Let. It. Go.

Longtime readers may recall the sorry saga of California insurance agent Glenn Neasham, whose conviction on apparently trumped-up fraud charges was recently dismissed.

Not content to lick her wounds and take the loss as an appropriate repudiation, Deputy Attorney General Hanna Chung is petitioning the California State Supreme Court to reverse the reversal.

Since I'm not a lawyer (nor do I play one on TV), I can't speak to the validity of Ms Chung's arguments. Hopefully, she'll be laughed out of (Supreme) Court; we'll keep you posted as this drags on goes forward.

Giving Thanks

Avoiding the Thanksgiving ObamaTax Rush

So it's come to this:

"White House officials, fearful that the federal health care website may again be overwhelmed this weekend, have urged their allies to hold back enrollment efforts so the insurance marketplace does not collapse under a crush of new users."

Which reminds me:

Did y'all see that plea from Amazon to take it easy on the orders come Black Friday?

Musta missed that one.

Thanksgiving Risk Parade

There's wild turkey (for the roaster, fryer or smoker) and then there's Wild Turkey (for the shot glass or the tumbler). While most of us are quite aware of the risks involved in preparing the former (salmonella, fire, etc), we shouldn't overlook the risks inherent in serving the latter.

Margarita (heh!) Tapia, of the IIABA tips us that "party hosts need to understand their responsibilities when inviting others into their homes and serving food and drinks."

That includes potent potables, of course, but also food that your guests may bring, or that you have catered in. The organization reminds us that:

"Even if food was prepared outside your home by a caterer, another guest, a local deli or the neighborhood pizza joint, YOU could be held liable if someone becomes ill from consuming it on your property. Make sure that you check food and don’t put anything out that you suspect may be undercooked, spoiled or contaminated. Use only reputable food purveyors. Follow proper food-handling, heating/cooling and storage recommendations. When in doubt, throw it out."

In that vein, Allstate has provided a useful "infographic" about some of the risks associated with Turkey Day Mayhem:

[Click to embiggen]

Allstate also notes that " an average of 67,500 homeowners insurance claims occur during the holidays, and some threats to home security and safety rise significantly during the holiday season."

Not to mention (but of course we will), "there are three times more turkey fryer claims during the holiday season than any other time of the year." And the "median cost for turkey fryer-related claims is almost $29,000."

That's some expensive bird.

Have fun tomorrow - but be careful, too.

Health Co-Ops Never Had a Chance

"[T]hese co-ops, started as a great hope for lowering insurance costs, are already in danger, says the Washington Post." (Tip o' the hat to John Goodman at NCPA.)

But wait.  I sense something, a presence I've not felt since . . .

. . . since January 4, 2013:   "Turns out, the CO-OPs are now taking their turn under the bus"

. . . or since January 7, 2013:  " Notwithstanding this generous, reckless federal plunge into more “investments” it does not understand, CO-OPs will encounter harsh reality . . .  I think the appropriate taxpayer response to CO-OPS, is “Uh-oh”."

. . . or since  June 12, 2013:  "[T]he Freelancers’ Union which in 2012 was granted $341 million in Federal loans to set up an insurance CO-OP under Obamacare  . . . says that Obamacare’s onerous regulations and taxes will burden its innovative health insurance model for the self-employed with enormous added costs.”  In other words, Freelancers’ problems are the same Obamacare problems that businesses and other insurance companies have been warning about for the past four years.   They were neither unpredictable nor unexpected."

Oh nowwww I get it.  The presence I sense is yet another impractical Obamacare Great Hope evaporating into thin air under the unforgiving sun of reality (and, lest we forget, the presence of yet more billions of taxpayer dollars evaporating along with it).

Cavalcade of Risk #197: Happy Thanksgiving edition

Louise Norris hosts a very special Thanksgiving edition of the Cavalcade. She's done a terrific job of adding her own thoughts and context to each post. Kudos, Louise!!

Government Motors Meets Obamacare

Our fleet of company vehicles is due for a major overhaul so today I am out car shopping. I’m looking at several different options because come January the prices of the cars are going up by 40%-80% and the selection of options for the vehicles will become extremely limited.

Lucky for me President Obama is allowing a couple of options to avoid the major aspects of his new car law. There are two options I can choose from. One is renewing my leases early without having the dealership check the mileage and wear and tear. The other is renewing my leases when they are due April 1st but now the dealer has the right to increase my price based on those three criteria. The question is, which option should I choose?

Early Renewal

The current leases expire in April of 2014 but I am able to renew my leases December 1st. The new price allows me to keep the cars that I like while only increasing my price by 8% a month. By extending my leases I have the ability to renew it for another 12 months now, which will carry me through November of 2014.

Renew and Retain

I also have the ability to keep my current lease price, but come April my lease price might change. It could go up quite a bit depending on the mileage and the wear and tear on the vehicles. And I can’t change any of the terms of my leases or I become subject to the new requirements. These new requirements will cause substantial price increases for new vehicles because they'll be required to include free roadside assistance and oil changes; I'll also be forced to purchase options like navigation systems and DVD entertainment units. The worst part is that I have no idea of what the costs will be for keeping my current leases, nor do I know what it will cost me to lease new vehicles.

Decisions, Decisions

As the business owner I have a limited budget and absorbing a large cost hike for the fleet could put us out of business. Since our current leased cars don’t meet the guidelines for vehicles set in March of 2010, I don’t have any choice but to change to the new ones available next year. I can potentially buy time through the early lease renewal program or I can roll the dice until April and hope that my employees have taken very good care of their cars. In that case I could keep my costs lower until April of 2015. My gut tells me to take the safe route and renew my leases with the 8% increase December 1st. At least that way I can budget for 2014. Because after that, all bets are off.

How many millions... [UPDATED]

Will lose their current plan? Turns out, those who thought that their employer-based coverage was sacrosanct are about to find out - the hard way - that it's not:

"Almost 80 million people with employer health plans could find their coverage canceled because they are not compliant with [the ObamaTax]"

This comes on top of the 5 million or so currently slated to lose their individual plans.

But remember, if you like your insurance, you can...oh. Never mind!

UPDATE: 80 million is a statistic, perhaps. But one is a tragedy:



[Hat Tip for vido: Ace of Spades]

My new article is up...

At Answers.com:

"Gap Filler insurance plans are a way to help mitigate the additional out-of-pocket expenses one may accrue due to co-pays and deductibles. They are often reasonably-priced, but it's important to compare different plans to see which, if any, fit your particular needs."

Told ya so

As we pointed out nearly 2 weeks ago, it's one thing for Our Betters in Capital City to magnanimously proclaim that, despite what the ObamaTax law actually mandates, "if you like your policy you can keep it." T'is quite another to make that a reality:

"It's one thing if an insurer erroneously cancels your policy... But it's quite another thing when the insurer must cancel an entire policy form"

As we asked then, "[h]ow can the government force carriers to re-file cancelled policy forms, and how do they handle the immediate problem that these plans are unlawful under the ObamaTax?"

Today we learn the answer, and it ain't pretty. Via email:

"Medical Mutual is not able to extend individual plans that do not comply with the Affordable Care Act (ACA) into the New Year, because we have no plans or rates approved by the Ohio Department of Insurance (ODI) for these products in 2014"

I suspect that they're not alone.

Monday Exchange Blues

Submitted by an anonymous reader:

[Click to embiggen]

Your tax dollars at work.

UPDATE: Timing is everything. Here's the latest from Ms Shecantbeserious, courtesy of our friends at Cornerstone:

All brokers – update on changes to ACA Individual Deadlines

INDIVIDUAL ACA ANNOUNCEMENTS – DEADLINE CHANGES

CMS announces extension date for individual sign-up to December 23, 2013

The Obama Administration announced (Friday, November 22, 2013) they are giving consumers an extra eight days to sign up for health coverage that takes effect Jan. 1, 2014.

The Centers for Medicare & Medicaid Services — a part of the U.S. Department of Health and Human Services and the parent of the Center for Consumer Information & Insurance Oversight — said it will push the individual coverage enrollment deadline to Dec. 23, from Dec. 15.

ALSO

HHS announces one-month delay for start of ACA sign-ups for 2015
HHS plans to delay by a month the start of next year's Affordable Care Act enrollment period for coverage in 2015 to give insurers additional time to set premiums and evaluate their experiences in 2014. Instead of the previously announced window of Oct. 15 to Dec. 7, 2014, enrollment for the 2015 plan year would start Nov. 15, 2014, and end on Jan. 15, 2015.

You really can't make this stuff up.

 

A simple solution for one of ACA's many problems...

Everybody that I've led through a CoveredCA application stumbles when they get to the subsidy section.  The problem lies in the estimation of next year's income.  The law asks you to predict the future and that's not possible to any degree of accuracy.  California addresses the issue by requiring enrollees to login and update their information every time their income changes...a requirement that'll be forgotten (or ignored) by most people.  I assume other states have a similar requirement.

My suggestion...Change the law to base next year's subsidy on the current year's income.  If someone is signing up in the October through December enrollment period, they should be able to estimate year end income far more accurately than next year's income.  And if you're signing up after January 1, the books are already closed.  A (not-so) simple change will eliminate a lot of surprises when tax returns are completed and people find out they under/over estimated their subsidy. 

$58, same as in town

In which we offer these two ObamaTax stories. Any perceived relationship is purely coincidental:

"Dana Howard, the deputy director of California’s Healthcare Exchange program ... revealed that enrollment counselors are paid $58 for each individual they successfully enroll in the California’s insurance exchanges."

And:

"The Affordable Care Act has been touted as a boon to America's self-employed ... That includes the independent contractors at the Moonlite Bunny Ranch, otherwise known as prostitutes."

My new article is up...

At Answers.com:

"As with any insurance policy, a Critical Illness plan is a risk management tool. In this case, the risk is that one may suffer a major, life-threatening illness or condition and need additional funds to pay for unexpected costs associated with it."

An Early Gift From The Obamacare Clan

After (or in spite of) all the "fumbling" and "glitches" the citizens of Obamanation have been

granted a gift in the form of an extra 8 days to sign up for your new Obamapolicy.

The Centers for Medicare & Medicaid Services — a part of the U.S. Department of Health and Human Services and the parent of the Center for Consumer Information & Insurance Oversight — said it will push the individual coverage enrollment deadline to Dec. 23, from Dec. 15.

Benefits Pro

That is 8 more days to try and sign on to healthcare.gov, hopefully without getting booted off or having your personal data compromised.

Or if you are like all of my clients, 8 more days to buy OUTSIDE of the exchange, get a better plan with a broader PPO network and not have to worry about giving out your income and tax information.

Did I mention it only takes 5 minutes to sign up for coverage when you buy OFF the exchange?

No ObamaScrooge here.

Cavalcade of Risk #197: Call for submissions

Jay Norris hosts next week's Cav. Entries are due by Monday (the 25th).

To submit your risk-related post, just click here to email it.

You'll need to provide:

■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post

PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like). And please only submit if you are willing to link back to the carnival if your submission is accepted.

What's the rush?

Or to put it another way, "if you like your accounting rules, you can keep your accounting rules."

Or maybe not.

As we've been saying, the HC.gov train-wreck and the "Keep Your Policy" debacle are only the two most visible manifestations of the ObamaTax. Here's another (or three) to keep you up at night.

Remember the other day, when we noted that Ms Shecantbeserious and her crew still hadn't finished building the website? Well, they also haven't quite gotten around to figuring out the various ObamaTax accounting rules:

"Insurance regulators are just starting to figure out the accounting rules for a core Patient Protection and Affordable Care Act component – a collection of three PPACA risk management programs."

Yes, you read that right - three (3) rules that involve hundreds of millions of your dollars, slated to be shoveled into the hungry maws of insurance carriers as they try to figure out who's paying for what. Two of them are supposed to be temporary [ed: suuuure], the other's supposed to provide a sort of insurance backstop for carriers who get stuck with more than their fair share of "undesirables" (that would be anyone who actually buys an ObamaPlan, methinks).

Topping it all off, the agency responsible for providing guidance on these rules hasn't.

I'm beginning to suspect that this whole program may not be well thought out.

A Modest Increase...

I was just looking over the list of my Anthem ACA plan replacements and came across this gem...

Current Plan - Clear Protection Plus 5000   $548/mo.
Replacement Plan - Anthem Core DirectAccess - CAAE  $1563.63/mo.

That's right.  Their family premiums are going up by almost 300%...over $1000 per month.  

They'll be uninsured after the first of the year.  But if they could afford coverage, at least it wouldn't be "substandard".

What's in a name?

So he was for ObamaCare before he was agin' it?

Health Wonk Review: Pre-Thanksgivukkah edition

Here's an interesting fact about this particular edition of the venerable HWR: it won't happen again for 78,000 years (at which time Julie will still be looking great, BTW).

How's that, you ask?

This year (2013/5774), the first night of Chanukah falls on Thanksgiving, and that happy (if confusing) confluence of events won't happen again for another 78,000 years. At which time, I certainly hope that the host of that 'Review will be kind enough to link back to this one (hey, traffic is traffic, right?).

So the theme of this edition will be freedom and gratitude, which also turns out to be the theme of both Chanukah and Thanksgiving (how serendipitous!):

"He is a wise man who does not grieve for the things which he has not, but rejoices for those which he has." - Epictetus

Although we typically limit participants to one post per 'Review, I'm invoking Host's Privilege with our first entry because:

a) Joe Paduda's the Founder of the Health Wonk Review, and
b) These really are a matched set

First, Joe explains why the Healthcare.gov website isn't going to be fixed by the end of the month. Then, he offers a helpful reminder that the Exchange itself is only one piece of a much larger effort.

"The will of the people is the only legitimate foundation of any government, and to protect its free expression should be our first object." - Thomas Jefferson

Longtime HWR contributor David Williams (who's been quoted - a lot! - in the MSM of late - Mazel tov!) explains that, while 'reference pricing' is a good idea, it’s only useful for a fraction of total medical costs and — despite what some observers want you to think-- it's not a great endorsement for the superiority of the free market.

“Make a pact with yourself today to not be defined by your past. Sometimes the greatest thing to come out of all your hard work isn't what you get for it, but what you become for it. Shake things up today! Be You...Be Free...Share.” - Steve Maraboli, Life, the Truth, and Being Free

David Harlow reminds us that, aside from the technological snafus, the slow beginning to enrollment in Obamacare plans shouldn’t be cause for alarm. After all, when Massachusetts health reform was introduced, it took months before folks started signing up in meaningful numbers.

"The unity of freedom has never relied on uniformity of opinion." - John F. Kennedy

My favorite econ-blogger, Jason Shafrin, observes that according to conventional wisdom, rural areas have poor access to advanced specialists. The CW, however, gets that one quite wrong: recent research indicates that access to oncologists may be much better than previously thought due to visiting consultant clinics.

"Let us be grateful to people who make us happy; they are the charming gardeners who make our souls blossom." - Marcel Proust

It is NOT true that Dr Jaan Siderov's hobby is dumpster diving. A top-secret memo from an insurance carrier's CEO just "happened" to fall into his lap. Hilarity, not to mention health business clarity, ensues.

At least, that's his story,and he's sticking to it.

"Those who deny freedom to others, deserve it not for themselves". - Abraham Lincoln

In the classic Doyle/Holmes tale The Silver Blaze, the absence of an event itself provided a critical clue. In Roy Poses' post, the absence of financial records served the same function, much to the chagrin of the president of the Upstate Medical University.

"As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them." - John F. Kennedy

Brad Wright offers a helpful Q&A on the ACA "fumbling" that's currently making the news, offering his own take on why it happened, what other problems we can anticipate seeing, and (perhaps most importantly) how it affects you.

"Everything that is really great and inspiring is created by the individual who can labor in freedom." - Albert Einstein

Something that a lot of folks haven't really thought through is "where are all the new doc's going to come from?" After all, these newly-insured folks will need someone from whom to actually receive care. Over at Wing of Zock, Jim Lewis notes that students just entering high school would graduate from medical school in 2025, and they'll have access to diagnostic and clinical tools likely even unimagined today. But where will they complete their residency training? The answers may surprise you.

 “You pray in your distress and in your need; would that you might pray also in the fullness of your joy and in your days of abundance.” - Kahlil Gibran

Louise Norris has more details on how plans in place today will fare at their next renewal, and predicts that at least a few folks may be pleasantly surprised at what happens to their premiums over the next few years.

“Gratitude is not only the greatest of virtues, but the parent of all others.” - Cicero

This may be my favorite post in this edition. Hospitalist Dr Bradley Flansbaum shares his experience with a naive international medical school graduate that opened his eyes to the benefits of working with folks cut from a different cloth.

“Some people grumble that roses have thorns; I am grateful that thorns have roses.”- Alphonse Karr

Jonena Relth discusses the ridiculousness of President Obama’s recent announcement that insurance companies may now choose to keep their previously cancelled policies. She asks "why would any insurance executive voluntarily choose to do this?" and observes that it doesn’t take a mathematician to see the alligators in this swamp!

"When we lose the right to be different, we lose the privilege to be free." - Charles Evans Hughes

At Workers’ Comp Insider, Tom Lynch discusses an important new report on how the work population is changing, and the challenges that a diversified workplace will pose to workplace health and safety. In particular, the report focuses on how those delivering healthcare and safety services will need to develop cultural competence, new skills and approaches to communicating with populations that have limited English proficiency. It's an interesting perspective on this brave new world of health care.

“Piglet noticed that even though he had a Very Small Heart, it could hold a rather large amount of Gratitude.” - A.A. Milne, Winnie-the-Pooh

Health Affairs' Tim Jost walks us through President Obama's proposal to extend existing policies, and then details the questions it raises, such as state and insurer reactions, the effects on the ACA and the exchanges, and political implications.

"I disapprove of what you say, but I will defend to the death your right to say it." - Voltaire

Also writing about President Obama's "end run" around House Republicans, Maggie Mahar wonders about "the catch." That is, under the proposal, carriers would need to notify their customers about which benefits their existing policies are missing and alert them to other options available in the ACA's marketplaces.

“Acknowledging the good that you already have in your life is the foundation for all abundance.” - Eckhart Tolle

At the eponymous John Goodman’s Health Policy Blog, guest author Greg Scandlen takes a look at the latest trends in consumer-driven healthcare, aka Health Savings Accounts, and the role they'll likely play as the ACA rolls along.

"Liberty means responsibility. That is why most men dread it." - George Bernard Shaw

Anthony Wright notes that, despite the issues with the federal website, California's ACA implementation is on track, with nearly 1/3 of the national enrollment, and now doing 2,000 enrollments a day, enough to meet state expectations. But, he adds, there's more to do.

And now, our own contribution:

 בָּרוּךְ אַתָּה יְיָ אֱלֹהֵֽינוּ מֶֽלֶךְ הָעוֹלָם שֶׁהֶחֱיָנוּ וְקִיְּמָנוּ וְהִגִּיעָנוּ לזְּמַן הַזֶּה

Ba-ruch A-tah A-do-noi E-loi-hei-nu  Me-lech ha-o-lam she-he-chee-ya-nu v'ki-yi-ma-nu vi-hi-gi-ya-nu liz-man ha-zeh.

(Blessed are you, Eternal God, Sovereign of the universe, for giving us life, for sustaining us, and for enabling us to reach this season)

This is a very special prayer, which we offer in times of great joy. It's also recited, along with the "regular" blessing, on the first night of Channukah. I offer it here as a token of my gratitude for the opportunity to host this 'Review, and for the freedom to do so.

Our post for this edition is a guest article from an actual expert in Quality Management, and his thoughts on how easy it might (will?) be to "game" the ACA.

Please join Jason Shafrin on December 5th for the next HWR.

[Hat Tips to Psychology Today, Good Reads and The Quotations Page for the great quotes]

ObamaTax goes to the dogs (Literally!)

From the "You Can't Make This Up Department:

"Fort Collins resident Shane Smith told KDVR he received a letter last week informing his dog,Baxter, that a health insurance account had been opened for the pup through Connect for Health Colorado."

It seems that Mr Smith used his pet's name for one of the "security" questions at the site, which then applied this information on his behalf.

The good news is that the canine now has "Affordable" Health Care.

The bad news is that his owner doesn't.

When reached for comment, HHS Secretary Shecantbeserious acknowledged "woof!"

Unclear on the Concept

From the official Exchange Certification curriculum:

Protecting Information

There are three key elements to protecting information:

Confidentiality: Protecting information from unauthorized disclosure to people or processes.

In addition to protecting your computer and related systems, it is critical that you protect various media forms as well ...  

Protect Your Area - Recognize, politely challenge, and assist people who do not belong in the work area to avoid potential security attacks, such as "Shoulder Surfing" or "Social Engineering".

Arrange Workstations so that the computer screen is not visible to individuals standing at a door or when first entering the room (e.g., "Shoulder Surfing"). Utilize privacy filter screens as necessary. [emphasis added]

And now here's Ms Shecantbeserious & Friends crashing a sign-up (courtesy of the Free Beacon):



Leaving aside the (unsurprising at this point) HC.gov site crash, notice anything else, um, amiss?

One step forward, one step back [UPDATED]

For a certain value of "forward," of course:

Thanks to FoIB Jeff M, we learn that the Tar Heel State Blues are willing to extend an olive branch to current policyholders:

"Blue Cross and Blue Shield of North Carolina (BCBSNC) has fiIed the necessary documents with the North Carolina Department of Insurance (NCDOI) to allow most of its non-grandfathered individual customers to keep their current health plans for another year."

After all, what could possibly go wrong?

UPDATE: That extension comes with a price, however:

"Blue Cross and Blue Shield of North Carolina said Tuesday that it will raise rates as much as 24 percent on 2013 individual health insurance plans that are being extended next year"

Still, that's probably a much better deal than they'd get with an Exchange policy.

Meanwhile, Minnesota Governor Mark Dayton has ruled out such a move for residents of the North Star State:

"Dayton's decision not to grant the one-year extension on existing plans followed harsh criticism of the proposal by major Minnesota insurance companies."

So what do they know that the Carolina Blues don't?

Got Cancer?

Got cancer? You may not want #Obamacare.   

Much has been said about "If you like your health insurance plan, you can keep it. Period".

Not so much about "If you like your doctor, you can keep them. Period."

Until now . . .

Since March 2007 United Healthcare has paid $1.2 million to help keep me alive, and it has never once questioned any treatment or procedure recommended by my medical team. The company pays a fair price to the doctors and hospitals, on time, and is responsive to the emergency treatment requirements of late-stage cancer. Its caring people in the claims office have been readily available to talk to me and my providers.

But in January, United Healthcare sent me a letter announcing that they were pulling out of the individual California market. The company suggested I look to Covered California starting in October.

WSJ

Covered California is the state run Obamacare health insurance exchange.

UCSD has agreed to accept only one Covered California plan—a very restrictive Anthem EPO Plan. EPO stands for exclusive provider organization, which means the plan has a small network of doctors and facilities and no out-of-network coverage (as in a preferred-provider organization plan) except for emergencies.

If you like your doctor, you CAN'T keep your doctor . . . if you buy an exchange plan.

But if you buy OFF the exchange . . . 

According to a popular insurance brokerage website there are 19 PPO plans available in San Diego. By design, PPO plans have broader networks that include most doctors and hospitals nationwide.

Perhaps Edie Littlefield Sundby needs to talk with a real insurance agent in her area rather than a navigator.

#EdieLittlefieldSundby

#CoveredCalifornia

#Obamacare

#Ifyoulikeyourplanyoucankeepit

My new article is up...

At Answers.com:

"Annuities can be an effective cash accumulation tool, and offer tax advantages during both the accumulation and payout stages. They also offer the unique ability to provide a lifetime income stream."

Sugar Daddy

With all the talk about high #Obamacare health insurance premiums (and subsidies offered

then taken away), what if you had a sugar daddy to pay your premiums.

Not the grand wealth redistribution taxpayer scheme dreamed up by DC, but a twist in the usual premium payer system.

You may or may not know it, but hospitals that rely on government funding are hurting. In the infinite wisdom of the creators of Obamacare it was decided that hospitals will no longer have uncompensated care so they won't need those federal dollars. As a result of these Democrat cutbacks, several rural hospitals are closing. Metro hospitals like Grady in Atlanta that typically serve the poor and uninsured are reducing services due to loss of federal dollars.

So what is a hospital to do?

One solution is to buy Obamacare health insurance on their sickest patients. This is much less expensive than cost shifting or writing down the cost of uncompensated care.

 It has been suggested that hospitals, other healthcare providers, and other commercial entities may be considering supporting premium payments and cost-sharing obligations with respect to qualified health plans purchased by patients in the Marketplaces. HHS has significant concerns with this practice because it could skew the insurance risk pool and create an unlevel field in the Marketplaces. HHS discourages this practice and encourages issuers to reject such third party payments. HHS intends to monitor this practice and to take appropriate action, if necessary.

J P Morgan

Before addressing the idea of a third party payer, I need to emphasize a point that has been made repeatedly at InsureBlog.

The exchange, AKA the marketplace, is not the ONLY place you can buy individual health insurance. There is no reason to buy on the exchange UNLESS you qualify for a significant subsidy and you don't care which doctor or hospital is a participating provider in your exchange plan.

In fact, if a hospital or other provider is considering funding the purchase of an Obamacare policy they would be advised to see if THEY are a participating provider in the policy.

Some will suggest this idea of a third party payer is gaming the system, to which I respond . . . . SO?

The closer we get to 2014 one wonders if Obamacare is a misnomer. Perhaps it should be called Frankencare since this is very definitely becoming a monster.

Success = Failure [STUNNING UPDATE]

[Scroll down for update - you won't might be sorry]
 
Tthe ObamaTax and its chief enabler are having a no good, very bad week. The chief enabler's vaunted sidekick TOTUS was nowhere to be found, leaving the President to sob inconsolably continue to communicate his message of Hope and/or Change:

"Repeating his lament that buying insurance turns out to be “complicated,” President Obama also repeated his omission that even applications processed by mail and by telephone have to go through the same computer system that is causing healthcare.gov its many problems."

Oy.

Well, the good news is that at least the folks that have managed to get through and sign up for a new ObamaPlan are happy, and reaping the savings they've been so long promised:

"Jessica Sanford was cited by the president as an Obamacare success story at a health care event he had here at the White House ... The 48-year-old single mom from Washington state purchased what she considered to be affordable health care, life-changing event"

Whew, I thought there was going to be a big "but" there.

Wait, what?

"But days, just really three days after she was mentioned by the president, Jessica Sanford started having problems ... she received a letter just last week telling her that her tax credit had been taken away all together"

That's a darned shame, really. But still, at least she has affordable, quality health insurance, right?

Um.....

"Now she says she can't afford insurance in Washington state because of the new developments ... I'm not going to be getting insurance"

One more satisfied ObamaTax customer.

UPDATE (courtesy of Ace of Spades): If you thought that it just couldn't get any worse, well, you're not paying attention.

Today, the Obamastration's Head IT Honcho Henry ("Hunkerin' Hank) Chao admitted that the vaunted Healthcare.gov site is still only, and I can't believe I'm typing this, only about 60% done:

"HENRY CHAO: I think it's, uh, just an approximation, we're probably sitting somewhere between 60 and 70 percent because we still have to build..."

So let me get this straight: they set an October 1 "drop dead date" (and boy, what a great term of art that turned out to be), and rolled it out when it was still at least 1/3 short of completion?

The mind reels.

And these are the folks who will now be in charge of our health care.

It's five o'clock somewhere, right?

Substandard?

Although the original Evil Mandate meme was predicated on the (long discredited) comparison to mandatory auto insurance, perhaps the latter may serve as a useful tool for comparison to the latest drivel from Our Betters in Government©.

The latest to weigh in on the matter is California Governor Mr Linda Ronstadt Jerry Brown:

"It’s not really a cancellation,” Brown said during the station’s Sunday Morning Q & A segment ... “these are Marylanders who are getting notices ... that you can renew your policy today and into 2014 but in 2014 you won’t be able to renew your current plan because it’s a substandard plan"

Interesting definition of "renewal" there, Guv.

But let's think about this for a minute.

What is "substandard" about existing plans? Well, most individual plans (and these are the ones being cancelled alternately-renewed right now, but don't assume that your group plan will be long immune) exclude normal childbirth, and birth control convenience items, for that matter.

Does this make them substandard, as compared with the new ObamaTax-compliant plans which mandate these coverages?

[ed: and BTW, why no prostate or testicular cancer screening bennies for us XY'ers?]

Let's take a look at a typical auto policy, shall we?

They (almost all) start with liability coverage; that is, to protect those whom you harm when you run into them in the intersection. This coverage will pay their medical bills, and fix their cars. But what about your car?

If you have a late model vehicle, odds are you have comprehensive and collision coverage to pay for those repairs. But say your ride is a dozen years old. Do you still carry comp and collision on it? Odds are, the answer's no, because it generally doesn't make financial sense. If it's worth only a few thousand dollars, and the comp/collision coverage is hundreds of dollars a year, then you're probably better off self-insuring. So you take a pass on the "extras," and cover the important, hard to self-insure portion (who has $250,000 sitting in the bank to pay off an injured stranger?).

Does this make your policy "substandard?"

I would argue "no," it makes your policy "appropriate to your needs." So why would maternity or pediatric dental, or any of the other EHB's be any different? If you're a 55 year old guy - or gal, for that matter - why would you want to pay for either of those?

Or is that too obvious?

The 80% Solution

So according to the Obamastration, up to 80% of those who try will succeed in signing up for their shiny new "metal" plan.

That is, their metric for success is 80%.

You know what had a better than 80% success rate?

Our now extinct health care system.

Exit question: so according to ObamaMath, if 80% of airplane landings were "successful" that'd be okay?

Good to know.

The ObamaTax Coast-to-Coast

Say what you will about the ObamaTax "fix" - no, wait, that's not right: don't say one word about it, unless it's "kudos," as the (now former) DC Insurance Commish has learned:

"Commissioner William P. White was notified Friday ... that his services are no longer needed ... White issued a press statement Nov. 14 saying that the [ObamaFix] ... undercuts the purpose of the exchanges"

Which is a rather roundabout way of observing that the Emperor has no clothes. Can't have that, of course.

And FoIB Jeff M tips us that over on the Left Coast, the Beaver State's Exchange is, well, kind of a bust.

And by "kind of," we mean "complete and utter failure:"

"Oregon, a progressive state that has enthusiastically embraced the federal law but has so far failed to enroll a single person in coverage through the state's insurance exchange."

As in zero, nada, zilch.

And that's after multiple millions of taxpayer dollars sunk into a "Marketplace" that's neither a Market nor a place. But never fear, they've got that old "can do" attitude:

"We're all surprised and frustrated that we're in the position that we're in now," said Jesse O'Brien, a health care advocate at the Oregon State Public Interest Research Group, which lobbied for the exchange."

Or maybe not.

Customer Service: How to do it right

So last night, the Better Half and I were shopping at our local Kroger's (grocery store) when two things happened:

Her phone went off with a weather update - a Tornado Warning had been issued for our immediate area.

And as we started to exit the store, the tornado sirens started going off.

At that point, the Kroger associates (their term for employees) invited us to join them and other customers in the back of the store (a "safe area") until the storm had passed. No panic, no flustering, just very calm, very professional people doing their best to keep their customers safe.

Of course we took them up on the offer, and guided ourselves and our cart to the back of the store, where we joined what looked to be about 100 other customers. At one point, an associate came back, guiding a very distraught customer who was shaking and crying, calmly telling her that "it'll be all right" in a tone that conveyed not condescension but genuine compassion.

We were all huddled in the back, mostly calm, everyone (or so it seemed) on their cells communicating with (one presumes) family and friends, and checking the local weather. After a while, a guy from the meat department wandered in, a great big grin on his face, and loudly asked "hey, anybody got a cellphone?" We all cracked up - it was exactly the right way to break the tension.

A few minutes later, another associate came back to let us know that the all-clear had sounded and that it was now safe to leave. What was remarkable was how calmly everyone left the safe area: no running or scrambling - the calm professionalism of the Kroger's staff had infected us with a sense that we didn't need to hurry out.

Bless you, Kroger's associates, for looking out for our safety, both physical and mental.

Calling All Agents

Anyone listening to the news over the last several years would think that the only way to buy your
#Obamacare health insurance plan is through Obama's website.

Yes, that would be the healthcare.guv we hear so much about.

You can also visit with a #navigator that may be hanging out in the parking lot of your local 7-11 or liquor store and sign up on the spot.

Allegedly.

But it is a little known fact, very little known, that licensed insurance agents that have been helping people make coverage decisions are still around. If you did not know any better, and you may not, you would think health insurance agents were beamed aboard the mother ship and whisked off to a galaxy far, far away where people still buy insurance the old fashioned way.

The folks at InsureBlog are pleased to tell you words of our early demise are greatly exaggerated. You can still find an agent willing to assist.

Here is what one agent shared about his 6 hour adventure in the Obamaland House of Horrors.

I've yet to have a single subsidized policy actually get my info attached to it correctly. Today I spent two hours (yes, really) on the phone and had to do two separate client conference calls to get my name added as the authorized representative. Here was the sequence of events on the most recent one that I did over the course of 4 or 5 days:

1. Client applies online, gets approved for subsidy. My agent info is included on the app.

2. healthcare.gov loses my information, says I am not attached to the app when I call

3. Client calls HC.gov help line to have my info added as their authorized representative. She verifies that I'm on there by calling back and checking a second time.

4. I call HC.gov and they can't find me anywhere in the system as an authorized rep

5. Client calls HC.gov again to do the same thing

6. I call, they can't find it again

7. Client calls a third time, gets the CSR's ID number which they aren't supposed to give out, and verifies again that I'm the authorized rep with specific instructions for the next rep on how to find me in the system

8. I call, they can't find it again. 45 minutes on hold for a supervisor and I give up.

9. We do a conference call with HC.gov to get my name added as authorized rep with client on the phone verifying it. We get the CSR ID number again which they aren't supposed to give out. 

10. I call back, they can't find it again. I talk to a supervisor, who tells me if I can get client on the phone AGAIN, she will make sure it's taken care of.

11. I call client for a second conference call. Supervisor says authorized rep can only be on the account for 14 days at a time, then we have to call back and do this all over again if it's more than 14 days out.

12. I let client hang up, ask about what plans and rates are available to her, they can't pull up any rates because the system is down.   

This was all after it took the client 6 hours to complete the online app. All of the CSR's except one had no clue what I was trying to ask them to do. I was put on hold for at least 15 minutes each time. What a joke.

The next time you hear someone say buying an Obamacare plan online is like booking a trip on Travelocity, just make sure it is not a trip to Hell.

Some additional thoughts on this past week

I share Bill's frustration, which is why I've been noodling two areas of concern regarding the current state of the train-wreck:

First: while all the oxygen in the room is currently being sucked up by the disastrous roll-out of Healthcare.gov and the world-class ineptitude of the administration vis the "keep your plan fix," I believe that the real nightmare is still under the radar.

Last night, I had the privilege of sharing a meal with three very accomplished, very experienced IT infrastructure nerds experts. As one might expect , the talk eventually turned to the HC.gov debacle. I opined that "we ain't seen nuthin' yet;" that the real problem is that, once the site is "functional," the data hub which drives it must then deal with this challenge: reaching out to, communicating with, and accessing data from DHS, HHS, Social Security, the IRS and other agencies which will presumably confirm that the applicant is a citizen, eligible for a subsidy, etc.

None of these agencies have the same computer or operating systems, nor is their data likely to be compatible. Unlike Mr Spock's Federation, there's no Universal Translator to help them put this all together. So, even if they're able to get the front-end "fixed" (any takers on that bet?), don't count on this ship sailing.

Second: All this talk of the President "summoning" health insurance executives to the Oval Office for a pow-wow (after his ill-advised and clumsy attempt at a "fix" for his broken promise) is a waste of time, both his and the execs'.

Here's why: throughout this entire process, no one in a position of authority, either in drafting the ObamaTax itself, nor its myriad of additional regulations, has ever reached out to the folks who have actual working knowledge of the existing (but soon to be extinct) system.

That would be insurance agents.

But Henry, you may object, they've had plenty of meetings with, and input from, insurance company presidents. What more do you want?

Yes, well: asking a company exec about how insurance actually works is of zero value.

Hunh?

It's simple, really: the President of (for example) Aetna this week was president of Coke last week, and president of Sony the week before that. That is, he (or she) has great knowledge of business principles, but no practical knowledge of insurance. This is not in any way to denigrate the executives; I'm sure they're wonderful employers with great experience and ideas who call their mothers every week. But they do not (for the most part) have experience in the industry itself, nor have they (again, for the most part) ever sat down with a client at their kitchen table or at the office with a proposal and a pen. I would love to be wrong about this, but I've seen no evidence to the contrary.

Okay, Henry, I'll give you that. But certainly the industry and agents' organizations provided input?

Again, you're missing the point: AHIP is the insurance companies, not folks with one-on-one experience. And the associations are run by, and for the benefit of, the carriers. You don't think dues pay the freight, do you? At the local, or perhaps even the state level, these organizations do a yeoman's job because they at least pay lip service to the agent's value. At the national level - which is the only one that counts in this disaster - their interests (and by extension, the interests of their clients) are of no value or import.

And that's why you see Congresscritters and the President flailing about demanding that the carriers fix the mess that the government made: they never asked the people who could have given them workable answers.