Wintery Knight

…integrating Christian faith and knowledge in the public square

Obamacare enrollment of young adults about 50 percent below target

If you remember, Obamacare works by forcing young people (especially young men) to pay for care they don’t need and won’t use. This lowers the costs of health care for younger women and especially for older, sicker people. The target is 2.7 million enrollments of people from age 18-34.  But are young people signing up for this plan in numbers like that?

Investors Business Daily has the answer.

Excerpt:

Data through five months of the open-enrollment period show that slightly fewer than 10% of eligible 18- to 34-year-olds have signed up for coverage. Among young men, roughly 1 in 12 has signed up.

The Kaiser Family Foundation puts the ObamaCare-eligible population at 28.6 million, with 40%, or about 11.4 million, in the 18-to-34 age group.

Compared to the size of the potential market, the first-year target of 7 million enrollees, including about 2.8 million young adults, was relatively modest.

Yet it’s now clear that the initial target is well out of reach. The Avalere Health consultancy projected that sign-ups — paid and unpaid — will end March at around 5.4 million.

Through February, not quite 1.1 million young adults had selected an exchange plan. Among this group, the male-female breakdown was about 45% vs. 55%. That matters because women at child-rearing age are more likely to run up big medical bills.

In February, 268,000 18- to 34-year-olds signed up, so a decent upsurge in March could lift the total close to 1.4 million. But that’s before winnowing out the people who don’t pay.

Anecdotal reports from a handful of states and large insurers now point to a paid rate of about 85%, possibly lower.

While that could improve before the March 31 deadline, there’s reason to suspect that the paid percentage might lag among young adults, since they are showing more reticence about signing up in the first place.

Once the unpaid group is subtracted, it appears likely that young-adult enrollees will fall at least 50% below the first-year target The White House had initially set that target at 2.7 million.

[...]The age mix is important because the exchanges charge younger people higher premiums relative to pre-ObamaCare individual market insurance, so that older people can be charged less without negating insurer profits.

If young adults make up just 25% of the ObamaCare exchange population, it would wipe out much, but not all, of the 3% to 4% profit margin insurers typically allow for in setting premiums, Kaiser Family Foundation experts figure.

Yet that calculation assumes the health status of those who do sign up is about average. In general, an insured pool comprising a smaller share of the eligible group raises concern that the covered group will be costlier than average.

So they are expecting 2.7 million, but even with a late surge of enrollments, they are only going to get 1.4 million young people. That’s bad for Democrats, but I am happy that young men are not signing up for this law. They have nothing to gain from it. Maybe this whole mess will be worth it if young men understand that big government rides on the backs of young men. They are expected to pay the taxes, but without getting any of the benefits. Sex changes? IVF? Maternity? Well woman exam? Birth control pills? We don’t use that. We don’t mind paying for that for our wives, but we don’t want to pay for it for complete strangers.

Filed under: News, , , , , , ,

Obama administration report: 65% of small firms face Obamacare premium hikes

From Investors Business Daily.

Excerpt:

Released into a news black hole last Friday, an official Obama administration report finds that ObamaCare will push premiums up for two-thirds of small businesses. Cross off another ObamaCare promise.

The report came from the actuary for the Centers for Medicare and Medicaid Services — which means it’s from the administration’s official ObamaCare number cruncher.

What it found was that 65% of small businesses that offer insurance will likely see their premiums rise thanks to ObamaCare. That translates into higher insurance costs for 11 million workers.

The reason? These companies generally employ younger, healthier workers and so had been paying lower-than-average rates.

But since ObamaCare bans insurance companies from considering health when setting premiums, these companies will get hit with higher costs.

“We are estimating that 65% of small firms are expected to experience increases in their premium rates,” the report said, “while the remaining 35% are anticipated to have rate reductions.”

The report doesn’t say how big these hikes will be, but we have good reason to believe the extra costs will be significant.

One study, for example, found that 63% of small employers in Wisconsin will see premiums jump 15% because of ObamaCare. A separate study found that 89% of small companies in Maine would see rate hikes of 12% on average.

Another, by consulting firm Oliver Wyman, concluded that ObamaCare would push up small group premiums nationwide 20%.

Is this how the bill was sold to us by the Obama administration and their supporters in the mainstream media?

No:

In 2009, Obama promised small businesses that his plan would “make the coverage that you’re currently providing more affordable.” Later he said it would drive small-business premiums down by 4% in its first year, and as much as 25% by 2016.

As recently as last summer, Pelosi was proclaiming that “if you’re a small business … it lowers costs,” while Waxman said the law would make “high-quality healthy insurance more affordable and more widely available for small businesses.”

Notice that nowhere — either before or after ObamaCare passed — did any Democrat say anything about two-thirds of small businesses paying more for health coverage so the lucky one-third could get rate cuts.

Next time you hear a big government liberal promising you goodies at no cost, keep in mind their record. They are making policy from emotions, not from mathematics. They believe that they are lying to you for your own good. Their goal is not to tell the truth at all. And don’t rely on the left-wing journalism crowd to hold them accountable, they flunked math too.

Filed under: News, , , , , , , , , ,

Does the last-minute Obamacare exemption fix anything?

One of my favorite writers on health care policy is Michael F. Cannon of the libertarian Cato Institute. He has an article in Forbes magazine that I think is a good level-set for the Obamacare changes that are happening in 2014 and beyond.

He writes:

[...]President Obama announced, just days before the deadline for purchasing coverage with a January 1 effective date, that he would offer a categorical “hardship exemption” from the individual mandate to anyone who had their insurance cancelled due to ObamaCare.

[...]If these folks choose not to buy health insurance, they will not face a penalty. They will also have the option to buy, “if it is available in your area,” the lower-cost catastrophic coverage that ObamaCare otherwise offers only to people under age 30, or who receive the separate “unaffordability” exemption from the mandate.

The obvious purpose of this policy is to give political cover to Senate Democrats who must face the voters next year, and are no doubt afraid of attack ads like this one.

[...]Yet this exemption may not be of much value to those who qualify, and is likely to create more problems for ObamaCare supporters than it solves.

The people who qualify for this exemption don’t actually want it. They want health insurance. They had affordable coverage, until ObamaCare took it away from them, and that’s what they still want now. Sebelius boasts that ObamaCare’s catastrophic plans cost 20 percent less than other ObamaCare plans, but don’t confuse that with affordable coverage. The Manhattan Institute’s Avik Roy — who is now the opinion editor for the sprawling Forbes empire – notes that ObamaCare’s catastrophic plans can still cost twice as much as what was previously available on the individual market.

But even if they like their catastrophic plan, they can’t keep it. Sebelius has complete control over the duration of the exemptions, which she has described as a “temporary” step “to smooth [consumers'] transition” to enrollment in Exchange plans. So in a matter of months, Obama will violate his “if you like your health plan” pledge again by kicking these folks out of their catastrophic plans. They will get another cancellation letter tossing them into the Exchanges. Their premiums will surge again. They may lose their doctor again.

The exemption means insurers will suffer losses this year, and rates will be higher next year, for all ObamaCare plans.

The president argued before the Supreme Court that ObamaCare’s regulatory scheme cannot work with out the individual mandate. Yet he has now exempted millions of the very people he most needs to comply with it. This exemption siphons good risks out of the Exchanges and destabilizes the risk pools for both the standard ObamaCare plans and the catastrophic plans. Participating carriers set the rates for their Exchange plans with the expectation that these folks would be purchasing bronze, silver, gold, and platinum plans through the Exchanges. But the healthiest members of this now-exempt group are the most likely to go uninsured or purchase a catastrophic plan. So Obama’s blanket exemption makes those risk pools older and sicker.

This blanket exemption also destabilizes the risk pools for the catastrophic plans. It opens those pools to lots of people over age 30, who have higher health expenses than people under age 30, and whom the insurers were not expecting to buy catastrophic plans when they set those rates.

So the effect of this is going to be to raise rates temporarily, because the insurers companies are not getting the younger, healthy people they need to make the rates as low as they originally calculated. They are going to lose a ton of money because the Democrats are changing the rules at the last minute. They people who have coverage are going to be the ones who make all the claims, and the people who normally don’t make claims are now exempt, temporarily – until the 2014 elections. This is going to be a huge hit to the health insurance companies.

As I noted before, the Democrats are going to have to bail out the insurance companies in order to account for the losses. It’s actually in the Obamacare law already, as David Freddoso explained. But will the Democrats use money from their political party to pay for their mistakes? Hell no – they will borrow it from your children, which is what they are so good at doing. There is a cost for electing incompetent people, and it’s going to continue to rise until the fools are voted out.

Filed under: News, , , , , , , , , , , , , , ,

Michigan House and Senate Republicans pass Abortion Insurance Opt-Out Act

Good news from Michigan, delivered by Live Action.

Excerpt:

[On Wednesday,] Michigan won an important pro-life victory.

It started this summer when over 315,000 registered voters, representing every county in Michigan, signed the NO Taxes for Abortion Insurance Petition, making it clear that the people of Michigan do not believe abortion is health care and we do not want to pay for it.

On December 11th, both the Michigan House and Senate passed this petition as the Abortion Insurance Opt-Out Act, with the House voting 62-47 and the Senate voting 27-11. According to this act, elective abortion will no longer be a standard benefit in health plans. Abortion coverage will only be available by purchasing a separate rider. This act also ensures that our tax dollars and insurance premiums will not go toward funding abortions.

Because the Abortion Insurance Opt-Out Act was initiated by citizens, as allowed by the Michigan Constitution, it does not require the governor’s signature to become law.

[...]The Affordable Care Act requires all the states to have health care exchanges (also called marketplaces) available by 2014. The ACA allows states to exclude abortion as a covered benefit in these insurance exchanges through legislation like the Abortion Insurance Opt-Out Act. Michigan is the 24th state to exclude abortion coverage from its insurance plans through this provision.

But not everyone was pleased. HHS Secretary Kathleen Sebelius was not pleased. And when questioned by Republicans about whether they could see the list of plans that do not support abortion, she declined to provide that list.’

CNS News reports.

Excerpt:

Although Health and Human Services Secretary Kathleen Sebelius said on Oct. 30 that she would provide Congress with a list of the Obamacare plans in the federal health exchange that do not cover abortion, she has yet to do so and, testifying on Dec. 11, backed away from that pledge and urged consumers to just look at the plan benefits on the exchange website.

At the Oct. 30 hearing before the House Committee on Energy and Commerce , Rep. John Shimkus (R-Ill.) asked Seblius, “Can you provide for the committee the list of insurers in the federal exchange who do not offer, as part of their package, abortion coverage?”

During a somewhat heated back-and-forth, Sebelis said, “I think we can do that, sir,” and added, “I know that is the plan, I will get that information to you.”

Yet during a Dec. 11 House subcommittee hearing, Sebelius declined to say whether she would provide the list requested and instead urged lawmakers and consumers to just look at the benefits package for each plan on the Obamacare exchange websites.

At Wednesday’s hearing, Rep. Shimkus said,  “Madam Secretary, you promised last time you were here that you would provide me a national list of those who cover and those who do not cover abortion and abortion services. We have yet to receive that list.”

[...]In an earlier, fractious exchange with Sebelius, Rep. Shimkus expressed frustration, saying, “This is why we’re frustrated, because we just don’t get the truth out of you.”

Oh those Democrats. Always trying to make us pay for abortions even if we are pro-life.

Filed under: News, , , , , , , , , , , ,

Doctor shortage: how Obamacare makes it harder to find a doctor

Remember how Obama promised that if you liked your doctor, then you could keep your doctor? It turns out that there is more to making policies than just saying what you’d like to do in a scripted campaign speech. The truth is that some health care policies will make you lose your doctor, regardless of what the President reads off of a teleprompter. Is Obamacare one of these policies? Let’s see.

Avik Roy writes about it in Forbes magazine.

Excerpt:

On Saturday, the Wall Street Journal reported that, due to Obamacare’s cuts to Medicare Advantage, among other factors, UnitedHealth expects its network of physicians “to be 85 percent to 90 percent of its current size by the end of 2014.” The result? Some retirees enrolled in Medicare Advantage will need to find new doctors. And it’s a trend that could accelerate in future years.

[...]Over the next ten years, Obamacare was designed to spend around $1.9 trillion on expanding health coverage to the uninsured. The law pays for this new spending with $1.2 trillion in new taxes, and $716 billion in cuts to Medicare, relative to prior law.

[...]The private insurers who supply Medicare Advantage plans, like UnitedHealth and Humana, have been responding to the cuts by squeezing out inefficiencies in the way they deliver care. One obvious way to do that is to pay doctors and hospitals less—or kick out the providers who refuse to accept lower reimbursement rates. And that’s what United has done, according to the WSJ report from Melinda Beck.

“Doctors in at least 10 states have received termination letters, some citing ‘significant changes and pressures in the health-care environment,’” writes Beck.

Another one of my favorite health care policy experts is the ex-Canadian Sally C. Pipes, who knows all about the horrors of single-payer health care. It killed her mother! Here’s what she had to say about the doctors shortage in a Forbes magazine article from earlier this year.

The first problem is that we have an aging doctor population and since we do such a poor job of educating our children (public school indoctrination centers) we aren’t making any new ones:

Right now, the United States is short some 20,000 doctors, according to the Association of American Medical Colleges. The shortage could quintuple over the next decade, thanks to the aging of the American population — and the aging and consequent retirement of many physicians. Nearly half of the 800,000-plus doctors in the United States are over the age of 50.

The second problem is that adding more regulations and burdensome paperwork makes a lot of people not want to be doctors any more:

Obamacare is further thinning the doctor corps. A Physicians Foundation survey of 13,000 doctors found that 60 percent of doctors would retire today if they could, up from 45 percent before the law passed.

The third problem is that the government isn’t reimbursing doctors as much as private insurance companies do, and it makes them refuse to take government-funded patients:

They’ve long limited the number of Medicaid patients they’ll treat, thanks to the program’s low reimbursement rates. According to a study published in Health Affairs, only 69 percent of doctors accepted new Medicaid patients in 2011. In Florida, just 59 percent do so. And a survey by the Texas Medical Association of doctors in the Lone Star State found that 68 percent either limit or refuse to take new Medicaid patients.

Medicaid pays about 60 percent as much as private insurance. For many doctors, the costs of treating someone on Medicaid are higher than what the government will pay them.

These underpayments have grown worse over time, as cash-strapped states have tried to rein in spending on Medicaid. Ohio hasn’t increased payments to doctors in three years; Kentucky hasn’t raised them in two decades. Colorado, Nebraska, South Carolina, Arizona, Oregon, and Arizona all cut payments in 2011.

By throwing nine million more people into the program without fixing this fatal flaw, Obamacare will make it even harder for Medicaid patients to find doctors.

It’s not just Medicaid that’s the problem, either. It’s the government-controlled exchanges.

Healthcare providers are signaling that they may turn away patients who purchase insurance through the exchanges, too.

In California, for example, folks covered by Blue Shield’s exchange plan will have access to about a third of its physician network. The UCLA Medical Center and its doctors are available to customers of just one plan for sale through the state exchange, Covered California. And the prestigious Cedars-Sinai Medical Center is not taking anyone with exchange insurance.

Now I know what you’re thinking – why not just force doctors to work for lower wages, like a good socialist country might? Well, that actually makes the shortage worse, because people don’t like to learn hard things and then work hard for little pay. And doctors work VERY hard – it’s not an easy profession to get into. That will just make all the doctors leave the country for other countries where they can be paid fairly for the work they do.

And in fact that is exactly what happened in a 100% socialized health care system in Venezuela, according to this report from the left-leaning Associated Press.

Excerpt:

Half the public health system’s doctors quit under Chavez, and half of those moved abroad, Natera said.

Now, support staff is leaving, too, victim of a wage crunch as wages across the economy fail to keep up with inflation.

At the Caracas blood bank, Lopez said 62 nurses have quit so far this year along with half the lab staff. It now can take donations only on weekday mornings.

I recommend reading that entire article for a glimpse of where the Democrats are trying to take us. There is not a dime’s worth of difference on policy between the Democrat party and the socialist party of Venezuela, except that the socialists have been in control in Venezuela for longer, and so they are further along the road to serfdom.

In other news, the Washington D.C. insurance commissioner was fired after raising concerns about the “fix” proposed by Obama in his speech last week. That’s also something that you might expect to see in a country like Venezuela. That’s what happens in authoritarian socialist countries. Whistleblowers and critics just disappear.

Filed under: News, , , , , , , , , , , , , , , , , , , , , , , , ,

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