Tag Archives: health care

An Unintended Consequence

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The health coverage plan providers, companies like Humana, Aetna, Anthem, et al., are gaming the Medicare system to keep their Medicare bonuses coming in.  Surprise.

It seems that when Obamacare was passed, it included a system of paying bonuses from Medicare to those plan providers that got sufficiently high ratings on the quality of their plans.

But wait….

Medicare ranks privately managed plans…on a five-star quality scale and provides financial bonuses to providers of top-ranked plans. [A plan-holder’s] plan was set to be downgraded, which would have cost Humana its bonus. So the company merged plans covering [the plan-holder] and more than a million others into different contracts with higher scores. That preserved the bonuses.

That’s called cross-walking, and it’s entirely legal, if maybe a tad shady.

This is the sort of thing that happens, though, when Government intrudes itself too far into a marketplace.  Private enterprise is more agile than government bureaucracies can ever hope to be, and they can move much faster than any government bureaucracy can hope to do.

It’s also why black markets flourish in centrally planned economies.

The existence of this ability to cross-walk is a function of our Federal government’s intervention in what should be a free, competitive market.  The question wouldn’t even exist if we had an actual health insurance industry that operated free of Government fetters in an actual freely competitive market.

A New Insurance Plan

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Idaho has one.  Blue Cross of Idaho says it’s going to take advantage of newly issued State regulations to start marketing a plan that won’t meet Obamacare requirements, and they’re going to sell the plan alongside its existing Obamacare-compliant plans.

The Idaho Department of Insurance last month became the first state regulator to say it would let insurers begin offering “state-based plans” for consumers that involved practices generally banned for individual insurance under the ACA, including tying premium rates to enrollees’ pre-existing health conditions.

In particular,

The new Blue Cross state plans’ premiums would vary based on an enrollee’s health status—for instance, for one of its new plans, the insurer suggested that the best rate for a healthy 45-year-old could be around $194.67 a month, while a person of the same age with worse health could pay as much as $525.69. For one of its “bronze”-level ACA plans, the premium for a 45-year-old, regardless of health history, would typically be around $343.09, the insurer said.

Risk-based premiums.  What a concept.  And lower risk brings a premium roughly half the Obamacare risk-be-damned charge.

A New Welfare Trap

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This one is in the offing at the State level, and comes as a result of the punitive tax for not buying health coverage was repealed last December.

At least nine states are considering their own versions of a requirement that residents must have health insurance….

And

Maryland lawmakers are pursuing a plan to replace the ACA mandate, which requires most people to pay a penalty if they don’t have coverage. California, Connecticut, Hawaii, Minnesota, New Jersey, Rhode Island, Vermont, and Washington, as well as the District of Columbia, are publicly considering similar ideas.

Notice that.  These are Progressive-Democrat-run states.

The less well off who couldn’t afford either the penalty or the remaining costs—high deductibles, low per centage of plan provider payments even after “coverage” kicked in—under Obamacare still won’t be able to afford mandated coverage in these States.

Beyond that, they won’t be able to leave the State and relocate to one that doesn’t inflict these costs.  Their already limited economic resources are a barrier to such relocation.  Added to that, though, will be the lack of portability of the mandated coverage plans: having been dragooned into one by, say California or DC, they won’t be able to take it with them, even to Connecticut or Minnesota.  Or to a State that doesn’t require them to buy something they don’t want.

Progressive-Democrats really are that desperate to keep their welfare “recipients” trapped in welfare cages. Aside from that bit of self-serving…nonsense…the move also demonstrates the Progressive-Democrats’ utter contempt for us Americans.  We are, their behavior and policies say, just too mind-numbingly stupid to be entrusted with our own choices.  We have to be led by our Betters, forced for our own good, to do certain things.

Working for a Living

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Indiana has joined Kentucky in getting approval to add a work requirement to its Medicaid program (separately: Federal approval should not be a requirement; the program should be a State-run and -funded program only).

Of course, there are objections.

Democrats and consumer groups are decrying the GOP push, saying it is antithetical to Medicaid’s goal of expanding health care.

That’s plainly not true, though (I’ll ignore the conflation of health care with health care coverage).  The push is exactly what’s needed to make health care coverage available to all who want it.  The plan, even as minimal as this one is (the work-related requirement would apply only to a small segment of Indiana’s Medicaid enrollees), will facilitate availability, not limit it.  By making it possible for folks to get off this welfare program and into jobs that can enable them to buy their own coverage—if they want it—it will allow the State’s Medicaid dollars be committed to those who truly need Medicaid because they’re too old, too young, and/or too infirm to get desired coverage on their own.

It’s a Start

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The Centers for Medicare & Medicaid Services has been instructed by President Donald Trump to adjust its rules to allow the States to adjust their own rules to require work for Medicaid payments.

This is a very good start.  There are two remaining steps, though.  The funds transferred to the States in support of Medicaid need to be converted to block grants with no strings attached.  Each State knows its own medical support needs far better than does the Federal government.

The last step is to begin reducing, over a short number of years, the size of those block grants until no funds at all are being sent to the States.  This will get the Feds out of the States’ business, remove an extortion tool from the Feds’ kit which the Feds use to push the States into doing (or not doing) things the Feds demand be done or not done, and it will greatly reduce Federal spending.  In 2016, the Federal government sent almost $350 billion to the States in Medicaid transfers.