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Wednesday, September 17, 2014, 9:07 p.m.
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Plan to simplify 2015 health renewals may backfire

By The Associated Press

This article was published July 27, 2014 at 10:33 a.m.

WASHINGTON — If you have health insurance on your job, you probably don't give much thought to each year's renewal. But make the same assumption in one of the new health law plans, and it could lead to costly surprises.

Insurance exchange customers who opt for convenience by automatically renewing their coverage for 2015 are likely to receive dated and inaccurate financial aid amounts from the government, say industry officials, advocates and other experts.

If those amounts are too low, consumers could get sticker shock over their new premiums. Too high, and they'll owe the tax man later.

Automatic renewal was supposed to make the next open-enrollment under President Barack Obama's health care overhaul smooth for consumers.

But unless the administration changes its 2015 approach, "they're setting people up for large and avoidable premium increases," said researcher Caroline Pearson, who follows the health law for the market analysis firm Avalere Health.

It could be a new twist on an old public relations headache for the White House: You keep the health plan you like but get billed way more.

"It was our preference for (the administration) to have the capacity to update people's subsidy information, but they haven't been able to get that built," said Brendan Buck, a spokesman for the industry trade group America's Health Insurance Plans.

Here's the issue, in a nutshell:

To streamline next year's open enrollment season, the Health and Human Services Department recently proposed offering automatic renewal to 8 million consumers who are already signed up.

But the fine print of the HHS announcement said consumers who auto enroll will get the "the exact dollar amount" of financial aid they are receiving this year.

That's likely to be a problem for a couple of reasons, not to mention inflation.

First, financial aid is partly based on premiums for a current benchmark plan in the community where the consumer lives. Because more plans are joining the market and insurers are submitting entirely new bids for 2015, the benchmark in many communities will be different.

Second, financial aid is also based on household income. If your income goes down, you are entitled to a bigger health insurance tax credit. If it goes up, you get less. The 2014 amounts could well be out of date and incorrect for many people. Financial assistance is also affected by age, family size and where people live.

And that doesn't get into another motivation for consumers to shop around: Premiums and choices for 2015 are changing, so your current plan may no longer be a good deal.

"Just continuing in the same plan with the same credit is not going to be the optimal outcome for most people," said Judy Solomon of the Center on Budget and Policy Priorities, which advocates for low-income people. "Your 2014 credit is going to be lower in most cases, and in some cases it could be too high."

About 8 in 10 of those who signed up for private coverage under the health care law are getting financial aid. In the 36 states served by the federal insurance exchange, the tax credits average $264 a month, reducing the average monthly premium of $346 to just $82.

Even with such generous subsidies, about 4 in 10 who bought a health law plan say they have trouble paying their premiums, according to a poll by the nonpartisan Kaiser Family Foundation.

Open enrollment starts Nov. 15, and consumers who already have a policy will have just about a month to renew or make changes to avoid a break in coverage Jan. 1. Millions of new customers are also expected to try to sign up for the first time.

New Health and Human Services Secretary Sylvia Mathews Burwell is hoping that auto renewal will simplify things, a welcome change from this year's website problems.

But the subsidy scheme created by Congress to keep premiums affordable has so many moving parts that it's turning out to be difficult for the government to administer.

Administration spokesman Aaron Albright says all consumers are encouraged to contact their health insurance exchange to update any changes in personal and financial details. You can do that at any time, before the open-enrollment crunch.

However, you will have to wait until the fall to change to a new plan for next year.

Even if the financial aid amounts are off the mark, some advocates say auto renewal is still a safeguard to keep some people from falling through the cracks.

"It is not a perfect solution, but I'm not sure that there is a better solution in terms of protecting people so they don't lose health coverage," said Ron Pollack, executive director of Families USA, an advocacy group supporting the overhaul.

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AntiPostmodernismLeague says... July 27, 2014 at 2:51 p.m.

It will be a great day when the Democrats are defeated by Republicans so this health insurance catastrophe will be erased. This insurance debacle is a nightmare.
.
According to the article, those paying $82 a month are struggling to pay their premiums. They also cannot afford the Deductible because it's most likely $6300 per calendar year. The welfare group and illegal immigrants are the only ones who are unaffected because they pay nothing.

( | suggest removal )

tenpoint says... July 27, 2014 at 3:12 p.m.

this insurance is not good for anyone. the federal government needs to put the insurance back like it was leave it alone.if it isn't broke don't fix it!!!!!!!!!!!

( | suggest removal )

DontDrinkDatKoolAid says... July 27, 2014 at 4:46 p.m.

Even if the Republicans come to hold the House, Senate and Oval Office, we would still have RINO's to deal with.

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Packman says... July 27, 2014 at 5:02 p.m.

Is there any end to the incompetency of Obamacare? The more we learn the more it becomes clear the law was written by a bunch of imbeciles. Alas, that's what happens when you put a community organizer in charge propped up by a bunch of anti-Capitalist wannabe socialists.
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It would be interesting to see the cost to taxpayers to implement Obamacare including expanded Medicaid, subsidies, and administrative costs versus the simple cost to expand Medicaid to income levels a few additional percentage points above the poverty line?

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FreeSpiritMan says... July 27, 2014 at 6:21 p.m.

FYI for the above 4 ill informed:
The problems with the Medicare Part D program continued even after the program went
live on January 1, 2006. Almost immediately it became clear that many patients that had had
their drug coverage changed from Medicaid to Medicare Part D would have difficulties getting
their medications. Pharmacists were not able to verify coverage for many patients who were
faced with large copays on drugs that they were supposed to receive for little or no charge. The
Department of Health and Human Services (HHS) did not update enrollment information for
plans rapidly enough, leaving many individuals who had signed up late for the plans unable to
access their new coverage.
Reports described “a crisis situation,” with the “neediest patients wrestling with missing
paperwork, confusing bureaucracy, and overwhelmed pharmacists.”14
One pharmacist described
the situation as “a nightmare;”15 another described a “total and complete disaster,”16 and a third
stated, “The ‘D’ in Medicare Part D stands for disaster. It is reaching biblical proportions.” 1
*
I experienced this with my wife and worked through Vic Snyder's office to get it corrected, took over 6 months.

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FreeSpiritMan says... July 27, 2014 at 6:27 p.m.

I was upset but I did not go ballistic to want it to fail. I have programmed computers for over 45 years and when you have a massive roll out of new software You will have problems and it will take some time to correct. packman what is the decimal equivalent 1011 binary without looking it up.

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cliffcarson says... July 27, 2014 at 7:33 p.m.

The problem is that Private Insurance Companies are involved. They all want to increase their bottom line. And who better to claim "The Sky is Falling" other than the Republican Party faithful.

Are these the same people who said "It wasn't going to happen?"

If the rules are set by Congress, improve the rules instead of going home for several weeks. The Republican Party is described as the Party of NO and they live up to the billing daily.

They will vote yes on starting wars, but war is a losing game for all but the 1%.

Maybe that explains it.

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