Health Care Exchange and Obamacare from the Crow’s Nest

The Health Care Exchange Signals that the Dog Race Has Begun

If you have ever been to the dog races you are familiar with the start of the race. The rabbit runs around the track. Just when it gets to the boxes housing the dogs, the doors swing open and the dogs explode from their confinement and begin chasing the rabbit with all they have. Likewise with health care reform, the rabbit is coming around the track and the doors are about to open.

Gate 1: The Below 250% of the Poverty Level

Behind door one on the inside in the pole position, are those below 250% of the poverty level who do not have insurance. They will be first out of the gate running after the no cost health insurance, subsidized deductibles, and co-insurance payments.

Gate 2: The Un-insured

Right behind them from gate two are the uninsured with already underway health conditions, waiting for treatment until January 1st. There will be gigantic losses on every one of these individuals for whoever is taking the risk; either the insurance companies or the government.

Gate 3: The Navigators

In lane three will be the 140,000 navigator jobs paying $20 to $40 per hour. This is more than the total number of IRS agents in America, which is under 100,000. They will be initiating a hostile takeover of duties that insurance agents and their staffs have handled for 70 years at an average pay rate and benefits that currently costs 1/3 what the navigators will be paid for wages and benefits. Tripling the costs and taking it from the private sector to government jobs.

Gate 4: The Small Businesses

In lane four will be the small businesses to whom it will be clear that cutting loose their employees to get subsidized coverage on the health care exchange will be better for their employees from a cost benefit perspective on their health insurance. In doing so it will make the business stronger, more likely to survive and provide more opportunities for their employees because they are freed from the burden of health insurance premiums.

Gate 5: The Rabid Angry Dog: Isn’t this free?

Out of gate five comes what appears to be a rabid angry dog. He thought this was going to be cost free and pain free. After several hours gathering information that has been very difficult to get, filling out intrusive forms, waiting weeks for a verdict, he discovered he has to pay hundreds of dollars every month if he wants to get the coverage he thought was going to be free.

Gate 6: The Health Insurance Companies

In gate six is the health insurance companies with a brain. They can clearly see the government game is “we give you $5 you give us $5 million,” because the truth is all those who want in are very high claims against small revenue. They are sitting down not leaving the gate.

Then there are the dogs that are not even in the box when the gate opens. Such as:

Gate 8: The Young and Healthy

Missing from gate 8 is the young and the invincible. Who before would not pay $60 a month in the past for health insurance, will now be asked to pay $150 after subsides on average through the health care exchange. He is a no show for the start of the race wanting nothing to do with it.

Gate 9: The Already Insured

In gate 9, the sentimental favorite of the powers that be, Mr. already insured. The low user of health insurance services. He has come up lame because his premiums have gone up dramatically and his perception is that it is time for him to exit the race. The cost benefit ratio no longer makes sense.

Gate 10: The Clueless

In gate 10 are the millions who have no clue what is happening with the health care reform and have no understanding on what they are suppose to do. They do not realize that there are penalties and high premiums that they are expected to pay. They did not even know there was a race or even a track. They have bigger and more important things going on in their lives, which are taking all of their attention. A complete no show.

Sitting in the Stands

In the wailing and gnashing of teeth section are the dependents on large group plans who are forced off the employee plan because mandated benefits drive up the employer’s cost. In order to keep employer’s costs in line, he either does not offer dependent coverage any longer, or requires the dependents to pay. One of the anomalies of Obamacare is these dependents are almost exclusively not eligible for subsidies in the health care exchange.

In the luxury box section are the government employees who exempted themselves from the chaotic mess of the little people.

The Rabbit

Finally, about the rabbit. He is still waiting to be built in Wichita Falls, but there is a shortage of materials and the union is on strike. The design does not seem to work on the track that has been built. The government says he will be ready….we will see.

So what are we to do?

Here are some current solutions to the problem:

1. Buy Health insurance now if you pay for your own. A known loophole has been released that carriers are holding premium rates until 2015 on policies purchased now. This will give you another year on lower premiums at a minimum and may let things sort themselves out before you are sucked into the vortex of it all.
2. If you are a small business, consider partial self-funding even if you have just a few employees. Many people today have $10,000 deductibles already. If the business took a $10,000 or $15,000 deductible and provided an accident benefit, critical illness, and a $1000 fund for Dr. visits, it would be a very manageable cost. It would escape from the burdensome regulations and mandated benefits of Obamacare.
3. Don’t be hogs to the slaughter. Push back with legislators, regulators, and elected officials telling them what you want and why.
4. The government now says the small group exchange will have only one choice for 2014. This does not mean that it is your only choice. You can have different options through regional HMO’s, the various carriers, and even faith based health plans.
5. Get an advocate adviser in your corner. Not the high paid, minimally trained, no experience, politically biased green peas the government is going to try to foist on you. Rather someone who has been putting the client first; trying to get their needs and desires met at the lowest possible cost for decades. Someone who has access to all the options in all the states and the knowledge and experience to know which option best serves the clients situation.