Welcome to the Improv: Insurers Balk at New Biden Mandate

After the Supreme Court delivered a major blow to his pandemic policies, President Joe Biden does not seem done with federal mandates. The new rule, which took effect this weekend, requires insurance companies to cover the costs of in-home tests. However, according to the New York Times, many insurers are balking that the mandate asks the impractical in the short term and will only create months of frustration for citizens. Indeed, one executive said it would send companies back to the old “shoe box days.”

Biden acted unilaterally to order companies to cover the costs of eight at-home tests per month. The problem is that such a guarantee requires a new system for these companies in covering over-the-counter tests as opposed to things like doctor visits. The latter are already part of a unified computer system with billing codes.

The Biden mandate will require companies to process receipt-based claims. Ceci Connolly, president and C.E.O. of the Alliance of Community Health Plans described it as “taking things back to the olden days, where you’ll have a person throwing all these paper slips in a shoe box, and eventually stuffing it into an envelope and sending it off to a health insurer to decipher.”

The controversy is particularly interesting after the mandate rulings. The justices in the major OSHA ruling ruled that “major questions” like a vaccine mandate should be resolved through the legislative process.  As stressed by Justice Neil Gorsuch in his concurrence: it is a matter of “who decides”:

Why does the major questions doctrine matter? It ensures that the national government’s power to make the laws that govern us remains where Article I of the Constitution says it belongs—with the people’s elected representatives. If administrative agencies seek to regulate the daily lives and liberties of millions of Americans, the doctrine says, they must at least be able to trace that power to a clear grant of authority from Congress.

The tests are different from the major question of a national vaccine mandate. This is more of an agency decision in determining what is covered.  However, the lack of preparation and process are indicative of the improvisational character of many of these new mandates. The legislative process allows such changes to be reviewed both from a policy as well as a process standpoint.

I do not believe that this rule is unconstitutional or an “executive overreach,” as suggested by some. However, it shows how such mandates can satisfy immediate political needs without addressing the logistical problems downstream. If these executives are correct, the public is likely to face difficulties in getting reimbursement for months. If the agencies order faster outlays, it is likely to increase fraudulent or erroneous payments.

There remain serious questions of why the Biden Administration did not act earlier on tests or, even more importantly, therapeutics with the likelihood of variants emerging. That includes creating a system for such reimbursements for tests. That will hopefully be the subject of bipartisan oversight, which is increasingly rare in our current political environment.

 

 

159 thoughts on “Welcome to the Improv: Insurers Balk at New Biden Mandate”

  1. Joe says, “You don’t have to worry about the insurance companies raising your rates cause we’ll just institute additional price controls.” “We’ll just get more tax dollars from our first responders to continue our ponzi scheme.” “Never let a good catastrophe go to waste.”

    1. Almost as misleading as the Republicans’ claim that the tax cuts for the rich would pay for themselves.

  2. The “science” suggests these test results are unreliable at best and only good for that “minute” the test is taken. Take another test 15 minutes later and you may get a different result.

    IF YOU HAVE SYMPTOMS = you are sick

    IF YOU HAVE MILD SYMPTOMS = you may be getting sick

    IF YOU HAVE NO SYMPTOMS = you are not sick

    There’s your TEST.

  3. Mass COVID tests are unwise. In the hands of untrained Americans, their false positive/negative results will cause further mayhem. Biden’s mandates are political theater executed by Biden’s handler.

    Roger Kimball states publicly what many Americans whisper privately. Touché

    Joe Biden: Deep State Puppet
    Will the country be able to survive three more years of a deep state conspiracy presided over by an angry, incompetent, and increasingly senile puppet?

    https://amgreatness.com/2022/01/15/joe-biden-deep-state-puppet/

    1. “Mass COVID tests are unwise. In the hands of untrained Americans, their false positive/negative results will cause further mayhem.”

      Absolutely.

      If I remember correctly during the Obama administration the numbers of cases and deaths rose at an alarming rate. Correct me, if I am wrong. I think Obama stopped counting or reporting the numbers.

  4. Hey ole man Joe, while your at it why not mandate that Kellogg provide four boxes of corn flakes to every household per month at absolutely no cost to the consumer. The only catch will be that it will be required to pay for the little “free” prize in each and every box. Even the smallest child will say, “Hey, whats going on here?” “I thinks I saw a puddy tat.”

  5. These pcr and antibody tests are crap. We have 30 people on quarantine in the Catholic faculty I work at, the majority are not sick. We had a security guard test positive and he demanded another test and he was negative. The CDC said the tests don’t work. The inventor said they don’t work. I really don’t get it.

  6. [Warning: Off-topic]

    “The Pro-Trump Network OAN Is Getting Booted From DirecTV In What May Be A Major Blow To The Station”

    https://uproxx.com/viral/oan-one-america-news-network-booted-directv/

    We should expect Turley to criticize DirectTV for removing One America News Network (OAN) even though he acknowledges that this would not constitute a violation of the First Amendment since DirectTV is not a government entity. On the other hand, OAN is a competitor of Turley’s own Fox News as the article notes:

    “Founded in 2013, OAN didn’t take off until the Trump presidency, especially when the former president got mad at Fox News for being insufficiently dutiful to him, directing his base to OAN instead. The network has had its share of controversies, not the least being when one of its hosts called for the execution of thousands of people he alleged were involved in fictitious voter fraud.”

    To my knowledge, Turley has never mentioned OAN in any of his articles much less criticized it for its overt advocacy journalism in favor of Trump! Why? He did not even condemn the host calling for the execution of Democrats involved in “stealing the election.” Accordingly, Turley may ignore this “Little Brother” censorship because he does not wish to raise the profile of one of Fox’s media competitors on the Right. By the same token, Turley does not criticize Newsmax’s obvious advocacy journalism in favor of Trump. It seems that it is not a good look for Turley to point his finger at Rightwing advocacy journalism when he endeavors to highlight SOLELY the advocacy journalism by Fox’s competitors on the Left.

    We shall see what Turley decides to do. My guess-

    Crickets….

        1. About what? You come on here all the time. No one cares about what you say except you. We get it. You hate Steve turley … You hate conservatives. Meh.

            1. Steve Turley is what Jonathan Turley is called by someone who does not know what he is talking about

      1. Trump isn’t a conservative. Conservatives believe in things like marital fidelity, personal responsibility, paying valid debts and respect for the law, none of which apply to Trump. Conferring that title on a fat narcissist who exists solely to seek attention and praise for his massive and fragile ego is wrong. OAN and News Max aren’t journalists either: they are Trump worshipping outlets that flourished after Fox kept getting sued for lying about Trump losing the election.

        1. What does a Democrat believe in? Other than, “the ends always justify the means” and ‘get power’ and hold onto it ‘by any means necessary”?

    1. Still off topic:

      So Jeff, what say you about this poll result? I rarely read Rasmussen polls these days – not as good since the founder was bought out and left. But I found this little piece disturbing: Are the D’s now in favor of health gulags?

      “– Forty-five percent (45%) of Democrats would favor governments requiring citizens to temporarily live in designated facilities or locations if they refuse to get a COVID-19 vaccine. Such a policy would be opposed by a strong majority (71%) of all voters, with 78% of Republicans and 64% of unaffiliated voters saying they would Strongly Oppose putting the unvaccinated in “designated facilities.””

      https://www.rasmussenreports.com/public_content/politics/partner_surveys/jan_2022/covid_19_democratic_voters_support_harsh_measures_against_unvaccinated

      1. I oppose. However, this country effectively banished smokers. Who’s more of a threat to the public? Smokers or the unvaccinated and unmasked? Second-hand smoke or Covid?

        1. Good question, but neither should be the basis for creating health camps to keep the “deplorables” out of sight

          1. I said that I disagree with putting the deplorables in health camps. They should be treated as second class citizens not unlike smokers. Smokers cannot pose a risk to those indoors and the unvaccinated cannot do so either.

            1. Jeff says,

              “I said that I disagree with putting the deplorables in health camps. They should be treated as second class citizens not unlike smokers. Smokers cannot pose a risk to those indoors and the unvaccinated cannot do so either.”

              It’s thinking like this that leads to dehumanization of others. Once you have established a class of people who are” less than” yourself, it becomes easier to inflict psychological, sociological, financial, and physical harm on them.

              Unlike many here, I actually read your comments. I really want to try to understand what people on the other side of the political spectrum are thinking. Treating person as less than yourself isn’t a good look Mr. Silberman. It’s thinking like yours that can lead to internment camps.

              1. Irregular+poster says:

                “It’s thinking like yours that can lead to internment camps.”

                The internment camps are the great outdoors for smokers and the unvaccinated. They are not being shut-in; they are being shut-out.

  7. The essential economic fact that needs to be recognized is that the Biden mandate is not free to the consumer. In the end, the consumer will pay higher premiums for their health insurance. We will be lucky if Biden’s plan doesn’t double the real cost of the home tests.

    Breaking down the additional costs isn’t so hard. There will be substantial administrative costs for reimbursement and high costs for the additional risk the insurers face. One has to add the cost of the test and how much extra will be tacked onto the price by the producers, recognizing that the consumer will be getting the tests for free. Fraud is an unknown factor, but since insurers are reimbursing costs, the program will incentivize people to use all their free tests or sell them at a profit. I have yet to include the additional gains to the producers, middlemen and retailers or their risks.

    This is a big-time expenditure. The economists have been through these types of calculations many times and recognize that the number of insured drops for every rise in premium.

    1. Exactly.

      This will also make insurance more expensive for employers, increasing the cost of labor. Again. Leading to layoffs, perhaps.

  8. Most home Covid tests cost $12. 8 tests per month is 96 per year. That’s a benefit with $1152 per year.

    At 329.5 million people in the US, the maximum cost to insurers possible would be $379,584,000,000. Plus overhead and administrative fees. Considering they have to create a new billing system and codes to handle receipts, that would be excessive.

    Granted, I am unclear if it’s 8 tests per month per person or per household. Not all Americans are insured.

    Think our premiums will go up?

    1. Without question. As I said above we will be lucky if the costs involved don’t double the costs. Insurance always causes a substantial rise in costs.

    2. Dear “expert” Karen: what do you think the cost for COVID hospitalizations have been in this country? What kind of a hit have health insurers taken due to COVID? Then, consider the fact that most hospitalizations and intensive care servies were due to those who have refused vaccination? Think our premiums will go up? Since you’re now an expert in economics, what is your considered opinion as to the cost for refusing vaccination, and who gets to pay for it? Then, what about the cost for those unvaccinated who have died, leaving minor children, for whom Social Security must send a monthly check until they are 18? What kind of hit did the Social Security fund take as a result of such deaths?

      1. Since you’re now an expert in economics, what is your considered opinion as to the cost for refusing vaccination, and who gets to pay for it?

        Casting the net wider, those Americans who refuse to lose weight, have a BMI >25, are responsible for driving up health care costs and insurance premiums. What is your BMI, Natacha? 2+ years ago, Paul S. Schulte used to badger you with this question but you purposely chose to ignore it. So I ask….what is your BMI?

        Anti-vaxxers Fat people claim that their not getting vaccinated in shape is their individual choice that does not affect others. They make this choice willingly. It is completely reasonable that with that choice comes responsibility and thus if they get sick due to Covid being fat they can be prevented from using health care resources. Covid Heart attacks and diabetes hospitalization are expensive (which they do not pay for out of pocket) and takes up valuable bed space from others. Why should their stubbornness be allowed to cause harm to others?”
        – DLAM

  9. I do not believe that this rule is unconstitutional or an “executive overreach,” as suggested by some.

    Health Insurance Companies operate under State licensing. That’s why ObamaCare struggles so. Insurance is a STATE wide business. In fact. Health insurance cannot be sold across state lines. I don’t believe the legislature could make such a demand. Insurance is a contract between a company granted a license in one State with an insured entity, of the same State.

    This reminds me of Obama declaring GM bond holders became common creditors, Thus losing their legal prefered status to a bankrupt companies funds. Obama threatened bond holders with IRS harassment if they challenged their demotion, to common creditor.

    1. Let’s all get covid. Some will be more likely to die.

      Lets all drive to Grandmas. Some will be more likely to die

      Lets all go to bed. Some will be more likely to die.

      the comment is stupid on stilts

  10. 8 home tests/month, 96 per year.

    Nothing is free. How much will premiums rise to cover that benefit? How much less would they have risen with a 5$ copay, waived for Medicaid?

    Most politicians do not understand math or business. They have grown so used to spending other people’s money, that they do not understand what things cost.

    1. Karen overstates:

      “Most politicians do not understand math or business. They have grown so used to spending other people’s money, that they do not understand what things cost.”

      And the masses are the asses.

    2. Since you apparently know so much about what things cost, what has been the cost for refusing vaccination, not just the amount expended for for hospitalizations, which are mostly due to anti-vaxxers, but for schools closing down, inability to go to work, extra child care costs, etc? Give us your considered opinion, and then compare the cost with Biden’s efforts to get COVID under control. Which is more expensive–to let the pandemic rage on, with hospitalizations and deaths–or to try to push for testing and vaccination to stop the spread?

        1. How can anyone prove anything to a ReTrumplican who gets his news from Fox, OAN, News Max, Breitbart and Info Wars? Check with: you state and local health departments and the CDC. Most of those who are overrunning hospitals with COVID infections,, especially the sickest–those in ICUs and on ventilators–are not vaccinated. This is part of the reason for so much frustration by doctors and nurses–the majority of sickest patients are those who refused vaccination. What do you suppose has been the cost, and how much will it cause health insurance premiums to rise? For the uninsured, they will start overrunning bankruptcy courts (unless they die).

      1. hospitalizations, which are mostly due to anti-vaxxers

        Check you emails. The narrative has shifted. Now covid is not so bad. Hospitals are not overrun with covid patients, they have patients, and those patients have turned out to have covid. And all the cases???Counting cases is so last year. Cases don’t matter, deaths matter. Things arent so bad. Biden is ON

      2. “Since you apparently know so much about what things cost, what has been the cost for” the fascist diktats that shut down the economy and the schools?

  11. I initially thought that this Administration would be Carter 2.0. No longer, as that comparison is an insult to Mr. Carter

  12. Of course this is executive overreach. How does the President have the authority to mandate contractual requirements? Such matters under Obama care and Medicare and Medicaid are subject to the Government Administrative Code.

  13. Typical Lefty approach: let’s give the people something “for free”; it buys votes.

    In reality that “free” gift will cost us all in higher insurance premiums.

    Lefties count of a complicit media and unthinking voters to hide the cost.

    Just look at the Lefty posters on this blog; emotional, unthinking, and rabid.

    Exactly what the Dems count on.

  14. Biden always fails at logistics and predicting roadblocks and consequences.

    He subscribes to the ideology that if government decrees it, it is good and everything will magically fall into place.

    Government decreed vaccine mandates. That led to the firing and early retirement of nurses and other healthcare staff, police, fire, truckers, workers in processing plants…

    In combination with Omicron infecting and spreading in the vaccinated population, this led to containers having no one to ship them, empty store shelves, food shortages, astronomical wait times in ERs, not enough cops and firemen.

    When you are going to have more people out sick, you don’t slash the workforce able to cover for them.

    When blue states like CA increased the felony threshold for theft, or decline to prosecute, you have entire trains looted, empty shelves, and businesses closing, taking jobs with them.

    It should also be noted that Biden did not add a single job to our economy. The CBO estimated 6.2 million new jobs for this time period as a result of Trump’s policies. If Joe Biden had done nothing, we would have had 6.2 million jobs. Instead we got 6.1 million. So he lost us 100,000 jobs.

    Also, frankly, new jobs can be misleading during a pandemic. If you shut down businesses for months, and then under reopening, the survivors hired back, those aren’t actually new jobs. If you paid people enough to stay home that many quit and refused to work, it’s not really new jobs when the benefits run out and they return to the workforce.

    1. Karen: [Biden] subscribes to the ideology that if government decrees it, it is good and everything will magically fall into place.”

      +++

      See: King Canute.

    2. The annual labor participation rate was falling until Trump became president, at which time the rate climbed. It fell with the pandemic and remains at its lowest for at least the past 25 years and hasn’t demonstrated the increase we should have seen.

    3. Karen always fails at trying to appear as an informed intellectual instead of what she is; a diehard Fox news disciple who regurgitates the rhetoric and lies she hears.. Biden has done everything humanly possible to try to save lives, unlike the hog you worship, who lied about the dangerousness of COVID on purpose because it makes him look bad. People who refuse vaccination have no right to go around infecting people they come into contact with–be they nurses, police officers, factory workers, firemen, or whatever. Resistance to vaccination is based on believing lies. Since billions of people worldwide have been vaccinated, the vaccines are proven to be safe. Since the sickest of those who are hospitalized are not vaccinated, this proves the vaccines are effective to do what they are supposed to do–prevent serious illness and death.

      The 10% unemployment rate inherited by Biden from the fat narcissist is down to 3.9%, and the GDP is the best since 1984. More people are now working and wanting to buy things, which is one reason for shortages. The Trump Recession resulted in fewer orders, due to unemployment, which resulted in lower consumer demand, which led to lower factory output. The shortage of goods needing computer chips is the direct result of Trump’s stupid trade war with China. So, the supply chain shortages are Trump’s fault, not Biden’s. And, you really need to stop repeating the lies you got from your alt-news sources. Joe Biden didn’t lose “us” anything.

  15. How can the government order insurance companies to cover up to 8 tests per month per person, without them being allowed to raise their rates immediately to cover the additional cost? Fair is fair. Or why doesn’t the government itself pay for these tests as they do for the vaccinations, so the insurance companies are not even involved. Problem solved! Too often government wants to force private individuals and companies to provide and pay for what government consider essential services, without any compensation to private individuals or companies for these additional services. My wife and I are victims of the government eviction ban which required us to provide free housing to renters that could not or would not pay us, We had to hope the government would pay us something eventually, with no guarantee we would receive anything or the full amount of rent due. We lost tens of thousands of dollars in rent that we could not recover from either the tenants or the government due to this. and this is what we rely on to supplement our own social security income.

  16. 8 home tests a month? So, inadvertently…this person is going to raise insurance prices! We are already struggling to feed our families (with what the stores seem to be able to supply) and put gas in our vehicles to get to work. This administration is a dumpster fire! 🤬

    1. Let’s go Brandon.

      That phrase has created an entire booming industry. Shirts, mugs, flags, bumper stickers, mouse pads, stickers, hoodies.

      I’ll bet the unifying disgust at the Biden Administration was measurable in the economy.

      1. Karen, Honey, there is no “America vs. Biden”–that is the theme pushed by Fox, and it’s not the case. There is no “unifying disgust at the Biden Administration”, which is another lie. People are rightfully frustrated with inflation, but Biden has brought unemployment under control, the GDP is the best since 1984, and they are working to get the pandemic under control as well. See, the people at Fox, OAN, News Max, Info Wars and other pro-Trump media use rhetoric to convince you that you Trumpsters are in the majority, which is not the case. And, that you think that this cutesy phrase is clever simply exposes the depths of your ignorance.

        1. Remember when Progressive women thought it was a cool, defiant way to protest Trump by wearing their “I’m a Nasty Woman” tee shirts?

          Or “F*CK Trump” paraphernalia?

          Or when it was cool for the Dems in Hollywood to say “F*UCK Trump” out loud at award ceremonies and get standing ovations and cheers?

          Yeah, “Let’s Go Brandon!” is just so crass, isn’t it?

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