Scandal: Obamacare Forces Insurers To Refund Millions!


As noted by the Denver Business Journal's Ed Sealover: while the Denver Post's health insurance supersleuth Art Kane continues his ongoing series of one-sided hit pieces "special reports" about the rollout of the Affordable Care Act in Colorado, wherein everything consumers have ever complained about with regard to health care delivery in the United States is laid at the feet of "Obamacare"–health insurers sometimes have billing problems!–consumers are seeing another benefit of the ACA in the form of a check.

Colorado consumers will receive nearly $3 million in refunds from insurance companies that did not spend enough money on patient care last year.

The U.S. Department of Health and Human Services announced Wednesday that nine companies must cut checks to 52,277 customers for a cumulative total of $2,721,701 for violating the medical loss ratio rule established in the federal Patient Protection and Affordable Care Act.

The rule requires insurers to spend at least 80 percent of premium dollars on patient care and quality-improvement activities or else refund a portion to consumers…

Sealover reports that this year's refunds to Colorado consumers are less than in the first year of Obamacare's "medical loss ratio" rule, which requires health insurance companies to spend 80% of small group and individual premium dollars directly on health care and services to improve care. For large group plans, the requirement is 85%. The lower rebate payout this year can logically be interpreted as compliance.

It's just another example of how the myths surrounding the Affordable Care Act are not being substantiated by voters' experience with the law. Public opinion persistently trends against "Obamacare," even as consumers reap the benefits of individual provisions like the medical loss ratio rule. Millions of consumers are saving big money with subsidized premiums, and for others those subsidies are the different between having insurance and not having insurance. Polling shows that while "Obamacare" is unpopular, the things that the law actually does enjoy broad public support.

We've been saying for years that opposition to the ACA would fall apart once the benefits of the law were generally known by the public, proving once and for all that the horror stories opponents predicted were hogwash. Working against that has been an opposition who clung to this issue well past the point of reason, an effective propaganda dissemination machine untroubled by reality, and a troubled initial rollout of the health insurance exchanges that gave opponents weeks longer to grouse.

But the bottom line hasn't changed. It can't go on forever.

28 Community Comments, Facebook Comments

  1. ZappateroZappatero says:

    Don't forget that Sealover was a Gazette Hack in a past life….

    • DavieDavie says:

      Sealover's coverage is fair.  It's Kane with the constant axe grinding.  He interviews one person with a gripe and then tries to expand that anecdotal example into a complete condemnation of Obamacare.  Very tiresome, hack "journalism" that is, for whatever agenda, being funded by the Post and, I believe, the Kaiser Foundation.

  2. Andrew Carnegie says:

    When are the rate increases going to kick in?

    When do the insurance companies get subsidized by the taxpayers to ensure their profitability?

    Happy, happy, joy, joy.

    • Diogenesdemar says:

      Ask your mommy if her insurance premiums ever went up — ever — for carrying the coverage on your worthless carcass . . . 

    • DaninDenDaninDen says:

      According to Thom Hartmann, for profit health insurance is illegal, in Switzerland, home to greatest number per capita of millionaires.

      Some are brainwashed into believing Corporations, must feast on the body politic, as it written into law Corps must make profit. Bring back annual renewal of those (charters) (of) Inc. ers & oinkers, & I’ll sign off on that.

      I guess some wealthy countries think it macabre to profit from the sick and dying. (Happy Joy?) That there are always those willing to “take one for team” (red and clueless) even though they wouldn’t even let you in the front door of their gated, Country Club insulated life.

  3. The sad part is that these nine insurance companies didn't manage to spend even 80 (or 85) percent of their premiums on actually insuring their customers. 15 to 20 percent overhead is an amount Republicans would be (rightly) furious about if it were happening in government. Of course, the various government health insurance / health care programs all run at well under 10% overhead – by some estimates well under 5% – making the private insurance companies look like the greedy bastards they are, if only someone were to do real investigative reporting.

    • ModeratusModeratus says:

      Have you ever considered that conservatives value profit, and the benefits of profit to our society? Only in the liberal world where all prosperity is scorned does that make sense. That's why liberals want to socialize everything, because you don't believe in the private enterprise that built America.

      Let's celebrate profit, not demonize it.

      • Ralphie says:

        So according to your way ot thinking, it's OK to charge the customers infinity and give them nothing, because that would maximize profit.

        Which is exactly why health care shouldn't be provided by for-profit companies.

      • Duke CoxDuke Cox says:

        Everything you just said is bullshit.

        A couple of quotes about labor, which, according to you and your friends, is secondary to (practically antithetical, in fact) to profit.


        "Labor is the true standard of value." The Collected Works of Abraham Lincoln edited by Roy P. Basler, Volume IV, "Speech at Pittsburgh, Pennsylvania" (February 15, 1861), p. 212.

        "The world is agreed that labor is the source from which human wants are mainly supplied. There is no dispute upon this point." The Collected Works of Abraham Lincoln edited by Roy P. Basler, Volume III, "Address before the Wisconsin State Agricultural Society, Milwaukee, Wisconsin" (September 30, 1859), p. 477.

        Liberals do not scorn prosperity. They understand that it is good and should be widespread, with the focus on "the Commonwealth", not the continued accumulation of the nations' wealth into ever fewer hands by the dominance of profit as an economic consideration.

        Liberals believe very much in the private enterprise that you claim "built America". But they believe it should not be possible in this country for a handful of powerful, elite, aristocrats, through the manipulation of our political system, to evicerate the middle class and push the majority of Americans into poverty.

        You don't actually know any "liberals", do you?

      • mamajama55mamajama55 says:

        Capitalist societies often have socialized medical programs,  like the UK, Canada, most of the industrialized world.  Great outcomes, too – less infant mortality, comparable immunization rates,  plagues and infectious diseases are quickly isolated, etc. I can put up links if you'll investigate them, but I suspect that you're aware of all this, anyway.

        • DavieDavie says:

          All Moddy is saying is that his definition of capitalism means that executives should get rewarded with multimillion dollar salaries and bonuses in exchange for delivering substandard products and services.

          It worked really well for the auto industry, right?

          • Ralphie says:

            Well, the socialist government bailed out the auto industry.  In a true laissez-faire economy, natural selection would have taken its course and we'd all be driving Hyundais.

            • DavieDavie says:

              Or more likely walking — if both Chrysler and GM had gone bankrupt, taking about 3 million jobs with them — that would have been a Depression to remember!

              Romney was probably kinda looking forward to picking over the rotting bones of the economy if he'd become president, sharing the spoils with his crony capitalists.

              But, back on topic of the health care industry — unfortunately Mayo Clinic and Kaiser's coordination of care and advanced medical records systems are the exception, not the rule.  And the thousands of private insurance companies and their byzantine rules and forms causing doctors and hospitals to game the system or give up entirely, are the major cause for our poorer outcomes and higher costs than "socialized" medicine can deliver.

      • SocialisticatProgressicat says:

        Oh Moddy, if you think the ACA is socialism in action, both Newt Gingrich and I need to have a talk with you.

      • Curmudgeon says:

        I have no problem with Profit. I just don't think it should be valued more than people.

      • I don't doubt that conservatives value profit. Nor do I doubt that they believe that profit works to society's benefit. In fact, I believe that many of today's conservatives have fallen down the rabbit hole into Ayn Rand Wonderland and have elevated profit above society believing that profit will lead to maximal societal benefit.

        I also believe that many conservatives – yourself demonstrably included – don't have a proper perception of liberals and their views of capitalism. Shocking as this revelation may be to you, we aren't communists. And we don't all hold the same views, either, so quit trying to lump us into some kind of like-minded herd.

      • FrankUnderwood says:

        You sound like a Ferenghi.  Or Gordon Gecko.

      • BlueCatBlueCat says:

        Pull the string and out comes more ignorant crap. 

  4. skeptical citizen says:

    AC – Review your history. Health insurance rate increases have been an annual occurrence since decades before the ACA.

    Moddy – Profit is great, but consider whether basic health insurance coverage should even be allowed to profit the health insurance countries. Please read the excellent book "The Healing of America" by T.R. Reid, where he states that even with the ACA that the US will continue to be the only developed nation that permits health insurance companies to make a profit on the basic package of coverage. Please also read the excellent book "Deadly Spin" by Wendell Potter for a detailed discussion of the medical loss ratio.

    Everybody have a great day.


  5. MooMooMoo0MooMooMoo0 says:

    The point isn't that profit is bad. The point is that people should get what they pay for and profit should directly coorelate with performance. In a market with perfect information, there would be no need for the ACA or any medicare for all scheme. Because that's not the case, it's good to band together, through Government if need be it doesn't matter how, to avoid getting scammed i.e. paying someone to do something and they not do it.


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