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Clarity on Obamacare

The press has been on fire over Obamacare. I feel so sorry for all the millions of folks out there that do not understand insurance. I guess this is one time I can say I am blessed to have been in the health insurance business for 35 years. (we in the industry are usually running for cover as we are criticized constantly).

Let me try clarify a few things about Obamacare. First there is all this noise about the President lying to America by saying we could keep the coverage we had. So what - this isn't his first lie. You got to keep what you had till essential benefits were decided in each state and then the insurance companies were forced to change your policy to comply or terminate it. If you had a limited benefit plan at a lower costs, chances are you are going to get a cancelation notice.

Here is why. Insurers based the price of a policy on many factors but the biggest is the plan design. If a policy limits what it pays then it will be cheaper. Since Obamacare forced essential benefits and most states used high end plans as their benchmarks, the new policy coverage minimums are now very rich. These big benefits cost much more and thus insurers take the safe route and terminate the old policies rather than take the heat of the press and regulators if they were to price the new revised essential benefit plan for current customers (with huge rate increases). Sad we have to come to this but...

So what can one do? Well, the good news is that with Obamacare there is no longer (1/1/14) any pre-existing condition limitation nor can anyone be denied coverage if they have a serious illness. The bad news is that since the new essential benefit plans are so rich and the insurers must take all comers with no limits, the cost are very high. In short, we got exactly what the majority asked for - rich benefits, no pre-existing limitations, guarantee issue and tons of new taxes. Are you happy now?

The surprise is that even the liberal folks who voted and supported this are now angry because they are seeing the costs. Well welcome to my world. Nothing is free and the more you get the more you pay. I hope that folks are learning a hard lesson from this and will let their votes count in the 2014 elections.

I always felt this program had major issues and sure enough it does. I did not expect the technology to be the first. You would think that with a program this big they would be double sure that all the tech worked flawlessly before they launched. I guess it is just another example of how the administration really feels about the citizens - they don't care! Now there is a mad scramble to fix the web tools and of course all the corporate hot shots want in so they can claim they saved the day -typical!. The tech will be fixed soon but damage has been done.

What to expect now? Well once the web tools are functioning as they should there will be a mad rush to enroll for 1/1/14. However the rush will be smaller than predicted because all those that have coverage now and can't qualify for a subsidy are going to sit this one out. I know I would. There will be thousands, maybe millions, who are going to qualify for subsidies and they will enroll - just like in Massachusetts. The individual penalty is not big enough to drive the folks with a choice to move now so they will just sit and watch.

Once we get past this onslaught then the real problems will begin. As the millions get added to the insured rolls they will want to use their coverage (as they should). When they try to go to a provider and find they have to wait for extended periods, the real bitching will start. And this time it will be from the poorest Democrats. You see we already have a physician shortage in the primary care specialty area. Add all these new patients and the system will slow considerably. Folks will have to wait weeks and months to see a doc. Testing will suffer as well as surgeries. We will start to rival Canada and Europe for waiting times.

What a mess and sadly one we could have all avoided. However, as my Jamaican nanny used to say, "if you can't hear you must feel". And we sure are going to feel - buckle up its going to be a rough ride.

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