Obama blinks!

Obama blinks!

Another arbitrary move that messes up the market place.

If you don’t want to change to the new Obamacare health plans, you can qualify for a one year exception. MAYBE! Only if you received a cancellation notice from your current carrier.

Today Show video explaining President's new position

Another fix for the botched rollout.

• One year exemption from penalties
• Buy catastrophic coverage (previously limited to those under 30)

Deadline is 3 days away if you want uninterrupted coverage.

So the law says you could buy catastrophic coverage (much less expensive) if you’re under 30, but the administration has opened that trick up to everyone who has received a cancellation notice. Of course the reason they’re receiving the cancellation notice is because their current policy doesn’t cover the expanded government wish-list (characterized as the 10 essentials of health insurance coverage).

So the government says you have sub-standard health insurance if it doesn’t cover maternity (even for males and couples past child-bearing years), pediatric dental (even if you don’t have kids) and expanded mental health services (even if you never needed them or wanted them).

Follow the logic...

1. If you don’ t have these 10 ‘essentials’, you have sub-standard coverage.
2. Obamacare outlaws sub-standard coverage.
3. Your insurer is required to cancel your sub-standard policy.
4. You can now ignore the penalties for a year or get catastrophic coverage which has even fewer benefits than the ‘sub-standard policy’ it is replacing.

BTW, there are more uninsured people in the US today, than when ACA was passed. I thought ACA was supposed to make insurance more affordable and reduce the number of uninsured.
WRONG ON BOTH COUNTS!!!

Of course, insurers are deeply concerned — they are forced to change their tried-and-true business model by doing the following: 

• Take all comers, even those with massive near-certain health costs
• Charge way more than they think people want to pay
• Force their clients into government-run insurance exchanges as the ONLY WAY to get affordable coverage.
• Offer VERY limited networks of providers on those exchanges (it's the only way left to insurers to try to control expenses).
• Pay kickbacks to government programs (through exchange fees, government reinsurance fees and more).
• Watch the system collapse or suffer huge premium increases with government-backed profitability guarantees for only 3-years, and out-of-control premium increases as healthier, younger consumers steer clear of what is being perceived as a trainwreck.

The Nightmare before Christmas

The Nightmare before Christmas

’Twas two nights before Christmas and all through the house
  not a person was covered, not even a mouse.

  The website was broken and when I would call
  Covered California had hold times that would stall, stall, stall.

  The list of doctors and hospitals was far from complete
  You’d have to look up each one and call them, by Pete.
                 With apologies to Tim Burton and Clement Clarke Moore

Yes. Today hold times at Covered California are 45 minutes to an hour.
If you call the number listed in their ads, you are told to HANG UP and call one of two other numbers — no reason given as to why there are two numbers, or if there are any reasons to call one over the other. BTW, you get the same message (IN ENGLISH!) when you call the SPANISH phone number. And they wonder why Spanish-speaking signups so far are practically ZERO. Geniuses!

The agent phone number isn’t working. 

Which makes sense. If you don’t have answers for the professionals you partner with, just don’t answer the phone.

So I have to call the main line and ask questions from the customers’ perspective.
Today I called in to ask whey I had to drive past 14 hospitals to get to the one 25 miles away (over an hour away in drive-time) as it is the ONLY ONE listed in my Enhanced Silver HealthNet HMO plan. The perky elf on the helpline said not to worry, not all of the hospitals are put in yet. They’re still working on it.


Then she wanted to know where I found a list of hospitals on the plan. “It doesn’t make sense that other hospitals aren’t in the plan. Just CALL each one and ask if they participate in Covered California, with the insurer name.”


I agree. It doesn’t make sense at all. The problem is... do I trust their assurances? Do I tell every client to call every doctor and hospital they want to use. BTW, many doctors offices don't know the details of all of these new plans, either. Just because they accept HealthNet HMO doesn't mean that they accept Enhanced Silver HealthNet HMO through Covered California.


AND Keep in mind this all has to happen BEFORE the deadline of December 23.


Here are some of the broken links. Interesting: NONE of the resources listed (in red) actually work.

Oops! The page you're looking for is no longer here...

Spanish, the missing language!

And, in care you are wondering, here is a list of languages at the Covered California website. Now I would typically expect that ENGLISH and ESPAÑOL would be close to one another, in importance AND alphabetically. But look at where Spanish is listed... 11th on the list. The list is so long, Spanish doesn't even show up on most computer screens without scrolling. Español (Spanish) is after Hmoob (Hmong), Korean and Russian, but before Filipino and Vietnamese. Is the list in alphabetical order? NO! In order of importance (number of California speakers)? NO! It is oddly random.

And they wonder why nobody Spanish-speaking is signing up. 

Geniuses!

You’re never more than a minute away from another problem

You’re never more than a minute away from another problem

How do you describe your experience on the CoveredCA website — the health exchange for California? Here is an experience with an actual client.

Sure he was incredulous when I showed him that his family would save $7000 a year. Actually that’s a little misleading. The insurance itself costs $2000 MORE than his off-exchange policy. It’s the taxpayer subsidy that brings the cost way down. That and shifting his kids to Medi-Cal (California’s version of the welfare program Medicare).

So the insurance costs more, but since it’s subsidized he pays a lot less. So it’s the taxpayers who are getting soaked! And since the client doesn’t pay the higher costs (yet) he is less likely to worry about them. Genius!

But then there is the issue of actually signing up. I helped him, step by step. Over the course of 2 hours: the website failed and kicked us off no less than 5 times. At one point we called the helpline for Covered California. We enjoyed their upbeat hold music for about an hour before we got through. We had moved past the original problem by then, but were glad we had stayed in the hold queue.

We found the doctors, we found the plan, we did everything and hit the button to choose a plan. Bamm! Kicked out again. About this time the client said the website experience was so frustrating that he would have given up some time ago. He summed up his take on it by saying “You’re never more than one minute away from another problem.”

Recipe for Massive Subsidy on Health Premium

Self-employed, married, 2 or more kids (including young adults in college, after college or performing volunteer service abroad). Of course you don’t have to be married, any household of multiple people will help you secure the subsidy.

• Control over your income (keep it in the $50k to $60k range—see the chart below)

•File your 2014 taxes by April 15, 2015.

Yes, we refer to information from you 2012 taxes to predict taxes on income that hasn’t happened yet, and which won’t even be reported until April 2015. Based on that, you receive a subsidy of $700/mo to $1000/mo. Which helps you not to notice that the unsubsidized premium is higher than you expected.

I have a special chart which shows a couple of important things.

 

First, where do you qualify for the subsidy. IMPORTANT! If you make too little you get NO SUBSIDY because you should be on Medi-Cal. And you have to make less than 400% of the Federal Poverty Level to qualify for ANY subsidy. So find your houehold size (first column), and see the income for 138% to 400% of FPL. For a larger family, say a couple, 2 kids in college and 2 kids at home, that would be...$10,500 a month.

But if you make less than 250% of FPL, say $78,975 a year, you qualify for Enhanced Silver Benefits. That means much smaller deductible, AND many services with NO DEDUCTIBLE. If you are in the golden square above, you qualify for Enhanced Silver Benefits.

Many business people who qualify for these generous subsidies don’t even know it.

So what could someone do with the savings? 

Pay for Long-Term Care insurance. Give it to your kids. Retire early. Adult orthodontia. Buy more life insurance. Take extra vacation time. Use some of it to go see the doctor you want.

Contact me and I’ll send you some helpful information. It includes the chart above, along with additional information about Obamacare. To know where you stand you need to know:

• The benefits
• The cost
• The penalties for not having it
• The exceptions

For some people, the penalty for not having insurance may be MORE than the (subsidized) premium. You owe it to yourself to find out where you stand.

And if you are part of a business: small businesses (less than 100 employees) can OPT OUT of many of the most onerous features of Obamacare. I can get you information on that as well. Opting out works best for 10-99 employees, but things can be done even for those with less than 10 employees.

The millionaire-next-door buys a health insurance policy

Moral of the story: 

Obamacare is a goldmine for self-employeds and small business owners if you know where to look.

Several years ago there was a book titled “The millionaire-next-door”. It told about the unassuming person who most likely drove a truck and owned a business. The kind of person who didn’t spend a lot (that’s important), but had enough to build a thriving business.
NYTimes.com/books Millionaire Next Door

The book contrasts the habits of that kind of millionaire to spenders, who drive expensive European cars, go on fancy vacations, buy lots of jewelry and up-brand items and display the trappings of wealth. In Texas terms: “All hat, no cattle.”

Let’s liken the millionaire-next-door to today’s self-employed person or small business owner. They control their own paycheck. The business pays for some (or most) of their heavy duty expenses (like transportation,fuel, smartphones & other electronics).

One such millionaire bought a health insurance policy yesterday. He is in his mid-50s, wife in her late 40s, 1 adult child (graduated from college, not employed on a full-time basis), 2 minor children. That’s a family of FIVE on an income of about $65,000 per year.

This year they pay $920/mo. Starting next year that goes to $243/mo, with both kids on MEDI-CAL. Even though they were quite willing to pay the premiums to ‘keep their doctors’, they will receive $9000/yr of TAXPAYER ASSISTANCE on their premiums. BTW, that is for Enhanced Silver plan, with a $500 deductible and many services provided with NO DEDUCTIBLE.

He could save even more by going with the Bronze HSA plan. It has a $5000 deductible, but over the last 10 years this client has amassed over $50,000 of tax-advantaged money in his Health Savings Account (HSA). But he’ll probably go with the Enhanced Silver plan, and leave the HSA invested.

Good news. He can use money from the HSA to pay for Long-Term Care insurance (LTCi). LTCi was originally included as part of Obamacare when it became law, but government officials decided it would be too costly to implement. So they decided to ignore that part of the Affordable Care Act. Isn’t it nice to be able to pick and choose which parts of the law you want to implement?

Moral of the story: 
Obamacare is a goldmine for self-employeds and small business owners if you know where to look.

It’s almost too bad we’re giving scarce taxpayer resources to people who don’t want it and don’t need it. Embrace the folly.

Premium Red Zones

Premium Red Zones

Cheer up. It could be worse. Did you know your rates for Obamacare are up to 50% higher?
That's right. If you live in Northern California, as opposed to Southern California, rates are higher across the board... as much as 50% higher (LA -vs- San Francisco).

 

Premiums vary from state to state AND from county to county.

Doctors and hospitals, too

And that's not the only thing: access to doctors and hospitals varies from county to county as well. Consider the case of the woman who lives in San Diego, but travels to Stanford University for life-saving treatment for her cancer. Those are two different zones!!! Plans from Palo Alto area don't include San Diego hospitals or physicians (so she can't get local emergency care near her home). Plans for San Diego area don't include Stanford (so she can't continue life-saving treatment protocols there). She has to pick one.

She's probably glad she can't keep her old sub-standard policy. It may have let her keep the doctors and specialists she wanted, but the thing that made it sub-standard in the government's view: it didn't include pediatric dental coverage.

HealthCare for the holidays

HealthCare for the holidays

People used to dream about “home for the holidays”. But now, government officials want you to use holidays as a chance to enroll your children and other family members.

First there were Thanksgiving Talking Points.

Now there is a campaign to help reduce “Christmas tree” violence. But notice: no mention of the word Christmas when describing Christmas trees. Bless their politically correct hearts.

Also note the innovative solution posted as a response...
If you are worried about staying safe and being injured by your tree --> put a chain around it so it can’t get upstairs to the bedrooms.

Food for thought.

Do as I say, not as I do...

White House: No Updates On When Obama Will Sign Up For ObamaCare (Dec 2, 2013)

Carney: Um, No, Obama Hasn't Signed Up For ObamaCare Yet, But Hey, He's Going To, Really 

White House Press Secretary Jay Carney admitted to reporters Monday that Barack Obama has not yet enrolled in ObamaCare, saying “I know he will and has said that he will…but I don’t have an update.”

When asked what Obama was waiting for and whether the White House would announce it when he does sign up, Carney laughed uncomfortably and said: I’ll get back to you on that.”

MikesRight blog 

Self-imposed (but vague) deadline for website fix

 

November 30th has come and gone. Will the website experience be improved? The improvement goals were really vague: A better experience for the ‘majority’ of users, while the ability to pay for the plans hasn’t been finished.

And there is still the issue of ‘orphan plans’: people who thought they signed up, the website told them they signed up, but the website didn’t actually transmit the data to the insurance company. Meaning, they have no coverage; but won’t find out about it until they try to use the non-existent medical coverage, presumably, for something important.

Of course, the government considers the website improvements to be a success if 80% of the people can create an account. Oh dear, nothing there about actually procuring and paying for a policy. Estimates are that 10% of people will still get dropped from the system.

And the administration is in a tough spot. They encouraged people to have the ‘turkey talk’ with their families about getting health care. But they can’t encourage everyone to go to the website, because that would definitely overload the system. Instead, they encouraging their supporters to use the website at off-peak hours and weekends.

The real question is: is it a good thing that the website works better?

So far Medicare enrollment has increased by 35%. That is a lot more people getting health care, but no one putting more money into the system.

Young adults (through age 26) can stay on their parents policies. That used to be free, but now is a cost item -- so what's the advantage? And now I have to collect W2s from the adult-kids of my clients before I can tell the parents how much their health insurance will cost.

The ACA amounts to a de-facto tax of 9% on the self-employed. That's on top of other self employment taxes that currently amount to 15.3% and before the new ACA surcharge of 0.9% (on earnings more than $200k). That's a total of 24.3% to 25.2%, BEFORE federal and state income taxes kick in.
CBS News: when to pay self employment tax

How many start-ups and entrepreneurs will end their year earlier (aka stop earning money) when they approach certain limits rather than pay higher taxes and surcharges. Small business owners usually have cars, computers, internet and other things paid for by the business. So they end up with a lot of flexiblity over how much they earn and when, without disrupting their lifestyle.


That also leads to millionaires (with low MAGI) qualifying for MAXIMUM TAXPAYER SUPPORT on their health insurance.

And about the only cost-containment tool the insurers and hospitals can use is to limit which hospitals and doctors you can actually use. You go to the hospital only to find out “you choose poorly” (apologies to Indiana Jones and the Last Crusade).