Obamacare still collapsing

Last year was a bad year for Obamacare. This year Obamacare might simply stop being available in many areas.

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Parts of the country are in jeopardy of not having an insurer offering Obamacare plans next year.
Humana announced this year that they’d be leaving the markets altogether next year. That means there are parts of Tennessee that will have no insurance options unless another insurer decides to enter.
And Anthem, which operates in 14 states, is getting nervous, an industry analyst told Bloomberg News this week. Its departure would be a much bigger problem. According to an analysis of government data by Katherine Hempstead at the Robert Wood Johnson Foundation, Anthem is currently the only insurance carrier in nearly 300 counties, serving about a quarter of a million people.
As you can see on our map of those counties, an Anthem departure could leave coverage gaps in substantial parts of Georgia, Missouri, Kentucky, Ohio and Colorado, as well as smaller holes in other states. In places where no insurance company offers plans, there will be no way for Obamacare customers to use subsidies to buy health plans.
Without an option for affordable coverage, they would become exempt from the health law’s mandate to obtain coverage. A result could be large increases in the number of Americans without health insurance.

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Even those maps above failed to show how Obamacare in Iowa is collapsing.

A second big shoe just dropped on Iowa's Obamacare marketplace.
Three days after Wellmark Blue Cross & Blue Shield said it would not sell new individual health insurance plans in Iowa in 2018, Aetna on Thursday said it also will not offer new Obamacare plans next year, citing "financial risk."
The moves leave Iowa with just two other insurers that, as of now, sell Obamacare plans in the state.
A third Iowa insurer, Medica, told CNBC is has not yet decided whether to continue selling plans there next year.

President Trump is threatening to hold back cost-sharing-reduction payments from the ACA in order to force Democrats to negotiate. This would essentially implode Obamacare for much of America.

If the CSR payments were to disappear, it would cause chaos in the healthcare marketplace, The Kaiser Family Foundation's Levitt said....
According to a recent study from Kaiser, to make up for the loss of CSR payments, insurers would have to jack up the price of premiums by an average of 19% more than the current projected increase for 2018. That would vary widely by state — from 9% over the current baseline in North Dakota to 27% above current projections in Mississippi.

Note the words "more than" in that statement.
as in a 19% increase in premiums on top of the regular increase in premiums.

The real kicker is that the decisions for insurers to declare in the next few weeks whether they’re in or out.
This will be happening at the exact same time as a federal government shutdown.

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Comments

Bollox Ref's picture

"Richest in the World™", still trying to figure out universal coverage for all!

Sad!

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21 users have voted.
dance you monster's picture

@Bollox Ref

We should be more precise in our phrasing. They aren't having trouble "trying to figure out universal coverage." That was done several decades ago, as reflected in VA and Medicare solutions. They are intentionally refusing to concede universal coverage universally, because that outcome would make the insurance vampires have to find a productive and societally beneficial line of work.

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26 users have voted.
Bollox Ref's picture

@dance you monster

Wink

In Trumpish mode.

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12 users have voted.
dance you monster's picture

@Bollox Ref

but the deductible is too high.

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16 users have voted.
Pricknick's picture

Obama and all government officials knew it. It wasn't budgeted. It intentionally left pharmaceuticals out. The real purpose is that it was meant for the blame to fall on others.
They threw a pacifier to placate the masses.
Suck on it.

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22 users have voted.

Regardless of the path in life I chose, I realize it's always forward, never straight.

snoopydawg's picture

@Pricknick
I don't understand why they wanted it to fail and have millions of people who don't have health insurance. Won't the insurance companies lose a ton of money if they aren't getting money from people or the billions for subsidies?

i would think that the insurance companies would fight for continuing to get their subsidies.

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6 users have voted.

What do I think about the Obama Presidency? I think it would have been a good idea.

k9disc's picture

"assistance" enslaves, @snoopydawg .

They would rather lose money and maintain the freedom to act as a supra-citizen than they would to be enslaved by the state?

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6 users have voted.

“Tactics without strategy is the noise before defeat.” ~ Sun Tzu

EdMass's picture

@snoopydawg We had a 20 to 40 million uninsured problem. Instead of fixing that the ACA threw the entirety of the healthcare/insurance industry and process into chaos.

As has been reported for years by quoted statements of those driving the bus (BO, Pelosi, Reid, Gruber and more), the real goal was a step toward forcing single payer and destroying the for-profit independent Health Insurance industry.

The exchanges are failing. Not often reported is the residual affects on Employer provided plans - ya know the ~ 80% to 90% of how people attain health insurance. In those plans the premiums are likewise rising along with deductibles and out-of-pocket limits. The ACA is taking everyone down.

As mentioned elsewhere, as another example, the Vermont Connect Exchange is backed by one insurer, BCBS. Raises the question if the exchange - which is supposed to supply a competitive environment from which to choose a plan - has only one insurer, then what's the point except to put a state middle man between the consumer and the provider, increasing expense and creating yet more bureaucracy requiring higher taxes? As Dukakis used to say, "good jobs at good wages".

To your question, the Insures are obviously calculating that even with Gubmint subsidies to them they are still going to lose $$. They also doubt the Gubmint will actually pay up, they have already sued for recompense.

This will not end well.

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7 users have voted.

Listen. Strange women lying in ponds distributing swords is no basis for a system of government. Supreme executive power derives from a mandate from the masses, not from some farcical aquatic ceremony.

studentofearth's picture

vehicle for healthcare. Medicaid was using the HMO model around the state of Oregon. Originally 2 or more HMO coverage was available in every county of the state. Within a few years multiple rural counties had no HMO coverage. Insurance companies saying there was not enough profit is rural areas.

Obamacare designed by many of the same people has the same pattern of decreased coverage options.

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13 users have voted.

Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

PriceRip's picture

@studentofearth

          We all learned along time ago that capitalism could not provide necessary (as in essential) services. Without "government" "intervention" paying for infrastructure we wouldn't be able to live in MOST of this country. So why is it such a difficult notion to get through the thick skulls in congress?

          Insurance companies saying there was not enough profit is rural areas.

          This excuse (it is not a rational as it have no logical foundation what so ever!) is not acceptable. There is absolutely no reason for any insurance company to refuse insurance to anyone. If there is logic in that then all insurance companies should be put out of business now.

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21 users have voted.

"I know you believe you understand what you think I said, but I am not sure you realize that what you heard is not what I meant."
Robert J. McCloskey, U.S. State Department spokesman. From a press briefing during the Vietnam war.

The Aspie Corner's picture

I only keep bringing this up because Florida is as ass-backwards as it gets on every issue, but ESPECIALLY things like this. Think I'm kidding? A good chunk of the state relies on fixed incomes. And Medicare plus whatever their retirement plans provide.

Things like a Universal Basic Income can't come soon enough.

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12 users have voted.
snoopydawg's picture

@The Aspie Corner
refused to expand Medicaid to their citizens. They get their health insurance paid for by their constituents but they won't help their poor citizens.
Look at how many hospitals have had to close because they couldn't afford to stay open.
Utah's congress and governor kept trying to go through a third party that would have profited and the costs to the state would have gone up. The Obama administration refused to let them. The next plan was to only cover 16,000 people and they were either recently released from prison or had drug addictions.
Fortunately I have Medicaid because I am disabled. But finding doctors who will take Medicaid patients are hard to find.

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8 users have voted.

What do I think about the Obama Presidency? I think it would have been a good idea.

k9disc's picture

Doesn't sound like it.

Obamacare (DIE MEME DIE!) markets are "thin". That's as close as you're going to get to the discussion of health -- a health euphemism for market performance. Fucking sad!

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15 users have voted.

“Tactics without strategy is the noise before defeat.” ~ Sun Tzu

k9disc's picture

Is that really what they are saying?

I'd love to see some teeth filled regulation to punish those insurers bailing from less-profitable markets.

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15 users have voted.

“Tactics without strategy is the noise before defeat.” ~ Sun Tzu

CS in AZ's picture

He's self-employed and a few years shy of Medicare. He previously had Humana insurance, but they dropped out of the marketplace here so then he has only one option available, which he switched to, only to be informed by his primary care doctor's office (where he's been a patient for 14 years) that they don't accept his new insurance. They cancelled his appointment and sent him home.

He's in the midst of cancer treatment, so he's now unsure which of his various specialists, hospitals and clinics, etc, are still going to see him. He said "I'm basically screwed" -- he has the required insurance, but since providers don't have to accept it, his ongoing medical care and treatments are in jeopardy anyway. At the least he has to find a new doctor and contact everyone else to assess just how screwed he is. This is not at all good for his health right now to be dealing with this.

Obamacare is collapsing and it's not just the problem of companies not selling on the exchange, it's the quality of their products and whether it actually gets you into the doctor's office or not. When it doesn't, people get really pissed off, and if you're older and/or have health issues, you can't help but notice how crappy your insurance is. This isn't working. They need to admit it and move on. Medicare for all.

And medical providers and services of all kinds must either be required to accept it, or be paid well enough to ensure they want to, because insurance is useless if your doctor suddenly dumps you because they don't like your insurance company.

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snoopydawg's picture

@CS in AZ
being treated for cancer.
You wrote that his doctor and treatment centers don't have to accept it . Does that mean that they could accept it but just don't want to or they can't accept it?
If that's the case then I don't know how they can just sit back and watch as he gets worse. Plus he isn't going to be able to get end of life care and will suffer from the pain.
I hope that there is something that can be done for him. And how many more people are going to be in his position across the country?
It's not just the republicans' plan to get sick and die quickly. This is on the democrats and Obama for not passing the best health CARE plan that they could have because they passed it without one republican voting for it. But they let them water it down on the pretenses of getting them to vote for it. And then they gave it to Baucus and they knew that Liz Fowler from WellPoint was on his staff and was writing the bill that would basically be what the insurance companies wanted in it.
Remember I will veto any health care bill that doesn't have the public option in it?
Gawd, what an asshole he turned out to be.

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12 users have voted.

What do I think about the Obama Presidency? I think it would have been a good idea.

eyo's picture

@snoopydawg I mean, cutting off cancer treatment equals death in some cases, I don't now specifics. That should be criminally prosecuted, not effing allowed to happen. On purpose. CEOs will Make America Great Again, what?

The headline of this essay made me LOL, which is pathetic I think. It really does feel Titanic, with rats jumping and deck chairs spinning, as the (Bernie) band plays on. Crash faster please, and take the EHR mess of corruption with. Thanks.

Medicare-for-all right now would be a disaster, there is too much "technical debt" built around the Windows monopoly. At this point every Health Center, the most basic (and best, in my view) access for everyone, is tied to Microsoft's profit schedule. Forced upgrades are a real problem, soon enough your whole life will be in their cloud (on their server). Microsoft can't or won't secure consumers from privacy theft, they encourage it (legal!). Who owns LinkedIn again? Huh! Goodbye Human Resources, hello Robot Algorithms. I guess gamers will enjoy the new Lifegiving Overlords, because why not. Glub glub or divest.

DebianMed, that is what community software building looks like. You just have to go somewhere else, anywhere but the U.S. to appreciate. Imagine if we the people owned the software infrastructure, that is what freedom looks like to me. Free Software, Free Society. Get Google Microsoft and Apple out of classrooms and watch local schools and markets thrive, little bazaars of freedom from corporate rule. Imagine that for a change.

It's hard at first, but I haven't used Windows or OSX in over a decade. I bought hardware that could run an OS I can learn to control, not count on some dumb-ass in Washington, state or D.C. to do it for me. In fact Oracle is a huge drain in California, monopolies at the state and federal level, Larry Ellison is untouchable. He is why Zuck yearns to buy his own private island, Ellison envy. They are two asshole peas in the same asshole pod, $ilicon Valley. Zuck thinks he'll be President one day. SV ka-ching! BOHICA, or try something different. There are no benevolent billionaires.

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7 users have voted.

On a blog.

CS in AZ's picture

@snoopydawg

Medical providers (doctors, labs, imaging centers, etc) have to negotiate with insurance companies on an annual basis to agree on reimbursement rates, i.e., what that insurance company will pay for their services.

If an insurance company pays too little, or is simply a pain to work with, providers can choose not to accept that insurance, and not see patients who happen to have that insurance. All medical providers, except those who don't take any insurance and are cash only or are in a co-op practice, have a list of accepted insurance companies and excluded ones. This list changes from time to time.

My friend's doctor can't decide on a case by case basis whether to accept the patient's insurance or not. A company is either on their list of payers they have agreements with, or not. If a patient switches to an insurance to a company they don't have an agreement with, that patient is out.

The doctor and staff won't have to watch him get worse or see any consequences, because they don't see him anymore. Out of sight, out of mind. It's a business to them.

This was his primary care doc. So he has to find a new one, hopefully some doctors do accept the one company now available on the exchange.

He's also in the process of checking with his oncologist and other providers to find out if they do or don't accept the new insurance. So we hope still that his cancer treatment won't be cut off in the middle. But it is possible. Fingers crossed.

The whole way the insurance industry works in the area of medical care is a mess. It sucks for patients, and it sucks for doctors and other providers. Getting paid for their work is a time consuming, confusing task and they are constantly negotiating with insurance companies.

A couple of years ago there was a big showdown between Blue Cross Blue Shield and a major provider and hospital network here, which began announcing that they would no longer accept BCBS at the end of the year, as the reimbursement rate negotiations broke down. Lots of people got very worried. At the 11th hour they finally made an agreement, so no patients got cut off, but it was close and it could happen to anyone.

As I've long said, having insurance doesn't mean you have access to care or a doctor. Talking about how many people are "covered" is a meaningless statistic. When people are "covered" by a policy from a company that is so shitty doctors won't work with them, it's useless and a waste of money.

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10 users have voted.

I am screwed.

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dervish's picture

You can choose any insurance company you want, as long as it's Anthem.

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9 users have voted.

"Obama promised transparency, but Assange is the one who brought it."

Who knew a scheme to ensure the profits of insurance companies would be so hard to maintain?

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