Daily Archives: January 3, 2015

A Tale of Special Enrollment Period Issues

How The Affordable Care Act Forced Me To Become Uninsured – Forbes.

The problem described is a Federal Marketplace Issue, I can absolutely assure you it is a Connect for Health Colorado issue as well. My clients and I have encountered numerous issues with Special Enrollment Periods, particularly those that allow the applicant to apply between the 16th and 31st of the month with coverage scheduled to start on the 1st of the next month.

As November 15 – the deadline for enrollment – approached, I had not received a bill from the insurance company. I called The Marketplace, and they said I had to wait until I got a bill from the insurance company. I called the insurance company, and they said they had not received my enrollment information from the Marketplace. I called The Marketplace, and they said that yes, the insurance company could not enroll me or bill me or accept a payment until they received the information, but they had sent it. They would send it again.

I have head this story so many times, most of the time with a strong implication that it is the insurance company that is at fault.

Read the whole thing…. it makes me wanna puke.

To continue, since we are presently in open enrollment this is not a huge issue. I expect this problem to rear it’s ugly head again simply because everyone has to work as a team to fix an issue like this. I’m going to let you in on a little secret:

They are NOT working as a team!

Let me ask a simple questions:

What is transmitting and receiving data so hard?

The whole computer industry operates on accurately transmitting and receiving data. Examples that quickly come to mind:

  • Read and Write to devices such as:
    • Hard drives
    • USB sticks
  • Data transmission
    • RS 232 serial ports (what the heck are those!)
    • USB interfaces (communication with all your USB devices)
    • Wireless internet (think 3G and 4G)
    • Wired internet

And these incompetent idiots can’t transmit enrollment information in an accurate and timely manner!?

You can’t make this stuff up.


Victims of Obamacare

Michelle Malkin | » Obamacare’s Annus Horribilis.

Michelle reminds us of all the promised benefits of Obamacare…

Let’s start with premiums. President Candy Land promised that he’d “lower premiums by up to $2,500 for a typical family per year.” But premiums for people in the individual market for health insurance have spiked over the last year. In fact, Forbes health policy journalist Avik Roy and the Manhattan Institute analyzed 3,137 counties and found that individual market premiums rose an average of 49 percent.

A legitimate question to ask is over what period of time did the 49% increase occur. I heard in one of the Fox news business block programs this morning that it was over 5 years. (See bottom of article for clarification) If that’s the case, as a stand alone issue it’s not that bad. There is no doubt there was a large spike in premiums due to Obamacare mandates. Summing up the meaning of “Affordable”…

“Affordable” doesn’t mean what White House truth-warpers says it means — just like everything else they’ve spewed about the doomed federal takeover of health policy in America.

…. and I am in full agreement.

Medicaid cuts…

Analysts on all sides of the debate agree that massive cuts in Medicaid payments to primary care doctors, which take effect on Jan. 1, will reduce patient access. Meanwhile, a Commonwealth Fund survey found that 26 percent of American adults waited six days or more to see a doctor — with only Canada and Norway performing worse. A separate physicians’ staffing company’s poll, reported by the left-wing New York Times, found that patients “waited an average of 29 days nationally to see a dermatologist [,] 66 days to have a physical in Boston and 32 days for a heart evaluation by a cardiologist in Washington.”

Translation: If you like your doctor, it doesn’t mean you’ll get to see your doctor. Tick, tick, tick.

I’m assuming these waiting times are for Medicaid patients?

She then addresses the insurance company bailouts ($1B) and the faltering Health Insurance Coops.

The silver lining?

One silver lining: A total of 16 Senators who voted for the federal health care takeover either failed to win re-election or declined to run for re-election.

Good riddance to them and farewell to Obamacare’s annus horribilis.

Regarding premium increases, I found Avik Roy’s analysis of Obamacare premiums. The linked article does not summarize the results nationwide, but he does mention increases from 2013-2014:

Last November, our team at the Manhattan Institute published a study indicating that Obamacare had increased the underlying cost of individually-purchased health insurance in the average state by 41 percent in 2014, relative to 2013. (emphasis added)

You can check out your own sitation with the interactive map: What Will Obamacare Cost You?


Affordable Care Act Creates a Trickier Tax Season

Affordable Care Act Creates a Trickier Tax Season – WSJ.

The law’s requirement that most Americans carry health insurance means all filers must indicate on federal tax forms whether they had coverage last year and got tax credits to help pay for it. Those who didn’t have coverage could face a fine, although reduced staffing at the Internal Revenue Service and certain changes to the law mean the so-called individual mandate is expected to be lightly enforced this year, tax preparers say.

Meanwhile, millions of Americans who got subsidies under the law may find they are getting smaller-than-expected refunds or owe the IRS because credits they received to offset their insurance premiums were too large. As many as half of the roughly 6.8 million Americans who got subsidies may have to refund money to the government, based on one estimate by tax firm H&R Block Inc.

“The ACA is going to result in more confusion for existing clients and many taxpayers may well be very disappointed by getting less money and possibly even owing money,” said Charles McCabe, president of Peoples Income Tax and the Income Tax School, a Richmond, Va., provider of tax preparation and education. “The whole implementation of Obamacare will be frustrating for tax preparers.”

But where there’s pain, there’s opportunity…

But the season could be a lucrative one for tax firms. Liberty Tax Service, a tax-preparation franchise, began calling hundreds of thousands of customers in November to invite them to a store to get help applying for an exemption to the insurance-coverage requirement. About half of the company’s 4,000 stores opened weeks ahead of their usual start date to provide health-law tax advice.

If you’re going to owe the penalty, my recommendation is to take profits from investing in the tax preparation services. NOTE: I am NOT qualified to give investment advice!


Dilemma over deductibles: The flip/flop in health care..

Dilemma over deductibles: Costs crippling middle class.

Physician Praveen Arla is witnessing a reversal of health care fortunes: Poor, long-uninsured patients are getting Medicaid through Obamacare and finally coming to his office for care. But middle-class workers are increasingly staying away.

“It’s flip-flopped,” says Arla, who helps his father run a family practice in Hillview, Ky. Patients with job-based plans, he says, will say: ” ‘My deductible is so high. I’m trying to come to the doctor as little as possible. … What is the minimum I can get done?’ They’re really worried about cost.” (emphasis added)

The issues is deductibles…

A recent Commonwealth Fund survey found that four in 10 working-age adults skipped some kind of care because of the cost, and other surveys have found much the same. The portion of workers with annual deductibles — what consumers must pay before insurance kicks in — rose from 55% eight years ago to 80% today, according to research by the Kaiser Family Foundation. And a Mercer study showed that 2014 saw the largest one-year increase in enrollment in “high-deductible plans” — from 18% to 23% of all covered employees.

Meanwhile the size of the average deductible more than doubled in eight years, from $584 to $1,217 for individual coverage. Add to this co-pays, co-insurance and the price of drugs or procedures not covered by plans — and it’s all too much for many Americans.

I have to say, I would LOVE to have a plan with deductibles this low. Perhaps the issue is the expectation of the typical American that someone else is supposed to pay for all of their health care.

All that said, I can confidently state that a large portion of my clients have substantially larger deductibles than the averages mentioned above and I can see them delaying medical care.

Moving on the article asks the important question, albeit a bit to generally: “Why is this happening?”

Why is this happening? Many patients and doctors blame corporate greed — a view insurers and business leaders reject. Some employers in turn blame the Affordable Care Act, saying it has forced them to pare down generous plans so they don’t have to pay a “Cadillac tax” on high-cost coverage in 2018. But health care researchers point to a convergence of trends building for years: the steep rise in deductibles even as premiums stabilize, corporate belt-tightening since the economic downturn and stagnant middle-class wages.

“It’s a case of companies trying to offer workers health insurance and still generate profit,” said Eric Wright, a professor of sociology and public health at Georgia State University. “But whenever costs go up for the consumers across the board … it promotes a delay in care.”

Others disagree, saying that when people pay for their care, they shop more intelligently. Chris Riedl, Aetna’s head of product strategy for its national accounts, says her company’s research does not indicate that insured patients are showing up sick in emergency rooms with long-neglected illnesses — which to her means, “intuitively, they’re not avoiding care.”

But many doctors contend it’s only a matter of time before the middle class begins crowding ERs. They say putting off care can be dangerous, exponentially more costly and, if it continues and spreads, can threaten the health of the nation.

Read the whole thing. This is a fairly well rounded article that takes a look from all sides.