"It"s A Crisis Situation": One Chart Explains Why Obamacare Is Locked In An Inescapable Death Spiral

Ever since it was signed into law in 2010, defenders of Obamacare have dismissed staggering surges in annual premiums by highlighting only the rates paid by those fortunate enough to receive subsidies.  In fact, last year we wrote about Marjorie Connolly"s, from Obama"s Department of Health and Human Services, response to the Tennessee insurance commissioner"s fear that the exchanges in his state were "very near collapse" after a staggering 59% premium surge:

“Consumers in Tennessee will continue to have affordable coverage options in 2017. Last year, the average monthly premium for people with Marketplace coverage getting tax credits increased just $2, from $102 to $104 per month, despite headlines suggesting double digit increases,” said Marjorie Connolly, HHS spokeswoman, in a statement.

We"re unsure whether Connolly"s comment was just propaganda intended to defend a failing piece of legislation or an intentional, blatant admission that the Department of Health and Human Services just doesn"t care about the majority of Americans, the so-called 1%"ers, who are facing debilitating increases in healthcare costs simply because they manage to live above the poverty line.  We"ll let you decide on that one.

Be that as it may, as the Miami Herald points out this morning, roughly half of all Obamacare participants, nearly 9 million people in aggregate, don"t qualify for the subsidies that Connolly praised and have been forced to absorb debilitating premium increases for the past several years.

Meanwhile, the pie chart above from 2017 doesn"t count the 1,000"s of unsubsidized "millionaire, billionaire, private jets owners" making over $50,000 per year who have already been forced to drop their healthcare coverage because it was simply unaffordable...a move which the Reiter family in Florida was forced to consider for 2018 after the premiums on their policy surged 54% to a cost of $40,000 per year.

As open enrollment for Affordable Care Act coverage nears the deadline of Dec. 15, and Florida once again leads all states using the federal exchange at healthcare.gov, Heidi and Richard Reiter sit at the kitchen table at their Davie home and struggle to piece together the family’s health insurance for 2018.

 

The Reiters buy their own coverage, but they earn too much to qualify for financial aid to lower their monthly premiums. For 2017, they bought a plan off the exchange and paid $26,000 in premiums for family coverage, including their two sons, ages 21 and 17.

 

Keeping the same coverage for 2018 would have cost the Reiters $40,000 in premiums, a 54 percent increase. So they selected a lower-priced plan that covers less but costs $29,000 in premiums.

 

“That’s more than a lot of people’s mortgage payments,” Richard Reiter said. “For me, it’s a crisis situation.”

Of course, while the Herald attempts to blame the Trump administration for Obamacare"s continued premium hikes in 2018, we would just remind everyone once again that premiums surged an average of 113% across the United States during Obama"s last term...

But sure, it"s all Trump"s fault.

Anthem Drops Obamacare In Ohio: 300,000 Without Insurance? Gruber Strikes Again

Authored by Mike Shedlock via MishTalk.com,

House Speaker Paul Ryan’s attempt to replace Obamacare was sheer madness. Left alone, Obamacare was imploding anyway. Republicans should have waited for Democrats to beg them to “do something”.

Left alone, Obamacare was imploding anyway. Republicans should have waited for Democrats to beg them to “do something”.

Republicans should have waited for Democrats to beg them to “do something”.

Bloomberg reports Insurer’s Obamacare Exit Could Leave 300,000 Without Options.

Anthem Inc.’s decision to quit Ohio’s Obamacare market will leave 13,000 people without any coverage option under the program next year. That number may rise to 300,000 if the health insurer follows suit in the rest of the states where it sells.

Anthem, which currently oversees Affordable Care Act plans for about 1.1 million people in 14 states, is one of the largest of the multistate insurers that hasn’t pulled back sharply from selling individual plans in the ACA. In April, it said it was “assessing our market footprint in 2018,” and on Tuesday the company said it would leave Ohio.

Currently, there are more than 30,000 people with Obamacare plans who are projected not to have an insurer under the program next year, according to data compiled by Bloomberg. An Anthem exit would raise that number to 300,000 people in seven states.

“Planning and pricing for ACA-compliant health plans has become increasingly difficult due to the shrinking individual market as well as continual changes in federal operations, rules and guidance,” Anthem said of its exit from Ohio. “The lack of certainty of funding for cost sharing reduction subsidies, the restoration of taxes on fully insured coverage and, an increasing lack of overall predictability simply does not provide a sustainable path forward to provide affordable plan choices for consumers.”

Anthem’s Ohio exit will leave 20 counties in the state without an Affordable Care Act coverage option in 2018. Blue Cross Blue Shield of Kansas City said last month it will pull out of the exchange in Missouri, leaving 25 bare counties and about 18,500 people without an ACA coverage option. Humana Inc. said earlier this year it would pull out from all 11 states next year where it currently sells ACA plans. Aetna Inc. said in May it would do the same, also announcing plans to abandon the few remaining states where it had been selling ACA coverage. UnitedHealth Group Inc., the largest U.S. insurer, has already exited ACA exchanges in most of the states where it sold plans. Some small and regional insurers have pulled out of states or counties as well.

If Anthem decided to leave the exchanges nationwide, another 310 counties could be without ACA plans in Colorado, Georgia, Kentucky, Missouri, Nevada and Virginia in addition to Ohio, bringing the total number of bare counties to 355. Anthem did file a rate request in Virginia for next year but could still decide not to sell there.

What if They All Pull Out?

As it stands huge portions of Missouri, Georgia, Nevada, and Kentucky may have no insurance. Smaller, but substantial, portions of Virginia, Ohio, and Colorado may have no insurance.

What would happen if the map was half red?

The New York Times explains in Bare Market: What Happens if Places Have No Obamacare Insurers?

The Obamacare marketplaces can be thought of as a government-run store. The government gives many customers subsidies, like gift cards, that they can use to buy insurance. But what happens if no companies want to sell their products in the store?

If all the insurers start leaving some stores, consumers there will find their options dwindling, and then their subsidies will become worthless. Most would end up uninsured. The problem could affect as few as dozens of customers — or spread more broadly to affect a substantial fraction of the approximately 11 million people currently enrolled in Obamacare coverage.

The markets created by the Affordable Care Act have always relied on the voluntary participation of private companies. If the government set up the right conditions for the market, the thinking went, insurers would want to jump in. But, as Sarah Kliff at Vox.com has reported, the law contained no real backup plan if that vision didn’t work out.

In theory, the bare market problem shouldn’t be a big worry. The federal government pays a large fraction of Obamacare premiums for most customers, and a single insurer can essentially name its price. Economists like Mr. Garthwaite see the situation as a happy circumstance for an insurance company. Who wouldn’t want a monopoly market where the government pays the bills?

“Why be at zero — why not come in and charge a freaking outrageous price and be the one?” said Jonathan Gruber, a health economist at M.I.T who advised the Obama administration when it was developing the Affordable Care Act. Then he answered his own question: “Many mysteries of life can be answered with the statement: Insurers are bizarrely risk-averse.”

If insurers do all decide to exit a market, no one is exactly sure what will happen next. Some experts have brainstormed about possible workarounds, but all would entail uncharted legal territory.

Officials at Covered California, the California state marketplace, produced a white paper outlining a series of options to fix the problem of so-called bare counties. But the top bullet point for nearly every option was: “Very difficult, if not impossible, to implement for 2018.”

Theory, Practice, Gruber

Jonathan Gruber, a health economist at M.I.T who advised the Obama administration, on Obamacare is back at it with his lies, formed innocuously in the form of a question.

“Why not come in and charge a freaking outrageous price and be the one?” asks Gruber. He knows the answer.

If insurers got to name their price, Anthem would not be requesting a hike in Virginia. Rather, Anthem would state it’s new price in Virgina.

If insurers got to name their price, major portions of at least 15 states would not be down to a single insurer.

Gruber on Voter Stupidity

Please consider Obamacare Depended on ‘Stupidity’ of Voters, Its Architect Says.

“Obamacare architect Jonathan Gruber said that lack of transparency was a major part of getting Obamacare passed because ‘the stupidity of the American voter’ would have killed the law if more people knew what was in it,” according to the Caller.

Gruber served as a technical consultant to the Obama administration and is widely recognized as the law’s architect.

But as challenges to the law have surfaced, the administration has sought to distance itself from Gruber, who acknowledged during the panel discussion that the legislation was purposely written in a confusing way to make sure that the Congressional Budget Office did not score the individual mandate as a tax, a part of the law the Supreme Court upheld on the assertion that it was, in fact, a tax.

“This bill was written in a tortured way to make sure CBO did not score the mandate as taxes. If CBO scored the mandate as taxes, the bill dies. Okay, so it’s written to do that,” Gruber said.

“In terms of risk rated subsidies, if you had a law which said that healthy people are going to pay in — you made explicit healthy people pay in and sick people get money, it would not have passed… Lack of transparency is a huge political advantage.

“And basically, call it the stupidity of the American voter or whatever, but basically that was really, really, critical to get the thing to pass… Look, I wish Mark was right that we could make it all transparent, but I’d rather have this law than not,” he said.

The National Review reported in July that Gruber was paid nearly $400,000 to consult with the administration, and that in 2012 he told an audience at a technical management support organization that tax credits were only available in states that set up their own exchanges.

In August, Breitbart News reported that the White House and ranking Congressional Democrats began distancing themselves from Gruber, after a federal appeals court ruled that people who bought their insurance from healthcare exchanges administered by the federal government in 34 states were not eligible for billions of dollars in tax subsidies.

Lies, Deception, Gruber, Obama

We have this tortured mess known as Obamacare thanks to purposeful lies and deception by Gruber and Obama.

Now, thanks to Republican silliness from House Peaker Ryan and Trump with their push for a replacement that no one is happy with, Republicans took sponsorship of the mess.

Trump Saves Obamacare Again... For Now

The Trump administration and the House have officially asked for another 90 days to work out a lawsuit over subsidies that help poorer people afford to use their Obamacare insurance plans, further delaying a long-running legal fight that’s already destabilizing the health law.

As Axio snotes, the key point is - "The parties continue to discuss measures that would obviate the need for judicial determination of this appeal, including potential legislative action."

Full motion below...

Bloomberg continues...

Without the payments, insurers have threatened to drop out of Obamacare or substantially raise premiums, and customers could face thousands of dollars in unexpected costs. The Trump administration could still choose to drop the appeal, though other parties are attempting to take up defense of the payments.

State officials, the health industry and Democrats in Congress have pushed for the payments to continue, saying that ending them would upend the insurance market and cost millions of people their health insurance.

“We need swift action and long-term certainty on this critical program,” Cathryn Donaldson, a spokeswoman for America’s Health Insurance Plans, said in an email.

“It is the single most destabilizing factor in the individual market, and millions of Americans could soon feel the impact of fewer choices, higher costs, and reduced access to care.”

The group is one of the main lobbying associations for health insurers.

However, as Bloomberg reports, while the latest delay is a reprieve for Obamacare, it does little to resolve the underlying uncertainty created by the case and by Republican efforts in Congress to repeal and replace large parts of the law. Health insurers are in the midst of deciding whether to participate in the Affordable Care Act next year, and what to charge customers. Some have already said they’ll raise premiums in 2018 because of uncertainty around the subsidies.

Trump previously threatened to use the CSR payments as a bargaining chip to bring Democrats to the table on health care if Republicans can’t muster enough repeal votes in the Senate. He also tried to use them as leverage to gain funding for a border wall with Mexico, saying he’d give Democrats a dollar in CSR money for every dollar for the wall.

Of course,  the Democrats had plenty to say...

Senate Majority Leader Chuck Schumer said the decision to continue the funding showed the administration knows that continuing the payments is the right thing to do. He criticized the uncertainty from Trump on their future.

"Unfortunately, by kicking the can down the road once again, the administration is continuing to sow uncertainty in the markets that will hurt millions of Americans," Schumer said in a statement. "Instead of hemming and hawing, they ought to step up to the plate and say once and for all that they will make these payments permanently, which help millions of Americans pay less for their health care."

House Democratic Leader Nancy Pelosi, of California, criticized the action to delay the lawsuit further rather than resolve it once and for all.

“Republicans cynically continue to sow uncertainty in the health coverage of millions of Americans,” Pelosi said in a statement. “At a critical period when insurers are deciding premiums for next year, Republicans are pouring uncertainty into the health insurance marketplaces.”

While the delay will move the next update for the case to mid-August, the deadline for insurers to submit their 2018 plans for Obamacare" exchanges in most states is June 21.