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12. LEGALLY TIE MEDICARE ADVANTAGE/MANAGED MEDICAID CONTRACTS TO EXCHANGE PARTICIPATION.
Andrew Sprung, Michael Hiltzik and I have all written about this before. I have no idea whether it's even legally feasible/practical or not, but if so, it makes a lot of sense to me: Remember, many of the same carriers whning about losing hundreds of millions of dollars on the individual market are simultaneously making billions of dollars in profit off of their other divisions...which include fat federal and state contracts to manage Medicare and/or Medicaid plans. If they want to play in the managed care sandbox, make exchange participation a requirement as well. I'm not saying they should have to treat it as a loss leader--they'd still be able to raise their premiums at an actuarially responsible rate as appropriate--but they should have to at least participate.
To summarize: For months now I've been predicting/warning that regardless of whatever legitimate risk pool issues the ACA exchanges may still be having in many parts of the country which could lead to significant rate 2018 rate hikes no matter what, there's the additional Fear/Uncertainty/Doubt factor which is being deliberately created by Donald Trump, Tom Price and the Congressional GOP. Insurance carriers hate uncertainty above all else, and I've been expecting them to do one of two things as the 2018 rate filing deadlines approach: Either jack their rates up significantly to cover themeselves for the unholy mess brewing ahead...or to simply get out of Dodge by either dropping out of the exchanges or fleeing the entire individual market altogether, on & off exchange. Most likely, I've been saying, it'll be a combination of both.
UPDATE: As I've been warning for months, several carriers have now openly stated that perhaps 40% of their requested rate hike is due specifically to concerns about the Trump administration & the GOP's ongoing sowing of confusion and outright sabotage of the ACA and the individual market.
Unlike most states, Connecticut did all the legwork for me, making it incredibly easy to plug the numbers into a spreadsheet for weighted average (requested, unsubsidized) rate hikes for both the individual and small group markets:
Over the past few months, my Congressional District Breakdown tables estimating how many people would likely lose healthcare coverage if the ACA were to be "cleanly" repealed (with no replacement) have gotten a lot of attention. This was followed by the Center for American Progress (CAP) running their own estimates of how many would likely lose coverage if, instead of a "clean" repeal of the ACA as a whole, the ACA were to be partially left in place, with the GOP's AHCA (Trumpcare) bill, which dramatically changes the ACA, being signed into law instead.
UPDATE: As I've been warning for months, at least one of Maryland's carriers has openly stated that perhaps 40% of their requested rate hike is due specifically to concerns about the Trump administration & the GOP's ongoing sowing of confusion and outright sabotage of the ACA and the individual market.
UPDATE: As I've been warning for months, at least one of VA's carriers has openly stated that perhaps 40% of their requested rate hike is due specifically to concerns about the Trump administration & the GOP's ongoing sowing of confusion and outright sabotage of the ACA and the individual market.
A couple of weeks ago I noted that Virginia is one of the first states to post their initial premium rate hike filings. At the time, they hadn't posted the actual filings but at least listed the insurance carriers which were planning on participating in the individual and small group markets next year, both on and off the ACA exchange:
There are so many stories I could be writing right now about the fallout, potential fallout, next steps and so forth of yesterday's House vote on the AHCA. But this one in particular really says it all.
Watch: Chris Collins admits he didn't read health care bill
WASHINGTON – Rep. Chris Collins told CNN that he didn't read the entire Republican health care bill that the House passed Thursday.
And then he told The Buffalo News that he was unaware of a key provision in the bill that decimates a health plan that serves 635,000 New Yorkers.
Asked by CNN's Wolf Blitzer if he had read the entire health bill, Collins, R-Clarence, said: "I will fully admit, Wolf, that I did not. But I can also assure you my staff did. We have to rely on our staff. ... I'm very comfortable that we have a solution to the disaster called Obamacare."
Welp. I've done everything I can to help stop them, but it looks like the House Republicans have decided to go ahead and vote on their big ol' dumpster fire of a bill after all.
No CBO score. No review. No debate. No transparency. No time for anyone to read the bill. Everything they falsely accused the Democrats of 7-8 years ago (yes, I gave a range of 7-8 years, because there was a solid year of debate, discussion, meetings, arguments and so forth before the final votes were cast).
Maybe they'll pull it off. Maybe they won't. If it passes the House, what'll happen to it in the Senate? Who the hell knows, but the fact remains that anyone who votes for this piece of crap doesn't deserve to hold office any more than the racist, misogynistic, xenophobic con-artist moronic pussy-grabbing asshole who leads their party.