Bye, bye Osamacare

[Mainecat]

Oh jeeze

[Rigid1]

Just now, Snoslinger said:

pay attention to some fucking current events once in awhile would you?

https://www.forbes.com/sites/brucejapsen/2017/07/31/big-week-ahead-for-insurers-as-trump-weighs-obamacare-subsidies/#57bc68b0752f

 

fuck,  leaving in april 2016, what did Tump do back then??

Big Insurer to Quit Obamacare Exchanges

Experts say that the insurer's impact will be small, but felt in rural and Southern counties.

By Kimberly Leonard, Staff Writer | April 19, 2016, at 4:35 p.m.

UnitedHealth Group, the nation's largest health insurer, announced Tuesday that it will be pulling out of Obamacare's insurance marketplaces in most states where it operates, raising questions about what the move would mean for customers and whether competitors would carry out their threats to leave as well.

 

 

New Report: Insurers Leaving Obamacare Exchanges in Droves

Justin Haskins

|

Posted: Apr 20, 2016 11:05 A

 

 

 

  According to Haislmaier, there are now only 287 “exchange-participating insurers,”down from 307 in 2015 and significantly less than the 395 insurers Haislmaier says were in operation in the 50 states and Washington, DC in 2013, only one year prior to the opening of the ACA health insurance marketplace.

 

[Snake]

34 minutes ago, Snoslinger said:

trump is trying to change the policies where insurance companies get reimbursed. because of that, some insurance companies are using this "uncertainty" as an excuse for dropping out. Obama wasn't fucking with the reimbursement policy to create this scenario, trump is. iceman asks who caused this "uncertainty" and racer responds with a comment like it "happens all the time" with obamacare. that is not true.

 

Did someone say reinbursement rates?

GAO Finds Payments To Insurers Under Affordable Care Act Are Illegal

The Government Accountability Office, the government's non-partisan watchdog agency, issued a ruling today holding that the Obama administration's diversion of billions of dollars from the United States Treasury to insurers selling individual policies on the ACA Exchanges was illegal. The GAO joins the Congressional Research Service, another non-partisan agency, in finding that these payments, which the Obama administration has insisted are lawful, are in fact completely unauthorized and inappropriate. For what it is worth, the GAO opinion is also largely consistent with views I have expressed on several occasions (here and here).

Here's what GAO concluded after 12 pages of careful legal analysis about section 1341 of the Affordable Care Act and the behavior of Health and Human Services (HHS):

In light of the foregoing analysis, we conclude that HHS lacks authority to ignore the statute’s directive to deposit amounts from collections under the transitional reinsurance program to the Treasury and instead make deposits in the Treasury only if its collections reach the amounts for reinsurance payments specified in section 1341. The agency is not authorized to prioritize collections in this manner. The agency must give effect to the extent possible to all of section 1341, and, to do so, is required to collect and deposit amounts for the Treasury, regardless of whether its collections fall short of the amounts specified in statute for reinsurance payments. HHS may not use amounts collected for the Treasury to make reinsurance payments.

The GAO ruling could result in yet more trouble for insurer's selling policies on the Exchange and criminal investigations of those who authorized the illegal payments. The Obama administration has already spent $16.2 billion on the program for 2014 and 2015 and another $5 billion is scheduled to be spent in 2016, at which point the program is supposed to expire. Of the money spent thus far, only $500 million (3.1%) has been sent to the Treasury; 96.9% has been sent to insurers. Under the GAO's interpretation of the law (section 1341 of the Affordable Care Act), no matter what amount the government collected for this program, 20% of the total belongs to the Treasury. The GAO found that the language of the statute was crystal clear and that the Obama administration's efforts to get around that language were "unpersuasive" and "internally inconsistent." (That's legalese for nonsense). Thus, insurers may have an obligation to return $2.74 billion to the federal government for 2014 and 2015. That's about 17.4% of what insurers received during that time frame. Moreover, insurers may be getting considerably less than they hoped for in 2016.

 

Getting the Money Back

To the extent insurers have to give money back, three things can be said.  First, a reimbursement requirement (which could be met partly by withholding any 2016 reinsurance obligations until the repayment obligation was met) will genuinely hurt insurers already struggling with the ACA. Insurers collected  roughly $92 billion in premiums in 2014 and 2015 for policies sold in the individual market on the Exchanges. Most lost a good deal of money even without any reimbursement obligation. On average, reinsurance payments amount to about 20.2% of premium revenue for 2014. So, if each insurer has to refund 17.4% of their reinsurance money, that will mean a loss of roughly 3.5% of their premiums for 2014.  For 2015, it looks like reinsurance payments will have been about 13% of premium revenues, so a 17.4% refund obligation means a 2.3% hit on premiums for that year. For both years, that's a significant hit for insurers, many of whom are already unhappy and struggling with the ACA.

Second, insurers and the public should hold CMS squarely responsible for the problem. CMS is the part of HHS that runs the reinsurance program. There would be no problem if CMS had simply collected the correct amount of money set forth in the ACA. The reason there is a problem is that CMS, either through stupidity or a belief thought that it would get away with it, collected too little money from the broad group of health insurers that the ACA obligated to pay into the system; CMS then decided to give almost all of it (not just 80%) to insurance companies selling policies on the Exchange. While conceivably there is an excuse for CMS getting it wrong in 2014 when it was new at the game -- although a supplemental assessment would have fixed the problem -- there is no excuse for CMS making exactly the same "mistake" in 2015, when it knew what its 2014 experience was looking like. And, of course, there's no excuse for the "oops I did it again" of using similar assessment methodology in 2016.

 

Third, insurers are not only going to fight with the federal government about this, they are going to fight among themselves. The GAO says the money should be paid pro rata.  But does that mean pro rata by year (16.7%/83.3% for the Treasury/Exchange insurers in 2014, 25%/75% for Treasury/Exchange insurers in 2015 and 20%/80% for the Treasury/Exchange insurers in 2016)? Or does it mean pro rata over the lifetime of the program -- 20% for the Treasury and 80% for insurers? It matters. If you are an insurer in the market only in 2015, you want it pro rata by year so that you would get 20% of whatever was collected in 2015.  On the other hand, if you were an insurer in the market only in 2014, you want it pro rata over the lifetime of the program so that you get 20% of whatever was collected. It gets very messy and the numbers involved are large enough to hire fancy lawyers to duke it out.

And there are two other possibilities. Just as CMS changed the reinsurance programs mid year to make them juicier for insurers -- raising the attachment point and increasing the reimbursement rate -- perhaps CMS could go back and undo the changes to something like what it originally planned.  This would result in insurers receiving less money. The refunds would not be a uniform percent but would very from insurer to insurer. If this is done, expect some insurers to be happier than others.

Alternatively, CMS might make a supplemental assessment on insurers for 2014 and 2015 so that the amount they collected equalled the amount they were supposed to collect. In many ways this is the simplest solution: health insurers selling policies on the Exchanges don't have to give back any money. The broader world of health insurers who are taxed, however, to pay for the reinsurance program are likely to protest this idea, however, as it will mean a modest retroactive tax increase (perhaps something like $10 per member per year). Although in the past this idea of a supplemental assessment has been scorned as requiring all sorts of elaborate rule making, perhaps it looks a lot more attractive now that the GAO has joined the list of those saying that CMS' prior behavior was illegal.

https://www.forbes.com/sites/theapothecary/2016/09/29/busted-gao-finds-payments-to-insurers-under-affordable-care-act-are-illegal/#2ee6e770b620

[AKIQPilot]

slinger has become one of, if not the biggest dipshit on this forum.  The guys is so eaten up by his cunts loss that he can't think or communicate clearly.  This is hard to watch.  

[Highmark]

Most reasonable people knew when Obamacare was passed it was simply a means to single payer.   It would be such a catastrophe that people would accept govt control as the only fix as Obamacare still had the "free market" as a part of it.  Look at what the dems are claiming is the problems with Obamacare not enough people on Medicare.  Now they want to take the wealthiest part of the population and pull them from the "free market" system.   Then when it collapses even more they will want the rest.    

 

Edited August 8, 2017 by Highmark

[AKIQPilot]

1 minute ago, Highmark said:

Most reasonable people knew when Obamacare was passed it was simply a means to single payer.   It would be such a catastrophe that people would accept govt control as the only fix as Obamacare still had the "free market" as a part of it.  Look at what the dems are claiming is the problems with Obamacare.  

 

I know you and I disagree on single payer but IMO that is the only way to get healthcare under control.  I've been a proponent of single payer for most all of my adult life.  Why should an insurance company make a profit on whether I'm healthy or not.  The game is rigged in their favor and they always win.  They are guaranteed to be profitable by either raising premiums or denying coverage.  

Affordable healthcare should be a right for every US citizen.  How can we consider ourselves a first world country when any one of is one accident away from bankruptcy.   

[Momorider]

17 minutes ago, AKIQPilot said:

slinger has become one of, if not the biggest dipshit on this forum.  The guys is so eaten up by his cunts loss that he can't think or communicate clearly.  This is hard to watch.  

[Mainecat]

1 hour ago, AKIQPilot said:

slinger has become one of, if not the biggest dipshit on this forum.  The guys is so eaten up by his cunts loss that he can't think or communicate clearly.  This is hard to watch.  

Profound

[AKIQPilot]

Just now, Momorider said:

So what is your opinion of the Canadian Healthcare System you guys have?  What is it called?  Does it work?

[AKIQPilot]

Just now, Mainecat said:

Profound

Don't worry.  You will always be #1 so we don't even count you when tallying up all the dipshits.  

[Momorider]

Just now, AKIQPilot said:

So what is your opinion of the Canadian Healthcare System you guys have?  What is it called?  Does it work?

Unsustainable costs are out of control and almost 50% of every tax dollar is going to pay for it

[AKIQPilot]

1 minute ago, Momorider said:

Unsustainable costs are out of control and almost 50% of every tax dollar is going to pay for it

So you're saying 50% of every dollar collected by your income tax goes to pay for health care?  

Do you pay a healthcare tax separately from regular income tax?  Do employers pay anything into the healthcare system?   

[Dave]

9 minutes ago, AKIQPilot said:

So what is your opinion of the Canadian Healthcare System you guys have?  What is it called?  Does it work?

If you have money...you go to the states to get things done....you will die waiting if its nothing major or life threatning...like a hip or knee replacement for example.

[AKIQPilot]

Just now, FAT DAVE said:

If you have money...you go to the states to get things done....you will die waiting if its nothing major or life threatning...like a hip or knee replacement for example.

How is the healthcare tax collected?  

[Momorider]

11 minutes ago, AKIQPilot said:

So you're saying 50% of every dollar collected by your income tax goes to pay for health care?  

Do you pay a healthcare tax separately from regular income tax?  Do employers pay anything into the healthcare system?   

A lot of people do have 3rd party insurance through employers buts its all supplemental not core care. 

Edited August 8, 2017 by Momorider

[Momorider]

3 minutes ago, AKIQPilot said:

How is the healthcare tax collected?  

Its general tax mostly but in Ontario they have a supplemental tax based on income also collected as part of your income tax other provinces may have similar  

[Dave]

4 minutes ago, AKIQPilot said:

How is the healthcare tax collected?  

By taxing us through the roof...we pay gst( government sale tax) on most things for example.

[Momorider]

Just now, FAT DAVE said:

By taxing us through the roof...we pay gst( government sale tax) on most things for example.

And services not just goods 

[AKIQPilot]

Just now, FAT DAVE said:

By taxing us through the roof...we pay gst( government sale tax) on most things for example.

So there isn't a specific line item tax that is for healthcare at 3% of gross or something.  

[Dave]

Just now, Momorider said:

And services not just goods 

Things?

[Dave]

Just now, AKIQPilot said:

So there isn't a specific line item tax that is for healthcare at 3% of gross or something.  

Not that ive seen?

[Momorider]

2 minutes ago, AKIQPilot said:

So there isn't a specific line item tax that is for healthcare at 3% of gross or something.  

In Ontario there is  http://www.fin.gov.on.ca/en/tax/healthpremium/

on top of what is already spent out of general tax revenue 

[Dave]

Sorry @AKIQPilot when I said government sales tax that was incorrect...gst actually stands for goods and services tax....but should really be called what I called it....its a complete joke.

[Highmark]

1 hour ago, AKIQPilot said:

I know you and I disagree on single payer but IMO that is the only way to get healthcare under control.  I've been a proponent of single payer for most all of my adult life.  Why should an insurance company make a profit on whether I'm healthy or not.  The game is rigged in their favor and they always win.  They are guaranteed to be profitable by either raising premiums or denying coverage.  

Affordable healthcare should be a right for every US citizen.  How can we consider ourselves a first world country when any one of is one accident away from bankruptcy.   

I understand the thought process behind the desire for single payer however I just don't want the govt to control that much a part of our lives.

First and foremost HCI is not why HC is so expensive.   I can post study after study that show's private HCI is more efficient than govt ran (Medicare/Medicaid) when comparing apples to apples.  The only way medicare shows to be more efficient is when looking at cost of administration to the cost of benefits.   This will always look low because older people have much higher average HC cost per visit.   When looking at the whole picture cost of administration per visit private comes out more efficient every time.  

Reality is there are tons of things in our society that we could say are a "right."   Food and energy come to mind.  Yes both those industries are highly subsidized by the govt but HC and HCI is already as well.   Has been for a long time.  In fact if you look at Medicare, Medicaid and the other govt money that goes into HC a huge % of people are already under UHC of some sort or another.  You want to be a a system as fucked up as the VA?  

The only way to dramatically control costs is control the care itself.   This means limits on what people are paid and what care is given out.  I read article after article on countries NHC having issues which are only beginning.  

https://www.forbes.com/sites/theapothecary/2016/09/04/british-government-hospitals-to-ban-smokers-the-obese-from-surgery-due-to-budget-constraints/#71caae773b99

Beyond the rationing of pay and care I've yet to hear one reasonable solution on how to deal with all the private ownership of the current HC and HCI industry.   Its real easy to just say we are going to Federalize them without understanding what and how that would even be accomplished.  People fail to understand that a significant portion of doctors and clinics are privately owned and a large portion of those by the doctors themselves.   Going in and telling them what they can and cannot charge will have tremendous impacts on our system.  These issues are just a drop in the bucket of what it takes to implement single payer in a country of 325 million people.  

Edited August 8, 2017 by Highmark

[Snoslinger]

1 hour ago, Rigid1 said:

fuck,  leaving in april 2016, what did Tump do back then??

Big Insurer to Quit Obamacare Exchanges

Experts say that the insurer's impact will be small, but felt in rural and Southern counties.

By Kimberly Leonard, Staff Writer | April 19, 2016, at 4:35 p.m.

UnitedHealth Group, the nation's largest health insurer, announced Tuesday that it will be pulling out of Obamacare's insurance marketplaces in most states where it operates, raising questions about what the move would mean for customers and whether competitors would carry out their threats to leave as well.

 

 

New Report: Insurers Leaving Obamacare Exchanges in Droves

Justin Haskins

|

Posted: Apr 20, 2016 11:05 A

 

 

 

  According to Haislmaier, there are now only 287 “exchange-participating insurers,”down from 307 in 2015 and significantly less than the 395 insurers Haislmaier says were in operation in the 50 states and Washington, DC in 2013, only one year prior to the opening of the ACA health insurance marketplace.

 

I never made the claim insurers didn't leave before trump. duh, that was obvious. you and racer still cannot follow directions properly. one more time...racer made the claim that things in obamacare have been changing since day one, comparing it to what trump wants to do now. if you still can't follow along, don't respond.