Kevin Knauss: Health, History, Travel, Insurance
Posts related to the implementation of the Affordable Care Act and potential changes to the rules, primarily in California.
Families that didn’t have their insurance cancelled by the ill-fated Covered California forced policy cancellation of December 31 are now wrestling if they should make their current health plan premium for January. The utter lack of communication between Covered California and the health plans has left many families without knowing if they do or don’t have health insurance.
A pregnant Bay Area woman who applied for health insurance through Covered California in November and has yet to receive any notification from her selected health plan or Covered California must now consider cancelling her prenatal doctor visits for lack of insurance. When asked about the status of the woman’s application a Covered California call center staffer said that it can take weeks for the insurance companies to receive the application. Essentially, Covered California has decided to ignore the woman, her family and unborn baby.
The Affordable Care Act regulations preclude individuals and families from receiving tax credits to lower health insurance premiums bought through an exchange if they are offered employer sponsored health insurance that is deemed to be affordable and meets minimum value. This rule is actually denying some families access to affordable health insurance and is set to penalize other families with a huge IRS tax bill in 2015.
The Affordable Care Act is failing families on two major issues that need immediate resolution. The employer sponsored health insurance regulation has left many spouses without affordable coverage and household income limits are placing children in Medicaid programs. Together, these two ACA regulations are unfairly fracturing the health insurance coverage for many families and need immediate changes.
I will happily attend any public enrollment event and assist anyone applying either for Medi-Cal or a health plan with or without premium assistance. However, hence forth, I will not attend any event where Certified Agents are allowed to discriminate against people based on their income and Medi-Cal eligibility. Further, if anyone is refused assistance from an agent because they might be Medi-Cal, please do us all a favor and report that agent to Covered California. Income discrimination practiced by Certified Agents needs to stop.
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
The California Assembly Republican Caucus has declared that people with pre-existing conditions are the root cause of escalating health care costs. From their statements on their website Covering Health Care: A California Resource Guide, one can only come to the conclusion that California Republicans feel that sick people should be denied guarantee issue health insurance so premiums of healthy people won’t be adversely affected.
So many words have been spoken and written about the Affordable Care Act there is hardly an angle that hasn’t been touched. Obamacare101 podcast produced by Staci Joy is a well balanced presentation that features several different Californians that are touched by the ACA and Covered California, the state’s health insurance marketplace. Just like the ACA itself is controversial, some of the sincere comments by those recorded for the Obamacare101 podcast may leave one thinking, “Did he just say that?”
I had just finished the family’s application into a new Covered California health plan when I realized that we hadn’t chosen a pediatric dental plan for their son. I had that sinking feeling when I screw up an application…or did I? According to a customer service agent, Covered California hasn’t released the children’s dental plans.
The eligibility requirements to receive premium assistance for the new ACA health plans offered through either the federal or state websites is based on a household’s estimated income in 2014. Past federal tax returns are a great starting point and guide, but an individual or family’s wages may have significantly changed in 2013 and may change again in 2014.
