Costs Are Flat in Mass?

[Winter_123]

Duval says Anthem raised premiums when everything else was flat. Man, that's news to some folks.

Also, Sebelius writes to Anthem and says that their premiums are rising 15 times faster than inflation. Yeh, so. What kind of measurement is that? Make your case based on how much the premiums are rising compared to costs in the industry, eh Tunklehead.

Nevermind. It is a waste of time. Base it on the CPI, the cost of gas, or a loaf of bread, or the rate of increase in France, whatever. It is all a crap shoot in commie economics. Just tell the carriers what the number is going to be. It's the commie way.

AFL-CIO NOW BLOG | Court Blocks Hikes Sought by Massachusetts Health Insurance Corps.

 

[HM-agent]

BCBS of Mass has nothing to do with Anthem.

 

[somarco]

Premium increases (usually) have little to do with medical care inflation and nothing to do with the CPI.

They are driven mostly by claims which are influenced more by utilization than anything.

During economic downturns, claims go up while premiums (not premium rates, gross premiums collected) are flat or decline. To "catch up" carriers must institute increases that reflect trend (medical care inflation) plus projections for continued utilization.

 

[Winter_123]

Premium increases (usually) have little to do with medical care inflation and nothing to do with the CPI.

Of course. My comment about Sebelius was in the spirit of "you might as well base it on the CPI as to judge by your current stupid method."

It's like telling the guy at the gas station he can only raise his rates based on inflation regardless of what cost of a barrel of oil is doing.

 

[Crabcake Johnny]

Somarco nailed it as usual. MA regulators cite that medical costs have only risen 5% which means premium increases should only rise 5%. That, however, has nothing to do with someone sitting out, then grabbing coverage to get that $15,000 procedure they need, then cancelling.

 

[ksigmtsu]

Do they not have a pre-existing waiting period in Mass?

 

[Winter_123]

Somarco nailed it as usual. MA regulators cite that medical costs have only risen 5% which means premium increases should only rise 5%. That, however, has nothing to do with someone sitting out, then grabbing coverage to get that $15,000 procedure they need, then cancelling.

That should be reflected in their loss ration though. Problem is, as discussed, these states and now the feds, have so many made-up tests and rules that they apply you dont know what the rules of the game are.

If you meet the minimum required claims loss then they ding you if your rate request does not square with general inflation in the economy (let alone cost inlfation in the industry). If you do well on the required payout and also the inflation tests, then (as in Maine) they just start looking at your general profit level nationwide and decide whether you are making "too much" already.

It is all arbirtrary stuff. More to come in the Anthem case in Maine. Regardless of the decisions in any of these states, the industry and the government have come up against the brick wall of cost containment that was never factored into any of the maocare or state maocare plans. It had to happen sooner or later, but it turned out to be sooner. They will dampen the rate increases to pile sandbags against the tide for another six months to a year, then the carriers and the government have some hard decisions to make. They very same ones that any *** could see coming but I digress.

The case in Maine is a real lu-lu. Frigging state just decided what the right premium increase should be without regard to any rules. Turns out the right increase was zero. As in Mass, the courts will also deal with the case here in some way that just kicks the can down the road for a couple more months. That's fine, if a couple months gets you anything. Then what?

 

[Crabcake Johnny]

Health care in this country implodes in 2018. Legislation takes effect in 2014 and my guess is four years later the gov't announces with the end to subsidies or greatly reduced subsidies.

Four years of rate increases starting in 2014 will all end up in court when come 2018 it costs a family "$1,800" a month to buy coverage, which is mandatory.

We'll end up with universal health care within 10 years and I prefer universal heath care to the legislation that was just passed.

 

[HealthGuy]

John: Right on target - this is what Obama wanted all along.

 

[Crabcake Johnny]

Controlling the carriers does not control costs. It also doesn't address the overall health of the country which, unless addressed, nothing will work.

Under the current legislation health related innovation chugs along which also affects costs. Far too many people will be forced to game the system, rate increases will be denied and everything, just like MA. will implode.

As carriers pull out of the market, people will just be dumped into the gov't pool which will eventually turn into universal health care.

By the way, just because we go universal health care doesn't mean the carriers go out of business. It would likely be a mix of coverage everyone under a national plan but still giving people access to private insurance.