Looking Back at 2013

This report is somewhat late due to last minute projects at the end of 2013 and the confusion about the individual mandate, the botched launching of health benefit exchanges and some other unexpected tasks

We reviewed the 'best"  Health Train Express posts of 2013 as measured by the number of comments and our analytics.

IRS VIOLATES HIPAA FACES LAWSUIT BY A "J Holiday Message for Health and Wellness WHY AREN'T DOCTORS INVOLVED IN HEALT Does Obama really want the Affordable Care Act Covered California What They Said Before the Train Wreck: The To Sebelius will be a no-show at Obamacare hearing The Beginning or The End to the Affordable Care Act There were many more 'favorites".  The highest number of page views was in the category of the Affordable Care Act. This was to be expected, given the high ranking of the ACA for search engines. Visit the sites on Health Train Express for many more interesting topics. Health Train Express has archived our posts dating back to 2005.  The focus of posts has changed over the  years, and reveals the dynamism of health care and reform.

ObamaCare: We Did Not Know What was In It Until It Passed

It did pass, and we still don't know what  is in it.  Each day we learn of waivers, modifications, amendments to 'fix' fatal flaws in the law.  This is the simple part.....getting people to sign on for health coverage....the doorway to health and wellness.

Dates have been set, mandates have been put on hold, insurance policies were cancelled, no wait..Obama says "Kings X", I take that back. Sebelius smiles and goes before congress, non-plussed.  She must be close to retirement so no problem and undoubtedly she will be through with her public service.  I wonder if she has health coverage?

Many of us have tried to take the high road and plan health reform logically analyzing each step as we proceed.  This is almost a futile endeavour, because the landscape is constantly changing.




Secretary of Health and Human Services Kathleen Sebelius testifies at a Congressional panel last week. The White House has outlined a new exemption under the Affordable Care Act

n a last-minute policy change, the Obama administration waived the so-called individual mandate under the Affordable Care Act for people whose individual health insurance policy is being canceled.

The act requires most Americans to have qualified health insurance starting in 2014 or pay a tax penalty, unless they meet one of myriad exemptions. One is if qualifying coverage would cost more than 8 percent of household income (the affordability exemption). Another is they can prove a hardship such as homelessness, bankruptcy, domestic violence, large medical debts, utility shutoff notice or death in the family.

Under new guidance issued late Thursday, the Centers for Medicare and Medicaid Services (CMS) said that having an individual insurance policy canceled now qualifies for the hardship exemption.

The process is not really that simple:

People who qualify for the cancellation hardship exemption have two options:

-- Don't buy coverage and don't pay a fine.

-- Buy a bare-bones catastrophic policy on an exchange. These catastrophic policies do not meet the requirements of the Affordable Care Act, but people who buy them won't owe a fine. Before Thursday's rule change, to buy this policy a person had to be younger than 30 or meet the affordability exemption.

To qualify for the new policy-cancellation exemption, consumers must complete a hardship application, which will let them purchase a catastrophic plan or receive a penalty waiver, according to Centers for Medicare and Medicaid Services. (For the application, see http://1.usa.gov/19YrBnK.)

To purchase the catastrophic policy, they must submit the form, and evidence of a canceled policy, to a company selling such policies in their area.

The announcement came just days before the Monday deadline for enrolling in coverage to start Jan. 1, and insurance companies are not happy.

When Obama announced another policy reversal in November - saying insurance companies could temporarily renew certain policies that were to be canceled because they did not comply with the act - he gave states the option of allowing that or not.

Covered California did not. As a result, most individual health policies in California that are not grandfathered will be canceled Dec. 31.

Some customers of Anthem Blue Cross and Blue Shield of California will be able to keep their non compliant policies until the end of February or March, respectively, under a settlement with the state insurance commissioner.

People with individual plans that are grandfathered, meaning they had them before the act was signed in March 2010, may keep them until the insurance company decides to cancel them.

It appears that nothing is guaranteed as to the roll out. Insurers, providers, hospitals are all nervously watching and waiting. 

Affordable Care Act "It ain't over until it's Over"

If you are reading this blog and waiting for me to tell you what is going to happen in health reform, you have come to the right place.  I know as much about this as Kathleen Sebelius or Barak Obama.

I am certain that makes you all feel better.

I know that is reassuring to my readers, because Obama and Sebelius had access to and heard many learned opinions on developing the affordable care act. However they were not listening and the elephant in the room was political intrigue, and 'what's in it for me ?"

Today my spouse received the magic letter from Covered  California stating that she has qualified, and now all she has to do is go to the website  log-in and pick her (Silver plan) That is no small task.

Among many other things, the subsidies make no logical sense to me (or others)  I need all of my funds to support myself and my disabled wife who has been unable to work for over ten years.  $250 USD would help pay for the pain medication she takes as a result of a bad wrist injury in 2002. After that she was uninsurable, so I am grateful that the ACA now affords her the ability to become insured until she reaches age 65 and  will be eligible for Medicare.

 It seems that my user id and/or password is incorrect, and I do not remember any of the questions, or answers for the security questions. Small wonder....their selection of Q&As is quite a mystery to me. I am so old I don't remember who my best friend in high school was, no the color of my first car, nor my favorite food (I like them all). Whatever happened to my mother's maiden name?

I called the telephone numbers listed on Covered California for lost user ids/passwords, and was either greeted with a busy signal or a 'we are busy right now, go to our web site, coveredca.com. Now would anyone call them if they had not already tried to use the web site.  The live on line chat room brings up a blank white screen.

The ACA has created stress for all of us, not knowing the eventual outcome...success or failure or some point in between  For those whose former policies  have been cancelled I say let's let them get to the front of the line.

It makes a lot of sense......they are already paying customers and the system needs their premium dollars now.

Everyone else should wait several weeks. Another month won't make much difference to those who have not been insured for the past decade or so.

Although I have never liked insurance companies, I do feel empathy for the mess the affordable care act has produced on top of the measly 15% margin they must operate upon now, and all those pre-existing condition patients waiting in the wings.

As Yogi Berra (byname of Lawrence Peter Berra) once told me, "It ain't over, until it's all over"  (Yes, he did tell me that personally when I was a sprite living in Connecticut.)  My Dad took me to at least a hundred Yankee games in the Bronx. I also have a signed Mickey Mantle original photo of the "Bronx Bomber"

So what does that have to do with the ACA? Let's listen and take seriously what Yogi had to say. I trust him, after all he was a Yankee on a team that broke all records winning  7 world series' back to back.

Would you rather trust President Obama, our Congress, or Secretary Sebelius?  After all Yogi batted left handed and threw right handed. (source Wikipedia)/