Tag Archives: exchanges

Individual coverage cancellation and Why buy a plan on the exchange anyway?

Here’s Why So Many Americans Are Getting Letters Saying Their Health Insurance Is Canceled – Business Insider.

“If you like your health care plan, you can keep your health care plan.” This was one of President Obama’s key talking points when selling the Affordable Care Act, and it was never true — as many of the 14 million Americans currently covered by individually-purchased health plans are now learning.

And here’s why…

  • Some old plans don’t meet new requirements under the ACA (essential health benefits)
  • Some existing plans have especially sick particpants pools, so insurers want to end them (The state high risk pools should be included here too)

The article goes on to explain why you should or should not buy on the exchange…

If subsidies are only available inside the exchange, and the regulations are mostly the same, why would any insurers offer plans outside the exchange, and why would anybody buy outside?

follow the link….


Why buy a policy from a health insurance exchange?

You are about to be deluged with advertising/marketing to purchase Obamacare plans with 10 essential health benefits from your state or the federal government health exchange.

Are you aware there is only one reason to purchase a plan on the exchange? If you are subsidy eligible, you should purchase from the exchange. The only place your can purchase a plan and receive a subsidy is the exchange.

If you are not subsidy eligible, there is NO reason to purchase from the exchange. Plans available on the exchange are available off the exchange PLUS there will be additional plans available off the exchange.

Keep that in mind as you won’t hear it from the well produced advertisements.


Lawsuit Challenging Obamacare Subsidies Moves Forward

Lawsuit Challenging Obamacare Subsidies Moves Forward | Washington Free Beacon.

The judge in Oklahoma ruled that the state of Oklahoma has the legal standing to sue the federal government over federal subsidies in federally run health insurance exchanges.

The Affordable Care Act, or Obamacare, requires that each state has its own exchange where individuals can buy health insurance. If a state refuses to set up its own exchange, the federal government steps in and sets up the exchange for it.

Oklahoma Attorney General Scott Pruitt argues in the suit that the Affordable Care Act only provides federal subsidies for exchanges set up by the states, as opposed to the federal government. The subsidies allow the federal government to enforce the employer mandate in states that refused to set up their own exchanges.

Potential consequences…

The suit threatens to undermine the individual mandate as well as the employer mandate, Matthews said. If the federal government cannot legally subsidize insurance on the exchanges it runs, then insurance could become unaffordable for many individuals. If they cannot afford the insurance, then they do not have to buy it, reducing the pool of the insured.

If the suit is successful and the federal government is barred from providing subsidies for the exchanges it runs, the viability of the exchanges could be in trouble, some experts predicted.

“That will just be a huge blow to the exchanges being able to operate,” said Sally Pipes, president of the Pacific Research Institute.

If the suit were to succeed, the Federal Government would use every tool in its arsenal to “make” the states take over the exchanges.


20-Somethings: Obamacare wants YOU

And so do the boomers: To cut health bills, boomers need 20-somethings – Marketwatch.

Baby boomers with individual health plans stand to benefit big-time when public insurance exchanges launch on January 1. The centerpiece of the Affordable Care Act, these state-level marketplaces will improve boomers’ access to health coverage and may even bring down underlying premiums for those who don’t qualify for a government subsidy, experts say.

But boomers may not see those cost benefits unless they get some help from a different demographic: Their kids and their friends’ kids. If enough young people stay out of the market, then the risk pool in each group will be older and, presumably, sicker. And that will eventually drive up costs for everyone who remains. “The big factor is: How many young, healthy adults can we get to buy insurance?” said Carrie McLean, senior manager of customer service at the national call center of eHealthInsurance.com, an online insurance marketplace. (emphasis added)

Thank you, thank you younger generation…

What’s more, new limits on the extra amount insurers can charge older people over younger ones will shift costs from boomers to millennials, experts predict. Today, premium differences for the same coverage between a 21-year-old male and a 64-year-old male can easily reach 5-to-1, according to the Kaiser Family Foundation, a nonprofit that studies health issues. (The difference is a little less pronounced for women.) The new law will limit these age bands, as they’re called, to 3-to-1. The result? Individual policy premiums are expected to stay stable, or even fall, for older consumers buying comparable coverage on the state-level marketplaces, even for those who make too much to qualify for government subsidies.

Fortunately, it’s not a total screw job for the young…

Nearly 10 million of the 11.2 million uninsured 20-somethings will qualify for either Medicaid or some level of premium subsidy, according to an analysis of Census Bureau data by the Young Invincibles, a youth advocacy group. The subsidies apply to anyone with gross incomes up to 400% of the federal poverty level—in 2013, $45,960 for an individual, $62,040 for a family or two, $78,120 for a family of three, or $94,200 for a family of four (higher levels apply in Alaska and Hawaii).

You can view a Federal Poverty Level table here. Although not detailed, the lower you place on the table, the higher subsidy you will be eligible for.

Once again, I want to encourage ALL young people to sign up so that the baby boomer generation can use your money. THANK YOU!

Edited: Changed link from Yahoo to source article at Marketwatch.


Insurers to exchange: You’re not my regulator

Well good for them. The insurance companies already have enough regulators without some exchange asshats on a power trip causing them grief.

Oh and I’m looking forward to this, but at least we get a year to prepare:

QHPs will not have to start asking enrollees to volunteer sensitive information, such as information about “race, ethnicity, sexual orientation, gender identity and disability status” until 2015.

QHPs will have to start asking enrollees for that information in 2015, because “reducing health disparities is a key goal,” staffers said.

QHP = Qualified Health Plan

There’s a simple answer to these questions and that is: “None of your effing business”. In fact my primary care doctor and I will have that discussion on my next visit.


Insurers Flock to Private Exchanges While States Grapple With Obamacare Marketplace

Insurers Flock to Private Exchanges While States Grapple With Obamacare Marketplace – Forbes.


“A well-constructed private exchange can benefit employees, employers and insurers,” said Ken Sperling, Aon Hewitt’s national exchange strategy leader. “Many of these insurance companies experienced positive enrollment results in the Aon Hewitt Corporate Exchange last fall so it is not surprising to see growing carrier participation in private exchanges for 2014.”

This article is mostly focused on the potential for privagte exchanges available to or created for large employers, not the individual exchanges that start January 1st, 2014. Note, the small business exchanges ARE starting January 1st BUT they are only allowing the selection of a single plan. That will change for 2015.


An Exchange races to be ready

Oregon’s ambitious health insurance marketplace races to meet federal reform deadlines | OregonLive.com.


Nationwide, millions of people have benefited from the Affordable Care Act, gaining free access to preventive services including cancer screenings and discounts on prescriptions. The real muscle of the law, though, kicks in the new year. That’s when the law calls for insurance for everyone, regardless of a pre-existing condition or age. Health marketplaces will offer tiered insurance plans to individuals and small businesses employing 50 or less.

What is this “free” stuff. None of it is free. Either it’s built into the premium you’re paying or someone else is paying for it.

In Oregon, more than 200,000 people initially are expected to sign up through Cover Oregon. While premiums will jump for some initially, supporters hope competition will tamp down health care costs over the long haul.

Continue reading An Exchange races to be ready