Expect Snags in Affordable Care Act Rollout (With Links to Additional Information)
Earlier this week I attended a workshop for Ohio Benefit Bank volunteers. All sessions I attended addressed different aspects of the Health Insurance Exchange. The take home message was that while there are challenges, there is hope that overall ObamaCare will do more good than bad.
It is very important to go to reliable resources for unbiased and timely information about ObamaCare
I strongly recommend the resources** listed below
There will be glitches when the major provisions of the Affordable Care Act are implemented starting Oct. 1. Huge glitches. Many glitches. Bet on it.
That is a prediction not only from those resolutely opposed to the ACA. Even those quite excited about President Barack Obama’s federal health law have the same expectation: The rollout of the biggest new social program in nearly 50 years is not going to be pretty.
“When you’re dealing with tens of millions of new clients, mistakes are inevitable,” said Henry Aaron, a health economist at the Brookings Institution. “You’re going to have thousands of mistakes.”
“People can make comparisons to Medicare Part D and to Medicare itself, but nothing this big has ever been tried.”
In the simplest terms, the task at hand is to enroll 16 million currently uninsured Americans into health insurance plans or an expanded Medicaid. That process begins Oct. 1 with coverage starting Jan. 1.
Although Americans have until the end of March to sign up for health insurance, a crush of demand at the very start could overwhelm exchange call-in centers, websites and personnel. No one will say this out loud, but administrators are hoping for a steady trickle rather than a flood, at least in the early going.
All of the eligibility determinations and subsidy calculations will require a seamless transfer of information. The exchanges will have to interact with the U.S. Treasury for income information. They will have to communicate with the Department of Homeland Security to verify citizenship. And all this information must be handled without violating the privacy of consumers.
“CMS (the Centers for Medicare and Medicaid Services) has designed and tested a system that they think is going to work, and they know where the risks and vulnerabilities are,” said Charlene Frizzera, president of her consulting firm, CF Health Advisors, and a former acting administrator of CMS. “The question is, how will they deal with those vulnerabilities they anticipated and those they haven’t anticipated?
Dennis G. Smith, also a former head of what is now CMS, believes one weak point will be in the calculation of Medicaid eligibility. He believes it is likely that the exchanges and state Medicaid offices will use different formulas or time frames for determining eligibility, leading to frustration and confusion for many consumers.
“Exchanges will send a whole bunch of people to Medicaid and Medicaid will say ‘Nope, they don’t qualify,’ and send them back to the exchanges,…
states with federal exchanges are doing no outreach at all, which raises the possibility that residents of those states will remain uninformed and do nothing.
Even people who get the message may arrive at the exchanges having never before purchased health insurance and unfamiliar with the way premiums, co-pays and deductibles work. Others may lack documentation proving citizenship, residency and income.
Perhaps the question that causes the most trepidation in the Obama administration is whether healthy young people will sign up for health insurance as the ACA requires. Because young people tend to be healthy and file relatively few insurance claims, their premiums are supposed to help pay for claims of older, sicker people. If the only people buying insurance are old and the sick, insurance premiums will be prohibitively expensive…
- Health Reform: Seven Things You Need to Know (Consumer Reports) - 15 pages with topics as newly enacted protections and benefits,what to expect in 2014, essential benefits defined, and how it will affect you
- Insurance Marketplace with links on information and how to enroll
- FAQ pages (Learn – All Topics ) from Healthcare.gov (U.S. Department of Health and Human Services) include
- Health Reform (Kaiser Family Foundation)
- Health Reform-Beyond the Basics (A Project of the Center on Budget and Policy Initiatives)
- Online health insurance exchange gearing up quietly in Mo. and Illinois (stltoday.com)
- Lookout for scams related to the Affordable Care Act (quinnscommentary.com)
- What to expect as Affordable Care Act comes into effect (wwltv.com)
- Affordable Care Act enrollment begins Oct. 1 (kgw.com)
- Obamacare to help, but not poorest in states that rejected Medicaid expansion: Tennessee, Georgia (timesfreepress.com)
- Obamacare Hasn’t Drastically Decreased Uninsured Rate (nation.time.com)
- For millions, insurance will cost less than $100/month (usatoday.com)