The Current State Of ObamaCare - ACA

[FLM2]

HERE IS MY SOLUTION, No pay no play, they can enroll themselves. If we help people after comp is pulled then WE ARE THE PROBLEM!

A message MUST be sent to CMS that WE control 50% of all enrollments and when some are not getting paid enrollment will drop and those that do it themselves a large percentage will get all jacked up... DO NOT ENROLL THESE PEOPLE!

Once this thing gets jacked on enrollment numbers and massive call center inbounds CMS will step in and mandate a comp

I agree 100%, actually 1000%!

I don't work for free and neither should anyone else.

The Marketplace solution to this is to spam everyone with an account with over 25 'touches' during Open Enrollment whether they've worked with an agent or not, it will cause massive confusion and drive everyone absolutely NUTS!

We are better as a nation than to have this pathetic, ridiculous implementation of healthcare reform, I could have done better on the back of a napkin.

 

[kgmom219]

DO NOT ENROLL THESE PEOPLE!

Once this thing gets jacked on enrollment numbers and massive call center inbounds CMS will step in and mandate a comp

2 of my favorites.....brilliant

Even if I help pick the plan, I'm sending them to the FFM for enrollment.

"I'm sorry, I can't legally be your agent when my E&O won't cover any claims"

 

[AllenChicago]

HERE IS MY SOLUTION, No pay no play, they can enroll themselves. If we help people after comp is pulled then WE ARE THE PROBLEM!

You tell'em Hillary...uh, I mean Tater! If insurers don't pay, they don't want us to play.

I did help a scant few do the front end of SEP's this Summer, but there was something to gain from helping them. One was a relative..the other 3 agreed to purchase a non-health product.

 

[Yagents]

Looks like somebody's awake on the left, and smelling the coffee (chit storm) brewing:

The Obamacare problem that Democrats don

This is true, but it also leaves out something important: that there are millions of people buying their own coverage outside of the marketplace. And none of them receive subsidies. So they don't have any financial cushion to protect against the larger premium increases most observers expect to see in 2017.

"They are the red-haired stepchildren of American health reform," says Kevin Coleman, head of research and data at HealthPocket. "They don't have strong sympathy within the government and have typically been ignored."

 

[kgmom219]

Looks like somebody's awake on the left, and smelling the coffee (chit storm) brewing:

The Obamacare problem that Democrats don

Oh BULL

If you choose not to use the FFM because of your hatred of Obamacare, Obama and liberals AND you are too stupid to use an agent who will tell you how much money you are leaving on the table, you are not a red-headed step child.

You are ignorant and short-sighted.

 

[TN_agent]

Oh BULL

If you choose not to use the FFM because of your hatred of Obamacare, Obama and liberals AND you are too stupid to use an agent who will tell you how much money you are leaving on the table, you are not a red-headed step child.

You are ignorant and short-sighted.

The article is talking about people who aren't subsidy eligible and so buy outside the exchange, not people who refuse to go through the exchange for political reasons.

I have many people who are off-exchange now because they aren't subsidy eligible and don't want to deal with the extra layer of bureaucracy.

For example, some carriers will reinstate (one-time only) if you terminate for non pay after 30 days and pay the full balance due. Has happened a time or two and the clients were grateful for the reinstatement. The federal marketplace will not, and they are SOL and cut off until open enrollment next year. Same thing with making changes without going to the marketplace, being able to change a mailing address, add a middle initial etc. There are also additional plans and networks available off-exchange, so why go through the exchange if you have no hope of a subsidy?

But, these people will use the exchange next year to get compliant coverage if they have to. They are bearing the full brunt of the year over year rate increases. I have a family of 4 who is paying $800 a month ($9600 a year) for a 5k ded (10 k fam). Same plan was about $600 last year. This plan is not available next year. Near as I can estimate (for the next few weeks), cheapest compliant plan next year will be about $1200. They make about $105,000 after deductions so aren't going to be subsidy eligible.

They don't have an extra $4800 a year laying around for premiums, they will cut back (no Christmas or vacation this year kids!) or go without. They will be "exempt" from the tax penalty most likely, but that doesn't get them health insurance.


I have plenty of other people caught in the family glitch who make 300% of FPL so the nonworking spouse and kids don't get subsidies or Medicaid and they are bearing the full cost of 40-60% rate increases (and 20-35% rate increases the year before that). Most of them are going to healthshares. They can't afford the $800 a month the employer would charge for family coverage, OR the $700 a month for mom and kids on a 5k deductible plan)


All those statistics of "85% of people get subsidies and can find a plan for less than $100" are crap. The stats are going to go away if everyone has to use the exchange.

From the article: "So the best we have is a handful of estimates on how big this market is. The Obama administration thinks there are 6.9 million people buying coverage off the marketplace. It thinks 2.5 million of those people would be eligible for subsidies if they switched to the marketplace."

They have absolutely no way of knowing how many of the total population are eligible for subsidies. There are TONs of people in family glitch (which you wouldn't know until they actually apply), married filing separately, covered by the VA but wish they weren't, etc. Not to mention those above 400% FPL.

 

[kgmom219]

The article is talking about people who aren't subsidy eligible and so buy outside the exchange, not people who refuse to go through the exchange for political reasons.

I have many people who are off-exchange now because they aren't subsidy eligible and don't want to deal with the extra layer of bureaucracy.

For example, some carriers will reinstate (one-time only) if you terminate for non pay after 30 days and pay the full balance due. Has happened a time or two and the clients were grateful for the reinstatement. The federal marketplace will not, and they are SOL and cut off until open enrollment next year. Same thing with making changes without going to the marketplace, being able to change a mailing address, add a middle initial etc. There are also additional plans and networks available off-exchange, so why go through the exchange if you have no hope of a subsidy?

.

I have gone round and round with other agents on this, so I'm not expecting to change any minds, but here's my 2 cents.

1. Unless the plan you want is only available off ex, there is no reason not to be on the exchange.
The middle inital arguement is bogus. Tell them to get their damn SSA cards and/or 1040 and type the info in correctly.
2. The FFM doesn't term for non payment of premium. The carriers do. (And being delinquent with your bills isn't going to get my sympathy, either. You are too good for the FFM and you don't pay your bills on time AND you either have a lazy agent who isn't running grace reports or you are too good for an agent, too)
3. Most of the people we write are self employed. How do they KNOW next years income? Just because you made $250K in 2016 doesnt mean the economy isnt going to collapse in 2017 and you income doesnt get to to under 400% of the FPL. Go On EX, hedge your bets. Same argument with people caught on the family glitch..hope the employed spouse doesn't lose their job, creating a significant income decrease)
4. Changing an address takes about 3 minutes via the FFM backdoor. Get over it
5. I agree that the 2.5 million number is bogus, but so what?
6. Take off the tin foil hats and be realistic. The government gets Off Ex info. So you can give it to them or the carriers will. One way or another, they've got it.
7. The increases are horrendous. But the dems are not going to care about a 3% segment, who are small business owners, which probably means they lean red already
8. From an internal agency issue, I LOVE having all my Indy clients on the Sherp. Takes 5 minutes to run a report, dump into a spreadsheet and go
9. I don't want to hear "I cant afford health insurance" unless you don't have cable TV or smart phones. You may not think its worth it (and you should count your blessings), but you can afford it. Its all about priorities. Ask someone in a chemo ward what their priorities are.
10. Don't get me started on sharing ministries.

For the record, only about 10% of my clients are truly subsidy eligible. The rest are either over 400% or have great financial planners that are manipulating the MAGI.

I am at 99% On Ex, with very few service issues.

 

[Yagents]

You can't have a ppo any more. (in most areas)
You can't buy an hsa any more. (in many areas)
It's hard to buy direct any more. (paper apps)
Must buy thru govt.
You will lose your doctors.
Price is going up 75%. (in some areas)
Horrible story to tell. (to everyone except the subsidized healthy folks)

 

[kgmom219]

Horrible story to tell. (to everyone except the subsidized healthy folks)

PPO...ok

HSA...hmmm, I want the numbers. I'm not buying "most".

But you nailed it with the word "healthy"

We always forget about the sick ones.....

Especially those who had more than 2 sinus infections in Texas pre-ACA. Cuz they couldn't an indy policy...

I don't think the FFM is the solution. But I also don't think its the worst thing since Seperate but Equal, either.

And the over 400% should be working with an agent to get a group, if a PPO and/or HSA is so critical.....

 

[TN_agent]

I don't think we are that far off in reality, I agree there are work arounds to many issues, but I find my on-ex clients to be EXTREMELY frustrated with the exchange. The more they make (yes, I have in fact sold non-subsidy eligible people on-ex for the reasons you outlined) , the more frustrated they are. Like when they try to cancel coverage and they can't terminate for two weeks.

If offering on-ex, a carrier has to follow the governmental rules regarding terminations, grace periods, etc. They have no leeway as they would off-ex. I don't appreciate the insinuation I am a lazy agent or they are all deadbeats, however. In my experience, there are often extenuating circumstances where it is good that there is carrier leeway.

I have MANY off exchange that are not self-employed yet not offered group coverage yet making decent money. Believe me, I get them on groups when/if I can. Probably a demographic difference between where you sell and where I do.