We interrupt this blog for Breaking News.
We have the results from the latest poll. We asked the students of Mr. Miller’s 4th grade class, here in East Podunk, Ohio, who they would vote for if the election was held today. And this is shocking! These student voters are equally divided – 33% for Donald Trump, 33% for Hillary Clinton, 33% for Beyoncé, and 1% for John Kasich. This is the first poll we’ve taken that has shown Kasich ahead of Jeb Bush.
4th graders. Could the report be accurate? Yes. Could it be 100% true? Sure. Does it mean anything? Absolutely Not.
Saturday’s Plain Dealer had a front page article – In 3rd year, NE Ohio insurance costs drop 6.3%. For most of you, that number is as real as Beyoncé’s electability.
All of the new individual policies, purchased on or off the government’s Exchange, renew on January 1st each year. Like my fellow agents, I have been reviewing the records of several hundred clients since the information was released a little over a week ago. One client at a time.
I have yet to see even one rate decrease.How can that be? Where are these rate decreases? My Anthem PPO clients, people who wanted a clear path into University Hospital, did not see their premiums shrink. And Medical Mutual of Ohio, the E Ticket into the Cleveland Clinic, had rate increases of up to 27%. How could the Plain Dealer be both 100% accurate and 100% irrelevant?
The answer lies at the heart of the Patient Protection and Affordable Care Act (PPACA or Obamacare). The focus has never been on health or health care reform. The point of the law is to reorganize how medical providers get paid. And, herding lower income people into lower cost providers is more efficient than allowing them to ring up big bills at expensive facilities that are eventually written off.
I went on to healthcare.gov today and looked at the least expensive policies for me, a 60 year old living in Cuyahoga County. Please remember that rates are gender neutral and that there are no health questions.
The lease expensive policy, $434 per month, is from Ambetter Insurance. The deductible is $6,800. This policy sends you to Metro Health and St. Vincent’s. More importantly, the Cleveland Clinic and University Hospital are not in their network. Never heard of Ambetter? Don’t want them? Too bad. They have lots of options on the Exchange close to this price point. None get you into U.H. or the Clinic.
The next insurer is CareSource at $444 per month with a $6,650 deductible. CareSource’s Medicaid policy has a great network, but if you are paying all or part of your premium you are again looking at a policy that fails to include University Hospital or the Cleveland Clinic.
Molina’s least expensive policy comes in at $468. Still no University Hospital of Cleveland Clinic.
Aetna has introduced a full portfolio of innovative group policies that provide great access to all of our major hospitals. Their least expensive individual policy at $520 per month does not. The deductible is $6,450. The doors to U.H. and C.C.F. are closed.
HealthSpan, an HMO, has a $4,500 deductible policy at $566 per month. This is the least expensive policy on the Exchange that grants access to University Hospital.
The new Anthem HMO policy is also $566. This policy has Anthem’s smallest network. Neither University Hospital nor the Cleveland Clinic are included.
HUMANA has a $6,450 deductible policy at $567 per month. University Hospital is in their network.
Medical Mutual of Ohio’s workhorse policy, the $6,000 deductible 100% plan, is $569 per month. This plan utilizes the old SuperMed Plus Network. It includes the Cleveland Clinic and the suburban facilities of University Hospital. This is not an HMO and it does not require a referral to see a specialist.
$569! It takes eight different insurers and over a dozen policy options to get to a policy that provides easy access to the majority of doctors and hospitals in Greater Cleveland. The price for access isn’t decreasing. It is increasing.
Are the rates decreasing on the Exchange? Sure. We are getting more and more offerings from the Ambetters, Molinas, and CareSources. But if we flood the market with Yugos, does it mean that the price of cars is going down?
The Plain Dealer reported that the price of insurance has decreased. Perhaps a more complete article would have noted the influx of limited access carriers. Would you really pay $434 - $566 per month to go to Charity Hospital? Do you really care how many 4th graders support Donald Trump?