Consider two tasks:
1) Get the healthcare.gov web site to work by November 30.
2) Use legislation and regulations to enable people to keep their plans and keep their doctors.
I think that (1) is more likely to be achievable. Not that I am optimistic about (1), and today’s WaPo reports,
The insurance exchange is balking when more than 20,000 to 30,000 people attempt to use it at the same time — about half its intended capacity, said the official, who spoke on the condition of anonymity to disclose internal information. And CGI Federal, the main contractor that built the site, has succeeded in repairing only about six of every 10 of the defects it has addressed so far.
But there may be workarounds. A reader sent me this link to a story about web developers who created a site in two weeks that enables you to browse for plans to find the best one.
You can’t actually enroll on the HealthSherpa site, but they do provide contact information for companies offering the plans. Users who find a plan they like can go directly to the insurance companies without ever using HealthCare.gov.
On the other hand, “keep your plan, keep your doctor” seems to me a pretty hopeless case.
1. Even if Obamacare had never been enacted, it would have been difficult to back this promise. What is to stop an insurance company from deciding to tweak a plan or to get rid of it altogether? What is to stop a doctor from refusing to accept insurance from the given company, or from any company at all? These sorts of changes used to take place all the time, with or without Obamacare.
2. But now, the situation is FUBAR. The old plans no longer exist. In order to revive them, the insurance companies would have to have to put together brochures, mail them to customers, and give customers time to look them over and decide whether or not to renew. But before they can do that, the insurance companies have to go through the process of signing up health care providers, including negotiating agreements concerning compensation. But before they can do that, the insurance companies have to run their plans past regulators to make sure that they comply with whatever legislation/regulation the bureaucrats in Washington and the states come up with as they try to enforce “keep your doctor, keep your plan.” And before they can do that, regulations have to be written, go through a comment period, and published.
I would be surprised if this can be accomplished before health insurance cancellations take effect.
As well as the other problems you list, the insurance companies should be afraid that the grandfathered plans will again become illegal in 6-12 months.
I have always found the “you can keep it” discussion surreal. Isn’t a large point of Obamacare that everyone is forced into the public, nationally-approved system? Aren’t the “mandates” required to make it all work? What kind of mandate would it be if nobody has to change what they are already doing?
I’ve noticed that if my wife and I get a divorce and change nothing else about our living situation, she and our children get health insurance for $0 per month. A roughly $12,000 per year savings in after tax income.
Add to that, financial aid for college is based on the income of just one of the divorced parents.
Has anyone found analysis of the marriage penalty implied by ACA?
On the other hand, “keep your plan, keep your doctor” seems to me a pretty hopeless case.
This will blow over. I am sure that the politicians knew about this. My assumptions is that they rightly understood that people really hurt by this are few and mostly not swing voters. Many for example are small business owners the Democrats do not much of that vote anyway.
It would be interesting to see a “hearing” at which those testifying would be comprised of all of the individuals involved in determining the regulations resulting in the design of the non–“substandard” provisions required of policies to comply with Obamacare.
The hearings should be aimed at determining who how and why the determinations were made concerning the requirements for policy compliance.
It may yet happen.
In the event of doubt about FUBAR, project ahead to the requirements for the submission of actuarial data that will support the premiums to be required for the benefits required for years following the initial year of issue. We are likely to see the largest withdrawal of firms from offering healthcare contracts under the terms required by the PPACA. In addition, the losses that will be incurred on those policies issued during this initial period may turn out to be catastrophic for some issuers. Not enough attention has been paid to the impact on Medicaid.
In addition, the reorganization of provider networks shows all indications of potential collapse, even with further consolidations into hospital organized practices.
This piece of legislation is a ship in a field of icebergs from which it cannot navigate and exit and in which every icebergs has additional collision points beneath the surface.
What I would have done starting October 2 is come up with an alternate, offline way to calculate personal subsidy, and allow individuals to learn their number or carriers to determine it on their behalf, then let everyone shop directly with the carriers. From what I can see, the information available on the exchange site isn’t detailed enough to make a truly informed decision between plans anyway. The most important variability is in the physician and hospital networks, and insurance companies don’t make it easy to compare networks.