Breaking: Silver State HIX Plot Thix

LifeHealthPro's Allison Bell tips us to this interesting news, thus far flying under the radar:

"The #Nevada exchange, @NVHealthLink, has canceled a meeting that was scheduled to take place tomorrow"

Last time we checked in, Nevada's Exchange was having trouble paying commissions on policies written through it by agents.

Was that a portent of things to come?

Retreat!

Obamacare (full Monty version) is not even 2 years old and already the riptide

effect is being felt as carriers such as Assurant are leaving the market.

There has been speculation as to which carrier will be the next to leave the dance and party talk has focused on Cigna, Aetna, Coventry (now owned by Aetna) and to a lesser extent, Humana.

Apparently this is more than just backroom talk.

Leerink’s Ana Gupte wouldn’t be surprised if Aetna (AET) merged with either Humana (HUM) or Cigna (CI):

Consolidation remains likely, with CEO Mark Bertolini asserting that government business is the focus for inorganic growth, while compatible cultures for post-merger synergies were viewed as the driver in all transactions, with cheap debt making either Aetna-Humana and Aetna-Cigna meaningfully accretive possibilities and imminent. - Barrons

The next few months could be interesting. How many carriers will actually go to the 2016 prom?

This is looking like a bad remake of Carrie.

Stay tuned.

Your Genes vs Your Job

Every once in a while, the question of genetic testing in the workplace - and especially as relates to employer-based health insurance - rears its (ugly?) head.

We've covered this several times over the years; in fact, our very first year we reported that "40 percent of people already undergoing genetic testing are worried that participation might affect their future insurance coverage.”

At the time, this seemed kind of a stretch, inasmuch as health insurance companies were forbidden to use these results in their underwriting process (and since group insurance has been guaranteed issue for almost 20 years, it was moot to begin with).

On the other hand, you really can't be too careful, and so we got the Genetic Information Nondiscrimination Act of 2008 (GINA), "which prohibits genetic information discrimination in employment" (the law went into effect the following year). In fact, the law goes even further, in that it also forbids the use of this information as regards benefits (including insurance).

And yet:

"Big companies are considering blending genetic testing with coaching on nutrition and exercise to help workers lose weight and improve their health before serious conditions like diabetes or heart disease develop."

At first glance, this specific use seems to skirt the letter of the law, so it's probably "kosher."  As long as the results aren't used to, for example, determine premium contribution or subsidy levels (ie how much of the premium the employer pays*), this seems to be a legitimate use of the data.

Now, the efficacy of using the information in the manner being proposed may indeed be questionable:

"[E]mployee benefits experts have doubts that such a novel approach will gain momentum. It first has to conquer steep challenges like ... employer skepticism about its effectiveness."

That is, whether or not there's actual value there, and whether it's worth the cost of implementation (these tests aren't necessarily cheap, and one presumes that the employer will be footing the bill).

A potentially more serious concern arises as to who will have access to this information, and how secure it will be. But that's another post.

[*For illustrative purposes only; regular IB readers know that employers actually pay 0% of the premium]

ObamaCare Aloha

Here's co-blogger Bob almost exactly a year ago:

"Hawaii Medical Services Association posted losses of $30.1 million in the first quarter and said it recorded $46.1 million in fees related to Obamacare."

Fortunately, the success of O'Care has helped immensely...

Wait. What?

"The Hawaii Health Connector has prepared a contingency plan to shut down operations by Sept. 30 after lawmakers failed to pass legislation to keep the state's troubled Obamacare insurance exchange afloat."

Looks like ObamaCare #Fail from sea to shining sea.

Under the plan, Aloha State residents will be cut off from enrolling in new plans at the end of this week, and be completely shuttered by the end of next February (costing another 73 hard-working Americans their jobs). It appears that Island citizens will be transitioned to the 404Care.gov site for Open Enrollment Season v3.0 beginning this fall.

Chalk up another one to the Unaffordable "Care" Act.

MassCare unraveling

We've been covering the Massachusetts health insurance Connector since it was merely a gleam in Johnathan Gruber's eyes. So it comes as less than a surprise to us that it continues to implode under the new ObamaTax regime. Thanks to the intrepid Josh Archambault (senior fellow at the Foundation for Government Accountability), we learn that the noose is tightening. Turns out, Bay State Brahmins:

■ Failed to execute a contract with CGI, the vendor hired to build the site, that would track the progress of the project and ensure on-time delivery of a product that included all required features

■ Failed to implement a governance structure that would ensure ongoing quality of the project

[And worst of all:]

■ Attempted to conceal these shortcomings by misrepresenting the progress of the health insurance exchange to a number of stakeholders including the Centers for Medicare and Medicaid Services [among others]

Major no-no there. In fact, their behavior was so egregious that the Feds "have subpoenaed records related to the commonwealth’s ‘connector’ dating to 2010.”

In other words, this is now a criminal matter, with actual fines and (hopefully) jail time potentially on the table.

One wonders which of the other 57 states will be next...

Bob G on O'Care

Our good friend Bob Graboyes (senior research fellow for the Mercatus Center at George Mason University) has some key insights into the failed ObamaTax roll-out. Among them:

"Other than “more people with insurance,” the law’s goals were never clearly stated, so there are few objective metrics on which to judge it. More are insured, but there’s no increase in supply of health care to meet any new demand."

As our own Bob Vineyard pointed out some years ago, this is an utterly predictable result of inelasticity:

"The economics of goods and services can be reduced to simple demand and supply. Health care is no different. It follows economic theory just like every other consumer good.At either extreme you have inelastic price curves and elastic curves. Most consumer items track a bell curve but some things are totally elastic or totally inelastic."

That is, more people may have insurance (although this remains unproven), but the supply of actual health care remains steady (or is, in fact, falling). So how valuable is your ObamaPlan if you can't find a provider who accepts it?

Then there's the little problem of administering your plan if you're fortunate enough to be able to afford and are successful in actually buying one:

"[T]he back end is still dysfunctional. It’s very difficult for a consumer to conduct a transaction as you would with, say, Amazon.com, that results in verifiable coverage. Pen, paper, and processing time are still required"

And how does one track changes made this way?

There's lots more, all of it good, all of it important.

Read the whole thing.

Health Wonk Review - Grumpy Cat edition

Steve Anderson hosts this week's compendium of health care policy and polity, channeling negative vibes into positive outcomes.

Kudos!