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Via email from The Rocket Surgeons in DC©:

"Last year during Open Enrollment 2016, agents and brokers enrolled consumers in Marketplace plans at a variety of retail locations, including Walmart stores across the country. The opportunity to be in Walmart stores will be available again this year during Open Enrollment for 2017"

Can't wait.

From the agent's perspective, this may make some sense: Walmart provides the overhead (literally and figuratively) and the foot traffic. And since ObamaPlans are guaranteed issue, there's no field underwriting problem. From Walmart's point of view, it's space they already own, and having agents on-site may be a draw, bringing in folks looking for more than just a policy.

From the government's viewpoint it's also win-win: there's zero cost to HHS, and the potential for signing up additional victims insureds.

If you're a licensed agent who's completed the 2017 Marketplace training and would like more info just click here.

Oh, and please pick me up a pack of paper towels. Thanks!

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Obamacare promised us government cheese.

New customers would get huge subsidies for insurance from the government which would give insurers millions of new paying customers. Customers would be able to keep their plans and doctors and insurers would be protected from excessive losses. The best part of all, Obamacare won't add "one dime" to the federal deficit.

Obamacare delivered us unicorn meat. 

Customers are receiving huge subsidies but premiums are rising. Many "would be" customers are still have trouble affording insurance. They can't keep their plans and in many cases they aren't able to keep their doctors either. It's been a nightmare for insurers too. They haven't been able to avoid excessive losses, even with the beloved 3 R's trying to help. The worst part of all, not one dime turned in to billions increasing the deficit.

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Reader Brian J offers some interesting insights into the double standard between those who toil in government and ourselves:

On a related topic about this failure of taxpayer-subsidized health insurance (i.e., Obamacare), I’m surprised that no one has brought up the fact that everyone in the U.S. who is employed by the federal government – from the President, Congress, Supreme Court, and all-related branches, all the way down to the local federal civil-service worker – has affordable taxpayer-subsidized health insurance;  everyone who is employed by State governments, County governments, local governments, defense contractors, anyone retired from any of those afore-mentioned levels of government/contractors, and every company (that offers health insurance) doing any type of work for any level of government, all have taxpayer-subsidized health insurance.  (Not to mention tens of millions of more people covered under Medicare, Medicaid, etc.)

With all these employers/entities – with their grand total of many scores of millions of covered employees – providing affordable taxpayer-subsidized health insurance, how is the individual person/small business owner to seek out -- in what’s left of our so-called “free market” -- affordable health insurance coverage on his/her own?

How, indeed?

Thanks, Brian!

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Context:

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The few health insurance carriers that still remain in the Obamacare market have stepped up to the line for 2017 and called an audible. Change of plan. They don't like what they see. Time to reconsider.

Four of the five major health insurance carriers are currently in discussions to trim their losses and merge.

In the interim, the Dept. of Justice has stepped in as referee and thrown a flag on the play. Presumably illegal procedure is the penalty.

Link to view video

Carefully considered my butt.

DC thinks they can control the behavior of individuals and business by regulation and intimidation. The DOJ believes they can preserve what little competition left in the health insurance market by blocking mergers.

It has not occurred to them that the reason why some carriers are willing to be bought (merged) is because they want OUT of the Obamacare market.

If the DOJ prohibits the merger they will simply withdraw from the market leaving only 3 major health insurance carriers in the 2017 game.

Which is precisely what the merger was intended to do. Remove weaker players from the game and leave the stronger ones in play.

The DOJ referees are doing nothing to preserve the market and increase competition. This move just continues to prove how incompetent they are and how little they understand about the health insurance game.


#ObamacareFail

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We've written before about the 'contestability clause ' in life insurance contracts. Briefly, these allow the insurer a (brief) window of time to "review a recently approved policy to see if there were any misstatements or misrepresentations, or if relevant information was omitted." Recently, the Principal National Life Insurance Company (PNL) was "caught out" on the application of this clause:

"A Connecticut federal judge has ruled that it was wrong for an insurer to refuse to pay out a $10 million life insurance policy on a Hartford lawyer who died of brain cancer."

Contestability clauses generally run for the first two years of a policy (carriers may choose a shorter run); in this case, the poor fellow expired only 15 months in, from a rare but aggressive cancer. When the beneficiary (in this case, a trust) submitted the claim, the carrier chose (as is its right) to invoke the clause. This offered them the opportunity to make sure that all the i's were properly dotted, and the t's properly crossed.

What they found, though, was a bit of an issue:

"Principal learned that Coassin had seen an ear, nose and throat specialist who treated his dizziness symptoms at a visit only nine days before they issued Coassin the life insurance policy. Principal did not know about this visit when they [it]."

So they denied the claim, and the legal fireworks took off.

Here's the rub: as FoIB (and carrier rep) Brian D points out, "even for The Principal a $10 million policy takes more than 9 days to underwrite. Therefore the appointment was probably conducted while the policy was in underwriting. There was no diagnosis that was troubling. What did he lie about on the app?"

Indeed. The decision really rested on the fact that none of the doc's Mr Coassin had seen had any inkling about the cancer [ed: as an aside, one wonders when the malpratcice suits will be filed]. Since the doc's didn't know, they couldn't inform Mr C, and thus he didn't materially misrepresent (aka "lie") about his health, and so the judge ordered PNL to pony up.

Lagniappe: There's also a little-discussed practice called "statement of good health" that is often required when delivering a policy that's been in underwriting a long time. Basically, it's a form the insured signs upon delivery of the policy stating that there's been no change in health, nor any doctor's visits, during that time. The article doesn't speak to this, so one presumes it wasn't utilized here, but one wonders if things might have turned out differently for PNL if they had required one to be signed and returned.

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Most health insurance carriers that allowed themselves to get sucked into the hope and change pitch

have regretted ever getting involved in Obamacare. Some of the larger carrier groups, like Anthem are cautiously optimistic while United Health Care has essentially washed their hands of this mess.

Anthem said it now believed it would see a "mid-single-digit" operating margin loss on its ACA plans in 2016, due to higher-than-expected medical costs. It expects better results next year, because it is seeking substantial premium increases.

(Double digit premium increases, in some cases above 30%).

UnitedHealth Group Inc. recently confirmed it is withdrawing almost completely from the ACA marketplaces in 2017, amid mounting losses. Humana Inc. recently said that in the wake of its own losses, it will also pull back sharply. Humana now expects to sell individual plans next year in 156 counties across 11 states, at most, down from 1,351 counties in 19 states this year. - NASDAQ

Meanwhile, back at the ranch, Centene continues to sound more like Brer Rabbit in the briar patch.

On Tuesday, Centene Corp., which like other Medicaid-focused insurers continues to see strong results from its own ACA plans, alarmed investors by booking a $300 million reserve fund partly due to projected problems with the legacy exchange business of Health Net Inc., which Centene recently acquired. Centene said it would pull back the former Health Net exchange presence in Arizona to one county, among other efforts to resolve the issues

In spite of the indigestion caused by swallowing Health Net, Centene should continue to do very well in the shark infested Obamacare pool.


#ObamacareLosses

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