Pelosi Watch: Highmark Jumps

Remember when Nancy Pelosi said we had to pass the healthcare bill to find out what was in it? Well, we’re finding out ever more:

Citing an estimated $500 million loss last year on health insurance plans sold on the Affordable Care Act marketplace, Highmark Inc. said Friday it plans to reduce what it pays doctors who treat patients with the plans.

Highmark plans to reduce payments to the physicians by 4.5 percent starting April 1 as part of a broad effort to stem losses related to the federal marketplace, said Alexis Miller, Highmark’s special vice president of individual and small group markets.

Miller estimated the insurer paid about $500 million more for patients’ care in 2015 than it collected in premiums for the plans sold on the federal marketplace, resulting in the loss. Highmark officials have said the people who signed up through the health law’s marketplace were sicker than the insurer expected.

This is precisely what was feared. Guaranteed issue would mean lots of sick people would sign up for insurance, costs would soar and insurance companies would either have to raise rates (triggering a possible death spiral) or cut what they pay doctors (driving some out of the system).

Keep something else in mind: Bernie’s Sanders absurdly optimistic single payer plan depends on cuts to reimbursement that are at least four times what Highmark is considering.

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