A Sweet Deal

(Cartoon by Eric Alley published 7/10/13 and featured at Cagle.com.  Click on image to enlarge and then return.)

As the deadline looms for obtaining health care under the Affordable Care Act, "Obamacare", some hints as to the problems to come were examined by the Los Angeles Times yesterday.

How sick they [policy holders] are and the size of their medical bills will be front and center in the weeks to come as insurers begin drawing up next year's insurance rates, which will become public this summer.

The outcome — hefty rate hikes or more modest increases — in the pivotal state of California could help shape political races nationwide and the future of enrollment for President Obama's signature law.

WellPoint Inc., parent of California's leading health insurer in the exchange, Anthem Blue Cross, has already predicted "double-digit-plus" rate increases on Obamacare policies across much of the country.    ...

But health insurers aren't wasting any time sizing up what patients are costing them now and what that will mean for 2015 rates.

Hunkered down in conference rooms, insurance actuaries are parsing prescriptions, doctor visits and hospital stays for clues about how expensive these new patients may be. By May, insurance companies must file next year's rates with California's state-run exchange so negotiations can begin.

"If rates in California increase by 20%," said Robert Laszewski, a healthcare consultant in Virginia, "enrollment will go down and any healthy people will bail."   [Emphasis added]

If the public thought the roll-out of the ACA website by the Obama Administration was a disaster, wait until those bills for the next year's premiums come due.  I predict a whole lot of howling, unless, of course, individual state insurance commissioners have the authority and the will to rein in those premiums where it is appropriate.

The difficulty is that even the most zealous insurance commissioners are going to have a tough time with the big companies simply because the ACA was written with the private insurance companies sitting at the table.  Yes, they finally agreed to cover pre-existing conditions, but they didn't give up the right to charge heavily for that coverage.  Nor did they agree to keep premiums low even if the insured should, heaven forfend, actually use the policy for health care.  And they made certain that a public option, a Medicare-like policy, was off the table before they even sat down at that negotiating table.

Now, there's some good stuff in the ACA, like the ability of parents to include their adult children up age 24 in their policy, and it is a first step in making medical treatment available to more people.  But it's only a partial answer, and we need that next big step into Medicare for all.

As I'm wont to say these days about all sorts of things, "How long, O Lord?  How long?"