Tag Archives: keep your plan

Doctors grade Obamacare

Why doctors give Obamacare a failing grade | TheHill.

  •  You can keep your doctors – NOT
  • Medicaid, not so great
  • Deluge of paperwork and reporting requirements

So what grade would doctors give Obamacare?

The Physicians Foundation made shockwaves last month when it released its 2014 Survey of America’s Physicians. The survey’s top-line finding: Of the 20,000 doctors surveyed, almost 50 percent stated that Obamacare deserves either a “D” or an “F.” Only a quarter of physicians graded it as either an “A” or a “B.”

Let’s take a closer look as to how Obamacare has affected Medicaid. Many of my (potential) clients are delighted if they qualify for Medicaid or if their children qualify for CHP+. Perhaps CHP+ offers better services than Medicaid for adults but I’m doubtful.

No matter which option they chose, Obamacare forced my patients to make trade-offs between pricing, access, and quality of care.

Obamacare’s Medicaid expansion exacerbated this patient crisis. Arizona, the state in which I practice, expanded Medicaid in 2013 under the assumption that it would give the poor better access to medical care. Yet many of the new Medicaid enrollees—perhaps as many as 80 percent of them, according to one recent study—were merely forced off their private insurance plans and into Medicaid.

Several of my patients experienced this first-hand. They have found that Medicaid offers sub-standard health care compared to the private insurance they used to have. Their choice of doctors has been severely curtailed, even more so when it comes to specialists. Often they resort to the local emergency room rather than waiting weeks to get medical attention in a doctor’s office. An Oregon study revealed a 40 percent increase in ER visits among new Medicaid enrollees.

Unsurprisingly, patient health suffers when illnesses and diseases remain untreated, hence Medicaid’s persistently poor ratings on patient health. Unfortunately, my patients were forced into this broken system without a second thought.

Perhaps it was without a 2nd thought or perhaps it was with malice. The government creates a problem and then only they can fix it. Of course, with their recent displays of incompetence, they may have overplayed their hand.

Let me also comment on Medicaid. Under Medicaid, reimbursement to doctors is much less than that of regular insurance or even Medicare. I don’t care how you slice and dice it, from a big picture point of view, if the doctors don’t believe they are being fairly paid, the qualify of care dispensed is going to decrease.


United Healthcare Medicare Advantage cuts doctor network

UnitedHealthcare to cut hundreds of Bay State doctors from its Medicare Advantage network – Nation – The Boston Globe.

National insurance giant UnitedHealthcare plans to cut up to 700 Massachusetts doctors from its physician network for seniors enrolled in its private Medicare plan as a way to control costs, according to company officials.

For elderly patients enrolled in the plan, the cuts mean they will have to find a new doctor or eventually switch to a new health plan that covers their current doctor.

The move, effective Sept. 1, follows similar cuts made by the insurer to its Medicare Advantage provider networks in 11 other states, including in Rhode Island and Connecticut, where the reductions drew outrage from patients, doctors, and lawmakers earlier this year.

Note these cuts are for Medicare participants who use Medicare Advantage plans. If you are using standard Medicare with a Medigap supplement you are unaffected by changes to Medicare Advantage programs. Why are Medicare Advantage benefits being cut? You guessed it, Obamacare.

The changes come amid a gradual reduction of reimbursements to private insurers that offer Medicare Advantage plans as a way to offset costs associated with President Obama’s health reform law.

Medicare Advantage provides coverage for 30 percent of Americans on Medicare through private insurers. Consumers often prefer the program over traditional Medicare because it is a one-stop shop for hospital and doctor coverage, and often includes prescription drugs, eyeglasses, and gym memberships.

For years the federal government has paid the private plans up to 14 percent more than traditional Medicare for identical services, a benefit to the insurance industry that cost taxpayers an extra $1,000 per beneficiary, according to the National Committee to Preserve Social Security & Medicare, a Washington-based advocacy group. The 2010 federal health law was supposed to close the gap, as well as provide new bonus payments to plans with the highest quality ratings.

Perhaps the decision to select either Medicare Advantage or traditional Medicare should involve a little more thought than the lowest premium?


We have a lot of work left to do in the next few days,”

says CMS spokesperson Julie Bataille. – No Thanksgiving Celebrations for Obamacare Website Team as Deadline Nears | TIME.com.

By my calculations there are 5,000,000 people who need to replace their insurance plans, not to mention new applicants that don’t have coverage. The number of days between Dec 1 and Dec 23 is… 23. That means on average, 217,000 people a day need to sign up.




Seventy-five percent of the people on terminated individual plans in Colorado have coverage through two carriers

That would be Rocky Mountain Health Plans and Kaiser Permanente – Colorado’s Canceled Health Insurance Count Tops 200,000 « CBS Denver.

So when Rocky Mountain Health Plans President and CEO Steve ErkenBrack states

The exchange and Medicaid have made some good progress, said board member Steve ErkenBrack, who is head of Rocky Mountain Health Plans in Grand Junction. But, he said, he knows there are many who desperately need to get through to a new policy by Dec. 15.

“This is not a theory for people, this is about real people with real problems, and we need to make sure that transition is as smooth as possible,” he said.

Well of course he does. He is responsible for many of these “real people with real problems” having their plans cancelled. Great job Steve.

Also, how did Rocky Moutnain Health Plans and Kaiser Permanente, not to mention the Colorado Department of Insurance, know that you couldn’t keep your plan prior to President Obama? Inquiring minds want to know.


Colorado’s canceled health insurance count tops 200K

Colo.’s canceled health insurance count tops 200K – The Denver Post.

More than 200,000 Coloradans are losing their health insurance because of the federal overhaul, the state Division of Insurance reported Thursday in a count of lives on health plans canceled by 23 carriers in the wake of new requirements.

The Division announced Wednesday that 106,083 people are on plans in the individual market that are getting canceled for reasons connected to the federal law.

Another 143,116 people are on canceled plans in the small-group market. They’re being directed to shop for new health insurance on Connect For Health Colorado, the state-run insurance marketplace.

It would be nice if a reporter would narrow down which companies are cancelling policies effective 12/31/2013. Anthem is mentioned, howver they are offering the option for their individual policy holder to extend their plans through 12/1/2014  whereas Rocky Mountain and at least some Kaiser individual plans are being cancelled as of  12/31/2013.

Oh but don’t worry, you can keep your plan.



Policy cancellations

Obama accused of breaking promise to consumers as health plans cancel policies – The Washington Post.

This about sums it up…

“The real problem is that people weren’t told the truth,” New Jersey Gov. Chris Christie (R) said Tuesday on “CBS This Morning.” “You can remember, they were told that they would be able to keep their policies if they liked them. Now you hear hundreds of thousands of people across the country being told they couldn’t.”

But perhaps the truth isn’t so important if you’re going to get a better policy…

Administration officials say the canceled insurance will be replaced by better policies.

Well, you get to be the judge.


White House admits the obvious

WH: ‘It’s True’ Some Americans Won’t Be Able to Keep Their Health Care Plan Under Obamacare

White House spokesman Jay Carney explained at today’s briefing that “it’s true” some Americans will not be able to keep their health care plan under Obamacare:

It’s good to know that now that every paper in the nation is runing stories about people losing their coverage that the White House can actually admit it’s happening.


Dropped Coverage: One Cancer-Surviving Doctor’s Story in the Age of Obamacare

The PJ Tatler » Dropped Coverage: One Cancer-Surviving Doctor’s Story in the Age of Obamacare.

And now, Obamacare is costing his own family its insurance.

What the article doesn’t make particularly clear is that Dr. Carpenter does have access to Obamacare where they don’t care about his pre-existing conditions. That is ASSUMING healthcare.gov is fixed. Which is a “Mythical Man Month” thing and may or may not happen.

But the implication of the article is “spot on”. He had insurance he liked, it covered his situation and suddently he’s losing it thanks to Obamacare and has to pay more for the replacement coverage with its 10 essential health benefits.

Why more? Because Dr. Carpenter most likely doesn’t qualify for a subsidy. He pays the full price.

Remember. President Obama promised us we could keep our plan and our doctor if we liked it? He also mentioned reductions in annual premiums too. Not just once or twice either. Dr. Carson and many others are paying the price.

Some companies are extending their current plans through 2014. Assuming Obamacare survivives, another group of individual policy holders will have to face the music of paying higher premiums.

… I’m not obivious to those Obamacare helps. I just got off the phone with potential clients who will benefit from the coverage. There is no easy answer, but there’s a better answer than this complex cluster…


Some Nebraskans’ premiums to triple under ObamaCare

Some Nebraskans’ premiums to triple under ObamaCare | Fox News.

Todd Blome’s phone has been ringing off the hook this week with clients seeking tax advice after learning they’ll get a “shocking increase” in their health insurance premiums when Obamacare’s health insurance exchanges begin operating.

Letters have been landing in mailboxes all over Nebraska explaining the impact Obamacare will have on people who buy insurance coverage on their own, rather than through work.

Blome, a Lincoln accountant, understands: He got a letter, too.

Blue Cross Blue Shield Nebraska informed Blome his health care plan will terminate at year’s end, and if he wants to move to a similar plan his new premium will go up 65 percent, costing him nearly $4,000 more per year.

He distinctly remembers President Obama looking into TV cameras and assuring Americans they would be able to keep their doctors, and policies.

His letter says otherwise.

“Stupid me, I took the president literally,” Blome said. (emphasis added)

That’ll teach him. Bet he won’t make that mistake again.  😉

Unfortunately, Tom most likely “lives” in the land of “no subsidy” and with no voice.


Now They Tell Us

Now They Tell Us: ObamaCare Has Huge, Hidden, Premium Costs – Investors.com.

So just how could ObamaCare pile on costly new benefit mandates, require that insurers take everyone, not charge the sick more than the healthy, and keep rates low? Did Democrats manage to find a loophole in the law of supply and demand?

Well, no. Just because ObamaCare premiums didn’t come in as high as some expected doesn’t mean they’re not pricey, particularly for young people.

In fact, the cheapest ObamaCare Bronze plan available to 25-year-olds in several states will cost more than the median-priced plan in those states today, even after taking account of the subsidies.

In Virginia, a low-income 25-year-old will pay $127 a month for the cheapest plan after subsidies, according to the Kaiser Family Foundation. But the Government Accountability Office found that the mid-priced plan in Virginia today costs just $112 a month.

And as the New York Times discovered, even these ObamaCare prices are misleading, since the only way insurance companies could keep them low was by severely restricting their networks of doctors and hospitals.

Silly me, I thought my clients could keep their doctors. Well, not really but my clients thought they could keep their doctors. In fact, they STILL think they can keep their doctors. Those who investigate Obamacare will discover differently in the upcoming months.

How do you compensate for the reduced network? Supplemental policies. Supplemental accident and critical illness policies will help to cover additional costs if you find yourself seeking out of network medical care. Suddently it will be much easier to be “out of network”.

As IBD concludes….

The result is that any patient who actually needs health care could end up having to choose between forgoing treatments or paying huge costs to go out of the network. Either way, they’ll get far less than promised. As the Times discovers, “having an insurance card does not guarantee access to specialists or other providers.”

Once again, think supplemental policies.


Creative Destruction | The Weekly Standard

Substandard catastrophic plans will be cancelled: Creative Destruction | The Weekly Standard.

But don’t worry, everyone will be covered, right? As the College Art Association notes in a “Brief message” to its members on its website, “Here’s the good news: PPACA includes comprehensive reform that is designed to provide affordable health coverage for all individuals. The average premium for individuals who purchase coverage directly today (i.e., they do not receive coverage through their employer) is expected to decline significantly.”

But the membership of these organizations should worry. Unless they are older or suffer from some preexisting condition that made coverage hard to obtain, freelance artists, designers, and musicians forced to enter the state-run exchanges are far more likely to see their rates go up—or to face the individual mandate penalties. This will be especially true, as alert observers of Obamacare implementation have noted, for those under the age of 30.

The youner applicants, better known as the “young invincibles”, can certainly look forward to increased rates, although coverage will be better. Most likely they will find the tradeoff unsatisfactory but I’m just speculating. Soon they will get to vote with their wallets.


Employers weigh health care costs, penalties

Employers weigh health care costs, penalties.

Small nonprofits that pay no taxes can get tax credits. Some businesses that currently provide generous insurance may stop. And organizations could fork over more money covering part-time workers than full-time workers.

Example after example of small groups (2 – 50 employees) and the headaches that the Affordable Care Act is causing.

During the time Barack Obama was running for office, he said multiple times, ‘If you like your coverage, you can keep it. You don’t have to change,’ ” Richards said. “That is not true. Here is why.

“You know who is going to choose whether somebody can keep their plan or not? That’s me. My employees can’t walk up to me and say, ‘We’re going to keep our plan.’ No. I’m the one who makes that choice. I’m the one that’s paying the bill.”

And an employer’s priority, Richards said, is to keep the business running.

I knew from the beginning that people who bought individual plans would not be able to “keep their plans”. The quagmire faced by small employers is pure quicksand. It’s only a matter of time until small employers stop offering coverage, pay the penalty and their employees will find coverage on their state health insurance “marketplace”. “Marketplace” is the politically correct trem for “exchange”.

At least these guys have an extra year now.

Prediction: Chaos



Employers dropping coverage for thousands of spouses over ObamaCare costs

Employers dropping coverage for thousands of spouses over ObamaCare costs | Fox News.

Both the University of Virginia and UPS told their employees recently they are no longer offering spousal coverage to those able to obtain insurance elsewhere; meaning thousands of Americans will no longer be able to choose the benefits they prefer.

UVA said Wednesday this is only one of many “major changes” coming to their health plans as a result of ObamaCare. The university says the changes are necessary because the law is projected to add $7.3 million to the cost of the university’s health plan in 2014 alone.

When do employers stop offering spousal coverage at all? Oh, not to mention, but I will anyway, I thought you could keep your plan!?

Prediction: Chaos