Monthly Archives: February 2014

$1.2 billion failed exchange amateur hour

Obamacare’s Failed State Exchanges –

The federal government spent more on broken state-run exchanges than it did on its own troubled system. Of the 14 states, plus the District of Columbia, that established their own health insurance coverage under Obamacare, seven remain dysfunctional, disabled, or severely underperforming. Development of those exchanges was funded heavily by the federal government through a series of grants that totaled more than $1.2 billion—almost double the $677 million cost of development for the federal exchange. (emphasis added)

When was the law passed, remind me one more time?

  • Passed the Senate 12/24/2009
  • Passed the House 3/21/2010
  • Signed by Obama 3/23/2010

What date is it now?  2/27/2014

Days from singing signing of Obamacare until today: 1437

Days from singing signing of Obamacare until open enrollment started: 1289

Yet 50% of the state run exchanges couldn’t get their act together.


Oregon exchange amateur hour

Congressmen want probe of Oregon’s Obamacare exchange.

An Oregon congressman and other legislators on Thursday called for a federal probe of Oregon’s deeply troubled Obamacare health insurance exchange, which has been unable to enroll anyone online despite receiving $305 million in federal grants.

“The catastrophic breakdown of Cover Oregon is unacceptable and taxpayers deserve accountability,” U.S. Rep Greg Walden, R-Ore., and other leaders of the House Energy and Commerce Committee wrote in a letter to the General Accountability Office, naming Oregon’s health exchange.

Apparently Oregon is the worst…

“Although the rollout of the Patient Protection and Affordable Care Act has been problematic nationwide, no state has had more complications than Oregon,” Walden and the other congressmen wrote. “The state of Oregon’s exchange website, Cover Oregon, has been such a technological failure that the site has been unable to enroll anyone months after the start of the open enrollment period.”

Wow, at least Maryland enrolled 33,000 people.

The site has had so many technical difficulties that its enrollment is a paltry 33,000—significantly below what officials had hoped to see for Maryland, which is one of just 14 states operating its own Obamacare marketplace.

Amateur hour. Remind me again, how long did they know this was coming down the road?


Maryland fires Obamacare exchange IT contractor

Amateur hour – Maryland fires Obamacare exchange IT contractor.

Some may say it’s a couple of months late and $65 million short, but Maryland finally fired the contractor that designed its botched Obamacare exchange.

It’s nice to know how much money is too much money. They should have done this months ago with less than 40 days left in open enrollment.


Obamacare on a roll in Florida despite sharp opposition

Obamacare on a roll in Florida despite sharp opposition | Bradenton Herald Editorials | Bradenton Herald.

Floridians are now flocking to Affordable Care Act plans with almost 300,000 residents enrolled through the federal exchange. The figure surged by 88 percent in one month as website obstacles were cleared.

In another dramatic development, Florida joins 11 other states in meeting or exceeding the Obama administration’s enrollment objectives by Feb. 1. The Sunshine State hit the 100 percent target of a little more than 295,000.

This success comes despite fierce political opposition out of Tallahassee and elsewhere, resistance that included a fruitless and expensive federal court challenge to the constitutionality of the law.

Like it or not, the Affordable Care Act is the law of the land. Despite the rocky rollout of the federal insurance exchange marketplace, online registration is working.

A comment and a question. Law of the land? Which version? Which law and how many changes to come? In regards to enrollment, yes it is good that many are signing up but I wonder if the enthusiasm to sign up is related to Florida’s demographics?  The editorial goes on to mention…

The number of young enrollees — between the ages of 18 and 34 — is rising but remains below the administration’s hopes before March 31. Higher enrollment would help keep premiums from rising by balancing the risk insurers will be carrying.

But gives no numbers. I’m guessing it doesn’t fit the narrative?

Read more here:
Read more here:

Obamacare’s winners include older Americans

Obamacare’s winners include older Americans – CBS News.

For many older Americans who lost jobs during the recession, the quest for health care has been one obstacle after another. They’re unwanted by employers, rejected by insurers, struggling to cover rising medical costs and praying to reach Medicare age before a health crisis.

These luckless people, most in their 50s and 60s, have emerged this month as early winners under the nation’s new health insurance system. Along with their peers who are self-employed or whose jobs do not offer insurance, they have been signing up for coverage in large numbers, submitting new-patient forms at doctor’s offices and filling prescriptions at pharmacies.

“I just cried I was so relieved,” said Maureen Grey, a 58-year-old Chicagoan who finally saw a doctor this month after a fall in September left her in constant pain. Laid off twice from full-time jobs in the past five years, she saw her income drop from $60,000 to $17,800 a year. Now doing temp work, she was uninsured for 18 months before she chose a marketplace plan for $68 a month.

Young invincibles need to sign up quickly or the risk pool will be way to lopsided.


10 tips to make sure Obamacare works for you

A word to the wise from USA Today/Kaiser Foundabtion editorial board.

  1. Carry your membership card everywhere.
  2. Understand your plan’s doctor and hospital network.
  3. Stay in the network.
  4. Try to stay in-network even if it’s for emergency care.
  5. Avoid all emergency rooms unless it’s really an emergency.
  6. Pay monthly premiums on time and accurately.
  7. Register online with your new insurance company.
  8.  Save paperwork. Make sure you really owe what doctors and hospitals bill you for.
  9. If you don’t get satisfaction from providers or insurers, try regulators.
  10. Do read the plan’s summary of benefits and coverage.


Did they mention STAY IN NETWORK? GOOD. My advice to you: STAY IN NETWORK.

It’s interesting that as a rule, my healthy clients are not overly concerned with the network coverage. Clients with medical conditions have a much greater awareness. I suggest that the healthy clients learn a lesson from those with medical conditions.


10 Top Questions Consumers Ask About Obamacare

10 Top Questions Consumers Ask About Obamacare | The Fiscal Times.

  1. How do I sign up, and is the website working better?
  2. When is the deadline to sign up?
  3. How much is the penalty?
  4. What kinds of plans are offered under the new exchanges?
  5. Do I get to keep my doctor?
  6. I heard some of the top hospitals aren’t accepting Obamacare, is that true?
  7. How expensive are Obamacare plans compared to employer-based coverage?
  8. Who qualifies for subsidies?
  9. Where can you find out if you qualify for a subsidy?
  10. How does the subsidy work?


Additional information on the Obamacare penalty here.


What to consider before deciding to go without health insurance

What to consider before deciding to go without health insurance –

Valuable information, except the information regarding why Sarah and her daughter are not eligible for premium assistance in incorrect.

Sarah and daughter are not eligible for a subsidy because her husband’s coverage is deemed “affordable” for him and the plan offers to cover the rest of the family. How much it costs to cover the rest of the family is not relevant to this situation. This is known as the “family glitch”.

If his plan did not offer to cover the rest of the family, then the household income would come into play.


Open Enrollment: 43 days to sign up for Obamacare

Including today, there are 43 days left to sign up for Obamacare. Open enrollment ends March 31st. After March 31st, to enroll into Obamacare requires a qualifying event. Examples of a qualifying event include birth of a child, divorce, lost of job, lost of company coverage, etc. A qualifying event does NOT include being injured in a car crash, diagnosis of a critical illness or any other medical issue.

If you miss open enrollment and there are no qualifying events, the soonest major medical coverage will be available to you is January 1, 2015.

There are other type of coverage available, but they are NOT major medical. If you’re in Colorado, Wisconsin or Michigan, please contact me, Chris Adams, at 303.495.3045 or 877-694,5164 to review your options.


Medicaid is a type of insurance but is their coverage?

Denver area has plenty of doctors, but few accepting Medicaid, says study – Denver Business Journal.

Adams, Denver and Arapahoe counties have the third-, fourth- and fifth-worst ratios of Medicaid enrollees to doctors who accept the lower-reimbursement insurance, all with less than one primary-care physician taking the insurance for every 2,400 enrollees.
And those numbers are likely to be exacerbated further as more people sign up for Medicaid.

If you are applying for premium assistance under Obamacare, if you fall under 133% of the Federal Poverty Level (FPL) you will be funneled into Medicaid in the states that have enacted enhanced Medicaid. Can you avoid Medicaid? Yes, you can elect to op-out of the Medicaid system. Is their a downside to opting out? Yes and it may be significant. You are NOT eligible to receive any premium assistance. That means paying full price for Obamacare coverage you want, very likely an unaffordable option.


Obamacare Penalty: 4 Things You Don’t Know

The best written article on the penalyt that I’ve seen – Obamacare Penalty: 4 Things You Don’t Know | The Fiscal Times.

A note on income: The penalty is actually based on 1 percent of your adjusted gross income (AGI) that exceeds your personal exemption and standard deduction. This is often referred to as your “tax return filing threshold.

”The “no insurance” fee is levied on a pro rata basis for every month you don’t have coverage, exceeding a three-month period. In other words, if you don’t have insurance for a portion of the year, 1/12 of the annual penalty applies to each month you’re uninsured. If you lack coverage for less than three consecutive months, you don’t owe a penalty.


Coverage gap in states that didn’t expand Medicaid

Millions Trapped in Health-Law Coverage Gap – Yahoo Finance.

Bob Miller for The Wall Street Journal Hair stylist Ernest Maiden doesn’t make enough money to qualify for federal subsidies to buy health insurance but also is ineligible for Medicaid.

The 2010 health law was meant to cover people in Mr. Maiden’s income bracket by expanding Medicaid to workers earning up to the federal poverty line—about $11,670 for a single person; more for families. People earning as much as four times the poverty line—$46,680 for a single person—can receive federal subsidies.

But the Supreme Court in 2012 struck down the law’s requirement that states expand their Medicaid coverage. Republican elected officials in 24 states, including Alabama, declined the expansion, triggering a coverage gap. Officials said an expansion would add burdensome costs and, in some cases, leave more people dependent on government.

The decision created a gap for Mr. Maiden and others at the lowest income levels who don’t qualify for Medicaid coverage under varying state rules. The upshot is that lower-income people in half the states get no help, while better-off workers elsewhere can buy insurance with taxpayer-funded subsidies.

This is not an issue with states that expanded Medicaid, of which Colorado is one.


Sick Kids Denied Specialty Care Due to Obamacare in Washington

I thought the old plans were the “junk” plans. Sick Kids Denied Specialty Care Due to Obamacare in Washington | The Weekly Standard.

“Administrators at Seattle Children’s today said they predicted this would happen, and it’s even worse than they expected,” says the local news anchor. “Patients being denied specialty treatment at the hospital by insurance providers on the Washington health benefits exchange. Children’s filed request on behalf of 125 of their patients. Of those, they say they got only 20 responses, eight of which were denials. Dr. Sandy Melzer says all this comes after reassurances of certain unique specialty cases would still be covered.”

I must admit this is not something I anticipated. Also, who ARE the insurance providers on the Washington State insurance exchange?