FEDERAL HEALTH BENEFIT EXCHANGES: COVERED CALIFORNIA, BREAKING NEWS

Exchange enrollments at 3.3 million, big jump in January

By Paul Demko 

Posted: February 12, 2014 - 5:15 pm ET

Tags: Costs, HealthCare.gov, Insurance

(Story updated at 6:15 p.m. ET)

Nearly 3.3 million individuals signed up for private insurance plans through the state and federal exchanges during the first four months of the open enrollment period, HHS reported Wednesday. The total represents significant growth in January, but is still less than halfway toward the goal of 7 million enrollments by March 31.

State exchanges enrolled 1.4 million individuals through the end of January, while 1.9 million individuals signed up through the federal exchange, according to figures released by the CMS on Wednesday. The federal exchange, in particular, showed momentum in January: Nearly 40% of total enrollments through the federal HealthCare.gov website occurred last month. 

It's very, very encouraging news,” HHS Secreatary Kathleen Sebelius said on a call with reporters Wednesday.  

However the total numbers only show a small part of the enrollment issues.  Demographics vary widely from state to state in terms of age, health, and gender.

“We're seeing a growing population of Americans who are young, healthy and well covered, and these younger Americans are signing up in greater proportions,” Sebelius said.

A significant number of new enrollees are from those who had pre-existing policies cancelled at the end of 2013.

Catastrophic Options

Hardship Exemptions  (Qualifications)

However, in some states exchange customers continue to skew significantly older. In Ohio and Wisconsin, for example, only 21% of enrollees were between the ages of 18 and 34.

A gender discrepancy is also emerging, with women representing 55% of those seeking coverage. In some states, the gender imbalance is even more pronounced. Women account for 60% of signups in Oregon and 62% of exchange customers in Mississippi.

HHS also issued data for the first time on the type of plans being purchased on the exchanges. More than 60% of state and federal exchange customers opted for silver plans, which are designed to cover 70% of medical costs

Last week, the Congressional Budget Office reduced its estimate for how many people will sign up for coverage in 2014 from 7 million to 6 million, due in part to the rocky rollout of the federal exchange and continued problems with some state marketplaces. 

There is still no data available on how many individuals have actually made their first premium payment. Even after enrollment and premium payment it remains to be seen how many will find a suitable provider. Magnifying this issue in California is massive errors in the provider directory listing providers who will not accept Covered California.

A massive  deception has been built into Covered California. Policies called Blue Shield PPO (Silver  Plan) are not ordinary Blue Shield PPO plans.  Not only that but there is a difference between group PPO plans and Individual Family Plans (IFP).

I contacted a wel established medical group (Inland Empire)  (120 providers)  to inquire about their providers enrolled in Covered California. I was told tthey accept the group Blue Shield PPO, but NOT the IFP. 

This will come as a great shock to those enrolled in many Covered California plans.

Precautionary note:  Check with your chosen provider to ascertain if they accept your specific plan under Covered California. Covered Callifornia is a general term and means very little. Be certain to find if the specific plan that was signed up for is truly available.

Many patients will present to the doctor's office and find they do not have a provider.

Important News:  Covered California is updating it's Provider  Directory.  Check with your chosen provider to corroborate their participation.  Urgent Care Centers are also specific to a planBe certain your chosen provider is aa member of the medical staff of your chosen hospital.

The Health Benefit Exchanges say that enrollment can be changed until March 31.2014.  

Note: This article will be updated weekly.

The Sad State of HHS and CMS

Many ask, "Has HHS and CMS bitten off more than it could chew?"

The Failed Whale

Perhaps health.gov should have used the 'Fail Whale' icon for it's failed website. Those of you who were on twitter when it first began would see the 'fail whale' when twitter was overloaded. We don't see this very much anymore.....HHS has inherited the 'Moby Dick" of the Affordable Care Act.  Has anyone seen Ishmael ?

Medicaid & Medicare  Pharmacies Braced for Cuts to Their Medi-Cal Payments LawMakers Reach Deal on Doctor Payments Health Reform News  U.S. lawmakers reach accord on paying doctors for Medicare Los Angeles Times - February 7, 2014 Exchange Mum on Premium Payments California Healthline - February 6, 2014 Aetna Expects to Lose Money on Health-Law Marketplaces Wall Street Journal - February 7, 2014 Obamacare Thrives In San Francisco's Chinatown Kaiser Health News and NPR - February 7, 2014 An interesting evaluation of an ethnic community health plan Ex Microsoft Exec Brings Lists and Whiteboard to Overhaul Obama Website How he wound up with this job...His road to this job was a long one. It began in July -- about 12 weeks before the launch of healthcare.gov -- when Microsoft CEO Steve Ballmer announced a massive reorganization  (their loss, our gain).  DelBene’s process is collaborative and open, his colleagues say -- which is important in his new role. “You can see him evolve his positions as he gets more data. It’s not like he’s established his positions and [listening] is just a formality -- just Kabuki ritual theatre,” says U.S. Chief Technology Officer Todd Park. Todd Park, the U.S. chief technology officer, praises DelBene for listening and being open to new ideas (Photo by Karl Eisenhower/KHN). After finishing up his part of the presentation, he felt a “tingle” at the back of his throat, as though he was going to start coughing. He didn’t want to disturb anyone, so he headed for the door to the hallway -- or so he thought. “I started opening the door to the closet!” he recalls, and there was laughter all around.  “Oh! The new guy!” the president said. The Health Benefit Exchange is a product of how government works. DelBene would never have released a product from Microsoft without assurances it did not have many "bugs.  Perhaps part of our government should be 'privatized' and failures should be penalized........just as it is in the real world.  How long will voters and taxpayers tolerate incompetence while paying the bill ?