Tag Archives: CHP+

Avoid the health exchange if you’re NOT subsidy eligible… Here’s why

Video: ObamaCare exchange not allowing addition of newborns to policies « Hot Air.

Let’s just say it’s one giant PITA.

Actually, no it wouldn’t be “more affordable” for families already paying for family coverage, which would likely be most of those seeking to add a newborn to their policy. And if they don’t qualify, then it’s a moot point anyway. That eligibility could have been determined through the ObamaCare exchange, had it been properly designed to deal with additions of newborns.

Instead, thanks to the run-around Healthcare.gov requires, families end up running out of time to add their newborns to their policies — and health insurers can’t step in and assist them any more:

Sure enough, CHIP denied her baby. Now when she turns to the marketplace to try and add her daughter, they turn her away.

“They denied us, saying we went over our time limit and there was no evidence we tried adding her to our insurance,” Maggie said.

Maggie says she protested sending marketplace workers copies of their own emails promising to extend the window but it did no good.

One executive from a Utah insurer says anyone who gave birth in 2014 will have the same problem, and it’s mystifying to Shaun Greene. “Insurance companies have been doing that for years,” Greene told KUTV about adding newborns to policies. “It’s not difficult.” Not until government takes it over, that is. (emphasis added)

I have not endured this particular situation in Colorado but have had some that are similar. However, I can say that Connect for Health Colorado is pretty good at creating incident numbers and allowing enrollment once the situation is resolved.

In Colorado, and apparently with healthcare.gov, almost any issue that isn’t a “straight enrollment” ends up being delayed. In the minds of the consumer, they are dumbfounded by the apparent incompetence. I have had two cases of adding family members, neither one has gone smoothly. In one situation, the family member was added the day after the enrollment was done. It took over 40 days and a plea to Connect for Health management to get this resolved.

This Rube Goldberg of a healthcare law boggles the mind.

If you’re not subsidy eligible, DO NOT use the exchange. In this case, it serves no purpose. However, if you are subsidy eligible or you might be, you MUST use the exchange if you want to preserve you eligibility. Even if you don’t want an advanced subsidy (monthly payments), you must use the exchange to claim your subsidy at the end of the year on your tax return.

 

 

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Connect for Health 1st month open enrollment statistics

Connect for Health recently (Dec 17) released enrollment statistics for the 1st month of the 2015 open enrollment period (Nov 15 – Dec 15). They are as follows:

  • Total enrollment: 136,315
  • Medicaid: 7,306   27,306 (corrected 12/29 @ 18:24p)
  • CHP+: 932 (Medicaid for Children)
  • Connect for health (Commercial insurance): 108,077

Although beside the point, I sure wish I know why Connect for Health Colorado calls private individual insurance “commercial” insurance. Never once have I ever told a client I am selling them “commercial” insurance.

Moving on…

I call out the CHP+ enrollment number as bogus. Why? Because the discrepancy between Medicaid and CHP+ is too large. For an adult to qualify for Medicaid, the family (or individual) income must be < 133% of the Federal Poverty Level (FPL). However, for children to qualify for CHP+, the family income only has to be less than 250% of the FPL. Thus it is substantially easier for children to qualify for CHP+ then it is for adults to qualify for Medicaid. In the real world what occurs for families with income between 133% and 250% of the FPL is the children are enrolled in CHP+ and the adults receive a subsidy and select coverage through Connect for Health Colorado.

If the CHP+ enrollment numbers are “bogus” that places the validity of the other enrollment numbers into question as well.

 

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