How Insurers Are Hiding Obamacare Benefits From Customers

[sactoking]

Because if you have a job you should have already received a letter explaining the HC exchange etc. The letter was required of employers with only one employee, and whether or not the employer provides a HC plan. The letter was due to be issued by Oct 1.

The point being this woman couldn't reasonably claim to be unaware of the HC exchanges etc even if she didn't have a TV, internet or read newspapers.

Fern

While the employer notices were required to be sent by 10/1 there was actually no punishment for failure to send them so it's certainly possible that an employer would have not bothered.

BCBS has always had NC locked up as pretty much the sole individual provider. I had no idea Coventry even existed before the exchange.

Anthem (a BCBS licensee in several states) just bought Coventry and is using the company to segregate its risks.

 

[dank69]

Look up North Carolina. I can't see where it has improved competition one bit. Most of our counties have exactly one option on the HC exchange. IIRC, about a third of the counties include a (small) second provider. That it's as best as I can tell.

Fern

Clearly that is Obama's fault or a result of Obamacare, so let's say it's both, just to be sure. Hopefully NC can break free of the union and finally be able to enjoy the healthcare that liberals are denying them.

All fun and games aside, it sounds like there is a huge business opportunity in NC assuming NC doesn't have some state laws/regulations in place killing competition for BCBS.

 

[OutHouse]

The non-subsided cost of a silver plan in Washington state for the article's family is $1248/month.
http://www.wahbexchange.org/index.php?cID=472

Cheap insurance isn't found here. The question is who pays for coverage, the individual being covered or the government/taxpayer, and the insurance company doesn't care who pays as long as someone pays.

Not to mention good luck in finding a hospital that accepts obama insurance. Many are just not taking it.

 

[dank69]

Because if you have a job you should have already received a letter explaining the HC exchange etc. The letter was required of employers with only one employee, and whether or not the employer provides a HC plan. The letter was due to be issued by Oct 1.

The point being this woman couldn't reasonably claim to be unaware of the HC exchanges etc even if she didn't have a TV, internet or read newspapers.

Fern

I'm not sure how me being informed about the exchanges helps our dear friend Donna. I also find it funny that you think it's impossible for people to be unaware of the exchanges, considering that 11% of young Americans can't find the US on a map.

 

[dank69]

Not to mention good luck in finding a hospital that accepts obama insurance. Many are just not taking it.

Are you even trying at this point?

 

[Londo_Jowo]

Are you even trying at this point?

The medical group I use here in the Houston area no longer accepts Aetna, if a person that currently uses this medical group happens to get an Aetna plan from the marketplace they will have to find a medical group that does.

 

[dank69]

The medical group I use here in the Houston area no longer accepts Aetna, if a person that currently uses this medical group happens to get an Aetna plan from the marketplace they will have to find a medical group that does.

Great example of medical groups denying obama insurance. :thumbsup:

 

[sactoking]

All fun and games aside, it sounds like there is a huge business opportunity in NC assuming NC doesn't have some state laws/regulations in place killing competition for BCBS.

Even though you don't paint the issue as black and white, it's still a lot grayer than you think. I'm speaking from experience here.

I don't believe that the lack of insurers on an exchange can be viewed as a "business opportunity", even with the allowance that there may be outside factors, such as state laws, dampening entry. The reason many insurers are avoiding the exchanges is they've done the game theory and the risks of losing money far outweight the potential for gain. The widely held belief is that those seeking coverage on the exchanges are going to be the riskiest, most costly demographics and there's no guarantee the "young invincibles" will buy in. That's a recipe for losing money. Sure there's the "3 Rs" programs (reinsurance, risk adjustment, and risk corridors) but nobody actually knows if they will work. Given that insurer solvency is such a huge issue in the regulatory world, very few insurers are willing to game their solvency (and the resultant receivership) on the hope that the exchanges will work. It could be several years before there's enough market stability to encourage new entrants.

Here in Nevada, we have 4 insurers offering on our exchange. That sounds like a good number until you break it down:
1 insurer is a CO-OP, which is legally required to offer on the exchange
2 insurers are the Medicaid MCO providers, which have to offer on the exchange per their Medicaid contracts
1 insurer is voluntarily on the exchange

We have 12 insurers offering off the exchange. That's a 3:1 ratio that could easily be 6:1 or 12:1 without outside forces.

Even with 4 insurers on the exchange none of them were willing to offer in the rural areas of the state. It took some negotiating to make that happen.

I guess what I'm saying is that, rightly or not, insurers view these exchanges as inherently risky and evaluation of items can't be done in a CNN-like "GOOD OR BAD?!?" vacuum.

 

[Londo_Jowo]

Great example of medical groups denying obama insurance. :thumbsup:

They stopped accepting Aetna at the beginning of 2011.

 

[OutHouse]

Are you even trying at this point?

Tell me why hospitals are opting out of insurance from the exchanges?

 

[dank69]

They stopped accepting Aetna at the beginning of 2011.

I'm so confused. Is Aetna "obama insurance" or not?

 

[dank69]

Tell me why hospitals are opting out of insurance from the exchanges?

I'll do my best but you'll have to provide me a link telling me that hospitals are opting out of insurance from the exchanges.

 

[Londo_Jowo]

I'm so confused. Is Aetna "obama insurance" or not?

Aetna is one of the Insurers in the Texas Marketplace.

http://www.zanebenefits.com/blog/bid/319033/Texas-Health-Insurance-Exchange-Update-Health-Plan-Rates

 

[dank69]

Aetna is one of the Insurers in the Texas Marketplace.

http://www.zanebenefits.com/blog/bid/319033/Texas-Health-Insurance-Exchange-Update-Health-Plan-Rates

Was it in the Texas exchange in 2011?

 

[Fern]

Clearly that is Obama's fault or a result of Obamacare, so let's say it's both, just to be sure. Hopefully NC can break free of the union and finally be able to enjoy the healthcare that liberals are denying them.

All fun and games aside, it sounds like there is a huge business opportunity in NC assuming NC doesn't have some state laws/regulations in place killing competition for BCBS.

We don't really have unions here; we're a 'Right to Work' state.

I'm not sure why we don't have more competition here. NC is a pretty large state so you'd think more insurers would be interested in doing business here.

I'm also unsure of how Obamacare could ever hope to increase business here. I could surely be wrong, but I thought to sell HI insurance companies had to register with, and perhaps be approved by, our insurance commission. I thought that was common among most states. In any case, it they weren't registering here before I don't see how Obamacare would change that.

Edit: It's not a matter of "blaming" Obamacare as you say. It was YOU who was stating that Obamacare increased competition, and it doesn't (at least as far as I've seen).

Fern

 

[Londo_Jowo]

Was it in the Texas exchange in 2011?

They started discussing the exchange in 2011.

http://www.zanebenefits.com/blog/bid/284579/Texas-Health-Insurance-Exchange-Guide

Texas Health Insurance Exchange - History

After the Affordable Care Act passed in 2010, the Texas Department of Insurance and the Health and Human Services Commission partnered to explore exchange implementation plans. Using federal grant funding they identified subcontractors to assist with the exchange planning process, to collect stakeholder feedback, and to investigate the state’s policy options. Texas held a public exchange planning symposium and solicited public comments in early 2011. Texas received a Federal Exchange Planning grant of $1 million in 2010, however the state has since returned $900,000 of this grant to the federal government.

On July 9, 2012, Governor Rick Perry announced that Texas would default to a federally-facilitated health insurance exchange.

 

[Doc Savage Fan]

Even though you don't paint the issue as black and white, it's still a lot grayer than you think. I'm speaking from experience here.

I don't believe that the lack of insurers on an exchange can be viewed as a "business opportunity", even with the allowance that there may be outside factors, such as state laws, dampening entry. The reason many insurers are avoiding the exchanges is they've done the game theory and the risks of losing money far outweight the potential for gain. The widely held belief is that those seeking coverage on the exchanges are going to be the riskiest, most costly demographics and there's no guarantee the "young invincibles" will buy in. That's a recipe for losing money. Sure there's the "3 Rs" programs (reinsurance, risk adjustment, and risk corridors) but nobody actually knows if they will work. Given that insurer solvency is such a huge issue in the regulatory world, very few insurers are willing to game their solvency (and the resultant receivership) on the hope that the exchanges will work. It could be several years before there's enough market stability to encourage new entrants.

Here in Nevada, we have 4 insurers offering on our exchange. That sounds like a good number until you break it down:
1 insurer is a CO-OP, which is legally required to offer on the exchange
2 insurers are the Medicaid MCO providers, which have to offer on the exchange per their Medicaid contracts
1 insurer is voluntarily on the exchange

We have 12 insurers offering off the exchange. That's a 3:1 ratio that could easily be 6:1 or 12:1 without outside forces.

Even with 4 insurers on the exchange none of them were willing to offer in the rural areas of the state. It took some negotiating to make that happen.

I guess what I'm saying is that, rightly or not, insurers view these exchanges as inherently risky and evaluation of items can't be done in a CNN-like "GOOD OR BAD?!?" vacuum.

We're all learning here. Just want to say thanks for making the effort to educate us! Much appreciated.

 

[OutHouse]

I'll do my best but you'll have to provide me a link telling me that hospitals are opting out of insurance from the exchanges.

http://health.usnews.com/health-new...2013/10/30/top-hospitals-opt-out-of-obamacare

even if Obama didnt lie about "if you want to keep your insurance..."

your doc or hospital does not have to keep you.

I have two choices on my exchange for Colorado. Kaiser and Colorado Health op. guess what my family doc of 17 years does not take either one. luckily I have insurance through my company and i don't have to deal with that exchange bullshit.

 

[dank69]

We don't really have unions here; we're a 'Right to Work' state.

I'm not sure why we don't have more competition here. NC is a pretty large state so you'd think more insurers would be interested in doing business here.

I'm also unsure of how Obamacare could ever hope to increase business here. I could surely be wrong, but I thought to sell HI insurance companies had to register with, and perhaps be approved by, our insurance commission. I thought that was common among most states. In any case, it they weren't registering here before I don't see Obamacare would change that.

Edit: It's not a matter of "blaming" Obamacare as you say. It was YOU who was stating that Obamacare increased competition, and it doesn't (at least as far as I've seen).

Fern

Have you bought a mattress lately?

 

[dank69]

They started discussing the exchange in 2011.

http://www.zanebenefits.com/blog/bid/284579/Texas-Health-Insurance-Exchange-Guide

So Aetna was on the exchange in 2011?

 

[Incorruptible]

More stupidity by liberals. Obamacare doesn't benefit the customers and if you want real benefits then repeal Obamacare and bring in a free market system.

 

[Fern]

Have you bought a mattress lately?

Nope

Fern

 

[Londo_Jowo]

So Aetna was on the exchange in 2011?

The decision was made and in effect long before the exchange meeting occurred in 2011.

 

[Jhhnn]

Not to mention good luck in finding a hospital that accepts obama insurance. Many are just not taking it.

Mere assertion.

 

[Jhhnn]

The insurance companies aren't the ones with any power. Auto insurance is such a good example. You aren't charged $5,000 for a tire because there is only one tire transplant facility for 500 miles, but that is the way healthcare works.

You've made that assertion repeatedly w/o supporting documentation of any kind.

Right now, it's just an example of Truthiness, of you believing it to be true because you want to. It's an argument based on thin air.

When an insurance co gets a bill they see as unreasonable, they negotiate. If the provider won't settle, the insurance co pays whatever they believe to be reasonable & the provider has to sue if they want more. They seldom do.