Tag Archives: insurance

If Obamacare Is Repealed, 3 Million With Pre-Existing Conditions Will Instantly Lose Health Care

by Shaun4585ihdn Posted on December 12, 2016

Mother Jones

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The Kaiser Family Foundation estimates that 52 million Americans have pre-existing conditions. How many of these are in the individual insurance market? “In 2015, about 8% of the non-elderly population had individual market insurance. Over a several-year period, however, a much larger share may seek individual market coverage.”

So let’s say 10 percent as a conservative round number. That’s 5 million people. Since Obamacare requires insurers to cover these people—and this is something Republicans can’t repeal—they will still have access to coverage even if other parts of Obamacare are repealed. However, there will be no subsidies, and the price of insurance will likely be high since this population skews older. At a rough guess, probably around 3 million of these people will be unable to afford insurance.

The full disaster of an Obamacare repeal goes far beyond this, of course, but it’s worth keeping this tidbit in mind. Once Obamacare’s subsidies are repealed, it’s likely that 3 million people with expensive pre-existing conditions will be instantly tossed out of the health care system, unable to get insurance and unable to afford proper care. And that’s just the beginning.

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If Obamacare Is Repealed, 3 Million With Pre-Existing Conditions Will Instantly Lose Health Care

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Raw Data: If Obamacare Is Repealed, 17-37 Million People Will Lose Health Coverage

by LionelHurd Posted on December 8, 2016

Mother Jones

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As Republicans merrily head down their stated path of repealing Obamacare without bothering to replace it, here are the latest CDC numbers on the uninsured:

Let’s put that into raw numbers. There are currently 273 million people in America under the age of 65. If we abolished Obamacare and returned to the 2013 percentage of uninsured, 17 million people would lose health coverage.

And that’s optimistic. If Republican recklessness caused the insurance industry to abandon the individual market altogether, the number of people who would lose coverage is somewhere in the range of 32-37 million. That’s about 22 million people who are currently in the non-group insurance market and another 10-15 million who benefited from Obamacare’s Medicaid expansion.

Repealing Obamacare makes a great campaign slogan, but now Republicans have to actually govern. Do they really want to be responsible for 17-37 million people losing health coverage? Really?

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Raw Data: If Obamacare Is Repealed, 17-37 Million People Will Lose Health Coverage

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High-Risk Pools Don’t Work, Have Never Worked, and Won’t Work in the Future

by GaryULNmsilfnrv Posted on April 28, 2016

Mother Jones

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Even among conservative voters, Obamacare’s protection of people with pre-existing conditions has always been popular. In a recent Kaiser poll, it garnered 74 percent approval from Democrats, 70 percent approval from independents, and 69 percent approval from Republicans.

Technically, this protection is guaranteed by two different provisions of Obamacare: guaranteed issue, which means that insurance companies have to accept anyone who applies for coverage, and community rating, which means they have to charge everyone the same price. But popular or not, Paul Ryan wants nothing to do with it:

In election-year remarks that could shed light on an expected Republican healthcare alternative, Ryan said existing federal policy that prevents insurers from charging sick people higher rates for health coverage has raised costs for healthy consumers while undermining choice and competition.

….”Less than 10 percent of people under 65 are what we call people with pre-existing conditions, who are really kind of uninsurable,” Ryan, a Wisconsin Republican, told a student audience at Georgetown University. “Let’s fund risk pools at the state level to subsidize their coverage, so that they can get affordable coverage,” he said. “You dramatically lower the price for everybody else. You make health insurance so much more affordable, so much more competitive and open up competition.”

It’s true that the cost of covering sick people raises the price of insurance for healthy people. That’s how insurance works. But there’s no magic here. It costs the same to treat sick people whether you do it through Obamacare or through a high-risk pool—and it doesn’t matter whether you fund it via taxes for Obamacare or taxes for something else. However, there are some differences:

Handling everyone through a single system is more efficient and more convenient.
High-risk pools have a lousy history. They just don’t work.
Implementing them at the state level guarantees a race to the bottom, since no state wants to attract lots of sick people into its program.
Ryan’s promise to fund high-risk pools is empty. He will never support the taxes it would take to do it properly, and he knows it.

This is just more hand waving. Everyone with even a passing knowledge of the health care business knows that high-risk pools are a disaster, but Republicans like Ryan keep pitching them anyway as some kind of bold, new, free-market alternative to Obamacare. They aren’t. They’ve been around forever and everyone knows they don’t work.

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High-Risk Pools Don’t Work, Have Never Worked, and Won’t Work in the Future

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A Closer Look at 2016 Obamacare Enrollment

by OsvaldoTeague Posted on October 17, 2015

Mother Jones

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Warning: Lotsa numbers ahead. Sorry about that. If you’re not interested, you can skip down to the last two paragraphs for the bottom line.

A couple of days ago, HHS projected that Obamacare exchange enrollment would reach 10 million by the end of 2016. That’s not much higher than the 9.1 million who are expected to be enrolled at the end of 2015. Has Obamacare enrollment stalled?

Maybe. But keep two things in mind:

This is probably a lowball figure. HHS would rather set a low bar and beat it than set a higher bar and have to explain why they missed it.
Charles Gaba, who has a pretty good track record with this stuff, estimates that 14.7 million people will sign up and 12.2 million will remain by the end of the year.

If Gaba is right, that’s an increase of about one-third from 2015. Not too bad. Still, it’s considerably less than the CBO’s original estimate of 21 million enrollees by 2016. Again, though, keep a couple of things in mind:

The CBO figure is for “average annual enrollment.” Since people drop out as the year progresses, this is probably equivalent to about 19 million by year-end.
CBO had estimated a drop of 8 million people from employer and other insurance plans. However, those numbers appear to have turned out lower than CBO’s estimates. This is a good thing—we’d prefer that people stay on their current coverage instead of being kicked off—but it obviously reduces the market for Obamacare enrollment. We should probably reduce CBO’s estimate by 3 million or so to account for this.

In other words, on an apples-to-apples basis, a best guess suggests that we’ll end up 2016 at 12 million compared to a CBO projection of 16 million. It’s still lower than CBO’s original estimates, but not by a huge amount. This could be due to (a) an overestimate by CBO, (b) weak performance by Obamacare, (c) an improving economy, or (d) nothing more than a difference in how fast Obamacare ramps up.

Bottom line: Because of all this, a more reliable metric of success is to skip all the details of who’s insured via what, and simply count the total number of uninsured. CBO originally estimated that the uninsured population would drop to 8 percent by 2016. That estimate changed after the Supreme Court made Medicare expansion voluntary, and CBO now figures that in 2016 the total number of uninsured will come to about 11 percent. The CDC estimates that in the most recent quarter the number of uninsured dropped to 10.7 percent. If Gaba’s numbers are correct, that will decline to about 10 percent or so by the end of 2016.

In other words, once you clear away all the underbrush it looks like Obamacare is meeting or beating its goals. Some of this might be due to an improving economy, but who cares? If the economy is doing well enough that more people are getting employer coverage and fewer are being forced onto the exchanges, that’s a good thing, not a knock on Obamacare.

POSTSCRIPT: Surveys consistently show that about half of the uninsured say they’re not on Obamacare because it’s too expensive. So for anyone who’s truly concerned that Obamacare isn’t hitting its enrollment targets, there’s an easy answer: increase the federal subsidies for the working poor so that more of them can afford coverage.

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A Closer Look at 2016 Obamacare Enrollment

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Hillary Clinton Challenges Big Pharma

by RhondaPWQR Posted on September 22, 2015

Mother Jones

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Hillary Clinton rolled out her latest policy plank in Des Moines, Iowa, on Tuesday afternoon. The Democratic front-runner described how, if elected president next year, she would try to rein in the spiraling costs of prescription medications.

Clinton is spending this week of her campaign touring the country explaining her proposals for health care and touting the benefits of the Affordable Care Act. Obama’s success in passing health care reform poses a tricky problem for Clinton: championing health care expansion has long been one of her signature causes going back to Bill Clinton’s first term as president. But the current Democratic president has already passed the overall infrastructure for covering the uninsured across the country. Now Clinton will need to run on protecting that legacy, while tinkering with the ACA around the margins to bolster its weak points.

“As president I want to go further,” she said Tuesday. “I want to strengthen the Affordable Care Act.”

Her drug plan would start by capping the amount of out-of-pocket expenses consumers can be charged under insurance plans at $250 per month. Of course, transferring the extra costs onto the insurance companies wouldn’t solve the all of the problems, since insurers would likely make up for their expenses through higher premiums.

She said earlier this week that her goal is to implement policies that would reduce spending on prescription medications by $100 billion over the next 10 years and proposed a number of strategies reach that goal. For example:

Speeding up approval of generic drugs to clear any backlog.
Allowing consumers to buy their medications from countries where American pharma companies sell them at cheaper rates. (This would require the FDA to ensure that the drugs being sold in other countries are the same medications as the ones sold here.)
Grant Medicare the power to negotiate with drug companies on the prices they charge. This has long been a standard proposal pushed by Democrats who argue that the 40 million Medicare recipients would have a system-wide effect on the price of drugs.
Add requirements to drug companies who receive federal support, forcing them to redirect more of their profits back into R&D.

You can read a full explanation of her suggestions on Clinton’s website.

Pharma was already gunning for Clinton even before her speech announcing the policy proposal. As The Hill reported, the head of the pharmaceutical lobby preempted her statement with its own that blasted the plan, saying it “would turn back the clock on medical innovation and halt progress against the diseases that patients fear most.” Pharma might have good reason to be worried. On Monday, Bloomberg attributed a quick, steep drop in Nasdaq’s listing of biotech stocks to a Clinton tweet in which she linked to a New York Times article on a company that had jacked up the price of an old drug, saying, “Price gouging like this in the specialty drug market is outrageous.”

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Hillary Clinton Challenges Big Pharma

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John Roberts Just Saved the Republican Party From Itself

by TristanFrank Posted on June 25, 2015

Mother Jones

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The Supreme Court’s Thursday ruling, written by Chief Justice John Roberts, that upheld a core tenet of the Affordable Care Act is good news for the millions of Americans whose health insurance was on the line. But it’s also, in a strange way, good news for a completely different group: the Republican politicians who have all but called for Obamacare to be shot into space on a rocket.

Had the court gone the other way, gutting federal subsidies while leaving the shell of the law on the books, congressional Republicans, as well as GOP governors such as Scott Walker and Chris Christie, would have been put in the uncomfortable position they’ve managed to avoid since Obamacare was signed into law—having to fix it. The Associated Press outlined Walker’s dilemma neatly on Wednesday:

About 183,000 people in Wisconsin purchase their insurance through the exchange and nine out of 10 of them are receiving a federal subsidy, according to an analysis of state data by Wisconsin Children and Families. The average tax credit they receive is $315 a month.

Health care advocates who have been critical of Walker for not taking federal money to pay for expanding Medicaid coverage have also called on the Republican second-term governor to prepare for the subsidies to be taken away.

And many of those Wisconsonites enrolled in the federal exchange are there because Walker put them there. As Bloomberg’s Joshua Green noted in a prescient piece in March, Walker booted 83,000 people from the state’s Medicaid program and put them on the federal exchange instead. That’s not the kind of crisis you want to be dealing with in the middle of a presidential campaign—or ever.

Conservatives would have been thrilled with a ruling in their favor on Thursday. But Roberts’ decision spares Walker and his colleagues from what would have come next, and frees them to continue lobbing rhetorical bombs at the law they’re now stuck with. As previous generations of Washington Republicans can advise, it’s much easier to go to war if you don’t need a plan for how to end it.

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John Roberts Just Saved the Republican Party From Itself

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Don’t Panic: Health Insurance Rates Aren’t About to Rise by 50 Percent

by EstellaMassie Posted on May 22, 2015

Mother Jones

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Here’s the latest Fox News bait from the Wall Street Journal:

Major insurers in some states are proposing hefty rate boosts for plans sold under the federal health law, setting the stage for an intense debate this summer over the law’s impact.

In New Mexico, market leader Health Care Service Corp. is asking for an average jump of 51.6% in premiums for 2016. The biggest insurer in Tennessee, BlueCross BlueShield of Tennessee, has requested an average 36.3% increase. In Maryland, market leader CareFirst BlueCross BlueShield wants to raise rates 30.4% across its products. Moda Health, the largest insurer on the Oregon health exchange, seeks an average boost of around 25%.

All of them cite high medical costs incurred by people newly enrolled under the Affordable Care Act.

Well, of course they do. It’s a handy excuse, so why not use it?

In any case, we’ve all seen this movie before. Republicans will latch onto it as evidence of how Obamacare is destroying American health care and it will enjoy a nice little run for them. Then, a few months from now, the real rate increases—the ones approved by state and federal authorities—will begin to trickle out. They’ll mostly be in single digits, with a few in the low teens. The average for the entire country will end up being something like 4-8 percent.

So don’t panic. Sure, it’s possible that the Obamacare shit has finally hit the fan, but probably not. Check back in October before you worry too much about stories like this.

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Don’t Panic: Health Insurance Rates Aren’t About to Rise by 50 Percent

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More Good News For Obamacare: Employer Health Coverage Hasn’t Crashed

by JasmineClancy Posted on December 19, 2014

Mother Jones

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The share of the population with employer health insurance has been slowly eroding for years. The chart on the right tells the story: total coverage rates have dropped from 70 percent to 62 percent since 2001. The trend is pretty clear: the number of workers covered by employer insurance has been dropping about half a percentage point per year for more than a decade.

So has Obamacare accelerated this trend? There have long been fears that it might: once the exchanges were up and running, employers might decide that it was cheaper to ditch their own insurance and just pay their workers extra to buy coverage on the open market. But a new study says that hasn’t happened:

We found essentially no change in offer rates throughout the study period. Overall, the rates stayed steady, at around 82 percent. Offer rates in small firms also held steady, at around 61 percent….We found no change in take-up rates overall, or by income or firm size, between June 2013 and September 2014.

….As with offer and take-up rates of employer-sponsored insurance, there were no significant differences in coverage rates for the insurance overall or for any subgroup. The rates stayed roughly constant at about 71 percent across all workers, about 50 percent among workers in small firms, and about 82 percent among workers in large firms. The rates also remained constant among low- and high-income workers in either small or large firms.

Note that the percentages themselves differ between the Kaiser numbers and the study numbers thanks to differences in methodology. And there are, of course, plenty of reasons we might see only small changes in employer coverage. The economy has improved. Inertia might be keeping things in check for a while. Perhaps as Obamacare becomes settled law and its benefits become more widely known, more employers will drop their own coverage.

Those are all possibilities. For now, though, it looks as though fears of employers dumping health coverage were unfounded. It’s yet more good news for Obamacare.

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More Good News For Obamacare: Employer Health Coverage Hasn’t Crashed

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Climate Change Is Kicking the Insurance Industry’s Butt

by olikellopas Posted on October 22, 2014

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In the months after Hurricane Sandy, insurance companies spooked by rising seas dropped coastal policies in droves.

That could become an increasingly common story, according to the largest-ever survey of how insurance companies are dealing with climate change, released today. Global warming is increasing the risk of damage to lives and property from natural disasters beyond what many insurers are willing to shoulder. And most insurance companies aren’t taking adequate steps to change that trend, the survey found. That’s a problem even if you don’t live by the coast: When private insurers back out, the government is left to pick up much of the damage costs; already, the federal flood insurance program is one of the nation’s largest fiscal liabilities.

Ceres, an environmental nonprofit, evaluated the climate risk management policies of 330 large insurance companies operating in the United States. The results are worrying. Only nine companies, 3 percent of the total, earned the highest ranking.

The insurers that scored highly on the survey (including several of the world’s biggest, such as Munich Re, Swiss Re, and Prudential) were those that have adopted a broad range of climate-conscious products and services, such as rate pricing plans that account for potential climate impacts like storms and fires. Some insurers are also investing in high-end climate modeling software to better understand where their risks really are. Others offer environmentally friendly plans like mileage-based car insurance and encourage their customers to rebuild damaged homes using green technologies. And some insurance companies are making significant efforts to monitor and reduce their own carbon footprint.

However, the report finds that one major way insurance companies are adjusting to climate change is by not insuring properties that are threatened by it, said Washington State Insurance Commissioner Mike Kreidler, a lead author of the report.

“As a regulator, it’s very bad to see markets being abandoned because of the threat that exists,” he said.

Certainly the threat is real. Globally, average annual weather-related losses have increased more than tenfold in the last several decades, from $10 billion per year in the period 1974-1983 to $131 billion in 2004-2013, according to the report. The insurance industry is not keeping pace: The proportion of those damages that are insured is steadily declining:

Tim McDonnell

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Climate Change Is Kicking the Insurance Industry’s Butt

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Obamacare Isn’t Perfect, But That’s No Reason to Give Up On It

by Andrianayhv Posted on September 22, 2014

Mother Jones

A few days ago I noted that health insurance companies were starting to price certain drugs at higher rates. Not just certain brands of drugs, but entire classes of drugs. This is being done in an apparent attempt to discourage patients with certain conditions from applying for insurance. Better to have some other insurance company pick up the cost of their expensive illness.

The reason this is happening is that Obamacare prohibits insurance companies from turning away customers with pre-existing conditions. So instead they need to find cleverer ways of making sure they’re someone else’s problem. David Henderson comments:

I predict that none of this will cause Kevin Drum to reconsider his pre-existing view that pricing for pre-existing conditions should be illegal.

Quite right. When it comes to Obamacare, there are two kinds of people. Henderson is the first kind. Whenever they hear about a problem, their invariable response is that this proves Obamacare is a hopeless mess and needs to be abandoned.

I’m the second kind. When I hear about a problem, my response is that we need to try to fix it. This is because I believe everyone should have access to decent health care at a reasonable price, and one way or another, we need to figure out how to provide it. We don’t give up just because it’s hard.

For what it’s worth, this particular problem is not something that’s taken any of us by surprise. Capitalism has a well-known capacity for motivating people to find clever ways to make money, and Obamacare supporters were all keenly aware that insurance companies would try to game the rules to maximize their profits. It was one of those things that required constant vigilance. Unfortunately, that never happened because it turned out that Republicans in Congress are so uncompromisingly opposed to Obamacare that they’ve prevented problems of any kind from being addressed, apparently in the hope that someday these problems will grow serious enough that the public will turn against the whole thing.

I guess you can decide for yourself if you consider that a praiseworthy response to a law you don’t like. I consider it loathsome myself. As for my pre-existing view about pre-existing conditions, that’s easily explained. I supported Obamacare as a good first step, but if I had my way the whole edifice would get torn down and replaced with a sensible national health care plan of the kind used by virtually every other civilized country on the planet. This is because health care of the kind that civilized people desire simply isn’t a good that can be efficiently provided by the free market, for reasons that are fairly obvious to anyone familiar with the literature. Nor is this just an academic point. Half a century of experience shows us that national health care works better on nearly every measure than our Rube Goldberg system. It’s not perfect, because nothing ever is. But it would be a big step forward.

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Obamacare Isn’t Perfect, But That’s No Reason to Give Up On It

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