Attacked With A Dull Knife

The Patient Protection and Affordable Care Act (Obamacare) is under siege. There is no need for a link here to back that up. You already know this if you haven’t been asleep for the last eight years. The law has withstood the faint-hearted assaults of the Congressional Republicans and a variety of presidential candidates. And now health insurance, the way most Americans pay for and access care, is being attacked by a guy wielding nothing but bluster and a dull knife. Obamacare vs. Trumpcare. In the eternal battle between something and nothing, something always wins.

It has been a little over two weeks since the Trump administration, specifically the Centers for Medicare and Medicaid Services (CMS) announced that it would stop collecting and distributing money from the Permanent Risk Adjustment Program. The government decided to retain $10,400,000,000 of the insurance companies’ money. There are no taxpayer subsidies involved.

That has now been reversed.

In an email release Tuesday (because Tweets are reserved for the really important stuff!) CMS announced that it would release the money and reaffirm one of the basic pillars of Obamacare. Here is a link to the final rule.

In CMS Administrator Seema Verma’s press release she notes, “Issuers (sic) that had expressed concerns about having to withdraw from markets or becoming insolvent should be assured by our actions today”.

The Cliff Notes Version: Nothing has changed! Sure there were a couple of weeks of unneeded aggravation and another attempt to undermine the stability of the insurance markets, but in the end… It is as if there really are adults, somewhere in Washington, who step in and stop Donald Trump before he can do too much damage.

We are a little over 90 days from the next Open Enrollment Period, the first without a penalty for failing to carry compliant coverage (Individual Mandate). We are bracing ourselves for the last acts of sabotage, the last attacks on our system prior to facing our clients. Thankfully, all he’s got is a dull knife.

DAVE

www.cunixinsurance.com

Picture – David L Cunix – The Weapon

 

Naked Aggression

Vladimir Putin was embarrassed on the world’s stage. Thousands of journalists, from print, TV, and online, were in Sochi for the 2014 Winter Olympics. The pictures and stories of inept plumbing and shoddy construction made Putin look foolish and unprepared. He changed the narrative and the world’s focus. He invaded Crimea. His attack of Crimea eliminated all discussion of the Sochi debacle.

Donald Trump appears to hold dictators and strongmen in high esteem. He has noted that Xi Jinping of China has a lifetime gig. He is outspoken in his appreciation of Rodrigo Duterte of the Philippines. And he appears to have learned a lot from Putin. Where Putin attacked Crimea, Donald Trump attacks our access to health care. Last week was a particularly challenging week for the administration and the President again attacked our health care system.

CMS Stiffs the Insurance Companies

On Saturday, July 7, 2018, the Centers for Medicare and Medicaid Services (CMS) announced that it on would stop collecting and distributing money from the Patient Protection and Affordable Care Act’s (Obamacare’s) Permanent Risk Adjustment Program. The Permanent Risk Adjustment Program had the insurers collect fees from everyone covered by insurance that would be distributed to the insurers proportionately to mitigate the costs associated with higher risk/claim clients. From The Center for Consumer Information & Insurance Oversite on the CMS website:

“Reducing the incentives for health insurance issuers to avoid enrolling people with pre-existing conditions: The permanent risk adjustment program will assist health plans that provide coverage to individuals with higher health care costs and will help ensure that those who are sick have access to the coverage they need.”

This is an integral part of the market stabilization built into the PPACA.

In an act of naked aggression, the Trump administration is holding $10,400,000,000 of the insurance companies’ money.

Are you distracted? Will you forget about Scott Pruitt or the future of the Supreme Court or the needless fights with our allies when your health insurance premiums spike again? The PPACA is surprisingly resilient. The attempts to repeal it, though often just for show, have not been successful. The sabotage from this Congress and President Trump have resulted in fewer choices and higher prices. Their goal has been to destabilize the insurance markets. Here is a record of their achievements:

• Remove the penalties of the Individual Mandate as of 2019
• Shorten the Open Enrollment Period
• Remove almost all funding for promotion and community outreach
• Threaten to eliminate the funding for the Cost Sharing Reduction and when that failed to do enough damage, follow through with the threat
• Attempted to eliminate or limit guarantees built into the PPACA
• Encourage the creation of association policies and other options designed to cherry-pick the healthy from the general insurance pool.
• Withhold money due the insurers and eliminate the future benefits of the Permanent Risk Adjustment Program.

Insurers, agents, and a variety of industry groups were surprised by the Saturday announcement. The 2019 rates need to be filed now. How should the industry respond to naked aggression?

There may not be a tank rolling into my parking lot, but I know when my clients and I are under attack.

DAVE

www.cunixinsurance.com

Picture – Aggression – David L Cunix