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To: Broken_Clock who wrote (959068)	8/25/2016 12:16:37 AM
From: Broken_Clock	Respond to of 1575826

Stiglitz Blasts 'Outrageous' TPP as Obama Campaigns for Corporate-Friendly Deal Andrea Germanos, staff writer Nobel Prize-winning economist Joseph Stiglitz has reiterated his opposition to...

To: Broken_Clock who wrote (959068)

8/25/2016 8:15:29 AM

From: FJB

1 Recommendation

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locogringo

Respond to of 1575826

A Public Option Would Cause More Problems for Obamacare’s Private Insurers, and That’s Probably the Point

The remarkable cascade of bad news from this spring and summer about the status of the Affordable Care Act — a.k.a. Obamacare — is convincing even the law’s ardent defenders that a problem is brewing:

Aetna announced that it is pulling out of eleven of the 15 states where it currently sells products on the ACA’s exchanges because of continued large financial losses from these products. The company has lost $430 million since January 2014 on insurance plans sold through Obamacare, with more losses coming through the remainder of this year.

Other major national insurers have also pulled back substantially from their participation in the ACA. United Healthcare has lost $1.3 billion so far on the exchanges and will reduce its participation in the program from 34 states to just three in 2017. Humana is reducing its participation in the program from 19 to eleven states.

Blue Cross Blue Shield of Tennessee estimates that it will have lost $500 million on the state’s exchange by the end of 2016. The insurer asked and received permission from the state’s insurance regulator to hike premiums 62 percent for 2017. The other major insurers in the state — Cigna and Humana — have received permission to raise premiums by 46 and 44 percent, respectively.

Texas Blue Cross has lost $1 billion on the ACA exchange in two years, and has asked for a 60 percent premium increase for 2017.

Blue Cross and Blue Shield of Minnesota has largely pulled out of the insurance exchange for 2017 because of $500 million in losses during the first three years. The Blues plan in North Carolina has lost $400 million on the ACA exchange and is currently evaluating whether to continue participating in the program in 2017 and beyond.

The average premium increase nationwide for plans offered on the ACA exchanges is 24 percent for 2017. In California, where premium growth for insurance plans offered on the state’s exchange was relatively modest in 2015 and 2016, the average increase for 2017 will be 13 percent.

The consulting firm McKinsey estimates that between 12 and 17 percent of exchange customers will be picking from plans offered by only one insurer in 2017.

Overall, the insurance industry is taking large losses from the plans they are offering because the risk profile of those signing up for coverage is much worse than they anticipated, or priced for.

The law’s defenders argue that some insurers are doing just fine, and that is true. But, in general, the plans that are surviving more closely resemble the managed-care plans offered to Medicaid recipients with very narrow networks of physicians participating in the plans. These are not the kind of insurance products typically offered to workers in the employer-sponsored setting.

Moreover, as the big national insurers pull back from participating in the exchanges, their high-expense enrollees will have to go somewhere to get coverage, and most likely that means enrolling in plans that, so far at least, haven’t yet experienced large losses. With more high-cost enrollees shifting their way, it wouldn’t be surprising if some of the plans that turned profits in the first three years saw those profits vanish in 2017.

It is not possible to operate an insurance market with an industry-wide negative margin. For a private-insurance market to survive, the insurers, on average, have to cover their costs plus a profit with their premium collections.

Pro-ACA advocates are now offering a three-part plan to shore up the exchanges. First, they are calling for a concerted marketing campaign aimed at persuading the young and healthy to sign up for coverage on the exchanges. Second, they propose deducting student-loan payments from the income calculation used to determine the subsidy amounts available to insurance enrollees. This would presumably benefit mainly younger applicants. Third, and most significantly, they want to resurrect the idea of a “public option” competing alongside the private plans.

The effort to draw in more young and healthy people is unlikely to succeed. The insurance offerings on the exchanges are appealing only for people who are getting most of the premium and cost-sharing requirements covered by federal subsidies. For everyone else, the plans are unattractive because the premiums are high (and rising), the deductibles are well above what most people are accustomed to, and many physicians are not participating in the plan networks. Better marketing will not change any of that. More generous subsidies for those with student loans might help at the margin, but it is unlikely to be sufficient to overcome all of the other reasons people are steering clear of the ACA products.

The public option is an entirely different matter. If the problem is an unstable environment for private insurance, a public option is definitely not the solution.

If the problem is an unstable environment for private insurance, a public option is definitely not the solution.A public option would be a government-sponsored and government-run insurance plan, probably modeled on the traditional Medicare program, which would be offered to customers on the exchanges as an alternative to the private-insurance plans. Unlike a private-insurance plan, there’s no particular reason why a publicly run product couldn’t experience ongoing losses, so long as the law provided for direct or indirect taxpayer subsidization. The Medicare program itself is funded heavily by taxpayer subsidies.

The most consequential difference between public and private insurance is the ability to regulate prices. Private insurers must negotiate contracts with their networks of hospitals and physicians. Public insurance, like Medicare, is in the business of regulating prices, not negotiating them. Medicare, for instance, sets regulated prices for the services it covers on a take-it-or-leave-it basis. Because Medicare is so important to the bottom lines of many providers, they have no choice but to take what Medicare pays, even though it is usually well below what private insurers pay for the same services.

But government-imposed price controls always have a predictable result, which is reduction in those willing to supply the service at the regulated price. This is evident in the Medicaid program. Many hospital and physicians purposely steer clear of the program because of its very low reimbursement rates. As a result, Medicaid enrollees often have much more trouble accessing care than do patients with private insurance.

This does not mean that a public option wouldn’t attract enrollment. It probably would because the regulated prices it would pay to providers would allow it to charge a premium below that charged by many of the private offerings. Some consumers would take that option not thinking much about what it might mean when it comes time to find a doctor to take care of them.

In selling Obamacare to the electorate, President Obama argued repeatedly that the law wouldn’t lead to “government-run” health care because the coverage would be delivered by private insurance, at least for those who get their insurance through the exchanges. But this was always more of a debating point rather than a statement based on conviction. The president himself has always favored public over private insurance, as do most of those who supported the legislation. The only reason a public option wasn’t included in the ACA in the first place was because a sufficient minority of Democrats in Congress feared the idea would sink the entire bill.

Now that the ACA is on the books, and the private-insurance options are on shaky ground, there’s no real reason for proponents of the ACA not to fully embrace the public option. It’s what most of them wanted all along, and the turbulence among the private insurers provides the perfect excuse to pursue it.

The fact that introducing a public option at this stage would only add to the instability of the private options offered on the exchanges is not a reason for the public-option advocates to abandon the idea because they never really wanted a functioning private-insurance marketplace anyway. The goal all along has been government-run health care, even if they haven’t always been willing to admit that.

— James C. Capretta is a resident fellow at the American Enterprise Institute.

To: Broken_Clock who wrote (959068)	8/25/2016 6:47:05 PM
From: John Vosilla	1 Recommendation Recommended By Old Boothby Respond to of 1575826

Should You Consider Medi-Share for Health Insurance? Here’s Our Take Health insurance can be incredibly expensive, especially if you don’t have coverage through your employer. And now that you can get fined under the Affordable Healthcare Act (ACA) for not being insured, some frugal families — particularly those who aren’t interested in Obamacare — are checking out other options. If you’ve heard ads for Medi-Share, you might be intrigued by its promises to cover your health care costs, so you don’t have to get government-mandated insurance. Curious? We looked into the details to find out how Medi-Share works — and whether it’s a good option for you. Here’s our honest, unbiased review of the program. What is Medi-Share?Medi-Share is a health-care sharing ministry made up of members united by their faith. This program and similar medical-sharing ministries are exempt from the rules of the ACA. They rely on their members to take care of one another through financial contributions, as well as prayer. The details work much like typical health insurance. Like having a deductible, members choose an amount they’ll contribute as a household before they can submit bills to the community for payment assistance. A monthly share payment works like a premium, ensuring your eligibility for assistance, should you need it. There’s no guarantee your medical expenses will be covered through Medi-Share, and there are plenty of exemptions to consider before you apply. But if you’re particularly religious — and healthy — you may want to consider this alternative to traditional health insurance. How Much Does Medi-Share Cost?First, the up-front costs: It costs $50 to apply, and you’ll pay a $120 one-time member fee with your first monthly payment. You’ll pay another one-time fee of $5 to have America’s Christian Credit Union (ACCU) set up your “sharing account,” and you can then save $3 per month by choosing to receive ACCU electronic statements. As for your monthly payment options, Medi-Share’s system is sort of like choosing a health insurance deductible and monthly premium. As an example, we calculated costs for a 30-year-old woman seeking membership for herself only. Share amounts change annually, based on the oldest member of the household. If she chose a $1,250 annual household portion — the amount of medical bills you have to pay completely before you’re eligible for sharing — her standard monthly share would be $235. If she met certain health and fitness requirements, she could qualify for a Healthy Monthly Share, which would lower her cost to $207 per month. When you need medical care and visit a Medi-Share provider, you pay $35 for doctor visits and hospitalizations, and $135 for emergency room visits. A search for providers near The Penny Hoarder HQ in St. Petersburg, Florida, turned up 171 doctors, including plenty of nearby options for internal medicine, pediatrics and even specialties like sports medicine. You submit the rest of your bills to Private Healthcare Systems (PHCS) for payment consideration. “We do not collect premiums, make promise of payment, or guarantee that your medical bills will be paid,” the Medi-Share website explains. “Sharing of medical bills is completely voluntary.” Christian Care Ministry, which operates Medi-Share, is a 501(c)3, but your payments aren’t tax-deductible. We asked personal finance blogger Philip Taylor (no relation to our founder Kyle Taylor), about his Medi-Share costs for his family of five. He signed up for Medi-Share in 2014, and has updated his review of the service several times since joining. Taylor initially signed up with a family share of $277 per month, which was a huge savings over his old insurance premium of $1,100 per month. “My share cost is now $288 per month,” he says. “So we’re still experiencing a tremendous amount of savings.” Do You Need to Be Religious to Use Medi-Share?Just as Medi-Share embraces the idea of a community of members supporting one another, it also believes in having a membership that embraces Christian lifestyles. The organization may even interview a church leader to verify your involvement before granting you membership. In addition to eschewing tobacco and illegal drug use, applicants “must only engage in sexual relations within a Biblical Christian Marriage.” And as you might suspect, Medi-Share doesn’t cover abortions or treatment for sexually transmitted infections. Medi-Share also assumes that if you’re willing to take care of your Christian community by sharing the burden of medical bills, you’ll do your best to take pretty good care of yourself. Some health conditions, like obesity, high cholesterol or diabetes, put applicants in the mandatory Health Partner program, which pairs you with a health coach and costs an extra $80 per month. What If You Have an Ongoing Health Condition?While this might be an appealing option if you’re healthy, anyone who suffers from a chronic health issue is probably better off turning to an ACA health insurance program for coverage. “The primary purpose of Medi-Share is to help share members’ burdens,” the program explains. “Burdens are those unexpected medical bills you are unable to plan for (ie. broken bones, cancer, etc). Low monthly share amounts enable you to budget for your family’s routine care, which can be planned.” Prescription drugs can be eligible for cost-sharing, but only for up to six months for the lifetime of the member. Likewise, if you have mental health conditions, you probably won’t benefit financially from Medi-Share. “Those with persistent mental health conditions, who need expensive prescriptions and therapy, would likely not see much benefit from becoming a member,” The Atlantic explained in a report on Medi-Share and similar programs. But here’s the big catch: Routine health screenings aren’t eligible for cost-sharing either. Well-patient care like annual physicals, pap smears and well-child checkups aren’t included. Dental and vision care aren’t eligible, either. For instance, if your doctor recommends getting a colonoscopy because you’ve reached a certain age, you can’t submit the test for Medi-Share payment. If you have symptoms warranting the same test, the program might grant payment. So, Is Medi-Share Legit?Here’s our conclusion: Medi-Share isn’t a scam. It’s totally legal and there’s a strong membership base to support it and similar programs. But it’s likely not the most affordable health care option for most people. The ideal candidate for Medi-Share is in excellent health and also has a robust savings account to pay out of pocket for routine medical care. One risk: Medi-Share and other cost-sharing programs aren’t subject to regulation like typical ACA programs. So while a typical health insurance benefits booklet might clearly explain what’s covered and guarantee coverage up to a certain amount or percentage, Medi-Share participants might not be able to figure out ahead of time which medical bills will be paid by the program. In addition, the cost-benefit analysis might not work in your favor. For example, let’s look at what one of our writers pays for health insurance. She has coverage through her state’s ACA exchange and pays $220 per month. She has a deductible of $1,500 and pays $25 each time she visits any doctor’s office. Medication for her ongoing conditions costs her less than $10 per month with her plan’s coverage. She might not be as wholesome as the typical Medi-Share member, but she’s paying about the same to stay in pretty good health. While Medi-Share probably isn’t the best financial choice for most people, it does at least serve as an option for anyone who doesn’t have access to a job-sponsored health insurance plan or who finds individual ACA coverage options prohibitively expensive. Taylor explained the magic combination of factors that makes Medi-Share worth considering: If you: Don’t have access to an employer-based group health insurance plan, don’t mind being held to the lifestyle standards, make enough money to miss out on Obamacare subsidies, and don’t have ongoing major medical issues. He noted that a Medicaid or ACA plan probably better serves those with chronic conditions. For Taylor, the numbers definitely work out. “I feel bad for those that don’t have this choice,” he said. Your Turn: Have you tried Medi-Share? We’d love to hear about your experience. http://www.thepennyhoarder.com/medishare-reviews/