AP Relays Left's Charges That Health Insurance Cos. Still Discriminate Against the Sick in Coverage

The Golden Age of Obamacare has apparently not led to the Golden Age of access to medical care anywhere, any time its promoters promised. Thanks to non-payments, the true enrollment numbers aren't what we've been told. The networks patients can access — approved by government regulators — are often highly restricted. Sky-high-deductibles are present in most Obamacare plans before any kind of reimbursed coverage kicks in. Finally, since this is for the time being a country where people usually can't be forced to provide money-losing service, many doctors are refusing to see Obamacare-"covered" patients.

Since things aren't working out as wonderfully as planned, the left and the Obama administration are on the prowl for scapegoats. The easiest targets are the insurance companies, some of whom foolishly thought that being on the Obamacare team would buy them immunity. According to a Wednesday Associated Press story by Tom Murphy, they're being charged with chasing sick people away — even though it appears, from a sentence eight paragraphs into the dispatch, that it's not financially advantageous for them to keep such patients out.


By the way, there appears to no specific evidence that insurance companies are actively engaging in the practices identified in the write-up for the express purporse of excluding certain patients. It's all speculative (bolds and numbered rage are mine):

3 WAYS INSURERS CAN DISCOURAGE SICK FROM ENROLLING

TomMurphyAPwide2

Insurers can no longer reject customers with expensive medical conditions thanks to the health care overhaul. But consumer advocates warn that companies are still using wiggle room to discourage the sickest - and costliest - patients from enrolling.

... Advocates and industry insiders say these practices may dissuade the neediest from signing up and make it likelier that the customers these insurers do serve will be healthier -- and less expensive.

(Paragraph 8 — Ed.) ... (But Obamacare) also calls for insurers to chip into a pool that compensates competitors who wind up with a more expensive patient population. That lowers their incentive for discouraging the sick from enrolling. [1]

... There are three major ways insurers still might steer sick or expensive patients away from their coverage:

- FORM NARROW NETWORKS

Insurers can lower their chances for covering patients with expensive medical conditions like cancer and autism simply by limiting the number of doctors and hospitals in a coverage network. [2]

... - CAUSE PRESCRIPTION STICKER SHOCK

Some plans are requiring patients to initially pay 30 percent or more of the bill for drugs that can cost several thousand dollars a month. HIV drugs and multiple sclerosis medications are among them.

... Insurers say their plans follow HHS guidelines and cover all medically necessary HIV drugs. [3] They also note that the price patients pay reflects, to some degree, what drugmakers charge for their medications.

... - ENTER MARKETS CAUTIOUSLY

Another way insurers might land a healthier population is by playing the waiting game.

The nation's largest health insurer, UnitedHealth Group Inc., will dive into the overhaul's public insurance exchanges with plans to sell 2015 individual coverage in 24 exchanges. That's up from only four in 2014.

... UnitedHealth's delayed growth could be a savvy way to avoid some of the sickest patients who likely rushed to sign up for insurance in the initial year of the exchanges, [4] said (Bob) Laszewski, the (insurance) industry consultant.

Notes:

[1] — So why would an insurance company go through all of this alleged effort to exclude sick patients if they will have to end up paying their competitors for the sick patients they took on? It doesn't make sense, and the presence of this Obamacare "feature" really demonstrates that there is no meaningfully competitive "marketplace" for health insurance.

[2] — The government approves the insurance companies' plan designs, including their coverage networks. When those networks are inadequate, whose fault is it? Even though the government said that what they were doing was okay, it's the insurance companies' fault — beause it can never, ever be the government's fault.

[3] — If the companies are following HHS guidelines and the results aren't what HHS expected, whose fault is that? The insurance companies' fault — beause it can never, ever be the government's fault. I should add here that this is one of many examples where the true fault for this outcome resides in President Obama's serially false claim that it you like your plan-doctor-provider-drug regimen, you can keep them.

[4] — Again, as noted in point [1] above, UnitedHealth's entry into a market will cause it to have to pay some of the costs of other companies' sicker patients. If UnitedHealth wants to try to protect its shareholders by staying out of a market until it sees how things are working out, why shouldn't it be able to?

Insurance companies which went along with Obamacare's passage because they thought it would inoculate them from political flak are learning the hard way that it doesn't work that way in progressives' "heads I win, tails you lose" political strategy.

The AP items appears to be the opening round of an attempt to demonize insurance companies for Obamacare's problems. If pollsters figure out that it's an effective way to motivate low-information voters, we'll see more of it.

Cross-posted at BizzyBlog.com.

Tom Blumer
Tom Blumer
Tom Blumer is a contributing editor for NewsBusters.