Wintery Knight

…integrating Christian faith and knowledge in the public square

Woman gets $36,000 medical bill because hospital not covered by Obamacare gold plan

From KOMO News.

Excerpt:

Alex Szablya just wants the best health care she can get for her children. So she got a gold plan, the highest level possible with the Washington Health Benefit Exchange.  She picked a plan with Lifewise, an affiliate of Premera Blue Cross.

In early March, her 16-year old daughter had a medical emergency. Alex drove her to the nearest hospital, which was Seattle Children’s. Alex says doctors there felt her daughter’s situation was so dire she needed to be admitted to the hospital immediately. She was there for nine days.

Then came news that her stay, which involved specialized mental health care for adolescents, was going to cost $36,000 and her insurance would only pay for half because Seattle Children’s was considered on out-of-network facility.

She thought by going for the highest premium PPO gold level coverage offered the state exchange, a majority of the bill would have been covered.

“I’m paying a premium for that and I’m willing to pay that premium, but I expect to get services that are not so limited by the insurance companies,” she said.

She’s not alone. Seattle Children’s says its treated more than 125 patients who are not covered by policies offered by the exchange. In October, the hospital filed suit against the Office of the Insurance Commissioner, claiming the state office failed to ensure adequate network coverage in plans from its biggest providers like Premera Blue Cross.

“Because Seattle Children’s was not included in the major plans, children coming for care here were going to be denied care and in fact that’s what we are seeing,” said Dr. Sandy Melzer, senior vice president and chief strategy officer for Seattle Children’s.

Alex says Lifewise offered similar alternative care at other hospitals but it required traveling a three hour drive to Yakima or a two hour trip and ferry ride to Bremerton.  Children’s is a five minute car ride from her north Seattle home.

“This limited network is preventing me to get the specialty services that my children and I need in this community,” Aex said.  She’s now facing an $18,000 hospital bill she wasn’t prepared for.

Here’s a sketch from Chris Rock (whom I can’t stand) explaining the Obamacare Gold Plan:

Well, I don’t see why this is a problem, because the Obamacare Gold Plan covers all the birth control pills that she could possibly need, and at any hospital. It’s Sandra Fluke approved! Why isn’t this greedy reactionary Seattle woman thanking Obama for saving her from all those worthless private health care plans that existed before Obamacare? After all, the only reason that Obama lied to us about lowering premiums, keeping our doctors and our health plans is because those old private insurance plans were garbage compared to the Robitussin Gold Plan. 

Please can we elect someone who understands health care policy in 2016?

Filed under: News, , , , , ,

Man signs up for Obamacare and goes into debt $50,000 paying for treatment

Story from Washington Free Beacon.

Excerpt:

Cancer patient Tony Angran has quite the fighting spirit: he is battling Stage 3 cancer and trying desperately to find funds to pay for his new Obamacare plan.

Angran… was diagnosed with stage 3 cancer of the esophagus had insurance, but due to a previous heart condition, the insurance did not cover the treatments he needed for his cancer. He was notified of his insurance plan’s limitations just moments before receiving life-saving chemotherapy.

“One of the workers came and said, ‘I need to talk to you,’ and so I went and talked to her and she says, ‘We found out that your insurance does not include chemo,’” Angran told WHO-IA.

Over the past two months, the Angrans have depleted their savings account and accrued $50,000 in debt to pay for his treatments.

They signed up for Obamacare in hopes of finding better, less expensive coverage, but have been dismayed with the price of the health insurance offered by the exchange. It will cost them more than $800 a month.

The insurance plan they enrolled in will not begin for another two weeks, leaving them essentially hanging by a thread.

Tony Angran has since lost the ability to swallow, now eating through a feeding tube, and he is no longer able to take his necessary heart medicine.

A Pastor, Angran has dedicated his life to the services others and has shown compassion through his ministry. He says that Obamacare, which promises to alleviate the financial burden associated with health insurance and aims to provide quality care for Americans, lacks compassion.

“I’m sitting here with Stage 3 Esophageal Cancer, and they’re taking me to the finance person and saying, ‘How are you going to pay for this?’” he said.

The Angrans have until the start of April to pay $7000- their copay under their new Obamacare health insurance plan.

Meanwhile, Democrat Senate majority leader Harry Reid says that all of these horror stories are untrue.

Filed under: News, , , , ,

Obamacare enrollment of young adults about 50 percent below target

If you remember, Obamacare works by forcing young people (especially young men) to pay for care they don’t need and won’t use. This lowers the costs of health care for younger women and especially for older, sicker people. The target is 2.7 million enrollments of people from age 18-34.  But are young people signing up for this plan in numbers like that?

Investors Business Daily has the answer.

Excerpt:

Data through five months of the open-enrollment period show that slightly fewer than 10% of eligible 18- to 34-year-olds have signed up for coverage. Among young men, roughly 1 in 12 has signed up.

The Kaiser Family Foundation puts the ObamaCare-eligible population at 28.6 million, with 40%, or about 11.4 million, in the 18-to-34 age group.

Compared to the size of the potential market, the first-year target of 7 million enrollees, including about 2.8 million young adults, was relatively modest.

Yet it’s now clear that the initial target is well out of reach. The Avalere Health consultancy projected that sign-ups — paid and unpaid — will end March at around 5.4 million.

Through February, not quite 1.1 million young adults had selected an exchange plan. Among this group, the male-female breakdown was about 45% vs. 55%. That matters because women at child-rearing age are more likely to run up big medical bills.

In February, 268,000 18- to 34-year-olds signed up, so a decent upsurge in March could lift the total close to 1.4 million. But that’s before winnowing out the people who don’t pay.

Anecdotal reports from a handful of states and large insurers now point to a paid rate of about 85%, possibly lower.

While that could improve before the March 31 deadline, there’s reason to suspect that the paid percentage might lag among young adults, since they are showing more reticence about signing up in the first place.

Once the unpaid group is subtracted, it appears likely that young-adult enrollees will fall at least 50% below the first-year target The White House had initially set that target at 2.7 million.

[...]The age mix is important because the exchanges charge younger people higher premiums relative to pre-ObamaCare individual market insurance, so that older people can be charged less without negating insurer profits.

If young adults make up just 25% of the ObamaCare exchange population, it would wipe out much, but not all, of the 3% to 4% profit margin insurers typically allow for in setting premiums, Kaiser Family Foundation experts figure.

Yet that calculation assumes the health status of those who do sign up is about average. In general, an insured pool comprising a smaller share of the eligible group raises concern that the covered group will be costlier than average.

So they are expecting 2.7 million, but even with a late surge of enrollments, they are only going to get 1.4 million young people. That’s bad for Democrats, but I am happy that young men are not signing up for this law. They have nothing to gain from it. Maybe this whole mess will be worth it if young men understand that big government rides on the backs of young men. They are expected to pay the taxes, but without getting any of the benefits. Sex changes? IVF? Maternity? Well woman exam? Birth control pills? We don’t use that. We don’t mind paying for that for our wives, but we don’t want to pay for it for complete strangers.

Filed under: News, , , , , , ,

Obama administration report: 65% of small firms face Obamacare premium hikes

From Investors Business Daily.

Excerpt:

Released into a news black hole last Friday, an official Obama administration report finds that ObamaCare will push premiums up for two-thirds of small businesses. Cross off another ObamaCare promise.

The report came from the actuary for the Centers for Medicare and Medicaid Services — which means it’s from the administration’s official ObamaCare number cruncher.

What it found was that 65% of small businesses that offer insurance will likely see their premiums rise thanks to ObamaCare. That translates into higher insurance costs for 11 million workers.

The reason? These companies generally employ younger, healthier workers and so had been paying lower-than-average rates.

But since ObamaCare bans insurance companies from considering health when setting premiums, these companies will get hit with higher costs.

“We are estimating that 65% of small firms are expected to experience increases in their premium rates,” the report said, “while the remaining 35% are anticipated to have rate reductions.”

The report doesn’t say how big these hikes will be, but we have good reason to believe the extra costs will be significant.

One study, for example, found that 63% of small employers in Wisconsin will see premiums jump 15% because of ObamaCare. A separate study found that 89% of small companies in Maine would see rate hikes of 12% on average.

Another, by consulting firm Oliver Wyman, concluded that ObamaCare would push up small group premiums nationwide 20%.

Is this how the bill was sold to us by the Obama administration and their supporters in the mainstream media?

No:

In 2009, Obama promised small businesses that his plan would “make the coverage that you’re currently providing more affordable.” Later he said it would drive small-business premiums down by 4% in its first year, and as much as 25% by 2016.

As recently as last summer, Pelosi was proclaiming that “if you’re a small business … it lowers costs,” while Waxman said the law would make “high-quality healthy insurance more affordable and more widely available for small businesses.”

Notice that nowhere — either before or after ObamaCare passed — did any Democrat say anything about two-thirds of small businesses paying more for health coverage so the lucky one-third could get rate cuts.

Next time you hear a big government liberal promising you goodies at no cost, keep in mind their record. They are making policy from emotions, not from mathematics. They believe that they are lying to you for your own good. Their goal is not to tell the truth at all. And don’t rely on the left-wing journalism crowd to hold them accountable, they flunked math too.

Filed under: News, , , , , , , , , ,

Only 11% of new Obamacare enrollees were previously uninsured

From the Wall Street Journal.

Excerpt:

Early signals suggest the majority of the 2.2 million people who sought to enroll in private insurance through new marketplaces through Dec. 28 were previously covered elsewhere, raising questions about how swiftly this part of the health overhaul will be able to make a significant dent in the number of uninsured.

Insurers, brokers and consultants estimate at least two-thirds of those consumers previously bought their own coverage or were enrolled in employer-backed plans.

The data, based on surveys of enrollees, are preliminary. But insurers say the tally of newly insured consumers is falling short of their expectations, a worrying trend for an industry looking to the law to expand the ranks of its customers.

About 48 million Americans were uninsured in 2012. The health law is expected to cut 25 million from that total by expanding state-run Medicaid programs and the pool of privately insured people who buy through state marketplaces, also called exchanges.

Only 11% of consumers who bought new coverage under the law were previously uninsured, according to a McKinsey & Co. survey of consumers thought to be eligible for the health-law marketplaces. The result is based on a sampling of 4,563 consumers performed between November and January, of whom 389 had enrolled in new insurance.

One reason for people declining to purchase plans was affordability. That was cited by 52% of those who had shopped for a new plan but not purchased one in McKinsey’s most recent sampling, performed in January. Another common problem was technical challenges in buying the plans, which 30% mentioned.

I thought that the point of Obamacare was to reduce the number of uninsured Americans. Well, I guess if you know 129 million people out of their current insurance, and some of those people who are now uninsured will be obligated by law to buy Obamacare health care plans, then that counts as reducing the uninsured, right? I mean – they were uninsured when you knocked them out of their current health plan, right? It makes sense. Like me robbing you of $500 and then giving you $50 back. Good deal, right?

Previously, the Wall Street Journal reported on how the number of young people enrolling was WAY below estimates, which will increase the losses of the private insurance companies.

Excerpt:

Just under a quarter of the roughly 2.2 million people who signed up for private plans nationwide by Dec. 28 were between the ages of 18 and 34, while one-third were in the 55-to-64 range, just short of the age at which most qualify for Medicare, the federal government program for the elderly.

[...]Under the 2010 Affordable Care Act, consumers no longer pay premiums based on their health risks. To prevent a sharp rise in premiums in 2015 and beyond, carriers say they need strong enrollment from younger people who are likely to be healthier. That would balance out the bills racked up by sicker and older people.

[...]“There’s no way to spin it: Youth enrollment has been a bust so far,” said Brendan Buck, a spokesman for House Speaker John Boehner (R., Ohio). “When they see that Obamacare offers high costs for limited access to doctors—if the enrollment goes through at all—it’s no surprise that young people aren’t rushing to sign up.”

Previously, I blogged about a study that showed that young people have to pay are much higher than pre-Obamacare health plans. That’s why fewer of them are enrolling than the Democrats expected. If the insurance companies take losses on this shortfall, then they will need to be bailed out by the government – and the Obamacare bill provides for this bailout. As it stands right now, Moody’s has downgraded health insurance companies  from stable to negative.

Filed under: News, , , , , , ,

Wintery Tweets

RSS Evolution News

  • An error has occurred; the feed is probably down. Try again later.
Click to see recent visitors

  Visitors Online Now

Page views since 1/30/09

  • 4,337,463 hits

Enter your email address to follow this blog and receive notifications of new posts by email.

Join 2,046 other followers

Archives

Follow

Get every new post delivered to your Inbox.

Join 2,046 other followers

%d bloggers like this: