Healthcare.Gov Misconceptions and Failures

Still A Mess

We are almost 7 weeks into the rollout of Obamacare (Affordable Care Act) and I think we can agree that the execution of the implementation has been less than perfect. There are many issues that persist with the ability to access the website as connectivity has been brought down to try to fix the structural issues with the flawed portal.

In this post I want to highlight some misconceptions I am seeing that you need to know about right now. Tries To Be The Orbitz or Kayak Of Health Insurance...And Fails

I didn't quite grasp how profoundly Americans had been "trained" to believe that the only source for information about health plans is the website. I recently had a conversation with a distant family member after providing him a quote for health insurance. We spoke briefly about the offerings and he said he really liked a specific plan he felt would meet his needs. His next statement floored me. Philip stated, "Ok, this looks great, when the website gets up and running I'm going to get some quotes there and then I'll get back with you!" Can you imagine my shock?

Obviously I had to hide my bewilderment, but this comment clearly underscores that Americans don't realize several key things about the Affordable Care Act, the health insurance market, and where you can obtain pricing information. Let's clarify these things right now so you can get correct information right now.

The Basics

Let's start with the basics. The ACA and Obamacare are the same thing. The ACA (Affordable Care Act) or Obamacare is a massive law that requires each US citizen to obtain health insurance. It also describes minimum benefits that an insurance company must provide and requires that insurance companies accept anyone who applies for coverage without increasing the price even if they have a pre-existing condition like cancer or heart attacks. Finally, in order to make the whole health insurance ponzi-scheme work, the government attempted to create an easy way to get everyone in the United States to sign up because they need lots of healthy people to support the expensive sick people who will rush to sign up. The marketing effort has been successful as we've been directed to over and over again and we've been led to believe that it is the only place to find health insurance!

A Marketplace & Financial Assistance

The site does two things. First it is the place you need to go to in order to obtain financial assistance if you qualify for a subsidy. The website serves as the portal where you'll input all of your private and sensitive information to determine if you will obtain help in paying your health insurance premiums. Qualification is based on how many members you have in your family and your modified adjusted gross income. Once you've entered in your information and it has been verified, the government website will tell you how much assistance you can receive. You have the choice to attempt to apply this tax credit against the gross monthly premium that you'll be charged for a plan. You also have the choice to NOT take this credit on a monthly basis and to simply get a tax refund at the end of the year. In fact, I have had several clients simply opt to skip this process now and plan to file a form 1095A in April of 2015 to obtain their tax refund. This will work and can be a fine workaround if you are able to cashflow the health insurance purchase process, BUT, you must purchase an ON EXCHANGE policy. Make sure to discuss this with us! If you purchase an OFF EXCHANGE policy, you will not get a premium tax credit.....ever! The only drawback to this process is that the government's site has been down and hasn't worked.

Let me state this again so there is no confusion. You cannot get a subsidy without going to the site AND you must buy an ON-EXCHANGE plan to get the subsidy even if you defer receiving the subsidy till you file your 2014 taxes. Purchasing an OFF EXCHANGE product (even though it looks exactly like an ON EXCHANGE policy) will result in you being ineligible to obtain a subsidy.

A Place To Buy...Maybe

The second major function of the site is to provide a place where citizens can come to find prices and to apply for health coverage. Just like tripadvisor, priceline, or other aggregator service, the site should allow you to make purchases of the policies you see. I find it very troubling though to find that information is presented in ways where it is difficult to compare prices, find details of plans, and make great decisions.

Finally, we are hearing that there have been all sorts of data communication errors once people purchase plans on the website. The issue is that once the purchase is made at the government site, the data must be sent to the specific insurance company to tell them that you bought their policy and that you are their client! Records have been reported to have missing fields, duplicated, incorrect, or simply lost. These issues lead me to ask, once you have your financial assistance number, why would you ever purchase from the government site? True, you've already disclosed so much personal and private information to them, but why trust them to complete the handoff of information to the insurance company?

When you work with an agent like us, you'll also have the extra help from our Texas Health Design website to monitor the status of your application in real-time, therefore you won't guess if the insurance company has your file and if the information is correct. We've had clients apply and receive approvals within hours this week. Our firm has been able to put nervous clients at ease providing policy numbers right away. Do you think an application submitted to will give you this type of service? Not even close.

Give us a call and we can walk you through the process of obtaining coverage. We want you to be informed about your options, your policies, and the process. As much as the President wants to tell you that this should be simple, it isn't. As much as the websites should function, they haven't. As much as these plans should be cheaper and provide better benefits, they often don't. If you'd like to see just how "easy" it is to sign up and receive coverage take a look at the recent disclosure by the government about the lack of success we've seen of searchers trying to obtain coverage. This link below shows the number of people in each state that have added a policy to their cart (not actually bought).

Updated Numbers Of Americans Signed Up

Clearly these numbers are high as we have clients click "apply" on our websites almost nightly, but only see about 20%-30% click through and actually buy a policy! If those statics ring true for this site, we're actually looking at something like 30,000 actually people signing up and obtaining policies! Ouch! The column next to this shows the number of Americans that have received cancellation notices that their individual or group plan will go away. Obviously there is a net loss in Americans receiving coverage.

Don't struggle without a guide! The prices you pay for insurance are the same if you purchase coverage with, directly with a carrier, or with us. Get help from a team that cares for you and is committed to you, now and throughout the year.  Let us help you with this challenging process. Call us today at 713-422-2935, request a quote or CONTACT US today.

Jason W Bohmann
Texas Health Design