November 26, 2013 by admin No Comments

Below is an article showing that Covered California is running much smoother than the federal exchange. is not without it’s problems, but in comparison to it is much better.

Early Start Gives Covered California An Edge In Health-Care Rollout

The Fresno Bee


The head of California’s health insurance marketplace didn’t flinch at questions about the almost nightly shutdowns of Covered California for revisions and repairs.

“So, night owls can’t enroll,” executive director Peter Lee said last week in Fresno.

Quick fixes to the Covered California website are a sign of good business, not failure, Lee said at a grand opening for the system’s third call center.

He has a point. While the federal government’s system for enrolling people in Affordable Care Act health plans has had more snags than a nylon sweater, California’s system has had a comparatively smooth start.

Since Covered California went live on Oct. 1, it has captured 30% of the total number of enrollees in the U.S., Lee said — even though the state only has 10% of the population.

“We hope the rest of the nation catches up,” he said.

Enrollment numbers through Tuesday show 79,891 Californians have selected health plans from the 11 offered in the state’s health benefit exchange. More than 360,000 have completed applications.

As of last week, more than 1,800 people in the San Joaquin Valley have enrolled in plans and more than 8,000 have completed applications.

But enrollment numbers — at least for the Valley — could have been higher if the state’s enrollment system functioned better, some health providers said.

Covered California got a “B-minus” grade earlier this month from Stephen Schilling, chief executive officer at Clinica Sierra Vista, one of the largest federally qualified health center systems in the state with clinics in Fresno and Bakersfield.

Clinica has 43 trained workers to help patients enroll in health plans, but until about a week ago they had been unable to log on to the system or would get booted off before applications could be completed.

Last week, Schilling gave Covered California good marks for improvement.

“The computers are not 100%,” he said. “But they are getting better every day. They’re not kicking us out as often. They’re faster, but they still are slow in the afternoons, and sometimes they still freeze and kick you out.”

The real test for Covered California could be yet to come.

Enrollment is expected to soar in December as the deadline approaches for people to sign up for health insurance to be effective Jan. 1. Californians have until Dec. 23 to choose a plan.

Californians can browse the state’s website,, to determine eligibility for subsidized health benefits and compare insurance plans. More than 2.5 million already have clicked on the website.

The browsing function proved to be a good decision. The federal website,, was harshly criticized because it lacked that feature when it debuted.

Lee said California had time to fine-tune and make revisions to its system during its development. The federal government didn’t have such a luxury, he said.

It wasn’t clear until a year ago how many states would create individual insurance marketplaces and how many would rely on the federally run exchange. Ultimately, 36 states opted for the federal system.

By that time, California had chosen Accenture LLC, a global management consulting, technology services and outsourcing firm, to develop the Covered California system at a cost of more than $300 million.

Also on the development team: Oracle, a multinational computer technology company based in the Silicon Valley, and GetInsured, an online company that operates a marketplace for health insurance.

The project was put on a fast track.

“Many people said this project should have taken 36 months, and once we contracted, it took 18 months,” Lee said.

Having Silicon Valley nearby, however, did not speed the work, he said. But having a small team — with one company in charge — made the project easier to manage.

Policy decisions about Covered California are made by Lee and Toby Douglas, director of the California Department of Health Care Services.

The online enrollment system is a joint venture between Covered California, an independent state government agency, and the Department of Health Care Services.

The system includes computer software for enrolling people in Medi-Cal, the state-federal insurance for the lower-income. California expanded Medi-Cal coverage under the Affordable Care Act to include more adults and families with incomes slightly above the federal poverty line.

With only two decisionmakers for Covered California, issues get resolved quickly, Lee said. The federal government likewise needs to have “someone where the buck stops,” he said.

Some of the decisions that Covered California made have frustrated consumers and insurers, Lee admitted.

For example, California health plans did not receive any completed applications from the exchange until mid-November, he said. The delay was intentional: “That was absolutely a very conscious choice of sequencing our work load.”

Shutting the system down for repairs also has been necessary but has prompted complaints.

The enrollment arm of the system has been taken down almost nightly for repairs to increase bandwidth and page-loading speeds, said Anne F. Gonzales, a Covered California spokeswoman.

“We’re moving as fast as we can to get all the fixes,” she said.

But only the enrollment function has been taken off-line, Gonzales said. The shop-and-compare and informational fact sheets about the exchange have remained on the website.

This weekend, part of the site is offline to prepare for small-business enrollments, Lee said.

Enrollment counselors at United Health Centers of the San Joaquin, based in Parlier, have reported problems connecting to the state computer system. Counselors are helping patients fill out paper applications at the clinics, said Norma Macedo, director of special projects.

She is OK with the delay, she said earlier this month. It’s given counselors time to study the application and offer better assistance to patients.

“With any implementation, you’re going to have these glitches,” Macedo said.

Covered California is acting swiftly to address complaints, spokeswoman Gonzales said. “We know everyone is anxious to get on the system.”

Lee said Covered California released results of surveys of people who had completed the enrollment process during the last three weeks of October: 70% found the application process easy to complete.

“The fact that the majority of consumers who actually used the website to enroll found it ‘easy’ should put to rest the drumbeat of stories about glitches and website problems and instead focus on the big story that Californians are enrolling in care easily and every day,” Lee said.

And Covered California is listening to consumers, he said. Language on the website is being changed based on suggestions from focus groups.

While the website is the portal to enrollment, Lee said he expects the focus to shift to call centers, such as the one in Fresno — and to enrollment counselors in communities — as the deadline to have insurance on Jan. 1 approaches.

Said Lee, “As we move forward, it’s going to be about person-to-person help.”


November 26, 2013 by admin No Comments

Below is an article that gives insight to the fact that it isn’t just the general public who is being effected by Obamacare. House Speaker John Boehner recently went shopping for a new health plan and below is what he found.

John Boehner’s Premiums Spike Under Obamacare



House Speaker John Boehner’s health insurance premiums will nearly double — and his deductibles will almost triple — as a result of the Affordable Care Act, according to figures provided by his office at POLITICO’s request.

Don’t expect to hear the Ohio Republican complain about his personal price spike, but he’s one of many older lawmakers and aides who are just finding out how much more they will have to pay as they move from the old Federal Employees Health Benefits system to coverage in the District of Columbia’s new health insurance exchange, as required by a provision in the Affordable Care Act and subsequent federal regulations. That will be true, too, for some consumers across the country who are transitioning into the exchanges.

“The Boehners are fortunate enough to be able to afford higher costs. But many Americans seeing their costs go up are not,” said Boehner spokesman Brendan Buck. “It’s because of them that this law needs to go.”

Boehner and his wife, Debbie, currently pay a monthly premium of $433 for family coverage from Blue Cross Blue Shield, with a deductible of $700, according to his office. Last week, the speaker began shopping for a new plan in the D.C. exchange, a search his office drew attention to by tweeting pictures of him trying to enroll.

This is what he found at the market: To keep a similar plan, the Boehners would have to pay $802 per month in premiums, with a deductible of $2,000. Instead, Debbie Boehner, who becomes eligible for Medicare when she turns 65 next month, will get coverage through the government’s insurance program for the elderly. She already had applied for Medicare Part A, which covers hospital care. When she adds in either Parts B and D, or Medicare Advantage, which acts to bundle the various parts of Medicare, she will pay between $350 and $400 per month in premiums, according to Boehner’s office.

The speaker, who is 64, chose to sign up for an individual plan with benefits similar to those he receives under FEHB. That will cost him $449 per month in premiums, and the policy carries a $1,000 deductible. So, he’ll pay more next year for himself than he paid this year for both himself and his wife — and, together, the Boehners will still pay roughly $800 per month in premiums with deductibles in
the $2,000 range.

While many younger lawmakers and aides — and many more folks outside the Capitol — will see their premiums go down under the Affordable Care Act, some House Democratic aides have complained in recent days of sticker shock for older employees who have begun shopping for new coverage under Obamacare, and a handful of lawmakers in their late 50s and early 60s have privately noted that they will see a huge spike in their premiums.


November 26, 2013 by admin No Comments


Covered California Launches Hotline for Consumers Facing Plan Transition
Service Center Representatives Will Be Trained to Care for Particular Needs

SACRAMENTO, Calif. — Covered California™ today established a special customer care unit and phone number dedicated to helping enrollees who are transitioning from current market health insurance plans to coverage under the Patient Protection and Affordable Care Act.

These consumers are encouraged to call the Coverage Options Hotline to get information about the new law and the transitions, explore health plans and benefits, and find options for the most affordable coverage.

The hotline, at (855) 857-0445, will operate Monday through Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 6 p.m. The unit will be housed at the existing Rancho Cordova Service Center.

The team is made up of 25 Service Center representatives getting customized training to handle questions from this specific group of enrollees. While 32 million Californians will keep their existing plans and another 4 million uninsured will get coverage beginning next year, it’s projected that about 900,000 Californians will be moved off policies that are discontinuing as of Dec. 31, 2013, because the plans don’t meet the minimum benefits of the Affordable Care Act.

Of those, about 310,000 policyholders are expected to get premium assistance with their new plans. Another 590,000 may not be subsidy-eligible but could see comparable rates or slight increases in costs. A remaining small number of consumers could see premiums rise but will have options to buy lower-cost metal-tier or minimum coverage plans, or use tax planning strategies to reduce costs.

If a consumer calls the main Service Center number, the caller will hear a brief message about the unit and can be directly routed to the Coverage Options Hotline.

Many of the questions received by this unit may require input or support from the health plan to address consumers’ detailed questions. Covered California representatives will be able to transfer consumers directly to health plan staff, or they can work with consumers on a three-way call.

Representatives are trained to speak with consumers to understand their situation, educate consumers about the Affordable Care Act and their options, calculate consumers’ eligibility for premium assistance or an affordability exemption, remind consumers of deadlines for getting insurance so there are no gaps in coverage and transfer consumers to health plan staff or arrange for a three-way call.

Covered California is also supplying information on helping these consumers to thousands of in-person assisters, including Certified Insurance Agents, Certified Enrollment Counselors and county eligibility workers.

About Covered California

Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information on Covered California, please visit


November 26, 2013 by admin No Comments

Below is an article that shows how North Carolina is being impacted by Obamacare.

House Panel Gets Earful on Obamacare in N.C.

ABC News

By Betsy Klein

GASTONIA, N.C. — As the Affordable Care Act rollout continues to plague the Obama administration, Americans are feeling the impact of the bill across the country, according to testimony by local residents at a field hearing Friday.
The House Oversight and Government Reform Committee packed the courthouse here for the first of four field hearings scheduled in the coming weeks to scrutinize the implementation of the president’s signature bill.

“Taxpayers have a right to know what they get from their government,” Chairman Darrell Issa, R-Calif., said. “We’re not here today to question [the Affordable Care] Act or its validity. Why we are here today is to review what is happening in light of its rollout.”


Rep. Patrick McHenry, R-N.C., said his constituents have struggled with healthcare implementation, and that “few states have been as hard-hit by Obamacare’s broken promises as North Carolina.”

“Through the first four weeks, 1,662 North Carolinians managed to select a plan on,” McHenry said. “Yet, over 180,000 North Carolinians have received notices that their policies, the ones that they chose and liked, are being cancelled.”

Several witnesses testified that the impact of the health care law has been felt in Gastonia, a small town outside of Charlotte built on small business. Dan Waters, the president of a local insurance agency, says his clients have seen their monthly costs “more than [double.]”


“Causes of frustration for our clients increased exponentially,” Waters said.

Sherry Overby, director of the Belmont Crisis Pregnancy Center, testified that she has also seen her healthcare costs increase dramatically. “My medically healthy insurance premium for 2013 is $395.60. Beginning in January 2014, my renewal rate will be $713.11,” which she says is higher than her mortgage and second mortgage combined.

Businessman Tav Gauss told the committee that the Obamacare rollout has impacted his hiring decisions. “Businesses are hesitant to invest in any people, plant, or equipment,” Gauss said. “They are not hiring people because of the unknown costs of Obamacare.”

The uncertainty has caused Gauss to cut back on full-time positions in favor of more part-time jobs without benefits.

“I am creating more part-time positions that will be for 28 or 29 hours per week, and making sure my seasonal or part-time help stays under 29 hours per week,” Gauss said.

Under the Affordable Care Act, Gauss is required to provide full insurance benefits for any employee working more than 30 hours per week.

No Democrats attended the field hearing.

Democrat Elijah Cummings, D-Md., issued a statement in response to the hearing.

“Rather than engaging in a destructive political exercise with the ultimate goal of tearing down the Affordable Care Act, promoting misinformation, and eliminating health insurance for tens of millions of people, the Committee should support constructive efforts to help educate and assist families who urgently need medical care and now have a chance to obtain it,” Cummings wrote.


November 26, 2013 by admin No Comments

Workers at the call centers for the federal exchange will have Thanksgiving off. See article below.

Health Website Call Center Closed on Thanksgiving


November 26, 2013 (AP)

If you’re planning to sign up for insurance under President Barack Obama’s health care law while the turkey is roasting, don’t count on getting help by telephone.

The Obama administration says call-center operators for have a day off for Thanksgiving, one of several scheduled holidays. Spokeswoman Julie Bataille (buh-TYE’) said the call center will be closed from midnight Wednesday until midnight Thursday.

There’s no day off, however, for the technical team fixing the troubled website. On Thanksgiving, they’ll be monitoring its performance under what may be a surge of holiday users.

The Obama administration says scheduled repairs should allow the site to be ready to handle 50,000 simultaneous users by the end of the month, close to the level first envisioned. That translates to about 800,000 visits a day.


November 26, 2013 by admin No Comments

Read the article below and you will realize that the slowing of health care spending is actually not something President Obama and his administration should be taking credit for. It turns out, health care spending has been slowing since before 2010, in other words before Obamacare was enacted.

Also, take a look at what the actuaries predict will happen with health care spending in the future.

The Next ObamaCare Mirage
The new line is that the health-care law will save money. That’s also not true.

The Wall Street Journal


Supporters of President Obama are working overtime to backtrack from his promise that “If you like your health-care insurance, you can keep it. Period.” While the president has conceded that this statement was inaccurate, the administration doesn’t seem to have learned its lesson. The damage control plan is to spread another falsehood about the Affordable Care Act.

The claim this time is that the health-care “cost curve is bending, and the ACA is a significant part of the reason.” That was what David Cutler —an influential Harvard economist and senior health-care adviser in Mr. Obama’s 2008 presidential campaign—wrote in a Washington Post WPO -0.07% op-ed on Nov. 10.

The president jumped on this theme in his press conference on Nov. 14. “I’m not going to walk away from something that has helped the cost of health care grow at its slowest rate in 50 years,” he said. On Wednesday, the White House Council of Economic Advisers published a report claiming that “the ACA is contributing to the recent slow growth in health care prices and spending.”

These assertions border on nonsense.

National spending on health care is projected to reach a record $2.9 trillion in 2013, according to the Centers for Medicare and Medicaid Services. This is more than 25% above pre-recession spending levels in 2007. Health-care expenditures per capita and as a percentage of GDP are also at record highs, expected to top out this year at $9,216 and 18% respectively.

The only apparent bright spot is that the average annual rate of health-care spending increases has slowed. Over the past three years, growth in health-care spending averaged 3.9% year-over-year, considerably slower than the historical average.

However, annual health-spending growth rates began to decline a decade ago. In 2002, health-care spending grew by nearly 10% in a single year. The growth rate dropped to 7.1% in 2004, 6.2% in 2007, and bottomed out at 3.9% in 2009—the worst year of the Great Recession, where it has stayed ever since. ObamaCare was enacted in 2010.

CMS and the Congressional Budget Office attribute the general slowdown in health-care spending increases over the past decade to a variety of factors, including increased cost sharing in private health plans and a slower rate of introduction of new health technology. An Urban Institute analysis points to how the mix of health-care payers has shifted over the past decade toward lower-paying government programs providing a greater share of coverage (particularly Medicaid).

Still, the recession is recognized by objective analysts as the single largest driver of slowed health-care spending in recent years. Many who lost their jobs lost their health insurance. Tight on cash, they opted out of surgery, hospital visits and prescriptions.

Changes in health-spending growth rates traditionally lag about two years behind changes in national economic growth. In September 2013, CMS reported that the depth and severity of the recession was more substantial than expected and revised its spending estimates downward accordingly.

In other words, champions of ObamaCare have little to crow about, once one recognizes that the persistently weak economic recovery has overlapped with the law.

And in the future? According to health-care actuaries at the Centers for Medicare and Medicaid Services, health-care spending will begin spiraling upward again starting next year, as the Affordable Care Act takes full effect. It will reach $5 trillion in 2022, or 20% of GDP, or $14,664 per capita. By 2022, ObamaCare alone is projected to increase cumulative health spending by roughly $621 billion, according to CMS.

In his 2008 campaign, Mr. Obama promised that his health-care reform plan would save a typical family $2,500 in annual premiums by the end of his first term. This was Mr. Cutler’s prediction, and it was based on projected rapid returns from larger federal investments in health-information technology, new reinsurance subsidies for high-cost workers, and savings on administrative costs for health insurance.

Those cost savings haven’t materialized. Mr. Cutler maintains they will, mostly through other untested reforms, and the White House Council of Economic Advisers report points to potential savings from fledgling Accountable Care Organizations, lower Medicare reimbursements, value-based payments and hospital readmission penalties. To be sure, some of these programs have and may result in small savings, but they had little effect on savings claimed from 2010 to 2013. For example, even the president’s Council of Economic Advisers hedges that some of the claimed savings from reduced hospital readmission rates “may not be entirely attributable to the ACA payment incentives.”

CMS actuaries find that any positive effects of the ObamaCare delivery system experiments on the cost of health care “remain highly speculative.” When they compare their September 2013 projections with earlier estimates in April 2010, these actuaries find that the law would increase national health spending higher than previously expected by an additional $27 billion in 2019 alone.

To argue that the Affordable Care Act has been and will be a key driver of slower health-care spending is irreconcilable with the most basic facts about such spending over the last decade, as well as with the judgment of the executive branch’s own team of actuaries responsible for health-care accounting and future projections.

Mr. Miller is a resident fellow at the American Enterprise Institute and former senior health economist on the Joint Economic Committee. Ms. McCloskey is program director of economic policy at the American Enterprise Institute.


November 26, 2013 by admin No Comments

For the first three years, health insurers were to receive help from the federal government to help offset the uncertainty of the cost to insure everyone who signs up.

Below is an article that discusses the adjustments and why they are occurring.

U.S. Government Plan Adjusts 2014 Risk Payments for Health Insurers


The U.S. government has issued a proposal that would likely increase risk payments in 2014 to health insurers offering plans on the Obamacare exchanges after the companies complained a recent policy change allowing people to keep their insurance policies had changed the financial equation.

The rule, published on Monday in the Federal Register, lowered the threshold at which risk payments kick in for the sickest health plan members. The government proposed paying insurers 80 percent of claims greater than $45,000 in 2014. Previously the lower limit was $60,000.

There is a 30-day comment period for the proposed rule.

In addition, the government has proposed a state-specific adjustment for risk payments based on how many people in the state extend their current polices, Citibank analyst Carl McDonald explained in a research note.

The exchanges are being created as part of President Barack Obama’s healthcare reform law. An estimated 7 million people are expected to sign up.

Insurers including Aetna Inc, Humana Inc, WellPoint Inc, Cigna Corp, UnitedHealth Inc and Molina Healthcare Inc have all offered plans on the state-based exchanges.

“Whether good or bad, it’s always worth pointing out that most of the publicly traded plans have little existing exposure to the individual market, while the exchange participation of several plans is quite limited in 2014,” McDonald wrote.

As an incentive for participating in the exchanges, the insurers were promised certain risk payments for the first three years to help offset uncertainty about the health of participants.

Technology problems on the exchange have slowed enrollment significantly, calling into question whether insurers will get the mix of healthy and sick people on which they had based their premium rates.

When Obama announced a plan about two weeks ago to allow individuals to keep their current plans longer, insurers complained it would remove even more people from the pool of applicants and asked for adjustments to the risk payments.

(Reporting by Caroline Humer; Editing by Jeffrey Benkoe)


November 26, 2013 by admin No Comments

The mandate that employers provide health insurance that covers birth control and family-planning methods is being challenged by Hobby Lobby, a craft chain, and Conestoga Wood Specialties Corp. They claim that the mandate violates their religious beliefs and the First Amendment. The cases will begin in the spring.

Below is an article with more details on the matter and a statement from the White House.

Supreme Court Agrees To Hear Huge Case Challenging Obamacare’s Birth Control Mandate

Business Insider

By Brett LoGiurato

The Supreme Court has agreed to review two cases involving the Affordable Care Act’s contraceptive mandate, setting up a high-profile showdown next year.

The decision to take up the challenge to the contraceptive mandate was expected. It will certainly reignite what has been a fierce debate over the provision of the federal health care law that requires employers to provide health insurance covering birth control and family-planning methods.

Hobby Lobby, a craft chain with about 13,000 employees, as well as at least 30 other for-profit companies, have filed lawsuits claiming that the mandate violates their religious beliefs and the First Amendment. They are suing under a 1993 federal law called the Religious Freedom Restoration Act.

The Supreme Court is taking up suits brought by Hobby Lobby and Conestoga Wood Specialties Corp.

Lower courts’ decisions in Sebelius v. Hobby Lobby Stores Inc. were mixed. In June, the Denver federal appeals court, ruled that religious freedom “can be communicated by individuals and for-profit corporations alike .” A Philadelphia federal appeals court had ruled in July that “for-profit, secular corporations cannot engage in religious exercise.”

The Obama administration is now seeking for the Supreme Court to reverse the Denver court’s ruling.

The cases are expected to be taken up in the spring.

The White House released a statement on the Supreme Court taking up the case, from press secretary Jay Carney:

The health care law puts women and families in control of their health care by covering vital preventive care, like cancer screenings and birth control, free of charge. Earlier this year, the Obama Administration asked the Supreme Court to consider a legal challenge to the health care law’s requirement that for-profit corporations include birth control coverage in insurance available to their employees. We believe this requirement is lawful and essential to women’s health and are confident the Supreme Court will agree.

We do not comment on specifics of a case pending before the Court. As a general matter, our policy is designed to ensure that health care decisions are made between a woman and her doctor. The President believes that no one, including the government or for-profit corporations, should be able to dictate those decisions to women. The Administration has already acted to ensure no church or similar religious institution will be forced to provide contraception coverage and has made a commonsense accommodation for non-profit religious organizations that object to contraception on religious grounds. These steps protect both women’s health and religious beliefs, and seek to ensure that women and families — not their bosses or corporate CEOs —c an make personal health decisions based on their needs and their budgets.


November 26, 2013 by admin No Comments

The article below discusses how not everyone’s costs for health insurance are going to go up. In fact, a lot of people’s health insurance costs are going to go down.

People are seeing numbers and making assumptions right away when they are actually reading the numbers incorrectly, like in the examples below. This is why it is strongly recommended to speak with an insurance agent or someone who can help you answer all your questions, rather than just getting health insurance on your own.

Health Insurance Costs Going Up?

Consumer Reports

I get a lot of letters from people angry because, they think, the new health care law is leading to higher premiums for them. But when I dig into their stories, it seems that confusion and a rush to blame the Affordable Care Act are to blame. Consider these two stories:

Q. I used all my savings to pay medical expenses during a prolonged period of unemployment and health problems. I now have a job paying $40,000 a year to support myself and my son, a college student. My new employer doesn’t offer health insurance. The Kaiser subsidy calculator says I’ll be paying a monthly premium of $3,267. I can’t afford this! Obamacare will destroy me.

Q. I’m a Florida retiree on Medicare, but my wife is 57 and needs insurance. We live on my Social Security, $19,000 a year. What’s my choices? I hate Obummercare. Higher prices. High deductibles.

In fact, both these people are in line for major financial help to purchase health insurance.

The distraught Pennsylvania dad’s mistake was easy to spot. He didn’t notice that the Kaiser Family Foundation’s subsidy calculator presents its results by the year, not the month. This father and son will actually be able to buy a Silver (midpriced) plan for $272 a month for both of them on their state’s Health Insurance Marketplace.

I used that same calculator to determine the cost of an “Obummercare” plan for the Florida man’s wife. The results showed pretty much the opposite of the “higher prices, higher deductibles” he was apparently led to expect. Because their income is barely above the poverty level, they will receive an enormous premium subsidy and his wife’s plan will cost $32 a month, less than the tab for a dinner for two of them at a sit-down chain restaurant.

Again because of her very low income, this premium entitles her to a special “Silver 94%” plan with extremely low out-of-pocket costs. I don’t have access to the specifics of these plans in Florida, but in California, a Silver 94% plan has a $0 deductible, a $3 copay for doctor visits, lab tests, and generic drugs, a $5 copay for specialist visits, X-rays, and brand name drugs, 10 percent coinsurance for hospitals and other high-cost services, and an annual out-of-pocket limit of $2,250.

It is true that not everyone will come out so well. A small number of people really are having to give up decent individual insurance that will be replaced with more costly or less generous coverage. But don’t let the politics surrounding the law discourage you from exploring your options. Not to sound like a broken record, but a good place to start is our free intractive tool,, which will tell you if you are in line for financial help and let you know what to do next.
Got a question for our health insurance expert? Ask it here; be sure to include the state you live in. And if you can’t get enough health insurance news here, follow me on Twitter @NancyMetcalf.

Health reform countdown: We are doing an article a day on the new health care law until Jan. 1, 2014, when it takes full effect. (Read the previous posts in the series.) To get health insurance advice tailored to your situation, use our Health Law Helper, below.


November 25, 2013 by admin No Comments

The article below discusses how some families who are low income are being forced into Medicaid even if they don’t want it.

ObamaCare Forcing People Into Medicaid

By Doug McKelway

One woman’s demoralizing experience with the ObamaCare website, which her daughter documented in an article this week in The Wall Street Journal, is shining a light on how the health care law is forcing people into Medicaid even if they don’t want it.

“How has it come to this?” Nicole Hopkins wrote of her mother’s experience.

After having had her insurance canceled this fall like so many millions of Americans, her mother Charlene sought a new insurance policy on But it gave her only one choice – Medicaid – which is the government’s traditional safety net to cover the uninsured poor.

Charlene Hopkins does not see herself as poor and resents having to stoop to what she believes is a taxpayer funded hand-out, when she prides herself on a life of independence and self-sufficiency.

It is a trait that was nurtured on the Wisconsin farm where Charlene was raised by parents who accepted no handouts of their own, and found dignity in work and in helping others. “The pride is from being able to take care of yourself in all ways, and health insurance, for example, is just one of those things you do,” she says.

The White House has repeatedly maintained that ObamaCare expands options, a mantra that White House Press Secretary Jay Carney repeated on Friday. “They’ll have choices they didn’t have in the past, including a range of options when it comes to levels of coverage,” he said.

But those options don’t apply to the millions who will be directed to Medicaid, many of them hardly impoverished.

“The system will automatically sign them up for Medicaid, even if they don’t want to be on Medicaid,” says James Capretta of the Ethics and Public Policy Center. “That’s what’s happening. So a lot of people are getting signed up for Medicaid just by virtue of what their income is.”

A case in point is a Virginia family, who asked to remain anonymous, but who came to Fox News with documents that demonstrate an apparent absurdity with Medicaid selection.

The father owns a $5 million house – entirely paid for. His kids attend expensive private schools. He owns three cars, but because he has earned his fortune and has stopped working , and his wife’s new start-up business has yet to produce an income stream, he is considered by the website to have no income.

The website put him on Medicaid. He protested in the website’s chat area. A screen grab of the dialogue reads: “Let 60 minutes show up in front of my 5 million dollars paid for house and tell America that this guy is on {Medicade} and that the American people are paying {fro} it!”

A navigator replied, “I do understand your frustration, however I have no other options to offer.”

There is also strong evidence Medicaid provides substandard care. The Manhattan Institute’s Avik Roy wrote in 2012, “Medicaid patients were almost twice as likely to die as those with private insurance; their hospital stays were 42 percent longer and cost 26 percent more.”

Many doctors refuse to accept Medicaid patients because payments are low. John Goodman of the National Center for Policy Analysis told Fox News, “One woman in Boston who was in Medicaid said she had to go through a list of 20 doctors before she found one who would see her.” He adds, “I asked if she was going through the Yellow Pages,” and she said, ‘No, I’m going through the list of doctors Medicaid gave me.’

“That tells you something about the standard of care on Medicaid,” he says.

Further compounding Medicaid’s problems, the CBO projects Medicaid spending will rise rapidly over the coming decade, not just because of ObamaCare, but because of the aging population, and rising costs per beneficiary, which may make Medicaid even more substandard than it is today.