No Client Left Behind

The Patient Protection and Affordable Care Act (PPACA or Obamacare) is the insurance equivalent of No Child Left Behind – incredibly frustrating and just as many mindless tests.

We are now through the first phase of this year’s Open Enrollment Period. This would be a good time to catch our breath and review our progress.

This computer stuff is harder than it looks. Our current crop of presidential aspirants constantly discuss shutting off part of the internet or controlling access to certain individuals. They discuss the internet and computers as if they were seasoned mechanics assessing a Chevy. This is year three of the Exchange. On Monday I had to switch to Chrome and enter everything in ALL CAPS to get the site to work. Sure it doesn’t crash as often as it did last year, but if this was my Chevy I would have utilized the Lemon Law to dump it long ago.

The computer issue isn’t limited to the government. A client asked to change her deductible for 2016. This was an off-Exchange policy so we only needed to visit the insurer’s website. The insurer, a big one, will remain nameless. It took over an hour to make an easy change. I would never send a client there which is a problem since the insurers are expecting their websites to carry the load as they cut back on staff.

Saying Goodbye. Some insurers have decided that selling on the Exchange is a losing proposition. Sheer incompetence has overcome others. Many of the Co-ops created under the PPACA have already been shuttered. UnitedHealth Care has announced that they will be pulling out of the Exchange. And then there is HealthSpan…

Cryin’ Won’t Help You. The first full year of the PPACA brought lots of tears. There were tears of joy as the previously uninsured gained coverage and others saved thousands. There were tears of frustration from dealing with healthcare.gov and the national call center. And there were tears of anger as some were blocked from coverage for up to a year. Now it is mostly tears of the betrayed.

I had to explain to a young family why they couldn’t have reasonable coverage. They own a small business and live in a Cleveland suburb. In 2015 they had qualified for a heavily subsidized Silver Level Medical Mutual policy based on their income in the mid 40’s. In 2016 they will get $355. That is only 35% of the cheapest Anthem Silver policy, the least expensive unfettered access to University Hospital. The cheapest Medical Mutual Silver policy is a touch more. It would cost them $669.99 per month. They can’t afford that. The subsidy is designed to give them access to the second lowest Silver Level policy. That would be an awful contract from CareSource. (Yes, their office is directly above mine.) For $366.65 per month this family can go to Akron General, MetroHealth, and LakeWest. There is nothing inherently bad about any of these facilities, but would you sacrifice 10% of your income for insurance that bars you from University Hospital and The Cleveland Clinic? I wouldn’t.

Deductibles. Fewer good choices and skyrocketing premiums have forced people to increase their deductibles. $4,000 and $6,000 deductibles are common. What is not common are the savings accounts necessary to withstand the hit of an unexpected illness or accident. How long will it be before doctors and hospitals ask for a credit card with your insurance card? The answer is SOON.

We have more people covered. We have more people covered badly. We have an insurance bubble, no less serious than the housing bubble of eight years ago. We are all along for the ride. And no client will be left behind.

 

DAVE