<p>Funny cartoon–Star Wars Darth Vader making a speech–“And if you like your planet, you can keep it…”</p>
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<p>Except that the front-end website did not/does not work. The back end-servers have not yet been built. That’s all on HHS.</p>
<p>The Prez has given numerous speeches and told folks to call the insurance companies directly bcos his website has been an unmitigated disaster. They companies shouldn’t be blamed for not planning on HHS/federal failures to perform.</p>
<p>(I realize that it is fun sport on cc to blame the Fortune 500 for many ills, but insurance companies generally do not hire the best and the brightest. Never have, since the average pay is not great. For B-school grads, insurance company jobs have always been down towards the bottom of the list.)</p>
<p>If insurance companies are screwing up in billing people who bought directly from them, not involving the exchanges in any way-- and insurance companies are doing exactly that-- then we are justified in blaming the insurance companies. </p>
<p>The fact that the back-end website for the exchanges is not built yet (well, maybe it is by now) is irrelevant. The back end has nothing to do with billing consumers.</p>
<p>Bluebayou, I am addressing the step that happens AFTER the data is transmitted to the insurance companies – it is all on them, their web sites, phone lines, and/or paper billing system. </p>
<p>Insurance companies are already in the business of issuing policies, billing consumers, and processing claims from providers – so this should be an easy issue. It can’t be blamed on poor quality of information they are receiving from the exchanges – because that doesn’t explain why people can’t get through on the phone to make payment arrangements. </p>
<p>Again, the process of phone handling could have been automated. A better voice mail system, to start with.</p>
<p>calmom:</p>
<p>I get that, but since we are just purely speculating (‘woulda, coulda, shoulda’), I would speculate that the ins. companies assumed that they would be receiving live, clean data from the feds in a timely fashion. And that data would be electronic, not paper, on a front end. Then, they plan to staff at an appropriate level, based upon those electronics submission assumptions. Since those assumptions were optimistic at best, or just plain wrong, the companies now appear understaffed today. (Now, they may have been understaffed anyway, but we’ll never know since the feds did not do their part.)</p>
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<p>It explains it to me. If they have a call center with xx bodies, planned to accept yy calls, and then the feds throw a curve ball and say, everyone HAS to call since electronic submission does not work (when they said it would)…voila, ins. cos. are overloaded. </p>
<p>CF: I disagree. The back-end can be used as a control or a validation check, once the front-end is completed (assuming it ever was).</p>
<p>And, btw, don’t forget that federal law require a 85% medical loss ratio, so any extra bodies hired to process paper applications/phone applications, counts towards the denominator and not the numerator.</p>
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<p>And the reason they can’t bill the customers who signed up directly with the insurance companies, rather than through the exchanges, would be what? Presumably they are getting live, clean data from themselves.</p>
<p>The insurance companies seem to be having equivalent trouble with the customers from the exchanges, and the customers who bought directly. They’re having the same problems with all their new customers. That can’t be because of the exchanges. That’s on the insurance companies.</p>
<p>Maybe just a simple clog? Or is that too simple? I don’t know how many company x is processing in a week. Or how many they used to, or projected. But seems to me there must be “piles” to go through. Folks on the hamster wheel. One glitch throws it all off. ?</p>
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<p>[Don?t</a> believe the hype: Health insurers think Obamacare is going to be fine](<a href=“http://www.washingtonpost.com/blogs/wonkblog/wp/2014/01/15/dont-believe-the-hype-health-insurers-think-obamacare-is-going-to-be-fine/]Don?t”>http://www.washingtonpost.com/blogs/wonkblog/wp/2014/01/15/dont-believe-the-hype-health-insurers-think-obamacare-is-going-to-be-fine/)</p>
<p>Wellpoint, the article writes, did exchange shopping simulations to help it do pricing. Interestingly, I’ve heard a lot of complaints about Anthem, Blue Cross and Blue Shield with regard to problems with billing. I haven’t heard Wellpoint’s name come up. But that may be because Wellpoint offered policies on fewer exchanges.</p>
<p>on edit: No, it’s because I’m an idiot. Wellpoint is Anthem’s parent.</p>
<p>Anthem is part of Wellpoint.</p>
<p>[Anthem</a> Blue Cross](<a href=“http://www.wellpoint.com/Companies/AnthemBlueCross/index.htm]Anthem”>http://www.wellpoint.com/Companies/AnthemBlueCross/index.htm)</p>
<p>Ok…I see your edit.</p>
<p>Nice link.</p>
<p>I think I beat you with the edit, dstark. 
After I posted the initial post, I did a teeny bit of Googling which revealed my error.</p>
<p>I do think it’s interesting that Wellpoint/Anthem believes they priced their policies right.</p>
<p>You beat me CF.</p>
<p>Yes, the comment about pricing was interesting.</p>
<p>"First, many approached 2014 as a test year for the Affordable Care Act and participated in only a handful of exchanges to test the waters. On average, the exchanges currently account for about 2 percent of insurers’ revenues, according to J.P. Morgan managed care analyst Justin Lake. Health plans expected that the first year would be rough, so they preemptively limited their exposure.
“Although they may garner the most headlines, we do not expect the new health benefit marketplaces to be a significant factor to 2014 earnings,” </p>
<p>Lake writes. “We think the downside risk of low initial enrollment for large, diversified managed care companies is limited given that this is a relatively small portion of their business.”
And even as the health exchanges grow, they will likely still remain a smaller part of a health plan’s business. The Congressional Budget Office
projects that, when fully implemented, the marketplaces will cover 7
percent of the population, or 30 million people."</p>
<p>I have said from the beginning there is not going to be a financial
catastrophe with Obamacare. Obamacare is toooo small.</p>
<p>There are 4 quartiles…positive attitude and being correct or positive
attitude and being wrong…</p>
<p>or negative attitude and being correct or having a negative attitude and being wrong.</p>
<p>The gloom and doomers are in the worst quartile. They have a negative attitude<br>
and they are wrong. </p>
<p>Why anybody would want to be a gloom and doomer and be wrong? I dont get it. That is beyond my pay grade. :)</p>
<p>It was always obvious, if you understand insurance, that what matters is not the risk pool but whether the risk pool was priced for. But it’s good that Wellpoint is saying it.</p>
<p>Yes it is…</p>
<p>There’s a very good blog post at a site called “tropicsofmeta” --the post is dated today (January 15) and called “How Obamacare has Affected me”. I can’t link to it because of CC TOS (it’s a random blog) - but here’s a synopsis and you should be able to find it with a Google search.</p>
<p>The article is by a young woman in her late 20’s who earns about $30K a year, in a relationship but not married to a man, early 30’s, earning about $20K. She had insurance before ACA which was better than the insurance she has now, but her partner did not. So she has described their respective experiences buying insurance on the exchange and has created a little bar chart showing before/after premiums, deductibles, out-of-pocket maximums, and copays. </p>
<p>I think this is basically some useful anecdotal information related to the issue of the impact of ACA changes as well as a look at how two individuals in that all-important “young people” demographic are faring. They are happy with the results because both qualify for subsidies, so now both have insurance, for a net premium cost that is less than what the young woman was previously paying to insure herself only. The writer also notes that she could have opted for a gold level plan that would have been more equivalent to the insurance she had previously, at a premium that would have been roughly $75 less than what she had been paying before – but she opted for the less expensive Silver for budgetary reasons. </p>
<p>Although the post doesn’t deal with it, this does also highlight the potential “marriage penalty” – I haven’t done the math, but I think that if the incomes of the two now-unmarried partners were combined, they would still qualify for subsidies, but the combined premiums would be higher and the partner would no longer qualify for cost-sharing reductions, so his plan would be weaker. </p>
<p>I’m just sharing this as a real-world example to balance out a lot of the speculation about how younger people will respond to ACA.</p>
<p>Bluebayou, you seem to miss the point that I am talking about insurance companies in California – “the feds” and their web site have nothing to do with it. The Covered Cal. site runs fine and I have seen no evidence that there have been any unexpected curveballs concerning data transmission, other than a last minute extension of deadlines.</p>
<p>Anecdotally, there are still a lot of people in California complaining that they can’t get through to Anthem to make payment, or that they have sent checks or submitted credit cards weeks ago with no confirmation and the payments still not having come through. I haven’t seen the same types of complaints recently with the other companies, but Anthem probably has a significantly higher share of the ACA and exchange enrollments.</p>
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Wellpoint is a publicly traded company. The Wellpoint CEO needs to paint a positive picture for shareholders. Of course the statement is probably true: they are in the business of selling insurance, so they priced policies in accordance with their expectations as to who would be buying them – and he’s leaving out the part about reducing networks and/or provider reimbursement rates in order to hold down costs.</p>
<p>I’m just saying that I’m not particularly surprised that the CEO of a for-profit, publicly traded company gives press interviews telling everyone how good business is and how they have planned well for all possible fortuities. Wellpoint is traded as WLP on the NYSE – stock closes at $88 today, down 3 points from yesterday.</p>
<p>The ACA cheerleading squad can have fun with this article: Another 25 million Obamacare victims</p>
<p>[Another</a> 25 million ObamaCare victims | New York Post](<a href=“http://nypost.com/2014/01/14/another-25-million-obamacare-victims/]Another”>Another 25 million ObamaCare victims)</p>
<p>I don’t really understand a need for the law to fail or pass based on how many enrolled. It will still be the law irrespective of how many think it failed vs succeeded. There is no need to duke it out here on a daily basis about it since it just seems to lead to unnecessary vitriol.</p>
<p>The thing I do understand is that the insurance companies have hedged themselves and we the taxpayers ensure their profit margin when enough don’t enroll or the right mix doesn’t (I am sure someone will correct me on the details). For that reason alone I would hope more enroll so the taxes don’t go to make up some corp’s bottomline but help people who need healthcare instead.</p>
<p>Wellpoint may or may not have priced correctly, and corporate CFOs are in the business of making rosy statements. But whether Wellpoint priced right or not, it was always true that what matters is if the insurer guessed right on the enrollees. It doesn’t matter if the enrollees are representative of the whole population, as long as the insurer prices right for the enrollees they actually get.</p>
<p>[A</a> Guide to Obamacare’s Backstop for Anxious Insurance Companies - Businessweek](<a href=“http://mobile.businessweek.com/articles/2013-11-19/a-guide-to-obamacares-backstop-for-anxious-insurance-companies]A”>http://mobile.businessweek.com/articles/2013-11-19/a-guide-to-obamacares-backstop-for-anxious-insurance-companies)</p>
<p>The 3 risks…</p>
<p>The risk corridor is the only one not funded. The CBO has the risk at zero. Even if the risk isnt zero, the risk spread out is very small. Insurance companies are not going to get rich because of the risk corridor and taxpayers arent going to lose much.</p>