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Top insurer warns that Obamacare enrollment mix worse than expected [Humana, Medicare Advantage]
Washington Examiner ^ | January 10, 2014 | Philip Klein

Posted on 01/10/2014 11:34:48 PM PST by Cincinatus' Wife

Humana Inc., the nation's fourth-largest health insurer by market share, warned Thursday that the risk pool of applicants for insurance through President Obama's health care law would be worse than previously expected.

Ever since the botched rollout of the health care law's exchanges in October, the policy community has been eager to know more about the mix of individuals signing up for insurance through the law.

Because the law forces insurers to cover those with pre-existing conditions, insurers need to attract a critical mass of young and healthy individuals with lower medical costs into the exchanges to offset the cost. But the Obama administration has yet to release demographic data on those who have picked a plan through the exchanges.

But in a filing with the Securities and Exchange Commission, Humana disclosed to investors, "as a result of the December 2013 federal and state regulatory changes allowing certain individuals to remain in their previously existing off-exchange health plans, the Company now expects the risk mix of members enrolling through the health insurance exchanges to be more adverse than previously expected."

The regulatory change Humana is referring to is the "administrative fix" announced by the Obama administration aimed at allowing individuals to remain enrolled in their current plans, which had been cancelled as a result of requirements imposed by the law. Obama announced the "fix" after a storm of criticism over his broken promise that anybody who liked their plan could keep it. Insurers had been depending on those with cancelled plans (who tend to be healthier) to end up obtaining insurance through exchanges.

Humana said that the company was "evaluating" the financial effects of the changes, but at this time, did not adjust their earnings forecast for 2014.

In the same filing, Humana said cuts to Medicare Advantage payments to private insurers made by the health care law would be steeper than expected, triggering changes to benefits.

"The Company expects to continue its standard process of seeking alternatives to minimize the disruption to Medicare beneficiaries this level of rate decline may cause," the filing read. "Such alternatives include clinical management programs, operating cost efficiencies, benefit changes, market exits and other operating strategies. In the interim, the Company also expects to continue its efforts to educate CMS, the Administration and Congress on the adverse impact such rate pressures have upon Medicare beneficiaries."


TOPICS: Culture/Society; Front Page News; Government; Politics/Elections
KEYWORDS: abortion; aca; deathpanels; fl; fla; florida; healthcare; humana; medicare; obamacare; unexpected; zerocare
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To: reformedliberal

I empathize with your friend.

I lived my first 40 years in south Florida and have had 4 skin cancers.

There is an acute shortage of dermatologists in many parts of the country.

Most medical specialists depend on federal funds for their advanced training after Medical School.

Essentially, there is an artificial quota imposed on how many dermatologists are trained each year.

On top of that, unless you raise hell like your friend did, they make you get screened by a physicians assistant before they will give you an appointment with a dermatologist, even if you have a history of skin cancer.


81 posted on 01/11/2014 11:03:10 AM PST by zeestephen
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To: Gene Eric

Healthy young people will simply not enroll, driving premiums even higher.


82 posted on 01/11/2014 12:23:54 PM PST by matt04 (I)
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To: pepsionice

Obama is patterning himself after Roosevelt...even the rhetoric is the same.

Roosevelt wanted as many on the dole as possible to ensure votes...that’s why he stretched the depression out purposely. Obama is going for the same thing.


83 posted on 01/11/2014 12:26:09 PM PST by what's up
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To: rcrngroup

Keep for later use!


84 posted on 01/11/2014 9:38:21 PM PST by rcrngroup
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To: okie01
The entire health insurance industry turns turtle and goes under is what.

Be careful how you cry chicken little.

You are sounding remarkably like any "progressive" (read communist) who insists that the only solution to the failure of government is more government!

Wrong, wrong, wrong! Let it fail, repeal it in toto and the free market will rebound so fast it will make your head spin!

85 posted on 01/12/2014 7:37:27 AM PST by bill1952 (Choice is an illusion created between those with power - and those without)
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To: bill1952
You are sounding remarkably like any "progressive" (read communist)...

That's horseshit, my friend.

If we willfully destroy the health insurance industry, only the government will be there to pick up the pieces.

Our objective should be the survival of the industry and the full withdrawal of the government.

86 posted on 01/12/2014 1:13:00 PM PST by okie01 (The Mainstream Media -- IGNORANCE ON PARADE)
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To: Cincinatus' Wife

bfl


87 posted on 01/12/2014 7:27:32 PM PST by gattaca ("If you tell the truth, you don't have to remember anything." Mark Twain)
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To: pepsionice
this was expected and not only that, but WANTED....they'll be a doom and gloom crisis over night and shazammm...we're then into no choice in health care except the govt choices.....welcome to 20% more cronies being paid by the govt and all those billion dollar contracts to the husbands or wives or both to all those horrible senators and congressmen....

we have to somehow get ourselves exempt....that or get off the grid if we can and have little income...

or move...or die I guess...

88 posted on 01/12/2014 8:32:11 PM PST by cherry (.in the time of universal deceit, telling the truth is revolutionary.....)
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To: JennysCool
I'm afraid that a lot of people on "our" side will do absolutely nothing about it especially if they are assured a nice fat return, like a guareenteed election...

no one speaks for the working/middle class....we have no representation at all....

89 posted on 01/12/2014 8:33:48 PM PST by cherry (.in the time of universal deceit, telling the truth is revolutionary.....)
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To: Cincinatus' Wife
better tell Maryland that the union nurses and union respiratory therapists and the union nurses aides and pharmacists are not going to take pay cuts so the govt can "save" all this money for Medicare/Medicaid...

the rats treat the assembly line unionists like gods and they better not think others are going to take the fall....

90 posted on 01/12/2014 8:36:29 PM PST by cherry (.in the time of universal deceit, telling the truth is revolutionary.....)
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To: pepsionice
the ONLY ones truly paying for healthcare are those paying premiums and deductibles and copays....we pay for the elderly subsidy, the govt worker subsidy, the poor subsidy and the illegal subsidy, plus anyone else they can dump on us....

I guess if we're fool enough to do it....

91 posted on 01/12/2014 8:38:49 PM PST by cherry (.in the time of universal deceit, telling the truth is revolutionary.....)
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To: zeestephen
the new enrollees on Medicaid had health care before this debacle...they just had to show up a clinic or hospital....they can't be denied treatment if they need it...

however now, they'll be in the "system" and their free for all ER visits demanding drugs will be carefully recorded....

they think they have it better now, but now, they'll have to go to a very limited number of drs, perhaps across town, and be limited in the kinds of drugs they'll be prescribed, and the number of ct scans etc....

92 posted on 01/12/2014 8:43:22 PM PST by cherry (.in the time of universal deceit, telling the truth is revolutionary.....)
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To: zeestephen
the new enrollees on Medicaid had health care before this debacle...they just had to show up a clinic or hospital....they can't be denied treatment if they need it...

however now, they'll be in the "system" and their free for all ER visits demanding drugs will be carefully recorded....

they think they have it better now, but now, they'll have to go to a very limited number of drs, perhaps across town, and be limited in the kinds of drugs they'll be prescribed, and the number of ct scans etc....

93 posted on 01/12/2014 8:43:47 PM PST by cherry (.in the time of universal deceit, telling the truth is revolutionary.....)
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To: cherry
Cherry, the news is actually worse than that.

Several years ago, Oregon expanded its Medicaid services to a system very much like ObamaCare.

Oregon claimed, just like ObamaCare has claimed, that demand for Emergency Room services would go down dramatically when everyone had insurance.

What happened?

New people who were enrolled in Medicaid INCREASED their E.R. visits by 40%!

94 posted on 01/12/2014 11:05:30 PM PST by zeestephen
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To: Liz

It’s a little easier than it was in the Ceausescu days. In order to monitor everyone’s conversations they had to install “improved” telephones in each home. Now the NSA handles that centrally.


95 posted on 01/13/2014 12:23:21 AM PST by ArmstedFragg (hoaxy dopey changey)
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To: ArmstedFragg

96 posted on 01/13/2014 6:37:04 AM PST by Liz
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To: okie01

No okie, its not horse manure.
It is exactly as stated.
YOU go ahead and defend piling on even more government and along the way defend obamacare.
The heath insurance industry is already gone- obamacare isn’t insurance at all.

I will simply sit here and laugh at your ignorance


97 posted on 01/13/2014 2:45:56 PM PST by bill1952 (Choice is an illusion created between those with power - and those without)
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To: zeestephen; cherry

Z, in our own state (I believe you are in Washington also; correct me if wrong), that really didn’t happen in general when Medicaid rolls increased in 2008-2009. However, a small number of individuals were notorious at racking up excessive numbers of ER visits — some practically every day. The state implemented a plan to limit non-emergency ER visits to 3/year. But this was thrown out by a court I believe and the limit policy was dropped subsequently. The state now tries to vector those patients to urgent care clinics and/or mental health, whatever is appropriate.


98 posted on 01/13/2014 3:03:26 PM PST by steve86 (Some things aren't really true but you wouldn't be half surprised if they were.)
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To: steve86
Yes, I do live in Washington state.

My understanding of Medicaid here, before ObamaCare, was that only children, pregnant women, SSI Disability, and people waiting for a Disability decision were eligible.

In other words, no able bodied adults qualified for Washington state Medicaid, regardless of income.

Under ObamaCare, if I'm correct, all adults and families who earn less than 130% of the poverty rate (so, below $15,000 for a single adult) qualify for Medicaid.

For several years before 2014, Oregon's Medicaid was income based, too.

It was those people, the “new” people in Oregon on Medicaid, who dramatically increased their ER visits.

99 posted on 01/13/2014 5:38:17 PM PST by zeestephen
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To: zeestephen

Same as Oregon, a few years ago Washington dropped the asset test for healthy adult Medicaid qualification and raised the income limit. How do I know? They sent us a letter saying we were being evaluated for it and had to do nothing but wait for a decision. There was nothing whatsoever we had done to request that. We didn’t qualify, because the money I have to withdraw from the IRA for living expenses was in excess of the limit for our family size. But they tried!


100 posted on 01/13/2014 8:12:22 PM PST by steve86 (Some things aren't really true but you wouldn't be half surprised if they were.)
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