Thursday, July 27, 2017

Health Insurance

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Classic Corruption
Ain't nothing like a little corruption to bring the two parties together.

New Jersey Governor Chris Christie wants to force the state’s largest health insurance company to dole out $300 million for a drug addiction treatment program for the poor, an egregious cash grab that media outlets call a “shake down” and “extortion.” Judicial Watch has launched an investigation into the Republican governor’s outrageous targeting of a nonprofit healthcare provider, Horizon Blue Cross Blue Shield, that functions as a tax-paying health services corporation with nearly 4 million policyholders.

Here’s some background before getting into the New Jersey Open Public Records Act (OPRA) request filed by Judicial Watch last week; months ago, Christie launched a peculiar campaign to dig into Horizon’s multi-billion-dollar surplus to fund addiction programs as part of an effort to crack down on the state’s opioid epidemic. The unusual plan has encountered fierce opposition from a multitude of sources, including Democrats and Republicans, not to mention Horizon and the insurance industry in general. Christie has kept pushing, insisting that legislation be introduced to force Horizon to fund his dubious addiction experiment. A local newspaper reported that New Jersey Assembly Speaker Vincent Prieto refuses to support such a measure, calling it a “bad bill”

The same newspaper article said that “Christie’s push to get some money from Horizon included a news conference on Wednesday to spotlight $15.5 million in citations against Horizon over its Medicaid contract compliance with the state, which the governor says predates his effort to use their surplus. He said the citations show that his proposal, which also includes adding board members and requiring the insurer to post information online, is needed.” However, Christie refused to reveal the citations and when the media tried to obtain them through the Open Public Records Act, the governor’s office asserted that “contractual obligations” prevented the release of the documents. Information involving the mysterious multi-million-dollar fine levied against Horizon is among the records Judicial Watch has requested from the Office of the Governor.

When disclosing the citations didn’t work, Christie threatened to withhold school funding unless state lawmakers pushed through legislation giving him $300 million from Horizon and power to add four political appointees to its board of directors. A local news report said Christie threw “an 11th-hour grenade” into state budget negotiations and called his Horizon cash grab a “raid.” This week a state Senate committee voted to allow the governor to control how much surplus Horizon may keep. “The state could require this extraordinary amount of control because Horizon’s charter would be changed to say it “shall have a charitable mission … to fulfill its obligation as an insurer of last resort in this state,” a local newspaper article states. The Assembly would still have to approve the measure and that seems unlikely according to the speaker’s public comments.

Many wonder what is really driving this issue for Christie. Why is the governor hitting a nonprofit healthcare provider with an excellent rating and modest reserves? Sources with firsthand knowledge of the situation tell Judicial Watch that the real story involves New Jersey insurance magnate George E. Norcross, who is chairman of the board of Cooper University Hospital in Camden and owns a piece of AmeriHealth, a small money-losing New Jersey insurer. Norcross is also Executive Chairman of Conner Strong & Buckelew, one of the nation’s premier insurance, risk management and employee benefits brokerage and consulting firms. He’s been trying to force Horizon to buy the ailing AmeriHealth firm, sources tell Judicial Watch, but Horizon has refused.

Christie’s former chief of staff, Kevin O’Dowd, works for Norcross at Cooper University Hospital. His official title is senior executive vice president and chief administrative officer. Judicial Watch’s public-records request asks for all communications between Christie, his current chief of staff, Amy Cradic, Norcross and O’Dowd concerning Horizon from June 2016 to date. This includes records regarding, concerning, or related to the following: The activities, operations, and/or management of Horizon Blue Cross Blue Shield of New Jersey, Inc; The activities, operations, and/or management of AmeriHealth Insurance Company of New Jersey, Inc; The activities, operations, and/or management of Cooper University Hospital and/or Cooper University Health Care; The activities, operations, and/or management of Conner Strong & Buckelew; The $15.5 million fine recently levied against Horizon Blue Cross Blue Shield of New Jersey, Inc; Any proposed legislative or regulatory changes that would significantly impact Horizon Blue Cross Blue Shield of New Jersey, Inc.’s operations. This includes, but is not limited to, the proposals to alter the composition of the company’s board of directors and to reallocate a portion of the company’s financial reserves for public use.

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Nearly half of all ObamaCare co-ops have collapsed – more could fail by year’s end

Critics said that healthcare co-ops set up to dispense “free” medical care to the nation’s uninsured under ObamaCare would collapse and, so far, nearly half of them have – leaving millions of “insured” Americans with nowhere to go when accidents or illnesses strike.

The states that have seen their ObamaCare co-ops financially collapse include Utah, Kentucky, New York, Nevada, Louisiana, Oregon, Colorado, Tennessee, South Carolina and a co-op that served both Iowa and Nebraska.

The failures, which have come more quickly than even those who opposed to ObamaCare originally predicted, have proved one thing. Despite the way ObamaCare was rushed through Congress and signed into law by President Obama or the way low-income voters cast their ballots on Election Day, healthcare isn’t free.

And the bloodletting isn’t over.

Experts say that the co-ops are failing because of artificially low premiums, strict regulations and the old and sick signing up for free healthcare while the young and healthy sit things out choosing to pay a fine instead.

This lethal combination of facts – which critics said were self-evident when ObamaCare was forced on the American people – are on track to run the remaining state healthcare co-ops out of business before the end of next year.

“In most cases, they priced too low relative to what their claims costs were going to be, that’s what the operating margins were all about,” said Thomas Miller, a fellow specializing in health care policy at the American Enterprise Institute.

“Now what made them attractive was they’re offering lower premiums so more people want to sign up for that, but that’s a dangerous proposition where you’re making up your losses on volume.” “You’re getting more people, but those extra enrollees you’re bringing in are being underwritten at a loss.”

Ali Meyer, writing for the Washington Free Beacon, quoted Nathan Nascimento, a senior policy adviser at Freedom Partners as saying:

“The co-ops are losing more than they’re bringing in because they’re paying out for older, sicker populations and don’t have enough younger, healthier people to help share the cost burden” “This is in part because the monthly premiums set up by the co-ops were set artificially low compared to other plans.”

“Co-op insurers are heavily subsidized and operate under strict regulations,” he explains. “They’re more heavily regulated than other insurance plans offered in the health care exchange.”

“When you have artificially low premiums, a pool of people requiring more payouts, increased regulations, and reductions in risk corridor subsidies, it’s the perfect storm of insolvency,” he said.

“They’re a public option comprise concept that clearly does not work – a thought experiment that is not practical in reality.”

Akash Chougule, deputy director of policy at Americans for Prosperity, says that as costs continue to rise, less people will enroll, causing more co-ops to go out of business.

“It doesn’t require an advanced degree in economics to see why this is unsustainable.” “As costs and premiums continue to increase, people will increasingly avoid enrolling.

And as co-ops succumb to the reality of higher rates, they’ll continue failing at their alarming pace.”

Nascimento added that:

“More co-ops will likely fail – they were doomed from the start.” “We’re already seeing another coop collapse, this time in Utah, with 66,000 people losing their health care coverage and costing taxpayers more money – $89,650,303 to be exact.”

As more state co-ops close down, people who bought into the idea of free or low-cost healthcare under ObamaCare will have fewer plan choices, could face higher co-pays and annual deductibles before “free healthcare” kicks in and would likely be penalized by the federal government if they drop out of the system.

One story out of New York describes a nightmare for hundreds of cancer patients who lost access to their doctors at the world-renowned Memorial Sloan Kettering Cancer Center in Manhattan. According to New York Post report:

“Health Republic Insurance of New York, which has lost $130 million dollars in 18 months, was the only ObamaCare exchange insurer contracted with the Memorial Sloan Kettering Cancer Center in Manhattan.

250 Health Republic members receiving care at Sloan Kettering need to find a new insurer by November 15 that the hospital takes or prepare to shoulder the cost themselves. New York is forcing their carrier to close shop at the end of this month for losing so much money.”

Did someone say “death panels”?

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In a survey conducted by the Center for State and Local Government Excellence, 45% of respondents cited “federal healthcare policy” as a top cost driver of health care increases for their workers and wards.

The increases, felt by most Americans are the result of the ironically named, “Affordable Healthcare Act,” known predominantly as Obamacare.

Of the 252 governments that took part in the survey, 57% were forced to increase cost sharing and place a greater burden on their employees to pay for increased premiums and costs.

Of the five top drivers for rising costs, four were related to the massive cost increases that are a direct result of Obamacare.

The fifth driver, “an aging workforce” was also a popular response for governments.

In order to control costs, local and state governments have already enacted extreme measures including funding and managing their own on-site clinics and programs.

One county in North Carolina event went so far as to transfer “offenders with extreme behavior problems” to mental health facilities, opening up rental space in their detention facility that was quickly filled by overcrowded community jails.

Since enacting Obamacare, premiums have sky-rocketed as much as 78.2% for some age groups.

Nationally, the average cost of health insurance has increased by double digits.


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