Some Little Known Subsidy Cuts to "Safety-Net" Hospitals, May Leave Some Without Care . . . . .

As various subsidies to hospitals that provide care to the uninsured, especially those that do not qualify for Medicaid, are implemented - some could be left with nowhere to go for much needed medical care.

The Medicaid expansion under the Affordable Care Act would have provided coverage to many of these people.  But - since Supreme Court ruled that the states would have to be given the ability to "opt out" of the Medicaid expansion, many did.  That leaves a gaping hole in the body of people who would have been covered by the expansion.  Without the expansion, many of these individuals will not qualify for Medicaid - AND - they may not qualify for a federal subsidy to purchase health insurance through the new health insurance marketplaces.  An individual must have a Modified Adjusted Gross income of $11,490 to qualify for a subsidy.  If you make less, but do not qualify for Medicaid coverage, you will have no options other than to pay full price for a health insurance policy - which many cannot possibly afford.

Hospitals that previously might have cared for these patients because they were subsidized for doing so, will now have those subsidies cut and may need to begin to refuse care or turn people away.

The Wall Street Journal published a good article that explains the predicament very well.  Read more here . . . .

Obviously, some adjustments will need to be made to the health care law to compensate for these unexpected situations arising out of modifications in the law to date.  A lot of delivery of care and coverage issues were hoped to be solved with the Medicaid expansion.  Since that was limited significantly, large groups of people who had counted on it as a mechanism for health care coverage will be left behind once again and will remain uncovered, unless something is done to correct that.

System Glitches? Really?

Haven't been able to get into the Federal Exchange to peruse pricing or see if you qualify for a subsidy?  Most people haven't.   The website & the press keep saying it's due to traffic and I say - not so.  Now, there's finally confirmation in print of what some agents have been saying all week. 

Read the Story Here . . . .

The Center for Medicare and Medicaid Services (CMS), who is running the Federal Marketplaces in 36 states could barely handle agent training, and then had a security breach after some agents completed the coursework - sending agent information along with related social security numbers "into the wind" by "accident".

I would advise anyone who feels they need Federal Subsidy money to pay for their plan, to wait and see through the month of October.  Wait to see how this plays out and to be sure that the systems are working and have some level of security before putting in all of your personal information.

You have plenty of time - if you want your insurance policy to take effect on January 1, 2014, you need to apply no later than December 15.  Then, you still have until March 31 during this initial enrollment for plans to begin with effective dates after that.

No hurry - believe me, they need time to work this out.

For those who feel they won't qualify for the Federal money, and still need or want to buy a new ACA compliant plan for 2014, the options are actually greater outside of the exchange.  You have more choices of companies and plans, and the plans have slightly different benefits than those on the marketplaces.

If you'd like any help in looking at those in MO and KS, I'd be happy to assist, as always.

Is the Affordable Care Act Actually Affordable?

I've been wondering that myself as I complete the training associated with being able to assist clients as the law is implemented.

My conclusion is that maybe it won't be - especially for some segments of the population.  Even with the federal subsidy money, I've been wondering whether or not people with very limited incomes will be able to afford the portion of the health insurance premium that is left for them to pay once the subsidy is taken into account.  Apparently, I'm not the only one.

This article from AlterNet takes a closer look:

Read the full article here.

Enrollment for new, ACA compliant plans is scheduled to begin on October 1 and will continue through 12/31/2013.  This is an extended enrollment period, since the government realizes that there will be a lot of confusion in the marketplace about when they must enroll or make changes.  After this year, the annual enrollment period for individuals and families under the age of 65 will be from October 15 - December 7 each year.

As new information becomes available, I'll be sure to communicate it.

Article about the Health Insurance Exchanges including common questions and answers

Interesting article about the Health insurance exchanges that will come into being in the next few years - very timely since I'm going to be attending a conference this week that will address this very topic.

Read the "Guide to Health Insurance Exchanges" here . . .