Monday, December 23, 2024
 
Big Insurers Are Gaming Obamacare Rules, and Readers Fume

WASHINGTON, D.C. Mar. 12 (DPI) – The Wall Street Journal reported that major health insurers get bonuses from the government for putting their customers in certain health-care plans, so – surprise – insurers arbitrarily move their customers into those plans to make sure they capture the bonus, no matter if additional benefits are provided. The practice, which took hold because of Obamacare rules, translates into hundreds of millions more for insurers every year.

The only consolation, according to The Journal report, is that last month’s budget deal contains provisions that may discourage the practice.

According to The Journal:

The bonus system was created by the 2010 Affordable Care Act. The intention of the ratings was to provide guidance to people shopping for plans, and the payments were supposed to create additional incentive for providers to upgrade the quality of their offerings. The system measures such factors as whether members get proper screenings and vaccines, and the quality of customer service provided by insurers. Plans that win four or more stars are entitled to bonus payments.

The stars are applied to insurers’ contracts with the Medicare agency. Each contract can contain dozens of plans covering thousands of members. If plans in a low-rated contract are moved—or crosswalked—into a contract with a high rating, the high rating automatically applies to the newly added plans.

Readers of course cited the nonsensical payouts as more evidence that government has made the health-care situation in the country worse rather than better. The highest recommended comments:

Wait just a minute!  Are you trying to tell me that if you create a complicated legal framework with millions of dollars in financial incentives on the line that people or corporations will seek out strategies to game the system?!?!  Here’s my question.  Should we be outraged at the corporations who legally take advantage of the system our politicians created or the politicians who created the boondoggle in the first place?

“The bonus system was created by the 2010 Affordable Care Act. …”  That’s all I need to know.  Read no further.

Why is this a surprise?  Every single announced government spending program and tax cut results in people immediately going to work to maximize their benefit and minimize their cost.  It is human nature. This is the core, fundamental reason that socialist, planned economies do not work.

 

 

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