Wednesday, August 21, 2013

Exchanges Plus/Minus

On the "plus" side, we learn today that:

"More Americans than predicted may decide to flock to the new public exchanges for health coverage ... at least 8.5 million consumers plan to buy insurance through exchanges ... a prediction far outpacing what the Congressional Budget Office has projected"

So, success.

That is, if they actually open on time, and if there are actually carriers participating, and if enough folks aren't turned off by the thought of their their personal financial, medical and tax information being in the hands of unlicensed, uninsured and under-educated Navigators.

Seems like that's a lot of if's, doesn't it?

On the other hand, it appears that the legacy media is just now learning something that InsureBlog readers have known for a while: that the subsidy reimbursement scheme has some major holes:

"One of the major concerns insurers have is whether the millions of individuals who buy insurance when the [ObamaTax] kicks in will be able to send in a premium check promptly every month"

Whoa there, Nellie! "Will be able?  How 'bout "why would they bother?" After all, as Bob asked earlier this summer, what if "a policyholder decides to exercise their right to a 90 day grace period and does not pay their premium for 3 months?" They (arguably) had coverage, but was it ever really in force?

And who cares?

Well, the providers do, and they've petitioned Ms Shecantbeserious to change a key provision:

"CMS’s approach also unfairly burdens providers who treat these patients because they will not get paid by the (insurance company) for covered services and will have to wait to try to obtain direct payment from the patient"

Maybe that's just the cost of being a provider in an Exchange-based network.
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