THE BLOG LINE: Game Changers
Today’s Blog Line examines a pair of issues that could change the entire health reform debate: how insurers might use so-called “mini health plans” to disrupt the exchanges prescribed by the health reform law, and how the existence of a second report by Medicare actuaries forecasts a gloomier future for the overhaul.
Igor Volsky of “The Wonk Room” writes that “insurers’ knack for manipulating the system holds important lessons for health reform implementers.” He examines the reform law’s provision allowing insurers to “lure younger and healthier Americans out of the exchanges and into so-called mini-health plans, which have low annual limits and very modest benefits.” Volsky provides an argument from BNET‘s Ken Terry: “If healthy people tend to buy low-cost insurance outside of the exchanges, the increasing proportion of sick people in the exchanges could force rates up and induce carriers to withdraw from them.” However worrisome the notion, Volsky writes that at least a few experts believe the problem of mini exchanges “is overstated.” He writes, “They claim that beginning in 2014, demand for the mini plans will naturally diminish since these policies won’t offer the standard benefit packages or meet the actuarial value of creditable coverage — the insurance that complies with the individual mandate requirements.”
Meanwhile, John Goodman at “The Health Care Blog” writes that Medicare’s “chief actuary not only refused to sign off” on the 2010 Medicare Trustees report, he encouraged readers “to ignore it and focus instead on an alternative report, prepared by the office of the Medicare actuaries,” which features less positive findings. While the “formal trustees report shows health reform dramatically reducing future Medicare spending,” it is because the trustees estimate that “Medicare doctors fees will be cut by 30% over the next three years” and that “going forward, the cuts become even more severe.” According to Goodman, this is unlikely unless we drastically cut care for seniors. He notes, “The problem for the [Obama] administration is that the Trustees report is too good. It’s embarrassingly good. It’s so good that no one in his right mind would ever believe it, unless you believe the country will accept that an elderly and disabled population are facing increasingly severe rationing and getting a quality of care well below what the rest of the nation has access to.”
by Matthew Wayt, staff writer
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