So, How Are We Doing? (The Update Post)

Pat Carr, the CEO of UnitedHealthOne, the individual health insurance division of UnitedHealthCare, had a goal.  On Tuesday, January 21st, Mr. Carr sent an email to insurance agents in which he shared the news that his company had had a record-breaking December.  His goal?  He pledged that his company would try to have 90% of those applications through underwriting by February 1st.  90%!

UnitedHealthOne isn’t buried under an avalanche of applicants taking advantage of The Patient Protection and Affordable Care Act (PPACA or Obamacare).  No, this deluge of new clients comes from individuals and families attempting to avoid the PPACA for at least another year.

Welcome to the PPACA, where much of what you’ve been told on TV is not quite true.

There were seven editions of Health Insurance Issues With Dave posted in the last quarter of 2013.  At the same time I sent an additional seven separate PPACA updates to my clients.  These updates have been more insurer specific and action oriented.  Today’s post will merge these two communications, at least for this week.

  • UnitedHealthOne – Mr. Carr’s email is an indication of a new attitude of transparency.  His company does not have an exchange policy in Ohio.  Their emphasis is on Short Term Policies (more of that later) and off-exchange contracts.
  • Medical Mutual of Ohio recently sent an apology to its agents.  The Cleveland-based insurer admitted that it has had significant service issues through the conversion and that it hopes to be back to normal soon.  Based on today’s experiences, soon can’t come soon enough.
  • Anthem Blue Cross is overwhelmed.  The clients and I have been underwhelmed.
  • The insurers and their websites were as unprepared for October 1st and the PPACA roll-out as the federal government.  The timing, a national insurance revolution in the middle of the annual Medicare Open Enrollment and the time of the year that American businesses reevaluate their group health policies, over-taxed our system.  This could not have been worse.
  • As reported in the Washington Post, over 20,000 Americans have filed appeals with the government over mistakes made by  Overcharges, denial of benefits, and being sent to the wrong policies are just some of the problems cited.  But the biggest problem is that the federal government has no way to correct the problems.
  • The upheaval we are witnessing overshadows the Medicare Part D (Rx) rollout of eight years ago.  This mess is closer to the disaster of Y2K.  And like Y2K, we will get through this, too.
  • There is no reason to go to unless you will qualify for a subsidy.
  • For those who will qualify for a subsidy, is working better.  I say that even though I spent close to three hours on the site yesterday attempting to help two clients.  We were not successful, and will be trying again later this week.
  • Applying for a subsidized policy through the insurers’ websites may still prove to be the easiest path.
  • The Medicaid Expansion will help millions of Americans access affordable care.
  • Will there be a tax / penalty for not purchasing a PPACA qualified policy in 2014?  A lot of people are guessing, NO.  Short Term Policies, once thought to be the victims of the new health care law, are having a revival.  These are G-d forbid policies.  They only cover accidents and illnesses that are new, big, and different.  And, they are very cheap.
  • Many healthy Ohioans, even ones who may qualify for a subsidy, are finding that their old policies are cheaper.  If you don’t need maternity, why would you change?
  • Unhealthy individuals and small employers who have been charged extra because of unhealthy employees are buying the new policies and saving a bundle.  For now.  $700 per month.  $900 per month.  $1,100 per month.  It is incredible.  Of course, if the only people rushing to purchase insurance are the people most likely to use it, the system will crash.  Politicians may shade the truth, but numbers don’t lie.

The government is still making up the rules and regulations on the fly.  The insurers are playing catch up.  And the consumers, you and I, are trying to keep the whole thing straight.  Almost 20% of our economy is devoted to our health care.  This will get fixed.

We are all in this together.






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