replace the ‘Rats ...
You’ve planned or done well. Our same medical advantage plan has gone from 70 plus dollars to 520 each over the same time. Many of my medications (all generics) have gone up by 2 or 3 hundred per cent triggering a max out on prescription expense by October and with two medications taken off the prescription coverage list (formulary I think they call it). I’m not in good health by any means and am being kept alive artificially with medicines and other treatments. My exercise/walking is limited by physical deterioration. It ain’t fun but it’s better than the alternative.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.