I'll make an attempt to explain this section of the law, in which the plans will go into effect as early as Jan 1. Everyone has until Mar 31 to enroll, otherwise the monetary penalty will take effect. Those who want the insurance to start on Jan 1 must enroll by Dec 15. The problems with enrolling have occurred primarily with those who are trying to register online. I will go into those issues later. But there are 3 other ways to register: call the 800 number on your State's exchange; download, print, and mail the application and a code will be sent back to you to finish the enrollment process online; or you can meet one-to-one with a navigator (a real person) at a designated site (look up the closest one on the online site) to choose a plan and find out the amount of discount you can receive.
Now, the problems on the web sites come from the fact that you have to register for a password in order to access the plans and prices on the exchange. Registering to look at plans does not mean that you must choose a plan. However, in order to see what discount applies to you, there is more information to complete, such as what you entered on your last income tax forms from 2012. So, first, you have to realize that without completing this additional information, you see plan prices that are higher than when you fill out the application (different from your registration information). By the way, the only health information requested is whether or not you smoke, since pre-existing conditions do not add to the price of a plan. Plan prices, deductibles, and copays are classified into bronze, silver, gold, and platinum. The least expensive plans are bronze, but they have higher deductibles and copays. Platinum plans cost the most, but may not have any deductibles or copays and also the lowest out-of-pocket maximums. Now, given all of this information, the ACA plans provide, by law, that PCP visits, recommended bloodwork, and recommended procedures are done at no-charge. The emphasis is on encouraging beneficiaries to get recommended primary care, in order to prevent the development of more expensive illnesses.
Most recently, the biggest controversy was that some plans announced that they were ending on Dec 31, so people who had purchased them are finding they have to look to the government health exchanges. Why did these plans announce a termination date after the President had assured the public that they could keep their current health plans and practitioners if they happened to be satisfied? Well, that was something the President couldn't control. Some insurance companies realized that their plans didn't comply with ACA, so they decided to stop offering those plans. Now, there were also dishonest companies which emphasized their end date, but then offered higher priced plans and their customers had to make a decision to pay the higher price or wait to see the health exchange prices. Some States recognized this as a scam and proceeded to fine the companies involved - KY did this in the case of Humana. A separate issue that might also cause confusion is that consumers can also access and buy insurance from commercial marketplaces, which look quite similar to the exchanges, but the prices can be higher and there is no subsidy. Make sure you are on the government site for your State, not these other marketplaces that look the same.
I spent most of Oct trying to enroll and was finally able to do so before the end of the month. Ease of use and functionality actually depend on the State in which you live. If you were so lucky to live in a State that designed its own exchange, like KY, the process was seamless, self-explanatory, and worked from the start. My State of MD designed its own, but has run into problems in the interface with the federal web site, the part which identified the individual and matched the person to income tax return. Actually, part of that fault arose because the State asked for this year's income, rather than last year's, so then there was trouble matching the person and the return, and then when that was corrected, somehow the connection with the plans got broken. But those States which developed their own exchanges also expanded those who qualified for Medicaid, so that those who earned a percentage higher than the poverty level now have a very economical way to access that more robust insurance. However, in WI, for example, Gov Walker was one of those who objected to ACA and he refused to develop the State exchange or expand Medicaid, all to the detriment of WI citizens. So, that left constructing the exchanges to the federal government. In addition, Gov Walker somehow allowed insurance companies which operate within the State to charge much more than they can in other States. The difference in price can cause insurance rates to be double the rates of most other States, so essentially those who live in WI have the highest prices in the US.
Why did the glitches online happen? Well, nothing is perfect in the digital world. Remember the many times that the Blackberry interface with the internet shut down? Remember how Windows Vista operating system disappointed users with its buggy interface? Even, MSN, which charges users to have full functionality has been known to crash. Then there are those denial of service situations, in which so many people try to get onto a website that all that usage causes the servers to stop working properly, as happened to the NY Times in Aug. It happens - and it can take quite some time to fix it. In fact, one site to which I subscribe and pay a fee to use, had changed to a different server company, only to find out that paying subscribers couldn't use it because they couldn't log on. It took that company 6 weeks to repair the problem. So, the fact that there was no quick fix was not surprising. In fact, what has been attempted with ACA was far larger than anything else that was ever done online. The biggest connecting piece was the fact that every exchange, all 51 (including DC), had to connect accurately with the IRS, which had to have the capability of identifying each person who enrolled. Not only that, but each exchange is different, because each State has different laws which apply to health insurance. This was quite an undertaking! But it is getting better, the numbers of enrollees continue to increase, and this isn't the end of the enrollment period. Remember, the enrollment period ends on Mar 31, when those who didn't enroll become subject to the tax penalty.
If you happen to be one of those people who believe you are invulnerable and really don't need health insurance, think again. It doesn't take much for you to find yourself waking up in the shock trauma unit with massive injuries and no way to pay. Not only did you gamble with your finances and your well-being, but you now face being charged the maximum the hospital can charge for your health care. You see, by having insurance, you can only be charged what that company negotiated with the health care facility, even if you have a catastrophic deductible. Now, not only do you have a disability from the injuries, you face bankruptcy, and every dollar that you can manage to earn, if you can continue to work will be garnished at a certain percentage to pay off the bills for your care. So, health care insurance looks more like a good investment for you. Don't gamble by not signing up for a plan!
Click Here: ARTICLE UNDERGROUND
No comments:
Post a Comment