The head of the federal healthcare exchange, Kevin Counihan, has been writing a lot of letters these days begging state commissioners to have mercy on the Administration and not approve big rate increases for ObamaCare plans next year.
His letter reads like a last-ditch effort by a boyfriend or girlfriend who knows they have done a lot of wrong to their significant other but is promising to change and do anything to keep the relationship going.
Insurance commissioners will soon approve the final rates for 2016 that insurers will charge customers both with ObamaCare and those who purchase individual plans through brokers outside of the ObamaCare exchanges.
Counihan is trying to stave off double-digit percentage price increases for some -if not most- ObamaCare clients across the country as insurers deal with the realities of a pool of customers who are sicker and use more services (submit more health claims) than the Administration promised. This will be very public and very painful for the pockets of ObamaCare customers when they get walloped with higher costs.
Counihan contends that newly enrolled ObamaCare customers are healthier than the first wave of enrollees so “risk pools” are expected to get healthier leading to fewer claims. Also, as the ObamaCare penalty doubles and triples over the next year to $325 or 2 percent of income for 2015 then $695 or 2.5 percent of income for 2016, they’re betting that those who opted to pay the fine rather than buy ObamaCare will have new motivation to purchase coverage. In addition, the Centers for Medicare and Medicaid Services (CMS) recently announced a couple of programs to pick up a bigger part of the tab from ObamaCare customers.
How convincing is Counihan’s arguments? Like a neglected significant other reading a list of promises they’ve heard before, commissioners don’t have much reason to trust with Counihan’s promises.
CNBC reports:
Despite HHS' arguments to the contrary, several insurance experts said Counihan's letter reflects legitimate worry that many 2016 rates will be significantly higher than now.
Kev Coleman, head of research and data for insurance comparison site HealthPocket.com, said the letter suggests, "The government is very concerned about the proposed rate increases, and the government is trying to aggressively arm state insurance commissioners with data to help them defend pushbacks on these proposed increases."
Robert Laszewski, president of Health Policy and Strategy Associates, said, "My first reaction is that they 'protest too much' if there isn't really a problem here."
"There is a problem, Laszewski said. "Not every carrier in every state but there is a clear pattern of the largest carriers with the most data having unacceptable financial results under the Affordable Care Act and responding with very large increases."
"By sending this letter the administration is clearly saying they have a problem," he said. "But jawboning in the face of hard data showing unacceptable results is going to have very little impact."
"Counihan argues that the experience should improve as more people enter the risk pool. The problem with that is not nearly enough people entered the risk pool, in the 2015 open enrollment. More troubling, the states that had big surges the first year had little or no growth the second year—California, Washington, Colorado, New York for example. This has actuaries very worried." Actuaries help insurers set premium prices by calculating expected health costs from customers.
"Only about 40 percent of those eligible for the Obamacare insurance exchanges signed up through the second open enrollment," Laszewski said. "We need to be closer to 70 percent. By income category, only the poorest are signing up with less than 20 percent of those making between 251 percent and 400 percent of the poverty level signing up."
"These numbers are simply not sustainable."
…
Counihan's letter comes on the heels of a number of news stories highlighting some of the larger proposed rate hikes.
And insurance companies are projecting that most people will be enrolled in plans with rates that are proposed to rise less than 10 percent.
HHS officials have also repeatedly stressed the fact that more than 80 percent of the over 10 million customers on government Obamacare exchanges receive subsidies that help offset the cost of their coverage.
Those subsidies are worth an average of $272 per month, which means that a double-digit percentage increase in plan prices would lead to much less dramatic increases for many customers in absolute dollar terms.
However, millions of people buy individual plans outside the exchanges, where subsidies are not available.
The Administration is trying to portray this as no big deal because–as they boast–more than 80 percent of the over 10 million ObamaCare customers on the exchanges received taxpayer-funded subsidies to help offset the costs of their coverage. So they posit that even if plan prices rise Obamacare clients won’t feel so much of the pain.
Do you know who will feel the pain? Us as taxpayers subsidizing these plans and taxes and fines built into the un-Affordable Care Act. The money must come from somewhere and what the Administration hides is that uncomfortable truth.
One of the biggest criticisms of ObamaCare is that it fails to even fulfill its official name – being affordable. ObamaCare distorts the healthcare market and drives prices for health insurance higher for too many people. The government then steps in with money to offset the higher costs. It is a vicious circle.