I saw this piece at Eclectablog and wanted to expand on it a bit:
The federal government has denied a request by the Michigan Office of Insurance Regulation to delay a regulation under health care reform that requires insurers to return $89 million to people who have purchased health insurance.
The decision means that eight health insurers in Michigan will return the $89 million to their subscribers, said Gary Cohen, acting director of oversight with the Center for Consumer Information and Insurance Oversight at the U.S. Department of Health and Human Services.”After careful consideration, the evidence does not establish reasonable likelihood (that the regulation would) destabilize the market,” Cohen said in a conference call this afternoon.
The evidence! Imagine that. There’s someone out that there still looks at evidence, rather than reading the collected speeches of Ronald Reagan and applying the principles contained therein.
“We do not believe any will leave the health insurance market,” Cohen said. Cohen said the medical-loss ratio rule has already benefitted consumers. “Insurers have reduced overhead and administrative costs, and we have seen a moderation in rate increases. That is true in Michigan,” Cohen said. Based on a federal analysis, some 9 million insured people could be eligible for rebates worth up to $1.4 billion starting in 2012.
So, that’s Michigan, and here’s Florida:
Some Floridians may get their premium payments back after the state’s request for an exemption from a federal law was shot down.
The federal government on Thursday denied Florida’s request for relief from a provision of the federal healthcare law that requires insurers spend at least 80 cents of every premium dollar on direct patient care.“We think that this is a very good decision for the insurance consumers in the state of Florida,” said Steve Larsen, the federal official who signed the denial letter. “It’s going to ensure that they continue to get value for their premium dollars.
The ruling by the U.S. Department of Health and Human Services means that all health insurers in Florida must meet or exceed the 80 percent standard, known as a medical loss ratio or the 80-20 rule, or provide rebates to policyholders.The medical loss ratio provision is part of the Affordable Care Act, derided by critics such as Gov. Rick Scott as Obamacare.
The Florida case was watched by advocacy groups across the country. Health Care for America Now, a nationwide grass roots organization that supports President Barack Obama’s Affordable Care Act, said the decision “sent a clear message to health insurance companies that their days of ripping off consumers are over.” “Our health insurance dollars should be going towards actual care, not excessive industry profits and inefficient business practices,” said Brad Ashwell of the Florida Public Interest Research Group. FPIRG was one of a number of consumer groups that opposed the waiver. Also, more than 3,000 Florida consumers signed a petition against it. Florida is the largest state so far to have its waiver request decided. About a dozen other requests are still pending
The GOP majority in the House held hearings on the 80/20 rule. Conservatives are OPPOSED to the idea that health insurance premiums should go towards purchasing health care.
House Small Business Investigations, Oversight and Regulations Subcommittee Chairman Mike Coffman (R-CO) today held a subcommittee hearing to examine new Patient Protection and Affordable Care Act’s (PPACA) Medical Loss Ratio (MLR) and its effect on job creation.
Under the health care reform law and its final rule, insurers must spend 80 percent of premium dollars on health claims for individual and small group policies. This Medical Loss Ratio means the amount that can be spent on administrative expenses is limited to 20 percent. If an insurer fails to meet the minimum requirements, it must issue rebates for the difference to its customers.“President Obama claims the new healthcare reform law will decrease healthcare costs for Americans,” said Coffman. “However, the new Medical Loss Ratio included in the law may have the opposite effect by forcing insurers to increase— not decrease— premiums, because insurers will be discouraged from investing in administrative services, such as anti-fraud or anti-waste services, that could save consumers money…
Blah, blah, blah. No rebates for you! Now get back to work.
Several states have applied for waivers, but I was able to find decisions on only Michigan and Florida, and those two waiver requests look like “pants on fire” claims, to use the rating system of the (thankfully) now-discredited Politifact franchise. If your state has applied for a waiver, I’d love to hear about it.
Yutsano
I hadn’t heard if McKenna has done this yet, but after the smackdown he got for opposing the health care law I’m thinking he’s smart enough to stay away from this for awhile. I hope that comes up in his impending governor run. If not Inslee is a HUGE idiot.
rikyrah
this is good news
kay
@Yutsano:
You’d think it would be wildly unpopular with broad swathes of people who pay premiums, opposing rebates, but maybe it’s not widely known that they’re doing it in these states.
Maude
Lose one for the Gipper.
This is proof that the ACA works.
Yutsano
@kay: I suppose it’s possible. McKenna joined the anti-ACA lawsuit without telling, well, anyone. Gregoire was PISSED when she found out. It started a minor civil war in Olympia that I don’t think ever simmered down.
slag
Oooohhh…”excessive” and “inefficient”…applied to business practices no less! Let the games begin!
Veritas
Check it out, leftists, one of your heroes is even fed up with Obambi now:
http://www.politico.com/news/stories/1211/70694.html
I think the Democrat base should think twice before automatically supporting Obambi now that one of their saints has bailed on him.
Yutsano
@Veritas: Oi. Really? Is this all you’re going to post today?
David Fud
@Veritas: I love it when you talk about pie.
MMMMM, pie.
Comrade Mary
Chavez is my hero? Oh! THIS Chaves. Yeah, she’s awesome.
slag
Good to see some Republicans realize that spending money can actually end up saving money. If only they could just learn to apply that realization here in reality land rather than in fantasy land.
rlrr
@Veritas:
Did Veritas get all itchy from building that straw man?
KG
Ok, explain it to me like I’m a 6 year old… If insurers have to return premiums if they don’t meet the standards, how exactly will that cost consumers more? Is the argument that fraud and waste will become rampant?
Dave
But I thought the ACA was either a socialist plot or a complete sellout. As opposed to a law that is getting millions of people coverage, making drugs more affordable for seniors and cutting premium hikes.
Yeah, this bill is horrible…
Dave
But I thought the ACA was either a communist plot or a complete sellout. As opposed to a law that is getting millions of people coverage, making drugs more affordable for seniors and cutting premium hikes.
Yeah, this bill is horrible…
Yutsano
@KG: Because how can any self-respecting health care CEO show his face at the country club without a second gold-plated yacht? If they can’t root out the waste and abuse all their money goes poof just like that.
Urza
Not to stifle free speech, but isn’t Veritas getting rather spammy today?
And really, where the hell do they come up with the idea that liberals like Chavez.
Frankensteinbeck
…has anybody noticed that after awhile conservative trolls start to drift? They have various schticks, but eventually they reach a point where their attempts to troll cease to even be insulting because they’re talking Moon Language. This is a great example, where pointing out Hugo Chavez being pissy just leaves people scratching their head instead of irritated.
Veritas
This year in wasteful government spending:
Republican and Democratic Party conventions: $17.7 million (each)
A mango-production program for Pakistani farmers that was abandoned after one year and caused many farmers to default on loans taken out in anticipation of increased productivity: $30 million
A project to convert three Air Force radar stations from diesel to wind energy that has since been abandoned: $14 million
The construction of an IHOP in the up-and-coming neighborhood of Columbia Heights (which Sen. Coburn refers to as “pancakes for yuppies”): $800,000
A promotional video for an Alaskan bridge that very well might not get built, titled ‘The Knik Arm Crossing, Bridge to Our Future”: $57,390 (out of $15.3 million spent this year on the bridge)
Pension payments to dead federal employees: $10 million
A fourth visitors center on the 54-mile Talimena Scenic Drive that runs between Talihina, Oklahoma (Pop. 2,522) to Mena, Arkansas (Pop. 5,637): $529,689
Funding for video game preservation at the International Center for the History of Electronic Games: $100,000
Aide to China, the U.S.’s biggest lender, for social and environmental programs: $17.8 million
Seed money for the “drug-themed” Mellow Mushroom Pizza Bakery in Austin: $484,000
“Celebrity Chef Fruit Promotion Road Show in Indonesia”: $100,000
Funding for Pakistan’s Rafi Peer Theatre Workshop to create “130 episodes of an indigenously produced Sesame Street”: $10 million
Research funding for the American Museum of Magic to “better understand its various audiences and their potential interest in the history of magic entertainment”: $147,138
Energy efficient home improvement tax credits for children, prisoners, and other people who do not own homes: $1 billion
Research funding for a study to determine if cocaine makes Japanese quail engage in sexually risky behavior: $175,587
The list goes on and on:
http://www.coburn.senate.gov/public/index.cfm?a=Files.Serve&File_id=b69a6ebd-7ebe-41b7-bb03-c25a5e194365
Any liberals care to defend spending our tax dollars on things like Sesame Street for Pakistanis and pancakes for yuppies?
KG
@Urza: because Chavez use to say bad things about Bush and Sean Penn took a picture with him once, or something…
Jerzy Russian
@Urza:
I don’t know, but it must be the same place where they get the idea that Obama is s—list.
JGabriel
@Veritas:
Veritas, I hear your heroes don’t like Gays, Jews and Blacks. It’s so tough being a right-winger.
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Downpuppy
Maine got a waiver last March.
JPL
Someone doesn’t want to stay on topic since they got nothing.
Thanks Kay! Continue posting about the positive changes occurring because of ACA.
JGabriel
@Veritas:
This year in Wasteful GOP Spending: Paying Veritas’ trolling-by-post fee.
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Snowball
@Veritas:
Just curious, what is Democrat base?
Frankensteinbeck
And now this list that basically proves government waste is an insignificant sliver in the budget and one of the basic premises of conservative dogma is a lie. Is this just part of the whole epistemic closure thing? Eventually to continue being conservative they have to get so far from reality that you can’t even communicate enough to have a screaming match?
Veritas
@JGabriel
I don’t like soc1alists (National or otherwise) or Jesus nuts, and don’t have anything against queers, so I’m not sure why you think those would be my “heroes”.
Villago Delenda Est
@Veritas:
The pathetic little Romneybot can’t get on topic…because the topics kick the ass of his hero, Mitt the Parasite.
Yutsano
@Veritas: Hi. This thread has a topic. You are not meeting said topic. This will be my last response until you are back on the subject at hand. Have a nice day.
Dave
@Veritas: Yeah. Compare that to the $9B it costs to build one Gerald Ford class aircraft carrier. Considering we have 11 carrier groups active at any one time and the rest of the world combined has 10 (8 by allies) I don’t think we need all of them.
Ask Senator Coburn if he can defend that.
Frankensteinbeck
@JPL:
You do have a point. It is at least a distraction. I can understand how he wouldn’t want people talking about the ACA being a giant success, the right thing to do, and on track to destroy conservatism in America as predicted. I wonder what effect getting their money back from insurance companies will have on voters’ feelings?
Snowball
@Veritas:
If I add up your items, the sum is peanuts when compared to the $800 billion we have already spent for your war in Iraq. We are expected to eventually spend trillions over there.
Why aren’t you concerned about that? Then again, this is not about wasteful government spending, is it? Instead it is about government spending you disagree with. You have no problem spending other people’s hard earned money on stuff you agree with
JGabriel
@Veritas:
Right. Because non-consensual sterilizer and Medicaid fraudster Tom Coburn is such a credible source.
Jackass.
.
JPL
Hopefully, the media will start covering this. Both local and network news covered the increase in coverage for adults between 20 and 26.
Veritas
@Snowball
Obambi’s failed “stimulus” spent more than the entire Iraq War, as did the bailouts.
JGabriel
@Veritas:
Of course you love Phelps and Hitler! All conservatives do. It’s like your false accusation that Chavez is a liberal hero, except it’s troooue.
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Yutsano
@JPL: I don’t think they’ll notice until people actually start getting the rebate checks in the mail. Although personally I’d take mine as a credit. And this could explain why my premium went down this year, even though my insurer is nominally a non-profit.
Also: please stop feeding the derailer. You’re playing its game.
MikeJ
@Snowball: Don’t mix it with Democrat acid!
Villago Delenda Est
OK, obviously there is an immediate need for drug testing for House members, because this asshole is high if he thinks that any of this goes into “anti-fraud or anti-waste” services. If it went into “anti-waste” services, the CEOs would be out on the street.
ThresherK
Our health insurance dollars should be going towards actual care.
Tangent: Having put several of these flyers in the circular bin since Halloween, I’d like register my disgust with those mailers from my HC co, the ones written on the idiot-level with suchwhich remind us to “drink something besides eggnog or champagne, eat something besides turkey, stuffing, full-fat mashed potatoes, sugar cookies, and pumpkin pie”, and “to walk further than from the bed to the garage to the kitchen to the couch”.
Doesn’t all that count as “wellness spending”, as spending for care?
My premium dollars are going for this junk? It doesn’t put one more person in, say, the “vaccinated against flu” column, or apply one more bandage to an ER patient.
(Yes, it’s not a democracy. Of course, I can “take my business elsewhere”, aka “change jobs”, a certain segment of society’s answer for every issue.)
JGabriel
Veritas @ 35:
The bailouts took place under George Bush, or have you forgotten the economy crashed in August 2008, under the GOP watch.
The so-called “failed” stimulus bill was approximately $750 billion, most of it in tax cuts (which Conservofascists like you are supposed to love).
The Iraq War, on the other hand, has a long-term cost estimated by the Congressional Budget Office of $2.4 trillion.
The Bush Tax Cuts added another 3.2 trillion to the country’s debt, according to the CBO and conservative former Reagan and Bush I advisor Bruce Bartlett.
Oh look! Here’s a chart that shows the impact on the debt of the Stimulus, the Bailout, the Iraq War, and the Bush Tax Cuts.
You’re jackassery is strong today, young Veritas.
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Jack the Second
This has always been the #1 part of the Health Care Reform debate I cared about the most. I did some research on it back during the debates, and back in the 90’s — you know, when our economy was functioning — insurance companies operated with a 90-95% MLR. 95%! And now they’re bitching that operating at a MERE 80% efficiency will cause their industry to COLLAPSE INTO NAUGHT.
This affects all of us, even those of us who have been lucky enough not to develop a “pre-existing condition” or lose our jobs.
JGabriel
@Villago Delenda Est:
The House member is basing his argument on the fact that the bill does not allow insurance companies to include the cost of anti-fraud or anti-waste spending in the 80%-85% that must be spent on health care. Note, I’m not saying it’s a valid argument, just that it has a marginal basis in the wording of the bill.
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SRW1
@Veritas:
Hey. farting twice doesn’t make you smell any better.
Mnemosyne
@Veritas:
So widows and orphans are no longer allowed to collect their dead spouse’s or parent’s pension? Why do you hate widows and orphans, Veritas?
Roger Moore
@Frankensteinbeck:
No, it just shows they mean something different when they talk about waste. There are two possibilities of what counts as waste: spending that doesn’t achieve the goals of the program it’s supposed to be supporting (i.e. wasteful spending), or spending on things you don’t think the government should be doing (i.e. wasteful programs). The Conservatives think there’s tons of waste because they’re talking about wasteful programs like Welfare, Medicare, Medicaid, etc. They just don’t want to spell out exactly what wasteful programs they’re talking about because that would turn off the voters who depend on those programs.
Mnemosyne
@Jack the Second:
That’s because back in the 90s, the majority of health insurance companies were non-profit. In the intervening decade or two, most of them switched to being for-profit.
That’s the dirty secret of our healthcare system that no one wants to talk about — the reason the ACA had to be different than the healthcare fixes proposed in the 90s is that the entire marketplace changed between now and then, and not for the better.
Southern Beale
Anyone on Facebook? Bill Frist asked on his Facebook page whether people would prefer traditional Medicare or would opt for a private insurance option. He was defending Paul Ryan’s “voucher care” by noting that it was similar to Frist’s own plan from 10 years ago.
I posted something imprudent on his wall. Others might want to let him and his corporate healthcare cronies what real consumers think of health insurance.
jibeaux
Just going out on a limb here, but if it actually saved consumers money, that would seem to be great for the requirement to spend at least 80% of premiums on health care, and if it were more of a long-term investment expected to pay out down the road, that sounds like the kind of argument that would be well-suited to a discussion of a waiver, right? Because isn’t the provision to request a waiver well suited to this sort of thing, rather than just assuming that “administrative costs” are all going to be terrific long-term investments? Rhetorical, I know.
FormerSwingVoter
@Veritas: They are your heroes in the same way that Chavez is a hero of ours – that is, not at all.
u c wat he did there?
FlipYrWhig
@Veritas: Uh, federal aid going to Alaska bridges and Oklahoma and Arkansas highways probably originated in requests by… Republican congresspeople. Maybe conservatives should have to defend those. Then again, it sounds like the defense is pretty simple: giving money to people to build stuff (i.e., creating jobs) that other people can then use for a long time (i.e., increasing mobility, which is important to commerce and employment). These are scandalous why?
FlipYrWhig
@jibeaux: Even more simply, if it’s such a great idea for the company and its customers, maybe they should implement it with the other 20% of the money they take in.
Calouste
@Dave:
That’s not even all of it. The US carriers are around 100,000 ton, and can carry 80-90 aircraft, the largest non-US carrier is 67,000 ton, but the rest of them are between 15,000 and 40,000 tons and can carry only 20-40 aircraft. The US also have 9 amphibious assault ships that can double as carriers that are about 40,000 tons each.
The carrier capability the US has is 3-4 times everyone else combined.
Warmongerer
@Veritas:
Columbia Heights has been developed in recent years but is still predominantly lower-income blacks and Hispanics. Has Coburn ever actually gone to the neighborhood? “Yuppie” is not the word to describe that neighborhood. A few blocks are gentrified, most blocks are dangerously unsafe at night.
Sesame Street for Pakistanis seems like a good way to project American values onto the youth of a developing country. Is there a more cogent objection or do you just hate money being spent on brown people?
The Japanese quail study sounds like a good way to study the effects of cocaine on the brain that will pay off down the line in drug rehab. Is this just a general objection to medical research?
Money for a museum on video games so….? Do you have a point? Do you just hate the concept of museums in general or do you think they don’t have any cultural relevance?
Talimena Scenic Drive: Why are the town populations relevant? You do understand that scenic drives and visitor centers are generally used by people who do not live in the area, right? The road goes through a national forest in the mountains including the tallest one in Arkansas.
The list amounts to peanuts financially and additionally never explains why these items are particularly “wasteful” in Coburn’s eyes. It just makes him look even more intellectually shallow and uninformed.
FormerSwingVoter
Huh.
The ACA is going to suddenly become a lot more popular once people start getting checks back from their insurance companies.
Roger Moore
@Calouste:
Also, too, the US has much better balanced air wings than anybody else does. For example, we’re the only country with a real ship-based AWACS platform, which is essential if you want to be able to use the rest of the planes effectively. IIRC, we’re still the only one with fixed wing ship-based ASW capability, too. Not to mention that our navy has massively more real-world experience in carrier operations, especially under difficult weather conditions, which is also vital to practical effectiveness.
FormerSwingVoter
@Veritas:
Heh. Why yes, hundreds of thousands of dollars – sometimes even millions, with an M!!!11one – are certain to have a massive impact on our multi-trillion dollar federal budget. Almost 0.003% of the budget is in that list alone!!!
Do conservatives honestly not understand what orders of magnitude are? Or numbers? Like, you can list any national expenditure, and it’ll be way bigger than anything you’d ever spend money on, but that is literally meaningless. These items are literally smaller than rounding errors.
Sentient Puddle
Here’s a map of how the waivers stand. Six states have been approved, and another seven have applications pending.
From my understanding, Florida was the big huge important one, though. The application was blatantly egregious, and they thought they could get away with it on the back of the law being unpopular and by being a big swing state.
kay
@Sentient Puddle:
Thanks so much. I guess the one to watch is Texas, on the merits, rather than on the politics. That “co-pay holiday” idea is interesting. Another way to meet the requirement.
xian
@Urza: as annoying as the especially damaged trolls may be, the upticks in their deployment do seem to track well with when the village narrative is pummeling the republicanards.
burnspbesq
@KG:
How silly of you to expect a Republican argument to make sense!
Emma
@Veritas: Jesus, and to think I bothered talking back to you. Arguing with a moron. Bad Emma. Baaaad Emma.
beabea
Louisiana applied for a waiver and was rejected late last month. The insurance commissioner was just re-elected the month prior, so I guess now we know who his real constituents are–the insurance companies! Here in one of the nation’s poorest, least healthy states, he wanted the health insurers to continue to be able to spend one-third of the money on Not-Healthcare this year, then one-quarter for the next two years to spare them the shock of, you know, having to actually provide more health care for our money. The Feds thankfully told him and them to suck it up.
Dunno if this is related, but I buy my own health insurance and got a rebate in November.
doofus
Here’s a handy map of waiver status
doofus
Lemme try that again. I’m not too good at embedding links. http://www.avalerehealth.net/news/spotlight/medical_loss_ratio-state_waivers.html
Eclectablog
Thanks for spelling “Eclectablog” correctly ;)
I think you can add New York to your list, as well.
Odie Hugh Manatee
@Frankensteinbeck:
I think the responses here are making Veritas scratch their head. The conservative pigs have been rolling around in the muck they have made and one of the ingredients of their muck is that liebruls just luv them sum Chavez. He’s left, they’re left, so that means LIEBRUL LOVE!! They have convinced themselves of this so well that pigs like Veritas run around dropping the “Liebruls heart Chavez” slop all over the place.
Unfortunately this leads to confusion at both ends; most on the left have no idea what the pig is talking about and the pig is confused because no liebrul has exploded in anger.
Win-Win. :)