Thursday, August 29, 2013

Obamacare Gets Personal--My Wife Will Lose Her Coverage

We Will Lose Our Current Coverage

We've all heard this over and over, but the President's own words bear repeating:

"If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no matter what."

At least he didn't say, "let's be clear."

My wife Heidi has a policy through Blue Cross Blue Shield of Michigan.  Although expensive, the big attraction is that they have no pre-existing condition exclusion.  That was true before Obamacare made that the rule for all policies.  She has extensive relationships built up with several doctors in their network.

We received a curious call from our broker a few weeks ago.  We called back and he said BCBSM will not be renewing these policies in 2014 and all policyholders will need to go to the exchanges.

I had not heard that BCBSM was pulling out of Michigan's individual insurance market so I called them directly.  Yesterday, I was told that although it is true that the current policies will not be renewed, they are working on new policies.  At this time, it is unknown even to them what the policies will be like or how much they will cost.  I asked whether a family policy might make sense for us, but they said don't bother until it becomes known what the policies will be.

I asked why the policies were being changed and they said the current policies are not compliant.  I asked if the problem was state or federal law.  They said state, but I'm not sure if that's right.  It seems more likely Obamacare's mandates have made certain aspects illegal and they have to fix them.  Apparently they don't qualify for grandfathered status either.

If you have a BCBSM policy, get ready for change, whether you want it or not.

Michigan Senate Approves Medicaid Expansion

Eight Michigan Republicans joined Democrats to approve a bill expanding Medicaid under Obamacare.  Obamacare expands Medicaid to many low income individuals, regardless of whether they have children.  The federal government promises to grant the state for the first few years but after that no one know what will happen.

Last year in the Sebellius case, the Supreme Court ruled that states are free to accept of reject the federal government's offer.  The Court found that it was unconstitutional to tie the Medicaid expansion to the threat of withdrawing all Medicaid funding (including existing grants not related to Obamacare).

With Republicans controlling both houses and the governorship, it was not clear whether Michigan would participate in the Medicaid expansion.  Now, the bill will move to the House.

What if They Gave an Obamacare and Nobody Came--Part 4

On my MichiganStartupBusiness blog, I had been running a series playing on Bertolt Brecht's poem asking "What if They Gave a War and Nobody Came?"  What if they gave an Obamacare and nobody came?

Part 1: Delays in implementation, states failing to accept the Medicaid expansion, exemptions for big business, and other delays and special deals.

Part 2:  What if employees are offered insurance but don't sign up?

Part 3:  Treasury Department announces delay in enforcing the employer mandate.

I didn't even get to Congress' evasion of Obamacare's requirements.

I also did not write anything about the delay in enforcing the out of pocket maximum rules.  The "affordable" part of the Affordable Care Act was annual limits placed on what a policyholder had to pay in a year.  For example, let's say you got really sick and had $10,000 of otherwise uncovered medical expense.  If your out of pocket maximum was $7000, the insurance company would pick up the additional $3000.  Under Obamacare, that limit was set by law and had to be the same for everyone in a given class.  Now, the government is allowing insurers to set those limits as high as they want or even have no limit at all.

It was just announced that agreements between insurance companies and the government regarding exchange-based policies will be delayed.  The policies to be sold on the online exchanges have to be approved by the government.  That has not happened yet, but needs to happen soon if the exchanges are to open on October 1.

I wonder what the odds are that the federal exchanges will not open on time.  If I were a betting man, which I'm not, I'd bet no.

Now, for Today's Obamacare headlines:

Right Wing Rants

Sen. Vitter (R, LA) found a town hall full of people supportive of delaying Obamacare.

Kentucky business owners don't like Obamacare.

Forsyth County Republicans want Obamacare repealed.

Obama's statement that policies will be cheaper than cell phones is a farce.

Left Wing Cheerleading

MLK would have liked Obamacare.

At least one person in Utah thinks Obamacare is a good thing.

Pres. Bill Clinton will help sell Obamacare.

Obamacare to be a work in progress for years to come.

Hard News

Michigan Senate approves Medicaid expansion.

Kaiser provides information in a user-friendly Q&A format.

Obamacare backers target back to school audience.

IRS issues final regulations on individual mandate penalties.

Starbucks CEO says they won't cut hours or coverage.

For Industry Insiders

ACOs are found to save money in Massachusetts.

Final regs on the individual mandate are out.

Do you need a good introduction to Obamacare?  Check out the brand new Small Business Guide to Obamacare.

PPACA $100/day/employee penalties can really add up.

Co-ops worried about established players.

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