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Thread: Southern governors secede from Medicaid

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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by tessaesque View Post
    Just a thought:

    Don't most insurance companies work on a reserves system? If one year is particularly "good" because claims are down, they have a reserve for the next year that's "bad" because claims shoot up.

    So let's say this 80/20 plan kills that year-to-year reserve...what happens in a "bad" year? What if they need to spend more than 80% on medical pay outs? What if they have to spend more than is paid in for some reason? What happens at that point?
    I think you have it a little mixed up.

    The law says that no more than 20% of payments from consumers can be used to pay for administrative costs. So it puts a cap on what insurance companies can pay in regards to salaries from revenue brought in by premiums.

    So in a bad year, an insurance company can, for instance, go 90/10 in regards to how much of its premiums are used to pay for administrative costs in order to pay for coverage. What the law limits, however, is, during good years, an insurance company using 70/30 of premium payments to be used to pay for administrative costs.

    So the 80/20 ratio is a cap, not a constant, and insurance companies can use more of the money from premiums to pay out for coverage but not less.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by samsmart View Post
    I think you have it a little mixed up.

    The law says that no more than 20% of payments from consumers can be used to pay for administrative costs. So it puts a cap on what insurance companies can pay in regards to salaries from revenue brought in by premiums.

    So in a bad year, an insurance company can, for instance, go 90/10 in regards to how much of its premiums are used to pay for administrative costs in order to pay for coverage. What the law limits, however, is, during good years, an insurance company using 70/30 of premium payments to be used to pay for administrative costs.

    So the 80/20 ratio is a cap, not a constant, and insurance companies can use more of the money from premiums to pay out for coverage but not less.
    It is primarily to keep new players out of the game, but it does limit the overhead/profit somewhat. The large companies must pay out 85% in direct medcial care costs. The scale of large insurance companies makes them much more stable and profitable, yet the new risk based limits on premiums, allowing only for age and smoking to be considered, along with many more "first dollar" coverage mandates will raise premiums for everyone. The obesity and gender risks were dropped, from actuarial premium consideration, by PPACA to due "political correctness" so now all will pay more instead of only those that pose higher risk.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by samsmart View Post
    No.

    People will pay for it themselves since there is an individual mandate.

    So because people will pay for their own health insurance, there are no "freebies."
    Oh, RIGHT, I forgot. NO SUBSIDIES. Taxpayers off the hook, thank G-d!
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Arbo View Post
    All which raise rates. Funny thing reality is, the more you cover, and the more that is covered, the higher the rates, as the 'risk' is higher.

    Unrealistic. What other industries has the government set limits on administrative costs on? When most of that industry is pushing paperwork?
    But WAIT! Obamacare bends the cost curve! O promised!!
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by tessaesque View Post
    Just a thought:

    Don't most insurance companies work on a reserves system? If one year is particularly "good" because claims are down, they have a reserve for the next year that's "bad" because claims shoot up.

    So let's say this 80/20 plan kills that year-to-year reserve...
    They could still have a reserve during a good year, it would just have to come out of the remaining 20%. Similarly, if they didn't have a reserve they could just post a corporate bond, and then pay its interest out of the remaining 20%.

    what happens in a "bad" year? What if they need to spend more than 80% on medical pay outs? What if they have to spend more than is paid in for some reason? What happens at that point?
    If it's just one year, no big deal. They borrow money and pay it back next time they have a good year. If it's a consistent problem, then they just aren't charging enough for premiums.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Wiggen View Post
    Why is it the only poll Republicans ever pay any attention to is Rasmussen - the poll that leans right on everything and everybody?

    Poll: 'Obamacare' Gains Support, Public Opinion Now Split | TPM Livewire
    Rasmussen polls the question more frequently. You like Gallup better?

    Americans See More Economic Harm Than Good in Health Law

    July 5, 2012
    Americans See More Economic Harm Than Good in Health Law
    Independents help tilt the balance to the negative

    by Frank Newport

    PRINCETON, NJ -- Americans are more likely to say the 2010 healthcare law upheld by the Supreme Court last week will hurt the national economy (46%) rather than help it (37%), while 18% say they don't know or that it will have no effect.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Wiggen View Post
    If you say so. I wouldn't go that far. I merely point out that the mental midgets running these states are the natural successor's to the clowns that voted for secession so that they could continue to own slaves.
    NEBRASKA???
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Arbo View Post
    First, they haven't had anywhere near 200+ years, do a bit digging into the history of actual healthcare.

    Second, if the people wanted it in any state, it would have happened. Suggesting that because x didn't happen, the people wanted x is a silly argument.
    Well, the people elected a US Congress and a US President that made it happen.
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    Re: Southern governors secede from Medicaid

    Quote Originally Posted by Wiggen View Post
    Except it isn't unpopular. The American public is evenly split on the issue, with some of those opposed taking that position because they don't feel Obamacare goes far enough. Really, get out of relying on Rasmussen for all of your information.
    Gallup has been saying roughly the same thing all along. Furthermore, the 2010 election was pretty conclusive.
    Last edited by wbcoleman; 07-11-12 at 07:43 PM.
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    Re: Southern governors secede from Medicaid

    Not surprised, seems like a hasty reaction to the supreme court decision from an outside vantage point. Something tells me they will reconsider their position when substantial political and lobby pressures begin mounting.

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