Posted on 01/18/2016 6:14:44 AM PST by Kaslin
The Affordable Care Act (ACA) was intended to solve the problem of affordable coverage for people with preexisting conditions by using an age-old strategy that politicians love. That strategy is often referred to as OPM (other peoples' money). For instance, ACA regulations force insurers to accept all applicants -- including unprofitable ones -- at rates unadjusted for their health risk. Premiums can vary somewhat by age, but not by health status. Thus, Obamacare is a bad deal for most people by design; the majority of enrollees are charged much more than their expected costs. In theory, this should allow individuals with health problems to obtain health coverage cheaper than they otherwise would. The problem with these schemes is they rarely work as advertised. Moreover, there are perverse incentives for individuals to cheat if they can -- and delay enrollment until they need expensive medical care.
This dubious policy was briefly tried back in the 1990s and it was a disaster. Overcharging healthy people caused them to avoid health insurance like the plague, resulting in a condition known as "adverse selection." Over time, health coverage became incredibly expensive. Premiums shot up 500 percent to reflect the higher costs in health plans composed of mostly unhealthy enrollees. Coverage became a bad value for everyone except the sick for whom any coverage was better than nothing. Sound familiar? It should: that's what's happening to Obamacare plans today. The ACA attempts to lessen the risk of adverse selection by forcing younger and healthier people to buy expensive health coverage that's a poor value.
A recent New York Times article examined how some people are gaming Obamacare health plans. Individuals remain uninsured despite the mandate -- only signing up for coverage when they need expensive medical care. In theory the uninsured cannot sign up until open enrollment periods for coverage that begins the following year. But eager to grow exchange plans as much as possible, the Obama Administration foolishly created multiple special enrollment categories. These allow just about anyone to sign up during the year, long after the open enrollment deadline has passed.
Insurers complain there is no concise list of the approved special enrollment categories. Special enrollment includes legitimate reasons, such as a job loss, marriage and the birth of a baby. But special enrollment is also allowed for about two dozen other reasons. Worse, there are no provisions to ensure the appropriate category is used. The rules are ambiguous about when insurers are allowed to decline applications for special enrollments when applicants don't qualify. Individuals often arbitrarily select a bogus category and sign up anyway.
This is a problem. Claims data shows that individuals signing up using special enrollments aren't just slackers who lost track of time during open enrollment. Late enrollees use more medical care than those enrolling during open enrollment. They are also more likely to drop coverage soon after receiving expensive medical care. Health insurer Aetna reports one-quarter of its 2015 enrollees signed up through a special enrollment category. Aetna enrollees who sign up during open enrollment tend to maintain coverage for eight to nine months on average, whereas those signing up during a special enrollment drop out in only half that time. Insurer Anthem also reports members who took advantage of special enrollment are twice as likely to drop coverage only months after signing up.
Another large insurer, United Healthcare, reports more than 20 percent of its enrollees signed up through special enrollment. Those late enrollees used more care on average than those enrolling on time. One-quarter to one-third of BlueCross enrollees in Illinois, Montana, New Mexico, Oklahoma and Texas were late enrollees who signed up through special enrollment. They too were much more likely to generate large claims soon after enrolling.
Anyone can legally drop coverage for two consecutive months, say November and December, and not owe a penalty. Individuals can also merely stop paying premiums and insurers cannot kick them off the rolls for 90 days (although insurers can stop paying medical claims after 60 days of missed payments).
Although this loophole has been closed, in 2014 and 2015 special enrollment was allowed near the tax filing deadline in April. Maybe a woman was expecting a baby due in August or September. She could sign up in April, stop paying premiums in August and her insurer could not kick her off the rolls until November. Imagine that! $10,000 worth of medical care purchased for the price of only four months' worth of premiums.
The Affordable Care Act is little more than a poorly-designed income redistribution scheme that is prone to fraud. Premiums have skyrocketed as Obamacare Deadbeats game the system, driving off honest people who can no longer afford Obamacare's sky-high premiums. Insurers need the authority to block these scam artists. Better yet, all consumers need the freedom to select health coverage of their own choosing -- not some ill-conceived redistribution scheme.
Oh, on the contrary ...
It was designed perfectly.
If you want Single Payer.
Ar you saying it’s not prone to fraud?
WAIT!!! Didn’t Obama sell the ACA solving all the problems that other healthcare programs having fraud?
Moaning and crying about “corruption” and waste in a monstrosity of a government spending program like Obamacare is a waste of time. Whenever billions or trillions are spent by the government, there is going to be waste because the government has much less incentive than the private sector to get rid of it. The best way to get rid of waste is to get rid of these programs, period.
I’m saying that ACA was built to be bad in every way possible. Fraud is one of the ways.
The Elite want Single Payer, so they made a costly, inefficient system that is prone to fraud. They hope that people will demand “something better”.
Not really. It was designed to put the insurance companies out of business so that Democrats can say, "See, we had to go to a single-payer (government only) system".
Well, our spineless Republican leadership wouldn't want to be accused of being mulattophobic now, would they?
Turns out it was not designed to protect those 15 million, but instead it was designed to pull the rest of the country off of their insurance and put them into federal care.
Meanwhile those 15 million who could not get medical insurance, only a small portion of them are being served through Obamcare.
So, who has signed up for it? Deadbeats and scam artists.
It was so obvious this would be the case that one has to make the next step and realize it was by design. It is yet another money laundering way to finance deadbeats and scam artists, aka, Democrats. See also Union dues from government employees.
They were expecting to get a raft of new enrollees, especially the under-30 crowd, and to have those who couldn't otherwise afford it get t paid for with tax money. It was supposed to be a free place at the gubmint money banquet, only it turned out to be full of poison pills.
Yet the Rat-B@$t@rd$ in congress exempted themselves.
Not really.
That was the plan.
It has a very fatal flaw.
One that took real stupidity (both in the implementors and in the detractors) to miss.
It opened up a possibility fair, understandable, easily explained, and accurate branding of incompetence upon every person and organization connected even remotely with conceiving and implementation the program.
There was an assumption that it would blow up in the future, and that blame could be shifted. Instead, It didn’t even fall apart right out of the box. They opened the box and little bits and pieces and liquid sludge sort of oozed out in a rancid sticky mess.
When people I know have health problems they can’t get care for, I pull up the analysis of Obamacare from findlaw.com. I explain that Obamacare guaranteed this , and show them that this legal analysis was made before the bill was passed. And if the person is family or has something terminal, I don’t pull any punches.
Do this, and get anyone even vaguely conservative or desirous of having good medical treatment available then we can get the people involved in implementing Obamacare excluded from implementation something else.
Because it doesn’t take much to force most people to admit that for all of its imperfections the system we had before was the best in the history of the world.
Well, United Health Care, the nation’s largest health insurance company, already announced that they are dropping out of Obamacare because they can’t make money by being forced to cover preexisting conditions.
It was designed to fail. We are half way to the ten year point that Obama and Bawney Fwank said we needed to usher in single payer government run healthcare....for us, not them.
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