Archive for Sunday, September 10, 2017

Insurers blame Washington politics for health care rate hikes; Colyer still blames Obamacare

September 10, 2017


— Two health insurance companies that offer Obamacare policies in Kansas said last week that Washington politics are largely to blame for the rate hikes they are seeking next year, but Lt. Gov. Jeff Colyer, a vocal critic of the program, said he still believes Obamacare itself is to blame.

Officials from Blue Cross Blue Shield of Kansas and Medica Insurance Co., based in Minnetonka, Minn., spoke last week after the Kansas Insurance Department announced the range of rate changes being proposed for next year.

Both companies said they plan to charge higher premiums next year, although most consumers will not feel the effects of those if they qualify for tax credit subsidies. And both said a big reason for the rate hikes is uncertainty over the future of the program and whether Congress and the Trump administration will fully fund it.

“One of the big issues is whether the cost-sharing will be funded,” said Medica spokesman Larry Bussey. “There are also issues about how aggressively the individual mandate will be enforced. If that’s not enforced, obviously that would tend to have healthy people stay out of the market.”

Under Obamacare, people with incomes below 250 percent of the federal poverty level, or $37,650 for an individual, can qualify for additional subsidies to offset their copays and deductibles if they buy a certain kind of mid-level, or “silver” health plan.

In those plans, insurers are expected to pay health care providers in full and then get reimbursed by the federal government for the copay and deductible that would otherwise be the patient’s responsibility.

In July, however, President Donald Trump threatened to cut off those cost-sharing payments, saying in a tweet that they were “bailouts for insurance companies.”

“Which of course, it’s not a bail-out,” said Blue Cross Blue Shield spokeswoman Mary Beth Chambers. “It was an agreement with the government that we would pay the providers up front and then we would get reimbursed. Month to month, there is still concern as to whether the government is going to continue reimbursing insurance companies for the cost-sharing reductions that they have paid.”

In fact, this year, Kansas Insurance Commissioner Ken Selzer specifically allowed companies to build into their rate plans increased costs that could result if Washington does not fund the cost-sharing program, Chambers said.

“We were allowed to, for that specific silver plan, kind of load in a rate that would cover the cost of cost-sharing reductions if we were not to get those payments from the government," she said.

The administration has also shortened this year’s open enrollment period to a six-week period, from Nov. 1 through Dec. 15. It has also reduced funding in the Department of Health and Human Services for advertising open enrollment and paying for the health care “navigators” who help consumers shop for plans on the exchange market.

During 2017, nearly 98,780 Kansans bought health insurance through the Obamacare exchange, according to HHS. The vast majority of those, or roughly 84 percent, received subsidies in the form of advance tax credits to pay their premiums, and more than half, 55 percent, qualified for cost-sharing assistance.

The vast majority of those plans were sold by Blue Cross Blue Shield of Kansas, which did not submit proposed rate changes this year because it plans to offer policies through a different corporate entity next year — an “exclusive provider organization” instead of its HMO — which technically makes Blue Cross a new carrier on the exchange market, Chambers said.

Chambers said the main reason it chose to make that change was the fact that Kansas lawmakers this year approved Gov. Sam Brownback’s proposal for a big increase in the privilege fee it levies on HMO policies in order to pay for restoring a 4-percent cut in Medicaid reimbursement rates ordered the previous year.

However, Chambers said, the premiums under the new Blue Cross plans will be higher than under the 2017 plans. She also said the benefits and the provider networks will be the same under the new plans.

Medica, which sold only about 6,000 policies in Kansas this year, submitted rate increases for two plans. Under one, rates would increase an average of 16.62 percent, and another averaging 29.79 percent.

Blue Cross sells plans only in the 103 counties outside of Johnson and Wyandotte counties. Medica sells policies in all 105 counties in Kansas.

The exact increase that an individual would experience depends on many factors, company officials said, including the person’s age, location, tobacco use and the size of their family, if they purchase family coverage.

In its rate filing, Medica cited a number of factors such as medical inflation, a sicker population than it initially predicted and “(an) unprecedented amount of uncertainty and risk inherent in the marketplace.”

The Insurance Department announced those proposed rates, which are still subject to public comment and approval, on Aug. 31. The next day, Lt. Gov. Colyer issued a statement that mentioned only the 29 percent rate hike, and blaming it all on flaws in Obamacare itself.

“The 29 (percent) increases for health insurance are another rung on the ObamaCare ladder of failure, just months after this broken system forced a major insurer to leave the Kansas City market,” Colyer said, referring to Blue Cross Blue Shield of Kansas City’s decision to drop out of the exchange market in 2018.

“This cost increase will force Kansans to cut their family budgets to obtain needed healthcare services,” Colyer continued. “I urge Congress to keep their promise to repeal ObamaCare and allow us to work with our stakeholders to create Kansas solutions for Kansas families."

In fact, most people who receive subsidies to buy their insurance will not see higher costs for themselves because the amount they pay is determined by their income, and the subsidies increase as the cost of policies increase.

The Journal-World attempted to contact Colyer to clarify his statement and to respond to the company officials who said the rate increases were largely due to uncertainty in Washington over the future of the program.

Through his spokesperson, Colyer issued another statement reiterating his first.

“The ObamaCare debacle has caused market instability in Kansas and all across the nation, to the detriment of low-income households who are forced to make tough decisions with their family budgets,” he said. “The true path forward is for Congress to repeal and replace ObamaCare so we can create Kansas solutions for Kansas families.”


Richard Heckler 4 months, 2 weeks ago

Colyer like Gov Brownback works for ALEC.

It's the medical insurance industry that decides to increase rates NOT ObamaCare.

It's also odd that USA citizens are forced to pay dollars to the medical insurance industry that which does not provide medical care. WHY? The medical insurance industry increases the cost of health care simply because the industry exists.

This industry and the pharmaceutical industry shells out health care dollars:

to high dollars CEO's

to golden parachutes

to 8 lobbyists per elected official

to dark money special interest political campaign sources

to generous commissions, salaries and bonus packages

none of which have anything to do with healthcare.


Richard Heckler 4 months, 2 weeks ago

The amount of tax dollars spent on health care as we speak could cover a large portion of Medicare Single Payer Insurance for ALL. Our tax dollars are essentially in place to work for us.

If only politicians and special interest campaign money would get out of the way.

Here are 10 great reasons to support Medicare Single Payer Insurance and Reduce Government Spending BIG TIME.

  1. Everybody In, Nobody Out. Universal means access to health care for everyone, period. Plus it is estimated to create 2.6 million new jobs!

  2. Portability. If you are unemployed, or lose or change jobs, your health coverage stays with you.

  3. Uniform Benefits. No Cadillac plans for the wealthy and Pinto plans for everyone else, with high deductibles, limited services, caps on payments for care, and no protection in the event of a catastrophe. One level of comprehensive care for everyone, regardless of the size of your wallet.

  4. Prevention. By removing financial roadblocks, a universal health system encourages preventive care that lowers an individual's ultimate cost and pain and suffering when problems are neglected and societal cost in the over-utilization of emergency rooms or the spread of communicable diseases.

  5. Choice. Most private insurance restricts your choice of providers and hospitals. Under the U.S. National Health Insurance Act, patients have a choice, and the provider is assured a fair payment.

  6. No Interference with Care. Caregivers and patients regain their autonomy to decide what's best for a patient's health, not what's dictated by the billing department. No denial of coverage 6for pre-existing conditions or cancellation of policies for "unreported" minor health problems.

  7. Reducing Waste. One third of every private health insurance dollar goes for paperwork and profits, compared to about 3% under Medicare, the federal government’s universal system for senior citizen healthcare.

  8. Cost Savings. A guaranteed health care system can produce the cost savings needed to cover everyone, largely by using existing resources without the waste. Taiwan, shifting from a U.S. private health care model, adopted a similar system in 1995, boosting health coverage from 57% to 97% with little increase in overall health care spending.

  9. Common Sense Budgeting. The public system sets fair reimbursements applied equally to all providers, private and public, while assuring that appropriate health care is delivered, and uses its clout to negotiate volume discounts for prescription drugs and medical equipment.

  10. Public Oversight. The public sets the policies and administers the system, not high priced CEOs meeting in private and making decisions based on their company’s stock performance needs.

P Allen Macfarlane 4 months, 2 weeks ago

Another Republican denier! I might believe that Obamacare was to blame it the claim came from a Democrat.

Steve Jacob 4 months, 2 weeks ago

I can blame both, but insurance rates will always go up no matter what a President does or laws that Congress pass. Any politician that says otherwise is wrong.

Dorothy Hoyt-Reed 4 months, 2 weeks ago

Exactly. They were going up and up even before the ACA. Profit is king in the US, and until we get a single payer, non profit system, then they will continue. And we need to rein in those drug companies too. Throw some CEO's in prison for price gouging.

Bob Smith 4 months, 2 weeks ago

The ACA has affected insurance markets in a profound manner. It's the 800-pound gorilla in the room. What would have happened without it? We'll never know for sure.

Greg Cooper 4 months, 2 weeks ago

Then how the hell do you know it's affected insurance rates, Bob? Maybe that gorilla is not even a monkey, ya think?

What it has affected is that millions of people now have medical insurance that they did not have before the ACA.

Why are you guys so incensed that some people might live now that may not have earlier?

Phillip Chappuie 4 months, 2 weeks ago

Before ACA my premiums were on the steady creep. !2% one year, 17% the next year, on and on. Those increases tended to have the net effect of wiping out any pay increases. It is clear to any reasonable person that as long as health care is based on profit driven all for the shareholders it will never get better. The over health of citizens is secondary and treatments are directed by the companies, not the doctor/patient. It sucks. And there is no reward or incentive for the healthy. Your premiums are still going to go up. Dump the ACA and ALL premiums will skyrocket.

Steve King 4 months, 2 weeks ago

Don't forget, this is the guy who loaned Brownback's campaign the same $500,000...three times. Right before the reporting peroids then took it right back. Padding the books my Dad called it. His ethics are questionable to say the least.

Fred Whitehead Jr. 4 months, 2 weeks ago

Health care costs money.......people are wanting free health care..............The Affordable Care Act was an attempt by the previous administration to find a cure for the fact that health care costs money. And people do not want to spend money on health care or take measures to protect their health. Let the government do it.

It was doomed to failure for one reason and one reason only...The incredible lack of any sort of sense of responsibility for one's health by engaging in health life styles.

No health care system can cause irresponsible behavior to cease.

Steve King 4 months, 2 weeks ago

People forget the ACA was a 3 legged stool. That 17 Govenors sued to have one leg removed. Those that expanded MC did fine. Those that didn't sabotaged it.

Richard Heckler 4 months, 2 weeks ago

Medicare Single Payer upgraded insurance is not government healthcare no way jose. The only government healthcare service is through active duty military and to some extent the VA. I say bring on Single Payer then move vets to that service because the VA is getting swamped due to the ongoing 24/7 war machine that has been active since 1980.

IMPROVED Medicare Single Payer Insurance is NOT free. Conservatives have zero respect for OUR tax dollars.

Richard Heckler 4 months, 2 weeks ago

Put forth choices which allow consumers aka voters to pick which seems more practical for their needs.

=== ObamaCare which retains the health insurance industry for those who are pleased with the medical insurance industry after all it is their dollar. This needs stiff federal regulations that cannot be superseded by the states. Offer a tax dollar rebate at the end of every year that would equal about what families would “payout” through taxes FOR Single Payer = $3300..

=== Single Payer Medicare for ALL = excellent coverage for those who wish to enroll. The absolute best choice on planet earth. This group does not need tax rebates because our taxes are working for this plan and we the taxpayers.

WE know that using the existing medicare template to service Medicare for All Single payer saves lots and lots of dollars over reinventing the wheel.

=== ALLOW self financed health care for those able to do so. Paying out of pocket is more efficient for this group. Offer a tax dollar rebate at the end of every year that would equal about what families would “payout” for Single Payer through taxes = $3300.

=== ALL Disabled vets should receive Medicare with a 100% benefit so they and their families can receive medical care immediately upon discharge. Make it retroactive.

=== Let the voters approve this package. NO ONE SHOULD BE UNDERINSURED AGAIN NEVER EVER. Under insurance should be prohibited.


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