Health insurers to investors: We’re good. Health insurers to lawmakers: Help(propublica.org)
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Health insurers to investors: We’re good. Health insurers to lawmakers: Help
https://www.propublica.org/article/health-insurers-to-investors-were-good-health-insurers-to-lawmakers-please-help
20 comments
Expensive and routine care has been cancelled but people are still paying for health insurance.
You’re 100% correct. I just received a check from my auto insurance due to covid and the decreased risk of accidents. Will I receive a check from my health insurance since I am unable to receive routine care? Why should I be paying for a service I cannot use?
My wife’s grandfather was scheduled for bladder surgery. They canceled it indefinitely. We do not live in a big metropolis and our hospitals aren’t crowded (I drive by daily). He’s in the most pain he’s ever been in and all they want to do is up the pain killers. It’s completely fucked.
My wife’s grandfather was scheduled for bladder surgery. They canceled it indefinitely. We do not live in a big metropolis and our hospitals aren’t crowded (I drive by daily). He’s in the most pain he’s ever been in and all they want to do is up the pain killers. It’s completely fucked.
The affordable care act specifies that 80% of premiums must be spent on medical expenses. If not, the consumer gets a rebate at the end of the year.
See e.g. https://www.investopedia.com/terms/m/medical-cost-ratio.asp
See e.g. https://www.investopedia.com/terms/m/medical-cost-ratio.asp
Note that this rule doesn't apply to the very large employers that self-insure.
Refer to: https://fas.org/sgp/crs/misc/R42735.pdf
Refer to: https://fas.org/sgp/crs/misc/R42735.pdf
Interesting, I never heard of this. Then isn't this just the smoking gun to explain why it seems health insurers in the US are apparently so cool with skyrocketing healthcare costs, which then increase the 20%?
The calculation for ACA is based on a three year average of low MCR, so you wouldn't get rebate solely due to a year of decreased medical loss
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Cigna spoke to its investors specifically about its various books of business with regards to coronavirus and COVID19 for 2020. A significant part of Cigna's business is as an administrator for self-insured companies meaning they don't bear financial risk for specific healthcare costs. This aspect of their business, along with the fact that the expected costs associated with a mild COVID19 outlook for their insurance markets contributed to their optimistic financial outlook over a month ago. This was a view shared by many large plans at the time.
Since the emergence of social policies designed to curb community spread over the past 6-8 weeks, economic conditions for their customers and members have deteriorated. A large percentage of these groups are considering member disenrollment or group termination. Public support of these groups to help ensure healthcare access is a good thing and the AHIP letter that Cigna supports advocates for this position.
As an aside, the social policies currently in place are crushing the business models of hospitals and medical offices. It's devasting financially, but largely seen as temporary until shelter-in-place requirements are lifted. The ensuing economic depression will hurt the majority of business sectors, which in turn will negatively affect health insurers financially later this year and next year.
For the time being, insurers are financially benefitting from lower medical loss, but this will likely be balanced out in the near future as pent-up medical demand returns. The long-term financial future of insurers will depend on how well people can predict COVID19 costs vs. actual utilization.
source: I help manage a community health plan
Since the emergence of social policies designed to curb community spread over the past 6-8 weeks, economic conditions for their customers and members have deteriorated. A large percentage of these groups are considering member disenrollment or group termination. Public support of these groups to help ensure healthcare access is a good thing and the AHIP letter that Cigna supports advocates for this position.
As an aside, the social policies currently in place are crushing the business models of hospitals and medical offices. It's devasting financially, but largely seen as temporary until shelter-in-place requirements are lifted. The ensuing economic depression will hurt the majority of business sectors, which in turn will negatively affect health insurers financially later this year and next year.
For the time being, insurers are financially benefitting from lower medical loss, but this will likely be balanced out in the near future as pent-up medical demand returns. The long-term financial future of insurers will depend on how well people can predict COVID19 costs vs. actual utilization.
source: I help manage a community health plan
It’s not just insurers maximizing profits. My patient volume is down 50% but the hospital who rents me my office is not giving any break on the rent. Neither is my malpractice insurance nor any other vendor.
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See anyone trying to get a loan vs anyone paying taxes. Duh!
Sliver lining: at least there is a place where lies/misinformation/propaganda doesn't fly in the US: the SEC.
I think you forgot the /s. The SEC is hopelessly corrupt.
relevant:
https://www.bloomberg.com/opinion/articles/2019-06-26/everyt...
>Securities fraud is a universal regulatory regime; anything bad that is done by or happens to a public company is also securities fraud, and it is often easier to punish the bad thing as securities fraud than it is to regulate it directly.
parent commenter is right, securities fraud is probably the best ways we have to prosecute "bad" behavior.
https://www.bloomberg.com/opinion/articles/2019-06-26/everyt...
>Securities fraud is a universal regulatory regime; anything bad that is done by or happens to a public company is also securities fraud, and it is often easier to punish the bad thing as securities fraud than it is to regulate it directly.
parent commenter is right, securities fraud is probably the best ways we have to prosecute "bad" behavior.
Health insurers to investors: it's safe to give us money. Health insurers to lawmakers: it's not safe to not give us money.