Sand
Footballguy
At least for the testing part a member of Congress got the head on the CDC to invoke his powers to declare that the feds would cover all testing costs.
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Obamacare: Obama just straight up lied to you, in your face (4 Viewers)
- Thread starter tommyboy
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Golf Guy 69
Footballguy
Yep, Katie Porter, she's a fireball.Sand said:
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CletiusMaximus
Footballguy
Absolutely. Make no mistake about it, US health insurers will profit from Covid-19. UnitedHealth Group released its first-quarter earnings report this morning, reporting $3.4 billion in profit for the quarter on $64.4 billion in revenue (up from $60.3 billion in the first quarter of 2019.) (https://www.unitedhealthgroup.com/content/dam/UHG/PDF/investors/2020/UNH-Q1-2020-Release.pdf)
UHG was just tabbed to administer the $30 Billion CARES Act Provider Relief Fund, meaning they will surely have a fantastic 2020. To call this the fox guarding the hen-house is a massive understatement.
UnitedHealth has begun demanding its network docs take pay reductions under threat of termination of their network agreements. The goal is to shrink its provider network, while at the same time they continue to buy up doctor practices across the country (UHG, an insurance company and claims adminstrator, is also the largest private employer of physicians in the US). Although insurers are waiving co-pays for testing, they are definitely not waiving co-pays for treatment. This will be a very expensive disease to get, especially if you need a week in the ICU, and even moreso if your doc stood up to UHG and got booted from your network, unbeknownst to you and his other patients. This used to be unthinkable, but now is quite common source of surprise billings - when your hospital or clinic is in-network but your doc suddenly is not.
Anyone who gets this disease needs to be very careful on the insurance side of things. Probably not something you want to be focusing on as you're being admitted to an ICU, but could easily be a decision with a $10k or more implication.
matttyl
Footballguy
Sorry for the delay in getting back to you, Rusty. With everything going on, things are pretty crazy in my line of work. I think your question(s) have been answered here, but just to reiterate, you are kinda stuck here. Well, when did you lose VA benefits? If that was recently, you may still be within a "qualifying event window" to enroll in an ACA plan. If that was more than say 60 days ago, then the system is set up to prevent someone from doing exactly what it is you're attempting to do (just buy coverage when you need it). There is also talk of having another "open enrollment" window for everyone - but thus far at least in Virginia that's only happened in the group markets, not individual.
Also, someone mentioned getting a job - that wouldn't qualifying you for getting coverage in an individual ACA plan, as your income is apparently already too high for a VA plan, I doubt the extra income from stocking grocery shelves would change much of anything on that end. If you could obtain employer sponsored (group) coverage with that employment, that's pretty much your only option now.
As to the part above that I bolded, the ACA is/are private plans. If you go onto healthcare.gov (or a state exchange if your state has one) you'll see plans offered by private companies. Those are "on exchange plans", but the off exchange plans are pretty much identical (might be a pricing difference, but the plans are still from private companies. If you mean short term plans or something like that - they will most definitely either deny you a policy, or not pay anything related to anything you've already got (aka pre-exisiting conditions).
matttyl
Footballguy
"UnitedHealth Group" is more than just their health insurance business. They have their hands in a lot of health related fields. If just looking at the health insurance piece (their largest piece) it was $2.9B earnings from $51.1B in revenues - an operating margin of 5.7%. Operating margins are generally higher in the first quarter of a calendar year for health insurers as they aren't yet paying huge benefits with people not yet hitting their deductibles/OOPs (for instance their operating margin the last 3 months of 2019 was only 4.3%).
Now, I understand that's a huge number - $2.9B for a quarter. But in total they coverage about 53M people over that time. Run the numbers, it's just under $53 per person in profit for the quarter, for what's generally their most profitable quarter. A good rule of thumb is that a commercial carrier, on average, makes about $100-200 in profit per person per year. They just need to cover a whole lot of people to get to those huge numbers. And one good sized health issue (like a pandemic) wipes it all out. I'm actually interested to see their numbers for this year with so many people delaying/canceling voluntary services - but also the additional expenses from covid.
ETA - on the bolded, lots of states (including my own) are putting laws in place to prevent these. Shouldn't be up to the individual to find out if every doc in a participating facility is in fact participating. It still happens, but this is the new hot topic the last year or two with networks shrinking to cut costs (and then, at least in theory, lower insurance costs).
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CletiusMaximus
Footballguy
UHC's numbers are broken down in the release. The insurance side is doing very well, although admittedly the growth was driven by other parts of the conglomerate. The takeaway, which I think should be obvious to all, is that health insurers are not going to suffer financially from CV19. Their public rhetoric will assure us that they are, above all, focused on their mission of ensuring the health and well-being of their insureds, but the focus will be where its always been - on growth and profit - and they will see this crisis as one of opportunity, not a matter of short-term sacrifice in the interests of public health.
Full disclosure - Optum and UHC are two of my biggest clients. My business would fold without them, so this is all good news for me on a purely selfish level.
Regarding state laws on out-of-network charges. My state put one in place yesterday. The wording, in my opinion, is not particularly helpful. One of the conditions is that an insurer is restricted from charging out of network rates only if no in-network doctor is available. Who decides what that means and how can anyone determine that in an emergency situation? Anyone who works in this industry knows full well - these companies are not going to give up anything due to this crisis. Its much more likely they are working hard to use the current situation to put permanent changes in place that further protect their massive profits at the expense of our healthcare.
Bottomfeeder Sports
Footballguy
I'm no fan of insurance companies, but I am a fan of paying our debts.
8-1 decision against the GOP reneging on risk corridor payments with Justice Alito dissenting in pure GOP talking point gibberish!
In the grand scheme of things this is likely to have minimal impact on much of anything as the damage was done long ago, more just a symbolic "slap on the wrist".
8-1 decision against the GOP reneging on risk corridor payments with Justice Alito dissenting in pure GOP talking point gibberish!
In the grand scheme of things this is likely to have minimal impact on much of anything as the damage was done long ago, more just a symbolic "slap on the wrist".
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