Tag Archives: PCIP

Young invincibles opt out of Obamacare?

Health insurers fear young people will opt out – Yahoo! News.

Dan Lopez is the definition of a “young invincible”….

Dan Lopez rarely gets sick and hasn’t been to a doctor in 10 years, so buying health insurance feels like a waste of money.

Even after the federal health overhaul takes full effect next year, the 24-year-old said he will probably decide to pay the $100 penalty for those who skirt the law’s requirement that all Americans purchase coverage.

“I don’t feel I should pay for something I don’t use,” said the Milwaukee resident, who makes about $48,000 a year working two part-time jobs.

I’d like to know where he get’s his crystal ball! Of course, he’s far from alone and with the increased premiums for the young invincibles, especially when they don’t qualify for a subsidy or it is very small, one can’t blame theme for seriously considering “opting out”.

Of course, “opting out” presents a serious problem for Obamacare…

Experts warn a lot of these so-called “young invincibles” could opt to pay the fine instead of spending hundreds or thousands of dollars each year on insurance premiums. If enough young adults avoid the new insurance marketplace, it could throw off the entire equilibrium of the Affordable Care Act. Insurers are betting on the business of that group to offset the higher costs they will incur for older, sicker beneficiaries.

The nonpartisan Congressional Budget Office estimates that about six million people of various ages will pay the tax penalty for not having insurance in 2014, the first year the law championed by President Barack Obama will be fully implemented.

I find the next paragraph troubling but typical of those who believe that coverage pre – Obamacare was “poor” and post-Obamacare is fantastic…

About 3 million 18-24 year-olds in the U.S. currently purchase their own insurance. Many pay high prices for scant benefits, with high deductibles and co-pays because they make too much to qualify for Medicaid and have no coverage options from their employers or parents. The Urban Institute estimates that the majority of adults in their 20s will qualify for government subsidies under the Affordable Care Act.

Continue reading Young invincibles opt out of Obamacare?


States fear losing aid for ‘uninsurables’

States fear losing aid for ‘uninsurables’ – Timesonline.com: National.

This has to do with the health insurance high risk pools that were set up under Obamacare. This program helps bridge the gap for patients who suffered from pre-existing conditions until next year, when under the new law insurance companies will be required to accept people regardless of their medical problems.Many states ran them based on funding from the government, where other states simply allowed residents to sign up for the government sponsored plans.

It appears cost overruns for the state run risk pools will become the responsibility for the states.

Delivered last Friday, the new contract stipulated that states will be reimbursed “up to a ceiling.”

“The `ceiling’ part is the issue for us,” Keough said in an interview. “They are shifting the risk from the federal government, for a program that has experienced huge cost overruns on a per-member basis, to states. And that’s a tall order.”

State officials say one likely consequence of the money crunch will be a cost shift to people in the program, resulting in sudden increases in premiums and copayments. Many might just drop out, said Keough.

Amateur hour.

We should ask these state government if they really want to partner with the government on Medicaid expansion?


States: ‘Blindsided’ by plan to shift costs of ‘uninsurables’ to them under ObamaCare

States: ‘Blindsided’ by plan to shift costs of ‘uninsurables’ to them under ObamaCare | Fox News.

In a letter this week to Health and Human Services Secretary Kathleen Sebelius, state officials said they were “blindsided” and “very disappointed” by a federal proposal they contend would shift the risk for cost overruns to states in the waning days of the program. About 100,000 people are currently covered.

Craziness. Best I can tell, this is an issue for the 27 states that elected to run their own high risk pools with money Continue reading States: ‘Blindsided’ by plan to shift costs of ‘uninsurables’ to them under ObamaCare


$5 bil Pre-existing Conditions Fund Set Up By ObamaCare Already In Red

$5 bil Pre-existing Conditions Fund Set Up By ObamaCare Already In Red – Investors.com.

We’re talking about the Obamacare PCIP (Pre-existing Condition Insurance Plan) that was set up to provide people with pre-existing health conditions insurance coverage until Obamacare plans started January 2014. Key points of this type of plan are (were):

  • Applicants have to have a significant pre-existing condition
  • Coverage could start the 1st of the month if a complete application was received by the 15th of the previous month
  • Applicant could not have had recent major medical coverage
  • There was not waiting period for pre-existing conditions

In other words, for those who knew how to “work the system”, if you qualify for coverage, there’s no need to actually apply for coverage until expenses are on the immediate horizon.

Continue reading $5 bil Pre-existing Conditions Fund Set Up By ObamaCare Already In Red