Anatomy of an Obamacare ‘horror story’

by Maggie Maher:

A lack of fact-checking by the media lulled into profiling the false accounts of individuals with a political agenda.

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Stupid News for the Math Challenged

Reaching a new low in sheer stupidity, CNN is now reporting that many Americans won’t be eligible for “Obamacare subsidies” because the insurance premiums in their states are too low, as if that means they are somehow being cheated.  They provide the example of subsidies in Portland, Oregon phasing out at the $28,000 income level for people under age 35 — and complain that the Obama administration had “promised”  a higher “threshold for government assistance.”

Or to put it simply:  CNN is upset that that insurance is being sold too cheaply to trigger the need for young people to get government help to pay their bills.

As if it would somehow be better if those youngsters in Oregon could be charged so more, so that more taxpayer dollars could be sent to the insurance companies.

So, here are a few pointers for the mathematically challenged: Continue reading

Forget the plan – let patients keep their doctors!

I think there are two important points that are missing from the intense media focus — and now the White House response – to the problem of the insurance cancellation notices on the individual market.  Both are the result of actions that have been taken by insurance companies which are now participating in the exchanges — in other words, they are barriers to acceptance of ACA created by the same insurance companies that are the chief beneficiaries of the new, heavily subsidized insurance market.

The promise that “if you like your insurance, you can keep your insurance” was essentially written into the law, by the express terms of the original ACA legislation. There was a “grandfather” clause which expressly allowed consumers to keep whatever plans they were enrolled in prior to March of 2010, subject to some requirements to strengthen those plans.

The problem is that many consumers who buy their own insurance on the market have switched plans since then, giving up their grandfathered status.  It’s not that they didn’t like the plans they had; rather, those plans got too expensive. So very often the switch was to another, seemingly better or less expensive plan offered by the same company.    Continue reading

The way it was

There has been a lot of media attention focused on various technical difficulties related to signing up for insurance under the ACA.  There is also a lot of attention being paid to the fact that individuals who had insurance on non-grandfathered plans are now receiving termination notices — though this is hardly “news”.  (A “grandfathered” plan is one that was in existence before passage of the ACA in March 2010; a “non-grandfathered” plan is a plan that an individual or employer group purchased or set up after that time. In order to be “grandfathered”, plans had to also be upgraded to meet certain specified requirements as to coverage).

I’ve recently discovered a document that was created by an insurance company (Anthem Blue Cross) to assist its agents in understanding the standards for coverage and setting rates. This 64-page Booklet, called The California Agent Guide: Policies and Procedures Sales and Underwriting for Authorized Agentss, is quite recent, published in May, 2013. But it’s worth reading as a very detailed reminder of the hurdles that everyone had to pass in order to purchase insurance.

The list of disqualifying conditions or medications is staggering.  Kid taking medication for ADHD? that’s a 25%-75% increase in premium.  Taking prescription meds for acne? Decline.   In fact there’s a whole page listing dozens of prescription medications that would preclude a person from getting insurance.

Continue reading

Applying on Paper

OK, so it’s pretty obvious that the web site enrollment thing isn’t working for a lot of people. 

As I’ve posted before, I think the most rational thing to do is to wait a couple of weeks while they iron out all the glitches.   But at least in California, it’s also quite possible to apply on paper.  Here’s a link:

Covered California Paper Application Form

Actually, even if you plan to apply online, I’d strongly encourage Californians to review this application brochure first — you’ll find that it answers a lot of your questions, and reviewing the form will help you to be ready with the information that you will need for an online application.

Tech Tip for Healthcare.gov

Tech tip:

Did you run into trouble trying to create a user account at http://www.healthcare.gov last week?

It might be a good idea to clear your browser cookies before you try to log on again this week.

(This tip was passed onto me by a good friend, but I have no way to test whether it is necessary for everyone. But it’s always a good thing to try if you are having problems associated with logging into a site).