What Color Was Your Volvo?

The Obamacare health insurance exchange is expected to be operational on 10/1/2013.

The key word here is expected.  

But to get past the first steps you may think you are being grilled by Sgt. Joe Friday.

The potential for problems will begin as soon as would-be buyers log onto their state exchange. They'll enter their name, birth date, address and other identifying information. Then comes the first IT handoff: Is this person who she says she is?

 To check that, credit bureau Experian will check the answers against its voluminous external databases, which include information from utility companies and banks on people's spending and other history, and generate questions. The customer will be asked which of several addresses he previously lived at, for example, whether his car has one of several proffered license plate numbers, and what color his old Volvo was.

It's similar to the system that verifies identity for accessing personal Social Security information. If someone gets a question wrong, he will be referred to Experian's help desk, and if that fails may be asked to submit documentation to prove he is who he claims to be.

CSMonitor

I have trouble remembering passwords for online accounts. And those challenge questions can throw you for a loop.

Give the name of the third pet you owned. (Does a goldfish count as a pet?).

Provide the name of your youngest third cousin on your mother's side.

Yeah, this can be a lot of fun for those wanting a subsidy.

Fortunately you are not REQUIRED to buy on the exchange. There will be a lot more offerings and richer plans OFF exchange.

The answers must be returned in real time, before the would-be buyer loses patience and logs off. If the reported income doesn't match the IRS's records, the applicant may have to submit pay stubs.

These federal computer systems have never been connected before, so it's anyone's guess how well they'll communicate.

Or if they will communicate . . .

The federal hub has to verify even more arcane data, such as whether the insurance offered to a buyer through his job is unaffordable, in which case he may qualify for federal subsidies, and whether the buyer is in prison, in which case she is exempt from the mandate to purchase insurance.

If someone's income qualifies him for Medicaid, or his children for the Children's Health Insurance Program (CHIP), software has to divert him from the ACA exchange and into those systems. Many of the computers handling Medicaid and CHIP enrollment are, as IT people diplomatically put it, "legacy systems," meaning old, even decades old.

What's the problem? Doesn't the NSA have all this?

I think Sen. Max Baucus' assessment was generous. Train wreck doesn't begin to describe what lies aheas.

In the news....

■ Is one ever too young to buy life or disability insurance? There are certainly some compelling reasons to do so: depending on the policy type, one can lock in much lower rates for a long period of time. And of course, it guarantees that you have at least some protection in place should your health go south. The WSJ has more.

■ Back in the day, President Obama promised that rates would decrease by 3000%. As we now know, that was, um....optimistic to say the least. Blue Grass blogger David Adams reports that "the Kentucky Department of Insurance has leaked data showing health insurance premiums under ObamaCare will increase by an average of eighty percent at the start of 2014"

■ And speaking of the WSJ, they also report something we've noted for a while now:

"The long-term-insurance industry now is shrinking, premiums are soaring and there is no fix in sight."

There are, of course, a number of contributing factors at work here, most notably retention and claims.

Hunh?

Here's the thing: Long Term Care insurance (LTCi) is most similar to disability insurance in terms of complexity and benefits. So it stands to reason that many (most?) carriers who've been in the market for a while based at least some of their rate structure on assumptions carried over from the DI side. One of those is "retention;" that is, how many policies stay in force over the long haul. It appears that many more folks have kept their LTCi plans than the carriers had anticipated.

Which sets up the next problem: claims. If more folks are holding onto their policies, then more folks than expected are experiencing claims. And the cost of care isn't abating, either, which tends to create a vicious cycle.

■ And finally, a while back we brought you the news that 3d printers were helping to fashion new organs. Apparently, that was only the beginning:

"Damaged bones could be fixed with a new technique that involves 3D printing ... if a child had a jawbone defect, you could take an image of the defect, feed it into a computer and print a replacement to precisely fill the defect using the patient's own cells"

Very cool.

[Thanks to FoIB Holly R and Gail S for their news tips]

What if your carrier exits the market and there is no exchange to fall into?

United Health just announced they are exiting the CA individual market.

http://www.latimes.com/business/la-fi-unitedhealth-insure-calif-20130702,0,4370321.story

"The nation's largest health insurer, UnitedHealth Group Inc., is leaving California's individual health insurance market, the second major company to exit in advance of major changes under the Affordable Care Act.

UnitedHealth said it had notified state regulators that it would leave the state's individual market at year-end and force about 8,000 customers to find new coverage. Last month, Aetna Inc., the nation's third-largest health insurer, made a similar move affecting about 50,000 existing policyholders."

That is 58,000 individuals/families that will not have insurance January 1st, 2014. Most will have no choice but to sign up in the Exchange. I have heard a number of people speculate that the government will push back  the start of the Exchanges as they will not have them ready in time. If they do, what happens to all these people whose carrier has exited the market?

This is the problem with comprehensive solutions like ACA: you miss on one part and you crash (or at least damage) the entire system. A more logical bill would have created the Exchanges without all the impact on the existing market until they were up and running smoothly. That way, if they missed, the impact would have been minimal.

This announcement also doesn't bode well for competition and choice. It appears the regulation is so onerous that even with 8000 or 50000 members it is not worth competing in the market. If established players don't want to join in, I can't imagine many upstarts wanting to give it a try.

Obamacare Gold Mine

Obamacare subsidies are a gold mine for those who know how to game the system and you can bet there are plenty of folks who are experts.   

Many "special ed" children live in foster homes. The foster parents receive monthly stipends for each child in addition to SSI. Often the parents qualify for other forms of government assistance including Medicaid, SCHIP and EIC.

Each program has guidelines and forms that must be completed. Many times the parents only sign the forms. Someone else, someone they paid to help in filling in the blanks, entered the answers. These "assistants" will charge $400 or more and guarantee you will get the maximum allowed for your situation.

Often these assistants work in the school or a welfare agency. In addition to their salary they have a sideline business completing forms. Some will make $30,000 - $40,000 or more in their sideline business.

All cash.

They complete the forms but never sign or file them. Once the form is done you pay for the completed work then it is your responsibility to file the form.

If there is ever an issue it is your responsibility to deal with the blow back.

Obamacare subsidies are just another government gold mine.

If you doubt this, consider how the federal government paid out an estimated $500 million in fraudulent Katrina claims to roughly 134,000 people who were ineligible.

Many did not own homes or live anywhere near the affected area.

This is not an isolated event.

A recent investigation by the Inspector General revealed the IRS paid over $46 million in tax refunds to 24,000 illegal aliens living at the same address.

The IRS sent 11,284 refunds worth a combined $2,164,976 to unauthorized alien workers at a second Atlanta address; 3,608 worth $2,691,448 to a third; and 2,386 worth $1,232,943 to a fourth.

How incompetent do you need to be to blow this much money in a short amount of time?

Any time there is a new government give away there are folks ready, willing and able to take advantage of the ineptitude of the federal government pig trough.

Obamacare and the subsidies are no different.

Big Hat, No Cattle

The folks in Texas have a saying.                      

Big hat, no cattle.

A phrase used to describe someone  or some thing that makes a lot of noise (brags) but has nothing of substance.

The U.S. Chamber of Commerce published a report on The Path Forward for Health Care Reform. Some of the tidbits.

The Mission:

To achieve greater value in health care, as measured by more affordable coverage options and greater access to higher-quality, prevention-oriented care, leading to better population health and sustainable U.S. health care costs. By prioritizing efforts to improve the employer-sponsored health system which covers millions of Americans, we will use these solutions to drive system-wide changes.

As Emily Litella would say, "Isn't that special?".

Sounds great but offers nothing you can, uh, hang your hat on.

The recommended changes released by the Chamber’s Health Care Solutions Council include:

-Facilitating and rewarding better coordination among all providers – nurses, hospitals, specialists, and primary care doctors;-Advancing efforts to define quality simply and clearly so that providers understand the metrics by which they will be measured;-Removing barriers to easily understandable and comparable information on the cost and quality of health care services;-Encouraging consumers to use this information to make health care decisions based on careful consideration of the expense and the likely outcome;-Protecting the ability to buy (or offer) affordable health care coverage that promotes higher-value care in the near term; and-Applying the lessons of these private sector reforms to improve Medicare and Medicaid by providing better care to the rapidly growing beneficiary populations served by these programs entitlement programs; and supporting innovations in the employer-sponsored system.

You need a secret decoder ring to figure that one out. 

Is There an App For That?

Obamacare needs people under 30, especially the healthy ones, to buy health insurance in droves if this master plan stands a chance of working. Without the under 30 crowd the rate structure will start to collapse.  

So why did Congress come up with a plan that increased rates on the under 30 crowd significantly more than those that are 50 and up?

Still waiting on a good answer to that one, along with a lot of other questions.

Less than 64% of employees under 30 working for large companies sign up for health insurance when it is offered by their employer, compared with at least 76% of all employees over 30, according to a new report by benefits administrator ADP. And Americans ages 18 to 34 are the least likely of any age group to be insured:

MarketWatch

I see no reason why Obamacare rates and benefits is going to change any of this, and the nominal penalties (greater of 1% of income or $95) certainly won't strike fear in the hearts of these young "adults".

As much as 70% of a company’s workforce doesn’t use any health coverage at all in a year, Ryan says, but insurance plans still need their contributions to pay for those who use more.

Not surprising.

Stats similar to this have been around for a long time. Which of course leads to the argument, "Why should I pay for something I never use?".

Anyone who has been around a while can answer that, but trying to tell the young, invincible crowd they need to buy health insurance is an uphill battle.

Not my "yob", man.

Et tu, Marian?

Last week, Bob asked a very crucial question: why, if it's such a great idea (and a requirement), "is the government still trying to sell the public on the greatness of Obamacare?"

It's a great question, especially in light of this:

"Up to 17,000 U.S. libraries will be part of the effort to spread the word about the [ObamaTax] ... The library association ... appears to be all in"

What, exactly, qualifies librarians as experts on health insurance? And why are my (municipal) tax dollars going to promoting a national law train wreck? Most important, of course, is why is this even necessary?