Government Shutdown? What Happens?
We've seen some interesting theatrics of late in the political world and I quickly wanted to write a post in order to clear up some confusion. We are getting emails and comments concerned about the threatened government shutdown and what that might do to the implementation of the Affordable Care Act or more affectionately known as "Obamacare".
The Money Is There!
I could write a long commentary delving into the motivations of both parties, but the bottom line is quite simple. The funding for Obamacare is already allocated and is deemed as core or part of the central function of the government. Because the ACA is flagged in this way, the dollars needed to pay for the IT support, phone assistance, and infrastructure will not stop flowing. The truth is that the flagship accomplishment of the Obama administration is not going to be delayed or halted by the Republican Congress. Other federal agencies and organizations may close, but the components necessary for the rollout of Obamacare will not.
Politics and posturing are taking their toll on many of our readers and clients as many have been looking forward to the promise of more affordable rates, the addition of maternity to all plans, and the addition of mental health coverage. (Of course many other clients have been concerned about higher rates and extra taxes!) Threats of delays serve to add stress to these concerned insurance owners. Unfortunately, we can safely predict that politicians won't stop blustering or wasting time and our taxpayer money. As citizens and consumers, we need to focus on what we have in front of us and make plans to reduce our costs and improve our plan benefits as much as possible.
Nothing Can Stop It
In summary, the government shutdown may keep you from going to a National Park or filing for a small business loan with the SBA, but it won't keep Obamacare from going live on October 1st. Wasting time listening to talk about defunding will frankly only fray your emotions and use up one of our most valuable resources....your time.
New Plans / New Networks / No Pricing Info!
Last week almost all of the Texas insurance carriers released copies of their plans to agents and brokers. We are studying all weekend to ensure that we can help you understand what each insurer is offering, what they are changing, and what types of doctor networks will exist.
A major takeaway from the meetings this week will be that you'll need to pay special attention to physician networks if you do qualify for a subsidy. Some carriers are offering HMO style plans to the "on exchange" clients which means that you'll need to have a primary care physician and a referral to see a specialist. THIS HAS MAJOR IMPLICATIONS ON PEOPLE THAT TRAVEL, so as usual, be careful that you take time to understand your policy and the rules associated with in-network benefits. Many of the HMO plans have ZERO benefits out of network.
Off exchange (no subsidy) plans will be traditional PPO plans so you'll typically have the same networks and network size we are accustomed to right now.
Finally, if you are like me, you want to know the real pricing of these plans right now. Carriers are saying they don't even know their final pricing and we'll get to see them when the system goes live October 1st. I'll do an analysis of the rates to compare in real terms the impact as this will be very important for people who are interested in buying in the next several months to lock in rates with the hope of avoiding paying higher prices in January with a full ACA plan.
Cross your fingers that they systems work well. There may be some delays, but we have until 12/31/13 to get applications submitted online, so we'll be able to handle any delays without trouble.
Jason W Bohmann
Texas Health Design