Out: Patient Protection and Affordable Care Act
In: Patently Preposterous and Achingly Complex A**wipe
I think I was wrong about this thing: it’s comedic gold.
A controversy has erupted in Massachusetts over an obscure provision of the federal Affordable Care Act that small health insurers say will force them to write fat checks to support the state’s dominant insurer.
“Fat checks”! Heeheeheehee!!
“Obscure provision”! Hhohohohoho!!! Oh my sides.
The law requires states to redistribute income among health insurers, so those whose members tend to be healthy will pay into a state-run pool, while insurers saddled with a high proportion of expensive, sick patients receive payment from the pool. The payments will be made for the first time this summer, based on 2014 data.
The Massachusetts Association of Health Plans contends that the state is using flawed data and bad methodology, threatening the futures of smaller insurers while shoring up the market’s behemoth, Blue Cross Blue Shield of Massachusetts.
Blue Cross, which is not a member of the association, counters that the federal requirement is necessary to level the playing field in a market in which insurers can design their plans to attract the healthy while discouraging the sick from joining.
What do you expect from something designed by Jonathan Gruber? And peddled by Pajama Boy, Ethan Krupp?
But if you’re swayed by the journalist’s writing about “fat checks” to “behemoths”, read on:
Andreana Santangelo, Blue Cross senior vice president and chief actuary, said Blue Cross covers a disproportionate share of sicker, costlier patients, and thus expects to receive a payment to compensate. She noted that the company, with 2.1 million members in Massachusetts, is losing money despite its size.
The federal law prohibits insurers from rejecting or charging higher premiums to people who are sick, and Massachusetts law has done the same for many years.
But insurers can still manipulate the market by the way they craft benefits. For example, a plan can offer a narrow network of providers that would be unattractive to people who see many doctors, or it can exclude from its preferred drug list medications popular with people who have an expensive illness, such as diabetes. Such plans tend not to appeal to sicker patients.
The behemoth is actually doing the Lord’s work, while the insurance Davids to Blue Cross’s Goliath can pick and choose whomever they want.
But the most important thing is that they hate each other, thanks to government intrusion into the marketplace, and cry like squealing brats to Mommy that the other isn’t being fair. That’s Obama’s “signature achievement”, and I thank him for it.