individual-medical-insurance-approaching-death-spiral

Individual medical insurance approaching ‘death spiral’

The most unpopular part of Obamacare, the individual mandate, is gone.

Conditions are right for a “death spiral” for healthcare insurance.

Bill Hammond, the Empire Center’s director of healthcare policy, explains the spiral is the result of insurance pools seeing, “healthy people leave, the rates go up, the premiums go up, more healthy people leave and it becomes a vicious cycle.”

This is the situation Hammond sees in New York State’s individual market for healthcare coverage. The vast majority of people get insurance through the government (Medicare, Medicaid and the Veterans Administration) or their employers. But some 300,000 state residents get individual or small group plans through more than a dozen different insurers.

These companies have petitioned the state Department of Financial Services for a 2019 rate increase. A weighed analysis (based on number of customers) done by the Empire Center put the average rate hike request is at 24-percent.

Much of that has to do with the death of the federal individual mandate. When President Trump signed the tax cut bill in December, it officially ended the Obamacare mandate that all adults under the age of 26 buy healthcare insurance.

The no-so-secret elixir of medical insurance is having lots of young people paying premiums because they tend not to use much healthcare, offsetting older Americans who often use much more medical services.

Fidelis Care, run by the state Roman Catholic dioceses, covers 100,000 customers on the individual market, by far the largest insurer in the category.

With the individual mandate in place, Fidelis was going to ask for a 12.7% rate increase from state regulators. Now that the mandate is no more, Fidelis is seeking triple that number, a 38.6% hike.

Asked about possible fixes to this death spiral scenario, Hammond mentioned a move both Massachusetts and New Jersey made, adding a state individual mandate. But Hammond immediately pointed out the political difficulty of doing that in New York because the mandate was the most unpopular part of Obamacare.

You may also like

Editorial: Cuomo’s problematic Medicaid maneuvers

“It’s everything that’s wrong with Albany in one ugly deal,” Bill Hammond, a health policy expert at the fiscally conservative Empire Center, told The Times. Read More

More New Yorkers covered by health insurance: report

An analysis by Bill Hammond of The Empire Center for Public Policy said the continued drop bolsters the case against the Albany Legislature passing a new law imposing a state government-run health insurance, which Democratic candidates for president are pushing for on a national level. Read More

What Cuomo’s executive order on vaping will and won’t do

“If you have these really young kids and teens getting hooked, then that’s not good," said Bill Hammond, director of health policy at the Empire Center for Public Policy. "But the first step would be to do some research, have a public hearing, get the best expert evidence that you have. Instead of reacting to headlines, find out what’s really going on and proceed with proposed regulations.” Read More

Medicaid bungle cost state $102 million over 4 years

“A little series of mistakes in a program this big can add up to a lot of money in a hurry,” Hammond told The Post. “A quarter of a million dollars is a lot of money. It’s important that the auditors are looking at this and are pointing to things that could be fixed.” Read More

New York City Hopes to Ease Strain on Its Emergency Rooms

Another hurdle is whether the new program can live up to the idea of universal health care, said Bill Hammond, a health-care analyst at the Empire Center, a conservative-leaning New York think tank. New Yorkers already had universal access, he said; the problem is how it is used. Health officials are rightly “trying to fix the delivery system,” said Mr. Hammond; meanwhile, the mayor, “made it sound like they’re fixing the coverage system.” Read More

Watchdog Group Questions New York’s Delayed Medicaid Payment

The Empire Center’s Bill Hammond says Governor Andrew Cuomo’s budget office quietly postponed a $1.7 billion dollar Medicaid payment in late March by three business days and made the payment instead in early April. That’s significant because the state’s fiscal year ended March 31 and a new one began April 1. If the payment were made in March, the state would have been over a statutory cap that limits growth of Medicaid spending to 3% last year. Read More

Universal Health Care For New Yorkers? Not Exactly

De Blasio’s claim was “very misleading,” said Bill Hammond, the health policy director at the Empire Center for Public Policy, a nonpartisan, New York-focused think tank. Voters might think he is referring to universal insurance or even a single-payer system, he said, neither of which is true. Read More

Why New York’s hospitals do terrible in federal rankings

In 2016, the Empire Center for Public Policy, a right-leaning think tank, found that New York had the lowest average score of any state, a paltry 2.26. Only the District of Columbia and certain U.S. territories were lower. Read More