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Ethan Rome

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Don't Be Fooled By the Big Insurance Companies

Posted: 06/12/2012 1:01 pm

Health insurance giants UnitedHealth Group, Aetna and Humana have announced that regardless of how the Supreme Court rules in the Affordable Care Act case this month, they will voluntarily continue some important consumer protections created by the law. These include preventive health care services without co-payments, coverage of children up to age 26 and elimination of lifetime policy limits. The Blue Cross Blue Shield Association is also encouraging its member companies to consider following UnitedHealth's lead.

This would seem to be a good thing, and some are praising these companies. But no one should be fooled. This didn't happen out of the goodness of the insurers' hearts. This isn't about corporations doing the right thing. And it didn't happen now, just a few weeks before the Supreme Court announces its ruling, by coincidence.

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This is a PR offensive. The coordinated announcements by three of the five biggest health insurance companies is a cynical tactic to signal to the high court that it's okay to gut the law and remove its consumer protections because the health insurance companies will act responsibly and police themselves. No more insurance company abuses. The free market won't cost consumers their health anymore. The insurers' message to the court, it would seem, is that it's a new day so we can stick with the old rules.

The insurers also are trying to give cover to the Republicans in Congress, who are sweating about what to do if the high court strikes down all or part of the law, including the consumer protections that people are getting used to and really like. The question has already split the GOP caucus because their mantra of "repeal Obamacare" also means taking away the popular parts of the law. Now the insurance companies are making it easier for the Republicans by saying they'll continue a few of the good things without the law.

But the insurance companies are only talking about voluntarily extending a few of the benefits they are now required to offer. This won't cost them a nickel because the benefits were cost-efficient to begin with and are already baked into their premiums. The families and businesses that purchase health insurance expect to have these benefits and insurers, not wanting to look like the guilty parties, won't yank them mid-policy year. This neatly solves their PR problem, at no cost to the CEOs and shareholders.

What the insurance companies didn't say -- and what they won't do -- is the real story. They aren't saying they will stop discriminating against people with pre-existing conditions as the law requires beginning in 2014. That would be a big deal, because that part of the law will stop 129 million people with chronic conditions like diabetes, high blood pressure and asthma from being over-charged or being denied coverage. They also have not offered to keep covering children with pre-existing conditions -- a provision which has already taken effect and insurers have fought.

The insurers got publicity this week for appearing to make a positive gesture, but the changes they've announced are voluntary, meaning consumers and small businesses can only count on the policies to last as long as it's financially convenient for the insurers. But goodwill gestures aren't enforceable when you're sick. Insurance companies can't be trusted to behave as good actors unless laws are on the books to prevent them from being bad actors.

 
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12:22 PM on 06/13/2012
Rome,

Thanks for sharing your feelings on this issue. I would like to see, however, a little real data and a little less "feelings" (yes, I know Progressives confuse their feelings with facts, but I expect more out of you). A couple of points to consider:

1. Keeping the coverages the carriers said they will keep DOES carry an opportunity cost, and NONE of them are net savers of money for an insurance company, not in the short or long run. They could all make more money by reverting to the pre-PPACA status quo.

2. Covering Pre-X (offering guaranteed issue coverage) DOES NOT WORK. You can take all their profits, and it still wont' cover the gaming that results when people can wait to buy coverage after they get sick (and they will, and they do). There are 8 state examples just in the last 20 years where GI coverage was required without a mandate in place. All 8 state insurance pools failed catastrophically and publicly. Just google "Washington State Health Insurance 1993-94" and you can read one of them for yourself.

If you want Single Payer, just say so. If you want an American National Health Service financed directly by taxpayer dollars and run by the Fed, just say so, and we can have an intelligent conversation about the hurdles to be overcome to make that work.

But if you are going to go after the carriers how about real numbers?

WR29, Healthcare Economist
10:32 AM on 06/13/2012
SCOTUS doesn't decide cases on the basis of what effect it will have on an (insurance) industry - they decide on the basis of constitutionality.
Insurance companies only help manage risk, they aren't another susidy program from the federal government. Obviously they are motivated by the potential to earn profits, as is any for profit business, and to villianize them for this is ridiculous. If they didn't earn a profit they wouldn't be around to honor any insurance claims; they would be out of business and added to the unemployment statistics.
The more regulated the industry becomes the less affordable (without subsidies) insurance will be and the less responsive it will be to the actual wants and needs of the consumers.
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HUFFPOST SUPER USER
MeinNH
Ooooo Silly Me
09:41 AM on 06/13/2012
What they are not telling us is that these "goodness of their heart" things will cost you in a higher premium, deductible and co-pays.....
10:33 AM on 06/13/2012
I suppose you were hoping to get more for less? How often does that work out for everyone involved?
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Eye See You Clearly
We "The People"
06:12 AM on 06/13/2012
Whenever the subject of Healthcare cost vs. the standard over-billing / negotiated rates nightmare comes up. Get back to me about the savings that could be realized and passed along to insured people. American's are tired of fighting to get bills paid when they are insured. We don't want to mail order medications with the risk of them being stolen from our mailboxes. We want to be able to speak with a pharmacist to discuss our needs and concerns in person. We don't want you substituting medication at your will. Generics are fine but we don't want something "like" what we were prescribed. We don't want you telling us what pharmacies, doctors or hospitals we must go to. Nuff said
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Eye See You Clearly
We "The People"
05:38 AM on 06/13/2012
In other words, they already have the added revenue on the books for the added participants under the age of 26 and they will make sure to keep that money.
12:26 PM on 06/13/2012
Whoops! Turns out that almost NONE of the kids to age 26 who were added to their parent's plans in the last 18 months (almost 2 million of them) paid ANY additional premium because their parents were already paying for family coverage. IN other words, the kids came back and it cost mommy and daddy nothing, or very little. A pure freebie.

And pure cost for your insurance company. Estimated by the ASA at a 1-1.5% premium increase for the rest of us.

WR29
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Eye See You Clearly
We "The People"
01:34 AM on 06/14/2012
almost none?
HUFFPOST SUPER USER
newleaf
~ Turn over a new leaf ~
12:26 AM on 06/13/2012
The incentive of the insurance company is to make money. It is not to help you with your care. It's just not. That's not how the for-profit system works.
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07:10 PM on 06/12/2012
Good rule of thumb: If an "agreed" obligation of a business is not clearly stated in a written contract it is worthless.
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HUFFPOST SUPER USER
Thor Halvorsen
Laugh til you fart, then laugh more!
06:58 PM on 06/12/2012
Remember rule #1... insurance companies care about stock holder's FIRST
Rule #2... the patient's claims are equated as a claim against the business... a LOSS, nevermind that we PAY them to provide these services..
Rule #3... refer to rule #1 when you see a denial letter.. they say, You, sick person, stop being silly, you're costing us money! We really didnt MEAN to care!!
12:28 PM on 06/13/2012
Absolutely correct, except for the 50% of americans who get their coverage through a carrier organized as a not-for-profit (no shareholders, Community Board of Directors) or an outright charity (like BCBSMA for example). Otherwise, yes, it's Bondholders, then Preferred Stockholders, then Common Stockholders, then Employees, and THEN insured. Just like every other corporation.

WR29
05:10 PM on 06/12/2012
Insurance companies cannot be trusted in ANY event.
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DC Liberal
The Republican Party - Brought to you by Fox News
03:43 PM on 06/12/2012
Insurance companies have never ever looked out for the best interests of their policy holders. Never! Ever!

Their fundamental responsibility is to maximize their shareholders' return on investment, and not the quality or longevity of their policy-holders' lives.
03:20 PM on 06/12/2012
Like always, follow the money. Like any business, the insurance companies are there to make a profit for themselves and their investors, period. They only make a profit by bringing in more than they pay out. They are not there to make sure people have access to health care, they are not there to optimize the health of their subscribers (other than ways to get them to spend less down the road), they are not there to make sure Suzie gets that life saving but expensive treatment. As long as there is a profit in paying for health care, don't expect the health insurance companies to change.
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parlimentMike
Terrorists keep you in fear
02:40 PM on 06/12/2012
It's the President and Congress' fault that Insurance companies are screwing up American's health. This has continued since Republicans first resisted Truman's efforts. At least then the Insurance Industry and Drug Industries didn't own the President too.

They spent enough time to be informed, but they showed zero consideration for what was best for the People of America. Now what's best is to scrap all involved, and start with a new government and universal single-payer.
01:45 PM on 06/12/2012
It feels to me like the Supreme Court has "telegraphed" its coming decision in some way to its industry and corporate overlords, leading them to start what only can be described as a propaganda campaign to mollify any reaction to the striking down of all or most of the Affordable Care Act. (Just because I sound paranoid, that doesn't mean that they're not out to get us.)
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Gestas
Mountain Man
01:16 PM on 06/12/2012
Romney confirms He will deny Insurance to millions with pre-existing conditions.
12:29 PM on 06/13/2012
Last I checked, Mitt Romney didn't insure or cover anyone. How can he deny something he's not empowered to offer? Even the President can't give you free healthcare.

WR29