GOP's Obamacare gotchas...not so much.

The GOP hyped their  anti  ObamaCare crusade with some gotchas  recently .  One   is   “aha, the President lied” about Obamacare (ACA, Affordable Care Act) when he promised “if you like your insurance, you can keep it.” . The other is  “the web site does not work”.  Gotchas? Maybe not so much.

 When the President first made those promises in 2010, he was not lying.  If your  individually purchased policy   in 2010 when the law was passed  was the same now, you get to keep it if you want to.  However, in the small print, if there were any new policies  issued or changes after March 2010, you would have to either upgrade it to meet new standards or find another one.

The other gotcha is the federal  web site does not work, but most concede that it eventually  will. Remember, too, Colorado runs its own marketplace and site and it is working. As of October 25, Connect for Health Colorado saw 44,935 accounts created and 3,164 people enrolled, not including Medicaid enrollments. This even beats the first month’s experience of Massachusetts, after which ObamaCare was modeled.

,The individual insurance  issue may not be a big deal for most of us, but it is a big deal for those individuals affected. Some are understandably  livid.    An estimated 8 million of the 12 to 15 million  who had bought insurance individually got letters recently from their insurers dropping their insurance or raising their rates because the old policies did not meet the new standards required by ObamaCare. Those impacted are about 5%. The rest of us , over 200 million with Medicare, Medicaid, employer provided insurance,  are not.

What may be of consolation to many of  those who got the drop or premium increases notices, is that they  are not  left without insurance.  The new policies are comprehensive, unlike their old policies , called by some as “ Swiss cheese full of holes”  or “junk”, as Consumer Reports called most of  them in March.  An estimated 50% of those dropped  will qualify for subsidized premiums in the exchanges and  pay less and get a better policy for their money. The rest can   have access to the exchanges which function much like large group policies and could even offer  a better deal. Shop first in the exchanges to get a grip on the alternatives..

The  minimum provisions  now required to be included in all insurance policies are   ambulatory patient services ,emergency services, hospitalization ,maternity and newborn care, mental health and substance use services , prescription drugs, rehabilitative and habilitative services and devices ,laboratory services, preventive and annual checkups and cancer screenings, chronic disease management, and pediatric services, including oral and vision care. There are also consumer protections in the new standards,  such as forbidding caps on the amount of coverage, denial because of pre-existing conditions, dropping  coverage when you get sick or are in the middle of treatment, charging more for women, outrageous out of pocket co pays and deductibles, and  administrative costs exceeding 20% of the policy spent on actual services.

Those liking their old policies may  never need all of these basics  such as maternity and child coverage ,  and they  treasure their  right to  gamble they will never need others . Their  right to buy underinsurance is indeed trampled, but the Supreme Court upheld the individual mandate over other rights. All  need to be in the pool to make any of the advantages of  the law financially feasible, including covering women’s health needs without charging them more, which has been the case in the past.   Grandfathering in substandard policies may be one of the tweaks that could be considered  by Congress..The issue then becomes  the  impact on financing the  law’s implementation and how to make up the difference with a “pay for”.

Colorado's Obamacare does well in its first week

Even with the disastrous web sign up system rollout, there are those who are beginning to realize that some of the conservative  cable talk show media  did not have it quite  right about Obamacare.   What must be puzzling to the dedicated Obamacare and Obama haters is why public approval of Obamacare (the ACA, Affordable Care Act) actually rose 8 points even as media and they  focused on the web system screw ups.  In fact,  a CNN poll released October 21 three weeks into the web rollout found “ that 53% either support Obamacare or say it's not liberal enough.”   Consumers are beginning to sort out  for themselves  what is fact versus the fiction of   misspeaking and  fear mongering anti Obamacare forces.

What we hear in Colorado differs from  the federal web sign up plan.   Colorado is one of the fifteen states that  opted to develop and manage their own market place exchanges and web site. The rest of the states  decided to let Uncle Sam do it and they did a disservice to their own citizens. Even in the first month of the sign ups state run Obamacare systems have worked much better than the federal one.

In Colorado, Connect for  Health Colorado is managing the  marketplace exchanges where consumers can shop, choose,  and enroll . Their web site is www.connectforhealthco.com. Colorado has also flooded the state with “navigators”,  allowing for  in person applications, certifying insurance agents to sign their customers up, and staffing call centers   for telephone sign ups and answering questions.(1- 855-752-6749.)  

The figures provided by the Colorado system  for the first week reveal a successful operation:

• Unique website visitors: 162,941
• Calls and chats with Customer Service Center Representatives: 9,658
• Accounts created: 18,174
• Average call and chat wait time: 5 minutes 44 seconds
• Enrollments: 226
• Covered Lives: 305

That enrollments were  low this first week  is not surprising . Experience with the Massachusetts system after which Obamacare was patterned, was that most enrollments did not occur until the last moment. It is a little early to expect much now  anyway since  open enrollment lasts for another five months , while coverage does not begin until January 1 for early birds  who enroll by December 15.

 The most popular pages visited on the Colorado website and questions asked  indicate visitors during the first week were mostly kicking the tires,  being  curious  about whether they qualified for lowered premiums, how to sign up,  and what the sticker price for them would be.  

Also, there are a wide range of plans from which to choose that require some thought and kitchen table discussion :  One major decision is whether one  should one choose a plan with low monthly premiums and higher deductibles and co pays or more expensive monthly premiums with less  subsequent out of pocket expenses.

Making sign up for Obamacare easier, applicants  will not have to fill out pages of  health history  because  all pre-existing conditions will be covered anyway.  Questions about  income will be asked and answers verified, however, to determine if customers are eligible for reduced premiums.  

Signing up young, healthy adults is critical to Obamacare’s financial success. Young people through 29 years old can get an ultra  low cost catastrophic plan as well as staying on their parents’ plans until they turn 26. There are those wringing their hands (or anti Obamacare forces are praying)  that young people will not sign up because they will be unable to deal with   a faulty computer program. They should neither  fret or hope .  Colorado systems are not faulty.  Having raised three teenagers and observed three teenage grandchildren close at hand, my experience is that if anyone has the ability and patience to apply on line, this computer savvy generation does. However, “ last minute”  is their middle name even into young adulthood.