If this Actually Works, then What?

I think the exchanges if they are up and running could be a huge success for the working poor.

Fully insured groups will get destroyed under the law.

Upper Middle class and high income will get devastated if they do not have access to large group.

ABC, direct and on-point. Two Thumbs Up! (Although I do disagree about the high-incomer's being devastated.)

I'd like to add that the 40 million new insured's crowding into these smaller networks will create havoc we can't imagine now. Supposedly, the BEST doctors will not be in many of the ObamaCare plan networks. Now, what do you get when you match millions of new, less-than-healthy patients with doctors who may have just become doctors, or are desperate for patients for one reason or another?
-ac
 
Where do you think the major hangups will be? Enrolling millions of insurance-illiterate citizens? Subsidy caclulation? Obtaining care? Claims? Spreading the word that the marketplaces are law and are working? Premiums? Networks? "Loopholes"?

Yes.

I guess this must be 20 characters
 
From today's Bloomberg. Does the below info mean that the doctors contracted by insurers are not the new and/or desperate ones, after all?

"The insurance industry also seems to be losing the negotiating battle with doctors and hospitals, with reimbursements in exchange plans ending up higher than what insurers had initially sought. Johnson, the CFO at Nashville, Tennessee-based HCA, said the hospital chain is winning exchange rates closer to its current commercial business rather than the lower payments it gets from the U.S.-backed Medicare program."

Source: UnitedHealth Spurns Obama Exchanges as Rules Stall Profit - Bloomberg

On the other hand, higher reimbursements mean smaller networks, to control costs. Right?
-ac
 
From today's Bloomberg. Does the below info mean that the doctors contracted by insurers are not the new and/or desperate ones, after all?

"The insurance industry also seems to be losing the negotiating battle with doctors and hospitals, with reimbursements in exchange plans ending up higher than what insurers had initially sought. Johnson, the CFO at Nashville, Tennessee-based HCA, said the hospital chain is winning exchange rates closer to its current commercial business rather than the lower payments it gets from the U.S.-backed Medicare program."

Source: UnitedHealth Spurns Obama Exchanges as Rules Stall Profit - Bloomberg

On the other hand, higher reimbursements mean smaller networks, to control costs. Right?
-ac

That tells me that the carriers that chose not to partake in Year 1 are going to be better off financially than those who did. Year 2 & 3 will be exceedingly interesting.
 
That tells me that the carriers that chose not to partake in Year 1 are going to be better off financially than those who did. Year 2 & 3 will be exceedingly interesting.

Carriers that opt out of HIX will have an advantage because the HIX business will have higher LR than non-HIX business.

You are right. This WILL be interesting.

I haven't really been paying close attention, but I don't recall seeing Celtic listed in the exchanges. No real surprise except they have been saying they would be around in 2014 and later.
 
I haven't really been paying close attention, but I don't recall seeing Celtic listed in the exchanges. No real surprise except they have been saying they would be around in 2014 and later.

Celtic is still stinging from the losses it's taking on the Massachusetts Connector exchange. Celtic's parent company, Centene Corporation, may have told them not to venture into another exchange. Centene is making a killing with big Medicaid contracts and doesn't want Celtic damping the party.
 
In the NAHU meeting today that both Yagents and I attended, they said carriers and AHIP are estimating that the real premiums will show up in 2015 and 2016, because right now the premiums they set are a shot in the dark, and its anyone's guess what premium levels are really needed to fund the claims.
 
In the NAHU meeting today that both Yagents and I attended, they said carriers and AHIP are estimating that the real premiums will show up in 2015 and 2016, because right now the premiums they set are a shot in the dark, and its anyone's guess what premium levels are really needed to fund the claims.

Right Ann. Let's take cancer for example. The National Cancer Society says that the average price for a year of treatment is about $90,000 per year ($7,500 per month). (Source: Annual Costs of Cancer Care | Cancer Prevalence and Cost of Care Projections )

To offset the cost of just one cancer patient, you need to have 25 people paying $300 per month in premiums...with no personal medical claims. Add in Diabetes, Heart Issues, and a host of other maladies that will flood into the insurance market in 2014 and it's no wonder that most health insurers decided to steer clear of the exchanges.
 
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