November 25, 2013 by admin No Comments

Below is an article which discusses the possible differences in premium costs for smokers and non-smokers through the new health insurance market.

ObamaCare Slams Smokers With Sky-High Premium Costs, Could Backfire

By William La Jeunesse

Published November 25, 2013

ObamaCare may have backfired in its goal of making smoking so expensive that users quit, public health experts say, as sky-high insurance premiums force smokers to drop coverage altogether and lose smoking cessation programs along with it.

“Tobacco surcharges are not proven to help tobacco users quit and there are major concerns that they will prevent people from getting health care coverage,” the American Lung Association’s Jennifer Singleterry said.

The ALA supports the Affordable Care Act, as does the American Cancer Society, but both oppose the tobacco penalty because they believe it makes insurance unaffordable for smokers.

“Charging tobacco users more in health insurance premiums, sometimes thousands of dollars more, studies have shown, will price smokers out of the market,” says Singleterry.

Unlike drug addicts, alcoholics, or the obese — all of whom represent higher-than-average medical costs — smokers are the only such group with a pre-existing condition that ObamaCare penalizes. It allows insurance companies to charge smokers up to 50 percent more than non-smokers for an identical policy, depending on the state and any subsidies the person might qualify for.

For example, premiums for a 64-year-old non-smoker, according to the Kaiser Health Calculator, cost $9,000 a year for a standard “silver” insurance plan.

The same policy for a smoker could cost $13,600.

“I can’t afford any insurance at that rate,” smoker Don Hampson said. “I thought that was what ObamaCare was about, to stop all this.”

Eleven states stepped in to prevent the surcharge, but a majority have not. In those, insurance providers will decide the surcharge.

But most concerning to public health advocates is the surcharge’s effect on low-income earners, since federal subsides cannot be used to offset the penalty.

A study by nonpartisan Institute for Health Policy Solutions found some smokers could pay as much as 33 percent of their income in health care premiums, well in excess of what ObamaCare considers “affordable” health care.

The study presented three scenarios:

1. The premium for a young, non-smoker earning roughly the minimum wage will cost $708. The same policy for a smoker would cost $3,308, or up to 400 percent more.

2. Before subsidies, a non-smoker who is 59 or older would also pay $708 for a “silver” or mid-level policy. However, a smoker of the same age would pay $5,908.

3. In a worst-case scenario, an older couple who smokes could be “literally impoverished” by ObamaCare premiums, said the report. That couple could pay an $11,352 health care premium, or one-half their annual income of $23,000. By comparison, a non-smoking person over 59 years old would pay 90 percent less, or just $952 after federal subsidies.

“There are certainly cases where the insurance company is applying the maximum significant surcharge where someone could be paying a significant share of their income toward health insurance,” said Larry Levitt, a Kaiser Family Foundation senior adviser.

Some smokers are feeling burned.

“Alcoholics, people who are terminally ill; I just feel like everybody should be treated equally,” said Carmen McCullum, a smoker in Los Angeles.

Thirty-four percent of the lowest-income Americans smoke, compared with only 13 percent of those earning $90,000 or more per year. Those who designed ObamaCare imposed the surcharge hoping it would convince users to quit — or price them out of the market. It also reflects the higher costs smokers present to insurers.

“There are competing goals here,” Levitt said. “There’s the goal of getting people insured and certainly the lower the cost of insurance, the more likely it is people will sign up. There’s also the goal of allowing insurance companies to recover their cost of covering certain kinds of people and the smoking surcharge is one way of doing that.”

However, some see smoking as an addiction, not a choice, and it is no different than any other pre-existing condition. Most state exchanges ask the question up front, “Are you a smoker?” Experts say users may try to lie, but insurers can file fraud charges if they learn a patient is lying.

Smokers may escape the penalty in the first year of ObamaCare thanks to another computer “glitch” in the federal website which can’t seem to charge older smokers the proper amount. That, however, isn’t necessarily true in all states.


November 25, 2013 by admin No Comments

It has been said over and over that is still not working almost 2 months after it’s rollout. Nov. 30 is the proposed date for when the site will be up and running, but what if it still isn’t operational?

The article below speculates it could result in a very interesting midterm election where Democrats may choose to distance themselves from the White House rather than show continued support for President Obama and Obamacare.

Obama’s Looming Deadline to Win Back His Own Party

By Jon Terbush

11:31am ET

Democrats are waiting and watching to see how fares come November 30.

The Obama administration has one week left before its self-imposed deadline to get working for the vast majority of users, and a failure to hit that goal could trigger yet another round of Democratic panic over the health care law.

Democrats, nervous about how health care will play in the midterm elections, have already distanced themselves from the White House over ObamaCare’s sputtering debut. And that, combined with Obama’s dismal approval rating and the threat of a ramped-up Republican attack on the health care law, has them eyeing an even greater break from the president if he can’t make good on his promise to have up and running on an already belated schedule.

“The president and his team have repeatedly assured us that the system will be working by Dec. 1,” Iowa Rep. Bruce Braley (D) told Politico. “That’s when I start looking at what we have to do in our oversight function to hold the administration accountable for making it work.”

Last week, ObamaCare’s tech surge manager, Jeff Zients, announced that would be able to handle 50,000 concurrent users — the load it was supposed to support when it went live in October — by next month. That would allow the site to handle a “conservative estimate,” Zients said, of 800,000 users per day.

However, that’s merely a projection, and the website could very well fall short of that goal. And even in a rosy scenario, the administration has said they expect the site to work for only about 80 percent of users by December. That would be a better success rate than before, but one that “wouldn’t be considered success in most industries,” writes National Journal’s Sam Baker, and one that “might not be good enough to stem the tide of negative anecdotes about ObamaCare enrollment.”

That underscores the tricky nature of the December deadline: Defining “success” for the health care law is nebulous, and will ultimately come down to public perception. Even with a supposedly fixed site, that perception could remain unchanged.

As public opinion surveys have shown, Obama doesn’t have a ton of credibility to offer. Polls have consistently found his approval rating well underwater, with a majority of Americans saying they don’t find him to be trustworthy or an effective leader.

If Obama still enjoyed a sterling reputation, selling the ObamaCare fix come month’s end would be an easier task. Now, it’s not clear the president can convince voters to trust him when he says, in the face of unrelenting GOP critiques, that the website is working.

A failure on that front would give shaky Democrats more incentive to back away from the White House and propose their own solutions to the health care site.

Thirty-nine House Democrats recently backed a GOP plan to allow users to keep health care plans that would otherwise be deemed unsuitable under ObamaCare. And some Senators, even after Obama announced an administrative fix for that same problem, have continued to push their own alternatives.

As of yet, Sen. Majority Leader Harry Reid (D-Nev.) has no intention of bringing any competing health care bills up for a vote, meaning the Democratic restiveness could amount to nothing more than pre-election positioning. Still, Democratic criticism of the president and his health care law would reinforce the GOP’s message of Democratic disjointedness, and lend Obama’s critics more ammunition to further their assaults in battleground states next year. (Probable attack ad: “Even Democrats XYZ think ObamaCare is a failure.”)

There are signs that the state-run exchanges are beginning to pick up steam which, if sustained, could counter some of the negative news about the federal exchange marketplace. Yet the administration, in order to prevent a larger Democratic defection, will have to ultimately get the federal site running as expected.

Doing so by December 1 would go a long way toward that end.


November 25, 2013 by admin No Comments

Is a secure website? Well, the experts who created the website says it meets the federal cyber-security standards, but other cyber-security experts say the site isn’t safe at all.

Recently, four cyber-security experts testified before Congress warning that the site was not secure. Three of the four experts said that the site needs 7 to 12 months of work to make it secure, which means the site would be shutdown all together. The other expert did not say the site needed to be shutdown, but he did say he would not personally use the site because of the security risks.

What does all this mean? Well, it means that signing up online through may make it much easier for someone to get your personal information such as where you live/work, your SSN, and your annual adjusted gross income.

The article below also discusses the President’s dwindling approval rating and what could possibly happen if isn’t operational by Nov. 30.

Will the Obamacare Website Woes Defang the Obamacare Penalties?

By Keith Speights

November 24, 2013

Oh, what a tangled Obamacare website they weave.

The more Americans find out about the Obamacare website woes, the more of a mess the situation seems to be. Now the possibility seems quite real that the financial penalties connected with the individual mandate, a linchpin of the Affordable Care Act, could be essentially defanged as a result of the website troubles. Here’s how — and why the implications are enormous.

Showing their fangs
A recent survey illustrates how things are going so far for the Obamacare website. Gallup reported this week that only 21% of uninsured Americans had even visited a health exchange. Of those individuals, 63% said their experience was either negative or very negative.

Federal authorities maintain that will be ready to support the “vast majority” of customers by Nov. 30. What constitutes a vast majority? The White House said this week that the Obamacare website will work for 80% of insurance shoppers by the deadline. Russian roulette gives better odds for a pleasant outcome.

To make matters worse, security experts who testified before Congress recently warned that the website isn’t secure. Three of the four cyber-security gurus said that should be shut down, with one estimating that at least seven to 12 months would be required to fix the security problems.

What about the one expert who didn’t say the Obamacare website should be shut down? Avi Rubin, director of Johns Hopkins University’s Information Security Institute, said he didn’t have enough information to make a call. However, Rubin added that he wouldn’t personally use the site as it stands now because of the security flaws.

White House officials have stated that the website is improving. And the experts responsible for security told a Congressional committee that the site meets all federal cyber-security standards. At the same time, though, the Obama administration appears to be scrambling to allow Americans to enroll directly with health insurers as an alternative.

Gumming things up
If Nov. 30 arrives and the Obamacare website proves to still not be ready for prime time — or, worse, a major security breach occurs — everything related to the health reform legislation could be gummed up. And it will likely start with the individual mandate penalties.

Public support for a delay of the Obamacare penalties is growing. Pressure will intensify should problems persist with So what happens if the website still isn’t fixed by the end of the month and politicians ultimately acknowledge that a delay in the penalties is needed?

First, expect howling from insurance companies. WellPoint (NYSE: WLP ) , the nation’s second-largest health insurer, chose to jump aboard the Obamacare individual insurance train in a more significant way than its peers by participating in the exchange websites in every state where the company operates.

A delay in the penalties means that WellPoint’s actuarial calculations used to set rates are completely blown. The Affordable Care Act cushions insurers to some extent through the use of “risk corridors,” but that probably won’t be enough to offset the losses that would be incurred.

Hospital chains won’t be happy campers, either. Tenet Healthcare (NYSE: THC ) has been in an acquisition mode as it positioned to take advantage of the highly anticipated swelling in the rolls of the insured — and corresponding decrease in the ranks of the uninsured. A delay in the penalties could very well translate to a delay in those hoped-for benefits.

Not everyone in health care will be rattled quite as much, though. Aetna (NYSE: AET ) and UnitedHealth Group (NYSE: UNH ) took more cautious approaches with the Obamacare exchange websites. Both insurers also, like WellPoint, stand to gain from Medicaid expansion resulting from the health reform legislation.

All bark and no bite?
The perception of the impact of a delay in the Obamacare penalties just might be worse than the reality of a pushback. Some observers have been skeptical about how effective the penalties would be in the first place. The Affordable Care Act didn’t bestow much authority to the IRS to enforce the penalties, anyway.

While it’s quite possible that the Obamacare website woes will defang the individual mandate penalties, those fangs were really never all that sharp in the first place. Does that mean that the negative consequences described above won’t happen if the problems lead to a penalty delay? Not necessarily. Even a dog that’s all bark and no bite can prove to be quite effective at causing a scare.

Sinking your teeth into Obamacare
Obamacare seems complex, but it doesn’t have to be. In only minutes, you can learn the critical facts you need to know in a special free report called “Everything You Need to Know About Obamacare.” But don’t hesitate, because it’s not often that we release a free guide containing this much information and money-making advice. Please click here to access your free copy.


November 23, 2013 by admin No Comments

Though there is lots of negativity surrounding Obamacare, there may be some good that could come out of the law. Below is an article that has some unique stories about individuals who will be positively effected by Obamacare because they are either small business owners or are looking to start their own business.

In the Health Law, an Open Door for Entrepreneurs
The New York Times
Published: November 23, 2013

In the weeks since the health insurance marketplaces of the Affordable Care Act went online, a well-publicized ripple of alarm and confusion has permeated the ranks of small-business owners. But less well known is the response of another contingent: newcomers to entrepreneurship who see the legislation as a solution to the often insurmountable expense of getting health insurance. Some even view the Affordable Care Act itself as a business opportunity.

The hopeful include founders of start-ups who otherwise wouldn’t have access to affordable health insurance — people like Rajeev Jeyakumar, a co-founder of Skillbridge, a Manhattan-based online job marketplace for business consultants.

Mr. Jeyakumar is uninsured. But unlike many people who were thwarted by the government’s faulty health care website, he was able to sign up for individual coverage three weeks ago. He will pay just $74 a month, after tax credits, for his new plan through the New York State exchange.

His story illustrates how, when finances are tight, new entrepreneurs often place the health of their businesses over their own health. “In the early days, a venture is often very much self-funded,” Mr. Jeyakumar says. “You always trade off between the money you need to survive in terms of paying rent and food. And when you have health care as an additional cost, it’s always very tempting to not put money into it.”

But come January, Mr. Jeyakumar will have a health plan that “even includes dental,” he wrote in an email. “I’m very pleased with the outcome.” Until then, he’s refraining from using his Citi Bike membership or playing sports, lest he sustain an injury requiring medical care.

And when it’s time to hire employees, he says he will most likely avoid the extra work of administering a company health insurance plan and instead encourage employees to shop the new health care exchanges on their own and bump up their salaries to cover the cost.

Research published in the journal Health Affairs showed that small businesses with 10 to 24 employees have paid 10 percent more than large ones for the same health care coverage, and that companies with fewer than 10 employees have paid 18 percent more until now. Small businesses’ plans were also more vulnerable to rate increases; as a result, they often provided less coverage, if they offered it at all, resulting in a competitive disadvantage in hiring.

Constantia Petrou, owner of Konnectology, a website that provides information on health care specialists, expects the new law to broaden her hiring options. When she started her company seven years ago in Burlingame, Calif., she realized that she couldn’t afford to offer a group plan.

“In terms of hiring, the health care expenses contribute a huge, huge component to your cost of operation,” Ms. Petrou says. So instead of bringing on full-time employees, she relied on contract workers.

She is looking forward to getting price information online from the Small Business Health Options Program, or SHOP, an exchange that was created by the new law. (Currently, business owners can obtain estimated SHOP prices online, but specific ones are only available by mail after filling out and mailing in a PDF downloaded from Some states, including California, have their own SHOP exchanges, and their procedures vary.)

Ms. Petrou says the law could enable her to hire full-time employees, depending on the new costs of coverage. If so, she will either pay for a portion of the individual plans that her employees shop for on the exchange, or she may take advantage of tax credits and offer a small group plan. “We now have options to explore,” she says.

Some experts say this type of flexibility may have a big impact on the economy over all.

“Assuming we get the website working, it’s going to be the biggest step we’ve had in a long time in the U.S. in terms of changing the structure of the economy,” says Craig Garthwaite, assistant professor of management and strategy at Northwestern University’s Kellogg School of Management. Mr. Garthwaite is a co-author of one of two recent studies that conclude that the Affordable Care Act could spur entrepreneurship by easing job lock — where people stay in a job mainly for the health insurance.

The act was aimed at people like Jeannie Armstrong, who in 2009 was planning to quit her job within a couple of years to start a private clinic for adolescents with substance-abuse problems. But then her 18-year-old son learned that he had diabetes. Fearing that he would be unable to find individual health insurance, she has stayed in her job so her son could keep receiving coverage under her employer’s health plan.

“We’re talking pre-existing condition, we’re talking no money, we’re talking health care costs out of the roof,” Ms. Armstrong says of her son’s situation.

But in January, her son will be eligible for individual health insurance. That will free Ms. Armstrong to quit her job as a social worker in the juvenile court system of Fairfax County, Va., and to pursue her entrepreneurial dreams. Now, instead of opening a for-profit clinic, Ms. Armstrong has decided to go the social-entrepreneurship route. In September, she founded the nonprofit Center to End Adolescent Substance Abuse Encounters.

Over the next year, she plans to stay in her job while her son finishes school; in her free time, she will assemble a board of directors and write the organization’s bylaws. By next fall, she plans to be running the nonprofit full time.

“I’m not hamstrung by having to stay in this job,” she says.

Ms. Armstrong sees the new law as an opportunity to start something new. But Kevin Kuhlman, manager of legislative affairs for the National Federation of Independent Business, says that while job lock is a real concern for entrepreneurs, he remains skeptical that the new law will be able to solve the problem.

The federation unsuccessfully challenged the constitutionality of the Affordable Care Act’s requirement that most people obtain health insurance or pay a tax penalty, in a case that went all the way to the Supreme Court last year. The plaintiffs were uninsured and didn’t believe that the government could require them to buy insurance.

Certainly, many established small-business owners are not clamoring for information on new health coverage. Barry Sloane, chairman and chief executive of Newtek Business Services, based in New York, says a majority of his customers
haven’t bothered to visit the exchanges.

“The negative publicity that’s come out about the site not functioning has kept people from thinking they can go to it and get a result,” Mr. Sloane says.

Some small businesses aren’t shopping the exchanges because they don’t yet need to, he says. Businesses with fewer than 50 people will not be required to offer health insurance; those with 50 or more employees will have to do so, but not until 2015.

Small-business owners are “very confused and they’re very concerned,” Mr. Sloane says. And those feelings are only intensifying amid news reports that just a tiny number of Americans have enrolled in the exchange plans and amid questions about the government’s ability to keep enrollees’ personal information secure. “The negative stigma around the Affordable Care Act is building steam,” he says.

A new crop of Internet companies, meanwhile, is convinced that Americans will need help navigating the new health care landscape. Benefitter, for example, based in San Francisco, provides business owners and individuals with information on the new law’s requirements.

The Young Entrepreneur Council, based in New York, is focusing on small-business owners and solo entrepreneurs with a website,, that it founded in September. It offers health insurance plans from six carriers.

“Whether the government is in there or not, whether corporations are in there or not, this is a big void,” Scott Gerber, the council’s founder, says of health care insurance for the small-business market.

Jack Hooper is among those who see the law as a business opportunity. A former intelligence analyst for the federal government, he enrolled at the Wharton School of the University of Pennsylvania in 2012 and hoped to start a company after graduation. His wife, Brittany, was to provide financial support and health care benefits through her job while he got the business going, but when she became pregnant with twins, those plans collapsed.

As he began investigating his own health care options, he realized that the Affordable Care Act could provide more than just access to coverage for his family.

“What’s been a very stagnant industry, health insurance, is being shaken up and people are starting to re-evaluate their plans,” Mr. Hooper says. He anticipates that premiums will remain expensive, pushing many Americans to high-deductible plans, and that these people will need help in managing care-related expenses.

Last spring, he started a service called Command Health, which he describes as “a or TurboTax for high-deductible health insurance plans.”

Based on his previous experience working for the federal government, he says, he is not surprised by the problems that have emerged in the site. Entrepreneurs like him will end up providing the ultimate solutions to the problems that have emerged from the Affordable Care Act, Mr. Hooper says.

Mr. Jeyakumar of Skillbridge says of the law’s rocky start: “Being a tech entrepreneur myself, I appreciate that technology is often not perfect in the first release, and a lot of great products from Facebook to eBay were buggy when they first came out.”

He adds: “I think the concept is good, and as with anything, it’s a wait-and-see on execution. If it works, great, and if not, we will fall back on existing alternatives.”


November 23, 2013 by admin No Comments

Below is an article that goes in to some detail about how the word redistribution has been avoided for sometime by Democrats. It also talks about how Obamacare effects the cost of one person to “help” another.

Don’t Dare Call the Health Law ‘Redistribution’


The New York Times

Published: November 23, 2013

WASHINGTON — Rebecca M. Blank was a top candidate in 2011 to lead President Obama’s Council of Economic Advisers, but then the White House turned up something politically dangerous.

“A commitment to economic justice necessarily implies a commitment to the redistribution of economic resources, so that the poor and the dispossessed are more fully included in the economic system,” Ms. Blank, a noted poverty researcher, wrote in 1992. With advisers wary of airing those views in a nomination fight, Mr. Obama passed over Ms. Blank, then a top Commerce Department official and now the chancellor of the University of Wisconsin. Instead he chose Alan Krueger, a Princeton economist.

“Redistribution is a loaded word that conjures up all sorts of unfairness in people’s minds,” said William M. Daley, who was Mr. Obama’s chief of staff at the time. Republicans wield it “as a hammer” against Democrats, he said, adding, “It’s a word that, in the political world, you just don’t use.”

These days the word is particularly toxic at the White House, where it has been hidden away to make the Affordable Care Act more palatable to the public and less a target for Republicans, who have long accused Democrats of seeking “socialized medicine.” But the redistribution of wealth has always been a central feature of the law and lies at the heart of the insurance market disruptions driving political attacks this fall.

“Americans want a fair and fixed insurance market,” said Jonathan Gruber, a health economist at the Massachusetts Institute of Technology who advised Mr. Obama’s team as it designed the law. “You cannot have that without some redistribution away from a small number of people.”

Mr. Obama’s advisers set out to pass the law in 2009 fully aware that fears among middle-class voters sank President Bill Clinton’s health initiative 16 years earlier. So they designed the legislation to minimize the number of people likely to be hurt.

Instead of a sweeping change to a government-run “single-payer” system favored by Democratic liberals, the administration sought to preserve the existing system of employer-provided health insurance while covering the uninsured through the expansion of Medicaid and changes to the individual insurance market.

They also added benefits available to any family, such as the ability of children up to age 26 to remain on their parents’ health plans.

But throughout the process, they knew that some level of redistributing wealth — creating losers as well as winners — was inescapable.

They were nonetheless acutely aware of how explosive the word could be. When Mr. Obama ran for president in 2008, Republicans tried to wound him by accusing him of waging “class warfare” to achieve wealth redistribution. That fall, the Republican presidential nominee, Senator John McCain, derided Mr. Obama as the “redistributor in chief” as he seized on Mr. Obama’s comments to an Ohio man later known as “Joe the Plumber” that he wanted to “spread the wealth around.”

Mr. Obama survived that episode and other instances when Republicans deployed old recordings of him using the word “redistribution” as evidence that he was a closet socialist. But Mr. Obama had learned a lesson.

After he took office, he cast his goal of rolling back President George W. Bush’s tax cuts for higher earners not as economic redistribution, but as the restoration of top-end rates from the Clinton years.

The Affordable Care Act was a similar semantic sidestep. The law targeted high earners, too, by raising their Medicare taxes enough to reduce their after-tax incomes by nearly 2 percent, according to the nonpartisan Tax Policy Center. That revenue helped finance coverage for those currently without insurance, who tend to have lower incomes and who in many cases will receive government subsidies to make their premiums cheaper.

And yet for those nervous about potential changes, the president promised stability. “If you like your current insurance, you will keep your current insurance,” Mr. Obama said the day he signed the legislation in March 2010, a promise he made repeatedly as the Oct. 1 opening day of the online health insurance marketplaces approached.

Hiding in plain sight behind that pledge — visible to health policy experts but not the general public — was the redistribution required to extend health coverage to those who had been either locked out or priced out of the market.

Now some of that redistribution has come clearly into view.

The law, for example, banned rate discrimination against women, which insurance companies called “gender rating” to account for their higher health costs. But that raised the relative burden borne by men. The law also limited how much more insurers can charge older Americans, who use more health care over all. But that raised the relative burden on younger people.

And the law required insurers to offer coverage to Americans with pre-existing conditions, which eased costs for less healthy people but raised prices for others who had been charged lower rates because of their good health.

“The A.C.A. is very much about redistribution, whether or not its advocates acknowledge that this is the case,” wrote Reihan Salam on the website of the conservative National Review.

Having obscured much of that vulnerability before, Mr. Obama has responded to recent political heat by apologizing — and expanding the scope of his discredited “you can keep it” promise.

Mr. Gruber of M.I.T. called redistribution a convenient tool for Republican opponents who would fight the law anyway.

In the end, America’s political culture may have made it unrealistic to expect a smooth public reception for the law, no matter how cleverly the White House modulated Mr. Obama’s language or shaped his policy to minimize the number of losers.

“The reality is, any big thing you take on, any big change, is hard to accomplish,” said David Axelrod, the president’s longtime strategist. In America, he said, “we’ve created a sense that everyone can expect to win — nobody has to sacrifice.”

At the same time, Mr. Axelrod argued that widening income inequality has, to some Americans at least, changed the meaning of redistribution. “The whole redistribution argument has shifted in the country because there’s a sense that a lot of redistribution has been to the top and not the bottom,” Mr. Axelrod said.

Still, the word is hardly a favorite of the president these days. The last time Mr. Obama used it in public, according to Federal News Service transcripts, was 18 months ago during his re-election campaign in Elyria, Ohio.

“Understand this is not a redistribution argument,” the president told his audience then. “This is not about taking from rich people to give to poor people. This is about us together making investments in our country so everybody’s got a fair shot.”


November 23, 2013 by admin No Comments

Below is an article that may help answer some of the questions that many Americans have about Obamacare.

Obamacare: Your Questions Answered

By Lisa Scherzer

November 22, 2013 2:48 PM

Yahoo Finance

It should come as no surprise that the troubles bedeviling Obamacare’s exchanges have sunk the law’s popularity.

But according to a Kaiser Family Foundation poll released Friday, the gap between positive and negative views of the law is almost the largest it’s been since Kaiser began tracking consumer sentiment about Obamacare in April 2010. Nearly half (49%) of Americans have an unfavorable view of the law and a third have a favorable view, a 16-percentage-point difference. The only time it was bigger (17 points) was in October 2011 – in the midst of the 2012 presidential campaign – when Republican candidates amped up their critique of the law. What’s more, favorable views of Obamacare dropped most among Democrats, after rebounding in September and October.

The past few weeks have brought a mix of news as the Obama administration works to fix’s technical snags in time for the promised end-of-November deadline. The administration said Friday it would give consumers until Dec. 23 – an additional eight days – to sign up for coverage that takes effect Jan. 1. The move allows more time for people to compare and shop for plans on the notoriously glitch-filled federally run exchange.

On Tuesday Health and Human Services Secretary Kathleen Sebelius told people at an event in Florida that the federal marketplace site is “far faster” than it was when first launched, and “the error rate is down to less than 1% and the volume capacity is continuing to be added to.”

House Speaker John Boehner on Thursday described his frustration attempting to sign up for Obamacare in the D.C. exchange on his blog: “After putting in my personal information, I received an error message. I was able to work past that, but when I went to actually sign up for coverage, I got this ‘internal server error’ screen,” Boehner wrote. (He succeeded after several tries.)

Earlier this month President Obama apologized for the rollout’s missteps and announced that he would give insurance companies (at each state’s discretion) the option to keep offering consumers plans that would otherwise be canceled because they do not meet the new minimum requirements of the law.

Now a major question is whether the hundreds of thousands of people who filled out applications on the exchanges – but didn’t actually enroll – will come back to do so. Cost was the most common reason among consumers who visited the marketplaces but didn’t enroll in a plan, according to a survey by Commonwealth Fund, with 48% saying they were uncertain they could afford coverage. Meanwhile, 46% of respondents said they were still trying to decide which plan they wanted, and 37% of those who didn’t enroll cited technical difficulties as the reason.

No doubt the steady trickle of hiccups and delays made to parts of the law since the exchanges launched on Oct. 1 are hard to keep up with. We’ve been answering readers’ questions about the ACA here. If you have questions about buying coverage on your state’s exchange or the federal marketplace, send them to And check Yahoo Finance on Monday, Dec. 2, at 2 p.m. EST for a live chat about Obamacare.

Here are answers to some of our latest questions from readers:

Q: Are the subsidies paid out monthly? If we can’t afford to pay the insurance premiums monthly, how do we even get coverage? Having this reimbursed at the end of the year doesn’t exactly work. Where are the subsidies monies coming from?

A: You can choose to receive the credits in advance because, as you note, many people won’t be able to afford paying their entire premiums upfront and wait until they file taxes to get reimbursed. Consumers also have the option to get a partial credit in advance or get reimbursed when they file their federal taxes. describes how this works here.

If you decide to get advance payments of the credit, you’ll need to file taxes for the year in which you receive them. For example, someone who got advance payments of the credit for the 2014 calendar year will need to file a tax return for 2014 before the April 2015 deadline, according to the Center on Budget and Policy Priorities’ Beyond the Basics of Health Reform.

Q: My job is seasonal, lasting from 6-8 months per year. During the season, my employer provides health care for myself and my spouse. During the off-season, my coverage lapses and I do not have insurance. Cobra coverage is too expensive with no income so we generally go without insurance until eligible for the next season. Will we be able to continue with this arrangement or will we be required to buy coverage?

A: The ACA requires everyone to have health insurance coverage, or else pay a tax penalty, unless they qualify for an exemption. You’re not at risk of incurring the penalty if you’re without coverage for less than three months. But it sounds like you and your spouse would be without employer-based insurance for longer, in which case you’re required to buy coverage. You can check to see if you’d be eligible for a subsidy through the exchange here.

Q: For my 7-year-old son who has a preexisting disability, my company’s health insurance won’t cover a specific therapy. On the exchange, the plan will cover the therapy. If I purchased both insurances [for] my son, one from the exchange and one from my company, how would that work?

A: You can’t get insurance through both an exchange and your employer – individuals and families must choose one or the other, says Janet Coffman, associate professor at UCSF School of Medicine.

If your employer offers family coverage, you can choose to purchase a plan through an exchange instead but you won’t be eligible for subsidies unless the employer-sponsored plan is deemed “unaffordable” or does not meet minimum value. As explained previously, a job-based plan is considered unaffordable if the individual employee’s share of premiums for the lowest-cost coverage that meets the law’s requirements is more than 9.5% of your family’s income. You and your spouse may want to compare total costs (premiums plus out-of-pocket expenses) for the employer plan and plans available on the exchange. Your employer should be able to tell you what the lowest cost of self-only coverage is and whether the plan meets minimum value, Coffman says.

Q: I am single, self employed, and my adjusted gross income last year was $32,000. I currently have a PPO with Blue Cross that also has an HSA (health savings account). If I decide to go on the exchange, can I keep my HSA to help cover my co-pays? Will I qualify for a subsidy?

A: Once you’ve established a health savings account, you can continue to make withdrawals for health expenses even if you’re no longer enrolled in an HSA-eligible plan, says Karen Pollitz of the Kaiser Family Foundation. You just can’t make new tax-free contributions to the account when you’re in a non-HSA-eligible plan. Many of the plans offered on the exchange will also be HSA-eligible plans, so you should check to see what’s offered, she says.

Q: If one member of the household is on Medicare, is the cost paid for the Medicare taken into consideration to determine the subsidy for the remaining family members?

No. One’s eligibility for subsidies and the amount of the subsidy will be based on family income. The amount your spouse pays for his or her Medicare, Medicare Part D and supplemental insurance premium costs will not be taken into account, according to the Kaiser Family Foundation.

Q: My wife will need Obamacare in 2014 and 2015 until she gets on Medicare. I want to know how much maximum out-of-pocket expenses will there be on the different plans in Obamacare.

A: The maximum out-of-pocket costs for any marketplace plan for 2014 are $6,350 for an individual plan and $12,700 for a family plan. Those totals include copayments and deductibles, but not premiums, and they apply only to plans that are not grandfathered under the law.

Q: In response to one of the questions to you, you had indicated the subsidy amount on the ACA premiums would be based on “MAGI,” or Modified Adjusted Gross Income. Why would it be based on “MAGI” & not “Taxable Income”? It would seem to me like “Taxable Income” would be a fairer & better number to use. Also, how would capital gains, capital gains distributions be considered in the calculations?

A: Brian Haile, senior vice president for health policy at Jackson Hewitt Tax Service, says the tax credit rules are based on MAGI, which is simply AGI (on line 37 of your 1040) with three “add backs” (i.e., nontaxable Social Security income + foreign earnings + tax-exempt interest income). So MAGI is actually higher than AGI. Capital gains and cap gains distributions are included in MAGI (but long-term capital gains are subject to rules separate from those governing ordinary income, Haile says).


November 23, 2013 by admin No Comments

Not only is ill-equipped to handle large numbers of people simultaneously on the website and can barely sign anyone up, there is now the question of the financial management of the website, which people don’t get to see. In the article below it is said that the back-end of the website is sorely behind schedule and could result in the mismanagement of funds that should be used to pay the premiums of people who have signed up for plans through

In turn, this could lead to people being told they are not covered even though they have paid their first months premium. The reason for this would be the financial management part of the website is not complete. It is stated in the article below that the building of the financial management part of is two months behind schedule. If it is not operational by Jan. 1 it could potentially lead to huge problems for the website and Obamacare in general.

Below is the article which talks about the back-end of the website.

Obamacare agency rushed in contractor without bids, documents show


By Sharon Begley

NEW YORK (Reuters) – Caught flat-footed by the challenges of building the financial-management and accounting parts of the U.S. government’s new online marketplace for health insurance, officials rushed to hire a familiar contractor without seeking competing bids, according to government procurement documents reviewed by Reuters.

The documents dated in August – less than two months before the opening of online marketplaces established by President Barack Obama’s landmark healthcare law – showed the agency in charge had only “recently learned” that building the financial management functions was “beyond (its) currently available resources.”

The Centers for Medicare & Medicaid Services (CMS) documents shed more light on the problems facing the agency as it worked on the marketplaces established by the law commonly called Obamacare and on its revelation this week that at least 30 percent of the marketplace is still being built.

Those problems and others have been revealed by congressional oversight investigators who released emails and outside reports that paint an administration scrambling to meet the technological challenges of the marketplace – and usually failing to do so.

CMS spokeswoman Joanne Peters said on Friday and on Saturday that representatives of the agency were unavailable to comment on the contract or on an estimate of when the financial management part of the marketplace is expected to be finished.

Although the consumer-facing part of the marketplace, the website, opened for enrollments on October 1, CMS had a goal of January 1, 2014 for the financial components of the system to be operational.

“The prospect of a delay…even for a few days, would result in severe consequences, financial and other,” CMS said in a “justification and approval” document explaining the lack of competition for the contract.

The contract, valued at nearly $12 million, was awarded on August 9 to Novitas Solutions, according to the documents. Novitas has numerous contracts with CMS, including to administer doctor and hospital claims in the federal Medicare program for elderly Americans.

The problem-plagued is being worked on by contractors racing to fix it by the end of November so that people can enroll in insurance plans for 2014 under the 2010 Affordable Care Act. The law aims to provide health care insurance to millions of uninsured people.


Federal agencies are normally required to solicit bids for work, so as to get the best deal for taxpayers, but can award a contract to a favored company in emergencies as long as they document the urgency.

A few weeks after taking office in 2009, Obama issued a memorandum to government agency heads ordering them to minimize the use of non-competitive contracts, calling them potentially “wasteful, inefficient, subject to misuse.”

The procurement documents made clear how crucial the financial functions on the healthcare portal are. If payments were not made on time and accurately, CMS said, “operation of the Marketplace and the Affordable Care Act will certainly be jeopardized.”

Financial management includes such functions as transmitting premium payments to insurers. Building that capability into the Obamacare marketplace “is already minimally two months overdue,” according to the August documents.

Just a few weeks before the financial-management contract was awarded, according to emails released last week by the House Energy and Commerce Committee, CMS officials were becoming increasingly concerned about the status of the federal insurance marketplace, asking for assurance that the lead contractor was not “going to crash the plane at take-off.”

On Tuesday, CMS’s deputy chief information officer, Henry Chao, author of the “crash” email, told a congressional panel that 30 to 40 percent of the federal marketplace was still under construction.

Invisible to consumers are what Chao called the “back office systems.” Those include accounting and payment systems to send premiums to insurers and transfer funds to insurers that attract more than their share of customers with high medical costs.

The no-bid contract awarded to Novitas includes these systems. Novitas is a subsidiary of Diversified Service Options, which is wholly-owned by Blue Cross and Blue Shield of Florida.

Asked about how Novitas was awarded the contract and the work it is doing, Florida Blue spokesman Mark Wright said a company official told him, “We’re not going to be able to get into this right now.”

Chao told a House Energy and Commerce subcommittee that CMS and its contractors had focused on building so it could launch on October 1, postponing construction of “the financial management aspects of the system.”

The lead contractor on, the U.S. subsidiary of Canada’s CGI Group Inc, is also involved in building the financial management piece of the marketplace, a company official said.

The construction “is a bigger problem than people realize,” said Robert Booz, a vice-president and healthcare specialist at technology consultant Gartner.

“Everyone recognizes it’s going to be a problem in January,” he said, referring to financial management. In the worst case, if financial records are wrong, then people who have signed up for, and paid a monthly premium for, insurance may be told incorrectly that they are not covered.

(Editing by Ross Colvin and Grant McCool)


November 23, 2013 by admin No Comments

Below is an article that is worth reading if your state doesn’t have its own exchange. As it turns out, some of the monthly premium estimates you receive for your health plan on are not really even an estimate. In fact, based on this article they sound more like a shot in the dark. Apparently, throughout the process of looking for plans in your area you will see reminders that your monthly premium might actually be less than what is given to you by the site. What it doesn’t tell you is that your premium could also be significantly more than what is given to you on the site. also doesn’t ask very many questions when giving you your estimate, which is probably one of the greatest factors in why the monthly premiums are not even close to accurate.

It is very important to sign up for something for which you have been given all the details. Blindly signing up can lead to getting coverage which may not do you any good or it could lead to you getting a plan that costs much more than what you initially thought.

Below is the article which talks about the misleading monthly premium estimates. Estimates May Be Misleading

November 22, 2013 4:18 PM

Browsers beware: The estimated monthly premiums on may be misleading.

The troubled federal website allows visitors to anonymously surf the site for exchange plans sold in their areas and provides them with estimated prices for each health plan. (Just click on the “See Plans Now” button on the homepage and follow instructions.) But here’s the problem: The monthly premium estimates provided on the website do not consider a person’s specific age, household size or tobacco use – all critical factors when estimating premiums. visitors using the site’s window-shopping tool are repeatedly told that “the final premium you pay may be lower, perhaps much lower, than the prices shown” once they fill out an application and apply for government subsidies. But what the site doesn’t say is that the actual premium may be higher, perhaps much higher, than the estimated premiums shown on the site.

We knew estimates would vary from the actual premiums once customers create an account, provide personal information and obtain accurate price quotes. discloses that on the page titled “How can I see Marketplace health plans and prices before I fill out an application?”

But we didn’t know how useless the website’s window-shopper tool can be for certain consumers – a fact brought to our attention by, a consumer finance website that provides its own comparison shopping tool for marketplace health plans. (Ezekiel J. Emanuel, a former White House adviser who helped design the Affordable Care Act, cites and other alternatives to in a Nov. 15 article he coauthored on Politico called “Who Needs”)

We decided to do a little comparison shopping of our own, based on the personal circumstances of two staffers. (Important note: Nobody at needs to shop on the individual market because, like most Americans, we get coverage through our employer — which in our case is the University of Pennsylvania.)

First example: 54-year-old man shopping for a health plan that would cover him, his 55-year-old wife and two dependent children (ages 14 and 21). The family lives in suburban Philadelphia. None is a smoker.

We first compared the estimated monthly premiums provided by with the estimates provided by, and then went to the insurance company websites for actual price quotes.

For our family of four, offers six Silver plans: four Independence Blue Cross plans and two Aetna plans. (We considered only the Silver plans to keep it simple.) The estimates ranged from $708.84 per month to $982 per month.

Now, doesn’t ask for ages or even an age range when providing plan information and premium estimates for family coverage. All it wants to know is the visitor’s home state and county. asks for a little more information. Besides county and state, window shoppers have to provide household size, as well as ages and tobacco use for all family members. That website’s estimates were higher — much higher. A whopping 69 percent higher for each exchange plan. The premium range: $1,201.44 to $1,666 per month. (And, remember, that’s for a family of nonsmokers.)

We then went to Independence Blue Cross and Aetna websites to get actual quotes using their marketplace browsing features. Both websites asked for the same information as — except that the insurance companies wanted birth dates, not just ages. We found, not surprisingly, that the insurers’ price quotes were almost exactly the same as the estimates provided by In fact, they were exactly correct in three of the four Blue Cross plans.’s estimates were slightly off — lower by no more than 4 .5 percent — for the two Aetna plans.

Why was the website so far off the mark? The website discloses up front, while you are browsing for plans and prices, that the premium estimates are “based on a limited set of sample ages.” But potential customers would have to dig deeper into the website to find out what sample ages the tool uses. (Go to the homepage, scroll to the bottom until you see “Quick Information,” and click on “Health Plans” under the header “Plan Information for Individuals and Families.”)

In the case of a family of four, the website assumes that the husband and wife are both 30 years old. In our real life example, they are 55 and 54. That’s important because the Affordable Care Act says insurance companies can charge older Americans up to three times more than younger ones.

Of course, the closer a couple is to 30 years old, the better the estimate will be. And that brings us to our second example: a 29-year-old single man living in the city of Philadelphia.

In the case of single adults, asks one additional question that it does not ask of those seeking family coverage. It asks for an age range (“49 or under” or “50 or over”). It informs visitors at this point that “[p]remium amounts in this tool are based on specific ages,” but again you have to dig deeper to find that the specific ages are 27 for someone who selects “49 or under” and 50 for someone who selects “50 or over.”

In our second example, the 29-year-old man is close enough to age 27 that provided better estimates — but they were still too low. For six Silver plans, provided cost estimates that ranged from $209.85 to $291, while the insurance companies provided quotes ranging from $224.07 to $322. underestimated the actual cost of the Blue Cross plans by 7 percent and the Aetna plans by no more than 12 percent. ( provided a range of $224.07 to $310.71, which again was more accurate than the exchange.)

Yes, we know that tells visitors that these are merely estimates and actual prices may vary. At one point in the process, this caveat is provided:

Important note: The monthly premiums shown DO NOT take into account your income and household details. Premium amounts shown in this tool are only examples, based on a limited set of sample ages and scenarios. They may not fully reflect your individual situation. Actual plan pricing can change based on your household size, income, ages, and tobacco use.
At no point during the process of browsing for plans and prices are visitors informed that they may pay more — in some cases much more — for insurance than the estimated prices shown on the site. But the site repeatedly tells visitors that the actual prices may be lower. Every page during the process of surfing for plans and prices carries a blue box that says:

IMPORTANT NOTE: The prices shown on this tool don’t reflect the lower costs you may qualify for based on household size and income.
Most people who apply will pay lower monthly premiums than those shown here. Households with yearly incomes up to about $46,000 for individuals or $94,000 for a family of 4 will qualify for lower costs. You’ll get final quotes for specific plans based on your income and household after you complete a Marketplace application.
On one page — just before you see the plans and cost estimates — you are told twice about the possibility of lower costs. On that page, you get the “important note” above, plus this:

Most people who apply will qualify for lower costs.
Most people who apply for coverage in the Marketplace will qualify for lower costs on monthly premiums based on their household size and income.
The chart on the right shows household sizes and income levels that qualify for lower costs. The lower your income within the ranges shown, the lower your premium costs will be.
Some people with lower incomes within these ranges will qualify to save money on out-of-pocket costs like deductibles and copayments.
It is true that many people seeking insurance on the individual market will receive government subsidies that will help offset the cost of insurance premiums. In an Aug. 14 report, the nonpartisan Kaiser Family Foundation estimates that “about half (48%) of people now buying their own insurance would be eligible for a tax credit that would offset their premium.” In addition, more than 1 million people now buying their own insurance will be eligible for Medicaid, the report says.

“Among the approximately half of current enrollees who will be eligible for tax credits, the average subsidy would be $5,548 per family, which would reduce their premium for the second-lowest-cost silver premium by an average of 66%,” the KFF report says.

Those estimates don’t include people who are not currently part of the individual market but will buy coverage on the state and federal exchanges. The nonpartisan Congressional Budget Office estimates that altogether about 80 percent of the 25 million Americans with insurance exchange plans in 2023 will receive subsidies.

So, it is important for to inform them that they may be eligible for a subsidy that could lower their costs.

But, by failing to disclose the fact that actual premiums may be far more than the estimates provided on its site, has the potential to mislead those same families as well as others who won’t be eligible for subsidies at all.

– Eugene Kiely, with D’Angelo Gore and Lori Robertson


November 23, 2013 by admin No Comments

So, the deadline to sign up for a health plan with a Jan. 1 effective date has been extended from Dec. 15 to Dec 23 to give consumers more time to find a health plan, due to the botched rollout of on Oct. 1. Now the questions remains, can the website be fixed in time to actually give consumers the amount of time they need to find a health plan? That remains to be seen. In the article below White House officials are making statements about how the website will be improved to handle a larger number of people per day and be able to handle 50,000 simultaneous users.

The President’s administration has also announced that the open enrollment period for next year (2014) will be delayed until Nov. 15. The White House officials say that the start date of open enrollment for 2015 plans has nothing to do with the midterm elections (even though the start date is a week after voters will have cast their votes for the election) which means no one will know what the premiums are for the open enrollment period until after the elections have already happened. So, if the premiums have increased by a substantial amount the voters will have no idea.

The President and his officials have commented that the delay in open enrollment has nothing to do with the midterm elections. Instead, it is about giving the insurance companies a longer period of time to calculate the new premium rates for the open enrollment period.

Below is an article that talks about the deadline extension/delay and some of the upcoming fixes for

U.S. scrambles to boost Obamacare enrollment as deadlines loom


By Roberta Rampton and Sharon Begley

The Obama administration announced a flurry of fixes to its troubled website on Friday that officials said would soon double its current capacity, a crucial step toward getting the system working by a November 30 deadline.

It also pushed back a deadline for people to enroll in insurance plans for 2014 under President Barack Obama’s Affordable Care Act in a nod to millions of applicants who have been unable to sign up because of technical glitches for nearly two months.

The healthcare reform, popularly known as Obamacare, aims to provide health benefits to millions of uninsured Americans. Obama’s biggest domestic policy achievement, however, has now become one of the biggest political crises of his presidency as polls show Americans increasingly souring on the reform.

As a result, the administration is in a race against time to fix the website, an online insurance exchange, that is central to Obamacare. People need to make decisions on healthcare plans in December if they want insurance in place by January.

People needing health insurance by January 1, 2014 will have eight extra days to sign up, officials said. The original deadline for year-end coverage was December 15, but now will be moved to December 23.

Jeffrey Zients, the troubleshooter named by Obama to oversee fixes to told reporters on Friday that the website will soon be able to handle 50,000 simultaneous users – twice its current capacity, and up from fewer than 1,000 in the days after its botched launch on Oct 1.

The website will be able to handle 800,000 people per day by the end of November, Zients said, largely because of more than 300 software and other fixes made to the site in the past seven weeks, and because of a doubling in the system’s hardware capacity, which will happen this weekend.


Some of the technical fixes will allow insurance companies to more easily directly enroll consumers in health plans, a senior administration official said.

The administration will run a pilot program for direct enrollment in three states with large numbers of uninsured people – Texas, Florida and Ohio – and use the results to expand the availability of the “direct enrollment” option.

“We do believe that it’s substantial. We’re looking at hundreds of thousands of people who we believe may well opt to do this,” the official told Reuters.

Insurance companies worked with the administration to address the technical challenges in the direct enrollment option, said Robert Zirkelbach, spokesman for America’s Health Insurance Plans, a lobby group.

“Getting direct enrollment working will enable health plans to do what they do best, and that’s enroll people in coverage,” Zirkelbach said.

Greg Thompson, a spokesman for Health Care Service Corporation, which operates health plans including Blue Cross Blue Shield of Texas, said he did not immediately know whether the Texas plan would participate in the pilot project.

“We are looking at a variety of ways that people can have access to enrollment,” Thompson said. “We want to make sure it can happen both on and off the exchanges.”


Officials were adamant that they have no plans to extend the ultimate deadline of March 31, 2014, the date when people without insurance must enroll in a plan or face a tax penalty.

But with the first enrollment period barely off the ground, the Obama administration also has decided to delay enrollment for the second year of the program to give insurance companies more time to calculate rates, White House spokesman Jay Carney told reporters.

The delay will mean consumers will start shopping for insurance for Year Two of Obamacare on November 15, 2014 – more than a week after voters go to the polls for midterm elections, when congressional Democrats are expected to face tough questions about the policy they supported.

“That means that if premiums go through the roof in the first year of Obamacare, no one will know about it until after the election,” said Republican Senator Charles Grassley of Iowa.

But Carney rejected any assertion that politics was behind the extension.

“The fact is, we’re doing it because it make sense for insurers to have as clear a sense of the pool of consumers they gain in the market this year, before setting rates for next year,” Carney said.


November 23, 2013 by admin No Comments

The State of California has announced that cancelled health plans will not be an available option to the consumers for 2014, even though President Obama has given the states that option.

This ultimately seems like the best move for California because offering cancelled plans could destabilize the health insurance market place and actually cause even more problems, which I doubt people really want after all the problems that have already occurred. It is better to move forward and adjust accordingly rather than to hold on to something that is only going to last until next year anyway.

Some other good news for consumers is that the deadline for a plan to have a Jan. 1 effective date has been extended from Dec. 15 to Dec 23. This will also give people a few extra days to really make a decision now that some of the dust has settled with all the controversy over the cancelled plans possibly being offered.

Below is and article from Covered California’s website on their decision to not offer the cancelled health plans.


Covered California Upholds Original Deadline for Ending Health Plans That Don’t Meet Law’s Standards
Strong Enrollment in New Health Insurance Marketplace a Factor in Decision

SACRAMENTO, Calif. — As consumer enrollment continues to grow, the Covered California™ Board unanimously voted today to uphold its Dec. 31, 2013, deadline for health insurance companies to discontinue plans that don’t meet basic standards. The board cited that extending the deadline offers no benefit to the consumer and may create confusion about accessing affordable health care coverage through Covered California.

The board, consistent with President Barack Obama’s recommendations, also urged Covered California staff to implement helpful tools for consumers currently enrolled in affected plans, to better understand their options.

The decision to maintain the original deadline also confirms the state exchange’s commitment to transitioning Californians into plans that are compliant with the reforms of the Patient Protection and Affordable Care Act, protecting consumers from double deductibles and stabilizing the risk pool to control costs for consumers beginning in 2014.

Additionally, Covered California is implementing five key strategies to sustain, if not increase, its enrollment momentum and help affected consumers:

Extending the deadline for enrollment for coverage taking effect on Jan. 1, 2014, from Dec. 15, 2013, to Dec. 23, 2013, and extending the deadline for payments due from Dec. 26, 2013, to Jan. 5, 2014.
Establishing a telephone hotline for consumers to resolve enrollment questions. The hotline, (855) 857-0445, will be available beginning Monday, Nov. 25.
Sending information directly to nearly 1.13 million affected individuals that provides clear options for coverage. The information will be sent from Covered California and the individual’s current insurance provider.
Collecting and reporting data, on a regular basis, showing the impacts of conversion for individuals.
Engaging consumers in their communities through the thousands of Certified Insurance Agents, Certified Enrollment Counselors and Certified Educators now deployed statewide.

“The consumer is front and foremost in Covered California’s policy decision process. These new strategies will provide consumers a better enrollment experience, more flexibility in the selection of a plan and, most importantly, increased knowledge with which to make the best health coverage choice possible,” said Covered California Executive Director Peter V. Lee.

The board and Covered California staff discussed options for maintaining or extending the deadline after President Obama last week gave state insurance exchanges flexibility on when policies that were not grandfathered and are not compliant with the Affordable Care Act could be ended.

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