Health insurers still the bad guy – LA Times journalistic malpractice

The attacks on insurance companies continue this morning, with Matt Drudge linking to the “Healthcare overhaul won’t stop premium increases” story at the Lost Angeles Times. Not once – not once – does the Times look into why the premiums are increasing.

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What is a “qualified” plan?

As you know, beginning in 2014, all individuals must have a “qualified” insurance plan, or pay a tax. Congressman Weiner’s protestations to the contrary notwithstanding, that tax will be enforced by the Internal Revenue Service as the tax imposed “shall be included in a taxpayer’s return”.  And, we all know who enforces information on tax returns.

But, I digress.  We don’t have the specifics, as the Secretary of Health and Human Services hasn’t written them yet, but we do know some things about a “qualified plan”.

A “qualified” plan must include, at a minimum, ambulatory, emergency, hospital, maternity, prescription drugs, rehabilitation services, laboratory services, preventive and wellness care, pediatric care (including dental and vision), mental health and new born care.  And, the scope of benefits must at least equal that provided under a “typical employer plan”.

Other than those requirements, the Secretary has complete discretion to add as many mandates as she wants either within the above categories, or as brand new categories.

Once all the Secretary’s mandates have been established, you will have a choice of plans each of which must contain all of the mandates.

The plans are labeled Bronze, Silver, Gold and Platinum.  A Bronze plan must include “benefits actuarially equivalent to 60% of the full actuarial value of the benefits”, a Silver plan must have benefits equal to 70%, a Gold plan must have benefits equal to 80%, and a Platinum plan, 90%.

Obviously, a Bronze plan will cost less than a Platinum plan, but, it is impossible to predict even a range of costs until the Secretary determines what services must be covered.  In other words, must hair transplants be covered, or not, must in vitro fertilization be covered, or not, must tattoo removal be covered or not?  Until those, and other coverage questions are answered by the Secretary, determining an actual cost is elusive.

But, whether you believe the Congressional Budget Office or not, the CBO states that

… premiums in the individual market will rise by 10% to 13% more than if Congress did nothing. Family policies under the status quo are projected to cost $13,100 on average, but under ObamaCare will jump to $15,200.

If the CBO is correct (and their historical track record isn’t exactly”spot on”), regardless of what must be in a “qualified plan”, expect to spend considerably more than you do now for insurance.

Obama continues attack on health care insurance companies

I guess he did not read my post last week. I put a lot of effort into it, you’d think the president would have at least had someone on the staff review it.

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Health insurance companies responsible for only 5% of premium increases

Read the headline again. Then, think about the written and spoken attacks on health care insurance companies from Congress, pundits and directly from the president. This industry is a convenient and popular target for the left, just like oil and banking firms with their $3 gas and $2 ATM fees.

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Obama suggests employer health care premiums will drop 3,000% – UPDATE: Heckled?

Three-thousand percent … 3,000% … Wow! Look, he probably misspoke in some way or TOTUS played another trick on the president yesterday, but it would be impossible to drop employer premiums by 3,000 percent, at least those of us who passed 6th grade math know that much. UPDATE below. Was he heckled?

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How $15 co-pays destroyed the health care system

I’m struggling with the headline since I know health care has not been destroyed by low co-pays, but those gold-plated plans with $15 co-pays to go see a doctor and $25 for an emergency room visit have destroyed our perception of value when it comes to health care. Read more

Obamacare: Senate bill limits summary of benefits to four pages

Sadly, there is no such page limit on any version of Obamacare drafted by Congress. Sen. Reid’s (D-Nev.) version of Obamacare, however, does mandate a page limit for insurance companies, and it should prove quite interesting in its implementation.

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The real cost of Obamacare

Whether you have your own health insurance, or, have your health insurance through your small business employer, get ready to pay a great deal more for that insurance should Obamacare become law.

For the past five months I have posted many articles about provisions of the proposed Obamacare legislation that will clearly cost you money.  But, to date, I have not been able to quantify that cost for you.  Now, thanks to a recent study released by WellPoint, I can.

WellPoint mined its own actuarial data to model ObamaCare in the 14 states where it runs Blue Cross plans. The study therefore takes into account market and demographic differences that other industry studies have not…

The results of this study are not pretty.

A healthy 25 year old male living in Columbus, Ohio currently pays about $52 per month for insurance.  Here is what Obamacare will do to his premiums.

First, add $79 per month because Obamacare requires all insurers to to cover anyone who applies regardless of their current health condition.  This is the piece of Obamacare that “ensures” that those with pre-existing conditions can obtain insurance.

Second, add $3 per month because Obamacare requires insurance companies to charge virtually the same premium to all insureds, regardless of health, age, etc.

Third, add $17 per month because Obamacare will mandate what must be included in your insurance policy (whether you want or need that coverage, or not) in order to have a “qualified” plan.  This will let you avoid paying a tax for having the audacity to have a “non-qualified” plan.

And finally, add $6 per month to cover the cost of the $80 billion in new non-deductible taxes on insurance companies that Obamacare also mandates.

So, under Obamacare, our young man from Columbus, Ohio will now pay $157 per month for his insurance, a svelte 199% increase!

Of course, this study doesn’t take into account the increased costs resulting from the $20.3 billion in new nondeductible taxes on drug manufacturers and importers, or the $40 billion in new taxes on medical device manufacturers.  But, as they say, at this point, who’s counting?

Baucus health care bill includes pay-offs to senators

You can call them bribes if you’d like. Sen. Max Baucus’s (D-Mont.) health care bill is filled with pay-offs, bribes and graft to other senators just to get his mark up (it’s not in legislative format yet) proposal through the Senate Committee on Finance. This post details those bribes and provides the full text of the mark up.

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Why isn’t the Baucus health care bill “affordable” Update: Video – Hatch Details Taxes

Update (Jim): Senator Orrin Hatch details the taxes that the Baucus bill will impose. I think it dovetails nicely with the SOS post. Plus hatch sounds so pained. I feel his pain and so will you. Video at the bottom.

(SOS): The first thing that struck me about the health care bill proposed by Sen. Baucus (D-Mont.) was that it wasn’t “affordable”.  Of course we all know it isn’t affordable, but I am referring here to its title.  The Kennedy-Dodd bill already drafted in the Senate is entitled, “Affordable Health Choices Act”, and the Waxman bill pending in the House is entitled “America’s Affordable Health Choices Act.  But, the mark up of the Baucus bill released yesterday is entitled “America’s Healthy Future Act”.

So I wonder, is the absence of the word “affordable” in the title of the most recent version of Obamacare a recognition by the Senate Finance Committee that what they are contemplating isn’t even remotely affordable?  Or, perhaps a recognition by the committee that the American public knows that it isn’t affordable, and will not be fooled by a “warm, fuzzy” title?

In either event, it seemed like a good idea to start this series of posts with the issue of “affordability” for those of you who, like me, have individual insurance. I can state unequivocally the Baucus bill – if implemented – ensures you will no longer be able to afford insurance, whether you like it or not.

The bill manages to accomplish this beginning at page 5.  (I will use the PDF page numbers for simplicity.)   It requires that your insurance company accept all applicants regardless of their health. That, in itself, is not a particular problem, as typically an insurer would simply charge the sicker people a higher premium than the healthy people in order to cover the increased costs that will have to be paid out for the sick.

The Baucus bill, however, prohibits that.

Issuers in the individual market could vary premiums based only on the following characteristics: tobacco use, age, and family composition.

The net effect of this is that premiums for all people who have individual insurance must rise to cover the influx of insureds who must be covered, who will require expensive medical care, and who cannot be charged more than you for their coverage.

And, just in case those provisions don’t make your insurance unaffordable, what is found on pages 8 and 9 most definitely will. All insurers will be required to collectively “contribute” $20 billion between 2013 and 2015 …

to help stabilize premiums for individual coverage during the first few years of operation of the state exchanges.

And exactly where does the good senator think the $20 billion in insurance company “contributions” will come from?

I’m beginning to understand why he didn’t have the nerve to use the word “affordable” in his proposal’s title.

Here’s the Hatch video … ughhhh.