Posted on 08/15/2016 3:47:10 AM PDT by reaganaut1
After the Affordable Care Act took effect in 2010, it created a review mechanism intended to prevent exorbitant increases in health insurance rates by shaming companies that sought them.
But this summer, insurers are turning that process on its head, using it to highlight the reasons they are losing money under the health care law and their case for raising premiums in 2017.
That has ignited an election-year fight between insurers and consumers, who are complaining bitterly about the double-digit increases being sought across the country.
The conflicts have been on vivid display at hearings in states like Pennsylvania, where Highmark, one of the state’s largest insurers, has proposed rate increases averaging 41 percent.
...
Highmark defended its request by saying it was paying out more in claims than it was receiving in premiums. Jeff Scheib, the vice president in charge of actuarial services at Highmark, offered a statistic to illustrate the problem.
“There were close to 250 individual A.C.A. policyholders in Pennsylvania who incurred over $100,000 each in claims and then canceled coverage before the end of the year,” Mr. Scheib testified. “This behavior drives up the cost to insure the entire pool, because people use insurance benefits and then discontinue paying for coverage once their individual health care needs have been temporarily met.”
(Excerpt) Read more at nytimes.com ...
Communism and capitalism don’t mix.
When you compromise with the devil, the devil wins and you lose.
Well well well. Democrats, Illegal Invaders, "minorities", and the irresponsible are often times Deadbeats. What? You insurance snakes who collectively supported ObamaCare didn't know that? The Takers don't "pay" for anything. They TAKE!
Where my free helfcare be at?
You mean there really is no such thing as a free ride? Say it isn’t so!
“You mean there really is no such thing as a free ride”
Ah, but there is!
Just not for you.
It would be good to know what percentage of those claims the insurance company actually had to pay out. It's in their interest to only mention the billed amount. But their contacted cost may be much less.
Don’t worry ! Remain calm !
Professor Gruber assures us that all is well !
With the new Fed drug laws I’m now FORCED to see my WORTHLESS Primary every 3 months for unneeded blood test just to get a 3 month supply of Valium 10 mg twice a day, that treats my Fibromyalgia. Yet they will give Lyrica 375 mg @ 6 per day, which is MORE addictive, and I’ve had 2 bad reaction to for 6 months. Can’t find a new Primary who will write my script, they want to send me to Pain Management which only wants to use Lyrica. Already been that route, Pain Management doc now retired said Lyrica was crap and he chose Valium because it works BETTER.
Just drives up my gas, time and insurance cost.
One of our doctor clients bills $150.00 for a quarterly med check which is his standard rate. If the patient has Blue Cross HMO the contracted rate is $38.82 and this plan pays 80 percent of that amount. You raise a very valid point about which rate they report but I bet it’s the billed rate.
Most everything is now totally automated from the checking of eligibility to paying claims via electronic funds transfer to doctor’s checking account. Very, very few employees required and many of them work from a computer at home so the need for office space is greatly reduced.
One of our docs recently received a letter requesting money back for a patient who was seen two years ago and ended up not paying their premium for that month. Pay up or the money is deducted from the doc’s checking account.
It is all just an absolute mess!
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.