Come for the politics, stay for the snark.

Fani Willis claps back at Trump chihuahua, Jim Jordan.

Russian mouthpiece, go fuck yourself.

Cole is on a roll !

The revolution will be supervised.

Not so fun when the rabbit gets the gun, is it?

Our job is not to persuade republicans but to defeat them.

People are complicated. Love is not.

This really is a full service blog.

This year has been the longest three days of putin’s life.

“Cheese and Kraken paired together for the appetizer trial.”

T R E 4 5 O N

Thanks for reminding me that Van Jones needs to be slapped.

Perhaps you mistook them for somebody who gives a damn.

“Jesus paying for the sins of everyone is an insult to those who paid for their own sins.”

The worst democrat is better than the best republican.

We’re not going back!

I’ve spoken to my cat about this, but it doesn’t seem to do any good.

They were going to turn on one another at some point. It was inevitable.

A lot of Dems talk about what the media tells them to talk about. Not helpful.

You come for women, you’re gonna get your ass kicked.

We are builders in a constant struggle with destroyers. let’s win this.

This isn’t Democrats spending madly. This is government catching up.

I’m sure you banged some questionable people yourself.

He wakes up lying, and he lies all day.

You are here: Home / Anderson On Health Insurance / FRIDAY is gone

FRIDAY is gone

by | 19 Comments

This post is in: 

The Colorado Department of Regulatory Agencies, the Colorado insurance regulator, released a new FAQ concerning FRIDAY Health Plans this morning:

 

Press release for Friday Health Plan to wind down by end of the year 2023

Friday had operations in Georgia, North Carolina, New Mexico, Oklahoma and Colorado in 2023 for the ACA marketplaces. In each state they had decent but not dominant enrollment.

Georgia is currently doing a mid-year termination. Colorado is claiming that they think they can get Friday’s operations in the state to last until the end of the year and end of the contract. Oklahoma, New Mexico and North Carolina are up in the air.

If you currently are covered by Friday, WAIT A MINUTE before you do anything. The range of options will vary by state.

I need to really sit down and think through my thoughts on VC funded insurance models in the ACA markets as two have blown up (BRIGHT, FRIDAY) and one burned through several billion dollars of capital with the hope of profitability for the first time after a decade of operations (OSCAR). I think that these models have created systemic risk via the risk adjustment channel which is as much a CMS enablement problem as a VC strategy problem. Lots of people are going to be moved around and plenty of people will fall through the cracks.

Reader Interactions

19Comments

  2. 2.

    Miss Bianca

    Well, shoot. I mentioned yesterday that I had Friday coverage for a couple of years through Connect for Health Colorado, the state healthcare network. I really liked them – they were easy to work with, they covered everything I needed, and my premium was very affordable.

    Then all of a sudden they weren’t affordable this year and my insurance agent advised me to switch to BC/Anthem, which has been…ok, but more of a pain in the ass – they’re big and there’s a lot of layers of bureaucracy to deal with. And I was disappointed that I couldn’t stick with Friday and wondered what was going on with them.

    RIP, Friday – you were good to me while you lasted.

  3. 3.

    TaMara

    @David – In Colorado, when Oscar started to fumble, healthcare providers stopped taking it as insurance, afraid they would not get paid. My friends contacted Connect for Health and they walked them through getting a new plan without having to wait for the enrollment period.

    This may be an option for any Colorado jackals who find themselves caught up in this…

  4. 4.

    Kelly

    Our first ACA plan was one of the Co ops. A good service which died when the R’s did the risk adjustment rug pull. Oregon managed a very clean transfer to new plans including rolling deductibles over to our new plan. The risk adjustment rug pull almost took out Moda, a long standing PNW insurer. It’s too long ago for me to recall the details but I think Oregon subsidized or guaranteed Moda to keep it afloat.

  6. 6.

    Tim C.

    Because I am a terrible person…

     

    FRIDAY!, FRIDAY!, can’t get health care from Friday, but everyone will be covered-covered….

     

    Sorry, I’ll go sit in the corner and think about what I just did.

  7. 7.

    misterpuff

    Friday’s gone with the wind.

    Friday’s gone with the wind.

    Friday’s gone with the wind.

    Coverage is gone with the wind.

  11. 11.

    Butch

    Sorry but I guess I’m just not hep to the jive.  What does “VC-funded” mean?

  12. 12.

    Anoniminous

    Just going to leave this here:

    A For-Profit Health Care Industry is obscene.

  13. 13.

    RaflW

    Since this is a healthcare thread, I’m just getting up to speed on this appalling NYT story (gift link) about Allina Health System. As a Minnesotan, I’m just irate.

    A ‘not for profit’ hospital chain that a) spends $12,000,000 of member surplus on a conference center while doing one quarter of the typical charity care — 0.5% of budget vs. a more typical 2% — while b) kicking patients out of the system for carrying as little as $4,500 in medical debt. That’s basically a couple of colds and maybe a broken bone for a small family.

    Absolutely awful. Something I might expect from the execrable, for-profit United Healthcare, who are based in my home state but can’t operate on the individual market here because they aren’t ‘not-for-profit’. But even these allegedly more altruistic systems get taken over by morally vacant money grubbers.

    eta: This, from the article, also just makes me hate our entire capitalist medical delivery system (it’s not a health care system) “An estimated 100 million Americans have medical debts. Their bills make up about half of all outstanding debt in the country.”

  14. 14.

    Butch

    @RaflW: I was “insured,” in some loose sense, by United after I was laid off.  Among other things I guarantee you I will never agree to an EFT with a health insurer again after my experience with United.

  16. 16.

    Anoniminous

    @Butch: ​
     
    Money to start the company was provided by Venture Capitalists with intent to profit, usually by a stock sale, i.e., Initial Public Offering.

  17. 17.

    RaflW

    @Butch: A bit convoluted, but I know (very acquaintance-ly) the son & daughter-in-law of the recently retired chief legal counsel of UHG. That job paid in the $6-7M per year range.

    Pay like that just blows the lid off my skull. It’s just insane how much the rich are pulling away from everyone else, and when they get these massive pay packets in effect by limiting care for people? Blammo, 2X head exploder.

  18. 18.

    OverTwistWillie

    @Kelly:

    OHSU looked at a purchase.

    Moda sold half the company as a defacto bridge loan while litigating; they won, then lost on appeal. Delta Dental of CA still owns half the company.

    Startups are hard, and healthcare is a mature and heavily regulated industry, with many entrenched interests.

  19. 19.

    Another Scott

    Dead thread, but this obviously goes here… Reuters:

    June 1 (Reuters) – Ford Motor Co (F.N) sued Blue Cross Blue Shield Association in U.S. court on Wednesday, accusing it of a price-fixing conspiracy that caused the automaker to pay inflated costs for health insurance products for its employees.

    The lawsuit Ford filed in Detroit federal court accused the insurer and its regional Michigan branch of unlawfully dividing up parts of the country in a scheme to reduce competition with each other in order to drive “astronomical profits.”

    The allegations from Ford, employing more than 170,000 workers worldwide, relate to a $2.7 billion settlement that Blue Cross Blue Shield Association and its three dozen member companies reached in 2020 with corporate and individual policy holders in Alabama federal court.

    Ford opted out of that settlement, which is now on appeal at the Atlanta-based 11th U.S. Circuit Court of Appeals, in order to pursue its own claims. The appeals court agreed to fast-track its consideration of the settlement.

    […]

    Something to watch!

    Cheers,
    Scott.

Comments are closed.