Cromnibus Gift to Blue Cross

[somarco]

The provision in the “cromnibus” bill, which would keep the government running until next October, would let the Blue plans count spending on improving health-care quality toward the 85% threshold.


How ‘Cromnibus’ Helps Blue Cross and Blue Shield - Washington Wire - WSJ

 

[GreenSky]

Thankfully we have a risk corridor. Can you imagine if the uninformed realized it was really a bailout?

Rick

 

[AllenChicago]

Thankfully we have a risk corridor. Can you imagine if the uninformed realized it was really a bailout?

Rick

Note the last paragraph of the article, regarding the risk corridor...

"Separately, Republicans are praising a section of the bill that would bar HHS from dipping into its trust funds to reimburse insurers who end up with a greater number of sick consumers than they anticipated. Instead, the program has to pay for itself. The Obama administration had already banked on the program being budget-neutral, but this takes away their safety net. The insurance industry’s main trade group, America’s Health Insurance Plans, says consumers will end up spending more on their health insurance premiums as a result."

 

[somarco]

consumers will end up spending more on their health insurance premiums as a result.

Say it ain't so!

We have a law that raises premiums for everyone but that same law provides loans to poor people (those who earn less than 400% of the FPL) so they can afford the higher premiums.

This kind of logic completely baffles me.

 

[RayNY]

Say it ain't so!

We have a law that raises premiums for everyone but that same law provides loans to poor people (those who earn less than 400% of the FPL) so they can afford the higher premiums.

This kind of logic completely baffles me.

All of ACA could have been avoided with just MLR for the carriers and the requirement that providers can only charge UCR/Medicaid rates. Use a multiplier for regional differences if needed so providers can be adjusted for the cost of living in their county.

Simple change solves the root of our high cost issue, rather than a poor attempt to mask the symptoms.

 

[somarco]

All of ACA could have been avoided with just MLR for the carriers and the requirement that providers can only charge UCR/Medicaid rates. Use a multiplier for regional differences if needed so providers can be adjusted for the cost of living in their county.

Simple change solves the root of our high cost issue, rather than a poor attempt to mask the symptoms.

That's an over-simplification.

Trashing a system that worked for two thirds of the population to save a few souls was just plan dumb.

The higher reimbursements from traditional health insurance is what keeps the providers that accept Medicaid and Medicare reimbursements in business. If (when) everyone is on M or M we will still have a two tier system where those who have the cash to pay will receive first class service and everyone else takes a number.

 

[RayNY]

That's an over-simplification.

Trashing a system that worked for two thirds of the population to save a few souls was just plan dumb.

The higher reimbursements from traditional health insurance is what keeps the providers that accept Medicaid and Medicare reimbursements in business. If (when) everyone is on M or M we will still have a two tier system where those who have the cash to pay will receive first class service and everyone else takes a number.

With a slight adjustment to the M&M reimbursement rates, they could pretty easily be doing the same thing as before with the same or better compensation. I'm not saying to destroy them, just reign in the abuses and wildly out of control cost variances. You shouldn't be charged $15,000 extra for the same procedure just because you went to hospital A instead of B.

Those who want to have a concierge doc/first class service certainly could, but for the other 99% of the population, the 3-tier system we have now (M&M/insurance/uninsured) is ripe for abuse, especially for the uninsured, who have the hardest time affording it in the first place.

Reforming insurance doesn't help them, reforming costs and billing practices would.