Bone Of Contention

 

This blog has sounded the alarm.  There is a concerted effort to dismantle regulations, at least those impacting business activity and business behavior.  And though this is Health Insurance Issues With Dave, we have to take a moment to talk about boneless chicken wings. 

Here is the link to the Court News Ohio article.  The two minute version is that an Ohio man, Michael Berkheimer, revisited a local restaurant in 2017 and ordered his usual, boneless chicken wings.  From the article: 

“Berkheimer followed his normal practice of cutting each boneless wing into two or three pieces. He was eating the third piece of a wing when he felt “a piece of meat [go] down the wrong pipe.” He went to the restroom to try to clear his throat but was unsuccessful. Over the next three days, he spiked a fever and had trouble eating. During a visit to the emergency room, a doctor discovered a thin chicken bone lodged in his esophagus. His medical records indicated it was a “5 cm-long chicken bone,” which is about 1-3/8 inches.” 

The Ohio Supreme Court has ruled that Mr. Berkheimer cannot sue the restaurant or anyone responsible for the production of not-boneless boneless chicken wings.  Our courts have decided that you have no right to assume that a product sold as boneless would actually not have any bones.  This faith in the marketplace to self-correct means that anyone can sell you anything.  No matter what, you should know better.

 I am not implying coordination.  Instead, I see a convergence of a particular mindset / political view with those who would exploit weaknesses in the regulatory system.  Specifically, I am looking at the way legislation pending in the Ohio legislature, H.B. 400 and H.B. 587, would work with the Heritage Foundation’s Project 2025. 

H.B. 400 – Changes the way Medicare Supplements are marketed.  The bill would allow Medicare Beneficiaries under age 65 to purchase Medicare Supplement coverage.  It would also allow these Beneficiaries to change their policies annually.  Since they are under 65 and already declared Medicare eligible due to sickness or injury, there can’t be any underwriting.  Key changes:

·         Sale of Medicare Supplements to <65

·         Change Medicare Supplement policies annually, guaranteed issue with Pre-Ex covered

·         A whole new market that is constantly eligible.

·         Pricing locked in to the age 65 rate

·         Medicare Supplement marketing is state regulated

·         NO MENTION OF MEDICARE PART D (Rx) WHICH HAS FEDERAL MARKETING REGULATIONS.

H.B. 587 – Changes the way Medicare Supplements are marketed within the State of Ohio.  Many of Ohio’s current regulations mirror the federal government’s Medicare Advantage / Medicare Part D (Rx) prohibitions.  This bill removes these consumer safeguards while ignoring the need to help the consumer understand and address all of his/her needs.  Someone purchasing a Medicare Supplement would also need a Medicare Part D (Rx) plan.  And that individual might even be better served with a Medicare Advantage Plan.  Current Federal regulations would prevent the marketing of those plans at that time.  Key changes:

·         “Print solicitations such as…door hangers left at residences or on motor vehicles.”

·         “In-person solicitations of individuals at the individual’s residence or in public or common areas such as parking lots, hallways, lobbies, or sidewalks.”

·         “Telephonic or electronic solicitation such as electronic voicemail messages, text messages, or direct social media messages.”

Please note that H.B. 587 does not address the likelihood that many of those solicited would not qualify for the purchase of a Medicare Supplement policy under the current rules due to their preexisting conditions.  Beneficiaries currently covered by a Medicare Advantage Plan would have to answer health questions and would be subject to decline if they have had the MAPD for over 12 months.  This bill does not address the Beneficiaries’ need for Medicare Part D (Rx) coverage.

 

Project 2025 – The Heritage Foundation’s Mandate for Leadership: The Conservative Promise.  If I may skip the 533 times tax and/or taxpayer are mentioned and the 199 times for abortion, the other key focus of Project 2025 is the privatization and / or move to state (non)regulation of federally regulated programs.  The privatization of Social Security and the move of programs such as Medicare to state regulation are an inherent part of Project 2025.  And this is the final connection:

·         If Medicare was regulated by the State of Ohio, we could lose all of the consumer protections:

A.      Minimum standards for MAPD policies

B.      Age restrictions on Medicare Supplements

C.      Meaningful guaranteed issue vs. underwritten times to purchase coverage

D.     All marketing regulations.  Once anyone on Medicare can routinely change plans, marketing restrictions would be ignored (see current call centers with MAPD) and eventually eliminated.

It is important to remember that this mindset is completely convinced that the market will correct any and all excesses.  That faith in market correction ignores the real world consequences of the damage done. 

This same thinking can be applied to their efforts to dismantle the Patient Protection and Affordable Care Act in our industry and countless other examples in other industries.  

Eliminate all consumer safeguards?  I have a bone to pick with that. 

Dave 

www.cunixinsurance.com

Picture – Dependably Boneless – David L Cunix 

Quick footnote – I hope that some of you, especially those of you who are insurance agents, will click on the links to the legislation.  Both bills are only a few pages.  Also, the Project 2025 link is searchable.