We're from the Government, and we're...

Well, you know. We're about three months out now from the Exchange roll-outs (maybe), and of course Top Men are making sure that things are proceeding apace.

Or not:

"Guess who has no idea who is going to be running the exchanges in those states?  Or how much a basic policy is going to cost?  Or who is going to be paying the difference between the amount a “low-income” person will have to pay and the cost of the policy? "

Definitely read the whole thing (but first, make sure to take your BP meds).

Hunger Games and the MVNHS©

Sometimes, the headline really is the story:

Nearly 1,200 people have starved to death in NHS hospitals because 'nurses are too busy to feed patients'

On the one hand, this apparently took place over four years, so that (presumably) "only" about 300 Brits per year were killed off this way. Still, death by starvation is no treat:

"Pain in the stomach often quickly develops, then can turn into digestive and waste-related syndromes such as severe and painful constipation followed by uncontrollable diarrhea. Early symptoms of starvation include faintness, weakness, and dizziness. Thirst may also rapidly increase."

Oh, and apparently starvation isn't the only problem facing patients victims of the Much Vaunted National Health Service©:

"[F]or every patient who dies from malnutrition, four more have dehydration mentioned on their death certificate."

No big deal, really: just think of it as a very dry Liverpool.

And speaking of the MVNHS© and pools, the good news for "aspiring glamour model" Josie Cunningham is that she'll be a knockout in a bikini. That's because the rocket plastic surgeons at the Much Vaunted National Health Service© gave the go-ahead for her "upgrade" to 36DD (and no, that's not her seat number).

The bad news is that these same folks took a pass on "upgrading" 2-year old aspiring walker Oliver Dockerty. Apparently the boobs in charge at the MVNHS© found Ms Cunningham's case more, ahem, compelling. After all, why would any two-year-old want to walk?

Obamacare Stress Relief

The Obamacare exchange opens October 1, 2013 but will it be ready to roll?

Probably not . . .

That process is complex enough by itself. How much coverage do you want? What deductible? Are family members on the plan? Do you need an asthma program? Do you want to keep your current doctor? What about dental?

Kaiser Health News

That's getting ahead of yourself.

Before selecting a plan, if you go through the exchange you need to know if you qualify for a subsidy. That is a 45 minute process.

Like other filtering software, Connecture’s program is a multi-step search engine, screening out inappropriate options (based on your input) to deliver a manageable menu. After getting past the basics (Stripped-down “bronze” plan or high-benefit “platinum”? High deductible or low?), the program asks if it’s important to keep your current doctor.

“Based on our research, the choice of doctor was probably the No. 1 and No. 2 [features] of what people are looking for in a plan,”

Good luck on that.

It may be almost impossible to find "your" doc on the exchange plans.

Need to see if your drugs are on the formulary?

Fat chance

To try to reduce sticker shock, Connecture shows your net premium price — after the tax credits are applied — early in the shopping process. But perhaps the most important feature is the one estimating the total cost of coverage, including deductibles and co-pays, based on your reported health status. Without that information somebody with a chronic condition requiring lots of care could choose a plan based only on a low premium, not realizing the total expense could be substantially reduced by paying a larger premium up front.

How is this working for you so far?

Might need to chill out a bit.

Friday Morning Updates

Updates on a couple of yesterday's items:

■ Unlike Aetna and UHC, Anthem will not be sending out rebate checks to Buckeye State insureds. Via email:

"On June 1, 2013, Anthem filed the required MLR report with Health and Human Services for the 2012 calendar year and met the required loss ratio for all lines of business for 2012. This means no notices will be sent and no rebates will be issued."

Good for them!

■ Hobby Lobby, much like Beckwith Electric, gets a reprieve on implementing the birth control convenience item mandate (Hat Tip: Hot Air):

"The 10th Circuit Court of Appeals moved to reverse a lower court's decision to deny Hobby Lobby Stores Inc.'s quest for an injunction against part of the Affordable Care Act that requires it to cover the cost of emergency contraceptives for some of its employees."

It's not a done deal, though: the case now goes back to the lower court for another round.

Still, some good news heading into the weekend.

Stuck in Folsom Prison

RIP Johnny Cash. Yes, he did spend time in prison but fortunately for him he had a trade to fall back on once he got out.

Perhaps the same is true for today's felons.

Republican senators slammed the Patient Protection and Affordable Care Act’s navigator program Thursday arguing that the rule is so lenient that a convicted felon could qualify as a navigator and get access to consumers’ confidential health information.

“The standards proposed by your Department could result in a convicted felon receiving federal dollars and gaining access to confidential taxpayer information," the letter stated. "The same standards allow any individual who has registered with the exchange and completed two days of training to facilitate enrollment, as if the decision to purchase health insurance is similar to the decision of registering to vote." 

Life Health Pro

and time keep dragging on . . .

Obamacare Whether You Like it or Not

They're baaaack: ObamaWaiver Mania

In fairness, this first item isn't so much an ObamaWaiver as a court-ordered time-out:

"A Largo high-tech engineering firm doesn't have to offer emergency contraception under its medical plan while its case challenging part of the federal health care law is pending in court"

The company's owner is a "devout Southern Baptist" whose religious beliefs [ed: remember when those were protected under the First Amendment? Good times, good times], prohibit abortifacients. Timing is everything, which seems to be working in Mr Beckwith's favor: since his "insurance plan was up for renewal this month, Beckwith could have been required to start covering the contraceptives while the case was under review. U.S. District Judge Elizabeth Kovachevich granted Beckwith a reprieve, saying the company may be due religious protections under federal law."

Whew!

There's no denying, though, that this one is a full-bore ObamaWaiver:

"The Obama administration on Wednesday broadened an exemption for American Indians from the new health care law's [Evil Mandate] ...  tribal advocates are pleased that the administration added an exemption for Native Americans who are eligible for services through an Indian health care provider."

Um, guys? Be careful what you wish for. You might just get it.

MLR: More Loony Results

And the hits just keep on comin'. Last week, LifeHealthPro's Allison Bell reported that "insurers did a better job of meeting the new federal minimum medical loss ratio (MLR) targets in 2012 than in 2011, and they will end up paying fewer rebates to a smaller number of people."

Maybe so, maybe not:

■ FoIB Jeff M tips us that "North Carolina health insurance consumers will receive close to $10 million in [MLR] rebates"

But how will the other 57 states fare?

■ Via email, we learn that "[b]eginning in June and by August 1st, Aetna is scheduled to mail rebate notices and checks to policyholders and subscribers whose plans are due a rebate ... In this second year of MLR reporting, Aetna's rebates represent 0.2 percent of the premiums we collected"

That's down quite a bit from last year (the first for which MLR "rebates" were due), which the carrier interprets as indicating that they've met their pricing goal.

■ United Healthcare is also rolling out their 2013 MLR rebate initiative. Via email we learn that:

"In the second Medical Loss Ratio (MLR) Reporting Year, UnitedHealthcare’s results show that 83 Aggregation Sets in total (group and individual combined) qualified to receive premium rebates totaling $149,861,252 for 2012."

That's also down from last year; in fact this year's rebates are less than half of last year's.

 ■ Interestingly, both carriers indicate that the checks will be going to the group (employer) for distribution. Chalk that up as one more accounting and tax headache for businesses.

Guess who pays for that?

Punchline: RomneyCare vs The ObamaTax

From Josh Archambault at Forbes:

"A very interesting ACA development is taking place in Massachusetts today as the state that “inspired” Obamacare tries to reconcile its current law with the new federal law ... The amendment that was filed would force President Obama’s good friend Governor Deval Patrick (D), and his Administration, to seek a waiver from certain elements of Obamacare." [emphasis added]

Too. Funny.

Cavalcade of Rick #186 now on line....

Van Mayhall hosts this week's grand collection of risk-related posts, covering everything from the new Insurer Provider Fee to the FHA's stance on mortgage insurance cancellations.

And a friendly reminder to newbies and regulars alike that, while it's not mandatory to give a link back, it’s the way that carnivals work best. If your submitted post has been included in the Cav, please remember to post about it on your blog because it helps us all.

OH! Still looking for a host for the July 10th Cav - how 'bout it?