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Insurers Wary of Obamacare Administration

Posted Dec 15 2013 8:49pm

Stanley Feld M.D.,FACP,MACE

The government is dependent on the healthcare insurance industry for administrative services.

Obamacare’s success is dependent on the healthcare insurance industry selling insurance to consumers who buy insurance from the healthcare exchanges.

Several insurance companies have opted not to participate in the health insurance exchanges.

The companies that are participating are the companies that have figured they will make a killing. The killing will come if there is a minimum of administrative services and a maximum of consumers who present little risk.

The government has  a commitment to the insurance industry to pay the total cost of healthcare insurance to the healthcare insurance companies for all subsidized consumers.

If partially subsidized consumers do not pay the insurance company their premiums the lag time before the insurance company can drop that consumer can be up to a year.  The consumer can enjoy the coverage benefits of the policy at a loss to the healthcare insurance company.

It is almost impossible to know whom to believe or trust.

Is the Obama administration lying or is it the insurance companies?

What are the real numbers?

Who is insured?

 How many people have applied through the health insurance exchanges?

 How many people have been approved for coverage by the Obama administration?

 How many are approved for Medicaid?

How many people of the 5.5 million who lost coverage are now covered under Obamacare?

What percentage of Obamacare covered consumers will have a preexisting illness?

 How many people have paid their premium and will have insurance January 1, 2014?

How many people who have lost their insurance have signed up and paid their premium?

 How many people are getting subsidies?

 How much is the subsidy?

 How many people have bought non-subsidized private insurance from the health insurance exchanges?

None of the answers are easily available. 

If President Obama didn’t exempt group insurance policy holders’ from Obamacare for one year, the nation would be experiencing a greater disaster.  

The public is becoming wary of the misinformation. President Obama has lost the public trust.

The news of increasing problems with implementation of Obamacare is becoming boring. People are becoming more frightened. 

This is just where President Obama wants us. He wants us to give it over to the government.

Can we trust government to run the healthcare system? The answer is no!

America cannot afford this incompetence medically or financially.

The attitude of Obamacare fans is that it happened, the President is trying to fix it. Let’s live with it. It is the law of the land?

President Obama has even blamed the structure of government agencies for the screw up. It is not his fault.

This should be the precise argument for why the government should not run the healthcare system. 

He might have found a way to shift the blame.  A New York Times/CBS poll said President Obama's approval rating is improving at the same time all the other polls said it has fallen below 39%.

Both the NYT and CBS are big Obama fans. Again, what is the truth?

The healthcare insurance industry is screaming bloody murder. There is no back end to the web site. There are errors in applications. One error begets another error. The insurance companies, rather that make a killing, will lose their shirt.

President Obama promised to make them whole without the companies providing evidence of loss.

Insurers say they don't know the full extent of back-end problems with healthcare.gov and are wary of the Obama administration’s claims they are fixing the issues quickly.

President Obama and White House officials are trumpeting new fixes to the Obamacare website, saying they met a self-imposed Nov. 30 deadline to deliver a smooth user experience to the vast majority of Americans trying to enroll in the online insurance exchanges.

As of December 13,2013 at least 20% of the applications have been plagued with problems.

“Insurers and federal officials sifting through insurance applications under the health-care law have identified a raft of errors , including missing customers and inaccurate eligibility determinations that mean people may be enrolled in the wrong coverage.”

 “In some cases described by a state official with knowledge of the matter, legal immigrants who aren't yet eligible for Medicaid in were nevertheless told they would be enrolled.”

The Obama administration has provided few details on the remaining back end technical bugs. These bugs are preventing insurance brokers from enrolling people in coverage. There is a great difference between applying for coverage, enrolling in coverage and finally obtaining coverage.

www.Healthcare.gov is supposed to transmit 834 forms to the insurer of the consumer’s choice by computer.

Insurers have either received these forms riddled with errors or not at all. They cannot possibly issue insurance to people who have applied and have sent incomplete or inaccurate information to the insurer.

The Department of Health and Human Services urged insurers to help avoid Jan. 1 mix-ups. The Obama administration modified coverage rules. Officials asked the healthcare insurance industry to cover people retroactively who missed paying for the premiums by January 1 because of defective applications. The Obama administration has asked the insurance industry to pay for drugs next month, even for customers who haven't yet fully enrolled.

This is not a good way to run a business. The Obama administration seems to be playing it by ear. They are changing the requirements of the law daily. Obama fans say it is a pragmatic adjustment. Others say it is unconstitutional. President Obama, you cannot play both sides of It’s “the law game.”

Insurance-industry executives warn, that some of these data problems will only emerge once customers begin seeking care in January at physicians' offices, pharmacies and hospitals.

  The result could be bureaucratic chaos as doctors and patients storm insurers' phone banks and federal officials work to clean up the inaccuracies.

 The National Association of Health Underwriters sent a letter to President Obama on Tuesday asking him to fix a bunch of back-end obstacles.

  “We want to make it clear that a number of back-end technical obstacles still exist for health insurance agents and brokers trying to actively support the federal marketplace,” she wrote.

“Agents and brokers would like to help increase marketplace enrollment as much as possible over the next few months, but technical barriers prevent them from doing so.”

I think everyone gets this point.

However, a more important point is that if this has happened with the web site can we trust the government to have control over the large slice of our economy that healthcare represents?

More importantly, can we trust the government to make our medical care decisions for us?

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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