Wednesday, January 28, 2015

Popcorn State Expansion

On February 1, 2015 Indiana will become the 28th state to expand Medicaid. Good news (I suppose) for
those under 138% of the FPL. No more insurance premiums.

But you may have trouble finding a doctor. This is nothing new nor indigenous to Indiana. Medicaid participants in all states have trouble finding doctors willing to take them as new (or even old) patients.
About 765,600 Hoosiers lacked insurance in 2013, according to the Kaiser Family Foundation. The state has estimated more than 300,000 Hoosiers — or 56 percent of those newly eligible for Medicaid — could enroll in the first year and more than 400,000 would sign up during the second year. - Indy Star
Agents that wrote Obamacare subsidized plans on those under 138% of the FPL can probably expect to lose those clients ....... and the revenue.

How is the expansion funded?
The federal government pays for 100 percent of the cost through 2016. That declines gradually to 90 percent by 2020, assuming Indiana's waiver is extended past three years. Indiana's share — estimated to be about $1.6 billion between 2015 and 2021 — will be paid for through the state's existing cigarette tax and from a tax on hospitals.
Funded by the federal government, which doesn't have any money.

And funded by smokers and hospitals.

Increasing the cost of cigarettes probably isn't bad in the big scheme of things but taxes on hospitals will increase the cost of health care. How is this a good thing?

So, what is a Hoosier any way? I have heard it comes from "Hoosier mama" which I suppose is a version of "Yo mama".

Regardless, I wonder if this is a good thing or not.

Some thoughts on subsidies

So, been having a bit of a Twitter-tussle with a well-regarded friend and colleague. At issue is the future of ObamaTax subsidies as we look forward to the resolution of Burwell/King/Halbig.

Which got me to thinking: Why we're having this discussion at all? After all, President Obama explicitly promised us that, under the ObamaTax, premiums would decrease 3000%, and that we would have comprehensive, affordable coverage.

If this were truly the case, then why would we need bribes subsidies in the first place? After all, who wouldn't want cheap, useful insurance coverage? Why would we need to be cajoled, nay, forced into buying it if it was such a great bargain?

And if, as Mike pointed out years ago, the folks in DC actually did their jobs, would we need to be expanding Medicaid?

Thought not.

Tuesday, January 27, 2015

Tuesday Spindle-clearing

In no particular order:

■ Coming as a surprise to no one who's been paying attention:

"A quarter of firms that that had offered insurance to their employees last year were canceling their health plans this year, and another 25% said they planned to do so next year."

This in Michigan, and focused on smaller companies not (yet) subject to the Employer Mandate. Talk about blizzards...

Could treating Alzheimer's really be this simple?

"Researchers say they’ve developed a nasal spray that could potentially improve memory and other mental capabilities for the more than 5 million Americans suffering from Alzheimer’s disease."

It's still a long way off (and currently being tested only on those with mild cases), but sounds promising.

Almost 5 years ago, we wrote about a "Lifespan Calculator:" an online widget that purported to predict how many days one had left. It appears that the technology is improving:

"A test to determine if elderly patients will die within 30 days of being admitted to hospital has been developed by doctors to give them the chance to go home or say goodbye to loved ones."

Corrected for accuracy:

"A test to determine if elderly patients will die within 30 days of being admitted to hospital has been developed by doctors to encourage them onto the Liverpool Pathway."

There, better.

But hey, "middle class:"

"I’m sorry sir,” the polite customer-service agent said. “There’s nothing I can do. You’re either going to have to enroll in Medicaid or you’re going to have to pay the full health-insurance rate.”

The problem, of course, is that the gentleman in question had the misfortune to fall within the one category for which the ObamaTax was supposed to work, but never quite has. As a grad student, he wasn't worried about his next BMW, but neither was he worried about his next meal. Couple that with the problem that, if one is eligible for Medicaid one is not eligible for a subsidy, and one begins to see the problem.

I really like the author's take on this, by the way: "Call me crazy, but in my book Medicaid is a last resort, not a first option."

It's so easy to forget that this is no game, no theory; it hurts real people, every day.

DC's Best Kept Secret

What with all the reports of how well Open Enrollment v2.0 has been going, it's no wonder the folks in charge want to keep this under wraps:

"It will cost the federal government – taxpayers, that is – $50,000 for every person who gets health insurance under the Obamacare law"

But that's only the tip of the proverbial iceberg:

"It will take $1.993 trillion, a number that looks like $1,993,000,000,000, to provide insurance subsidies ... and to pay for a massive expansion of Medicaid and CHIP"

But hey, worth it to provide universal health insurance coverage.

Wait, what?

"The best-case scenario described by the CBO would result in 'between 24 million and 27 million' fewer Americans being uninsured in 2025, compared to the year before the Affordable Care Act took effect."

So after 15 years and $1,993,000,000,000, they still won't have everyone covered?

Gee, sure glad they passed it to find out...

(And notice, one has to go to the UK press to find this)

Monday, January 26, 2015

Solution for Austerity Cuts in Health Care

If your government is running out of money and cutting services to balance the budget, what
do you do?

Elect a liberal.

Greece has been teetering on bankruptcy for years thanks to too much government and too many social give away programs. All that is about to change as a result of this weekends election
In Greece’s biggest hospital, the Evangelismos Hospital in Athens, conditions were worse than those I have seen in developing countries.
The moment the hospital doors open on ‘emergency’ days, people flood in. The collapse in official primary and community health care services means everyone who needs healthcare comes to A+E - whether for a major accident, medication for a long term condition or to get their child immunized. Staff told me that serious trauma cases often have to wait hours for X-rays and treatment due to understaffing and that, if too many cases come in at the same time, people die before they can be treated. - Open Democracy

The "austerity program" has saved the country but at what price? 
The government had closed all the polyclinics then reopened some recently but with only 30% of the doctors that they need. Whereas previously there had been 150 doctors providing services to the district, there were now only 50. A polyclinic for a population of 400,000 people had no gynaecologists, no dermatologists, and only two cardiologists.
 “We want our doctors back” – said one of the volunteers I spoke to. Thousands of doctors have left the country. Those that remain – including senior hospital doctors - earn about €12,000 ( $13,400 US) a year.
The good news?

Greater access to health care (presumably).

The bad news?

Eventually Greece will run out of money (again) and they are back to square one. There is no free lunch.

CoOpportunity assumes room temp

Last month, we reported on the travails of Iowa's CoOpportunity Health, a start-up recently taken over by Hawkeye State regulators. FoIB Josh Archambault tips us that they've now been shuttered:

"Iowa’s insurance regulator plans to shut down insurer CoOportunity Health, marking the first failure of one of the nonprofit cooperatives created under the Affordable Care Act."

T'won't be the last.

Saturday, January 24, 2015

P&C Files: That's *NOT* How It Works!

[click pic to embiggen]

[Hat Tip: DoIB Sarah S]

Friday, January 23, 2015

Flashback Friday

Our 2nd ever post here was a recap of the "Top Insurance Swindlers" of Ought-four. It was a rogues gallery that included a "greedy granny" and an arsonist pastor, among others (no mention of the apocryphal cigar owner). In fact, you'll notice an edit dated earlier this month: a business owner had emailed me requesting that I modify an entry because - ten years on - it was adversely affecting her business.

Fast forward a decade, and we have the truly inspirational story of an entire family of (alleged) insurance fraudsters:

"Authorities said the ensuing probe uncovered a decades-long pattern of questionable insurance claims ... Six other people, including her husband, two children and daughter-in-law, also face charges."

Bet Thanksgiving dinner is a hoot.

Thursday, January 22, 2015

Obamacare with Thin Crust or Thick?

Next time you order a pizza think about Obamacare. The same folks that brought us lower health insurance
premiums and better coverage are helping us make better choices when it comes to pizza.
The FDA finalized an Obamacare-mandated rule in November that requires restaurants to display calorie information on their menus. However, there appears to be some confusion over what the FDA calls a “menu.”
I J Review

A menu is what the server hands you in a restaurant.

But it can also be a web page, advertising flyer, clip and save coupon .........

To make matters more complicated,
Considering that Domino’s customers can customize their own pizzas, there is an endless number of possible combinations of toppings, each of which has a different calorie count. Liddle said a low-ball estimate of combinations Domino’s offers is 34 million. Pizza Hut has 2 billion possible combinations.
Maybe pizza's should be broken down into 4 simple categories.

Bronze, silver, gold and platinum.

That would simplify everything.

Medicaid and Long Term Care

Many folks continue to believe - erroneously - that Medicare will cover most (if not all) of their long term care needs. It won't. But Medicaid probably will, if you lack the assets to self-pay.

Unfortunately, this requires that one "spend down" one's assets, accumulated over a lifetime of toil. To qualify for assistance from Medicaid to cover long term care expenses, one is allowed to keep only a small amount of cash, a home and a car, maybe a few baubles.

The good news is that buying a Partnership-qualified long term care insurance plan, one may offset some of that spend down, and keep more assets.

And, as local ElderCare Law guru Michael Millonig informs us via email this morning:

"Level of Assets That Spouses of Medicaid Recipients May Keep Rises for 2015 ... [For example] If a couple has $100,000 in countable assets on the date the applicant enters a nursing home, he or she will be eligible for Medicaid once the couple's assets have been reduced to a combined figure of $52,000 -- $2,000 for the applicant and $50,000 for the community spouse."

Click on through for more details.

Wednesday, January 21, 2015

Is really just a massive voter data collection tool for DNC? [UPDATED]

[Scroll down for update]

Seeing how Obama has abused the IRS and voter registration this isn't such a stretch:
"Daoudi's company — Catchpoint Systems— came across some 50 third-party connections embedded on They attracted attention because such connections can slow down websites. They work in the background, unseen to most consumers.
The AP was able to replicate the results. In one 10-minute visit to recently, dozens of websites were accessed behind the scenes. They included Google's data-analytics service, Twitter, Facebook and a host of online advertising providers."
A list of 9 million potential voters who "benefited" from government largess along with their facebook and twitter friends would be very valuable come Get Out the Vote time.  

UPDATE [HGS @ 1/21/15]: And it gets worse:

"... – the flagship site of the Affordable Care Act, where millions of Americans have signed up to receive health care–is quietly sending personal health information to a number of third party websites."

Including, Twitter and even Youtube.

Hey, if you like your privacy, you can keep....

A Giveaway is Now a Threat

As open enrollment creeps across the finish line in year two, many organizations that support Obamacare are changing their marketing plans. The first year and the opening of this year focused on the ever popular "giveaway" model. It came in two parts.

1. Give people something for free. From free birth control to free preventive care people should sign up for health insurance because these benefits wouldn't cost anything. Never mind the fact that doctors and pharmacies aren't really giving this stuff away.

2. Explain that Government thinks this is important for you to have insurance so they are paying the majority of your premiums. Never mind the fact that if your income is above $20,000 to purchase a Silver Level plan you will pay 5% of your income for it. Never mind the fact that cheap insurance means high out-of-pocket costs for health care.

Now comes the third marketing campaign:  Explain the consequences of not buying insurance. The dreaded and unpopular individual mandate and the tax you have to pay for not buying government approved health insurance with free stuff in it. Never mind the fact that you are being taxed to help pay for parts one and two above.

Yep, that should do the trick.