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Kevin Knauss: Health, History, Travel, Insurance

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Posts related to the implementation of the Affordable Care Act and potential changes to the rules, primarily in California.

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Greedy doctors kick patients out of their practices

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California doctors, upon finding that the new Covered California health plans may not reimburse them enough to maintain their vaunted lifestyle, are kicking existing patients with the new health insurance out of their practices. These doctors are the epitome of the maxim “Putting profits before people.” Most of these greedy doctors haven’t exercised the common decency to notify their current patients before their appointments that unless they have the right color of health insurance, they won’t be served.

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Covered California math error creates more delays

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In what has become routine for Covered California, they alerted agents to another CalHEERS enrollment website problem late on a Friday afternoon. The latest email notified agents that the system has been calculating the wrong Advance Premium Tax Credit (APTC) on submitted applications. While the Covered California email blast wasn’t real specific, it sounds like the APTC number is wrong when the applicant confirms the health plan purchase, but correct in the “Eligibility Results” page.

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Covered California’s SHOP not ready for occupancy

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The Small Business Health Options Program (SHOP) from Covered California has unfortunately proved itself to be just as inept at processing enrollments as the individual and family plan side. What promised to be a stream lined and easy process for small employer groups to offer health insurance to employees through Covered California is beset with a dysfunctional enrollment website and poorly trained support staff. They make Anthem Blue Cross’ decision not to offer plans through SHOP absolutely prophetic.

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What are the real Covered California enrollment numbers?

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Covered California has provided basic statistics and pretty pie charts on enrollment numbers into the ACA health plans that they offer. But what is left out is the statistical data that economists and demographers would like to have to ascertain if the Affordable Care Act is merely working or if it is actually fulfilling the promise to reduce health disparities in our communities with affordable health insurance.

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Health Net slashes agent commissions

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Health Net notified all their California agents by a letter dated January 29th, that effective March 1, 2014, they will slash the sales commission by over 50% on four of their five individual and family plans offered in California. This further reduction in compensation for agents since the ACA was passed continues to make customer service oriented health insurance agents a “family of dinosaurs” who will quickly become extinct.

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An alternative to the Individual Mandate

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The Individual Mandate of the Affordable Care Act psychologically chafes folks who don’t appreciate the government telling them what they have to purchase. Count me in that segment. If one of the goals of the Individual Mandate is to make people take responsibility for expensive health care, an alternative might be an unforgivable tax liability on those people who have chosen to forego health insurance and incur large medical expanses that go unpaid.

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Insurance companies deny health care with restricted networks

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When the insurance companies are having their risk for unexpectedly high health care expenses subsidized they should not have the luxury of creating tight doctor and hospital networks. The restrictions on network providers for cost containment purposes is exceptionally irritating when it is the plan members that are helping fund part of the risk reduction provisions by having to pay for the reinsurance fee on qualified health plans. Restricted networks and new EPOs are just a “work around” solution to allow health insurance companies to selectively limit health care like they have done in the past.

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IRS limits on ACA Advance Premium Tax Credit repayment

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One of the hidden dangers of the Affordable Care Act’s Advance Premium Tax Credit (APTC) provision to lower the cost of health insurance is the possibility of having too much tax credit issued for the tax payer’s final income. If the ACA applicant doesn’t report increases to the household income during the year, which triggers a corresponding decrease in premium assistance, the tax payer will be liable to pay the excess back. Fortunately, there are limits to the repayment of excess APTC based on household income.

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Covered California makes me want to vote Republican

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I’ve tolerated the many failures of Covered California until yesterday when they absolutely refused to help an applicant that has been left without health insurance. Miss B’s situation where her application has mysteriously become lost after allegedly being transmitted to the carrier is not unique to me or Covered California.

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Anthem Blue Cross California extends payment until January 31st

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At a hastily arranged conference call for insurance agents to address a variety of issues involving new individual and family health plans for California, the Anthem Blue Cross Regional Sales Manager for Northern California announced they were extending the payment deadline until January 31st for policies sold through Covered California with effective dates of January 1st, 2014. This is the third time Anthem has extended the deadline for new enrollments.

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