Hey now, as an actual actuary in the health field, I can tell you for sure that whoever the heck wrote that law was most assuredly NOT working for the interests of my company, nor of my field, nor of any company I know, nor in the interests of any health actuary I know. Pretty much the entire field of health actuaries thinks ACA is decidedly non-scottish.
Rubbish. I'm an economist and I was paid almost $40K by my own state to estimate the costs of universal care here in Alaska. Boy they must not have liked my report because they buried it so deep I am probably the only one with a copy of it now. This isn't of pedestrian interest to me. One of the things I did in that report was demonstrate how vastly superior a single payer system was than the rube-Goldberg piecemeal approach alternatives they had me consider.
Here is a Forbes article for demonstrating how optimistic insurance companies are about profit growth expected from Obamacare (before they got the rug pulled out from them):
http://www.forbes.com/sites/brucejapsen/2013/10/26/despite-glitches-obamacare-profit-windfall-to-insurers-well-underway/
Liz Fowler, as vice president of WellPoint whose profit increases are discussed in the article above, wrote the 87 page White Paper that served as a foundation for the law, and she has been publicly credited for that by, for example, Senator Max Baucus. Let Google do the work for you there, I want to focus on pointing out to people the ghastly train wreck that is coming. This is something of vital importance and we have to set down partisan crap so that we can all come to an understanding about what is happening.
Actually, only two of them are tax-funded, and one of those is directly taxed. The Risk Adjustments are zero-sum market neutral; fees for the administration of that program are assessed directly to insurance policyholders at the state level.
That is exactly right, thank you. I thought too about emphasizing the taxpayers were subsidizing, not 100% covering losses. The reason that is important is because they will still be losses and the insurance company lobbyists will go into overdrive trying to amend the law or get more executive orders to compensate, and this chaos is one of the things that is the most frightening about what is developing. They have every right to demand the law be changed again to cover the losses because it was the government who removed the mandates that made it possible for the insurance companies to profit from Obamacare. You have to understand that the biggest problem is a cascade of one "fix" requiring another "fix" and this has been dealt with by unconstitutional executive orders instead of congress re-writing the law. There are grave questions here going beyond just the health care law but go straight to the root of how the rule of law is supposed to work.
Except that employer coverage, at least for large employers, doesn't really work that way. They don't get cancelled in the same fashion. Insurers work collaboratively with the employer to alter or replace the coverage so that it is in compliance. The employees won't find themselves in the wind in the same way that policyholders in the individual market have.
Look, please work with me here and be absolutely forthright. I need people that deeply disagree with me philosophically to come together on this and shed light on what is happening. Employer provided policies are being made illegal. Employers will pay far more for these policies and the workers will suffer from reduced pay on account of it. They will also do things like stop employment at 49 people to evade the law, etc. Do not pretend they are not being cancelled and that there will be nothing to worry about because they are not being cancelled "in the same way".
Someone asked what is different about this than other countries. Let me emphasize better what is going to happen that scares the willies out of me:
First of all, the Administration is lying about "enrollments". Prior to the debacle the HHS considered someone enrolled if they
paid for a policy. You are not insured unless you PAY for it. How many have actually PAID for an insurance plan and are INSURED? Well since the back end of the system that actually pays insurers has not been started yet, that number might be zero. Is there anyone on this forum who has both selected an actual plan and paid for it willing to please tell us about it?
Since the roll-out was a debacle, the Obama administration has been using the term "enrollment" in a different way in order to make the numbers look better even though they are ghastly enough as it is.
The back end of the system concerns what are called the 834 transactions. These are all the data transfers and administration that actually gets policies paid for and put into effect. One analyst I read indicated it would take a year to straighten this part of it out but it is certainly more time than the weeks they gave their new administrative Czar to fix.
The security concerns are another thing, not just because it will be a system rife for offing with people's information for identity theft, but because that fear will also keep healthy people from signing up whereas the deathly ill are not going to care anywhere near as much because the stakes are so high from them.
When the website is fixed insofar as the USERS are concerned, and this is the only thing the Obama administration has promised to the tune of only 80% - we will have millions upon millions of people who think they have "enrolled" but for which no policy has actually been put into effect because it has not been paid for and because the insurance companies are getting garbage 834 data like they told us in the beginning. The administration is refusing to tell us what the error rate is in the 834's now and that tells us all we need to know.
So while the administration right now touts "enrollment" figures, as appalling as they may be, nobody is going to give a damn that they are "enrolled" if they
don't have insurance. To get it, it has to be
purchased.
Amazon dot com and any other private sales company has one metric: you either bought the product and it will be delivered to you, or you have not bought it and it will not be delivered. If you put something in your shopping cart but the computer does not let you make the transaction then sure, you can call that "enrollment", but the product is not yours and when you go to the doctor there is no insurance to pay for your service.
So it is simply irrelevant whether people on December 1 are capable of "enrolling". The question should be
can they buy insurance. The way the law is written you have to go through the Obamacare computer nightmare in order to qualify for a subsidy. You can purchase the insurance that is legal by going directly to the insurance company instead -
but you will have to pay the full cost.
I urge all of us to set down our rose-colored glasses and partisan bickering to come to a full understanding of how much worse this is than Obama is admitting. It is hard to know if he sees it and is too afraid to face the facts or if he is really this ignorant. Giving a speech is one thing, but managing a takeover of 1/6th of the economy is altogether another. We are watching Obama make knee-jerk political reactions to get through the day but which undermine the very law he pushed through - and the more of it he does the greater chaos there will be. He had to keep the employer and individual mandates in order for this to work, and instead of abandoning the mandate to have the penalty for not enrolling ratchet up every year to ensure the healthy people are subsidizing the sick. They have already abandoned that and the law cannot work without it.
I have no glee over what I see coming. It scares me and I am not a republican who thinks this disaster is good for my team. My team is my wife and children.
