Wednesday, September 15, 2010

Humana vs PPACA

First, Humana continues to be a valued player in the health insurance market, which is a good thing (I'm a big proponent of competition). This post is about mail I received from them this morning, but is not to be taken as a slam on Humana; rather, it is illustrative of the destruction being wrought by ObamaCare©. I fully expect to see similarly worded missives from other carriers over the next few days.

Remember that promise that "more people will be able to get insurance?"

Well, not so much going forward.

From the letter:

"As of Sept. 18, 2010, we will stop quoting coverage for applicants under age 19 ... We will not issue a policy for applicants under age 19 with an effective date on or after Sept. 23, 2010"

This is a direct result of the Guaranteed Issue provisions of ObamaCare©. Since the carrier cannot turn a minor away, and it's unlikely they'll be able to price for the as-yet-unknowable risks, they've shut the door. This is an entirely rational and justifiable decision, by the way, and one which should have been seen by HHS Secretary Shecantbeserious as her agency started implementing the various provisions.

"If a dependent under age 19 applies with a parent or legal guardian and the parent or legal guardian is uninsurable, the dependent is ineligible."

This is consistent with the first condition stated above, and makes sense from a risk-management perspective. The overarching theme is that we now have fewer, and much more expensive, choices.

That extra expense, by the way, doesn't buy better benefits. Quite the contrary. In another Humana mailing we received this morning, the carrier announced substantial changes to its prescription drug benefits. For example, there are increased pre-authorization requirements for refills. On the other hand, quantities of refills are being reduced, which will add to the total out-of-pocket cost of their members' health care.

Most PBM's (Pharmacy Benefits Managers) assign medications to various "tiers," which then dictate a medication's co-payment amount. Those are changing, as well:

"[I]f members fill or refill a prescription for one of the drugs changing levels ["tiers"], they may pay a higher copayment."

Again, this makes sense, but, as we noted previously, it puts the lie to the notion that ObamaCare© will lower the cost of either health care or health insurance.

As Bob says: Smaller cars, bigger health insurance headaches, Poppa Washington.
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