US health insurers to pay $1.1 bln in rebates

Discussion in 'Politics' started by SLO MO, Jun 21, 2012.

  1. SLO MO

    SLO MO Registered

    I'm not sure why the health care reform is such a bad thing, its a lot of opinions here, can someone tell me whats the issue with it?
    Timeline of the Affordable Care Act |

    Below is an article on one of the stipulations which basically mandates that providers spend no less than a certain % of funds on actual health care or improvements and not advertising or bonuses, if they dont then they are to refund the difference to the policy holders. :thumbsup:

    UPDATE 1-US health insurers to pay $1.1 bln in rebates-HHS | Reuters
    Rebates from plans covering 12.8 million beneficiaries

    * No word on how many would receive direct payments

    * Plans covering 67 million people met new reform standard (Adds market breakdown and payments by states)

    By David Morgan

    WASHINGTON, June 21 (Reuters) - U.S. health insurance companies are due to pay out $1.1 billion in rebates to employers and individuals this summer, under a new industry regulation imposed by President Barack Obama's health care law, the administration said on Thursday.

    But whether the rebates actually reach those recipients depends on if the U.S. Supreme Court strikes down the 2010 Patient Protection and Affordable Care Act in a ruling expected by the end of next week, experts said.

    Twenty-six U.S. states have asked the high court to overturn Obama's reforms on grounds that they exceed the federal government's constitutional authority. If the court decides not to uphold the law, it could overturn the entire legislation or selected provisions.

    The U.S. Department of Health and Human Services, which has kept up a steady drum beat of announcements about the law's benefits for consumers ahead of the court ruling, said rebates due by Aug. 1 would be paid out by health insurance plans that cover 12.8 million beneficiaries in the individual and group markets.

    HHS officials could not fully estimate how many of those beneficiaries would receive an actual check from their insurers. They also could not identify specific insurers that would be required to provide rebates.

    Just over $700 million in rebates, or nearly two-thirds of the $1.1 billion total, will be paid by insurance plans in the group markets for small and large employers. The remaining one-third comes from insurers in the individual market.

    The rebates stem from a provision of the healthcare law that requires insurers to spend at least 80 percent of premiums on medical care or quality improvements, rather than advertising and administrative costs, salaries or bonuses. Insurers that devote less to actual healthcare services must pay customers the difference.

    About 4.1 million people who are covered by individual insurance plans would receive a direct rebate, which HHS said would average $152 per family.

    But the remaining 8.7 million beneficiaries are covered through the small and large employer markets and would receive only a portion of the rebate value depending on their share of premium costs. Officials said employers may choose to pass along the value of the rebate due their employees in forms other than cash, such as lower premiums or added benefits.

    Insurance plans covering 67 million beneficiaries met the standard this year, HHS said.

    The $1.1 billion total is below earlier independent forecasts of between $1.2 billion and $1.3 billion.

    Independent experts attributed the difference to insurance industry adjustments and the ongoing effects of joblessness and economic weakness that have slowed the growth of healthcare costs to historically low levels in recent years.

    Rebates worth over $500 per family on average are due beneficiaries in 10 states, six of which are among those suing to have the law overturned, according to HHS data.

    The rebates are among a handful of consumer benefits set in place by the Affordable Care Act before Jan. 1, 2014, when it is scheduled to come into full force.

    Others include a rule that allows adult children to remain on their parents' health plans until age 26, prescription drug discounts for senior citizens and health coverage for about 60,000 people with preexisting conditions.

    Those benefits could also be vulnerable if the Supreme Court ruling proved unfavorable to the law. (Reporting By David Morgan; Editing by Bernard Orr and Tim Dobbyn)
  2. skydivr

    skydivr Jumps from perfectly good Airplanes Donating Member

    In a nutshell the law will break all the private insurers, so the public option becomes the last one standing, and you just put your full faith and trust in SOCIALIZED MEDICINE. Gov't ends up with FULL CONTROL.
  3. dadofthree

    dadofthree Seasoned Beef Donating Member

  4. sanket_420

    sanket_420 Registered

  5. nealio

    nealio Registered

    This is the way I see it. First of all, I dont know anyone that likes to have things forced on them. In this instance, the problem I see is that by forcing a percentage-based spending program, you are actively forcing the need for more company income. If the overhead you have as an insurer for things like advertising and bonuses isn't under the 20% cap Uncle Sam is imposing then what will the insurer do? Spend less on advertising and bonuses ( :rofl: ) ? I personally don't believe that for a second. If I had to guess, I would say bring more money in so that the 20% slice of the money pie is bigger. Anybody care to guess how they would go about generating more income? Maybe I'm wrong, but that's my take.
  6. BusaWhipped

    BusaWhipped Moderator

    The issue isn't whetether health care reform is needed, its how to implement it. Once the Gov't puts the private insurance companies out of business and becomes the single payer in the country, there is no reason for them to spend a penny curing anyone. The majority of the problems in the health care system are the result of the Government regulations all but eliminating competition between the providers. In a few years Congress will be looking at health insurance as an entitlement, same as they are the Social Security insurance we've paid 15% of our income into our whole lives to have the payout reduced and eventually taken away.
  7. skydivr

    skydivr Jumps from perfectly good Airplanes Donating Member

    Yep, the government has done such a good job with my retirement, that I'd sure be willing to let them control my heathcare.....
  8. SLO MO

    SLO MO Registered

    Thanks interesting take, I looked for some studies on the effect to the private insure and it seems that they win no matter what, it actually says they are very confident that they will compete so large companies are pumping lots of money into private exchanges. If I may ask where did you see that affordable health care act would break private insurers? I would like to read over it thanks.

    Private insures forming Health insurance exchanges.
    Private insurers forming their own health insurance exchanges -

    AHIP: Private Insurance Exchanges Will Prevail Regardless of SCOTUS Ruling
    Excerpt of the findings:

    Private health insurance exchanges will thrive no matter what action the Supreme Court takes on the matter of the Patient Protection and Affordable Care Act,. That's the collective opinion three panelists offered during a Wednesday session at the annual conference for America's Health Insurance Plans in Salt Lake City.
  9. skydivr

    skydivr Jumps from perfectly good Airplanes Donating Member

    I'm not going digging to look for references. We already got notified by our corporate insurance provider of our huge rate increase - but of course, it would be cheaper to stop insuring and pay the government penalty - which is part of the entire plan. You can put lipstick on a pig, but it's still a pig.

    Funny how Obamacare passed, and he immediately gave a by to a lot of big corps/unions who now don't have to follow it. Leaving small and medium businesses (and the taxpayer) to pick up the tab..

    I agree something is going to have to be done, but you can't do it by breaking the Constitution, it's a line you don't want to cross.
  10. SLO MO

    SLO MO Registered

    OK I understand that part, up until 2 years ago my company paid 100% of our medical but because the actual cost of the plans rose we ended up having to pay a small premium which went from $0 a pay period to $86, then this year it's $102 for family coverage, we use United Health Care as a provider. My company offers pay incentive to opt out and be covered on a spouses plan, they also asked that everybody sign a form saying that a spouse could not be covered on any other companies plan to help keep the cost low, mainly because it was free at one time and still cheap so of course every employee had the whole family on the plan.

    Why do you say it would be cheaper to stop insuring when part of the bill states the small to medium business will get tax breaks and credits which totaled over 300 million last year for the companies that took advantage of them? According to the plan the govt also offers other incentives that help with cost and by 2014 each state has to have an private exchange set up which offers different options and actually lowers the cost because in puts people in a larger pool of insured diluting the overall cost.

    I'm just trying to get a fact based answer to why people oppose it, so I can have a better understanding of it, I don't know it all so I like to research what I don't know from different angles. I figured since a lot of people oppose it here I could get some good references as to why and the source of that info. I've looked through what's proposed and what it's trying to fix which is mainly an option to fill in the gaps for every American to have health care and force health care companies to provide better services to everyone.
  11. SLO MO

    SLO MO Registered

    The 80% rule for insurers: Since 2011, insurance companies have been required to spend at least 80% of every dollar on medical care and not administrative costs -- or refund the difference.

    This rule, known as the medical loss ratio, is especially important for small businesses. Administrative costs typically have taken up a much larger chunk of small companies' insurance costs when compared to large companies.
    The rule has already been shown to work, at least in California, where 4,400 companies received $3.5 million in refunds from insurance company UnitedHealth this month. UnitedHealth was forced to return the money to comply with the 80% rule.
    Eliminating the ratio would drive up insurance costs for many small companies.
  12. BusaWhipped

    BusaWhipped Moderator

    This is how the Single Payer system begins. People cheering because companies are having to give rebates based on the Government putting regulations on them that they Government does not have to comply with themselves. Do you really think the Government spends less than 20% on administration of anything they do? Every action results in a reaction. The insurance companies will either decide there isn't enough profit in small to mid-size companies and drop them. No problem the Government plan will pick them up. Or the isurance companies will figure out how much of a rate increase is needed to remain profitable with the 80% rule. The small to mid-size companies will drop them becasue they can't afford the increases. No problem the Government plan will pick them up.

    Its never a level playing field when the Government decides it's going into business against the private sector. Who's regulating the Government? The regulator and the provider become the same entity. Game over.
  13. skydivr

    skydivr Jumps from perfectly good Airplanes Donating Member

    At what price would you sell your soul? That's pretty much what we are talking about here....

    I think/hope/pray that SCOTUS is going to decide it's unconstitutional as you can't FORCE every single American to buy anything.

    Cracks me up, people who show up in the Emergency room for an ouchie are going to continue to so. They aren't gonna buy squat.
  14. nabusa

    nabusa Registered

    Also tax payers will be funding abortions.
  15. VIPER

    VIPER Formerly known as viperblackbusa. Registered

    EXACTLY!!! Also dont get your hopes up OP you wouldnt see any of the money at all. Your employer will snag it and keep it i garrantee that.

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