Thursday, August 7, 2014

Actuary: Admin's Attempted Fix to 'If you like your plan, you can keep it,' Lie Could Cost Taxpayers $474 Per Insured Per Year

An absolutely fascinating little nugget surfaced in a story about Patient Protection and Affordable Care Act (PPACA or Obamacare) Exchanged-based insurance renewals for 2015 in the state of Connecticut.  The column centers around exactly how much insurers should be charging in 2015 for their renewals in the Nutmeg State.

What I found most interesting is what the Connecticut Insurance Department's actuary said about per member per month insurer claim-savings as a result of HHS' last minute changes to the Transitional Reinsurance Program (insurer bailouts and here and here) last November, just prior to Thanksgiving.

As readers of this blog will recall, President Obama was given PolitiFact's Lie of the Year "award" in 2013 for saying that those who like their insurance plans, could "keep them."  When that turned out to be untrue the President wanted to soften the harsh appearance of his lie by attempting to re-write PPACA, via a press conference, directing states to consider allowing individuals to keep non-compliant Obamacare plans.  The offer was almost certainly not legal.  Practically speaking, it was so late in the game that many states and people had already moved ahead with compliant, more expensive plans.

Mark Steyn authored the most wonderful description of the debacle at the time:
On Thursday, [the President] passed a new law at a press conference. George III never did that. But, having ordered America’s insurance companies to comply with Obamacare, the president announced that he is now ordering them not to comply with Obamacare. The legislative branch (as it’s still quaintly known) passed a law purporting to grandfather your existing health plan. The regulatory bureaucracy then interpreted the law so as to un-grandfather your health plan. So His Most Excellent Majesty has commanded that your health plan be de-un-grandfathered. That seems likely to work. The insurance industry had three years to prepare for the introduction of Obamacare. Now the King has given them six weeks to de-introduce Obamacare.
The President's press conference angered many insurers. In order to keep them from revolting, HHS reduced the PPACA large claim attachment point for insurers.  In laymen terms this meant that PPACA's elaborate reinsurance program would funnel money to insurance companies who had a claim exceed $45,000 as opposed to the $70,000 that had been planned.  It meant less risk and more money to insurers.

Now, at least one state has quantified that cost; which will ultimately fall on taxpayers when there is not enough "profits" in PPACA's Robin Hood scheme to take from rich insurers and give to poor ones.

This is from Allison Bell at LifeHealthPro:
A move by the U.S. Department of Health and Human Services (HHS) to lower the deductible, or "attachment point," for the reinsurance program to $45,000, from $70,000, should cut individual major medical costs by about 4.5 percent, or $39.50 per member by month, according to Paul Lombardo, a [Connecticut Insurance] department actuary. ... 
HHS lowered the attachment point to $45,000 to help compensate insurers for a last-minute change in commercial insurance rules.  
A cool $39.50 per PPACA enrollee per month means a "savings" to insurers (or ultimate taxpayer cost) of $474 per enrollee per year.

And because we are on the topic, we must revisit this - who can forget Remy's great video on the "like your plan" lie?