Obama Regime Begins Muscling Private Insurers
(The Washington Times) — Obama administration on Monday called on a Mennonite-owned health insurance company to cancel its proposed 11.6 percent rate hike, marking the first time the government has tried to pressure a private company under the new health care law.
While Pennsylvania-based Everence Insurance said it needs to raise rates on about 5,000 customers to cover costs, Secretary of Health and Human Services (HHS) Kathleen Sebelius called the increase “unreasonable,” holding it up as evidence that the government has an important role to play in reining in the cost of coverage.
“This sends a message to insurers around the country that the days of unchecked, double-digit increases are over,” Mrs. Sebelius said.
But Everence officials disputed the methods used by HHS to reach its conclusion, arguing that the agency calculated the plan’s loss ratio over a one-year period, instead of calculating rates based on a two-year period that they said would give a better idea of gains and losses.
“The Everence experience indicates that a longer experience period reduces premium volatility, which works better for group clients,” said Vice President Dave Gautsche. “We’d welcome the opportunity to have a conversation with HHS officials about how we determine our rates.”
For their part, HHS officials accused Everence of calculating loss based on nationwide statistics instead of just within Pennsylvania. That method, they said, would have led the company to predict fewer losses — a claim Everence denies.
“The issue here was the company used the national experience, which has a much higher loss ratio than the local experience in Pennsylvania,” said Steve Larsen, a director for HHS.
With the first plan to be ruled unreasonable by the administration, Everence indicated it would not back away from the rate hike, although the Mennonite-affiliated company will be required to publicly justify it on the website healthcare.gov.
On Sept. 1, HHS began scrutinizing companies that want to significantly raise premiums. A provision in the Affordable Care Act requires insurers to notify the government and submit to a rate review when they want to hike rates by at least 10 percent — one of several measures aimed at making coverage more affordable for Americans.
States, which can either conduct the rate reviews themselves or farm it out to the federal government, are being awarded $250 million in federal grants to set up or improve their rate-review process, but the federal funding is not accompanied by enforcement authority.
Even if states or the federal government deem a premium increase to be unreasonable, they still lack the authority to reject the proposal, despite efforts by Sen. Dianne Feinstein, California Democrat, to include such a provision in the health care law.
So far, insurers nationwide have submitted 114 plans covering about 450,000 people for review, with HHS responsible for reviewing 37 of them, Mr. Larsen said. The agency has already deemed an 11 percent hike Everence is imposing on Montana customers to be reasonable.
The cost of health care coverage is an issue fraught with tension, with medical costs and premiums continuing to rise faster than the rate of inflation. The average annual premium for family coverage this year increased 9 percent over 2011, reaching $15,073 — a figure that has doubled since 2001.
Posted by WM on Monday, November 21, 2011, at 8:47 pm | 
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It’s nice of Hussein to apply his many years of experience in the insurance and financial industries to help this company keep costs down
Does he have muscles because I’ve never seen them….
@ anna
One big one… sphincter
Just who the hell are they to demand how a private company sets its rates in a “free” market? What companies have they run that gives them insight into how business REALLY works?
Communists. Disgusting.
Question: If you take an oath to uphold and defend the Constitution, and then, with malice, work to destroy it, is that not perjury? Treason is not too strong a word for what is going on in D.C.
Inst it so great having THE GODFATHER as president making them a offer they dare not refuse
If life imitated the movies, I would wish for Groundhog Day…..we could keep working at the last election until we got it right. Dreaming on…..
Oh, I can just hear that smug tone in Kathleen Seabiscuit’s voice now.
Sebelius called the increase “unreasonable,”
——–
Is that now the criteria for being in violation of the law? Is the standard made-up on the spot?
Is there a different standard for every insurance company?
Sounds like a smokescreen to me. He (and Timmah) gots bigger problems with AIG’s Sharia insurance business. Seems they allowed the use of TARP money to start this little venture. See http://www.zerohedge.com/article/geithner%E2%80%99s-other-hot-mess-taxpayer-seeks-divesture-billions-aig-alleging-funding-islamic-ins
more Obamacare nonsense…
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http://www.lifenews.com/2011/11/21/pelosi-bashes-catholics-they-have-this-conscience-thing/
Pelosi Bashes Catholics: “They Have This Conscience Thing”
Former House Speaker Nancy Pelosi is at it again, bashing Catholics for their pro-life position when she has promoted abortion in defiance of Catholic Church teaching at every turn.
This time, Pelosi is upset that the nation’s Catholic bishops are protesting a potential Obama administration decision forcing insurance companies to cover birth control, contraception and drugs that could cause abortions. They say certain religious groups may not be exempt from providing the insurance, which would violate their moral and religious views.
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wonder why rates are going up… look at what the companies must cover
“Oh what tangled webs we weave when at first the practice is to deceive….”
Somewhere, someone came up with that saying (or a version of it) and it has stuck around with time.
Sure, there is aspects of the private insurance companies that needs betterment. I don’t think national healthcare is the answer however.
So while the Pres finds important things to accomplish like telling private insurance companies how to carry on with business, he tends to overlook the interference of shipping ports and bad behavior in general. Yet, he does tell the Tea Party type people to “tone it down”. It’s so confusing.
http://www.rightofanation.com/2010/04/01/obama-tells-opponents-to-tone-it-down/
Let me first say, health insurance companies have monopoly, BUT…. the way to reduce rates is not by strong arming them, its with more competition, more across the state line competition…
SO first the fraud says to these companies, do X, Y, Z, these health companies try to comply, it costs more, then pass those costs on, I don’t like this, but I accept it, all companies off all types do this.
So, why the hell should the govt be telling private insurers they have to do all this, and then the govt officials are stupid to be surprised that this costs more, which the companies will of course past those costs on.
These idiots have to be the stupidest people I’ve seen, not one freaking economic class taken by any of them.
Where are Carl Bernstein and Bob Woodward when we need them?
Won`t be long until the jump is made from healthcare to bullets. either way these sumbitches are going to kill us
Like Kathleen or Obama know shit about running a business. God these people make me ill
Having been employed in the medical realm prior to the advent of the infamous DRG’s, time has revealed the system is a part of why the medical insurance companies are increasing costs, why hospital systems are sagging. Add in the mix of free medical care to illegals. There is a fair share of info on the internet about the DRG system. In theory it should be an excellent way to reign in costs/expenses, but somehow, it has mutated into something all together from what it’s original intent was. As far as I can gather about it.
http://www.questia.com/googleScholar.qst?docId=5002144310
More shakedown evil from none other than the evil enemy in the White House obama. arrest obama, the evil fraud punk and puke now for treason, sedition, and RICO violations.
Just like the shakedown of BP with the spill. One person spoke up and was slammed for the truth and then wussied out anyway from the RINO party establishment called GOP. Still RINOing also with that evil Rove and Co.
Evil is growing. Please stand up to the evil enemy now.
Uphold the U.S. Constitution as OUR troops do here and abroad.
Can we all agree now that we no longer live in a Republic but are instead being ruled by an embryonic communist dictatorship? Anybody disagree?
BHO is testing out what he learned from Hugo Chavez.
“Sebelius called the increase ‘unreasonable,’ holding it up as evidence that the government has an important role to play in reining in the cost of coverage.”
What is unreasonable is passing a law for everyone to submit to, then immediately granting waivers to organizations that are politically-connected.
F*cking tools!
Cue imperial death march music.
I’m going to remind everyone here when Obamacare was still in play Sebelius came out and threatened Human for disclosing to it’s customers about how their rates would go up, even though the law specifically stated that Humana was obligated to do so.
Another perfect example of government creating the problem in order to offer the solution.
Ubamacare inherently jacks up insurance cost, its designed that way. Next, the avg company/individual will no longer be able to afford premiums, grabberment steps in with single pay/universal care.
Fait accompli.
Seems kind of pathetic that first American people are being told what they must buy and now sellers are being told at what price they must sell.
Why don’t we just face it that Big Joe is running the show here.
Kathleen Sebelius called the increase “unreasonable,” holding it up as evidence that the government has an important role to play in reining in the cost of coverage.
Huh- so someone has annointed sebelius the arbiter of what is and is not “reasonable” when I wasn’t looking. That’s nice.
Funny thing- was not aware the gov’t had any sort of role to play in setting prices in a capitalist economy.
“This sends a message to insurers around the country that the days of unchecked, double-digit increases are over,” Mrs. Sebelius said.”
True- that’s the job of the feckless, inept, completely out its depth government and its horrifically bad appointees we’ve been cursed with.
Mennonites! Talk about self-supporting as a whole. None better……..
The Cabinet is full of lunatics………….
If your not Muslim your subject to harsh penalties.
If you are Muslim, the DOJ will cover your errors with a word.
Never more “favortism” shown for any group except servants of the true God.
Thank you so very much for covering this story; I would not have known of it otherwise. I am in shock, because the company involved, Everence, happens to be my own insurer! I cannot even begin to tell you all they have done for me and my family. Suffice it so say that you simply will not find a more ethical, honest, responsible, caring insurer.
There is a really perverse and shocking irony in the fact that this wonderful, tiny, Christian company would be the very first one Sebelius and her minions would choose to go after. It’s further evidence, for me at least, that Obama, Sebelius & Co. really are doing Satan’s work.