Race to the Bottom in the ObamaCare Exchanges

The ObamaCare health insurance exchanges are supposed to open for business next Tuesday. Despite huge subsidies and despite daily publicity, these exchanges are expected to enroll only 11 million of 48 million uninsured Americans over the next year.

Those who do enroll may not be happy with their experience. We now know quite a lot about how these exchanges are going to function and the picture doesn't look good.

Attracting the healthy, avoiding the sick. In most states today insurers are allowed to charge individuals premiums that reflect their expected health care costs. This practice is no different than it is in life insurance, casualty insurance or most any other kind of insurance. In a free market, you expect to pay premiums that are actuarially fair.

The Affordable Care Act will end this practice. Instead, insurers will be required to practice a form of community rating, under which the healthy and the sick will all be charged the same rate.

You don't have to even be in the business to understand what kind of incentives that creates for the insurers. If the healthy are overcharged so that the sick can be undercharged, then insurance companies can expect to make profits on the healthy and losses on the sick. This means that it is in the self-interest of every insurer to attract the healthy and avoid the sick.

How do you do that? One way is to design plans that on the surface redistribute resources from the sick to the healthy.

Traditional insurance theory holds that patients should pay out of pocket for expenses that are small and over which they have a great deal of discretion. Insurance, on the other hand, should pay for expenses that are large and over which patients don't have a lot of discretion. The insurance being offered in the exchanges turns that theory on its head, however.

Under a typical California plan, for example, patients will make only nominal copayments when they see a doctor, get a blood test or an X-ray exam ? activities that are often discretionary and the source of a great deal of unnecessary care. But if they go into a hospital (where patients have almost no control over what is done or what anything costs) they will be charged from 10% to 20% of the total bill. For an individual earning only a few thousand dollars above the poverty level, a hospital visit will cost $2,500. For a lower-middle income patient, the charge will be $6,350. A moderate income family can end up paying hospital expenses of $12,500 ? every year!

Clearly this plan will be attractive to people who don't plan to enter a hospital and unattractive to people for whom a hospital stay is likely.

Race to the bottom on access to care. Think of an insurance plan as having three main components: (1) a premium, (2) a list of covered benefits and (3) a network of doctors, hospitals and other providers. Under the Affordable Care Act, there is very strict regulation of benefits ? right down to free contraceptives, questionable mammograms and non-cost-effective preventive procedures. At the same time health plans have been given enormous freedom to set their own (community rated) premiums and choose their own networks. They are using that freedom in yet another way to attract the healthy and avoid the sick.

In the ObamaCare exchanges, the insurers apparently believe that only sick people (who plan to spend a lot of health care dollars) pay close attention to networks. Healthy people tend to buy on price. Thus, by keeping fees so low that only a minority of physicians will agree to treat the patients, some insurers are able to quote very low premiums. They are banking on attracting the healthy and they may even have the good luck to scare away the sick.

Community rating is what makes this strategy work. In the ObamaCare exchanges, if I am healthy why wouldn't I buy on price? If I later develop cancer, I'll move to a plan that has the best cancer care. If I develop heart disease, I'll enter a plan with the best heart doctors. And these new plans will be prohibited from charging me more than the premium paid by a healthy enrollee. (See a more comprehensive analysis.)

The Obama administration doesn't seem to be bothered by this development. In fact they have been touting the fact that the premiums have been lower than expected, even though the reason is that the networks are narrower and skimpier than expected.

DR BEN CARSON ... the freedom of Americans to control their own health care needs is being threatened by massive governmental interference....an attempt to fundamentally change America, to take control of our most important possession: our health.....

We're mad as h*** and we're not gonna take it any more. Get going, Freepers.

TALKING POINTS Obama/crats are attempting to tax, gather data, and otherwise collapse what remains of the private healthcare delivery system. Obamacare is not about healthcare or even insurance coverage, it is about centrally controlling from DC every aspect of your life.

Your doctor will be their informant on how you live, work and eat while their IRS agents will monitor every financial aspect of your life in the guise of keeping you healthy. There will not be one part of your life they will not only know but control through the Unaffordable Healthcare Act. This is a dream come true for the central planners who run the Communist....er, I mean....…Democrat Party and the worst nightmare for your average American.

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How to middle finger the O/Crats: We know the O/Care ship is listing---ready to heave--- maybe do a Costa Concordia into the Potomac.

THE BAD NEWS KEEPS COMING Reuters reports the US government on Wednesday scaled back its projections for Obamacare's impact in 2014, saying the law would generate slower healthcare spending growth and provide coverage to only half as many of America's uninsured as anticipated last year.

The biggest factor in the change stems from the U.S. Supreme Court verdict last year allowing each state to decide whether to expand the public Medicaid program for the poor under Obama's healthcare reform law. Republican leaders in nearly half of the nation's 50 states have rejected the expansion.

HHS now expects 11 million uninsured Americans to obtain coverage next year, down from about 22 million projected a year ago, according to the report, which appeared in the journal Health Affairs. (Excerpt) Read more at reuters.com ...

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There's also lawsuits and state problems.

HERE'S HOW THEY'RE STOPPING OBAMACARE A West Virginia nonprofit has turned down a federal grant it received to help residents navigate new health insurance options under the Affordable Care Act after it received an inquiry from Attorney General Patrick Morrisey about how it would protect consumer information. Clarksburg-based West Virginia Parent Training Inc. did not respond to a letter it received from Morrisey directing it to answer 26 questions about the group's personnel and hiring practices, including employee background checks and employee monitoring programs, the Sunday Gazette-Mail (http://bit.ly/17M1QVe) reported. (Excerpt) Read more at sanluisobispo.com ...

YOUR TURN--Contact your state AG---ask him/her to issue a letter of inquiry to groups receiving federal "Navigator" grants. The inquiry should center on questions WRT how the group intends to protect consumer data.

In particular, the questionnaire should ask if the tax-funded "Navigator" program intends to transfer personal/ financial/medical data of the insured to the local/county/national Democrat Party, relevant Unions, banks, investment companies, drug companies, insurance companies. Trial Lawyers' associations and whether "Navigators" have sub rosa contracts with these, and other groups, plan to profit, to provide significant info to enrich databases for pecuniary purposes.

The AG also needs to confirm (1) whether the "navigator" was ever convicted of a felony....... and....(2) whether the "navigator" can be bonded.

Most importantly demand that your AG enforce the requirement that "Navigators" must have a state insurance license (consists of a comprehensive test on all aspects of insurance and compels a background check).

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PLANNED PARENTHOOD WILL HAVE ACCESS TO SS#, TAX, MEDICAL INFORMATION
Breitbart Big Government ^ | 8/23/2013 | William Bigelow / FR Posted by markomalley

EXCERPT Planned Parenthood is about to obtain access to your Social Security number, tax form, bank account, and medical records.

With the advent of ObamaCare, consumers buying health insurance through health care exchanges will be required to speak to “navigators.” “Navigators” are supposed to help consumers find the best coverage and ascertain whether they are eligible for a federal subsidy.

Any “navigator” will have access to the federal data hub, which holds information from the Department of Health and Human Services, the IRS, the Social Security Administration, the Department of Homeland Security (DHS), the Defense Department, the Office of Personnel Management, the Veterans Health Administration, and the Peace Corps.

Planned Parenthood received $655,000 from the Obama administration to hire navigators. In Iowa, Planned Parenthood of the Heartland received $214,427; in Montana, Intermountain Planned Parenthood, Inc. got $295,604; and in New Hampshire, Planned Parenthood of Northern New England raked in $145,161.

And there is not much scrutiny over who these “navigators” will be; HHS will not require background checks or fingerprinting, and a previous criminal conviction, even if it was for identity theft , will not trigger a rejection. To make matters worse, the administration has cut the new employees’ training from 30 hours to 20 and reduced screening.

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OKLAHOMA WINS FIRST OCARE BATTLE: Quoting AG Pruitt--- "Obamacare was meant to be so open-ended that it could mean anything. We are seeing thousands of pages of new rules being written, both by HHS and the IRS. The open-ended interpretation of Obamacare enables this.....if the law doesn't contain a particular provision, no problem. They just make it up as they go along."

"Such is the case that involves the OK lawsuit."

“The court rejected the federal government’s argument that Oklahoma lacked standing to challenge the law, allowing us to proceed with this pivotal case,” “We’re optimistic the court will recognize what states have known for months that the IRS disregarded the law by making the large employer mandate effective in Oklahoma or in any of the 33 other states without a state health care exchange.”

REFERENCE Oklahoma challenged implementation of the Affordable Care Act after the IRS finalized a rule that would allow the federal government to punish “large employers,” including local government, with millions of dollars in tax penalties in states without state health care exchanges, which is not allowed under the health care law.

“Congress provided a choice for Oklahoma and other states in implementation of the health care law, and the IRS is attempting to take that away by rule,” General Pruitt said. “The administration miscalculated how many states would support this law, so now they’re using the IRS to push through provisions that Congress did not pass.”

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PROTECT YOURSELF---Obamacare is easy pickins for identity thieves. Steps to take to minimize risk of identity theft:

1. Contact the IRS Identity Protection Specialized Unit at 1-800-908-4490

2. Order a tax account transcript from the IRS that verifies basic personal data along with details of your tax return filed, which may come in handy if you are checking to see whether someone else filed a fraudulent return on your behalf

The Federal Trade Commission (link at website) also lists several steps you must take if you have been a victim of identity theft.

SOURCE http://www.cnbc.com/id/100918004

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Obamacare pulse rate low.....vital signs at dangerous levels.

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