Will Poors Pay The Fine Now That ACA Coops Strangled?

This will be short because smart phone, but sharing it in hopes others will find it as interesting as I did. Have a number of relatives who are surely faced with paying the ACA fine for no coverage.

Ah, yes, remember when we realized we got punked by Mr. Obama , maybe felt slightly hopeful when Senator Sanders got Coops added to ACA ?

Here's the latest on the death throes of a state coop and the choices faced by people afterward.

Thanks, Obama!

http://www.chicagobusiness.com/article/20160716/ISSUE01/307169993/obamac...

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SNIP

Land of Lincoln recently sued the federal government for about $73 million that the co-op claims it's owed from an Obamacare program, while also facing a nearly $32 million federal bill that it can't afford. The startup, which lost $90.8 million in 2015, is in the process of liquidating after three years in business. It joins more than half of the co-ops.

“We hate that the co-ops might end up being a cautionary tale,” says Jason Montrie, Land of Lincoln president and interim CEO.

The insurer's nearly 50,000 customers can choose a new plan from the exchange until enrollment begins again Nov. 1. While those customers might have racked up bills with Land of Lincoln, other insurers could actually carve out a profit on them by controlling access and cost, says Steve Riedl, Chicago-based senior consulting actuary at Willis Towers Watson. Most of these insurers' networks are smaller, with cheaper hospitals and doctors.

With its cachet and vast footprint (about 80 percent of the 2014 statewide individual market), Chicago-based Blue Cross likely will pick up a good chunk of Land of Lincoln's enrollees despite causing an uproar last fall when it ditched its broad PPO plan for one that left out many local academic hospitals.

But here's Riedl's fear: As exchange plans get more expensive and less appealing, some people just might forgo insurance altogether and pay the federal fine instead. For 2016, that's at least $695.

Did you catch that " carve out a profit ' bit? What a wonderful moral perspective! /s

My only

I'll be voting for Stein. Dr. Jill Stein. DLC have left me no choice.

Barring a Birdie miracle, once again for me its Jill Stein, because fck thus shit.

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divineorder's picture

Think Delbert McClintock song is where that came from.

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A truth of the nuclear age/climate change: we can no longer have endless war and survive on this planet. Oh sh*t.

that is blowing up this year. As I've detailed in other essays.

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TheOtherMaven's picture

and instead of pushing on in, all the Very Smart People said, "Good enough, let's not do anything more".

Which just goes to show that the Very Smart People can be VERY, VERY DUMB (when they aren't very, very greedy).

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There is no justice. There can be no peace.

...that this is the result of all greed, minimal dumb.

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Greyhound's picture

No for-profit insurer can hope to compete with community health care, it's just not possible as they have 30%+ built-in disadvantage. The only way to beat them is to never let them form.

The whole ACA Circus was produced from day one to get health care off the table.

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enhydra lutris's picture

posting this. FWIW, the big guys' financials look like this (exaggerated)

net profit from insurance +/- 00000000001
net profit from re-insurance +/- 00000000001
net investment income (Bermuda) + 10000000000

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That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

divineorder's picture

Are stopped over now on way back from our usual camping in three countries Africa visiiting retired Swiss educator friends. They took us to a couple of parties, fun except invariably having to answer questions about election to their friends. Sucks. One banker who had to quit because serous health issues disabled him told of investment ank that brought in a US CEO who in 8 months cashed in his options for many millions while the company was down. When ased to wait for a turn in the market he acted puzzled, said, 'Hey, I workedhardfor this, its mine, I earned this.' No empathy gene, apparently no team spirit.... Cue the layoffs of the little people.

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A truth of the nuclear age/climate change: we can no longer have endless war and survive on this planet. Oh sh*t.

enhydra lutris's picture

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That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

probably won't be subject to any penalties. I would think they would be covered under Medicaid expansion (if they aren't already).

The tax penalties are a bigger issue for people in the middle class. If your rich, you'll pay a higher penalty, but it will probably hit discretionary income.

Thought this article had some good background on why the co-op failed.

http://www.stltoday.com/business/local/why-land-of-lincoln-and-other-hea...

e.g. The problem is that there are massive barriers to entry for new insurers getting into the market, so most of these efforts will be doomed to failure -- and that's probably by design on the part of legislators who hacked away at the co-op provision.

Personally, I think Obamacare is still a net positive over the system that proceeded it. The problem is that the system that came before it set the bar incredibly low.

There are some good things in the law -- no lifetime caps, no denials for pre-existing insurance, in some markets there is competition and the law makes it easier to price comparison shop, Medicaid expansion is a huge component of the law as well. But the law is also unnecessarily complex and it's too expensive for consumers. Most of the far-right concerns haven't materialized. But there were criticisms from the left that do hold. e.g. in some exchanges there isn't much competition, so you get the worst of all worlds -- an uncompetitive market, where people are compelled to buy the product. That's a major problem. In larger markets where there is more competition, the law is a net positive, but still not as good as single-payer.

One of the risks that was apparent even in 2009, was that the law would help to further entrench a broken system. I do think that Medicaid expansion redeems the law on some level. That's single-payer for millions of people who didn't have coverage before. Millions more people in GOP controlled states could have access to single-payer coverage through Medicaid expansion if their representatives had more empathy, intelligence and class.

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Unabashed Liberal's picture

for several reasons.

Too late to go into all of my objections this evening, but one of my biggest gripes is the Medicaid program--which amounts to a 'loan' program for a low income person's health care. I cannot support it until it is drastically reformed. (Until that happens, I think that those folks should be transferred to Medicare.) Any program which sets up its citizens to strip them of assets--even if they never set foot in a physician's office--is practically criminal, IMO. (That is because of capitation fees, ACOs, HMOs, etc.)

Of course, all the ACA accomplished was a major cost shift. And, the small percentage of Americans who were even affected by the pre-existing conditions clause could have been taken care of without destroying employer-provided group health plans for tens of millions of people.

From all that I've read since I heard about FSC's MFM (Medicare For More) proposal--it will further entrench the our current health care system (ACA)--not move us toward a single-payer system.

Oh, and it appears that the so-called 'buy-in' will likely be unsubsidized. The estimate for the unsubsidized premium (for one) was approximately $636 in about 2007/2008. Surely, it's even higher by now.

I'm planning to Tweet Bernie's campaign to see if they can clarify the premium cost. I'm sure that I would never get an answer from FSC's people. The reporting is that she is 'mum' on details.

I bet!

For the life of me, I can't understand the people that keep voting for 'the Grifters!' (FSC and WJC)

Wink

Hey, have a good one.

~ ~ ~ ~ ~

Hey, DO--thanks for this essay!

Bye

Mollie


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National Mill Dog Rescue (NMDR) - Dogs Available For Adoption

Misty May - NMDR

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Everyone thinks they have the best dog, and none of them are wrong.

But in the case of Medicaid, it may depend on the state, but the old system, you would have to liquidate your assets in order to qualify for coverage. Under Medicaid expansion, the threshold in states that have adopted it is based on income, not wealth and assets. e.g. if a person makes 133 percent of the poverty level or less, they qualify. Over that and they're into the insurance exchange system. Of course, it depends if local governments have accepted Medicaid expansion funding, and some of the states have been granted waivers that might shift more costs onto people receiving the coverage.

What I've read doesn't really jibe either with the idea that coverage was "destroyed" by the ACA. Employers dropped millions of people from coverage in the years before the enactment of the law, because health care costs have skyrocketed in this country. Individual insurance premiums doubled, on average, in the 8 years before the ACA became law. Businesses that held onto insurance coverage saw a spike in rates AND higher deductibles. The one state outside of Massachusetts that attempted to resolve the pre-existing conditions issue -- New York state -- enacted policy of "guaranteed issue" without an insurance mandate. The net result was an insurance death spiral, where rates were jacked up in the small group and individual insurance market in order to cover the more expensive insurance pool, as a consequence healthy people dropped coverage, and costs increased higher.

http://waysandmeans.house.gov/the-lesson-of-state-health-care-reforms/

It might be possible to deal with the pre-existing conditions issue with some form of reinsurance. e.g. the government reimburses insurers for more expensive customers. We effectively do this in other areas of government policy -- crop insurance, or flood insurance for properties in more flood prone areas. Guaranteed issue without a mandate, however, won't work.

I'll have to look into the Medicare buy-in "Medicare for More" details.

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Citizen Of Earth's picture

It appears like a systematic dismantling of Coops by ACA "new rules". Say goodby to lower cost options. Neoliberal states of America doing gawds work.

HealthyCT [a Non-Profit Coop] is required to pay the hefty sum because of a federal risk adjustment program built into the Affordable Care Act. It takes profits from certain health care providers with less risk and shifts those funds to other providers with higher risk. A statement from the Insurance Department Tuesday says this redistributes "funds from insurers with generally healthier policyholders to companies with sicker policyholders and higher claims costs."

http://ctmirror.org/2016/07/05/state-deems-insurance-co-op-healthyct-fin...

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Donnie The #ShitHole Douchebag. Fake Friend to the Working Class. Real Asshole.

It was such a sad day when the Republicans managed to defund the reimbursement provisions. The loss of the coops is clobbering the working poor who are right above the medicaid cutoff. A lot of us knew from the beginning that if costs were not controlled, the new system would not work. There are only so many subsidies that can be politically possible.

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Twain Disciple

http://www.oregonlive.com/business/index.ssf/2016/07/oregons_second_heal...

State regulators will take the first steps Monday to take the Oregon's Health Co-op into receivership. The company's board of directors voted Friday to consent to the receivership order, paving the way for the state to liquidate the troubled company's assets.

Oregon's Health Co-op is a nonprofit consumer operated and oriented health insurer formed under the Affordable Care Act. It's tiny by industry standards, with just 20,600 policyholders in Oregon.

"It is with great sadness that I announce Oregon's Health CO-OP is shutting down its doors immediately," said Phil Jackson, the co-op's top executive. "The board of directors agreed that it is in the best interests of our members and community that we wind down our operations."

It is the third Oregon insurance company driven into financial crisis after federal financial assistance failed to appear. The insurer was expecting to receive about $5 million from the Centers for Medicare and Medicaid Services as part of the federal government's risk adjustment program. Instead, the feds informed Oregon's Health Co-op that it owed $900,000 to the agency.

However, state is looking to keep individual policy holders going until Dec. Group policies end in 2 weeks.

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