President pushes ObamaCare despite double-digit rate hikes

[Teh One Who Knocks]

FOX News and The Associated Press


http://i.imgur.com/33NKQXb.jpg

Despite rate and deductible increases, President Obama on Thursday defended his namesake health care program and said millions of Americans “now know the financial security of health insurance” because of the Affordable Care Act.

His remarks came as ObamaCare sticker shock is getting even worse in some parts of the country, as more and more states are approving soaring rate increases for next year- with one Arizona town seeing a 75 percent hike and another in Minnesota seeing a 190 percent increase in deductibles over the course of four years.

“It’s absolutely unaffordable,” Minnesota Republican House Speaker Kurt Daudt told FoxNews.com. “I don’t even consider that health coverage.”

With some families forced to shell out $2,000 a month for insurance that comes with a whopping $13,000 deductible, Daudt said for some the only option is to pull their coverage and pay a fee for not having insurance, which in 2016 came out to $695 per adult and $347.50 per child (up to a maximum of $2085.)

“It’s catastrophic,” Daudt said, adding that he’s talked to Minnesotans who are being forced to financially drop their coverage, pay the fine and save money on the side for medical emergencies.

However Obama, speaking in Miami, maintained “It’s worked,” but admitted the program wasn't perfect. “No law is.”

Obama was in south Florida to trump up support for the ACA before the Nov. 1 start of the enrollment period.

Problems with rising premiums in many parts of the country as well as major insurers calling it quits have left consumers with few or in some cases no choices next year.

The hikes are fueling criticism of the law, though the White House is now openly pushing the possibility of a public option.

The troubles have bolstered arguments of Republicans and added some top Democratic allies to the crowd of critics, including former President Bill Clinton, who called ObamaCare “the craziest thing in the world,” while Minnesota Gov. Mark Dayton said it’s “no longer affordable.”

In Arizona, after months of health insurer exits from the Affordable Care Act marketplace, state regulators have approved plans from two companies that will be the only marketplace insurance providers in 2017.

Maricopa County residents' only health care option will be Centene Corp., which said it will sell its “Ambetter” plans at a 74.5 percent increase next year.

The amount people pay will vary on their age, coverage levels and income, which in turn will determine whether an individual qualifies for subsidies that help offset the cost of monthy premiums. Nearly 70 percent of Arizonans with a marketplace plan get subsidized coverage.

Jumps in finalized rates for big health insurance plans around the country illustrate the challenge the Obama administration faces as it seeks to stabilize the president’s landmark health care legislation before he leaves office.

According to a roundup by The Wall Street Journal, market leaders continuing to sell coverage through HealthCare.gov or a state equivalent are seeking premium increases of 30 percent of more in Delaware, Hawaii, Alabama, Mississippi, Kansas and Texas.

In Montana, Oklahoma, Tennessee and Pennsylvania, the approved rate increases for the market leader top 50 percent.

Blue Cross Blue Shield in New Mexico agreed to start selling plans through the online exchanges after pulling out last year. They agreed to return to the state only if they would be allowed to increase rates 93 percent of their 2015 level.

[RBP]

His push for a "public option" is expanding Medicaid. This despite the fact that medicaid in some states is run through managed care organizations (MCO) now because it's gotten so complicated. So there's a profit layer in there that muddies the water on "public".

But the elephant in the room is that Medicaid reimbursement rates are so incredibly low that health care facilities cannot exist on Medicaid alone without being completely understaffed, mismanaged, shitholes, if then. Private insurance has always defacto subsidized Medicaid. Hospital, doctors, clinics, can sometimes afford to see a limited number of medicaid patients because they have reasonable reimbursements from private insurance. Unless the whole reimbursement structure is fixed, that would be completely disastrous.

If they want to go that route they have to blow it up and start over.

[deebakes]

:ffs:

[lost in melb.]

His push for a "public option" is expanding Medicaid. This despite the fact that medicaid in some states is run through managed care organizations (MCO) now because it's gotten so complicated. So there's a profit layer in there that muddies the water on "public".

But the elephant in the room is that Medicaid reimbursement rates are so incredibly low that health care facilities cannot exist on Medicaid alone without being completely understaffed, mismanaged, shitholes, if then. Private insurance has always defacto subsidized Medicaid. Hospital, doctors, clinics, can sometimes afford to see a limited number of medicaid patients because they have reasonable reimbursements from private insurance. Unless the whole reimbursement structure is fixed, that would be completely disastrous.

If they want to go that route they have to blow it up and start over.

So what's the solution, if any? By that line either you raise that rate (and bankrupt the state) or scrap it and bring in a private system that excludes those that can't afford it?

[RBP]

So what's the solution, if any? By that line either you raise that rate (and bankrupt the state) or scrap it and bring in a private system that excludes those that can't afford it?

I do not know. And frankly. it's not my job to figure it out. But our politicians are uninformed at best, and lying at worst.

[Godfather]

His push for a "public option" is expanding Medicaid. This despite the fact that medicaid in some states is run through managed care organizations (MCO) now because it's gotten so complicated. So there's a profit layer in there that muddies the water on "public".

But the elephant in the room is that Meidicaid reimbursement rates are so incredibly low that health care facilities cannot exist on Medicaid alone without being completely understaffed, mismanaged, shitholes, f then. Private insurance has always defacto subsidized Medicaid. Hospital, doctors, clinics, can sometimes afford to see a limited number of medicaid patients because they have reasonable reimbursements from private insurance. Unless the whole reimbursement structure is fixed, that would be completely disastrous.

If they want to go that route they have to blow it up and start over.



I do not know. And frankly. it's not my job to figure it out. But our politicians are uninformed at best, and lying at worst.

That's a good recap for an outsider... I just don't understand why he'd push so hard for this unless it was fully universal coverage? Why was it ever launched until a plan was in place to make it available and affordable to all? The need for private healthcare should in theory be next to none when the government is insuring you (up here all my extra healthcare does through work covers is dental, optional semi-private hospital rooms and TV's, and a few other none-covered frills like massage and eye check-ups - plus half my monthly MSP premium of about $30)?

Disagree with the premises or not, if it was going to get launched, there are a dozen countries they could've consulted with who are getting it done more efficiently/cheaper...

Then again you hear about these US hospital bills where an IV drip 'costs' $200 whereas up here MSP is billed dollars or pennies by hospitals/docs for the same thing. There's something fucky on the hospital's end too no?

[RBP]

That's a good recap for an outsider... I just don't understand why he'd push so hard for this unless it was fully universal coverage? Why was it ever launched until a plan was in place to make it available and affordable to all? The need for private healthcare should in theory be next to none when the government is insuring you (up here all my extra healthcare does through work covers is dental, optional semi-private hospital rooms and TV's, and a few other none-covered frills like massage and eye check-ups - plus half my monthly MSP premium of about $30)?

Disagree with the premises or not, if it was going to get launched, there are a dozen countries they could've consulted with who are getting it done more efficiently/cheaper...

Then again you hear about these US hospital bills where an IV drip 'costs' $200 whereas up here MSP is billed dollars or pennies by hospitals/docs for the same thing. There's something fucky on the hospital's end too no?

I can kind of explain the $200 thing. Such numbers are thrown around all the time, but they are meaningless. What that usually represents is a "billing rate". That's what some hospital "charges". The "charge" is then compared by an insurer to a "reasonable and customary" scale. If it's too high, it is reduced to an "allowed" charge. The "allowed charge" is then compared to a "negotiated rate" which is the reimbursement schedule the hospital agree to in contract negotiations. Or, in the case of Medicare and Medicaid, accepting those patients means you agree to the governments stated reimbursement rate that is non-negotiable.

In the IV example, let's say the hospital charges $200. The allowed charge may be $90. The negotiated or stated reimbursement rate may be $20. That's before deductibles, coinsurance, or copays are applied.

The $20 might end up being paid by the patient or partially covered by the insurance carrier. But you'll get an explanation of benefits (EOB) that shows you how your insurance carrier saved you $180.

Wow, that was close, thank God I'm insured! My insurance saved me $180!!

no it didn't *eye roll* Those were all bullshit numbers to begin with.

[RBP]

Which, by the way, is why I am extremely skeptical (dismissive?) of comparisons between system costs. I don't know what comparisons they use to determine it; you can't compare American "billing" rates to single payer total expenses.