It's not just United Health, Blue Cross/Blue Shield and boutique commercial insurers initially praised by the president as a model for his massive healthcare experiment. The trend of health insurance providers losing money on Obamacare's disproportionately older and sicker (and therefore more expensive to cover) enrollees is a nationwide problem that's driving companies out of the individual market and forcing rates upward. Fewer choices, higher costs, and disappointing enrollment statistics. Via John Sexton, here's a Politico report on the 'Affordable' Care Act's unstable, unsustainable status quo:
For the insurance companies doing business in the state–the ones issuing policies to those 600,000 people–Obamacare has turned into a financial sinkhole. UnitedHealth Group, the nation’s largest insurance company, is pulling out of the Obamacare business in North Carolina next year. Blue Cross Blue Shield of North Carolina, which dominated the individual market with more than a half-million customers, reported that losses on its Obamacare business in 2014 and 2015 topped $400 million. The insurer said that figure includes government payments designed to shield insurers from big losses during the early years of Obamacare. The only other current competitor, Aetna, wants to hike rates by nearly 25 percent next year...
What's happening in North Carolina is repeating itself in state after state across the country and represents the most acute structural threat to the marquee achievement of President Barack Obama's presidency. A POLITICO review of 2015 financial filings from nearly 100 health plans across a dozen geographically and politically diverse states found that less than a quarter of them hit the standard break-even point for insurers, at which payouts are kept to about 85 percent of premiums taken in. And 40 percent of them had medical costs that outright exceeded the premiums they brought in. Those numbers do not include government payments that compensate plans for particularly high-cost customers. Even so, many of those insurers lost tens of millions of dollars on their Obamacare policies last year — and now they're seeking big rate hikes.
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Hillary Clinton, who basically invented Obamacare, looks at all of this and thinks, "it's working." Her campaign just started attacking Mike Pence for wanting to repeal the law -- which is actually a pretty popular position, so I hope they keep it up. And as Obamacare's co-ops keep dropping like flies (undercutting one of the "solutions" she mentioned in this revealing exchange), she's also re-embracing the so-called public option. As is the White House. The public option was defeated in 2009 and 2010 because even the Pelosi/Reid Democratic majorities couldn't muster the votes to sustain a provision that would have created a government option on the exchanges -- which critics correctly noted would undercut and subsume the private market, resulting in many more Americans being dumped into the government-funded and -operated "option." Democrats' infamously-shattered "like your plan" pledge, aimed at the large majority of Americans who were satisfied with their existing arrangements, would have disintegrated for even more consumers, a lot sooner. And now they're pushing for it again. People who don't want to keep their plan or doctor, who would like to see a hastened demise of the private market, and who would prefer something closer to the VA's scandal-plagued and bureaucrat-run system should vote for the Democrats. Otherwise, there's an alternative, which we discussed last month. Here's conservative healthcare wonk Jim Capretta giving an overall thumbs-up to that House GOP's Obamacare replacement plan:
The plan is practical. It recognizes that more than 150 million Americans are enrolled in job-based health-insurance plans today, and, for the most part, they like what they have. These workers and their families are not that interested in proposals to upend employer-sponsored plans based on the promise of something better on the other end. To their credit, the authors of the House GOP plan recognized this reality. The only change for employer-sponsored coverage in the House plan is an upper limit on the tax preference for such coverage, set at a level that would bring cost discipline to the most expensive job-based offerings (the plan did not specify the level of the upper limit but made clear that it would affect a relatively small percentage of plans). This upper limit would replace the despised “Cadillac tax” of the ACA, which imposes a 40 percent excise tax on all plans above a certain threshold...
For individual and families who do not have access to employer coverage, the House GOP plan would provide a refundable tax credit that could be used to offset the premium of a health-insurance plan. The tax credit would be available to anyone who wasn’t offered an employer plan, regardless of their income, so it would provide much more help to the middle class than the ACA’s premium credits, which are gradually reduced as household income rises and eliminated altogether for families with incomes above four times the federal poverty line. The tax credits in the House proposal are a very important part of the overall plan. With this proposal, the House GOP can rightfully say that it has offered a plan that would ensure that all Americans have access to affordable health insurance. There would be no reason for anyone in the United States to go without health insurance if they want it.
And here's Capretta explaining how the detailed, sweeping Republican post-Obamacare proposal would resolve the 'pre-existing conditions' problem, which was one of the more politically and morally potent arguments in favor of changing the pre-Obamacare system:
The plan also addresses the question of consumers with expensive pre-existing conditions. Insurers would be barred from charging higher-than-normal premiums to, or restricting coverage for, customers who have stayed continuously insured. This means that people who have a chronic condition, or have previously battled an expensive disease like cancer, can move freely from employer coverage to the individual market, and vice versa, without penalty so long as they have continued to stay covered. Unlike the ACA, which may be encouraging some young and healthy people to go uninsured (since they can wait until they get sick to buy coverage, knowing that insurers will be legally required to insure them), the House plan provides strong incentives for everyone to stay insured and thus remain under the umbrella of the plan’s “continuous coverage protection” approach.
Read the whole column, as well as Capretta's piece refuting the president's recent contribution to the Journal of the American Medical Association defending his failing and unpopular law. Fittingly, Obama originally issued some of his most egregious false promises in support of the Obamacare legislation at...the American Medical Association. Which reminds me that it's always a good time to re-up this video:
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