500 Million Lines of Code

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Re: 500 Million Lines of Code

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WASHINGTON (The Borowitz Report)—Residents of the District of Columbia were roused from their sleep by a massive fireworks display over the White House just after midnight, as President Obama declared what he called “a national day of gloating.”

“It would not be productive for this nation, going forward, to crow about our victory over political adversaries,” he said in a nationally televised address. “So let’s get it all out of our systems today.”

Immediately after the President’s speech, loudspeakers outside the White House blasted “We Are the Champions,” and the national day of gloating began.

In addition to a ticker-tape parade, the day’s events will include a screening on the Mall of a clip reel of Texas Senator Ted Cruz’s marathon Senate speech, punctuated by sad trombone sounds.

“Starting tomorrow, my message to the Republicans is, ‘Let’s work together for the American people,’ ” said Obama, wearing what appeared to be a beer hat. “But today my message is, ‘We won, bitchaz.’ ”
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Re: 500 Million Lines of Code

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I don't believe he's ever been interested in working together.
Let's see how affordable health care is in five years. I'm very skeptical, but would be happy to be wrong.
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Re: 500 Million Lines of Code

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The Ginger Beard Man wrote:I don't believe he's ever been interested in working together.
He can't even get HHS to work together.
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Re: 500 Million Lines of Code

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There's more than a touch of absurdity in the way an industry fee in President Barack Obama's health care law is being passed along to state taxpayers.

As Alice in Wonderland might say, a curious tax just got curiouser. The burden to states could mount to $13 billion in less than a decade.

The Health Insurance Providers Fee was aimed at insurance companies. The thinking went: Because insurers would gain a windfall of customers, they ought to help pay for the expansion of coverage. Insurers say they have raised prices for individuals and small businesses to cover the new tax.

As it turns out, they are raising their prices to state Medicaid programs, too.

The federal government issued guidance in October requiring states to build the tax into what they pay for-profit Medicaid health plans that serve low-income people. The first year's tax was due to the IRS in September, and state governments are now settling up with insurance companies.

It works like this: State governments pay insurers for the tax. The insurers then pay the tax to the federal government. The federal government then reimburses part of the cost to the states.

It may sound absurd, but it's not amusing to state governments, which wind up losing 54 cents for every dollar of the insurance tax. State taxpayers end up the biggest losers, without any added benefit to their state's low-income Medicaid patients.

"It's like a merry-go-round with an extra loop in the middle," said Rebecca Owen of the Society of Actuaries.

The extra loop? The health law tax is not deductible for the insurance companies when they file their corporate income taxes, and state governments must kick in extra to cover that cost, too.
http://www.nytimes.com/aponline/2015/05 ... .html?_r=3
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Re: 500 Million Lines of Code

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The Oregon Insurance Division says it is pushing health insurers to charge higher individual rates in 2016 because they are reporting huge underwriting losses for 2014.

The insurers collected just $703 million in premiums for 2014 and spent $830 million on 2014 claims, officials say.

See also: Feds toughen CO-OP plan reporting rules

Laura Cali, the Oregon insurance commissioner, said in her statement that the division's mission is to protect the state's consumers.

"That means consumers are not overcharged for health insurance, but it also means that rates must cover the cost of patients' medical bills," Calli says. "We have proposed increased rates in order for consumers to continue counting on the coverage they have purchased."
http://www.lifehealthpro.com/2015/06/19 ... e-benefits

Props to Oregon for their understanding of the long term insurance market. Of coarse, part of the reason for the rate request is because Oregon is funding their Medicaid program by charging a 6% fee on private market insurance plans statewide. They're also missing the fact that these plans all maintain very narrow networks in the higher cost populations (i.e. sick people).
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Re: 500 Million Lines of Code

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The Kentucky Health Cooperative, the largest insurer on Kynect, Kentucky’s Obamacare health insurance exchange, proposed a 25.1 percent health insurance premium rate increase for 2016.

Despite the daunting numbers, Kentucky Gov. Steve Beshear (D) is unconcerned about the double-digit rate in his administration’s signature policy.

“System-wide averages don’t give a good picture of what an individual’s out-of-pocket costs may be,” Beshear said.

Beshear bypassed the legislature and created Kynect, the nation’s first state-run health-insurance exchange, through an executive order.

“The rates for private health plans on Kynect have been filed but have not yet been approved or certified, so we don’t yet know what the final numbers will be,” Beshear said. “Changes still may occur, and rates should be finalized sometime in mid-July, but we do expect that some plan rates will go down, some will go up, and some will stay close to the same as last year.”

Financial Problems Loom

In May, Standard and Poor’s (S&P’s) reported Kynect is in serious financial trouble, especially because no federal bailout money will be provided after 2016, when Obamacare’s risk corridor program ends.

S&P’s report indicates the Kentucky Health Cooperative booked an amount of risk corridor receivables, which is money from a risk pool paid out in varying degrees to insurers who collected significantly less in premiums than the cost of providing benefits, equal to 117 percent of its capital. Kentucky had the second highest number of risk corridor receivables in the nation in 2014.

Rate Hikes Will Vary

Beshear says rate changes will impact enrollees differently depending on their region, age, household income, and smoking status, and he argues the average numbers don’t specify how much those rate fluctuations may affect individual policyholders.

Despite Beshear’s assurances, all enrollees will pay significantly higher premiums in 2016.

BlueCross BlueShield of Tennessee’s 36.3 percent average premium rate increase will result in increased premiums ranging from 19.5 percent to 59.5 percent. The top end of premium increases in New Mexico, where exchange market leader Health Care Service Corp. is asking for an average hike of 51.6 percent, would be even steeper.

The current 25 percent increase sought by the Kentucky Health Cooperative would mean the cooperative will have increased rates by 45 percent in Kynect’s first two years of existence.
http://news.heartland.org/newspaper-art ... mium-hikes
Heartland's bias is well known, but the news isn't good-- because of it's (poor) health stats, Kentucky is probably the most important state in the nation to go all in on Obamacare, especially since they've got above average retention ratios:
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Moar on why Kentucky is so important.
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Re: 500 Million Lines of Code

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As federal trustbusters prepare to investigate the massive insurer consolidations now on the table, legal experts say the outcome of those reviews remains an open question.

Aetna CEO Mark Bertolini said the insurer is ready for government examination as it prepares to buy Humana for $37 billion. Aetna has already discussed possible divestitures.

“We took a conservative view of what we thought we would need to divest,” Bertolini said during a conference call with investors this week.

But the review process will likely be a complex one given the size and reach of Aetna and Humana, experts say. And continuing insurance consolidations might also sway how regulators view the Aetna-Humana deal and others.

In recent weeks, Centene offered $6.3 billion for Health Net, and Anthem has offered about $47 billion in cash and stock for Cigna. The five largest for-profit health insurers in the nation—UnitedHealth Group, Anthem, Aetna, Humana and Cigna Corp.—have all been the subjects of various merger talks.
http://www.modernhealthcare.com/article ... /150709914
Flashbacks anyone?
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Re: 500 Million Lines of Code

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First year Medicaid expansion results are in-- costs are 22% higher than projected. They haven't expanded into the high cost areas yet either.
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Re: 500 Million Lines of Code

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Five years in, and price transparency is still virtually nonexistent in 90% of states.

A bit of a long read, but may be worth it for those who buy their own health insurance. IMHO they use a good methodology and write their explanations in english.
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Re: 500 Million Lines of Code

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Re: 500 Million Lines of Code

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The largest private provider of health insurance policies on Kynect, Kentucky's health insurance exchange, is going out of business.

The Louisville-based Kentucky Health Cooperative Inc. announced Friday that it will end current memberships on Dec. 31 and will not add new members because of financial problems. It will not offer health insurance plans on Kynect when open enrollment for 2016 coverage starts on Nov. 1. The cooperative has about 51,000 members in all 120 Kentucky counties.
http://www.kentucky.com/2015/10/09/4079 ... .html?rh=1
An Oregon health insurance co-op is withdrawing from the 2016 market and has begun a "wind down of business," citing the federal government's recent announcement that it will only honor 12.6 percent of insurance companies' risk corridor payment.

This means the 15,000 members the nonprofit insurer currently serves will have to shop for new coverage at HealthCare.gov come open enrollment on Nov. 1. About 10,000 of the members are employees of small businesses, according to a press release.
Health Republic is one of three co-ops across the country that announced its imminent closure this week. Community Health Alliance in Tennessee and Colorado HealthOp also will stop offering plans after the end of 2015.
http://www.statesmanjournal.com/story/n ... /74058362/

And why are they closing?
Health insurers that sold plans and lost money on the Affordable Care Act's exchanges in 2014 will receive only a portion of their promised safety-valve payments, according to government data released Thursday.
http://www.modernhealthcare.com/article ... /151009996

Summary: Government announces they won't keep their end of a bargain on October 1, vulnerable health insurers drop like flies within two weeks. If the data had been released 45 days prior, like it was supposed to be, people losing coverage would likely have had time to adjust.
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Re: 500 Million Lines of Code

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The major insurers are losing their asses too.
http://www.wsj.com/articles/unitedhealt ... d=yahoo_hs
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Re: 500 Million Lines of Code

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Employers have not historically played a significant role in helping workers enroll in Medicaid. But Gillingham’s insurance broker told him about a startup called BeneStream, which is based in New York City and facilitates enrollment in the government program.

Founded two years ago with seed money from the Ford Foundation, BeneStream now helps more than 6,500 workers at 125 companies across the country get Medicaid. CEO Benjamin Geyerhahn said moving workers from private insurance to Medicaid helps firms shift their costs to the government.

“The savings is quite significant,” he said. “Our average is about 250 percent — so about two-and-a-half times the money you spend on us comes back to you in the form of saved premium.”

Geyerhahn said going onto Medicaid, which is nearly free for employees, is a good deal, though it lacks the generous benefits of more expensive plans. If employees make so little that they’re eligible for Medicaid, he says, they probably can’t afford regular insurance premiums, especially when combined with the high deductibles that undermine much of the benefit of insurance.
http://khn.org/news/turning-to-medicaid ... employees/
And the Ford Foundation usually only goes for social justice causes: http://www.fordfoundation.org/work/our- ... -database/
Last edited by Turdacious on Thu Jan 21, 2016 5:37 pm, edited 1 time in total.
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Re: 500 Million Lines of Code

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Eager to maximize coverage under the Affordable Care Act, the Obama administration has allowed large numbers of people to sign up for insurance after the deadlines in the last two years, destabilizing insurance markets and driving up premiums, health insurance companies say. The administration has created more than 30 “special enrollment” categories and sent emails to millions of Americans last year urging them to see if they might be able to sign up after the annual open enrollment deadline. But, insurers and state officials said, the federal government did little to verify whether late arrivals were eligible.

That has allowed people to wait until they become ill or need medical services to sign up, driving up costs broadly, insurers have told federal health officials. “Individuals enrolled through special enrollment periods are utilizing up to 55 percent more services than their open enrollment counterparts” who sign up in the regular period, the Blue Cross and Blue Shield Association, whose local member companies operate in every state, told the administration
http://www.nytimes.com/2016/01/10/us/po ... .html?_r=0
Apparently health insurance works the way every Introductory Econ textbook says it does.
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Re: 500 Million Lines of Code

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No biggie
UnitedHealthcare, the biggest health insurer in the United States, said Tuesday that it plans to exit most of the Affordable Care Act state exchanges where it currently operates by 2017.
The health insurer had already indicated that it was dropping coverage of the plans, more commonly known as Obamacare, in Arkansas, Georgia and Michigan.

But during a conference call with analysts Tuesday, CEO Stephen Hemsley noted that "next year we will remain in only a handful of states."

Hemsley explained that UnitedHealth will leave most states by 2017 because the markets for these exchanges are relatively small and also have higher risks for the company over the short-term.

As such, he said UnitedHealth (UNH) could not serve these exchanges on an "effective and sustained basis."

It shouldn't come as a huge surprise. UnitedHealth had previously said that it lost $475 million on the ACA exchanges last year and could lose another $500 million this year.
http://money.cnn.com/2016/04/19/investi ... anges-aca/
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Re: 500 Million Lines of Code

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Adverse selection is leading to moral hazard.
A type of limited health coverage with features largely banned by the Affordable Care Act is flourishing, as some consumers grab onto an alternative they say is cheaper than conventional plans sold under the law. Sales of short-term health insurance are up sharply since the health law’s major provisions took effect in 2014, according to insurance agencies. New sales figures show the temporary policies, traditionally sold to consumers who are trying to fill coverage gaps for a few months, have continued their surge recently—even though people who buy them face mounting financial penalties because the coverage doesn’t meet the ACA’s standards.

Robin Herman, the 34-year-old owner of a marketing firm in San Francisco, bought a short-term policy in December. The monthly cost of her short-term coverage, plus conventional ACA-compliant plans for her two children, is roughly one-quarter of what she would have paid for conventional health plans covering all three of them, she says.

“This is saving me a ton of money for the year,” she said, despite the penalty. Plans that comply with the health law’s rules cost more than her old pre-ACA policy and are “just not affordable,” she said.

Ms. Herman’s new policy, like many short-term plans, doesn’t cover pre-existing conditions, a limitation no longer allowed in full health coverage. Ms. Herman’s plan also caps total benefits at $1 million, another feature prohibited in ACA plans. It doesn’t cover most prescription drugs. To get the plan, Ms. Herman had to qualify as healthy by answering a questionnaire. ACA plans are sold to every consumer regardless of health status.
http://www.wsj.com/articles/sales-of-sh ... 1460328539
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Re: 500 Million Lines of Code

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About 28 percent of the uninsured are eligible for Medicaid or the Children’s Health Insurance
Program (Medicaid/CHIP), and 21 percent are eligible for marketplace tax credits. About 12 percent
fall in the assistance gap (those with very low incomes but who are ineligible for Medicaid or marketplace assistance because their states have not expanded Medicaid eligibility; figure 1). About 16 percent are undocumented persons who do not qualify for any assistance under the ACA, and another 24 percent do not qualify for assistance because their incomes are too high or they have an affordable offer of coverage from an employer.

Fully 66.5 percent of uninsured children are eligible for Medicaid/CHIP compared with only 20.6 percent of uninsured adults [...]

For example, within both the Medicaid/CHIP and marketplace populations of most interest, over 80
percent of the uninsured live in metropolitan statistical areas. In addition, majorities (67 percent of those eligible for Medicaid/CHIP and 53 percent of those eligible for tax credits) live in families in which at least one member is already receiving the earned income tax credit (EITC) or at least one other public benefit, such as the Supplemental Nutritional Assistance Program (SNAP) or a free or reduced-price school lunch
http://www.rwjf.org/content/dam/farm/re ... rwjf427898

The biggest group of uninsured are those who are eligible for a pre-existing insurance program. It's almost like states are trying to save money on Medicaid expenses. Hard to believe Medicaid expansion didn't work.
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Re: 500 Million Lines of Code

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A nonprofit health insurer in Ohio set up under ObamaCare is going out of business, regulators announced Thursday. It is the latest in a string of failures for “co-op” health plans. The Ohio Department of Insurance announced that the co-op, known as InHealth Mutual, will be shut down, forcing its nearly 22,000 enrollees to find other plans within the next 60 days.

“Our examination of the company’s financials made it clear that the company’s losses would prevent it from paying future claims should its operations continue,” Lt. Gov. Mary Taylor, who is also the Ohio director of insurance, said in a statement. The closure represents a significant disruption for the enrollees. The Obama administration and state regulators had worked to shut down any financially shaky co-ops before 2016 enrollment began on Nov. 1, in an attempt to avoid such failure in the middle of the coverage year [...] Just 10 of the original 23 will now remain.
http://thehill.com/policy/healthcare/28 ... o-finances
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Re: 500 Million Lines of Code

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For years, Heartland Regional Medical Center, a nonprofit hospital in the small city of St. Joseph, Missouri, had quietly sued thousands of its low-income patients over their unpaid bills.

But after an investigation by ProPublica and NPR prompted further scrutiny by Sen. Charles Grassley, the hospital overhauled its financial assistance policy late last year and forgave the debts of thousands of former patients.

The hospital “deserves credit for doing the right thing after its practices were scrutinized,” Grassley, R-Iowa, wrote last week in a letter to his Senate colleagues, “but it should not take Congressional and press attention to ensure that tax-exempt, charitable organizations are focused on their mission of helping those in need.”

While the changes at Heartland, which now goes by Mosaic Life Care, are a boon to its poorest patients, ProPublica has found numerous cases across the country of nonprofit hospitals, which pay no income tax, filing suits by the thousands.

Some have filed more suits than Mosaic ever did. In Evansville, Indiana, for example, Deaconess Hospital filed more than 20,000 lawsuits from 2010 through 2015. Like Mosaic, Deaconess reconsidered its financial assistance policies after questions from ProPublica last week and said it would be making changes.
https://www.propublica.org/article/nonp ... i=30188607
Translation: we still have the same problems the ACA was supposed to solve.
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Re: 500 Million Lines of Code

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The Obama administration said Wednesday that the financial outlook for Medicare’s hospital insurance trust fund had deteriorated slightly in the last year and that Social Security still faced serious long-term financial problems [...]

Under existing law, the trustees said Wednesday, Medicare’s hospital trust fund would be depleted in 2028, two years earlier than projected in last year’s report.

In addition, they said, the Social Security trust funds for old-age benefits and disability insurance, taken together, could be depleted in 2034, the same year projected in last year’s report. Tax collections would then be sufficient to pay about three-fourths of promised benefits through 2090, they said.

Social Security and Medicare account for about 40 percent of all federal spending.

Obama administration officials often say the Affordable Care Act has slowed the growth of health spending, compared with estimates made just before the law was adopted in 2010.

But the trustees said Wednesday that the short-term financial outlook for Medicare had worsened in the last year because of changes in their assumptions and expectations. Medicare actuaries now expect higher use of inpatient hospital services, as well as lower projected improvements in workers’ productivity and lower payroll tax revenue, as a result of slower growth in wages in the next few years.

In their report, the trustees — four administration officials — said that the costs of Medicare and Social Security would grow faster than the economy through the mid-2030s because of the aging of the baby boom generation. As for Medicare, they said, “growth in expenditures per beneficiary exceeds growth in per capita gross domestic product over this time period.”
http://www.nytimes.com/2016/06/23/us/po ... .html?_r=2
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Re: 500 Million Lines of Code

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Today, Blue Cross and Blue Shield of North Carolina sued the Obama administration, claiming that they were owed $130 million through Obamacare’s so-called “risk corridors.” The government would only pay 12.6% of the money the insurer claimed. Highmark brought a similar suit last month, claiming it only received $27 million out of the $223 million it was owed. Both suits make virtually identical allegations, and were filed by the same lawyers from Reed Smith in the Court of Federal Claims. Health Republic Insurance filed a similar complaint in February, seeking class action status. It were represented by Quinn Emanuel.

Since their inception, the “risk corridors,” known as “insurance company bailouts” have been extremely unpopular. In 2014 and 2015, Congress blocked HHS from paying these funds from CMS’s permanent appropriation. (President Obama signed that budget into law). As a result, HHS lacked the funds to pay the insurance companies their full amount due. According to one of the complaints, in 2014 there were only $2.9 billion in losses, and only $.4 billion was actually paid.

If the Court of Federal Claims (an Article I court) rules in favor of the insurance companies, and awards them the hundreds of millions of dollars they seek, those amounts would come out of the judgment fund. This is a permanently appropriated fund that, for all intents and purposes, is unlimited. In other words, even if Congress expressly deprives the Executive of funding for the risk corridors, if the insurance companies receive a favorable court ruling, the government can pay out that amount through the judgment fund.
http://joshblackman.com/blog/2016/06/03 ... companies/

Not claiming to understand the legal aspects of the claim, but I have a pretty clear idea of the affect that poor government management like this has on small providers and on insurance rates.
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Re: 500 Million Lines of Code

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Turdacious wrote:
Today, Blue Cross and Blue Shield of North Carolina sued the Obama administration, claiming that they were owed $130 million through Obamacare’s so-called “risk corridors.”
...
Since their inception, the “risk corridors,” known as “insurance company bailouts” have been extremely unpopular. In 2014 and 2015, Congress blocked HHS from paying these funds from CMS’s permanent appropriation. (President Obama signed that budget into law)
In short: Crony Capitalists (Blue Cross, etc.) lobbied for bailouts in ObamaCare, which was rammed through Congress without a single R vote.
Now, the R's have taken over both Houses and they are fucking the Crony Capitalists. Obama goes along with it.

Now it goes to the courts, which apparently have a direct siphon into taxpayers' wallets that can not be stopped by Congress.
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Re: 500 Million Lines of Code

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johno wrote:
Turdacious wrote:
Today, Blue Cross and Blue Shield of North Carolina sued the Obama administration, claiming that they were owed $130 million through Obamacare’s so-called “risk corridors.”
...
Since their inception, the “risk corridors,” known as “insurance company bailouts” have been extremely unpopular. In 2014 and 2015, Congress blocked HHS from paying these funds from CMS’s permanent appropriation. (President Obama signed that budget into law)
In short: Crony Capitalists (Blue Cross, etc.) lobbied for bailouts in ObamaCare, which was rammed through Congress without a single R vote.
Now, the R's have taken over both Houses and they are fucking the Crony Capitalists. Obama goes along with it.

Now it goes to the courts, which apparently have a direct siphon into taxpayers' wallets that can not be stopped by Congress.
From another legal analysis:
The important point is that the federal government isn’t taking a “sue and settle” approach to the risk corridor litigation. The feds are fighting—for now. And they will keep fighting at least through the summer of 2017, when they receive the data from health plans to make their final risk corridor calculations.
http://theincidentaleconomist.com/wordp ... -lawsuits/
And in 2017 we'll have a new administration. Pretty good job of buck passing.
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Re: 500 Million Lines of Code

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A federal appeals court has ruled that consumers must be allowed to buy certain types of health insurance that do not meet the stringent standards of the Affordable Care Act, deciding that the administration had gone beyond the terms of federal law. The court struck down a rule issued by the Obama administration that barred the sale of such insurance as a separate stand-alone product.

“Disagreeing with Congress’s expressly codified policy choices isn’t a luxury administrative agencies enjoy,” the United States Court of Appeals for the District of Columbia Circuit said on Friday in a decision that criticized “administrative overreach” by the Department of Health and Human Services.

At issue is a type of insurance that pays consumers a fixed dollar amount, such as $500 a day for hospital care or $50 for a doctor’s visit, regardless of how much is actually owed to the provider. Such “fixed indemnity” insurance is normally less comprehensive and less expensive than the “minimum essential coverage” required by the Affordable Care Act. Under the rule, issued by the Obama administration in 2014, fixed indemnity policies could be sold only to people who already have the more comprehensive coverage that meets detailed federal standards. State officials and insurers estimate that as many as four million people might have fixed indemnity policies without major medical coverage [...]

“Even after the Affordable Care Act, lower-income consumers may not be able to afford major medical coverage,” said Quin M. Sorenson, a lawyer at Sidley Austin who represented the plaintiffs. In states that have not expanded Medicaid eligibility, he said, three million people fall into a coverage gap: They make too much to qualify for Medicaid, but not enough to qualify for subsidies in the public insurance marketplace, and they cannot afford major medical coverage on their own.
http://www.nytimes.com/2016/07/06/us/po ... .html?_r=0
Unanimous decision too.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule

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Turdacious
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Re: 500 Million Lines of Code

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Five blood tests were performed in March at Torrance Memorial Medical Center. The hospital charged the patient’s insurer, Blue Shield of California, $408. The patient was responsible for paying $269.42. If that were all there was to this -- which it’s not -- you’d be justified in shaking your head and wondering how it could cost more than $80 apiece for blood tests. These weren’t exotic procedures. The tests were for fairly common things such as levels of vitamins D and B12 in the blood. It‘s what happened next, though, that this makes this story particularly interesting.

The patient, who for privacy reasons requested that I use only her first name, Caroline, was curious about why she needed to pay almost $300 for a handful of routine tests. So she called the hospital. “I was completely surprised,” Caroline told me. “The woman I spoke with in billing said that if I’d paid cash, the prices would have been much lower.” How much lower? Try this on for size: Tests that were billed to Blue Shield at a rate of about $80 each carried a cash price of closer to $15 apiece [...]

“This is one of the dirty little secrets of healthcare,” said Gerald Kominski, director of the UCLA Center for Health Policy Research. “If your insurance has a high deductible, you should always ask the cash price.” Cash prices are intended for uninsured patients -- and are frequently still much higher than insured rates. But cash prices for many common procedures have come down thanks to changing regulations and consumers increasingly being able to shop around for cheaper providers [...] Not all medical facilities will be open to sharing their cash prices with an insured person, Kominski said, but many will.
http://www.latimes.com/business/lazarus ... story.html
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule

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