On Anecdotes & Data

So, about that 3000% rate decrease:

Working on a renewal (actually, one of several dozen at the moment, but this one's pretty representative); mom, dad, some ankle biters. Grandfathered HSA plan, $3,000 per person, $6,000 per family deductible, then 100%. As with all plans nowadays, first-dollar preventive care coverage (for mom and the kids only, of course, except for dad's colonoscopy every 5 or 10 years).

Current rate is $770 per month, heading north by 30% to a nice round $1,000. That's $12,000 in premiums before any meds or any major medical expense is covered, but after that, no worries. Plan is Grandfathered, so no coverage options (like a higher deductible to bring down that rate).

So, start shopping, and of course, the "best" alternative I can find is $1,140 per month, with a $6250 per person, $12,000 family deductible. So that's almost $1,700 a year in additional premium, plus thousands of dollars in potential additional out-of-pocket.

It does come with "free" birth control, though...

Oh, did I mention that Mom's 43 (and done)?

Sweet deal.

New Republic vs EPC

"The Equal Protection Clause of the 14th amendment of the U.S. Constitution prohibits states from denying any person within its jurisdiction the equal protection of the laws."

Reason I bring this up is because of the recent shuttering of the Empire State's New Republic (NR) CO-OP. Most of the time, there's a "cushion" between the time a plan is told to shut down and when folks actually lose coverage. This isn't the case with NR: coverage for its insureds ends on November 30th, period. This leaves them with a couple of challenges:

First, obtaining new coverage for December. The state has figured out a way to "auto-enroll" these folks in a new plan with intact carriers. One supposes that they could also choose a Short Term Medical plan (assuming those are still available in New York). And, of course, losing coverage in this manner is itself a Special Open Enrollment trigger (as regards December coverage).

The problem is that some (many? most?) of these folks will have met some or all of their 2015 deductibles (and, perhaps their entire maximum out-of-pockets). These are not going to be acknowledged by their new carrier; that is, they'll have an entire new annual out-of-pocket for December then again starting January 1st.

This is truly a bummer.

And it's also not legally correctable.

Here's why:

There is no way to compel the new carrier to credit expenses covered by a previous one, regardless of when they were incurred. So the fact that these poor folks are left high-and-dry for December is too bad, but there's nothing that can legally be done to resolve that. If the state (or the Feds, for that matter - CO-OPS are purely an invention of the ObamaTax) were to grant this kind of relief to victims previous NR insureds, they'd have to do that for everyone who's been in that situation.

And who would those folks be?

Well, anyone who lost employer coverage in, say July (or March, or a week ago) and had to obtain a new plan with another carrier. Or anyone else who's been recently eligible for a Special Open Enrollment and had (or chose) to switch carriers. If the NR folks are entitled, then everyone else in similar straits are, too.

Thanks, EPC!

Friday Spindle Clearing

In no particular order:

■ The Ohio Department of Insurance is touting its (not-so-new) lost insurance policy service, available to Buckeyes (and/or their beneficiaries) looking to see if Grams or Gramps had any unaccounted-for life insurance policies or annuities. It's a free service, but there's some paperwork involved.

■ The much-touted new Agent Hotline set up by the rocket surgeons in DC has turned out to be a big dud:

"A hotline set up ... to assist brokers with the public exchanges will only assist agents with user IDs, site registration and training questions — not client issues."

Which was to have been the whole point of the exercise in the first place.

Shocking, I know.

■ FoIB Jeff M tips us to this bolt from the blue:

"North Carolina consumers who buy their own health insurance are facing major price increases  ... it’s approved rates covering about 610,000 people that will be one-third to one-fifth higher in 2016"

Fortunately, that'll all be offset by the promised 3000% rate decreases any day now.

Right?

■ And now for something completely different:

The Pastry Artist's Adventure is a blog written (and updated frequently) by an aspiring pastry chef (and delightful young lady, to boot), currently in her 2nd year at the prestigious Sullivan University Culinary Arts program. It's fun to see the next generation of great bakers and chefs starting to spread their wings.

Ch-ch-changes: Adult "children"

The ObamaTax allows "adult children" to stay on their folks' insurance until age 26. Here in Ohio, the rocket surgeons in Columbus upped the ante, and let them stay on to age 28.

Now that's changing: as of January 1, 2016 the Buckeye State will fall into line with the other 57:

"I have my adult dependent child on my insurance coverage.  Will he/she still be able to stay on my health insurance? 

◦Dependent children can stay on their parent’s insurance until they turn 26."

Small steps.

[Hat Tip: Medical Mutual of Ohio]

MVNHS© Taking on Water

Last time we checked in with Britain's Much Vaunted National Health System©, we learned that new mums with breast cancer don't fare very well, healthcare-wise. Turns out, that was just a harbinger of things to come.

To wit:

"UK now has one of the worst healthcare systems in the developed world, according to OECD report"

Now what in the wide wide world of sports would prompt that pronouncement?

Oh:

"Hospitals are now so short-staffed and underequipped ... Staff are too rushed to improve levels of care ... obesity levels are “dire”

In other words: Thursday.

Here's the best part, though: all those folks bemoaning how we spend so much money on health care with poor results, and point to schemes like the MVNHS© as models to follow?

Guess what:

"Mr Pearson said the UK was spending “considerably less” than many OECD countries and that “you get what you pay for” in healthcare."

So if spending more doesn't help, and spending less doesn't, either, then maybe (just maybe) there are other factors to consider?

Wonder what those could be...

And the winner (loser?) is...

LifeHealthPro has just released the results of its survey of consumers' rankings of various health insurers.

Coming in dead last is United Healthcare, with just 62% of respondents willing to recommend it.

Interestingly, Aetna and Coventry are in 11th and 12th place (respectively); I don't really "get" this, since they're joined at the hip corporately. Perhaps the survey was conducted prior to Aetna's Coventry acquisition?

Our old friend Anthem is solidly in the middle, holding down 8th place.

Leading the pack, though, is Horizon Blue Cross/Shield of New Jersey, with a solid 85% of those surveyed willing to recommend it.

Two observations:

First, over half of the list is made up of various Blue Cross/Shield affiliates; this makes sense when you consider market share.

Second, and more discomfiting, is that it's not clear whether this reflects group plans or individual ones, nor on- or off-Exchange purchases. I think this is a major oversight, and would like to see it addressed in any future versions.

Obamacare - Just Say No

Even if you like your Obamacare health insurance plan don't count on using it.

one thing is out of the government's control: whether doctors and hospitals will agree to accept patients who buy these plans.

Some newly insured patients wonder whether it's worth paying for coverage they can't actually use. Even when they do find a provider, reports show they face crippling out-of-pocket costs they didn't expect. - US News

If that isn't bad enough, there is the problem with smaller networks.

In most states, doctors can choose not to participate in the networks offered in the marketplaces, also known as exchanges, created by the Affordable Care Act, President Barack Obama's signature health care law. Then again, they can choose not to participate in any other type of health insurance plan as well. Some doctors opt out of Medicaid, the government's health program for low-income Americans, and others opt out of Medicare, the government's program for adults 65 and older. Others limit the percentage of patients they'll accept who are covered by these plans.

What do you do?

Good question.

Now that your ONLY choice is an Obamacare design, you are pretty much screwed.

#ObamacareFail