Obamacare News of the Day

Washington Post: Healthcare.gov can't handle appeals of enrollment errors

• Roughly 22,000 Americans have filed appeals with the government to try to get mistakes corrected, according to internal government data obtained by The Washington Post. They contend that the computer system for the new federal online marketplace charged them too much for health insurance, steered them into the wrong insurance program or denied them coverage entirely.
• For now, the appeals are sitting, untouched, inside a government computer. And an unknown number of consumers who are trying to get help through less formal means — by calling the health-care marketplace directly — are told that HealthCare.gov’s computer system is not yet allowing federal workers to go into enrollment records and change them, according to individuals inside and outside the government who are familiar with the situation.
• The Obama Administration has not made public the fact that the appeals system for the online marketplace is not working. In recent weeks, legal advocates have been pressing administration officials, pointing out that rules for the online marketplace, created by the 2010 Affordable Care Act, guarantee due-process rights to timely hearings for Americans who think they have been improperly denied insurance or subsidies.
• The exchange is supposed to allow consumers who want to file appeals to do so by computer, phone or mail. But only mail is available. The roughly 22,000 people who have appealed to date have filled out a seven-page form and mailed it to a federal contractor’s office in Kentucky, where the forms are scanned and then transferred to a computer system at CMS. For now, that is where the process stops. The part of the computer system that would allow agency workers to read and handle appeals has not been built, according to individuals familiar with the situation.

Huffington Post: Millions Are Now Realizing They're Too Poor For Obamacare [Much of the usual liberal claims about expanding Medicaid or else people die in this column; however he comes close to making a good point when he suggests that the Obamacare exchange subsidies are not available to those below the Federal Poverty Level (FPL). In fact, many of the intended beneficiaries of Obamacare subsidies (in Medicaid expansion states 138% of FPL through 400% of FPL and in non-Medicaid expansion states 100% of FPL through 400% of FPL) will not get subsidies because of the way they are structured; a rough estimate suggests it could be more than one million people. Sadly, many poor people fed up with Medicaid won't be able to access a private health plan because the exchange subsidies are aimed at the middle class.]

• For those who don't qualify for Medicaid coverage, Obamacare offers tax credits for private health plans sold through the law's health insurance exchange marketplaces. But those subsidies are available only to those making between the poverty level, or about $11,500 for an individual, and four times that amount. In states not expanding Medicaid, people who earn less than poverty wages get nothing.

Wall Street Journal: Administration Weighs Extending a Change to Health Law

• The Obama administration said Friday that it is considering ways to extend into 2015 efforts to prevent consumers whose health coverage changes from suddenly losing access to particular doctors.
• Federal officials announced in December that they were “strongly encouraging” insurers to continue covering at standard rates patients’ visits to doctors they had seen under their old policies, even if those doctors weren’t part of a new plan’s network.
• The White House official said one option being weighed is whether health insurers’ procedures for letting patients stay with familiar providers, and the accuracy of their provider directories, should be a condition of selling coverage through the exchanges.

Dr. Gottlieb, Forbes: New Filing Shows How Much Money Obamacare Plans Are Losing [Republicans have labeled the "three Rs" (reinsurance, risk adjustment and the most notorious risk corridors) as insurance company bailouts. It turns out that insurance companies have, not shockingly, built the taxpayer funded bailout into their premiums. Meaning, once these subsidies expire or are repealed, premiums and/or deductibles are going up]

• The insurer Wellpoint put out data today about its California health plans that will bolster these “bailout” arguments. The filing from Wellpoint shows how much money the insurer is bleeding ["an average 16% increase in the premiums charged for grandfathered health plans sold in California this year. The hikes will take effect April 1 for some 300,000 consumers who currently have health plans they purchased in the individual market."] on the Obamacare plans, and how much reinsurance money is be used to offset these losses.
• Wellpoint is assuming in its proposed rates that its ObamaCare-compliant health plans (sold both on and off the exchange) will be very unprofitable for 2014, but for the anticipated recoveries from the reinsurance fund. Wellpoint’s projections for non-grandfathered plans includes expected reinsurance recoveries of 10.8% of premium.
• This also suggests that insurance premiums will continue to rise well into the future, as these various reinsurance mechanisms start to sunset, and insurers have to make up the difference. By 2016, the $25 billion reinsurance fund is expected to wind down entirely. Right now, without those subsidy dollars, these plans lose money for the foreseeable future.

Politico: House GOP considers tying debt hike to Obamacare

• During a closed meeting at their retreat here Friday morning, rank and file Republicans seemed to be gravitating toward trying a lift in the borrowing limit to the cancellation of the the so-called risk corridors and reinsurance fund in Obamacare. Both provisions are meant to limit the risk insurers have to take and prevent premium spikes. Advocates for the Affordable Care Act say these items are needed to help insurers balance the cost of accepting more patients.

Michael Barone, Wall Street Journal: How Obamacare Misreads America