Two Minute Blog
Moderate “average” rate increases for 2015 exchange plans over 2014 exchange plans have been widely reported in the press and elsewhere. Well here’s another “not so fast my friend!”
Many folks who purchased ACA plans in 2014 on the exchange may be surprised when they get their January invoices.
Here’s how the wolf disguised as sheep reference plays out.
The “average rate increases” (increases spread across all plans offered without regard to market share) that some experts are proclaiming and the media is reporting are masking a more practical barometer of how policyholders are impacted.
For a little Halloween fun, I’ve compiled a few articles that have to do with healthcare tricks and treats. All related to Obamacare, or the Affordable Healthcare Act, of course…
Trick: Gov. Kasich’s four Obamacare tricks by Washington Examiner
Treat: Ebola: Obamacare’s ultimate pre-existing condition by The Fiscal Times
Trick: Government close to closing loophole that lets employers offer substandard insurance by The Washington Post
In last week’s Did You Know Series on Obamacare we pointed out a major glitch or loophole in the healthcare law that actually may allow large employers to avoid health-law penalties by offering stripped down plans that have no hospitalization coverage. Well, in the words of colorful former college football coach and current ESPN College Game Day host Lee Corso “Not so fast my friend!”
While there’s no official word yet, it sure sounds like this loophole was a screw up, is now on the administration’s radar screen and is likely to be fixed soon. We’ll continue to keep you posted on developments as they unfold. For more about this, here’s the link to a recent article on this topic from Kaiser health News that also appeared in The Washington Post.
Here is my final post in the Obamacare…Did you know? series…
Many low-income consumers who bought bronze plans with low premiums but high deductibles in order to comply with Obamacare’s individual mandate are discovering they still can’t afford health care. Reports are that many with insurance coverage purchased on the exchange are returning to the community health centers for treatment. Community health centers cannot turn anyone away. Wonder if the narrow networks that are associated with the exchange products and the well documented problems with these networks including the limited number of providers participating have also had an impact on this?
Read Some say Obamacare’s affordable coverage isn’t affordable for them
A recent Associated Press-GfK poll that finds that nearly 75 percent of Americans find healthcare reform “difficult” and nearly half say it is “very hard” to understand.
Health insurance is both expensive and complex. We work for many great employers who work hard to provide strong coverage to employees while covering much of the cost. These employers provide leadership, guidance, and pay for a substantial share of the employee’s premium, if not all of it. Their employees should be thankful that they don’t have to wade into current individual market quagmire, most especially the exchanges, to find their own way.
Obamacare: Did you know #1
Obamacare: Did you know #2
Obamacare: Did you know #3
I’m doing a series on things I think you should know about Obamacare. Here is installment #3…
There’s a major glitch or loophole in the healthcare law that actually allows large employers to avoid health-law penalties by offering stripped down plans that are devoid of any hospital benefits. That’s right. No hospital benefits at all. Obamacare regulators created an online calculator to certify whether plans offered by large self-insured employers that pay their own medical claims meet the Affordable Care Act’s toughest standard. The Obamacare calculator is used to test “minimum value” for adequate benefits. Many, including your 2-Minute Drill author, were surprised to read in a recent Kaiser Health News story that the calculator approves these plans lacking any hospital benefits.
Word is that numerous large, low-wage employers with high turnover that haven’t offered medical coverage in the past — retailers, hoteliers, restaurants and other businesses with high worker turnover and lower pay — are considering driving a truck through this loophole by offering plans without any hospitalization coverage. By doing so, they thus protect themselves from some of the employer mandate penalties that come into play next year. Some of the talking heads in the industry claim the calculator was purposely designed this way by the administration. However, I tend to agree with respected consultant Bob Laszewski. He’s quoted as saying “That’s baloney. Nobody said we’re going to have health plans out there that don’t cover hospitalization. That was never the intention…I think they just screwed up.” Stay tuned for more on this.
Obamacare…Did you know? #1
Obamacare…Did you know? #2
I’m doing a week-long series “Obamacare…Did you know?”
Last week I talked about how as we move into the open enrollment phase for 2015, more complexities arise and more computer glitches are expected. Read my post Obamacare…Did you know? #1
Just recently a federal judge in Oklahoma ruled that subsidies can’t go to those who purchased health coverage through a federal exchange (most states). This decision adds to a mix of rulings on whether individuals in states utilizing the federal marketplace can legally be provided with premium subsidies. Many expect that this subsidy issue, which is a major component of the Affordable Care Act, will wind up before the U.S. Supreme Court. In July, two U.S. appeals courts issued conflicting rulings on health-law subsidies, raising questions about the fate of tax credits/premium subsidies provided to several million Americans. While this issue makes its way through the courts, subsidies remain available.
Read more about this in an article on Politico
Stay tuned for more this week on Obamacare…Did you know?
Believe it or not, you can expect the second year of Obamacare to be even more chaotic than the first. Last week we attended a market update meeting related to this year’s open enrollment which begins November 15. The meeting was sponsored by one of the major insurance companies. Any notions we had for a smoother rollout and less disrupted market this year were quickly dispelled. With little more than 6 weeks to the start of open enrollment, it was pretty clear to those of us in attendance that there were still many more questions than answers.
So, over the next few days, I’m going to provide you with some important “Did you know?” points that I think you need to be aware of. Here’s the first installment:
Did you know…Additional complexities are expected in the enrollment process. Specifically, re-enrollment for those who signed on in the first year, i.e. those who qualified for subsidies in year one must re-qualify. And, more computer glitches are expected. Just yesterday the Wall Street Journal reports that in order to participate in any systems testing, insurance carriers must first agree to confidentiality of the testing process. Disclosure of testing results is strictly prohibited. There’s essentially a gag order for those carriers. Hmmmm. Color me skeptical but it sure doesn’t foster confidence that things will be improved this year. Also, makes one wonder if keeping it all hush-hush has anything to do with the upcoming mid-term elections.
Read 5 things we need to know before Obamacare enrollment starts again from The Washington Post.
Despite the fact that narrow networks continue to come under fire, we believe they will remain an integral part of the fabric of health plan options.
Narrow network strategies are employed by carriers as a means to control costs, offer lower-priced health insurance options, and still comply with new provisions of the Affordable Care Act such as medical loss ratio requirements and qualified health plan actuarial values. The rub with narrow networks is that while narrow networks can help lower premiums, they can also limit choice, access and potentially even quality. Plus, despite lower rates they can ultimately cost individual patients a lot more.
In the cases of these newly reported lawsuits, some docs that were originally listed as participating were dropped from the network. Patients were then faced with very high and unexpected medical bills from the newly out-of-network docs. Some enrollees sued the insurance companies claiming that the carriers failed to let them know that the docs were no longer participating.
For some, narrow networks can be the right choice, e.g. those who focus on monthly premiums above all else. While we believe that to be true, we’ll continue to bang the drum loudly that before selecting a narrow network plan, buyers need to do their homework. Know who is in the network and re-confirm participation before seeking care whenever possible.
Read Consumer Group Sues 2 More Calif. Plans Over Narrow Networks from The KHN Blog.