Tag Archives: Insurance

SCOTUScare: Texas Rep Introduces Bill To Force Supreme Court To Enroll In Obamacare

Following the Supreme Court decision on Thursday to uphold Obamacare subsidies, Rep. Brian Babin (R-Texas) introduced the “SCOTUScare Act of 2015,” a bill that would force each of the Supreme Court justices and their aides to sign up for Obamacare.

In the case of King v. Burwell, the Supreme Court ruled, 6-3, that federal subsidies can be paid to customers throughout the United States, not just in the states that have established their own insurance exchanges under the Affordable Care Act (ACA).

Babin said that he created the “SCOTUScare Act” as a way to make the Supreme Court justices and their employees “see firsthand what the American people are forced to live with,” by removing their exemptions and making them join the national healthcare law’s exchanges.

[pull_quote_center]As the Supreme Court continues to ignore the letter of the law, it’s important that these six individuals understand the full impact of their decisions on the American people. That’s why I introduced the SCOTUScare Act to require the Supreme Court and all of its employees to sign up for Obamacare. By eliminating their exemption from Obamacare, they will see firsthand what the American people are forced to live with![/pull_quote_center]

The term “SCOTUScare” was used by Justice Antonin Scalia on Thursday, in reference to the Supreme Court’s decision on Obamacare.

In his dissent, Scalia said that while the Act that Congress passed makes tax credits available on an “Exchange established by the State,” this Court “concludes that this limitation would prevent the rest of the Act from working as well as hoped.”

“So it rewrites the law to make tax credits available everywhere,” Scalia wrote. “We should start calling this law SCOTUScare.”

Are Obamacare’s 22 Health Insurance Co-ops Near Financial Collapse?

By Richard Pollock

Ominous signs are proliferating among 22 Obamacare health insurance co-ops of imminent financial collapses that could leave more than a million Americans without coverage, according to a Daily Caller News Foundation Investigative Group analysis.

All but one of the federally funded co-ops are experiencing accelerating net losses. President Obama’s signature health care reform program established the co-ops to provide non-profit competition to private sector health insurance providers.

Many of the 22 co-ops could soon follow an Obamacare co-op that defaulted earlier this year, suffering $163 million in operating losses in a single year. That collapse left 120,000 customers without coverage on Christmas Eve.

“We’re certainly going to have fewer co-op’s by the end of the year,” Thomas Miller, a resident health care fellow at the American Enterprise Institute think tank, told DCNF.

New figures compiled by Miller and Marie-Grace Turner, president of the Galen Institute, show that net losses for the co-ops reached a record $614 million in 2014. Both AEI and Galen are Obamacare critics.

The figure is nearly three times the $234 million in losses suffered through the first three quarters of 2014 as reported by Standards & Poor’s in a February 2015  report. It means that the burn rate for the experimental Obamacare co-ops is quickening.

“All but one of the co-ops,” S&P noted, “reported negative net income through the first three quarters of 2014.”

Insurance ratings firm A.M. Best also warned in January that as of September 30, 2014, “the ratio of surplus notes outstanding to capital and surplus exceeded 100% for all of the co-ops.”

Arizona’s Meritus Mutual Health Partners co-op has long-term loans that are nearly 1,000 percent of the value of its capital and surplus, according to A.M. Best.

S&P identified the co-ops suffering the worst capital ratios as those in Illinois, Arizona, Colorado, Nevada and Maryland.

The Community Health Alliance co-op in Tennessee reported that it’s net losses were 314% of its federal funding, according to the S&P report.

Community Health said in January that it would no longer offer insurance on the state exchange, according to the Tennessean daily newspaper. The co-op enrolled 140 customers and received $73 million from Obamacare, a cost of more $521,ooo per enrollee.

Another indication of serious co-op financial weakness is the fact that CMS gave out $317 million in additional “solvency loans” to one out of every three co-ops last year.

The injection of the federal funds was to prevent co-op capital reserves from falling below the minimum capital rates set by each state insurance commissioner.

The emerging picture of massive losses across all of the federal co-ops was forecast by an original White House Office and Management and Budget estimate that warned up to four of every 10 co-ops could default.

The human wreckage left behind a failing co-op was seen earlier this year when regulators in Iowa and Nebraska liquidated the assets of a failing federal health care co-op known as Co-Opportunity Health.  Insurance regulators officially declared the co-op was in “hazardous condition” last December.

Co-op supporters hailed Co-Opportunity health because it had initially enrolled 50,000 customers, the second highest in the nation.

“We are very pleased with the market response to our products,” said David Lyons, Co-Opportunity’s chief executive officer and a politically-connected former Iowa insurance commissioner.

What Lyons failed to say was that Co-Opportunity slashed prices and offered very low, below-market premiums to attract new customers.

The low premiums came at a cost. Co-Opportunity’s ratio of costs to premiums was 140 percent. That meant that for every dollar it collected in premiums, it had to pay out $1.40 in medical claims.

The ratio is not much better among the other remaining co-ops.  According to Scott E. Harrington of the University of Pennsylvania’s Leonard David Institute of Health Economics, “The ratios for the first three quarters of 2014 produced “a total ratio of costs-to-premiums of 116 percent.

“Most co-ops’ weak operating performance is a result of high medical claims,” concluded S&P, adding, that the medical costs were “hopelessly high” for many of the co-ops.

Brian Gillette, the chief operating officer of the Urbandale, Iowa-based Group Benefits Limited, said that the unexpected closure of Co-Opportunity Health was “massively disruptive” to 800 of his employer groups and for thousands of individual policyholders.

“We were notified on Christmas eve that the insurance division was taking over Co-Opportunity Health,” Gillette told the DCNF in an interview. “I’ve never seen anything like this,” he said. “This was without precedent in my career.”

Hints of the financial Co-Opportunity debacle came last September when the co-op abruptly announced it was dumping more than 10,000 of its poorest and sickest customers and transferring them to the state’s Medicaid program.

That harsh action appeared contrary to the originally stated mission of the consumer-oriented co-op as presented by Obama administration officials.

At its formation, federal officials at the Centers for Medicare and Medicaid Services promised the co-ops would offer “affordable, consumer-friendly and high quality health insurance options.”

Sally Pipes, another Obamacare critic who is president of the Pacific Research Institute think tank, called the dumping of enrollees “totally, absolutely immoral.”

“If I were dumped on Medicaid, I’d be furious,” she said.

Ultimately, the Iowa Insurance Division reported in court that Co-Opportunity suffered $163 million in operating losses in its lone year of operation.  More than 120,000 customers lost their coverage.

Some co-ops are taking steps to stem their large losses with huge new rate increases.

Health Republic in Oregon, for example, boosted its 2015 rates by a whopping 37.8% according to state data.

On April 8, its president and CEO unexpectedly resigned, saying he wanted to return to his home state of Louisiana.

But Co-Opportunity Health didn’t suffer the worst losses, according to S&P.

Obamacare co-ops in Utah, Colorado, Michigan, Tennessee, Maryland, Oregon, Connecticut, Illinois, Arizona, Massachusetts and Nevada “had net loss-to-surplus ratios that were worse than Co-Opportunity’s,” S&P said. “That means their net losses represented a larger portion of their remaining funds compared with Co-Opportunity, as of Sept. 30.”

Co-Opportunity Health received an initial $145 million in low-cost loans from the CMS in 2012. Then last September it received an emergency $32 million in new “solvency loans.”.

CMS officials turned down a third Co-Opportunity request for an injection of another $55 million in a solvency loan, according to Nick Gerhart, Iowa’s insurance commissioner in an interview with the DCNF.

Explaining the rejection, CMS spokesman Aaron Albright told the DCNF that “CMS did not have sufficient funds” to cover the $55 million.

Albright’s comments underscore the financial dilemma facing all the co-ops.

Unlike traditional insurance companies, Obamacare from the start restricted the co-ops from regular access to conventional credit markets. They cannot obtain short-term bridge loans, offer stock, seek equity or other forms of private capital. All the co-ops are funded with federal tax dollars.

Miller warned that the co-ops are in such precarious shape they many could fail very quickly. “One lesson is that this happens very quickly,” he said. “These things could suddenly explode and leave a lot of injured parties to clean up.”

The speed with which Co-Opportunity failed was recounted by Gillette, whose firm was the largest general insurance agency for the co-op.

“Only a couple of weeks prior to the announcement, maybe two weeks prior to the announcement, we met with their senior leadership to discuss financial performance because we were aware what were disturbing trends,” Gillette said. “We were given every assurance that they had a sustainable model, not just for 2015 but well into the future.”

“They don’t have any other cushion except for taxpayers to bail them out or lend them more money.  When that’s gone, so is the co-op,” explained Miller.

Gerhart agreed, telling the DCNF that once Washington turned off the spigot, the co-op was gone.

“A lot of traditional insurance companies have a lot of different tools at their disposal to raise capital.  And insurance, as you know, is a very capital-intensive business,” the commissioner explained.

“If you’re a more traditional company, if you run into problems, you try to offer debt, you try to offer stock to folks,” he said. “You go to financing that’s more flexible, maybe. There’s a lot of different financing tools available that’s just not available to a co-op.”

“It wasn’t realistic given the structure of the non-profit,” he observed. “So they weren’t able to raise the capital necessary,” he recalled.

“Our message to Iowans and Nebraskans was they should be get out. ‘Get out now,’” he said.

Follow Richard on Twitter





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Did President Obama finally sign up for Obamacare?


Just before Christmas Eve President Obama enrolled on the healthcare exchange. Obama was signed up for the bronze plan. The internet buzzed from those on the left desperately seeking to prove that Obama is “one of us”. Malia, Sasha and Michelle did not sign up.

Healthcare.gov would not function for Obama either. A White House official had to travel to the D.C. office to sign him up while Obama and family were in Hawaii on vacation. Also, Obama’s private information is not available on the government database (unlike yours).

The President’s actions were nothing more than a poorly planned charade.  In fact, the act proves just how wasteful Washington D.C. really is. Obama, Commander in Chief, will still have his healthcare provided by the finest military doctors in the world. Yet, he signed up for the bronze plan and your tax dollars will be paying for it. The plan costs $400 a month, or $4,800 a year.

Gracepointe Healthcare PLLC, a private healthcare group based in Nashville, Tennessee, which does not accept insurance, provides clients with unlimited doctor visits, labs and diagnostic tests, free telephone consultations, free prescription refills, and discounted house-calls for only $588/year. Adding a catastrophic healthcare insurance plan, which will cover catastrophic events, through a private company will set most people back less than $100/month. For only $1,788/year an individual could be provided far better healthcare than the bronze plan provides. Obama could have given 2.5 individuals healthcare under this structure. Instead, taxpayers will throw away $4,800/year so that Obama can play charades with the American public.

Follow Michael Lotfi on Facebook and on Twitter: @MichaelLotfi

Obama’s Trick Or Treat: “I Just Lost My Doctor”

“We will keep this promise to the American people. If you like your doctor, you will be able to keep your doctor. Period,” President Obama (2009). It was repeated again, again and again all over the country. It was, in fact, the propagandized phrase that sold the health care bill. That, and “This is not a tax!” …Oh, but it is.

Moments before the clock struck midnight to usher in Halloween one woman saw first hand– It was all a trick. Whitney Smith, a Tennessee citizen, arrived home from work to see a letter from her insurance company. After ignoring the letter for a while to settle in at home, as many of us do, she finally opened it.


What she saw didn’t shock her. “I’m shocked… not,” says Smith. Her doctor is no longer a provider with her Aetna insurance group. Smith tells us that her doctor is leaving the insurance group to opt for cash only practice because of Obamacare. The plan that the doctor provided didn’t meet the requirements of Obamacare.

Smith says she was more than happy with their family doctor. “He was extremely affordable, I could see him fast and easily get a referral.” says Smith. The insurance plan was provided under Smith’s husband, a firefighter for a local city

Reports surface every day of doctors no longer accepting health insurance and moving to cash only practices. (Video Below)

Other doctors are simply being dropped from insurance providers, which is causing thousands of people to be left out in the cold without their doctors. Smith’s situation seems to be a combination of both. (Video Below)


The go to retort for Obamacare proponents is that the health care law says nothing about insurance prices going up, people losing their doctors, or their health care plans being dropped. Of course the law doesn’t say that. What these proponents fail to account for are the tens of thousands of pages of regulations, which generate countless negative economic externalities in the health care industry.

-Happy Halloween

Follow Michael Lotfi on Twitter: @MichaelLotfi

FEDS will force taxpayers to spend $2 billion every year to promote Obamacare

Obamacare, also known as the Affordable Care Act, has never been embraced, or even accepted, by the American people.  Indeed Obama spent the majority of his first two years in office – years in which he was backed by a Democrat majority in the House and Senate – pushing the program, with the methods fueling the first scandal of Obama’s presidential career, the flag@whitehouse.gov scandal.

After it passed, the program grew less and less popular.  Dozens of lawsuits – at least one of which will probably get to the Supreme Court – sought to modify the law on religious grounds.  Multiple companies have cited its provisions as the reason for cutting jobs and hours, and the implementation of the employer mandate has even been delayed because of the strain it would place on small businesses.  Insurance premiums have already risen for individuals, and studies have shown that young people would be financially better off paying the fines for having no coverage than purchasing coverage.


Even Union leaders have spoken against the law, saying it would “destroy the foundation of the 40 hour work week that is the backbone of the American middle class.”  Meanwhile, its backers, like Harry Reid, have said that it would necessarily lead to the creation of a Canada, UK or France-style single payer system, an idea the American people opposes even more strongly.

The government’s response to this opposition and skepticism, however, has not been to reconsider, modify or eliminate the program.  Instead, the writers of Obamacare included Section 4002.  Section 4002, according to Kent Masterson Brown, creates a fund used for promoting Obamacare.  Between 2010 and 2015, the money appropriated increases from $500 million to $2 billion per year.

The “Prevention and Public Health Fund” will “Provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs.”  It almost admits in this wording that its purpose is to promote the program, though it doesn’t reveal the extent to which this is the case.

According to Brown, this funding has gone to symposiums for journalists, and it’s also gone to media companies like the Washington Post, NBC, Reuters and CBS.  In addition, it’s gone to putting promotions of Obamacare on Modern Family, Grey’s Anatomy and other primetime TV shows.  It’s also helped to fund non-profit organizations committed to promoting Obamacare.

More traditional uses of promotional funds have also been paid for.  $8 million, for instance, has gone to a public relations contract to help increase public support of the program, or in other words, “to convince skeptical – or simply confused – Americans that the ACA is good for them and convince them to enroll in a plan.”

Using taxpayer money to convince citizens to support a partisan agenda is unconscionable and a very dangerous policy.  Creating a government program with such funds built into its very structure is insane.  Government is meant to represent the people, not lead them at an expense of $2 billion per year.

Obamacare: Insurance Rates to Spike A High Fever

Like many conservatives and liberty-minded Americans have long assumed, President Barack Obama’s Affordable Care Act (ACA), widely known as Obamacare, is truly not affordable. According to a report by the House of Representative’s Energy and Commerce Committee, insurance rates will grow an average of 100 percent to as much as 400 percent.

The report requested rate information from 17 insurance companies including heavyweights like Blue Cross Blue Shield and the Kaiser Foundation.

A North Carolina family saw their BCBS insurance deductible increase to $1500 per person for each (7) family members last month. The father told Benswann.com, “we simply cannot afford this. We are now forced to sell our home because we cannot afford this increase.”

Blue Cross Blue Shield of North Carolina released its own report, alerting customers of rate changes. After new federal subsidies and grandfathered plans are factored in, the company expects about two-thirds of its individual market customers to see rate increases similar to those of recent years or decreases in 2014. The remaining one-third of individual market customers will see larger increases because of the Affordable Care Act. These rate changes come because several of the Affordable Care Act’s new requirements will be implemented Jan. 1, 2014.

“Beginning next year, individuals who buy their own health insurance will feel a wide variety of impacts as new components of the ACA take full effect,” said Patrick Getzen, BCBSNC vice president and chief actuary. “The ACA expands access to coverage and increases benefits. This is a good goal, but it comes with a cost. Subsidies will offset the higher cost of premiums for some of our customers, but more sick people in the insurance pool, more benefits, and new taxes and fees will drive rates up.”

Unlike the President’s promises, the Affordable Care Act won’t deliver. The Energy and Commerce Committee report ends, “Despite promises that the law will lower costs, (Obamacare) will in fact cause the premiums of many Americans to spike substantially. The broken promises are numerous, and the empirical data reveal that many Americans, from recent college graduates to older adults, will not be able to afford the law’s higher costs.”

These shortcomings are one of the many reasons that conservatives have tried to defund this fraud of a program. According to the Daily Caller, a petition in circulation has reached over 1 million signatures, urging the defunding of Obamacare. The petition movement is being spearheaded by Utah Republican Senator Mike Lee and Texas Republican Senator Ted Cruz.

“The American people are standing up, speaking out and demonstrating their absolute disdain for the unaffordable and unfair train wreck that is Obamacare,” said Lee in a statement.

Democratic Leader Harry Reid needs 60 votes to fund Obamacare, but there are only 54 Democrats in the Senate. If Republicans hold strong, they can stop it.

 dont fund it

The petition launched July 27. It took only 37 days to accrue 1 million supporters.

To learn more about the petition or to sign it, visit http://www.dontfundobamacare.com/.

In addition to the petition, 2014 Senate candidates are also being asked to sign a promise to help defund Obamacare. In South Carolina, candidates Lee Bright, Nancy Mace and Richard Cash have signed the pledge. Incumbent Lindsey Graham has not signed the pledge.

The promise includes the following text: “I, ___________, pledge to the taxpayers of the state of ___________, and to the American people, that I will: ONE, support the full repeal of Obamacare (also known as the Patient Protection and Affordable Care Act); and TWO, oppose any bill or budget resolution that provides funding to implement or enforce any part of it.”