Jennifer Harris needs a new health insurance plan
Jennifer Harris, a self-employed lawyer in Orange County, has been paying $98 a month for an individual health insurance plan that provides less coverage than the Affordable Care Act requires. The cheapest alternative she’s found so far costs more than twice as much. (Mark Boster, Los Angeles Times / October 24, 2013)


October 26, 2013, 7:42 p.m.


Thousands of Californians are discovering what Obamacarewill cost them — and many don't like what they see.
These middle-class consumers are staring at hefty increases on their insurance bills as the overhaul remakes the healthcare market. Their rates are rising in large part to help offset the higher costs of covering sicker, poorer people who have been shut out of the system for years.
Although recent criticism of the healthcare law has focused on website glitches and early enrollment snags, experts say sharp price increases for individual policies have the greatest potential to erode public support for President Obama's signature legislation.
"This is when the actual sticker shock comes into play for people," said Gerald Kominski, director of the UCLA Center for Health Policy Research. "There are winners and losers under the Affordable Care Act."
Fullerton resident Jennifer Harris thought she had a great deal, paying $98 a month for an individual plan throughHealth Net Inc. She got a rude surprise this month when the company said it would cancel her policy at the end of this year. Her current plan does not conform with the new federal rules, which require more generous levels of coverage.
Now Harris, a self-employed lawyer, must shop for replacement insurance. The cheapest plan she has found will cost her $238 a month. She and her husband don't qualify for federal premium subsidies because they earn too much money, about $80,000 a year combined.
"It doesn't seem right to make the middle class pay so much more in order to give health insurance to everybody else," said Harris, who is three months pregnant. "This increase is simply not affordable."
On balance, many Americans will benefit from the healthcare expansion. They are guaranteed coverage regardless of their medical history. And lower-income families will gain access to comprehensive coverage at little or no cost.
The federal government picks up much of the tab through an expansion of Medicaid and subsidies to people earning up to four times the federal poverty level. That's up to $46,000 for an individual or $94,000 for a family of four.
But middle-income consumers face an estimated 30% rate increase, on average, in California due to several factors tied to the healthcare law.
Some may elect to go without coverage if they feel prices are too high. Penalties for opting out are very small initially. Defections could cause rates to skyrocket if a diverse mix of people don't sign up for health insurance.
Pam Kehaly, president of Anthem Blue Cross in California, said she received a recent letter from a young woman complaining about a 50% rate hike related to the healthcare law.
"She said, 'I was all for Obamacare until I found out I was paying for it,'" Kehaly said.
Nearly 2 million Californians have individual insurance, and several hundred thousand of them are losing their health plans in a matter of weeks.
Blue Shield of California sent termination letters to 119,000 customers last month whose plans don't meet the new federal requirements. About two-thirds of those people will experience a rate increase from switching to a new health plan, according to the company.
HMO giant Kaiser Permanente is canceling coverage for about half of its individual customers, or 160,000 people, and offering to automatically enroll them in the most comparable health plan available.
The 16 million Californians who get health insurance through their employers aren't affected. Neither are individuals who have "grandfathered" policies bought before March 2010, when the healthcare law was enacted. It's estimated that about half of policyholders in the individual market have those older plans.
All these cancellations were prompted by a requirement from Covered California, the state's new insurance exchange. The state didn't want to give insurance companies the opportunity to hold on to the healthiest patients for up to a year, keeping them out of the larger risk pool that will influence future rates.



http://hotair.com/archives/2013/10/26/video-obama-wh-rosy-claims-belied-open-secret-of-poor-obamacare-performance/




NYT: Obama, WH rosy claims belied “open secret” of poor ObamaCare performance


POSTED AT 2:31 PM ON OCTOBER 26, 2013 BY ED MORRISSEY

What did the President know about ObamaCare, and when did he know it? The New York Times raised that question yesterday, offering a video montage of pre-rollout claims about the Healthcare.gov exchange from White House officials, including Barack Obama himself at the Clinton Global Initiative one week before the launch.  However, behind those rosy predictions were big red flags being raised — and now the question is whether the White House didn’t see them, didn’t want to see them, or purposely ignored them:


That kind of enthusiasm wasn’t just for public consumption, reports Michael Shear and Sheryl Gay Stolberg. The same kind of cheerleading went into briefings on Capitol Hill among lawmakers and staffers. The expectation was that initial consumer enthusiasm would create “a few bumps,” but that the website was solid and Healthcare.gov was ready for launch.

But is that what the Obama administration really believed? Contractors working on the system told Congress that they repeatedly warned senior administration officials that the system had serious problems — and some of those people wanted to delay the rollout:
The executives testified that “end to end” testing of the Web site did not take place until two weeks before the site made its debut — about the same time that the briefings by Mr. Simas and Mr. McDonough were taking place. And they said problems with the software that powers the Web site were communicated to senior officials in the president’s administration. …
According to some accounts, the project’s managers at the Department of Health and Human Services assured the White House that any remaining problems could be worked out once the Web site went live, but other senior department officials predicted serious trouble and advised delaying the rollout.
The tech sector already knew this would be a huge failure, even according to one of Obama’s Presidential Innovation Fellows — a man who set up Obama’s 2008 online campaign systems:
But among technology experts, the federal government’s poor performance in developing Web sites was an open secret.
Clay Johnson, a founder of Blue State Digital, the company that ultimately developed Mr. Obama’s 2008 campaign Web site, turned down a chance to work on HealthCare.gov last year, when he spent six months as a Presidential Innovation Fellow.
“It was a project I wanted to steer clear of,” he said.
Why didn’t the administration listen? Politics, according to Harry Reid’s former chief of staff Jim Manley:
Some Democrats said that, given the Republican assault on the measure, the White House was right to deliver upbeat presentations promoting it.
“To downplay expectations would have fed into the Republican narrative,” said Jim Manley, a former top aide to Senator Harry Reid of Nevada, the Democratic leader, who attended a session in the Roosevelt Room of the White House with other allies of the administration.
In other words, “some Democrats” would prefer to hear lies for political purposes than to find out the truth about incompetence in the Obama administration.  That’s not exactly a confidence builder for the ObamaCare project rolling forward.  It’s also a good indicator of the level of honesty we can expect from the White House on the status of this program at any time, too.
Margaret Carlson understands the crisis. She agrees with my argument this week that this is an existential moment for big-government progressivism, and that the incompetence and prevarications threaten the entire agenda of the Left (via Instapundit):
The rollout of Obamacare had to be absolutely perfect. Obama needed to treat it like a 21st-century Manhattan Project, full of 20-something geeks pulling all-nighters and managed by geniuses from Apple Inc. and Google Inc. who can fill in that blind spot between the techies and end users. Instead, he took the pedestrian route and spent $400 million on a Canadian company that our Good Neighbors to the North once fired for incompetence.
That brings us to those determined to stop Obamacare and, by extension, Obama himself (that’s why they call it Obamacare). They’re happy to watch the president making excuses. They’re gloating now, just a few days after the president did his own gloating over Republican incompetence during the government shutdown.
The website failure gives credence to those who warn that government can’t be trusted to get big things right, and that the market, not bureaucrats, should fix health care. It’s not just the crazies who doubt government now. According to the Pew Research Center, the competence of officialdom is on shaky ground, with only 19 percent of Americans saying they trust in government “just about always” or “most of the time.” …
This was supposed to have been Obamacare’s moment of truth, when the president disproved bitter Republicans and showed that government could do something great. According to Bloomberg News, HealthCare.gov went live without a dry run, and just last week the computer code — 500 million lines of which might have to be reconfigured — contained place-holder language that is used in preliminary drafts. Yet contractors have been paid as if they performed.
Republicans may yet get their delay, not because they shut down the government, but because the president didn’t use his power to make his hard-fought legislation work.
It’s worse than that.  It’s that the President couldn’t care less about exerting the kind of leadership needed to ensure success, and contented himself with listening to yes-men so he could spout a bunch of happy talk in public rather than be honest with the American people.  This is a crisis for the progressive agenda to be sure, but at its core it is a crisis of leadership. We have none.


Two key missives from Karl D !


http://market-ticker.org/akcs-www?post=225462
Two Other GIGANTIC "Screw You" Parts Of Obamacare
Two additional things that I haven't seen discussed often (if at all) or which are given only flippant service -- but which could easilybankrupt you.
Actuarial Value.  This is a complicated way of saying "what percentage of total health care expense" is the policy expected to cover?  For abronze plan (the least-expensive, but still expensive policy) the answer is 60%.
You may have heard the "actuarial value" but you probably didn't understand what it meant.  Let's put some numbers on this.  Assuming you will pay $300 a month for your "bronze" plan under Obamacare, or $3,600 a year.
The policy can of course, at most, pay $3,600 per year, per person who has it on average or the company will go out of business because it will lose money.  Eventually all firms that lose money continually go bankrupt.  Therefore, on average it must pay out less than this much per person, assuming zero overhead (which is of course impossible.)
This means that on average you are expected to fork up about another $2,400 in cash for your medical care on top of the $3,600 in premiums, or $6,000 annually.
Don't have $6,000 in disposable income?
Tough crap.
Now note that these are averages, and further disregard inefficiencies.  In other words, the total you are expected to spend will be somewhat less, because the inefficiency goes not to provide care but to run the insurance company.  Nonetheless this illustrates the problem -- you think it's $3,600 a year but it's really$6,000 you're signing up for!
The worst part of it is that while there will be some people who will "win" (and spend less or even zero beyond the premium as they use no services) there will be just as many people who get raped for much more.  That's how averages are -- they're statistical things and apply only over large groups of people, not to individuals.  But on average, and quite-likely, you are not going to spend $3,600 -- it's going to be much closer to $6,000 instead when all is said and done.
Worse is another problem that I am just starting to get reports on -- and which has not been cleanly disclosed.  With most conventional insruance there is a fair bit of "out of network" coverage.  Most people think of this as a big deal when they want to see a doctor that is not "in network" because they like him or because there is some specialty need.
I am getting multiple reports that many of these Obamacare policies have zero out-of-network coverage and this is not clearly disclosed up front until you sign up for the policy itself.  Indeed, I've seen exactly no clean disclosure on this point before you create an account if you're "just shopping."
Now add to this that previously insurance was sold on a state-wide basis. Under Obamacare it is sold on a county-by-county basis.
Why is this a big deal?
Because if there is no out-of-network coverage at all what happens when you are traveling out of your immediate home area and either get sick or have an accident of some sort (other than in a car, where your auto insurance likely provides injury coverage)?
You're screwed -- you will pay 100% with no limits as your insurance is worthless if there is no out-of-network coverage!
I wonder why there's been no widespread public discussion and clear disclosure on these two points.......


http://market-ticker.org/akcs-www?post=225427



Here It Comes (ObamaCare ALREADY Detonating)
This is (thus far) anecdotal, but if it plays out anywhere near what I'm hearing reports of this law is done and so is the Federal and State budget process.
Specifically, I am hearing that of the (few) people who have managed to actually (1) create an account on the federal health care system exchanges and (2) go through the process nearly all of them are winding up referred to Medicaid.  What's nearly all?  There are reports that it is in the 90% range in many if not most area!
Got that?  Almost none of the so-called "enrollees" are actually paying customers.
What's worse is the rest of the screwjob that is being foisted off on those who do look at the plans -- there is further (anecdotal, again, as this information isextremely hard to find) evidence developing that the "in-network" lists -- that is, which doctors and hospitals are "accepted" by these plans are effectively identical to the choice that Medicaid patients have -- in other words, half or more of the medical facilities and physicians, including probably your current doctor, will not accept these plans.
I was utterly unable to find, without registering, exactly what was "in-network" in this area among the "plans" offered for this county.  Of course I have not provided any personal information, but this is one of the key shopping points for people who are buying "health insurance" -- they want to know where they can use it!
Between these two points calling this a "revolution" in health care may be rather correct but not in the way that Pelosi, Reid and Obama intended.  Rather it may cause quite the other sort of revolution for two reasons:
  • It appears that it is going to instantly detonate State and Federal budgets, even among those states that did not "expand" Medicaid (many states rejected that attempted expansion) because it is going to flood the existing system with new enrollees, many of whom will immediately use their "free" services.

    and
  • There are effectively zero young, healthy ("millennial") enrollees among those who are signing up and paying.  As I expected and predicted only the truly and catastrophically sick have put up with the crap required to actually go through the process.  These people are going to immediately and irrevocably consume dramatically more health care cost than they pay in premium.
In short there is effectively nobody signing up who is going to be a net payer of premium into the system from a statistical point of view.
The inbound tsunami that is going to come ashore in both Federal and State budgets, not to mention the outrageous premium ramps that will appear in Year #2 for Obamacare if enrollment continues to look anything like it is today will detonate our economy.
Obama and the Democrats cannot blame this one on the Republicans -- or George Bush.  They own this crapfest; it is now apparent that a classmate of Michelle Obama is an executive at the company given the no-bid $675 million contract to build the non-working federal exchange that is largely responsible for this cluster****.
So we have Solyndra in Health Care, an utter and complete waste of money, but unlike Solyndra which was just a siphon of good funds to cronies of the President this is far worse because it has stomped into the ground what little capitalism remained in the health care sector.
There is only one way to fix this crap -- repeal Obamacare immediately and in the same legislative act pull all of the monopoly protections in the health system by (1) making CON laws or any other machination that restrains trade per-se unlawful and violations of The Sherman Act, (2) repealing any other law giving similar "protections" to other parts of the health and insurance industry.
We can fix the health system and its explosive cost for Americans any time we are willing to demand it.  But you cannot get there from here by demanding that one person be robbed to pay for another person's doctor or pharmacy bill.  You can only get there by allowing the market to work, and this means ending all means of legalized extortion and theft in the medical system that exist today.
It starts with level, open billing and price lists for each device and procedure, posted prominently by each medical care provider in clear English where you can see it before services are performed and where each person pays the same thing for the same procedure in a given facility or performed by a given person.  It continues with vigorous enforcement of the Sherman and Clayton acts against companies, whether insurance, good or service-providing in the sector, who act to restrain trade such as by enforcement of cross-border price controls that currently cause you to pay 5, 10, or even 4,000% more here for a drug or device than you pay in another state, facility or country.  At the same time we must jail those in the industry who engage in force-tied sales and similar tactics; if IBM was prosecuted for trying to tie service contract sales to hardware (and it was) the practice of physicians referring work to facilities they own, or of hospitals buying up all the clinics in a given area, must be treated exactly the same way and draw the same criminal charges.
I have been pounding the table on this since 2009 when "Health Reform" was first proposed.  Many have said that I was nuts, and that what Obama proposed and got passed would work and lower costs.
We now are seeing the first pieces of evidence that not only will it not work it will destroy our medical system and both state and federal budgets if it is allowed to continue.
Those of you on the left who advocated for this and those on the right who have pushed for continuing the outrageous financial******job served upon us by the existing medical system need to "Come to Jesus" and repent lest our nation's economy be laid waste.