Showing posts with label health insurance exchanges. Show all posts
Showing posts with label health insurance exchanges. Show all posts

Tuesday, November 19, 2013

How KY, CT and WA got Obamacare to work

How'd they get Obamacare to work in the states Connecticut, Kentucky and Washington?  Step 1: Giving a damn.  Step 2: Less bitching at Washington and more working at home.

Republican state politicians, take note!


By Jay Inslee, Steve Beshear and Dannel P. Malloy
November 18, 2013 | Washington Post

In our states — Washington, Kentucky and Connecticut — the Affordable Care Act, or “Obamacare,” is working. Tens of thousands of our residents have enrolled in affordable health-care coverage. Many of them could not get insurance before the law was enacted.

People keep asking us why our states have been successful. Here’s a hint: It’s not about our Web sites.

Sure, having functioning Web sites for our health-care exchanges makes the job of meeting the enormous demand for affordable coverage much easier, but each of our state Web sites has had its share of technical glitches. As we have demonstrated on a near-daily basis, Web sites can continually be improved to meet consumers’ needs.

The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding health-care coverage and have avoided the temptation to use health-care reform as a political football.

In Washington, the legislature authorized Medicaid expansion with overwhelmingly bipartisan votes in the House and Senate this summer because legislators understood that it could help create more than 10,000 jobs, save more than $300 million for the state in the first 18 months, and, most important, provide several hundred thousand uninsured Washingtonians with health coverage.

In Kentuckytwo independent studies showed that the Bluegrass State couldn’t afford not to expand Medicaid. Expansion offered huge savings in the state budget and is expected to create 17,000 jobs.

In Connecticut, more than 50 percent of enrollment in the state exchange, Access Health CT, is for private health insurance. The Connecticut exchange has a customer satisfaction level of 96.5 percent, according to a survey of users in October, with more than 82 percent of enrollees either “extremely likely” or “very likely” to recommend the exchange to a colleague or friend.

In our states, elected leaders have decided to put people, not politics, first.

President Obama announced an administrative change last week that would allow insurance companies to continue offering existing plans to those who want to keep them. It is up to state insurance commissioners to determine how and whether this option works for their states, and individual states will come to different conclusions.

What we all agree with completely, though, is the president’s insistence that our country cannot go back to the dark days before health-care reform, when people were regularly dropped from coverage, and those with “bare bones” plans ended up in medical bankruptcy when serious illness struck, many times because their insurance didn’t cover much of anything.

Thanks to health-care reform and the robust exchanges in our states, people are getting better coverage at a better price.

One such person is Brad Camp, a small-business owner in Kingston, Wash., who received a cancellation notice in September from his insurance carrier. He went to the state exchange, the Washington Healthplanfinder, and for close to the same premium his family was paying before got upfront coverage for doctor’s office visits and prescription drug , vision and dental coverage. His family was able to keep the same insurance carrier and doctors and qualified for tax credits to help cover the cost.

Since Howard Stovall opened his sign and graphics business in Lexington, Ky., in 1998, he has paid half the cost of health insurance for his eight employees. With the help of Stovall’s longtime insurance agent and Kentucky’s health exchange,Kynect, Stovall’s employees are saving 5 percent to 40 percent each on new health insurance plans with better benefits. Stovall can afford to provide additional employee benefits, including full disability coverage and part of the cost of vision and dental plans, while still saving the business 50 percent compared with the old plans.

In Connecticut, Anne Masterson was able to reduce her monthly premiums from $965 to $313 for similar coverage, including a $145 tax credit. Masterson is able to use her annual premium savings of $8,000 to pay bills or save for retirement.

These sorts of stories could be happening in every state if politicians would quit rooting for failure and directly undermining implementation of the Affordable Care Act — and, instead, put their constituents first.  Health reform is working for the people of Washington, Kentucky and Connecticut because elected leaders on both sides of the aisle came together to do what is right for their residents.

We urge Congress to get out of the way and to support efforts to make health-care reform work for everyone. We urge our fellow governors, most especially those in states that refused to expand Medicaid, to make health-care reform work for their people too.

Obama lied, my health plan died?

(Actual headline from an hysterical Michelle Malkin op-ed).

I exposed this lie recently, but here's a much better explanation. All of you accusing President Obama of "lying" should read this.

It is much more the other way around: insurers are lying about Obama "forcing" them to "cancel" private health insurance plans for individuals.

It's very easy for insurers and their enablers in the media to get away with this lie, because as Semro notes, 149 million Americans have health insurance through their employer. They have never had to purchase individual insurance like 19 million other Americans. Most Americans don't know that these plans typically last one year, then they must be renewed -- or "cancelled" in current parlance -- with higher premiums, deductibles, lower coverage -- whatever the insurer offers instead. There has NEVER been a guarantee in the market of keeping ANY kind of health plan, because we have an economic system of free enterprise. 

Meanwhile, many people in the private insurance market don't know they can get cheaper plans through an ACA exchange, and/or qualify for subsidies. 

"But Obama still lied, he said we could keep our plans no matter what!" you still complain. Yes, it was a stupid thing of him to say, but he obviously meant that if the insurer wanted to comply with the grandfathering rules, then people could keep their plans. Many insurers chose not to comply with the grandfathering rules, which were well-known years ago:

A grandfathered plan is any policy in existence before March 23, 2010, when the ACA became law. Grandfathered plans must eliminate lifetime benefit caps, offer coverage to dependent children over age 26 and eliminate pre-existing condition exclusions in 2014, but they are exempt from most other ACA reforms.

The idea was to limit the impact of the ACA on those plans so that insurance companies would continue to offer them and employers and individual consumers could continue to enroll in them.

Under the ACA, a grandfathered plan can lose its status if out-of-pocket costs increase above the rate of medical inflation plus 15 percent, co-insurance rates increase, annual benefit limits decrease, employer contributions decrease by more than 5 percent, or the plan eliminates coverage for a previously covered condition.

So why are some people with ACA-compliant plans going to pay more? First, because Obamacare was a great excuse for insurers to raise their prices, let's be real. Secondly [emphasis mine]:

Should a grandfathered plan end, any new plan is subject to all of the ACA's reforms, including a minimum level of covered benefits. The 10 "essential benefits" required by the ACA include coverage for prescription drugs, preventative care, maternity care and mental health treatment. These new policies will offer consumers better coverage, but the expanded benefits may lead to higher premium prices for some. For others, this coverage may be comparable to or even more affordable than in the past. According to MIT economist Jonathan Gruber, approximately one-half of Americans in the individual market will likely have to purchase a new policy that may cost more.


By Bob Semro
November 16, 2013 | Huffington Post

Saturday, January 19, 2013

The irony of Walmart's health exchanges

Irony can be pretty ironic sometimes. Take Walmart. Its profitable business model requires hiring only part-time workers and paying them minimum wage with no benefits -- including no health insurance.

Now Walmart wants to open its own "health insurance exchange" under Obamacare. Walmart already runs its own medical clinics and pharmacies.

When it comes to using Walmart's buying power and marketing power to negotiate with insurance companies to give its customers a good deal on health insurance, that's just dandy and a valid reason for Walmart to flex its free-market muscles.

So why can't Walmart do the same for its own employees' benefit? In state after state, impoverished Walmart employees receive more Medicaid and food stamp benefits than any other company. That's right: U.S. taxpayers subsidize health coverage for Walmart's employees by Walmart's design; meanwhile, Walmart plans to turn around and sell health coverage to U.S. taxpayers. Huh-what?!

And Walmart's opening health insurance exchanges at its stores is doubly ironic, because the same "free-market" forces that allow it to negotiate cheaper insurance for its customers, are exactly the same forces that would allow the U.S. Government, under a single-payer health insurance system, to win even better deals for all of us. But then that would be goddamn "socialism."  Whereas it's "capitalistic" to overpay for the same thing.

And oh, by the way, the Walton family that controls Walmart is wealthier than the bottom 40 percent of Americans, combined. God bless America!  

P.S.  Read Ralph Nader's recent wonderful open letter to Walmart CEO Mark Duke here.