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“It’s harder to… May 12, 2014

Posted by QUOTEBROKER in Insurance Quotes.
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“It’s harder to rehab your house while you’re still living in it”: How the state that inspired Obamacare failed to implement Obamacare

When the Affordable Care Act’s various exchanges opened for business in late 2013, millions flocked to take advantage of these new health insurance platforms. But for one state, this was old news.  Massachusetts had long before implemented their own version of healthcare reform- in fact, the major principles of Obamacare were largely borrowed from it.  These principles being:

  • expanding coverage to all citizens, regardless of pre-existing conditions
  • requiring all citizens to be covered, also known as the “individual mandate”
  • providing financial assistance to lower income individuals and families to help pay their premiums

Given that Massachusetts already had a program extremely similar to Obamacare, one might expect the transition would be smooth, if not flawless.  Nothing could be further from the truth. Last week Massachusetts announced it would be scrapping its exchange, in favor of either an entirely new contractor or merging with the federal Healthcare.gov site.  What went wrong?  Vox.com examines today. They found several issues

“It was a management failure. Like the federal system, the state should have thrown the best IT support into it.” says Don Berwick, a current Massachusetts candidate for governor and former Obama administration healthcare implementation overseer. Massachusetts went with contractor CGI to build the exchange- the same contractor behind the initial failure of Healthcare.gov.  The state had trouble converting its subsidy system, which was entirely paper-based, to comply with Obamacare’s requirement of a real-time subsidy determination.  

“In some ways it’s harder to rehab your house when you’re still living it,” says Jon Kingsdale, the Connector’s first executive director.  State exchanges with the opportunity to start from scratch may have found the process easier than adapting existing systems and technology to legislation that was largely similar but different enough to cause fatal issues.. On the other hand, Oregon had that opportunity and completely blew it.

So how can it be fixed? Right now, Massachusetts ranks 49th in the nation in the number of actual insureds vs. eligible insureds at 12.2%, well below the national average of 28%.  Much of this can be attributed to the failed exchange, as hundreds of thousands of individuals are insured in transitional programs meant to provide temporary coverage while the state refocuses its strategy.  The first option is to hire a new exchange builder- at an estimated cost of $121 million, in addition to the $175 million already spent on the failed exchange. The alternative is to default to the federal health exchange- quite the fall from grace for not only an early Obamacare adopter, but also its blueprint.


Obamacare enrollment numbers are in- but what do they mean? May 6, 2014

Posted by QUOTEBROKER in ACA, COBRA, Employee Benefits, Group Health Insurance, Health Care Reform, Health Insurance, Insurance Quotes, Obamacare.
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Obamacare enrollment numbers are in- but what do they mean?

The Obama administration has released a report detailing the enrollment numbers from the first enrollment period.  Note that these numbers are still incomplete, as final enrollments were still trickling in from the two week grace period given to consumers who had difficulty enrolling before March 31, 2014.  The big number that has been bandied about is “eight million enrolled” citizens into Obamacare plans- but what does that number actually mean?  Vox.com issued a nice summary at the link above.

The eight million figure comprises:

  • Consumers who created a marketplace account on an exchange, whether federal or state, and enrolled in a health insurance plan
  • “enrolled” in this case means “had their information sent to the insurance company
  • Some percentage of these folks have not and will not pay for their premium- an estimated 10-15%, based on numbers recently released by AHIP– America’s Health Insurance Plans.

The figure does NOT include:

  • Private enrollments made through carriers directly outside of the marketplace
  • Medicaid enrollments
  • Group enrollments
  • Those young adults under age 26 who were eligible to enroll in their parents’ health plan

Attempting to calculate Obamacare’s true reach is extremely difficult. We can count who signed up for insurance, but we can’t determine who only signed up because the legislation caused them to lose their plan in the first place.  We can count who signed up for Medicaid, but we can’t calculate who signed up that was newly eligible based on the new Medicaid expansion rules.

We will also see these numbers fluctuate throughout the “offseason” between open enrollments.  Special Enrollment Periods, unlocked with major qualifying life events, will be used to move into marketplace plans even now that open enrollment has closed. Marriage, birth, adoption and especially job loss are common triggers of Special Enrollment Periods. The individual health insurance industry always had some degree of turnover, much of it attributable to consumers getting new jobs and leaving the individual market to join their employer-sponsored group plan.  The same will continue under the ACA, as will the reverse scenario of consumers leaving their jobs with employer-sponsored plans and entering the individual market, as the lack of pre-existing condition exclusions will allow free movement between group and individual programs. These “final” enrollment numbers released by the administration are anything but.

How to Enroll in Health Insurance After Open Enrollment Has Closed May 2, 2014

Posted by QUOTEBROKER in Insurance Quotes.
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The much-publicized deadline to enroll in health insurance has come and gone.  Consumers now enter a new world where they can no longer enroll in health insurance or jump between health insurance carriers freely.  However, there are still ways to get health insurance in the new “offseason” created by the Affordable Care Act.

  • Special Enrollment Periods for those with Qualifying Events
  • Group Insurance
  • Short-term health insurance

Today’s focus is on Short Term health insurance.  Short term health insurance, in most cases, does not have the 10 Essential Health Benefits and is thus not “ACA compliant” and does not count as Minimum Essential Coverage. This may sound entirely bad for you as the consumer, but there are some advantages to not being classified as Minimum Essential Coverage

  • Insurance carriers can offer short term coverage year-round
  • Because they are not bound by the metal tier system, short term plans can be more flexible in offering different plans and rates, allowing you to customize a plan to your liking withouto fitting into one of the five ACA benefit tiers.

Short Term plans are commonly used to bridge the gap between two other insurance policies.  If you just got a new job and have to wait several months for your plan to start, Short Term coverage can give you peace of mind until the new plan kicks in.

  Short Term plans are offered in two forms:

  • Month to month, with a maximum number of months depending on your state
  • Lump sum- paying for the entire policy up front can often save you a significant percentage of the total premium

There are some downsides to short term plans:

  • Medical underwriting can still be used for short term plans, meaning you can be denied for a pre-existing condition
  • you can only be on a short term plan a certain number of times per time period, and a certain number of months consecutively. These exact figures vary by state.
  • Short Term plans are not ACA compliant, and thus for purposes of the penalty tax, you are considered uninsured.

While not for everyone, Short Term plans can be a great option for those in a transitional phase between two plans, those who missed the deadline to enroll but want a safety net in case they become sick or injured, and those who want more flexibility in plan choice, among others.

As always, visit http://www.quotebroker.com or call 800-783-0802 for more information on Short Term health insurance plans.


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