tag:blogger.com,1999:blog-8512362.post7850732119323599511..comments2024-03-10T13:59:19.230-04:00Comments on xpostfactoid: ACA marketplace remake: Iowa leverages Wellmark's warm cooperationAndrew Sprunghttp://www.blogger.com/profile/17601269968798865106noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-8512362.post-20455703385395801902017-08-25T13:54:02.868-04:002017-08-25T13:54:02.868-04:00Wait wait wait, now I'm confused. I was adding...Wait wait wait, now I'm confused. I was adding up what the <i>insurers</i> would take in and pay out with and without ISM. I'm trying to look at this from the point of the insurers. Let's consider the person with the income of 199% of FPL, with and without the ISM, with a plan that would have a deductible of $7350. They are facing a procedure that was supposed to cost them $5000. With cost sharing, they pay let's say $200, the Feds pay $4800, the insurance company pays $0. With ISM, they would pay $5000, the Feds would pay nothing, the insurance company would pay nothing. In that scenario, the insurer doesn't get any savings from ISM because they weren't paying anyway.<br /><br />So I don't see how taking away the CSRs here is saving the insurers very much money. To be sure, under ISM the insurance company would be saving some money for their portion of what would have been their costs of the foregone care. But is this huge? It doesn't seem like it's nearly big enough to account for the savings Iowa says they'll get. Cardinal Fanghttps://www.blogger.com/profile/07895278919938671087noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-48119603195479590032017-08-25T13:03:13.043-04:002017-08-25T13:03:13.043-04:00Sorry I was dim here; initially was thinking you w...Sorry I was dim here; initially was thinking you were talking about Gold enrollees and not people under 200% of poverty. Those 20,000 people wouldn't have insurance under this ISM plan, under any reasonable definition of insurance, any more than you or I would have insurance if we had something with a five million dollar deductible. The cynical ISM plan is to take insurance away from 20,000 poor people in order to entice more middle income people, and younger people, to buy insurance. Cardinal Fanghttps://www.blogger.com/profile/07895278919938671087noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-56921658122071462322017-08-24T18:54:15.243-04:002017-08-24T18:54:15.243-04:00Seems like there's about $8150 per person coll...Seems like there's about $8150 per person collected in the stopgap proposal, vs. about $9925 in the ACA marketplace.Andrew Sprunghttps://www.blogger.com/profile/17601269968798865106noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-91956998520642505872017-08-24T18:38:38.758-04:002017-08-24T18:38:38.758-04:00KFF says that in 2016, Iowa had 2906 Gold enrollee...KFF says that in 2016, Iowa had 2906 Gold enrollees. http://www.kff.org/health-reform/state-indicator/marketplace-enrollment-by-metal-level/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7DCardinal Fanghttps://www.blogger.com/profile/07895278919938671087noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-33915203124507659622017-08-24T18:19:35.424-04:002017-08-24T18:19:35.424-04:00If I accept that 25% more people have only 10% mor...If I accept that 25% more people have only 10% more claims, how is 3.5% more money enough to pay those claims?Cardinal Fanghttps://www.blogger.com/profile/07895278919938671087noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-39667572535275344982017-08-24T18:11:47.774-04:002017-08-24T18:11:47.774-04:00Hey, thanks for that. I had the actuary report ope...Hey, thanks for that. I had the actuary report open from a different link, and it didn't include that. As for the numbers...a) about 20,000 enrollees go from AV ~90% to AV 70%, and b) wealthier enrollees might be healthier?<br />Andrew Sprunghttps://www.blogger.com/profile/17601269968798865106noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-36465838763304420062017-08-24T17:54:16.010-04:002017-08-24T17:54:16.010-04:00On page 2 of the additional materials, the actuari...On page 2 of the additional materials, the actuaries compare what would happen in 2018 without and with the Iowa Stopgap (ISM). With the ISM, total enrollment would go up 25%, total claims would go up 10% and total premiums plus fed reinsurance money plus Iowa reinsurance money would go up 3.5%. <br /><br />This makes no sense to me. How does it work? How do the insurers afford this, and why are we assuming that if enrollment goes up 25%, claims will go up only 10%? <br />Cardinal Fanghttps://www.blogger.com/profile/07895278919938671087noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-83245839375906397082017-08-24T17:14:18.722-04:002017-08-24T17:14:18.722-04:00Iowa seems to be proposing magic. The feds will pa...Iowa seems to be proposing magic. The feds will pay what they would have paid anyway absent the waivers and everybody will pay the same or less than they would have in premiums. How is redeploying the $48M that would have been paid in CSRs enough to achieve this miracle? Cardinal Fanghttps://www.blogger.com/profile/07895278919938671087noreply@blogger.com