Why are we losing insurance?
Imagine a system that forces you to get rid of something you want and then penalizes you for not having it. That’s Obamacare!
Why are people losing their insurance? A few reasons.
Starting in 2014, most health plans will have to cover 10 “essential health benefits” and limit out-of-pocket expenses to no more than $6,350 for an individual or $12,700 for a family. And they have to meet a minimum actuarial value, meaning that across a “population” they insurer will have to expect to pay at least 60% of health care costs. If a current plan does not meet these requirements, it will likely be canceled. And the new plan, forced to carry extra benefits, will likely be more expensive, especially if you’re young and healthy and don’t qualify for a premium subsidy.
There are three types of plans that are NOT required to add Essential Health Benefits.
• Large Group fully insured plans
• Administrative services ASO plans (an organization funds its own employee health insurance but has an insurance company process claims for them)
• Grandfathered plans
Grandfathered Plans: If you purchased your health insurance before Obamacare became law in March 2010, then your plan does not have to meet the requirements of Obamacare. However, for plans sold after that date the plan has to be cancelled if it does not meet the 10 Essential Health Benefits.
Obamacare has implemented strict rules and guidelines outlining what an insurance plan MUST have in it and if that plan does not contain everything he requires, then the plan must stop. According to Gerry Kominski, director of public health policy at UCLA, “About half of the 14 million people who buy insurance on their own are not going to be able to keep the policies that they had previously.” Other estimates I have seen say as many as 70% of 16 million people. Unfortunately, we really don’t know how many are going to lose coverage.
What do we have in place for the expected 7-9 million people losing coverage?
The Washington Post reports that 476,000 applications have “been started,” but NOT COMPLETED. (closer to 193,000 if Medicaid applications are removed) But, we really do not know how many people have applied because the Obama administration refuses to release any numbers, even to his loyal supporters.
Several states have released some numbers.
• South Dakota – 23 people
• North Dakota – 20 people
• Alaska – 7 people
In California more than 125,000 people have started the application process. But the board will not release how many people completed the application. They do say they are looking to enroll more than five million people.
Here is what does appear to be happening. Few people are signing up for the private plans. But, the expanded Medi-Cal (Medicaid) will grow now that anybody making less than 138% of federal poverty level are eligible for free coverage.
The big question is this, what do these 100s of thousands of people without insurance do now? The majority of the people losing insurance will not qualify for the expanded Medi-Cal. They lost the insurance they had, and can’t afford the new plans.
How is this math? In just 3 states over 500,000 individuals have lost their insurance. In all 50 states, only 476,000 applications have been filed, whatever that means from a secretive government that refuses to provide actual numbers.
More Medicaid enrollments than private insurance
Connecticut: of 3,847 individuals who signed up for coverage, 1,857 qualified for Medicaid.
Washington state: of 40,400 applications submitted, only 4,529 ended up for private coverage.
Oregon: has signed up 56,000 new Medicaid enrollees.
A significant portion of the Medicaid enrollees are for those that were currently eligible, but not previously enrolled. (All 56,000 in Oregon, in fact.) As a result, this population is not eligible to receive the higher ACA federal reimbursement rate, and state taxpayers will be paying more for their coverage.