Implementation of the Affordable Care Act––More Evidence That Rate Shock is Coming

The Society of Actuaries is out with another estimate of health insurance rate increases as a result of implementation of the Affordable Care Act ("Obamacare").

While there is a great deal of difference between states, they are estimating an average increase of 31.5% on account of the new underwriting reform and benefit expansion requirements of the health law:

These rate increase projections by the Society do not include the big jumps that are coming for younger people driven by the laws requirement that age bands be narrowed so that older people pay no more than three times the premiums of the youngest. The combination of these baseline increases will about double the cost of health insurance for those in their 20s and early 30s––and perhaps decrease costs for those in their late 50s and 60s––in the majority of states that haven't already narrowed these age-related costs.

On this blog back in December, I predicted the same thing given the industry conversations I was having with those inside the companies tasked with calculating the new rates:

On average, expect a 30% to 40% increase in the baseline cost of individual health insurance to account for the new premium taxes, reinsurance costs, benefit mandate increases, and underwriting reforms. Those increases can come in the form of outright price increases or bigger deductibles and co-pays. 

At that time, I also pointed out that such increases would be way more than was first estimated when the law passed the Congress:

In a November 2009 report, the CBO estimated that premiums in the individual market would increase 10% to 13% on account of the health insurance requirements in the ACA. In the under 50-employee small group market, the CBO estimated that premiums would increase by 1% to a decrease of just 2% compared to what they would have been without the ACA. All of these differences in premium would be before income based federal subsidies are applied to anyone's premiums.

Defenders of the Affordable Care Act, including the administration, have been quick to point out that these increases won't be felt by those receiving premium subsidies––likely 60% of consumers.

That is right.

But, most of the cost of the Affordable Care Act is the cost of the coming health insurance subsidies––the Medicaid expansion is the other big part. So the federal government, that will pay the excess premium on account of those getting subsidies, will feel the impact of these big rate increases. Santa Claus is not going to be paying these higher subsidized premiums––federal taxpayers will be. Given that the CBO initially said the increase would only be about a third of what is coming, I have to question the original cost estimate for the new law.

That said, the 40% of consumers who will not be eligible for subsides are going to see some very high prices. Existing individual and small group customers, particularly those not in "grandfathered" plans are going to be shocked by what will happen to their premiums come January 1 in the vast majority of states.

The law also allows insurers to surcharge smokers' premiums by another 50%.

It is interesting to watch the most strident of the new law's supporters trying to spin the growing and overwhelming evidence of what is coming. The spin ends on October 1 when the promised new health insurance exchanges are scheduled to launch with the new health insurance offerings and their prices.

Readers of this blog likely saw my other post this week calling attention to a survey of health insurance industry insiders working with the new exchanges exhibiting little confidence the exchanges will launch smoothly.

"Obamacare" supporters in denial had better get ready for reality.

This is all shaping up to be a tough launch.

I told them not to call if the Affordable Care Act.

Recent post:
Six Months to Go –– Will the Health Insurance Exchanges Be Ready on Time? Survey: Health Plan Execs Don't Think So

View the original article here

Implementation of the Affordable Care Act––More Evidence That Rate Shock is Coming

The Society of Actuaries is out with another estimate of health insurance rate increases as a result of implementation of the Affordable Care Act ("Obamacare").

While there is a great deal of difference between states, they are estimating an average increase of 31.5% on account of the new underwriting reform and benefit expansion requirements of the health law:

These rate increase projections by the Society do not include the big jumps that are coming for younger people driven by the laws requirement that age bands be narrowed so that older people pay no more than three times the premiums of the youngest. The combination of these baseline increases will about double the cost of health insurance for those in their 20s and early 30s––and perhaps decrease costs for those in their late 50s and 60s––in the majority of states that haven't already narrowed these age-related costs.

On this blog back in December, I predicted the same thing given the industry conversations I was having with those inside the companies tasked with calculating the new rates:

On average, expect a 30% to 40% increase in the baseline cost of individual health insurance to account for the new premium taxes, reinsurance costs, benefit mandate increases, and underwriting reforms. Those increases can come in the form of outright price increases or bigger deductibles and co-pays. 

At that time, I also pointed out that such increases would be way more than was first estimated when the law passed the Congress:

In a November 2009 report, the CBO estimated that premiums in the individual market would increase 10% to 13% on account of the health insurance requirements in the ACA. In the under 50-employee small group market, the CBO estimated that premiums would increase by 1% to a decrease of just 2% compared to what they would have been without the ACA. All of these differences in premium would be before income based federal subsidies are applied to anyone's premiums.

Defenders of the Affordable Care Act, including the administration, have been quick to point out that these increases won't be felt by those receiving premium subsidies––likely 60% of consumers.

That is right.

But, most of the cost of the Affordable Care Act is the cost of the coming health insurance subsidies––the Medicaid expansion is the other big part. So the federal government, that will pay the excess premium on account of those getting subsidies, will feel the impact of these big rate increases. Santa Claus is not going to be paying these higher subsidized premiums––federal taxpayers will be. Given that the CBO initially said the increase would only be about a third of what is coming, I have to question the original cost estimate for the new law.

That said, the 40% of consumers who will not be eligible for subsides are going to see some very high prices. Existing individual and small group customers, particularly those not in "grandfathered" plans are going to be shocked by what will happen to their premiums come January 1 in the vast majority of states.

The law also allows insurers to surcharge smokers' premiums by another 50%.

It is interesting to watch the most strident of the new law's supporters trying to spin the growing and overwhelming evidence of what is coming. The spin ends on October 1 when the promised new health insurance exchanges are scheduled to launch with the new health insurance offerings and their prices.

Readers of this blog likely saw my other post this week calling attention to a survey of health insurance industry insiders working with the new exchanges exhibiting little confidence the exchanges will launch smoothly.

"Obamacare" supporters in denial had better get ready for reality.

This is all shaping up to be a tough launch.

I told them not to call if the Affordable Care Act.

Recent post:
Six Months to Go –– Will the Health Insurance Exchanges Be Ready on Time? Survey: Health Plan Execs Don't Think So

View the original article here

NOAA: ‘Robust, Unambiguous’ Independent Evidence Confirms The Recent Global Warming Measured By Thermometers

Yes, The Modern Instruments Are Right. Just Ask The Coral. Or The Caves. Or The Ice Cores. Or The….

Climate deniers claim you can’t trust thermometers because they change0 locations or are too close to warmer urban environments. They have tried and failed to disprove millions of temperature observations all over the world. But the myth still persists.

Here’s some good news for science: NOAA’s National Climatic Data Center, the University of South Carolina, the University of Colorado, and the University of Bern in Switzerland have found that the warming trend can be revealed using not a single thermometer:

A new compilation of temperature records etched into ice cores, old corals, and lake sediment layers reveals a pattern of global warming from 1880 to 1995 comparable to the global warming trend recorded by thermometers. This finding, reported by a team of researchers from NOAA’s National Climatic Data Center, the University of South Carolina, the University of Colorado, and the University of Bern in Switzerland, resolves some of the uncertainty associated with thermometer records, which can be affected by land use changes, shifts in station locations, variations in instrumentation, and more.

“Using only temperature-sensitive paleoclimate proxy records, un-calibrated to instrument data, it is possible to conclude that the warming trend in the global surface temperature record is supported by independent evidence,” said David Anderson, head of the Paleoclimatology Branch at NOAA’s National Climatic Data Center and lead author of the paper. The new research is detailed in “Global Warming in an Independent Record of the Past 130 Years,” published online this week in Geophysical Research Letters.

The thermometer-based global surface temperature record provides meaningful evidence of global warming over the past century, and it is critical to have independent analyses, like this one, to verify that record. For this analysis, the team used environmentally sensitive proxies to compile a temperature record that is independent of thermometer-based records. Proxies such as coral growth layers, shells of tiny marine plankton, lake sediments, ice cores, and caves are biologically, physically, or chemically connected to environmental conditions. For example, coral skeletons and plankton shells record temperature changes in the ratio of oxygen isotopes.

This paleoclimate dataset used 173 independent proxy datasets to draw a record from 1730 to 1995. To ensure the paleoclimate dataset was independent of the instrumental record, the scientists used raw data rather than reconstructed temperatures. Paleoclimate records and trends are affected by multiple environmental influences, not just warming, and the scientists minimized non-temperature influences by averaging together many records.

“The correlation of this paleoclimate dataset with the global surface temperature record has important implications in climate science and provides evidence of the significance of paleoclimate research,” said Thomas Karl, Director NOAA’s National Climatic Data Center. “Temperature reconstructions, like this one, continue to play a significant role in understanding the global climate by quantitatively extending the record back in time in an independent, objective way.”

In addition to their shared long-term trend, many smaller-scale features also appear in both the paleoclimate and instrument temperature records. For example, the warm interval of the 1940s in the global surface temperature record also appears in the paleoclimate record. Both records also show that the global warming in the last 15 years of the record (1980–1995) is significantly faster than that of the long-term trend (1880–1995).

View the original article here

Law Enforcers Block Access To Exonerating DNA Evidence

In yet another case, DNA evidence has suggested the innocence of a man who has spent 11 years and counting in maximum security prison for a serious crime. Joseph Buffey, like some 10 percent of the hundreds of individuals exonerated by DNA testing, pleaded guilty in a rape and robbery case that DNA evidence links to another individual. Buffey was persuaded to take a plea by his lawyer, who said he wrongly assumed Buffey had committed the crime, and thought a defendant as young as 19 would get no more than a 10-year sentence. Buffey was sentenced to 70 years in prison.

But what’s most confounding about Buffey’s case is that it took 18 months of litigation by the nation’s top wrongful conviction lawyers to even secure the DNA testing. From the New York Times:

The Innocence Project lawyers got involved in this case after Mr. Buffey sent them a letter a few years ago. When they ran the test on the victim’s rape kit in the spring of 2011 and it showed that it was not Mr. Buffey’s DNA present at the crime scene, they asked to run the results through the West Virginia database of felons to see if another match existed. The judge approved, but the prosecutor refused, saying that the laboratory that had done the testing was not certified by the state. The judge then said he did not have the authority to order the state to violate its own rules.

The Innocence Project offered to run the test again through a certified lab. But the prosecutor turned down the request, saying there was “no good reason to do so” and adding, “the state does not believe such testing will or can prove the defendant’s innocence after his guilty plea.”

The judge ordered the test to go forward. The state again resisted but a month ago backed down.

Unfortunately, the vast majority of defendants are persuaded to take guilty pleas in a system increasingly designed to incentivize deals over trial. And most defendants don’t have the advantage of leading experts on wrongful conviction to litigate an appeal on their behalf. But even those like Duffey who do face immense obstacles to even access available DNA evidence. In a disheartening 2009 decision, the U.S. Supreme Court ruled 5-4 that a defendant who was willing to pay for a DNA test at his own expense was not entitled to the test. Allowing William Osburne to prove his potential innocence, Chief Justice John G. Roberts said, risks “unnecessarily overthrowing the established system of criminal justice.”

The prosecutor in Buffey’s case expressed a similar attitude, saying that even DNA evidence linked to another individual and not Buffey “only tells us that someone else took part.” The victim’s testimony that there was only one attacker casts serious doubt on Romano’s assertion. But whether or not he is right should not have any bearing on a prosecutor’s willingness to provide the defendant, the judge and the jury with definitive, scientific information like DNA evidence.

In a system that study after study has shown is fraught with bias and error, DNA evidence should be a welcome bastion of accuracy. But because it is the government that investigates crimes, the prosecutors are the gatekeepers to evidence that should be equally available to both parties. And while some individual prosecutors are supportive of greater DNA access, law enforcers have an institutional interest in winning their cases. Only nine states have laws granting defense lawyers access to a national DNA database. As National Association of Criminal Defense Lawyers President Steven Benjamin said, “Juries expect the defense to be able to prove that if your client didn’t do it, who did? Science doesn’t belong to the government, but they act like it does.”

View the original article here