Missouri doesn’t have a “cooperative” plan, but it does have what amounts to for-profit equivalents experiencing adverse selection problems nearly identical to those of the co-ops. How are these Missouri insurance plans dealing with these financial problems? Rate hikes, of course.

New data for the 37 states that use the federal HealthCare.gov marketplace, rather than run their own exchanges, suggest that premiums for next year will be going up far more in the Kansas City area than in many other large cities.

The monthly premium for the benchmark silver plan will increase by an average of 6.3 percent for the 30 cities included in the new data from the Department of Health and Human Services. But in the Kansas City area, premiums for that plan will jump by 20.1 percent next year.

. . . Rates appear to have escalated in Kansas City because Coventry, which had the second-lowest-priced silver plan this year, raised its rates for 2016 by an average of more than 25 percent, said Ron Rowe, vice president for sales of Blue Cross and Blue Shield of Kansas City.

Simply telling people they have coverage is not the answer to America’s health care policy problems—a fact the ever-growing list of failed and failing Obamacare insurance plans bears out. Until we get a handle on the cost of health care as a country, it will be very difficult to substantively guarantee access to care to the people who need it most, whether in the private market or in a welfare program like Medicaid. We can, and must, do better.

The post Kansas City Obamacare Insurance Premiums Expected to See Double-Digit Hike appeared first on Show-Me Institute.

If you’re short on time, however, the case deals with what happens when a state declines to set up an insurance exchange under Obamacare, forcing the federal government to do so instead. Here’s the big question in King: Does the Affordable Care Act (ACA) block federal subsidies from going to insurance plans purchased in government exchanges that were not, as the law says, “established by the State”? If the answer is yes, it could simultaneously take subsidies away from millions of insurance plans and protect millions of taxpayers from the law’s mandates. It’d be a body blow to the law.

Why would Congress condition subsidies on states building their own exchanges? The answer is reasonably straightforward: Congress didn’t want the burden of creating exchanges to be on the federal government—that is, Healthcare.gov—and thought offering the subsidy as a carrot would get states to do the heavy lifting. Congress never thought the federal government would be running the exchanges for basically two-thirds of the country, as it’s doing today. Healthcare.gov’s rollout disaster was part and parcel of this miscalculation by Congress.

Supporters of Obamacare now contend the “established by the State” language was a drafting error, but there is lots of evidence that runs against that claim. The state exchange “carrot” strategy had appeared in prior, contemporaneous bills that were combined to form the ACA—suggesting that at least some legislators were well aware of the system they were creating. In fact, in the years that followed, Obamacare architect Jonathan Gruber famously repeated what the consequences of states not building their own exchanges would be:

With most states declining to create their own exchanges, the Internal Revenue Service then wrote rules that would extend the federal subsidies not only to exchanges “established by the State,” but also to federal exchanges. The problem is that since the federal subsidies are the basis for penalties that, thanks to the IRS, would suddenly apply to tens of millions of Americans in states that didn’t create exchanges, those subsidies could be an illegal tax. Thus, we have the King litigation.

After Wednesday’s oral arguments, we’ll likely see a decision handed down on the case sometime this summer. How will it turn out? We’ll keep you posted.

The post King v. Burwell: A Quick Preview appeared first on Show-Me Institute.

The disastrous rollout of HealthCare.gov may have another serious problem: A CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there’s concern there won’t be enough healthy people buying health insurance for the system to work….

CBS News has confirmed that in Washington, of the more than 35,000 people newly enrolled, 87 percent signed up for Medicaid. In Kentucky, out of 26,000 new enrollments, 82 percent are in Medicaid. And in New York, of 37,000 enrollments, Medicaid accounts for 64 percent. And there are similar stories across the country in nearly half of the states that run their own exchanges.

So the exchanges, billed as a private market solution to America’s health care problems, appear to be putting more people into a long-broken government program than into private insurance. That’s a huge contradiction in policy and puffery that undercuts the entire law. What assurances do taxpayers have that individuals aren’t being improperly added to the Medicaid program? And why would any legislature expand Medicaid just as Obamacare is boosting the program’s cost to the states?

The post Uh Oh: Are The Exchanges Goosing State Medicaid Rolls? appeared first on Show-Me Institute.

Twenty North Dakotans have enrolled for health insurance through the new federal health exchange, according to figures from the three North Dakota companies offering coverage on the marketplace.

The online marketplace at healthcare.gov, where health insurance is sold, is a key aspect of the health insurance law signed by President Barack Obama commonly known as Obamacare. It has been plagued by traffic issues and widespread glitches since it went live about three weeks ago.

So far, there have been no reports of the enrollment numbers in Missouri, at least to my knowledge. I have reached out to the insurers who are in the Missouri exchange and hit a brick wall when it comes to actual numbers. HHS records suggest there are technically four insurance providers in the Missouri exchange: two affiliated with Blue Cross Blue Shield, and two affiliated with Coventry. (Because affiliates don’t really compete with one another, consumers are effectively left with only two insurer options in each county, in general.) Both Blue Cross affiliates — Anthem Blue Cross and Blue Shield, and Blue Cross and Blue Shield of Kansas City — said that they will not be releasing their numbers. I have yet to receive a return call from either Coventry affiliate.

While we wait, the email I received from Anthem is below. It pretty well summarizes the position of Blue Cross.

Anthem Blue Cross and Blue Shield in Missouri’s parent company has just begun to receive confirmation of enrollment in the federal exchanges from CMS. Although it is too soon to provide Missouri enrollment details at this time, we have seen unprecedented call volumes and heavy web traffic for our exchange plans which is consistent with the experience reported by some state exchanges. We believe consumers will continue to be attracted to our trusted brand name and quality product offerings on the exchanges.

Deb Wiethop
Communications Director
Anthem Blue Cross and Blue Shield in Missouri

Naturally, “volume” and “web traffic” aren’t “enrollment,” so it looks like the actual enrollment figures will remain unknown. Why insurers are so unwilling to release the numbers is a subject of considerable speculation, but if Thursday’s movement toward a delay of the individual mandate is any indication, North Dakota’s enrollment experience may not be unique.

The post How Many Missourians Have Gotten Coverage Through The Exchange? Insurers Keep Mum appeared first on Show-Me Institute.

Plans in the Marketplace are primarily separated into 4 health plan categories — Bronze, Silver, Gold, or Platinum — based on the percentage the plan pays of the average overall cost of providing essential health benefits to members. The plan category you choose affects the total amount you’ll likely spend for essential health benefits during the year. The percentages the plans will spend, on average, are 60% (Bronze), 70% (Silver), 80% (Gold), and 90% (Platinum). This isn’t the same as coinsurance, in which you pay a specific percentage of the cost of a specific service.

Keep in mind that if you qualify for subsidies, this spreadsheet will only provide the pre-subsidy cost to you. Also keep in mind that the data the government has made available only has very broad categories; consider these your ballpark estimates for what your plan would actually cost.

In my case, the most comparable plan in the marketplace to the one I have now is nearly twice the price. That would also be the price I’d pay, because I don’t qualify for subsidies.

Happy hunting.

Note: Pricing is for monthly premiums. As you peruse those premiums, the columns proceed in this order: Premium Adult Individual Age 27, Premium Adult Individual Age 50, Premium Family, Premium Single Parent Family, Premium Couple, Premium Child.

The post Looking For (Broad) HealthCare.Gov Pricing For Missouri? We Have It appeared first on Show-Me Institute.

This could be the result of a few things: lazy programming, bad programming, and/or purposefully bad programming. The underlying dataset the tool uses is probably based on this data, which I downloaded from HealthCare.Gov on Oct. 1. Notice that of the columns divided by age, the two ages are . . . 27 and 50. Programmers probably just split the population into the two groups they found in the spreadsheet and dropped everyone into these pricing categories, even though those prices only applied to two ages of people.

Obviously, a 27-year-old’s insurance is not priced the same way as a 37-year-old, or a 45-year-old, or a 49-year-old. Why the government’s “experts” would put out demonstrably false information — information that anyone who knows anything about insurance pricing would know is wrong — is just beyond me. Are these really the people we want running our health care system?

The post HealthCare.Gov Now Delivering . . . Incorrect Plan Pricing appeared first on Show-Me Institute.