Aetna joins the parade

Monday, February 29, 2016
Aetna, and its Coventry affiliate, becomes the next major player to cry "no mas" on new business. In email this morning:

"We will not pay commissions for sales with coverage effective dates after March 1, 2016, and continuing through December 31, 2016 effective dates.  This applies to on- and off-exchange business."

Again, this is unquestionably a sound business (from their point of view): the fewer agents writing business (because let's face it: no one wants to work for free) the fewer new policies, and thus fewer claims.

Why is this important? Well, because the carriers are finding that off-Open Season enrollees tend to generate more (and more expensive) claims, and are more likely to drop coverage. What better way to tamp down on this abuse than by drastically curtailing the opportunity for it?

Gee, who coulda seen that coming?

Oh, yeah.

What Single Payer looks like

Words fail:

Tucson News Now

[Hat Tip: RedState]

SvenCare© Failing

Friday, February 26, 2016
It's been a while since we checked in on the Swedish national health care scheme (most recently here). Despite the country's relative homogeneity (which, to be fair, has come under increasing challenge due to the influx of, um, refugees), the system has gone on overload, with increasingly long wait times and a corresponding decrease in actual health care delivery.

As a result, almost 10% of the population now owns private health insurance, -

Wait: you didn't know that countries with national health care schemes also harbor the deep, dark secret shame of private health insurance? Regular IB readers know -

which amounts to almost half a million folks. And what does such a policy provide? Well, for one thing, much shorter wait times, which translates to faster return-to-work times, so it's win-win for those hard-working Swedes.

[Hat Tip: Co-blogger Mike F]

Suing for The Slush Fund


The Federal Government is being sued by an entity that was entirely funded by...the Federal Government.

Yes, you read that correctly. According to the Portland Tribune Oregon Co-op Health Republic has filed a $5 Billion dollar class action lawsuit on behalf of all of the insurers who didn't receive funding from the Risk Corridor program. The lawsuit was filed on February 24th in federal claims court against the United States of America, acting through HHS and CMS. In the lawsuit Health Republic of Oregon claims that for 2014 and 2015 they are owed roughly $22 million dollars in Risk Corridor payments.

The Risk Corridor program was designed to fund insurance companies who lost money on Obamacare policies with money from insurance companies who were profitable on Obamacare policies. The Obama administration assured companies that the program would be deficit neutral, but guess what happened? Essentially nobody was profitable. (shocked face) Instead of companies receiving $2.7 Billion in payments they will only receive $362 Million - a shortfall of over $2.5 Billion. While the language in Obamacare isn't clear, it was assumed that if there was a short fall that HHS would simply authorize the fund to be paid out. This changed when Republicans in Congress inserted language in the budget bill that required the program to be deficit neutral - exactly how the Obama administration had portrayed the program.

In its previous life Health Republic is the artist formerly known as the Freelancers Union. The head of Freelancers was none other than Obama favorite Sara Horowitz. (ed note: good gracious how many times have we documented this relationship) What makes this lawsuit "special" is how this company was started in the first place.

Health Republic is an insurance cooperative. Health insurance cooperatives were created by Obamacare to compete against traditional insurance companies. They were promoted as more affordable non-profit insurance companies that would save consumers on premiums. They were fully financed by revenues generated through the (un)Affordable Care Act with low/no interest loans.

Freelancers/Health Republic received three loans for their three entities - Health Republic of New Jersey, Health Republic of New York, and Health Republic of Oregon. In total they received $435 million dollars to start up and sell insurance in their respective states. Now, only two years into Obamacare and both New York and Oregon have gone belly up. Oregon burned through their $61 million - plus premiums - and only had 15,000 members at the end of their run in 2015.

Now they want their money - more appropriately, taxpayer money - to help bail them out. Knowing the DOJ and the Obama Administration they will find a way to make it happen.

#TooBigToFail, insurance-style

Thursday, February 25, 2016
So this headline caught my attention:

MetLife in talks with MassMutual for premier client deal

Briefly, Met's looking at spinning off its US advisor force, which caters to "middle- to upper-income consumers, including small-to-medium sized company executives and small business owners."

Intriguing, yes, but (way) outside my wheelhouse, so I called on my resident guru of all things "advisorish" FoIB Jeff M:

"Hey Jeff, I have a feeling this is important, but I don’t really understand it. Help?"

As usual, he jumped right into the fray, explaining:

"A week or so ago, the Feds declared Met as "too big to fail" thereby telling them..."You need to sell some of your business 'cause if one of your business units fails, it will cause grave harm to the US economy." Therefore and henceforth, Met is talking with Mass about Mass buying Met's life business.

Clear?
"

Crystal.


Of course, there's a shorter version, as well:

"Nice business ya got here, be a shame somethin' were to happen to it...."

Hmmm.

Health Wonk Review: One step forward edition

Just when I think that the HWR can't possibly get any better, along comes good friend Louise Norris to prove me wrong. In fact, it may take me a while to read through all the great posts, from BHP's to pregnancy-as-SEP, digital health to those pesky 1040's, just terrific content.

Thanks, Louise!

Wednesday Afternoon Linkage

Wednesday, February 24, 2016
Courtesy of FoIB Jeff M, we learn that North Carolina's Blue Cross/Shield is continuing to take on water as its customer information interface melts down:

"Moncol learned all of the information several weeks ago when she went online to check her family's health savings account and found data on the McAllister family instead. After a few more clicks, she found she could access the investment accounts tied to the HSA."

Ooops. In fact, she could have actually changed pretty much all of that other family's info, or stolen their identity were she "that kind of person" (which, thankfully, she's not). But talk about a security hole big enough to drive a Mack truck through. Looks like the Tar Heel State's Blues could give the security-flawed 404Care.gov site a run for its money.
 

As we've long noted, the above-mentioned 404care.gov site is rife with security issues, and as FoIB Holly R alerts us:

"During the two years before the disastrous opening of HealthCare.gov, federal officials in charge of creating the online insurance marketplace received 18 written warnings that the mammoth project was mismanaged and off course but never considered postponing its launch"

Well of course not, silly: why would massive security flaws hold us up?
 

Another long-term topic has been faith-based (primarily Christian) "sharing ministries," a sort of religious crowd-funding arrangement for health care financing. Co-blogger Bob V sent us this latest news:

"The use of so-called “health sharing ministries” has soared in the wake of President Barack Obama’s health care reforms ... membership has more than doubled, from about 200,000 to about 530,000"

At over half a million participants, this is definitely a force with which to be reckoned. The usual caveats apply, of course: "the plans offer members no guarantee their medical bills will be shared, and ministries aren’t obligated to include a range of care that insurance companies are."

Still, by saving thousands of dollars in potential fines, and tens of thousands in deductibles and co-insurance, it sure seems that these folks have found something that works for them. and the fact that their ranks have swelled so fast and so far is pretty good proof of its appeal and effectiveness.