Thursday, October 31, 2013

"I’ve seen a eunuch with a more functional front end."

From via Instapundit:

Happy Halloween!

Promises, promises...

Apropos of nothing much (P&C edition)

Via email, I just learned a new word, "Nutraceutical:"

"Do you have clients involved in the manufacture, distribution, or packaging of vitamin, nutritional or supplement products? ... [We are] pleased to provide our expertise in Primary Product Liability Coverage for the Nutraceutical Industry"

Since this is way outside my wheelhouse, I would normally have just deleted it. But how can one resist that term? Although I must admit, my first thought was of boats.

Thanks, A. J. Renner & Associates!

Promises, Promises

PresBo lied, your policy died:

[Hat Tip: The Conversation]

Because Shut Up, That's Why is the symptom....

FoIB Bob Graboyes has a wonderful, insightful post up over at Forbes, in which he notes the confluence of Israeli daycare, Blue Grass State healthcare (well, health insurance, to be precise) and the SCOTUS tax-scare:

"[D]ay care centers in Haifa, Israel, had a problem with tardy parents retrieving their children after closing time ... monetary penalties would discourage parents from flouting the no-tardiness mandate"

The problem is that they aimed low, and shot themselves in the foot. How? By imposing only a nominal fine, they ended up reinforcing the behavior.

And then there was Kentucky's ill-fated 1994 attempt at its own version of RomneyCare the ObamaTax:

"Insurers could neither refuse purchasers nor drop them for health reasons. Insurers could not differentiate premiums on the basis of gender, health status, or claims experience ... Insurers fled the state by the dozens ... By 2000, guaranteed issue was gone"

I remember this debacle well - in fact, I taught a CE class on it, back in the day. I recall how frustrating it was for Kentucky agents, since the only carrier left was Blue Cross. Lots of choice there.

Which brings us to the SCOTUS and liver. To this day, I'm ambivalent about whether CJ Roberts' decision was a gift or a curse. Bob offers his own take, and I can't say that I disagree.

Read the whole thing©.

Top. Men. (Redux)

Back in April, Bob reported on the CGI Group's recruitment as ObamaTax Exchange developers. In case you were wondering, the "C" in CGI apparently stands for "Canadian," since the firm is headquartered there.

And apparently they use igloos as data warehouses, since their last big government contract didn't go so well:

"Their most famous government project was for the Canadian Firearms Registry. The registry was estimated to cost in total $119 million, which would be offset by $117 million in fees. That’s a net cost of $2 million."

Not a bad deal: register 7 million rifles at a net cost of about $4.50 (assuming that's Canadian dollars, that works out to about US$4.38 in 2004 currency values),

Turns out, they underestimated the actual cost a bit: the original $119 million bid ballooned into an impressive $2 billion final price tag; a staggering "thousand times more expensive."


But here's the kicker: "Canada’s auditor general reported to parliament that much of the information was either duplicated or wrong"

Sound familiar?

Oh, the epilogue:

"CGI was hired to create an entirely new CFIS II, which would operate alongside CFIS I until the old system could be scrapped ...  $81 million was thrown at it before a new Conservative government scrapped the fiasco in 2007"

Wouldn't it have been less expensive - and certainly more efficient - to just flush a fully-laden Brink's truck down a toilet?

[Hat Tip: Ace of Spades]

Wednesday, October 30, 2013

Halbig is it?

Last week, we noted that Michael Cannon's years-long coverage of the subsidy vs Federally-run Exchange issue had passed another hurdle:

"A federal judge ... refused to dismiss a case that could fatally cripple the Obamacare health insurance law ... 'The IRS cannot rewrite the law that Congress passed'"

This was a substantial blow to proponents of the ObamaTax, and this week, Michael has more details on why this is, in fact, a very big deal. I highly recommend that you click on through.

But I wanted to highlight a few items. Joel L. McElvain is the government's Obamastration lawyer arguing the case on behalf of his masters. Here he attempts verbal jujitsu, with predictable effect:

"Congress is creating a “legal fiction” that each state has established an Exchange. If a state does not establish an Exchange, “the premise stands” that it has. Therefore, when the federal government establishes an Exchange, it is, fictionally but legally, “an Exchange established by the State.”

I told Michael that this gave me a headache, and wondered how Mr McE could say that with a straight face.

A bit later, we run into our old "friend," Timothy Jost. Esteemed co-blogger Patrick recently skewered Mr J here:

"So tell me Tim, as a law professor which quote of yours is correct?"

Definitely read Michael's piece, it's quite enlightening.

Stupid Chamber Tricks

We have been members (and supporters) of our local Chamber of Commerce (South Metro Regional Chamber of Commerce) for many years, during some of which we've been more active than others. But we have always felt that it was important to support the Chamber's efforts, as they have supported - to a greater or lesser degree - ours.

But no more.

This morning, we received an email that the SMRCOC has decided that rather than support us, they wish to compete with us, by contracting with an out-of-town outfit to sell and administer the Chamber's own private employer health insurance Exchange, in direct competition with us and other member agents.

They've never reached out to us for help or advice on this, or even asked if we'd like to participate as a professional and experienced sales partner.

That's obviously their prerogative, as it is ours to immediately resign.

Here's what's sad: we are not the only agents who've been active and supportive members for many years, and yet the "leadership" has decided that, instead of a mutually beneficial relationship with folks who have donated time, effort and money, they would rather cast their lot with an organization who will never be in a position to financially support (as in patronize) the very businesses that the SMCROC claims to represent and support.

I'd call that pretty shortsighted.

Obamacare Co-ops - The Next Big Scam [UPDATED]

Evergreen, a health co-op in Maryland, came to life as a result of a $65 million loan from the federal government. The idea of the co-op is to provide lower cost health insurance to fulfill the promise of premium savings in the #Obamacare sales pitch.

However, there is a problem.
Just days into the Obamacare enrollment fiasco, CEO Dr. Peter Beilenson had to blow up his business plan.
"We actually called a meeting immediately, upon learning of he difficulties with the exchange, of our entire 35-person staff and said, 'Listen, guys, we're going to have to switch our marketing strategy, our strategy of going after folks," Beilenson said.
That means forgetting about individuals for now and instead targeting small businesses the old-fashioned way, with phone calls and TV ads.
It's not just the lack of new enrollee's that is creating the problem.
Their biggest fear is that with the website problems, more of the people who enroll will be the sickest and most motivated. If that happens, insurers would have no choice but to raise premiums and that could cause more healthy customers to flee.
Well duh.
Heavily subsidized health insurance is like an "all you can eat buffet for a buck".
Why does this remind me of #Solyndra?

UPDATE [HGS]: Meantime, HHS Secretary Kathy "Baghdad Bob" Shecantbeserious weighs in lies through her teeth:

Cavalcade of Risk #195: Choose Your Own Adventure edition now up

Jason Hull makes his CavRisk hosting debut with a true blockbuster of a post. His introduction makes some terrific points, perhaps the most eloquent of which is that "[o]ne of the biggest mistakes I see people make is accepting risks they should be insured against and insuring risks that they should be accepting."

It's also helpful that he gives each featured post helpful context.

Kudos, Jason!!

HOSTING BLEG: We're looking for a few good hosts for late Fall Cav's. Just click here to grab yours!

Tuesday, October 29, 2013

No, no, no - A thousand times no!

This has been making the rounds:

"The law states that policies in effect as of March 23, 2010 will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered."

Which is true, and puts the lie to the claim that "if you like your insurance, you can keep your insurance."

But some folks, not content to let the truth speak for itself, have added a flourish: that even premium increases will render a plan "ungrandfathered."

No. It. Won't.

Premiums increase all the time. I am looking at one client's grandfathered plan, which has had 3 rate increases since it was written in January 2010, and it is still grandfathered.

Please, people, the ObamaTax is bad and destructive enough on its own; it is in fact counterproductive to mischaracterize additional defects.

So stop it.

Docs Just Say No to Obamacare

If you like your doc, they may not like you. 
A poll conducted by the New York State Medical Society finds that 44 percent of MDs said they are not participating in the nation’s new health-care plan.
Another 33 percent say they’re still not sure whether to become ObamaCare providers.
Only 23 percent of the 409 physicians queried said they’re taking patients who signed up through health exchanges.
And you thought the new rates + higher deductibles were your only problem.
Nearly eight in 10 — 77 percent — said they had not been given a fee schedule to show much they’ll get paid if they sign up.
Go ahead and treat the patient, doc. Trust us. You will eventually get paid.
“Any doctor who accepts the exchange is just a bad businessman/woman. Pays terrible,” argued one doctor.
Remember "If you like your plan you can keep it"?
Too bad that was a lie.

ObamaTaxAgeddon Break: CanuckCare

I don't know about you, but I'm getting a bit burned out on the sheer volume of ObamaTax glitches, snafus, cock-ups and crashes. So, for a change of pace, let's look to our Neighbors to the North© for some inspiration.

Oh, wait.

"Canada's Supreme Court has ruled that under the "law of the land" in Ontario, a government board, not the family or doctors, has the ultimate power to pull the plug on a patient."

This reminds me of something, what do you suppose that is?

This Sceptered Isle - Part DLXXIV

NHS pulls the plug on its £11bn IT system

Hey, isn’t that good news!??!  This means the Fair Kathleen has lots more programming and systems design expertise available to help her fix the federal Exchanges she’s responsible for!

In theory, the UK system was intended "to result in improved quality of care and lower costs. This theory is also widely touted by health care observers in the U.S."  As we noted at the time (6 years ago!):

As with all theory, the true test is whether it works in real life. No better way to tell than to try it out. And - maybe - the best place to try it out is somewhere else not here.”

Now, after lo! these many years and mountains of British taxpayer money, the U.K government has decided that real life is tougher than they thought - and expresses its regret (well, sort of), to wit: “a department spokesman said: "The Government recognises the weaknesses of a top-down, centrally imposed IT system.” Not to mention the cost - 11 billion British pounds sterling is nearly 18 billion US dollars.

Just to clarify, it’s the U.K. Government – not ours - that recognizes its strategic error.

Sadly, our present administration has not learned this lesson.  And with each passing day it becomes more obvious that learning this lesson is going to cost American taxpayers a lot more than $18 billion.

Monday, October 28, 2013

You’ve sold it, now what happens…

Recently, co-blogger Bob V sent me a link from his list-serve that concerned co-payments:
I have a client, who currently has UHC RPPO, the copay is $0 for her PCP. I find out today that her Primary care doctor has been charging her a $35 copay every time she sees her. The doctor is clearly listed as a "Primary Care Physician" in the directory, and not a specialist, So I cannot figure out why she would get billed a copay like this. I have not had a chance to contact the doctor yet to investigate, but when I found this out, I was outraged, i wanted to go down to her doctor's office and demand they give her her money back.

While I admire this agent's chivalry, before he cold-cocks a doctor, maybe we should review the situation, beginning with: what is a co-payment? A co-payment is an amount of money a patient agrees to pay a physician for an appointment, as set by the insurance company, which the physician agrees to accept. These co-payments are to be collected at time of service, hopefully before the appointment ( but I digress). Some companies determine the co-payment by the type of provider (eg  Family Practice or Specialist) or by appointment type (eg Physical Therapy), or even a single co-payment regardless of the appointment type or provider. In this situation, the Family Practice Doctor was charging the higher Specialist co-payment to the patient.

Let’s assume that the doctor is collecting the higher co-payment. When the doctor electronically bills the insurance company for the appointment, the co-payment of $35.00 will be reflected in the bill, so the insurance company will know what the patient paid and the charge by the provider. If the co-payment is incorrect, the doctor will receive an EOB with the $35.00 taken out of his payment and probably a note reflecting that the insurance refunded the patient the $35.00. In the end the doctor still makes the same amount of money, and it will be reflected in the doctor’s practice management system that a co-payment is not due. Insurance companies are very competent in ensuring that doctors are not, in any way, overpaid for the services they render.

To be honest, unless this provider is practicing in the dark ages, without any type of electronic practice management system or EMR, this scenario does not often play out, for two reasons:
1) The HITECH Act, passed several years ago, outlines 20-plus meaningful uses that each physician’s office must adhere to in order to continue to get their Medicare monies. One of those meaningful uses is to verify insurance and the patient’s financial responsibility. This is then recorded into the software, and when the patient arrives with their insurance card and driver’s license and their paperwork filled out completely, then the patient is charged their co-payment as set by the insurance company.
2) Patients do not know much about their health insurance but they, by God, know how much their co-payment is and will REFUSE to pay one penny more than they owe; oftentimes they don’t even want to pay their co-payment, but again I digress.

So, I would not worry too much about the co-payment: the patient and the insurance will surely keep the doctor in line.

Privacy, Shmivacy

This story has been making the rounds, and it's bad enough. If and/or when one finally does manage to log on to the ObamaTax website, if one looks closely enough, one will find this disclaimer:

"You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this information system"

Now there are actually two things terribly wrong with this picture:

First, the disclaimer is itself hidden inside the Terms & Conditions agreement (to which one must consent before moving forward with the process); it's available only by "using a web browser's "View Source" feature."

Talk about passing it to find out what's in it.

But that's not even the most egregious part: after all, if one is resourceful enough (and aware of its existence) one may find the CYA clause fairly easily.

No, what's truly scary is this:

Not long ago, I suffered through underwent the training and certification process which allows me to sell new "metal" plans on the Exchange (someday, maybe). Fully 30% of that training was focused exclusively on privacy and security measures that agents must take in order to be compliant.

Section 5 promised that its completion would allow me to:

■ Define PII (Personally Identifiable Information)
■ Identify the extent to which PII may be used and disclosed
■ Identify key privacy responsibilities and restrictions associated with PII under the Marketplaces

Two key points to remember about this definition:

1. This definition may be different than definitions provided under other laws. It is important that you are familiar with this federal definition and how it applies to Marketplace information.

2. A key component to the definition is that PII involves information that is linked or linkable to a specific individual. Therefore, if it is possible to link information to an individual, this information would be considered PII, even if it has not yet been linked to that individual.
Now compare that with what the Navigators on the phone at the actual government-run web-site have privy to, and yet are completely exempted from, and the web-site itself, which is also exempted from these burdensome requirements.

The purpose of Section 6, we're told, is to enable us to:

■ Define the term "information security"
■ Identify three key elements to protecting information
■ Identify the differences between threats, vulnerabilities, and risks to information
■ Identify certain controls that agents and brokers can take to protect information within the Marketplaces
■ List steps that agents and brokers can take to help promote information security in the Marketplaces
■ Identify types of security incidents
■ List steps for responding to a privacy breach as it relates to information security management

And here's a snippet from that section:
• Information security is achieved through implementing technical, management, and operational measures designed to protect the confidentiality, integrity, and availability of information

• The goal of an information security program is to understand, manage, and reduce the risk to information under the control of the organization.

• In today’s work environment, many information systems are electronic; however the Department of Health and Human Services (HHS) has a media neutral policy towards information. This means that any data must be protected — whether it is in electronic, paper, or oral format.
Both "snippets" are culled from the actual on-line coursework, which is available by clicking the highlighted sections. I figure Ms Shecantbeserious is entitled to just as much privacy as the rest of us.

Saturday, October 26, 2013

Friday, October 25, 2013

Cavalcade of Risk #195: Call for submissions

Jason Hull hosts next week's Cav. Entries are due by Monday (the 28th).

To submit your risk-related post, just click here to email it.

You'll need to provide:

■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post

PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like). And please only submit if you are willing to link back to the carnival if your submission is accepted.

My newest article is up...

Thursday, October 24, 2013

Did Anyone Conduct Due Diligence on Sebelius?

From an insurance agents perspective, when you look at the way #Obamacare was cobbled
together (the law, not the website) you have to ask yourself if HHS Secretary Sebelius learned anything at all during her 8 year tenure as Insurance Commissioner.

The answer is, she must have slept through the entire 8 years because she certainly did not learn anything.

But her lack of knowledge of the insurance industry apparently is not the only shortfall.
Sebelius oversaw numerous costly and disastrous government website projects during her six-year governorship (2003-2009), including a failed update of the Department of Labor’s program to provide unemployment pay and other services and similar updates pertaining to the Department of Administration and the state’s Department of Motor Vehicles (DMV) services.
“In the Kansas Senate, I chaired the Commerce committee. We had oversight over the Department of Labor. For years, we watched as the Department of Labor under Sebelius worked on that computer program. After seven years and $50 million, something should work,” Brownlee told TheDC.
“In Kansas if you have a 40 or 50 million dollar project, that’s a lot of money,” Brownlee said, noting that the Labor Department project was funded by federal money while other Sebelius website projects sucked up state taxpayer dollars. “They started and stopped that project with at least 3 different major contractors.
She had experience, if you can call it that, in blowing through $50 million on a project that still didn't work right.
Her reward was to put her in charge of a project that started out as $90 million and quickly grew to over $600 million . . . and counting.
Only in DC would a move like that make sense.

Health Wonk Review - Ignore at Your Peril edition is up

Jaan Siderov, one of my very favorite wonk-bloggers, presents this week's snarky but effective round-up of posts on health care policy and polity, And it looks like IB's contributed a new catchphrase - but you'll have to read the 'Review to find out what it is.

Kudos, Jaan!

My new article is up...


"Short Term Medical plans continue to offer affordable coverage for specific time-frames. They also appear to fill a potential need for those who find themselves uninsured and out of Open Enrollment"

Wednesday, October 23, 2013

Let's clear something up

Over at RedState, Moe Lane has a post up detailing a conversation ("online chat") between a potential ObamaTax buyer and one of the helpful help-desk folks. The whole thing's worth a read (it's pretty short), but here's the lede:

"You have until March 2014 to enroll ..."


"... health insurance coverage typically starts on the first day of a given month, and it takes up to 15 days to process applications ... to successfully accomplish that you have to send in your application by the middle of February."

So what else is Dean (et al) getting wrong?

Breaking: ObamaTax website fixed!

The RH Group has managed the impossible - a working ObamaTax website.

Click here to check it out.

And for those who really want to know, JWF has found the unsecured HHS site with real premiums (unsubsidized). Unfortunately, these aren't a joke.

Cannon-fire scores a hit

A while back, we noted that uber-wonk Michael Cannon claimed that citizens of states with Fed-run Exchanges weren't eligible for ObamaTax subsidies, and that the employer mandate was inoperative in those states. At the time, the story didn't have a lot of "legs;" indeed, the IRS ran rough-shod right over it, announcing far and wide that they were going to ignore that part of the actual, written, passed-by-Congress and sign-by-the-President law.

As one might imagine, this hasn't sat well with various and sundry folks who feel, perhaps nostalgically, that the law-as-written should mean something, and so a group of them filed suit to have it enforced.

The lawsuit has languished for a while, but has now been given new life by a Federal judge who - gasp! - understands that the plaintiffs have a legitimate case:

"A federal judge on Tuesday refused to dismiss a case that could fatally cripple the Obamacare health insurance law ... 'The IRS cannot rewrite the law that Congress passed'"

But of course they can do just that, and so far what's stopping them?

Bueller? Anyone?


It's been a while since we've heard from the Much Vaunted National Health System© (aka that which the ObamaTax seeks to become), which is a shame, since it provides a glimpse into our own future, health-wise.

First up, the Independent reports that "free" health care isn't really, um, free:

"Stagnant health spending combined with ever rising costs and demand mean the NHS is facing "the most challenging period in its 65-year existence," ... In a frank assessment of the dangers faced by the health service, senior officials ... say that the two years following the next general election will be pivotal in deciding whether the NHS can continue to provide free health care for all patients."

I think that we can all surmise what the answer will be. Math is relentless.

Next, the Daily Mail reports that the MVNHS© may well have found its cost-cutting groove:

"GPs have been paid bonuses to put elderly patients on controversial ‘death lists’ in an attempt to save the NHS money by cutting the number of people who die in hospital"

At $81 (£50) a pop, a doc could make a nice living on these one-way tickets to Liverpool (Pathway, that is).

Easy come, easy go.

[Hat Tip: Ace of Spades]

Twins Separated at Birth?


Monday, October 21, 2013

NEWS FLASH! Obamacare Program Released On 35 Floppy Disks!

Having problems logging in?  Now you can have your very own version of ObamaCare...

Rumor has it that the 6 CD version should be out sometime in 2016. 

Hannity Calls Obamacare Hotline

Talk radio host Sean Hannity calls the Obamacare hotline. After finally getting through to an operator
he asks for feedback.

HANNITY: They're really telling you to tell us to check back in on the website in off-hours. Does that mean that I should go on at like three in the morning?

OPERATOR: It was saying early in the morning and late at night, but some people say they do that and still can't get in.

HANNITY: So people are reporting to you the real deal?

OPERATOR: Yes sir, they are.

HANNITY: Have you ever got anybody that really likes it yet?

OPERATOR: Umm, no, not really.

Sunday, October 20, 2013

Are We There Yet?

Remember when you were a kid and you were taking a long trip in the car with your parents? Every ten minutes you would ask "are we there yet?" and your parents would answer "we're getting closer!" even though you had another three hours to go...

The difference is, this time you might not ever get there.

So, How Many Actually BOUGHT ObamaInsurance?

Administration officials say about 476,000 health insurance applications have been filed through federal and state exchanges,

I suspect this number is not only inflated but misleading.


Because of this.
However, the officials continue to refuse to say how many people have actually enrolled in the insurance markets.
The initial step, that begins at healthcare.guv, is to complete a financial colonoscopy application to learn if you qualify for a subsidy.

After you go through that procedure the next step in the House of Horrors is the dreaded Sticker Shock.
Cabinet members and other top administration officials will also be traveling around the country in the coming weeks to encourage sign-ups in areas with the highest population of uninsured people.
Is this really a smart move?

To drum up support for a site that supposedly has problems caused by "pent up demand"?

Somehow I doubt the makers of Edsel and Corvair felt the solution to their problems was to try and sell more cars before fixing the underlying problems.

Friday, October 18, 2013

More website fun

Yesterday, The Weekly Standard published an interesting article about some of the computer code running on  It appears that some sections were plagiarized from a British company.  The software in question was published under the  GPL license, which means it's free to use, AS LONG AS THE COPYRIGHT NOTICE is left intact.  The brainaic programmers behind took it out.  That's called software piracy in most quarters...

See:  for more details.

Smooth move guys.  Not only doesn't it work, but you stole it to boot....

Thursday, October 17, 2013

InsureBlog Exclusive: Maryland Exchange rates

Thanks to a generous (and anonymous) benefactor, we've got ObamaTax-compliant rates and plan details for potential Old Line State consumers (assuming they can actually log-in).

Click here for Plan Details

Click here for Plan Rates

Why are these important?

Because these are the actual, non-subsidized rates - what these plans really cost.

Read 'em and weep.

Obamacare Meltdown

Unless you have been living under a rock for the last 2 weeks, you are aware of the dysfunctional #Obamacare website

But did you know Obamacare is impacting ice cream?
the Bonnie Doon plant and downtown Mishawaka location. They tell us there are many reasons for the shutdown such as the declining economy and the rise in production costs. But the number one factor? The anticipated cost of the Affordable Care Act.
 "With the Obamacare it just will affect the businesses too much so that was their main reason for shutting down the ice cream plant at this time."

1 Down, 6,999,999 to go


"Delaware officials are celebrating the state's first health insurance exchange enrollee."

Here's the bad news:

"59-year-old Janice Baker of Selbyville the first confirmed resident to enroll in the marketplace."

Why is this bad news?

Because the ObamaTax requires more young, healthy Americans to sign up in order to pay for folks like Ms Baker, who's premiums are directly subsidized by substantially higher rates for younger folks. Absent large numbers of the latter, the system's economic assumptions fail. Miserably.

Unfortunately, the Cavalry ain't comin' obver the hill any time soon:

"The number of visitors to the federal government's Web site plummeted 88 percent between Oct. 1 and Oct. 13"


Wednesday, October 16, 2013

Adventures On The Marketplace

My journey to “affordable”insurance continues. After giving HHS the benefit of the doubt that these “glitches” were going to be fixed, I decided to return to and continue the process of signing up. After getting back into the system (6 failed attempts first) I clicked on ENROLL and...error message!
So, I called the 800 number and got a very friendly voice named Mackenzie. Mackenzie was very helpful. She told me that there are these things called “glitches” that keep happening because too many people are getting on the site. She said: “2.5 people are on it at a time and the site keeps having problems.” Of course I asked her what types of problems to which she promptly replied “It’s not recognizing passwords, email addresses, usernames, and stuff like that.”

At that point I kindly told her thanks and asked one last question – How bad do you hate your job right now? The response sums up the whole marketplace experience.

“Oh, it’s okay. I really wish we could help somebody. The problem with calling us to help enroll is that we are looking at the same system you are. When you can’t log in neither can we. I like that you have been nice. Many callers are angry, yelling profanity at me.” I said, it’s not your fault. Did you share with them that people can’t start coverage until January 1st? Her reply: “No, no, you can start insurance coverage on November 1st as long as we have your application done by October 15th. If it is after the 15th then you don’t get insurance until the following month. You know, December.”

Yep, that's our hard earned tax money giving wrong information again.

Cavalcade of Risk #194: Fantasy edition

Claire Wilkinson hosts this week's "easy come, easy go" edition of the Cavalcade. On the one hand, she's got a great selection of posts, and has done a great job of presenting them.

On the other, now I've got a Queen-induced ear-worm.

Thanks, Claire!

Tuesday, October 15, 2013

No Health Insurance? That's Fine.

North Georgia Staffing, a "boutique" staffing agency is facing a tough decision. This husband and wife company has 18 full time employees and 400 part-timers.

They have survived a recession, but may not make it through Obamacare.
"We have very good employees, and we want to take very good care of them," Debbie Underkoffler said.
But under ObamaCare, the Georgia company now faces a tough choice -- cover all of its temporary workers as well, or pay a hefty fine.
Fox News

Obamacare uses screwy rules to come up with "full time equivalent" employees. In this case 400 part time employees = 200 full time employees.

Got it?

That means NGS must offer affordable health insurance (Obamacare design, of course) to their employees or pay a fine.
under the health care law, they'd have to provide insurance coverage to all, or pay a $2,000-per-worker fine. In the Underkofflers' case, the fine might be the more affordable option.
One of those unintended consequences that impacts a successful business.

Of course HHS Shebullshits would say there is no problem since their 400 employees will now have access to affordable health insurance on the exchange.

Assuming they can log on to the website . . .
Those penalties could add up to $400,000 in just the first year. That comes right off their bottom line. Still, it's a fraction of what providing health care could cost them. That tab could top $2 million per year.
Simple math.

Obamacare. The gift that keeps on giving.

Sensible Carrier Tricks

Humana has announced that they are discontinuing so-called "HIPAA plans" in Ohio. This follows Anthem's announcement last month that they're pulling their version. One presumes that any other carriers that still have these on the books will soon be following suit.

"HIPAA Plans" came about as a result of, well, the Health Insurance Portability and Accountability Act of 1996. Briefly, the law said that if you were uninsurable in the individual (underwritten) market, you must be offered a standardized guaranteed issue plan. There were two versions, Standard and Basic, both with the same out-of-pocket maximums, but different deductibles and co-insurance levels to get you there. Depending on timing, these plans would also have to cover any pre-existing conditions. The plans were modestly mediocre, and priced on the expensive side (which makes sense, as only folks with substantial health issues were going to need it).

It makes sense, too, that carriers will be deleting these plans: after all, when all health insurance plans must be guaranteed issue, who needs these?

Well, other than the folks who liked their plans and doctors.

Interesting Carrier Trick

Got this in email this morning (from Anthem):

"We recently changed several UW guidelines which will allow your clients to qualify for more aggressive pricing.  Example:  We are no longer rating for smoking, smokers will now receive a P1 rating (assuming they have  no other ratable conditions). [emphasis in original]

This applies to Ohio, but may also be available in other states.

Anthem, along with various other carriers, is also reaching out to current plan-holders with early renewal offers (such as we've seen in the small group market).

The email also reiterated something they've previously announced:

"List Bills are No Longer available for NEW Business.  If you have clients currently on a List bill they will be removed when they MIGRATE to an ACA Plan.  GF ["Grandfathered"] members will be able to remain on list bill."

List Bill is (well, was) a mechanism where one could "bundle" several individual plans into a common monthly invoice that would go to one address. Typically, this would have been for small employers who didn't offer a "group" plan but were willing to do the admin necessary for folks to have their premiums withdrawn from their paychecks. It was more a convenience item than anything else. But with new ObamaTax rules this service is going away.

Just another example of how the ObamaTax has negatively impacted our choices.

My new article is up...


"While the HSA concept is still alive, it has been drastically changed by the ACA"

Train Wreck - Been There, Done That [Updated & Bumped]

In the midst of spin from DC on how there are just a few "glitches", plus the almost 100% media blackout of information on problems individuals are having signing up, it is nice to hear from someone who has real world experience.

Aetna CEO Mark Bertolini weighs in.
"We were pretty nervous as we got further along," Bertolini said. "As they started missing deadlines, we were pretty convinced it was going to be a difficult launch."
"It's nothing you ever like to repeat," Bertolini said. "Because it's very difficult. I've been there. It's career-ending in a lot of cases."
Career ending.
In the real world, yes.
But in DC, no.
You get reassigned to a position out of the spotlight in some do-nothing job . . . at the same pay.
"I think the bigger issue is, will enough people sign up to make it work?" 
"I think the attention span of the younger generation in using technology is that if it doesn't work the first time, it's going to be pretty hard to get them back the second time," he said. "If the program blows up because people don't sign up, then the program's not going to move ahead
Short attention span.
That's an understatement.
 it could take three years or so before the marketplace's problems are fully sorted out.
That takes us through of the 2014 and 2016 elections.
UPDATE - Now with video:

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RomneyCare --> ObamaTax

One presumes that this is a rhetorical question:

"Why is it so hard to find a doctor? Half of primary care physicians in [Massachusettes] are not accepting new patients."

The author posits that it's a function of age; that is, many patients are Baby Boomers, and so are their doc's. As the former group ages and needs more care, those in the latter are ready to retire.

One supposes that there is a grain of truth in this, but the real reason comes in a bit of belated self-awareness:

"Meanwhile, when the state reformed health care in 2006, it expanded insurance coverage, increasing access to care without boosting the supply of doctors."

Gee, ya think?

Monday, October 14, 2013

Avik cuts to the chase

If you're not regularly reading Avik Roy's "The Apothecary" (and you should be - it's in the sidebar), you're missing out on some of the most accurate, cutting-edge analysis of health care policy and polity available. Here, Avik explains with cystal clarity exactly why the ObamaTax Exchanges are a colossal failure:

" forces you to create an account and enter detailed personal information before you can start shopping ... HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away." [emphasis added]

The key concept here is "no wrong door." Simply put, the entire process begins (and, for most, ends) at the front gate. The "no wrong door" philosophy is that, once one gets through the initial portal (and some do), the very first thing that happens is that one is directed to a widget that determines what, if any, subsidy one may be entitled to, and then applies that subsidy when one begins "shopping" for plans.

And there's a very simple, elegant reason for this: the actual premiums would cause a normal person to seek immediate medical help, and we can't have that. Only after the subsidy (and whether one is truly eligible has become a matter of debate, as well) has been applied are the proles "customers" allowed to see the prices.

This is brilliant.

Evil, but brilliant:

The most important demographic, from the ObamaTax POV, is the "young invincibles;" those people, in their twenties and early thirties, who have very little in the way of health care costs (save for, perhaps, maternity) but who are counted on to provide outsized premiums to subsidize their healthcare-consuming elders. After all, someone has to pay the piper, neh?

And remember, the ObamaTax mandates that there can only be a threefold difference in prices between the young invincibles and seasoned citizens. If the former are scared off early - as they most assuredly would be if they knew the true price of their "free" health care insurance - then the system grinds to a halt.

If one were a cynic, one might consider that a feature, not a bug.

Obamacare Navigator Blues

Navigators. Those folks authorized under Obamacare to collect your most personal financial information and be entrusted to keep it safe. If you apply through the exchange, you are expected to provide your name, address, Social Security number, tax filing status and wage information.

That kind of stuff.

Wouldn't you expect someone responsible for the safekeeping of your information to be trustworthy? Surely they have been through a background check to make sure there is nothing in their past to make them suspect.

OK, I am only kidding. Joke's on you.
A woman with an outstanding warrant for her arrest is currently serving as an Obamacare “navigator” in Lawrence, Kansas.
Rosilyn Wells — the Director of Outreach and Enrollment for the Heartland Community Health-care Center (HCHC) – is “the only full-time Affordable Care Act navigator in Lawrence,” according to the Lawrence Journal-World.
Wells was certified as an Obamacare navigator despite her financial history, which includes a bankruptcy in 2003, a 2007 civil charge from a local check cashing business called Midwest Checkrite for writing a bad check, being more than $1700 behind on her state tax bill, and having an outstanding arrest warrant in nearby Shawnee County. Wells lives and works in Douglass County.
And you thought the only issue was a $600 million website that doesn't work