Kevin Knauss: Health, History, Travel, Insurance
Posts of my opinion and analysis of Donald Trump.
We will see some health plans not be offered if there is a parallel marketplace with non-subsidized plans that have gaps and caps. Healthy people will migrate to the lower cost health plans leaving people who need health care services in the subsidized plans. This will cause the death spiral of the health plan as claims expenses increase with shrinking premium dollars.
The cost of the individual mandate is nothing compared to the cost of a decent health insurance plan. People are not enrolling in health insurance because it is too damn expensive. I don’t know what percentage of the decline in new enrollments for Covered California is due to expensive health insurance and they don’t know either. Talk to any health insurance agent they will tell you they fielded many calls from consumers wanting a lower rate on health insurance. They were willing to take anything, even if crappiest of plans if they could just afford it. I don’t sell them, but I had to inform people of the health care sharing ministries. These health care sharing plans are not insurance, but they can seem like a health plan for half the cost of a Covered California plan. How many people enrolled in these health care sharing plans and by-passed Covered California and the off-exchange plans altogether?
For the family of a small business owner, the reduction of the MAGI because of the 20% deduction could drop any dependents under 18 years old into Medi-Cal. A family of four earning $70,000 makes all the household members eligible the tax credit subsidy through Covered California. If the family reduces their income by the 20% deduction, the new income is $56,000. That is below 266% of the federal poverty level for a family of four and all dependents 18 and younger are then deemed eligible for Medi-Cal.
Short-term, limited-duration insurance, which is not required to comply with federal market requirements governing individual health insurance coverage, can provide coverage for people transitioning between different coverage options, such as an individual who is between jobs, or a student taking time off from school, as well as for middle-class families without access to subsidized ACA plans.
Under the Department’s new rule, AHPs can serve employers in a city, county, state, or a multi-state metropolitan area, or a particular industry nationwide. Sole proprietors as well as their families will be permitted to join such plans. In addition to providing more choice, the new rule makes insurance more affordable for small businesses. Just like plans for large employers, these plans will be customizable to tailor benefit design to small businesses’ needs. These plans will also be able to reduce administrative costs and strengthen negotiating power with providers from larger risk pools and greater economies of scale.
Today, the Centers for Medicare & Medicaid Services (CMS) issued the HHS Notice of Benefit and Payment Parameters for 2019. The final rule will mitigate the harmful impacts of Obamacare and empower states to regulate their insurance market. The rule will do this by advancing the Administration’s goals to increase state flexibility, improve affordability, strengthen program integrity, empower consumers, promote stability, and reduce unnecessary regulatory burdens imposed by the Patient Protection and Affordable Care Act.
The RFI is not a serious attempt at gathering comments on how to stabilize the health insurance markets across the country. Trump and Price have already set in motion the slow dismantling of regulations that kept the ACA markets relatively stable. This is a thinly veiled attempt to generate regulation gutting suggestions that will further destroy meaningful health insurance for Americans. I can guarantee that any real suggestions that would work to contain health care costs, which are the real driver of ever escalating health insurance premiums, will be ignored.
Given the Republican philosophy that less government is better government, Covered California’s reason for existence may evaporate. But it all hinges on Trump’s term ‘transition’. Does he want to transition away from the Marketplace Exchanges, or is he merely suggesting transitioning away the Qualified Health Plans as a requirement for the tax credit?
The Tower Theater in downtown Roseville was the site of a peaceful, but loud, protest demonstration by residents of Republican congressional representative Tom McClintock’s district in Northern California. Rep. McClintock had scheduled one of his Town Hall meetings at the Tower Theater in Roseville. But I don’t think he was prepared for the hundreds of people who turned out to protest his support of President Trump’s Executive orders.
Covered California has been studying how different changes to the ACA will impact their ability to meet their projected budget and offer affordable health insurance to consumers. At the Covered California January Board meeting they released six reports they commissioned that studied consumer attitudes toward health insurance and potential changes to the ACA.
