Monthly Archives: September 2013

A Guide to the New Exchanges for Health Insurance

A Guide to the New Exchanges for Health Insurance –

 I recommend following the link for a very excellent Q & A/ FAQ at the end.

But after much anticipation, the curtain will finally rise on the exchanges next week, providing millions of consumers with an online marketplace to compare health insurance plans and then buy the coverage on the spot.

The exchanges are likely to be most attractive to people who qualify for subsidized coverage. Individuals with low and moderate incomes may be eligible for a tax credit, which can be used right away, like a gift card, to reduce their monthly premiums. People with pre-existing conditions will no longer be denied coverage or charged more (this applies to most plans outside the exchanges, too). And all of the plans on the exchanges will be required to cover a list of essential services, from maternity care to mental health care. (emphasis added)

CORRECTION: ALL major medical plans off or outside the exchange offer the exact same benefits and guarantees as plans on the exchanges. Plans on the exchange will also be offered off the exchange.

As the article implies, the only reason to apply on the exchange is to get subsidies or you can apply for Medicaid coverage as well by the exchange process.

I do object to the metaphor that subsidies are like “gift cards”! A subsidy can turn into a substantial liability. If your income changes (increases) and you do not report it to the exchange, you may find yourself with a substantial obligation when you file your taxes to refund subsidies you received but were no longer eligible for.


Florida Among States Undercutting Health Care Enrollment –

Florida Among States Undercutting Health Care Enrollment –


As many states prepare to introduce a linchpin of the 2010 health care law — the insurance exchanges designed to make health care more affordable — a handful of others are taking the opposite tack: They are complicating enrollment efforts and limiting information about the new program.

Chief among them is Florida, where Gov. Rick Scott and the Republican-dominated Legislature have made it more difficult for Floridians to obtain the cheapest insurance rates under the exchange and to get help from specially trained outreach counselors.

Missouri and Ohio, two other states troubled by the Affordable Care Act, have also moved to undercut the law and its insurance exchanges, set to open on Oct. 1. In Georgia, the state insurance commissioner, Ralph T. Hudgens, has said he will do “everything in our power to be an obstructionist.”

So far the article hasn’t given specifics as to actions the states have taken. We do get this specific example…

Even among states hostile to the law, Florida became an outlier this year when it passed a bill removing for two years the state insurance commissioner’s ability to approve insurance rates for new health plans, she said. This leaves Floridians vulnerable to higher rates at a time when the new health plans will be introduced.

It will soon become apparent if this resulted in higher rates for Floridians or not. It could be that they have higher rates BUT more complete doctor/facility networks.


Study: Insurance costs to soar under Obamacare

Study: Insurance costs to soar under Obamacare – CBS News.

New research from the Manhattan Institute estimates that insurance rates for young men will rise by 99 percent. Rates for younger women will rise between 55 percent to 62 percent, according to the right-leaning New York think tank.

The precise impact of the new health law is likely to vary markedly from state-to-state, however. That’s largely because different states have had different requirements for what had to be included in health insurance policies in the past. The Affordable Care Act, commonly known as Obamacare, overrides these rules and sets a federal overlay that demands a wide array of mandatory coverages. The Manhattan Institute has drawn up an interactive map that may help forecast the rise in cost for individuals.

Avik Roy of the Institute and Forbes magazine columnist notes…

“You hear all these excuses from the [Obama] administration — that people are exaggerating the effect of the law,” he says. “But real people are getting notices from their insurers now. My blog is flooded with comments from people saying that they just got a huge premium hike.”

Then there’s the “keep your policy promise…

Additionally, the promise that you could keep your old policy, if you liked it, has proved illusory. My insurer, Kaiser Permanente, informed me in a glossy booklet that “At midnight on December 31, we will discontinue your current plan because it will not meet the requirements of the Affordable Care Act.” My premium, the letter added, would go from $209 a month to $348, a 66.5 percent increase that will cost $1,668 annually.

The conclusion…

“This is a redistribution of wealth from the healthy to the sick, from the young to the old, from the people who have always had insurance to the uninsured,” Roy said.

A standard policy for wellness and catastrophic coverage for an unexpected, unavoidable ailment or accident could have been provided for a fraction of what Obamacare coverage costs, Roy added. “Obamacare forces insurers to offer products that carry all sorts of bells and whistles that most people don’t want but everyone will now need to pay for.”

Of couse the overriding question is: “Why don’t these people have insurance”? And there are a wide variety of answers….

  • Once they see even todays rates, many people decide their fortune telling crystal ball is very clear and they can see the future. Their vision of the future tells them there is no need for insurance. Translated: They don’t see the value.
  • There is certainly a group that can’t afford the premiums
  • The “pre-existing conditions” issue. Keep in mind almost all states have (or had) state risk pools to cover those who couldn’t qualify for private individual plans. Of course affordability could still be an issue.
  • There is a group of people who decide that using the ER is the best way to receive medical care and purposely don’t have insurance.
  • And finally the group that expects the government to provide it.

The solution for all of these people is apparently Obamacare which provides:

  • Extensive up front coverage, although deductibles can be fairly high
  • Guaranteed issue with no medical underwriting
  • The 10 “essential” health benefits
  • Subsidies for applicants with household incomes in the 133% – 400%  range of the Federal Poverty Level (FPL)
  • Does very little if anything at all to lower the cost of medical care
  • Has led to Hospitals buying private practices leading to higher costs of medical treatment. (For example, if your doctor prescribes an MRI, that send you to the hospital he’s associated with. Any idea what the most expensive facility to get an MRI or CT scan is? Yep, you guessed it.

A Very Quick Guide To Health Insurance Exchanges

Very informative: A Very Quick Guide To Health Insurance Exchanges – Kaiser Health News.

Do keep one thing in mind as you read the article. If you are not subsidy eligible, there is no reason to purchase through the health insurance exchange/marketplace. There will be additional ‘metal’ plans available outside the marketplace that will provide the same bronze, silver, gold and platinum coverage that is availble through the marketplace.


Why Congress is (or isn’t) exempt from Obamacare

Why Congress is (or isn’t) exempt from Obamacare. The Obamcare government exemption explained…

Of all the arguments against the Affordable Care Act that congressional Republicans are mustering in the debate over the spending bill, one hits closest to home. Congress, they say, is exempt from the very law that applies to everyone else.

The truth: Members of Congress are treated differently under Obamacare, but they’re not exempt. In fact, by forcing them to purchase health insurance through publicly run exchanges, they’re impacted more by that key provision than similar employees in private sector — or even in government.

But members of Congress will also be able to purchase their insurance under terms that are more favorable than other employees — in government or in business — who have access to employer-provided health care.

Not a bad deal to be living inside the castle walls!


Washington Health Insurance Exchange Set To Open

The exchanges are getting ready for blast off – Washington Health Insurance Exchange Set To Open | KUOW News and Information.

Starting Tuesday, Oct. 1, uninsured people will be able to shop online for private insurance in health insurance marketplaces, also known as exchanges. In Seattle, nonprofits and other organizations have been out educating people about how to sign up for insurance through the exchange.

And insured people can sign up too!

Washington state set up a website called the Health Benefit Exchange where people can compare healthcare plans, find tax credits and get financial aid. The healthcare marketplace goes live and open enrollment runs from Oct. 1 to March 31.


Some Nebraskans’ premiums to triple under ObamaCare

Some Nebraskans’ premiums to triple under ObamaCare | Fox News.

Todd Blome’s phone has been ringing off the hook this week with clients seeking tax advice after learning they’ll get a “shocking increase” in their health insurance premiums when Obamacare’s health insurance exchanges begin operating.

Letters have been landing in mailboxes all over Nebraska explaining the impact Obamacare will have on people who buy insurance coverage on their own, rather than through work.

Blome, a Lincoln accountant, understands: He got a letter, too.

Blue Cross Blue Shield Nebraska informed Blome his health care plan will terminate at year’s end, and if he wants to move to a similar plan his new premium will go up 65 percent, costing him nearly $4,000 more per year.

He distinctly remembers President Obama looking into TV cameras and assuring Americans they would be able to keep their doctors, and policies.

His letter says otherwise.

“Stupid me, I took the president literally,” Blome said. (emphasis added)

That’ll teach him. Bet he won’t make that mistake again.  😉

Unfortunately, Tom most likely “lives” in the land of “no subsidy” and with no voice.


Obamacare is Real Insurance so… It’s Better than You Think

Obamacare: It’s Better Than You Think | Dean Baker.

This is good news. It means that tens of millions of people who are uninsured now will likely be insured in the next year or two as a result of the Affordable Care Act (ACA). However, this is actually the less important aspect of the program. The more important part is that those of us who now have insurance will have real health care insurance for the first time. (emphasis added)

My response to this claim is…


Hmmm. I guess the money my individual policy paid out for my daughter’s seven stays at Children’s Hospital was fake money since it wasn’t from a “real’ insurance policy. Oh and that is easily over $200,000 of fake money.

Believe me, I was very happy to have that “not real” insurance. In fact, I plan on keeping it since it’s a grandfathered plan. Guess is must be OK? Or the more obvious conclusion is that I’m a stupid neanderthal.


Colorado Subsidy Calculator

Alert readers may notice I added a link at the top of the right hand column to the subsidy calculator at the Connect for Health Colorado Marketplace website. This is an updated calculator that uses actual premium data to determine your monthly subsidy amount. It should give you a good approximation of actual subsidy and if you qualify for a subsidy.