The Problem Is That Overall ObamaCare Is a Terrible Deal

By: Monday February 11, 2013 7:15 pm

The problem is that the Affordable Care Act is overall a bad idea if you look at it from this lifetime perspective. Let’s even leave aside the huge issue that it does nothing to address the fact that the government allow hospitals, drug companies and doctors to charge Americans prices way above international norms.


Businesses Taking Heat Over What to Do With Health Insurance Rebates

By: Friday August 10, 2012 3:30 pm

A couple weeks ago, when everybody was hailing the power of the medical loss ratio to send rebate checks to health insurance subscribers, I pointed out that a large percentage of the rebates would just revert back to employers, who could then do with them whatever they pleased, within certain limits.

Many Insurance Company Rebates Just Revert Back to Employers

By: Monday July 30, 2012 2:50 pm

Under the Affordable Care Act, insurance companies that fail to spend 80% of their premium dollars on medical care in the individual and small group markets, or 85% for large-group employer-based plans, must return the balance of the premiums back to the subscriber. But in employer-based plans, the rebates go to the employer which may or may not apply them to the benefit of the insured employee.

McDonald’s Threat on Health Insurance Coverage Proves that Exchanges Will Be Bigger Than Expected

By: Thursday September 30, 2010 2:50 pm

My first reaction to this story about McDonald’s potentially dropping its health insurance coverage for employees was to ask myself, “McDonald’s offers health coverage to employees?” The answer is yes. They offer really bad health coverage.

Insurance Industry Taking Every Possible Advantage of Affordable Care Act

By: Tuesday September 21, 2010 9:45 am

In addition to having to fend off the slow chipping away of the health care law by the GOP, especially if they gain power over one or both houses of Congress, Democrats have to deal with the foxes they left in the henhouse, who are systematically working to preserve their own profits at the expense of consumers.

Consumer Advocates Do Well in First Round of Medical Loss Ratio Rulemaking

By: Wednesday August 18, 2010 7:00 am

At the NAIC (National Association of Insurance Commissioners) conference yesterday, regulators approved the medical loss ratio “blank” — the form that will get sent to health insurers to determine how much of their premium revenue gets spent on medical care. And in an unexpected early victory, the NAIC rejected many of the procedures that the insurance industry wanted to include as counting under the MLR.

Some States Lack Authority to Enforce Health Care Regulations

By: Monday August 16, 2010 8:00 am

During the health care debate, one of the biggest question marks that I had was whether the insurance regulations, which would be handled by the states and not a federal regulator, would be enforceable. Countless examples of insurance companies getting off scot-free, or of state insurance commissioners lacking the will or the resources to stop them, raised my concern. Now, Robert Pear and Kevin Sack at the New York Times add to that concern by discovering that some state insurance commissioners don’t even have the authority to uphold the regulations in the Affordable Care Act.

As Insurers Game the Medical Loss Ratio, Key Members of Congress Weigh Steps to Fight Back

By: Tuesday July 27, 2010 5:21 pm

I was able to ask Franken about this in a one-on-one interview at Netroots Nation. He said this was an example of the need to stay vigilant in the implementation process on bills of this nature. “I mean, I like to call what we passed ‘The Health and Human Services Secretary Shall … Act of 2010,’” Franken said, pointing to all the parts of the bill that need to be clarified by that federal agency. However, Franken seemed confident that pressure on the insurers would aid in reducing the amount of reclassification in the system. “It’s not like the medical loss ratio hasn’t been computed before,” Franken said. “I have full confidence that Kathleen Sebelius can get this right.”

Who’s Enforcing the Medical Loss Ratio?

By: Wednesday December 23, 2009 7:15 pm

The insurance industry is already looking for ways to game this requirement.

All Hail the Almighty CBO and Its Crippling of Medical Loss Ratio

By: Saturday December 19, 2009 10:56 am

I wish for the day when legislation is written by our legislators and not by some unelected accountant. Because Senator Harry Reid wanted to make the CBO score look prettier he will allow insurance companies to waste an extra 10% of your premiums on not providing health care. All hail the almighty CBO.

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