Why are the insurance companies being allowed to Jack up premiums to enrich themselves and their stockholders while being assured by both parties that the taxpayer will pick up the tab?
An investigation showed that insurance companies routinely accept applications for insurance from nonexistent, people. Why wouldn't they? They get the same subsidies for non existent people as they do for real people.
And even better, because the nonexistent people will never file a claim.
A new GAO undercover investigation reveals that the Affordable Care Act’s exchanges are profoundly vulnerable to fraud.
paragoninstitute.org
That needs to be cracked down on with a vengeance. Congress also needs to set a limit on how much they can increase premiums.
Base limits on the inflation rate, or on the prime lending rate, or just pick a number out of the air. Anything is better than giving them carte blanche, with their only limits being how outrageous can they be without having a taxpayers demand an end.
Lets cut to the chase and demand an end now, instead of these silly arguments over how much free money to give the insurance companies.
Obviously, you have no understanding of how the insurance market works. Health insurance companies, car insurance companies, property insurance companies, they all have to file rate increases with their respective state. In many cases, there is a loss ratio requirement. Those rate increases have to be approved.
These ACA subsidies, it is not free money for the insurance companies. That money is needed to pay claims. A big problem is people really don't understand the cost of health insurance. I mean they have a job, I would think many people here only insure themselves. And if you have company provided health insurance the company foots a huge part of the bill. Is that free money to the insurance companies?
Or maybe you are retired. On Medicare, enrolled in a Medicare Advantage plan with no plan premium. You pay your Medicare Part B premium and you think your Medicare Advantage plan is "free". Uh, no, the federal government is sending that provider hundreds of dollars per month, maybe even a thousand. Is that "free money" for the insurance companies?
Now, the OP article, that type of fraud, damn Skippy, that is free money for the insurance companies. Getting paid premiums for people that don't exist? Hell yeah, that is called a loss ratio of 0%. Whoo Hoo. But I doubt the insurance companies are doing that on purpose. Regardless, there should be increased due diligence on their part, or they face crippling fines and perhaps banishment from the program.
But honestly, the ACA marketplace, Medicare Advantage marketplace, they are shit shows. I mean just nasty. Literally, the wild, wild, West. I mean just a real world example of how those on Capital Hill are absolutely clueless as to how this real world operates. And it is not like they have not been given all the clues. Medicare Advantage, zero premium plan. Hell, some pay cash back, like with a grocery card or some bullshit. I guess that is next up with the ACA.
But let me give you the down and dirty. That Medicare Advantage plan, well it pays over a $600 commission to the signing agent. And worse, it can also pay out up to a thousand dollars to the FMO that sponsors that agent. It cost the person signing the contract nothing. I mean WTF you think was going to happen? Now, I heard the ACA was worse. I mean commissions on those policies might hit 5%. Those dudes got to turn and burn.
So how damn surprising is it that the fraud is rampant? I mean we have seen this in the Medicare Advantage market, billions have been paid out in fines and penalties. When this fraud is discovered, well it is claw back time. Reclaim the money and ask questions later. Is that not what they do when they pull you over for a drug bust?
There are some easy fixes. All those tax returns not complying, easy damn fix. Currently, the ACA is automatic re-enrollment. Do nothing, and you roll right back into the same plan. Hell no. And if your tax return doesn't comply, you done. Companies with a significant number of these "ghost" policyholders, they are done. Give them fair warning, like a quarter, and then it game on. They will be banned.
I mean this is how far we have fallen. Do you know what a book agent is? Back in the day, the book agent came by your house, every week. Probably had a set schedule, and he picked up his quarter, or maybe even a couple of bucks, for the life insurance premiums, on probably, everyone in the household. And what is so wild, you can actually see the results of their work, fifty years later. Financial discipline, ingrained in the next generation. Responsibility, forged within relationships.
Now, you buy your Medicare Advantage plan from some dude, in Cambodia, virtually chained to a desk. Nothing short of slave labor, barely surviving after fleeing China, and now hawking Medicare Advantage plans via the phone at the end of a whip. I mean it is not all that bad. They do have some domestic competition. Remote agents, paid hourly, maybe get some small spiffs.
But the next level. Well it is a damn money machine. The insurance business has never, ever, been about the upfront commission. It has always been about the trail, the renewal. And it still is. These FMO's burn through agents like no one's business, and they don't care. They get the marketing dollars, they bank the renewals, it is like a printing press. Time we took it back to the basics.
She was WAY ahead of her time.
