ACA Federal Marketplace updates

[mpeirce]

> but it is the law now, so let's make it work the best way possible

Naw, bad laws are worth fighting against. And repealing.

Heck, we (the US) has even had a constitutional amendment repealed when most people decided that was the right thing to do.

 

[Mulligan]

> but it is the law now, so let's make it work the best way possible

Naw, bad laws are worth fighting against. And repealing.

Heck, we (the US) has even had a constitutional amendment repealed when most people decided that was the right thing to do.

Well for my wallet, fighting it the way they are advocating will just make it worse. Advocating young people to just pay the fine will make my premium go up more. State not taking money from Feds will cause people with no insurance to rack up bills that get passed on to my premium.

 

[MichaelB]

Lets keep the thread focused on PPACA news and preparedness.

 

[alaska55]

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.

And you trust the federal goverment!

 

[bUU]

Yes: The federal government is demonstrably more trustworthy with regard to these things than many of the state governments. I believe you'd acknowledge that if you could look past your desire to frivolously disparage the federal government.

 

[travelover]

Yes: The federal government is demonstrably more trustworthy with regard to these things than many of the state governments. I believe you'd acknowledge that if you could look past your desire to frivolously disparage the federal government.

Don't feed the trolls.

 

[bUU]

Don't feed the trolls.

My apologies. You're correct.

 

[Gatordoc50]

Having been subsidized by my DWs employer for the past 27 years, I am surprised at the cost of health insurance. We pay 182 dollars per month for the whole family! Of course, our choices are somewhat limited and wages aren't the best but it's been a good trade off. I am keeping my fingers crossed that it stays the same, otherwise it won't make sense for my wife to continue working and then she'll find out how little I do in any given day!

 

[wmc1000]

Gatordoc50 - she already knows if she's anything like my wife! The $1000 - 1500 per month for Health insurance is what keeps me working - my wife retired 5 years ago.

 

[pb4uski]

This was one of the better calculators that I have seen in that it shows both the gross premium and the net cost after subsidy for various levels of plans at a glance. I believe that the gross premiums are based on the average of the 2014 premiums for the two carriers (BCBS-VT and MVP).

Subsidy Calculator | Vermont Health Connect

 

[Gatordoc50]

This was one of the better calculators that I have seen in that it shows both the gross premium and the net cost after subsidy for various levels of plans at a glance. I believe that the gross premiums are based on the average of the 2014 premiums for the two carriers (BCBS-VT and MVP).

Subsidy Calculator | Vermont Health Connect

All ages pay the same?

 

[pb4uski]

Yes, I believe so.

BCBSVT developed the table of rates without regard to age, tobacco use or geographic area, as required under the Vermont community rating law, and so the requirements listed in 45 CFR 154.301(a)(4)(v) and (xiv) do not apply.

 

[meierlde]

I found an article in the Fort Wayne News Sentinel with at least a glimpse of Indiana Exchange Pricing, a 21 year old on the silver plan is 214 a month and a 55 year old couple with 3 kids under 20 would pay 1362 a month, both are for non smokers.
Here is a link to the article:
New PHP premiums show price of Obamacare | FortWayne.com - Fort Wayne IN

 

[alaska55]

Another Delay

http://www.nytimes.com/2013/08/13/u...alth-care-law.html?partner=MYWAY&ei=5065&_r=0

WASHINGTON — In another setback for President Obama’s health care initiative, the administration has delayed until 2015 a significant consumer protection in the law that limits how much people may have to spend on their own health care.

​

 

[samclem]

From the link posted by alask55:

The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.

It appears to be an exception for group plans, it might not affect the "exchanges."

Hopefully, employers (or the health insurers they contract with) will at least be required to notify employees that they won't have the caps that were supposedly going to be in place.

I'm surprised that there's so much "flexibility" concerning the when and how of implementation of legislation that contains some pretty hard dates. Maybe there's a branch of government empowered to either make the legislation match the reality or make reality match the legislation.

 

[ShokWaveRider]

I wish they would leave it alone and concentrate on making it better. I vote for single payer.

 

[MichaelB]

Daily reminder to keep the thread focused on the PPACA please. It's really not that difficult.

 

[Htown Harry]

Some perspective on cost comparisons

This article succinctly lists several points made here by various posters.

ObamaCare's effects difficult to measure: Column

• there is a tendency to conflate premiums for insurance purchased on ObamaCare's new exchanges with those in the private market.
• the impact of the Affordable Care Act varies widely for different subsets of the population.
• the estimated cost of purchasing insurance on the exchanges depends greatly on whether you take into account the federal subsidies that many people will receive.
• whether premiums appear attractive depends on what you compare them with.
• the effect of the exchanges depends on how you compare premiums. [average vs. average, lowest vs. lowest, etc.]

 

[MichaelB]

http://www.nytimes.com/2013/08/13/u...alth-care-law.html?partner=MYWAY&ei=5065&_r=0

​

This link is an announcement that group plans with different managers for major medical and pharmacy benefits are allowed an extension of one more year to combine total out of pockets for each into one single amount. In the meantime they can continue with each counted separately and subject to current (2013) limits, which may be greater than the upper limit established by the PPACA.

No effect on policies sourced from the state health exchanges. This will impact employees with group coverage that were expecting to see a cap and possibly a reduction on their total out of pocket, and the immediate effect would be on people with very high drug bills.

 

[misanman]

Employees at our company were told today that our benefits would renew effective 12/1/2013 as opposed to 1/1/2014. That gives the company 11 more months to avoid ACA.

 

[pb4uski]

and 11 more months to figure out how they want to deal with ACA. Sounds like a smart business move to me.

 

[Silver]

I am not clear on how the enrollment periods will work. Initially, open enrollment is October 1, 2013 until March 31, 2014. How does one enroll after that? Will there be annual open enrollment times, or does there need to be an 'event" (i.e. - current healthcare insurance lost, divorce, etc.) to enroll?

 

[M Paquette]

I am not clear on how the enrollment periods will work. Initially, open enrollment is October 1, 2013 until March 31, 2014. How does one enroll after that? Will there be annual open enrollment times, or does there need to be an 'event" (i.e. - current healthcare insurance lost, divorce, etc.) to enroll?

The ehealthinsurance.com folks have put together a couple of good pages on this.

https://www.ehealthinsurance.com/affordable-care-act/news/obamacare-countdown-step-5-2

https://www.ehealthinsurance.com/affordable-care-act/news/open-enrollment-the-basics

There will be annual open enrollment periods, in the last quarter of each year, and 'events' like losing group coverage from a job will also allow enrollment.

 

[teejayevans]

So if I already have a policy (and either it's grandfathered in or it will compliant starting next year), then I still qualify for the subsidy and can skip the exchange process, yes?
TJ

 

[M Paquette]

So if I already have a policy (and either it's grandfathered in or it will compliant starting next year), then I still qualify for the subsidy and can skip the exchange process, yes?
TJ

Yes, sort of. You would receive the subsidy as a tax credit on filing your 2014 individual income tax return if eligible (Modified adjusted gross income low enough, and a subsidy-qualified plan.) In order to get the advance subsidy paid to your insurer, you would need to go through the exchange program.

(This MIGHT wind up varying from state to state depending on state insurance rules. California requires going through the exchange.)

My HMO provider has arranged to automatically flip me to a compliant plan. Their literature lays out how I can also go to the state exchange, and apply for the same or a different plan and get the subsidy. They'll know I'm already an HMO member and will just treat it as a continuation of coverage on the selected policy.

The online signup process is very simple. On the first screen you set up a user account. This is similar to setting up an E-R.org account. The second screen presents a bunch of privacy related information, because the online app will be sending parts of your information to the tax folk's server to do income verification. Click "Agree" just liek in iTunes... Next you have to tell the app who is to be covered. Finally, you tell the app your adjusted gross income (the prototype presents the number from the tax folks and lets you disagree if needed), and whether you have employer coverage. Then you 'electronically sign' the document (check the little box), and you're done.

(I'm sure they'll find something to change. Heck, they've got two whole months to diddle around with it...)