Quote:

 

http://www.breitbart.com/InstaBlog/2014/05/01/About-that-67-Obamacare-Payment-Rate

About that 67% Obamacare Payment Rate
by JOHN SEXTON

Yesterday the House Energy and Commerce Committee released a statement about the Obamacare payment rate which got a lot of attention. The committee reached out to individual insurers in states using the federal Obamacare exchange and then collated the response. What they found was "as of April 15, 2014, only 67 percent of individuals and families that had selected a health plan in the federally facilitated marketplace had paid their first month’s premium and therefore completed the enrollment process."

The 67% claim surprised a lot of people because, for several months, we've been hearing that the payment rate was closer to 80-85 percent. Could it really be that much worse than expected? How did this happen?

In order to find out we'd need to know a couple of things. First, how many people have signed up. Second, how many who signed up followed through and paid. In theory the insurers should be able to provide this information. Then we simply divide one by the other and multiply by 100 find out what percentage paid. In this case, the E & C Committee is telling us the answer is 67 percent.

But how exactly did they arrive at this? They give us one of the numbers we need in the press release, "insurers informed the committee that only 2.45 million had paid their first month’s premium for coverage." Working backwards we find that 2.45 million is 67% of 3.65 million. I contacted the Committee and they confirmed that their data found only 3.65 million people had signed up for Obamacare using the federal exchange.

But there's a problem with that figure. Today HHS released the signup data for April which gives us totals for the entire enrollment period. They found that 5.4 million people signed up via the federal exchange. That's about 1.8 million more people than the Committee claims signed up. Obviously, that's not a minor difference. I sent a followup question to the Committee but they appear to have left for the day.

Is this a situation where we can just assume the payment rate (67%) is right even if the totals are off? Not necessarily. One of the problems we have is that not everyone who signed up at the end of the enrollment period would have passed their individual payment deadline. So, for instance, if 25% of the people being counted as signups still have time to pay, we can't really consider them as non-paying. Maybe some of them paid at the deadline, which was after the cut-off for the E & C questionnaire sent to insurers.

To be fair, the Committee was pretty clear that this was incomplete data. Their press release states, "Due to the administration’s repeated and unilateral extensions and changes, as well as the fact that many insurers have reported that individuals will still have time to pay their first month’s premium, the committee plans to ask the insurers in the federally facilitated marketplace to provide an enrollment update by May 20, 2014." That followup, which will come after everyone's first premium is due, should provide a much clearer understanding of the payment rate.

nyesq83

May 1 2014, 11:06 PM

My policy took effect today and I have no paperwork or contact from Healthkeepers Anthem BCBS. I need to get a check up this month and see specialists ASAP. This month. And I realize the monthly premium is exclusive of the deductible and annual max OOP expense...

Quote:

 

http://online.wsj.com/article/BT-CO-20140430-723284.html

Report: Two-Thirds of Insurance Exchange Enrollees Paid Premiums -- Update

Around two-thirds of people who had picked insurance plans through HealthCare.gov paid their first month's premium by April 15, according to a report released Wednesday by Republican lawmakers using data from insurers.

The GOP-led House Energy and Commerce Committee asked for payment data from 160 health plans selling policies in the Affordable Care Act's federal insurance exchange. The committee's leaders said that responses showed that across the 36 states served by the federal exchange, 67% of people who had finished the sign-up process had made the premium payment to insurers and had been enrolled in coverage as of April 15.

The proportion is lower than the rates some large individual insurers have released, though some of the time frames for those estimates vary. On Wednesday, WellPoint Chief Executive Joseph R. Swedish said during an earnings call that around 90% of those who have enrolled in health-law marketplace plans have been paying their premiums. Aetna Inc., in its earnings call last week, said it was generally seeing about an 80% payment rate among those enrolled. The Obama administration's top health official has put the rate between 80% to 90%.

The House report is likely to be seized on by opponents of the law, who have emphasized the difference between picking plans and being enrolled in coverage. Earlier this month, President Barack Obama said that as of April 15, eight million people had picked plans through federal and state-run exchanges.

Supporters of the law raised questions about the report, and also said they expected the percentages to change because of a late enrollment surge. A Department of Health and Human Services spokeswoman, Erin Shields Britt, questioned whether the report had captured every insurer participating in the federal exchange and pointed to the report's divergence from the public comments made by big insurance companies.

"Additionally, given the significant surge in enrollments at the end of March, it stands to reason that not all enrollees would have paid by the date of this so-called report, since many people's bills were not even due yet," she said.

The House report's figure doesn't include details about the 14 states that are running their own exchanges, some of which were still allowing people to sign up as of April 30 or later. The committee didn't make the responses from insurers available.

The committee's leaders said the data showed that across the country, only 25% of the enrollees who had paid their premiums as of April 15 were in the highly sought-after 18-to-34 demographic. Starting this year, insurers are no longer allowed to charge people higher rates based on their medical history. As a result, they are keen to enroll as many younger people as possible, to balance out the expected higher medical claims from older and sicker enrollees.

White House officials recently said that 28% of the people picking plans in the federally run exchanges were in the 18-to-34 demographic.

Under the health law, most Americans who wanted to buy coverage through the new insurance exchanges had until March 31 to sign up for a plan through HealthCare.gov. The administration required insurers to begin covering people as of May 1 if they made their first payment by April 15.

Amid a surge of last-minute interest that prevented many people from completing the process, federal officials said they would give those people until April 15 to finish picking their plans. In practice, some insurers allow people to have coverage effective May 1 even if they pay after the middle of the month. As a result, the percentage of premium payments is expected to climb, though it is unclear by how much.

The Blue Cross Blue Shield Association has said that around 80% to 85% of people who had picked plans through February had gone on to make the first month's premium. HHS Secretary Kathleen Sebelius cited similar estimates for a similar time frame, saying that around 80% to 90% of people who had picked plans had also paid.

WellPoint said it had signed up about 400,000 paid members through the health-law marketplace through Feb. 15. The insurer said it was projecting it will reach more than 600,000 total when the entire open-enrollment period is tallied.

WellPoint also said that the demographics of the exchange sign-ups are generally matching its expectations, with the later enrollees skewing younger than those who came in at the start. WellPoint is selling individual plans through the public exchanges in 14 states, including New York and California, which are both running their own exchanges.

Aetna said it had signed up about 230,000 paid exchange members in time to be included in its first-quarter results, and was projecting it could have around 450,000 by the end of the year.

Mark Bertolini, Aetna's CEO, said that, so far, "medical cost indicators for this population remain within a manageable range, as compared to our pricing assumptions." Aetna is participating in the health-law exchanges in 16 states and the District of Columbia, the most of any insurer.

A refresher to start

May 1 2014, 09:17 AM

abb

Apr 30 2014, 07:48 PM

Found: The lamest anti-Obamacare column of all (thus far)

Michael Hiltzik

1:53 PM PDT, April 28, 2014
Advertisement

As we've recently observed, conservative opponents of the Affordable Care Act have pulled out the stops to paint the law as an unmitigated disaster--notwithstanding its documented gains in health insurance coverage for millions of Americans nationwide.

But we think we've found the dopiest entry in this competitive field. Tip your hat to Michael F. Cannon of the libertarian Cato Institute, who wins the prize with a piece entitled "ACA Exchanges at risk." Cannon is director of health policy studies at Cato, which is a little scary. His column appeared April 22 on the opinion page of the Los Angeles Register (whatever that is) and also is published on the Cato website.

Its theme is that Obamacare "creates so many incentives for enrollees to drop their coverage" that this year's enrollment numbers can't be sustained. The piece goes even further, stating that people are financially better off if they drop their coverage and "wait until they get sick to re-enroll."

That argument places Cannon squarely in the disreputable camp of conservatives who advise Americans not to sign up for Obamacare because there's no downside to going without coverage. That was the implicit point made recently by the right-wing blogger Matt Drudge, who says he'll never sign up for Obamacare and claimed (implausibly) that he had already paid his 2014 penalty for shunning the ACA's legally mandated individual health coverage.

It should be obvious that advising anyone to go without health insurance, especially when it's been made affordable by the ACA, is the height of irresponsibility. That's even more true when the advice is based on nonsense.

So let's take a gander at where Cannon, Cato's health policy expert, goes off the rails.

First, he claims that "for most healthy people, going uninsured before Obamacare, at least for a time, was already a safe bet.... The odds that they would have to deal with unmet medical needs, or unpaid medical bills, were low."

That's true, up to a point. Of course the flaw in this reasoning is that the time span dividing healthfulness from dire medical need can be a nanosecond--the time it takes to be hit by a car, feel a sudden chest pain, or to take a phone call from a doctor bearing a cancer diagnosis. You want to roll the dice, go ahead. Just remember that you are rolling the dice.

Then Cannon gets really ghoulish. "Suppose the day after you cancel your health insurance, you receive a serious diagnosis like diabetes, or cancer," he posits. No problem! Under Obamacare, you can't be denied insurance coverage or charged extra for that illness!

On the other hand, Cannon concedes, you may have to wait until open enrollment for the following year to sign up, which means your coverage won't start until next January.

Big deal, Cannon suggests. What's the risk that you'll have to wait, say, 11 months to see a doctor for your cancer? How many cancers kill people that fast, anyway? "You may have to wait until January for that coverage to take effect," he writes, "but even so the downside risk of going uninsured is much smaller."

Anyway, he says, there are plenty of ways to sign up for coverage without waiting a year. For example:

--Get married. "Newly married couples can enroll in an Exchange plan on their wedding day," he observes. (You can get divorced the day after enrollment, he advises.) And happily, "states that recognize gay marriage have effectively doubled the pool of potential 'Obamacare spouses.'"

--Move to a new state. You can sign up on its exchange when you take residence.

--"If you live in one of the 25 or so states implementing Obamacare’s Medicaid expansion, you can get coverage immediately by reducing your income below 138 percent of the federal poverty level ($16,102 for a single adult). You can then restore your income when you enroll in an Exchange plan in January."

--Get pregnant. You can enroll in an exchange the day your baby is born. (Of course, this works only for about half the U.S. population.)

--Rely on "friends, family, or the kindness of strangers." (Yes, he actually wrote this.)

As it happens, Cannon left out a couple of options. You can get yourself fired; loss of a job makes you immediately eligible for an exchange plan. Alternatively, you can become a member of an Indian tribe; tribal members can sign up for exchange plans throughout the year. (This may not be an option for everybody.)

So to sum up, here are the ways the Cato Institute proposes for you to scam Obamacare: You can get married, have a kid, impoverish yourself so you qualify for Medicaid, or commit fraud. If you've been diagnosed with a dire disease, you can uproot yourself and move to another state.

These are the options, Cannon says, for "rational" people. Cato and its health policy expert plainly have a different definition for "rational" from the rest of us. But why would a truly rational person take their advice?

Thanks Abb!

There are not many that know the Obamacare law much better than Cannon. I'm not sure WTH the point was in Hiltzik's column that identified the facts Cannon presented as being "[t]he lamest anti-Obamacare column of all."

In his efforts to ID specific faults, he completely ignores any patient can use an ER, it's probably much cheaper for many to just file medical bankruptcy if needed versus paying premiums, and most medical needs can be delayed just as it appears to be SOP at the VA hospitals.

The closest Hiltzik comes to showing the facts Cannon presented were irresponsible was within these 2 paragraphs:

• 
  
• (1) That argument places Cannon squarely in the disreputable camp of conservatives who advise Americans not to sign up for Obamacare because there's no downside to going without coverage. (2) That was the implicit point made recently by the right-wing blogger Matt Drudge, who says he'll never sign up for Obamacare and claimed (implausibly) that he had already paid his 2014 penalty for shunning the ACA's legally mandated individual health coverage.
  
  (3) It should be obvious that advising anyone to go without health insurance, especially when it's been made affordable by the ACA, is the height of irresponsibility. (4) That's even more true when the advice is based on nonsense.

(1) Cannon does NOT say there is "no downside to going without coverage," the the message of his column was to point out Obamacare "REDUCES the downside of going uninsured."

(2) The "implicit point made" by Matt Drudge was that the NEW TAX was due when he made his quarterly estimated tax deposits. It's gibberish tossed in that shows NOTHING in his effort to classify Cannon's column as being "lame."

(3) The cost factor of risk versus financial security is what influences anyone to buy any type of "insurance," look up the definition of what it is. Identifying the faults in the Obamacare law is not "advising" people to go without it, nor an act of "irresponsibility," it merely shows what the risks are for going without that insurance. Meanwhile, Hiltzik's method of judgments for "irresponsibility," if he wishes to make a point, should be applied to those that enacted a law that would leave 30+ million UNinsured in a best-case-scenario.

(4) Hiltzik concludes those paragraphs by identifying the facts Cannon provided as being "advice is based on nonsense." Again, it was not "advice," merely commentary based on facts of the law.

That's even more true when the advice is based on nonsense.

Just as a refresher, here are the first two paragraphs of Cannon's column I had previously posted here:

• 
  
• President Barack Obama says he has enrolled 7.1 million Americans through his new health insurance Exchanges. If so, that may prove to be the easy part: Obamacare creates so many incentives for enrollees to drop their coverage that maintaining those enrollment numbers may start to resemble something like pushing millions of people up a greased poll.
  
  For Obamacare to work, people must enroll and stay enrolled. An estimated20 percent of those who signed up have yet to pay their first premium, and as many as 5 percent stopped paying after the first month. If too many drop out, premiums could climb until the Exchanges collapse.

Where Cannon was going by citing facts and where Hiltzik took it from there are miles apart. I'm not sure what Hiltzik hoped to accomplish in his weak efforts to use moral or ethical means to redefine the law and Cannon's column.

Quote:

 

http://www.latimes.com/business/hiltzik/la-fi-mh-still-clueless-20140502,0,7473508.column#ixzz30fsU0prv

Cato's healthcare expert: Still clueless about health insurance

Michael F. Cannon, whom the libertarian Cato Institute courageously describes as its "director of health policy studies," is unhappy that I called him out the other day for writing "the lamest anti-Obamacare column of all."

We know he's unhappy because he charged me with "falsely" attributing to his column, which appeared in the Los Angeles Register and on Cato's website, a position he says he doesn't have. Well, let's see.

I wrote that he was one of a cadre of "conservatives who advise Americans not to sign up for Obamacare because there's no downside to going without coverage." In a reprint of his column in Wednesday's Orange County Register he adds some verbiage contending that he advises no such thing.

Really? Here's what Cannon originally wrote:
"You see, for most healthy people, going uninsured before Obamacare, at least for a time, was already a safe bet.... The odds that they would have to deal with unmet medical needs, or unpaid medical bills, were low.... Obamacare makes going uninsured an even safer bet. It increases premiums for healthy people, and the penalty for not buying health insurance is largely toothless. So if you earn too much to qualify for subsidies and/or you take steps to avoid paying the penalty, going uninsured will save you even more money than before."

Maybe I misunderstood Cannon. But it strikes me that by making the argument that while it always was a "safe bet" to go without health insurance (which is a bizarre assertion in itself), it's now "an even safer bet," and adding that you can save "even more money than before" by doing so, his words were indistinguishable from actually advising people to do so. Otherwise why make those claims?

Cannon's defense is that he wants people "to have stable, secure health insurance," but that the Affordable Care Act "creates so many incentives for people to free-ride that insurance markets could collapse."

There he merely circles back to the argument that made his original column so asinine. His basic claim then was that there are so many ways to sign up for ACA coverage as soon as you get sick, you might as well avoid enrolling until you do get sick.

As I wrote, most people in the individual market can't sign up for ACA coverage except during annual open-enrollment periods, and then only for coverage that starts the following Jan. 1. Cannon's list of subterfuges that allow instant enrollment outside the open-enrollment window simply don't apply to the vast majority of customers. As I wrote, his suggestions boiled down to: "get married, have a kid, impoverish yourself so you qualify for Medicaid, or commit fraud [by misrepresenting your real income]."

Cannon asserts that I conceded his point that "the worst-case scenario under Obamacare is that you would need to cover a few months of medical bills." That is, between the day you drop coverage and the next Jan. 1, when it can be started up again.

Actually, I didn't concede his point. I ridiculed it. I pointed out that what he calls "a few months" could be as long as a full year, and that some people with serious injuries or diagnoses of dire diseases could well die within that time frame. Even for patients who survive, "a few months of medical bills," uncovered by insurance, could render many families bankrupt. That's if they take Cannon's -- yes -- advice.

Cannon's utter cluelessness about the whole point of having health insurance -- shocking for a health policy "expert" -- is underscored by a question he put to me today via Twitter: "True or false: ObamaCare makes it safer to drop one’s health insurance than it was pre-ACA."
[Never answered! The LATimes man is mixing Twitter discussion with the facts cited by Cannon in his article to try to discredit Cannon, though he fails]

Cannon seems to be unaware that the goal of Obamacare is to make it easier to obtain health insurance, not easier or "safer" to drop it. The assumption underlying the ACA is that it's unsafe to not have health insurance; that must be plainly evident to everyone in the country, except Michael Cannon. (You don't even have to be a health policy "expert" to know it.)

To be absolutely fair, I qualified my assessment of Cannon's original column by calling it only the lamest such column "so far." There will be plenty of opportunities in the coming months and years for enterprising conservative pundits to better Cannon's mark for obtuseness and irresponsibility. But he has set a pretty high bar.

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http://avalerehealth.net/expertise/managed-care/insights/avalere-analysis-exchange-enrollment-outpaces-expectations-in-22-states

Avalere Analysis: Exchange Enrollment Outpaces Expectations

Analysis assumes 85 percent of enrollees pay first month’s premium.
["assumes" = clueless guess]

A new analysis from Avalere Health finds that exchange enrollment meets or exceeds expectations in 22 states (44%), even after accounting for any attrition due to nonpayment of premiums. Assuming 15 percent of enrollees do not take the final enrollment step and pay their premiums, over 6.8 million people who enrolled through April 19 will have coverage effective as of May 1.

“The large uptick in enrollment in March and early April brought many states over the finish line in terms of projected enrollment for 2014,” said Caroline Pearson, Vice President at Avalere. “Even after accounting for potential non-payment, enrollment exceeds 100 percent of projections in nearly half of states.”
["projections" = what fits best]



Avalere’s analysis compares exchange participation at the end of open enrollment to state projections based on the Congressional Budget Office (CBO) estimate that 6 million people would enroll in exchanges. Florida, California, and Idaho lead in enrollment compared to expectations, while Hawaii and the District of Columbia lag behind with less than 50 percent of expected enrollees paying their first month’s premium. Notably, while New York has the fourth largest number of enrollees nationwide, the state enrolled only 49 percent of its expected participants.

“Once again, the data paint a diverse and complex picture. Enrollment significantly beat expectations in some states but fell short in others,” said Elizabeth Carpenter, Director at Avalere. “Regional variation is a key feature of the current exchange marketplace, and it could impact carrier decisions to participate in some markets in 2015.”

Avalere’s analysis assumes 85 percent of individuals who chose a plan on the exchange will pay their first month’s premium.**

* Note:
These estimates do not include Medicaid beneficiaries who may be enrolled in exchange plans via “premium assistance” models in Arkansas, Iowa, and Pennsylvania.

**Assumes 85 percent of individuals who enroll pay first month’s premium per public comments by America’s Health Insurance Plans (AHIP).
[See more on this below!]

Methodology:

Avalere’s analysis incorporates the HHS enrollment figures released on May 1, 2014, as well as updated state-specific tracking from publicly-available resources in Colorado, Minnesota, and Oregon.
[The HHS did NOT NOT NOT release "enrollment figures," it was what they call "sign ups."]
Enrollment projections are based on Avalere’s projections for enrollment distribution by state at the end of 2014 applied to the CBO’s February enrollment projection of 6 million.
[There's the dumb down number... they lost the 7 million when they started the magic math!! Just reduce the 7 to a 6, divide it by unofficial numbers and we have SUCCESS.]
This approach assumes smooth implementation across states; that is, eligible populations take up coverage at similar rates across states.
[Best I can make of that is they quickly used 6 million divided by what a state's percentage of the national population was to assign state "expectations." If so, they're incorrect here also.]
Avalere assumes 85 percent of people who choose a health plan will effectuate coverage by paying their first month’s premium, per estimates released publicly by America’s Health Insurance Plans (AHIP).
That makes it sound like some published study or something worthy!

View Avalere's full press release attached: http://avalere-health-production.s3.amazonaws.com/uploads/pdfs/1399038948_20140502_April_Enrollment_Release.pdf
[The pdf to make it look official]

Baldo

May 5 2014, 12:21 PM

Nevada: Own a small business? Brace for Obamacare pain

......The law’s employer coverage mandate doesn’t take effect until 2015, but early plan renewals are starting to roll in. And for some businesses, the premium jumps are positively painful.

Local insurance brokers are reporting spikes ranging from 35 percent to 120 percent on policies that renew from July to December. The increases are especially acute among employers with workforces made up of younger, healthier men. That’s because Obamacare prohibits offering lower rates to healthier groups. It also narrows the allowed premium gap between older and younger enrollees....snipped

http://tinyurl.com/kxgrtnf]

Way to go Harry!

BTW Young Male voters how do you like that Obama vote now?

Quote:

 

...The premium hikes could have political implications, as well. Nolimal estimated that as many as 85 percent of small-group plans will renew in November and December. Because new premiums go out 60 days before coverage takes effect, those price hikes will hit mailboxes in September and October — just before November’s elections.

That may be why Wright said Nevada lawmakers seemed keenly interested in hearing what he and other brokers had to say during a recent visit to Washington.

He said lawmakers were “very receptive” to the idea that Nevada officials should embrace a federally established transition period that would let businesses keep their existing plans for at least one more year to blunt the effect of today’s higher costs.

Nevada Insurance Commissioner Scott Kipper said March 25 that he doesn’t have the discretion to allow noncompliant plans to stay in place, based on advice from Nevada Attorney General Catherine Cortez Masto. That decision mirrored a fall conclusion that it would be illegal to reinstate the first wave of canceled plans....

Quote:

 

http://cnsnews.com/news/article/patrick-goodenough/kerry-rails-against-terrorists-they-don-t-offer-health-care-plan

Kerry Rails Against Terrorists: 'They Don’t Offer a Health Care Plan'

...“I will tell you, my friends, I have seen this scourge of terror across the planet, and so have you,” he continued. “They don't offer anything except violence. They don’t offer a health care plan, they don’t offer schools. They don't tell you how to build a nation, they don’t talk about how they will provide jobs. They just tell people, ‘You have to behave the way we tell you to,’ and they will punish you if you don’t....