Affordable Care Act, ObamaCare, plans pose actuarial and rate challenges for insurers, rate to skyrocket in 2015

By Jay Hancock, Saturday, April 26, 3:06 PM  -  Washington Post  -  E-mail the writers

With the results sure to affect politics as well as pocketbooks, health insurers are preparing to raise rates next year for plans issued under the Affordable Care Act.

But how much depends on their ability to predict how newly enrolled customers — for whom little is known regarding health status and medical needs — will affect 2015 costs. 

Republicans have been sharply critical of the rule and of the many ways people can skirt it.

“We’re working with about a third of the information that we usually have,” said Brian Lobley, senior vice president of marketing and consumer business at Pennsylvania’s Independence Blue Cross. “We’ve really been combing the data to get a first look.”

At stake are price increases that buyers on the federal exchange, HealthCare.gov, and other online marketplaces will encounter when they get renewal notices this year. Forecasting success or failure could also affect whether insurers stay on the exchanges, a key pillar of the health overhaul.

The 2014 enrollment period closed at the end of March for most consumers. But carriers selling medical plans on HealthCare.gov must file initial 2015 rate requests with federal regulators in late May or June — even though they have little idea about the health and potential costs of their newly enrolled members. Deadlines also loom for state-run exchange filings.

WellPoint, the biggest player in the online exchanges, is talking about double-digit rate hikes for 2015. Such increases would give ammunition to Republican critics before the November elections.

Analysts’ expectations vary, but nobody is predicting decreases.

“We’ll see rate increases in the marketplaces, but I think it’s anyone’s guess” about what the precise changes will be, said Sabrina Corlette, project director at the Georgetown University Center on Health Insurance Reforms. “It’s like nailing Jell-O to a wall.”

The health law required insurers to accept all applicants this year for the first time without asking about existing illness. That reduces what they know about customers and raises the likelihood that they’ll sign sicker, more expensive members who were previously denied coverage.

At CoOportunity Health, a nonprofit carrier in Iowa and Nebraska, many enrollees scheduled medical treatments — including surgeries — as soon as possible after their coverage began Jan. 1, said chief operating officer Cliff Gold. Among the procedures were several expensive transplant operations, including heart and lung procedures that can cost more than $1 million each.

But insurers tend to receive pharmaceutical claims long before hospital bills. They are poring over these early prescription records for clues about new members’ medical status.

Pharmacy-benefit manager Express Scripts published data April 9 showing that marketplace enrollees in January and February were substantially more likely than average to have HIV infections, chronic pain, depression and other high-cost ailments.

But that doesn’t necessarily mean average costs will soar.

For one thing, insurers figured they would cover more sick patients this year and priced plans accordingly. Early pharmacy data at Independence Blue Cross, Lobley said, are “on par for what we expected.”

Even if carriers signed more chronically ill customers this year than planned, the health law includes “reinsurance” and other safety valves designed to keep high-cost members from pushing up rates.

A sign-up surge at the end of March is another reason not to rely on early claims information.

Just as the first enrollees were more likely to need immediate care, insurers think people who pushed the deadline may be healthier and younger. If so, they would balance the risk and help cover the cost of the early birds.

“It’s clear that sick people were signing up” for January coverage, said David Axene, a fellow of the Society of Actuaries working with insurers to set 2015 rates. “The question now is, were the later people healthier?”

Nobody knows. While March enrollees seem to have been younger on balance, their health status remains largely a mystery.

Blue Shield of California signed more than 50,000 people during the last two weeks of March.

“It’s still too early to draw conclusions,” said Amy Yao, Blue Shield’s chief actuary. “I have the best actuarial team in the whole country. Even with that, it’s less than 50 percent confidence” that they’ll hit the rate-setting sweet spot for 2015, she said.

It’s unclear how many of the 8 million who enrolled through the exchanges were previously uninsured. Many who did have coverage switched carriers this year, meaning their new insurers couldn’t see their health histories.

At CoOportunity Health, a start-up created with funding from the health law, every one of the 74,000 customers is new.

“It is an actuarial nightmare to try to guess what you’re going to get,” Gold said.

It’s not just member health that insurers have to think about. President Obama allowed many people to keep old plans that aren’t compliant with ACA rules. Carriers must calculate how that exception (people covered under old plans are thought to be healthier on average) affects average costs in their new policies.

Backup resources for plans with disproportionate shares of sick and expensive members will become a little weaker next year. Insurers have to factor that into their rates.

And they need to look at the big picture.

What economists call the cost trend — how high prices rise per procedure and how many procedures Americans get this year — may be the biggest variable in setting prices for 2015, experts said.

And the trend seems to be up. After several years of relatively tame increases that many tie to a sluggish economy, medical spending accelerated late last year.

Even so, the forces affecting 2015 premiums may not drive up ACA prices as much as some are forecasting. Finding that insurers have gotten discounts from select hospitals and doctors, the Congressional Budget Office recently lowered its estimate for the cost of premiums and taxpayer subsidies under the health law.

“I’m not expecting double digits like some people have predicted” for 2015 rate increases, Axene said. “I’m expecting mid-to-high single digits” — from 6 to 8.5 percent.

That would still be far higher than growth in the economy or family incomes.

Given the uncertainties that come with a major new social law, officials at Independence Blue Cross don’t think the picture will become clear until much later.

“We always viewed this as a three-year plan,” Lobley said. “We always thought there would be a lot of volatility in years one and two. We really thought 2016 would [bring] market stability in the individual market.”

Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.

Related: 

2.7 Million ObamaCare Enrollees Still Unaccounted For

Aid organizations across the country were jammed with people racing to get insurance under the Affordable Care Act..

Feds prepare to take over Oregon’s health exchange

21 ACA deadline extensions, in one chart

Technorati Tags: ACA,Affordable Care Act,ObamaCare,ObamaCare Costs,Wake-Up,ObamaCare Surprises,PPACA,Insurance Exchanges,Health Insurance Providers,Kaiser

ObamaCare Cost Increases Shocking to Many…

Fabulous Obamacare Success Stories

EIB: BEGIN 10.03.13 TRANSCRPT

RUSH: James Taranto, the Wall Street Journal, has a story of a guy named Brendan Mahoney, who did succeed. It's a Hartford Courant story, and this guy's being joked about as the man who saved Obamacare. The subhead is: "Great news! They got a 30-year-old dude to sign up!" And here are the details. "Meet Brendan Mahoney, the young man who is saving ObamaCare. He's 30 years old, a third-year law student at the University of Connecticut. He's actually been insured for the past three years -- in 2011 and 2012 through a $2,400-a-year school-sponsored health plan." So he's already got insurance and he went to the exchange. This year he is insured "through 'a high-deductible, low-premium plan that cost about $39 a month through a UnitedHealthcare subsidiary.'" But even though he already had plan, at 39 bucks a month, "he wanted to see what ObamaCare had to offer."

"He tried logging in to the exchange's website at 8:45 a.m. yesterday, which is impressive in itself. Most young people don't get up that early. 'He said the system could not verify his identity.'" He's got insurance, don't forget. He's paying $39 a month through a United Health Care subsidiary, high deductible, low premium plan, school-sponsored health plan. When the system couldn't verify his identity, "he called the toll-free help line, whose operator also encountered computer trouble. 'But then he logged on a second time, he said, and the system worked.'"

He told the Hartford Courant, "'Once it got running, it was fast. It really made my day. It's a lot like TurboTax.' He obtained insurance through ObamaCare. Now, he says, 'if I get sick, I'll definitely go to the doctor.' Even better, if he stays healthy, he won't need to go to a doctor, and his premiums will support chronically ill policyholders on the wrong side of 40."

This is the guy, this is what they're looking for. Now, hang in there with me, folks. This is not over. This is exactly what they're looking for, a 30-year-old healthy guy to sign up and pay the freight so that nanaw and grandpa can be treated. They're looking for 30-year-olds who are not gonna get sick, not gonna put any financial strain on the system. They pay the premium, they pay the freight. This guy had a premium of 39 bucks. He wanted to see if he could beat that on Obamacare, and he did.

"So, how much of a premium is strapping young Brendan Mahoney paying to help make ObamaCare work? Oops. The Courant reports that Mahoney 'said that by filling out the application online, he discovered he was eligible for Medicaid.'" So 30-year-old strapping, healthy dude, Brendan Mahoney, beginning next year will not pay any premium at all because Obamacare, the exchange, told him, based on the way he filled out the data, that he is eligible for Medicaid.

What a fabulous success story for Obamacare's first day. Here we have a future lawyer -- remember, now, this guy is I think a 3L at the University of Connecticut. He was gonna be a lawyer, might still be a lawyer. He was already paying for insurance, and he's been converted into a welfare case. And that, ladies and gentlemen, is the objective. When you strip it all away, this shows how all of this is really designed to work.

Now, on the surface -- and everything I've told you here is true -- this 30-year-old guy signs up, he's paying a premium of $39, but, you know, he's curious. He's a tech savvy guy. He wanted to find out what it was all about. Maybe he could beat the 39 bucks. So he fills out all the necessary forms, inputs all the data, and he finds out at age 30 he qualifies for Medicaid, and therefore he's become a welfare case.

So this 30-year-old guy -- and hopefully, theoretically millions like him who are gonna be signing up and paying all these premiums so that nanaw and grandpa can get health coverage and treatment, qualified for Medicaid. So a 30-year-old guy -- who was gonna be a lawyer, so you figure he's got some decent earning power -- has been converted by Obamacare into a welfare case. And he didn't pull any strings. He didn't know anybody. He didn't ask for special treatment. This is just what the system spat out.

So now he doesn't have pay 39 bucks. Now he can get rid of that health plan he's got at school. At 30 years of age, he discovered he was eligible for Medicaid. He's a healthy guy. I is a joke here that they're saying, "Here we have great news, a 30-year-old guy signed up," because the story is nobody's been able to sign up. But lo and be, "Hey, we got a guy!" You know, the regime can tell everyone, "We got a guy! We got a guy! It's this guy in Old Clayneck, Connecticut, 30 years old. Look at this, what we did here. We got a guy! We got a guy.

"He's exactly who we want to sign up here," and Obamacare turned him into a welfare case. They turned him into a ward of the state. A guy that's gonna be a lawyer, is gonna have decent earning power is now a Medicaid recipient. "Oh, come on, Rush! It's just a first-year glitch. These things will get ironed out." A little companion story here from the Washington Free Beacon. "Health insurance premiums for young people will rise in all 50 states under Obamacare, with an average increase of 260 percent, according to a study released Thursday.

"The young and healthy segment of the uninsured is considered crucial for the Affordable Care Act to succeed. Former President Bill Clinton suggested last week that Obamacare only works 'if young people show up.'" Well, what the hell, folks? Here we got this young guy that showed up and the system made him a Medicaid recipient. He didn't game it. He is just going through the process and found out that he qualified for Medicaid -- and I'm telling you, in my not so cynical opinion, I think that is the long-0term objective is to turn everybody into a welfare case in this country, folks.

That's the long-term objective of not just Obamacare, but of the Democrat Party. Turn everybody into a dependents. Make everybody dependent on government for things they consider really important, like their health care. Here's another one. The Associated Press: "A Bumpy First Day for New Affordable Care Act Insurance Marketplaces -- The technical trouble couldn't dampen the relief Hussein Daoud felt for himself, his wife and their six children. The 51-year-old Detroit man came to apply for insurance at the Dearborn-based nonprofit organization ACCESS. With the help of counselors, he learned that his annual income of $14,500 made him eligible for Medicaid, and he likely won't have to pay for a plan that covers his family."

He's 51 years old. He, his wife, and six children -- and an annual income of $14,500? What in the world...? (interruption) Yeah, eight people for free, but before you get there, how are eight people getting by on his $14,500 annual income? Well, I know. Food stamps and all the other stuff, but so eight people in Dearbornistan go in to sign up and he end up becoming wards of the state. Health care for them is free as well, in addition to the strapping young 30-year-old Brendan Mahoney in Connecticut. (laughing)

On one hand, this is the biggest collection of Keystone Cops and incompetence running. On the other hand, this is a really, really profoundly dangerous thing that's happening here. But there's a part of me that, I'm sorry, cannot suppress my laughter at raging... I know you might think it's a conflict to call them incompetent when they're registering all these wards of the state. I am here to tell you, folks, that they did not intend for 30-year-olds to be comped. That was never part of the plan. That's who is going to have to pay. How in the world...?

The way that they make those people wards of the state is take all of their disposable income in the form of health care premiums and make them dependent in other ways. But they do need money flowing into the system. They do need some people paying premiums, and they can't get by with just the rich paying premiums; there isn't enough money there to cover everybody. So they need these strapping, young, 30-year-old guys and women, who aren't gonna get sick, paying into the system -- and the system's converting 'em to welfare recipients. (Raspberry) Hee-hee-hee-hee-hee.

BREAK TRANSCRIPT

RUSH: Here's Lee, New York City. Lee, it's great to have you on the EIB Network. Hello.

CALLER: How are you? Hey, you spoke about the Obamacare success story with 30-year-old guy in law school getting a free ride.

RUSH: Yeah.

CALLER: They're probably tickled pink about this because what's gonna happen in a few years or less than that this guy starts earning six figures and he's stuck in the program? Hello, premiums!

RUSH: Now, that's a good point. He's talking about the first story I had in the Stack today, a Hartford Courant story about Brendan, some 30-year-old law student at University of Connecticut. He is in, folks, an insurance plan right now at school where he has a $39 a month premium. So he went to the Obama exchange in Connecticut on the website, and he got through, and he signed up.

Well, he found out that he qualifies for Medicaid as a college student. He doesn't have any income, not to speak of, so he's poor. So he qualifies for Medicaid. So right now, he doesn't pay anything. Now, the regime... He's 30, still in school. The regime wants people like this guy paying full freight to pay for nanaw and grandma. So people are making a big joke about the fact that this Brendan guy -- a healthy, strapping 30-year-old -- has been converted into a ward of the state by Obamacare.

But Lee's point here is, if this guy finishes school and does become a lawyer and does find a job (and all of those are questionable) then he's no longer qualifying for Medicaid, is he? He won't qualify for Medicaid once he gets a job as a lawyer, 'cause he won't qualify for Medicaid anymore. As Lee points out, this 30-year-old strapping young Brendan guy, he's not gonna like it. He's not gonna like the revelation that his premiums are gonna skyrocket, and that's true. That's gonna be a delayed reaction, because that requires old Brendan to graduate and then find a job at a decent law firm where he hangs his own shingle or what have you.

It's a great point, Lee. I appreciate that.

BREAK TRANSCRIPT

RUSH: Here's Nancy, Salt Lake City. Hi, Nancy, great to have you on the program. Hi.

CALLER: Hello. Nice to speak with you. Thank you for your time. I'll get right to the point 'cause I know you're busy. I want to tie in your very first story in the first hour and the story in your second hour about the Medicaid. I'm a single mom. I make $5,000 a year. I qualify for Medicaid, but my spend down premium is $460 a month. I am not eligible for any tax credit subsidy because my income is below 100% of the federal poverty level, which is 99% of my household income. This is a mess, it's a chocolate mess.

RUSH: Wait a minute. You make $5,000 a year?

CALLER: Yes. I'm a student and I make $5,000 a year and I'm trying to get out of the toilet.

RUSH: Oh, okay, student. And you don't qualify. You make too little to qualify for poverty?

CALLER: I do qualify. I am 100% below the federal poverty level.

RUSH: Yeah.

CALLER: But for me to have Medicaid I have to pay the state of Utah $460 a month.

RUSH: Well, how did this clown in Connecticut get onto Obamacare and he's not gonna pay anything?

CALLER: Exactly, and he doesn't even have a child that he has to raise.

RUSH: Well, not that we know of.

CALLER: Well, that's true, too.

RUSH: Not that he knows of.

CALLER: I'm still trying to see the future pay-in, you know. But, anyway, so I'm not available for any tax credit subsidies that they claim that the poor people get to help them --

RUSH: This is incredible. So people at or below 100% of the poverty line cannot get Obamacare subsidies?

CALLER: Correct. You are correct. I have it right here in black and white. I do not qualify for any of the subsidy. But yet they want 99% of my household --

RUSH: You know, I could be really insensitive and say, "Welcome to my world."

CALLER: Yeah.

RUSH: But I wouldn't do that.

CALLER: But that's okay.

RUSH: I'm not doing that, Dawn, don't shake your head. I wasn't doing that. I told her I could, but I wouldn't. I'm not doing that. I just want you to know I don't get subsidies, either.

CALLER: Yeah. It blows you away, doesn't it, how this Obamacare is supposed to help the poor and --

RUSH: Yes, I know.

CALLER: -- blah, blah, blah.

RUSH: I did not know that you could be too poor to qualify for Obamacare. You're supposed to get Medicaid, but you have to pay $460 bucks a month did you say for Medicaid?

CALLER: Correct.

RUSH: That doesn't sound like it makes any sense. Anyway, I've gotta run. I'm outta time. I'm very sorry, Nancy, but that we'll have to look into. Don't go away, folks. Be right back.

BREAK TRANSCRIPT

RUSH: I don't understand having to pay $400 a month for Medicaid. I've never heard of that before. I'm not challenging what she said; I just haven't heard about it.

END TRANSCRIPT

Obamacare To Double Cost Of Insurance For Average Californian

Originally Posted 06/02/2013 22:18 –0400 at ZeroHedge

Last week, the state of California claimed that its version of Obamacare’s health insurance exchange would actually reduce premiums. But, as Forbes reports, the data that the executive director of California's 'exchange' released tells a different story: Obamacare, in fact, will increase individual-market premiums in California by as much as 146 percent. The exuberance that Peter Lee exclaimed over the 'savings' is a misleading comparison. He was comparing apples - the plans that Californians buy today for themselves in a robust individual market-and oranges - the highly regulated plans that small employers purchase for their workers as a group. If you're a 25 year old male non-smoker, buying insurance for yourself, the cheapest plan on Obamacare’s exchanges is the catastrophic plan, which costs an average of $184 a month; but in 2013, on eHealthInsurance.com, Forbes explains, the median cost of the five cheapest plans was only $92. In other words, for the typical 25-year-old male non-smoking Californian, Obamacare will drive premiums up by between 100 and 123 percent. The desperate spin of the PR disaster is incredible as talk of a 'rate shock' is now very prescient, "these extraordinary increases are up to 15 times faster than inflation and threaten to make health care unaffordable for hundreds of thousands of Californians."

Via Forbes,

Last week, the state of California claimed that its version of Obamacare’s health insurance exchange would actually reduce premiums. “These rates are way below the worst-case gloom-and-doom scenarios we have heard,” boasted Peter Lee, executive director of the California exchange. But the data that Lee released tells a different story: Obamacare, in fact, will increase individual-market premiums in California by as much as 146 percent.

...

“The rates submitted to Covered California for the 2014 individual market,” the state said in a press release, “ranged from two percent above to 29 percent below the 2013 average premium for small employer plans in California’s most populous regions.”

That’s the sentence that led to all of the triumphant commentary from the left. “This is a home run for consumers in every region of California,” exulted Peter Lee.

Except that Lee was making a misleading comparison. He was comparing apples—the plans that Californians buy today for themselves in a robust individual market—and oranges—the highly regulated plans that small employers purchase for their workers as a group. The difference is critical.

...

If you’re a 25 year old male non-smoker, buying insurance for yourself, the cheapest plan on Obamacare’s exchanges is the catastrophic plan, which costs an average of $184 a month.

... But in 2013, on eHealthInsurance.com (NASDAQ:EHTH), the median cost of the five cheapest plans was only $92.

In other words, for the typical 25-year-old male non-smoking Californian, Obamacare will drive premiums up by between 100 and 123 percent.

...

Obamacare’s impact on 40-year-olds is steepest in the San Francisco Bay area, especially in the counties north of San Francisco, like Marin, Napa, and Sonoma. Also hard-hit are Orange and San Diego counties.

...

How did Lee and his colleagues explain the sleight-of-hand they used to make it seem like they were bringing prices down, instead of up? “It is difficult to make a direct comparison of these rates to existing premiums in the commercial individual market,” Covered California explained in last week’s press release, “because in 2014, there will be new standard benefit designs under the Affordable Care Act.” That’s a polite way of saying that Obamacare’s mandates and regulations will drive up the cost of premiums in the individual market for health insurance.

But rather than acknowledge that truth, the agency decided to ignore it completely, instead comparing Obamacare-based insurance to a completely different type of insurance product, that bears no relevance to the actual costs that actual Californians face when they shop for coverage today. Peter Lee calls it a “home run.” It’s more like hitting into a triple play.

Everyone needs to go through the process of finding out what ObamaCare will cost them and then send the quote on to your Congressman and Senator… and ask them Why?  What happened to the promises?!?

Related:

Anyone Who Is Buying That the Republicans in the House Are Unreasonable Needs to Read This… NR: 100 Unintended Consequences of ObamaCare

Technorati Tags: ObamaCare,ObamaCare Costs,ObamaCare Mandates,California,ACA,Medicaid,Rush,EIB

Congressional Report: Obamacare Leads to Skyrocketing Premiums, 200 Percent Possible

NewsMax: An exhaustive study by three congressional committees delivers startling news about the dire effects of Obamacare: President Barack Obama’s signature legislation could increase health insurance premiums by over 200 percent and render insurance coverage unaffordable for millions of Americans.

Broadly, the new report declares that Obamacare “breaks its core promise” to make healthcare coverage affordable.

The report, “The Price of Obamacare’s Broken Promises,” was prepared by the House Committee on Energy and Commerce, Majority Staff; Senate Committee on Finance, Minority Staff; and Senate Committee on Health, Education, Labor and Pensions, Minority Staff.

“Studies and analyses from the Congressional Budget Office, independent actuaries, state insurance commissioners, health plans, benefit consultants, and others have reached the same conclusion: Obamacare will significantly increase premiums,” the congressional report states.

“Some estimates show some Americans facing startling premium increases of 203 percent because of the law.

“Higher healthcare premiums are the last thing single young adults and working families can afford. Yet contrary to what the president promised, that is exactly what Obamacare is projected to do.”
When Obamacare’s most costly requirements go into effect in 2014, households earning as little as $46,000 a year will receive no premium assistance, yet will be forced to accept “unaffordable” premium increases, according to the report.

The Affordable Care Act will have an especially harsh impact on young Americans ages 21 to 29 — those with individual coverage will see their healthcare premium rise by an average of 189 percent.
The report points to several factors that will result in significantly higher healthcare costs for Americans:

• The healthcare reform bill mandates that individuals pay the same premiums regardless of future anticipated medical expenses, leading to sharply increased premium costs for those under 50.
• Obamacare requires that individuals purchase coverage that includes a range of “essential” health benefits, including coverage for preventive services, chronic disease management, and rehabilitative services, thereby restricting consumers’ choice in the design of their health plans and adding to their insurance premiums.
• The law imposes $165 billion in new taxes and fees on health plans, drug manufacturers, and device makers, and these costs will be largely passed on to consumers in the form of higher premiums. One study cited by the report predicts that Obamacare’s health insurance tax will boost premiums by more than $7,000 over a decade.

The report notes that a number of states have already imposed requirements on health coverage and the result has been fewer choices and higher premiums.

In New York, for example, a 30-year-old male paid an average of $1,200 a year in annual premiums in 1993, but one month after the state passed Obamacare-like reforms, premiums soared to $3,240.
At the time Washington state passed similar reforms, 19 insurance carriers wrote policies for state residents. Within six years, only two carriers remained in the state.

According to the report, even the left-leaning Center for American Progress acknowledged that “Massachusetts along with several other northeastern states passed insurance market reforms similar to those in the Affordable Care Act, eliminating or restricting the ability of insurance companies to discriminate against the ill either in prices or coverage exclusions. The result in each state was very high nongroup insurance prices.”

The congressional report also warns, as others have previously, that Obamacare’s requirement that insurers cover pre-existing conditions will allow many relatively healthy Americans to delay buying insurance until medical attention is needed, thereby leaving less healthy individuals in the insurance pool and raising premiums.

The report concludes: “Taking into account empirical evidence from past state-level experiences, as well as future projections, upon implementation Obamacare will make coverage dramatically more expensive and unaffordable for individuals and families.

“In short, Obamacare breaks its core promise to make healthcare coverage affordable as Americans across the country swallow higher premiums. For young adults to middle-class families, higher premiums will soon be the harsh reality of Obamacare.”

Technorati Tags: ObamaCare,ObamaCare costs,ObamaCare lies,healthcare costs rising with ObamaCare,defund ObamaCare,repeal ObamaCare,wake-up America,stand-up America,Affordable Care Act,Congressional ObamaCare Report

Thanks To The Affordable Care Act, The Cheapest Family Insurance Policy In America Will Cost $20,000 Says IRS

Written By: Rob Port Feb 1, 2013 4:39pm – Say Anything Blog

There’s an old joke among conservatives about government health care programs. It goes something like, “If you think health care is expensive now just wait until it’s free.”

I can’t help thinking about that as I read what the “Affordable Care Act” is doing for the affordability of health insurance in America.

(CNSNews.com) – In a final regulation issued Wednesday, the Internal Revenue Service (IRS) assumed that under Obamacare the cheapest health insurance plan available in 2016 for a family will cost $20,000 for the year.

Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the IRS.

The IRS’s assumption that the cheapest plan for a family will cost $20,000 per year is found in examples the IRS gives to help people understand how to calculate the penalty they will need to pay the government if they do not buy a mandated health plan.

The examples point to families of four and families of five, both of which the IRS expects in its assumptions to pay a minimum of $20,000 per year for a bronze plan.

“The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000,” the regulation says.

Bronze will be the lowest tier health-insurance plan available under Obamacare–after Silver, Gold, and Platinum. Under the law, the penalty for not buying health insurance is supposed to be capped at either the annual average Bronze premium, 2.5 percent of taxable income, or $2,085.00 per family in 2016.

That gap between what a health insurance policy is going to cost in this coming era of Obamacare, and what the tax will be if you don’t buy a policy, could well be what does the law in. George Will referred to this problem in a column a couple of weeks ago.

The Supreme Court upheld the legality of the individual mandate based on the idea that the mandate’s penalty was a tax and not a penalty. But the Supreme Court noted in its ruling that the difference between a tax and a penalty is a matter of degree. As long as the tax for not buying health insurance stays low enough to not be considered punitive, it’s a tax. But if it’s raised, it becomes a penalty.

This is all a lot of nonsensical parsing, of course, but what it does mean is that if the federal government intends to raise the tax for not having health insurance the law is susceptible again to being overturned by the courts. But if they leave it as low as it is now, a lot of Americans are going to see the big difference between paying the tax and paying for cost-inflated health insurance and opt for the former.

And who could blame them?

Technorati Tags: ObamaCare,ObamaCare costs,ObamaCare surprises,ObamaCare taxes,wake-up America,healthcare insurance costs,Affordable Care Act,IRS,health insurance costs

Obama concedes: Obamacare didn’t do anything for rising health care costs

HotAir: It started out with such high hopes:

“I will sign a universal health care bill into law by the end of my first term as president that will cover every American and cut the cost of a typical family’s premium by up to $2,500 a year.”

That was on the trail in 2008, an audacious promise Politifact ruled flatly “Broken.” Obama repeated the promises of lower premiums and bent cost curves as a central part of his pitch in passing the health care law. It is called “The Affordable Care Act.” But most supporters of Obamacare have stopped talking about cost savings and started focusing on increased benefits, acknowledging (sometimes explicitly and sometimes implicitly) that expanded coverage and more benefits will actually cost more money, not less, but that the trade-off is worth it.

President Obama joined that crowd in his second Inaugural address Monday. It came as Obama just barely grazed two issues rather important to the American people at the end of this paragraph:

We understand that outworn programs are inadequate to the needs of our time. So we must harness new ideas and technology to remake our government, revamp our tax code, reform our schools, and empower our citizens with the skills they need to work hard or learn more, reach higher. But while the means will change, our purpose endures. A nation that rewards the effort and determination of every single American, that is what this moment requires. That is what will give real meaning to our creed. We, the people, still believe that every citizen deserves a basic measure of security and dignity. We must make the hard choices to reduce the cost of health care and the size of our deficit.

And, now for the “but,” clause, which includes all the reasons he can’t actually ever make hard choices:

But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future.

President Obama spent two years of his first term passing a giant health care bill that was supposed to address rising costs. This claim was front and center in his appeal to a joint session of Congress on the matter in 2009:

Then there’s the problem of rising costs. We spend one-and-a-half times more per person on health care than any other country, but we aren’t any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. It’s why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely. It’s why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage. And it’s why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else’s emergency room and charitable care.

Finally, our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close.

These are the facts. Nobody disputes them. We know we must reform this system.

And, so we did, allegedly with an eye toward “bending the cost curve down” and lowering premiums for families. It has been more than two years since the law passed. Critics of the law have been proven right again and again in their skepticism that it could do those things.

HHS, 2010:

President Obama’s health care overhaul law will increase the nation’s health care tab instead of bringing costs down, government economic forecasters concluded Thursday in a sobering assessment of the sweeping legislation.

A report by economic experts at the Health and Human Services Department said the health care remake will achieve Obama’s aim of expanding health insurance — adding 34 million Americans to the coverage rolls.

But the analysis also found that the law falls short of the president’s twin goal of controlling runaway costs. It also warned that Medicare cuts may be unrealistic and unsustainable, driving about 15% of hospitals into the red and “possibly jeopardizing access” to care for seniors.

The mixed verdict for Obama’s signature issue is the first comprehensive look by neutral experts.

Kaiser, 2011:

The Kaiser Family Foundation shows family premiums topped $15,000 a year for the first time in 2011, increasing a whopping 9% this year, three times more than the increase the year before. The study says that up to 2% of that increase is because of the health care law’s provisions, such as allowing families to add grown children up to 26 years old to their policies.

CLASS Act turns out to be fiction, not revenue, 2011:

How did a program so obviously unsustainable that the White House had no choice but to shut it down produce an $80 billion surplus for ObamaCare accounting purposes? Very simply, actually. The Democrats designed the first five years of CLASS to be a “vesting period” in which enrollees would pay into the program but receive no benefits yet. In other words, for the first five years, the program would have been pure profit for the government — and then, when benefits finally kicked in, the hemorrhaging would begin. The reason they did it that way is the same reason they delayed the start of ObamaCare until 2014: They knew that CBO “scores” new legislation based on its first 10 years of operation, so the more they could game the numbers during those first 10 years, the better the “score” for ObamaCare would look while Democrats were trying to sell it to the public. It was a massive accounting fraud designed to make health-care reform seem much less expensive than it really was. According to Klein, CLASS’s phony “savings” accounted for fully $70 billion of ObamaCare’s supposed $143 billion in deficit reduction.

The 1099 reporting rule turns out to be overburdensome regulation, not revenue, 2011:

The very first part of ObamaCare to get the knife was the 1099 reporting requirement. That extremist bit of legislation passed the Senate 87-12 and the House, 314-112, and landed on the President’s desk for signing on April 14. The 1099 reporting requirement was one of the funding fictions ObamaCare supporters used to make it look as if the President’s plan would fulfill his promise not to “add a dime to the deficit.” Post-passage it was almost universally recognized as unworkable. It would have required businesses to fill out an IRS form (1099) for every $600 of staples and printer paper they bought at Target within a calendar year. It closed a loophole, and that loophole was shopping.

When it was repealed, Obama called it “a big win for small business.”

Centers for Medicare and Medicaid Services, 2012:

When President Obama began pushing national health care legislation in 2009, he argued that reform was needed to rein in the unsustainable growth in health care spending that was crippling the budgets of businesses, states and the federal government. But a new government actuarial study finds that as a result of the law, health care spending will be $478 billion higher over the next decade than it would have otherwise been had no law been passed.

Furthermore, as a result of the health care law, about 50 cents of every dollar of health care spending in the United States will be financed by government by 2021, according to the report from the actuary’s office at the Centers for Medicare and Medicaid Services, unveiled today in the journal Health Affairs.

Then there’s the $63 Obamacare’s newly written regulations added to everyone’s premium in December, which even if it were the only increase for which Obamacare was responsible, would still put Obama $2,563 off his promise.

The charge, buried in a recent regulation, works out to tens of millions of dollars for the largest companies, employers say. Most of that is likely to be passed on to workers.

Oops, electronic records raise costs instead of lowering them, 2013:

The report predicted that widespread use of electronic records could save the United States health care system at least $81 billion a year, a figure RAND now says was overstated. The study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems.

“RAND got a lot of attention and a lot of buzz with the original analysis,” said Dr. Kellermann, who was not involved in the 2005 study. “The industry quickly embraced it.”

But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services.

Politico discovers mandates of more benefits and more coverage paid for with more taxes might hike premium costs, 2013:

If you work for a small business, your next health insurance premium may give you sticker shock.
Many of the small-business and individual insurance policies are working the health reform law’s 2014 fees into their 2013 bills, contributing to double-digit premium increases for some people.

All those new consumer benefits packed into the health reform law — birth control without a co-pay, free preventive care and limits on when insurers can turn down a customer — had to be paid for somehow.

So the law’s drafters included a new tax on health insurers, starting at $8 billion in 2014 and increasing to $14 billion within four years, to help meet the new expenses. And insurers in 2014 will also have to pay a “reinsurance contribution” to cushion health plans that end up with a lot of sick customers under new rules requiring them to cover people with pre-existing conditions.

The Government Accountability Office, 2013:

The Government Accountability Office (GAO)’s annual audit of the government, released Thursday, raises serious concerns about the federal government’s long-term financial stability and the effectiveness of the Affordable Care Act’s cost-curbing measures.

The report found “that—absent policy changes—the federal government continues to face an unsustainable fiscal path.”

Obamacare has already failed in its promises. Our president spent two years, during the worst economic downturn since the Depression, passing a law more than 50 percent of the public still hates because 85 percent of them were satisfied with their current coverage, imperfect though it was. He turned the crayon box upside down to draw a picture no one wanted and we all must now pay more money to enjoy his vision. The only spending problem he’ll concede we have has been exacerbated by his own signature “achievement.”

These are the facts. Nobody disputes them. Not even Obama.

Technorati Tags: ObamaCare,ObamaCare costs,healthcare costs,Obamaland,ObanaTax

ObamaCare fee of $63 per person to begin in 2014 (Just for pre-existing conditions) - Hang onto Your Hats Folks the ObamaCare Fees Are Just Beginning!

Monday, December 10, 2012 11:04:23 PM · by 2ndDivisionVet The Washington Times / The Associated Press ^ Ricardo Alonso-Zaldivar, AP

Your medical plan is facing an unexpected expense, so you probably are, too. It’s a new, $63-per-head fee to cushion the cost of covering people with pre-existing conditions under President Obama’s health care overhaul.

The charge, buried in a recent regulation, works out to tens of millions of dollars for the largest companies, employers say. Most of that is likely to be passed on to workers.

Employee benefits lawyer Chantel Sheaks calls it a “sleeper issue” with significant financial consequences, particularly for large employers.

“Especially at a time when we are facing economic uncertainty, [companies will] be hit with a multimillion-dollar assessment without getting anything back for it,” said Mr. Sheaks, a principal at Buck Consultants, a Xerox subsidiary.

Based on figures provided in the regulation, employer and individual health plans covering an estimated 190 million Americans could owe the per-person fee.

The Obama administration says it is a temporary assessment levied for three years starting in 2014, designed to raise $25 billion. It starts at $63 and then declines.

Most of the money will go into a fund administered by the Health and Human Services Department. It will be used to cushion health insurance companies from the initial hard-to-predict costs of covering uninsured people with medical problems. Under the law, insurers will be forbidden from turning away the sick as of Jan. 1, 2014.

The program “is intended to help millions of Americans purchase affordable health insurance, reduce unreimbursed usage of hospital and other medical facilities by the uninsured and thereby lower medical expenses and premiums for all,” the Obama administration says in the regulation. An accompanying media fact sheet issued Nov. 30 referred to “contributions” without detailing the total cost and scope of the program.

Of the total pot, $5 billion will go directly to the U.S. Treasury, apparently to offset the cost of shoring up employer-sponsored coverage for early retirees.

The $25 billion fee is part of a bigger package of taxes and fees to finance Mr. Obama’s expansion of coverage to the uninsured. It all comes to about $700 billion over 10 years, and includes higher Medicare taxes effective this Jan. 1 on individuals making more than $200,000 per year or couples making more than $250,000. People above those threshold amounts also face an additional 3.8 percent tax on their investment income.

But the insurance fee had been overlooked as employers focused on other costs in the law, including fines for medium and large firms that don’t provide coverage.

“This kind of came out of the blue and was a surprisingly large amount,” said Gretchen Young, senior vice president for health policy at the ERISA Industry Committee, a group that represents large employers on benefits issues.

Word started getting out in the spring, said Ms. Young, but hard cost estimates surfaced only recently with the new regulation. It set the per-capita rate at $5.25 per month, which works out to $63 a year.

America’s Health Insurance Plans, the major industry trade group for health insurers, says the fund is an important program that will help stabilize the market and mitigate cost increases for consumers as the changes in the Obama law take effect.

But employers already offering coverage to their workers don’t see why they have to pay into the stabilization fund, which mainly helps the individual insurance market. The redistribution puts the biggest companies on the hook for tens of millions of dollars.

Elections have consequences and this is only one of many that are coming.  But, if you voted to re-elect Obama because you wanted ObamaCare or because you didn’t inform yourself before voting, you can only blame yourself.  The information was all out there and plenty of people were trying to warn what was coming.  This is only a small fee, wait until the real fees and surprises hit.

Technorati Tags: ObamaCare,repeal and replace ObamaCare,elections have consequences,ObamaCare fees,ObamaTax,ObamaCare surprises,wake-up America

60% of firms to kill health insurance or charge more under Obamacare

The Examiner - A majority of small business owners and manufacturers are mulling drastic changes to comply with Obamacare, with 21 percent set to drop health insurance to workers altogether and 38 percent planning to make employees pay much more.

In a poll done for the National Association of Manufacturers and National Federation of Independent Businesses, 59 percent said that they will have to consider changes once the full law kicks in because increased costs will jeopardize their operations. According to the poll, 67 percent expect Obamacare to raise healthcare costs.

The fears about spending more on health care are adding to growing concerns among small businessmen and women about staying in business, said the poll from Public Opinion Strategies.

Pollster Bill McInturff noted that the combination of a bad economy, greater regulations and increased economic uncertainty have forced 24 percent of the firms polled to lay off workers, 23 percent to tap their own savings to stay open and 11 percent to kill health coverage for workers.

"The climate in Washington is a concern to them," said McInturff. Dan Danner, president of NFIB added: "Why would I invest in this environment?"

The polled were so down on President Obama and Congress that many said they wouldn't start a business today. Asked if they would start a new business, 55 percent said no. Among the reasons they cited were high taxes, health care costs, regulations and an uncertain economy.

Said McInturff, "The data paints a bleak picture, with a majority of respondents saying in the last three years, the national economy is in a worse position for American businesses and manufacturers." What's more, he found, businesses see little evidence that the economy will brighten soon.

Technorati Tags: ObamaCare,healthcare costs rising with ObamaCare,Repeal and Replace ObamaCare,ObamaTax,Single Payer System coming,wake-up America,watch the other hand

The Hospital Gestapo: You May Never See Home Again

Agenda 21 - seizing assets/ property…

The Hospital Gestapo: You May Never See Home Again
The PPJ Gazette  -  By Angela V. Woodhull, Ph.D./licensed private investigator

September 14, 2011

$ Predatory Guardians $

American hospitals have devised a scheme to guarantee they never get stuck with an unpaid bill.  It’s called guardianship.

Thinking of checking into a hospital?  Think again.  You may never see home again.

• Ginger Franklin, Hendersonville, Tennessee, fell down the stairs in her condo and suffered a bump on her head.  She was declared “temporarily mentally incapacitated” and a guardian was appointed through the courts.  Within six weeks, the guardian had sold Franklin’s home, car, furniture, and drained her bank account.  Today,Franklin has her freedom back, but she is having to start all over.

• Michael Kidd, 72, of Richardson, Texas, fell in his yard and broke a hip.  Now, he is living in Countryside Nursing Home with his wife.  Both were removed from their home when the state of Texas petitioned the courts claiming that the Kidds were mentally incompetent.  Their house sits vacant and neglected, with rotting food still remaining in the refrigerator.  The Kidds have been confined to a single room in the nursing home, while the state appointed guardian burns through their money an gives them a mere $60 a month spending allowance which they have been using to buy “real” food.

• Robert Milton (not his real name) was taken to the hospital because he fell “one time too many” at his home, and although his stepson had been given power of attorney to make all of his health care decisions, a court-appointed corporate guardian placed Milton against his will in a nursing home where he is now isolated from his family and friends.  Meanwhile, his money is being spent as quickly as possible by the Orlando-based guardian and her attorneys.

How It Commences

Joseph Niedesky (not his real name) was air lifted to a hospital in Orlando from Ocalaby helicopter after he was the victim of a motorcycle crash.  But something went terribly wrong during Niedesky’s surgery and he aspirated on his own vomit, causing some brain injury.  That’s when a corporate guardian was contacted by the hospital and appointed by the court as Niedesky’s full plenary, permanent guardian.

What Happens Next

The corporate guardian who petitioned the court stated in the court papers that Niedesky had no family.  In reality, Niedesky had been married for more than 20 years and had four teenage children.  It took more than two months for Niedesky’s wife to discover what had happened to her husband and where he was located.

The Family is Always Portrayed as the “Devil Incarnate”

What happened to Niedesky is becoming a commonplace occurrence in America.  A family member is rushed to the hospital.  Surgery occurs and something sometimes goes terribly wrong.  However, by quickly petitioning the courts for guardianship, the hospital avoids any kind of lawsuit for negligence or wrongful death.

Niedesky’s wife wanted to bring him home and get him out of the guardianship.  The guardian, however, kept moving Niedesky from location to location, city to city, until the statute of limitations for suing the hospital had expired.  Shortly after the statute of limitations ended, Niedsky just happened to die.

“The hospital saved itself millions in a lawsuit.  It is typical that shortly after the statute of limitations runs out, the ward just happens to suddenly die,” stated David Newman, Gainesville, Florida, a civil rights guardianship reform advocate.

Niedesky’s wife was portrayed in the court record as uncaring, incompetent, over-meddling, and negligent, and although these descriptors seem to be a contraction of terms, you will typically find the most cynical descriptions of family members in most court files where an involuntary guardianship has been granted by the courts to a total stranger.

For example, in Milton’s case, Milton’s stepson had been named long ago as his power of attorney and health care surrogate.  That designation, however, was destroyed by the court and the corporate guardian even accused the stepson of stealing several thousands over the years from his stepfather.

Today, Milton’s stepson, a 65 year old retired veteran, finds himself in a legal nightmare gathering bank records and hiring attorneys and forensic accountants to prove his innocence.  Meanwhile, the corporate guardian is spending Milton’s money like water.

The Other Scenario

Tom Griffith (not his real name) wonders why an Orlando-based corporate guardian would be interested in his father at all.

“He has no money.  All he gets is a small monthly cheque from Social Security of about $800.00.”

I explained to Griffith that his father has been marked for destruction and will mostly likely not be among the living in a very short period of time.  “We live in a country that is ruled by corporations, not the U.S. Constitution.  If there is not enough money for the nursing home to cover its expenses, there is ‘no reason’ to keep your father alive.”

I explained to Milton how Thomas Chada’s father was sent to him as a box of ashes and how other wards seem to always turn up “expired” shortly after a corporate guardian and her attorneys have burned through all of an elderly person’s money.

But in this case, Griffith said there was no reason to destroy his father.  “There is no money to gain.”

“Yes, but that is the point.  The corporate guardians have a symbiotic relationship with the nursing homes.  Sometimes, the nursing home gives them a wealthy resident that they can bilk.  At other times, the corporate guardian does them a favor by making premature end-of-life decisions when there is not enough finances to cover the elderly person’s day-to-day expenses.”

In the case of Griffith’s father, who just received quadruple open heart bypass surgery, it was determined that the ward, age 74, now needed dialysis, a very costly ongoing treatment.

“The doctors said my father does not want dialysis,”Milton stated.  “But I know my father wishes to live; he is only 74.”

“They probably got your father to sign such a statement without him even knowing what he was signing,” I explained.

Milton wanted to know what he could do to rescue his father out of this dangerous and life-threatening situation.

“You can hire an attorney, but you might end up spending more than $500,000.00 of your own money to become your father’s guardian.”

“I don’t have that kind of money,”Griffith declared, shocked.

It was obvious that the scenario I was describing was greatly upsetting Griffith.   Those of us who have already lived this scenario remember going through the predictable stage of “mental shock” followed by the overwhelming urge to seek justice—at any cost.  I explained to Griffith that he may find himself bankrupt as a result of trying to help his father out of this doomed guardianship situation.

My phone continues to ring as victims, desperate to find a solution, want to know what they can do.

In a country that is ruled by corporations and corporate greed, there will be no solution to The Guardianship Nightmare until a public uprising is so severe that these kinds of abominable– yet commonplace situations– will no longer be able to occur.

Angela V. Woodhull, Ph.D.  -  licensed private investigator

(352) 327-3665  -  angelavwoodhull@yahoo.com