Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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@GailL1 wrote:

@john258 wrote:


 

 

 

 

 


Lets go by the numbers.


3. No one has been harmed by this law.

 

They have been harmed by the far right Reb. in states they controlled for the most part. There were co-ops set up in states to keep premiums down. The Govt. made money available as grants to the states. After they were set up the Reb. Congress changed the grants to loans, and wanted the money repaid. That made what was an asset of the Co-Ops into a liability and under most state laws made them go under. There were States who did not expand Medicaid which had an adverse effect on the program. These are 2 examples. All new medical insurance programs need a few years to stabilize and during that time an Insurance Co. uses its older business to do that. In this case the Govt. had to do it, and it did.


 



 

People who have not had their premiums subsidized by the government have been harmed by huge premium hikes - that is why many of them are leaving the marketplace for other plans like MediShare type plans -

 

No, john258, the initial seed money for the CO-Ops to start up were Obamacare loans - they had (5) years to repay these loans.  Grants were given prior to the loan in order for them to get set up with networks, plan specifics, hire staff, secure office space, etc - to give them a running start, so to speak.

 

I think you forget or maybe you just didn’t know all the details -
Of the 23 Obamacare Co-Op’s that had already gotten their loans before funding was cut, only (4) remained open for the 2018 exchange offer.  The four CO-OPs slated to offer coverage in 2018, in five states: Maine, Montana, Idaho, New Mexico, and Wisconsin.

The co-ops stand out as perfect examples of how Obamacare's idea of government-managed "competition" was doomed to fail.  All that failure has been pricey. Taxpayers are out $ 1.7 BILLION in federal loans that these co-ops will never pay back.

This is the story of the comedy of errors -

Obamacare CO-OP Program as passed in 2010 created the Consumer Operated and Oriented Plan (CO-OP) program to foster the creation of non-profit, member-run health insurance companies in all 50 states and District of Columbia to offer qualified health plans. To be eligible to receive funds, an organization must not be an existing health insurer or sponsored by a state or local government, substantially all of its activities must consist of the issuance of qualified health benefit plans in each state in which it is licensed, governance of the organization must be subject to a majority vote of its members, must operate with a strong consumer focus, and any profits must be used to lower premiums, improve benefits, or improve the quality of health care delivered to its members. (Appropriate $4.8 billion to finance the program and award loans and grants to establish CO-OPs by July 1, 2013)

https://www.kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/

The Consumer Operated and Oriented Plan, or Co-Op, portion of the health care law established nonprofit health insurers that would receive federal funding and were intended to compete with private, for-private insurers on the exchanges as a way to lower prices. They were supposed to be small-scale single-payer systems that would be free from the profit motive; a progressive's dream solution to the problem of providing health insurance for all.

But the co-ops established under the health care law were subject to a series of regulations that make you wonder how they were ever supposed to succeed in the first place.

For starters, the co-ops were barred from hiring anyone who had served at an executive level at any health insurance company in the country.

Think about that for a second. This was essentially a brand new business venture that was prevented from relying on the expertise of anyone who might have the slightest idea what they were doing.

Another regulation prevented the co-ops from raising any capital aside from what was provided via those federal loans. Other rules prevented the co-ops from being allowed to turn a profit, and if one happened to accidentally make money anyway, it wasn't allowed to use its profits to help it grow.

https://reason.com/archives/2015/11/26/why-obamacare-co-ops-keep-failing

They had 5-years to repay the government loan and there were also some government grants which they could use to do the initial setting up of the plan.  The loans were actually the seed money to get them up and running.

The “Fiscal Cliff” Deal, done by VP Joe Biden and Senator Mitch McConnell cut funding for establishing any more Co-Ops.  The Deal eliminated most of the $1.4 billion in remaining funding for these health plans.

The ObamaCare health insurance co-ops were created to compete with the major insurance companies, but they would have been run by people who basically know nothing about health insurance – but with billions of dollars in government money at their disposal.

Initially, the health law allocated $6 billion to help start the co-ops. In 2011, Congress reduced that funding to $3.4 billion as part of broader budget cuts.

The Obama Administration Department of Health and Human Services had already awarded nearly $2 billion in loans to 24 proposed state co-ops. Those loans WERE NOT affected by the cuts.  

https://www.forbes.com/sites/gracemarieturner/2013/01/20/with-obamacares-repeal-blocked-congress-wor...

Now what happened to those 24 -
They were to operate much like any private insurer on the exchange -
They were to compete for customers.
They were to pay claims
They were to repay their loan to the government
They were to pay into the Risk Corridor fund IF their claims were less than revenues
They were to share in the (then) Risk Corridor funds for losses fo high claims

The startups were supposed to shake up the traditional marketplace by being member-owned and nonprofit. But it was tough to figure out how much to charge. Plans available through the co-ops tended to be priced low, and customers poured in - most of them grew very rapidly, but that did not serve them well.

Yet many of these new customers, it turned out, had costly medical conditions, so when co-ops had to start paying their bills, the math didn't add up.

On top of that, co-ops were counting on a variety of funding streams from the federal government, and some of that money never materialized. Of the 23 health co-ops that opened in 22 states with the advent of Obamacare, just 11 are still in business as of November 26, 2015.

https://www.npr.org/sections/health-shots/2015/11/26/456220743/many-health-co-ops-fold-others-surviv...


PBS - 10/30/2015 - Why nearly half of the Obamacare co-ops have folded

Then there were 24
Then there were 11

Then there were  7
Now there are 4 -
Somewhere along the way they were suppose to become self-sufficient - I see the one in your state recently (2018) was obtained by another - with the hopes of getting back some money from the government.   http://mynmhc.org/In_the_News.aspx

 

We can discuss without all the insults, inuendos, and putdowns -


What you talk about is something called shifting. People who had their Premiums subsidized  by the Govt. were hurt by the far right when they ended it. That also increased the amount spent on total health care because what they went to cost the total system more money. Cost shifting. The person save on that part but we all pay more due to that so it was a cost increase to the total system. One the co-ops it was the start up money I was talking about. They had to change the way it was listed from an assets to liab. when the far right changed it to a loan. Fact. Notice you had to go back to 2013. Well do some more research. One of your support articles says the reg. were written in to law, and that is what I was referring to. The reb. did that.

We can not discuss this as you do not know the health care system. What you do know is how to find articles on the web, but by not knowing the system you do not understand the articles, and that leads to your answers being incorrect all the time, and they are incorrect this time. Once you learn about health care we can discuss, but until then it makes no sense as you have shown in the past you are wrong 90% of the time. It is people that do not understand or care about health care for all that have created this problem. The ACA was the first step to remake the system and you hate it. The final step will be facing the fact that all have health care now, and get rid of the ER care part which means a medicare for all approach. The far right Reb. have caused the health care mess just like they have caused most of the other problems we have. By your post you are part of the far right.

By the way just saw tonight the GA is leading the way in using Charter Schools to re start keeping blacks out of school again.

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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 12 of 24

@john258 wrote:


 

 

 

 

 


Lets go by the numbers.


3. No one has been harmed by this law.

 

They have been harmed by the far right Reb. in states they controlled for the most part. There were co-ops set up in states to keep premiums down. The Govt. made money available as grants to the states. After they were set up the Reb. Congress changed the grants to loans, and wanted the money repaid. That made what was an asset of the Co-Ops into a liability and under most state laws made them go under. There were States who did not expand Medicaid which had an adverse effect on the program. These are 2 examples. All new medical insurance programs need a few years to stabilize and during that time an Insurance Co. uses its older business to do that. In this case the Govt. had to do it, and it did.


 



 

People who have not had their premiums subsidized by the government have been harmed by huge premium hikes - that is why many of them are leaving the marketplace for other plans like MediShare type plans -

 

No, john258, the initial seed money for the CO-Ops to start up were Obamacare loans - they had (5) years to repay these loans.  Grants were given prior to the loan in order for them to get set up with networks, plan specifics, hire staff, secure office space, etc - to give them a running start, so to speak.

 

I think you forget or maybe you just didn’t know all the details -
Of the 23 Obamacare Co-Op’s that had already gotten their loans before funding was cut, only (4) remained open for the 2018 exchange offer.  The four CO-OPs slated to offer coverage in 2018, in five states: Maine, Montana, Idaho, New Mexico, and Wisconsin.

The co-ops stand out as perfect examples of how Obamacare's idea of government-managed "competition" was doomed to fail.  All that failure has been pricey. Taxpayers are out $ 1.7 BILLION in federal loans that these co-ops will never pay back.

This is the story of the comedy of errors -

Obamacare CO-OP Program as passed in 2010 created the Consumer Operated and Oriented Plan (CO-OP) program to foster the creation of non-profit, member-run health insurance companies in all 50 states and District of Columbia to offer qualified health plans. To be eligible to receive funds, an organization must not be an existing health insurer or sponsored by a state or local government, substantially all of its activities must consist of the issuance of qualified health benefit plans in each state in which it is licensed, governance of the organization must be subject to a majority vote of its members, must operate with a strong consumer focus, and any profits must be used to lower premiums, improve benefits, or improve the quality of health care delivered to its members. (Appropriate $4.8 billion to finance the program and award loans and grants to establish CO-OPs by July 1, 2013)

https://www.kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/

The Consumer Operated and Oriented Plan, or Co-Op, portion of the health care law established nonprofit health insurers that would receive federal funding and were intended to compete with private, for-private insurers on the exchanges as a way to lower prices. They were supposed to be small-scale single-payer systems that would be free from the profit motive; a progressive's dream solution to the problem of providing health insurance for all.

But the co-ops established under the health care law were subject to a series of regulations that make you wonder how they were ever supposed to succeed in the first place.

For starters, the co-ops were barred from hiring anyone who had served at an executive level at any health insurance company in the country.

Think about that for a second. This was essentially a brand new business venture that was prevented from relying on the expertise of anyone who might have the slightest idea what they were doing.

Another regulation prevented the co-ops from raising any capital aside from what was provided via those federal loans. Other rules prevented the co-ops from being allowed to turn a profit, and if one happened to accidentally make money anyway, it wasn't allowed to use its profits to help it grow.

https://reason.com/archives/2015/11/26/why-obamacare-co-ops-keep-failing

They had 5-years to repay the government loan and there were also some government grants which they could use to do the initial setting up of the plan.  The loans were actually the seed money to get them up and running.

The “Fiscal Cliff” Deal, done by VP Joe Biden and Senator Mitch McConnell cut funding for establishing any more Co-Ops.  The Deal eliminated most of the $1.4 billion in remaining funding for these health plans.

The ObamaCare health insurance co-ops were created to compete with the major insurance companies, but they would have been run by people who basically know nothing about health insurance – but with billions of dollars in government money at their disposal.

Initially, the health law allocated $6 billion to help start the co-ops. In 2011, Congress reduced that funding to $3.4 billion as part of broader budget cuts.

The Obama Administration Department of Health and Human Services had already awarded nearly $2 billion in loans to 24 proposed state co-ops. Those loans WERE NOT affected by the cuts.  

https://www.forbes.com/sites/gracemarieturner/2013/01/20/with-obamacares-repeal-blocked-congress-wor...

Now what happened to those 24 -
They were to operate much like any private insurer on the exchange -
They were to compete for customers.
They were to pay claims
They were to repay their loan to the government
They were to pay into the Risk Corridor fund IF their claims were less than revenues
They were to share in the (then) Risk Corridor funds for losses fo high claims

The startups were supposed to shake up the traditional marketplace by being member-owned and nonprofit. But it was tough to figure out how much to charge. Plans available through the co-ops tended to be priced low, and customers poured in - most of them grew very rapidly, but that did not serve them well.

Yet many of these new customers, it turned out, had costly medical conditions, so when co-ops had to start paying their bills, the math didn't add up.

On top of that, co-ops were counting on a variety of funding streams from the federal government, and some of that money never materialized. Of the 23 health co-ops that opened in 22 states with the advent of Obamacare, just 11 are still in business as of November 26, 2015.

https://www.npr.org/sections/health-shots/2015/11/26/456220743/many-health-co-ops-fold-others-surviv...


PBS - 10/30/2015 - Why nearly half of the Obamacare co-ops have folded

Then there were 24
Then there were 11

Then there were  7
Now there are 4 -
Somewhere along the way they were suppose to become self-sufficient - I see the one in your state recently (2018) was obtained by another - with the hopes of getting back some money from the government.   http://mynmhc.org/In_the_News.aspx

 

We can discuss without all the insults, inuendos, and putdowns -


* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 13 of 24

@Roxanna35 wrote:

@Centristsin2010 wrote:

Consequences? Patriots don't sit and just take it....they do something about it!  Vote in November!!!  Dems and moderates NEED to VOTE!!!  Repubs will show up....


Yes  do you remember how long it took Obama to even have his own party actually vote for Obamacare? Yes, I do...ya know, when you create a plan that includes about 1/6 of the economy, there's a LOT of planning and legislation involved. There was the public option that was on and then off the table, etc.  It wasn't as if there was a plan to vote on as soon as he was elected.  I know that he did what he could with the support that he had. but We should have had a National Health Care system there wasn't support for that and there isn't now either. and that is what it should have happened,  lol.....again, there wasn't enough support for that.....you do know you can't just wish upon a star and make it happen. instead now we have nothing.  Silly.....we have nothing you like; doesn't mean we have nothing.  Look, I agree we can and need to do better, but there will need to be a significant consensus to get to a national health coverage or Medicare for all.


 


"FAKE 45 #illegitimate" read a sign at the Woman's March in DC, 1/27/2017
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Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 14 of 24

You guys are missing what I think is a huge dynamic resulting from the GOP destruction of Obamacare. Trump supporters are low IQ voters who do no research. Do you think they will know the GOP spent almost 2 years destroying Obama care? 

 

Of course not, they're going to blame President Obama.

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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 15 of 24

John258 wrote IP:

The Individual mandate has to be  in place if you get rid of the Pre Ex since for the program to work all must be insured. It was the Reb. once again who caused the problem because rather than act for the people, they acted to hurt Obama, and the people.

There were co-ops set up in states to keep premiums down. The Govt. made money available as grants to the states. After they were set up the Reb. Congress changed the grants to loans, and wanted the money repaid. That made what was an asset of the Co-Ops into a liability and under most state laws made them go under. There were States who did not expand Medicaid which had an adverse effect on the program.

 

The GOPerLords want to destroy Obamacare because their Insurance Corps made MUCH more money when they could exclude pre-existing conditions and had no minimum requirements for their insurance and sold worthless, highpriced policies to those least able to afford being the victims of such scams. They NEVER had a plan to replace it because it would have to be better FOR THE PEOPLE and they are devoted to redistributing all the wealth of the people into the hands of the Oligarchs. Screwing people on their health insurance is just another way they redistribute wealth from the 99% to the very top of the 1% - PPACA stopped that, which is the real reason GOPers demand PPACA be stopped.

 

WHY IS THE USA THE ONLY MODERN DEMOCRACY WHERE YOU CAN LOSE EVERYTHING IF YOUR KID GETS SICK?

 

Because Republicans WANT it that way.

 

If you do NOT want it that way, you must GET RID OF THE ELECTED REPUBLICANS

 

VOTE OUT THE NRAGOP IN NOVEMBER... while you and your kids still have a chance to receive affordable health care.

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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 16 of 24

@Centristsin2010 wrote:

Consequences? Patriots don't sit and just take it....they do something about it!  Vote in November!!!  Dems and moderates NEED to VOTE!!!  Repubs will show up....


Yes  do you remember how long it took Obama to even have his own party actually vote for Obamacare? I know that he did what he could with the support that he had. but We should have had a National Health Care system and that is what it should have happened, instead now we have nothing.

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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 17 of 24

Consequences? Patriots don't sit and just take it....they do something about it!  Vote in November!!!  Dems and moderates NEED to VOTE!!!  Repubs will show up....


"FAKE 45 #illegitimate" read a sign at the Woman's March in DC, 1/27/2017
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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 18 of 24

That is what happens when the program that we should have had didn't happen. If a National Health Care system was instituted. now we wouldn't be seeing any of this problems.

Sorry, guys, we missed the boat. now, simply swallow the consequences.

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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 19 of 24

Of course it will make premiums increase that much higher....it's just another example of how the GOP will negatively impact those covered and point the finger at Dems.  It's all part of their plan to defund the plan as much as possible and say, "See?  We told you it would implode."

 

Yep ............ constant attack from Republicans, the plan is not to make the ACA work, the plan is to make the ACA fail.

 

Detractors on these boards do their part in that.

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Re: Court REJECTS Claim that Health Insurers are Owed Billions in Obamacare Risk Corridor Payment

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Message 20 of 24

@GailL1 wrote:

The ACA has been falling apart bit by bit from the moment it was passed. 

Not only did the law itself have problems but many of the rules that were written by the Obama Administrators had problems too - - just like these risk corridor payments.

 

When the SCOTUS ruled that the individual mandate penalty was a "TAX" - that threw it back into the hands of Congress because it is this body that controls taxes.

 

The people who have really been harmed by the Law out of their own pocketbook are the ones that receive NO subsidy - otherwise, the government is the one that is making up those increase in premiums or the loss of those cost subsidy reductions.

 

I don't know where it will all end, if the law will be further morphed, or killed all together by market forces as a result of changes this Administration is making - it is ultimately in the hands of Congress (all of them) to fix it or create something else.  

 

But since we don't seem to have enough members In Congress wanting to negotiate any type of conclusion  - I'm not holding my breath.

 

 

 

 


Lets go by the numbers.

1. Not true it has not been falling apart. The Reb. have been trying to kill it since it started and that is the main problem. The rest of what you say is not true. This type of program was written by a Reb. think tank and worked in MA. under a Reb. Govoner. The same person who worked the program for Romney did for Obama to.

2. The Individual mandate has to be  in place if you get rid of the Pre Ex since for the program to work all must be insured. It was the Reb. once again who caused the problem because rather than act for the people, they acted to hurt Obama, and the people. This was the start of what you now see from them and their leader Trump.

3. No one has been harmed by this law. They have been harmed by the far right Reb. in states they controlled for the most part. There were co-ops set up in states to keep premiums down. The Govt. made money available as grants to the states. After they were set up the Reb. Congress changed the grants to loans, and wanted the money repaid. That made what was an asset of the Co-Ops into a liability and under most state laws made them go under. There were States who did not expand Medicaid which had an adverse effect on the program. These are 2 examples. All new medical insurance programs need a few years to stabilize and during that time an Insurance Co. uses its older business to do that. In this case the Govt. had to do it, and it did.

4. If the current far right Reb. have their way this program would have been ended by now, and the medical system would be a lot more expensive to all, and cost a lot more, plus the death rate would be up. The approach of some Reb. States is like what your old Gov., and former Congressman told people. If they do not have Insurance let them die in the Streets.

5. If we throw  the Reb. out of power we will solve the problem. If not Let  them die in the streets will prevail. The answer is Medi Care for all as it is the cheapest of all.

 

You do not understand the health care system and we have covered this for years. When this program took effect you were posting on all parts and ended up supporting and opposing just about every section with supporting articles you found on line. As I said to you then being a good article finder on the web does not mean one understands Health Care. Sadly there are a lot of people preaching about health care, and advising people on what to do that have no understanding of the subject, and that is why States require people to be licensed before they give advice. A few months ago I received unasked for advice from a poster in here which if I had followed would have cost me over $1,000 per year.

What can we do now. Get rid of Trump and the far right, then let the good people who know the subject and want to solve the problem will. The ACA was the start of solving the problem.

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