Minnesota’s own UnitedHealth just made headlines by announcing that it is dropping out of the pool of private companies that would offer individual policies in California.  Aetna has also dropped out of the California market.  Source: http://www.latimes.com/business/la-fi-unitedhealth-insure-calif-20130702,0,4370321.story

It’s not a tragedy for Californians.  Both of those companies only had a combined 58,000 customers who can now seek new coverage in one of 13 Covered California providers.  What’s apparent, however, is that private companies are dropping out of even lucrative markets such as California where they can’t create policies that keep their costs down and rates up.  It’s the equivalent of taking their ball and going home, which in UnitedHealth’s case is employer-offered plans.

Another company isn’t going home, but they’re not playing either.  Wellmark Blue Cross and Blue Shield of Iowa and South Dakota has elected not to offer its policies on those respective states’ exchanges until the year 2015.  Analysts say the company is worried that the newly insured will be too sick (and therefore too expensive to cover).

The elderly, the self-employed, the-poor-but-not-too-poor, and those with pre-existing conditions may struggle to find insurance they can afford, especially in other states, but why?  The Affordable Care Act was designed to make healthcare coverage available to everyone. Because the Affordable Care Act sets standards that private insurance companies must meet: the coverage must provide value to the consumer; and it must be available to more people with more health issues.  All very noble ideals.

The true irony to these stories is that insurance companies lobbied hard to dictate the terms they had to play under nationwide.  ACA was nearly trampled to death by all the Gucci loafers from “K” street, and now, rather than play by those rules, however, UHC and Aetna decided to leave.

What will happen in states where there are fewer catch-alls, such as Wisconsin?  Look at another state with citizens with health concerns, Mississippi.  Thousands of residents in the Delta-36 of 82 counties-still have no provider that is willing to offer subsidized policies.  That’s more than 50,000 people who can’t find insurance even though they now qualify, according to Kaiser Health News.

Insurance companies are trying all kinds of tactics to keep the cost of healthcare down and profits up, including wellness programs, incentives to lower premiums, and brokering lower rates with hospitals, as Blue Cross and Blue Shield of Minnesota recently announced (and then delayed).  With hospital care being 31 percent of national healthcare costs, expect insurance companies to do more to contain what they pay hospitals.  It will be interesting to see if insurance companies push those hospitals to be more effective, to produce better patient outcomes, to reduce medical mistakes, and maybe even staff more nurses (which we know results in all of the above).

ACA continues to be like that big house we thought about and ultimately decided to buy.  We knew what we were getting from the outside, but there are some cracks we didn’t see on the inside.  In the end, we may be sorry we didn’t wait a little longer and buy that nice single-payer home we really wanted.

NOTES ON NURSING

More Cancer Specialist Nurses Improve Hospital Care   Patients of better staffed trusts were more likely to report that people treating and caring for them worked well together and they received enough emotional support during outpatient treatment.

HEALTH CARE NEWS

Obamacare Postpones Employer Mandate for a Year    Employers who don’t provide health insurance will be spared penalties of up to $3,000 per worker until 2015, a one-year delay of a major component of President Barack Obama’s health care reform law.

Kickstart Your Medical Bills   The Kennett family of Alexandria is one of thousands turning to the Internet to raise money for medical bills. The sites that host these campaigns operate much like online business fundraising sites such as Kickstarter.

American Way of Birth Is Costliest in the World   The couple had to approach the nine months that led to the birth of their daughter in May like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors.

Why Our Health Care Lets Prices Run Wild   So why is our health care spending more than 17% of our gross domestic product, far more than any other country?

LABOR UPDATES

NLRB Uncertainty Benefits Big Corporate Donors   Republican senators who support a lawsuit that could shut down the National Labor Relations Board have received more than $6 million over the years from corporations that have already benefited from the lawsuit, according to a new analysis of campaign finance data.

Hyatt Workers Win Deal After Full-Court Press    Over the last three years, hotel workers employed nearly every tactic of a modern corporate campaign against Hyatt.

Rise of the Blue-Collar “Permatemp”   A recent ProPublica analysis found that at least 840,000 temp workers across the U.S. work blue-collar jobs earning them less than $25,000 a year. These aren’t day laborers, but regular employees of temp agencies working in the supply chains of some of America’s largest companies, such as Walmart and Nike.