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April 08, 2014 at 12:56 PM
To me, what’s most hilarious about the new public health insurance exchanges’ lack of respect for how much it costs to get people into health insurance plans is that it shows that the exchange runners’ aren’t too big on risk management.
The exchanges wanted to pay agents about $50 per qualified health plan (QHP) enrollee. Agents suggested that $200 to $300 might be a realistic minimum.
In the real world, the most efficient, gungho, volunteer-run operations seem to be spending at least $80 per QHP enrollee head, typical enrollers are spending a few hundred per head, and some enrollers are averaging thousands of dollars in grant money per head.
Of course, the exchange managers tell healthy young consumers that they need QHP insurance because something could go terribly wrong.
The young invincibles could go snowboarding down a black diamond trail and, somehow, mysteriously, find that the ground is in the way and causes a leg to break.
But the exchange managers seemed to base their open enrollment plans, and enrollment budgets, on the idea that they could just read from a script about how wonderful the Patient Protection and Affordable Care Act (PPACA), the PPACA marketplace system, and the QHPs, are, and enrollment websites would populate consumers into the plans licketty split, because the little people inside the Internet pipes would see how great and noble the marketplaces and QHPs were and force the computers to behave themselves.
An operational guide for the PPACA exchanges run by the U.S. Department of Health and Human Services included just one paragraph about what would happen if the magical Internet fairies didn’t lead exchange systems to work properly.
On the one hand: The truth is that I’m a wild optimist who believes that every new day will be better than every day I’ve ever had before, that every new restaurant will serve better food than the last one, and that every article I write will flow smoothly out of my fingers into the computer.
