Sunday, October 18, 2015

Drop Out

The next sign up for insurance is November 1. For those covered by individual policies our policies will be cancelled under the vague mention that the current plan does not meet the obligations under the Affordable Care Act. This is my third time with this story and my third insurer.

I shopped via the Washington Healthplan Finder and the first year simply took the State insurance. Bare bones bare minimum I never used it. This year I actually used the insurance. I was rejected for one visit as I did not see pre authorization as I went to a walk in clinic with a massive painful rash that I could not wait weeks to see a primary care Doctor. For the record these are public health clinics with massive wait times. That has not changed with ACA. So I chose an emergent care clinic. That was 200 dollars out of pocket.

The next was for eye exam and to a dermatologist to look at the rash that was healing after I found a naturopathic treatment that began to heal it.

The eye exam was a provider and still rejected. But as I bought glasses, not covered, they absorbed the cost. The dermatologist appears to be covered. I have no idea.

On September 24 I was told that the Washington Exchange would no longer process payments. Irony is that this is a state organization/department processing payments for the state health care provider whose office is in Arkansas. So on the last day of the plan I received a bill for over $500. They had neglected to bill me monthly for my care. I received invoices at times marked for 87 dollars and other months with 0. I paid when I owed and did not pay when I didn't. They fucked up. Whoops. So on the last day I charged the remaining 500. I never received any invoices or bills from the carrier until Friday, October 16, for what amount? 500. Wow this insurance is way more expensive.

So I printed out the original agreement, subsidies, the invoices and payments received and made and will send them to both the insurer and a copy to the Washington Exchange. I suspect nothing will be done as in 2 weeks we start anew. So my coverage will lapse for the remaining months of the year as I start again.

I won't be. And I am not the only one. I move in a few months I will risk it. I would prefer to put the money in savings and if I need it use it for walk in care at the same public health clinics that I am to go to now with insurance, so is there a difference? I have no idea.

Obamacare is the gift that gives. It is an STD that whomever takes office needs to heal.

Little Growth Predicted on Health Exchanges

By ROBERT PEAR
The New York Times
OCT. 15, 2015


WASHINGTON — In a surprisingly pessimistic forecast, the Obama administration predicted on Thursday that health insurance enrollment on the Affordable Care Act’s public marketplaces will only inch up from current coverage levels by the end of 2016.

After an elaborate analysis of demographic data, Sylvia Mathews Burwell, the secretary of health and human services, said that 10 million people were expected to have marketplace coverage at the end of next year, up only about 100,000 from recent levels and millions short of earlier projections. She called that “a strong and realistic goal.”

“We still have work to do to bring access to affordable, quality health insurance to all Americans,” Ms. Burwell said. “But we’re getting closer to that goal.”

About 9.9 million people had coverage through the federal and state insurance exchanges at the end of June, and administration officials predict that the enrollment will decline to 9.1 million by the end of this year. Some people fall off the rolls because they fail to pay their share of premiums. Others may obtain employer-sponsored coverage through a new job.

The next open enrollment period for the insurance marketplaces begins Nov. 1 and continues until Jan. 31.

Because of gains in coverage in the last two years, Ms. Burwell said, there are fewer uninsured Americans, and “they are a little harder to reach.”

In addition, she said, “the remaining uninsured have a lot of concerns about whether they can afford coverage,” even with the financial assistance available under the Affordable Care Act.

The Congressional Budget Office predicted in March that enrollment through the exchanges would reach 11 million this year and 21 million in 2016.

But administration officials said that estimate was based on assumptions that proved to be invalid. For example, they said, the budget office assumed that significant numbers of employers would drop coverage and send their workers into the insurance exchanges, but that has not happened.

Discussing plans for the coming enrollment campaign, Ms. Burwell said, “Our target assumes that more than one out of every four of the eligible uninsured will select plans.”

The new enrollment goal could serve a political purpose for Democrats running for election in 2016. They can more easily defend the Affordable Care Act if they can show it is achieving a goal set by the government. For their part, Republicans on Thursday seized on evidence of difficulties to buttress their claim that the law has been an expensive failure.

Census Bureau reports, considered the most authoritative source of data, show that nearly nine million people gained health insurance last year, lowering the ranks of the uninsured to 10.4 percent of the population, down from 13.3 percent in 2013. The change reflected the expansion of Medicaid in many states, as well as the purchase of subsidized insurance through the exchanges.

Obama administration officials said their efforts to expand coverage this fall would focus on five areas with large numbers of uninsured people: Dallas, Houston, northern New Jersey, Chicago and Miami.

Ms. Burwell laid out a series of intricate calculations to arrive at the goal of having 10 million people enrolled through the exchanges at the end of 2016.

She estimates that 7.3 million to 8.8 million people who now have marketplace coverage will select plans or be automatically re-enrolled in 2016. She estimates that 2.8 million to 3.9 million uninsured people will select plans in the coming enrollment period. And she predicts that 900,000 to 1.5 million people who bought insurance outside the exchanges this year will switch to policies sold through the marketplaces in 2016.

Combining these projections, Ms. Burwell estimates that 11 million to 14.1 million people will select health plans from November through January. Of these, she said, 9.4 million to 11.4 million will pay their premiums and retain marketplace coverage next year.

“I believe in clear metrics and goals,” Ms. Burwell said. “So I have picked a point that we will manage for, and that point is 10 million people with effectuated enrollment at the end of 2016. That’s nearly one million more than this year.”

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