One more black eye for Obamacare

One more piece of Obamacare that is scheduled to take effect on Thursday, has encountered a problem…major insurance companies will not provide the insurance.

Aetna, Cigna, Wellpoint, Humana, United Health Group, and, at least in Florida, Blue Cross Blue Shield have stopped writing new children only insurance policies.  Why, you ask?  Well, beginning Thursday any “child” applying for insurance must be accepted regardless of their health condition.  The insurance companies were understandably concerned that parents would wait until their child needed expensive medical care before applying for coverage.  And, why wouldn’t they?  Why pay for health insurance until you need health care?  And why continue to pay for health insurance when you don’t need health care.

Here is what Aetna spokesman, Matt Wiggin said concerning Aetna’s decision:

Folks seeking coverage would be those who need immediate services for high-cost conditions…[Aetna] made the decision to protect its existing  child-only policyholders from rising premiums

Because, that is exactly what would happen.  The folks in need of expensive care would apply for and receive insurance, remain insured until they were cured, and then drop coverage, leaving the rest of the policy holders to pay for that expensive care in the form of ever increasing premiums.  See: Maine or Massachusetts.

Of course, children can still be covered by their parents’ policy, but, parents can’t wait until their child becomes sick to apply. 

The ironic thing, however is that these child only policies were extremely popular.

Child-only policies are often purchased in one of three situations: by families where the parents’ employers don’t contribute to dependent care, by parents who can’t afford to insure themselves or by those who can’t get their own coverage but want to cover their kids.

Sorry, this looks like yet another example of Obamacare’s unintended consequences.

We’re the government and we are here to help you.

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SoundOffSister

The Sound Off Sister was an Assistant United States Attorney for the Southern District of Florida, and special trial attorney for the Department of Justice, Criminal Division; a partner in the Florida law firm of Shutts & Bowen, and an adjunct professor at the University of Miami, School of Law. The Sound Off Sister offers frequent commentary concerning legislation making its way through Congress, including the health reform legislation passed in early 2010.

27 Comments

  1. Dimsdale on September 22, 2010 at 5:42 am

    The costs of the Øbamacare black eye will require generations to fix, if ever.   That is a long time to stand in line.   The "cure" is not supposed to be worse than the sickness.

     

    Isn't this why Congress is supposed to deliberate these bills and consider the consequences, short and long term?



  2. chris-os on September 22, 2010 at 6:19 am

    These 5 cos. had record profits last year!

    What happened-1. the prez tried to get a fair health care bill through.

    2. the repugs watered it down and blocked any real reform.

    yep, make SURE nothing happens at the expense of corporations-even if it means the lives of babies.

    disgusting!.

     



  3. rickyrock on September 22, 2010 at 7:08 am

    Pure profit motive is driving the insurance companies and nothing more.Sound off sister why don't you sound off about retained asset accounts.This is where the insurance company holds the death benefits from fallen soldiers in a retained asset account which is not FDIC insured and which the insurance company pays .5 percent while earning 4.5 percent on the dead soldiers money……….where's your outrage????
    http://www.bloomberg.com/news/2010-07-28/fallen-s



  4. Dimsdale on September 22, 2010 at 8:35 am

    How do you "water down and block reform" on a bill that was rammed through with no Republican input?  Remember the closed door meetings?  Where is the watering down?  In fact, they didn't even allow the bill to go back to the Senate for revisions because they didn't have the votes!

     

    I agree with you ricky, but your link is dead.  At any rate, it does not nullify what SOS is saying, particularly about people buying insurance only when they need it, and leaving the insurance company holding the bag (which means that the costs are distributed to the rest of us).  I know: it is happening in MA (MA healthcare reform is failing us: http://www.boston.com/bostonglobe/editorial_opini… Since inception, our rates have gone up precipitously (Five painful health care lessons from Massachusetts: http://money.cnn.com/2010/06/15/news/economy/mass… They pay less than the procedures they demand the companies provide cost, and rates are still spiraling upward.

     

    It is a mess.



  5. rickyrock on September 22, 2010 at 9:02 am

    Sorry about that dead link ………..don't know what I'm doing wrong……….It is a mess …..

    Thanks Dim



  6. SoundOffSister on September 22, 2010 at 10:52 am

    chris,

    I understand your passion about this.  But, let me explain the problem.  According to the Orlando Sentinel article that I linked to, a girl between 7 and 10 years old could get coverage in Palm Beach Gardens, Florida for $68 per month.  Let's say that girl's parents learn that she will need medical care over the next 3 months totalling $30,000.  So, the parents apply for, and must be given insurance.  The parents spend $204 for insurance over that 3 month period, receive $30,000 in medical care, and then cancel the insurance.  The $29,796 difference between premiums collected and claims paid has to be paid by someone.  No insurance company, regardless of its profits can remain in business for long if it "eats" the $29,794 itself.  And, even if it "ate" a piece of it, premiums would have to be raised for other children in the plan to cover the remaining cost until those parents, as well, dropped coverage due to the ever increasing premiums.

    Children only insurance policies were very popular because they were so inexpensive.  Now, thanks to Obamacare, they no longer exist, thus depriving many children of coverage, and exposing their parents to great cost.

    We can't change economic realities no matter how passionate we may be.  What we must do is take both the economic reality and the passion to develop a system that allows children to obtain insurance at little cost…something like the system we already had.



  7. TomL on September 22, 2010 at 11:57 am

    Chris when companies announce record profits it may not be a whole lot compared to what they spend. In my business I had record profits last year but I made a $100 bucks more than the previous year. Do you see what I'm getting at.Companies need to make profits to keep their bosses ( stockholders ) happy.



  8. Tim-in-Alabama on September 22, 2010 at 11:57 am

    I think I understand. The woman who dared question Obama at the townhall is to be called names and told to take care of herself, but people who can't game Obamacare to cover their children are the victims of a profiteering insurance industry. Parents have no responsibilty, only victimhood, when it comes to their children's healthcare.



  9. NH-Jim on September 22, 2010 at 12:15 pm

    The adjective "record" regarding profits is concerning to me even as a conservative.  I believe any corporation is entitled to its own profit unless it is regulated as a monopoly.  What must be asked is why at this tumultuous time would insurance companies jack-up rates (mine went up 40% and another 18% coming, Ouch), thus, drawing more negative attention to them?  It makes no logical sense.  What has occurred to give reason for these increased rates other than rising health care costs?…Health Care Reform.

    As for children, our state (where these types of programs should reside, not federally) provides a good program named <a title="CT Husky" href="http://http//www.huskyhealth.com/hh/site/default.asp&quot; rel="nofollow">HUSKY.
    For those of you not children (but still young at heart) there is the <a title="Charter Oak" href="http://www.healthinsurancesort.com/health-plans/charteroak.htm?utm_source=bing&utm_medium=cpc&utm_campaign=charteroak&quot; rel="nofollow">Charter Oak plan.



  10. Dimsdale on September 22, 2010 at 1:20 pm

    Why, I do believe that you have hit the proverbial nail on the head, Tim!   And hard!  😉

     

    I am looking forward to chris' response.



  11. weregettinghosed on September 22, 2010 at 2:00 pm

    Profits are a necessity in business without them there is no growth and no business. The government would have done us all a great favor had it quite meddling into capitalism, allowing free trade of insurance companies across the country thus creating competition within the field. Competition always is good for business, allowing growth and reform on it's own. Children would have been insured, rates would be reasonable and no Obamacare to frighten our future. Insurance companies have to protect themselves to the extent they must have clauses not allowing children with preexisting conditions or at least not pay for any medical care relating to that condition for a said period of time.

    Obamacare is worse than the worse migraine, it gives you a migraine thinking of it. We need for the sake of our children, grandparents and anyone else on the list to be tossed out to the wolves; complete and total recall of the bill. Nullify it, get rid of it, and allow the process that works to work. Free trade, competition and price reductions it all works because money makes money, economies keep moving along with money.



  12. PatRiot on September 22, 2010 at 2:45 pm

    The system we had was a bit flawed but better than this debacle.

    The flaws were a lack of:  1.  Adhering to the program.   2.  Cracking down on abusers.  #.  Making adjustments for improvement.  4. Promoting self reliance, responsibility and preventative care techniques.  

    A new program in the same hands won't work whether it is better or not. 

    Like the elected officials, these folks are getting paid, but not doing their jobs.



  13. chris-os on September 22, 2010 at 2:45 pm

    SOS, I see that your point about that example-but, it makes no sense.

    Those cheapo plans like the one your newspaper cites have a $ limit!

    Have you ever heard of cos. denying bone marrow transplants for children with leukemia, children with coverage through their parents' policies? Sorry, there have been death panels in existence for decades. Do I think Obamacare is the answer-absolutely not.

    Public option, only way.



  14. SoundOffSister on September 22, 2010 at 3:16 pm

    chris,

    I checked.  These aren't "cheapo" plans.  They cover everything.  Do they have $ limits, sure, just like any insurance you buy for your house or your car, or, if you are rich enough, for your boat.  If the issue was $ limits, then Obamacare should have left a good program alone and only addressed the $ limits.  It didn't.  Instead, it trashed a perfectly good program that many people counted on. 

    And, as to the public option, personally, I don't want some govermnent bureaucrat deciding what my medical care should be.  I almost died because a doctor prescribed the "standard" treatment for my condition.  How dead would I have been under the public option before my heirs could have convinced the federal government that the "standard" treatment for my condition didn't work for me?



  15. weregettinghosed on September 22, 2010 at 3:57 pm

    Limits have to be put upon any insurance. When it is the life of your loved one or yourself it is hard to put a limit on their life, hence people go into debt over these things. Should a doctor or hospital hold money over your life? While limits are necessary when you reach a limit and it becomes your money or your life, things have to move, there are always circumstances that a company or hospital or doctor can work or should I say, should work with. When such a circumstance arises, I see the insurance company getting together with the doctor and/or hospital to compromise on charges to make things happen. Of course one could call me Pollyanna for thinking in this fashion but it is possible, anything is possible. When doctors say a treatment can not be given because an insurance company denied it, two things should happen; one, the insurance company should allow the doctor to give reason as to why this treatment is recommended and it should be his choice, not the insurance company as to if it is the best choice for that particular illness; second, the doctor should make it clear to the insurance company it is his patient and it is his expertise that dictates what treatment will save his patient and if the insurance company does not agree, the insurance company should give the doctor the payment for whatever treatment they want to pay for, and in good faith the doctor should do the treatment that is necessary with whatever funds the insurance company pays. Again, sounds Pollyannaish however, this is exactly what happened to my daughter. The doctor would not back down, the insurance company paid him for the lesser treatment and he did what was necessary. He does this on a regular basis with his patients. If a busy Manhattan doctor can do it, other doctors could as well.

    The doctors answer is don't kill your patients, give them a fighting chance. The government's answers is kill the weak so we do not have to worry about supporting them. Sounds like Germany in 39, the old, the febrile, the mentally ill, if you were not perfect you were eliminated. Americans will not stand for it.



  16. chris-os on September 22, 2010 at 4:10 pm

    sos,

    An option is just that, an option. You can keep your coverage-worst case scenario would be  the cost, because of the competition, would be less.

    If you almost died, your md was at fault, not the insurance co. -unless they refused an  alternative treatment= because it was costlier-standard procedure nowadays.

     

     

     



  17. Lynn on September 23, 2010 at 3:46 am

    I sold Health Insurance in CT. One tiny little example of the idiocy of Obamacare is the mandates. Men between the age of 21 – 35 paid $80 or less per month for a great policy. Under Obamacare the mandate is, the policy must cover all people for a colonoscopy, once a year. Men or women that age don't need one. At 50, is the recommended age for colonoscopies and you don't require one once a year. This age group will now pay many times that to pay for a policy. This is spreading the costs. This age group is just starting out and not making a lot of money, but they will be mandated in 2012 to pay for a policy that meets the mandated policy requirements or pay a penalty. Is that fair? this is just ONE of the nonsensical mandates.

    It would have been much less expensive to make the companies HAVE to cover everyone regardless of their health and make a pool of the high cost people, as we do in CT, in all states,and have the Federal Govt. help to supplement these costs. Use the tools of capitalism to force the Insurance co. to sell across state lines and allow people to pick a policy that meets their individual needs. We could decide how much risk we want to absorb. A higher or lower deductible and whether we need prescriptions or not. I was surprised at how many people well into their 70's do not take any prescriptions. Why should they have to pay for them in a policy? Talk about making jobs. Small insurance companies would spring up all over the country offering specific policies that would meet individual needs. Now because the way Obamacare is written the insurance co. will be forced to raise their prices so high we will be forced to have a single-payor system. The most important is Tort Reform but I fear there are too many lawyers in Congress to get this, because they protect their own.I'm sorry, I could go on and on but I don't write as well as Paul Ryan. Read his book!



  18. NH-Jim on September 23, 2010 at 3:58 am

    The analogy of auto insurance compared to health insurance is brought up frequently in this debate.

    One solution to the uninsurable or those that are high-risk is to have a "pool".  Whether it be children or adults that are afflicted with preexisting conditions, these individuals shall be entered in to this "pool" and every insurer/insurance company must take a non-selected and equal percentage of these individuals at a set capped amount.  It will create competition even in the high-risk cases.  It works for auto insurance.

    Now, if I had made this too simplistic, or as weregettinghosed puts it, Polyanna-like, then I look forward to your comments.



  19. chris-os on September 23, 2010 at 4:13 am

    Lynn-wow where to start?

    <<Now because the way Obamacare is written the insurance co. will be forced to raise their prices so high we will be forced to have a single-payor system.>>

    Forced? because they Have to keep their 20% profit margin? OMG, the CEO of Cigna may have to get $12 million/year instead of his $20 million?

    And if the public option was passed or reduction in age qualification for medicare (no, no, no competition for the big insurance cos.) there wouldn't be the outcry we definitely will have for single payer).

    Tort reform-Texas did that-it resulted in absolutely no decrease in premiums-well the md's and hospitals may have seen a decrease in their malpractice premiums-but it was not passed on-that does not work! (So tired of that talking point).

    It is better the way it is, like getting your coverage dropped when you become ill, excluding your children because of a pre-existing condition-vote republican to bring back the good ole days for the insurance cos!

    We don't need no stinkin reform-yep, keep the absolute dictatorship by the insurance cos. over our lives-oh, and while we're at it, we need to keep apologizing to the oil companies.



  20. Steve M on September 23, 2010 at 4:34 am

    @Chris – 20 percent profit margin? ROTFLMAO. The net profit margin for the most recently reported full year of the top 11 health insurance companies is 3.49 percent (best net profit margin 7.3 percent). Most recently released quarter … 2.52 percent (best net profit margin was 7.26 percent).



  21. Lynn on September 23, 2010 at 5:27 am

    Chris, I tried to write as simple as possible. I purposely did not use technical terms. You missed the whole point. Mandates are what are making the private policies so HIGH. We should not be forced to pay for health procedures we do not need.

    Obamacare has done NOTHING to reduce costs. it has taken over the whole system added a whole level of IRS agents (more govt jobs for us to pay benefits and salaries for), not fixed medicare.  We could do this by state where we have more control. Not get the whole stupid federal govt. involved.

     

    If you do not get this, talk to a Liberal who has a mother in Canada who could not get heart surgery because she was 90 years old. She could afford to come to the states to get the surgery, but Canada would not let her come back to heal because they would not pay for the rehabilitation. These liberals told us the dangers of a single-payer system. They said private insurance MUST still be affordable and allowed so that the scenario above could be avoided.



  22. weregettinghosed on September 23, 2010 at 7:09 am

    When you look at all the mandates Obamacare has put in there, it is clear the bill was written to abolish all private health insurance. Where are the brains behind these insurance companies, did they not see this coming or did they believe it was better to pass it and then read it? Anyone that read the bill could plainly see no company could exist as it would like to, [making a profit] under this bill. Many will go out of business, cut back employees or cut back salaries. Each scenario will mean less for some American. The more people lose jobs the more our whole way of life will decrease; the ultimate goal shall then be achieved. Obama will step in, look like the Messiah and fix everything with his control. One thing is missing still; the tanks in the streets, the bread lines and concentration camps. This guy is way of control, to stop Obamacare and save us we need to stop him first because I am afraid he has far more up his sleeve.



  23. Dimsdale on September 23, 2010 at 9:13 am

    Don't you wish everybody could read this?  Or wanted to?

     

    The real bottom line is that a bill of this proportion should have been debated for ages, to flush out the crap and leave us with the gold.  Instead, we get a rushed bill that creates more problems than it solves, and that the landslide majority of voters simpley DO NOT WANT.  If Congress had spent its time addressing the glaring faults of the present system, one at a time, so that everyone could see and rationalize it, we would have health reform without having our economy and health insurance industry deformed.  Just look up here at MA: it is a mess and costs are skyrocketing.  Look at Great Britain, Canada etc.  They are all trying to get out of the socialized medicine hole they have dug for themselves.

     

    Can't we just learn from other's mistakes without having to reinvent the square wheel?

     

    Chris: please provide the source for your figures.



  24. Dimsdale on September 23, 2010 at 9:13 am

    "simpley" = simply.



  25. Lynn on September 24, 2010 at 3:28 am

    Ok, I'll admit it, I am addicted to this blog. I can't stop. Weregettinghosed. the brains in the insurance companies did see this coming, at least in CT. I know, because I asked this question myself at a Connecticare Seminar at least 3 years ago. I called and talked to the VP of Connecticare, he sent me the recommendations to which a group of all but one insurance co. agreed. I was astounded at the depth and care put into this document. They were truly looking out for the good of CT and were willing to absorb a big hit to implement it. Unfortunately, (I will not name the co. but it was the biggest gorilla in the room). they were assuming the single-payer system that the General Assembly was contemplating would go to them. They had no reason to sign on and lose the golden goose. The rest of the companies could simply not sign on and be tied to an agreement that would cause such big costs when the one hold out would not be restricted and could cut their costs. I think most business people understand what I am saying. Thus, no reform in CT. I assume this also happened elsewhere. But NOW?????



  26. TomL on September 25, 2010 at 9:18 am

    I heard that a hidden tax in HC is a tax on the sale of your home. Anyone else heard it?



  27. Dom Rosa on September 28, 2010 at 2:29 am

    Shortly after ObamaCare was passed, Dick Morris appeared on the O'Reilly Factor. According to Morris, the insurance and pharmaceutical companies had spent millions of dollars (about $70 million if I remember correctly) on lobbying efforts to insure that the law served their interests.



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