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How Long Will Health Insurers Continue to Put Up With Obamacare?

People are gaming the system, and losses in the health law's exchanges are piling up.

Whitehouse.govWhitehouse.govObamacare’s defenders have long insisted that its mandate to purchase health insurance was necessary to prevent people from gaming the system—signing up for coverage under the law in advance of expected high medical bills, then dropping coverage after those expenses have been incurred. Combined with a limited annual enrollment period, the mandate would prevent that sort of behavior, ensuring that everyone paid consistently into the system.

To make sure this plan works, however, requires fairly stern enforcement: Everyone either buys coverage or pays a fine, and those who don’t have to wait until next year’s enrollment period to get insurance. Ideally, almost everyone buys coverage and then stays covered, and it all just works.

In practice, that’s not how it’s turned out. Enrollment has been more sluggish than initially expected, with just about 12 million sign-ups likely this year. That’s better than the 10 million or so officials projected back in October, but far less than the 21 million the Congressional Budget Office estimated as the law was taking shape.

Part of the problem seems to be that people are finding ways to game the system by signing up outside of the limited annual enrollment period and then dropping insurance shortly after. The law has a number of exemptions that allow people to buy coverage at any time throughout the year, such as changing or losing a job, having a child, moving, and getting married.

The people who come in via those special enrollment exemptions, it turns out, are far more expensive to cover. In an earnings call last November, an executive with UnitedHealth, the nation’s largest insurer, said that people buying in outside of the standard enrollment period cost about 20 percent more. UnitedHealth, which covered about 700,000 people through Obamacare’s exchanges last year, issued a bleak warning about its losses in the exchanges, which it put at about $425 million, and declared that there were no indications that the picture would improve in the coming year. The company threatened to drop out of the program entirely.

UnitedHealth’s announcement was understandably viewed by many as bleaker than was really accurate, an attempt to get all the bad news out of the door at once. But it turns out that the company’s losses were actually far worse than initially estimated. On Tuesday, the company downgraded its earnings forecast, and said that losses would probably be more like $500 million.

The administration responded this week by tightening rules surrounding the special enrollment periods, eliminating a half dozen special events that would qualify someone to sign up outside the standard enrollment period, at any time during the year.

This move may be too small a move to make much difference. There are still dozens of qualifying events left on the books, giving motivated people plenty of leverage and opportunity to sign up mid-year. Or it may mean that, at the margins, more people don’t sign up at all, further depressing the low overall sign-up totals.

The big long-term question raised by all this is whether Obamacare can keep insurers on board. UnitedHealth’s participation isn’t strictly necessary to keep things going, but it may signal a larger problem.

Aetna, for example, has already dropped out of the exchange market in two states. A dozen of the 23 non-profit co-op plans backed by the law have already closed up shop, causing about 600,000 people to lose health plans, and a Politico analysis indicates that most of the remaining co-op plans are in trouble. Blue Cross Blue Shield of Texas and North Carolina both lost a sizable chunk of money on its exchange business during the program’s first year. The financial outlook for a number of insurers participating in Obamacare, in other words, doesn’t look good. And there are few signs that it is set to improve in the near future. 

Maybe these are just growing pains as the law comes online. But as UnitedHealth's warnings indicate, insurers will only put up with this for so long, and only if there's hope of a payoff down the road, a hope that looks fairly dim. The insurer's analysis of the Obamacare marketplace going forward was about as grim as could be. “We saw no indication of anything actually improving,” one company executive said during the earnings call in November. “The trends are not going to improve.” This week’s announcement of even bigger losses than previously expected suggest that the gloomy outlook may be the right one.

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  • Heroic Mulatto||

    Your next multi-million dollar idea, courtesy of Youtube comments:

    Andulasis 1 month ago
    +Indy There is an app like Tinder where you meet with people you wanna fight with
    

    Say what you want, but that's fucking brilliant. Imagine the Scottish market alone.

  • ||

    Who needs Tinder? I know what my family look like.

  • Hamster of Doom||

    Word.

  • Heroic Mulatto||

    Some of us are only children, bro.

  • Agammamon||

    Parents? Cousins?

  • Agammamon||

    Spouse? Children of your own?

    There's a ton of options for some intra-family warfare.

  • Heroic Mulatto||

    To be fair, the context of the app is fist-fights.

  • Plàya Manhattan.||

    No weapons? That's bullshit.

  • Heroic Mulatto||

    There's the Tinder of fights and then there's the Grindr of fights.

  • Agammamon||

    Fistfights with *gay* relatives?

    Fabulous!

  • MSimon||

    Fights with lesbians. I want to see who gets licked.

  • Florida Man||

    No weapons? That's bullshit.

    I choose sabers. If you're still pissed enough to fight after someone thrust an edged weapon in your hand, it's probably a legit gripe.

  • Agammamon||

    Fist fights are the most *honest* part of family relations.

  • Heroic Mulatto||

  • ||

    Irish. Bare knuckles and weapons of convenience (blunt unless they break sharp) No knives.

  • Kevin Sorbos Manful Locks||

    +1 common sense shillelagh control.

  • Heddin_South||

    @Agammamon Parents? Cousins?

    Both, maybe?

  • Tak Kak||

    "There is an app like Tinder where you meet with people you wanna fight with"

    I thought it was all a marketing hoax

  • Florida Man||

    I don't really see a fix. The best solution is a completely free market and decoupling from employer programs, but so many people are use to "free" insurance, I don't see them advocating for that.

  • Agammamon||

    Whenever there's a problem created by government that needs to be solved, none of them ever offer 'let's just undo the government regulation that caused the problem in the first place' as a solution.\

    Which is really sad since the 'problem' the government solution was supposed to fix in the first place is an attempt to fix *another* problem caused by government regulation - wage freezes during the Great Depression - that simply isn't applicable anymore.

    We don't have a government-mandated wage freeze so there's no need for companies to compete on benefits to attract employees. So there's no need to give a tax break to medical benefits when paid for by the employer to help them out. So there's no need for people to have employer-sponsored insurance policies. So there's no need for people to worry about things like 'portability' or not being able to afford 'proper' insurance because your employer doesn't offer it. So there's no need to build a huge edifice that spits in the face of the rule-of-law to provide insurance for significantly less than 10% of the population that was going uninsured.

  • Florida Man||

    I'm sympathetic to those born severely disabled. I believe Americans are generous enough on the whole to provide charity for these people. I would if I wasn't being robbed to the tune of 40 percent.

  • Agammamon||

    ut we're talking about health *insurance* here. Insurance is NOT a medical payment plan. Its a risk-management tool. Its there to cushion the worst blows that life can throw at you. Someone born severely disabled may need health 'welfare' - but they're already past the point that insurance is intended for.

    They don't need to hedge against calamity - its already happened, now they need a way to pay those bills. Insurance is for the healthy *in case* they become severely disabled.

  • Agammamon||

    In any case - health care and health insurance would, like pretty much everything else, be far more affordable to those of lesser means if there were far less regulation preventing competition from ruthless searching for and exploiting efficiency gains in the search for profit.

  • Florida Man||

    You are correct. I always think of the disable during insurance discussions because they are the equivalent of piles of dead children in gun debates.

  • some guy||

    It's a valid point. If a person is born disabled, they have had no opportunity to purchase insurance against becoming disabled. These are really the only people who have anything close to an expectation of charity.

    And yet the majority of people bankrupted by medical expenses were not born with a disability.

    I'd almost be for a system that has universal health care for those children and a truly free market for adults, as a compromise against the current system. Theoretically, it addresses all the people who honestly drew a short straw in childhood, while forcing adults to take responsibility for themselves or suffer the consequences. This may not be as good as a completely free market, but it would be much better than the current system. Of course, it would never get passed because too many people are unwilling to responsibility for themselves in adulthood.

  • Florida Man||

    I honestly believe charity could cover the congenitally disabled. Hopefully with better screening and genetic counseling we can get close to zero Americans born disabled.

  • some guy||

    I agree that charity could cover all childhood heath needs, not just the congenitally disabled. We'll never get back to that system, though, because of politics.

  • Agammamon||

    The thing is - there are actually *functional* government run health care schemes.

    Smelly snail-eaters actually have a really good single-payer health care system. But, and this is the part that almost impossible to believe, I mean its *France* after all, the government doesn't actually *run* health care provision.

    http://www.ncbi.nlm.nih.gov/pm.....MC1447687/

    And that's the problem with the US - all the working 'socialist' states work by taking a hands-off approach at the lower levels and simply layering on (punitively IMO) redistributionist taxes. But US politicians will not get behind a program that doesn't give them opportunities to meddle.

    France's health care sector is built much the same way - government mostly stays out of who gets what and how much care from who and mainly concerns itself with managing the overall funding.

  • some guy||

    The thing is - there are actually *functional* government run health care schemes.

    Depends on what your definition of "run" is. Your own comment indicates a difference between paying for something and actually "running" it. I think we will all agree that less government involvement is always going to be better.

    Also, I'd argue that our scheme is functional based on my own experiences with it. It's just damned expensive and soul-suckingly frustrating. But you can almost always get the service you need in a timely manner if you are willing to spend a lot of time on the phone with generally unpleasant people.

  • Agammamon||

    Of course, it would never get passed because too many people are unwilling to responsibility for themselves in adulthood.

    Well that and also because people like me would resent having to help bear the burdens of those who choose to have children.

    While I'll accept that having a disabled child is an excessive burden on par with starving in the street - and so 'voluntarily' contribute to a mandatory charity scheme for those parents - children *in general* are a *choice* and I firmly believe that people need to bear the *full* consequences of their choices - after all, they get the full benefits of those choices and without facing the full costs their incentive structure is skewed.

  • some guy||

    Well that and also because people like me would resent having to help bear the burdens of those who choose to have children.

    Understood. I'm not saying it's the best solution, just that it would be much, much better than the current situation and would address the best argument the bleeding hearts have for universal health care.

    Also, I'd point out that for some people, having a child they can't afford isn't seen as a burden at all. As a result, the child bears the full consequences of its parents' decision. Of course, you'd have to completely restructure the criminal justice system if you wanted to force parents to take responsibility for their children... (just thinking out loud now.)

  • Will Nonya||

    There seems to be a lot of violent agreement. The fly in the ointment is that anytime we identify a group as special, minority or disabled people push to expand the definition for inclusion in those groups.

    Under this charitable plan how long before anyone who doesn't achieve a stellar IQ is considered disabled and therefore entitled to free medical care?

    It isn't that far fetched and would provide a gateway to coverage for all but the elite among us.

  • MarkLastname||

    I would say that if there's one segment of the population for which I'm sympathetic toward socializing anything, it's children. Some measure of guaranteed health care for minors is as justified as almost any government program could be. Pretty unfair to have to die of a curable disease because one's parents are too stupid, lazy, apathetic, or unlucky to buy insurance.

  • Hamster of Doom||

    Repeal EMTALA, no more certificates of need, apply collusive pricing regulations to the industry like every other industry in the country, and stand back and watch the market do its thing.

    Actually, I'm good with stopping at "repeal". All of it. Take every medical law, loophole and regulation on the books and chuck 'em. The market will find a balance.

    Solving the problems in the Middle East, curing disease and poverty - these things are complicated. Fixing medical industry pricing schemes is merely math, and fifth grade math at that.

  • Florida Man||

    Now I want you to find 3 random people and tell them you want to decouple insurance from their employer/gov and they pay directly for their insurance like auto/home and watch their heads explode.

  • Hamster of Doom||

    In this county, I may not know three people who pay for their own insurance by any means. On the other hand, as you inferred, mathematically their feelz don't mean shit. Mathematically, they are demanding a solution to an equation that cannot work. They can feel whatever they want, get all explody-heady-tantrumy, and all I have to do is wait.

    I don't even get mad, brah. When you see someone banging nitroglycerine canisters together to scare away the dark, best thing to do is quietly find a corner a long way away and leave them to it.

  • Catatafish & Woodchips||

    "I don't even get mad, brah. When you see someone banging nitroglycerine canisters together to scare away the dark, best thing to do is quietly find a corner a long way away and leave them to it."

    Thank you for this, Hamster. I needed it.

  • Tommy_Grand||

    i pay for all of it, so u know 1

  • Hamster of Doom||

    Are you out my way? Small world! So, are you related to my husband, or did you just go to school with him/his sisters? Apparently the entire county falls into one of these.

  • robc||

    You dont know 3 self employed?

  • The Last American Hero||

    Except the person banging the cannisters is the government, and the number of people telling them to bang harder outnumbers you 10 to 1. So what corner of the country are you supposed to go to and hide?

  • RAHeinlein||

    I pay 100% of my insurance - so that's two...

  • Overt||

    And technically, people getting insurance from their employer are paying their own as well. That a company takes a portion of their total compensation and applies it to a health insurance premium is just accounting gimmicks.

  • Agammamon||

    Its weird how people think its just fine that they pay their own insurance in *every other part* of their lives but health insurance is primarily through their employer.

    And never consider that all their other insurance is relatively inexpensive - except the one policy that they have the least control over and is the most heavily regulated.

  • some guy||

    Oh there are plenty of people who will complain about their ridiculous auto insurance. They're the ones constantly getting tickets and fender benders.

  • Hamster of Doom||

  • some guy||

    Do they want to insure only irresponsible drivers? Because that's how you get to insure only irresponsible drivers.

  • The Last American Hero||

    Even more odd is that in areas such as food and housing - both more critical than health care on a daily basis - the public mood is generally "yes we should provide some basic level, but it will be a shitty food stamp program and sucky housing. Then we get to health insurance and it becomes "I need the government to pay all my medical costs."

  • some guy||

    I'd say Medicaid is a pretty sucky medical program. There's a reason Sanders wants "Medicare for everyone", not "Medicaid for everyone".

  • Juice||

    Before Obamacare, my individual policy was pretty damned cheap. Almost as cheap as my auto liability insurance. If I had collision, my car insurance would have been more expensive.

  • MarkLastname||

    Ironically this is among the best arguments for the irrationality of markets (or specifically, consumers). They don't mind their employer subtracting X money from their wages to buy them insurance, but so help you if you should suggest they take the X (or X +) dollars as a may increase and buy the insurance themselves. It just doesn't register with most people that having someone take your money out of your allowance and buy something for you costs as much as you buying it yourself, or more.

  • Will Nonya||

    People dont see it as a part if their compensation or as their money paying for it. And if this scheme were abolished how many people would see a pay rise equivalent to the employer "contribution"?

    I imagine a majority of people would lose their employer coverage without recovery in the hidden wages which pay for it.

  • rudehost||

    In the short term you might be right but corporate profits are mean reverting. Eventually that lower cost finds its way into either higher prices or lower wages. Profit margins are just not going to permanently double.

    Still that does bring up an important point. Libertarian solutions likely can't be turned on like a switch without chaos. If we closed all of the government schools tomorrow it isn't as if by Monday every kid in America would be placed in an awesome cheaper private school. It took a long time to build the dung pile. It will take a long time to clean it up. Plus we are still adding to it.

  • rudehost||

    Grrr read that lower prices or higher wages.

  • ||

    Didn't Obamacare basically guarantee a cost plus billing/taxation model for the Insurance companies? If they made money, they'd get to keep most of it, but if they lost money, the Feds would make them whole?

  • Agammamon||

    Sure - make them whole out of the funds appropriated for such a thing.

    And then they (of course) only appropriated enough funds to cover a fraction of the actual costs. And then issued IOU's when the money ran out. Government is like the Japanese - they'll never tell you know, only 'not right now' or 'its difficult'.

  • Kevin Sorbos Manful Locks||

    My wife says "not right now" entirely too much.

  • SimonD||

    I didn't think they allocated funds at all. I thought there was an account in which insurers who made extra profits from the increase in business had to deposit a portion of their windfall. THAT was the funding to pay those insurers who had losses.

  • ||

    If they made money, they'd get to keep most of it, but if they lost money, the Feds would make them whole?

    This part was only temporary, and doesn't appear to involve sufficient funds either.

  • JWatts||

    "This part was only temporary, and doesn't appear to involve sufficient funds either."

    The Obama administration did attempt to procure more funds but Congress blocked them.

  • MSimon||

    So a Republican Congress limited what could be paid to what Democrats passed? Well the Democrats should have asked for more when they were in charge.

  • Rt. Hon. Judge Woodrow Chipper||

    The Obama administration did attempt to procure more funds but Congress blocked them.

    Gee, I wonder why they purposely designed such a retarded system.

  • dinkster||

    It works if the right men are in charge.

  • ||

    "You fucked up. You trusted us." I'm glad everyone gets treated the same.

  • SimonD||

    It's like the Aesop's fable. Now the horse (the insurance companies) has the bit in its mouth and the saddle on it's back. The Federal Government has control, and isn't giving it up.

    The health insurance industry is well and truly permanently fucked.

  • SimonD||

    ...as an aside, do they teach Aesop's fables in school anymore? Anyone with half a brain should have seen this coming....

  • MarkLastname||

    Maybe they all did see it coming, but accepted it as an inevitability, and so focused their efforts on scrambling over each other to make sure that they at least got to sit at the top of the pile of shit?

  • Will Nonya||

    You don't see the failure of the insurance industry as an opportunity for the government to "do something"?

    I dont think most of those involved in creating this were clever enough to see any of the consequences but those who did would have seen it as a means to their goal of the multimillion payer "single layer" option.

  • steve sturm||

    Sounds familiar, Mr McArdle.

  • Enjoy Every Sandwich||

    That's just one of the defects of a centrally-planned system. There's no way to stop people from gaming the system, no matter how many bajillion regulations you write.

  • albo||

    The target constituency of any government program is always smarter than the program, the people running it, and the legislators who created it.

    It's just human nature that rational persons will approach the program looking for ways it will benefit them, not how it will benefit every body else or the entire country, the latter which is what the government created the program for.

  • some guy||

    Also, the target constituency for "aid" programs are often in a position where their time isn't worth very much, so it's actually a good investment to spend that time trying to game the system.

  • Illocust||

    It'll be interesting to see if we end up back in a defacto employer provided insurance system. If prices keep going up in the individual market then the number of sick vs. healthy will keep getting worse. Employer only insurance may be the only guys able to keep their costs down.

  • brokencycle||

    I don't feel bad for UnitedHealth at all. They decided to get in bed with ObamaCare because they thought they could help game the system for their benefit over their competitors. They deserve exactly what they get.

  • Fist of Etiquette||

    Obamacare doesn't cover Schadenfreude.

  • albo||

    It does cover one point and laugh. There's $20 co-insurance if you want a snort and smirk.

  • JWatts||

    " There's $20 co-insurance if you want a snort and smirk."

    Seems worth it. Slaps down a Jackson.

  • SimonD||

    how about a fin for an eyeroll and a throaty chuckle?

  • DaveH||

    The health insurers supported this, expecting to be the cronies who profited by their political ties. It is really hard to sympathize when they discover they are on the menu, and the politics is not in their favor.

    That said, they may be the next industry that's too big to fail.

  • Migrant Log Chipper||

    They won't fail, they will just pull out of the exchanges. This thing is going to die on it's own whether team red tries to legislate it's demise or not. If they were smart (I know, I know) they would just wait it out.

  • Ken Shultz||

    Being gouged by providers to make up the difference for all the losses the latter take on caring for Medicare and Medicaid patients wasn't the insurers' fault. If the government was squeezing the insurers by the balls, I can hardly blame them for trying to get their own handle on the situation.

    And if there wasn't any way Obama was about to deregulate the industry, then what were the insurers supposed to do. Say "thank you, sir" and grab their ankles?

  • Ken Shultz||

    There are two questions I really want to understand:

    1) Is the government reimbursing insurers for the losses they take on the exchanges?

    2) If so, how much longer are those reimbursements meant to continue?

  • Agammamon||

    1. Yes. Sort of. They ran out of money for the year already.

    2. Until a Republican is in the White House. Then the Democrats will demand that those IOUs from past years be made good and its only Rethuglican recalcitrance that prevents the USG from paying and that this is a deliberate R plan to force the destruction of Obama's signature legislation because they're a bunch of racists who want your grandma to die.

  • R C Dean||

    As I understand it, the insurers who make money help fund a pool with some of their profits, and the insurers who lose money get to draw on this pool. Not sure if the feds are supposed to be putting any of their money into the pool.

    I don't think there's enough in the pool now to cover all the losses. The question really is, will the feds put (more?) of their money into the pool? They aren't currently authorized to do so.

    I'm also not sure how long this pool is supposed to operate.

  • Ken Shultz||

    See my quote from below.

    It appears to be an unfunded mandate.

    The risk pool is apparently obligated to reimburse them, but there's no room in the inn.

    If that obligation expires, the insurers will really start pulling out before the net disappears.

  • some guy||

    It would take an act of Congress to put more money in the pool and the House will be run by the GOP for the foreseeable future. Since the GOP is the stupid party they will probably end up letting the donkeys score political points on the issue, then they will cave anyway and fund the mandate. At least that's what the recent past has taught me.

  • Ken Shultz||

    Or the insurers could sue the government. If the obligation is written into the law, it may be up to the government to figure out how to pay for it.

  • Ken Shultz||

    Or the insurers could sue the government. If the obligation is written into the law, it may be up to the government to figure out how to pay for it.

  • Diane Reynolds (Paul.)||

    EVERYONE OUTTA THE POOL!

  • Rt. Hon. Judge Woodrow Chipper||

    will the feds put (more?) of their money into the pool?

    All the fed can put into the pool is unpayable IOU's.

  • Ken Shultz||

    "Whatever may be United’s concerns with the marketplaces, underpayment from the risk corridor program for 2014 was not one of them.

    The November 19 guidance reaffirmed what CMS has been saying all along — that it understands that the ACA requires the government to make full payment of all 2014 risk corridor obligations. The Department of Health and Human Services (HHS) will make up 2014 shortfalls from 2015 or 2016 collections if possible and if not will “explore other sources of funding for risk corridors, subject to the availability of appropriations. This includes working with Congress on the necessary funding for outstanding risk corridors payments.”

    The ACA is indeed quite clear on this obligation, but how insurers will be able to collect on it other than through a lawsuit in the Court of Claims is far from clear.

    http://healthaffairs.org/blog/.....ketplaces/

    When I read that, it seems to suggest that United Health (and others) aren't likely to get reimbursed for their shortfalls past 2014 unless they sue the government or the Republicans in Congress throw ObamaCare a lifeline.

    Did the ACA state that the risk corridor reimbursements would run indefinitely, or were those assurances only temporary?

  • Sevo||

    "Did the ACA state that the risk corridor reimbursements would run indefinitely, or were those assurances only temporary?"

    Irrelevant!
    What did Valerie's email say last Friday evening? She'll announce how the king has ruled.

  • R C Dean||

    it understands that the ACA requires the government to make full payment of all 2014 risk corridor obligations

    Is the money appropriated for that? Is the ACA drafted so that no specific appropriation is needed? Or is CMS just going to write a check, regardless?

  • Ken Shultz||

    That's what I'd like to know!

    Is there an expiration date on the obligation, too?

    Enquiring minds want to know.

  • Rt. Hon. Judge Woodrow Chipper||

    Is the money appropriated for that? Is the ACA drafted so that no specific appropriation is needed? Or is CMS just going to write a check, regardless?

    Sounds like a question for the Magic 9.

  • Horatio||

    A theory floated when OCare was being proposed was that it is designed to fail and cause huge losses for insurers, paving the way for Democrats to promote a full on single slaver health care. Perhaps that's happening, but faster than intended

  • albo||

    Single payer, just $1.5 trillion more a year. But you won't have to pay premiums! Free, and worth every penny you pay for it.

  • Agammamon||

    It'll be like the NHS - the brits keep telling me its a 'wonder of the world'.

    When they're not killing people (Liverpool Care Pathway).
    Fudging admissions numbers or flat out lying about wait times (just like our own VA - which is, coincidentally, almost identical to the NHS in form).
    Telling people that they won't set a broken foot until you stop smoking.
    Telling a terminal patient that if you top off your treatment outside the NHS system with your own money (because the NHS decided that it simply wasn't cost effective to treat you anymore) , the NHS will send you a bill for the treatment they've already provided (and you've already paid for).

    You've been coughing up blood for a week, your urine looks like coffee, and you can't feel your toes - yeah we can get you an appointment to see the GP in three months. Hope your still alive then.

  • ||

    "It's a good deal!"

    -B. Sanders

  • Plàya Manhattan.||

    Obamacare anecdotes?

    My Co-pays just doubled as of the new year. That's on top of all of the other shit that I've already bitched about.

  • Florida Man||

    I'm in a HDP with HSA. I don't go to the doctor so I have no idea if my co-pays have changed.

  • Plàya Manhattan.||

    Pharmacy too.

    I have a concierge doc, and he rarely bothers to bill my insurance unless it's something really expensive.

    I'm sure you're in a similar position with your job. You have ways of getting meds without sitting in a waiting room for 3 hours. Everyone else, FYTW.

  • Florida Man||

    Usually I can swing by the pharmacy or ask one of my coworkers for a prescription. My wife breaks my balls to go to the PCP because she wants me to live "forever". I've tried to explain the grim reaper is random, buts she doesn't want to hear it.

  • Plàya Manhattan.||

    What is the PCP going to find out that you don't already know? Basically, your wife is just calling you dumb.

  • Florida Man||

    Basically, your wife is just calling you dumb.

    Pretty much.

  • Agammamon||

    Just ask her who's dumber - the dumbass or the chick who married the dumbass?

  • JWatts||

    Just asking that kind of question makes the issue kind of moot.

  • Florida Man||

    Also I just got 1/2 a free beer, new Belgium 1554, lucky day.

  • Florida Man||

    I just found a fly in my free beer. Scratch the lucky day thing. And to answer all the smart asses, yes, I am going to finish it.

  • MSimon||

    yes, I am going to finish it.

    One less fly carcass to worry about.

  • Sevo||

    And protein!

  • R C Dean||

    Enrollment has been more sluggish than initially expected, with just about 12 million sign-ups likely this year.

    I'm hearing that the number of sign-ups is significantly less than the number of people who actually pay for and keep their insurance for the whole year. There should be a better metric.

  • Plàya Manhattan.||

    I think you have that backwards, but yes. There is a significant portion of "covered" people who never pay a premium.

  • Florida Man||

    What's the grace period on non-pavement? 3 or 6 months.

  • Plàya Manhattan.||

    Mine is 30 days.

    On the exchanges, the policy isn't in force until they get their 1st payment, where a lot of people sign up and never make any payment at all. Those people are still counted as "insured".

  • Florida Man||

    I though once you signed up you couldn't be dropped from the exchange until you missed X number of payments.

  • JWatts||

    I think the rule is that after you've paid you have two months of non-payment before they drop you. So if you sign up and pay for a single month, you can get 90 days of coverage. I don't know if you can manage to do that every year. Can they block you this year for not paying 2 payments last year? I'm guessing you would probably have to pick a different company, but that you would be fine.

  • rac3rx||

    Not sure, but a friend of mine who was on OCare just told me that if you enroll and then obtain insurance by other means, they won't cancel you even if you request it and show proof of coverage. You just have to not pay the bill. I asked her how long she had to not pay the bill before she got dropped and she's not sure either. She thinks you have to not pay for 3-4 months.

  • SimonD||

    I had an issue with that. It took 6 months to get the original insurance cancelled. Then every single bill became a huge food fight between the two entities (Medicare and Anthem). (I have severe heart defects, so I have to go to a clinic once per month, plus have blood clots, so have to take Coumadin, which means ANOTHER visit once per month).

    For those 6 months, I ended up paying two insurance bills and having to pay the medical bills myself because both entities claimed it was the others' responsibility.

  • R C Dean||

    I think you have that backwards

    You are technically correct, sir.

  • Plàya Manhattan.||

    What does Jonathan Gruber have to say about it?

    Evil as he is, he seems to be the only one remotely capable of telling the truth about Obamacare.

  • Ken Shultz||

    Yeah, but only when he doesn't think anybody's paying attention . . .

    And then it's: I'm not sure what it was you think I said, but however you took it, that wasn't the way I meant it.

  • Plàya Manhattan.||

    There was only one way to take most of it, and it was the naked truth.

  • Ken Shultz||

    It was a pun.

    I was being sarcastic.

    Um . . . my ex-wife made me do it!

    Uh . . . I misspoke!

    . . . or something.

  • Ken Shultz||

    It was a pun.

    I was being sarcastic.

    Um . . . my ex-wife made me do it!

    Uh . . . I misspoke!

    . . . or something.

  • Florida Man||

    IT WAS A GODDAMN GOOF SPEAK-O!!!

  • Rt. Hon. Judge Woodrow Chipper||

    +1 Jake Blues

  • Horatio||

    I was hopeful that when Obama was elected that leftists would finally be emboldened enough to say what they actually want and their ideas could be debated out in the open. Then I realized, esp at the national level, their ideology REQUIRES that they relentlessly lie to supporters, detractors, and themselves.

  • Remnant Psyche||

    Hey, a sizable number of them are openly excited about a self-admitted socialist candidate.

    If you had told those same people even 5 years ago that would happen, they would have called you a conspiracy theorist Tea Party nutjob Rethuglikkkan. And yet here we are. They're being totally honest about what they want.

  • Diane Reynolds (Paul.)||

    He wanted future gigs with the administration.

  • JWatts||

    "What does Jonathan Gruber have to say about it?"

    He's probably too busy cashing those checks.

  • Diane Reynolds (Paul.)||

    Obamacare’s defenders have long insisted that its mandate to purchase health insurance was necessary to prevent people from gaming the system—

    Personal story:

    I was unemployed for a year, and signed up for Obamacare through my state's exchange. I would only pay my premium after three months. Between month 3 and 6, I got a new job and got new insurance. I stopped responding to any communications from my Obamacare insurer. Cold. As a conscious form of protest. At some point, I saw a communique saying I owed like $2200. I ignored it.

    Just recently (new year) I got a communique saying I owed $450. The previous $2200 is just gone. *poof*.

    Yet I'm a statistic that says I'm a happy, paying Obamacare customer.

  • Diane Reynolds (Paul.)||

    I like how in the Sidebar, I'm getting ads from my State's exchange warning you of the hefty fine if your ass isn't towing the lion. It's not "get covered and reap the benefits", it's been reduced to "get covered or else!"

  • Diane Reynolds (Paul.)||

    I'm wondering if all this will give Insurance companies pause before supporting the next political douchebag who comes up with a Big Idea.

  • The Last American Hero||

    There's a lot of valid criticism about Obamacare's woes, but it doesn't even pass the most basic test of whether it's a success.

    At the time it was passed, I mean reconciled, Obamacare supporters would have said there were two major problems with healthcare - 1) 44 million uninsured under the current system and 2) sky high insurance premiums that were making life hard for those hard working middle class citizens.

    Regardless of cost, has the program even delivered on those two items?

    1) Not even close - we are 5 years in and have only insured about a quarter of those 44 million. Absolute failure.
    2) Cost - average family of four was supposed to save $2,500 per year. Not only has there not been that sort of savings, there hasn't even been good cost containment. Absolute failure.

    There are lots of government programs that more or less accomplish the stated goal - just not in a timely or cost effective manner. This monstrosity doesn't even begin to achieve it's goals.

  • Diane Reynolds (Paul.)||

    1) Not even close - we are 5 years in and have only insured about a quarter of those 44 million. Absolute failure.

    This is called a "pause" in the process.

    2) Cost - average family of four was supposed to save $2,500 per year. Not only has there not been that sort of savings, there hasn't even been good cost containment. Absolute failure.

    But for Obamacare, our premiums would be Weimar Republic-level by now.

  • Rt. Hon. Judge Woodrow Chipper||

    It was NEVER intended to meet its goals. How can you mulct more money for a program that is meeting its goals? You sound like you've worked private sector your whole life.

  • Michael Hihn||

    It was the insurance industry who DEMANDED the mandate, for which they'd agree to ignore pre-existing conditions, It was when Obama had been elected but not yet taken office. Obambanauts were too stupid to know that denials for pre-existing conditions were banned for maybe 80% of working households -- essentially on switching (or losing) a job with healthcare to a job with healthcare. Portability.

  • Lawman45||

    They entire Health Insursnce community ASKED, no, they BEGGED for Obsmacare because they planned to rip off the new 33 million customers to enrich themselves. Like all insurance companies they are in business to pay high salaries to their officers and directors AND prooduce huge profits for their shareholders. Ha, Ha.

    They put it all on black 5 when the roulette wheel stopped on red 46. I have no pity for these losers.

  • Micu5||

    I always assumed that the insurers loved the mandates and built-in bailouts. Hmmm. I guess sleeping with the devil, and all that.

  • Michael Hihn||

    The insurers DEMANDED the mandates, in return for ignoring pre-existing conditions.
    Probably a safe bet idea when they did it -- between Obama's election and and inauguration.
    Obama's campaign had opposed a mandate to attack Hillary, also saying a mandate would require a HUGE penalty (obviously). The final Obamacare had such a tiny penalty as to be useless for avoiding the "death spiral" of only sick people signing up -- which is still killing them.

  • JPyrate||

    You say that the common people hate Libertarians. You call yourself a Libertarian, then you defend Obamacare.

    I think I found out why 98% of teh voters do not identify as Libertarians. =)

  • Sevo||

    Michael Hihn|1.21.16 @ 5:04PM|#
    "The insurers DEMANDED the mandates, in return for ignoring pre-existing conditions."

    Hey, Mike! Did you report us to the Koch brothers for making fun of you? Did they laugh in your face?
    Fuck off, you tired old shit.

  • ||

    insurance industry is gaming the system too. threatening to leave, to increase the side deals.

  • AD-RtR/OS!||

    How long?
    As long as the checks keep coming from HHS.

  • NedStarksBastard||

    Everyone needs to get over this assumption that Obamacare was meant to work. It is merely an intermediate step to Universal Single Payer designed to totally wreck the existing system to a point of no return.

  • Alan@.4||

    Looking at the thing from another point of view brings the following question: How long will the insured put up with insurance company double-talk, double-dealing and what comes perilously close to outright theft.

  • FreedomsAdvocate||

    So, the plan to 'force' us into a single payer system is right on track...duh.

  • JPyrate||

    Embrace the suck. =D

  • Heddin_South||

    This is BS, intended to extract even more money from taxpayers in a polished media campaign coordinated with our corporate-enslaved representatives in Washington. Insurance companies have been making a killing since Obamacare came into effect. Check their financials. Anthem, Inc. stock has risen 122% since 2013 and has been completely unscathed during the January stock crash. That's after the $13.5 million pay package siphoned off by the CEO, Joseph R. Swedish.

    The only losers have been the nonprofit coops, whose compensation, that was supposed to come from a fund supported by the profiting health insurers, has been cut off.

  • Peter Verkooijen||

    Bankrupting the insurers is a feature, not a bug. The goal is to clear the path for a single-payer system. Net neutrality will eventually do the same for the internet, communication and media.

  • Wildbill2u||

    The only way to insure a burning barn is to charge a premium equal to the value of the barn plus the cost of administration of the claim. By mandating coverage for all illnesses plus some extra perks, you have increased benefits without any compensating premium risk penalty. The burning barn is 'insured' and all the neighbors pay for it.

    Essentially, Obamacare is using this ridiculous model rather than a traditional insurance model of assessing risk premiums based on the actual risk that is expected in the future.

    So what you get in Obamacare is benefits payments first and then premium adjustments to pay for the benefits plus the administration costs. This isn't insurance at all. This is payment transfers to those who use the system.

    The Democrats and their 'experts' had to know that this model wouldn't work. That's why Barney Frank admitted in a TV interview that Obamacare was just a stop on the road to a complete government takeover of healthcare which goes under the radar by the calling it 'single payer' insurance.

    The funny thing is that poor people got healthcare at the local level through county hospitals and clinics before Obamacare. It was largely free because it was based on their income and financial condition. You can't name a single community in the nation where there were dead people lying in the street for lack of health care. The specter of "millions of uninsured' without healthcare was one of those liberal myths that they use to steer the debate.

  • Curmudgeon44||

    Nobody seems to even notice this article talks about ACA exemptions which don't even exist. Isn't the truth even a little more important than the narrative?

    An exemption for having children? I don't think so.
    An exemption for changing jobs? Not really. There IS an exemption for a 2-month gap in coverage, nothing to do with changing jobs.

    People are gaming the system? More plausible that companies game it. Where is the evidence that people are even smart and informed enough to game the system? I see a lot of lower income people doing tax returns, and most of them really do not understand much at all about the ACA. Or taxation, but that's another matter. Now Earned Income Credit, that is one thing people do understand enough to game.

    I really do think the reporting is faulty here.

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