December 1, 2013 Recent News




The federal website was fixed according to the administration but there is still an error rate of 0.9% per page.  This may lead to problems with people who open up more than one page at a time.  This is vastly improved over the 6% error rate prior.  The response rate has also improved from six seconds to under one.  The programmers will attempt to fix the myriad of back end problems which have prevented information getting to insurers.  Bloomberg states that it should be noted that the president was not front and center on the December 1 fix announcement.

On December 3 Obama finally made an appearance.  He wanted to wait to see how things went before showing his face.  He gathered all the non-Medicaid enrollees in Obamacare (10) and made an announcement that people should no longer focus on the terrible website but on the benefits.  He forgot to mention the costs.  This is his latest campaign to attempt divert attention to the Obamacare most popular notions and away from the rest.  

The Washington Post states that enrollment is still plagued by bugs.  The enrollment records are not accurate for about 1/3 of the people who have signed up using  This is now an imperative for the programmers.  The administration doesn't believe the numbers but is not giving out theirs.  The insurers were not getting the needed 834 reports.  The administration states that people who think they have signed up call the insurers and make sure.

The New York Times reports that insurers are having major problems getting the needed information to enroll people in the exchanges.  This means people who believe they have coverage will not have it. If the insurers can not get the correct information then they can not issue a policy nor be able to tell the consumer how much they will be paying.  The insurers will not pay claims for those not enrolled nor if they have not been paid by the feds for their part of the premium. 

Aetna has decided not to follow the Obama doctrine of allowing those who lost their coverage being able to keep it for a short period of time.  They stated the time frame is too short.  This is a national plan whereas some of the smaller state plans have decided to go along with the pres.

A Gallup Poll showed that nationally about 28% will choose a penalty over Obamacare insurance.  There was no difference in those above or under 30 years old. 

Through November 30 over one million people have signed up for Obamacare in both the federal and state exchanges combined.  These are 2/3 Medicaid and 1/3 private insurance.   Remember the Obama quote that the goal is 7 million private and 9 million Medicaid subscribers in the first year.  This rate of enrollment is about 38% of the need amount.  The current numbers are not corrected for people whose information was erroneous when it reached the insurer and is not the number that have actually paid for their insurance.  The actual number of people actually insured is much much smaller. This also needs to be balanced against the 4-5 million people that lost their coverage due to not having adequate insurance.  It also should be noted that no state has the critical mass necessary for insurance.  To date Oregon has signed up 44 people.

There has been a successful pilot program where the consumers may enroll directly with the insurer and bypass website.  Very soon this will be allowed for all who are enrolling in the federal system.

Now coming to the pocketbook of the Obamacare users are the fees.  They include a temporary reinsurance program fee from 2014 to 2016.  It is a fee to help pay for the insurance of those with medical bills above $60,000.  Another fee is the market share fee.  This is to help fund the insurance payments of low income people.  There is also a fee of 3.5% for those who purchase their insurance directly from the insurer.   On the other end of the stick is not being allowed to deduct medical expenses unless they are over 10% of the AGI for those under 65 years of age.  

UnitedHealth has stated that they will lose in the next year $1.9 Billion in taxes and fees directly related to Obamacare.  The CEO when giving these figures did not state that this was the reason for their dumping physicians.

Covered California insurers are also limiting the hospitals and physicians who may tend to their patients.  Of course, Medicaid patients in the state already are not able to see private physicians and get their care via clinics and county hospitals.  Some of the insurers are offering payments for private patients at the same rate as Medicaid and many physicians will not accept.

Connecticut has gone a different route.  The medical society sued United and won a TRO prohibiting the insurer from deleting physicians from their Medicare Advantage plans.  The Court of Appeal upheld the TRO.

Kaiser Family reports that marketplace exchange networks of hospitals are very skimpy.  This is especially true in the lower cost plans. 

Also Covered California has a backlog of about 25,000 paper applications that they want help from the brokers to get into electronic form.        Top


UnitedHealth is dropping thousands of physicians nationwide from their Medicare Advantage roles.  These include the only specialists in some areas.  There is a federal law suit just filed against them by the medical societies in Ohio.  Medicare has stated they will not interfere.  States will need to make sure the insurers have adequate panels for their patients.  United states the reason is the $150 Billion reduction of payments over ten years that is law under Obamacare.         Top 


 DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.