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UnitedHealth’s ObamaCare Reckoning

Original Source

Insurers are learning that the law was a Faustian bargain.

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This Tuesday, Oct. 16, 2012, file photo, shows a portion of The UnitedHealth Group Inc.’s campus in Minnetonka, Minn. Photo: Associated Press

Updated Nov. 22, 2015 9:06 p.m. ET

Health insurance stocks took a nasty tumble last week, and maybe the markets are realizing that ObamaCare isn’t performing as well as the political class pretends. Sooner or later, reality tends to assert itself—for President Obama’s domestic legacy no less than his foreign policy.

The immediate cause of the selloff was UnitedHealth Group’s shock $425 million downgrade to its earnings forecast for 2015, almost entirely driven by losses on the Affordable Care Act exchanges. UnitedHealth is the largest U.S. insurer by enrollment, and the company is warning it may withdraw from ObamaCare in 2017. The insurer has already suspended advertising for its ObamaCare coverage and stopped paying commissions to insurance brokers for signing people up. It literally doesn’t want consumers to buy its products.

On a UnitedHealth call Thursday with Wall Street analysts, Josh Raskin of Barclays asked, “Simply, how long are you willing to lose money in exchanges?” and then followed up, “Are you willing to lose money again in 2017, Steve?” UnitedHealth CEO Stephen Hemsley replied: “No, we cannot sustain these losses. We can’t really subsidize a marketplace that doesn’t appear at the moment to be sustaining itself,” adding that “we saw no indication of anything actually improving.”

UnitedHealth reported one problem after another: An expensive risk pool that lacks the younger and healthier consumers who are supposed to buy overpriced plans to cross-subsidize everyone else. Enrollment growth continues to lag. People join the exchanges before they incur large medical expenses—insurers are required under ObamaCare to cover anyone who applies—and then drop out after they receive care. The collapse of the ObamaCare co-ops is recoiling through the market.

UnitedHealth sat out the first year of ObamaCare but then did a big-bang expansion for 2015-2016, offering coverage on 24 of the 34 federal exchanges, and it now covers some 540,000 people. Morgan Stanleyestimates UnitedHealth’s average premium increase for 2016 was 9%, so the company was rationally raising prices to offset rising costs. It still thinks it will lose money.

The reason the UnitedHealth disclosure jolted investors is that other insurers are almost certainly experiencing the same problems. Companies accountable to shareholders are not charities, and for all the new regulatory control that ObamaCare imposed on the industry, the government can’t force them to do business. (Not yet, anyway.) But the law is ever more obviously the Faustian bargain that we predicted and that insurers should have known better than to accept when they lobbied for the bill in 2009.

None of this means ObamaCare is rapidly “collapsing under its own weight,” as some Republican like to imagine. The entitlement will continue to trundle along, especially as it becomes ever more a vast Medicaid expansion. Commercial insurers are being displaced by Medicaid managed-care HMOs, with their ultra-narrow physician networks and closed drug formularies.

Then again, this trend is itself another symptom of decline. While liberals can continue to insist all is well, businesses don’t enjoy the same political luxury.

Note: Below is an example of someone who has to pay a higher increase in premium due to mandates imposed by Obamacare.

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New York Cancer Patients Are ObamaCare’s Latest Victims

Original Source: New York Post

By Post Editorial Board

November 9, 2015 | 2:00pm

Add 250 New York cancer patients to the long list of victims of ObamaCare’s lies — just one more snapshot of the program’s ongoing death spiral.

These New Yorkers are getting treatment at world-renowned Memorial Sloan-Kettering Cancer Center — but their ObamaCare policies are about to vanish, as Health Republic, one of the largest health insurers on New York state’s exchange, and the only one to cover Sloan-Kettering treatment, is shutting down at month’s end after losing $130 million.

The state exchange’s “solution”: It’ll give them an extra two weeks to find a new policy — but it has nothing that will save them from having to change hospitals and medical teams. (It is in talks with the hospital about trying to give them an extra year of coverage there — but with no word on who’ll pay.)

Robert Goldberg, vice president of the Center for Medicine in the Public Interest, warned of the problem two years ago in The Post: ObamaCare’s design screws cancer patients, as well as those with AIDS and other serious conditions.

To save cash, exchange policies offer very narrow networks of providers, and also stint on which medications are covered, while imposing hefty out-of-pocket costs on patients.

“The whole point of the Affordable Care Act was to make it affordable,” Vince Capone, a retired dentist with pancreatic cancer, told Newsday. “If this plan was set up but was priced too low and then went out of business, then I guess the whole thing was a sham.”

Yeah, sham is a good name for it.

The wheels on the ObamaCare bus are falling off one by one. Then again, this isn’t anything new.

Take Health Republic, whose failure is forcing 100,000 New Yorkers to find new coverage. It’s just one of 23 “health cooperatives” across the country launched with a total in $2.5 billion in taxpayer cash — and eight are closing, with another 13 headed there.

ObamaCare’s defenders insist the problem is that Congress wouldn’t give the co-ops even more cash. Others point to how the health “reform” law said the co-ops couldn’t hire anyone with insurance-industry expertise, or spend a dime on marketing.

Anyway, the exchange policies run by for-profit insurers aren’t far behind. They’re hiking premiums big-time this year – up 13 percent on average for the cheapest (“bronze”) plans, according to an Avalere Health study.

And, by the way, new sign-ups are running at half the level once predicted by the Congressional Budget Office.

Worse, the folks who are buying exchange coverage tend to be sicker and older than the “reformers” had expected — which means they’re more expensive to cover, which means premiums will have to keep rising.

Which means that folks who aren’t sick will be even less inclined to buy an ObamaCare plan.

And 2016 is the last year the taxpayers have to provide extra “risk corridor” payments to ObamaCare insurers who lose money because they didn’t charge high-enough premiums — which makes it likely future price spikes will be even larger.

So much for affordable health care.

THE HILL: In Year 3, Many Hit with Obamacare Sticker Shock

Original Source

In year 3, many hit with Obamacare sticker shock

CBS News

Jericka Duncan

November 1, 2015

Sign-up season started Sunday for health insurance under the Affordable Care Act, or Obamacare, now in year 3.

Premiums are going up an average of 7.5 percent, but they could be much higher depending on where you live.

Self-employed accountant Fred Imel of Oklahoma buys insurance for his family through the Health Insurance Marketplace.

He just learned his premiums are going up from $1,100 per month, to $1,700.

That means Imel could pay $20,000 next year for health insurance — an increase of 66 percent.

“The first job when I got out of school was $16,500,” Imel said. “You know that’s a lot of money.”

The Affordable Care Act requires every state to set up a marketplace for the uninsured or allow the federal government to do so.

But when some insurance providers back out of that market place, as some did in Fred Imel’s state, consumers pay more.

Premiums vary widely — and are actually decreasing in a few places. Indiana is down 12.6 percent, and Mississippi is down 8 percent. But in most states, premiums are rising, up 31.5 percent in Alaska and up nearly 36 percent in Oklahoma.

Elisabeth Benjamin, who helps people get health care coverage, said there are many reasons for the changes.

“That could be because of market consolidation, could be providers asking for more money or drug prices going up,” Benjamin said. “There is this clause that if your rate increases over 10 percent you should be scrutinized by regulators.”

According to the Department of Health and Human Services, with tax credits, more than 7 in 10 current market place enrollees could find plans for $75 per month in premiums, or less.

But Fred Imel doesn’t qualify for tax credits, forcing him to shop around.