Trump/GOP Obamacare Sabotage Has Raised Premiums

Trump promised less expensive health insurance that would cover all Americans during his campaign. Instead, he and the GOP sabotaged Obamacare without improving anything, and their sabotage is causing Americans across the country to have to pay significantly higher premiums for their health insurance.

Here is how Charles Gaba describes it in an op-ed for The New York Times:

The Affordable Care Act is still in effect, and the 2019 open enrollment period just ended for most Americans. The recent ruling by a Texas judge declaring the act invalid doesn’t change that.

But the Trump administration and Republicans are still undermining the health law.

People who earn too much to qualify for financial assistance for policies purchased through the A.C.A.’s health insurance exchanges or directly from insurers — five million now enrolled, including three to four million enrolled off-exchange — will pay for that sabotage in higher premiums. (Another nearly five million are uninsured and priced out of the market.) In the graphic below, I estimate how much more these unsubsidized enrollees will have to lay out in 2019 than they would have if not for the Trump administration’s actions.

Its sabotage efforts in 2018 included cutting off subsidy reimbursement payments for low-income enrollees (the cost of which insurers pass along to unsubsidized consumers), slashing the marketing budget by 90 percent and gouging the outreach-assistance budget by 40 percent. Next year will have those plus the repeal of the individual mandate and the expansion of non-Obamacare-compliant policies that don’t include the law’s patient protections.

These moves siphon off healthy enrollees, damaging the A.C.A. “risk pool,” so that its customers tend to be sicker and more expensive to carriers. In setting their premiums, many insurers specifically point to these actions as reasons for rate increases.

The estimates above are based in part on 2019 rate filings by insurance carriers in each state and modeled in part on estimates by the Urban Institute. Nationally, I estimate an average impact of $49 per month — or nearly $580 per year — for each unsubsidized enrollee.

A Majority Worry About Higher Costs For Health Insurance

This chart was made from results of a recent Gallup Poll -- done between November 1st and 11th of a national sample of 1,037 adults, with a 4 point margin of error.

Republicans were surprised that health care was a big issue in the last election, and tried to reassure voters at the last minute. It didn't work, and the damage Republicans did to health insurance turned out to be one of the major reasons voters ousted them from power by flipping 40 seats in the House of Representatives.

A large percentage of the public (about 61%) say they are worried about the rising costs of their health insurance (and afraid of higher deductibles with that insurance). And a significant percentage (42%) are so worried about it that they also worry about having to do without any health insurance at all.

Obamacare didn't fix all the problems with our broken health care system, and costs of insurance and medical care was one problem it didn't fix. But the Republicans, in trying to abolish Obamacare, just made things worse. Their doing away with mandatory participation is a primary reason why insurance premiums are skyrocketing. Now those same Republicans want to cut money for Medicare and Medicaid.

That's dumb, and it will just continue to hurt them. They need to join Democrats and fix the medical system -- controlling costs and covering more people with insurance. And they need to get rid of their mean-spirited belief that health care is a product. It's not. It's a right that should be shared by all citizens.

Report Shows Trump Is Responsible For Higher Premiums

(This caricature of Donald Trump is by DonkeyHotey.)

After his GOP-controlled Congress failed to repeal Obamacare, Trump has said he'll just wait for it to implode on its own. That is not really true. Obamacare is not imploding -- and most of the higher insurance premiums under the program are actually due to threats by Donald Trump. In other words, he is actively trying to destroy the program.

Here is part of a very good article on the situation by Ricardo Alonso-Zaldivar at AP News:

Actions by the Trump administration are triggering double-digit premium increases on individual health insurance policies purchased by many people, according to a nonpartisan study.

The analysis released Thursday by the Kaiser Family Foundation found that mixed signals from President Donald Trump have created uncertainty “far outside the norm” and led insurers to seek higher premium increases for 2018 than would otherwise have been the case.

Republicans in Congress have not delivered on their promise to repeal and replace the Obama-era Affordable Care Act. Trump is insisting that lawmakers try again and that the health overhaul is collapsing. At the same time, he’s threatened to stop billions of dollars in payments to insurers. Some Republicans are considering fallback measures to stabilize markets.

Kaiser researchers looked at proposed premiums for a benchmark silver plan across major metropolitan areas in 20 states and Washington, D.C. Overall, they found that 15 of those cities will see increases of 10 percent or more next year.

The highest is a 49 percent jump in Wilmington, Delaware. The only decline: a 5 percent reduction in Providence, Rhode Island.

About 10 million people who buy policies through HealthCare.gov and state-run markets are potentially affected, as are 5 million to 7 million more who purchase individual policies on their own.

Those in the government-sponsored markets can dodge the hit with the help of tax credits that most of them qualify for to help pay premiums. But off-marketplace customers pay full freight, and they face a second consecutive year of steep increases. Many are self-employed business owners.

The report found insurer participation in the ACA markets will be lower than at any time since they opened for business in 2014. The average is 4.6 insurers in the states studied, down from 5.1 insurers this year. In many cases insurers do not sell plans in every community in a state.

The researchers analyzed publicly available filings through which insurers justify their proposed premiums to state regulators. Insurers are struggling with sicker-than-expected customers and disappointing enrollment, and an industry tax is expected to add 2 to 3 percentage points to premiums next year.

On top of that, researchers found that mixed signals from the administration account for some of the higher charges. Those could increase before enrollment starts Nov. 1.

“The vast majority of companies in states with detailed rate filings have included some language around the uncertainty, so it is likely that more companies will revise their premiums to reflect uncertainty in the absence of clear answers from Congress or the administration,” the report said. Once premiums are set, they’re generally in place for a whole year.

Insurers that assumed that Trump would make good on his threat to stop billions in payments to subsidize copayments and deductibles requested additional premium increases ranging from 2 percent to 23 percent, the report found.

Insurers that assumed the IRS under Trump would not enforce unpopular fines on people who remain uninsured requested additional premium increases ranging from 1.2 percent to 20 percent.

“In many cases that means insurers are adding double-digit premium increases on top of what they otherwise would have requested,” said Cynthia Cox, a co-author of the Kaiser report. “In many cases, what we are seeing is an additional increase due to the political uncertainty.”

CBO - Repeal Would Double Insurance Premiums By 2026

(Cartoon image is by Matt Boss at thenib.com.)

The Republicans are still trying to claim that the repeal of Obamacare will be good for Americans, and will reduce the cost of health insurance. But the non-partisan Congressional Budget Office (CBO) disagrees. Here is part of the summary of their latest estimates on what will happen if Obamacare is defunded (or repealed):

In brief, CBO and JCT estimate that enacting that legislation would affect insurance coverage and premiums primarily in these ways:

• The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill. Later, after the elimination of the ACA’s expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces, that number would increase to 27 million, and then to 32 million in 2026.
• Premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by 20 percent to 25 percent—relative to projections under current law—in the first new plan year following enactment. The increase would reach about 50 percent in the year following the elimination of the Medicaid expansion and the marketplace subsidies, and premiums would about double by 2026.

The ways in which individuals, employers, states, insurers, doctors, hospitals, and other affected parties would respond to the changes made by H.R. 3762 are all difficult to predict, so the estimates in this report are uncertain. But CBO and JCT have endeavored to develop estimates that are in the middle of the distribution of potential outcomes. . . .

Estimated Changes Before the Elimination of the Medicaid Expansion and Subsidies

Following enactment but before the Medicaid expansion and subsidies for insurance purchased through the marketplaces were eliminated, the effects of H.R. 3762 on insurance coverage and premiums would stem primarily from repealing the penalties associated with the individual mandate.

Effects on Insurance Coverage. CBO and JCT expect that the number of people without health insurance coverage would increase upon enactment of H.R. 3762 but that the increase would be limited initially, because insurers would have already set their premiums for the current year, and many people would have already made their enrollment decisions for the year. Subsequently, in the first full plan year following enactment, by CBO and JCT’s estimates, about 18 million people would become uninsured. That increase in the uninsured population would consist of about 10 million fewer people with coverage obtained in the nongroup market, roughly 5 million fewer people with coverage under Medicaid, and about 3 million fewer people with employment-based coverage.

Most of those reductions in coverage would stem from repealing the penalties associated with the individual mandate. However, CBO and JCT also expect that insurers in some areas would leave the nongroup market in the first new plan year following enactment. They would be leaving in anticipation of further reductions in enrollment and higher average health care costs among enrollees who remained after the subsidies for insurance purchased through the marketplaces were eliminated. As a consequence, roughly 10 percent of the population would be living in an area that had no insurer participating in the nongroup market.

Effects on Premiums. According to CBO and JCT’s analysis, premiums in the nongroup market would be roughly 20 percent to 25 percent higher than under current law once insurers incorporated the effects of H.R. 3762’s changes into their premium pricing in the first new plan year after enactment. The majority of that increase would stem from repealing the penalties associated with the individual mandate. Doing so would both reduce the number of people purchasing health insurance and change the mix of people with insurance—tending to cause smaller reductions in coverage among older and less healthy people with high health care costs and larger reductions among younger and healthier people with low health care costs. Thus, average health care costs among the people retaining coverage would be higher, and insurers would have to raise premiums in the nongroup market to cover those higher costs. Lower participation by insurers in the nongroup market would place further upward pressure on premiums because the market would be less competitive.

Estimated Changes After the Elimination of the Medicaid Expansion and Subsidies

The bill’s effects on insurance coverage and premiums would be greater once the repeal of the Medicaid expansion and the subsidies for insurance purchased through the marketplaces took effect, roughly two years after enactment.

Effects on Insurance Coverage. By CBO and JCT’s estimates, enacting H.R. 3762 would increase the number of people without health insurance coverage by about 27 million in the year following the elimination of the Medicaid expansion and marketplace subsidies and by 32 million in 2026, relative to the number of uninsured people expected under current law. (The number of people without health insurance would be smaller if, in addition to the changes in H.R. 3762, the insurance market reforms mentioned above were also repealed. In that case, the increase in the number of uninsured people would be about 21 million in the year following the elimination of the Medicaid expansion and marketplace subsidies; that figure would rise to about 23 million in 2026.)

The estimated increase of 32 million people without coverage in 2026 is the net result of roughly 23 million fewer with coverage in the nongroup market and 19 million fewer with coverage under Medicaid, partially offset by an increase of about 11 million people covered by employment-based insurance. By CBO and JCT’s estimates, 59 million people under age 65 would be uninsured in 2026 (compared with 28 million under current law), representing 21 percent of people under age 65. By 2026, fewer than 2 million people would be enrolled in the nongroup market, CBO and JCT estimate.

According to the agencies’ analysis, eliminating the mandate penalties and the subsidies while retaining the market reforms would destabilize the nongroup market, and the effect would worsen over time. The ACA’s changes to the rules governing the nongroup health insurance market work in conjunction with the mandates and the subsidies to increase participation in the market and encourage enrollment among people of different ages and health statuses. But eliminating the penalty for not having health insurance would reduce enrollment and raise premiums in the nongroup market. Eliminating subsidies for insurance purchased through the marketplaces would have the same effects because it would result in a large price increase for many people. Not only would enrollment decline, but the people who would be most likely to remain enrolled would tend to be less healthy (and therefore more willing to pay higher premiums). Thus, average health care costs among the people retaining coverage would be higher, and insurers would have to raise premiums in the nongroup market to cover those higher costs. CBO and JCT expect that enrollment would continue to drop and premiums would continue to increase in each subsequent year.

Leaving the ACA’s market reforms in place would limit insurers’ ability to use strategies that were common before the ACA was enacted. For example, insurers would not be able to vary premiums to reflect an individual’s health care costs or offer health insurance plans that exclude coverage of preexisting conditions, plans that do not cover certain types of benefits (such as maternity care), or plans with very high deductibles or very low actuarial value (plans paying a very low share of costs for covered services).

Effects on Participation by Insurers. In CBO and JCT’s estimation, the factors exerting upward pressure on premiums and downward pressure on enrollment in the nongroup market would lead to substantially reduced participation by insurers and enrollees in many areas. Prior experience in states that implemented similar nongroup market reforms without a mandate penalty or subsidies has demonstrated the potential for market destabilization. Several states that enacted such market reforms later repealed or substantially modified those reforms in response to increased premiums and insurers’ departure from the market.

After weighing the evidence from prior state-level reforms and input from experts and market participants, CBO and JCT estimate that about half of the nation’s population lives in areas that would have no insurer participating in the nongroup market in the first year after the repeal of the marketplace subsidies took effect, and that share would continue to increase, extending to about three-quarters of the population by 2026. That contraction of the market would most directly affect people without access to employment-based coverage or public health insurance.

Effects on Premiums. In total, as a result of reduced enrollment, higher average health care costs among remaining enrollees, and lower participation by insurers, CBO and JCT project that premiums in the nongroup market would be about 50 percent higher in the first year after the marketplace subsidies were eliminated—relative to projections under current law—and would about double by 2026.

2015 Premium Prices Expose The Outrageous GOP Lie

The Affordable Care Act was passed in 2010, but it wasn't fully implemented until this year. That gave the Republicans four years to tell outrageous lies about the program (commonly called Obamacare). One by one, those lies have been exposed. But there is one that couldn't be exposed until we saw what was going to happen with insurance premiums. The Republicans had claimed that Obamacare would cause a huge rise in the price of insurance.

The cost of premiums went down in many states because of the provision that at least 80% of money raised through premiums must be spent on medical care for consumers. But what was going to happen in the second year to those premium prices? Would they rise more than normal as the Republicans claimed?

We now know the answer to that question -- and it is NO. The Kaiser Family Foundation, one of the most respected sources on what is happening with medical care, has checked on the premium prices in a large city in every state for 2015. What they found is illustrated in the four charts below. Premium prices rose in some state and dropped in others -- but even in the states where the prices rose, it was a smaller rise than in past years (before Obamacare was fully implemented).

The premium prices I have shown are for the Silver Plan -- the most popular plan. And for the United States as a whole, the average premium price did not rise at all -- it fell by 0.2%! For the cheaper Bronze Plan, the average price rose by 3.2% -- a much more modest rise than premiums have exhibited in the past.

This exposes the last of the outrageous Republican lies -- that Obamacare would cause a drastic rise in premium prices. The truth is that, just as the program architects predicted, Obamacare has fostered competition among the insurance companies -- and that new competition has kept prices down.

More Bad News For The GOP Regarding Obamacare

After their failure to keep the Affordable Care Act (Obamacare) from becoming law, the congressional  Republicans told a whole stack of lies about it. Among that stack of lies was the claim that Obamacare would drive up health care costs -- both for health care insurance premiums, and for actual health care itself. We already know that insurance premiums are not rising as the GOP predicted. They are going down in some states, and rising slower than in the past in other states -- thanks to Obamacare.

Now we have evidence that shows Obamacare may well be working as hoped to keep medical care costs down, instead of driving up costs as the GOP claimed would happen. The chart above was made with information from the Department of Health and Human Services (Office of the Assistant Secretary for Planning and Evaluation). Their recent report shows that the uncompensated care costs (UCC) incurred by hospitals is slated to drop by about $5.7 billion this year in all states, and the reason for the drop in UCC is due to more people having health insurance due to Obamacare.

The biggest reason for this drop in uncompensated costs is due to more people being covered by Medicaid. Hospitals used to have to eat the cost of treating these people in their emergency rooms (and sometimes in their care units). These costs would normally be passed on to other patients in the form of higher overall hospital charges -- which would drive up the co-pay of patients and the costs paid by insurance companies (which would drive up the premium price to customers).

That's what would happen in private hospitals. In public hospitals, the prices would also rise to help pay for the hospital's UCC, but part of the UCC would also be paid for through higher city, county, or regional taxes. That means Obamacare is not only helping to keep hospital costs down, but also helping to keep the tax burden from rising.

We know that most of the reduction in hospital UCC is due to expansion of Medicaid, because 74% of the reduction in UCC has happened in states that have expanded Medicaid. But costs in states that did not expand Medicaid also went down (about 26% of the reduction in hospital UCC happened in these states) -- and that was also due to Obamacare.

It comes form people who could not afford insurance before Obamacare. Since they didn't have insurance, a large medical bill would bankrupt these people and cause the hospital to have to eat the cost of their care. These people made too much to qualify for Medicaid under Obamacare, but the new law gave them a subsidy to help them buy insurance -- and since they now have health insurance, the hospitals are getting paid for the medical care they provide to these people.

Once again, the Republicans are exposed as being liars about Obamacare. Obamacare has helped hospitals to keep their costs for patients down by making sure they get paid for a higher percentage of those patients. And while the hospitals located in states that have expanded Medicaid are seeing the biggest drop in uncompensated care costs, Obamacare has also reduced those costs in other states.

I still believe we should institute a government-run single-payer health insurance system. It would be more effective in both covering everyone and keeping medical costs down. But it is now an undisputed fact that Obamacare has been a huge improvement over what we had before it was passed.

The Last Republican Lie About Obamacare Is Being Exposed

Last month I wrote a post about all the falsehoods the Republicans have told about Obamacare -- and how they have all been exposed as the outrageous lies most of us knew they were. That is, all but one -- the claim that Obamacare would cause huge premium increases for health insurance. That one couldn't be exposed until we saw what the insurance companies were asking for next year premiums.

Well, many of those premium requests from the insurance companies have now come out, and the Kaiser Family Foundation has taken a look at those requests. The 16 major cities on the chart above have received their requests for 2015, and they certainly don't show any radical raising of premium prices. In fact, the premiums will be falling in seven of the cities, and the largest increase requested is 8.7% in Nashville (certainly not out of line with previous premium increases).And the average of all 16 cities is actually a small decrease (-0.8%) over 2014's premium average.

This is a pretty representative sample of the cities across this nation -- and there is no reason to believe when other cities receive their final premium requests they will be any different from those above. The last excuse the Republicans had for bad-mouthing Obamacare is being exposed. It is now clear that absolutely none of their outrageous claims were true -- and the American people will start to realize that as the new premium costs are announced.

Obamacare Is Under Attack In The Courts Again

(The image above was found at nywcc.org.)

The die-hard opponents of the Affordable Care Act (Obamacare) have not given up. This time they are attacking the provision of the law that helps those not making enough to buy insurance with a government subsidy -- and unfortunately, they have found some judges that agree with them. A three-judge panel of the District of Columbia Circuit Court of Appeals has decided, in a 2-1 vote, that the federal government cannot give a subsidy to those who bought their insurance through the federal government exchange.

The two judges (both appointees of George W. Bush) based their decision on a section of the law that said tax credits can only be applied "through an exchange established by the state". The federal government disagreed with that interpretation, saying the intent of Congress was clear that the subsidies should apply to all citizens who qualify for it, regardless of what state they live in -- and in fact, that intent is why the federal exchange was created.

Further complicating this matter is the fact that a different appeals court, the 4th Circuit Court of Appeals (in Virginia), reached just the opposite conclusion -- that the subsidies granted through the federal exchange were legal and permissible. If both of these decisions stand, then this issue will have to go to the Supreme Court for a final decision. That might be avoided by an appeal to the full District of Columbia Circuit Court of Appeals (where 7 of the 11 judges are Democratic appointees).

This is a serious matter, and could gut Obamacare -- especially in the Republican-controlled states that refuse to create a state insurance exchange. There are currently 36 states without a state exchange -- and in those states about 5.4 million people signed up for insurance through the federal exchange (and about 87% of them received a subsidy to help pay for the insurance -- about 4.7 million people). If the decision is allowed to stand, it would mean these states would forfeit about $36 billion in subsidies (with Texas at $5.6 billion and Florida at $4.8 billion being the hardest hit states) -- and insurance premiums for those who needed subsidies would rise by an average of 76%. That means millions in those states could no longer afford insurance.

I don't think the House and Senate Democrats should wait for a court decision -- by either the full Distict of Columbia Circuit Court of Appeals or the United States Supreme Court. They should immediately file a bill to fix this supposed "glitch" in the law -- and dare the congressional Republicans to block it.

If the Republicans did block it, which they would probably do to keep their teabagger base happy, then Democrats should make sure that blockage gets as much coverage in the media as possible -- and keep reminding voters of it until election day. It could be a difference-maker in November, because the millions who will lose their insurance, or have to pay a much higher premium, are not going to be happy voters.

Bill Clinton Is Wrong

(The caricature of Bill Clinton to the left is by the inimitable DonkeyHotey.)

The Republicans have been making a big deal out of insurance companies canceling some insurance policies that don't meet the basic standards of the health care reform in the Affordable Care Act (Obamacare). They say the president lied when he said people could keep their current policies if they liked them.

That's not true. These few policies were nothing more than a scam perpetrated on consumers by the insurance companies -- and did not offer adequate insurance coverage for those consumers. The insurance companies could have brought the policies up to meet the new standards, but they chose not to. They decided to just cancel them (and now the Republicans are trying to blame the president for the actions of these insurance companies).

And sadly, former president Bill Clinton has fallen into the Republicans trap -- and seems to be accepting their lies as having some validity. Clinton says:

"I personally believe, even if it takes a change in the law, the president should honor the commitment the federal government made to those people and let them keep what they got."

He is wrong. No one should be allowed to keep those inadequate insurance policies -- most of which are closer to a scam than a real policy to cover medical costs. What is going to happen when someone with one of those policies contracts a serious (and therefore expensive) illness? Many of them are going to have to declare bankruptcy and ruin their credit. The new standards imposed by Obamacare actually protects these people -- by requiring coverage of more medical expenses, and by capping the amount any consumer would have to pay out-of-pocket for medical expenses.

And it also protects the rest of us. How? Well, someone has to pay those medical bills that the consumers with inadequate policies incur. The hospitals can't afford to absorb those costs, and you can bet the insurance companies won't pay a penny more than they are required to pay under the terms of the policy. It's hard enough to get them to pay for the things a policy does cover.

That leaves the rest of us ordinary Americans to pay those costs. If those people with bad policies got their care in a public hospital, then we will pay through higher taxes. If they got their unpaid care in a private hospital, then the hospital will raise its prices and insurance companies will have to pay those higher prices (which means everyone will pay a higher premium).

Obamacare's basic insurance standards doesn't just protect the people who currently have inadequate insurance -- it protects all of us by insuring that we won't have to absorb those costs. Bill Clinton is just mistaken. These scam insurance policies must not be allowed to continue -- even if some foolish people still want them.

I like Bill Clinton -- but he is wrong on this issue.

Did President Obama Lie About You Being Able To Keep Your Insurance?

(This photo of President Obama is from the The White House website.)

The newest anti Affordable Care Act (Obamacare) story going around is nothing less than a personal attack on President Obama -- and sadly, it seems that a lot of the mainstream media is falling for it. It concerns a promise that President Obama made when the Affordable Care Act was being passed. He told Americans that if they had insurance they liked, they would be able to keep it.

Now we are hearing that some Americans are getting notices from their insurance companies saying their policies are going to be cancelled and replaced with new policies -- and that those new policies may come with a higher premium cost. The story is being reported as though it will affect most Americans who have insurance. Is this true? Did the president lie?

First, we must realize that although their are some cancellations, it will only affect about 6% of all Americans -- those who have purchased policies on their own. Employer-provided insurance plans are not affected. Next we need to understand why those policies are being cancelled. They are being cancelled because they do not provide the basic coverages now required by law. In other words, they were junk policies that people were scammed into buying.

Some might now say that they were happy with those junk policies. If so, it's only because they were lucky enough to not get a serious illness and need those policies to pay out for that illness. If they had gotten that serious illness, they would have been shocked at what little coverage they had been paying for -- and they would have been left out in the cold while the insurance companies refused to pay for their medical expenses.

So, are all of that 6% going to have to pay more for their new policies? A few will, but at least half of them (or more) won't be paying even more -- and some may actually pay less. That's because the insurance companies must now pay out at least 80% of their premiums in actual medical costs for their consumers (which is already resulting in premium reductions in many states). And many of those who do see their current premium rise will be able to find a less expensive policy in the insurance exchange -- a policy with all of the basic coverages now required of all insurance policies.

The president didn't lie to anyone. He just assumed that people wouldn't want a policy that was junk insurance, and didn't even provide the basic coverages all Americans really need. He underestimated the greed of the insurance companies, and their willingness to scam Americans into buying junk insurance with little or no real coverages.

These few Americans may be upset right now, and a few may even have to pay a little more, but they will all now have real insurance with the coverage they will need when they get a serious illness.

Rick Perry's Latest "Oops" Moment

Rick Perry's career has been full of blunders, and those "oops" moments go much farther than just in some Republican debates. It extends to the policies he proposes and enforces -- policies that have made Texas the laughing-stock of the nation.

The latest comes with his absolute refusal to go along with the Affordable Care Act (Obamacare) and extend Medicaid to cover millions of poor Texans. While he has told Texans that he is protecting them from higher insurance prices with this refusal, now evidence is coming out that his ridiculous actions have had exactly the opposite effect.

A recent Kaiser Family Foundation review of insurance premiums of states that have accepted Obamacare (and expanded Medicaid) shows that insurance premiums are dropping in those states. But a RandCorporation report says the rates will Texas will be rising -- by about 9.3%. And they blame this rising of insurance premiums on Texas' refusal to expand Medicaid.

A Dallas Morning News article says this is because some of the poor uninsured will purchase insurance through the federal exchange (set up because the state refused to create an insurance exchange), and since the poor generally have poorer health, that will drive up premiums for everyone. That may be true, but I suspect an even bigger reason is that while those millions will not be covered by Medicaid, many of them will still need health care and they will get it in the hospital emergency rooms -- and since the hospitals cannot afford to give free care and can't legally deny care, they will pass this cost on to other patients and their insurance companies (thus driving up the premiums charged to Texans).

But either way, the primary cause for the rate increase is Perry's absolute refusal to expand Medicaid (even though the cost would be born by the federal government for ten years, and Texas would only pay 10% of the cost after that). So when you get your insurance bill and see it has gone up (whether an employer or an individual), thank Governor Perry for the increased cost. It's his latest "oops" moment, and Texans will have to foot the bill for it.

(The image above of Rick Perry is from mariopiperni.com.)

Insurance Rates Jump 39% In California

For months now, the Republicans have been trying to tell Americans that there is nothing wrong with our health care system that some minor reforms (like abolishing pre-existing conditions) wouldn't fix. They have gone out of their way to defend the private insurance companies and protect their massive profits at the expense of consumers.

So how do the insurance companies react to this fealty from the Republicans. Well, if you are Anthem Blue Cross of California, you raise rates for most of your consumers by 30-39% for the second year in a row. This is pure greed based on their belief that real health care reform is now dead and they don't have to worry about it anymore.

If this was a company in trouble that was losing money it might be different, but the parent company of this insurance carrier earned 8 times their normal profit in the last three months of last year. This company just decided to go for even larger profits and screw most of their 800,000 California customers out of their hard-earned money. You can bet if they get away with this, other companies will do the same and it will quickly spread to other states.

This is what progressives and Democrats have been trying to tell Americans for over a year now. These private insurance companies are not in business to see that Americans get good health care at a reasonable price. They are only interested in ever greater profits. That's why we must remove the profit motive from health care, and the best way to do that is with public single-payer health insurance.

Secretary of Health and Human Services has written Anthem Blue Cross demanding an explanation of the ridiculous rise in premiums. Here's what she had to say to the company:

"With so many families already affected by rising costs, I was very disturbed to learn through media accounts that Anthem Blue Cross plans to raise premiums for its California customers by as much as 39%."

"These extraordinary increases are up to 15 times faster than inflation and threaten to make health care unaffordable for hundreds of thousands of Californians, many of whom are already struggling to make ends meet in a difficult economy."

"I believe Anthem Blue Cross has a responsibility to provide a detailed justification for these rate increases to the public. Additionally, you should make public information on the percent of your individual market premiums that is used for medical care versus the percent that is used for administrative costs."

"Policyholders in the individual market deserve to know if their premium increases would be invested in better medical care or insurance company overhead costs like salaries, profits, and advertising. I am aware that the state of California is investigating this matter, and urge Anthem Blue Cross to cooperate fully. In the meantime, I will be closely monitoring the situation."

"At a time when health care costs are a critical threat to families as well as the nation's economy, I hope you appreciate the urgent nature of this request. I look forward to your prompt reply."

That's a great letter, but I doubt it will accomplish anything such as lowering the rates. In fact, I would be surprised if she even gets a response from the company. The government needs to pass some real health care reform before the private insurance companies price everyone but the rich out of the market (and that probably won't be long).

Health Care Premiums Skyrocketing

Amazingly, there are still people in America who don't think we have a problem with health care, especially private health insurance. All I can say is these people must be rich, or they don't have to pay for their own health insurance.

They're certainly not among the nearly 44 million Americans without health insurance, or the millions more who have to pay their own premiums for health insurance. These people know what a mess the private insurance companies have made of our health care system. The first group already can't afford private health insurance and the second won't be able to afford it much longer.

In the last ten years, median incomes have risen by about 20% (mostly among high-income earners, since low and middle incomes have been stagnant). But this 20% pales in comparison to the rise in private insurance premiums. These premiums have risen a whopping 92% -- nearly five times the rise in median income.

Ten years ago, the average annual private health insurance premium for a family was $6638. Today it is $12,721, and unless there is real health care reform enacted soon, it will probably continue to rise by nearly 10% each year.

It's no wonder that more and more companies are ceasing to provide employees with health insurance. They're simply being priced out of the market. And if the companies can't afford to pay the premiums, you know the employees won't be able to pay them either.

Making matters even worse, the higher premium prices won't buy the same coverage offered ten years ago. The insurance companies are not just raising prices, but they are thinning the coverage at the same time. Current policies will not pay for many procedures, and those they do cover are usually accompanied by a high co-pay.

The insurance company lobbyists may be successful in killing effective health care reform, but that does not mean it's not badly needed. Americans are in trouble -- even those who don't yet realize it.