Daily Archives: September 24, 2013

Why buy a policy from a health insurance exchange?

You are about to be deluged with advertising/marketing to purchase Obamacare plans with 10 essential health benefits from your state or the federal government health exchange.

Are you aware there is only one reason to purchase a plan on the exchange? If you are subsidy eligible, you should purchase from the exchange. The only place your can purchase a plan and receive a subsidy is the exchange.

If you are not subsidy eligible, there is NO reason to purchase from the exchange. Plans available on the exchange are available off the exchange PLUS there will be additional plans available off the exchange.

Keep that in mind as you won’t hear it from the well produced advertisements.


Subsidy cliff: Obamacare work disincentives

subsidy cliff

PJ Media » Obamacare’s ‘Cool Calculator,’ Part 1: Work Disincentives Like We’ve Never Seen Before.

Let me translate this graph for you. If the couple, age 60, depicted in the graph have an annual income of $62,040 their health insurance premium is $5,890. If they make a single dollar more, their health insurance premium rises to $16,382. Let’s call this phenomenon “the Subsidy Cliff”


You see, Kaiser’s “cool calculator” makes the exact points Robert Rector at the Heritage Foundation and yours truly have been arguing since early 2010 — namely, that the Affordable Care Act will deeply discourage work and virtually any other attempt at financial improvement. It will also throw new obstacles in the way of couples wishing to get and stay married, even to the point of encouraging marital breakups of families with children.



The article concludes with these examples…

Many will conclude that earning extra money isn’t worth it, or will strive mightily to find ways to earn income under the table. This is not the recipe for growing an economy which already more resembles the awful 1930s in key statistical aspects than it does any other economy post-World War II.

Even if they somehow stay motivated while the government is taking one-third to one-half of each additional dollar they earn, what single person in their 50s or 60s who understands all of this is going to move to a new position or accept a promotion which increases their salary from $46,000 to $50,000?

What sane married couple in their 50s or 60s will want to increase their family’s income from $60,000 to $70,000, when doing so means either taking home almost nothing extra or losing money in the bargain?

This is NOT good for society. Un-American is a phrase that comes to mind.

Of course, the reason there is such a large “subsidy cliff” is that the actual cost of healthcare is “too damn high”.


You can keep your doctor….

BJC likely excluded from policies sold on Mo. health insurance exchange : Business.

BJC Healthcare, which is Missouri’s largest health provider, is likely to be excluded from the state’s new health insurance exchange because of BJC’s high medical charges, according to St. Louis area health brokers and consultants.

Anthem Blue Cross & Blue Shield in Missouri, the state’s largest seller of individual health insurance policies, has decided to operate a “narrow network” both on and off the health insurance exchange that would not include BJC Healthcare facilities and physicians, according to those experts.

They also said that Anthem is still deciding whether or not to include Chesterfield-based Mercy Health’s hospitals and physicians in its network of health providers for individual policies sold on the Missouri exchange.

Any decision by Anthem to exclude BJC Healthcare would be a blow to consumers and may also be a setback for BJC, a nonprofit hospital chain that is the St. Louis area’s largest employer — that is, if it desires to participate in an insurer’s network on the Missouri exchange. If not, it could be one reason for sticking to its current prices.

Don’t think this is just a “show me state” issue.


Obamacare: One blow after another

Obamacare: One blow after another – Jennifer Haberkorn and Carrie Budoff Brown – POLITICO.com.

The Obamacare that consumers will finally be able to sign up for next week is a long way from the health plan President Barack Obama first pitched to the nation.

Millions of low-income Americans won’t receive coverage. Many workers at small businesses won’t get a choice of insurance plans right away. Large employers won’t need to provide insurance for another year. Far more states than expected won’t run their own insurance marketplaces. And a growing number of workers won’t get to keep their employer-provided coverage.

More on the good and bad at the link.


One man’s ObamaCare nightmare… (perhaps)

One man’s ObamaCare nightmare | Fox News.

“When I saw the letter when I came home from work,” Andy said, describing the large red wording on the envelope from his insurance carrier, “(it said) ‘your action required,benefit changes, act now.’ Of course I opened it immediately.”

It had stunning news. Insurance for the Mangiones and their two boys,which they bought on the individual market, was going to almost triple in 2014 — from $333 a month to $965.

The insurance carrier made it clear the increase was in order to be compliant with the new health care law.


This article is misleading with an good dose of the truth.

Yes, a metal plan from Humana in the region of Kentucky will cost the Mangione’s what the article states IF they elect to purchase it today. However, here are the “buts”….

  • What do plans from other carriers cost?
  • Are the Mangione’s eligible for a subsidy? If so, they can most likely purchase the same plan from the health insurance marketplace for a lessor cost starting October 1st.
  • In general, Humana is offering their clients the option to stay with the plan they have until December 31st, 2o14

This type of reporting is not helpful, although it IS a counterbalance to the MSM. That said, it sure isn’t “fair and balanced”.



Now They Tell Us

Now They Tell Us: ObamaCare Has Huge, Hidden, Premium Costs – Investors.com.

So just how could ObamaCare pile on costly new benefit mandates, require that insurers take everyone, not charge the sick more than the healthy, and keep rates low? Did Democrats manage to find a loophole in the law of supply and demand?

Well, no. Just because ObamaCare premiums didn’t come in as high as some expected doesn’t mean they’re not pricey, particularly for young people.

In fact, the cheapest ObamaCare Bronze plan available to 25-year-olds in several states will cost more than the median-priced plan in those states today, even after taking account of the subsidies.

In Virginia, a low-income 25-year-old will pay $127 a month for the cheapest plan after subsidies, according to the Kaiser Family Foundation. But the Government Accountability Office found that the mid-priced plan in Virginia today costs just $112 a month.

And as the New York Times discovered, even these ObamaCare prices are misleading, since the only way insurance companies could keep them low was by severely restricting their networks of doctors and hospitals.

Silly me, I thought my clients could keep their doctors. Well, not really but my clients thought they could keep their doctors. In fact, they STILL think they can keep their doctors. Those who investigate Obamacare will discover differently in the upcoming months.

How do you compensate for the reduced network? Supplemental policies. Supplemental accident and critical illness policies will help to cover additional costs if you find yourself seeking out of network medical care. Suddently it will be much easier to be “out of network”.

As IBD concludes….

The result is that any patient who actually needs health care could end up having to choose between forgoing treatments or paying huge costs to go out of the network. Either way, they’ll get far less than promised. As the Times discovers, “having an insurance card does not guarantee access to specialists or other providers.”

Once again, think supplemental policies.