Tag Archives: Obamacare

Obamacare demise of the health insurance broker

An article in the Thanksgiving edition of the Atlanta Journal-Constitution shows the myriad inconsistencies and irrationalities of the new health insurance overhaul law — dubbed “health care reform” — and spells out how the federal government is paving the way for the demise of the health insurance broker. Easy To Insure ME has the answers

Some incredible excerpts taken directly from the story, and my highly insightful comments:

“The process of creating this new way to shop for health insurance will be costly and enormously complicated.” — Duh, they want to reinvent the wheel…of course it’s going to be expensive and cumbersome! Imagine, if you will, the federal government requiring the states to come up with a plan to create a new distribution system for consumers to buy food products, even though we already have  a system called “the grocery store.” A daunting task? You bet! And frankly, not necessary.

“States that take on the task of running an exchange will have a significant amount of discretion that will determine the level of competition, the amount of choices for consumers and ultimately whether market forces work to help control insurance costs, as the law intends.” — So, the Obama Administration and Congress believe that the states should control competition among privately owned businesses, and also allow them to determine whether or not to allow the market to control costs. Yeah, show me any state or federal agency that allows the American public to determine how much taxes are taken and what is spent by the government, and I will show you a pit bull that prefers bon bons over raw meat. The states will determine whether or not the market should dictate costs? Which way do you think they will go with that…set the costs themselves, or allow the market to do it?

“Anybody who shops on the Web today for products where they can go up there and put in preferences and pull up a set of choices that are relevant to those preferences, for a hotel or an airline or whatever, that is the vision of the exchange for health care,” said Joel Ario, director of the Office of Health Insurance Exchanges at the U.S. Department of Health and Human Services. — OK, if that isn’t seen as an overt indication that the Obama Administration and its operatives consider the broker to be completely irrelevant in the health insurance distribution process, then I don’t know what does. It is reminiscent of earlier this year, when a staff blogger at USA Today wrote that the health exchange system originally proposed by the House would imitate Travelocity, since the fed would control the entire thing, which the Senate version (closer to what we now have) would allow the states to manage it. It appears, however, that Mr. Ario, a onetime Pennsylvania insurance commissioner who worked directly with carriers and brokers, has swallowed the Kool-Aid and seems to think that providing health care coverage is as easy as reserving a room at Motel 6.

“Most employees of large companies should expect to continue to get their coverage at work, experts said. But some small and medium-size employers could end up dropping their coverage and shifting their workers to the exchange. How many companies might do that is a big unknown.” — speaking as an experienced journalist who seeks to back up blanket statements with facts, I have to say that this is one of the most irresponsible and egregious acts of unprofessional journalism I have seen in recent memory, and also one of the biggest misconceptions if not outright lies proffered by those in favor of state-run health insurance. What facts does the writer use to back up her assertion that “most employees of large companies” will continue with employer-sponsored coverage? Did she quote any employers, to at least show anecdotally that employers will keep employees covered? Or is she relying simply on unnamed “experts,” whose affiliations are conveniently omitted from the story? And “some” small and mid-size companies could put workers on the exchange? Is this again from the “experts?” Or is this complete conjecture? It appears to be. At least the writer is being upfront when she states that it is a “big unknown,” but making such concrete statements such as “most” and “some” and then admitting that it is really unknown, is poor form. In reality, we might see a majority of American workers form both large and small firms pushed onto the exchanges, where they will not only have to find their own insurance (required by law), but pay for it out of their own pockets, at rates that will likely be higher than what the employer was paying in the first place. Nice.

“The way the law is written, some employers will be penalized for failing to offer coverage. But paying the penalty might be more cost-effective than providing the coverage.” — Strike the word “might” and replace it with “will,” and this statement will

Health insurance quotes reform Obamacare updates

Health care spending projections for the next decade, published in the journal  Health Affairs last week, appeared to have a little something for everyone. Prepared by Medicare’s Office of the Actuary, the report notes that health care spending will increase 0.2 percent faster than previously projected due to the health reform law’s many changes to the system. As a result, The New York Times proclaimed that the “health plan won’t fuel big spending,” causing an annual spending increase of 6.3 percent rather than 6.1 percent. The Christian Science Monitor, on the other hand, warned that reform will definitely cause health insurance costs to rise and that Americans should be on guard for big increases in 2014 when many of the law’s major provisions kick in. Spending on health insurance is expected to increase 12.8 percent in 2014 as millions of uninsured Americans gain coverage. However one interprets the results of the report, it is clear that rising health care costs remain unfinished business.

ARIZONA: The Senate has established an Ad-Hoc Committee on the Impacts of Health Care Reform Implementation. The Committee will hold its initial meeting later this month. The preliminary agenda includes: Arizona Health Care Cost Containment System (Medicaid) requirements; insurance reforms; impacts on health care providers; and tax implications. Members appointed to the committee include AHIP retained counsel, clinical and employer representatives, and representatives of the Goldwater Institute, a conservative think tank.

COLORADO: The Division of Insurance (DOI) has applied for a million health insurance exchange grant. If awarded, the funds will be used for research and developing recommendations for implementation of an exchange. Specific areas mentioned include modeling on adverse selection, value choices, increasing actuarial staff and determining the actuarial effects of benefit packages within an exchange and in the external regulated market. The Department of Regulatory Agencies finalized three regulations that define the standardized electronic identification and communications systems to be used by all health plans operating in Colorado. The regulations are the result of 2008 legislation requiring carriers to use systems certified by the Committee on Operating Rules for Information Exchange (CORE). Carriers must be able to demonstrate their compliance by Sept. 1, 2012.

DELAWARE: The Department of Insurance (DOI) has issued a bulletin regarding recently enacted legislation that prohibits rescissions based on medical claims underwriting. The legislation signed into law by Governor Markell on August 30th prohibits rescission, cancellation, or limitation once an enrollee is covered, except in cases of fraud or intentional misrepresentation of a material fact. Effective Sept. 23, 2010, prior approval by the Commissioner or her designee is required before a health insurer may rescind, cancel or limit existing coverage based on written health or medical information.

LOUISIANA: The DOI has applied for a grant related to health insurance exchanges. Aetna, along with the Louisiana Association of Health Plans, will participate in a meeting with the DOI to discuss the grant and other issues related to health care reform.

NEW JERSEY: The Department of Banking & Insurance (DOBI) last week issued a bulletin providing template contract riders that insurance carriers can use for the large group market and the (non-reform) individual and small employer markets to describe changes to comply with the Patient Protection and Affordable Care Act (PPACA). The rider templates, which may be used by carriers without submission to DOBI for formal review or approval, address the following health benefit plan requirements: Extension of coverage to dependents; annual and lifetime dollar limits; first-dollar coverage of preventive services; limitations on preexisting condition exclusions; and rescissions. A carrier not using the rider template must submit their own forms for DOBI’s formal review and filing, or approval to bring benefit plans into compliance by September 23, 2011.

OKLAHOMA: DOI Commissioner Kim Holland and staff hosted an informational stakeholder meeting last week to discuss the DOI’s plans for creation and implementation of Oklahoma’s exchange under the PPACA. DOI intends to use issue-specific working groups to manage the task going forward. The state’s online Medicaid enrollment process went live September 7 and processed over 2,000 applications with a 60 percent approval rate the first 28 hours. Over 400 apps came from hospitals that provided overwhelmingly positive feedback. This web tool was referenced as a possible “starting point” of the exchange’s eventual infrastructure. The DOI submitted an application for a million Exchange Planning Grant in August and expects to hear a decision from HHS by the end of this month. If