Monthly Archives: October 2013

Hospitals reject six ObamaCare plans

Be careful out there – Hospitals reject six ObamaCare plans | New York Post.

While most people have only 4 classes of plans to choose from, Bronze, Silver Gold and Platinum the big issue is the completeness of the network. Many plans on the Colorado Marketplace are classified as HMO’s. That translates into reduced networks.

The bottom line, if you want a larger network, especially if you travel, you should seriously consider a higher priced plan with a PPO network.


Obamacare subsidy? First stop Medicaid

If you are applying for an Obamacare plan and believe you are eligible for a subsidy, the first step is to apply for Medicaid. If you are denied by Medicaid, they you may be eligible for a subsidy. If you are eligible for Medicaid, you will ber placed on Medicaid and are not eligible for a subsidy.

Colorado residents, to proceed with your Connect for Colorado application, you will need a Medicaid denial number. This is the first step after registration and you can not pass “go” without the denial number. To “apply” for Medicaid, you need to visit the Colorado Peak website.


Analysis: Obamacare glitches scare off many Web site users

Analysis: Obamacare glitches scare off many Web site users.

The number of visitors to the federal government’s Web site plummeted 88 percent between Oct. 1 and Oct. 13, according to a new analysis of America’s online use, while less than half of 1 percent of the site’s visitors successfully enrolled for health insurance the first week.

Lookng at this graph, of the 9.7 million that visited the site, 271,00o successfully logged in. You can’t even look at plans and pricing at this stage. Will young invincibles, who are so important to Obamacare, tolerage a non-functional website?

Amateur hour and that’s being kind. Heck, prediction Chaos is being kind.


Obamacare Exchanges Vs. Employer Health Insurance

Obamacare Exchanges Vs. Employer Health Insurance |

If you already have health insurance through your job, you’re probably wondering whether Obamacare will give you some new options. Will you be able to comparison-shop for a plan on the new online exchanges that might be better than your employer health insurance? The answer is a big, resounding “maybe.”

Well, in almost all cases the answer is “no” if your employer is offering major medical coverage.

Here’s the big hiccup: Unless your employer’s coverage for an individual is considered unaffordable under the law (that is, if your share of the premiums costs more than 9.5 percent of your household income) or inadequate (picking up less than 60 percent of the cost of covered benefits), you aren’t eligible for a government subsidy to help pay for your insurance. Subsidies are one of the things that can make plans on the new state exchanges appealing.

And if you’re not eligible for a government subsidy, the cost of coverage through the “Marketplace”, the politically correct term for “exchange”, is going to be high, as many are finding out.

Of course shopping and comparing SHOULD be SIMPLE. For exchanges that are run by the states, that may be the case. For example, in Colorado it’s very easy to shop without registering. You can even get an accurate estimate of your subsidy and receive quotes with the premium adjusted for your subsidy. ALL WITHOUT REGISTERING!!!

The government exchange,, which covers 37 states does NOT allow you to browse. In fact, you can’t see plans and pricing to the very last step of the process. This is detailed by Avik Roy in his Forbes colum: Crashing Because It Doesn’t Want You To Know How Costly Its Plans Are

A growing consensus of IT experts, outside and inside the government, have figured out a principal reason why the website for Obamacare’s federally-sponsored insurance exchange is crashing. forces you to create an account and enter detailed personal information before you can start shopping. This, in turn, creates a massive traffic bottleneck, as the government verifies your information and decides whether or not you’re eligible for subsidies. HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away.

HHS didn’t want users to see Obamacare’s true costs

“ was initially going to include an option to browse before registering,” report Christopher Weaver and Louise Radnofsky in the Wall Street Journal. “But that tool was delayed, people familiar with the situation said.” Why was it delayed? “An HHS spokeswoman said the agency wanted to ensure that users were aware of their eligibility for subsidies that could help pay for coverage, before they started seeing the prices of policies.” (Emphasis added.)

I don’t see how you can argue this conclusion.


An annonymous clients encounter with Obamacare premiums

I had a conversation with a client today. This family of 4 has an Anthem HSA plan with a $5500 deducticle then 100% coverage.  This is a family deductible, so all medical expenses go into a single deductible bucket. The maximum out of pocket for the year is the same as the deductible, $5500. There present premium is approimately $850/mo.

The lowest premium available to them on the exchange is approximately $1230 and the plan has a maximum out of pocket of $6300 for an individual and $12,600 for the family. A $480 increase in premium and a $7100 increase in maximum out of pocket. Talk about higher pricing and lower benefits. I believe that’s called a “lose lose”!

Additionally, at first glance it appeared the family income was just above the subsidy cutoff level. If they were to lower their annual income a few thousand dollars an $8400 subsidy would become available. Further investigation showed that their income would be adjusted upword for the purpose of subsidy determination and that was not a reasonable strategy.

That said, I have a problem with a government subsidy providing an incentive to be less productive, fudge or hide income, etc.  Beam me up!


New Obamacare “mandate”….

Fox News – Breaking News Updates | Latest News Headlines | Photos & News Videos.

Though Republicans have considered over the last several weeks a range of provisions relating to ObamaCare, the one they settled on in this package would force Congress, the president, and many other administration officials and staff onto ObamaCare without additional subsidies. GOP lawmakers described the proposed mandate as a matter of “fairness.”

“If the president and Senate Democrats are going to force the American people to live under ObamaCare, then they and all Washington leaders should not be shielded from the law,” one GOP aide said.

If the bill passes, the House would effectively dare the Senate to hold up the bill — and risk missing the debt-ceiling deadline — because senators don’t want to submit to ObamaCare.

I like it. There is no provision in Obamacare for employers to subsidize or reimburse their employees for premiums. Many Americans living in the real world will NOT receive any subsidies due to their income. Our representatives and their staffs can play by those rules as well.


Patients Pay Before Seeing Doctor as Deductibles Spread – Bloomberg

Patients Pay Before Seeing Doctor as Deductibles Spread – Bloomberg.

Hospitals say they need to charge patients prior to treatment because Americans are increasingly on the hook for more of their own medical costs. And once care is provided, it’s often difficult for hospitals to collect.

“It used to be taboo to look like you were looking for money at a time when you were supposed to be focused on patient care,” David Williams, president of Boston-based consulting firm Health Business Group, said. “It’s not taboo anymore.”

I experienced this with my shoulder surgery in January. Then they billed me another $1000 and now they are trying to collect on $28 after my insurance company said that it was included in the negotiated price.

My only issue is if the doctors are going to start doing this, they need to start posting their prices.


Another ObamaCare ‘Glitch’: $30B blown on non-operational medical record system | Fox News

Another ObamaCare ‘Glitch’: $30B blown on non-operational medical record system | Fox News.

We’re talking electronic medical records….

Health care IT providers were tasked with creating a system connecting patients, health care professionals, hospitals, laboratories and medical facilities. But despite being paid vast incentives by the government’s Centers for Medicare & Medicaid Services (CMS), they’ve dragged their feet.

Doctors have so far received $14 billion in sweeteners, and hospitals have been handed more than $16 billion. Officials indicate that incentives could eventually reach $45 billion, though there is no universally integrated system anywhere in sight.

Taxpayers lose here, but so do patients.

Yes, patients lose their privacy is the system ever gets up and running. Since my doctor was an early adopter, you also end up answering questions about your sex life and habits. I’ve put up with that for the last 2 years but not any more. I’m looking for another doctor and a requirement is keeping paper records.

They really need to get off these complex grand solutions. They simply result in one boondoggle after another at tapayer expense.

Why don’t we start with something simple like being able to create an encrypted memory device that has your medical records on them in a prescribed format? Passwords could be kept on a database accessible by medical professionals if the patient was unconsicous or was unable to respond to questions. Or, it would be accessible by using fingerprint access. Yes I know, this would require electronic records but it would at least “feel” much less invasive.


Federal Exchange amateur hour is larger than the end user experience

Obamacare’s Federal Exchanges are Failing at Every Level – Hit & Run :

More then likely you have already read about all the issues the end users are experiencing. Unfortunately, that is only a small part of this complex system. It also appears the information being transmitted to the actual insurance companies is bogus. Reason reports….

Here is one example from a carrier–and I have received numerous reports from many other carriers with exactly the same problem. One carrier exec told me that yesterday they got 7 transactions for 1 person – 4 enrollments and 3 cancelations.

For some reason the system is enrolling, unenrolling, enrolling again, and so forth the same person. This has been going on for a few days for many of the enrollments being sent to the health plans. It has got on to the point that the health plans worry some of these very few enrollments really don’t exist.

The reconciliation system, that reconciles enrollment between the feds and the health plans, is not working and hasn’t even been tested yet.

So far, has documented issues with it’s web interface to the public and it’s interface with health carriers. Take a look at the flowchart below and see how many other communication interfaces that need to work flawlessly for to operate as expected.


Anatomy of Obamacare flowchart





How federal cronies built — and botched —

How federal cronies built — and botched — | E government – InfoWorld.

“All but one of of the 47 contractors who won contracts to carry out work on the Affordable Care Act worked for the government prior to its passage,” the report reads. Some of the names ought to be familiar: Northrop Grumman, General Dynamics, Deloitte, and Booz Allen Hamilton, all of whom assumed different roles and worked on different aspects of the project.

As familiar as those names might be, especially to those who follow Beltway lobbying practices, few of them would be as commonly associated with large-scale IT projects as, say, Google,, or Dell would be — especially when it came to building the public-facing components of the system.

What a waste of taxpayer money has been to date. Amateur hour extraordinaire.

I’m hopeful in a few weeks we can look back on this and it’s water under the bridge. Color me doubtful.

New readers, do a blog search on the phrase “prediction chaos”.