Skip to comments.Insurance cancellation notices, confusion about Obamacare abound in Pa
Posted on 10/31/2013 12:25:51 AM PDT by Cincinatus' Wife
Insurers are canceling coverage for thousands of Pennsylvanians who buy their own health insurance and expected to be grandfathered from sweeping changes of the Affordable Care Act.
The cancellation notices are providing fodder for critics of the so-called Obamacare law. They say the result is higher premiums for some people, and they point to pledges by President Obama that individuals can keep their existing coverage if they like it.
But insurers and supporters of the law say that many of those who are being dropped can buy better and cheaper coverage under Obamacare.
Insurers say the law requires them to phase out plans for individuals that don't meet minimum requirements for coverage, such as emergency visits, maternity care and mental health treatment. Others are getting cancellation notices because the law no longer allows individual business owners to buy health insurance in groups.
The developments couldn't come at a worse time for the Obama administration. Health and Human Services Secretary Kathleen Sebelius apologized on Wednesday to Congress for the troubled launch of the health care website, healthcare.gov. As she spoke to a House committee, people who tried to log onto the site got this message: The system is down at the moment.
What we hear overwhelmingly is just confusion, said Steven Shivak, president of SMC Business Councils, a trade association based in Churchill. The group had been able to buy insurance for its more than 250 members, most of them individual business owners and their spouses.
People are confused because the cancellation notices don't give them a specific answer. The first thing you see, the emotional charge is, I'm being canceled.' And you think, You're kidding me,' he said.
Those affected, including 40,000 people previously covered by Highmark Inc., have been directed to buy coverage through the troubled online exchange or by calling a toll-free number.
Those plans, which expire at the end of the year, were sold to people with pre-existing conditions. Insurers are expected to roll out new plans at new prices for those customers, many of whom the government and insurers say should pay less based on federal subsidies though some will pay more.
No one should panic, said Jim McTiernan, area vice president at Triad Gallagher, a Downtown benefits consulting firm. What the insurance companies are doing is really perfectly legitimate and logical.
Sebelius told the House committee that the cancellation notices do not contradict Obama's repeated promise that the health care overhaul would allow Americans to keep their current health insurance.
Just before the hearing, Rep. Tim Murphy, R-Upper St. Clair, read an email from a constituent who'd received a cancellation notice. Murphy described the email from the single mother as moving and emotional. He said the woman, who had not given authorization for her name to be released, had to buy more expensive coverage from the exchange.
It's not a glitch, it's a disaster, Murphy told the Tribune-Review later. People are seeing the sticker shock.
The Obama administration has countered that individuals whose policies existed prior to 2010 can be grandfathered into the new law to keep their existing coverage as long as it had not drastically changed. Murphy doesn't buy the argument.
Grandfathering is for a plan that doesn't change in cost or coverage, he said.
Highmark, the Pittsburgh region's Blue Cross-Blue Shield provider and the state's largest health care insurer, has sent notices telling 40,000 Pennsylvanians with its so-called guaranteed-issue coverage that they will have to shop for a new plan. Philadelphia-based Independence Blue Cross says it has told 24,000 members their plans are being phased out.
Highmark spokeswoman Kristin Ash said its guaranteed-issue customers will find better insurance at lower rates because all insurers starting Jan. 1 will have to cover individuals regardless of their medical conditions.
These new plans will be lower cost for those sick individuals, she said.
An additional 140,000 healthier individuals with different plans will have one more year before they switch over, she said. Their plans will disappear by the end of 2014. Because they are healthier, those individuals would likely have had to pay more if they switched to a new plan before the end of the year, she said. That's because federal law prohibits insurers from screening people's health status before offering a price.
UPMC Health Plan spokesman William Modoono said most individual plans issued by carriers today do not meet the minimum coverage required by the Affordable Care Act. He declined to say how many individual customers buy coverage from UPMC Health Plan.
Aetna Inc. and its Coventry and HealthAmerica subsidiaries are informing individual policyholders that they can renew for one more year, but then their current policies will disappear.
Some plans are being replaced because they no longer comply, Aetna spokesman Walt Cherniak said. No one is being thrown off a plan.
The plans for sole business proprietors, which were typically sold through associations, aren't allowed under Obamacare, said Highmark's Ash. Several hundred members of those plans have been notified so far, and more will be notified in coming months, she said.
Shivak said most of the business members he's been helping have been pleased once they understand their options. Some are choosing to stay with their plans for an additional year because they are concerned about the instability of the federal website.
If they have an increase, and it's something you can swallow and they're comfortable with what they have in terms of coverage, then why would you change? he said.
Confusion? Over what?
Oh, you Democrats thought that the only people getting screwed over would be the rich, the white, the male and the Republican. Sorry, but in the new Omerika, we are all slaves on the plantation.
Now, shutup and work faster.
I would compare this level of confusion to the possible opening and closing hours of your local Wal-Mart shifting every day. Monday, it might open at 6AM and close by noon. Tuesday, it might open at midnight and shut-down by 7AM. You can line up a hundred people and ask them for the legitimate current situation of the ACA episode. Most would start off and ask what the heck is ACA, and then realize it’s ObamaCare. Less than five people would have any clear idea of the current situation.
The administration is acting like everyone is tuned into TV national news, the internet, or Time magazine. That simply isn’t true for the nation. I’d say over seventy percent of the country just isn’t following any of this to the extent that they grasp laws, or what they mean for them.
Folks would forget to pay their property tax or vehicle tax, unless that stupid card came to them in the mail. Same is true with Social Security changes...most have a view of the rules from the 1970s, and no idea how Social Security works.
We are a nation without any firm grasp of Democracy, the business of health care, or the problems with big government spending.
Millions of these clowns voted for the kenyan klown, now they’re pissed about this? Reap what you sow.
I’m sure this is happening in all states. I have had BC/BS in NC for the past two years that I have paid for privately. My rate this year as of March was $267. per month for 80/20 coverage. I got a letter from BC/BS saying my plan didn’t meet the requirements of Zero Care. They offered me an alternative plan that I would have to pay 40% of my Dr. visits and prescriptions for only $728 per month! I know of two other people in the same boat. We can’t afford the increased cost so I guess we will pay the fine and hope we stay healthy. I have contacted my Congress-critter but I am afraid he has drunk the Koolaid. Time to send him home, course he won’t have to worry about how to pay for it, WE ARE!
Those of us who do understand need to continually stay in contact with our Representative and Senators, our local government and communities. They need to know that thinking, working, tax paying citizens are out here and that we are watching, voting and fielding conservative candidates.
You hit upon a key issue that no one is talking about. Sure, we can vote these scumbags out of office, but they will never have to worry about going under obamacare - and if they are a Demoncrat - they voted for this debacle. This is sickening.
so you will pay the “fine” (eventually will be 2% of your income) and hope you stay healthy - and you will be uninsured
welcome to the democrat ingenious way of raising taxes on the middle class and having them feel grateful to pay it
and having no health insurance, so paying out of pocket for services (until that becomes illegal for the middle class)
How predictable. They fired up the gigantic machine of destruction, and now they are whining that the said machine is running all over them. The machine, once started, does not care. Your desktop computer has more compassion than the bureaucracy.
They are now upset that they are forced to buy insurance against events that they are very unlikely to encounter. But that's exactly the principle of socialism - everyone pays for everyone else. If you live healthy life - or if you burn your health as if there is no tomorrow - you all pay the same [high] price. It's insane. But the machine does not care - it averages you and him and them, and comes up with just enough money to give an average person an average treatment. IF it comes up with enough money, which is a completely different question. In most socialist economies, mysteriously, there was only enough money to keep an average worker bee healthy enough so that he can work.
Shut them down, stop paying taxes.
Interesting that the insurers and Pittsburgh Tribune-Review are defending Obamacare. They do not mention some people are paying more. They also do not mention that Obama said emphatically you would not need to change your insurance.
Who is your congress critter? You must live in the Triangle area. They are the worst in that area. Bedwetters they are.
the establishment - and harry reid - are banking on the middle class being willing and able to just “swallow” higher premiums and keep going
they are clueless to how a tight household budget actually works
Casey doesn’t give a rat’s rear end what anyone thinks. He just got re-elected, so he’s fat, dumb, and happy for another 5 1/2 years, and he’s hoping the stench of Fubocare blows away by 2018.
The Trib isn’t defending Obamacare. This is a news article and it pretty reasonably tries to give both sides some ink.
I just love these satire articles.
True. (Big sigh.)
Even those with college degrees do not understand basic economics.
Just wait until the rationing begins and the evil IPAB starts to wield its power over life and death.