OBAMACARE DEBACLE - Update 4/22/2014

[bsteadman]

Dem Congressman on Obamacare: The Worst Is Yet to Come, It’s ‘Going to Hit the Fan’

National Review Online
Andrew Johnson
4/21/2014

Excerpt:

Massachusetts representative Stephen Lynch isn’t just worried about the negative impact Obamacare will have on his party’s performance this fall — he also thinks its worst effects on our health-care system are still to come. Lynch, who voted against the Affordable Care Act in 2010, warned that the situation is “going to hit the fan” when the law’s delayed provisions go into effect down the road.

“There are parts of Obamacare, or the Affordable Care Act, that were postponed because they are unpalatable,” he told the Boston Herald. The “Cadillac tax” that goes into effect in a few years and taxes employer health plans over a certain value, he said, will be “the first time in this country’s history that we have actually taxed health care.”

Repeal is now impossible, he says, because of the number of Americans who’ve signed up for the law’s exchanges. Democrats will take big political hits on the law this fall anyway, Lynch said.

“We will lose seats in the House,” he said. “I am fairly certain of that based on the poll numbers that are coming out from the more experienced pollsters down there, and I think we may lose the Senate.”

View the complete article, including video, at:

http://www.nationalreview.com/corner...andrew-johnson

[bsteadman]

Insurer Admits Nearly 1,000 Doctors Wrongly Placed On Covered California Provider List

CBS San Francisco Bay
4/21/2014

Excerpt:

SAN FRANCISCO (KPIX 5) — Two months after KPIX 5 ConsumerWatch first reported about some doctors listed on the Covered California exchange were actually not accepting the plans, insurer Anthem Blue Cross admitted that nearly 1,000 doctors were erroneously listed.

According to a statement by the California Medical Association, the insurer recently notified 965 physicians that they were wrongly placed on the exchange’s list. The notice, which was posted on April 9th, stated that the doctors were “inadvertently” listed for “a certain period of time” during the open enrollment period.

The CMA said Anthem Blue Cross acknowledged the error after receiving a number of complaints from physicians who believed they were listed inaccurately as participating.

Guda Venkatesh, a Covered California enrollee, was one of those affected. He told KPIX 5 in February that he chose an Anthem plan because the website said the plan had a variety of Stanford doctors near him.

“Except when I started going through the doctors, each one and calling them up, none of them actually accepted the Covered California plan,” Venkatesh said.

“The premise of Covered California is that you’re able to compare plans and see which one is best for you. But if they are presenting that they have all these doctors in network but they don’t, then it doesn’t work,” he said in February.

State regulations allow insurers to change their provider lists without notice. Lists must be updated quarterly, but regulators admitted to KPIX 5 that there is no system in place to check.

Anthem said the affected physicians were paid at 100 percent of Prudent Buyer PPO rates for services between January 1st and March 31st. Claims for dates of service on or after April 1st will be reimbursed as out-of-network, according to the insurer.

Regarding patients, Anthem said they notified those who saw an out-of-network that they would need to either select a new in-network physician or change to a different plan by March 31st, or face higher out-of-pocket costs. Patients were also advised of their right to request continuity of care with the out-of-network physician.
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View the complete article at:

http://sanfrancisco.cbslocal.com/201...lifornia-list/

[bsteadman]

Looking at Costs and Risks, Many Skip Health Insurance

The New York Times
Abby Goodnough
4/21/2014

Excerpt:

LOUISVILLE, Ky. — Steve Huber, an affable salesman who is still paying off an unexpected medical bill, was not among the millions of Americans who signed up for health insurance under the Affordable Care Act during the enrollment period that ended March 31.

After seeing television ads for Kentucky’s new online insurance marketplace, Mr. Huber, 57, made several attempts to explore the website but found it too complicated. Moreover, his income has dropped in recent years, he said, and he felt certain that he could not afford coverage. So he never priced plans or researched whether he qualified for financial assistance.

“I realize that I’m gambling,” he said, stopping at a coffee shop before a sales call. “But I don’t have a lot of patience, and I’m on a pretty tight budget anyway.”

After a surge of last-minute sign-ups, eight million people bought private coverage through the federal and state marketplaces during the initial six-month enrollment period, exceeding the Obama administration’s target. Mr. Huber represents the next challenge for the administration as it struggles to reduce the ranks of the uninsured and broaden support for the president’s signature health care law.

For every individual who did sign up, there were others who resembled Mr. Huber: people who have decided to stay uninsured for now, despite the law’s requirement that most Americans get coverage this year or pay an income tax penalty of $95 or more.

A common thread running through stories of the unenrolled is cost. Many people either do not qualify for federal subsidies or believe that the assistance is not enough to make insurance affordable, interviews with consumers and experts suggested. According to enrollment counselors in several states, people who have gone without health insurance or major illness for years can be especially resistant to investing in coverage.

To be sure, some of those who chose not to sign up were motivated by ideological opposition to Mr. Obama, to the law’s mandate that they buy insurance, or to both. And for many others, confusion and lack of understanding, including about whether they could get financial help buying coverage, were the overriding reasons.

But a New York Times/CBS News poll of uninsured people in December found that of those who did not plan to get coverage, half said that cost was the main reason. Nearly three in 10 said they objected to the government’s requiring it, while about one in 10 said they felt they did not need it.

Heidi Reinberg, 53, a freelance documentary producer who lives in Brooklyn, said she had gone uninsured for most of her adult life and had managed just fine.

She did check out her options through New York’s marketplace but said she was not impressed. She did not qualify for a subsidy based on her 2013 income, she said, and was particularly put off by the high deductibles on many of the plans available to her.

With an income that fluctuates unpredictably, she said that she could not justify a new expense for something that was “not a priority.”

“It doesn’t scare me not to have it,” said Ms. Reinberg, adding that she exercised, ate healthily and rarely got sick. “I’d rather pay down my credit cards than take on another bill for something I don’t know that I’m going to need.”

She acknowledges that she could have major medical expenses as she ages. And she might buy insurance in the future if her income stabilizes, she said. But for now, like many others, she has decided that the financial penalty for not buying insurance is more palatable than the cost of premiums and deductibles.

“I know what the penalty is going to be,” she said, “and I can get my head around that.”

There is no demographic data on the uninsured who could have bought coverage through the exchanges but chose not to. But a federal report last year on the overall uninsured population eligible for coverage under the new law estimated that 45 percent had incomes low enough to qualify for financial assistance buying exchange plans. Many others were poorer and eligible for Medicaid because their state opted to expand the program. Another federal report last year said that young and healthy people made up nearly half of the uninsured, and that more than half were men.
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View the complete article, including photo, at:

http://www.nytimes.com/2014/04/22/us...insurance.html