Blue Cross of NM pulls out of Obamacare exchange

Thousands of New Mexicans will need to shop for new health insurance plans later this year after a decision by Blue Cross Blue Shield to stop offering individual insurance plans through the state health exchange beginning Jan. 1.

Company President Kurt Shipley announced the move Wednesday in a letter to individual customers that was also posted on the insurer’s website, www.bcbsnm.com.

The letter said Blue Cross Blue Shield of New Mexico lost $19.2 million in 2015 on the 35,000 individuals covered by plans they purchased on and off the exchange.

“We were unable to reach an agreement with the Office of Superintendent of Insurance … that would allow us to continue to offer coverage on the state’s health insurance exchange with rates that would be adequate to cover the anticipated needs of our members for the coming year,” Shipley wrote.

Blue Cross will offer a basic-level insurance plan outside the exchange in 2016, which will be available to all consumers at the same rate as in 2015.

Insurers can sell health insurance to individuals off the exchange as long as they comply with the same rules under the Affordable Care Act. But consumers who don’t buy through the exchange are not eligible for premium subsidies.

The ACA subsidizes premiums for consumers who purchase their plans through exchanges, based on income.

Existing policies will remain in force until the end of the year. And the insurer’s small group, large group, commercial, Medicare Advantage Prescription Drug, Medicaid and individual dental plans will not be affected.

Insurance Superintendent John Franchini earlier this month rejected Blue Cross Blue Shield’s request for a rate increase averaging 51.6 percent. Franchini said he was prepared to instead approve a 24 percent increase and was waiting for Blue Cross Blue Shield’s response.

He had approved much smaller rate increases for the other insurance companies that offer plans on the exchange – Presbyterian Health Plan, Molina Healthcare of New Mexico, Christus Health Plan and New Mexico Health Connections.

Those insurers say they are willing to accommodate Blue Cross members who decide to pick their plans. The open enrollment period to purchase plans on the exchange will begin Nov. 1.

“We are extremely disappointed that BCBSNM will not be an option for our customers on the New Mexico Health Insurance Exchange in 2016,” Shipley said.

Franchini said Blue Cross could return to the exchange after one year and offer plans for 2017.

Blue Cross actually lost more than the $19.2 million the company cited in the letter Wednesday but received more than $23 million from a pool set up by the Centers for Medicare and Medicaid Services to help insurers offset unusually high claims. The pool is financed with mandatory contributions from insurers.

Via: Albuquerque Journal

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Obamacare’s Bill Is Due

N

ow that the Supreme Court has once again saved Obamacare, can we have an honest talk about it?

Let me explain. On one side—you don’t need me to spell out which—the Affordable Care Act was demonized. It was going to bankrupt the health care system; destroy the United States’ reputation for excellent service; steal you away from your doctor; and, by some means never quite explained, lead us straight to communism. Today, subsidized health care premiums and an end to pre-existing condition exclusions; tomorrow, Stalin and FEMA detention camps located in semisecret parts of Texas. You know how it goes.

Under this assault, all too many ACA defenders turned into fanboys and fangirls, dismissing any issue raised against the law as inconsequential and exaggerated. And besides, it’s not like legislation to improve any aspect of it would get through our paralyzed, polarized, and now Republican-run Congress anyway.

But this strategy might well come back to bite the Democrats. The bill for the health care expansion is coming due, just as the recipients will be heading to the ballot box to vote in the first primaries for the 2016 election. More than a few are likely to be annoyed. 

Last week Oregon’s insurance commissioner, Laura Cali, announced that the state had approved a 25 percent premium increase for the largest health insurer on the state’s exchanges. The second largest insurer did even better: It received permission to boost its monthly charge to consumers by 33 percent.

Oregon might be the first health insurance exchange equivalent of a penguin getting shoved off an ice floe, but it won’t be alone in the freezing-cold waters for long. For example, BlueCross BlueShield of Tennessee requested an average 36 percent price increase for the plans it offers—after receiving a 19 percent bump last year. And that sounds like a relative bargain compared with Minnesota and New Mexico, where the BlueCross BlueShield family is looking for increases of more than 50 percent. Even if the final numbers are lower than the asks, it seems quite likely these states will approve substantive premium increases.

The problem is simple. As Trudy Lieberman reported this month in Harper’s, the ACA made a decent stab at solving the problem of Americans lacking insurance. Unfortunately, the bargain struck to get the bill to a point where lobbyists for the hospital, insurance, and pharmaceutical industries to sign on, or at least not fight it, did not adequately address the issue of overall medical costs.

And that’s where the consumer comes in. Someone is “it,” the party paying the bill. And that “it” is increasingly you, whether you receive insurance on the exchanges or from an employer.

Via: Slate

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20,000 Montanans' health insurance 'discontinued' by 'Obamacare'

HELENA – In Montana, as many as 20,000 holders of individual health insurance are getting or will get letters from insurers saying their current policy doesn’t comply with "Obamacare" regulations, and is being “discontinued.“

But insurers say the letter is not a cancellation, and that they’re instructing those policyholders how to get comparable coverage, which may or may not cost more.

“It’s important to note that we are not dropping members from their coverage,” said John Doran, director of strategic marketing services for Blue Cross and Blue Shield of Montana. “Our goal is to provide customers with as many options as possible.”

The letters, which are being sent by insurers not only in Montana, but also across the country, have sparked a national outcry from critics of the Affordable Care Act.

They say the letters contradict President Barack Obama’s earlier promise that the ACA, also known as Obamacare, would allow people to keep their current health coverage, if they wanted to.

“We told you Obama’s ‘If you like your health insurance, you can keep it’ promise was false,” Montana Republican Party Chairman Will Deschamps said Wednesday. “We told you Montanans would lose their insurance coverage.”

Under the ACA, virtually all health insurance policies must offer a set of “essential benefits,” starting next year.

Most current policies don’t meet these requirements, so insurers are discontinuing those policies and offering new, ACA-compliant policies for 2014. For some customers, the new policies will be more expensive because they have more generous coverage.

For example, the ACA prohibits policies with extremely high deductibles or high out-of-pocket costs. If a customer has to buy a plan with a lower deductible or lower out-of-pocket costs, the premium likely will be higher.

Via: NRO

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Woman Spent Six Weeks Trying to Get Out of Obamacare Insurance

A Missouri woman spent six weeks trying to unenroll from Obamacare using its “navigators” and online help.

Lesli Hill was stuck talking to multiple Obamacare navigators who would transfer her calls over the month-and-a-half time period, Fox News reported. After being deferred to multiple navigators, both online and by phone, Hill drove to her insurance company in Kansas City to deal with the problem.

Hill’s experience stands as a cautionary tale to anyone who, for whatever reason, is trying to bow out of insurance they purchased on the exchanges. Hill’s troubles started last fall, after the high-risk pool coverage she had was discontinued due to the health law. For lack of options, she went on the exchange and bought a policy with a $950-a-month premium. [..]

However, shortly afterward Hill, 62, learned she could once again purchase an individual plan — with better benefits — outside the exchange. She checked with Blue Cross Blue Shield in early December and was told she’d have to cancel her ObamaCare plan first. [...]

Hill first tried the HealthCare.gov help line, and “literally was on hold for several hours a day,” she said. After multiple attempts, without much luck, she tried the online chat. She was redirected back to the help line. The “script” that operators were reading from did not seem to address how someone could actually cancel a plan. 

ViA WFB

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New ObamaCare Fees Coming in 2014

WASHINGTON — Here comes the ObamaCare tax bill.

The cost of President Obama’s massive health-care law will hit Americans in 2014 as new taxes pile up on their insurance premiums and on their income-tax bills.

Most insurers aren’t advertising the ObamaCare taxes that are added on to premiums, opting instead to discretely pass them on to customers while quietly lobbying lawmakers for a break.

But one insurance company, Blue Cross Blue Shield of Alabama, laid bare the taxes on its bills with a separate line item for “Affordable Care Act Fees and Taxes.”

The new taxes on one customer’s bill added up to $23.14 a month, or $277.68 annually, according to Kaiser Health News. It boosted the monthly premium from $322.26 to $345.40 for that individual.

The new taxes and fees include a 2 percent levy on every health plan, which is expected to net about $8 billion for the government in 2014 and increase to $14.3 billion in 2018.

There’s also a $2 fee per policy that goes into a new medical-research trust fund called the Patient Centered Outcomes Research Institute.

Insurers pay a 3.5 percent user fee to sell medical plans on the HealthCare.gov Web site.

ObamaCare supporters argue that federal subsidies for many low-income Americans will not only cover the taxes, but pay a big chunk of the premiums

But ObamaCare taxes don’t stop with health-plan premiums.

Via: Fox News

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ObamaCare May Devastate the Real Estate and Travel Industries

Americans are among the most mobile people on earth, but ObamaCare may soon start freezing them in place. Millions are losing their health insurance policies and being forced onto the ObamaCare exchanges, where most plans only provide local medical coverage. As Americans realize they must pay for all non-emergency medical care when they leave their home county, their decisions may have a profound impact on the real-estate market, particularly the second home sector, and on the travel business.

I recently interviewed a woman I'll call Sue, whose story may become increasingly common. Sue, a 60-year-old retiree, and her husband bought a second home in South Carolina to escape the Connecticut winters. "I had a Blue Cross Blue Shield policy in Connecticut, and I used it with no problem in South Carolina. I found an internist and ophthalmologist and dermatologist down here, and kept the rest of my doctors up north."

"The price was reasonable. It cost me $450 a month, with a $2,500 deductible. It was slightly more for out of network; there was no co-pay, and I got my prescriptions filled in both states with no problem."

"Then I got the letter telling me that my policy would no longer exist, because it didn't comply with the new health care law. They wanted to transfer us into a new plan that doubled my premium to $900 a month. The deductible went up to $3,500, and it covered zero out of network."

Via: American Thinker

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My Obamacare Cancellation - "Seething at a President I helped elect."

We received the letter in the mail a couple months ago. The good people at Regence Bluecross Blueshield were pleased to inform us that due to Obamacare, our current low monthly premium and comically high deductible medical policy would no longer exist come January 1, 2014. Pleased, because a new and better plan would be offered in its place. Old monthly premium: $578 for a family of four (non-smoking, helmet-wearing and paternally snipped). New premium: $1,123. A 94% increase.

Once the sound of boiling blood dissipated, I heard my Republican friends in my head chuckling at the sight of a liberal Democrat hoisted ten stories high on his own petard. How’s the view up there, Obamacare Ollie? 

For the past 15 years my wife and I have made our living as freelance writers. (To young readers, I say: Do not do this. Your bliss is marvelous, but its following will need to be supported by a banker, plumber, union machinist or tenured faculty member.) As such, our health insurance is our own concern. Over the years we’ve held on to our coverage by letting our co-pay and deductible rise and our covered procedures fall. You may be aware that the three-tiered state exchange policies are labeled Gold, Silver, and Bronze, reflecting their price and level of coverage. If our policy still existed it would fall into the column of Wood.

But Wood we had—and Wood we liked.

No more. Okay, into the state exchange we go. I voted for it. Fair enough.

Via: New York Observer

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Obamacare Web site mocked by, yes, insurance company

Wellmark Blue Cross Blue Shield decides to launch three ads that tell people to avoid the Healthcare.gov Web site, because its own site works so much better.

Such a struggle.

(Credit: Wellmark/Ad Age screenshot by Chris Matyszczyk/CNET)

A couple of days ago, I received two letters from my health insurance company.

One welcomed me to its autopay system -- which was a touch odd, given that I had been in its autopay system for many years.

The second told me that I was about to have my health insurance cut off, as I hadn't paid my monthly bill.

Please forgive me, then, if I'm not bathed in admiration for the way health insurance companies do business. There is one, however, that wants me (and you) to believe it's the apogee of efficiency.

Wellmark Blue Cross Blue Shield wants you to know that the Obamacare Web site is just a painful affair, while its Web site will cure you of all ills.

I am grateful to AdAge for revealing three ads that this no doubt fine, efficient, and gloriously well-priced insurance company has released in Iowa and South Dakota.

These ads portray health-related situations that somehow go wrong. There's the urine sample jar that won't open, the blood pressure gauge that insists on farting, and the reflex test that causes the wrong knee to react.

The words offer you enormous comfort in this hour of your need: "Things don't always work like they're supposed to do. Good thing the government exchange isn't the only place to buy health insurance."

Via: CNET

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My Obamacare Cancellation - "Seething at a President I helped elect."

We received the letter in the mail a couple months ago. The good people at Regence Bluecross Blueshield were pleased to inform us that due to Obamacare our current low-monthly premium, comically-high deductible medical policy would no longer exist come January 1, 2014. Pleased, because a new and better plan would be offered in its place. Old monthly premium: $578 for a family of four (non-smoking, helmet-wearing, and paternally snipped). New premium: $1,123. A 94% increase.

Once the sound of boiling blood dissipated, in my head I heard my Republican friends chuckling at the sight of a liberal Democrat hoisted ten stories high on his own petard. How’s the view up there, Obamacare Ollie? 

For the past 15 years my wife and I have made our living as freelance writers. (To young readers, I say: Do not do this. Your bliss is marvelous, but its following will need to be supported by a banker, plumber, union machinist or tenured faculty member.) As such, our health insurance is our own concern. Over the years we’ve held on to our coverage by letting our co-pay and deductible rise and our covered procedures fall. You may be aware that the three-tiered state exchange policies are labeled Gold, Silver, and Bronze, reflecting their price and level of coverage. If our policy still existed it would fall into the column of Wood. 

But Wood we had—and Wood we liked. 

No more. O.K., into the state exchange we go. I voted for it. Fair enough.

Via: New York Observer

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Jim Clyburn says Democrats are 'in bed' with insurance companies over Obamacare

Rep. Jim Clyburn, D-S.C., conceded that Democrats got "in bed" with insurance companies while crafting Obamacare, as he argued that the companies should do more to promote the law.

"We need to push this out into the insurance companies," Clyburn said on MSNBC's "Morning Joe." "If we are going to be in bed with them, let's bring them into this process. A lot of these insurance companies could be signing people up, they could be informing their policy holders — this letter that they're sending out, don't just cancel the policies, let them know what their alternatives are."

Clyburn's comment concurred with NBC's Chuck Todd's analysis, who explained why "the White House is disappointed" with the insurance companies' failure to promote Obamacare.

"They're in bed with the insurance companies," Todd said. "They're disappointed that the health insurance companies aren't more publicly enthusiastic since this law was essentially designed to give them more business."

Clyburn seems not to realize that insurance companies are directing policyholders to new Obamacare plans, but some of those policies cost more to provide less. For instance, the city workers in Bel Aire, Kan., lost their coverage only to have inferior alternatives offered to them.

"I simply wanted you to know the pain this is causing me and my staff in losing the terrific health coverage we had through Blue Cross Blue Shield in exchange for worse coverage at a higher price," city manager Ty Lasher wrote in a letter to Rep. Mike Pompeo, R-Kan., last week.

"BCBS offers other plans that we can choose from based on the government’s standards," Lasher wrote. "All offer higher deductibles and the two closest to our old plan each cost more than what we were paying. In addition, because we are under 50 employees, we no longer get a ‘group’ rate so everyone is being judged as a single."

Via: Washington Examiner

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