No One Seems Ready for ObamaCare
For industry outsiders, you need to know that a typical insurance company needs at least a year to plan and implement a new health insurance product. Guess what? They’re not going to get it.
With the national health law’s political future now entrenched, a deluge of new rules is expected in the coming days and weeks as the Obama administration fleshes out the law’s complex components…
For the administration, some of the trickiest decisions concern how insurance policies must be designed, priced and sold starting next October, when open enrollment begins for the new online marketplaces, called exchanges, that will offer plans to individuals and small businesses. For instance, the law allowed insurers to alter their prices for people based on their age, family size, where they live and tobacco use. The Department of Health and Human Services has to determine how insurers can go about setting those prices…
The government also has to specify how cost-sharing rules for consumers will work, and what types of medical services must be covered in health plans sold in the exchanges. Twenty-six states have already chosen an existing health plan as a benchmark identifying what “essential benefits” their state’s insurers must provide. In those states that don’t establish a benchmark, the administration is empowered to choose one. Until the government does, insurers say they are hampered in devising what kind of insurance policies to offer…
Other insurance regulations are also expected. The government has to clarify new standards for companies that insure their own workers, including what level of coverage is sufficient, how a new tax on premiums included in the health law will be assessed and how wellness programs designed to encourage employees to adopt health behaviors will operate.
I guess its time to let the insurance company start planning.
The process is entirely bureaucratic. thousands upon thousands of pages of regulations are difficult for states to digest.
i wonder if they’ll continue to delay implementation since states may not be ready for the new rules and regulations and if so how would the entire law be impacted?
Failure is part of the plan. It will result in government complete takeover, the real goal. Obama the candidate said essentially that in his primary season campaign five years ago. The ultimate goal is single pay, government medicine.
Everything about this legislation is authoritative. Sooner than later everything will be imposed to us, nothing will be a choice any longer. What the administration wants is to control all of our decisions and of course nobody is ready for it. It’s a hard reality we all need to adjust to.
Alright, I’ll play devil’s advocate…
Shouldn’t they have already been planning for this contingency?
As a longtime veteran of the insurance industry, my suspicion is that many companies have in fact studied all the coming regulations, and have concluded that they cannot make money in the Exchanges.
Without underwriting to fall back on, and without the ban on pre-existing conditions, any company that joins the exchanges could easily take on a huge number of bad risks. The company could lose millions of dollars in the first year alone, and yes, they could raise premiums in year two- but that would make them very unattractive in the exchanges.
Buried deep in the ACA ia a provision for risk adjustment, where any insurers who lose money on providing care are sustained behind the scenes by money from more profitable carriers. (The Dutch and Swiss and Germans have done this for years.)
I do not think that the Federal bureaucracy has done anything about this.
What if you gave a health exchange party and no one came? That would delay or defeat the ACA without Congress lifting a figure and in spite of Democratic victories.