Another day, another healthcare co-op failure. In July alone, three co-ops, HealthyCt in Connecticut, Community Care of Oregon, and Land of Lincoln in Illinois announced they are closing up shop. They join 13 other failed co-ops out of the original 23 that were a centerpiece of the Affordable Care Act’s vision for the future of healthcare organization — an unrealistic vision based on wishful thinking and sabotaged by the ACA itself.
The ACA created Consumer Operated and Oriented Plans (co-ops) — private, state licensed, non-profit health insurance companies — to provide low-cost, consumer friendly coverage to individuals and small businesses. The theory was that since the co-ops didn’t have to show a profit, they could charge lower premiums, provide more services and be more responsive to their members. They would use collective purchasing power to lower administrative and information technology costs and keep members healthy through preventive care and evidence-based medicine.
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“No one can see a bubble. That’s what makes it a bubble.” That was Christian Bale’s character’s summation of a market bubble in last year’s hit movie “The Big Short,” which chronicled the few investors who saw the signs pointing to the mortgage market collapse. With terrorism, email scandals and race relations dominating the headlines, has a healthcare bubble been filling up quietly behind the scenes?
Since the 2010 passage of the Patient Protection and Affordable Care Act (ACA or ObamaCare), the health care industry has seen record growth and increased revenues. Why? Illness, especially chronic, sadly is a moneymaking business. Illness requires more office visits, more hospitalizations and inevitably more bills. ObamaCare halted insurance companies’ practice of rating premiums based on a customers illness history, or as more commonly known, preexisting conditions.
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Six years after ObamaCare was signed into law – and countless assurances later that the law is “working” – America’s major insurance companies are facing mounting losses and threatening to pull out of the exchanges, leaving customers facing higher costs and fewer options.
In the most recent example, Tennessee regulators are bowing to pressure to let insurers refile their 2017 rate requests, which could lead to steep hikes for customers. A state official acknowledged to The Tennessean they are “not alone” in letting companies seek bigger increases — as some insurers head for the exits.
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Americans should be more worried than ever about Medicaid, which provides health insurance for America’s most vulnerable. The cost of the $500 billion program is expected to rise to $890 billion by 2024, according to the Centers for Medicare and Medicaid Services. Yet more spending doesn’t necessarily mean better care for beneficiaries, 57% of whom are low-income minorities. The expansion of Medicaid is one of the most misguided parts of ObamaCare—shamefully expanding second-class health care for the poor.
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OF ALL the big health-insurance companies, Aetna may have been the last anyone expected to pour cold water on Obamacare. The company has over the past several years enthusiastically participated in the marketplaces the law created. Now, Aetna just announced, it is canceling plans to expand its Affordable Care Act (ACA) business and reviewing its existing products.
Aetna is not alone. UnitedHealth Group and Humana have recently made announcements in a similar vein. Among other things, many big insurers complain that their Obamacare divisions are losing money, requiring them to pay out more in medical bills than they collect in premiums. The law’s critics have seized on the news, using it as fresh evidence that Obamacare is deeply, perhaps fatally, flawed.
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Humana recently announced that next year it is withdrawing from 88% of the counties where it sold Affordable Care Act (ACA) exchange plans this year. United Healthcare forecasts higher earnings in 2017, stemming in part from its decision to shut down most of its exchange business. Aetna has cancelled plans to expand its ACA market footprint and is instead reevaluating its current participation. At least four states, Alaska, Alabama, Oklahoma and Wyoming will likely have only one exchange insurer this coming year. Sixteen of the 23 co-ops initiated with ACA funding have collapsed. And researchers supportive of the ACA estimate that insurers are requesting average gross premium increases of 23% next year These data points suggest the ACA’s individual market changes are faring poorly thus far.
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Twenty-three co-op plans, funded with $2.4 billion in government loans, opened enrollment in 2013. By the end of 2015, 12 plans had failed, leaving $1.3 billion in delinquent loans, more than 700,000 people in 13 states scrambling for coverage, and hospitals and doctors with hundreds of millions of dollars in losses uncovered by the assets of the failed co-ops.
This result is hardly surprising. The people running the co-ops had no experience running an insurance company – co-ops were forbidden to have anyone affiliated with insurers on their boards. Their premiums were too low and their benefits too high. The failed co-ops went on to lose $376 million in 2014 and more than a billion in 2015. Only one co-op turned a profit in 2014, and all lost money in 2015.
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As college students and their parents finalize their enrollment and pay tuition and fees for fall, many face one fewer headache than in years past: no more worrying about whether they’ve waived the optional health-insurance coverage in time to avoid being charged for it.
In large part because of changes brought by the federal Affordable Care Act, a number of colleges have stopped providing student health insurance.
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Aetna announced in early August that it would not expand into additional Obamacare markets and that it might consider leaving existing markets. It’s just the latest example of the failures of this massive healthcare law.
In an editorial, Investor’s Business Daily declared: “Obamacare is failing exactly the way critics said it would.” The outlet explained that Aetna had already lost $200 million thanks to Obamacare, but had expected to break even in 2016. That didn’t happen, so the company will no longer expand into five additional states and is rethinking whether it will stay in the 15 states it already offers Obamacare plans.
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Blue Cross Blue Shield of Alabama is seeking an average rate increase of 39 percent on individual plans offered through the Obamacare marketplace, according to the Centers for Medicare & Medicaid Services.
The proposed rate hikes will affect more than 160,000 people in Alabama who purchase insurance through the federal exchange, or about 5 percent of Blue Cross membership.
Rate increases range from 26 to 41 percent, depending on the type of plan. Proposed increases are lowest for bronze plans, which offer the least amount of coverage, and greatest for the most popular silver plans.
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