ACA Federal Marketplace updates

[Htown Harry]

Looks like e-Health will have some competition. Kaiser health news reports ...

Nice reporting by Kaiser. I always enjoy reading "before we started asking questions, the web site said..."

This quote nicely captures my point on the business side of this being fascinating. Risks and rewards are reallocated in all kinds of interesting ways when markets are disrupted.

[Consumers Union rep]: "Someone got into the insurance market and yelled, 'Free money! New demand!' They're all trying to figure out how to be the place where people spend their tax credit dollars," she says.

 

[marko]

Looks like e-Health will have some competition. Kaiser health news reports

I checked out the ehealth site and played around with it. I realize that it's still early but was disappointed to see that here in Mass, there is only one provider quoting.

I also read somewhere that one state offers HI for $300 a month but Mass' minimum seems to be just under $1000 a month, at least through ehealth.

 

[ziggy29]

I checked out the ehealth site and played around with it. I realize that it's still early but was disappointed to see that here in Mass, there is only one provider quoting.

Now or in 2014? I thought Massachusetts already was operating their own "exchange", so perhaps most insurers compete through there and not through this site?

https://www.mahealthconnector.org/portal/site/connector

 

[marko]

Now or in 2014? I thought Massachusetts already was operating their own "exchange", so perhaps most insurers compete through there and not through this site?

https://www.mahealthconnector.org/portal/site/connector

That could be. The site only went out to the end of the year, not 2014 so I had to use current dates. I got an error msg if I went out past Oct.

When the day does arrive, (DW's job currently provides HC) we'll relocate our permanent/formal residence to FL and save $700/mo on HC (not to mention about $10K in state income taxes)

 

[Mulligan]

That could be. The site only went out to the end of the year, not 2014 so I had to use current dates. I got an error msg if I went out past Oct.

When the day does arrive, (DW's job currently provides HC) we'll relocate our permanent/formal residence to FL and save $700/mo on HC (not to mention about $10K in state income taxes)

Marko, I imagine you are only seeing premium costs that are under the current health insurance system. They won't have any bearing on next years cost.

 

[marko]

Marko, I imagine you are only seeing premium costs that are under the current health insurance system. They won't have any bearing on next years cost.

You're probably right, but I don't expect prices to go dramatically down...

I'd love to get the premiums others states are quoting but we've already established that "$1000 a month is what the market will bear" here.

Still find it hard to believe that with only 4 months to go, nobody can tell me what I'd be paying.

 

[MichaelB]

Still find it hard to believe that with only 4 months to go, nobody can tell me what I'd be paying.

In the 7 or so years I've been dealing with policies for the group we are in we have had about 6 weeks notice before prices are available for the following year. Never two months. For state exchanges, upcoming prices will be published 3 months prior to effective date. This is not an exchange issue, it is how the health care insurance business currently works.

 

[samclem]

Developments in Michigan

The legislature in Michigan is exploring some avenues, within the constraints of the ACA, that may reduce medical costs, administrative costs, and provide more options for patients.

Michigan Senate Bill 460 , sponsored by Senator Pat Colbeck, would be the first step toward setting up an infrastructure that would allow individuals to contract directly with primary caregivers (no insurance company forms/paperwork/etc) for Direct Primary Care Services (DPCS). These arrangements are increasingly popular in the private sector--pay a doctor/practice a fixed fee monthy/annually, go in as often as you need to. For specialized/more expensive issues, the patient uses a high-deductible insurance plan (HDIP) (purchased within an HSA--with all the tax advantages). The federal subsidies etc would still be in place, but the subsidy checks are used by participants to buy their DPCS contracts and their HDIP, and to pay co-pays, etc. All of this is independent of the "exchanges," I suppose Michiganders could still buy from the exchanges if they want. Michigan also hopes to use the same mechanism to cover their Medicaid patients, with the money coming from the same sources (federal/state) that now pay for the program.

A rather obscure portion of the ACA (Section 10104 (3) ) authorizes what they call "Qualified Direct Primary Care Home Plans", so waivers might not be required for implementing some portions of the Michigan proposal.

The bill has been voted out of committee and will now be considered on the floor of the Michigan Senate.

The states are supposed to be the laboratories. If Michigan implements this and it works, I suppose it might spread to other states.

 

[MRG]

I checked out the ehealth site and played around with it. I realize that it's still early but was disappointed to see that here in Mass, there is only one provider quoting..

I'll trade you, 'I get your area is not covered'. ( Not really both issues stink, and as consumers I don't think we should have to deal with it.)

My current status no state exchange, feds not ready.

I love the guys that are still fighting over ACA. Its the law guys, make it work.

Oh, did one if you want my vote?

MRG

 

[sheehs1]

Just called Anthem here in Virginia. My current plan (Premier) is going up 11% as of September ($42.75 extra a month). My plan is not grandfathered nor does it have some of the ACA requirements (like maternity). I suppose this is just their regular yearly increase (?). The increase, even though their regular increase, was not as bad as I thought it might be.

They could not tell me anything else. We did not get "the letter" in July we were suppose to get concerning ACA. Now they saying September stating that things are changing too much and they don't want to give out inconsistent information.

It's possible there will be another rate change come Jan 1st. As I understand it, I may be able to keep this plan and this premium for one more year until going to an ACA compliant plan but I'm not certain of that.

So...no real news for Virginia. At least not from Anthem.

 

[Htown Harry]

Looks like e-Health will have some competition.

Another web-based broker is approved by HHS

Getinsured.com signs exchange hub agreement | LifeHealthPro

 

[pb4uski]

.....I'd love to get the premiums others states are quoting but we've already established that "$1000 a month is what the market will bear" here.

Still find it hard to believe that with only 4 months to go, nobody can tell me what I'd be paying.

Below are the 2014 rates for one of your neighbors. Done and approved. I wish we had more choices (only 2 carriers) but that has been the case ever since they eliminated pre-existing conditions as I recall.

Time for the Bay State to get its act together

http://healthconnect.vermont.gov/si...Designs with Final Rates_updated 7 31 v 4.pdf

 

[MichaelB]

The Vermont summary includes HSA plans. Nice. Great link.

 

[MichaelB]

Another web-based broker is approved by HHS

Getinsured.com signs exchange hub agreement | LifeHealthPro

According to the report

Some news organizations are reporting that as many as five Web brokers may have negotiated data hub agreements with CMS.

Five brokers sounds feasible, we've already heard from three. Wouldn't surprise me if we went from "not enough information" to "too much information" over the few weeks.

 

[pb4uski]

It will be interesting to see how this all works out. If it does work out it'll be an interesting contrast on government getting things done compared to private enterprises getting things done. That said, some states seem to be in pretty good shape for October 1, and others are playing catch-up.

 

[MichaelB]

Connecticut rates

Connecticut rates Obamacare insurance rates get final approval | The CT Mirror

.

 

[Big_Hitter]

http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/income-verification-8-5-2013.pdf

mods please move if this isn't in the right spot

FORE!

 

[Mulligan]

Connecticut rates Obamacare insurance rates get final approval | The CT Mirror

.

I liked your chart Michael (though not the dollar amounts ). Looks like according to the chart, I am in the "everything goes to hell and falls apart" age bracket. The rates from mid 40s to mid 50s percentage wise are higher than the next bracket taking you up to Medicare. I am surprised at that.

 

[MichaelB]

http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/income-verification-8-5-2013.pdf

mods please move if this isn't in the right spot

FORE!

It's fine here, but an explanation or snippet would be useful.

The link is to a CMS statement on how it intends to deal with income verification.

Q: Will Marketplaces be verifying the income of consumers as a part of the eligibility process for advance payments of the premium tax credit and cost-sharing reductions?

A: Yes

A much more detailed response can be viewed following the link.

 

[Mulligan]

Maine has released some premium rates broke out by decade. A 50 year old buying the Bronze can be had at $328. Only 2 companies competing. Anthem, the other company was about $100 higher of same plan.

http://www.zanebenefits.com/blog/bi...-Exchange-Update-Individual-Health-Plan-Rates

 

[Htown Harry]

Pennsylvania has announced the names of companies submitting exchange policies for review, but no policy details or rates have been disclosed.

8 health insurers signal interest in Pa. marketplace | Distil Health Insurance Exchanges

Companies want in on Pennsylvania's health exchange

In: Four of Pennsylvania’s Blue Cross/Blue Shield insurers, as well as Aetna, UPMC, Geisinger and Coventry Health Care.

Out: United Healthcare and Cigna

 

[Htown Harry]

This doesn't sound good.

On the other hand, it's not necessarily a step backwards because TDI has a reputation for minimal consumer advocacy.

State to Feds: We Won't Enforce Insurance Reforms | The Texas Tribune

Because Texas did not create its own state-based marketplace, known as a health insurance exchange, under the Affordable Care Act, it must use a federally facilitated one instead. By federal law, the state must enforce provisions and regulations related to the insurance exchange and market reforms unless it notifies the federal government that it cannot or will not. If a state does not enforce those reforms, the federal Centers for Medicare and Medicaid Services will step in to do it.

Texas, Arizona, Alabama, Missouri, Oklahoma and Wyoming have all notified the federal government that they will not be policing the health law, according to the article.

 

[MichaelB]

I imagine CMS sees this as both positive and negative. They won't have the budget to carry out the enforcement they want, but it does give them a chance to pursue a more uniform implementation across the states.

 

[bUU]

It's a federal law; it makes sense for the federal government to police it. Many states cannot be trusted to do a honest job of it anyway.

 

[Mulligan]

I imagine CMS sees this as both positive and negative. They won't have the budget to carry out the enforcement they want, but it does give them a chance to pursue a more uniform implementation across the states.

I have to admit I haven't been waving the Pom pons on this law as I am going to be disproportional hit on this, but it is the law now, so let's make it work the best way possible. Living in one of these 6 states and following the news about my state stonewalling as much as possible it can,I have a dreadful feeling it is going to make it all the more painful to my wallet.