<p>The true test of the success of the ACA was measured last night. 1 line in the SOTU. (You know they focused grouped and polled the whole speech). </p>
<p><a href=“http://usatoday30.usatoday.com/money/industries/health/story/2011-09-09/health-insurance-denial-rates-kaiser-health-news/50362322/1”>http://usatoday30.usatoday.com/money/industries/health/story/2011-09-09/health-insurance-denial-rates-kaiser-health-news/50362322/1</a></p>
<p>Being denied is not the same thing as being uninsurable.</p>
<p>“Citing its own 2009 study, America’s Health Insurance Plans, an industry trade group, says 87% of people who apply nationally for individual coverage are offered a policy. That figure, however, includes people who are turned down for one policy but offered another that may cost more or have fewer benefits.”</p>
<p>That is from the link. </p>
<p>The number of denials is greater than 1 out of 7. The numbers are a health industry trade numbers. They are similar to the numbers that came from health insurance companies because … They are industry numbers. </p>
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<p>No that was not the bottom line, as I read it, but I do not want to do the research again. The program struggled to bring in enrollees. It did not come close to the 375,000 projected for the first two years. It was <em>after</em> that time period for projected enrollment passed that the feds ran out of the $5billion, because they spent more on the 135,000 that they had than expected. So then they shut the program down. There was no one banging on the door to get in when they shut it down.</p>
<p>How about people who apply and are turned down but then reapply 3 weeks later and get accepted? That was me. And I really can’t be the only one.</p>
<p>Really, what does it matter? One way or another this problem would have been fixed and the numbers are still not gigantic.</p>
<p>And what about the person who applies to all 4 insurers, is denied by all, then starts a job with employer coverage? That one guy alone counts as 4 denials, but he is now covered. So again, the number of denials alone doesn’t show the number uninsured.</p>
<p>Right, they had problems with PCIP and right, we discussed it extensively before. Part was that they couldn’t easily identify all the folks who would qualify. There was no one list or bucket with those names in it. And then the issues contacting and informing, determining if they were likely to qualify, then the app process, approval process and implementation. Articles were linked.</p>
<p>*Anything short of cheerleading for it is seen as negative. It gets old. * Look, those who dispute the negative “facts” or blogoids, have been (too many times to count) labeled cheerleaders or knee jerk pro-ACA or there have been comments mocking, “Oh, right, it’s the insurers” or various forms of that.</p>
<p>It’s too easy to just point a finger or call labels. Not all the posters who see the role of insurers (and insurance commissions, legislatures, critics, false or slanted media reports, and whatever else,) are totally pro-ACA, cheerleaders. Oh, that’s been said multiple times, too. </p>
<p>Are we seriously back on the PCIP thing AGAIN?! Oy vey already. </p>
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<p>Right, this is what created a problem for some people, and what re-started this Oy vey discussion again. How many were uninsured pre-ACA due to pre-existing conditions? …crickets… Oh, I thought this was a major reason for upending the current system for 300 million people. You mean we don’t know?</p>
<p>Bay, millions of people are affected by preconditions in the individual market. There were only 300,000+ people in state risk pools and pcip. Let’s get real. :)</p>
<p>"The company said 500,000 new individuals have enrolled in its plans, with the majority of them coming through the new health exchanges.
“We do feel good about what we’ve seen so far on the exchanges,” CEO Joseph Swedish told analysts on the company’s conference call, after its fourth-quarter earnings release. “Our applications are coming in better than we expected.”</p>
<p>Here is something real…</p>
<p><a href=“http://www.cnbc.com/id/101374564”>http://www.cnbc.com/id/101374564</a></p>
<p>Great. How many of them were uninsured pre-ACA due to pre-existing conditions?</p>
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<p>But what was the impact of that 6-month, no-other-insurance rule?</p>
<p>Suppose they had a rule that said that a person could only collect unemployment after they had been without work for 6 months, and that any sort of employment – even part-time or occasional work – would disqualify the person from applying? We’d have a lot fewer people collecting unemployment, but that wouldn’t mean that more people would have jobs. It would just mean that there was a greater percentage of unemployed people who didn’t qualify for benefits. </p>
<p>But that is exactly the barrier that the PCIP erected. The only way to even begin to qualify was to forego any sort of insurance – for example, a high-deductible catastrophic policy that explicitly excluded whatever the pre-existing condition was – it’s really hard for me to envision many people opting for that path unless the primary barrier is financial – and if that’s the case, it’s unlikely that the person could have afforded the PCIP premiums. </p>
<p>“Great. How many of them were uninsured pre-ACA due to pre-existing conditions?”</p>
<p>Dont know, but I do know that preconditions are a thing of the past. :)</p>
<p>It’s getting pretty nasty out there. I am not going to name any names because I want to keep this apolitical, but a certain well-known economist and columnist suggested that a particular Senator who has cancer and recently announced he lost his cancer doctor because of ACA is an example of garbage journalism. Wow!</p>
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<p>I think the benefits of ACA are worth repeating, as dstark has done, because certain people cannot seem to see how this affects anyone but themselves. When someone complains over and over that the world is ending because they can no longer go to the most expensive hospital on the West coast, then we need to keep in mind that there’s a reason for that. Some people will be able to get cancer screenings for the first time in their lives. Other people will have to settle for providers who don’t charge 10 times what nearby providers do. I personally am willing to wait an extra month for my annual lady exam, if it means that other women who’ve previously been shut out can get their lady exams.</p>
<p>GP, he also said that he’s getting great care. At less cost.</p>
<p>Again, no-one has ever disputed that there were benefits in the ACA. Good grief. The thing is thousands of pages. Of course, there are benefits. Free screenings, I personally don’t consider a huge benefit since they already existed pre-ACA, and this relatively inexpensive stuff is not why most people buy insurance, but whatever.</p>
<p>When someone comes on this thread to alert people to the fact that he now has a 44K dollar doctor bill because of ACA and is basically blown off and wished luck on his appeal while supporters go on and on about eliminating pre-existing conditions for an unknown number of people and someone else is told that her appointment is in April because she messed up somehow, it’s a little odd. No wonder most people have stopped posting here. </p>
<p>What I find weird about so many of the comments is that the situations being described are not in the least bit different than ones I’ve personally experienced long before Obamacare. First there weren’t drug formularies, and then there were. And there were problems with needing drugs not on the plan, and the need to do appeals to get drugs covered. I used to be able to have blood draws done at the doctor’s office, then I had to go to Quest, and now there is some other provider I need to go use, otherwise I pay a penalty. Some hospitals were in-network, and some were out-of-network. Ditto on doctors. I had to pay out-of-pocket to see a certain specialist I wanted to continue to see for the year that his practice wasn’t contracted. We had a couple years when we were on an HMO, with a very restricted set of doctors and all sorts of requirements for preauthorizations. We had inaccurate provider directories, and years when they changed the formulary on a monthly basis. </p>
<p>And all through this I’ve had insurance companies that have been ok, and insurance companies that have behaved badly. I’ve had ok experiences with mail order pharmacies, and problems so bad I had to report the mail order pharmacist to the state board of pharmacy (which lit quite the fire under Medco’s behind). </p>
<p>And I also dealt with Medicare for my parents and MIL – and for a “national” system you might be surprised at how differently the rules and rulings are determined region by region, with the same exact procedure or drug acceptable in one region and not in another. (See Local Coverage Decisions)</p>
<p>I’m a little surprised if someone who’s in late middle age hasn’t had to surf these kinds of insurance-related issues in the past. They simply do not seem like new problems – and certainly not anything unique to Obamacare. </p>
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<p>I’m not sure what kind of insurance you had before ACA, but I never had a free screening in my life prior to the new law. </p>
<p>Co-pays for preventive care and screenings maybe be “relatively inexpensive” for you and me, but for millions of people they made primary care unattainable. Not everyone is financially comfortable. </p>