Goooood politics. I’m 90 percent sure it won’t pass, but last week I would have told you I was 100 percent sure. At the rate O and his boondoggle are melting down on the Hill, there’s no down side to trying to force Democrats to vote on all sorts of bills that would chip away at parts of O-Care. Worst-case scenario: They fail but with some Democratic support, which means a rolling PR disaster for the White House and a very small margin of error going forward lest the Democratic turncoats in Congress start thinking maybe it’d be better to repeal this thing and be done with it.
How about it, Mary Landrieu? Yes or no to tossing billions in hard-earned tax money at insurers to clean up the gigantic mess you, they, and Obama have made?
Obamacare includes a provision that allows the federal government to funnel taxpayer dollars to insurers that face the prospect of losing too much money under the new health care law, and conservative critics want to repeal it.
Sen. Marco Rubio, R-Fla., said the provision could amount to a bailout of the insurance industry, which stands to lose if the troubled Obamacare exchanges fail to enroll enough people to make the system financially viable. Obamacare enrollment has already been stymied by glitches at the healthcare.gov sign-up site and it could be dampened again under an administrative fix President Obama proposed this week to resolve problems with millions of cancelled policies…
“We need to protect taxpayers from having to bail out anyone as a consequence of Obamacare,” Conant said in an email exchange with the Washington Examiner. “Rubio’s bill will fully repeal the ‘risk corridor’ provision in Obamacare, preventing a bailout.”
If you’re unfamiliar with the “risk corridor,” read David Freddoso’s short but useful explainer from last month. Nutshell version: An insurer who’s offering a plan on the ObamaCare exchange sends a cost projection for that plan to HHS. If it comes in a bit under cost, they cut a check to HHS for the difference; if it comes in a bit over cost, HHS cuts them a check to make up the shortfall. It’s a way for insurers to spread the risk of cost miscalculations among themselves. Adrianna McIntyre, the economist who inspired Freddoso’s post, calls it “insurance for the insurers.” So far, so good. Problem is, there’s no cap on losses that HHS might be forced to cover if lots and lots of individual plans end up costing way more than the insurers projected. If a plan’s actual cost exceeds 103 percent of the projection, Uncle Sam covers half of the overrun; if actual cost exceeds 108 percent of the projection, Uncle Sam covers 80 percent.
If ObamaCare was working perfectly, the risk of many plans coming in way over budget would be small. Healthy people would be enrolling by the millions on Healthcare.gov, flooding insurers with tons of new revenue they could use to pay for sick people’s preexisting conditions. Thanks to President Bumblefark’s incompetence, though, Healthcare.gov is a smoking ruin; young healthy people can’t sign up, which means no cash for insurance companies to cover their hefty new expenses. That leaves Uncle Sam partially on the hook for the difference. The punchline, though, is that Obama’s “fix” yesterday only makes it worse. If insurers bring back the old, cheap plans, all of the healthy people who’ve had their coverage dropped and who are supposed to provide new revenue by buying the more expensive exchange plans will revert to their old coverage. That’ll leave the exchange plans with even more sick enrollees and fewer healthies, compounding insurers’ losses. Uncle Sam’s on the hook for even more now.
Via the Weekly Standard, here’s David Cutler, one of the architects of O-Care, admitting last night that an insurance industry death spiral isn’t out of the question here. In fact, though, the “risk corridor” is designed to reduce the risk of a death spiral; so are the taxpayer subsidies for lower-income enrollees on the exchanges, which can (at least theoretically) be increased to keep pace with premiums if/when they start to rise. Without the risk corridor and the subsidies, the only way for insurers to make back their losses this year is to jack up premiums next year, which will further discourage healthy people from enrolling, which in turn will make the exchange risk pools even sicker and more costly, and thus the death spiral is set in motion. Thanks to Uncle Sam’s “generosity,” they might not have to do that. But all of this points to the same basic fact: The more adverse selection there is on the new exchanges, the more unanticipated costs there’ll be. Those costs will be borne either by the insurance industry, if Rubio’s bill prevails and the “risk corridor” provision is eliminated, or mostly by the federal government, in the form of a bailout and higher subsidies. The political challenge of Rubio’s bill for Democrats is that they don’t want to be on the wrong side of yet another TARP-like government giveaway to an unpopular industry, but on the other hand they can’t take away insurers’ “risk corridor” safety net or else the industry might turn on ObamaCare and then the whole thing will implode. Dilemmas, dilemmas.