This time around, however, the victim (well, in addition to its current enrollees) is a private company, albeit a not-for-profit one: WINhealth Partners:
We’re a not-for-profit managed care company founded by professionals, and we’re changing the way that healthcare works for you – because we believe your insurance should help you to be at your best in life.
The nonprofit, consumer-governed health plans were included in the law as an alternative to the so-called public plan option. Modeled on successful health insurance cooperatives such as Group Health Cooperative in Washington, the CO-OPs were designed to broaden the coverage options available to consumers, inject competition into highly concentrated health insurance markets and provide more affordable, consumer-focused alternatives to traditional insurance companies.
To help these new plans find footing, the health law offered low-interest loans that were tied to a number of requirements designed to differentiate CO-OPs from traditional insurers (which were barred from the program). Recipients were required to:
The short version is that there were 3 funding programs put in place under the Affordable Care Act designed specifically to help smooth the waters and keep insurance carriers afloat for the first few years until they got past the bumpy transition period. One of these was called the "Risk Corridor" program. Basically, the carriers who lose their shirts the first 3 years were supposed to have at least a portion of their losses covered to tide them over; call it "training wheels" for the insurance industry. The funding was supposed to come partially from the other insurance companies which did better than expected...but any shortfall was supposed to be covered by the federal government, with the caveat that any surplus paid to the government stayed there as a type of profit.
In my most recent Maryland exchange update, I noted that after months of ACA exchange enrollments increasing during the off-season (if slowly), net policy cancellations finally started to outweight off-season additions starting in August:
As of Aug. 13th, 606,226 Marylanders have enrolled in quality, affordable health coverage for 2015 through Maryland’s state-based insurance marketplace.
That includes 123,673 people enrolled in private Qualified Health Plans (QHP) and 482,553 people enrolled in Medicaid through the marketplace since open enrollment for the year began on Nov. 15, 2014. Nearly 94 percent of all Marylanders who have enrolled through Maryland Health Connection for coverage this year received financial assistance.
Today, the exchange tweeted out a quickie update ahead of the 2016 Open Enrollment period:
A couple of days ago I noted that Covered California is adding a very good feature this year: They're opening up 2016 enrollment nearly 3 weeks early...for those who are already currently enrolled. Starting this monday, Oct. 12, current enrollees will be able to renew or switch to a different CoveredCA plan, 19 days ahead of he official Nov. 1st Open Enrollment launch.
I clicked through and saw this listed under the Frequently Asked Questions:
1. How do I enroll in kynect?
Simply visit kynect.ky.gov or talk to your insurance agent. If your insurance plan is up for renewal, you may be eligible to enroll through kynect today. You can also call Customer Service at 1-855-4kynect (459-6328).
My entry was about how the AP utterly misrepresentated the actual security situation a year ago, then compounded their mistake (I'll be gracious and assume it was done out of ignorance, not malice) a year later in their follow-up story. As for the actual HC.gov security situation, the short version was:
Those who follow me on Twitter know that I almost always include 3 hashtags with every Tweet: #ACASignups, #ACA and #Obamacare. During the 2016 Open Enrollment Period, I'll be changing the #Obamacare tag to simply #OE3, not out of any disrespect towards the President but simply because of the character limit.
Twitter followers also know that my personal feed (@charles_gaba) also includes all sorts of non-ACA-related stuff. If you want to keep up with my ACA-specific stuff but don't care for my unrelated political rantings, just follow the official@ACASignups Twitter account instead!
I planned on posting about this earlier today, but had to deal with a crisis for one of my Day Job clients (yes, I still have one believe it or not).
Early this afternoon, Covered California, the largest state-based ACA exchange in the country, held a conference call accompanied with a lengthy press release and a very nice slideshow full of pie charts and data points, giving a comprehensive overview of where things stand in the Golden State.
I've said before that there are a few areas of the ACA which I simply don't consider myself knowledgable enough about to try and explain to others in depth. One of these is the so-called "Cadillac Tax" on high-end employer sponsored insurance policies. The other (well 3 others, really) are the "3R" programs which were set up to try and smooth out the transition period for insurance carriers for the first few years. The "3 R's" are "Risk Adjustment", "Reinsurrance" and "Risk Corridors".
Risk adjustment is a process that deters insurance plans from trying to attract healthy enrollees (“cherry picking”), and protects companies that may—by chance or because of their particular benefits—attract sicker than average customers (“adverse risk selection”). Though the Affordable Care Act bans carriers from turning people down or charging them more based on their health, the incentive to attract healthier enrollees remains because healthier customers increase profits by reducing companies’ payouts.
