Tag Archives: Medicare Advantage

Humana to quit Obamacare exchanges in 2018, providing fuel for Trump’s ‘repeal’ efforts

obamacare2

From Yahoo:  While Republicans continue to grapple with plans to repeal and replace Obamacare and stabilize health insurance rates, Humana (HUM) is the first major insurer to say it is dropping out of the individual market for 2018.

“Based on our initial analysis of data associated with the company’s health-care exchange membership following the 2017 open enrollment period, we continue to see further signs of an unbalanced risk pool,” said Humana CEO Bruce Broussard, on a conference call with analysts Tuesday. “Therefore, the company has decided that it cannot continue to offer this coverage for 2018.”

In the wake of the news, President Donald Trump tweeted that the insurer’s decision was another example of the failure of the Affordable Care Act, and he reiterated his plan to “repeal, replace & save healthcare for ALL Americans.”

The health insurer made the announcement with its earnings update, following the mutual termination of its $34 billion merger agreement with Aetna (AET) earlier in the day. The two insurers agreed to part ways , after a federal court judge blocked the deal on antitrust grounds.

Humana now expects to earn $10.80 to $11.00 per share for 2017, excluding anticipated losses on its exchange business.

Humana cut back its Affordable Care Act exchange participation to 11 states last July, when the Department Of Justice sued to block its deal with Aetna. The insurer said that despite efforts to mitigate losses on its exchange plans in 2017 through narrower networks and selective market participation, it is seeing early signs of high pharmacy utilization among its new members.

Right now, the insurer estimated that it will lose a modest $45 million on ACA exchange plans, but it cautioned that this is an early estimate and “a number… that we’re going to have to evaluate.”

Other health insurers have threatened to pull out of the individual market if there is no clarity from Capitol Hill or Trump’s health officials on stabilizing the markets, but Humana is the first to say that it will pull out altogether.

Leading up to 2017 open enrollment, the exchange markets experienced tremendous turbulence last year, after most major insurers, including Humana, cut back on participation after suffering big losses on exchange plans.

Humana is a leading Medicare Advantage plan provider, and executives said that they don’t believe that they can achieve the same kind of health-care models on the Obamacare exchanges that they achieve with health plans for seniors.

The company does not hold out hope for more detail on Republican “repeal and replace” plans in the near term.

“We’re really feeling that this organization needs to stay focused on what we do well,” Broussard said, and the company can’t do that with Obamacare plans. “I think with that particular program, the way it is designed today and most likely the way it is designed in the future, will limit our ability… to get back into that marketplace.”

DCG

 

 

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Obama is raiding Medicare to fund Obamacare

Shovel ready Obamacare

In October 2013, I did a post on thousands of elderly Americans on Medicare’s Advantage program discovering they’d lost their trusted doctors because their HMOs (health maintenance organizations), in a move to trim costs, have fired those physicians. An example is UnitedHealthCare (UHC), which sent thousands of pink slips to Connecticut doctors caring for Medicare Advantage patients.

I wrote in that post:

Why are thousands of Medicare Advantage doctors being fired?

The answer is ObamaCare.

Under Obamacare, federal funding to Medicare Advantage is being reduced by billions of dollars in coming years. Obama said spending on the Advantage program is higher than regular Medicare and is “unsustainable.”

Mark my words: The firing of Medicare Advantage doctors is just the beginning. President Lucifer is gunning for the Advantage program itself, and ultimately all of Medicare.

Just think: What he and the Demonrats really want is the government’s takeover of the health “care” of all Americans via a “single-payer,” i.e. government-run nationalized, healthcare system.

That’s the ultimate goal of Obamacare.

Once this super-sized Obamacare is in place, Medicare would be superfluous and will be jettisoned, if not sooner.

Last week came news that the POS has proposed a 3.55% cut to Medicare’s Advantage program.

Now, Florida Gov. Rick Scott is confirming what we suspect.

Greg Richter reports for Newsmax, Feb. 25, 2014, that, citing proposed cuts in Medicare Advantage plans, Florida Gov. Rick Scott says the Obama administration is raiding Medicare to pay for Obamacare.

In Washington over the weekend for a National Governors Association meeting, Scott said in a press release on Feb. 24:

“We learned last week that Medicare is being raided to pay for Obamacare, which is hurting our seniors, who could lose access to the doctors they liked and were told they could keep. We need to give our seniors a voice and ask the president directly to not pay for Obamacare by raiding Medicare. He has stopped and delayed other broken parts of the healthcare law. He should do the same with this.”

Appearing on Fox News Channel’s “Your World With Neil Cavuto,” Gov. Scott said he’s seen 300,000 Floridians lose health plans they were promised they could keep, and now senior citizens, a significant part of the state’s population, are telling him they can’t find a doctor who accepts Medicare. “It’s totally different from what our citizens were promised,” Scott said.

Cavuto noted that several of Scott’s fellow governors said during the weekend conference that Obamacare isn’t going to be repealed, so it is up to them to find ways to make it work.

Meanwhile, as Oklahoma Republican Sen. Tom Coburn, a medical doctor, points out, enrollment in MEDICAID has increased 1,290% since its inception in 1966, from 4 million to 55.6 million people in 2012. Spending in MEDICAID has increased a whopping 31,212.5%, from $800 million in 1966 to $250.5 billion by 2012.

Medicaid is welfare, but Medicare is not.

Just like Social Security, Americans who work pay into their supposed Medicare benefits via Medicare deductions from our paychecks.

Just like Social Security, the Medicare program is being raided to “re-distribute” the monies to those who don’t work.

To all Americans who are on Medicare:

Just how much longer will you tolerate this?

Until you wake up morning to discover you no longer have Medicare coverage?

UPDATE:

Minutes after I published this post, I received an email from Townhall.com that the POS also slashed another part of Medicare — the home health care services:

On January 1, 2014, ObamaCare cut nearly $22 billion from Medicare home health care over four years. That means an estimated 3.5 million poor and ill homebound senior citizens woke up on New Year’s Day to discover that ObamaCare had slashed funding for their home health care program.

Last year, Medicare home health services were delivered to approximately 3.5 million Medicare beneficiaries. According to the federal government’s own data, these seniors are older, poorer and sicker than the Medicare beneficiary population as whole. Many of these seniors also reside in rural communities, where home health care is especially important because other sources of treatment are often located many miles away.    

~Eowyn

Obama Admin Announces 3.55% Cut To Medicare Advantage Programs.

Outraged

GOP lawmakers, trade groups rail against proposed Medicare 

Advantage cuts.

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By Tom Howell Jr.   The Washington Times  Saturday, February 22, 2014

Republican lawmakers cried foul Friday night over an Obama administration proposal to cut payment rates to private insurers who administer Medicare Advantage, a popular alternative to the government-run health program for seniors.

The Centers for Medicare and Medicaid Services (CMS) announced a proposed cut of 3.55 percent to insurers like Humana Inc. and United HealthGroup Inc., although the reductions would not become final until spring.

Although not a surprise, the proposed cut come after an intense lobbying effort by the insurance industry against slashing rates, citing the potential for higher costs to seniors, and GOP lawmakers this year are sure to use the cuts as further ammo against the Affordable Care Act and its Democratic supporters.  

“The health law cut more than $300 billion from the popular Medicare Advantage program, potentially forcing hundreds of thousands of beneficiaries to find new health care plans, despite the president’s promise,” said Rep. Joe Pitts, Pennsylvania Republican and chairman of a House panel on health. “The cuts announced today will only exacerbate the effect this will have on the health care of millions of our nation’s seniors, leaving them with higher costs and fewer choices.”

About 15 million people, or slightly less than a third of all Medicare recipients, are enrolled Medicare Advantage plans, while the rest rely on the government’s fee-for-service model to reimburse doctors.

CMS officials insisted late Friday that the program is on the right course. It said Medicare Advantage premiums have fallen by 10 percent since the Affordable Care Act passed in 2010, while enrollment has increased to an all-time high 15 million enrollees.

“We believe that plans will continue their strong participation in the Medicare Advantage program in 2015 and beneficiaries will continue to have a wide array of high quality, high value, low cost options available to them while at the same time we are making certain that plans are providing value to Medicare and taxpayers,” said Jonathan BlumCMS’s principal deputy administrator.

But top Republicans like House Majority Leader Eric Cantor of Virginia jumped all over Friday’s proposal, saying Democrats are taking another swipe at a popular program after Obamacare ushered in a first round of cuts.

“ObamaCare has already caused millions to lose the healthcare plans they liked, and now it is directly harming seniors who rely on the care they have through Medicare Advantage,” he said. “Our nation’s grandparents should not have to wake up tomorrow worried they no longer can access the care they want because of ObamaCare.”

The move is also a setback to trade groups who lobbied hard against the cuts in TV ads and through other means, arguing the cuts could destabilize rates.

“You know, we vote,” an elderly woman says in one frequently aired ad.

America’s Health Insurnace Plans has frequently warned the government not to slash Medicare Advantage payments and will likely redouble their efforts to combat Friday’s proposal.

“Another round of payment cuts would be devastating to the more than 15 million seniors and people with disabilities that have chosen to enroll in Medicare Advantage for the better benefits and higher quality coverage these plans provide,” AHIP President and CEO Karen Ignagni said.

~Steve~

SEE ALSO: Obama doubles down on minimum wage; GOP still zeroed in on Obamacare

Read more: http://www.washingtontimes.com/news/2014/feb/22/gop-lawmakers-trade-groups-rail-against-proposed-m/#ixzz2u9Hm2fQa

Elderly Americans in a panic over losing doctors because of Obamacare

Shovel ready ObamacareHere’s another noxious wholly-intended consequence of the poisonous pill called Obamacare.

It is not just hundreds and thousands of Americans who are in shock from having their health insurances cancelled.

Countless elderly Americans on Medicare are discovering they’ve lost their trusted doctors because their HMOs (health maintenance organizations), in a move to trim costs, have fired those physicians.

Jocelyn Maminta reports for WTNH that UnitedHealthCare (UHC) sent thousands of pink slips to Connecticut doctors caring for ‘Medicare Advantage‘ patients — a UHC plan that’s marketed to Seniors to provide additional services.

A mix of primary care and specialty physicians are affected by it. The firing comes at a time just when open enrollment for Medicare had begun on Oct. 15, introducing chaos and uncertainty as to which doctors are still in the United
network.

UnitedHealthCare spokesman Ben Goldstein says “Members with questions are encouraged to call the customer service number on the back of their member ID card for more information” and that “With the many changes happening in health care, we are building a network of health care providers that we can collaborate with more closely to have the most positive impact on the quality of care for our members. We are prepared to help our members transition to new providers.” Blah. Blah. Blah.

The same thing is happening in New York.

There are 2.6 million elderly New Yorkers who receive Medicare, one in three of whom (nearly 900,000) are enrolled in Medicare Advantage — Medicare HMOs run by private insurers.

Carl Campanile reports for the New York Post that New Yorkers in Medicare Advantage are in a panic after getting notices that insurance companies are booting their doctors as a result of the shifting medical landscape under ObamaCare.

The insurance companies include UnitedHealthcare, EmblemHealth, and Empire Blue Cross-Blue Shield.

Dr. Jonathan Leibowitz, who serves 30 patients under Medicare Advantage at his Brooklyn practice, was told by UnitedHealthcare that because of “significant changes and pressures in the health-care environment,” he would be getting the ax on January 1. Leibowitz said he was blindsided: “A patient can’t see his doctor? What are they doing!”

Leibowitz’s patients are furious. Alfred Gargiulio, who has cerebral palsy with a seizure disorder, has been seeing Dr. Leibowitz since 1993: “Obama had said I could keep my doctor. Now they’re doing away with my doctor. They kicked him out! After 20 years, that’s not right. We love Dr. Leibowitz.” Another patient, Wilma Streicher, 76, was equally baffled: “Of course I want to keep Dr. Leibowitz. I don’t see why they want to push him out.”

Lung-cancer patient Jeannette Campregon, 79, received a letter from EmblemHealth saying that her internist, George Ruggiero, was terminated from her VIP High Option Medicare Advantage network. Campregon said, “I’m going absolutely nuts. I don’t want to change my doctor!”

The firing of so many doctors leaves patients with unenviable choices: keep the same insurance plan and find another doctor, pay out of pocket or look for another plan where their physician is a member.

The Connecticut State Medical Society is fighting back. The Society’s president, Dr. Michael Saffir, says the firing of Medicare Advantage doctors “is clearly not a patient centered decision.” He recommends to doctors that they  call UnitedHealthcare to find out why they were terminated without cause, and to seniors affected by this, they should call the office of the HealthCare Advocate of Connecticut at 1-866-466-4446.

Why are thousands of Medicare Advantage doctors being fired?

The answer is ObamaCare.

Under Obamacare, federal funding to Medicare Advantage is being reduced by billions of dollars in coming years. Obama said spending on the Advantage program is higher than regular Medicare and is “unsustainable.”

Mark my words: The firing of Medicare Advantage doctors is just the beginning. President Lucifer is gunning for the Advantage program itself, and ultimately all of Medicare.

Just think: What he and the Demonrats really want is the government’s takeover of the health “care” of all Americans via a “single-payer,” i.e. government-run nationalized healthcare system.

That’s the ultimate goal of Obamacare.

Once this super-sized Obamacare is in place, Medicare would be superfluous and will be jettisoned, if not sooner.

~Eowyn

Medicare cuts benefits to pay for Obamacare

tohurt

Dr. Laurie Roth is a political commentator and host of the nationally syndicated political talk show, The Roth Show. Roth has a Ph.D. in counseling; she is not an M.D.

On Feb. 21, 2013, NewsWithViews published an essay of Roth’s with the alarming title “Obamacare is a Killing Machine and Millions Will Die.” Here are excerpts:

This week I gasped in horror when I learned that Obama care had ordered Medicare to cut reimbursement for 4 million diabetic seniors by 66%. It also reduced all the companies that were supplying blood sugar monitoring supplies from 1000 to 15. I also learned via the research of Elizabeth Vliet M.D. that one of her 80 year old patients was told he was not covered anymore by Medicare when he went to the pharmacy so couldn’t get his medication. His choice was to pay cash or die.

Pause for a second and snap out of being mildly annoyed and grow a backbone and a few fangs over this. Just with Diabetic and Heart patients alone you are talking many millions of people, mostly seniors with coverage simply cut off or largely cut back — setting them up to die. That is unless they are millionaires and can afford expensive medication out of pocket. This is called as in the days of Nazi Germany, targeting a group of people for extermination and murdering them.

Millions will suffer and many will die just representing the pull back of coverage with Diabetic and Heart disease patients. Think about all the other diseases and seniors represented with dramatic or total cut backs by Medicare. Just as in Britain’s socialized medicine now, state-of-the-art drugs will be denied for all kinds of common cancer, multiple sclerosis, rheumatoid arthritis and others.

Medicare is cutting reimbursements to diabetics by as much as 66%? Elderly people are told their prescription meds are no longer covered by Medicare?

Those are very alarming assertions, but Roth provided no sources for her claims. So I scoured the Internet to look for confirmation of the claims.

There is a Dr. Elizabeth Vliet, M.D., who founded the Hormone Health Strategies medical practices in Tucson AZ and Dallas TX. Here’s her web-site. For Dr. Vliet’s op-eds on Obamacare, go here. But I cannot find any writing of Vliet’s about her 80-year-0ld patient being denied Medicare coverage for his medication.

What I did find is an article by Dr. Susan Berry for Breitbart.com, Feb. 20, 2013, on recently-announced Medicare cuts to fund Obamacare. Here are excerpts:

During the 2012 election campaign, Democrats denied that ObamaCare made $716 billion in cuts to Medicare in order to provide funding toward $1.9 trillion in new entitlement spending over the next ten years.

In an announcement on Friday, however, the Obama administration revealed that it would be significantly reducing funding for Medicare, a move that one health insurance analyst said “would turn almost every plan in the industry unprofitable.”

Health insurance stocks tumbled following the announcement that a big chunk of the Medicare cuts would come from the popular Medicare Advantage program, a market-oriented system in which participants can choose coverage by a private company that contracts with Medicare to provide all Part A and Part B benefits.

According to health care analyst Carl McDonald, the new rates proposed by the Obama administration will have the net effect of reducing payments to Medicare Advantage plans by 7% to 8% in 2014. […] According to Richard Foster, former chief actuary to the Medicare program, ObamaCare’s cuts to Medicare Advantage will likely force half of its current participants back into the old Medicare program, originated in 1965. It is estimated that this change will cost Medicare enrollees an average of $3,714 in 2017 alone.

Democrats have long been unfriendly toward the Medicare Advantage plan, which was passed as part of the Balanced Budget Amendment of 1997 and has seen tremendous growth over the past 10 years. Today, more than 25 percent of seniors receive their health benefits through Medicare Advantage.

[…] The administration’s proposal is open to outside comments until March 1st, ahead of the final announcement of the cuts on April 1st.

What I do know is that in 2012, the Congressional Budget Office (CBO) calculated that Obamacare (or the Patient Protection Affordable Care Act) will require more than $1.7 trillion in gross federal spending over the period 2012–2022, some of which will be offset by penalties and tax increases related to coverage, resulting in net spending of more than $1.2 trillion for the insurance portion of the bill.

That net federal spending of more than $1.2 trillion will have to come from somewhere. That somewhere includes Medicare.

Elections have consequences.

I hope all those currently receiving Medicare — 40 million people age 65 and older, and 8 million younger people who are receiving Social Security Disability Insurance payments — who had voted for the POS last November, are happy.

H/t FOTM reader Joan W.

~Eowyn

If you’re on Medicare, you need to watch this!

Obamacare is costly.

Some of the funding for Obamacare comes from cuts to Medicare and Medicare Advantage.

The largest cut to Medicare Advantage will begin in about a month, on October 15, 2012, but seniors won’t feel the full impact of those cuts until well after the November 6 election.

~Eowyn & Joan

Another Day, Another Dirty Deal