Wednesday, April 20, 2016

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Deserting ObamaCare: UnitedHealth, nation's largest health insurer, bolts, fears huge losses


The nation’s largest health insurer, fearing massive financial losses, announced Tuesday that it plans to pull back from ObamaCare in a big way and cut its participation in the program’s insurance exchanges to just a handful of states next year – in the latest sign of instability in the marketplace under the law.
UnitedHealth CEO Stephen Hemsley said the company expects losses from its exchange business to total more than $1 billion for this year and last.
Despite the company expanding to nearly three dozen state exchanges for this year, Hemsley said the company cannot continue to broadly serve the market created by the Affordable Care Act's coverage expansion due partly to the higher risk that comes with its customers.
UnitedHealth Group Inc. said it now expects to lose $650 million this year on its exchange business, up from its previous projection for $525 million. The insurer lost $475 million in 2015, a spokesman said.
UnitedHealth has already decided to pull out of Arkansas, Georgia and Michigan in 2017, and Hemsley told analysts during a Tuesday morning conference call that his company does not want to take the financial risk from the exchanges into 2017.
"We continue to remain an advocate for more stable and sustainable approaches to serving this market," he said.
The state-based exchanges are a key element behind the Affordable Care Act's push to expand insurance coverage. But insurers have struggled with higher-than-expected claims from that business.
A recent study by the Blue Cross Blue Shield Association detailed how many new customers nationwide under ObamaCare are higher-risk. It found new enrollees in individual health plans in 2014 and 2015 had higher rates of hypertension, diabetes, depression, coronary artery disease, HIV and Hepatitis C than those enrolled before ObamaCare.
On the heels of Tuesday's announcement, Sen. Ben Sasse, R-Neb., said in a statement it’s a sign of “the President’s broken promise that families would have more choices under ObamaCare.”
The Kaiser Family Foundation, in an analysis on the prospect of United's exit, said “the effect on insurer competition could be significant in some markets – particularly in rural areas and southern states” if it is not replaced.
In the most extreme scenario, “If United were to leave the exchange market overall, 1.8 million Marketplace enrollees would be left with two insurers, and another 1.1 million would be left with one insurer as a result of the withdrawal,” the analysis said.
UnitedHealth had moved slowly into the newly created market by participating in only four exchanges in their first year, 2014. But the company then expanded to two dozen exchanges last year and said in October it would add to that total. It currently participates in exchanges in 34 states and covers 795,000 people

A month after announcing its latest exchange expansion, UnitedHealth started voicing second thoughts. The insurer said in November that it would decide by the first half of this year whether to even participate in the market for 2017.
Insurers say they have struggled, in particular, with customers who have signed up for coverage outside regular enrollment windows and then dumped expensive claims on their books, a problem the government has said it would address.
A dozen nonprofit health insurance cooperatives created by the ACA to sell coverage on the exchanges have already folded, and the survivors all lost millions last year.
Other publicly traded insurers like Aetna have said that they have lost money on this business as well. But some companies, like Molina Healthcare, have said they have managed to turn a profit from the exchanges.
Analysts expect other insurers to also trim their exchange participation in 2017, especially if they continue to struggle with high costs.

New York comptroller orders audit after reports of voting issues


The city's comptroller has ordered an audit of its Board of Elections after reports that some voters were turned away from polling sites during the state's presidential primary.
Comptroller Scott Stringer said his office had received complaints that some people couldn't vote and others had to deal with polling locations that opened late or had malfunctioning ballot scanners.
"The people of New York City have lost confidence that the Board of Elections can effectively administer elections, and we intend to find out why the BOE is so consistently disorganized, chaotic and inefficient," he said.
Stringer also questioned the fairness of a board process to cancel the registrations of people who haven't voted in recent elections and didn't respond to notices asking them to confirm their addresses.
Between Nov. 1 and April 1, the number of registered Democrats and Republicans in the city was trimmed by roughly 1.4 percent, from 3.58 million to 3.53 million, according state Board of Elections statistics. Much of that decline occurred in Brooklyn, where the number of people registered in the two parties fell by 64,000.
The city Board of Elections' executive director, Michael Ryan, dismissed the issues Tuesday, saying the "overwhelming majority of voters cast their ballot without an issue."
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He said the purging was part of a routine review of voter records and was in response to a scathing report that was issued in 2013 accusing the agency of failing to maintain updated voter logs.
Specifically addressing the issue in Brooklyn, Ryan said that between the fall and the primary 126,000 voters in the borough either were removed from voting lists or had their statuses changed to "inactive" because they had moved, their mail was returned as undeliverable or they failed to vote in two federal elections and didn't respond to letters.
Voters on the inactive list are still eligible to vote but must do so by affidavit ballot.
Stringer's complaints were echoed by fellow Democratic lawmakers, including Brooklyn Borough President Eric Adams and Mayor Bill de Blasio, who said monitors reported voting lists that "contain numerous errors, including the purging of entire buildings and blocks of voters from the voting lists."
State Attorney General Eric Schneiderman, whose office runs a state elections hotline, said the majority of the 700 complaints it received by Tuesday afternoon were from people who said they were told they weren't registered to vote or they weren't registered in a particular political party.

Dem tensions flare as superdelegates flock to Clinton, even in states Sanders won


When Democrats caucused in Washington state last month, Bernie Sanders scored an overwhelming victory – winning 73 percent to Hillary Clinton’s 27 percent.
But that wide margin did nothing to sway the state’s superdelegates, party insiders and officials free to back whomever they choose. Of the 16 up for grabs, all nine who have announced their support have gone for Clinton.
All are elected leaders, including Gov. Jay Inslee. “I’m endorsing Hillary Clinton,” Inslee said. “I’ve worked with her for over 25 years, I know she’s tough, I know she can really be an effective leader.”
But the disconnect with the voters who put Inslee and other Democrats into office has sparked a backlash. The same tensions over superdelegates are flaring in states across the country. Sanders supporters want party insiders and elected leaders to follow their lead, and not – as it so often seems – act as a counterbalance to their vote.
“The danger in my mind, as a Democrat, is it makes our Democratic party look corrupt,” said David Spring, a leader of WashingtonforBernieSanders.com.
Over the last month, the Vermont Democratic socialist has won seven of eight nominating contests. That’s netted him two-thirds of the pledged delegates that were up for grabs in those states. But, among the superdelegates in those same states, Clinton leads 25-1.
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After winning the Wisconsin primary on April 5, Sanders started lobbying to change some minds.
“I think that a lot of superdelegates are going to be looking around them,” Sanders told a crowd in Laramie, Wyo., “and they’re going to be saying ‘which candidate has the momentum, which candidate is bringing out the numbers of people.'”
Democratic Party officials point out that superdelegates are free to switch candidates and they’ve never been the deciding factor in any nomination since being created before the 1984 presidential election. But there always could be a first -- if it’s this year, those currently ‘feeling the Bern’ might simply feel like they got burned.
Sanders’ backers, though, are turning up the heat with websites aimed at pressuring Clinton superdelegates to switch candidates. One, www.superdelegatesdemocracy.com, gives the social media accounts of all 469 superdelegates pledged to Clinton. Another recently described itself as a hit list and gave phone numbers and emails of Clinton superdelegates.
Washington state’s delegation has been especially targeted. Rep. Rick Larsen, after wishing Facebook friends a Happy Easter, was greeted with "happy last term as a congressman." Democratic Rep. Suzan DelBene was accused in one post of “undermining her constituents.” And Rep. Derek Kilmer was told his support for Clinton made him “the same type of subhuman.”
The Sanders camp says it has no connection to the websites and denies any attempt to embarrass or harass Democratic superdelegates. But Sanders supporters say the current system is undemocratic. Former Seattle Mayor Mike McGinn wrote an op-ed piece saying superdelegates poisoned the nomination process by trying to create an air of inevitability early on.
A Sanders supporter in Colorado who attended a campaign event in Wyoming agreed.
“There is something completely wrong and the superdelegates currently have the power to change the outcome,” said Victoria Bard. “And we want the people to be able to decide the outcome.”

Trump, Clinton cruise to New York wins; Cruz must rely on contested convention


Republican Donald Trump and Democrat Hillary Clinton regained their stride in the presidential race Tuesday night, winning their respective primaries in New York — and sending a message to their rivals that their campaigns are back on track after recent stumbles. 
Trump, in his home state, notched what appeared to be his biggest victory yet. Speaking to cheering supporters Tuesday night at Trump Tower, he declared: “We don’t have much of a race anymore.”
“[Texas] Senator [Ted] Cruz is just about mathematically eliminated,” Trump claimed. “We’re really, really rockin’.” Indeed, Cruz's poor showing left him with no mathematical chance of clinching the nomination before the Republican convention in July, though Trump could still end up short of the needed 1,237 needed to seal victory before the gathering.

With 94 percent of precincts reporting, Trump had garnered 60 percent of the vote, his highest total in any state. He had claimed at least 89 of New York's 95 Republican delegates.
Ohio Gov. John Kasich finished second in the state with 25 percent of the vote, leaving Cruz to finish third with 15 percent. Kasich was awarded at least three delegates, leaving Cruz in danger of getting shut out.
As of Tuesday night, Trump had 845 delegates. Cruz had 559, and Kasich had 147.
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Cruz, who infamously panned Trump's "New York values" earlier in the primary, had been bracing for a tough showing in the Empire State and showed no signs of throwing in the towel. The Texas senator was already looking ahead, turning his attention to Pennsylvania, where he delivered a speech calling on Americans to join together to move the country forward.
"It is time for us to get up, shake it off and be who we were destined to be,” he said.

In the Democratic race, Clinton soundly defeated Vermont Sen. Bernie Sanders in her adopted home state, which she represented in the Senate for eight years. Despite the Brooklyn-born Sanders’ hard-fought attempt at an upset, the former secretary of state successfully staved off that possibility Tuesday night. With 94 percent of precincts reporting, Clinton had 58 percent to Sanders’ 42 percent.
“There’s no place like home,” Clinton said at her victory rally.
Clinton claimed the race for the Democratic nomination is now entering the “home stretch” and “victory is in sight.” In an apparent bid to bridge divides in the party amid an increasingly bitter primary, she directed a message to Sanders voters: “There is much more that unites us than divides us.”
Clinton and Trump both were seeking rebound victories Tuesday after recent setbacks. Cruz had complicated Trump's path to the nomination by winning recent contests like Wisconsin and getting allies elected to state delegate slates. On the Democratic side, Sanders had been on a winning streak up until Tuesday – winning seven of the eight prior contests.
Whether Trump and Clinton's performance Tuesday will help either wrap up the race in the coming weeks remains an open question. The campaigns head next to five Eastern states that vote next Tuesday: Pennsylvania, Maryland, Connecticut, Rhode Island and Delaware.
It’s potentially friendly territory for the front-runners. But unless Trump can drive Kasich and Cruz out of the race, the billionaire businessman still may have to fight all the way to the final primary contests on June 7 – including delegate-rich California, which may end up being the deciding race – to see if he can clinch the nomination.
On the Democratic side, Clinton could easily attain the necessary 2,383 delegates to win by June. The question is whether Sanders would accept it – as her tally includes the support of party insiders known as “superdelegates,” and the Sanders campaign has suggested they shouldn’t count toward that 2,383-delegate threshold.
As of Wednesday morning, Clinton had 1,893 total delegates, compared with Sanders’ 1,180.
Sanders also campaigned in Pennsylvania Tuesday. He hammered his campaign themes about a “rigged” economy and “corrupt” campaign finance system, while urging voters to join him in challenging the status quo.
“We’re gonna win this election,” Sanders vowed. However, his senior adviser Tad Devine told the Associated Press that the campaign planned to "sit back and assess where we are" after a next week's contests.

According to an Associated Press tally, Clinton won at least 135 of New York's 247 delegates. Sanders had won 104, with eight delegates outstanding.
The importance of every last delegate has increased in recent weeks as Cruz has appeared to outmaneuver Trump’s campaign in the behind-the-scenes preparations for July’s convention.
Cruz has been laying the groundwork for a contested convention – one in which where no candidate has the required number of delegates – by getting allies elected as delegates. That way, if voting extends to a second round, some of those pledged to Trump on the first round could peel off and support Cruz. This has heightened the pressure on Trump to clinch the nomination before the convention.
A Kasich campaign memo, meanwhile, touted the Ohio governor’s chances in the upcoming state contests – and his prospects for securing delegate support in the event of a contested convention.
“The next 7 days are absolutely critical," the memo concluded. "It’s now or never to stop Trump and save the Republican Party."
The primary-day voting was not without its problems in New York. Voters ran into an array of polling-site glitches earlier Tuesday as they tried to cast ballots – with some locations opening late and others using broken machines.
The Wall Street Journal reported that some voters waited hours to cast ballots at a site in Brooklyn, where workers apparently did not have the keys when it was supposed to open Tuesday morning. Elsewhere in the borough, voters reportedly were turned away due to technical problems.
New York City Mayor Bill de Blasio also responded Tuesday to reports that thousands of registered Democrats have been dropped from the rolls, especially in Brooklyn. In a statement, the mayor called for major reforms to the election board and voiced support for an audit -- which the city comptroller has ordered.
“It has been reported to us from voters and voting rights monitors that the voting lists in Brooklyn contain numerous errors, including the purging of entire buildings and blocks of voters from the voting lists,” he said in a statement. “I am calling on the Board of Election to reverse that purge and update the lists again …”

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