Jul 16

obamacare will hurt

Illinois Obamacare Co-Op Goes Bust Leaving Tens of Thousands at Risk:

The fact that Obamacare is a gigantic train wreck barreling uncontrollably into a brick wall is pretty much undeniable at this point. I’ve covered this reality from several angles in 2016, with one of the more popular posts being, The Health Insurance Scam – “Coverage” Doesn’t Mean Affordability or Access, in which I noted: 

Politicians, particularly those of the Democratic persuasion, love to throw around statistics about how many additional people have healthcare coverage without ever talking about the cost of such coverage, or whether it actually translates into actual access in the real world.

While a greater number of Americans having health insurance is a good thing when it comes to protecting against unexpected catastrophic events or extended hospital stays, it doesn’t tell you anything about two very important variables: 1) How much does it cost? 2) What kind of access does it provide? As usual, the devil is in the details.

We’ve all seen headlines about higher monthly premiums, but that’s just the tip of iceberg. Once you’ve paid your premium, you’re far from off the hook. Another one-two punch of deductibles, copays and out of pocket maximums appear which can collectively run into the thousands if not tens of thousands of dollars for families.

In my opinion, the above situation represents the number one failure of Obamacare, but there are others. Today’s piece focuses in on the state of Obamacare co-ops, which were “created under the federal health law to provide cost-effective coverage and competition in state insurance markets.”

Just like with Obamacare in general, stark reality is not living up to the sales pitch, and 16 of the 23 nonprofit cooperatives created nationwide have now failed.

As the Chicago Tribune reports:   

The Illinois Insurance Department moved Tuesday to shut down Land of Lincoln because of its unstable financial health, leaving about 49,000 policyholders in a lurch. They will lose coverage in the coming months, but neither regulators nor the company have said exactly when.

Policyholders will be able to buy insurance from a different carrier to cover them for the rest of 2016, according to the state Insurance Department. But switching plans is going to cost them.

The co-pays and deductibles enrollees have been paying since January will not transfer to new plans. A new plan will reset deductibles and out-of-pocket maximums paid by consumers.

Beyond the impact on consumers, the demise of Land of Lincoln is a significant setback for the Affordable Care Act in Illinois. The insurer was one of 23 nonprofit cooperatives nationwide created under the federal health law to provide cost-effective coverage and competition in state insurance markets. With Land of Lincoln’s failure, the list of co-ops has shrunk to seven.

Just last week, Connecticut took control of its health insurance co-op, but policyholders will have coverage until the end of the year, avoiding the disruption that is coming to Illinois, disruption that Illinois’ top insurance regulator warned the federal government about two weeks ago.

After a slow start in 2014, Land of Lincoln grew rapidly last year, finishing 2015 with more than 35,000 individual policyholders and about 15,000 members in small and large employer plans. The co-op captured about 6 percent of the individual market in Illinois, which was good for second place but well behind Blue Cross’ 83 percent market share.

Pretty massive concentration for a “free market.”

But Land of Lincoln lost more than $90 million in 2015, as the premiums it collected fell well short of the health-care costs of its enrollees. The shortfall in premium revenue was a problem also experienced by large, established insurers like Blue Cross that also participated in the restructured individual markets.

Shortfalls in anticipated levels of federal funding also put Land of Lincoln in a bind. While big insurers have the financial reserves to cushion against losses, Land of Lincoln was in a precarious condition at the end of last year. Still, Illinois insurance regulators allowed the company to sell plans for 2016 to consumers.

The company has continued to lose money this year, even after increasing rates by an average of 29.7 percent. Through May, the co-op lost more than $17 million, according to the state Insurance Department.

Land of Lincoln is the latest casualty in the health-care law co-op program. According to Americans for Tax Reform, the company is the 16th co-op to fail. The federal government financed co-ops with low-interest loans totaling $2.4 billion. In Illinois, the Metropolitan Chicago Healthcare Council, a hospital trade association, received $160 million in funding to start Land of Lincoln.

The company’s collapse will hit hospitals and physicians throughout Illinois. The company had nearly $49 million in unpaid claims at the end of the first quarter.

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