Have Any of You Actually Read the Health Care Reform Bill?

[Tom Highway]

You can find it here:
http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

VERY interesting stuff.
Subtitle D, about Medicare Advantage, starts on p. 331.

Many of the folks here have been talking about how MA is going the way of the 8 track tape, with supps becoming more attractive, but the proof is in the pudding. Look for yourself in the document, but here are some of the bullet points for MA plans:

- quality bonus payments, plans will be designated as high quality to receive bonus
- establishment of outcome based measures
- ranking of plans by quality
- authority to disqualify certain plans based on low quality scores
- shortening of AEP from 11/15 to 12/31 to 11/01 to 12/15
- ELIMINATION of OEP! No more enrollment from the first of Jan to the end of March!
- elimination of ongoing special election for SNP plans (not sure about medicaid, but definitely medical SNPs)
- plans must maintain a .85 medical loss ratio
- if plans fall below .85 for 3 (sometimes 5) years, all plan members can have rebates of premiums paid
- reducing the Part D coverage gap
- allowing mid year changes in enrollment because of negative formulary changes

If you're only selling MA plans, you should definitely start to see the handwriting on the wall. How can an agent survive under these conditions??

 

[somarco]

One of my co-bloggers made this observation on MA plans.

As of March 2009, Kaiser Family Foundation estimated total Medicare Advantage enrollment was about 10 million seniors. That's 22% of the total Medicare-eligible population of 45 million – about one out of five. Wait, there's more: since 2003, the enrollment in Medicare Advantage plans has doubled.

And don't overlook the fact that Mr Fixit actually admitted the government can't compete with private industry in his controlled town hall meeting yesterday. He said UPS and FedEx do quite well, but the Post Office is having all the problems.

 

[Crabcake Johnny]

And there's no better example of how private industry beats the gov't; Fex vs. USPS. When you think of sending a package you don't think of the USPS. Why would that be.

Some socialists have pointed out that our schools are "free" and gov't run. Really. Let me take you on a tour of inner city Baltimore schools.

 

[Tom Highway]

I noticed something in the bill that talks vaguely about limiting the cost sharing that med supps can provide. It seems like a lot of the unbiased reports I've heard/read are right - Obama is trying to socialize medicine and force us all to be on a substandard government run plan.

To me, the big losers in this (well, other than the medicare beneficiaries, people on medicaid, insurance companies, people who earn a living by WORKING under the existing system, etc) will be hospitals. The bill makes it very clear that hospital reimbursement will be cut drastically, and many hospitals are already struggling to remain in the black.

This just keeps getting better every day.

 

[Crabcake Johnny]

The biggest losers will be anyone earning over 300% of FLP who will watch their premiums double or triple.

 

[Norwayguy]

I don't sell MA's but I would think moving from a 11/15 - 12/31 enrollment to 11/01-12/15 which is almost identical in days and moving it a little bit before the christmas holiday season would actually be a good thing. But if there is no open enrollment does that mean someone would never be able to change MA plans once enrolled in one? Terrible system.

 

[annuityseller]

no I'm waiting for it to come out on CD!!!!!!!!

 

[stormtracker]

Thanks for the analysis Highway. The idea of "bonuses" for "quality" just reeks of malfeasance. That has fraud written all over it.

 

[annuityseller]

Mal What!!!!!

 

[stormtracker]

Mal What!!!!!

–noun Law. the performance by a public official of an act that is legally unjustified, harmful, or contrary to law; wrongdoing (used esp. of an act in violation of a public trust).