Obamacare execution called 'flawed'
Commissioner’s attorney explains health reform, problems in rollout
November 18, 2013
The chief legal counsel of the state commissioner of securities and insurance Friday said the rollout of the Affordable Care Act and changes made since the rollout have caused some serious problems.
Jesse Laslovich, chief legal counsel for the office of Montana Auditor Monica Lindeen, said in a meeting in Havre Friday that President Barack Obama likened the problems in rolling out his signature health care reform to a fumble in a football game. Obama made the reference during a press conference Thursday about problems with the federal health insurance online marketplace and insurance companies cancelling policies after Obama said people could keep their policies if they wanted to.
Laslovich likened the problems to giving the opposing team an interception and score.
“I would call it a pick-six,” Laslovich said. “It’s going to take a lot to overcome.”
Laslovich was in Havre at a Bear Paw Development Corp. strategy meeting, presenting information and taking questions on the health care reform, commonly called Obamacare.
Laslovich said the intent
of the reform was to give more people insurance, spreading the risk and keeping down cost increases in medical care and health insurance.
He said that includes
helping 195,000 Montanans who do not have health insurance coverage.
“The concept … I think
in theory, with the Affordable Care Act was a good one,” Laslovich said. “I think the execution has been flawed, to say the least.”
Laslovich said a key to the reform was making sure people could look at their insurance options — comparing plans listed on the same page, for the first time — and see what that insurance would cost, including any federal subsidies available.
But that requires the online insurance exchange, with which people still are having problems.
Laslovich said the only way to receive the federal subsidies to pay for insurance — available to people with income from 100 percent to 400 percent of the federal poverty level — is through the online marketplace.
“The problem has been, obviously, the marketplace is not working,” he said.
Laslovich said Obama’s announcement last Thursday that the federal government would not enforce requirements in 2014 that all health policies meet the requirements of ACA — allowing companies to continue to offer policies for which they had recently sent out cancellation notices — is another problem.
A main goal of the reform is to spread the risk in a larger insurance pool, reducing the cost to each individual.
What Obama’s announcement means, Laslovich said, is younger, healthier people who don’t want all of the coverage required by the reform can still get cheaper policies, while people who want better health coverage will get the new policies — which will create two smaller pools instead of one larger pool.
Another problem is that companies already have prepared the policies to meet the new requirements. Laslovich said the coalition of companies that bought Blue Cross Blue Shield Montana, Health Care Services Corp., the fourth-largest insurer in the nation, had 1,200 people working to get their policies prepared for the changes.
At a Havre Area Chamber of Commerce meeting Nov. 6, a representative of Blue Cross Blue Shield Montana said he had mailed out the cancellation notices as required by law, and when people were close to the cancellation date the company would notify them of the new plan most similar to their original plan they would be switched to.
Laslovich said before Friday’s meeting that the companies’ new plans meeting the requirements would be more expensive, although he said during the meeting that the increase generally was not dramatic in Montana.
State law already required health insurance include many of the requirements under the health reform act.
But now, Laslovich said, the companies have to decide whether to keep offering the old policies.
“Now we have to put the toothpaste back in the tube,” he said.
He added that Lindeen met Thursday with representatives of Blue Cross Blue Shield and PacificSource Health Plans, two of the companies offering plans on the Montana Marketplace.
Montana Health Co-op is the third.
Laslovich said PacificSource representatives indicated they still would cancel the noncompliant policies, while Blue Cross Blue Shield still was thinking it over.
Lindeen also can require the noncompliant policies be canceled.
While the online exchange is not working so well even yet — the Obama administration has worked on repairing the problems since the rollout, and continues to say fixes are being implemented — other online resources are available.
The state auditor has one. Lindeen’s office has a web page at http://montanahealthanswers.com that helps explain the changes taking full effect next year.
Laslovich listed another. He said a page at the website of the nonpartisan Kaiser Family Foundation at http://kff.org can show the cost, and federal subsidy available, for a silver-level plan under the Affordable Care Act. The person using the calculator enters answers to seven questions and the calculator shows the household income level, the premium in a silver-level plan, the estimated government subsidy, if any, and the amount the person would pay for the insurance.