Obamacare Success: Inexorably Crushing the Life out of the Insurance business

[dblack]

The insurance industry isn't going to suffer from PPACA, quite the opposite. It sets them up as permanent middle-men in nearly every health care transaction. You really can't do better than mandated customers.

You didn't really just say this?

Lets just start with this....

1) Coverages Mandated
2) Premiums mandated
3)All pre-existings MUST be covered
4) .80 cents of EVERY dollar payed toward claims....

Private insurers are for profit, the law leaves no ROOM for profit.
Educate yourself.

With all due respect you have no idea as to what you are talking about.

You're looking at it from the perspective of a business operating in a free market. With PPACA, the insurance industry has removed itself from such concerns. They are becoming, essentially, public for-profit utilities. The regulations will be adjusted as necessary to preserve that arrangement.

Their acquiescence on "reform" was no coincidence. They saw the writing on the wall. The model of corporate group health insurance is fundamentally dysfunctional and doomed. It's driving prices relentlessly higher and they've bleed the market for all they can. By "collaborating" with government, they get to maintain their dominance (and profits) indefinitely. PPACA is a bailout of the insurance industry.

Who Wrote the PPACA?

http://www.huffingtonpost.com/2012/12/05/liz-fowler-johnson-johnson_n_2245367.html

 

[Antares]

The law itself is designed to crush private insurers, sorry.

It is designed to NOT allow a company to "make" money through insurance..

It is designed to usher in the single payor Obama wants....there will be no profit and very soon you will see Companies dropping their plans.

The insurance industry isn't going to suffer from PPACA, quite the opposite. It sets them up as permanent middle-men in nearly every health care transaction. You really can't do better than mandated customers.

You didn't really just say this?

Lets just start with this....

1) Coverages Mandated
2) Premiums mandated
3)All pre-existings MUST be covered
4) .80 cents of EVERY dollar payed toward claims....

Private insurers are for profit, the law leaves no ROOM for profit.
Educate yourself.

With all due respect you have no idea as to what you are talking about.

You're looking at it from the perspective of a business operating in a free market. With PPACA, the insurance industry has removed itself from such concerns. They are becoming, essentially, public for-profit utilities. The regulations will be adjusted as necessary to preserve that arrangement.

Their acquiescence on "reform" was no coincidence. They saw the writing on the wall. The model of corporate group health insurance is fundamentally dysfunctional and doomed. It's driving prices relentlessly higher and they've bleed the market for all they can. By "collaborating" with government, they get to maintain their dominance (and profits) indefinitely. PPACA is a bailout of the insurance industry.

Who Wrote the PPACA?

 

[dblack]

The law itself is designed to crush private insurers

I don't see it. Otherwise the insurance industry would have never went along with it. It will radically change the nature of how they generate profits. But if anything, it's saving them from the corner they've painted themselves into.

It is designed to NOT allow a company to "make" money through insurance..

It's designed to alleviate them of the burden. All they have to do is collect it, from their mandated customers. They give 20% and "give" the rest back to us in benefits.

It is designed to usher in the single payor Obama wants....there will be no profit and very soon you will see Companies dropping their plans.

Well, we'll see how goes. I do think you'll see lots of mergers and consolidation - conceivably even down to one company. But from my perspective, the entire point of the industry's lobbying efforts re PPACA was to prevent the public option, which they saw as an inroad to single payer and the beginning of their end. Time will tell whether it's a permanent deflection or just buying time.

I think perhaps we're seeing the same thing from a different perspective, and a different assessment of the motives involved. Ultimately, this a merging of corporate and state power. The two might actually become so coupled that we'll have something like "single payer".

 

[Vandalshandle]

Obamacare is succeeding as planned, not in lowering cost, but in crushing the private insurance business so that one day the Federal government will be the bankrupt insurer of last resort.

Obama recently issued guidelines that mandate costly coverage, the carriers have to pass the cost on to the buyers, so the companies are dropping spouses from the plan.

Why your boss is dumping your wife - MarketWatch

Companies have a new solution to rising health-insurance costs: Break up their employees’ marriages.

What a deal!

Swabb Health Care Fund (mutaul fund of health insurance companies). Purchsed $5,000 in shares on 4/11/08. Worth $8,170 on 3/1/13. Thank you president Obama!

SWHFX Schwab Health Care Fund SWHFX Quote Price News

 

[Antares]

I don't see it. Otherwise the insurance industry would have never went along with it. It will radically change the nature of how they generate profits. But if anything, it's saving them from the corner they've painted themselves into.

They had no choice, IF Obamacare stands there will be NO competition, it madates EVERYBODY cover the same things and charge the same prices.

It's designed to alleviate them of the burden. All they have to do is collect it, from their mandated customers. They give 20% and "give" the rest back to us in benefits.

They get 20 cents on the dolar to pay their administrative costs and salaries, you have never run a business have you?

Well, we'll see how goes. I do think you'll see lots of mergers and consolidation - conceivably even down to one company. But from my perspective, the entire point of the industry's lobbying efforts re PPACA was to prevent the public option, which they saw as an inroad to single payer and the beginning of their end. Time will tell whether it's a permanent deflection or just buying time.

You are right, there will be a major culling at this time I see 3, BCBS, United Health Care and Aetna, they are gobbling the other companies.
MOST companies have already terminated their agent contracts.

this a merging of corporate and state power

And this is called?

 

[Greenbeard]

Now suppose they figure out a new medical management program that helps keep people out of the hospital or helps people avoid expensive surgeries, thereby reducing claims costs. And that program increases admin costs a little.

So now that same insurance company goes from $80 in claims down to $70 in claims, while their admin costs go from $16 up to $20, and they price for a premium that keeps their $4 profit. So their new premium = profit + claims + admin = 4 + 70 + 20 = 94, and their new MLR = 70 / 94 = 74.5%. N

So they got more efficient by reducing medical costs, avoiding needless surgeries and hospital stays, and decreased the premiums they charge, but are now non-compliant with the MLR rule.

No.

The medical loss ratio is specified in law as the ratio of the amount of premium revenue expended by an insurance issuer on the costs of (1) reimbursement for clinical services provided to enrollees under such coverage + (2) activities that improve health care quality to the total amount of premium revenue.

In other words, premium revenue spent on activities to improve health care quality don't count against an insurer, it actually helps it to meet the MLR requirements, just as direct spending on clinical services through claims would. Activities to improve health care quality, as defined in regulation, include your example.

(b) Activity requirements. Activities conducted by an issuer to improve quality must meet the following requirements:

(1) The activity must be designed to:

(i) Improve health quality.
(ii) Increase the likelihood of desired health outcomes in ways that are capable of being objectively measured and of producing verifiable results and achievements.
(iii) Be directed toward individual enrollees or incurred for the benefit of specified segments of enrollees or provide health improvements to the population beyond those enrolled in coverage as long as no additional costs are incurred due to the non-enrollees.
(iv) Be grounded in evidence-based medicine, widely accepted best clinical practice, or criteria issued by recognized professional medical associations, accreditation bodies, government agencies or other nationally recognized health care quality organizations.​

(2) The activity must be primarily designed to:

(i) Improve health outcomes including increasing the likelihood of desired outcomes compared to a baseline and reduce health disparities among specified populations.

(A) Examples include the direct interaction of the issuer (including those services delegated by contract for which the issuer retains ultimate responsibility under the insurance policy), providers and the enrollee or the enrollee's representative (for example, face-to-face, telephonic, web-based interactions or other means of communication) to improve health outcomes, including activities such as:

(1) Effective case management, care coordination, chronic disease management, and medication and care compliance initiatives including through the use of the medical homes model as defined in section 3606 of the Affordable Care Act.
(2) Identifying and addressing ethnic, cultural or racial disparities in effectiveness of identified best clinical practices and evidence based medicine.
(3) Quality reporting and documentation of care in non-electronic format.
(4) Health information technology to support these activities.
(5) Accreditation fees directly related to quality of care activities.​

(B) [Reserved]​

(ii) Prevent hospital readmissions through a comprehensive program for hospital discharge. Examples include:

(A) Comprehensive discharge planning (for example, arranging and managing transitions from one setting to another, such as hospital discharge to home or to a rehabilitation center) in order to help assure appropriate care that will, in all likelihood, avoid readmission to the hospital;
(B) Patient-centered education and counseling.
(C) Personalized post-discharge reinforcement and counseling by an appropriate health care professional.
(D) Any quality reporting and related documentation in non-electronic form for activities to prevent hospital readmission.
(E) Health information technology to support these activities.​

(iii) Improve patient safety, reduce medical errors, and lower infection and mortality rates.

(A) Examples of activities primarily designed to improve patient safety, reduce medical errors, and lower infection and mortality rates include:

(1) The appropriate identification and use of best clinical practices to avoid harm.
(2) Activities to identify and encourage evidence-based medicine in addressing independently identified and documented clinical errors or safety concerns.
(3) Activities to lower the risk of facility-acquired infections.
(4) Prospective prescription drug Utilization Review aimed at identifying potential adverse drug interactions.
(5) Any quality reporting and related documentation in non-electronic form for activities that improve patient safety and reduce medical errors.
(6) Health information technology to support these activities.​

(B) [Reserved]​

(iv) Implement, promote, and increase wellness and health activities:

(A) Examples of activities primarily designed to implement, promote, and increase wellness and health activities, include—

(1) Wellness assessments;
(2) Wellness/lifestyle coaching programs designed to achieve specific and measurable improvements;
(3) Coaching programs designed to educate individuals on clinically effective methods for dealing with a specific chronic disease or condition;
(4) Public health education campaigns that are performed in conjunction with State or local health departments;
(5) Actual rewards, incentives, bonuses, reductions in copayments (excluding administration of such programs), that are not already reflected in premiums or claims should be allowed as a quality improvement activity for the group market to the extent permitted by section 2705 of the PHS Act;
(6) Any quality reporting and related documentation in non-electronic form for wellness and health promotion activities;
(7) Coaching or education programs and health promotion activities designed to change member behavior and conditions (for example, smoking or obesity); and
(8) Health information technology to support these activities.​

(B) [Reserved]​

(v) Enhance the use of health care data to improve quality, transparency, and outcomes and support meaningful use of health information technology consistent with § 158.151 of this subpart.​

 

[dblack]

I don't see it. Otherwise the insurance industry would have never went along with it. It will radically change the nature of how they generate profits. But if anything, it's saving them from the corner they've painted themselves into.

They had no choice, IF Obamacare stands there will be NO competition, it madates EVERYBODY cover the same things and charge the same prices.

Exactly. That's my point. What business wouldn't dream of operating in a "market" where there's no competition? We're setting up a state sanctioned cartel of insurance companies and handing them mandated customers on a plate.

It's designed to alleviate them of the burden. All they have to do is collect it, from their mandated customers. They give 20% and "give" the rest back to us in benefits.

They get 20 cents on the dolar to pay their administrative costs and salaries, you have never run a business have you?

I have, actually. And no, you couldn't make that work in a free market. In a free market, you have to actually produce something customers want to buy. But with PPACA they've regulated away competition, and mandated customers - how can they lose? They'll all basically do the same math - they'll cut back on whatever they have to max out their 20% while meeting token minimum coverage requirements.

this a merging of corporate and state power

And this is called?

Broadly, it's corporatism - but not because corporations are involved. Corporatism is the entire mode of government where power sharing deals (like PPACA) are commonplace and group rights supersede individual rights.

 

[Queecho Feecho]

You didn't really just say this?

Lets just start with this....

1) Coverages Mandated
2) Premiums mandated
3)All pre-existings MUST be covered
4) .80 cents of EVERY dollar payed toward claims....

Private insurers are for profit, the law leaves no ROOM for profit.
Educate yourself.

With all due respect you have no idea as to what you are talking about.

The insurance industry isn't going to suffer from PPACA, quite the opposite. It sets them up as permanent middle-men in nearly every health care transaction. You really can't do better than mandated customers.

What does #2 "Premiums mandated" mean?

Which section of the law is that? Or can you point me towards a regulation that lays that out?

 

[CrusaderFrank]

Now suppose they figure out a new medical management program that helps keep people out of the hospital or helps people avoid expensive surgeries, thereby reducing claims costs. And that program increases admin costs a little.

So now that same insurance company goes from $80 in claims down to $70 in claims, while their admin costs go from $16 up to $20, and they price for a premium that keeps their $4 profit. So their new premium = profit + claims + admin = 4 + 70 + 20 = 94, and their new MLR = 70 / 94 = 74.5%. N

So they got more efficient by reducing medical costs, avoiding needless surgeries and hospital stays, and decreased the premiums they charge, but are now non-compliant with the MLR rule.

No.

The medical loss ratio is specified in law as the ratio of the amount of premium revenue expended by an insurance issuer on the costs of (1) reimbursement for clinical services provided to enrollees under such coverage + (2) activities that improve health care quality to the total amount of premium revenue.

In other words, premium revenue spent on activities to improve health care quality don't count against an insurer, it actually helps it to meet the MLR requirements, just as direct spending on clinical services through claims would. Activities to improve health care quality, as defined in regulation, include your example.

(b) Activity requirements. Activities conducted by an issuer to improve quality must meet the following requirements:

(1) The activity must be designed to:

(i) Improve health quality.
(ii) Increase the likelihood of desired health outcomes in ways that are capable of being objectively measured and of producing verifiable results and achievements.
(iii) Be directed toward individual enrollees or incurred for the benefit of specified segments of enrollees or provide health improvements to the population beyond those enrolled in coverage as long as no additional costs are incurred due to the non-enrollees.
(iv) Be grounded in evidence-based medicine, widely accepted best clinical practice, or criteria issued by recognized professional medical associations, accreditation bodies, government agencies or other nationally recognized health care quality organizations.​

(2) The activity must be primarily designed to:

(i) Improve health outcomes including increasing the likelihood of desired outcomes compared to a baseline and reduce health disparities among specified populations.

(A) Examples include the direct interaction of the issuer (including those services delegated by contract for which the issuer retains ultimate responsibility under the insurance policy), providers and the enrollee or the enrollee's representative (for example, face-to-face, telephonic, web-based interactions or other means of communication) to improve health outcomes, including activities such as:

(1) Effective case management, care coordination, chronic disease management, and medication and care compliance initiatives including through the use of the medical homes model as defined in section 3606 of the Affordable Care Act.
(2) Identifying and addressing ethnic, cultural or racial disparities in effectiveness of identified best clinical practices and evidence based medicine.
(3) Quality reporting and documentation of care in non-electronic format.
(4) Health information technology to support these activities.
(5) Accreditation fees directly related to quality of care activities.​

(B) [Reserved]​

(ii) Prevent hospital readmissions through a comprehensive program for hospital discharge. Examples include:

(A) Comprehensive discharge planning (for example, arranging and managing transitions from one setting to another, such as hospital discharge to home or to a rehabilitation center) in order to help assure appropriate care that will, in all likelihood, avoid readmission to the hospital;
(B) Patient-centered education and counseling.
(C) Personalized post-discharge reinforcement and counseling by an appropriate health care professional.
(D) Any quality reporting and related documentation in non-electronic form for activities to prevent hospital readmission.
(E) Health information technology to support these activities.​

(iii) Improve patient safety, reduce medical errors, and lower infection and mortality rates.

(A) Examples of activities primarily designed to improve patient safety, reduce medical errors, and lower infection and mortality rates include:

(1) The appropriate identification and use of best clinical practices to avoid harm.
(2) Activities to identify and encourage evidence-based medicine in addressing independently identified and documented clinical errors or safety concerns.
(3) Activities to lower the risk of facility-acquired infections.
(4) Prospective prescription drug Utilization Review aimed at identifying potential adverse drug interactions.
(5) Any quality reporting and related documentation in non-electronic form for activities that improve patient safety and reduce medical errors.
(6) Health information technology to support these activities.​

(B) [Reserved]​

(iv) Implement, promote, and increase wellness and health activities:

(A) Examples of activities primarily designed to implement, promote, and increase wellness and health activities, include—

(1) Wellness assessments;
(2) Wellness/lifestyle coaching programs designed to achieve specific and measurable improvements;
(3) Coaching programs designed to educate individuals on clinically effective methods for dealing with a specific chronic disease or condition;
(4) Public health education campaigns that are performed in conjunction with State or local health departments;
(5) Actual rewards, incentives, bonuses, reductions in copayments (excluding administration of such programs), that are not already reflected in premiums or claims should be allowed as a quality improvement activity for the group market to the extent permitted by section 2705 of the PHS Act;
(6) Any quality reporting and related documentation in non-electronic form for wellness and health promotion activities;
(7) Coaching or education programs and health promotion activities designed to change member behavior and conditions (for example, smoking or obesity); and
(8) Health information technology to support these activities.​

(B) [Reserved]​

(v) Enhance the use of health care data to improve quality, transparency, and outcomes and support meaningful use of health information technology consistent with § 158.151 of this subpart.​

If you still had any doubts about Greenbeard being on Cass's payroll to post here...

 

[Antares]

Exactly. That's my point. What business wouldn't dream of operating in a "market" where there's no competition? We're setting up a state sanctioned cartel of insurance companies and handing them mandated customers on a plate.

No, we are setting it up for a Gov single payor system.

Broadly, it's corporatism - but not because corporations are involved. Corporatism is the entire mode of government where power sharing deals (like PPACA) are commonplace and group rights supersede individual rights.

It's called Socialism.

What does #2 "Premiums mandated" mean?

Which section of the law is that? Or can you point me towards a regulation that lays that out?

It means that ANY plan offered on the Exchanges are ALL the same price.

SEC. 2701. FAIR HEALTH INSURANCE PREMIUMS.

`(a) Prohibiting Discriminatory Premium Rates-
`(1) IN GENERAL- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market--
`(A) such rate shall vary with respect to the particular plan or coverage involved only by--
`(i) whether such plan or coverage covers an individual or family;
`(ii) rating area, as established in accordance with paragraph (2);
`(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c)); and
`(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and
`(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).

Bill Text - 111th Congress (2009-2010) - THOMAS (Library of Congress)

 

[Queecho Feecho]

Now suppose they figure out a new medical management program that helps keep people out of the hospital or helps people avoid expensive surgeries, thereby reducing claims costs. And that program increases admin costs a little.

So now that same insurance company goes from $80 in claims down to $70 in claims, while their admin costs go from $16 up to $20, and they price for a premium that keeps their $4 profit. So their new premium = profit + claims + admin = 4 + 70 + 20 = 94, and their new MLR = 70 / 94 = 74.5%. N

So they got more efficient by reducing medical costs, avoiding needless surgeries and hospital stays, and decreased the premiums they charge, but are now non-compliant with the MLR rule.

No.

The medical loss ratio is specified in law as the ratio of the amount of premium revenue expended by an insurance issuer on the costs of (1) reimbursement for clinical services provided to enrollees under such coverage + (2) activities that improve health care quality to the total amount of premium revenue.

In other words, premium revenue spent on activities to improve health care quality don't count against an insurer, it actually helps it to meet the MLR requirements, just as direct spending on clinical services through claims would. Activities to improve health care quality, as defined in regulation, include your example.

(b) Activity requirements. Activities conducted by an issuer to improve quality must meet the following requirements:

(1) The activity must be designed to:

(i) Improve health quality.
(ii) Increase the likelihood of desired health outcomes in ways that are capable of being objectively measured and of producing verifiable results and achievements.
(iii) Be directed toward individual enrollees or incurred for the benefit of specified segments of enrollees or provide health improvements to the population beyond those enrolled in coverage as long as no additional costs are incurred due to the non-enrollees.
(iv) Be grounded in evidence-based medicine, widely accepted best clinical practice, or criteria issued by recognized professional medical associations, accreditation bodies, government agencies or other nationally recognized health care quality organizations.​

(2) The activity must be primarily designed to:

(i) Improve health outcomes including increasing the likelihood of desired outcomes compared to a baseline and reduce health disparities among specified populations.

(A) Examples include the direct interaction of the issuer (including those services delegated by contract for which the issuer retains ultimate responsibility under the insurance policy), providers and the enrollee or the enrollee's representative (for example, face-to-face, telephonic, web-based interactions or other means of communication) to improve health outcomes, including activities such as:

(1) Effective case management, care coordination, chronic disease management, and medication and care compliance initiatives including through the use of the medical homes model as defined in section 3606 of the Affordable Care Act.
(2) Identifying and addressing ethnic, cultural or racial disparities in effectiveness of identified best clinical practices and evidence based medicine.
(3) Quality reporting and documentation of care in non-electronic format.
(4) Health information technology to support these activities.
(5) Accreditation fees directly related to quality of care activities.​

(B) [Reserved]​

(ii) Prevent hospital readmissions through a comprehensive program for hospital discharge. Examples include:

(A) Comprehensive discharge planning (for example, arranging and managing transitions from one setting to another, such as hospital discharge to home or to a rehabilitation center) in order to help assure appropriate care that will, in all likelihood, avoid readmission to the hospital;
(B) Patient-centered education and counseling.
(C) Personalized post-discharge reinforcement and counseling by an appropriate health care professional.
(D) Any quality reporting and related documentation in non-electronic form for activities to prevent hospital readmission.
(E) Health information technology to support these activities.​

(iii) Improve patient safety, reduce medical errors, and lower infection and mortality rates.

(A) Examples of activities primarily designed to improve patient safety, reduce medical errors, and lower infection and mortality rates include:

(1) The appropriate identification and use of best clinical practices to avoid harm.
(2) Activities to identify and encourage evidence-based medicine in addressing independently identified and documented clinical errors or safety concerns.
(3) Activities to lower the risk of facility-acquired infections.
(4) Prospective prescription drug Utilization Review aimed at identifying potential adverse drug interactions.
(5) Any quality reporting and related documentation in non-electronic form for activities that improve patient safety and reduce medical errors.
(6) Health information technology to support these activities.​

(B) [Reserved]​

(iv) Implement, promote, and increase wellness and health activities:

(A) Examples of activities primarily designed to implement, promote, and increase wellness and health activities, include—

(1) Wellness assessments;
(2) Wellness/lifestyle coaching programs designed to achieve specific and measurable improvements;
(3) Coaching programs designed to educate individuals on clinically effective methods for dealing with a specific chronic disease or condition;
(4) Public health education campaigns that are performed in conjunction with State or local health departments;
(5) Actual rewards, incentives, bonuses, reductions in copayments (excluding administration of such programs), that are not already reflected in premiums or claims should be allowed as a quality improvement activity for the group market to the extent permitted by section 2705 of the PHS Act;
(6) Any quality reporting and related documentation in non-electronic form for wellness and health promotion activities;
(7) Coaching or education programs and health promotion activities designed to change member behavior and conditions (for example, smoking or obesity); and
(8) Health information technology to support these activities.​

(B) [Reserved]​

(v) Enhance the use of health care data to improve quality, transparency, and outcomes and support meaningful use of health information technology consistent with § 158.151 of this subpart.​

Trust me, I already knew that. That is why I used in my example the phrasing of "new medical management program...reducing claim costs", and specifically did NOT phrase it as "new medical management program...improving quality".

That is because many of the programs that improve quality do NOT reduce costs, and similarly, many of the programs that reduce costs do NOT improve quality, and therefore would not get added to the numerator in the MLR calculation.

It would have more obviously stayed away from what you point out if rather than I refer to a 'medical management' program that reduced costs, I had instead referred to a 'fraud prevention' program, or expenses incurred to negotiate lower reimbursements to providers to lower costs, neither of which improve quality.

 

[Queecho Feecho]

Exactly. That's my point. What business wouldn't dream of operating in a "market" where there's no competition? We're setting up a state sanctioned cartel of insurance companies and handing them mandated customers on a plate.

No, we are setting it up for a Gov single payor system.

Broadly, it's corporatism - but not because corporations are involved. Corporatism is the entire mode of government where power sharing deals (like PPACA) are commonplace and group rights supersede individual rights.

It's called Socialism.

What does #2 "Premiums mandated" mean?

Which section of the law is that? Or can you point me towards a regulation that lays that out?

It means that ANY plan offered on the Exchanges are ALL the same price.

SEC. 2701. FAIR HEALTH INSURANCE PREMIUMS.

`(a) Prohibiting Discriminatory Premium Rates-
`(1) IN GENERAL- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market--
`(A) such rate shall vary with respect to the particular plan or coverage involved only by--
`(i) whether such plan or coverage covers an individual or family;
`(ii) rating area, as established in accordance with paragraph (2);
`(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c)); and
`(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and
`(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).

Bill Text - 111th Congress (2009-2010) - THOMAS (Library of Congress)

The part I bolded/underlined in the quote, which I'll reiterate here since it might get lost in all the other formatting above, is wrong

"It means that ANY plan offered on the Exchanges are ALL the same price."

That isn't true. Wait and see. There will be a great deal of price competition on the Exchanges (and off the Exchanges for that matter). The premium subsidies (aka the Advanced Premium Tax Credits, the phrase you'd want to search for if you're gunning for more information) are determined via a method that functions like an intense bidding mechanism.

The insurance companies have tons of incentive to compete on price in 2014.

 

[dblack]

Exactly. That's my point. What business wouldn't dream of operating in a "market" where there's no competition? We're setting up a state sanctioned cartel of insurance companies and handing them mandated customers on a plate.

No, we are setting it up for a Gov single payor system.

Broadly, it's corporatism - but not because corporations are involved. Corporatism is the entire mode of government where power sharing deals (like PPACA) are commonplace and group rights supersede individual rights.

It's called Socialism.

What does #2 "Premiums mandated" mean?

Which section of the law is that? Or can you point me towards a regulation that lays that out?

It means that ANY plan offered on the Exchanges are ALL the same price.

SEC. 2701. FAIR HEALTH INSURANCE PREMIUMS.

`(a) Prohibiting Discriminatory Premium Rates-
`(1) IN GENERAL- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market--
`(A) such rate shall vary with respect to the particular plan or coverage involved only by--
`(i) whether such plan or coverage covers an individual or family;
`(ii) rating area, as established in accordance with paragraph (2);
`(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c)); and
`(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and
`(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).

Bill Text - 111th Congress (2009-2010) - THOMAS (Library of Congress)

The part I bolded/underlined in the quote, which I'll reiterate here since it might get lost in all the other formatting above, is wrong

"It means that ANY plan offered on the Exchanges are ALL the same price."

That isn't true. Wait and see. There will be a great deal of price competition on the Exchanges (and off the Exchanges for that matter). The premium subsidies (aka the Advanced Premium Tax Credits, the phrase you'd want to search for if you're gunning for more information) are determined via a method that functions like an intense bidding mechanism.

The insurance companies have tons of incentive to compete on price in 2014.

Sadly, what they can't compete on is any meaningful differences in coverage. If anything should be clear to us by now, it's that the widespread use of employer provided, group health insurance to finance our health care has been a disaster. It's destroyed the market it meant to 'cover', driving prices outside the reach of average patients. We desperately need new ideas and new approaches to financing our health care. PPACA blocks this (quite deliberately, I think), attempting to squeeze a few more years out of a defunct business model, while converting the industry into a quasi-public utility.

 

[CrusaderFrank]

Economic 101: Government Mandates that Make Insurance prohibitively expensive will hurt consumers and Insurance companies

"By ANNA WILDE MATHEWS and LOUISE RADNOFSKY

Health insurers are privately warning brokers that premiums for many individuals and small businesses could increase sharply next year because of the health-care overhaul law, with the nation's biggest firm projecting that rates could more than double for some consumers buying their own plans"

Health Insurers Warn on Premiums - WSJ.com

Go ask Greebeard if he'll cover you under his government policy

 

[Queecho Feecho]

"more than double"

Yes, for some. That is cherrypicking to generate a scary tagline.

Don't get me wrong, many costs will go up because of Obamacare, but cherrypicking like that isn't too legitimate in my opinion. Tell the whole story, don't just point to the most affected.

 

[Antares]

You haven't read the law at all.

The exchanges will offer 3 plans, with three varying price points....a basic plan, a middle plan, and a "cadillac" plan...but no company can charge more or less for them.

THEY cannot vary the rates.

Read it then get back to me.

Exactly. That's my point. What business wouldn't dream of operating in a "market" where there's no competition? We're setting up a state sanctioned cartel of insurance companies and handing them mandated customers on a plate.

No, we are setting it up for a Gov single payor system.

Broadly, it's corporatism - but not because corporations are involved. Corporatism is the entire mode of government where power sharing deals (like PPACA) are commonplace and group rights supersede individual rights.

It's called Socialism.

What does #2 "Premiums mandated" mean?

Which section of the law is that? Or can you point me towards a regulation that lays that out?

It means that ANY plan offered on the Exchanges are ALL the same price.

SEC. 2701. FAIR HEALTH INSURANCE PREMIUMS.

`(a) Prohibiting Discriminatory Premium Rates-
`(1) IN GENERAL- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market--
`(A) such rate shall vary with respect to the particular plan or coverage involved only by--
`(i) whether such plan or coverage covers an individual or family;
`(ii) rating area, as established in accordance with paragraph (2);
`(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c)); and
`(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and
`(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).

Bill Text - 111th Congress (2009-2010) - THOMAS (Library of Congress)

The part I bolded/underlined in the quote, which I'll reiterate here since it might get lost in all the other formatting above, is wrong

"It means that ANY plan offered on the Exchanges are ALL the same price."

That isn't true. Wait and see. There will be a great deal of price competition on the Exchanges (and off the Exchanges for that matter). The premium subsidies (aka the Advanced Premium Tax Credits, the phrase you'd want to search for if you're gunning for more information) are determined via a method that functions like an intense bidding mechanism.

The insurance companies have tons of incentive to compete on price in 2014.