When you read health insurance articles here, or anywhere else, you probably end up wanting to throw the article against a wall about five times per article.
This is a particularly dangerous situation when you're reading the articles on a phone, or a tablet, and you really could throw the article against a wall, and end up with glass in your eye. And maybe a strong suggestion from the folks around you that you ought to look into stress management.
Here's a look at some of the ideas floating across my screen this week that are challenging my own stress management skills.
1. It's not that big of a deal for the Patient Protection and Affordable Care Act (PPACA) public exchange system if UnitedHealth Group Inc. (NYSE:UNH) (and Assurant Inc. (NYSE:AIZ), and, partly, Humana Inc. (NYSE:HUM), and many, many CO-OPs, and, you know, a bunch of others) leave the exchange system, because there are still a lot of insurers selling plans through the exchange system.
The Bloomberg editors presented one spectacularly mindless version of this argument in an editorial we published, just to give readers an idea of the kinds of views that are out there.
The most irritating part of that particular editorial is the editors' blithe assertion that executives at Aetna, Anthem and Humana are all happy with their companies' PPACA exchange programs. But, note: Executives at all of those companies expressed concerns about the performance of their companies' exchange programs during third-quarter earnings calls, and Humana has already announced plans to cut back on its 2016 exchange plan efforts. Humana also announced plans to jump into Aetna's arms about the same time insurers were figuring out how the PPACA 3R's risk management programs — the reinsurance, risk-adjustment and now-infamous risk corridors programs — would really work.
Elsewhere in that editorial, the Bloomberg editors say that all that has to happen for the exchanges to do better is for Congress to extend or expand the 3R's programs.
OK. All that has to happen is for Congress to help strengthen PPACA programs.
And on what planet, exactly, is that going to happen?
Of course, to be charitable: Congress could do something. Insurance companies and hospitals give money to Republicans, too. But the idea that Paul Ryan will let a PPACA helper bill sail through the House does not seem to be a sure thing.
2. Calm statements from the U.S. Department of Health and Human Services (HHS) about how vibrant and viable the exchange system is are helpful. One of the huge problems with everything to do with PPACA implementation is that we can never tell whether insurance company executives and state-based exchange program managers are really happy, whether they're unhappy but being sincerely polite, or whether they're furious but muzzled by HHS nondisclosure agreements.