History Can Be Fun

Shortly after ACA was enacted into law in 2010, Senate Finance Chairman Max Baucus, whose Committee wrote most of it, "tried to calm an angry Montana voter by saying this: “Mark my words, several years from now, you’re going to look back and say, “Well that wasn't so bad after all”. 

Senator, we did mark your words.
 
It’s now been several years. 

It's pretty clear the average person today would NOT say: “Well, that wasn’t so bad after all”.  

In fact, a great many Americans are still looking for a good reason to calm down about Obamacare.

I think perspectives like these help explain why history can be fun.

Now in fairness to Senator Baucus, he had begun to change his opinion of Obamacare, in fact had become a critic, within a couple years of its passage.  Not necessarily because he disagreed with Obamacare's goals; more likely because the Administration's fumbling, bumbling, and rumbling threatened to prevent the law from accomplishing its goals.

The Washington Post reported Senator Baucus' changing opinion during 2013.   Early that year,  the Senator told HHS Secretary Kathleen Sebelius, “I just see huge train wreck coming down. You and I have discussed this many times and I don't see any results yet.” Later that year, the Post reported Senator Baucus commented (about the health-care exchanges and the government enrollment Web site) "Let's just see how much of this can be put together, how much Humpty Dumpty can be fixed, in the next month."

Well, hmmm.  Mmmaybe it WAS so bad, after all?  Even my Magic 8-Ball replied "It is decidedly so".  

I suspect Senator Baucus' deteriorating confidence in the success of Obamacare may have been a factor in his decision to retire from the Senate at the end of his term in 2014.  I also wonder if Senator Baucus' public criticism of Obamacare, especially his use of the descriptions "train wreck" and "Humpty-Dumpty," was a factor in prompting Mr. Obama to name him an Ambassador in 2014 and get him out of the country.  China, to be exact.

I think questions like these also help explain why history can be fun.

An Open Letter to Max and Tom

Dear Senator Harkin and Senator Baucus:

Recently you both have made comments with unfavorable views on how dollars from PPACA are being spent. Senator Baucus, you have characterized the law as a "train wreck" and put outreach and education as your top reason why people aren't engaged. Senator Harkin, you have chastised the White House and HHS for continuing to take money from the Prevention Fund and using it for implementation of the law. Both of these concerns are legitimate.

As a professional health insurance advisor I help design benefit plans, resolve claims disputes, conduct educational meetings, facilitate enrollments/terminations, solve billing issues, and help clients comply with complex state and federal laws like HIPAA, ERISA, and of course, PPACA.

Being a member of this profession requires proper licensing and a stringent continuing education program including course work and testing. We have ethical and moral obligations to our clients to always serve in their best interest and we also must carry professional liability insurance as a protection to the consumers we advise.

Here is a solution that solves your concerns and won't cost the federal government a single dime. Not only that, but it will provide job security to hundreds of thousands of people. The solution is simple. First, engage health insurance professionals to aid in the outreach, education, and enrollment. Second, eliminate the role of Navigators.

Health insurance professionals are always looking for new clients. We already have the business model built. Use our marketing and education tools to generate interest in purchasing health insurance. We compete to earn the business of those we educate on the options they have available. Instead of adding another layer of bureacracy and cost into this "train wreck" (your words not mine Senator) why not strengthen a profession of private sector business people? It makes way too much sense not to.

Guest Blog: Stranger Danger - Health Insurance Exchange Edition

[Patrick Paule is a regular reader and commenter here at IB. Recently, he emailed us regarding an article about "insurance enrollers" in Exchanges. His extensive background in insurance and securities gives him a unique perspective on this potentially dangerous development, so we asked him to pen this Guest Post to explain the issue to our readers. HGS]

On January 1, 2014 you hear a knock at the door. Open it up and there stands a complete stranger. First thing he says is that he is an "insurance enroller" from -Insert Community Organization Here- . He asks to come in and help you understand health insurance. He will also explain the process of enrolling into an Obamacare exchange. Then he finishes his pitch by telling you that if your income level is low enough that it might be your lucky day and your insurance could be "free". What the person doesn't tell you is where the train wreck begins.

The LA Times had a nice little article on "insurance enrollers" last week. These are the people that the Federal Government believes can enroll people into Health Insurance Exchanges/Marketplaces (whatever they are calling them this week). California is one of the few states that has decided to create their own Exchange. Cover California, the state agency assigned with the task of implementing this train wreck, has taken an initial stance that these "insurance enrollers" should be screened to deter fraud and protect consumers. In fact, Obamacare backer and California Insurance Commissioner Dave Jones agrees, saying that without background checks and fingerprinting he thinks "there is a very real probability of immense consumer fraud." This seems pretty reasonable to me. After all, licensed insurance professionals must go through the process of background checks, fingerprinting, carry an E & O policy, and also have continuing education requirements every two years.

However, Cover Cal officials are preparing for a "battle" with community organizations over whether or not these “enrollers” should undergo background checks and fingerprinting (never mind the fact that they aren't even considering licensing these folks). Robert Ross, a Cover California board member and CEO of California Endowment, had the following to say about background checks:

"I have fears about adding bureaucratic mountains that slow us down." He goes further to say that "fingerprinting can come across in many of these diverse, ethnic communities as a scary, big-government thing." (Side note, isn't Obamacare a "scary, big-government thing?")

The "insurance enrollers" will play an important role in helping individuals understand complex terms like deductible and actuarial value, and to guide consumers through the “simple application process.” In order to complete the application, "insurance enrollers" will have access to information including: social security numbers, personal residence addresses, income data, tax returns, employment information, and dates of birth. 

Cover Cal is projecting that they will need 20,000 "insurance enrollers" to enroll the projected 1.4 million people this year and that outreach is extremely important. State officials will be paying these "insurance enrollers" $58 (!) per application. Depending on how you interpret this, it can obviously be a very lucrative deal or a very low income deal. But for the taxpayers of California, paying out $81,200,000 next year is not a simple drop in the bucket.

Cover California, and insurance exchanges in general, will be full of fraud and will cause more headache than good. Most people who enroll will have no idea exactly what they are purchasing. This will be the case especially if unlicensed idiots ”insurance enrollers” who don't have to undergo background checks or continuing education are allowed to perform the transactions. So, come January 1, 2014, the best thing to do when you hear that knock at the door would be to not answer it.

Thanks, Patrick!

Ha! [Updated & Bumped]

Two-and-a-half (2 1/2) years ago, Mike noted that "Senate Finance Chairman Max Baucus, who wrote most of the [ObamaTax] ...  is telling me not to worry about all the rattles I hear in this Cadillac he sold me (that I can't afford)"

Fast-forward to today:

"[Senator Max Bacus (D-Montana)] who helped write President Obama's health care law stunned administration officials Wednesday, saying openly he thinks it's headed for a "train wreck."

Oh really?

Appears that the "esteemed" Senator from Big Sky Country is an IB reader.

UPDATE: But of course it's a "train wreck," Max. Here you tell us that you couldn't read the bill which you wrote because you didn't understand it because you let the "experts" write it so you didn't need to:



That about right, Max?

[Thanks to co-blogger Patrick P for the video!]

Dangerous Musings [Updated & Bumped]

[Originally posted February 19, 2013 - scroll down for update]

The National Association of Alternative Benefit Consultants is the organization which sponsors my CBC designation. It's made up of, and run by, good folks, and does a good job of hunting up interesting ways for agents to expand their business. Sometimes, though, I just shake my head in bemusement at what they send out.

Case in point, a recent email with the provocative title "HSAs, HRAs - Alive & Well Under PPACA‏"

I'm going to elide over the HRA (Health Reimbursement Arrangement) for now - although that model has some interesting challenges under The ObamaTax, as well - and focus on Health Savings Accounts.

As we've written, HSA's are essentially outlawed under the 'Tax, because despite their built-in cost efficiency (or perhaps because of it), they fail to meet the minimum essential coverage requirements under the train wreck law. NAABC's email avers that "many employers will switch to CDHPs, either in the Exchanges or through ERISA plans to escape the regulations of the PPACA.  Even a one-deductible, 100% coinsurance plan will qualify under the "Bronze" level in the exchanges."

Their position relies on this statement from the IRS:

"Section ... directs that the limit on deductibles described ... for a health plan offered in the small group market be applied so as to not affect the actuarial value of any health plan. We interpret and implement this provision through our proposal ... by authorizing a health insurance issuer to make adjustments to its deductible to maintain the specified actuarial value for the applicable level of coverage required ... we propose that a plan may exceed the annual deductible limit if it cannot reasonably reach a given level of coverage (metal tier) without doing so.”

Which should clear up any confusion on that issue.

But of course it doesn't, any more than relying on the IRS hotlines during tax season. The agency goes on to "clarify" its position:

"We propose to use a ‘‘reasonableness’’ standard and request comment on what evidence or factors should be required from an issuer and considered in determining whether this standard is met with respect to health insurance coverage ... While it may be possible to develop plan designs to meet all of these constraints, we believe it could be difficult to develop plans with reasonable coinsurance or equivalent cost sharing rate" [emphasis added]

Talk about weasel words. Does any sane person really think it's a good idea to rely on the generosity and open-mindedness of the IRS? The NAABC seems to think so, because they end their email with this citation from the IRS regs themselves:

"A health plan’s annual deductible may exceed the annual deductible limit if that plan may not reasonably reach the actuarial value of a given level of coverage a ... without exceeding the annual deductible limit"

Uh-hunh.

So it seems that the IRS has left us a loophole through which we can drive our HSAs.

Or does it?

ObamaTax "Train Wreck"

It sure is nice to see someone else using this metaphor:

"Illinois wants to be the engine that pulls states toward the Affordable Care Act, yet a metaphorical “train wreck” is just around the bend ... Illinois saved $1.1 billion last year, but lawmakers were expecting $1.6 billion in savings. The state has $2.3 billion in unpaid Medicaid bills."

Ooops.

Turns out, when you rob Peter to pay Paul enough times, Pete ends up flat broke, but Paul still needs his "money fix." Who'da thunk it?

And the hits just keep on comin':

"Hamos expects 509,000 new Medicaid patients in Illinois by 2017, when the [ObamaTax] is fully operational."

Just keep that last phrase in mind...

[Hat Tip: FoIB Holly R]

Monday Morning LinkFest

Have you ever driven by a car wreck just as it's happening? Time seems to slow down, everyone and everything appears to be moving in slow motion. Well, that seems to be happening with the ObamaTax. FoIB Elena Marie notes this little gem:

"Five insurers, including two of the nation’s largest, already decided to stop selling health insurance in Indiana, mainly because of the [ObamaTax] edict ... And the American Enterprise Group, citing the medical loss ratio and other regulatory burdens, will stop offering individual insurance in more than 20 states, causing 35,000 people to lose their coverage and create a less competitive insurance market."

But remember, "if you like your health plan..."

Meanwhile, in our nation's capital, the local politicos think they've stumbled on the health insurance panacea:

"A board has required D.C. small businesses and individual buyers to purchase health insurance through the newly minted health exchange."

There's some question as to that Board's authority to enforce the new regs, but it's interesting to note that its chairman, Dr. Mohammad Akhter (doctor of what is left unspecified) opines that "[i]f you have a business license here in the District of Columbia, then you participate through the exchange."

Looks like some folks have a problem grasping that whole "pro-choice" concept.

On the other hand, it looks like actual health care providers are none too pleased with the ObamaTax:

"A new survey shows Mitt Romney with a commanding lead over President Barack Obama among doctors, with Obamacare helping to sway their votes."

Well over half of the doctors surveyed say they favor repeal of the train wreck.

Our last item this morning also comes to us courtesy of Elena Marie.

Seems that the Much Vaunted National Health System© is continuing its crackdown on folks who want to, you know, stay alive:

"Forty-three hospital patients starved to death last year and 111 died of thirst while being treated on wards ... There were 558 cases last year where doctors recorded that a patient had died in a state of severe dehydration in hospitals."

Remember, this is the model for the ObamaTax that we'll soon be living dying under.

UPDATE: Looks like the ObamaTax may have another potentially damaging challenge:

"Tucked inside the Supreme Court's lengthy list of orders ... was an indication that the fight over President Obama's health care law soon could be back before the high court ... Liberty University, a Christian college in Virginia, has been fighting the employer mandate since the law was enacted ...  the Supreme Court ruled that the Anti-Injunction Act did not serve as a barrier to lawsuits challenging the health care law."

Earlier, the 4th Circuit had turned down the case as "premature" since no one had yet been penalized for not paying the Employer Mandate fine tax. The Supremes, though, have just re-opened the door for Liberty to re-file.

We've written before about the ill-conceived Employer Mandate; this seems to indicate that it'll be back on the radar soon.

The Willard Scott Conundrum

For many years, Willard Scott would announce each morning those lucky folks who'd hit the 100 year marker in life. They likely didn't know, however, the impact that reaching such a milestone would have on any "permanent" life insurance they owned.

Wait just a minute there, Henry: what's with the "scare quotes?"

Glad you asked.

Recently, co-blogger Bob V tipped me to this article by insurance industry heavyweight Joseph Belth:

"For decades, life insurance carriers ... sold permanent universal life insurance policies, marketed as "insurance for life," utilizing outdated mortality tables that did not take into account the fact that Americans were, and are, increasingly living to and past the age of 100."

In his book "My Life in Court," the late, great litigator Louis Nizer wrote of a case where a young man was killed when the train he rode on his daily commute crashed and he was killed. The court originally based his lost and future wages on an older mortality table which generated a relatively modest settlement; Mr Nizer was able to show that this was a grave injustice due to more recent tables, and won a more substantial settlement for the young widow.

Now, what does a 1950's-era train wreck have to do with a centenarian's life insurance policy?

Well, it turns out that the life insurance industry seems to have been playing fast and loose with that word "permanent." The case at hand concerns a Universal Life policy, but this issue would appear to affect Whole and Variable Life plans, as well.

The problem is that when plans "mature" (end) at age 100, they aren't permanent:

"The life insurance industry has left its customers (who faithfully paid their premiums with the expectation that they would have coverage for the remainder of their lives) uninsured."

And it gets better:

"These terminations have exposed customers to adverse tax consequences that are in direct contradiction to the guarantees made when these policies were purchased."

One of the great benefits of cash value life insurance (another industry term of art, perhaps much more useful in this discussion) is that the equity in the policy grows with no taxes due if the policy is paid out as death benefit (those that do  cash in their policies early may have a tax liability if the amount they receive is greater than the premiums paid in). But what if you've paid your premiums in the expectation that the plan would pay out whenever it was that you shuffled off this mortal coil, only to learn that, upon reaching that wonderful milestone you'd be uninsured and, adding insult to injury, owe a potentially astronomical tax bill?

Now, some (many?) carriers have addressed this by issuing policies that go to age 120 (or 121). But that's only good for folks who've bought plans from these carriers in recent years. The vast majority of folks, I daresay, don't fall into this category.

And frankly, I'm a bit nonplussed that this issue has been so long under the radar. Why's that you ask?

Well:

"The United States currently has the greatest number of known centenarians of any nation with 53,364 according to the 2010 Census"

Of course, not all of them own life insurance, but even a small percentage means thousands, perhaps tens of thousands do.

What then?

Mr Belth proposes a class action lawsuit. My own understanding of these is that they generally benefit the lawyers that file them much more than the plaintiffs themselves. Still, if that's the clue-by-four my industry needs to address this, well...

Unexpected! Dismal ACA enrollment ahead

It will come as no surprise to regular IB readers that the outlook for Open Enrollment v3.0 isn't bright. What may be a surprise is the magnitude of the train-wreck:

"[W]hen the law was passed, the Congressional Budget Office projected that enrollment would grow by 8 million in 2016, and reach a total of 21 million effectuated enrollees. In other words, Obamacare’s exchanges are on track to achieve less than half of the enrollment that was originally predicted."

Now one might do well to ask just how the rocket surgeons in DC could miss the mark by so much. The answer to that is revealing (and more than a bit disturbing): According to HHS Secretary Burntwell, "our target assumes something that is pretty challenging, which is that more than one out of every four of the eligible uninsured will select plans.”

That is, despite all the hype, all the hoopla, and the billions of subsidy dollars being doled out, the folks at CMS still can't entice even a quarter of uninsureds to sign up. And why is that? Perhaps it's the fact that, despite Washington's assumptions, Americans aren't that terrible at math, and can see the value in paying (perhaps) the fine penalty tax, vice thousands - or even tens of thousand - of dollars in total out-of-pocket.

But hey, Ms Sylvia, by all means go with "challenging."

Mid Friday Good news, Bad news

First, from our friend Holly R, the good news:

"5 Body Parts Scientists Can 3-D Print"

As we've mentioned before, this tech is a potential game changer for dealing with diseased or damaged organs, blood vessels, even bones.

Now the bad:

"Gallup surveyed 1,021 U.S. adults ages 18 and older in mid-August, it found only 15 percent of all participants “were very familiar” with PPACA. Eighteen percent said they were “not too familiar,” and 12 percent admitted they were “not all familiar” with the law."

Now admittedly, this is only "bad news" to proponents of the train wreck. That is, after all the money and efforts thrown at educating the public about the (supposed) benefits of the ObamaTax, for its most crucial demographic to be this uninformed is quite amusing.

Oh, and this just in: President Obama's promise that premiums would decrease 3000% under the ObamaTax appears to be coming true:

"The average employer-provided family health insurance premiums have climbed $2,976 since 2009"

This from the right-wingers at the Kaiser Family Foundation, so there's that.

ObamaCare goes to college (a double whammy)

While I've never understood the connection between health care and college loans, they are nevertheless an integral part of ObamaCare. And just as that train-wreck has greatly depleted Medicare, it also threatens student loans in general, and how the 58 states will have to balance college needs and folks on Medicaid:

"Parents and students facing sky-high state-run college tuitions aren't likely to be thinking about ObamaCare ... ObamaCare relies heavily on Medicaid — the federal/state program that provides health insurance for the poor — to expand coverage."

Okay, we get it, poor folks need health care, too. But what's that got to do with the price of tomatoes, or college?

Just this:

"Medicaid is already swallowing up state budgets, forcing states to cut back on everything else, especially support for two- and four-year public colleges."

As ObamaCare forces more and more folks out of the private insurance market, and onto Medicaid, something's gotta give. And that something, it turns out, is young peoples' dreams:

"As the Medicaid mandate rises, the educational funding declines. That is passed on to universities and they raise tuition in order to make up for it."

That's why we've always called mandates "hidden taxes:" there are no free lunches. Someone has to pay for health care. And since SCOTUS has green-lighted the individual mandate, the problem is exacerbated. That is, buying health insurance is now the law, but going to college is a choice. The former trumps the latter every time.

But the problem with Medicaid doesn't stop there: in addition to "regular" health care, the program is also expected to pick up the tab for long term care (aka nursing home costs). The problem is that there are only so many dollars available, so states will be looking at individuals to pick up more and more of the tab. We saw this with the new Partnership Plans - the government implicitly recognized that folks need to fend for themselves, and so it waved a big carrot. But the stick isn't far behind:

"Some 29 states currently have laws making adult children responsible for their parents if their parents can't afford to take care of themselves."

This is a completely separate issue from the so-called "look-back" provisions, which merely dissuaded folks from transferring assets to their kids. These "filial responsibility" laws (which, as the article notes, are nothing new) require even more blood and treasure from kids who may have already reached a breaking point paying off college loans, which are inflated because the cost of that education keeps going up (helped in no small part - as noted above - by ObamaCare).

Seems like this vicious cycle is just getting revved up.

[Hat Tip: FoIB Brian D]

The Mandate Update: Evil AND a Tax

Looks like Aunt Nancy was wrong on this: we didn't need to "see the plan to know what's in it" as regards the (evil) Individual Mandate:

"In order to protect the new national health care law from legal challenges, the Obama administration has been forced to argue that the individual mandate represents a tax -- even though Obama himself argued the exact opposite while campaigning to pass the legislation."

Whoa – The Obamaman lied about ObamaCare©?!

I'm shocked, shocked I tell ya!

Well, not really, since we had already made that call early on. This is a significant development, though, because it not only puts the lie to claims that the mandate is not in fact a tax, but that it is an unprecedented one, at that.

Until now, taxes were levied on things we bought or owned, but this is a tax on merely existing. Unlike the red herring that auto insurance is mandated, being taxed because one demurred from participating means that you'll be taxed simply for being a living American. I used to joke that these folks would tax the air that we breathe if only they could; turns out, this piece of ObamaCare© does just that.

If there's a bright side, it's that as more and more "clarifications" come forth, an overwhelming majority of Americans want this train-wreck repealed. It remains to be seen, of course, whether or not that translates into action, but it's a hopeful sign that folks understand just how bad this is, and that the pro-ObamaCare© forces are being forced to defend the indefensible.

¡Hola, 404Care!

One of the most (unintentionally?) humorous things I ever saw on TV was back in the 70's: The Streets of San Francisco paired an older, experienced detective (Karl Malden) with a younger partner (Michael Douglas). In one episode, they arrive at the storefront of a Latino business, only to see a sign on the door: "El Close-o." (Really!)

I was reminded of this by the news that the Spanish-language version of the train wreck website isn't any more well designed or implemented than the English one. In fact, well, it was apparently written by Adam Sandler:

"The site, CuidadoDeSalud.gov, launched more than two months late. A Web page with Spanish instructions linked users to an English form."

Not only that, but the translations themselves are straight out of 'Spanglish:'

"...the name of the site itself can literally be read "for the caution of health."

On second thought, that may actually be a case of truth in advertising.

Midweek Link-Fest

For your edification and edutainment pleasure:

First up, it's the one year ObamaVersary©, and the Pioneer Institute hosted a debate on the financial impact of this train-wreck. Courtesy of Josh Archambault, the Institute's Director of Health Care Policy, here's the highlight reel:

2011 Hewitt Health Care Lecture from Mike Dean on Vimeo.

The full debate's available here.

Next, Jane Sanders has put together a pretty alarming graphic about the specific costs of obesity. Here's an excerpt:

Get the rest of the big picture here.

And finally, FoIB Jeff M reports that public employee benefits-cut fever has arrived in North Carolina, where state workers "would pay more for health insurance but get fewer benefits" under a new budget proposal. On the one hand, the proposed changes "scrap a provision that pushed cigarette smokers and those who were very obese into less-generous coverage until they quit puffing or lost weight" (see item above).

On the other hand, the proposal would impose onerous new contribution requirements on said employees, forcing "all active state employees and those retirees in a more-generous plan to pay monthly premiums of between $11 and $22 a month." [emphasis added]

Oh, the humanity!

Doctor's orders

"ObamaCare is ... demoralizing doctors, distracting providers toward bureaucracy and away from patient care. It is disrupting quality and access, and damaging health."

Says whom?

Says Dr Charles Willey, "CEO of Innovare Health Advocates in St. Louis, a medical group employing five physicians and five nurse practitioners in five offices."

Dr Willey is suing the Feds to try to derail the "train wreck," focusing on the IRS's unique and powerful role in enforcing ObamaTax provisions. He points to government overreach like  the IRS's "attempt to enforce those penalties in states like Missouri" which, like 32 others, opted out of establishing its own state-run Exchange.

Best of luck to you in your efforts, Dr W.

[Hat Tip: FoIB Holly R]

HSA's vs The ObamaTax: Part XXCVI

As we've previously noted, the survivability of Health Savings Accounts (HSA's)  and High Deductible Health Plans (HDHPs) under the ObamaTax has been questionable. The challenge is that the train-wreck limits one's total out-of-pocket costs and, as important, Exchange-qualified plan designs themselves.

Still, there's no denying the appeal of a plan that offers (potentially) lower premiums coupled with the ability to sock away tax-advantaged dollars to help offset those out-of-pocket costs. While I still have my doubts as to whether these plans will survive unscathed, the folks at Life Health Pro firmly believe that this will be the case:

"Whether your clients fear direct premium increases or higher annual deductibles, their out-of-pocket costs can be slashed using a tax-preferred vehicle that has been on the market for years: the health savings account (HSA) ... For 2013 and 2014, an HDHP is a plan with an annual deductible of not less than $1,250 for self-only coverage or $2,500 for family coverage."

And of course, there may be additional coinsurance that increases one's potential out-of-pocket liability. There are two major obstacles here:

First, Exchange-qualified plans are standardized. That is, there are pre-approved plan designs (often referred to as "metal plans" due to their names - "gold," "silver," etc). I have yet to see one called "aluminum."

Second, plans must meet stringent actuarial value standards, some of which have yet to be finalized. So while I'm hopeful that these plans will, in fact, continue to be available after full ObamaTax implementation, I'm not holding my breath.

Stupid Carrier Tricks: EOY Edition

The Yiddish word for "scandal" is "shanda;" the term implies not just shame, but a sense of shock. And it's the perfect word to describe the letter I received this morning (note the date: December 23) from Humana:

"This letter is to inform you about a change in Humana's participating network...the difficult decision to discontinue our contract with Premier Health Partners effective January 1, 2009."

The missive is dated December 10.

Even with a platoon of Cliff Clavens, it doesn't take almost two weeks for these things to arrive; it's obvious that they held it back. And this is important: Premier comprises almost half of the hospitals in the Dayton area, as well as a huge chunk of associated providers (physicians, etc). Dropping this little bombshell at the end of the year makes it nearly impossible to move Humana insureds to other carriers by the first of January, leaving them vulnerable to out-of-network charges at the height of cold, flu and accident season.

This is unconscionable.

Yes, carriers routinely update their networks: providers come and go throughout the year. But this is wholesale change, at a time when their insureds can not easily transition to other carriers. I find it unlikely that Humana wasn't aware of this impending train-wreck until now, and wouldn't be surprised if this was exactly the result they wanted: insureds with few options, and little (or no) time to make appropriate changes.

I am appalled.

My first order of business, of course, is to see if I can move at least some of my Humana insureds to other plans; if not by January, then at least by February. This is important: deductibles accrue beginning on January 1, and expenses that satisfy one carrier's deductible aren't applicable to another's. The later in the year we move folks, the more they're likely to be hurt.

Thanks, Humana, for nothing.

Some harsh words from Our Future

In the midst of the disastrous roll out of the ObamaTax, it's heartening to see that there may, indeed, be a light at the end of the tunnel:

"A University of Michigan graduate penned an open letter ... as she described how President Barack Obama’s signature health care law hurts the working poor, and has “raped” her future."

The 26-year-old, Ashley Dionne, is a 2009 University of Michigan graduate,  who's had trouble finding jobs ("she was told she was “too educated and wouldn’t stay” at low-paying jobs"), and suffers from several serious health problems, including "ulcers, and mild cerebral palsy."

Given all that, you'd think she'd be a poster child for the train wreck. But that's not how she sees it:

"Obamacare takes my monthly rate from $75 a month for full coverage on my “Young Adult Plan,” to $319 a month. After $6,000 in deductibles, of course"

She must be lying, though: the President himself promised us that rates would go down 3000 percent.

Dribbling the ObamaTax

Back in the day, Ms Shecantbeserious had Matlock to Hawk the train-wreck. Fast forward a bit, and she's Cavalierly bringing the Heat in her efforts to work her Wizardly Magic on that Nugget:

"The Obama administration has reportedly tried to enlist the NBA in helping it sell Obamacare"

Whatever works to sell this Maverick idea to the masses, right, Kathy?

But lets give her the benefit of the doubt and presume that this new gimmick will work (hey, it could happen!). Good thing that the Exchanges new Marketplaces will be on their game for the roll-out.

Wait, what?

"Government officials have missed several deadlines in setting up new health-insurance exchanges for small businesses and consumers ... and there is a risk they won't be ready to open on time in October"

Ooopsies.

Looks like those darned Canucks are throwing us under the bus.

About Those ACA Signups (GIGO)

As the first phase of Open Enrollment v4.0 winds down, it may be helpful to get a sense of how successful the whole effort's been thus far (for certain values of "success"). ObamaCare proponents like to boast that the train-wreck insured some 20 million Americans.

But is this really accurate?

It will come as no surprise to IB regulars that the answer is a resounding 'No:'

"The Department of Health and Human Services claims that 20 million people have gained health coverage ... 17.7 million people gained health insurance from Obamacare’s first open enrollment period."

Which is all well and good, except that these numbers are based entirely on survey data, not actual, verified enrollment numbers. When one examines those, a very different picture emerges:

"Just over 14 million people gained coverage from the end of 2013 to the end of 2015. Of those 14 million, 11.8 million gained their insurance through Medicaid."

So roughly 85% of those being counted are not, in fact, insured: they're enrolled in Medicaid, which is not insurance. So less than 15% of the folks who ACA proponents claim became insured under the ObamaTax actually did so.

Of course, they'll never admit this, because: #Narrative.