Affordable Care Act and Health Benefit Exchanges

Health Train Express is searching for a ‘volunteer’ to help with research and writing for the blog.  We are struggling to keep up with the surge in interest in health reform.The ideal candidate would be a graduate student in MPH program or in a health related MBA program.  Full attribution will be given to writers, and your contribution would be subject to the ‘Creative Commons” copyright regulations. You may use this material as a reference.

The blog is focusing on the credibility of the ACA. Your activity is very important at this time to  ‘expose’  Obamacare. 

The lastest information regarding premiums, exclusions, and special conditions are brought to  you courtesy of Matthew Taber .  Keep in mind that these figures are from the Federal HBX, subject to change, delayed deadlines, and inaccurate statements.

Scroll down to the bottom of the page for a viable legal alternative to the Affordable Care Act.

 Click here

“October 28, 2014

Keep in mind all of the data concerning premiums and subsidies (subsidies on federally run state exchanges are illegal per ACA) are completely screwed up but below should give you at least an idea of what they could be.
*Note on smokers.  Insurers charge a tobacco surcharge of up to 50% of total premium. Tax subsidy can not be applied to the tobacco surcharge *
Healthy single non-smoker  30 year old living in Cypress TX making $26,000 a year
Silver plan  -  $2,614 per year
Subsidy      -  $737 per year (covers 28% of overall premium)
Amount you pay  -  $1,877 per year (7.22% of household income, 72% of overall premium)
Healthy single non-smoker 30 year old living in Nashville TN making $26,000 a year
Silver plan  -  $2,006 per year
Subsidy      -  $129 per year (covers 6% of overall premium)
Amount you pay  -  $1,877 per year (7.22% of household income, 94% of overall premium)
Healthy single non-smoker  30 year old living in Riverside CA making $26,000 a year
Silver plan  -  $2,790 per year
Subsidy      -  $913 per year (covers 28% of overall premium)
Amount you pay  -  $1,877 per year (7.22% of household income, 67% of overall premium)
Healthy single smoker 30 year old living in Pinehurst NC making $26,000 a year
Silver plan  -  $3,139 per year
Subsidy      -  $1,262 per year (covers 40% of overall premium)
Amount you pay  -  $1,877 per year (7.22% of household income, 60% of overall premium)
Healthy single smoker 30 year old living in Gulf Shores AL making $26,000 a year
Silver plan  -  $2,650 per year
Subsidy      -  $773 per year (covers 29% of overall premium)
Amount you pay  -  $1,877 per year (7.22% of household income, 71% of overall premium)
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Healthy family with two children living in Cypress TX  making $40,000 a year
Silver plan  -  $8,866 per year
Subsidy      -  $6,901 per year (covers 78% of overall premium)
Amount you pay  -  $1,965 per year (4.91% of household income, 22% of overall premium)
Health family with two children living in Nashville TN  making $40,000 a year
Silver plan  -  $6,805 per year
Subsidy      -  $4,840 per year (covers 78% of overall premium)
Amount you pay  -  $1,965 per year (4.91% of household income, 29% of overall premium)
Healthy family with two children living in Riverside CA  making $40,000 a year
Silver plan  -  $9,465 per year
Subsidy      -  $7,500 per year (covers 79% of overall premium)
Amount you pay  -  $1,965 per year (4.91% of household income, 21% of overall premium)
Healthy family with two children living in Pinehurst NC  making $40,000 a year
Silver plan  -  $10,649 per year
Subsidy      -  $8,684 per year (covers 82% of overall premium)
Amount you pay  -  $1,965 per year (4.91% of household income, 18% of overall premium)
Healthy family with two children living in Gulf Shores AL  making $40,000 a year
Silver plan  -  $8,989 per year
Subsidy      -  $7,024 per year (covers 78% of overall premium)
Amount you pay  -  $1,965 per year (4.91% of household income, 22% of overall premium) “

You can avoid all of the above stipulations by using a ‘Direct Payment” program, such as MedicalAccessUSA and by purchasing a ‘catastrophic health insurance plan”  If you are curious and want more details, click on the ‘Contact Us’ black tab on the upper right hand corner of the landing page.  No obligation, this is an informational demo site only.

Author disclosure:  No guarrantees of coverage or benefits should be accrued to this message.  Informational purpose only.

 

Technorati Tags: medicalaccessusa,aca,affordable care act,direct payment,healthy family,health benefit exchange failures,hbx

CORDS : Coordination of Rare Diseases at Sanford

 

Not to be confused with ‘Stanford University School of Medicine, CORDS offers a centralized web site for patients with Rare Diseases, and Researchers in the field of rare diseases.

  Register Here

Mission statement, as stated on web site.

At Sanford Research, we are committed to finding cures and advancing therapies for rare diseases. There are approximately 7,000 rare diseases affecting 25 million Americans and 350 million people worldwide. Many new developments in the diagnosis and treatment of human disease rely on research that involves the collection and analysis of data, but research into rare diseases is challenging due to a lack of information, the low numbers and geographic spread of individuals affected by rare disease, and data collected and stored in separate databases. To help address these challenges and advance research into rare diseases, we established the Coordination of Rare Diseases at Sanford (CoRDS).

Click here to view CoRDS Metrics & a list of diseases represented in CoRDS.

These diseases, although serious with morbidity and mortality are rare and often do not qualify for research grants because there are so few patients with each of these diseases.

The aims of the Affordable Care Act may optimize treatment for these rare diseases.  As the Affordable Care Act rolls out we will see how well it addresses this challenge.  Will it affect the number of children and adults who are not eligible for  health insurance.?

Activities such as this from a small rural hospital system in South Dakota do much to illuminate the  research, progress and patient advocacy for rare diseases. It was originally founded to fund raise for Breast Cancer by  Mr. Denny Sanford.

In 2007, Mr. Sanford made history with his gift of $400 million to Sanford Health—the largest donation ever to a health care organization.

 

Technorati Tags: #cord,#sanfordreseardh,#rare,#cords

Twitter and the Affordable Care Act

 

Statistical analysis of social media interest in health reform. (The Affordable Care Act)

What was it that caused twitter activity to spike on the 24th ? Tweet me the answer @glevin1l or reply here in comments.

#tags by #symplur.

 

Technorati Tags: #hcsm,#hcsmcourse,#symplur,#affordable care act,#twitter

Educating in Health Care with Social Media

 

What you can learn using social media..

Edutopia, and Mimi Ito  bring a fresh perspective about social media, and it’s entertainment value for education.  It applies to adults as well as children.

The requirements  for Continuing Medical Education  for medical license renewal converts a previously enjoyable learning experience into an exercise in frustration signing up for useless CME courses in order to meet a mandate for CME.

Learning should be fun, creative and stimulating. Social Media has the capability to accomplish all of that.  The most creative people are those activating “their inner child”

Mimi Ito elaborates in this video. Much of this applies to adult education and professionals as well.

On the flip side of this, Social Media Courses for physicians, termed residencies to align the format with CME courses and CME credits have grown and presented by several large established educational institutions.  Who could have predicted that physicians would line  up to apply for a  social media residency ?  Lee Aase as head of Mayo Clinic’s Social Media Department.

Lee Aase has been known for his traditional social media, and now his lead role in health care social media as demonstrated by his writings, and lectures.

"Mayo Surgeons Use Twitter as Teaching Tool", ABC5 Eyewitness News (St.Paul-Minneapolis), 16 April 2009

"Why Doctors Are Tweeting During Surgery", ABC Good Morning America (New York), 16 April 2009

"Mayo Turns to Social Media to Reach Out to Potential Patients", St. Paul-Minneapolis Star Tribune (St. Paul-Minneapolis), 19 April 2009

"How to Use Social Media: An Interview with Lee Aase of Mayo Clinic", American Express Open Forum, 23 June 2009

"Social Media Smarts: Interview with Lee Aase", Online Marketing Blog, 3 August 2009

"Mayo Clinic's Lee Aase: Simple Marketing in Action", Simple Marketing Blog, 13 August 2009

"Social Media Case Study from Lee Aase of Mayo Clinic", Gaspedal's Business Blogging Blog, 14 October 2009

"Lee Aase, Mayo Clinic: The future of health brands and social media", Trajectory4brands.com,

 

Social Media Use in the United States: Implications for Health Communication:  as published in the Journal of Medical Internet Research

Social Media has large implications for patient education, physician education, physician-patient education and peer-to-peer knowledge transfer.

 

Technorati Tags: lee aase,mayo clinic social media,education,cme,medical education,edutopia,mimi ito

The Affordable Fiasco

For the past two weeks I had unsuccessfully attempted to access the Covered California online enrollment website.

I had been met with a variety of problems, none of which I had not experienced on other websites, private or governmental.  Some of the messages….

“error 404”

“page unavailable”,

“blank screen with whirling circle”,

“website is busy”,

“please wait”,

“blank screen….”

“try again later”,

“refresh to submit information again, do not click on back arrow”.  I have also had some success although on different occasions I hit a stone wall at different places on Covered California, and each time the ‘glitch’ occurred at a different stage of ‘’enrollment’. 

Along the way I came across an article by Paul Ehrlich about the 13 greatest error messages from computers.

The upside was that none of the messages were DOS errors, i.e.  Abort, Retry, Fail which is usually just before the “Windows Blue Screen of Death”

  Anyone who has seen this screen knows the next event is the computer shutting down and if you are lucky it will re-boot on it’s own. 

“To err is human, but to really foul things up you need a computer.” So goes an old quip attributed to Paul Ehrlich.  So one sees that this is not an Affordable Care Act failure, at all.

Never once did I receive positive reinforcement nor a ‘successfully enrolled’.  On one occasion I did see a screen with the different plans, and calculators which revealed subsidized plans and premium rates based upon your level of near poverty or destitution….It is hard to believe how many of us are on the thin line and impoverished, living from paycheck to paycheck.

I discovered a secret path and backdoor by searching on Google.  It took me to another non-official looking site that allowed me to look up plans and premiums.

Finally after two weeks of unenthusiastic attempts to register I submitted to the old fashioned  “P.O.T.S.”  It worked ! I was able to reach a person in one minute without going through a telephone triage system. The entire process took about five minutes. I will receive a mail (snail) within ten days informing me of eligibility and plans I from which I will chose.

This ‘foolproof’ system cost a lot less than $ 650 million dollars, and has been around for at least one hundred years.

(My telephone---the worst that happens is, there is no dial tone.)

For the young crowd (those who are mandated to obtain health insurance, to pay for the rest of us old codgers  P.O.T.S. is the abbreviation for  “Plain Old Telephone Service”  This was in the age before transistors and silicon valley.

My answer to Californians is to dial  800-300-1506 . Overly simple for most and it worked the first time.  (Don’t tell anyone else, until you have enrolled)

In all  fairness here is what the  HHS blog had to say,

We’re listening — and improving every day

October 21, 2013

---

---

We know using HealthCare.go has been frustrating for many Americans. The initial consumer experience of HealthCare.go has not lived up to the expectations of the American people. We are committed to doing better.

We’ve been gathering feedback since the day we launched – from our customer service representatives, social media channels, and through hundreds of thousands of online surveys and comments. And we’re listening.

We’ve been making changes to respond directly to your feedback and will continue to do so. A few of our most important changes so far:

• You can now preview plans and prices available in your area without filling out the online application.
• You can find out, with an improved calculator, whether your income and household size may qualify you for lower costs on your monthly premiums and out-of-pocket costs.
• You can apply for coverage 4 ways: By phone, online, by mail with a paper application, or with the help of an in-person assister.
• We’ve been adding educational online content where you tell us you need more information: About estimating your income, accounting for people in your household, eligibility rules, and more.

And please keep the feedback coming – on this blog post below, on any of our social media pages, or by using the little “Was this page helpful?” survey that appears near the bottom of most pages on the site.

We won’t rest until every American who needs affordable, high-quality coverage can get it - using whatever method works best for them.

 

Technorati Tags: covered california,health benefit exchange failures,pots,telephone,blue screen,paul ehrlich

Physicians Digital Marketing Guide for 2014

 

Most physicians shy away from marketing. Our ethics discourage self-aggrandizement and most marketing falls into that category.

However there are alternative positive reasons for promoting your medical practice.

Charitable and Philanthropic Goals

      

Public Health Informational Content

      

Mission positive statements

      

Clarity and Distinction from other Medical enterprises

Informational, educational and training opportunities

  

Location Information using Mapping technology, Directions to facility

With these ideas in mind, today’s lesson will be on Digital Marketing for 2014.  The information is time-limited due to the nature of electronic media.

White papers on digital marketing, social media, organic marketing, are readily available online,in digital form and for downloading as printed documents.

Conventional 20th Century marketing in industry publications, journals, meetings,and even emails are passé. 

 

Emails are considered spam and frequently deleted without being opened. Email is also considered a viral threat is attachments and/or links are opened.  Readers will frequently not click on a link in the body of the email.

Online marketing can be a challenge to analyze what, when and where potential clients (patients) read online content.

Recent experience and reports from media experts also reveal the fluid and ever-changing tools and structure of social media platforms.

Social media is dynamic and must be interactive, with Q&A capabilities. Social media platforms allow for business pages (Facebook, Google +)

Not only is what you say important, but how you say it, where it is placed in your content, and who reads your material.

Modern search algorithms have morphed into natural language processing and semantic interoperability.  If your content is designed properly it will favor  a ‘viral message’

 

 

Technorati Tags: digital health products #hitsm #hcsm,marketing,medical marketing,semantic,semantic interoperabilitiy,viral messaging,social media,facebook,google +,twitter,search,charitable,philanthropic,mission,goals,public health,cme,education,training

How Long Does Obama Have To Fix Healthcare.gov?

 

By Julie Appleby

KHN Staff Writer

OCT 21, 2013

“They've got a few weeks.

But if federal officials can’t get the new online insurance marketplace running smoothly by mid-November, the problems plaguing the three-week-old website could become a far bigger threat to the success of the health law, hampering enrollment and fueling opponents’ calls to delay implementation, say analysts.”

That is only 3 weeks from today   October 22, 2013.  According to sources, there are over 3 million lines of ‘code’ to review and correct as necessary.

If the administration solves the problems before the end of October, “this would just be a blip on the radar,” said Dan Mendelson of consulting firm Avalere Health in Washington.

If problems cannot be resolved that quickly, Mendelson said “there are other options for getting people enrolled,” noting that Medicare beneficiaries signed up for coverage for decades without using computers.

 

 

The president also mentioned those options Monday, saying consumers could sign up by telephone, in person with trained assisters or by downloading an application and mailing it in. (28 pages)

But those options are not ideal, mainly because millions of applications would have to be manually checked across several federal agencies.

“That would take significantly longer than if it was automated,”

Some analysts suggest that if problems persist into late November or December, that the Obama administration will need to consider extending the open enrollment period.

Such a decision, however, would have political and financial ramifications.

These events have created a political and administrative bonfire. It impacts financial planning by insurance companies, and to say the least…..the object for affordable care, the patients themselves. Unfortunately patients are left for last, covered in dust, smoke and mirrors.

Because the health law is primarily aimed at low to moderate income people – and their household cash flow is often drained by holiday gift spending and replenished by February tax refunds -- getting the exchange working by November isn’t critical, said Brian Haile, senior vice president of healthcare policy at Jackson Hewitt tax service.

“If you’re trying to sell something you need to do it at a period during which you don’t have competing consumption,” said Haile. “After Nov. 1 … foremost on their minds is not, ‘Am I going to buy insurance?’ but ‘What am I going to put under the tree?’ ”

Jay Hancock, Anna Gorman and Philip Galewitz contributed.

Health Beneficiary Exchange: How is Social Media Involved?

 

#navigator #hbx

The recent roll out of the Health Benefit Exchange has not gone exactly as planned.

The latest on the Health Benefit Exchange snafu : HHS maintains a ‘blog” as part of their “Digital Strategy” web pages.

In a post published Sunday on the HHS "Digital Strategy" blog, the Obama administration said it has formed a team of IT experts from the public and private sectors to help resolve the technical glitches that have plagued the Affordable Care Act's federally run health insurance exchange website

Although the Navigator program envisioned by HHS to educate and assist patients in navigating health benefit exchanges, there are several problems. The Navigator program is not fully implemented and difficult to find and/or contact.

Much of the affordable care act is targetted at young people, those who are on social media platforms including Google +, Facebook, and Twitter as well as many others, Pinterest, Myspace, and a host of other sites.

It makes sense that social media can be used with better comunication than all other media. Mobile provides ubiquitous messaging with apps for all of the above social media sites.

Illinois is one of the first to harness social media to broadcast their ‘message’.

llinois Social Media Experts Seek To Help Frustrated Exchange Users

Chicago marketing agency FleishmanHillard has deployed a small team of social media experts to monitor and respond to online comments about glitches associated with the federally run health insurance exchange under the Affordable Care Act, the AP/Washington Post reports (AP/Washington Post, 10/18)

Since the Oct. 1 start of the open enrollment period, many consumers have experienced technical glitches on HealthCare.gov  that have hindered their attempts to enroll in coverage (iHealthBeat, 10/15).

Since the website opened for enrollment Oct. 1, consumers and health insurers have continued to report application delays and errors with HealthCare.gov that extend beyond the high visitor traffic and software issues that HHS officials initially identified as the causes of the problems

In Illinois, the federally run Get Covered Illinois website teaches state residents about their insurance options before sending them to HealthCare.gov.

According to FleishmanHillard, the agency has put on hold all paid advertisements.

Instead, social media experts now are engaging with discouraged consumers and posting new information and advice on Twitter, as well as other social media websites.

The team also is using Facebook to post updates about HealthCare.gov.

Meg Poulelis -- a social media expert working for the outreach campaign -- said, "We're making sure we're listening [to consumers] and we're supportive and we're there for them when they're having difficulties."

Dave Kerpen -- social medial strategist with New York-based Likeable Media -- said, "Given people's frustrations with the federal website, Get Covered Illinois has to be able to respond promptly with great care to their customers."

Several other avenues will be email, and networking with influential bloggers.

However, a word of caution….some social media users have ulterior motives and may offer highly biased views if they oppose the Affordable Care Act, or are out to market self-interest views.

 

Dr. Manny: America, stop turning to social media for information on Obama Care

Dr. Alvarez notes that many politically inclined ObamaCare enrollment continues, the folks in charge of informing Americans about health care are politically biased individuals who don’t necessarily care about or understand health care issues, but rather simply want to promote a progressive agenda of a socialized America.

For all the questions you can’t find answers to about Health Benefit Exchanges #hbx or #navigator may help to begin.

The Obama Code

 

Few people don’t know about the run up and hype about the national  HealthCare.gov launch as a pre-mature birth.  HealthCare.Gov is now being rushed to the NICU (neo-natal intensive care unit).

Obamologists are running some quick diagnostics on the new baby, to determine if it’s a hardware or software problem. 

Early indicators are that despite President Obama’s announcements,this will not be a quick recovery from a birth with an Apgar score of less than 4.  At that level any prognosis is guarded.

It’s all  in the code…..or is it the hardware, servers, and networks? Experts are being rushed in to replace and/or augment government contractors from the space, and military industry.  Outside experts not familiar with, or having no desire to file for a government contract and it’s byzantine contracting process have been sought to fix another government fiasco. Will this be through a bidding process or just another government contract over-run with which we are all too familiar?  After all isn’t software for health the same as for rockets, space-craft and running the IRS?

The Health and Human Services Department, which administers the site, said Sunday it has recruited "some of the best and brightest" technology experts from inside and outside the government to resolve the defects.

Internet users have been unable to create accounts, received confusing error messages and had to endure pages loading slowly or failing to respond in a timely way.  President Obama considers those problems "unacceptable. Thank you Mr President, so do the rest of us.

When and if Mr.Obama’s aides read the ACA he is in for some even bigger surprises. After enrollees enter the door and enroll in whatever plan they chose, there will be even bigger surprises. Some will enter the system, chose a provider (maybe an MD, or a PA or NP).  Some will find surprisingly high premiums and a sticker shock of 10,000 dollar deductibles as a trade-off for lower premiums.

For Example:

 

Technorati Tags: health benefit exchange,covered california,obamacare,deductibles,premiums,health benefit exchange failures

Betrayals, Lies, and Deception

 

As I was sitting down this Sunday morning to think about my next blog posting, my twitter feeds, facebook and Google + lighted up my smartphones, tablets and desktop PC.

A life-long friend, David Fox sent me an email about Dan Bongino who is a candidate for the Congressional seat (2nd district), Maryland about Obamacare which he sent to his former employer.

Mr. President,

In one of your famous Obamacare speeches you stated, "If you like your plan, you can keep your plan."
Well, as evidenced by the letter below, which my wife and I just received, you lied. We did "like" our plan.  But we were informed in this letter that our plan will no longer exist and we will be forced to purchase a new plan, from a website which doesn't work, for a higher monthly premium, for services we don't want.
Now, I know I am not one of your connected cronies and insiders, who were all given waivers from this disastrous piece of legislation. I was just one of your Secret Service agents who put my life on the line for you every day. I was still praying that given our middle-class existence, operating a small-business in Maryland, that your "fundamental transformation" of America would have stayed out of our home. Apparently that is not the case as my public battle against your disastrous presidency has just become very personal.
Regards,

Dan Bongino

Letter from Blue Shield

 

Technorati Tags: health insurance,obamacare,affordable care act,bongino,obama,maryland congress

Sebelius will be a no-show at Obamacare hearing

 

The title of this blog post says it all, and confirms the disdain HHS show for providers, patients, pharma, insurance companies, hospitals and Congress.

The  Affordable Care Act assigns authority and responsibility to HHS for the implementation and mandates of the Affordable Care Act. Kathleen Sebelius is the personification of HHS as her appointed title indicates. She was confirmed by Congress several years ago, prior to passage of the Affordable Care Act.

Health and Human Services Secretary Kathleen Sebelius will not testify at a congressional hearing Thursday into breakdowns in the rollout of the federal Affordable Care Act, drawing more heat from House Republicans.

An HHS official confirmed Saturday that the secretary would not attend, citing a conflict in her schedule.

"We are in close communication with the committee and have expressed our desire to be responsive to their request,” the official said.

 

The hearing, before the House Energy and Commerce Committee, was scheduled this week to address glitches in the Obamacare website. Chairman Fred Upton, R-Mich., ripped Sebelius when initial reports indicated she would not attend.

Sebelius states that she is too busy to attend due to prior commitments.  Is this cowardice, or merely indicating  her lack of  priority for the Affordable Care Act?

Health experts, including consultants are overly analytical attempting to prove or disprove the merits of the ACA with tables, graphs and diagrams outlining ObamaCare, how much it will cost and how much it will save, and how many more souls will now have health insurance.

They ignore the common sense question….why is there much opposition to the law?

And as more deadlines approach for mandates the opposition grows. The nuts and bolts which account for success or failure are whirring and grinding.  Is it because it was planned in committee rooms and in the planning process key experts who did not follow the Democratic vision were excluded from the process early on. Isn’t this why the Republicans could not or would not vote for the ACA. Is this what led up to the Budget Stalemate and the Debt Ceiling Crisis?

Failure does not have to be the end of the Affordable Care Act, however the early phases should set off loud alarm bells at HHS and in Congress.  Mr Obama has two choices….to fall on his sword and ask both parties to reconnoiter and rethink Health Reform either by amending the law or have it repealed.

The Affordable Care Crisis

 

Opposition to the current roll-out of the Affordable Care Act has grown and has come center-stage. Proponents of the new law seem to have taken a less visible role, and public opinion has gradually drifted to changing the mandate deadlines. From a practical stand point the health benefit exchanges do not seem to be entirely ready, and have generated confusion and more anxiety.  The Dept. of HHS hyped the HBX and raised unrealistic expectations.  It became more of a marketing ploy than a real value proposition.

It is time to back off and take a breath to re-evaluate the goals and what must be implemented to assure a smooth and successful health reform .  It may require major revisions during the next 24 months.   The compressed time schedule from 2010 when the law was passed until 2013 is really a very short time to transition a huge industry. Much of it evolves only if all the steps take place in an orderly fashion. It is a bit of a domino game and a false step or missed opportunity may crash the project entirely. 

Health care has not and will not been reformed by the Affordable Care Act.

Another indicator of the error in thinking, HHS failed to realize that health will still operate in an open marketplace, save for those at the bottom tier who will have to rely on a legacy medi-caid system, an antiquated poverty level, and a maze of federal-state-county eligibility system.

In the current system counties calculate benefits based upon maintance costs, also legacy and badly out of date poverty level figures. For one thing poverty levels are determined for the nation at large. Poverty level in California is far different from Poverty levels in the midwest or Arkansas as one example.  In fact poverty levels vary greatly in each state, such as a state with wide disparity  in income zones.One size will not fit all and nothing has been mentioned regarding specifics of how the medi-caid system will be modified to adapt to ObamaCare.

Obamacare and the Federal Poverty Level

Who gets help from Medicaid (AHCCCS in Arizona) and who gets help with their health insurance premiums under Obamacare?  It all depends on a person’s, or a family’s income in relation to the federal poverty level.

An individual or a family will get help with their health insurance premiums if their income is between 133% and 400% of the federal poverty level (FPL).

In addition to getting help with health insurance premiums, some people will get help with co-pays that are part of their health insurance plan. Individuals or families making less than 200% of the federal poverty level (but higher than 133%) will get this help if they enroll in a Silver plan. (I guess I need to explain the coverage levels next.)

Here is a chart that shows the FPL changes based on the number of people in a family.

The Beginning or The End to the Affordable Care Act

 

By now perhaps 20 million or more Americans have tried to log into the National Health Benefit Exchange, or one of the State-run portals.

There is probably no way to tell exactly since the analytics are not working for the site. However Google could probably tell us. (Maybe HHS should have contracted with  them.

These are not glitches,” said an insurance executive who has participated in many conference calls on the federal exchange. Like many people interviewed for this article, the executive spoke on the condition of anonymity, saying he did not wish to alienate the federal officials with whom he works. “The extent of the problems is pretty enormous. At the end of our calls, people say, ‘It’s awful, just awful.' ”

The reluctance for many states to join the national HBX effort is outlined by the following.

Interviews with two dozen contractors, current and former government officials, insurance executives and consumer advocates, as well as an examination of confidential administration documents, point to a series of missteps — financial, technical and managerial — that led to the troubles.

Politics made things worse. To avoid giving ammunition to Republicans opposed to the project, the administration put off issuing several major rules until after last November’s elections. The Republican-controlled House blocked funds. More than 30 states refused to set up their own exchanges, requiring the federal government to vastly expand its project in unexpected ways.

Deadline after deadline was missed. The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process. As late as the last week of September, officials were still changing features of the Web site, HealthCare.gov, and debating whether consumers should be required to register and create password-protected accounts before they could shop for health plans.

 

From the Start, Signs of Trouble at Health Portal

Dr. Donald M. Berwick, the administrator of the federal Centers for Medicare and Medicaid Services in 2010 and 2011, said the time and budgetary pressures were a constant worry. “The staff was heroic and dedicated, but we did not have enough money, and we all knew that,” he said in an interview on Friday.

There are opposing opinions as to how long it will require to unravel another Gordion knot.  Some say weeks and others say several months.

How much will it cost? Like every government project it will most likely come in over budget, which can also be said about the entire Affordable Care Act.

And while I compare apples to oranges, at  $150 million USD a pop for a state of the art F35 stealth fighter, that will sound like a Walmart special, as compared to Obamacare.  

And like Health Benefit Exchanges, there is a web site dedicated to the F35 Raptor .