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Uncovered California

For those who have just perked up, whose eyes opened wide, sorry, this column contains no nudity or salacious content.
[additional-authors]
October 20, 2014
For those who have just perked up, whose eyes opened wide, sorry, this column contains no nudity or salacious content.  Parts of it may be obscene, yes, but not for the reason the words “Uncovered” together with “California” might portend. This is a family website, after all.  (It is, right?)
 
California’s Obamacare exchange is known as Covered California, and the Golden State, being the most populous, has the highest number per state of Obamacare marketplace enrollees at 17.5%, or 1.4 million people.  Because open enrollment is less than a month away, and Covered California is allowing early renewals, the airways, at least here in Los Angeles (so I am sure elsewhere in the state) have been inundated, it seems, by ads promoting the exchange, and by definition, Obamacare.  (And where is Covered California getting all that advertising money anyway?  Commercials here cost a fortune.) 
 
The president’s signature achievement, whose official name is the Affordable Care Act (ACA), is off the front page, but absolutely not off the kitchen table. Remember Politifact’s 2013  “Lie of the Year?”  “I intend to keep this promise, if you like your doctor, you will be able to keep your doctor, if you like your health care plan, you will be able to keep your health care plan.”  Thirty-seven times President Obama or a top administration official made that claim, along with other untruths about lower costs.  Well, and forget the healthcare.gov website fiasco, many people found out the president lied, because it became public he was aware of what would eventually happen.  NBC News reported a year ago, “… the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.”
 
 
So what happened?  In 2013, millions of plans were canceled as insurance companies moved to comply with new federal requirements and subsequent increased costs.  And as individuals and families scrambled to find plans that worked for them, they discovered they would get less coverage for higher premiums, not the lower ones promised, and not be able to even keep their doctors in some way.  The small company mandate of new requirements was delayed, not the individual plan mandate, and some did benefit for sure, those getting government subsidies and others who never had insurance.  But, and the government still will not release all demographic data, the Department of Health and Human Services did admit that only 8 million became newly insured (not 10 million as some have reported), when the main point was to insure the 30 million+ uninsured.
 
The much ballyhooed goal of 7 million enrollees necessary to pay for the program was publicized for months, and when it was reached there was White House celebration, but even that so-called fact was not definitive.  According to the RAND Corporation's comprehensive Obamacare study, only a little over a third of the enrollees were previously uninsured.  The vast majority were those whose plans they preferred were canceled, and who had to get a new plan many of them just did not like.
 
Companies, insurance companies and insurance brokers have found all kinds of ways, some even illegal, to get around the new requirements of Obamacare, and so, the much higher associated costs.  Also, laying off workers or turning full time employees into part-time ones, or hiring part-time employees, to stay under the requisite number of 50+ employees when insurance must be offered, became a nasty by-product of Obamacare that harmed families and the economy.
 
For larger companies, the bad news is coming.  In fact, some of it is already here. This made the news last week: “Wal-Mart Stores Inc. is cutting health insurance for another 30,000 part-time workers and raising premiums for its other employees, as U.S. corporations push to contain costs in the wake of the federal health-care law.”  And, as delayed parts of the ACA (done so for political reasons) get close to implementation, other companies and insurance companies have already done the same as Walmart, and more will.  And many health care companies will just shut down operations or leave states where costs are just too prohibitive.  Some have already done so or announced they will, and they are even pulling their non-Obamacare plans.
 
And speaking of politics, watch this exchange from last week between Jonathan Karl of ABC News and Josh Earnest, the White House spokesman.  Karl asked, “Why is it that last year Oct. 1 was the (start of the Obamacare enrollment period) date, and this year it’s Nov. 15?  Why is it that people have to wait until after the election to find out whether they have a premium increase or decrease? And, as Earnest danced, this from Karl, “Can people be forgiven for thinking this looks like a political move?  People will not find out how much they are going to have to pay for their health insurance until after the election, whereas last year they found out on Oct. 1. Doesn't it seem a little bit convenient that people now have to wait ten or eleven days after the election to find out how much their insurance was going to cost?”
 
And Investor’s Business Daily just reported a couple days ago,“ObamaCare shoppers in search of the lowest-cost plan may come down with a mild case of rate shock when 2015 exchange enrollment begins next month.  An examination of next year's rates in the biggest city in 15 states and Washington, D.C., reveals that the cost of the cheapest bronze plan will jump an average of 13.9% for 40-year-old non-smokers earning 225% of the poverty level ($26,260).”Some cities will have lower costs, most higher, Seattle a whopping 64%.  Los Angeles will have an increase of 27%.  Do you think premiums for the more expensive silver, gold and platinum plans, across the board, won’t jump as well?  And what about non-exchange marketplace private and company-associated plans?  Do you think that when the new regulations mandate delay completely expires, their premiums won’t go higher? Much higher?
 
Look, universal health care is a noble and important goal, and I am glad there is coverage for people who would otherwise go without. I also think it was a good idea to allow young adults up to age 26 to remain on a parent’s plan.  But I wish both major parties could have settled their differences to make things work, because turning the whole system upside down was unnecessary, reckless, not carefully and completely thought out, and disastrous.
 
And unlike a number of private market plans such as Anthem and Blue Shield, Obamacare exchange plans including the same and other insurers, ration hospitals and doctors, making it very difficult to keep or find a health care provider that is available and affordable.  To make matters worse, many providers who are allowed to be included within exchange plans are deciding, or will decide, to exclude themselves or opt out, because in an atmosphere where provider business monetary return is being squeezed more and more, reimbursement for Obamcare exchange plan services is just way too low. Providers can’t be blamed for trying to stay profitable, but this adds to the feeling of anxiety and abandonment by subscribers, the patients who have lost their personal practitioner comfort zone.
 
Also, Obamacare was supposed to promote competition among those insurers who joined the exchanges, but there are states and counties where only one insurer is available. In fact, as reported by Forbes magazine, “In one of every six counties in America (17 percent), the state exchange offers only one insurer – a monopoly.  For another 35 percent of counties, only two insurers offer coverage. In another 25 percent, only three insurers are selling coverage.  To recap, consumers in more than half of the nation’s counties can “pick” from only one or two insurers on an Obamacare exchange. In more than three of every four counties, competition is limited to three or fewer insurers.”  And sadly, residents of some of the poorest counties in the country, where affordable health care is so desperately needed, are now at the mercy of only one insurer from which to choose.
 
Everyone wanted the uninsured covered.  And everyone agreed that pre-existing condition bias was unfair and needed to be eliminated.  Mandates and certain new requirements on everything and everyone, as well as shifting around moneys and existing federal health insurance programs, such as Medicare, only caused the baby to be thrown out with the bath water.
 
Very simply, most everything should have been left alone.  There were many things that worked but got scrapped, or were adequate enough but made dysfunctional, because liberal ideology frustrated what was really best for the country, snowballing into more and more bureaucracy, and in many cases resulting in mandatory, silly health care plan additions, whether needed or wanted or not, increasing costs and throwing everything into turmoil.  Many blame insurance companies for plan and coverage cancellations, but could insurers be trusted to keep everything the same and not try to recoup moneys that would be lost, at least for a short period of time?
 
Regarding a couple major points in the debate, Republicans should have given up, at least for the interim, their push for tort reform, which would limit lawsuit judgment dollars, something the Democrats and their trial lawyer supporters are vehemently against. Democrats, at least for the interim, should have agreed to allow consumers to shop for a health care company in any state, the kind of laboratory test competition which could drastically lower overall costs, but success would dash any hopes of a government-run, single-payer option, which is what the Democrats really desire.
 
Maybe over time, more uninsured than only the current 10% will enroll, but the turmoil that continues to this day has been horrible. Ask anyone in the health care industry – and I don’t mean the insurance companies – what they think about what has happened, not only with Obamacare exchange plans, but with the system as a whole.  You will find even the most ardent Obama supporters admitting that what may have been bad became a heck of a lot worse.  Ask doctors, billers, health care workers and of course patients, and especially the husband and wife sitting around the kitchen table trying to pick a plan that gives their family the coverage they want and need at a reasonable cost.  Most of the country has been spared the nightmare others have endured, but soon, the horror show will affect everyone.
 
So there you go.  There are many more problems related to Obamacare that I could note, but I think this has been enough.  Even my own eyes are glazing over, as I get more disgusted at what has been happening; I have been personally affected, and in a negative way. The parties could not come together to do what was best, what was right, so a pox on both their houses.  But who knows? Maybe, just maybe, in the coming months and years, the errors will be corrected.  But don’t hold your breath.  And I don’t just mean that as an idiom.  With whatever plan you have, you may not be able to find a doctor in your area, should you damage your lungs or heart.
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