Holding on for 2014

[Winter_123]

Everything be groovy then.

Of course everything is already groovy in Maine. Otherwise the feds would not be following this model, eh?

Change you can believe in..

Transition period brutal for many employees | The Kennebec Journal, Augusta, ME

 

[VolAgent]

A classic in the article, and yet proof that people just don't get it.

Dugan said Anthem's rates are filed and reviewed on annual basis and premium increases are a direct reflection of medical claims.
"The individual consumer -- someone who does not have insurance through their employer -- is impacted more directly by rising cost of care, whereas someone in a group plan may have their employer picking up some of the premium cost," Dugan said.
Ditre agreed. He said families and individuals don't have the bargaining clout that the huge health insurance plans do, so they end up in high-deductible health insurance policy.
"Individuals need bulk purchasing," Ditre said. "We need a shoppers' club just like Sam's Club so they can take advantage of joining larger groups with bargaining clout," he said. "The Affordable Care Act will allow states like Maine to offer an individual market for families and individuals. All these groups will be able to combine to get bargaining clout, but again that won't happen until 2014."

Joe Ditre may be the executive director for Consumers for Affordable Health Care, but apparently he still doesn't understand how health care and health insurance work.

 

[Winter_123]

A classic in the article, and yet proof that people just don't get it.



Joe Ditre may be the executive director for Consumers for Affordable Health Care, but apparently he still doesn't understand how health care and health insurance work.

Oh, he has some things down to a science such as lobbying against rate increases. Anthem would tell you that he knows how that piece works pretty well. The other part of his shop has a contract with the state to go around and do information/consumer assistance workshops to get as many people as possible on medicaid. Lots and lots more funding coming to his organization. Feds were just up to Maine to tell us what leaders we are and of course the gravy will just keep flowing over to his type of advocacy/navigation/consumer assistance etc.

He doesnt need to understand how private insurance works much anymore. He just needs to understand how obamacare works so that he can get in on the pig-out and he does that about as well as anyone I know. Each state will have their own cluster of obamacare groupies soon who may not be in the know but are nevertheless running things.

Change you can believe in.

 

[VolAgent]

I also love how the article tries to bash Anthem for a profit of $350 million since 2000. It appears they are collecting just under $1 billion a year in premium. Assuming every year was the same, which it wasn't, that is $35 million a year in profit, or about 3.5%. That is pretty mediocre for a large corporation.

 

[Winter_123]

It is part of the ruse going on in the state that is now going on nationally. You have people around the country, and many on this forum, reading up on the mlr requirements and working their little calculators and seeing what that equates to for rate increases and breathing room for commissions etc.

The reality is that Maine has mlr requirements. In recent years, Anthem has met them when requesting rate increases (not defending anthem just saying what the rules are). Lo and behold, last couple years the comrades down at the Bureau just decided that Anthem was making "enough" money nationwide so it didnt need a rate increase whether it was meeting mlr requirements or whether they could show cost increases. The worked it around a bit in courts and got some increase but not what they were able to demonstrate under the rules. And they are backed up a couple years in the courts on rate requests so I think last years is still in question.

This is the same thing that will happen nationally. You think there are these little mlr payout rules that will guide some parts of the process but that is all a crock. There will be people who simply decide whether you as a carrier "need" a rate increase or not depending what they think "enough" profit is for you.

Same thing has already happened with, for example, med advantage commissions, and will happen with other commissions. Regardless of what margin the carriers have to pay commissions or incentives they want to provide, they will be bound by those who "know" how much you should be making.

Change you can believe in.

I also love how the article tries to bash Anthem for a profit of $350 million since 2000. It appears they are collecting just under $1 billion a year in premium. Assuming every year was the same, which it wasn't, that is $35 million a year in profit, or about 3.5%. That is pretty mediocre for a large corporation.

 

[somarco]

Would you two like to get a room?

 

[VolAgent]

Would you two like to get a room?

Only if you join us.

 

[somarco]

Thanks, but no. My voyeuristic needs are satisfied in other ways.

 

[trumbullcity]

It seems like some of these reforms are similar to things that happened in the 90s- stuff that conservatives railed against, saying it would destroy the economy, is just taken for granted now but makes so much sense we can't imagine why it wasn't always like that.