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NYC employees not getting breast pumps because of ACA exemption

Posted by Olog-hai on Sat Mar 8 20:52:03 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d
NYDN

Mom must pay up for breast pump despite Obamacare mandate

Despite a provision in the Affordable Care Act requiring health insurance plans to cover the lactation device, city employees' grandfathered plans are not buying them.

By Corinne Lestch
Saturday, March 8, 2014, 6:30 PM
When Jessica Steinhart gave birth to her son Lyle in January, she thought the breast pump she needed would be covered by her husband's health insurance.

But her husband is a public school teacher, and city employees’ insurance companies don’t pay for the $300 lactation device despite a new provision in the Affordable Care Act that requires many plans to cover it.

"Why would it be any different for city employees? I'm angry," said Steinhart, 34, of Park Slope. "I can't even secure the tools that I need in order to return to work."

The Obamacare provision covering breast pumps and other preventive-care services kicked in starting Jan. 1, 2013.

The city is not violating the new healthcare law because plans already in effect before Obamacare passed can be exempt from some of the law's regulations.

Aligning to Obamacare’s requirements to cover such services without co-payments — which could cost tens of millions — will be part of negotiations starting this week between the city and unions, officials said.

"We recognize this is an important issue," city spokeswoman Marti Adams said.

"The city is not legally required to cover breast pumps, but once they lose grandfather status, they will be required to provide it," said Anna Benayo, senior health policy analyst at the National Women's Law Center. "It's not about a date and time the plan has to be ungrandfathered. It's more about changes in the plan that trigger whether they lose that status."

Doctors say the breastfeeding tool helps women who can't be with their baby all the time, especially for those who need to return to work quickly.

They also say nursing helps reduce a host of health problems, including respiratory diseases and childhood obesity.

N. Tanya Ohly, an instructor in obstetrics and gynecology at Columbia University Medical Center, argues that moms who can't get breast pumps covered by their insurance are facing a major disadvantage.

"It's already overwhelming to take home a newborn," she said. "And then to sort out the details of your insurance plan and whether you can get a breast pump, it's extremely aggravating."


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Re: NYC employees not getting breast pumps because of ACA exemption

Posted by italianstallion on Sat Mar 8 23:25:32 2014, in response to NYC employees not getting breast pumps because of ACA exemption, posted by Olog-hai on Sat Mar 8 20:52:03 2014.

fiogf49gjkf0d
So?

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Re: NYC employees not getting breast pumps because of ACA exemption

Posted by SelkirkTMO on Sat Mar 8 23:58:22 2014, in response to Re: NYC employees not getting breast pumps because of ACA exemption, posted by italianstallion on Sat Mar 8 23:25:32 2014.

fiogf49gjkf0d
This is a breakthrough! Olog is now endorsing ACA and explaining why bad insurance policies had to go and be replaced with ACA. What's not to like? ;)

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Re: NYC employees not getting breast pumps because of ACA exemption

Posted by LuchAAA on Sun Mar 9 00:25:10 2014, in response to Re: NYC employees not getting breast pumps because of ACA exemption, posted by italianstallion on Sat Mar 8 23:25:32 2014.

fiogf49gjkf0d
you're all worked up even after Italian Day?

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Re: NYC employees not getting breast pumps because of ACA exemption

Posted by italianstallion on Sun Mar 9 18:00:15 2014, in response to Re: NYC employees not getting breast pumps because of ACA exemption, posted by SelkirkTMO on Sat Mar 8 23:58:22 2014.

fiogf49gjkf0d
My thoughts exactly.

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Re: NYC employees not getting breast pumps because of ACA exemption

Posted by SelkirkTMO on Sun Mar 9 18:05:06 2014, in response to Re: NYC employees not getting breast pumps because of ACA exemption, posted by italianstallion on Sun Mar 9 18:00:15 2014.

fiogf49gjkf0d
Olog ... an enigma wrapped in a crêpe. :)

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Re: NYC employees not getting breast pumps because of ACA exemption

Posted by italianstallion on Sun Mar 9 18:06:58 2014, in response to Re: NYC employees not getting breast pumps because of ACA exemption, posted by SelkirkTMO on Sun Mar 9 18:05:06 2014.

fiogf49gjkf0d
Or a crap.

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Re: NYC employees not getting breast pumps because of ACA exemption

Posted by SelkirkTMO on Sun Mar 9 18:17:12 2014, in response to Re: NYC employees not getting breast pumps because of ACA exemption, posted by italianstallion on Sun Mar 9 18:06:58 2014.

fiogf49gjkf0d
It's pronounced "creepy." :)

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Charlie Crist: "God bless" POTUS for ACA (Crist = SMAZ??)

Posted by Olog-hai on Mon Mar 10 13:30:05 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d


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Re: Charlie Crist: ''God bless'' POTUS for ACA (Crist = SMAZ??)

Posted by italianstallion on Mon Mar 10 16:59:52 2014, in response to Charlie Crist: "God bless" POTUS for ACA (Crist = SMAZ??), posted by Olog-hai on Mon Mar 10 13:30:05 2014.

fiogf49gjkf0d
Crist leading current GOP Gov. Scott by 7 to 30 points, depending on the poll.

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Casino workers are no fans of ACA

Posted by Olog-hai on Thu Mar 13 01:25:40 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d
CNN Money

Why casino workers hate Obamacare

By Tami Luhb
March 11, 2014: 2:58 PM ET
Casino workers are preparing to strike against several Las Vegas establishments, but their real target is President Obama.

Culinary Workers Union Local 226 is pushing about a dozen of its employers to contribute more money to its health insurance fund to cover rising Obamacare costs.

Currently, employers pay 100% of the premiums. The union, which is in contract negotiations, wants to keep it that way. But the spike Obamacare-related expenses could make it tougher to convince employers to pony up more money.

Union workers picketed outside the Stratosphere over the weekend, ahead of a March 20 vote that would give the union the right to call a strike.

At issue are Obamacare fees and mandates that have greatly increased the health insurance fund's expenses in recent years. What's angering the local, along with many unions nationwide, is that the fund doesn't qualify for federal subsidies to cover low-income workers that for-profit insurers do. The union fund wants these subsidies to help offset the added costs.

Those subsidies, which go directly to insurers, help lower-income Americans purchase insurance on the individual market through state and federal exchanges. But since union plans are considered employer-sponsored plans, there is no federal money to subsidize its members.
So far, White House officials have not made an exception for the unions.

"The administration has made change after change to meet other groups' needs," said Yvanna Cancela, the local's political director, noting the union would like to see the president keep his promise. "Our members want to keep their health plans."

Many unions, who supported President Obama's push for health reform, feel betrayed because the administration failed to accommodate their health insurance funds in the Affordable Care Act. These plans, called Taft-Hartley funds for the regulations that govern them, cover 20 million Americans and pool contributions from multiple employers to provide health and pension benefits for their members.

The Local 226 fund provides health insurance for about 55,000 kitchen workers, housekeepers, bartenders, bellman, porters, laundry workers and others, as well as 70,000 dependents. Employers contribute $3.96 per worker per hour to cover health and pension benefits. Workers don't pay a premium, but are responsible for about 10% of their out-of-pocket medical costs.

Since Obamacare was passed in 2010, the culinary union's fund has had to shell out $23 million to cover members' children up to age 26, Cancela said. And this year, it is facing a transitional reinsurance fee of $63 per insured person, which adds another $7 million to the cost. The reinsurance fee reimburses insurers on the exchanges who face high claim costs.

But since union members can't strike against the White House, it is pressing its employers to boost their contributions by 35 cents per worker in the first year, 50 cents in the second and 55 cents in the third. So far, the union has reached agreement with five casino operators, leaving 7,000 union members with expired contracts.
If the remaining employers don't agree to the terms, the union may strike.

Ultimately, the local and its umbrella organization, Unite Here, want the Taft-Hartley plans to be considered qualified to participate on the Obamacare exchanges and receive subsidies. Those federal payments will help defray the costs of the Obamacare mandates and fees.

But that is not an easy step, said Tim Jost, a health law professor at Washington and Lee University School of Law. The insurers on the exchange are providing plans to people who aren't getting coverage through their employers.

"The key reason they can't participate in the exchanges and receive federal subsidies is that they are not individual market plans. They are group plans," Jost said, of the union funds.


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Re: Casino workers are no fans of ACA

Posted by SelkirkTMO on Thu Mar 13 01:36:57 2014, in response to Casino workers are no fans of ACA, posted by Olog-hai on Thu Mar 13 01:25:40 2014.

fiogf49gjkf0d
So ... by posting this, you're showing your solidarity with socialist union workers (because it blasts Obama as you see it) and believe that unions SHOULD get taxpayer money in subsidies ...



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Re: Casino workers are no fans of ACA

Posted by Dan Lawrence on Thu Mar 13 10:22:31 2014, in response to Re: Casino workers are no fans of ACA, posted by SelkirkTMO on Thu Mar 13 01:36:57 2014.

fiogf49gjkf0d
You do know that Olog-hi is 100% crazy!!!

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Limited doctors mean limited care under ACA ("if you like your doctor"???)

Posted by Olog-hai on Fri Mar 21 02:30:58 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d
CNN Money

Got Obamacare, can't find doctors

By Tami Luhby
March 19, 2014: 10:28 AM ET
Terri Durheim and her family now have health insurance, thanks to Obamacare. What they don't have are local doctors and hospitals who will take it.

This worries the Enid, Okla., resident since she has a teenage son with a serious heart condition. They now have to find a pediatric cardiologist in Oklahoma City, more than an hour away.

And if there's an emergency … "obviously we'd have to pay out of pocket and go here in town, but that defeats the purpose of insurance. I'm truly grateful we have insurance. It's reasonable and affordable, but it's not doing me a lot of good," said Durheim, who just had to drive 90 minutes to Stillwater, Okla., for a CAT scan for herself. "It's so frustrating."

Like Durheim, many Americans who've enrolled on the Obamacare exchanges are realizing they have access to a relatively limited set of doctors and hospitals. In many areas, the largest hospitals are not participating and many doctors are not accepting the coverage.

That's by design. To keep premiums down for silver and bronze plans, insurers narrowed the networks of doctors and hospitals, often excluding the priciest and most specialized providers.

"The unavoidable truth is that health care costs are growing faster than people's income," said Sara Collins, a vice president for the health care coverage and access program at the Commonwealth Fund. "Narrow networks are a reflection of that."

Limiting access to providers isn't new, but it is becoming more common as the Obamacare exchanges expand coverage to more people. So many people have complained that the Obama administration said last week it will require insurers in 2015 to maintain networks that provide enrollees with access to doctors "without unreasonable delay."

McKinsey looked at how hospital access in 20 cities has changed over the past year for those buying individual policies. Last year, 33% of the offerings contained narrow networks. This year, the same carriers are offering more policies, but 68% of the options have limited networks.

Narrow networks were defined in the study as those with fewer than 70% of the city's top 20 hospitals participating.

Narrow networks, however, don't mean inferior care, said Jessica Ogden, associate partner in McKinsey's healthcare practice. The hospitals in the narrower networks scored similarly in the Centers for Medicare and Medicaid Services' quality and patient satisfaction metrics.

Some Americans, particularly those who were uninsured before, may not care if they can only go to certain providers. But others are dismayed that their current doctors aren't in the plans or that they can't go to the ones they think are best for them. Still, others say there are local doctors listed in their networks, but they can't get appointments or the providers aren't accepting new patients.

Compounding the problem is that many enrollees had a tough time getting the list of providers in particular plans in the exchanges. Some had technical trouble accessing the information, while others found the lists were inaccurate or incomplete.

That's what happened to Durheim, who owns a small appliance store with her husband. She called her doctors and hospitals, who said they take Blue Cross Blue Shield. So she picked a silver preferred plan with a low deductible for $328 a month.

Her mistake, she acknowledged, was that she didn't look specifically at the provider network for "preferred" plans on the Blue Cross website, instead searching the network for all tiers Blue Cross offers. So she didn't realize that these providers don't take her plan until she wanted to use it.

Blue Cross Blue Shield of Oklahoma said that she can upgrade the policy to a "choice" plan, which may cost her between $50 and $100 more a month, through healthcare.gov. But the site will not let her switch, and the exchange representatives said she'll have to wait until next year. A Blue Cross spokeswoman said the insurer will help her switch plans now.


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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by gp38/r42 chris on Fri Mar 21 02:39:22 2014, in response to Limited doctors mean limited care under ACA ("if you like your doctor"???), posted by Olog-hai on Fri Mar 21 02:30:58 2014.

fiogf49gjkf0d
This actually happened to a woman I know too.She did wind up switching to more exexpensive plan when she realized the local hospital and her doctors didn't take the originalplan. Her pper Obama plan was dropped and now she pays double what she did pretty ahca.
So much foe this lowering costs....she pays double.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 02:40:52 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by gp38/r42 chris on Fri Mar 21 02:39:22 2014.

fiogf49gjkf0d
Ain't that nice. When she goes broke, at least she can qualify for Medicaid (and starve to death instead).

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by SelkirkTMO on Fri Mar 21 02:44:14 2014, in response to Limited doctors mean limited care under ACA ("if you like your doctor"???), posted by Olog-hai on Fri Mar 21 02:30:58 2014.

fiogf49gjkf0d
Welcome to "coverage by insurance companies" instead of a national health plan. Insurance companies are still playing the same old tired game except for where the law prohibits them from not paying at all.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 03:13:35 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by SelkirkTMO on Fri Mar 21 02:44:14 2014.

fiogf49gjkf0d
This is a national health plan, or so they claim. The insurers had to jump through hoops just to comply with the big mess.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by gp38/r42 chris on Fri Mar 21 03:17:52 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Olog-hai on Fri Mar 21 03:13:35 2014.

fiogf49gjkf0d
Exactly.

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(1166244)

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by SelkirkTMO on Fri Mar 21 03:18:41 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Olog-hai on Fri Mar 21 03:13:35 2014.

fiogf49gjkf0d
No, this is the "compromise" ... Teddy Kennedy wanted Medicare for all, and THAT shit's still working.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by SelkirkTMO on Fri Mar 21 03:18:56 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by gp38/r42 chris on Fri Mar 21 03:17:52 2014.

fiogf49gjkf0d
False.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 10:14:38 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by SelkirkTMO on Fri Mar 21 03:18:41 2014.

fiogf49gjkf0d
LOL! We know about the single-payerists. This is why Britain had to have private health insurance on top of NHS. No shortage of NHS horror stories, and you want that here.

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Pelosi: "It's called the Affordable Care Act", versus Obamacare

Posted by Olog-hai on Fri Mar 21 11:04:28 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d
I can see why you never ask God to bless Nancy Pelosi.



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Ezekiel Emanuel (ACA "architect"): Vast majority of employers will drop healthcare coverage

Posted by Olog-hai on Fri Mar 21 12:25:08 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d
NY Times

In Book, Architect of Health Law Predicts a Shift Away From Employer Coverage

By John Harwood
March 20, 2014
Ezekiel J. Emanuel, who helped devise the Affordable Care Act, has a vision for how it will eventually work. Democrats hope it will not materialize anytime soon.

Mr. Emanuel expects the law to produce an unadvertised but fundamental shift in where most working Americans get their health insurance — specifically, a sharp drop in the number of employers who offer coverage to their workers. That scale of change would dwarf what took place last fall, when a political firestorm erupted over President Obama’s “if you like your plan you can keep it” pledge.

His former colleagues in the Obama White House say there is no evidence the law will bring “the end of employer-sponsored insurance,” as Mr. Emanuel puts it in his new book with the mouthful of a title, “Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System.”

The law fines large companies that do not offer health coverage, but most have voluntarily offered coverage for many years. The proportion of Massachusetts employers offering health coverage actually increased when the state passed a similar health law a few years ago.

But now Mr. Emanuel thinks that a number of well-known national companies will break the mold and begin a trend. By his estimation, the proportion of private-sector workers who receive health care from employers will fall below 20 percent by 2025. Currently, just under 60 percent of private-sector workers get health care from employers.

“It’ll be a matter of a few big employers, blue-chip companies,” Mr. Emanuel said in an interview. “Then it’s going to be the norm.”

Mr. Emanuel, the brother of Rahm Emanuel, the mayor of Chicago and Mr. Obama’s former chief of staff, said that shift “will be a good thing” by helping control costs and enhance consumer choices. He concluded that “you might put it under positive, unintended consequences.”

Many health experts, both liberal and conservative, agree that it would be a good thing.

The American system of employer-provided health insurance was an accident of history spawned by wage controls during World War II. Employers were limited in giving employees raises, so many decided to reward workers with heavily subsidized health care instead. Since then, the practice has been widely blamed for limiting choice and accelerating health cost inflation.

Right now, an end to employer-paid health care is about the last thing Democrats want, especially as they face midterm elections in a defensive crouch after the administration’s bungled rollout of the health care law last fall. “It would be a big, big problem politically,” said Jonathan Gruber, an M.I.T. health economist who also advised the White House on the law.

Would-be health reformers have long struggled with how much change American consumers and voters will accept. In 2008, Senator John McCain of Arizona, the Republican presidential candidate, experienced the dangers when he proposed a plan eliminating the tax break for employer-provided health coverage — and faced blistering “tax increase” attacks from Mr. Obama.

As president, Mr. Obama intended his program to limit the number of changes required. He grafted expanded coverage and changes in the individual insurance marketplace onto the existing system rather than building an entirely new one. He also left mostly undisturbed the much larger employer-provided insurance market, which currently serves an estimated 149 million people. “If you’re happy with it and your employer’s happy with it, keep it,” the president said at one point.

But Mr. Obama included a feature sure to make some employers less happy: To help finance his plan and constrain health costs, he reversed course and supported a new tax, beginning in 2018, on the most generous health care plans that some large companies provide.

Mr. Emanuel argues that this “Cadillac tax,” along with taxpayer subsidies now available for Americans with modest incomes, will expand and accelerate the trend away from employer-provided health care.


Even though the health law’s “employer mandate” requires that companies with 50 or more workers pay a penalty of $2,000 per employee if they do not provide health care, many large companies now spend far more than that to offer coverage. As a result, Mr. Emanuel says they will be able to pay the penalty, give workers a raise and shed the burden of providing coverage by sending workers to the public exchanges.

“By 2025, few private-sector employers will still be providing health insurance,” Mr. Emanuel writes in his book.

So far, his view remains an outlier among health policy experts. “There’s not going to be massive erosion” in employer-provided coverage, Mr. Gruber said. Similarly, White House advisers argue that large companies will continue to view health coverage as a crucial competitive tool for attracting the best employees. The Congressional Budget Office has projected a comparatively modest drop affecting three to five million people annually by 2019.

Avik Roy, a senior fellow at the conservative Manhattan Institute who advised Mitt Romney’s Republican presidential campaign in 2012, said shifts would be most likely among retailers and restaurants with heavy concentrations of low-wage workers eligible for public subsidies. But if it happens, a large-scale shift would give Republicans a fat new political target. They would argue that Mr. Obama had once again expanded the role of government, forced taxpayers to subsidize a growing number of workers “dumped” onto exchanges and further misled the country to win passage of the law.

Mr. Roy hopes fellow conservatives will react with restraint, not out of sympathy for Mr. Obama but because the shift would bring a market-friendly improvement to American health care. “He did lie, and he should be held accountable,” Mr. Roy said. But, he added, “It’s a better world where people shop on their own.”

The caveat is that a switch from employer-provided health care will become an issue only if the public exchanges evolve into the easy-to-navigate, Amazon-style marketplaces the Obama administration promised in the first place. Mr. Obama says the public exchanges are operating smoothly as the March 31 deadline for 2014 coverage approaches, but for Mr. Emanuel’s vision to be realized, they have to be.

“A lot of that’s going to depend on how good the exchanges are,” said Mr. Emanuel, who now teaches health policy at the University of Pennsylvania. With consistent attention, he insists, government can solve the technical problems just as major retailers have.

“Zappos didn’t put up a website and go home,” he said.


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Almost half of Covered California callers give up (ACA/Medicaid)

Posted by Olog-hai on Fri Mar 21 12:46:41 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d
LA Times

Half of callers to Covered California give up as deadline looms

By Chad Terhune
March 20, 2014, 5:39 p.m.
Nearly half of callers to California's health insurance exchange in February and March couldn't get through and abandoned their call, state figures show.

Those service woes could worsen as more people try to beat the March 31 deadline to get Obamacare coverage under the Affordable Care Act.

Also Thursday, the Covered California exchange reported progress on another front: low enrollment among the state's large Latino population.

At its monthly board meeting, the exchange said 32% of health plan enrollees in the first two weeks of March described themselves as Latino. That was up from 18% during the first three months of enrollment that ended in December.

"That is a very substantial increase," said Peter Lee, executive director of Covered California.

Robert Ross, an exchange board member, applauded those gains with Latinos, but he expressed disappointment at the low sign-up rate among African Americans. It stood at less than 3% of health plan enrollment through mid-March.

California has led the nation with more than 1 million people enrolled in health plans through March 17, and it's a bellwether state for the national rollout of the healthcare law.

An additional 1.5 million Californians have enrolled or been deemed eligible for an expansion of Medi-Cal, the state's Medicaid program for the poor.

On the service front, Lee said the exchange has been able to reduce wait times on the phone from about 50 minutes to 30 minutes. The state has hired more call-center workers and added phone capacity in preparation for a last-minute rush.

Still, less than 5% of calls are answered within 30 seconds and about a third of callers get a busy signal, state data show. Overall, 40% of exchange customers surveyed said they found the enrollment process difficult.

Covered California has also been criticized by its certified enrollment counselors for payment delays. The exchange pays $58 for every successful enrollment by a counselor.

The state doesn't pay them directly. Rather, it pays certified enrollment entities, which are primarily nonprofit groups, community organizations and clinics that oversee many of the 5,100 enrollment counselors statewide.

The exchange said the first payments were sent March 14, and it attributed the delay to the logistics of “getting a new system up and running along with a high volume of enrollments.”

Covered California is considering an increase to the $58 fee after hearing complaints from field workers. Many of them have said that amount doesn’t adequately compensate them for the level of work involved.

The complexity of the healthcare law and the amount of information consumers must sort through often requires considerable time and multiple discussions before a person can complete the process.


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Biden: Obama fit "for sainthood" w.r.t. ACA rollout (Biden = SMAZ?)

Posted by Olog-hai on Fri Mar 21 13:24:17 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d
The Hill

Biden: After healthcare rollout pains, Obama fit 'for sainthood'

By Justin Sink
March 21, 2014, 11:47 am
Vice President Biden told healthcare workers that "patience and empathy" are required to deal with frustrated ObamaCare enrollees and that the president demonstrated saint-like levels of both during the rollout.

Speaking to a conference of community health centers in New York, Biden conceded that enrolling in ObamaCare could be "tedious," and early problems with HealthCare.gov worsened the problem.

"We didn't help you much at the front end here, man," Biden said, adding that he wanted to recommend President Obama "for sainthood" because he maintained his patience through the early technical problems with the website.
"The president and I were as frustrated as anyone you ever knew," Biden said.

But the vice president pressed navigators helping individuals through the enrollment process to reassure those purchasing insurance that "there's no reason to be embarrassed that it's complicated."

"You look these people in the eye. And the first thing you do is, you calm them down," Biden advised.

"How many people you'd spoken to you can tell by the look on their face they're almost embarrassed to ask you the questions?" Biden asked. "Because they don't want to feel stupid. … You dispel their fears; you put them at ease; and you walk them through the process."

Biden said it would be foolish to think enrolling "would not be difficult for people who never, ever, ever had insurance."

"Anybody ever thought this was going to be easy never, ever had insurance," Biden said. "Seriously. Assume you're a very wealthy person; you can buy whatever insurance you want. It's a complicated business. It's a complicated business. It doesn't matter whether you have a GED or a Ph.D."

The vice president's comments came amid a last-ditch push by the administration to enroll uninsured Americans before the March 31 open enrollment deadline.

On Thursday, President Obama pitched the law during appearances on "Ellen" and ESPN Radio. The administration also recruited athletes, including Tony Hawk, Kevin Durant, Carmelo Anthony, Dwayne Wade, and David Ortiz, to promote the law on their Twitter accounts.

The Department of Health and Human Services said earlier this week that more than 5 million individuals had enrolled through federal and state exchanges.


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Re: Almost half of Covered California callers give up (ACA/Medicaid)

Posted by italianstallion on Fri Mar 21 13:38:34 2014, in response to Almost half of Covered California callers give up (ACA/Medicaid), posted by Olog-hai on Fri Mar 21 12:46:41 2014.

fiogf49gjkf0d
Incredibly high demand for Obamacare.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by italianstallion on Fri Mar 21 13:40:35 2014, in response to Limited doctors mean limited care under ACA ("if you like your doctor"???), posted by Olog-hai on Fri Mar 21 02:30:58 2014.

fiogf49gjkf0d
A fix is coming:

"the Obama administration said last week it will require insurers in 2015 to maintain networks that provide enrollees with access to doctors "without unreasonable delay." "


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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by italianstallion on Fri Mar 21 13:42:55 2014, in response to Limited doctors mean limited care under ACA ("if you like your doctor"???), posted by Olog-hai on Fri Mar 21 02:30:58 2014.

fiogf49gjkf0d
I found it hilarious when people like you post such articles. You don't give damn about people who never had insurance before and now have it, yet you post articles that criticize Obamacare for supposedly letting such people down. Execrable.

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ACA (www.healthcare.gov) "glitch" raises premiums drastically for those eligible for tax credits

Posted by Olog-hai on Fri Mar 21 13:50:59 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

fiogf49gjkf0d
Philadelphia Inquirer

A glitch in Obamacare marketplace no one noticed

Don Sapatkin, Inquirer Staff Writer
Last updated: Friday, March 21, 2014, 1:08 AM
Posted: Thursday, March 20, 2014, 9:26 PM
Nearly six months after the disastrous launch of Healthcare.gov, with the website running smoothly and more than five million people signed up as open enrollment heads to a close, a new glitch has come to light: Incorrect poverty-level guidelines are automatically telling what could be tens of thousands of eligible people they do not qualify for subsidized insurance.

The error in the federal marketplace primarily affects households with incomes just above the poverty line in states like Pennsylvania that have not expanded Medicaid. The mistake raises the price of their insurance by thousands of dollars, making insurance so unaffordable many may just give up and go without.

The error, which The Inquirer discovered while running scores of income scenarios through Healthcare.gov, again raises questions about the site's accuracy that made daily headlines in early winter and that have cost President Obama considerable political capital.

It also highlights what some public policy experts say is a troubling lack of transparency in the marketplace's eligibility determinations.

"It is almost impossible to work back from a decision and see what they did," said Judy Solomon, vice president for health policy at the Center on Budget and Policy Priorities in Washington. Ideally, she said, a notice would say, "We have found that your income for 2014 will be X, and based on that income your tax credit will be Y."

But the official determination letters simply state the amount of your tax credit and resulting insurance premium. "I would have no idea if it's right or wrong," Solomon said.

Neither she nor other national and local health-policy analysts had noticed that the site's window-shopping tool was relying on poverty guidelines for the wrong year. Nor, apparently, had the Centers for Medicare and Medicaid Services (CMS), which oversee Healthcare.gov

"This tool is intended only to be used as an unofficial estimate that consumers could use before completing their application, which is where they get their official determination," Richard Olague, a CMS spokesman, said in a brief statement Thursday night.

"While there is a small difference between the poverty levels from year to year, we will change this tool for clarity. We encourage consumers to complete their marketplace application, where they will get an accurate determination of their tax credits."

Analysts outside CMS, however, said many if not most visitors to the site probably heed the government's advice and use the tool before applying. If it responds "not eligible," they might not go any further.

"I wonder if CMS has the capacity to recontact people," said Timothy Jost, a health specialist at Washington and Lee University law school.

'It doesn't help'

Most health-policy experts agreed with CMS's statement that formal applications would not be affected.

"I think this will all reconcile. But it doesn't help somebody who doesn't think they are eligible," said Robert Laszewski, a former insurance-industry executive who is president of Health Policy and Strategy Associates. "It's just another one of those, 'Why did they do that?' "

He predicted the public would react to the news with a sense of deja vu: "They screwed it up again. Can't do anything right."

Though many of the website's early issues had to do with its complexity, in this case the error was simple: It's the wrong year's data.

At issue is the set of federal poverty guidelines used to determine eligibility for financial assistance. The guidelines, based on a combination of income and household size, are raised every January to keep pace with inflation. Hundreds of state and federal programs are using the new 2014 poverty levels to assess eligibility on a particular date for public benefits like food stamps and Medicaid.

The federal marketplace works more like commercial health insurance, and its open-enrollment period spans the last three months of last year and the first three of this year. The Affordable Care Act specified using 2013 poverty guidelines to determine subsidies this year.

Healthcare.gov is using the higher 2014 guidelines for its window-shopping tool.

In theory, tens of millions of people are getting wrong information nationwide. The new income guidelines are just 1.5 percent higher on average than the old, but the marketplace is designed so small income changes trigger corresponding subsidy differences.

And consumers whose incomes slightly exceed the high end of eligibility initially discover they are eligible for tax credits to lower their premiums. In theory, accepting a tax credit for which you're not eligible could make you liable for unpaid income tax when the IRS processes the return, said Jocelyn Guyer, a director at Manatt Health Solutions who helped states that set up their own marketplaces.

In practice, however, as people click through the website to view their insurance options, a different calculator gives more specifics — and correctly says financial assistance is not available.

Though 400 percent of poverty is the ceiling for subsidies, 100 percent is the floor. A couple who enter an income of $15,600 — 101 percent of poverty in 2013 — into the window-shopping calculator get this response, in big, bold letters: "Not eligible for help paying for coverage."

If they ignored the message and clicked through to view the plans, another tool would correctly indicate they may qualify for a tax credit of $760 a month to lower their premiums, or more than $9,000 a year. Additional cost-sharing savings in the form of discounted deductibles, co-pays, and coinsurance add up to $8,000 to $10,000 more, depending on the plan.

"I hadn't seen that before," Brian Haile, senior vice president for health policy at Jackson Hewitt, said of the errors.

Haile did some back-of-the-envelope calculations using data from the Census Bureau's Current Population Survey to estimate how many people might be seriously affected. He concluded about 70,000 uninsured with household incomes in the sliver that separates the 2013 and 2014 poverty levels live in states that have not expanded Medicaid, and so might have gotten the incorrect response. That includes 5,000 Pennsylvanians.

In Pennsylvania and other non-expansion states, marketplace subsidies begin at 100 percent of poverty.

But in states like New Jersey that accepted the law's expansion of Medicaid up to 138 percent of poverty, marketplace subsidies for most people begin where Medicaid ends.

At other sites

And because Medicaid determinations are based on 2014 poverty levels — the same year the marketplace uses in error — people at the low end of poverty in those states would not have encountered the problem. The website responds correctly with their Medicaid eligibility.

Some states chose to run their own marketplaces. It was unknown Thursday night whether any had made the same error; a spot check of Covered California found that state-run marketplace was correct. All those states have opted to expand Medicaid, so the impact would be minimal anyway.

Healthcare.gov is not the only website to make this mistake. The calculator at Independence Blue Cross' site also used the wrong guidelines until a reporter asked about them this week. A spokeswoman said its vendor had mistakenly included marketplace responses when it updated the tool with 2014 poverty guidelines for Medicaid.

And HealthSherpa.com, a popular site that offers detailed information akin to the government site, discovered it was using the wrong year last week, a cofounder said.

The Kaiser Family Foundation's calculator has been correct all along.

But every applicant for financial assistance must go through the federal website to get a subsidy; the main exception is if people call the 800 number, and operators there work with Healthcare.gov.

"I have to say, I probably would have made the same mistake if I were in charge," said Laszewski, the former industry executive. "But they're not supposed to make that mistake."


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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 13:53:32 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by italianstallion on Fri Mar 21 13:42:55 2014.

fiogf49gjkf0d
LOL! When all else fails, switch to Alinskyite bullshit.

Not my fault that the mainstream media is piling on. There are very few cases of "people who never had insurance before and now have it" (the media can't seem to find those people either; it ain't my fault that the media is accentuating the extremely negative (and it is extreme). You're too old to have to grow up now; you shoulda done that a half-century ago.

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Re: Almost half of Covered California callers give up (ACA/Medicaid)

Posted by Olog-hai on Fri Mar 21 13:57:40 2014, in response to Re: Almost half of Covered California callers give up (ACA/Medicaid), posted by italianstallion on Fri Mar 21 13:38:34 2014.

fiogf49gjkf0d
Yeah, induced demand due to all those forcibly-canceled policies in spite of the "if you like your plan, you can keep your plan" lie.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Fred G on Fri Mar 21 14:28:59 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by italianstallion on Fri Mar 21 13:42:55 2014.

fiogf49gjkf0d
Those people are just political markers to them, just like the unemployed, veterans and the working class. Money comes first, then dogs, then people :)

Your pal
Fred

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by SelkirkTMO on Fri Mar 21 14:51:07 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Olog-hai on Fri Mar 21 10:14:38 2014.

fiogf49gjkf0d
According to you guys, we already HAVE it here. :)

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 15:02:48 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Fred G on Fri Mar 21 14:28:59 2014.

fiogf49gjkf0d
Yes, markers for libs, who happen to not be helping them.

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(1166371)

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 15:05:10 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by SelkirkTMO on Fri Mar 21 14:51:07 2014.

fiogf49gjkf0d
Who said that?

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 15:07:06 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by italianstallion on Fri Mar 21 13:40:35 2014.

fiogf49gjkf0d
Sure; "fix" it by fiat. Until it's "broken" again. Doesn't undo the "if you like your doctor/healthcare plan" fiasco.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by SelkirkTMO on Fri Mar 21 15:10:03 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Olog-hai on Fri Mar 21 15:07:06 2014.

fiogf49gjkf0d
If you like your doctor, choose the insurer that put them in their network. These are laissez faire times, caveat empty. :)

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Re: ACA (www.healthcare.gov) ''glitch'' raises premiums drastically for those eligible for tax credits

Posted by SelkirkTMO on Fri Mar 21 15:11:35 2014, in response to ACA (www.healthcare.gov) "glitch" raises premiums drastically for those eligible for tax credits, posted by Olog-hai on Fri Mar 21 13:50:59 2014.

fiogf49gjkf0d
Good old private sector IT ... they shoulda let government handle the code.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 15:13:00 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by SelkirkTMO on Fri Mar 21 15:10:03 2014.

fiogf49gjkf0d
Majority of times, they are not available. And even if you really could, the canceled plans do not undo "if you like your healthcare plan, you can keep it" . . .

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Re: ACA (www.healthcare.gov) ''glitch'' raises premiums drastically for those eligible for tax credits

Posted by Olog-hai on Fri Mar 21 15:14:24 2014, in response to Re: ACA (www.healthcare.gov) ''glitch'' raises premiums drastically for those eligible for tax credits, posted by SelkirkTMO on Fri Mar 21 15:11:35 2014.

fiogf49gjkf0d
LOL! From DC's lips to Lucifer's ears.

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(1166381)

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by SelkirkTMO on Fri Mar 21 15:18:17 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Olog-hai on Fri Mar 21 15:05:10 2014.

fiogf49gjkf0d
You and a bunch of others ... yeah, let's go back to paying out the ass for scam insurance and when you actually need it, you get refused and stuck with the bills. MUCH improvement there.

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by SelkirkTMO on Fri Mar 21 15:19:13 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Olog-hai on Fri Mar 21 15:13:00 2014.

fiogf49gjkf0d
Are you like ... on your period or something? :-\

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Re: ACA (www.healthcare.gov) ''glitch'' raises premiums drastically for those eligible for tax credits

Posted by SelkirkTMO on Fri Mar 21 15:25:51 2014, in response to Re: ACA (www.healthcare.gov) ''glitch'' raises premiums drastically for those eligible for tax credits, posted by Olog-hai on Fri Mar 21 15:14:24 2014.

fiogf49gjkf0d


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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Fred G on Fri Mar 21 16:22:40 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Olog-hai on Fri Mar 21 15:13:00 2014.

fiogf49gjkf0d
What did you do for your health plan? The 3 options I had all let me keep my doctor and dentist.

your pal,
Fred

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Fred G on Fri Mar 21 16:28:23 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Olog-hai on Fri Mar 21 15:02:48 2014.

fiogf49gjkf0d
Trying to help. You righties hate us for it.

your pal,
Fred

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

Posted by Spider-Pig on Fri Mar 21 17:08:43 2014, in response to Ezekiel Emanuel (ACA "architect"): Vast majority of employers will drop healthcare coverage, posted by Olog-hai on Fri Mar 21 12:25:08 2014.

fiogf49gjkf0d
It's about fucking time.

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

Posted by Olog-hai on Fri Mar 21 18:07:38 2014, in response to Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage, posted by Spider-Pig on Fri Mar 21 17:08:43 2014.

fiogf49gjkf0d
Sounds like something a "fucking" statist would say. LOL! You really wanna get sick and not have coverage, then that's what you'll get.

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(1166416)

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Re: Limited doctors mean limited care under ACA (''if you like your doctor''???)

Posted by Olog-hai on Fri Mar 21 18:10:54 2014, in response to Re: Limited doctors mean limited care under ACA (''if you like your doctor''???), posted by Fred G on Fri Mar 21 16:22:40 2014.

fiogf49gjkf0d
I sense "exemption".

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

Posted by Fred G on Fri Mar 21 18:11:18 2014, in response to Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage, posted by Olog-hai on Fri Mar 21 18:07:38 2014.

fiogf49gjkf0d
No separating health insurance from wages is good.

Your pal,
Fred

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