Health Insurance

Whistleblowers Sue City’s Top Health Insurance Providers

March 20, 2018 By Brigid Bergin, Wnyc.org Educate! Health Insurance, Lawsuit, Whistleblowers

Three whistleblowers representing New York City employees and retirees are suing the city’s top health insurance providers for defrauding taxpayers of more than a billion dollars. The lawsuit unsealed in New York Supreme Court last month alleges that GHI, along with parent company EmblemHealth and their partner, Empire Blue Cross Blue Shield, engaged in a long-running scheme that provided inadequate healthcare to city employees and retirees — while collecting $3 billion in premiums from the city each year. The GHI-Empire plan covers 600,000 people — about 75 percent of city workers, retirees and families. In a 63-page complaint, the plaintiffs say the companies filed false claims to overstate their expenses by an average of $55 million dollars a year between 2008 and 2014.

Health Insurance And Pharma Block Hopes For Single-Payer Health Care

February 1, 2018 By Josh Finkelstein, Opensecrets.org Educate! Big Pharma, Health Care, Health Insurance, Single payer health care

Senator Bernie Sanders of Vermont hosted a town hall recently to discuss the Medicare for All Act, during which he emphasized a conflict of interest around involving the private sector in healthcare. “Right now, we have a healthcare system that is not designed to provide quality care to all people in a cost effective way,” Sanders said at the town hall. “Let us be frank, we have a healthcare system designed to make enormous profits for insurance companies and drug companies. And disease prevention is not very high on their lists.” Sanders isn’t alone in his sentiment. A number of polls last year (see here, here, and here) indicate that a growing plurality of Americans support switching to a single-payer healthcare system, including a substantial majority of Democrats.

Fragmented Health System Paves Way For CVS-Aetna Merger

November 11, 2017 Aaron Mate, www.therealnews.com Educate! Health Care, Health Insurance, Merger, Monopoly

By Aaron Mate for The Real News. It's The Real News. I'm Aaron Maté. In what is being called the biggest merger in the history of the health insurance industry, CVS is reportedly making a $66 billion bid to buy Aetna. CVS operates pharmacies all over the country, while Aetna sells health insurance policies. Now, the cost of both pharmaceutical drugs and health insurance plans are already sky high, so could a merger of these two giants make those prices even higher? Joining me is Bill Black, associate professor of economics and law at the University of Missouri, Kansas City. Welcome, Bill. So, your thoughts on this potential merger.

Republicans Protect Insurance Industry, Call It ‘Stablizing Obamacare’

February 17, 2017 Peter Sullivan, www.thehill.com Educate! Congress, Health Insurance, Obamacare, Republican Party

By Peter Sullivan for The Hill - The Trump administration on Wednesday proposed a regulation aimed at “stabilizing” the ObamaCare marketplace by making changes favorable to insurers to help prevent them from bailing out or hiking premiums. The move is surprising, given that President Trump has vowed to repeal the Affordable Care Act. But his administration is now in the position of trying to shore up the law’s marketplaces, at least temporarily, while Congress debates replacement plans and timing options. Now that he’s president, Trump faces the possibility of being blamed for premium hikes or insurers dropping out if the market deteriorates. Trump has also taken steps to chip away at ObamaCare. Most prominently, he signed an executive order that, while not specific, called on agencies to loosen ObamaCare requirements.

Communities Plagued By Uninsurance Also Suffer From Breakdowns In Trust

February 3, 2017 Tara McKay, www.theconversation.com Educate! ACA, Health Insurance, Obamacare

By Tara McKay for The Conversation - Dismantling the Affordable Care Act (ACA) without a replacement plan is projected to increase the nation’s uninsured population by 18 million in the first year after repeal and by 32 million in 2026, according to recent estimates by the Congressional Budget Office (CBO). As lawmakers and the American public consider repealing portions of the ACA, it is an important time to reflect on what limiting access to health insurance might mean for Americans and their communities. If a repeal occurs, not only individuals, but also their communities, could be affected. Whether we like it or not, health insurance affects our lives in significant ways.

Obama Must Confront Monopoly Practices In Health Insurance

August 15, 2015 Lawrence J. Hanley, www.huffingtonpost.com Create! Corruption, Health Insurance, Monopoly, Obama

By Lawrence J. Hanley in The Huffington Post - The flurry of recent merger announcements from the handful of remaining national health insurance providers is cause for alarm for all Americans. The Affordable Care Act (ACA) has taken nearly full effect and it is clear that staggering annual increases in health insurance premium costs are still with us. The skyrocketing costs of health insurance and health care treatment are pushing working American families well past the breaking point. There is a limit to what working people can afford to pay for what should be a human right. The most recent corporate advances down the road of health insurance monopolization are the announcements that the enormous Aetna intends to absorb rival Humana, and at the same time the Anthem corporate giant -- formerly Wellpoint -- is maneuvering to swallow Cigna.

Obamacare Enrollees Highly Dissatisfied With Health Coverage

August 10, 2015 Kate Randall, www.wsws.org Educate! ACA, Health Insurance, Medicare, Obamacare, Single payer health care

By Kate Randall for WSWS - A new study, however, shows that those enrolled through Obamacare are more dissatisfied with their coverage than any other group of insured Americans. The poll from the Deloitte Center for Health Solutions, research arm of the consulting firm, finds that only 30 percent of people with insurance through the ACA exchanges are satisfied with their plans, mainly due to cost. By contrast, 58 percent of Medicare enrollees are satisfied, while 42 percent of those with insurance through their employer are satisfied. The most affordable plans offered for sale on the ACA exchanges come with deductibles in excess of $5,000 annually and other out-of-pocket costs. Data from the Deloitte poll shows that enrollment in an Obamacare plan is no guarantee that health care coverage will be affordable or accessible. Researchers surveyed 3,887 people who had purchased health insurance on either the state exchanges or the federal web site, HealthCare.gov. The poll found that only 24 percent of ACA enrollees felt they could get affordable care when they needed it, and an abysmal 16 percent felt fully prepared to handle future health care costs.

The Fight Over Obamacare Was A Giant Political Charade

July 5, 2015 Sonali Kolhatkar, www.truthdig.com Educate! ACA, Health Insurance, Healthcare, Obamacare

By Sonali Kolhatkar for Truthdig. The constant attacks on the ACA, including this last attempt, were less ideological than political, and in the end, the Supreme Court ruling was an affirmation of the supremacy of capitalism over human needs. It is true that 6.4 million Americans currently receiving subsidies for insurance would have lost their coverage had the court not voted to preserve the ACA. The vote was 6-3, with conservative Chief Justice John Roberts joining swing voter Anthony Kennedy and the four liberal stalwarts (Sonia Sotomayor, Elena Kagan, Ruth Bader Ginsburg, and Stephen Breyer). The fact that Roberts voted for it, and wrote the majority opinion, speaks volumes about what the ruling really means. According to him, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.” That single sentence clearly lays out the problem with what the right has sardonically named “Obamacare.” In voting to preserve the health care reform law, the court sought to “improve health insurance markets,” not access to health care.

Subsidies Upheld, But Health Needs Still Unmet

June 25, 2015 Dr. Robert Zarr, www.pnhp.org Organize! ACA, health, Health Care, Health Insurance, Single payer health care

By Dr. Robert Zarr for Physicians for a National Health Program. Washington, DC - Today’s decision by the Supreme Court in King v. Burwell to uphold the Affordable Care Act’s premium subsidies in about three dozen states will spare more than 6 million Americans the health and financial harms associated with the sudden loss of health insurance coverage. For that reason alone the decision must be welcomed: Having health insurance is better than not having coverage, as several research studies have shown. That said, the suffering that many Americans are experiencing today under our current health care arrangements is intolerable, with approximately 35 million people remaining uninsured, a comparable number underinsured, and rapidly growing barriers to medical care in the form of rising premiums, copayments, coinsurance and deductibles, and narrowing networks.

Obama Plan For Health Insurer Losses A ‘Bailout’

May 24, 2014 Noam N. Levey, www.latimes.com Educate! Affordable Care Act, Barack Obama, Health Care, Health Insurance

The Obama administration has quietly adjusted key provisions of its signature healthcare law to potentially make billions of additional taxpayer dollars available to the insurance industry if companies providing coverage through the Affordable Care Act lose money. The move was buried in hundreds of pages of new regulations issued late last week. It comes as part of an intensive administration effort to hold down premium increases for next year, a top priority for the White House as the rates will be announced ahead of this fall's congressional elections. Administration officials for months have denied charges by opponents that they plan a "bailout" for insurance companies providing coverage under the healthcare law. They continue to argue that most insurers shouldn't need to substantially increase premiums because safeguards in the healthcare law will protect them over the next several years. But the change in regulations essentially provides insurers with another backup: If they keep rate increases modest over the next couple of years but lose money, the administration will tap federal funds as needed to cover shortfalls.

“Obamacare” And The Bogus Healthcare Debate

May 9, 2014 Andy Piascik, www.indypendent.org Educate! Health Care, Health Insurance

The biggest secret of politics in the United States is that a majority of the population is to the left of both major parties. This can be amply demonstrated by comparing public opinion on a host of issues to the policies pushed by corporate and political elites. Whether it’s US aggression overseas, raising taxes on corporations and the super-rich, expanding social services or any number of other issues, there is a vast disconnect between the people and those who purport to represent them. This perhaps more than anything explains the widespread lack of public interest in voting. Rather than a result of apathy or ignorance, as many elite pundits arrogantly assert, public withdrawal from the electoral process is actually an informed choice. Since the policies of both major parties are generally in opposition to the will of the public, people often rightly view voting as a lose-lose proposition. As a result, voter turn-out in the United States is significantly lower than anywhere else in the industrialized world, plus millions who do vote - perhaps even a majority - do so with little enthusiasm. On no issue is the disconnect between elites and the public more striking than health care. For decades, public opinion has favored a single payer system such as exists in every other industrialized country. Simultaneously, corporate elites and their representatives in the two major parties have been waging an unrelenting war on the people’s right to comprehensive health care.

Insurance Rip-Off: Injured Good Samaritan Billed $165,000 By Aetna

April 26, 2014 Robert Anglen, www.azcentral.com Resist! Health Care, Health Insurance

The accident happened in an instant. One second, traffic was moving steadily. The next, metal debris was flying past Cliff Faraci's windshield as cars skidded across Loop 101 near Scottsdale Road. Faraci jammed on his brakes. In front of him, a battered red car was stopped sideways and steaming. Inside, a teenage girl, covered in blood, slumped in the driver's seat. Faraci ran to the car and tried to help her out. The driver and passenger doors were jammed. He talked to the girl, told her everything was going to be OK. "I noticed smoke coming from under the hood," Faraci said, describing the March 2013 accident as if it were still unfolding in front of him, the way it will play out inside his head for the rest of his life. "I reached in through the driver's window to turn off the ignition ... but I could not reach it ... I reached further into the car with both arms and upper body. ... I was halfway through the driver's window." The engine ignited. Faraci, standing in a puddle of gasoline, was enveloped by searing heat and yellow flames. He jerked away, trying to stop the burning. The ruptured gas tank exploded and Faraci watched the girl inside the car die.

Saying ‘Hell No’ To Obamacare

April 23, 2014 Dennis Trainor Jr, www.PopularResistance.org Resistance Report ACA, Affordable Care Act, Conscientious Objector To Obamacare, Dr. Margaret Flowers, Health Insurance, health insurance industry, Healthcare.gov, Margaret Flowers, Obama health insurance, Obamacare, Single payer health care, universal healthcare

Recently, Dr. Margaret Flowers initiated an online petition declaring herself a consciences objector to the Affordable Care Act and asking others to send a message to President Obama that the ACA is a scam. Dr. Margaret Flowers (MFlowers8) is a pediatrician from Baltimore who is an organizer at PopularResistance.org, co-directs ItsOurEconomy.us and co-hosts Clearing the FOG on We Act Radio. She is adviser to the board of Physicians for a National Health Program and is on the steering committee of the Maryland Health Care is a Human Right campaign.

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