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Posts Tagged ‘Bull Valley’

Trump Is Being Vague About What He Wants to Replace Obamacare. But There Are Clues.

Tuesday, April 9th, 2019

The New York Times reports:

“We don’t know what will emerge as President Trump’s plan to replace Obamacare, which he has promised to unveil immediately after the 2020 elections. But he has recently endorsed several proposals, and they could provide clues.


Governor Rauner, veto HB 2624

Tuesday, August 21st, 2018

American Thinker reports:

“Illinois HB 2624, introduced by Representative Laura Fine, limits the duration of short-term health insurance plans to 181 days.  The intent of HB 2624 is to ensure that healthier people do not enroll in the short-term health insurance plans that will be able to last up to 36 months without new underwriting under the new Health and Human Services guidelines, thus preserving the Illinois exchange.


What is Trump’s New Short-Term Health Insurance Order?

Tuesday, May 8th, 2018

Investopedia reports:

“On February 20, 2018, the Departments of Health and Human Services (HHS), Labor and the Treasury released a proposed rule that would increase the length of coverage for short-term health insurance plans from three months to 364 days. They proposed this rule in response to an executive order President Trump issued in October 2017 telling these departments to propose regulations or guidance that would make this type of insurance more available in order to encourage consumer choice and provider competition in the health insurance market.


Mendoza criticizes Illinois’ ‘lawless’ fiscal climate

Wednesday, March 8th, 2017

Crain’s Chicago Business reports:

“Hospitals and doctors treating patients on the state payroll are now owed a collective $4.3 billion, Democratic Comptroller Susana Mendoza highlights in a new report that reflects a “lawless fiscal climate.”

The annual state report for the fiscal year ended June 30 “paints a worsening outlook” for Illinois’ financial future, the comptroller’s office said in a statement.


Here’s What Medicare Part B Costs and Covers in 2016

Tuesday, January 26th, 2016

According to The Motley Fool:

“Learn how this part of the Medicare program works. 

Retirees rely on Medicare to help them with their healthcare expenses, but getting a better understanding of how the program’s different components can be challenging. Medicare Part B plays a key role in the everyday aspects of healthcare, and below, you’ll learn more of the specifics of how much Part B costs and what it covers.

What Medicare Part B costs
Medicare participants pay a monthly premium to get Part B coverage, but one of the more confusing things about the program in 2016 is that different participants pay different amounts. The standard charge for most new participants this year is $121.80 per month. But because of a law that ties Medicare increases to cost-of-living adjustments for Social Security, the majority of existing participants will pay the $104.90 monthly premium they paid in 2015. (more…)

With Michigan Closure, More Than Half of Obamacare CO-OPs Have Now Failed

Monday, January 11th, 2016

Energy & Commerce Reports:

“WASHINGTON, DC – The number of failed Obamacare CO-OPs grew to one dozen today as Michigan became the latest to announce it was closing. To date, 12 of the original 23 CO-OPs have closed, bringing the total cost to taxpayers at more than $1.23 billion. This Thursday, the Subcommittee on Oversight and Investigations will hold a hearing on “Examining the Costly Failures of Obamacare’s CO-OP Insurance Loans.” (more…)

Is Blue Cross’ parent company too big, or not big enough?

Monday, July 13th, 2015

Crain’s Chicago Business reports:

“In health insurance, as in so many businesses, it helps to be big.

Larger insurers enjoy many advantages over smaller rivals. They have more clout in pricing negotiations with doctors and hospitals, greater economies of scale in back—office operations, broader customer bases that limit risk. “The bigger you are, the better off you are,” says analyst Vishnu Lekraj, who follows the health insurance industry at Chicago-based Morningstar.

Size has paid off for Health Care Service Corp. of Chicago. The owner of Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas is the nation’s sixth-biggest health insurer by market share. With dominant positions in all its markets, HCSC books more than $20 billion in revenue annually. HCSC’s deep pockets have helped it absorb cost pressures under Obamacare and capitalize on expansion opportunities created by health care reform.

Trouble is, “big” is a relative concept that changes over time. A company that’s large by today’s standards may not seem so big tomorrow.

Industry consolidation can raise the bar quickly, creating giants of unprecedented scale. Megamergers magnify the benefits of size to the detriment of companies that don’t keep pace. Goliaths are forming in the consumer products, technology and telecommunications industries, to name just a few. Sure, we’ve seen some corporate bust-ups, but many of the companies created in those transactions already have been scooped up by larger entities.

Now health insurance appears poised for consolidation: No. 5 Humana is looking for a buyer. A Humana acquisition could lead to more health insurance tie-ups, Lekraj says. If so, HCSC’s base of 15 million customers could start looking smaller.

The extent to which consolidation shifts the competitive balance against HCSC would depend on how much strength expanding rivals gain in local markets. Despite its enormous size, health care remains a largely local and regional business. Few hospital networks and doctors groups operate nationally.

This makes health insurance a local game, too. HCSC has played it exceptionally well, competing effectively with rivals more than twice its size. HCSC plans control anywhere from 50 to 70 percent of their individual markets.

Humana wouldn’t give a buyer the heft to match HCSC in any of those markets. Still, cost pressures have unleashed a consolidation trend that may eventually jump local boundaries. Hospital networks already are expanding across broader geographic areas, which eventually could lead to the formation of national chains. In the process, they’re acquiring physicians groups.

Leemore Dafny, an economist at Northwestern University who studies health care markets, says product capabilities matter, too. Humana, for example, is strong in Medicare Advantage plans, a sector that’s growing as more baby boomers qualify for Medicare. Dafny says an acquisition “could possibly create a more robust competitor to HCSC in the Medicare Advantage space.”

Of course, HCSC could respond with deals of its own. With an accumulated surplus of more than $10 billion, it has plenty of coin. And CEO Patricia Hemingway Hall has shown an appetite for acquisitions—she picked up Blue Cross & Blue Shield of Montana in 2013. A spokesman says HCSC doesn’t comment on possible deals.

Another advantage for HCSC is its status as a private company owned by policyholders. Unlike publicly traded competitors, it’s not subject to pressure from Wall Street analysts and activist investors who often push companies into mergers.

So Hall has plenty of options and can take her time. But the long-term imperative is clear: Keep HCSC big.

Even U of C Medicine and Rush have health insurance problems

Friday, February 27th, 2015

Crain’s Chicago Business reports:

“Proving that no one is immune to the changes sweeping the health care industry, two of Chicago’s most prestigious teaching hospitals are being dinged by insurance companies trying to control costs.

Humana is ending a 20-year relationship with University of Chicago Medicine, which will be eliminated from the insurer’s networks April 1.


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