“Today, the Department of Health and Human Services announced that, ‘Trustmark Life Insurance Company has proposed unreasonable health insurance premium increases in five states—Alabama, Arizona, Pennsylvania, Virginia, and Wyoming. The excessive rate hikes would affect nearly 10,000 residents across these five states.’… This rate increase action by HHS is just political grandstanding as the Obama administration tries to sell a still unpopular law.
But it is dangerous grandstanding.”
“If you’ve never heard of the law’s medical loss ratio (MLR) provision, you’re certainly not alone. This simple calculation has had the effect of radically reducing what health insurance agents earn. That, in turn as greatly restricted their ability to help million of Americans navigate the maze of approvals needed for medical procedures and processing claims. It has also had a devastating effect on these agents’ businesses and is disrupting the insurance market.”
“Will the Patient Protection and Affordable Care Act (ACA) improve the performance of the U.S. health care system? The quality of the major interim final regulations issued under the ACA in 2010 gives three main reasons for pessimism on this score.”
“Republicans and a Democrat on a House Small Business subcommittee Dec. 15 expressed concerns that a key insurance requirement of the health care reform law will reduce competition and harm health insurance brokers… The Patient Protection and Affordable Care Act‘s medical loss ratio (MLR) provision, which requires insurers to spend at least 80 percent of premiums on medical claims or quality improvements in the individual and small group markets and at least 85 percent in the large group market, is likely to deter small insurers from entering the market and lead to established insurers leaving the market, Coffman said.”
“Beginning September 1, 2011, health insurers must
submit requests to state or federal reviewers if they
wish to increase insurance rates by 10 percent or more.
This “rate review” process is required by Section 2794
of the Public Health Service Act (PHSA), which was
added to Section 1003 of the Patient Protection and
Affordable Care Act (PPACA), Pub. L. 111-148…
The goal of this mandate is to reduce health care costs
by addressing the asymmetry of information in the
health insurance market between consumers, providers
and industry actors. However, despite the stated goals
of the mandate, it fails to ultimately address the
underlying issues accelerating health care costs.”
“Voters in Ohio approved a measure Tuesday night disapproving of President Obama’s healthcare law. Ohioans passed an amendment to the state constitution that says Ohio residents cannot be forced to buy health insurance… But even with strong turnout around a traditionally Democratic issue, 66 percent of voters had supported the anti-mandate initiative at the time the Associated Press called the vote.”
“The Obama administration has failed to meet more than half of the new health care law’s deadlines, from submitting plans for new, value-based Medicare purchasing programs to publishing criteria for determining the medically underserved. A report requested by Sen. Tom Coburn, Oklahoma Republican, indicates that the Department of Health and Human Services and other federal agencies missed 18 of 30 deadlines since the Affordable Care Act was passed in March 2010.”
“Two tiny health insurance companies are exiting Florida’s individual market because of Democrats’ health law, the state’s insurance department announced Thursday in an effort to bolster its request for a waiver. Florida has asked for a waiver from the medical loss ratio requirement that requires insurers to spend at least 80 percent of premiums on medical care or give customers rebates. Several consumer advocacy groups argued Thursday that the state doesn’t need such a waiver.”
“ObamaCare’s rate review regulations are premised on the notion that rising health insurance premiums are somehow caused by excess profits and wasteful spending. But insurer profits are actually quite small. The Congressional Research Service reports that in 2009, health insurers’ average profit margin was just 2.6%. The cost of insurance is rising because the cost of health care has increased dramatically. True health reform would’ve addressed this underlying problem.”
“Last Thursday, the Institute of Medicine finally released its long-awaited set of recommendations for how the Secretary of Health and Human Services should accomplish the impossible–determining the ‘essential health benefits’ for tens of millions of Americans under the to-be-implemented Affordable Care Act. Early reviews indicate that, not surprisingly, there is no way to please everyone, or perhaps even anyone, in this highly political exercise. The countervailing pressures ‘essentially’ are that one side wants to ensure that benefits are more comprehensive and generous to ensure that everyone either gets what they want, or what other interests and experts think they must get anyway. “