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CPBJ Extra Blog

I was wrong -- but ...


I can admit it when I'm wrong.

Back on Oct. 10, 2013, for instance, I opined that the marketplace glitches might be good for Obamacare, because once people actually saw what was being offered, they might be disappointed.

What actually happened was that the feds pulled the marketplace’s front end together and more people than predicted signed up, and then, several months in, reported being mostly happy with their plans.

That’s not to say there aren’t some disgruntled people out there who lost their plans or saw their prices rise or looked at the marketplace options and found none to their liking or within their financial reach. Such things did happen. But, after all, the average subsidy for those getting help with marketplace plans was a whopping 74 percent in Pa., and 47 percent of those getting help paid premiums of $50 a month or less, which even with a big deductible and narrow network looks pretty sweet ... particularly if all you happen to need to avail yourself of is the free preventive services.

And, of course, let us not forget that, thanks to generous exemptions, the number of people who will have to pay a fine this year for not being insured has dropped about 2 million from the original projections, to just 4 million of the roughly 30 million non-elderly uninsured in the U.S.

All in all, it adds up to a better run than I expected Obamacare to have this year. So there you have it: I was wrong, and the world did not end.

If that was gratifying for you, however, you might want to stop reading there. Because, looking forward, I have many “buts” to append. And I’m going to plunge into them headlong.

• If the back-end problems with the federal marketplace were ever resolved, I missed the jubilant memo.

This report says fewer than 2 in 5 people are confident in the technical capabilities of the marketplaces; only 1 in 12 report lower monthly health care spending now than a year ago; and 37 percent say they feel “more negative” now than they did a year ago about Obamacare’s impact on their own health care.

CMS is delaying the launch of the Physician Payment Sunshine Act website -- which should have been a major points-scored occasion for Obamacare advocates -- because of problems.

• In the words of renowned health care reporter Sarah Kliff, “This graphic really underscores how confusing the *next* Obamacare enrollment period will be.”

• And speaking of the next enrollment period, pundits have been having a field day with rate increases, or the lack thereof, in other states, but we here in Pennsylvania still have no idea what they look like.

Halbig and King are still, collectively, a lurking presence.

• Speaking of lurking presences, let us not forget about the upcoming tax season.

In other words, I expect the next few months to be interesting. And let us make no final judgments on anything at this time.

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Deb C. October 16, 2014 5:43 am

"and 47 percent of those getting help paid premiums of $50 a month or less, which even with a big deductible and narrow network looks pretty sweet"

Call me stupid, but I fail to see HOW those only able to pay $50.00 a month will be able to pay the big deductible - every year, no less. HOW will that work? Doesn't that defeat the purpose?

Bryan August 15, 2014 3:47 pm

No one ever said the health care was "free". Just more affordable and available to everyone. If there was help on both sides this could get fixed and run much smother.

Stop trying to kill healthcare for those who need it. In America, everyone should be able to have healthcare. We should strive to make that happen no matter what.

vince phillips August 14, 2014 12:57 pm


As always, a good article. I may not share your optimism however given:
- Large numbers of exchange enrollees whose income numbers do not match the Government's; hence, the IRS will want a return of the unearned tax subsidy
- Some of those original miscalculations may have been deliberate (shame on them) or a result of lack of expertise of the navigators or certified application counselors. In an ideal world, ACA would have simply required insurance agents who could be sued for E&O for such a mistake. Customers put in that position could have legal recourse and now they have none.
- PA has pending legislation requiring navigators and certified application counselors to register with the Insurance Department and undergo criminal background checks (House Bill 1522 and Senate Bill 1268). Until these are passed by the General Assembly, people utilizing unlicensed persons to get into the exchange have cause for concern. Agents, in contrast, are regulated by the Insurance Department and must go through a criminal check before they get a license, not so with navigators et al.
- HHS still wants to have an agent-free environment although thankfully they may have realized problems in their system that agents could have helped them avoid.
- Automatic renewal of enrollees may be easier for HHS to keep the numbers up for next year but it reduces customers' ability to choose between qualified health plans. Using an agent would avoid that problem.

Jim C. August 14, 2014 10:06 am

Let's not forget that almost every funding source in the original Act has been reduced or delayed while subsidies are greater than projected. It should be interesting to see how the Feds balance the books without a large tax increase to pay for our "free healthcare"/

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