Monday, January 31, 2011

Radio Bob

Bob's on the radio (again!) in the morning (7:00 AM!!) to talk about today's court ruling outlawing "ObamaCrap." Click here and then hit the "listen live" button.

Breaking News: Judge Rules ObamaCare© Unconstitutional

The good news is that the US District Judge in Florida - you know, the 20+-state case judge? - has ruled the (Evil) Individual Mandate unconstitutional. Further, he found that it was such an integral part of "The Act" as to render the rest moot.

The bad news, if it can truly be deemed that, is that it is not dispositive; that is, the case will continue "upstream" to the Supreme Court, where it will join its sister cases before that august body.

As always, we'll keep you posted.

HHS Secretary Shecantbeserious in HD?

Maybe she just can't help herself; after all, when you're not the sharpest scalpel on the tray, you're not really expected to make a lot of sense. And, of course, Ms Shecantbeserious is rather dull, which may explain this little non-sequitor:

"[I]f I don’t have a 27-inch TV for the Super Bowl, I can’t demand on the day of the Super Bowl that somebody deliver that TV because I have a right to it. On the other hand, if I don’t have insurance, I come through the door of an emergency room and get treated and get cared for, and somebody else picks up the tab."

What Madame Secretary is referring to is EMTALA, a law that predates ObamaCare© by decades, and requires only immediate, critical care, not a long-term return to health. It should surprise no one, of course, that Kathy thinks that watching the Super Bowl is akin to saving someone's life; after all, these are the folks bringing us Death Panels.

Her point, so far as she actually has one, is that citizens should be forced to buy health insurance, whether they want to or not. It's not clear whether or not she also wants to make watching the Super Bowl mandatory; in such an event, perhaps the Death Panels don't look so bad after all.

It's almost amusing: having lost the "health insurance is the same as auto insurance" debate, the forces of ObamaCare© are reduced to "the Super Bowl is the same as health insurance." What's not funny, of course, is that these are the same folks granting waivers hither and yon, and who think that the public is stupid enough to buy their silly arguments.

Don't bet on it.


In the comments, Bob (correctly) points out that he'd made this call some ago. Timeless, and timely.


PowerLine's John Hinderaker gets the WaiverMania impetus exactly right:

"[T]he vicious strategy at the heart of Obamacare [is to] pass terrible legislation, and then collect a toll by exempting your friends--those who pay you lots of money--from that legislation, while your enemies have to live with it."

In this case, the toll actually came before the legislation: look at how many of these waivers go to PresBo's union buddies, who so vociferously (and generou$ly) supported him and his policies. These organizations allegedly represent the interests of millions of workers, those for whom ObamaCare© was ostensibly designed to protect. One wonders how to reconcile these transparently contradictory goals.

I can, however, think of a term which describes it.

Guess what! We're THIS MANY Years Old!

Yes, six years (and 4,000+ posts) later, we're still going strong. Thanks to our readers for sticking by us, and a Special Thanks to my co-bloggers for their great insights.

Sunday, January 30, 2011

Shecantbeserious Channels Barney Fife

When she's not granting ObamaWaivers© to PresBo's minions, HHS Secretary Shecantbeserious manages to help an escaped convict elude Federal Marshals:

"While one federal agency was doggedly hunting a fugitive drug smuggler who fled the country 31 years ago, others arranged for his return to South Florida and even loaned him money for housing when he landed here."

And who were these mysterious "others?" Well, none other than "the U.S. Department of Health and Human Services" under the (ahem) watchful eye of Ms Shecatbeserious.

And these are the folks slated to run our health care system?

[Hat Tip: Ace of Spades]

Saturday, January 29, 2011

Obamacare - Another One Bites The Dust

Obamacare has led to one more health insurance company withdrawing from the market. This means less competition, fewer choices, higher rates. Aetna is pulling out of the Colorado market as of 2/1/2011. They will no longer offer health insurance for individuals, families or self employed in Colorado.

Aetna decided to withdraw from the small group health insurance market in Colorado last October (2010), so this is a natural progression.

Existing major medical policyholders will be offered one 12 month renewal before their coverage with Aetna terminates.

Aetna is still under a cloud imposed by CMS (Center for Medicare Services) and is enjoined from offering Medicare Advantage plans anywhere in the United States. This sanction has lasted for a year with no indication it will be lifted any time soon.

As for now, Aetna has not indicated they will withdraw from the individual major medical market or small group market in any other states, including Georgia. Given their relatively small market share we would not be surprised in seeing them systematically withdraw from other states over the next few months.

If you currently have Aetna coverage for individual major medical or small group coverage, now might be a good time to consider making a change.

Employer group health plans can move at any time without loss of coverage.

Individuals in GA and other states are not as lucky. Only those who can pass underwriting will be able to move to a new health insurance company. Do not drop your Aetna coverage until you have secured new coverage from a new health insurance company. Do not make application with a new health insurance company until you have had your medical conditions pre-screened by a competent health insurance agent.

Friday, January 28, 2011

Seeing through the MVNHS©

As we've long since noted, our country's cancer survival rates put those of our Cousins Across the Pond to shame. And it's episodes like this one which help explain why:

"At least one of four people whose cancer diagnosis was delayed at Londonderry's Altnagelvin Hospital has since died ... The delays happened after written assessments of 18,500 X-rays were not carried out."


Here's a poser:

"It is not yet clear whether the delay in diagnosis contributed to the death."

And yet:

"The huge backlog emerged last July when it came to light that important reports had not been completed by clinicians."

Move along, nothing to see here.

Seniors in the Crosshairs - Medicare and Social Security

Seniors are caught up in a financial heart attack over funding for Social Security and Medicare. Reports out of Washington, released AFTER the State of the Union speech, hold daunting news for seniors dependent on SS and Medicare to get by.

As reported by NPR, the CBO has this to say about Social Security.

Social Security will run at a deficit this year and keep on running in the red until its trust funds are drained by about 2037

Based on my family history, I figure St. Peter will call me home about the time Social Security runs out of money, so maybe I am in the clear.

This year alone, Social Security will pay out $45 billion more in retirement, disability and survivors' benefits than it collects in payroll taxes, the nonpartisan Congressional Budget Office said. That figure nearly triples to $130 billion when the new one-year cut in payroll taxes is included.

That doesn't sound good. Wonder how our line of credit with the Chinese is holding up?

This year alone Washington is expected to spend $1.5 trillion more than they take in which means those extra dollars have to come from somewhere.

So how about Medicare?

Well Medicare is sick too.

Medicare's Chief Actuary Richard Foster (the green eye-shade guy) says Obamacrap won't live up to it's promise to save money.

Well, duh!

Foster was asked by Rep. Tom McClintock, R-Calif., for a simple true or false response on two of the main assertions made by supporters of the law: that it will bring down unsustainable medical costs and will let people keep their current health insurance if they like it.

On the costs issue, "I would say false, more so than true," Foster responded.

As for people getting to keep their coverage, "not true in all cases."

Blow me away!

Obamacrap will not reduce health care costs and if you like your plan and want to keep it, too bad.

Seems like the public is getting screwed and no one bothered to buy us a drink or bring us flowers.

And bad news for Medicare beneficiaries as well.

Costs could also increase if Medicare cuts to hospitals, nursing homes and home health agencies turn out to be politically unsustainable over the years. The actuary's office has projected those cuts would eventually force about 15 percent of providers into the red. The health care law funnels savings from the Medicare cuts to provide coverage to uninsured workers and their families.

If the cuts cause Medicare providers to lose money, care to guess what happens then?

Do you suppose it will be harder to see a Medicare doctor?

Yeah, probably.

Doesn't sound good for those with Medicare Advantage plans either.

As for people getting to keep their health insurance plan, Foster's office is projecting that more than 7 million Medicare recipients in private Medicare Advantage plans will eventually have to find other coverage, cutting enrollment in the plans by about half.

Medicare Advantage plans will go poof.

We expect that to hit hard later this year (2011) when Medicare Advantage carriers send out notices of non-renewal.

Ceridian's 2-cent Moment

As you may have read, cancer patient Ron Flanagan lost his insurance coverage because his premium payment was $.02 short.

Problem is, that's only part of the story, and as we've seen before, the press rarely looks beyond the popular narrative to see if, perhaps, there's more to the story.

And there is.

First, a quick primer on how COBRA works: when one leaves a COBRA-compliant employer (generally, any company with 20 or more full-time employees) one is entitled to stay on that employer's group plan for up to 18 months, as long as one pays the premium (plus a nominal handling charge) fully and on time. Since tracking this can be a time-consuming (and potentially legally treacherous) course, many employers out-source COBRA compliance to one of the many services which specialize in it. Ceridian is one such service. They are required to follow the law, which they (apparently) did.

I spoke briefly with a Ceridian spokescritter yesterday, who told me that once they were informed of the situation by both Mr Flanagan and the press, they persuaded the employer to reinstate coverage. Unfortunately, the rest of our conversation was off the record. I had hoped to confirm several other pieces of information, but Ceridian doesn't appear anxious to "set the record straight."

Which is a shame, really, because there's some obvious problems that should be addressed by pretty much all the parties involved. I'll start with Ceridian, which really should have more human-centric systems in place to alert them that a "de minimis" (that is "short") payment shouldn't automatically trigger a cancellation. Perhaps this was at the request of the employer (as seems probable), but in this age of automation it doesn't seem far-fetched that this could simply generate an electronic "red flag."

The problem then becomes "what's a de minimis" payment: 2 cents? 2 dollars? 20 dollars? 200 dollars? When you start making exceptions, you open yourself up to a lot of litigation.

Next, let's turn our attention to the Flanagan's. One can certainly sympathize with their plight, and it's easy to make a simple mistake on a check. But they were notified of the shortage and apparently did nothing to confirm that their coverage was still intact until they got to the doctor's office. If someone's suffering a life-threatening illness, doesn't it make sense to make sure that all the i's are dotted and t's crossed? From the accounts that I've read, it appears that Ceridian attempted more than once to alert them to the potential loss of coverage.

It's still not clear to me how this all played out "behind the scenes." For example, was this a self-funded plan, and is that perhaps relevant? Was it fully insured, and thus the cancellation generated by the carrier? Certainly, Ceridian had no reason to arbitrarily cancel the policy: for one thing, they weren't paying any claims; for another, it cost them whatever fees they were being paid on Mr Flanagan's behalf.

Should Ceridian have been more pro-active before issuing the cancellation? Perhaps, but COBRA law and regulations are murky at best, and it's often prudent to simply follow the letter of the law. That's not to excuse anyone, but to acknowledge reality.

Thursday, January 27, 2011

Email on Email: Retirees and HSAs

About three years ago, we answered a reader's email about HSA's and retiree medical coverage. Recently, we received a follow-up email from another reader:


I just read your ... entry on HSA's and those eligible for Medicare. We have a related question: If the employee is 63 and has an HDHP with an HSA, and his wife is 65 and has Medicare Parts A and B, can she still be on his HDHP? Can he make the family contribution amount into the HSA, ie $6150 plus his catch up contribution since he is the employee and is not on Medicare and he is the eligible employee and she is the dependent?

Or, is she just not able to participate in the HSA so therefore he can only make a single HSA contribution of $3050 plus his catchup contribution?

Thank you,

[Loyal Reader]

We're always happy to answer our readers' questions, and sometimes (such as in this case) share them as a post (maintaining anonymity, of course). It seems to me that, as the Boomers come of age, a lot of folks will be asking these questions. So, I turned to our own on-call FlexBenefits guru, Alissa Culp of FlexBank. Alissa's graciously answered our questions (which I've already forwarded to our correspondent):

Q: If the employee is 63 and has a HDHP with a HSA, and his wife is 65 and has Medicare Part A and Part B, can she still be on his HDHP?
A: Yes.

Q: Can he make the family contribution amount ... ie $6150 + his catch up contribution?
A: He can make the family contribution only if he has family coverage.

Q: Is she just not able to participate in the HSA ... he can only make a single HSA contribution of $3050 plus his catchup contribution?
A: His maximum contribution into his HSA depends on his coverage type. If he has family coverage, he can contribute the family maximum. If he has single coverage, he can contribute up to the single maximum.

Alissa also sent along a helpful guide that expands on some of this information; drop us a line if you’d like a copy.

Thanks, Alissa and [Loyal Reader]!

WaiverMania: Catch the Waive! [UPDATED & BUMPED]

By our most recent count, 222 plans had been granted waivers from all or part of ObamaCare©.

You just knew there'd be more, but who could have known just how many?

IB readers had a clue.

And they were right:

"President Obama’s health department made public new waivers for more than more than 500 groups."

Although I was told that there'd be no math, that figure is more than double the previous total. At this rate, we may not have to even worry about ObamaCare© at all: pretty soon, everyone will be waived.

We wish.

The current tally, by the way, stands at over 2 million participants whose plans are not subject to the draconian mandates set forth in the plan we had to "pass to see what's in it."

Never let it be said, though, that HHS Secretary Shecantbeserious has no sense of humor:

"HHS said Wednesday night that it wants to make the waiver process transparent."

Oh, it's transparent, Kathy: we can see right through you.

UPDATE: Well, well, well. Apparently, those Republican party-poopers in Congress aren't catching The Waive:

"The Obama administration’s waivers ... are a “perfect example of special interests” having influence in the administration and will be looked into by Congress"

Sen Charles Grassley of Iowa is calling the Obamastration on its early promise to eschew "special interests," citing the fact that so many of those granted waivers seem to be unions and their ilk. Although the investigations will take place in the House, the Senator has pledged to aid them in their quest to shed some light on the process.

Things could get interesting...

Sure beats the lizard!

Now this is a great car insurance commercial:

[Major Hat Tip to Russell at Chatswood Moneyblog for the vid]

California Gold Rush

First we were delivered from the evil health insurance companies by Obamacrap. As originally written and signed in to law, Obamacrap prohibited health insurance companies from excluding pre-existing health insurance conditions from coverage on children under the age of 19.

And the mob was pleased.

But the clowns that wrote the law, which they never read until after it was passed, left the insurance companies an out.

Essentially the way Obamacrap was written, IF a health insurance company issued a policy on a child under the age of 19 they would be required to cover any pre-existing medical conditions.

That was a big "if".

If a condition was overly expensive to treat, creating a situation where the carrier would lose money by issuing a policy, Obamacrap allowed them to just say no.

Enter the chief clown to the rescue.

HHS Secretary Shebullshits issued a decree which applied to all carriers throughout the land. Henceforth, by command of Shebullshits, health insurance companies could not refuse to issue a policy on a child.

In essence, she created a provision by fiat that did not exist in the law.

Carriers again reacted by agreeing to issue policies on children, but only if applied as a dependent of a healthy adult.

Again the mob complained that this was not fair. To deny coverage for sick children was bad, but to require parents as part of the package wasn't right.

Enter the California goon squad to save the day. California declared it was unlawful for carriers to require parents to buy health insurance if they wanted coverage on their children.

Think about the irony for a moment.

A key provision of Obamacrap, and one that has generated the loudest protest, is the individual mandate. Once fully implemented, all citizens of this formerly free nation, will be required to buy health insurance or else pay a tax unto Caesar.

But when an insurance company seeks to apply a mandate that adults purchase health insurance in order to also cover their children, this is also considered unfair.

California officials listened to the mob and henceforth declared a mandate for adults of minor children is unjust and passed a law making the parental mandate illegal.

Just like that, the parental mandate is illegal in CA but the Obamacrap mandate is legal . . . at least for now.

But the fire sale on children's health insurance in California is about to end. When the lefty state declared that carriers MUST cover children they conceded there MIGHT be adverse selection unless a window of opportunity was created.

And that window is about to close.

The LATimes reports Cali lawmakers are urging parents to act responsibly and secure coverage for their sick children, creating, in effect, a new kind of gold rush.

The law, which took effect Jan. 1, allows parents to apply for the coverage during an open enrollment period that runs until March 1, or in the month after their children's birthdays.

"The law is only effective if parents take advantage of it

Well, duh!

So parents of sick children, apply now before it is too late.

The carriers have agreed to comply with this mandate, as if they had a choice, but have come back with their own response.

Blue Shield of California has asked for a 59% rate increase on health insurance plans.

Somehow I doubt they will be the last to ask for a significant rate increase. There is also speculation that Blue Shield will bow out of the individual health insurance market.

And so it goes . . .

ACO's - How They Work

Yesterday we learned how an Accountable Care Organization might be set up. Today we will look at an ACO in practice.

Or maybe not . . .

Wednesday, January 26, 2011

This Just In: ObamaLied©

Not to put too fine a point on it, of course, but here's what the (ostensibly) non-partisan Medicare Actuary just officially announced:

"[ObamaCare©] probably won't hold costs down, and it won't let everybody keep their current health insurance if they like it."

In other related news, the sun is expected to rise in the east tomorrow, and next month is expected to be February.

That is all.

ACO's - Accountable Care Organization

Accountable Care Organizations will deliver a more affordable health care system, save money, and allow Obama to be re-elected.

Well, maybe . . .

Cavalcade of Risk #123 now online

Notwithstanding blog presents this week's roundup of risk-related goodness. Take a chance and stop on by!

And please note: If your post is included, you are expected to link back.

Tuesday, January 25, 2011

Another One Bites the Dust

Remember that ObamaPromise© that "if you like your health insurance, you can keep your insurance?" And remember when (just 3 short months ago) The Principal and UHC put the lie to that vow? Well, it just got kicked again:

"Today, Guardian announced plans to withdraw our medical insurance product line from all states, pending regulatory approval. This means we will no longer quote any new medical insurance business and we will work to wind down our existing medical business over the next two years."

[ed: That's from an email we just received; so far, this hasn't shown up at the company website]

Around these parts, Guardian wasn't exactly a major player in the medical insurance arena, so the impact is likely to be fairly small. Still, it's one more notch in ObamaCare©'s belt.

To paraphrase Bob, "Poppa Washington: less choice, fewer carriers."

UPDATE: No sooner did I hit the "go" button on this post than another email arrived, this one from UHC:

"UnitedHealthcare Employer & Individual has entered into an agreement to renew medical insurance coverage for The Guardian Life Insurance Company of America's medical plan customers."

Does anyone else see a pattern emerging here? Is anyone else just a wee bit concerned about it?

1 + 1 = 0

As we've long since noted, one of the (unintended?) effects of ObamaCare© is a shortage of physicians. As we reported last month, "40% of doctors said they would "retire, seek a nonclinical job in health care, or seek a job or business unrelated to health care." Dr Bradley Wertheim, looking at the facts through a slightly different lens, finds that new physician training standards will exacerbate the problem:

"[S]taffing requirements further underpin the argument for 30-hour shifts and 80-hour workweeks. The problem is simple: We have too many patients and too few doctors."

In a related development, FoIB Holly R tipped us to news on the doctor-owned hospital front. Previously, we reported that the "health care overhaul law closes the door on future physician-owned hospitals;" Holly's link expands on that point:

"The construction of physician-owned hospitals, which has been halted or jeopardized due to Section 6001 of healthcare reform, could have provided $200 million in tax revenue and 30,000 jobs to local communities ..."

The point is that it's not just the doc's who are affected by this, but the architects, contractors, carpenters, plumbers ... well, you get the picture. It's a very expensive ripple effect. And it affects us health care consumers, as well: fewer hospitals means less competition, and thus higher prices. And, of course, higher health care costs means higher health insurance costs.

And it's not just those direct costs that matter. According to the Physician Hospitals of America, "physician owned hospitals pour millions into local businesses, collectively spending $4.2 billion per year, or $15 million for every community that has" one. That's a lot of economic impact, now frittered away.

Oprah, Tom and Tiger vs MLR

What do a talk show host, a movie star and a golf legend have to do with Medical Loss Ratios (MLR)? This clever video has the down low:

My only real quibble with the vid is that it continues the conflation of health care with health insurance. For a more detailed explication of MLR, be sure to check out Mike and Bob's take on the subject.

[Video Hat Tip: Avik Roy]

Monday, January 24, 2011

Health Care Reform - Walking Down Memory Lane

Been there, done that.

For those too young to remember, here is a refresher course on health insurance mandates and how it affects small (and large) business.

Godfathers is a large, small business.

Godfather stores are mostly franchises, with about 100 that are company owned. Franchise owners are small business men and women who must balance costs, including payroll, against prices they can charge in a competitive market.

Restaurants have been hit hard during this recession, and increased costs in the form of forced health insurance could very well force those businesses to close down.

Government operates on the basis of spending whatever they wish without regard to balancing a budget and the belief that if they need more money, all that is required is to raise prices (taxes).

The raising taxes part works for them because they do not have competition and they have the power to do whatever they want with impunity (except at election time).

And of course we know how well the balanced budget part is working . . .

Of course Clinton's health care plan never got off the ground, and thank God for that.

Along comes Obamacrap with the same issues as with HillaryCare but an economy that is even less able to absorb the increased taxes and job losses.

Same game, different name.

Stupid Carrier Tricks: Empty Threats Edition

Got this in email from United HealthsCare:

"All Savers will require notification from all groups at renewal, regardless of whether or not a plan change is being made."

AllSavers is UHC's latest rendition of group coverage. At renewal time, groups have several options: stay with the current (or similar) plan, change benefits, and/or shop around. Typically, a group has to respond only if it's going to make changes; absent an affirmative response to the contrary, the carrier will assume that the group wants to "let it ride."

Here, UHC is "requiring" that the group respond, regardless. To which I replied: "Or else what?"

No response is needed, of course, since they can huff and puff all they want, but they can't refuse to renew a group because said group didn't send them a form.

The good news is that this came via email, so all that was wasted were some relatively inexpensive pixels (and my time).

Wherefore art thou, Gramps?

Another ObamaPromise© under the bus:

"After health care reform was enacted on March 23, 2010, we chose to grandfather most of the medical plans in our portfolio ... Since that time, we have seen muted market interest in retaining grandfathered status."

This is from Anthem, but I suspect that other carriers share this experience. It's simple, really: all 'grandfathering" does is tie a group's hands: it can't make substantive changes to bring down rates at renewal, and it adds a whole host of complications to the renewal process itself. And, as we've mentioned, the whole phenomenon will go away in a few short cycles since groups must make changes to rein in costs, thereby "un-grandfathering" their plans.

As a result, Anthem isn't even going to go through the motions any longer. Beginning with April renewals:

"We will release all renewals as nongrandfathered plans."

Sure, they'll still offer groups the option of remaining grandfathered (as opposed to the current "default" position), but that's going to be a bit more complicated going forward, since the carrier, the agent and the group will have to determine whether any changes have already been made that would obviate grandfathered status. In fact, there's a rather extensive "laundry list" of issues that must be addressed in that process.

It's just one more (egregious) example of how ObamaCare© does not, in fact, have anything to do with managing the cost of health insurance, let alone health care.

Benefits Package #4 is up!

Jennifer Benz takes the baton from us, and presents a great roundup of benefits-related posts. Do stop by.

Friday, January 21, 2011

Windmill Tilting?

As tempting as this idea may be on paper, one wonders whether it's the least bit legit:

"Idaho's Republican-dominated Legislature now plans to use an obscure 18th century doctrine to declare President Barack Obama's signature bill null and void.

Lawmakers in six other states -- Maine, Montana, Oregon, Nebraska, Texas and Wyoming -- are also mulling "nullification" bills

The basic premise of "nullification" is that the states themselves empower the Fed's, and that this power can be "switched off" if the latter oversteps its bounds. Even if one accepts this notion (and it's sorely tempting when it comes to ObamaCare©), it's important to recall that the Supremes swatted it down back in the 50's. That was then, of course, and this is now, but it's hard to imagine that the Supremes would renege on their own precedent.

Meantime, FoIB Holly R informs us that my own Buckeye State has also joined the lawsuit against ObamaCare©:

"Iowa, Kansas, Maine, Ohio, Wisconsin and Wyoming will join the coalition of states that have filed a lawsuit in federal court in Florida."

The plot thickens.

Cavalcade of Risk #123: Call for submissions

Notwithstanding Blog hosts next week's roundup of risk-related blogetry. Submissions are due by Monday (the 24th), and must include:

■ Your blog's url
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post

And PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).

You can submit your post via Blog Carnival or email.

NB: The Cav is about risk, but not necessarily or exclusively about insurance. So feel free to think outside-the-box, risk-wise.

Thursday, January 20, 2011

About that RepealIt vote...

Regular readers may be wondering why we haven't yet weighed in on this historic occasion. There is no question that it represents an important first step in the abolition of ObamaCare©. Frankly, though, it's something we've been touting all along, so it's surprising to us only that the new Congress fulfilled a campaign pledge.

I do have some concerns about how one begins to undo the damage wrought so far by this train wreck. For example, will all those 20-somethings now be kicked back off mommy-and-daddy's plan? What will happen to groups and individuals who've already renewed, and are (literally) paying the increased price? Will carriers reinstate lifetime maximums and rescind first-dollar preventive care benefits?

And what about the few people that did sign up for one of the ObamaPools©? Will the states keep them in place until the cash cow runs dry, or simply fold up shop?

Mind you, none of these are earth-shattering in implication, but they are potentially messy loose ends that need to be tied up.

One last thing: despite the fact that it's now up to the Democrat-led Senate, this vote was far from merely "symbolic." The very best take on the "symbolism" comes from Cato's Mike Cannon:
"The symbolism of today’s House vote is striking. Within a year of ObamaCare’s enactment, the House of Representatives has voted overwhelmingly to repeal it.

That didn’t happen with Social Security. It didn’t happen with Medicare ...

Today’s vote makes it more likely that someone with the power to scrap ObamaCare will do so"
Amen, brother.

Silly Interweb Insurance Info

So I log off email, and see this link on the home page: "Seven Insurance Policies That Aren't Worth the Money." Intrigued, I click over, curious to see what profound wisdom is to be had.

Turns out, not much.

Here are the 7 policy types, a brief description of each, the author's take, and my own:

1. "Mini-Med" Insurance

The agent quoted here is not a fan of these policies, claiming that "(b)uyers should know that these policies are best used for minor cuts and scrapes." While I know that there are some cases where this is true, I think this brief and arrogant dismissal misses the mark: for some people, this may be the only kind of coverage for which they qualify or that they can afford.

2. Accidental Death and Dismemberment

I agree with the article that these are - at best - a waste of money. I'd also add that the AD&D rider on life insurance policies has never made sense to me, either: dead is dead, regardless of cause. And how does it make sense that your wife needs more cash if you're hit by a bus than if you die of cancer?

3. Divorce Insurance

The article's agin it; I've never even heard of it. Of course, I hadn't heard of virginity insurance before, either. The idea is that a couple buys the policy and, if they get divorced after 4 years, they get some quick cash. Uh-hunh.

4. Comprehensive or Collision Coverage for Old Cars

I'm not a P&C guy, so I asked my friend Bill M for his take. Bill's a 30+ year industry veteran, a CIC and independent agent. Here's his take:

"I advise customers to consider dropping comp and collision when the value of the vehicle hits $ 3,000 or less. At that point a minor fender bender can total your car. You also need to look at the premium charged versus the potential benefit in that decision."

5. Car Rental Insurance

Again, we turn to P&C guru Bill M:

"As far as the car rental insurance goes, you need to check your rental contract to see if you are responsible for loss of use or diminished value, two items not normally cover by your own auto insurance.

If you are going out of the country you need to check that your coverage extends to where you are going.

All of these items should be discussed with your insurance agent about your specific policy."

6. Term Life Insurance

Is term insurance really a "big waste of money" as the article claims? No more than auto, home or health insurance are: none of those pay off if you don't have a claim, either. I agree that it's often not the best choice ("permanent needs require permanent solutions" as my own mentor used to say), but if you think it's really just money down the rat-hole, consider a Return of Premium plan.

7. Mortgage Insurance

First, there is no such thing as "mortgage insurance." That's simply a marketing wrapper for folks who don't want to buy "life insurance." Second, there's no industry-standard definition of what one means by the term. The article uses it to describe a term plan that's payable to the lender. But you can make any insurance policy payable to pretty much anyone you want to. Back in the day, "mortgage insurance" was a euphemism for "decreasing term life;" that is, the face amount ostensibly declined along with one's mortgage. The premium stayed the same, though, meaning the coverage got more and more expensive with each passing year.

As they say, YMMV.

Wednesday, January 19, 2011

Godwin's Law and "Representative" Steve Cohen

Godwin's Law is a well-known (if often misquoted) internet meme that says:

"As an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches."

Today, Democrat Representative Steve Cohen of Tennessee broke it in the real world, managing also to ignore President Obama's request for rhetorical civility:

They say it’s a government takeover of health care, a big lie just like Goebbels ... You say it enough, you repeat the lie, you repeat the lie, and eventually, people believe it. Like blood libel. That’s the same kind of thing, blood libel. That’s the same kind of thing.”

I hereby invoke my own Absolute Moral Authority and soundly denounce the heated, hateful, fact-free and decidedly uncivil rhetoric spewed by the "Representative." It is exactly the same as left-leaning pundits comparing global warming skeptics to Holocaust deniers: it trivializes the real Holocaust and its millions of innocent victims.

It is beyond the pale that the ignorant and self-hating Mr Cohen would liken foes of ObamaCrap to those who actually killed innocents. Recently, a (non-Jewish) politician used the term "blood libel" precisely as it should have been used, both in context and in meaning. Rep Cohen, who should know better, uses it to smear political opponents who recognize that ObamaCrap is, in fact and demonstrably, a government take-over of our health care system.

Rep Cohen, you owe us an apology for this brutal and spiteful shanda.

[Hat Tip: RedState]

Doc's On ObamaCrap

A (moving) picture's worth...

[Video courtesy The Heritage Foundation]

Tuesday, January 18, 2011

More BS from ShecantBeSerious

What to make of this:

"The Department of Health and Human Services study ... concludes that somewhere between 50 million and 129 million non-elderly Americans have a pre-existing condition."


First, way to laser in on the actual numbers there, Kathy! The forces of ObamaCare© have now given up all pretense of rational, fact-based debate and are resorting to just picking numbers out of their Pelosi's.

More critically, why is this even an issue? Either they they have such a condition or they don't. If they do, then how come, in 2000+ pages, you couldn't have given them all immediate coverage? After all, it'd be the right thing to do, wouldn't it?

But wait: you did!

Then why is it that all of these uninsured - and ostensibly uninsurable - folks aren't flocking to the ObamaPools© that have been online since last summer? After all, these wonderful new plans are guaranteed issue and cover pre-existing conditions.

Part of the answer is that, as noted above, there are no "129 million" uninsurables. It's just another example of ShecantBeSerious BS:

"While the title shouts that 129 million people could be denied coverage, the so-called study defines preexisting conditions to include those “that would result in an automatic denial of coverage, exclusion of the condition, or higher premiums.”

Catch that little sleight of hand?

Here it is in slo-mo:

"... the so-called study defines preexisting conditions ... “that would result in an automatic denial of coverage, exclusion of the condition, or higher premiums.”

An exclusion is not a denial, and in the real world, an increased premium is called "pricing the risk." So they're not even competent at making it up. And we're supposed to trust these clowns to actually run our health care system?

What could go wrong?

Avik Roy has his own tremendous takedown of this ShecantBeSerious BS, including this must read insight:

"Sebelius and her HHS colleagues try to morph the definition of “preexisting conditions” into “conditions.” Take this random sample of Sebelius’ assault on the English language:
An analysis of a survey that follows people over time found that, among healthy people—reporting very good or excellent health with no chronic conditions—today, 15 to 30 percent (depending on their age) will develop a pre-existing condition within the next eight years.
So, let’s get this straight. Fifteen to 30 percent of Americans will, in the future, develop a preexisting condition. This only makes sense if the HHS has also invented time travel.

A person who has health insurance, and later becomes ill, does not have a preexisting condition. He has a condition of the plain old “existing” kind—one that his insurance will help pay for. This is exactly how insurance is supposed to work."

Read the whole thing.

Death and Taxes (But Mostly Taxes)

As might be expected, we tend to look at the insurance (and health) aspects of ObamaCare©, but as Bob's pointed out, there are some pretty significant tax issues, as well. Some are hidden, of course, but two readers, Bob D and Sam B, have drawn our attention to some of the more overt tax increases contained in the bill we had to pass to see. As we've discussed before, the (Evil) Individual Mandate is a tax, as is the (Stupid) 1099 Rule. But these are only two examples of the tax perfidy to which we're about to be treated. Here's a handy cheat sheet to many others:

Last year saw a $2.7 billion tax on indoor tanning, and a $22 billion hit on drug innovation companies.

This year will see the implementation of a $5 billion "Medicine Cabinet Tax" (on generic med's under HSA, FSA and HRA plans) coupled with a $1.4 billion spike in HSA withdrawal penalties. We'll also be treated to the new Employer reporting requirements (more on this issue here).

In '12, we'll see the roll-out of much-despised and derided "Corporate 1099-MISC Information Reporting" requirement, expected to cost over $17 billion.

2013 looks to be a "banner year" for ObamaTaxes©: we'll see the $123 billion Surtax on Investment Income [ed: which has to do with healthcare, how?], an $86.8 billion increase in the Medicare Payroll Tax, a new cap on Flexible Spending Accounts as they relate to special needs kids (why does Barry hate the children?), a $20 billion tax on manufacturers of medical devices (why does Barry hate sick people?), an increase in the itemized deduction requirements that's expected to cost taxpayers an additional $15 billion, along with the elimination of the deduction for employer-provided prescription med benefits that looks to cost $4.5 billion.

Looking ahead to 2014, we see the much anticipated (and Evil) Individual and Employer Mandates in full swing, along with a new tax on certain insurers. That last little goody's looking to cost insurers $60 billion. Wait, did I say "cost insurers?" Just kidding! It looks to cost insureds $60 billion.

And waaay down the road - 2018, to be exact - we have a shiny new, $32 billion Excise Tax to look forward to.

Isn't it grand that we had to pass it to learn all this?

Grand Rounds is up...

George Van Antwerp hosts an engaging 'Rounds, focusing on patients' access to and understanding of health care.

Monday, January 17, 2011

You say that like it's a *bad* thing!

Quick, who said this:

"(P)romising fundamental changes to the country's expensive and over-stressed ... health care system ... the reforms would cut red tape and improve treatment, but critics claim they will cause chaos ..."

Nope, not BarryNancyHarry. This is "The New MVNHS©" and it's the rallying cry of Prime Minister David Cameron. The primary issue seems familiar: who's in charge of health care decision-making, the docs or the bureaucrats? Currently, it's the latter, but that could change:

"(B)y giving control over management to family practitioners rather than bureaucrats, and allow private companies, charities and social enterprises to bid for contracts within the public health service ... Making health care more efficient ..."


So at a time that many here want to see us adopting a British-type system, the Brits themselves are seriously considering scrapping it? Wow!

Worse yet (from our own statists' perspective) is that Mr C is taking direct aim at those self-same bureaucrats:

"Cameron promised to get rid of "topdown, command-and-control bureaucracy and targets."

Whoa there, fella, that's some dangerous rhetoric.

For those who continue to deplore the (alleged) 17% of our GDP that goes to health care, keep this little number in mind:

"The health service is Britain's biggest employer, costs more than 100 billion pounds ($158 billion) a year." [emphasis added]

Looks like that ostensibly superior health care scheme hasn't been any more successful at reining in health care costs (or demands) than we have.

The MVNHS© Strikes Again. And Again.

No, these aren't the opening sentences of a bad prose contest, they're for real:

"It was a bitterly cold night in January when Geraldine Weller gave birth in the car park of a London hospital. Three hours earlier, the maternity unit had sent her away."

The good news is that Mrs Weller (the article points out that this isn't her real name) and her baby survived the ordeal, no thanks to the understaffed facility. Her story is just one of thousands in similar straits, though, all because the "world class" health care scheme is ill-prepared and ill-equipped. And it's getting worse:

"(A)n investigation by The Sunday Telegraph discloses widespread fears among health professionals that maternity services are sliding into crisis, as small units close, and funding fails to keep up with a decade-long baby boom."


As mentioned, the baby survived (no thanks to the MVNHS©), but it's not all sunshine and lollipops. Heaven forfend that the poor child catch a nasty germ; as we pointed out last month, the Brits' health care "safety net' has some rather conspicuous holes:

"The NHS Direct helpline is at ‘breaking point’ as parts of Britain experience the worst flu outbreak in a decade."

But that's okay, the system's first response is "to do no harm." Right?

Thanks to Mike, we know the answer and it's "um, not so much:"

"Healthy people buying the flu jab have compounded shortages in the NHS and left those at greatest risk struggling to get the vaccine, claimed Dr Clare Gerada, the chairman of the Royal College of GPs."

Their solution? Well, regular readers know what's coming next:

"Dr Gerada said that allowing those who could afford it to buy the jab had upset the “delicate balance” of availability and contributed to shortages ... healthy individuals who had paid to have the jab on a private patient basis at pharmacies shared some of the blame for the shortages."

See, if you're not part of the solution, you're the problem.

And if you are part of the solution, you're still the problem.

Exit question from Mike: "Say, wasn't UK all worried about not enough people getting vaccinated?"

Sunday, January 16, 2011

Blues vs Shecantbeserious: The Plot Thickens

Last week, we reported that the California Blues were playing a bit of "chicken" with their rate hike request. To wit, an astounding 59% increase in premiums. The Golden State's Department of Insurance responded by asking the carrier (and others) to delay their proposed increases for two months, but lacks any enforcement powers to make them comply. Which turns out to be a good thing, given this:

"The company said it expects to lose $20 million to $30 million this year on individual policies."


But how could that be, since ObamaCare© promised to lower health care costs?

Well, not so much:

"In the past three years, the company said, its costs for hospitals, physicians and prescription drugs have risen by an average of 15 percent annually."

That's 45% right there; add in another 10 or 15 points or so since the advent of ObamaCare© last September, and Bob's your uncle. It's not a stretch, then, to see how these numbers make sense. The ball is now in Ms Shecantbeserious' court: does she have the will, let alone the means, to derail these increases?

Time will tell.

Friday, January 14, 2011

RepealIt Update [UPDATED & BUMPED]

The House vote to repeal ObamaCare© is back on track:

"As the White House noted, it is important for Congress to get back to work, and to that end we will resume thoughtful consideration of the health care bill next week"

Meantime, the forces of the 10th Amendment continue to march on the judicial front:

"That brings the number of states on the Florida suit to 23 and the total number of states suing to stop Obamacare (which includes Virginia and Oklahoma) to 25."

The misleading headline is most likely due to a rounding error (after all, 25 is less than half of 57).

UPDATE: And now Dorothy, Toto and the gang are joining in the fun, too:

"The state of Kansas recently asked to join the lawsuit challenging the constitutionality of the Obama health care plan filed by 20 state governments ... That brings the total number of state governments litigating against the plan to twenty-six."

Granted, that's still less than half of the 57, but it's getting closer.

And, oh yeah: "Ohio, Wisconsin, and Wyoming are also seeking to join the multistate lawsuit, while Virginia and Oklahoma have filed separate challenges to the law."

Isn't that called "piling on?"

California DOI: FAIL!

This is hysterical:

"Dave Jones, the new California insurance commissioners, is asking big carriers to refrain from increasing premiums for at least 60 days after the effective dates of their most recent rate filings."

Remember, it was folks like Mr Jones who rushed ObamaCrap through Congress, and now he wants to slow things down? Hey Davey: Why don't you approve the rate hikes so you can see what's in them?


Wednesday, January 12, 2011

Good on the MVNHS©!

It appears that the Much Vaunted National Health Service© has learned a lesson from us Colonials:

"The lives of more than 5,000 cancer sufferers will be saved each year under an £800 million [about $1.25 Billion] government drive to make England’s survival rates among the best in Europe ... Under the plans, GPs will be given the power to order a range of cancer tests direct from hospitals without having to refer the patient first to a consultant."

It's true that there are still a few plans here in the States that require such a referral, but a) they're few and far between and, b) one isn't forced to buy such plans (yet). It's also true that our cancer survival rates soar above our Cousins Across the Ponds'. On the downside, that 5,000 survivors apparently represents about one third of 1% of those who might otherwise succumb. Baby steps and all that.

In the event, about $15 million of that total will go towards encouraging folks to "see their doctor sooner if they develop symptoms." Sounds sensible.

Cavalcade of Risk #122 now up!

David Williams presents this week's roundup of risky posts. Take a chance and stop on by! And please note: If your post is included, you are expected to link back to the Cav in a timely manner.

Tuesday, January 11, 2011

On the Oregon Trail

FoIB Holly R forwarded the link to this story, about which I can only ask "on what planet is Hannah Wallace living?" It is so full of inconsistencies and outright misinformation, one wonders how The Onion could possibly do better.

Let's start at the beginning, shall we?

"For a writer living in New York state, there were plenty of reasonably priced plans"

Really? The actual numbers tell a different story.

Ms Wallace continues apace:

"That’s largely because in Oregon, “medical underwriting”—during which insurance companies cherry-pick healthier customers ... it’s one of five states with so-called “guaranteed-issue” laws that mandate insurance companies cover anybody regardless of health status."

(See above)

The last thing we want to be doing as a state is hampering that sector with high insurance costs. It’s exactly the wrong way to stimulate the economy ... Yet this is precisely what Oregon is doing by not providing affordable health insurance options."

We've written about Oregon's insurance situation before; they have a very effective (if lethal) way of dealing with increased health care costs (which, of course, drive health insurance costs).

But wait, there's more!

"The only plan I can find here that would cover my pre-existing condition costs more than half my rent"

This is another of those little "throwaway" canards that's never made any sense to me: what does one's rent have to do with one's insurance? If Ms Wallace lived with her parents, then her insurance would be infinitely higher than her rent, yet that is no more meaningless (or meaningful) than her comparison.

She continues:

"I don’t want just so I don’t become one of the 51 million Americans who are uninsured."

And again with the oft-debunked number of uninsured (anyone else notice how that number keeps growing, despite the advent of wonderful ObamaCare©?). It's a bogus number to begin with; that it keeps growing is itself a wonder.

Are we done yet? Of course not:

What really needs to happen for you is that it needs to be 2014 ... when the new Patient Protection and Affordable Care Act ... will eventually force insurance companies to cover everyone, pre-existing conditions or not. They have had to cover sick children since September; adults, however, have to wait until January 1, 2014—three long years away."

Except they haven't; healthy kids hardest hit. And if you want to see what's in store for '14, you need look no farther than the current ObamaPool© programs. These are guaranteed issue plans which cover all pre-existing conditions (sound familiar, Hannah?), yet their reception has been, well, underwhelming. Why would any rational person believe that's going to change in 3 years?

Bu the very best (well, funniest) line comes near the end:

"For freelancers ... Massachusetts is mecca"

Oh, absolutely, it's just been so successful! If that's Mecca, then one shudders to think what Armageddon looks like.

Grand Rounds: It's (Not Really) Complicated

Tony Chen presents an outstanding edition of Grand Rounds. It's obvious that he's read every submission, and worked hard to make them flow together (no mean feat when you consider subjects from diabetes to autism). Best of all, it's not overly long (as these things can grow to be), so it's easy to read through.

Monday, January 10, 2011

ObamaCare© Repeal Update

The vote on the (aptly named) "Repealing the Job-Killing Health Care Law Act" has been postponed due to Saturday's tragedy in Tucson.

There is no question that the events over the weekend were horrific, but I have to question whether this is an appropriate response. I'd be very interested in our readers' take on this:

Ohio Department of Insurance News: Update

FoIB Holly R just dashed my, alerted us to this new development:

"In his first official acts as governor after the inauguration, Kasich named Lt. Gov. Mary Taylor director of the Ohio Department of Insurance..."

Mazel Tov, Mary!

The Blues play chicken with Shecantbeserious

The term "neener-neener!" comes to mind:

"Another big California health insurer has stunned individual policyholders ... this time it's Blue Shield of California seeking cumulative hikes of as much as 59%."

But, but, but:

"HHS will require that health insurance companies “disclose and justify any rate increases of 10 percent or more.”

What to do, what to do.

Well, as Mike pointed out in his post, "rate hearings will also remind people in every state what a fraud the government has perpetrated in claiming to have "reformed" health care." And hearings there will be:

"[Newly elected CA Insurance Commissioner Dave] Jones said the Blue Shield move underscored the need for the Legislature to give the insurance commissioner legal authority to regulate insurance rates the same way he does automobile coverage.

At present, the commissioner can block increases only if insurers spend less than 70% of premium income on claims. Jones' office said Blue Shield's March 1 increase was under review

There we go again, comparing health insurance and auto insurance. They are not the same, and their rate structures are based on very different methodologies. Not to mention the fact that auto policies aren't (currently) required to cover oil changes and tune-ups. What do you think would happen to auto rates if (when?) they do?

The bigger issue, of course, is "why?" The Blues claim that "the increases were the result of fast-rising healthcare costs and other expenses resulting from new healthcare laws." But of course that can't be true: after all, the folks who passed the bill so that we could see what's in it promised us that it would result in lower, not higher, insurance costs.

The wheels on the bus go thump-thump-thump.

The Benefits Package: New Year's Edition

Welcome to the first Benefits Package of the new year (and, indeed, of the new decade). We're grateful to Evan for the opportunity to be the first "non-Evan" hosts, and to this week's participants for sharing their insights and ideas.

I'm also pleased to help launch a new "niche carnival;" that is, one with a more narrowly defined focus. It seems to me that these smaller versions are less intimidating for hosts and readers alike. Certainly, it's a lot easier to edit and post a carnival with 8 or 10 (or a dozen!) entries than some of the "big boys." So if you're even remotely interested in hosting a future edition, please drop Evan a note: I guarantee you you'll find it a simple, yet rewarding, experience.

And now, on with the show:

■ David Kerrigan looks under the hood at what, exactly, drives the decision to keep or change group insurance carriers. You may be surprised at the role played by network size.

■ The Cato Institute's Michael Cannon wonders if the administration is perhaps playing fast and lose with their numbers-crunching, at least regarding how it deals with expenditures and the private sector. Great food for thought.

■ Anne Freedman combines some (scary) statistics with good old-fashioned common sense as she explores the growing problem of an aging work-force. Specifically, older workers may be playing an outsized role in keeping out "new blood." This doesn't bode well for our current unemployment situation.

■ Only David Williams could combine coupons, bullets and FuzzBusters and come up with an intriguing post on why it's bad policy for drug companies to make your co-payment for you.

■ Benefits Package founder (and uber-wonk blogger) Evan Falchuk shares some important lessons he learned from a group of Longhorn business folks. He's careful to point out that it's less prediction than recognition.

■ Another great health policy wonk, David Harlow, takes aim at Jeff Goldsmith's recent article on Accountable Care Organizations (ACO's). While acknowledging that Mr G makes some valid points, David's convinced that the basic ACO model is still salvageable.

■ Jennifer Benz and Ed Bray provide us with a handy two-minute overview of PPACA (known around these parts as ObamaCare
©); just the ticket when the boss asks "what's this all about?" It's handy, brief and timely.

■ There's no question that prescription drug prices play a key role in how much we pay for health benefits. George Van Antwerp lays out the case for efficient innovation in how PBM's (Pharmacy Benefits Managers) market themselves to demonstrate the value they bring to the table.

■ Just as pharmacy benefits impact the cost of health care, so may improved utilization of Information Technology (IT). Blogging at Action for Better Healthcare, Kester Freeman reports on a new IT initiative currently underway by IBM and Premier Health Alliance that hopes to effectively address the issue.

■ As Keith McMurdy explains, pension benefits are also affected by the current economic downturn, and could lead to a "withdrawal liability" problem.

■ In our own contribution, we discuss how some employers are going mental over mandates.

And that wraps up the Benefits Package, Third Edition. Be sure to stop by Jennifer Benz's place on the 24th for the next exciting installment!

Friday, January 07, 2011


Have you ever watched a game of Ping-Pong? Your head constantly swivels back-and-forth, following the ball as it (hopefully) passes over the net. That's kinda how it feels watching the Congressional Budget Office (CBO) whipsaw over how much repealing ObamaCare© will cost.

Er, save:

"The Congressional Budget Office, in an email to Capitol Hill staffers... has said that repealing the national health care law would reduce net spending by $540 billion in the ten year period from 2012 through 2021 ... Repealing the bill would also eliminate $770 billion in taxes."

The email comes in response to a request from Rep Paul Ryan (R-WI) that the CBO "score" the bill without all the double-counting of revenue and taxes that marked its initial take on the Repealing the Job-Killing Health Care Law Act on which we reported yesterday.

Anyone know if ObamaCare© covers whiplash?

ObamaCare©: "Wait" for it....

Courtesy of the "evil" folks at Anthem, we learn about a few more gotcha's in the bill we had to pass to see. In health insurance, there are two very important, and different, uses of the term "waiting period." One refers to how long a carrier can put off covering pre-existing conditions, and the other to how long an employer can put off adding a new employee to an existing plan.

First, regarding pre-ex, we already know that policies with plan years that begin (or renew) after last September can no longer apply a waiting period for "the children" (under age 19). Insureds 19 years or older may still be subject to such a wait.

Beginning in '14, of course, no such waiting periods are allowed. I'm sure that will lead to reduced premiums, right?

As to those waiting periods for group eligibility, also beginning in '14, the waiting period is capped at 90 days (this is currently the law in Ohio, anyway, so no change here). Interestingly, the "employer fine" calculation isn't applicable during that waiting period (so long as it's no more than 90 days).

Frankly, this provision doesn't really strike me as too onerous: after all, either the new guy's going to work out in 3 months, or he's not. Extending the waiting period beyond 90 days doesn't seem critical.