How ObamaCare May Disrupt Your Health Plan

Forbes ^ | Sept. 29, 2010 | Avik Roy

[prairiebreeze]

Imagine if you ran a business, and one day the government told you that you would be fined if you: (1) minimized unnecessary expenses; (2) hired workers to specialize in customer service; (3) invested resources in order to ensure you wouldn’t get victimized by fraud. What would you do? Think quickly: because three months from now, this very system will be the law of the land for our nation’s health insurers.

Last Friday, the National Association of Insurance Commissioners—the association of the 50 state insurance commissioners—issued its draft guidelines for how insurers will need to calculate “medical-loss ratios,” or MLRs. The wonkiest among you will recall that the medical loss ratio is loosely defined as the dollar amount that an insurer spends on the health care of its beneficiaries, divided by the total dollar amount the insurer collects in premiums. Section 2718 of our new health care law mandates that insurance plans sold to individuals and small employers must spend at least 80 percent of their premiums on health care, and plans sold to large employers must spend at least 85 percent.

But, like everything else with Obamacare, the devil is in the details: how do you define health care? How do you define “insurance plan”? Now that the NAIC has spoken, we have a good idea of how the final regulations will look. And the news is not good: the MLR regulations are likely to lead to a significant disruption of the health insurance market, with many insurers exiting the market, driving premiums up and choices down.

[leapfrog0202]

Freepathon challenge:

RedMDer will sponsor the first 10 FReepers at $10 each.

Please FReepmail or ping me to give credit to your state. Let’s roll.

[Waco]

Yeah, but it’s so much more fun to aid and abet treason, ain’t it?

[muleskinner]

It is already affecting my company. We used to be able to chose between Aetna, Blue Cross and Kaiser. Now it's ONLY Aetna with higher premiums and higher fee's per visit.

Thanks for NOTHING Obama, you bloody hump.

[nina0113]

The flex-spending cap is going to wreck anyone with a chronic illness. We go through 5K a year now, and it’s not enough. Capping it at 2500 means we’ll have to come up with an extra grand or so for the taxes. Thanks, Obama!

[Renegade]

I think Aetna also uses a TRIAD group (usually out of your home state) that will decide if you really NEED a certain treatment.

[Nateman]

This article makes it clear that for this aspect alone Zerocare needs to be repealed.

[2ndDivisionVet]

What will happen to us disabled veterans, does anybody know? I currently use the VA Medical System. Is he cutting back or eliminating that, despite generations of promises from the Federal government?

[prairiebreeze]

It seems the state insurance commissioners have done their part to screw things up even further. I used to audit patient hospital bills on behalf of insurance companies. Typically, the insurance co. would recover money, sometimes quite a lot of money, generally not because the hospital was nefariously overcharging, but usually due to data entry or human and computer billing errors. (Sometimes the hospitals also found unbilled charges as well, but the insurance companies usually had a pretty good idea as to which bills might contain errors and overcharges.)

Now, this sort of cost containment can’t be factored into the MLR and will certainly be passed onto the consumers.

And that’s just one illustration of how being competent and frugal is being punished.

[usconservative]

The flex-spending cap is going to wreck anyone with a chronic illness. We go through 5K a year now, and it’s not enough. Capping it at 2500 means we’ll have to come up with an extra grand or so for the taxes.

Great, as if my taxes aren't high enough being one of the "high income" earners, I spend about $11,000 on medication a year, which I pay for with pre-tax dollars. Now I'm going to have to pay taxes on $8500 because I'm capped at $2500 *and* have the burden of paying for my own meds that my insurance company announced they were dropping?

I can't wait for November 2012 to vote this asshole out. I really can't.

[prairiebreeze]

Good question, 2ndDV. I honestly don’t know about that. Nothing, but nothing would surprise me any more...

[cashless]

The author or editor of this article should be ashamed of the title. “May Affect.” Are you freaking kidding me? Everyone that I have talked to expects their insurance costs to soar along with the deductible limits.
And my company, a formerly great film company in the Northeast, is aiding and abetting the Democraps by changing the sign up period. For nearly every year I can remember, our sign up for the following year's plan was always completed by Nov. 1. But this being an election year and the Democraps getting ready to be handed their rear ends, my esteemed, evidently socialist supporting, company will not even start sign ups until AFTER the election. Nice try corporate rats but your sleight of hand has been exposed for what it is: you are trying to provide coverage for the DEMOCRAPS but it is a losing effort. I can only assume these chameleons will suck up to the the Repukelicans when they assume control. You think your contributions and deductibles are bad this year, just wait until you have to pay for them with no pay raise and increased taxes next year!

[prairiebreeze]

I hear ya’. We’re self employed.

[ChocChipCookie]

One bright spot on the horizon is that all of this is happening right before the November election. Believe me, it will be on the minds of every single voter, Republican or not.

[prairiebreeze]

I sure hope so.

[beethovenfan]

FUBO!!!!!

[VeniVidiVici]

The heavy hand of excessive government regulations.

[RoadTest]

It’s a very bad bill, and nothing but total repeal will do.

[Texas resident]

How obamacare WILL disrupt your health plan intentionally.

[flowerplough]

ObamaCare in a nutshell: New Federal laws that drive premiums up and choices down.