<p>LF, did you have a policy on the individual market in Rhode Island before 2014? Was the deductible per person $2,500 (which is what you indicated in prior posts)? Your deductible now is $3,000 (silver plan) and your premium decreased without subsidies. Is that correct? Has the network of doctors and hospitals changed for Obamacare plans in Rhode Island. If you are going to try to prove to me what a great deal Obamacare is, I would like to get the correct facts, not some stuff about a 7-state PPO, which you then admitted in a subsequent post had gone away 4 years ago.</p>
<p>GP, read what I wrote. Process any two separate things I say as two separate things, especially if I intro it as “Something else.” It went up $500 to $3000, so it was $2500 before. </p>
<p>I’m not pulling out the papers again, for a comparison for you. I sense you would like to dispute this. Here’s what I wrote on 3/31: “The Silver family plan my insurer “chose” for me was better. The premium dropped $30/mo, visit charges dropped, all Rx co-pays dropped, other co-pays after ded stayed the same %, the max oop went down by $2300 [individual,] but the individual ded went up $500 (family ded went up 1k.) Obviously, my Silver via the exchange is even better.” Btw, family coverage before was $1149. You don’t need to know my family circumstances beyond that. </p>
<p>Not one change in doctors. (Any doc who wishes to accept BCBS agrees to accept it from all, no matter the source. All docs who accept are in-network. I don’t have the catch phrase on the tip of my tongue.) All the hospitals I could think of are covered (no, I didn’t check every conceivable one- we have 3 super ones within 5 miles and I checked places like MSK and Dana Farber- and in D2’s college town.) I also asked a host of other questions that came up in this thread. My D2 can go to a PPO doc in her college town (200 miles) and there are plenty, I checked. And for fun I checked Albany NY (another cpl hundred miles in another direction.) </p>
<p>You may need to breathe, nicely meant. My position all along has been that YOU, over there in CA, with your desire for coverage at Cedars and your other particulars, cannot speak with authority about how this is in the whole country and for all others. If we cycle back to your predictions, I have said my piece on this.</p>
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<p>If I were to count, there were 10 families (2 with only single person insured in the family). 3 got verified online without calling. 3 had visa questions and definitely needed to go through calling. The other 4 got stuck online and had to be called. So we spent a week calling to get most verified, and knew the 3 visas could only be enrolled by calling because once the people work on it, you don’t have access to your app online. One really interesting part was that if the person helping you had a screen freeze, the 1 hour you spent talking and filling the form was totally gone. For one of the people with a complicated situation (4 family members on visa) the process took 2+ hours and got lost through screen freezing! He had 4 separate apps in the end. One citizen had to go to SS office to get his card name changed which he had been using for 20 years although his name was misspelled on it and he had been a citizen for 10 years (he was ontime in trying to apply but we had this issue and so it got moved to May now). This guy was slightly easier since he went through everything on one call once SS issue got fixed. The other 8 out of 9 were verified but had to start over describing everything all over when we went back for enrollment into a plan. Btw, the bills showed up within a week! </p>
<p>We as an organization have tremendous savings by moving people to these plans and were very motivated to get it done. If I was young immortal winging it and got stuck online and called, I am not sure I would have bothered to spend so much time but I could be totally wrong on that. What I don’t understand is why they kept refusing to accept the verified IDs when we went back and instead kept starting over. This is one reason I would like to see premiums paid at some point to validate the numbers being published but personally I don’t obsess over how many enrolled since I would really care only about how many more people have insurance since Dec 31.</p>
<p>Btw, several of you have have been extremely helpful in doing our research for us and whether they know it or not, my organization should be thanking all of you. We will have to consider you as providing in kind donations to our org!</p>
<p>LF, I am assuming you live in Rhode Island. I think you said that in earlier thread. I went to the Blue Cross Blue Shield RI website and checked to see what hospitals are included in their networks. BTW, this one insurance company has sold 98% of all the plans on the exchange. They have no competition. From what I can see, no hospitals in NY, Ma or Conn. are included in network. I don’t see MSK or Dana Farber either. </p>
<p>Oh, brother.</p>
<p>So you had 4 households who didn’t have visa issues, who got stuck online somehow? And then once they called the phone help, they couldn’t go back to their applications themselves? That’s not a good system in my opinion.</p>
<p>Thanks for answering these questions, texaspg. I like to understand how the system is working for real people who try to use it.</p>
<p>LF, so I just priced your Vantage Blue Select 3000/6000 plan and the premium for my wife and me is $1282 a month. That is even higher than the plan offered to me by Blue Shield in Ca., although the deductible is lower. The bronze plan ($5000/$10,000 deductible) similar to the one offered to me in Ca is $906 a month. Better than Ca but still much more expensive than the plan I previously had.</p>
<p>CF - Tthe process could be a lot more efficient and I am not sure what happened to those apps when people waited a week to pick the plan. If they picked a plan right away when they were verified, I think it was going to go through. I still don’t know why only person was able to go online and complete enrollment in a plan a week later when at least 4 others could have done it by themselves since the applications seemed to be accessible but they could no longer pick a plan. We are still trying to get some subsidies verified and figure out why one spouse plan never came through but our admin said it was impossible to get through last week to ask questions. We will probably get back to calling to clear up some issues next week.</p>
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<p>I’ve worked with fairly large name & address databases (thousands, to tens of thousands of entries) and selling stuff online for roughly 20 years now. There are always some duplicates in the databases and also sometimes confusion of whether not records are duplicates: are John P. Jones and John Jones, Jr. who both live at the same address the same person, or are they father and son? Is Mary Smith in Phoenix the same person as Mary Smith in Tucson, who but with a new address – or are they two different Mary Smiths? </p>
<p>So that’s simply the nature of trying to collect that sort of information. It probably explains why they are so keen on verifying the id in the first place, as cumbersome as that makes the process.</p>
<p>When it comes to selling stuff: there’s always some attrition. People who place orders with credit cards that don’t work; people who buy stuff and then demand refunds, etc. That’s also part of the cost of doing business – the goal is to keep those numbers down to manageable small fraction. </p>
<p>I’ve also dealt with computer API’s – the mechanism by which one computer talks to another – and those are also tricky and error ridden. We see it all the time on the merchant end with the credit card verification and shipping issues – there’s nothing wrong with the customer’s Visa card, but the system can’t verify the address. </p>
<p>So all of these issues are too be expected. </p>
<p>I would agree that most of the exchanges have done a very poor job of implementing their systems and the error rates for the issues are much higher than they should be… Healthcare.gov is one of the worst, but I believe that Nevada, Oregon, and Hawaii might have botched things even more badly. </p>
<p>But it’s a new system, and obviously government contracting and software design don’t mesh well – but those are glitches that will be worked out over time.</p>
<p>I would consider a 90% overall completion rate (through payment) of enrollees to be pretty good – my guess is that it might look more like 85% the first year out. So with the attrition on one end and the continued trickle of people coming in either because of extended sign up dates or mid-year life changes rendering them newly eligible for the exchange (like college students graduating in June) – I won’t be surprised if that 7 million ends up being 6.5 million. But that’s a good enough number for the system to work… and bugs will be ironed out, and the process of enrollment will be a lot smoother in future years. </p>
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<p>Oregon botched things up so badly they resorted to paper applications for everyone. But let’s not forget Maryland. They are going to scrap their exchange entirely, after a comically bad rollout.</p>
<p>“obviously government contracting and software design don’t mesh well”</p>
<p>Why stop here? It would be more accurate to say that almost all the things govt attempts to do which could be done in the private sector are done slower, less efficiently, at much greater cost and with far less responsiveness to the public. </p>
<p>Good points, calmom. I agree with you that if when the dust settles, we end up with 6.5 million, that’s a good first year. Some expert I heard on NPR (didn’t get his name, d’oh!) said that we have to remember that this is just year one. Next year, perhaps we’ll get 2 or 3 million more new enrollees, the year after that, around 2, etc. According to this fellow, he thought that eventually we’d get up to 94-95% of the American population insured, but it would be a multi-year process. </p>
<p>It will go MUCH more smoothly in future years. Basically, this year was the beta. </p>
<p>“I believe that Nevada, Oregon, and Hawaii might have botched things even more badly.”</p>
<p>Don’t forget Massachusetts, Vermont and Minnesota</p>
<p>Well numbers will also stabilize a few years down the line – as people move in and out of the individual market - getting jobs or becoming eligible for employer coverage through marriage – or moving off of employer-based coverage due to job changes, changes in marital status, etc. </p>
<p>Exactly. It’ll take 5 or 10 years to get a moving average. </p>
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<p>LOL. Any old scrap of anti-ACA propaganda, and you’re on it like a dog on a scrap of red meat, GP.</p>
<p>Here’s the situation in Minnesota. We did have some glitches in our state exchange website, but public outcry about it has been minimal and muted. Maybe it’s partly because 91% of us were already insured pre-ACA (compared to about 82% nationally), partly as the result of having one of the highest rates of employer-sponsored health insurance in the country. (It’s just a Minnesota thing; being basically Nordic types, we feel responsible for each other and for our communities, and most employers feel it’s their responsibility to step up and make sure their employees have health care coverage, there being no reliable public system in place). Maybe it’s partly because we have the lowest premiums in the country for exchange plans, so most people who went to the exchange got an excellent product at an excellent price, despite any momentary frustrations with website glitches. Maybe it’s partly because we have outstanding health care providers including the world-renowned Mayo Clinic and the excellent University of Minnesota health care system (UMN medical school ranked #6 nationally for primary care and #34 nationally for research) and plenty of competition on the provider side, so pretty much every doc and every hospital is competing to be part of every insurer’s network. Maybe it’s partly because Minnesota stepped up and expanded Medicaid coverage, making tens of thousands of Minnesotans eligible for federally subsidized health care for the first time–and tens of thousands of them took advantage of it. Maybe it’s partly because, on top of Medicaid, we have MinnesotaCare, a state-subsidized health care program that deeply subsidizes health insurance for over 100,000 Minnesotans who are just above the cutoff for Medicaid eligibility (and which as the result of Medicaid expansion bumped MinnesotaCare eligibility to even higher levels of income and assets this year). Maybe it’s partly because Minnesota has the most generously funded high-risk pool in the nation, which the legislature wisely elected to keep in place rather than forcing high-risk consumers onto the exchanges, where they feared their coverage might be worse and their premiums higher.</p>
<p>But whatever the contribution of these and possibly other factors, Minnesota managed to exceed its goals for sign-ups on the exchange and as a consequence is driving its already low (by national standards) rate of uninsured even lower, to the point where it is realistic to think that in the near future we can challenge Massachusetts for the title of the state with the fewest uninsured in the nation, somewhere south of 5%. Thanks to the ACA, on top of thoughtful and compassionate state policies already in place pre-ACA. </p>
<p>Well, bc, this long in-depth article by Kaiser Health News disagrees with you about the success of the MN exchange.</p>
<p><a href=“What Went Wrong With Minnesota’s Insurance Exchange | KFF Health News”>http://www.kaiserhealthnews.org/stories/2014/march/12/what-went-wrong-with-the-minnesota-insurance-exchange.aspx</a></p>
<p>"MNsure has so far enrolled 117,000 people in health insurance. But at that rate, the agency will suffer a budget shortfall by 2015.</p>
<p>And it’s unclear how many of those new policy holders have been enrolled by hand. Right now, the system is cobbled together by manual workarounds that are sucking resources at MNsure, county offices, clinics and at insurance companies selling policies on the site.</p>
<p>In the coming weeks, MNsure officials will announce a plan to right the troubled site. Interim CEO Scott Leitz, who replaced Todd-Malmlov, has said making sure people get coverage is his top priority between now and the end of open enrollment in March." </p>
<p>BTW, the CEO of the Mayo Clinic is not nearly as optimistic about Obamacare as you are.</p>
<p><a href=“http://www.cnbc.com/id/101162215”>http://www.cnbc.com/id/101162215</a></p>
<p>You should ask the employees of the Mayo Clinic how much they like Obamacare</p>
<p><a href=“Obamacare Archives - Washington Free Beacon”>http://freebeacon.com/issues/obamacare-increasing-health-insurance-costs-for-mayo-clinic-employees/</a></p>
<p>According to what I have read, the Mayo Clinic only accepts one exchange plan (silver) from one insurance company in the state. In many parts of the state there are no exchange plans that cover the Mayo Clinic. Please correct me if I am wrong.</p>
<p>Let’s parse the numbers for MNSURE</p>
<p>MNSURE BY THE NUMBERS</p>
<p>Medical Assistance</p>
<p>-- Projected enrollment: 12,240</p>
<p>-- Current enrollment: 73,086</p>
<p>MinnesotaCare</p>
<p>-- Projected enrollment: 44,084</p>
<p>-- Current enrollment: 27,512</p>
<p>Individuals</p>
<p>-- Projected enrollment: 69,904</p>
<p>-- Current enrollment: 36,176</p>
<p>Small business</p>
<p>-- Projected enrollment: 8,925</p>
<p>-- Current enrollment: 677</p>
<p>Total</p>
<p>-- Projected enrollment: 135,153</p>
<p>-- Current enrollment: 137,451 </p>
<p>The state exceeded its Medicaid numbers by 600% but fell behind all its other projections for exchange plans on and off the exchanges. As a matter of fact, the projected numbers for MNSURE were downgraded in February when it became clear they were nowhere near them. So now the head of MNSURE is claiming they have met their goals by counting Medicaid signups and lowering their projections.</p>
<p><a href=“It’s%20just%20a%20Minnesota%20thing;%20being%20basically%20Nordic%20types,%20we%20feel%20responsible%20for%20each%20other%20and%20for%20our%20communities,%20and%20most%20employers%20feel%20it’s%20their%20responsibility%20to%20step%20up%20and%20make%20sure%20their%20employees%20have%20health%20care%20coverage,%20there%20being%20no%20reliable%20public%20system%20in%20place.”>quote</a>
[/quote]
</p>
<p>Just wanna say, BC, that thanks to Garrison Keillor exposure as a young 'un, I’ve always loved your state 
I’m a stand for y’all reaching 100% :)</p>
<p>Re: exchange experience…I had been prepared for the worst when I enrolled my son and ourselves and prepared my employee to do the same. Despite the need for verification of pr card for son and myself, it went very smoothly for us. But we deliberately avoided peak periods, and deliberately waited until the system seemed stable. Don’t know in our case if that helped. </p>
<p>For me, the biggest improvement in the system would have been to pay immediately and online. My BCBS can NOW be paid online via 3rd party vendor…so maybe that will be extended to the exchange. That would put an end to any discrepancy between enrolled and paid ;)</p>