Covered California: Obamacare And Reality Collide

In the midst of a government shutdown, the ACA exchanges open to much fanfare and success. Well, actually, no they didn’t.  CNN and MSNBC tried all day to get them to work and could not sign up on live television. People browsing often couldn’t access the site or proceed through the process.  They tried to blame this on traffic, but even ACA supporters have dismissed this canard.

“I’m a very very big supporter of the health-care act, but I don’t buy the argument that the load was too unexpected.” – Washington Post

But Covered California had 5 million visits. That’s certainly a lot right?

Dana Howard, a spokesman for Covered California, said the error was the result of internal miscommunication. “Someone misspoke and thought it was indeed 5 million hits. That was incorrect,” he said.

Further, it appears that not one person has signed up in the entire state of California.

“Since Obamacare’s exchanges opened, none of the 645,000 people who visited California’s online exchange, coveredca.com, have enrolled in the healthcare program, California news station KUSI-CA reports.”

But you’re a do-it-yourself kind of person, so you want to go and do a rate comparison yourself.  According to Covered California, that’s impossible.

The reasoning for this you get to find in the brochure on Covered California’s website.

Apparently it is impossible to compare these rates with rates you could have obtained because — well, because they say so.  It’s not as if someone can’t say “I paid x over the last 3 years, and now I pay y,” but I digress. The truth is that ACA has been designed to fail your average consumer and shift the cost burden to the young and healthy. Insurers, as you can see above, are no longer allowed to set prices based on your risk, but to charge everyone based on the risk level of a much sicker person even if that does not apply to you. The only variables allowed are age and geographic region, which also leads to some odd effects within a single state.  Many are finding that they can get a policy cheaper if they lived in another pricing region. California has 19 pricing regions. Clearly we can’t have interstate competition on insurance plans because that might actually offer consumers competitive choices, and now we can’t even have competition within a state.

I’ll walk you through what awaits a working family of four (two adults age 40 and two kids) if they were forced to purchase a policy through Covered California.  The first thing you encounter, if you happen to be gainfully employed, is this:

Well, that’s disappointing. But I’m sure the rates are affordable. I mean they used the word “Affordable” twice so it’s got to be right?

Well, that isn’t my idea of affordable. At least the coverage is better than what I have now and I won’t pay as much out of pocket.

Nope, these plans have an annual out-of-pocket maximum of $12,700 for families after you meet the deductible of either $2,000 for the Silver plan or $5,000 for the Bronze plan. So for the Bronze plan, after you spend $745/month — plus a $5,000 deductible — you’ve spent $13,940 a year. But if you are a single guy, you can breathe a sigh of relief, since now you have to purchase maternity coverage.

Well, at least its nice to be able to shop one place and figure out if I can keep my doctors — since if I don’t buy insurance, I have to pay the mandate tax.

That’s just my experience at Covered California you say. Here’s one from a self-employed Californian, Steve Dushesne

“Surprisingly, the representative also guaranteed that the $666 monthly premium would not increase for the rest of this year. The plan, and every other Anthem policy available to individuals in California for that matter, did not meet federal requirements under the Affordable Care Act, he explained. As a result, it would not exist beyond Dec. 31. So, as a bone to its individual market captives, Anthem would not increase the premium for the remaining 11 months. We could then buy new insurance through the state’s Obamacare exchange for coverage in 2014.

I have visited the state exchange, CoveredCA.com, and what I found is not encouraging. In fact, it’s frightening, with few policy choices, higher monthly premiums and higher out-of-pocket costs.”

“Relieved to see Anthem, which has provided my family’s health insurance policies for nearly 10 years, I was stunned by the $900 monthly premium, not to mention higher out-of pocket costs. Like our current plan, Anthem’s Obamacare policy would cover three doctor visits per person per year, but with a 35 percent increase in the monthly premium.

The sticker shock did not end at the premium. Our doctor office co-payment would double from $30 under our current policy to $60 under the Obamacare policy, and in the event of a trip to an emergency room, our co-pay would triple from $100 to $300. Our current policy includes no co-pay for an urgent care visit; Obamacare would hit us for a co-pay of $120.”

This couple in California, who voted for Obama share their story

But people with no pre-existing conditions like Vinson, a 60-year-old retired teacher, and Waschura, a 52-year-old self-employed engineer, are making up the difference.

“I was laughing at Boehner — until the mail came today,” Waschura said, referring to House Speaker John Boehner, who is leading the Republican charge to defund Obamacare.

“I really don’t like the Republican tactics, but at least now I can understand why they are so pissed about this. When you take $10,000 out of my family’s pocket each year, that’s otherwise disposable income or retirement savings that will not be going into our local economy.”

Both Vinson and Waschura have adjusted gross incomes greater than four times the federal poverty level — the cutoff for a tax credit. And while both said they anticipated their rates would go up, they didn’t realize they would rise so much.

“Of course, I want people to have health care,” Vinson said. “I just didn’t realize I would be the one who was going to pay for it personally.”

I wonder who exactly Vinson thought was going to pay for it.