Thursday, September 11, 2014

Healthcare.gov the Sequel

Hard to believe it has been almost a year since Obamacare gave birth to healthcare.gov. 

The first year for hc.gov was in many ways no different from the first year of life for a newborn.

The crying, constant attention, midnight crises, messes that need to be cleaned up. This billion dollar baby was never really ready for prime time.

And it still isn't.

Bob Laszewski at Health and Policy Market pretty much nails it.
With almost no valid claims data yet and the "3Rs" Obamacare reinsurance program, insurers have little if any useful information yet on which to base 2015 rates and the reinsurance program virtually protects the carrier from losing any money through 2016. I've actually had reports of actuarial consultants going around to the plans that failed to gain substantial market share suggesting they lower their rates in order to grab market share because they have nothing to lose with the now unlimited (the administration took the lid on payments off this summer) Obamacare reinsurance program covering their losses.
We won't know what the real Obamacare rates will be until we see the 2017 rates––when there will be plenty of valid claim data and the Obamacare reinsurance program, now propping the rates up, will have ended.

This kind of analysis has flown under the radar, at least for the general public.

The translation goes like this.

Those who bought subsidized Obamacare plans haven't really seen the impact this new way of doing business has pushed premiums higher. Taxpayer funded subsidies hid the real cost of health insurance from the participants.

On the carrier side the scenario is similar. At this point the carriers have less than 6 months of real claim data and it is probably more like 3 months.

In addition to nominal claim data the federal reinsurance program (also funded with tax dollars) will shield the carriers from realizing the impact of large claims. 

2015 rates are just a wag at this point.

It will be another 2 years before the claim data is mature enough to evaluate AND the government reinsurance program goes away and carriers realize the real cost of this mess.
The HealthCare.gov backroom is not built yet––a year and counting after it should have been.
How many people are enrolled in Obamacare? Without a government to insurance company accounting system yet built, no one knows. 

Yes, that's right. Goodluck.gov is still incomplete. No one really knows how many people are insured, how many have paid, how many received a subsidy (but weren't legally entitled to), and how many that bought coverage on the exchange had prior coverage.

In spite of the claims of success by D.C. the truth is, they don't have the metrics to back up their claims.

And they probably don't care since they are accountable to no one.
While the administration tells Obamacare policyholders their automatic renewal will go smoothly, the fact is every one of these subsidy-eligible people needs to go to the exchange website and re-enroll. 
Major glitch.

This is deja vu all over again.

Even if you like your Obamacare plan you can't keep it.

Even if you like your taxpayer subsidy you can't keep it.

You have to re-enroll via healthcare.flub to find out what your new plan and new subsidy will be.

An estimated 5 million will need access to 404.gov in order to complete the re-enrollment process plus an estimated 5 million new enrollees will the site be ready?

Oh, and did I mention the window of opportunity begins on 11/15/14 and ends 30 days later?

No worry.

Been there done that with the "energy crisis". Some of us are actually old enough to remember endless waits in line just to get $3 worth of gas.

Of course gasoline was a lot cheaper then.

And so was health insurance.


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