Welcome back my friends to the show that never ends.
We are so glad you could attend.
Come Inside, Come inside.
As promised a week ago, I have returned to the topic of the Affordable Healthcare Act and the Healthcare.gov marketplace website.
The strangest thing happened to me today.
I discovered a message on my home phone from the Healthcare Insurance Marketplace letting me know that I should call them because “my eligibility results are ready.”
To make matters even stranger, I received an email telling me the same thing.
Is the Obamacare infrastructure finally working?
Will I be able to find out what insurance alternatives are available to me and at what costs?
Is it only December 12, 2013 a couple of days over 45 months since the PPACA was signed into effect and a little over 10 weeks since the Healthcare.gov website was opened for business?
My trusting friends, I did finish out my application again, answering the same questions again (many were already pre-loaded with my previous answers), reviewing my same profile again and making sure to give the government permission again to dig even further into my personal life so I could find out what type of programs laid waiting for me in the healthcare pot ’o gold.
I finished with my signature verification and guess what………I was verified !!!
Verified yes, but my application still needed to be reviewed.
I leaped through a couple of introductory questions and miraculously found myself…………wait for it…………..ON HOLD.
But alas, things must be getting better.
Within 3 minutes a nice women named Taylor (she sounded like a US Citizen) came on the line and said my application was successfully completed (I guess they don’t interact with the website?), she would help me with the programs I qualified for and she would help me pick a health insurance plan that would fit my financial budget.
Has Hell frozen over?
Are you folks excited right now, because I sure as heck fire am.
After a few minutes research, Taylor let me know that with my financial expectations for 2014, I would probably qualify for the State Medicaid Program and that the APA would not affect or help me until I verified my eligibility with the AHCCCS office that handles Medicaid in Arizona.
Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents.
I chose this figure for 2 reasons:
1. It is the closest (I probably will be higher in my savings usage in 2014 but see #2) representation to my current living status and
2. The income I chose of $40K is very close to top of the income levels that allow government subsidies for Obamacare insurance.
In other words, I wanted to see what options the healthcare marketplace offered the “middle aged US average Joe” who is just getting by.
Although the median “household” income in the US is listed as just over $50,500 ($26,965 per person on average) that figure is driven upward heavily by the incomes of the top 4% of the wage earners in the US making $200K per year or more.
I wanted to represent the largest wage earning portion of the US population which is 66% of our country’s workers that are making less than $41,212 a year.
I apologize for keeping you all hanging but when I started this trip I thought everything would be easy and straightforward.
Well, we know that wasn’t true was it?
Anyway, I will contact our local Arizona AHCCCS Health Insurance people VERY SOON to see what they have to offer me since I discovered that their response to applications is listed as “within 45 days; 20 days if pregnant”.
Hmmmm........another government run program.
I guess I won’t be one of the “lucky few” with any insurance come January 1st.
From the looks of things I won’t be alone.
From the scarce data provided on signups so far during the first open enrollment period under Obamacare, the majority of people gaining new coverage are being declared eligible for Medicaid rather than being provided with subsidies to purchase private insurance through the health care exchanges.
While that will create severe problems for the financial stability of the system, regardless of which way the government provides health insurance to these new enrollees, the American health care system is heading for a split into two (or even three) almost completely separate tiers.
The federal government will be in control of the health insurance for a majority of Americans starting in 2014.
The government provides health insurance for seniors through Medicare, teams up with the states to extend insurance to poor people through Medicaid, and will be providing subsidies for and otherwise heavily involved in the insurance policies offered by private insurance companies through the health care exchanges.
We’ll get back to your guesses as to where the US healthcare system is going wind up next year in a future blog.
This is a great example from USA Today showing what we are up against in trying to get insurance from the new Obamacare program.
OBAMACARE COSTS EXAMPLE
We have a 54-year-old man shopping for a health plan that would cover him, his 55-year-old wife and two dependent children (ages 14 and 21). The family lives in suburban Philadelphia. None is a smoker.
For our family of four, HealthCare.gov offers six Silver plans: four Independence Blue Cross plans and two Aetna plans. (We considered only the Silver plans to keep it simple.)
The HealthCare.gov estimates ranged from $708.84 per month to $982 per month.
Now, HealthCare.gov doesn't ask for ages or even an age range when providing plan information and premium estimates for family coverage.
All it wants to know is the visitor's home state and county.
ValuePenguin.com asks for a little more information.
Besides county and state, window shoppers have to provide household size, as well as ages and tobacco use for all family members.
That website's estimates were higher — much higher.
A whopping 69 percent higher for each exchange plan.
The premium range: $1,201.44 to $1,666 per month. (And, remember, that's for a family of nonsmokers.)
Both websites asked for the same information as ValuePenguin.com — except that the insurance companies wanted birth dates, not just ages.
We found, not surprisingly, that the insurers' price quotes were almost exactly the same as the estimates provided by ValuePenguin.com.
In fact, they were exactly correct in three of the four Blue Cross plans.
ValuePenguin.com's estimates were slightly off — lower by no more than 4.5 percent — for the two Aetna plans.
The website discloses up front, while you are browsing for plans and prices, that the premium estimates are "based on a limited set of sample ages."
But potential customers would have to dig deeper into the website to find out what sample ages the tool uses.
Go to the homepage, scroll to the bottom until you see "Quick Information," and click on "Health Plans" under the header "Plan Information for Individuals and Families."
In the case of a family of four, the website assumes that the husband and wife are both 30 years old.
Why I don't know?
In our real life example, they are 55 and 54.
That's important because the Affordable Care Act says insurance companies can charge older Americans up to three times more than younger ones.
As shown in the example above, don’t be surprised that the costs that you initially see on the healthcare website are much lower than the true costs quoted directly to you from the insurance companies themselves.
And as far as subsidies are concerned……….who knows.
You’ll probably wind up talking to your local state Medicaid office like me.
I’ll keep you posted on my progress.
Thanks for joining me………………………………