Will Obamacare get its act together in time?

[giblets]

I guess they could enroll people in the exchanges by snail mail while they're still trying to figure out how the internet works.

[The Mad Monk]

Now that the mandated requirements are on line, insurance companies are canceling the plans that don't make the cut.

Health insurance cancellation notices soar above Obamacare enrollment rates
4:16 PM 10/24/2013

Katie McHugh


Hundreds of thousands of Americans who purchase their own health insurance have received cancellation notices since August because the plans do not meet Obamacare’s requirements.

The number of cancellation notices greatly exceed the number of Obamacare enrollees.

Insurance carrier Florida Blue sent out 300,000 cancellation notices, or 80 percent of the entire state’s individual coverage policies, Kaiser Health News reports. California’s Kaiser Permanente canceled 160,000 plans — half of its insurance plans in the state — while Blue Shield of California sent 119,000 notices in mid-September alone.

Two major insurance carriers in Pennsylvania, Insurance Highmark in Pittsburgh and Independence Blue Cross in Philadelphia plan to cancel 20 percent and 45 percent of their total plans, respectively.

Nearly 800,000 New Jersey residents’ health-care plans will not longer exist in 2014, forcing insurers to create new ones for individuals and small business owners that hew to the Obamacare’s new regulations, The New Jersey Star Ledger found in early October.

“I don’t feel like I need to change, but I have to,” Jeff Learned, a television editor in Los Angeles, told Kaiser Health News. Learned now needs to scramble to find a plan to coverage his teenage daughter, whose health problems have required several surgeries.

More Americans have lost their individual health coverage in Florida and California than have gotten past the login screen on HealthCare.gov, according to The Washington Post, which reports that 476,000 applications have “been started,” but not completed. HealthCare.gov’s dysfunctional website has helped enrollment grind to almost a complete halt. (RELATED: HealthCare.gov contractor: We had only two weeks to test site)

But it’s difficult to determine exactly how lopsided the rates of cancellations versus the rates of enrollment are — the Obama administration jealously guards the official enrollment numbers, refusing to release them to even the law’s loyal Democratic supporters.

“It’s screwed up,” New York Rep. Charlie Rangel said of the White House’s secretive maneuvers.

Several states have released Obamacare enrollment data, however, revealing extremely low rates. South Dakota reported that only 23 people enrolled in the exchanges, a mere 0.0000276 percent of that state’s population. North Dakota enrolled only 20 residents.

Alaska, meanwhile, comes in at seven total enrollees, or 0.00000957 percent of Alaskans.

Sources inside the Department of Health and Human Services told The Daily Mail that only 6,200 Americans signed up for coverage the day HealthCare.gov launched, while only 51,000 applied in the first week. (RELATED: Obama administration will not release number of Obamacare enrollees on opening day)

During his campaign to pitch the law to voters back in 2009, President Barack Obama vowed that Obamacare would merely lower costs for Americans with health insurance while providing coverage to the uninsured.

“[N]o matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period,” Obama said to an audience at the annual conference of the American Medical Association. “If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.”

“Again, [the Affordable Care Act] is for people who aren’t happy with their current plan. If you like what you’re getting, keep it. Nobody is forcing you to shift,” he later added.

Read more: http://dailycaller.com/2013/10/24/he...ollment-rates/

[Berzerker]

so Obama didn't tell the truth when he said we could keep our insurance plans?

[The Mad Monk]

Yes, but that's okay, because if we were smart we would have known it was impossible and just a platitude anyway.

[Sava]

ZOMFG ITS PANDEMONIUM

[The Mad Monk]

Yes, yes it is.

[DinoDoc]

ZOMFG ITS PANDEMONIUM

[Sava]

[DinoDoc]

White House Thrilled With Record Number Of People Who Thought They Signed Up For Healthcare

[Dinner]

This will be a big problem in deep red states like Mississippi.

http://america.aljazeera.com/articles/2013/10/27/mississippi-obamacare.html

[Captain ******* Kirk]

It will be a problem in all 36 states that rely on some degree of federal assistance to run their marketplaces, not all of them red states.

[Dinner]

Drake, there is an especially big problem in Mississippi mostly because the people are so ignorant of the realities of the ACA and because so many of them don't even have computers or internet access. I mean they still haven't even gotten into the 1980's yet. :\

Another big problem is native Americans and how so many of them don't know anything about the ACA and have never even heard of it.

http://america.aljazeera.com/watch.html

[The Mad Monk]

That's okay because they don't have to sign up anyway.

Affordable Care Act a hard sell for Native Americans
Christine Vestal, Pew/Stateline Staff Writer 3:01 p.m. EDT October 15, 2013
country doctor 2010

(Photo: Jack Gruber, USA TODAY)
Story Highlights

Native Americans are guaranteed free health care, won't face penalty if they don't buy insurance
The 5.2M Native Americans have less access to health care than the rest of the U.S. population
Health insurance exchanges could give them access to care beyond tribal facilities

For most uninsured Americans, the motivation for checking out the health insurance exchanges is simple – they could face stiff penalties if they don't sign up. For Native Americans, the decision is more complicated.

Longstanding treaties with the federal government guarantee all Native Americans free health care. As a result, the Affordable Care Act exempts them from paying a penalty if they choose not to purchase insurance. More than 2 million Native Americans receive free health care at federally supported Indian health facilities. Many others receive care from tribal facilities and urban Indian organizations.

So why would an American Indian or Alaska Native sign up for reduced-rate insurance on the exchanges?

Indian health advocates said the benefits are many. "It's an unprecedented opportunity," said Roxane Spruce Bly, who is working with New Mexico's health insurance exchange to provide outreach to Native Americans. "It's the biggest thing to happen in Indian health in my lifetime. It solves so many problems for Indian people."

Although tribal members are entitled to free health care, most Indian health facilities do not offer a full array of services. When patients need major surgery or cancer treatments, for example, they are referred to specialists outside of Indian lands. At least two-thirds of those referral claims are rejected, Bly said. That puts Indians at risk of either paying major medical bills themselves or doing without needed treatments. In addition, about half of Native Americans live in urban areas that are great distances from tribal health facilities.

As a group, the nation's 5.2 million Native Americans have poorer health and less access to health care than the rest of the U.S. population. Their uninsured rate is nearly 30 percent, compared to 15 percent for the country as a whole. And nearly half of all Indians have incomes low enough to qualify for Medicaid in states that have chosen to expand coverage, according to the Center on Budget and Policy Priorities. More than 1 million Native Americans are already enrolled in Medicaid.

Still, Bly and others said the idea of purchasing health insurance, even if deeply discounted, is a foreign concept for most tribal members. Even optimistic advocates for Indian enrollment in the exchanges said convincing tribal leaders and individuals to sign up could take years. Bly's goal is to sign up 10 percent of New Mexico's eligible Native Americans by the end of 2014.

Special advantages

The ACA includes provisions for American Indians and Native Alaskans that make purchasing insurance on the exchange an even better proposition than it is for everyone else. They can sign up at any time – there are no open enrollment deadlines. Tribal members with incomes below 300 percent of the federal poverty level ($34,470 for an individual) are exempt from paying deductibles and copays, so they can purchase the cheapest plans without worrying about out-of-pocket expenses. All tribal members, no matter what income level, are exempt from out-of-pocket payments if they receive services from Indian health facilities. And unlike employers, tribes can pay exchange premiums for their members without paying taxes.

In addition, a separate law that has governed Native American health care for decades – the Indian Health Care Improvement Act – was amended when the ACA was signed. New provisions make it easier for Indian health facilities to accept payments from other insurers, including Medicaid, Medicare and private insurance. The new law also expands the types of services the facilities can offer and requires inclusion of behavioral health and substance abuse treatments.

For Indians enrolled in Medicaid, Indian health providers receive a fee-for-service that is much higher than other providers receive. In addition, they can collect fees from private insurers if Native Americans take advantage of the exchanges.

“They haven't had the greatest experience with government programs in the past”
— Ed Fox

The new income sources are expected to help Indian health facilities expand and improve their services. Some, for example, do not now include dentistry or deliver babies. Few offer preventive services. According to a 2011 Centers for Medicare and Medicaid (CMS) report, the Indian Health Service budget—$4.2 billion in 2010—"is only sufficient to provide about half the necessary health services required."

Ed Fox, a member of a tribal advisory group to the CMS, estimates the ACA could result in as much as $4 billion in additional revenue for Indian health services. But that's only if tribal leaders take advantage of it, he said.

A tribal member himself, Fox conducts outreach meetings with tribal leaders in Washington state. He said so far the leaders he's talked with plan to wait and see what other tribes do about the health insurance exchanges before they make a decision.

"They haven't had the greatest experience with government programs in the past," Fox said. If he walks into a meeting and says, "I'm with the federal government and I'm here to help you," most tribal leaders simply laugh.

Medicaid expansion

In states that expand Medicaid in January, enrolling newly eligible Native Americans will be less of a challenge than selling the exchange concept. But it will still take substantial state and federal outreach and education, an effort that is required by the ACA.

According to a report from the Government Accountability Office, Native American enrollment in Medicaid could double under the expansion.
States with the most Native Americans

13 states with the highest Native American populations.
Source: Census Bureau
Anne Godlasky, USA TODAY

But the GAO said the CMS and the Indian Health Service are not doing enough to spread the word about health insurance exchanges and new Medicaid coverage. States are also responsible for getting the word out.

In New Mexico, Medicaid director Julie Weinberg said members of her staff have been crisscrossing the sparsely populated state since August and have visited more than 200 tribal locations. The agency has also purchased radio, print and television ads. "It ends up being fairly costly," Weinberg said. "We're digging way down deep into our administrative budget to do the outreach."

Montana and California have received a federal Medicaid waiver to directly reimburse tribal leaders for Medicaid expansion outreach efforts. Alaska and Washington have pending waiver requests, and three other states are interested, according to the GAO report.

In general, the federal government will pay 100 percent of all costs for newly eligible Medicaid enrollees for the first three years. After that the federal share tapers to 90 percent. Traditionally, however, the federal government has paid 100 percent of all Medicaid costs for Native Americans.

"The most important thing for state administrators," said Carolyn Ingram of the Center for Health Care Strategies, "is to talk to tribes early and often." She and others agree that most individual Native Americans are not likely to take full advantage of the health law without the support of their tribal elders.

Stateline is a nonpartisan, nonprofit news service of the Pew Charitable Trusts that provides daily reporting and analysis on trends in state policy.

edit: they moved it, so I quoted it.

[DinoDoc]

This will be a big problem in deep red states like Mississippi.

http://america.aljazeera.com/article...obamacare.html

Take heart. We're doing better than Oregon from your PoV.

Cover Oregon: some significant progress fixing health exchange: still no enrollment; feds delay penalty deadline

[Captain ******* Kirk]

in Mississippi ... so many of them don't even have computers or internet access. I mean they still haven't even gotten into the 1980's yet.

1. This is a laughable and insulting claim. Sadly, I expect nothing better from you.

2. Mississippians would actually be better off than the rest of the country if they didn't have computers or internet access, since it's the federal government's online marketplace that is so ****ed that the President himself had to encourage people to apply for health insurance over the phone. The backward white trash in your fever dreams about Mississippi would actually have the advantage of having applied for something over the phone in their daily lives, unlike actual Americans in 2013.