It's Time to Call This Obamacare Experiment an Utter Failure

WVU82_rivals

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May 29, 2001
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http://www.fool.com/investing/2016/07/16/its-time-to-call-this-obamacare-experiment-an-utte.aspx

Although this program was designed to facilitate competition among insurers, it's cost taxpayers more than $1.7 billion and left more than 800,000 people searching for a new health plan.

The Affordable Care Act, better known as Obamacare, is a controversial law, and we need look no further than survey statistics of how many people do and don't favor the health law of the land for evidence.

Since Obamacare was signed into law in March 2010, you can count on two hands how many months the Kaiser Family Foundation's Health Tracking Poll has observed a higher percentage of Americans favoring the law than not. On the other hand, we have more than 50 months' worth of readings suggesting that Americans, as a whole, aren't too thrilled about Obamacare.

What can't be debated are the enrollment figures, which the Centers for Medicare and Medicaid Services recently updated. Through the end of March, around 11.1 million people were enrolled through an Obamacare marketplace and paying their monthly premium. A nearly similar number of lower-income individuals and families have found coverage through the expansion of Medicaid programs in 31 states, which raised the eligible threshold for full coverage to 138% of the federal poverty limit from the tradition 100% of the FPL.

Based on data from both national pollster Gallup and the Centers for Disease Control and Prevention, Obamacare has helped push the uninsured rate to its lowest level on record.

Let's face the facts: This experiment was a failure
Another component of Obamacare that's now beyond debate is that its experiment with the risk corridor and healthcare cooperatives, or co-ops, was a complete and utter failure.

The risk corridor was designed as a method of risk-pooling for insurance companies to entice them to join Obamacare's marketplace exchange in order to create a competitive marketplace where consumers would have ample choices. The basic idea of the risk corridor was that overly profitable insurers would put their excess profits into a fund that would, in turn, pay out funds to insurers that were losing excessive amounts of money because they priced their premiums too low. The risk corridor was designed to give insurers a year or two to find the "sweet spot" where their premium prices made underwriting Obamacare plans sustainable.

The problem? There just weren't very many overly profitable insurers, and the federal governmentbacked outof its initial pledge to help fund the risk corridor with federal dollars if profitable insurers failed to generate enough money for the program. In total, insurers wound up requesting $2.87 billion worth of funds because of excessive losses but wound up receiving just 12.6% of this amount.

The result was the closure of more than half of Obamacare's healthcare co-ops heading into 2016. These 23 co-ops were to be run for the people, by the people, and they were designed to be a low-cost alternative to national health-benefit providers. Unfortunately, low premiums were also their demise, and the lack of risk-corridor funding pushed many to shutter their doors. Just this past week, three more healthcare co-ops -- Healthy CT in Connecticut, Land of Lincoln Health in Illinois, and Oregon Health Co-Op -- announced that they were shuttering their doors as well after extensive and unsustainable losses. Healthy CT will allow its roughly 40,000 members to maintain their plan through the remainder of the year, while Oregon's Co-Op will close at the end of this month.

With the closure of Healthy CT, Land of Lincoln Health, and Oregon's Health Co-Op, 16 of Obamacare's 23 alternative health-plan options have now shut down, costing taxpayers more than $1.7 billion, and causing more than 800,000 people to look for a new health plan in the coming months.

While Obamacare has had its share of success stories, this has most definitely not been one of them.

A boon to national insurers, but a headache to consumers
The closure of roughly two-thirds of Obamacare's healthcare cooperatives isn't great news for the consumer -- especially the highly cost-conscious consumer looking to buy the cheapest bronze or silver plan, which is often the space healthcare co-ops occupied. Less in the way of competition in each state, along with the absence of a low-cost option, could push prices considerably higher in the years that lie ahead.

We may already be witnessing this inflation, with the Kaiser Family Foundation, in an analysis of 14 major cities in June, estimating an average premium price increase for the lowest-cost silver plan in each city of 11%. For the roughly 15% of enrollees not receiving a premium subsidy, this magnitude of increase could be a tough pill to swallow.

On the other hand, the end of the risk corridor, and the simultaneous failure of two-thirds of Obamacare's approved health co-ops, could give the larger health insurers that chose to ride out Obamacare's hiccups new life.

Think about it this way: The risk-corridor program was designed to facilitate the entrance of new players by providing a financial floor for their losses. It also encouraged low-cost healthcare players to enter the playing the field. Without the risk corridor, we're unlikely to see many new entrants, and the chances of low-balling the premiums of national insurers decreases dramatically since insurers' plans need to be sustainable over the long-term. What this ultimately means is that national insurers are getting even more of their pricing power back.

AlthoughUnitedHealth Group waved the white flag in many of the 34 states it's operating in because of excessive losses, national insurers such asAnthem(NYSE:ANTM)could prove to be a big beneficiary of the co-op closures. Not only is Anthem's pending acquisition ofCIGNA going to broaden its reach and result in cost-saving synergies, but a lack of competition in select states should help it justify premium increases that keep it ahead of the cost curve of rising healthcare inflation.

Keep in mind that the failure of the risk corridor and Obamacare's healthcare cooperatives doesn't mean Obamacare itself has failed. With 85% of enrollees receiving some form of subsidy on their premium, they remain mostly shielded from premium price hikes. But for the remaining 15% who aren't receiving a subsidy, as well as those who aren't insured but have thought about purchasing insurance, things could be about to get a whole lot more expensive.
 
Sep 6, 2013
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Yep, my premiums stayed exactly the same, my prescription costs dropped significantly and I have friends with cancer that can now find insurance (not being dropped for catastrophic limits are not being denied because of a pre-existing condition).

What a failure.
 

MountaineerWV

Sophomore
Sep 18, 2007
26,324
194
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Yep, my premiums stayed exactly the same, my prescription costs dropped significantly and I have friends with cancer that can now find insurance (not being dropped for catastrophic limits are not being denied because of a pre-existing condition).

What a failure.

I know! I'm suffering like you, too.

Let's see, who is suffering here? Perhaps those business owners who use to pocket every bit of profit they could at the expense of offering their hardworking employees health insurance they much needed and desired? Oh...yeah....now there are claims that these business owners are having to "cut back" on employment opportunities, hours, and wages because of the health care law. Keeping those profits high, and blame the health care bill.....

And to tell the truth, they are "suffering" because they got so used to putting a lot more in their pockets while their employees went without coverage. I know, I have several family members who are small business owners and they ***** and complain about how much they DO NOT make anymore because of HAVING to offer insurance. And how they are looking for options to get around this so they can put more money in their pockets again. Yes.....that's true.
 

Airport

All-American
Dec 12, 2001
86,514
7,320
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I know! I'm suffering like you, too.

Let's see, who is suffering here? Perhaps those business owners who use to pocket every bit of profit they could at the expense of offering their hardworking employees health insurance they much needed and desired? Oh...yeah....now there are claims that these business owners are having to "cut back" on employment opportunities, hours, and wages because of the health care law. Keeping those profits high, and blame the health care bill.....

And to tell the truth, they are "suffering" because they got so used to putting a lot more in their pockets while their employees went without coverage. I know, I have several family members who are small business owners and they ***** and complain about how much they DO NOT make anymore because of HAVING to offer insurance. And how they are looking for options to get around this so they can put more money in their pockets again. Yes.....that's true.

Businesses are formed to provide goods and services that the owner hopes people want. It does not exist to provide a job for other people. Jobs are created by business if they are needed. Some businesses are very small and others are large. A business does not exist for employees, I know that socialist have a hard time understanding this. A business only exists if there are profits. Healthcare has become an enormous costs for business. Mandates from government has not lowered the cost. Businesses have raiised the deductible to keep the per month cost down. Businesses that have a certain number of employees that have to provide more benefits, with the economy growth not good enough to provide the revenues to absorb the cost, will not hire more people if the money is not there. Each business is free to operate, within the law, as it sees fit. I downsized my staff, cut back hours and cut back benefits. We do have a 401k but no health ins. I've lost 25% in revenues since 2011, what would you do? I have a family and bills to pay, several mortgages, etc.. I do not exist to provide more money for my staff. I exist to provide my services, a dentist, that people may or may not need. If you want better wages, do away with immigration of unskilled labor and undo government pressure on business in the form of taxes and future mandates. Without a job, you really don't care whether you have insurance or not.
 

Airport

All-American
Dec 12, 2001
86,514
7,320
113
Yep, my premiums stayed exactly the same, my prescription costs dropped significantly and I have friends with cancer that can now find insurance (not being dropped for catastrophic limits are not being denied because of a pre-existing condition).

What a failure.
How about your deductible? My group policy in 2000 for four people was less than my individual policy was three years ago. That was with a deductible of $250.00/ Blue Cross/Blue shield. Govt. mandates have done nothing. The same number of people that were not covered have remained the same since the ACA was implemented.
 

MountaineerWV

Sophomore
Sep 18, 2007
26,324
194
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Businesses are formed to provide goods and services that the owner hopes people want. It does not exist to provide a job for other people. Jobs are created by business if they are needed. Some businesses are very small and others are large. A business does not exist for employees, I know that socialist have a hard time understanding this. A business only exists if there are profits. Healthcare has become an enormous costs for business. Mandates from government has not lowered the cost. Businesses have raiised the deductible to keep the per month cost down. Businesses that have a certain number of employees that have to provide more benefits, with the economy growth not good enough to provide the revenues to absorb the cost, will not hire more people if the money is not there. Each business is free to operate, within the law, as it sees fit. I downsized my staff, cut back hours and cut back benefits. We do have a 401k but no health ins. I've lost 25% in revenues since 2011, what would you do? I have a family and bills to pay, several mortgages, etc.. I do not exist to provide more money for my staff. I exist to provide my services, a dentist, that people may or may not need. If you want better wages, do away with immigration of unskilled labor and undo government pressure on business in the form of taxes and future mandates. Without a job, you really don't care whether you have insurance or not.

Well, perhaps your Republican politicians could get out from under the tit of the Health corporations and work to get them to lower the costs and then perhaps a universal health care plan would not be needed????? Instead, keeping the status quo of "ah, health insurance is not needed" attitude just isn't going to cut it. At one time, don't you think people said "we don't need to spend tax dollars on these roads, bridges, schools, etc."??? Just like the creation of those, the beginning years will ALWAYS be worse than the later years once it has established itself.
 

mneilmont

Sophomore
Jan 23, 2008
20,883
166
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Businesses are formed to provide goods and services that the owner hopes people want. It does not exist to provide a job for other people. Jobs are created by business if they are needed. Some businesses are very small and others are large. A business does not exist for employees, I know that socialist have a hard time understanding this. A business only exists if there are profits. Healthcare has become an enormous costs for business. Mandates from government has not lowered the cost. Businesses have raiised the deductible to keep the per month cost down. Businesses that have a certain number of employees that have to provide more benefits, with the economy growth not good enough to provide the revenues to absorb the cost, will not hire more people if the money is not there. Each business is free to operate, within the law, as it sees fit. I downsized my staff, cut back hours and cut back benefits. We do have a 401k but no health ins. I've lost 25% in revenues since 2011, what would you do? I have a family and bills to pay, several mortgages, etc.. I do not exist to provide more money for my staff. I exist to provide my services, a dentist, that people may or may not need. If you want better wages, do away with immigration of unskilled labor and undo government pressure on business in the form of taxes and future mandates. Without a job, you really don't care whether you have insurance or not.
Did you get copyright protection on this? May I use it frequently to explain to those who lack basic understanding of the business world?

You have got to be one of those greedy business owners who got into business to screw your employees. How can you live with yourself when you will not sacrifice your profits for your employees jobs? Can you not cut your annual vacations? How about children's clothing allowance? You will probably vote for Trump. Did you get your education just for money to buy all the niceties and required equipment for your profession?
 

Airport

All-American
Dec 12, 2001
86,514
7,320
113
Well, perhaps your Republican politicians could get out from under the tit of the Health corporations and work to get them to lower the costs and then perhaps a universal health care plan would not be needed????? Instead, keeping the status quo of "ah, health insurance is not needed" attitude just isn't going to cut it. At one time, don't you think people said "we don't need to spend tax dollars on these roads, bridges, schools, etc."??? Just like the creation of those, the beginning years will ALWAYS be worse than the later years once it has established itself.

Yep, governmented. Poeple like you think that govt is the answer. If you want a starting point, let insurance companies sell across state lines. Your hero Obama fashioned the plan, those who are smart knows it was designed to fail. They were so arrogant tht they thought they would come back and institute a single payer plan. The public figured things out and kicked the dems out. The public wants nothing to do with ACA, and they have showed it.
 

Mntneer

Sophomore
Oct 7, 2001
10,192
196
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Yep, my premiums stayed exactly the same, my prescription costs dropped significantly and I have friends with cancer that can now find insurance (not being dropped for catastrophic limits are not being denied because of a pre-existing condition).

What a failure.

You are the ONLY person I "know" that can make such a claim. I don't know a single person who's had premiums drop, most all had 15%+ increases, along with increases in deductibles, and I personally know a family who's struggle since the passage of the ACA to get family coverage because of a son with a heart condition.

Then I talk to my wife, who works on the billing side of the industry and I'm convinced, the next potential economic bubble will be health care. It can't be sustained the way it's going.
 

mneilmont

Sophomore
Jan 23, 2008
20,883
166
0
You are the ONLY person I "know" that can make such a claim. I don't know a single person who's had premiums drop, most all had 15%+ increases, along with increases in deductibles, and I personally know a family who's struggle since the passage of the ACA to get family coverage because of a son with a heart condition.

Then I talk to my wife, who works on the billing side of the industry and I'm convinced, the next potential economic bubble will be health care. It can't be sustained the way it's going.
Obamacare will insure everyone at a lower cost. It is amazing that people would actually agree with that when they were trying to sell it. They even got upset with us when we said "no way in hell". We were even called racists for saying it.

All of the costs have not hit yet and still have people who believe in Obamacare. $20 trillion will look pretty damned good within 3-4 years. Nice about getting old - die and leave it.
 

MountaineerWV

Sophomore
Sep 18, 2007
26,324
194
0
We (The United States) spends over $35 BILLION of taxpayer dollars each year to give aid out to foreign countries, but Americans get pissed off because the government spends tax dollars in an attempt to alleviate the health insurance problem this country has (and yes, we have a problem folks).....We have sick and dying kids here, in the United States, that do not have health insurance......but you guys don't want a dime of your precious tax $$$ spent to help that.....but let's keep giving BILLIONS to other country's kids who are starving or have illnesses. Wow.....
 

Airport

All-American
Dec 12, 2001
86,514
7,320
113
We (The United States) spends over $35 BILLION of taxpayer dollars each year to give aid out to foreign countries, but Americans get pissed off because the government spends tax dollars in an attempt to alleviate the health insurance problem this country has (and yes, we have a problem folks).....We have sick and dying kids here, in the United States, that do not have health insurance......but you guys don't want a dime of your precious tax $$$ spent to help that.....but let's keep giving BILLIONS to other country's kids who are starving or have illnesses. Wow.....

I don't have a problem with cutting back foreign aid. But, if you think govt programs are clost effective, I have oceanfront property in Nevada I want to sell you.[winking]
 

DvlDog4WVU

All-Conference
Feb 2, 2008
47,277
3,354
113
I know! I'm suffering like you, too.

Let's see, who is suffering here? Perhaps those business owners who use to pocket every bit of profit they could at the expense of offering their hardworking employees health insurance they much needed and desired? Oh...yeah....now there are claims that these business owners are having to "cut back" on employment opportunities, hours, and wages because of the health care law. Keeping those profits high, and blame the health care bill.....

And to tell the truth, they are "suffering" because they got so used to putting a lot more in their pockets while their employees went without coverage. I know, I have several family members who are small business owners and they ***** and complain about how much they DO NOT make anymore because of HAVING to offer insurance. And how they are looking for options to get around this so they can put more money in their pockets again. Yes.....that's true.
Thank you for illustrating so well your complete and utter lack of understanding of corporate economics.

And if you want lower healthcare costs and the conversation doesn't start with Tort Reform which would reduce the malpractice insurance requirements then we needn't continue this conversation.
 

bornaneer

All-Conference
Jan 23, 2014
30,989
1,700
113
Thank you for illustrating so well your complete and utter lack of understanding of corporate economics.

And if you want lower healthcare costs and the conversation doesn't start with Tort Reform which would reduce the malpractice insurance requirements then we needn't continue this conversation.
Every Republican healthcare reform proposal has always started with Tort Reform. Guess who is stuffing money into the pockets of Democrat lawmakers across this country.
 

DvlDog4WVU

All-Conference
Feb 2, 2008
47,277
3,354
113
Every Republican healthcare reform proposal has always started with Tort Reform. Guess who is stuffing money into the pockets of Democrat lawmakers across this country.
Hahahaha, talk Tort Reform and the left gets really squeamish. Go it one further, talk max fee % of 10-15% and see if they don't just pass out.
 

BigLickMountee

Redshirt
Nov 10, 2003
26,693
6
0
Every Republican healthcare reform proposal has always started with Tort Reform. Guess who is stuffing money into the pockets of Democrat lawmakers across this country.
the sheer number on the books makes it impossible to change it into something that not only works well for the country but improves the health of its recipients.
 

mule_eer

Freshman
May 6, 2002
20,439
59
48
Hahahaha, talk Tort Reform and the left gets really squeamish. Go it one further, talk max fee % of 10-15% and see if they don't just pass out.
I hate the hard limit tort reform - mainly because it screws over the victims when someone in the healthcare industry really screws up. Texas did a hard limit, and cases where people incurred lifetime expenses in the millions got capped at something like $250k. I'll add that I've never been a big fan of "pain and suffering" expenses being given, and I'm fine with dropping or severely limiting those sorts of payments. I do think that if you can show what new expenses you've incurred due to malpractice, those should not be capped. That just makes most of those people dependent on the state anyway, and it usually leads to those same people filing bankruptcy despite winning a max settlement.

I've proposed the idea of trying to limit malpractice insurance costs by having malpractice insurance provided by the state as part of the medical licensing fee. The state is already reviewing the credentials of the doctors, so this shouldn't be that hard to do. The licensing fees go up significantly, but the malpractice insurance costs are gone. You can add some level of tort reform into that system as well, something based on expected value of anticipated new expenses or losses due to the results of the malpractice. I guess the hard part here would be to define how to determine loss in the case where someone died, especially a child. The loss there is not a financial one. You'd get a lot of screaming about putting a price on a life when you capped that.
 

mneilmont

Sophomore
Jan 23, 2008
20,883
166
0
I hate the hard limit tort reform - mainly because it screws over the victims when someone in the healthcare industry really screws up. Texas did a hard limit, and cases where people incurred lifetime expenses in the millions got capped at something like $250k. I'll add that I've never been a big fan of "pain and suffering" expenses being given, and I'm fine with dropping or severely limiting those sorts of payments. I do think that if you can show what new expenses you've incurred due to malpractice, those should not be capped. That just makes most of those people dependent on the state anyway, and it usually leads to those same people filing bankruptcy despite winning a max settlement.

I've proposed the idea of trying to limit malpractice insurance costs by having malpractice insurance provided by the state as part of the medical licensing fee. The state is already reviewing the credentials of the doctors, so this shouldn't be that hard to do. The licensing fees go up significantly, but the malpractice insurance costs are gone. You can add some level of tort reform into that system as well, something based on expected value of anticipated new expenses or losses due to the results of the malpractice. I guess the hard part here would be to define how to determine loss in the case where someone died, especially a child. The loss there is not a financial one. You'd get a lot of screaming about putting a price on a life when you capped that.
Help me with the difference in cost of malpractice insurance going to an insurance company, and a like amount added into the state license fee? The complaint is the cost of doing business, not the recipient of the payment. Surely you are not suggesting the state underwrite that liability. Most states are at or near bankrupt now if they accept accrual accounting.

Ambulance chasing lawyers and liberal jurors are the problem. There has to be some limitations placed on the rewards, and some sort of reasonableness attached to the legal fees. Perhaps jurors need a quick study of the economic impact on the people who ultimately pay those maxi-awards.
 

mule_eer

Freshman
May 6, 2002
20,439
59
48
Help me with the difference in cost of malpractice insurance going to an insurance company, and a like amount added into the state license fee? The complaint is the cost of doing business, not the recipient of the payment. Surely you are not suggesting the state underwrite that liability. Most states are at or near bankrupt now if they accept accrual accounting.

Ambulance chasing lawyers and liberal jurors are the problem. There has to be some limitations placed on the rewards, and some sort of reasonableness attached to the legal fees. Perhaps jurors need a quick study of the economic impact on the people who ultimately pay those maxi-awards.
The state wouldn't operate for profit, so that would limit the cost some. I agree that some awards are excessive - paying people for pain and suffering instead of incurred expenses, now and into the future. I'm fine with limiting pain and suffering penalties. If you can provide a basis for a large settlement based on cost of current and future healthcare or related costs, I don't think that should be limited. If the current value of those expenditures is a handful of million, I'm fine with that as the decision. I'm not so good with several million because your piano playing days are over.
 

mneilmont

Sophomore
Jan 23, 2008
20,883
166
0
The state wouldn't operate for profit, so that would limit the cost some. I agree that some awards are excessive - paying people for pain and suffering instead of incurred expenses, now and into the future. I'm fine with limiting pain and suffering penalties. If you can provide a basis for a large settlement based on cost of current and future healthcare or related costs, I don't think that should be limited. If the current value of those expenditures is a handful of million, I'm fine with that as the decision. I'm not so good with several million because your piano playing days are over.
That sounds like a definite maybe. You are willing to pay a handful of millions and I would not disagree if you can prove "pain and suffering" Offered by a lawyer who bills as a % of total. Why not put a cap on that billing? And you want to reduce the state fee by some profit amount that the company might receive. Do you add cost of new clerical staff at the gov't agency? Or is it OK to allow taxpayers to fund that?

Do you differentiate in your fee structure between the Drs who have never been found guilty of negligence vs. those who have had to be deported for negligence?

How much do you pay a prodigy piano player who can never play again.
 

mule_eer

Freshman
May 6, 2002
20,439
59
48
That sounds like a definite maybe. You are willing to pay a handful of millions and I would not disagree if you can prove "pain and suffering" Offered by a lawyer who bills as a % of total. Why not put a cap on that billing? And you want to reduce the state fee by some profit amount that the company might receive. Do you add cost of new clerical staff at the gov't agency? Or is it OK to allow taxpayers to fund that?

Do you differentiate in your fee structure between the Drs who have never been found guilty of negligence vs. those who have had to be deported for negligence?

How much do you pay a prodigy piano player who can never play again.
I'm fine with the pay out being in the millions if that level can be justified. You'd have to set specifics for what you might pay out - lost earnings to some level, medical expenses, etc. Also, you act as if attorneys are just raking in all sorts of money in all of these cases. The build up to trial usually means that the attorney is floating expenses for the case. Most attorneys eat those expenses if they lose the case. There's a risk on the part of the attorney. They shouldn't be compensated? You could push it all to a fee based system, and that's part of what gets paid if the case is won. I'm not sure I'm opposed to that, but that's a regulatory thing.

The state will incur some cost, and figuring out how to pay for that is part of the discussion. I'm not saying this is the solution. It's something that I've thought might work, and I have never heard any discussion of it before. I do know that the federal government (FEMA in particular) does flood insurance because the cost of it commercially is very high. You could look to that as a model for your fee basis. Some areas are higher risk than others with respect to flooding - do the people in higher risk areas pay more for that insurance?

I knew the piano playing thing would come back to that question. If you earn a living playing piano, that's something that could go into the calculus of lost earnings.
 

WhiteTailEER

Sophomore
Jun 17, 2005
11,534
170
0
You are the ONLY person I "know" that can make such a claim. I don't know a single person who's had premiums drop, most all had 15%+ increases, along with increases in deductibles, and I personally know a family who's struggle since the passage of the ACA to get family coverage because of a son with a heart condition.

Then I talk to my wife, who works on the billing side of the industry and I'm convinced, the next potential economic bubble will be health care. It can't be sustained the way it's going.

You don't know me, but my premiums dropped slightly as well. No change to my deductible.