Health Insurance Companies Seek Big Rate Increases for 2016

[CatWoman]

Source: http://www.nytimes.com/2015/07/04/us/health-insura

WASHINGTON — Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they are determined to see that the requests are scaled back.

Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives.

The Oregon insurance commissioner, Laura N. Cali, has just approved 2016 rate increases for companies that cover more than 220,000 people. Moda Health Plan, which has the largest enrollment in the state, received a 25 percent increase, and the second-largest plan, LifeWise, received a 33 percent increase.

Jesse Ellis O’Brien, a health advocate at the Oregon State Public Interest Research Group, said: “Rate increases will be bigger in 2016 than they have been for years and years and will have a profound effect on consumers here. Some may start wondering if insurance is affordable or if it’s worth the money.”

President Obama, on a trip to Tennessee this week, said that consumers should put pressure on state insurance regulators to scrutinize the proposed rate increases. If commissioners do their job and actively review rates, he said, “my expectation is that they’ll come in significantly lower than what’s being requested.”

The rate requests, from some of the more popular health plans, suggest that insurance markets are still adjusting to shock waves set off by the Affordable Care Act.





Read more: http://www.nytimes.com/2015/07/04/us/health-insurance-companies-seek-big-rate-increases-for-2016.html?_r=0

[NRaleighLiberal]

1. WTF? "saying their new customers under the Affordable Care Act turned out to be sicker than expected

These are folks that probably haven't been able to do any preventative care or have issues taken care of.

sometimes the incredibly stupid things that "companies" say are simply beyond all belief.

[Sunlei]

16. Let us pay premiums to the non-profit medicare system instead of the 'for profit' Corps.

We have to cut out those middlemen.

'for profit' health care will change their tune when they lose the Federal subsidies from ACA.

[daleanime]

52. +1

[rury]

66. +1million

[trillion]

87. Bernie should run on doing just this. I think he would get the votes from both sides of the aisle if

[Chemisse]

88. There we go.

[PatrynXX]

54. face palm yes...

meanwhile bc/bs wellmark FU!!! worthless scumbags

[24601]

113. My wife had an aortic aneurysm and open heart surgery at The Cleveland Clinic. BC/BS covered three

days of outpatient pre-op, the surgery, a week of post-surgery hospitalization, and outpatient follow-ups at 3 and 12 months. The EOB for the surgery alone was $108K. Our total out of pocket was zero, including prescriptions. We had to cover our travel to Cleveland and lodging. I'm not unhappy with BCBS primary insurance or secondary TRICARE at all.

[CrispyQ]

2. "...their new customers under the Affordable Care Act turned out to be sicker than expected."

Well yeah, duh. You deny people healthcare for so long, they aren't going to be as healthy.

Who didn't see this coming? Now it's not even going to be the Affordable Care Act. Maybe people will wake up & realize that health insurance does not equal health care.

on edit: I hate living in a country where the 'for profit' mentality has taken over everything. Some things should not be done for profit. Healthcare is one. Incarceration of criminals is another. Basically, if it's something that serves the common good, it should not be privatized. The profit factor always corrupts.

[NRaleighLiberal]

3. GMTA!

[CrispyQ]

11. It just amazes me that they didn't see that coming!

Remember the summer the health care debate was going on Remote Area Medical had that big event in LA? It brought droves & droves of people from all over the country, that's how desperate Americans are for healthcare. What a sad, sad statement.

http://www.nytimes.com/2009/08/13/health/13clinic.html

It was 2009, the same summer the dems remained quiet while Palin & her crazies ranted about death squads & killing Grandma. The dems should have said, "Hey, this is what single payer would be like, only better. You'll be able to go to the doctor of your own choice in your own town and it won't cost you." But no, they were silent & we got ACA, which will soon just be CA.


At any rate,

[CatWoman]

22. that sentence stuck out like a beacon for me as well

[onecaliberal]

4. Single Payer, now!

[Auggie]

7. +1,000,000,000,000,000

[rury]

67. YES!!!!

[mountain grammy]

5. Fuck em. Medicare for all! Stop this insanity!

[totodeinhere]

28. When we instigate Medicare for all we need to eliminate the 20% copay.

With today's high health care costs 20% of a hospital bill can be a heck of a lot of money. And so-called medigap plans are very expensive as well.

[mountain grammy]

37. Yes, I would agree with that.

[kath]

60. YES. It's good we have Medicare, but the coverage is absolute crap compared to what the Europeans

And Canadians have. the out-of-pocket costs can be enormous.

I have been saying for a long time that Europeans/Canadians would kick and scream bloody murder if you tried to give them Medicare-for-All instead of the coverage they have currently (and have had for DECADES, dammit!)

[YOHABLO]

109. On Medicare SSDI and the 20% is killing me. It's still hard on people like me. What about Dental?

[totodeinhere]

110. Yes, comprehensive dental care should be available to all Americans.

That should be a given. Medicare should cover it but then all Americans, not just Medicare recipients should have it. And cuts to dental coverage for Medicaid patients should not be happening either. And vision coverage for all Americans as well.

[former9thward]

6. In Oregon the regulator demanded the insurance company raise

their premiums even when they did not want to.

Oregon’s insurance regulator has approved big premium increases sought by health plans for 2016 under the health law, and in some cases ordered higher raises than insurers requested, signaling that the cost of insurance for people who buy it on their own could jump after two years of relatively modest growth.

Around the U.S., the biggest insurers have proposed hefty premium increases for the year ahead, based on what they say they now know about the costs of covering people newly enrolled under the Affordable Care Act. Supporters of the law have been counting on state regulators to rein in hefty premium increases for the law’s third year in full effect.

But in Oregon, the first state to announce final 2016 rates, Insurance Commissioner Laura Cali approved an average 25.6% increase for Moda Health Plan Inc., the biggest plan on the state’s health exchange. She also gave a green light to average increases of 30% or more for four smaller companies. And she required plans that hadn’t attempted to raise rates to do so anyway, including Kaiser Foundation Health Plan of the Northwest, by an average of 8.3%.

http://www.wsj.com/articles/SB20130211234592774869404581084361976805004#mod=todays_us_nonsub_journalreports

This is why the insurance companies totally supported the ACA.

[Travis_0004]

23. There is some logic

In the past a large insurance company could offer cheap plans and loose money for a few years, but put out of business smaller insurance companies who could not afford to loose money for several years. Then without competition, they raise their rates.

So what Oregon is saying to insurance companies, if you lost money, you have to raise rates, to even the playing field and avoid putting smaller insurance companies out of business.

[newthinking]

40. Thanks for clarifying it.

[former9thward]

49. Yes, the smaller companies that are raising their premiums 30%.

We really need to keep those in business. Thanks ACA!

[Dustlawyer]

91. The insurance companies already control the regulatory agencies that govern them.

Industry has a great deal of control over all regulatory agencies. Congress and state legislatures keep the agencies starved where they cannot do the job, and the revolving door assures that they are run by industry insiders.
This is a big area where Bernie has vowed to clean up, has Hillary mentioned this problem?

[former9thward]

99. The problem is that insurance is regulated at the state level.

I don't think Bernie or Hillary for that matter can do much about it.

[Dustlawyer]

101. Bully Pulpit for the state corruption!

The Federal and state agencies are both compromised this way, it's part of the U.S. Chamber of Commerce playbook. This needs first, a candidate that will talk about it, enter Bernie! Hillary really can't do more than platitudes due to who's money she took/takes.

When you elect a politician who is supported by the .01%, you get a candidate that supports the .01%! It's not hard to understand!

[yallerdawg]

8. The individual mandate was supposed to offset higher care costs.

All those young, healthy people who passed on health insurance would now be pitching into the pool.

Also, the profit margin is regulated, and we receive refunds if more money comes in than necessary to hit the 15-20% margin. The amount specific to actual health costs rather than administrative or 'other' is also mandated.

Obviously it didn't take long for the insurers to figure out 20% of a billion is a lot better than 20% of a million, so of course higher costs are no problem, they are directly proportional to higher profit!

The insurance companies are going to work the angles as long as they have a hand in the pot.

[Erich Bloodaxe BSN]

29. Yeah, I pointed that angle out as soon as they mentioned the profit margin regulation during the

initial debate. It was obvious that the way to larger total profits was to both charge more and pay out more, not to charge less and pay out less. That was pretty obvious to anyone who lives in the real world. More care, more coverage, more treatment and testing, whether or not it was really needed equals better total profits.

[yallerdawg]

34. If we could have the Medicare pricing system...

Medical products, treatments, drugs capped at an analyzed 6% profit margin, then we would have something.

I think this whole program is an icebreaker, trying to get everyone engaged in health care and finances - to get everyone to understand the only way to control this is to go socialist.

We are all in this together, and we take care of each other for the common good.

Hard to do when so many were content with what they had, and couldn't care less about anyone else.

[CrispyQ]

98. "...and couldn't care less about anyone else."

[PoliticAverse]

38. The problem is the penalty for not having insurance wasn't high enough to make that happen,

so too few healthy people signed up.

[yallerdawg]

42. That penalty goes up every year.

I believe it is eventually onerous enough to make purchasing insurance the better option. The penalty will be as much as a policy.

I know a lot of people also got caught in this new "proof of insurance" tax requirement. It was a pretty small penalty for last year, but if you don't have insurance and you don't have an exemption from the "health exchange" you will get hit with a refund penalty.

[former9thward]

57. No one checks this.

The tax form only asks if you were covered or not. It did not ask for a company or a policy number. Easy to check 'yes' and move on. The IRS is not doing follow up on it.

[yallerdawg]

102. H & R block checks it!

We had to verify our exemption with a print-out from the federal health exchange, or we would pay the penalty.

Our 24 year-old son had to verify VA medical coverage.

Our 21 year-old daughter was unemployed but had no exchange registry and printable exemption, and she had to pay a half-year penalty for half the year she wasn't covered.

This is a tax fraud issue if you check yes and had no coverage. I hope people understand - the IRS does require documentation, and we are going to be required to register through our state exchanges to get exemptions from coverage based on income or lack thereof.

You can bet, when the penalty gets bigger, IRS collection will get bigger. I know lots of people with extensive tax issues that go back years. What you report can come back and bite you. We have a whole new tax regulation just in its infancy. It is critical to the shared cost of health care coverage - this is only going to get more intrusive and more punitive.

[former9thward]

103. The IRS does not require documentation.

I don't use tax services. I do my own taxes as well as the taxes of several of my friends. The situation is exactly as I described. If you want to live in fear, go for it.

[yallerdawg]

104. This penalty program just started this year for required coverage.

This year, H & R Block would not allow us a yes on coverage unless they had documentation of coverage available for IRS audit/review.

Following the law is not an act of fear, is it?

[former9thward]

106. Do you never violate the speed limit?

Fear is thinking the IRS boogyman are going to come after you. They aren't. If they were interested in documentation they would have asked for the insurance company name, policy number, policy period. They don't ask for ANY of that. The penalty will never come close to the cost of premiums. Young people are not buying insurance nor are they paying any penalty. I can do math so I don't need to go to tax services.

[DebJ]

83. excellent point, thanks! n/t

[bread_and_roses]

9. Thanks, Liberals & Obama

And all of you who settled for and now defend the ACA, which was never anything but a huge give-a-way to the Vampire Insurance industry.

[CountAllVotes]

12. +1,000 !!!

n/t

[Fred Sanders]

18. Yeah, that is the message from a premium REQUEST, in one State by a few companies...attack Obama?? You on the right site?

This IS a liberal and Obama site, maybe you should look at the TOS.
In case someone wants to abandon the bluster in favor of knowledge:

http://kff.org/health-reform/issue-brief/analysis-of-2016-premium-changes-and-insurer-participation-in-the-affordable-care-acts-health-insurance-marketplaces/

[PSPS]

25. "This is a liberal and Obama site"?

This IS a liberal and Obama site, maybe you should look at the TOS.

Um, no, this isn't an "Obama site," my friend. It's called "Democratic Underground." However, it is true that the swooners continue to conflate the two. The rest, not so much anymore.

[Fred Sanders]

41. My opinion is that as long as it is President Obama (D), this site is what I said it is. Check the TOS and

check out the anti-Obama, anti-Democratic Party, anti-TOS comment you rather tepidly defend....again.

My favorite part of the TOS is the last sentence:

"Remember: DU is supposed to be fun — don't make it suck."

Any comments on the Kaiser Foundation research?

[Skittles]

72. there's plenty of folk here who think this is an "Obama site"

they have their own room and they still think no criticism is allowed anywhere on DU

[Le Taz Hot]

51. Liberals were against the ACA as it didn't go far enough.

Democrats were for it. Two different animals.

[bread_and_roses]

89. I'm of the Chris Hedges camp on "Liberals."

I'd say Progressives were against it ... and that "Liberals" did what they always do and settled for a miserable crumb instead of systemic change.

But that's a nomenclature that I know not everyone uses. And the essence of your distinction IS the same I was drawing.

[Le Taz Hot]

90. I know that the terms shouldn't be iterchangeabe

technically, but people do it anyway and I include myself in that list. Mainly because of the Establishment "Democrats" moved away from that label in the 1980's because the conservatives made the word "liberal" a pejorative and the "Democrats" who didn't back Carter in the 1980 election, ran far far away from it.

But Liberals or Progressives if you will, would NEVER back shit like the TPP, for-profit MANDATORY insurance
(as opposed to health care), nor would Social Security and Medicare ever have been on the austerity chopping block.

I didn't get the distinction part in your post so I just thought I'd throw those in there.

[bread_and_roses]

96. Exactly so

Sorry if I was unclear - meant my point was the same as yours in re: to ACA

(and TPP - and many other things, lol - if my memory serves, I am usually in agreement with your posts)

[Le Taz Hot]

100. No problem.

[Nay]

10. This was always going to be a problem with handing insurance companies the

whole business -- either the companies themselves would raise and raise the rates, or Republicans bent on destroying "Obamacare" would make insurance companies raise their rates higher than even the insurance companies wanted to. When you can completely game a system to either enrich yourself or break it, you can bet that either or both of these things will happen. The system MUST be taken out of the capitalistic 'game' or it will not survive.

[hobbit709]

13. I'm shocked, shocked I tell you.

[BrotherIvan]

19. Who could have known??????

My insurance has had 20-40% increases since a year before the ACA was enacted. My insurance is now three times what it was before and has a $6k deductible and doesn't work out of state. It is junk insurance. A lot of people are going to find that out when they try to use their plan.

Medicare for all!

[Ed Suspicious]

14. This on the heels of yet another of my annual rent increases that I received last week.

We sent the neuro-spine people $20.00 for my wife's injection last month. We were sent a letter thanking us for our payment but not nearly good enough. If we don't send at least $60 per month they will be forced to send us to collections where they will increase the bill by 1/3. Not much blood left in this old turnip. Bankruptcy is sounding better and better all the time.

Blue Cross Blue Shield is our insurer through my wife's employer.

[bucolic_frolic]

15. Insurance and Risk Management Runs the World

It's a for profit industry. Insuring ships from colonial times led to the
limited liability corporation - so shareholders weren't liable when the
ships sunk.

There's a lot of overhead in insurance. CEO and executives, sales
personnel, and did you notice any corporate headquarters that weren't
palatial? They usually have the largest and fanciest place in town.

Same with other types of insurance. Then when you try to file a claim
you get a big song and dance that blames you, they're not responsible,
it was pre-existing. You are a profit center to them - as long as they
don't pay a claim.

Wish I could walk away from all of them. That is one goal in my life, though
it will take a long time and in the meantime you have to be prudent and
pay them to accept your risk.

[Journeyman]

17. Yet we were told this week the "merger mania" among insurers was a result of the increased profits…

brought about by the Affordable Care Act.

It certainly makes it harder to believe the lies when they issue contradictory tales in the same news cycle. Not impossible for some, but harder for most to swallow their bilge. Maybe hubris will, indeed, be the death knell for corporate insurance pirates.

[Elmer S. E. Dump]

20. Ok fuckers, you had your chance - single payer!

🌝

[LuckyLib]

21. But they have no problem with outrageous CEO salaries

"The big winners have been the top executives of those companies, led by Mark Bertolini, CEO of Aetna, the nation’s third largest health insurer. Bertolini’s total compensation of $30.7 million in 2013 was 131 percent higher than in 2012.

If the stock prices of these firms keep growing at the current pace, Bertolini and his peers can expect to be rewarded even more handsomely this year, especially if they can hike premiums high enough to satisfy shareholders."

Bingo!

http://www.publicintegrity.org/2014/06/09/14912/skyrocketing-salaries-health-insurance-ceos

[RufusTFirefly]

24. The die was cast as soon as the ACA restricted the overhead percentage

You don't have to be an Einstein to figure out how to make more money when your overhead is limited to 20 percent.

20 percent of $1,000 = $200

Raise the premium to $1,500 and you make $300 instead.

[Hoyt]

31. Unless another insurer's premium is $1200, and a bunch of your insured jump ship.

Besides, most insurers have been cutting payments to providers.

A 9% premium increase - reported by Kaiser Foundation - is a lot less than premiums increased before ACA.

[Fred Sanders]

59. Not to mention the standard minimum coverages by law, no preconditions, etc...folks are forgetful.

[Fred Sanders]

43. It is not overhead that is limited, it is direct delivery of health care services. Sheesh.

Part of a provision in the health care law requires insurance companies to use 80 percent of collected premiums on medical services. Repeat: Medical Services.

If they don’t, they have to send rebates to policyholders for the difference.

And all those rebate checks that went out...remember them?

The inhumanity!

Sorry to say your comment is infamously accepted as correct in certain RW circles....that DU folks have to be made to understand is.....disappointing.

Perhaps you like to go back to the good old days when profit was unlimited and delivery of medical services unregulated?

The ACA is regulation of an industry, previously unregulated, same as regulation of any other. As conformed twice by SCOTUS. It is not complex, but it is also not as simple as so simply claimed.

[DebJ]

86. Interesting. I'd like to see the direct wording. What I had read previously was

that overhead + profit, combined, is what was restricted.

[Fred Sanders]

94. It is restricting profit - by forcing a certain level of spending you force a cap on profits....the company can have as

much overhead as it wants as long as 80% of premiums are used for health services.

That you have not heard this before is not surprising.....the corporate media has also gone silent on most economic news as well...shifting to foreign policy because good news is not news at all to them.

[tymorial]

80. Of course this was obvious

The problem is that many people just wanted to stop considering at "people will get healthcare" That made them feel good and far too many people only base their opinions on how they feel. Projected outcomes, objectivity are secondary.

Person 1. Yay for people getting healthcare....
Person 2. The government got in bed with the insurance industry which is completely corrupt
Person 1. Yay for people getting healthcare....
Person 2. The insurance companies will never allow their profit margin to be lost. Healthcare is ridiculously expensive, expect ever rising premiums and ridiculous deductibles under which will be everything beyond prescriptions and talking to your doctor. Labs and Radiology will be out of pocket until you meet the deductible.
Person 1. But people are getting healthcare now...
Person 2. How are people going to come up with 2000 bucks out of pocket when they are just making ends meet
Person 1. Finger in the ears.. la la la la la can't hear you.

[flamingdem]

26. The same old game

Where are the lawyers to protect consumers?

[awoke_in_2003]

45. They are being retained by the insurance companies. nt

[jtuck004]

27. I wonder if two great slums will be big enough. I used to think all these little temp fixes like the

ACA, and paying the bank$ter/donors their profits while they screw over working Americans would eventually implode and people would migrate toward great slums in the center of the country, one North and one South.

I no longer think that. Things like this, and the growing inability of people to pay the growing rents, are going to be more ultimately harmful, and will likely implode with greater destruction than I thought.

So now I think there will need to be at least two more great slums, in the West and the East.

I am stockpiling those plastic tarps and ropes they have in the substandard hardware store catalogs. I figure people will need at least a little shelter from the rain in between fighting government troops/police.

[Frustratedlady]

30. Make them prove they need to raise rates.

How much is their CEO making? Top staff members? What are their perks?

[appalachiablue]

58. Who the heck will make them prove rate hikes when they bankroll govt. officials?

In Greed We Trust.

[Fred Sanders]

61. Obamacare covers that!

[Doctor_J]

32. This may be good news for Sanders, since Clinton wants to keep the profiteers in the system

Yet another issue on which Clinton is basically a republican.

Two years ago, when heritage care kicked in, the company that supplies health insurance to my 300 person non profit doubled our rates. Our administration decided on a cheaper plan, so our premiums went up a little but the annual deductible and co pay went from 500/yr to 8500/yr.

Americans got screwed horrifically on the ACA, in that now we will have the insurance companies around our collective neck forever. For those who are ready to scream about how the republicans voted 1000 times to repeal it, here's a clue: that was nothing but theatre.

[GeorgeGist]

33. Affordable care. eom

[SoapBox]

35. I haven't seen bunches of them filing for bankruptcy...

Maybe the CEO's are scared that their multi-million dollar bonuses won't be big enough.

[Fred Sanders]

62. For the first time ever medical bankruptcies have DROPPED along with difficulties paying medical bills

I blame Obama, as always.

[CANDO]

74. Every time I see a Dr....

I end up with months of medical debt because of shitty insurance. And I pay extra premiums for lower deductibles.

[Wellstone ruled]

36. Appears this was baked into the

Law from the get go. Couple of observations,notice in the last few days merger talk with the 2 largest Medicare under writers,and,more are expected before the end of the year. And,this from some one inside the Hill Crowd,some increases will be 60%. Sounds like there are or have already been huge checks cut for any Senator or Congressperson on any Health and Welfare committee. The skids have been greased and the Populace does not get it,well this time it will smart. And this is what the GOP wants for 2018.

[awoke_in_2003]

47. of course it was...

they wrote the ACA

[Wellstone ruled]

48. Yup,and our Nation thinks it was a

Left Wing Democrat who did the deed. How about former Senator Dave Durenburger and his Insurance Bud's,and that folks is sure not someone from the Liberal Side of the Aisle.

[RoccoR5955]

39. I hope that they don't get it.

They already make too much profit.
Look at what the CEOs of the big health insurance companies make. The creep running United Healthcare took home more that sixty seven million last year!
Let these bastards take a cut in pay to make up for this shortfall.

What we really need is a universal system, like the rest of the civilized world has, not this handout to the insurance companies.

[awoke_in_2003]

44. No one could have anticipated this

[Renew Deal]

46. How are their current profits?

I bet they're fine.

[Doctor_J]

63. all-time high, and going up every quarter

that was the whole point of the aca.

[Le Taz Hot]

50. This was absolutely predicted

during the debate on ACA. Locked into being FORCED to pay premiums or take a hefty penalty. Ain't "free enterprise" grand?

[Spitfire of ATJ]

53. Aw,...poor babies were looking forward to new customers while providing ZERO care.

[Vinca]

55. This is exactly why a public option was needed.

Big insurance has gotten millions of new customers on the line and now they're reeling them in for the kill. Republicans will do nothing productive to solve this, so our only hope is Democratic majorities and a Democratic POTUS in 2016. Medicare for all!

[DirtyHippyBastard]

56. Selling health for corporate profit is evil. God told me so. eom

[DebJ]

84. Yes, it is evil and immoral, by any philosophy except the Love of Greed. n/t

[Doctor_J]

64. BTW all of these increases will be absorbed by people with employer plans

The poor can't pay any more obviously, the lobbyists will make sure that the rich don't get hit. Those who can afford Obamacare will shop around (though price-fixing will be rampant). That leaves the ever-increasing profits to fall on those who get their health insurance through the employers. Small businesses will probably take the biggest wallop.

Mandatory for-profit health insurance - an idea that should have led to guillotines being oiled up

[LibDemAlways]

65. What is "affordable" about astronomical premiums for

limited benefits? A family member was shelling out $550 a month in premiums for a "Silver Plan" during a period of unemployment. An emergency necessitated an ambuance. The uncovered portion of a brief stay in the emergency room was $6000 and the uncovered portion of the ambulance bill was $800. I fail to see how any of this can be considered "affordable." It's unconscienable.

[cstanleytech]

68. The rate increases should be denied across the board imo.

If they want to take it as tax write off to reduce their tax bill thats ok but they shouldnt be allowed to take advantage of people who are required by law to get health insurance just so they can line their pockets with a rate increase.

[cosmicone]

69. This is why we absolutely must have a "public option" n/t

[Hoyt]

70. Do you really think it will be much cheaper, unless there is some tough restrictions

on utilization? I to am for a public option, but it is going to be very expensive. I don't think most Americans are going to be willing to see their taxes increase. They should, but most want the other guy to pay.

[cosmicone]

107. It will be at least 31% cheaper

since most insurance companies' overhead is 35% whereas medicare's is 4%.

[Hoyt]

108. Actually it won't. ACA limits "overhead" to 20%, out of that 20% come credentialing of

providers, utilization/quality review, payment for all the up front capital required to pay claims and other administrative functions (something our current government will not take on), risk, marketing (which will still have to be done to some extent to promote good health, negotiating drug prices (which Medicare won't do), reporting on quality of care, answering beneficiary questions, coordinating care (something Medicare does very little), and a whole lot more. Most of that will still have to be done.

At best, you might save 5% or so by eliminating profit, after you figure out a way to administer the program without insurance companies. Medicare currently uses insurance companies to do all the heavy administrative work. Medicare officials write regulations and the insurance companies that administer the program get it done. Sure it could be done by the government, but they gotta gear up to do it. I don't see that happening anytime soon.

Point is, you won't save anywhere near what you think, if you could make it happen.

With all that said, we need to continue working on the transition to single payer, but we are nowhere near getting it done for practical reasons, not to mention our Congress won't enact it and appropriate upfront money to do it.

[Skeeter Barnes]

71. The idea of govt. health care will be ruined forever by Obama's insurance scam.

We asked for single payer or at least a public option, got charged full price for half a loaf and received crumbs.

[marmar]

73. Which just proves that insurance companies need to be extracted from health care altogether.

[TexasBushwhacker]

75. They will price themselves out if business

Because of the ACA, we now have many more choices than before, both for individuals and for businesses that provide health insurance.

However, I think insurance companies could do a better job of keeping costs down. They're business model has been to deny coverage or to pass increased costs onto the consumers. Hospitals charge $20 for a single Tylenol because insurance companies will pay it. A knee replacement can cost as little as $11K in Montgomery, AL or as much as $70K in NYC. I realize the overhead is higher in NYC, but SEVEN FOLD?

[The Jungle 1]

76. What "value added " do healthcare insurance companies add to healthcare in America

These crooks take 25-30% of every healthcare dollar we give them but what do they do. They collect the money keep a lot of it and produce nothing. It is a useless scam.

Healthcare Insurance companies do nothing for America.

[Hoyt]

77. I guess that is why most states have turned to private insurers to save money on Medicaid.

Last edited Sun Jul 5, 2015, 09:54 AM - Edit history (1)

And why Medicare uses private insurers to ajudicate claims, manage provider networks including credentialing, perform audits to prevent abusive billing, and more.

Could the government do better? Probably, if they were willing to invest the hundreds of billions it would take to manage a giant health care system, tell patients they ain't paying for costly drugs and procedures that aren't likely to prove cost effective, take politics out of budgets, cut providers to the bone, remove free choice of providers and utilization because coordinated care is better and cheaper than uncoordinated care, willing to put up with the griping and criticism, willing to increase taxes (even though people are too stupid to get they pay for it now but not as a tax), and a lot more
. . . .

[bread_and_roses]

93. Right - must be why everywhere else the people hate their national system

Don't we see them demanding that their governments convert to our privatized system?

Are you seriously defending the vampire health insurance industry?

[Hoyt]

95. Nope. I'm defending the transition to a national system. Medicare

is not it. Read.

[bread_and_roses]

97. Sorry if I misread you

I have a three-year old in tow at the moment so my attention is fractured - at best. My apologies for misunderstanding your post.

However, your admonition is condescending and unwarranted. I do not think your post was as crystal clear as you seem to, even on a second and third re-read.

So call me an idiot if you like. I come here for my own entertainment, and couldn't care less.

[The Jungle 1]

111. You work for an insurance company?

Be honest.

[Hoyt]

112. Not hardly, but I used to work for a state Medicaid agency decades ago and follow

things. Almost every state has gone to private companies, mostly insurance companies, to handle the day-to-day administrative functions of Medicaid. Similar, but somewhat different, for Medicare. Part of the reason is that states just don't have, or won't spend, the millions of dollars necessary to gear up to administer the program, pay claims, audit records, keep up with quality of care, coordinate care, maintain provider networks, and take the flak if something goes wrong (it's a lot easier for a Medicare Commissioner to blame it on AmeriGroup or Blue Cross than people who work directly for him/her), etc.

Again, could the government do better? Probably, if they'd appropriate the necessary upfront money and hire people who know what they are doing. But, nowadays, it just doesn't happen many places.

Now be honest, what experience do you have?

[The Jungle 1]

114. Only bad experience

I hate private healthcare insurance companies.
I am presently in the middle of an 8 month battle to get payments on 6 months of claims from last year. Insurance company blaming the provider and the provider blaming the insurance company. 8 months this has been going on. Just recently was informed by the insurance company that all the information they had provided me with is incorrect. Turns out the provider is not in network. The insurance company had assured me they were in network. What a stinking rotten pile of dung.
Many years ago it took 2 years for the insurance company to pay for my child's birth. We have had one problem after the other with healthcare insurance. It does not work. It is a scam.

I admit I am surprised to learn that states are using insurance companies to administer Medicaid. I did know that many self insured companies use insurance companies to administer healthcare payments.

Who administers healthcare payments in single payer countries?

[tymorial]

78. This was destined to occur

The government got in bed with the biggest baddest bloodsucking vampires in history... health insurance companies.

[DallasNE]

79. A Lot Of These People Are Seeing The Doctor For The First Time

In many years so going forward there should be some decline in requests for medical care. That expected bubble should not permanently drive up insurance costs. Another thing that would lower costs is for those States that have not done so yet, opt in for Medicaid expansion. I have no idea why the insurance companies are fainting that they were blindsided when what happened should have been expected.

[the_sly_pig]

81. insurance companys need to suck it up..

just like the rest of us. whiners.

[Astraea]

82. Which is exactly why

people's health shouldn't be at the mercy of the market. Medicare for all, NOW.

[candelista]

92. Thanks, Obama!

[L2-Cache]

105. According to the KFF report, avg increase is 4.4% for the 2 lowest silver plans.

Misleading article is misleading.