<p>10,000 a day in CA would be about 330,000 between now and Jan 1. </p>
<p>Refresh my memory… How many cancellation notices went out to individual policy holders in California?</p>
<p>So, taxpayers are also paying for advertising? This is all very odd. Weren’t the CA cancellations over 1-million?</p>
<p>Why the emphasis on cancellations? Do you have any reason to think that most people whose insurance was cancelled would go to the exchange? GP isn’t going to the exchange. </p>
<p>A sizeable percentage of people who got notices saying their current plan was being cancelled and they’d be moved to a new plan unless they did something would say, Oh, OK, and send in the new payment. Especially if the new premium was lower, or not much higher, as was true for some people.</p>
<p>And another good chunk would buy directly from insurance companies instead of going to the exchange, like GP.</p>
<p>And then another percentage, particularly those who had junk insurance, would go on Medicaid.</p>
<p>So I figure most people who got cancellations wouldn’t be likely to go to the exchange to get themselves covered. Do you have a reason I should believe otherwise?</p>
<p>And, of course, the number of people signing up on the exchanges has been increasing, in California. Do you have a reason why I shouldn’t think it will continue to increase?</p>
<p>I wouldn’t believe anything Covered Ca says about their exchange plans. I still remember Peter Lee crowing last June about the great premiums and how much cheaper the exchange plans were compared to existing plans</p>
<p>The bottom line is until people start making their premium payments, we have no idea how many people will have an exchange plan.</p>
<p>Anyway, if anyone thinks these are real plans, they should go to the Blue Shield website and look at the networks for some of the regions.</p>
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<p>Why wouldnt you want to get into that juicy market of 106,185 subs! And unprofitable ones at that. </p>
<p>WP and Cigna and Aetna each have more than 40M subs. I dont see that fighting for these table scraps other than as political tokenism.</p>
<p>One wonders how many more doctors could have been educated for the cost of a single boondoggle of a website? Insurance does not = health care.</p>
<p>interesteddad – I agree with you, a straight across-the-board tax credit would have been a better option, for all ACA-qualifying plans. That is, if the plan is good enough to meet the requirements to avoid a penalty, then it should also be eligible for a credit, regardless of where purchased. I do think that the exchanges are appropriate and needed for anyone who want to apply for advanced payment of the credit, or to qualify for the enhanced cost-sharing Silver plans (for those with incomes under 250% FPL) – but I think the whole system would operate more smoothly if people like me who are unsure of whether we will qualify for a credit could just purchase the plan directly from the insurer. A lot less confusing that way, and those of us who have letters terminating our old policies but automatically rolling us over to a new policy wouldn’t have needed to do anything at all, if we wanted to stick with whatever policy the insurance company wanted to roll us into. </p>
<p>I think it would save the government money too, as I think many more taxpayers would opt to defer payment of the credit if it meant they didn’t have to hassle with applications and web sites. Deferred payment means less administrative costs for the government as well.</p>
<p>To GP (and anyone else in California concerned about networks but not eligible for subsidies): I have found out that Cigna is offering individual insurance off-network. Cigna opted out of Covered Calif, but the 2014 policies it will be selling are ACA compliant, with metal tiers. Their premiums are somewhat higher but networks may be broader. You might find it worthwhile to visit the Cigna web site and call an agent.</p>
<p>Also, if you hurry, you might still be able to get an old-style Cigna plan that would require medical underwriting and be good through December 2014. But that might give you a better premium and possibly broader network.</p>
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“Cancellation” notices is something of a misnomer. </p>
<p>Most of us got letters saying that our current plan (Plan A) would be terminated as of the end of the year, and that the insurance company would automatically enroll us in the new, ACA-compliant plan (Plan B) unless we told them not to.</p>
<p>So the default position is automatic enrollment in a new policy. Very few people left uninsured.</p>
<p>Calmom, are you envisioning that the subidies would be the same amount as now, but you could get them directly from the insurer? That is supposed to be happening, but I don’t know how soon.</p>
<p>An insurance company signing up to be on the exchange means they also sign up for risk adjustment. Some companies might not want to be involved with risk adjustment, because it might mean they have to pay money instead of getting money.</p>
<p>California restricted the number of plans on the exchange. Other states did not. I’m not sure why California chose to restrict the number of plans-- it may have been the irrationality that you and I learned about, where people presented with five choices choose one, and people presented with 23 choices just refuse to choose.</p>
<p>GP, I have a question for you, since you keep complaining about the networks:</p>
<p>Do you and/or your wife currently receive regular or ongoing care at UCLA or Cedars Sinai?</p>
<p>Or is your concern more of a “what it” scenario: that is, you want those hospitals available just in case some serious medical need arises in the future?</p>
<p>FYI: to anyone counting on subsidies through the federal exchange. A month ago, a federal judge granted standing in a lawsuit that challenges giving subsidies to insurance obtained through the federal exchange. The reason? The law only allows subsidies for insurance obtained on a state exchange. </p>
<p>It could take years before this lawsuit is decided but there it is. There is little chance the Congress in its current make up would vote to fix this.</p>
<p>According to this article, many of the subscribers whose plans were cancelled will now be eligible for subsidies, and therefore they will be re-enrolling on the exchange, correct? Or can you get a subsidized plan directly from the insurer?</p>
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<p>[Hotline</a> Opened for Cancellation Issues - California Healthline](<a href=“http://www.californiahealthline.org/capitol-desk/2013/11/hotline-opened-for-cancellation-issues]Hotline”>Hotline Opened for Cancellation Issues - California Healthline)</p>
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<p>NO, I didn’t say that: I said I that if someone wanted ADVANCE payment of their tax credit or a cost-reduction plan, they would have to go through the exchange – but if they just wanted to buy a regular metal plan and wait until they file their tax return in 2015 to get any credit, they should be able to sign up directly with the insurance company and pay the full premium.</p>
<p>Right now the law only allows a tax credit for policies purchased through an exchange-- so a lot of people who are unsure of whether they will qualify for a tax credit or whose tax credit would be fairly low are forced to go through the exchange, or risk losing a potential tax credit down the line.</p>
<p>There is no need for an advance determination of financial status if the person does not want or need the premium reducing advance tax credit. The information to determine tax credit down the line will be available to the IRS as part of the tax return (and if not, it could be made available simply by requiring all insurers to submit an appropriate informational return – some sort of 1098 specific to to ACA needs).</p>
<p>Calmom,
I cannot imagine that very many people would opt to defer realizing the credit/subsidy, as I thought the whole point was that these people cannot afford the full monthly payment. If they can afford to defer, then perhaps they don’t really need it, so why are we giving it then?</p>
<p>Calmom, I have been aware of Cigna for some time. In case you didn’t know they are only in Los Angeles and San Francisco for 2014. I am considering their 2013 plan, not sure I want to deal with the underwriting requirements for just one year.</p>
<p>My wife and I have used Cedar Sinai in the past. Many years ago, my wife had a very difficult pregnancy and her obstetrician referred us to a doctor in Los Angeles. She ended up having a procedure there, which couldn’t be done locally.</p>
<p>I am totally frustrated with Anthem. It is almost Dec 1 and they still don’t have a provider search tool on their website. Are you kidding me. Blue Shield’s network stinks in my region. You would have to be crazy to take one of their plans.</p>
<p>Calmom, you and interesteddad are talking about two different issues. </p>
<p>I agree that Anthem is not making things easy.</p>
<p>So I talked with an old friend in Washington State who currently has insurance, but whose decision about insurance is based on a single med. For the past four years, instead of spending $1,000 a month on the med through his insurance (that’s after insurance), he has been getting it for $350/month from Canada. No one so far has been able to tell him about what his particular med will cost under the various plans (or even whether it will be covered), though they all have a theoretical “out-of-pocket” maximum. (Does anyone know whether the out-of-pocket maximum applies to meds?) He is currently very frustrated (though hopeful.)</p>
<p>It should apply as long as the med is in the plan’s formulary, which is not a given.</p>