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"content": "\u003cfigure id=\"attachment_16239\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/114385518.jpg\">\u003cimg class=\"size-large wp-image-16239\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/114385518-640x428.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>President Obama announced Thursday morning that insurance companies now have the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/14/insurance-canceled-obama-now-says-companies-can-offer-renewals-obamacare-aca/\" target=\"_blank\">option to offer renewals\u003c/a> to people whose\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/22/thousands-of-consumers-get-insurance-cancellation-notices-due-to-health-law-changes-obamacare-aca/\" target=\"_blank\"> plans were cancelled\u003c/a>.\u003c/p>\n\u003cp>But that doesn't mean insurance companies are required to take the president up on his offer.\u003c/p>\n\u003cp>Patrick Johnston, CEO of California Association of Health Plans, said in a statement that California \"needs to stay the course and transition people into the more comprehensive policies that meet the requirements of the Affordable Care Act.\"\u003c/p>\n\u003cp>He also pointed out that contracts with Covered California, the state's health insurance marketplace, \"require all non-grandfathered health plans to be ACA compliant by 2014.\"\u003c/p>\n\u003cp>But California's insurance commissioner Dave Jones is taking the opposite approach. In a press conference, he said he asked Covered California on Thursday to release insurers from their contracts to cancel non-ACA compliant policies by Dec. 31.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jones has long argued that consumers should be allowed to keep their plans through 2014. In recent weeks, he fought first \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/05/state-insurance-commissioner-forces-blue-shield-to-delay-cancellations-obamacare/\" target=\"_blank\">Blue Shield \u003c/a>and more recently Anthem Blue Cross which, he says, gave insufficient notice of cancellation of some consumers' plans.\u003c/p>\n\u003cp>But Jones lacks authority under state or federal law to force plans to permit consumers to renew. That decision appears to be up to Covered California, which issued an exceptionally brief statement of its own Thursday afternoon -- just two lines:\u003c/p>\n\u003cblockquote>\u003cp>We are assessing the impact and analyzing our options on how Covered California will incorporate this modification into our existing policy and direction.\u003c/p>\n\u003cp>Covered California understands the urgent need for clarity around this segment of policy and is working closely with health plans, regulators, and policy makers to quickly determine how the President’s new guidance will be fulfilled for Californians.\u003c/p>\u003c/blockquote>\n\u003cp>Roughly 2 million people currently purchase insurance in California's individual market and about half of them have received cancellation notices. Still, at least some of those people whose policies were cancelled will see better options in terms of benefits and/or costs on the Covered California marketplace. In addition,\u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthReformTranslationInfographic1.pdf\" target=\"_blank\"> 5.5 million Californians are uninsured\u003c/a>.\u003c/p>\n\u003cp>California's current \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/22/thousands-of-consumers-get-insurance-cancellation-notices-due-to-health-law-changes-obamacare-aca/\" target=\"_blank\">individual market is healthier \u003c/a>than the population as a whole. If people in the current pool were allowed to renew their current policies, that would keep them out of the Covered California risk pool and potentially destabilize the insurance market.\u003c/p>\n\u003cp>Chris Rauber at the \u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2013/11/obamcare-delay-doi-changes.html\" target=\"_blank\">San Francisco Business Times\u003c/a> cites Karen Ignagni, CEO of America's Health Insurance Plans:\u003c/p>\n\u003cblockquote>\u003cp>Premiums for next year's policies have already been set, Ignagni said, \"based on an assumption of when consumers will be transitioning to the new (Obamacare exchange) marketplace,\" and indicated a fear that if fewer young, healthy people sign up on Healthcare.gov and state exchanges (like Covered California) premiums will jump and the number of options for consumers will shrink.\u003c/p>\n\u003cp>\"Additional steps must be taken to stabilize the marketplace and mitigate the adverse impact on consumers,\" Ignagni concluded.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Should be pretty interesting to see how this all shakes out in the coming days.\u003c/p>\n\n",
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"excerpt": "President Obama announced Thursday morning that insurance companies now have the option to offer renewals to people whose plans were cancelled.\r\n\r\nBut that doesn't mean insurance companies are required to take the president up on his offer.\r\n\r\nPatrick Johnston, CEO of California Association of Health Plans, said in a statement that California \"needs to stay the course and transition people into the more comprehensive policies that meet the requirements of the Affordable Care Act.\"",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16239\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/114385518.jpg\">\u003cimg class=\"size-large wp-image-16239\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/114385518-640x428.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>President Obama announced Thursday morning that insurance companies now have the \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/14/insurance-canceled-obama-now-says-companies-can-offer-renewals-obamacare-aca/\" target=\"_blank\">option to offer renewals\u003c/a> to people whose\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/22/thousands-of-consumers-get-insurance-cancellation-notices-due-to-health-law-changes-obamacare-aca/\" target=\"_blank\"> plans were cancelled\u003c/a>.\u003c/p>\n\u003cp>But that doesn't mean insurance companies are required to take the president up on his offer.\u003c/p>\n\u003cp>Patrick Johnston, CEO of California Association of Health Plans, said in a statement that California \"needs to stay the course and transition people into the more comprehensive policies that meet the requirements of the Affordable Care Act.\"\u003c/p>\n\u003cp>He also pointed out that contracts with Covered California, the state's health insurance marketplace, \"require all non-grandfathered health plans to be ACA compliant by 2014.\"\u003c/p>\n\u003cp>But California's insurance commissioner Dave Jones is taking the opposite approach. In a press conference, he said he asked Covered California on Thursday to release insurers from their contracts to cancel non-ACA compliant policies by Dec. 31.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Jones has long argued that consumers should be allowed to keep their plans through 2014. In recent weeks, he fought first \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/05/state-insurance-commissioner-forces-blue-shield-to-delay-cancellations-obamacare/\" target=\"_blank\">Blue Shield \u003c/a>and more recently Anthem Blue Cross which, he says, gave insufficient notice of cancellation of some consumers' plans.\u003c/p>\n\u003cp>But Jones lacks authority under state or federal law to force plans to permit consumers to renew. That decision appears to be up to Covered California, which issued an exceptionally brief statement of its own Thursday afternoon -- just two lines:\u003c/p>\n\u003cblockquote>\u003cp>We are assessing the impact and analyzing our options on how Covered California will incorporate this modification into our existing policy and direction.\u003c/p>\n\u003cp>Covered California understands the urgent need for clarity around this segment of policy and is working closely with health plans, regulators, and policy makers to quickly determine how the President’s new guidance will be fulfilled for Californians.\u003c/p>\u003c/blockquote>\n\u003cp>Roughly 2 million people currently purchase insurance in California's individual market and about half of them have received cancellation notices. Still, at least some of those people whose policies were cancelled will see better options in terms of benefits and/or costs on the Covered California marketplace. In addition,\u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthReformTranslationInfographic1.pdf\" target=\"_blank\"> 5.5 million Californians are uninsured\u003c/a>.\u003c/p>\n\u003cp>California's current \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/22/thousands-of-consumers-get-insurance-cancellation-notices-due-to-health-law-changes-obamacare-aca/\" target=\"_blank\">individual market is healthier \u003c/a>than the population as a whole. If people in the current pool were allowed to renew their current policies, that would keep them out of the Covered California risk pool and potentially destabilize the insurance market.\u003c/p>\n\u003cp>Chris Rauber at the \u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2013/11/obamcare-delay-doi-changes.html\" target=\"_blank\">San Francisco Business Times\u003c/a> cites Karen Ignagni, CEO of America's Health Insurance Plans:\u003c/p>\n\u003cblockquote>\u003cp>Premiums for next year's policies have already been set, Ignagni said, \"based on an assumption of when consumers will be transitioning to the new (Obamacare exchange) marketplace,\" and indicated a fear that if fewer young, healthy people sign up on Healthcare.gov and state exchanges (like Covered California) premiums will jump and the number of options for consumers will shrink.\u003c/p>\n\u003cp>\"Additional steps must be taken to stabilize the marketplace and mitigate the adverse impact on consumers,\" Ignagni concluded.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Should be pretty interesting to see how this all shakes out in the coming days.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Insurance Canceled? Obama Now Says Companies Can Offer One-Year Renewals",
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"content": "\u003cfigure id=\"attachment_16227\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/187988217-e1384456349299.jpg\">\u003cimg class=\"size-large wp-image-16227\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/187988217-640x432.jpg\" alt=\"President Barack Obama speaks on the Affordable Care Act in the White House briefing room. (Win McNamee/Getty Images)\" width=\"640\" height=\"432\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Barack Obama speaks on the Affordable Care Act in the White House briefing room. (Win McNamee/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>WASHINGTON (AP) — Bowing to pressure, President Barack Obama on Thursday announced changes to his health care law to give insurance companies the option to keep offering consumers plans that would otherwise be canceled.\u003c/p>\n\u003cp>The administrative changes are good for just one year, though senior administration officials said they could be extended if problems with the law persist. Obama announced the changes at the White House.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The impact is unclear. While insurance companies will be able to offer people renewals, companies are not required to do so.\u003c/aside>\n\u003cp>\"This fix won't solve every problem for every person, but it's going to help a lot of people,\" the president said.\u003c/p>\n\u003cp>He acknowledged that \"we fumbled the rollout of this health care law\" and pledged to \"just keep on chipping away at this until the job is done.\"\u003c/p>\n\u003cp>He also promised to work to regain the trust of the American people.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"I think it's legitimate for them to expect me to have to win back some credibility on this health care law in particular and on a whole range of these issues in general,\" he said.\u003c!--more-->\u003c/p>\n\u003cp>Obama has been under enormous pressure from congressional Democrats to give ground on the cancellation issue under the health care overhaul, a program likely to be at the center of next year's midterm elections for control of the House and Senate.\u003c/p>\n\u003cp>It's unclear what the impact of Thursday's changes will be for the millions of people who have already had their plans canceled. While officials said insurance companies will now be able to offer those people the option to renew their old plans, companies are not required to take that step.\u003c/p>\n\u003cp>Insurance companies will be required to inform consumers who want to keep canceled plans about the protections that are not included under those plans. Customers will also be notified that new options are available offering more coverage and in some cases, tax credits to cover higher premiums.\u003c/p>\n\u003cp>Under Obama's plan, insurance companies would not be allowed to sell coverage deemed subpar under the law to new customers, marking a difference with legislation that House Republicans intend to put to a vote on Friday.\u003c/p>\n\u003cp>Only last week, Health and Human Services Secretary Kathleen Sebelius told a Senate panel she doubted that retroactively permitting insurers to sell canceled policies \"can work very well since companies are now in the market with an array of new plans. Many have actually added consumer protections in the last three-and-a-half years.\"\u003c/p>\n\u003cp>Republicans were unimpressed with the changes.\u003c/p>\n\u003cp>House Speaker John Boehner, speaking in advance of the president's announcement, insisted it was time to \"scrap this law once and for all.\"\u003c/p>\n\u003cp>\"You can't fix this government-run health care plan called Obamacare ,\" he said. \"It's just not fixable.\"\u003c/p>\n\u003cp>Obama, for his part, made clear he would continue to fight ongoing attempts to sink the whole program, saying, \"I will not accept proposals that are just another brazen attempt to undermine or repeal the overall law and drag us back into a broken system.\"\u003c/p>\n\u003cp>\"We're going to solve the problems that are there, we're going to get it right, and the Affordable Care Act is going to work for the American people,\" he pledged.\u003c/p>\n\u003cp>While the White House deals with the cancellation issue, the administration is also promising improvements in a federal website so balky that enrollments totaled fewer than 27,000 in October in 36 states combined. The administration had said in advance the enrollment numbers would fall far short of initial expectations. After weeks of highly publicized technical woes, they did.\u003c/p>\n\u003cp>Adding in enrollment of more than 79,000 in the 14 states with their own websites, the nationwide number of 106,000 October sign-ups was barely one-fifth of what officials had projected — and a small fraction of the millions who have received private coverage cancellations as a result of the federal law.\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/13/covered-california-enrolled-more-than-35000-people-in-october-new-data-shows/\" target=\"_blank\">California Dramatically Outperforms Healthcare.gov on Obamacare Enrollments\u003c/a>]\u003c/strong>\u003c/p>\n\u003cp>The administration said an additional 1 million people have been found eligible to buy coverage in the markets, with about one-third qualifying for tax credits to reduce their premiums. Another 396,000 have been found eligible for Medicaid, which covers low-income people.\u003c/p>\n\u003cp>Administration officials and senior congressional Democrats expressed confidence in the program's future. \"We expect enrollment will grow substantially throughout the next five months,\" said Sebelius, who is in charge of the program.\u003c/p>\n\u003cp>\"Even with the issues we've had, the marketplace is working and people are enrolling,\" she added.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Bowing to pressure, President Barack Obama on Thursday announced changes to his health care law to give insurance companies the option to keep offering consumers plans that would otherwise be canceled.\r\n\r\nThe administrative changes are good for just one year, though senior administration officials said they could be extended if problems with the law persist. Obama announced the changes at the White House.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16227\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/187988217-e1384456349299.jpg\">\u003cimg class=\"size-large wp-image-16227\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/187988217-640x432.jpg\" alt=\"President Barack Obama speaks on the Affordable Care Act in the White House briefing room. (Win McNamee/Getty Images)\" width=\"640\" height=\"432\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Barack Obama speaks on the Affordable Care Act in the White House briefing room. (Win McNamee/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>WASHINGTON (AP) — Bowing to pressure, President Barack Obama on Thursday announced changes to his health care law to give insurance companies the option to keep offering consumers plans that would otherwise be canceled.\u003c/p>\n\u003cp>The administrative changes are good for just one year, though senior administration officials said they could be extended if problems with the law persist. Obama announced the changes at the White House.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The impact is unclear. While insurance companies will be able to offer people renewals, companies are not required to do so.\u003c/aside>\n\u003cp>\"This fix won't solve every problem for every person, but it's going to help a lot of people,\" the president said.\u003c/p>\n\u003cp>He acknowledged that \"we fumbled the rollout of this health care law\" and pledged to \"just keep on chipping away at this until the job is done.\"\u003c/p>\n\u003cp>He also promised to work to regain the trust of the American people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I think it's legitimate for them to expect me to have to win back some credibility on this health care law in particular and on a whole range of these issues in general,\" he said.\u003c!--more-->\u003c/p>\n\u003cp>Obama has been under enormous pressure from congressional Democrats to give ground on the cancellation issue under the health care overhaul, a program likely to be at the center of next year's midterm elections for control of the House and Senate.\u003c/p>\n\u003cp>It's unclear what the impact of Thursday's changes will be for the millions of people who have already had their plans canceled. While officials said insurance companies will now be able to offer those people the option to renew their old plans, companies are not required to take that step.\u003c/p>\n\u003cp>Insurance companies will be required to inform consumers who want to keep canceled plans about the protections that are not included under those plans. Customers will also be notified that new options are available offering more coverage and in some cases, tax credits to cover higher premiums.\u003c/p>\n\u003cp>Under Obama's plan, insurance companies would not be allowed to sell coverage deemed subpar under the law to new customers, marking a difference with legislation that House Republicans intend to put to a vote on Friday.\u003c/p>\n\u003cp>Only last week, Health and Human Services Secretary Kathleen Sebelius told a Senate panel she doubted that retroactively permitting insurers to sell canceled policies \"can work very well since companies are now in the market with an array of new plans. Many have actually added consumer protections in the last three-and-a-half years.\"\u003c/p>\n\u003cp>Republicans were unimpressed with the changes.\u003c/p>\n\u003cp>House Speaker John Boehner, speaking in advance of the president's announcement, insisted it was time to \"scrap this law once and for all.\"\u003c/p>\n\u003cp>\"You can't fix this government-run health care plan called Obamacare ,\" he said. \"It's just not fixable.\"\u003c/p>\n\u003cp>Obama, for his part, made clear he would continue to fight ongoing attempts to sink the whole program, saying, \"I will not accept proposals that are just another brazen attempt to undermine or repeal the overall law and drag us back into a broken system.\"\u003c/p>\n\u003cp>\"We're going to solve the problems that are there, we're going to get it right, and the Affordable Care Act is going to work for the American people,\" he pledged.\u003c/p>\n\u003cp>While the White House deals with the cancellation issue, the administration is also promising improvements in a federal website so balky that enrollments totaled fewer than 27,000 in October in 36 states combined. The administration had said in advance the enrollment numbers would fall far short of initial expectations. After weeks of highly publicized technical woes, they did.\u003c/p>\n\u003cp>Adding in enrollment of more than 79,000 in the 14 states with their own websites, the nationwide number of 106,000 October sign-ups was barely one-fifth of what officials had projected — and a small fraction of the millions who have received private coverage cancellations as a result of the federal law.\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>[Related: \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/13/covered-california-enrolled-more-than-35000-people-in-october-new-data-shows/\" target=\"_blank\">California Dramatically Outperforms Healthcare.gov on Obamacare Enrollments\u003c/a>]\u003c/strong>\u003c/p>\n\u003cp>The administration said an additional 1 million people have been found eligible to buy coverage in the markets, with about one-third qualifying for tax credits to reduce their premiums. Another 396,000 have been found eligible for Medicaid, which covers low-income people.\u003c/p>\n\u003cp>Administration officials and senior congressional Democrats expressed confidence in the program's future. \"We expect enrollment will grow substantially throughout the next five months,\" said Sebelius, who is in charge of the program.\u003c/p>\n\u003cp>\"Even with the issues we've had, the marketplace is working and people are enrolling,\" she added.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_15508\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>California’s new health insurance exchange enrolled more than 35,000 people during its first month of operation, or one-third of the 106,000 people enrolled nationwide, according to federal government \u003ca href=\"http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/rpt_enrollment.pdf\">figures released Wednesday\u003c/a>, which covered the period from Oct. 1 to Nov. 2.\u003c/p>\n\u003cp>When compared against the 36 states which have elected not to set up their own exchanges and instead rely solely on the troubled website healthcare.gov, California’s enrollments dwarf that of all those states — combined. In the 36 states, about 27,000 people have enrolled. Kathleen Sebelius, President Obama’s secretary of health and human services released the numbers in a press conference.\u003c/p>\n\u003cp>But later Wednesday afternoon, Covered California held a press event of its own and released data up to Tues., Nov. 12 – bringing total enrollees to about 59,000 people.\u003c/p>\n\u003cp>Momentum appears to be building. On average, about 1,000 people enrolled in Covered California every day in October, but in the first 12 days of November, average enrollments exceeded 2,400 a day. \u003c!--more-->\u003c/p>\n\u003cp>Peter Lee, executive director of Covered California, said he was “very pleased with the numbers.” He also said he expected momentum to continue, as the Dec. 15 deadline for coverage that starts Jan. 1 approaches. “The four-week period from Nov. 15 to Dec. 15 is going to be big enrollment,” he predicted.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In addition to the people who have selected a health plan, another 72,007 people were found to be eligible for Medi-Cal, the state’s version of Medicaid, with coverage starting on Jan. 1.\u003c/p>\n\u003cp>Anthony Wright, executive director of Health Access, a consumer advocacy group, said the increasing rate of enrollment suggests “that there’s a trend line that’s going up.” Still, he said the numbers do not necessarily show success or failure. Rather, “they’re a sign of where we need to do additional work. We need to redouble our marketing efforts and training of counselors to enroll people.”\u003c/p>\n\u003cp>Consumers can shop on the Covered California website or talk to trained staff directly at call centers or at many social service agencies. Insurance brokers are becoming certified to enroll people through Covered California. Lee said there are currently about 6,000 brokers certified, but he expects 20,000 insurance agents in total will be certified by the end of November.\u003c/p>\n\u003cp>In addition to the Dec. 15 deadline, the other big date for Covered California is March 31, 2014, when open enrollment ends. Lee said that Covered California “forecasts” enrollment of between 500,000 and 700,000 people eligible for subsidies. While 75 percent of the people who signed up in October were not eligible for subsidies, Lee referred to October as an “anomalous month\" because it was the first month.\u003c/p>\n\u003cp>By comparison, when Massachusetts was implementing its own version of health care reform in 2007, the first month of sign-ups was also pretty anomalous. \u003ca href=\"http://www.newrepublic.com/article/115309/obamacare-enrollment-massachusetts-statistics-suggest-it-will-be-slow\">Just 123 people\u003c/a> signed up – about 0.3 percent of the total number who enrolled by the end of open enrollment.\u003c/p>\n\u003cp>Some information critically missing from Wednesday’s release was any detail on demographics, especially age of enrollees. Covered California needs to enroll young, healthy people in order to spread risk and keep premiums from spiking next year. Lee said some of that data will be released at the Nov. 21 Covered California board meeting.\u003c/p>\n\u003cp>Wright cautioned against reading too much into initial breakdowns on enrollees. “The people who were the sickest would sign up the quickest,” he said. “They are the ones desperately waiting for coverage. We would expect that the younger folks will be signing up later, just because they may feel the urgency a little bit less.”\u003c/p>\n\u003cp>Covered California also released survey data from users on Wednesday. Nearly 70 percent of respondents said they found Covered California’s enrollment process “easy to complete,” and 88 percent said they “were able to choose a health plan that is right for them.”\u003c/p>\n\u003cp>Right off the bat at the press conference, Lee said those were “two of my favorite numbers.”\u003c/p>\n\u003cp>Covered California is using that kind of feedback to differentiate itself from the problem-plagued healthcare.gov website. “We’re changing our marketing,” Lee said. “We’re running radio ads that say, ‘We don’t know what you’ve heard, but the IT system is working great. You can enroll in 15 minutes.’”\u003c/p>\n\u003cp>Lee said the website is “constantly being improved” and that it will be offline for two days this weekend while changes are being made.\u003c/p>\n\u003cp>\u003cem>This post has been updated with detail from the Covered California press conference.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "California's new health insurance exchange tentatively enrolled 35,000 people during its first month of operation, fully one-third of the number enrolled nationwide, according to government figures released Wednesday. When compared against the 36 states which have elected not to set up their own exchange and instead rely solely on the troubled healthcare.gov, California's enrollments dwarfs that of all those states —combined. In those 36 states, 27,000 people have enrolled.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15508\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\">\u003cimg class=\"size-full wp-image-15508\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/coveredca.jpg\" alt=\"Screenshot from CoveredCA.com, the website of Covered California.\" width=\"640\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/coveredca-320x180.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Screenshot from CoveredCA.com, the website of Covered California.\u003c/figcaption>\u003c/figure>\n\u003cp>California’s new health insurance exchange enrolled more than 35,000 people during its first month of operation, or one-third of the 106,000 people enrolled nationwide, according to federal government \u003ca href=\"http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/rpt_enrollment.pdf\">figures released Wednesday\u003c/a>, which covered the period from Oct. 1 to Nov. 2.\u003c/p>\n\u003cp>When compared against the 36 states which have elected not to set up their own exchanges and instead rely solely on the troubled website healthcare.gov, California’s enrollments dwarf that of all those states — combined. In the 36 states, about 27,000 people have enrolled. Kathleen Sebelius, President Obama’s secretary of health and human services released the numbers in a press conference.\u003c/p>\n\u003cp>But later Wednesday afternoon, Covered California held a press event of its own and released data up to Tues., Nov. 12 – bringing total enrollees to about 59,000 people.\u003c/p>\n\u003cp>Momentum appears to be building. On average, about 1,000 people enrolled in Covered California every day in October, but in the first 12 days of November, average enrollments exceeded 2,400 a day. \u003c!--more-->\u003c/p>\n\u003cp>Peter Lee, executive director of Covered California, said he was “very pleased with the numbers.” He also said he expected momentum to continue, as the Dec. 15 deadline for coverage that starts Jan. 1 approaches. “The four-week period from Nov. 15 to Dec. 15 is going to be big enrollment,” he predicted.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In addition to the people who have selected a health plan, another 72,007 people were found to be eligible for Medi-Cal, the state’s version of Medicaid, with coverage starting on Jan. 1.\u003c/p>\n\u003cp>Anthony Wright, executive director of Health Access, a consumer advocacy group, said the increasing rate of enrollment suggests “that there’s a trend line that’s going up.” Still, he said the numbers do not necessarily show success or failure. Rather, “they’re a sign of where we need to do additional work. We need to redouble our marketing efforts and training of counselors to enroll people.”\u003c/p>\n\u003cp>Consumers can shop on the Covered California website or talk to trained staff directly at call centers or at many social service agencies. Insurance brokers are becoming certified to enroll people through Covered California. Lee said there are currently about 6,000 brokers certified, but he expects 20,000 insurance agents in total will be certified by the end of November.\u003c/p>\n\u003cp>In addition to the Dec. 15 deadline, the other big date for Covered California is March 31, 2014, when open enrollment ends. Lee said that Covered California “forecasts” enrollment of between 500,000 and 700,000 people eligible for subsidies. While 75 percent of the people who signed up in October were not eligible for subsidies, Lee referred to October as an “anomalous month\" because it was the first month.\u003c/p>\n\u003cp>By comparison, when Massachusetts was implementing its own version of health care reform in 2007, the first month of sign-ups was also pretty anomalous. \u003ca href=\"http://www.newrepublic.com/article/115309/obamacare-enrollment-massachusetts-statistics-suggest-it-will-be-slow\">Just 123 people\u003c/a> signed up – about 0.3 percent of the total number who enrolled by the end of open enrollment.\u003c/p>\n\u003cp>Some information critically missing from Wednesday’s release was any detail on demographics, especially age of enrollees. Covered California needs to enroll young, healthy people in order to spread risk and keep premiums from spiking next year. Lee said some of that data will be released at the Nov. 21 Covered California board meeting.\u003c/p>\n\u003cp>Wright cautioned against reading too much into initial breakdowns on enrollees. “The people who were the sickest would sign up the quickest,” he said. “They are the ones desperately waiting for coverage. We would expect that the younger folks will be signing up later, just because they may feel the urgency a little bit less.”\u003c/p>\n\u003cp>Covered California also released survey data from users on Wednesday. Nearly 70 percent of respondents said they found Covered California’s enrollment process “easy to complete,” and 88 percent said they “were able to choose a health plan that is right for them.”\u003c/p>\n\u003cp>Right off the bat at the press conference, Lee said those were “two of my favorite numbers.”\u003c/p>\n\u003cp>Covered California is using that kind of feedback to differentiate itself from the problem-plagued healthcare.gov website. “We’re changing our marketing,” Lee said. “We’re running radio ads that say, ‘We don’t know what you’ve heard, but the IT system is working great. You can enroll in 15 minutes.’”\u003c/p>\n\u003cp>Lee said the website is “constantly being improved” and that it will be offline for two days this weekend while changes are being made.\u003c/p>\n\u003cp>\u003cem>This post has been updated with detail from the Covered California press conference.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Bay Area Groups Struggle to Enroll Filipinos in Covered California",
"title": "Bay Area Groups Struggle to Enroll Filipinos in Covered California",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16180\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Ochavillo-News-Story.PhotoCROP-e1384284709202.jpg\">\u003cimg class=\"size-large wp-image-16180\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Ochavillo-News-Story.PhotoCROP-640x359.jpg\" alt=\"Filipino Youth Coalition presents information about Covered California in an event at the Milpitas Library. (Vanessa Ochavillo/Peninsula Press) \" width=\"640\" height=\"359\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Filipino Youth Coalition presents information about Covered California in an event at the Milpitas Library. (Vanessa Ochavillo/Peninsula Press)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Vanessa Ochavillo,\u003c/strong> \u003ca href=\"http://peninsulapress.com/2013/11/06/covered-california-enrollment-filipino-community/\" target=\"_blank\">Peninsula Press\u003c/a>\u003c/p>\n\u003cp>Filipino health advocates in the Bay Area are working overtime to educate the community about the Affordable Care Act and to enroll as many people as possible in California’s health insurance online marketplace before the Dec. 15 deadline.\u003c/p>\n\u003cp>The rollout of the state’s new exchange was accompanied by an ambitious outreach program that awarded grants to community organizations that would use their “trusted relationships” to get target populations enrolled.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“We get so many calls to make presentations, and we can only do so much. The resources are so limited.”\u003c/aside>\n\u003cp>But a lack of adequate funding and manpower has made it difficult to educate eligible, uninsured Filipinos about \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, the state’s health insurance exchange.\u003c/p>\n\u003cp>The problems in the Filipino community — the largest Asian minority in California — come as uninsured Americans across the country struggle to enroll in a plan because of widespread technical problems with the federally-run \u003ca href=\"https://www.healthcare.gov/\" target=\"_blank\">HealthCare.gov website\u003c/a>. California residents can sign up for a plan via a separate website run by Covered California which has encountered some glitches but not on the scale that the federal website has seen.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Filipino Youth Coalition, the community organization leading Filipino outreach in the Bay Area, started out as a youth service provider for Filipino-American high school students. But since open enrollment for Covered California began, the organization has had to remake itself into a health insurance education resource for all ages.\u003c/p>\n\u003cp>“There’s a lot of work to be done,” said Sarah Gonzalez, executive director of the coalition. “We get so many calls to make presentations, and we can only do so much. The resources are so limited.”\u003c/p>\n\u003cp>Gonzalez has recently resorted to paying out-of-pocket for transportation to and from presentations, as well as for refreshments, which -- although not mandatory -- are customary at Filipino gatherings.\u003c/p>\n\u003cp>Open enrollment will continue until March 31, 2014. But outreach workers are working under the pressure of the Dec. 15 deadline, which is the last day to enroll in order to receive coverage beginning Jan. 1. After that, uninsured individuals may incur a federal penalty.\u003c/p>\n\u003cp>Through its partnership with Asian Americans Advancing Justice, the only Asian and Pacific Islander community organization to receive a grant from Covered California, the Filipino Youth Coalition secured a small grant, which advocates said would be inadequate to fund the entire effort over the next five months.\u003c/p>\n\u003cp>But for outreach specialists like Gonzalez, delivering presentations and setting up information tables at events is worth the extra work. “At every presentation, the response is awesome,” she said. “It’s just, ‘Tell us what to do. Tell us where to sign.’”\u003c/p>\n\u003cp>By going through these familiar sources of information, including community centers, clinics, and churches, Covered California hopes to overcome the language barrier that had been identified as a major deterrent in applying for insurance in the past, said Iyanrick John, senior policy analyst at Asian and Pacific Islander American Health Forum, an advocacy group that closely studies health care in the Asian and Pacific Islander community.\u003c/p>\n\u003cp>As part of this “culturally sensitive” strategy, Covered California has pushed vigorously for resources to be delivered in native languages. Fact sheets and call lines are available in Tagalog, the primary Filipino dialect, as well as 11 other non-English languages.\u003c/p>\n\u003cp>“One of the aspects of the Affordable Care Act is that everybody must have equal access to get health insurance through the marketplace,” John said. “Covered California has done a pretty good job at that.”\u003c/p>\n\u003cp>Despite increased language access, both educators and enrollees struggle with the program’s criteria for qualifying for benefits. Certified outreach workers said those benefits were not thoroughly covered -- if at all -- in their three-day training conducted before the Oct. 1 launch. And educators found that they could not answer all enrollees’ questions like: Are children of undocumented immigrant parents covered but the parents not? Or, how are subsidies classified?\u003c/p>\n\u003cp>To better prepare for upcoming events, educators are regularly tuning in to informational webinars hosted by Covered California.\u003c/p>\n\u003cp>Recognizing the difficulties in signing up minority communities since the Oct. 1 launch, Covered California is ramping up its outreach.\u003c/p>\n\u003cp>Officials posted a series of video advertisements to YouTube on Oct. 17 in different Asian languages, though awareness about them remains low. The Tagalog version received just 145 views after nine days on the web.\u003c/p>\n\u003cp>Not everything can be done online. John explained that older, especially first-generation, immigrants prefer to get information through in-person assistance or via ethnic media, including newspapers or radio.\u003c/p>\n\u003cp>Some popular Asian TV spots and radio stations have already started airing advertisements in multiple languages.\u003c/p>\n\u003cp>Specific to the Filipino community, Tagalog, English and a mix of the two will be the focus languages in Covered California’s print advertisement running in November.\u003c/p>\n\u003cp>“Reaching out to communities with culturally-sensitive information delivered in their languages will be vital to our mission of expanding health care coverage in this state,” said Peter Lee, Covered California executive director, in an Oct. 21 press release announcing the launch of an Asian-language ad campaign.\u003c/p>\n\u003cp>This month, the state will expand advertising to paper mail, billboards, transit signs and other outdoor media, increasing awareness on the streets, where it is lacking.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To effectively distribute the additional resources, the program will continue to certify more educators. As of late last month, more than 4,200 potential enrollment counselors still awaited certification.\u003c/p>\n\n",
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"excerpt": "Filipino health advocates in the Bay Area are working overtime to educate the community about the Affordable Care Act and to enroll as many people as possible in California’s health insurance online marketplace before the Dec. 15 deadline.\r\n\r\nThe rollout of the state’s new exchange was accompanied by an ambitious outreach program that awarded grants to community organizations that would use their “trusted relationships” to get target populations enrolled.",
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"description": "Filipino health advocates in the Bay Area are working overtime to educate the community about the Affordable Care Act and to enroll as many people as possible in California’s health insurance online marketplace before the Dec. 15 deadline.\r\n\r\nThe rollout of the state’s new exchange was accompanied by an ambitious outreach program that awarded grants to community organizations that would use their “trusted relationships” to get target populations enrolled.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16180\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Ochavillo-News-Story.PhotoCROP-e1384284709202.jpg\">\u003cimg class=\"size-large wp-image-16180\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Ochavillo-News-Story.PhotoCROP-640x359.jpg\" alt=\"Filipino Youth Coalition presents information about Covered California in an event at the Milpitas Library. (Vanessa Ochavillo/Peninsula Press) \" width=\"640\" height=\"359\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Filipino Youth Coalition presents information about Covered California in an event at the Milpitas Library. (Vanessa Ochavillo/Peninsula Press)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Vanessa Ochavillo,\u003c/strong> \u003ca href=\"http://peninsulapress.com/2013/11/06/covered-california-enrollment-filipino-community/\" target=\"_blank\">Peninsula Press\u003c/a>\u003c/p>\n\u003cp>Filipino health advocates in the Bay Area are working overtime to educate the community about the Affordable Care Act and to enroll as many people as possible in California’s health insurance online marketplace before the Dec. 15 deadline.\u003c/p>\n\u003cp>The rollout of the state’s new exchange was accompanied by an ambitious outreach program that awarded grants to community organizations that would use their “trusted relationships” to get target populations enrolled.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“We get so many calls to make presentations, and we can only do so much. The resources are so limited.”\u003c/aside>\n\u003cp>But a lack of adequate funding and manpower has made it difficult to educate eligible, uninsured Filipinos about \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, the state’s health insurance exchange.\u003c/p>\n\u003cp>The problems in the Filipino community — the largest Asian minority in California — come as uninsured Americans across the country struggle to enroll in a plan because of widespread technical problems with the federally-run \u003ca href=\"https://www.healthcare.gov/\" target=\"_blank\">HealthCare.gov website\u003c/a>. California residents can sign up for a plan via a separate website run by Covered California which has encountered some glitches but not on the scale that the federal website has seen.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Filipino Youth Coalition, the community organization leading Filipino outreach in the Bay Area, started out as a youth service provider for Filipino-American high school students. But since open enrollment for Covered California began, the organization has had to remake itself into a health insurance education resource for all ages.\u003c/p>\n\u003cp>“There’s a lot of work to be done,” said Sarah Gonzalez, executive director of the coalition. “We get so many calls to make presentations, and we can only do so much. The resources are so limited.”\u003c/p>\n\u003cp>Gonzalez has recently resorted to paying out-of-pocket for transportation to and from presentations, as well as for refreshments, which -- although not mandatory -- are customary at Filipino gatherings.\u003c/p>\n\u003cp>Open enrollment will continue until March 31, 2014. But outreach workers are working under the pressure of the Dec. 15 deadline, which is the last day to enroll in order to receive coverage beginning Jan. 1. After that, uninsured individuals may incur a federal penalty.\u003c/p>\n\u003cp>Through its partnership with Asian Americans Advancing Justice, the only Asian and Pacific Islander community organization to receive a grant from Covered California, the Filipino Youth Coalition secured a small grant, which advocates said would be inadequate to fund the entire effort over the next five months.\u003c/p>\n\u003cp>But for outreach specialists like Gonzalez, delivering presentations and setting up information tables at events is worth the extra work. “At every presentation, the response is awesome,” she said. “It’s just, ‘Tell us what to do. Tell us where to sign.’”\u003c/p>\n\u003cp>By going through these familiar sources of information, including community centers, clinics, and churches, Covered California hopes to overcome the language barrier that had been identified as a major deterrent in applying for insurance in the past, said Iyanrick John, senior policy analyst at Asian and Pacific Islander American Health Forum, an advocacy group that closely studies health care in the Asian and Pacific Islander community.\u003c/p>\n\u003cp>As part of this “culturally sensitive” strategy, Covered California has pushed vigorously for resources to be delivered in native languages. Fact sheets and call lines are available in Tagalog, the primary Filipino dialect, as well as 11 other non-English languages.\u003c/p>\n\u003cp>“One of the aspects of the Affordable Care Act is that everybody must have equal access to get health insurance through the marketplace,” John said. “Covered California has done a pretty good job at that.”\u003c/p>\n\u003cp>Despite increased language access, both educators and enrollees struggle with the program’s criteria for qualifying for benefits. Certified outreach workers said those benefits were not thoroughly covered -- if at all -- in their three-day training conducted before the Oct. 1 launch. And educators found that they could not answer all enrollees’ questions like: Are children of undocumented immigrant parents covered but the parents not? Or, how are subsidies classified?\u003c/p>\n\u003cp>To better prepare for upcoming events, educators are regularly tuning in to informational webinars hosted by Covered California.\u003c/p>\n\u003cp>Recognizing the difficulties in signing up minority communities since the Oct. 1 launch, Covered California is ramping up its outreach.\u003c/p>\n\u003cp>Officials posted a series of video advertisements to YouTube on Oct. 17 in different Asian languages, though awareness about them remains low. The Tagalog version received just 145 views after nine days on the web.\u003c/p>\n\u003cp>Not everything can be done online. John explained that older, especially first-generation, immigrants prefer to get information through in-person assistance or via ethnic media, including newspapers or radio.\u003c/p>\n\u003cp>Some popular Asian TV spots and radio stations have already started airing advertisements in multiple languages.\u003c/p>\n\u003cp>Specific to the Filipino community, Tagalog, English and a mix of the two will be the focus languages in Covered California’s print advertisement running in November.\u003c/p>\n\u003cp>“Reaching out to communities with culturally-sensitive information delivered in their languages will be vital to our mission of expanding health care coverage in this state,” said Peter Lee, Covered California executive director, in an Oct. 21 press release announcing the launch of an Asian-language ad campaign.\u003c/p>\n\u003cp>This month, the state will expand advertising to paper mail, billboards, transit signs and other outdoor media, increasing awareness on the streets, where it is lacking.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To effectively distribute the additional resources, the program will continue to certify more educators. As of late last month, more than 4,200 potential enrollment counselors still awaited certification.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How the Affordable Care Act Is Supposed to Pay for Subsidies",
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"content": "\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_16141\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/140007839-e1383845514894.jpg\">\u003cimg class=\"size-large wp-image-16141\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/140007839-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"http://www.npr.org/blogs/health/2013/11/07/243584170/how-the-affordable-care-act-pays-for-insurance-subsidies\" target=\"_blank\">\u003cstrong>By John Ydstie\u003c/strong>\u003c/a>, \u003ca href=\"http://www.npr.org/blogs/health/2013/11/07/243584170/how-the-affordable-care-act-pays-for-insurance-subsidies\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>The new health care law will provide around $1 trillion in subsidies to low- and middle-income Americans over the next decade to help them pay for health insurance.\u003c/p>\n\u003cp>Johanna Humbert of Galien, Mich., was pleasantly surprised to discover that she qualifies for an insurance subsidy, since her current plan is being canceled. Humbert makes about $30,000 a year, so she'll get a subsidy of about $300 a month. The new plan is similar to her current one, but it will cost $250 — about half of what she pays now.\u003c/p>\n\u003cp>But where will the money come from to pay for subsidies like these?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On his show last Friday, liberal comedian Bill Maher called the Affordable Care Act a \"Robin Hood\" plan. \"It does take from the rich to make better the poor,\" he said.\u003c/p>\n\u003cp>You can certainly make a case for that, says economist Joseph Antos of the American Enterprise Institute. \"In a general sense, the rich, of course, subsidize the poor. The rich pay more income taxes,\" he says. \"So, yes, absolutely, that's how subsidies are supposed to work.\"\u003c!--more-->\u003c/p>\n\u003cp>So if you're a low-income person getting a tax credit from the U.S. Treasury to subsidize your health care, a big chunk of that credit is coming from taxes paid by the well-off.\u003c/p>\n\u003cp>\u003cstrong>The Cost Of Subsidies\u003c/strong>\u003c/p>\n\u003cp>But the authors of the Affordable Care Act didn't want the subsidies to become a drain on the Treasury and add to the deficits. So they included provisions designed to offset the cost of the subsidies.\u003c/p>\n\u003cp>MIT economist Jonathan Gruber, who helped develop the law, says about half the costs are offset by projected savings in Medicare payments to insurers and hospitals. Another quarter is offset by added taxes on medical-device makers and drug companies.\u003c/p>\n\u003cp>\"The other source of revenue is a tax increase on the wealthiest Americans,\" he says. \"Those families with incomes above $250,000 a year will now have to pay more in Medicare payroll taxes.\"\u003c/p>\n\u003cp>Those provisions actually make the bill a net positive for the federal budget, \u003ca href=\"http://www.cbo.gov/topics/health-care/affordable-care-act\" target=\"_blank\">according to \u003c/a>the nonpartisan Congressional Budget Office. By the CBO's accounting, Obamacare will produce a surplus. Gruber says the law will \"actually lower the deficit by about $100 billion over the next decade and by $1 trillion in the decade after.\"\u003c/p>\n\u003cp>However, many Republicans have expressed skepticism about those findings.\u003c/p>\n\u003cp>\u003cstrong>New Policy, New Marketplace\u003c/strong>\u003c/p>\n\u003cp>The subsidies do mean some low-income people will pay almost nothing for insurance, while higher-income people will pay the full market price.\u003c/p>\n\u003cp>Dentist Aaron McLemore of Louisville, Ky., makes more than $100,000 a year and doesn't qualify for any subsidy on the Obamacare exchange. The 31-year-old's current policy is being canceled. A new policy from the exchange will more than double his monthly premium and boost his annual deductible to $7,000.\u003c/p>\n\u003cp>His higher costs aren't subsidizing lower-income policyholders, whose subsidy has already been paid by the government. But he is providing a subsidy in another way: The Affordable Care Act requires him to buy a policy with features he doesn't need.\u003c/p>\n\u003cp>\"Seeing as I'm a single male with no kids or dependents, and I'm paying for pediatric dental care and maternity care, it doesn't make a whole lot of sense to me,\" McLemore says.\u003c/p>\n\u003cp>What Obamacare is doing is moving McLemore out of the individual market — where people are sorted by age and health history and scope of coverage — to a market more like the traditional, employer-based group policy, in which young and old workers get the same coverage and pay the same premium.\u003c/p>\n\u003cp>Gruber, the MIT economist, says that model reflects the basic idea of insurance.\u003c/p>\n\u003cp>\"The notion of insurance is we're protected against risk,\" he says. \"What that means is that [during] a period of time when we're healthy, we pay more in premiums than we collect in benefits. In those periods of time we're sick — and we all go through them — we collect more in benefits than we pay in premiums.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Young, healthy people subsidize older people, who are more likely to be sick. Of course, most of those younger folks will eventually become old folks and experience the same benefit.\u003c/p>\n\n",
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"excerpt": "The new health care law will provide around $1 trillion in subsidies to low- and middle-income Americans over the next decade to help them pay for health insurance.\r\n\r\nJohanna Humbert of Galien, Mich., was pleasantly surprised to discover that she qualifies for an insurance subsidy, since her current plan is being canceled. Humbert makes about $30,000 a year, so she'll get a subsidy of about $300 a month. The new plan is similar to her current one, but it will cost $250 — about half of what she pays now.\r\n",
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"description": "The new health care law will provide around $1 trillion in subsidies to low- and middle-income Americans over the next decade to help them pay for health insurance.\r\n\r\nJohanna Humbert of Galien, Mich., was pleasantly surprised to discover that she qualifies for an insurance subsidy, since her current plan is being canceled. Humbert makes about $30,000 a year, so she'll get a subsidy of about $300 a month. The new plan is similar to her current one, but it will cost $250 — about half of what she pays now.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_16141\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/140007839-e1383845514894.jpg\">\u003cimg class=\"size-large wp-image-16141\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/140007839-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"http://www.npr.org/blogs/health/2013/11/07/243584170/how-the-affordable-care-act-pays-for-insurance-subsidies\" target=\"_blank\">\u003cstrong>By John Ydstie\u003c/strong>\u003c/a>, \u003ca href=\"http://www.npr.org/blogs/health/2013/11/07/243584170/how-the-affordable-care-act-pays-for-insurance-subsidies\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>The new health care law will provide around $1 trillion in subsidies to low- and middle-income Americans over the next decade to help them pay for health insurance.\u003c/p>\n\u003cp>Johanna Humbert of Galien, Mich., was pleasantly surprised to discover that she qualifies for an insurance subsidy, since her current plan is being canceled. Humbert makes about $30,000 a year, so she'll get a subsidy of about $300 a month. The new plan is similar to her current one, but it will cost $250 — about half of what she pays now.\u003c/p>\n\u003cp>But where will the money come from to pay for subsidies like these?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On his show last Friday, liberal comedian Bill Maher called the Affordable Care Act a \"Robin Hood\" plan. \"It does take from the rich to make better the poor,\" he said.\u003c/p>\n\u003cp>You can certainly make a case for that, says economist Joseph Antos of the American Enterprise Institute. \"In a general sense, the rich, of course, subsidize the poor. The rich pay more income taxes,\" he says. \"So, yes, absolutely, that's how subsidies are supposed to work.\"\u003c!--more-->\u003c/p>\n\u003cp>So if you're a low-income person getting a tax credit from the U.S. Treasury to subsidize your health care, a big chunk of that credit is coming from taxes paid by the well-off.\u003c/p>\n\u003cp>\u003cstrong>The Cost Of Subsidies\u003c/strong>\u003c/p>\n\u003cp>But the authors of the Affordable Care Act didn't want the subsidies to become a drain on the Treasury and add to the deficits. So they included provisions designed to offset the cost of the subsidies.\u003c/p>\n\u003cp>MIT economist Jonathan Gruber, who helped develop the law, says about half the costs are offset by projected savings in Medicare payments to insurers and hospitals. Another quarter is offset by added taxes on medical-device makers and drug companies.\u003c/p>\n\u003cp>\"The other source of revenue is a tax increase on the wealthiest Americans,\" he says. \"Those families with incomes above $250,000 a year will now have to pay more in Medicare payroll taxes.\"\u003c/p>\n\u003cp>Those provisions actually make the bill a net positive for the federal budget, \u003ca href=\"http://www.cbo.gov/topics/health-care/affordable-care-act\" target=\"_blank\">according to \u003c/a>the nonpartisan Congressional Budget Office. By the CBO's accounting, Obamacare will produce a surplus. Gruber says the law will \"actually lower the deficit by about $100 billion over the next decade and by $1 trillion in the decade after.\"\u003c/p>\n\u003cp>However, many Republicans have expressed skepticism about those findings.\u003c/p>\n\u003cp>\u003cstrong>New Policy, New Marketplace\u003c/strong>\u003c/p>\n\u003cp>The subsidies do mean some low-income people will pay almost nothing for insurance, while higher-income people will pay the full market price.\u003c/p>\n\u003cp>Dentist Aaron McLemore of Louisville, Ky., makes more than $100,000 a year and doesn't qualify for any subsidy on the Obamacare exchange. The 31-year-old's current policy is being canceled. A new policy from the exchange will more than double his monthly premium and boost his annual deductible to $7,000.\u003c/p>\n\u003cp>His higher costs aren't subsidizing lower-income policyholders, whose subsidy has already been paid by the government. But he is providing a subsidy in another way: The Affordable Care Act requires him to buy a policy with features he doesn't need.\u003c/p>\n\u003cp>\"Seeing as I'm a single male with no kids or dependents, and I'm paying for pediatric dental care and maternity care, it doesn't make a whole lot of sense to me,\" McLemore says.\u003c/p>\n\u003cp>What Obamacare is doing is moving McLemore out of the individual market — where people are sorted by age and health history and scope of coverage — to a market more like the traditional, employer-based group policy, in which young and old workers get the same coverage and pay the same premium.\u003c/p>\n\u003cp>Gruber, the MIT economist, says that model reflects the basic idea of insurance.\u003c/p>\n\u003cp>\"The notion of insurance is we're protected against risk,\" he says. \"What that means is that [during] a period of time when we're healthy, we pay more in premiums than we collect in benefits. In those periods of time we're sick — and we all go through them — we collect more in benefits than we pay in premiums.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Young, healthy people subsidize older people, who are more likely to be sick. Of course, most of those younger folks will eventually become old folks and experience the same benefit.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "San Francisco Obama Supporters, Cancelled by Obamacare",
"title": "San Francisco Obama Supporters, Cancelled by Obamacare",
"headTitle": "State of Health | KQED News",
"content": "\u003cdiv>\n\u003cfigure id=\"attachment_16097\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/153494074CROP-e1383673996387.jpg\">\u003cimg class=\"size-large wp-image-16097\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/153494074CROP-640x433.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"433\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Charles Ornstein,\u003c/strong> \u003ca href=\"http://www.propublica.org/article/loyal-obama-supporters-canceled-by-obamacare?utm_campaign=bt_twitter&utm_source=twitter&utm_medium=social\" target=\"_blank\">ProPublica\u003c/a>\u003c/p>\n\u003cp>San Francisco architect Lee Hammack says he and his wife, JoEllen Brothers, are “cradle Democrats.” They have donated to the liberal group Organizing for America and worked the phone banks a year ago for President Obama’s re-election.\u003c/p>\n\u003cp>Since 1995, Hammack and Brothers have received their health coverage from Kaiser Permanente, where Brothers worked until 2009 as a dietician and diabetes educator. “We’ve both been in very good health all of our lives – exercise, don’t smoke, drink lightly, healthy weight, no health issues, and so on,” Hammack told me.\u003c/p>\n\u003c/div>\n\u003cdiv>\n\u003cp>The couple — Lee, 60, and JoEllen, 59 — have been paying $550 a month for their health coverage — a plan that offers solid coverage, not one of the skimpy plans Obama has criticized. But recently, Kaiser informed them the plan would be canceled at the end of the year because it did not meet the requirements of the Affordable Care Act. The couple would need to find another one. The cost would be around double what they pay now, but the benefits would be worse.\u003c/p>\n\u003cp>“From all of the sob stories I’ve heard and read, ours is the most extreme,” Lee told me in an email last week.\u003c!--more-->\u003c/p>\n\u003cp>I’ve been skeptical about media stories featuring those who claimed they would be worse off because their insurance policies were being canceled on account of the ACA. In many cases, \u003ca href=\"http://www.newrepublic.com/article/115457/obamacare-victim-florida-happy-she-can-get-real-coverage\">it turns out\u003c/a>, the consumers could have found cheaper coverage through the new health insurance marketplaces, or their plans weren’t very good to begin with. \u003ca href=\"http://www.latimes.com/business/hiltzik/la-fi-mh-debunked-20131030,0,6010994.story#axzz2jnQTZ53H\">Some didn’t know they could qualify\u003c/a> for subsidies that would lower their insurance premiums.\u003c/p>\n\u003cp>So I tried to find flaws in what Hammack told me. I couldn’t find any.\u003c/p>\n\u003cul>\n\u003cli>The couple’s \u003ca href=\"http://www.propublica.org/documents/item/815690-kaiser2013benefits\" target=\"_blank\">existing Kaiser plan was a good one\u003c/a>.\u003c/li>\n\u003cli>Their new options were indeed more expensive, and the \u003ca href=\"http://www.propublica.org/documents/item/815691-kaiser2014benefits\" target=\"_blank\">benefits didn’t seem any better\u003c/a>.\u003c/li>\n\u003cli>They do not qualify for premium subsidies because they make more than four times the federal poverty level, though Hammack says not by much.\u003c/li>\n\u003c/ul>\n\u003cp>Hammack recalled his reaction when he and his wife received a letters from Kaiser in September informing him their coverage was being canceled. “I work downstairs and my wife had a clear look of shock on her face,” he said. “Our first reaction was clearly there’s got to be some mistake. This was before the exchanges opened up. We quickly calmed down. We were confident that this would all be straightened out. But it wasn’t.”\u003c/p>\n\u003cp>I asked Hammack to send me \u003ca href=\"http://www.propublica.org/documents/item/815690-kaiser2013benefits\" target=\"_blank\">details of his current plan\u003c/a>. It carried a $4,000 deductible per person, a $40 copay for doctor visits, a $150 emergency room visit fee and 30 percent coinsurance for hospital stays after the deductible. The out-of-pocket maximum was $5,600.\u003c/p>\n\u003cp>This plan was ending, Kaiser’s letters told them, because it did not meet the requirements of the Affordable Care Act. “Everything is taken care of,” the letters said. “There’s nothing you need to do.”\u003c/p>\n\u003cp>The letters said the couple would be enrolled in new Kaiser plans that would cost nearly $1,300 for the two of them (more than $15,000 a year).\u003c/p>\n\u003cp>And for that higher amount, \u003ca href=\"http://www.propublica.org/documents/item/815692-kaiser2014lee\" target=\"_blank\">what would they get\u003c/a>? A higher deductible ($4,500), a higher out-of-pocket maximum ($6,350), higher hospital costs (40 percent of the cost) and possibly higher costs for doctor visits and drugs.\u003c/p>\n\u003cp>When they shopped around and looked for a different plan on California's new health insurance marketplace, \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, the cheapest one was $975, with hefty deductibles and copays.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/18/why-some-are-seeing-premiums-go-up-as-affordable-care-act-goes-into-effect-obamacare/\" target=\"_blank\">Why Some Are Seeing Premiums Go Up As ACA Goes Into Effect\u003c/a>]\u003c/p>\n\u003cp>\u003ca href=\"http://www.whitehouse.gov/the-press-office/2013/10/30/remarks-president-and-governor-deval-patrick-affordable-care-act\" target=\"_blank\">In a speech in Boston last week\u003c/a>, President Obama said those receiving cancellation letters didn’t have good insurance. “There are a number of Americans — fewer than 5 percent of Americans — who've got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident,” he said.\u003c/p>\n\u003cp>“Remember, before the Affordable Care Act, these bad-apple insurers had free rein every single year to limit the care that you received, or use minor preexisting conditions to jack up your premiums or bill you into bankruptcy. So a lot of people thought they were buying coverage, and it turned out not to be so good.”\u003c/p>\n\u003cp>\u003cstrong>Seems like lose-lose situation\u003c/strong>\u003c/p>\n\u003cp>What is going on here? Kaiser isn’t a “bad apple” insurer and this plan wasn’t “cut rate.” It seems like this is a lose-lose for the Hammacks (and a friend featured in a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/04/obamacare-downside-reports-of-premiums-going-up/\">report last month\u003c/a> on this blog.)\u003c/p>\n\u003cp>I called Kaiser Permanente and spoke to spokesman Chris Stenrud, who used to work for the U.S. Department of Health and Human Services. He told me that this was indeed a good plan. Patients in the plan, known as 40/4000, were remarkably healthy, had low medical costs and had not seen their premiums increase in years. “Our actuaries still aren’t entirely sure why that was,” he said.\u003c/p>\n\u003cp>While many other insurance companies offered skimpier benefits, Stenrud said, “our plans historically have been comprehensive.”\u003c/p>\n\u003cp>Kaiser has canceled about 160,000 policies in California, and about one third of people were in plans like Hammack’s, Stenrud said. About 30,000 to 35,000 were in his specific plan.\u003c/p>\n\u003cp>“In a few cases, we are able to find coverage for them that is less expensive, but in most cases, we’re not because, in sort of pure economic terms, they are people who benefited from the current system ... Now that the market rules are changing, there will be different people who benefit and different people who don’t.”\u003c/p>\n\u003cp>“There’s an aspect of market disruption here that I think was not clear to people,” Stenrud acknowledged. “In many respects it has been theory rather than practice for the first three years of the law; folks are seeing the breadth of change that we’re talking about here.”\u003c/p>\n\u003cp>That’s little comfort to Hammack. He’s written to California’s senators and his representative, House Minority Leader Nancy Pelosi, (D-CA), asking for help.\u003c/p>\n\u003cp>“We believe that the Act is good for health care, the economy, & the future of our nation. However, ACA options for middle income individuals ages 59 & 60 are unaffordable. We’re learning that many others are similarly affected. In that spirit we ask that you fix this, for all of our sakes,” he and Brothers wrote.\u003c/p>\n\u003cp>Consumer advocate Anthony Wright said it’s important to remember the way the insurance market worked before the act was passed, when insurers could deny coverage based on pre-existing conditions. “It’s impossible to know what the world would have looked like for these folks in the absence of the law,” said Wright, executive director of the group Health Access.\u003c/p>\n\u003cp>“We certainly had an individual market, especially in California which was the Wild Wild West, where there was huge price increases, cancellations, a range of other practices.\u003c/p>\n\u003cp>“That doesn't mean that there were certain people who lucked out in the old system, who wound up in a group with a relatively healthy risk mix and thus lower premiums,” he added. “The question is: Is health insurance something where people get a rate based on the luck of the draw or do we have something where we have some standards where people who live in the same community, of the same age, with the same benefit package are treated equally?”\u003c/p>\n\u003cp>Wright said discussions should focus on how to provide consumers like Hammack with assistance if they barely miss qualifying for subsidies.\u003c/p>\n\u003cp>So what is Hammack going to do? If his income were to fall below four times the federal poverty level, or about $62,000 for a family of two, he would qualify for subsidies that could lower his premium cost to as low as zero. If he makes even one dollar more, he gets nothing.\u003c/p>\n\u003cp>That’s what he’s leaning toward — lowering his salary or shifting more money toward a retirement account and applying for a subsidy.\u003c/p>\n\u003cp>“We’re not changing our views because of this situation, but it hurt to hear Obama saying, just the other day, that if our plan has been dropped it’s because it wasn’t any good, and our costs would go up only slightly,” he said. “We’re gratified that the press is on the case, but frustrated that the stewards of the ACA don’t seem to have heard.”\u003c/p>\n\u003cp>\u003cem>Editor's note: Ornstein posted this follow up story \u003ca href=\"http://www.propublica.org/article/answered-why-two-obama-loyalists-lost-their-health-policies\" target=\"_blank\">Answered: Why Two Obama Loyalists Lost Their Policies\u003c/a>, explaining much more about the couple's situation.\u003c/em>\u003c/p>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "San Francisco architect Lee Hammack says he and his wife, JoEllen Brothers, are “cradle Democrats.” They have donated to the liberal group Organizing for America and worked the phone banks a year ago for President Obama’s re-election.\r\n\r\nSince 1995, Hammack and Brothers have received their health coverage from Kaiser Permanente, where Brothers worked until 2009 as a dietician and diabetes educator. “We’ve both been in very good health all of our lives – exercise, don’t smoke, drink lightly, healthy weight, no health issues, and so on,” Hammack told me.",
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"description": "San Francisco architect Lee Hammack says he and his wife, JoEllen Brothers, are “cradle Democrats.” They have donated to the liberal group Organizing for America and worked the phone banks a year ago for President Obama’s re-election.\r\n\r\nSince 1995, Hammack and Brothers have received their health coverage from Kaiser Permanente, where Brothers worked until 2009 as a dietician and diabetes educator. “We’ve both been in very good health all of our lives – exercise, don’t smoke, drink lightly, healthy weight, no health issues, and so on,” Hammack told me.",
"title": "San Francisco Obama Supporters, Cancelled by Obamacare | KQED",
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"headline": "San Francisco Obama Supporters, Cancelled by Obamacare",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cdiv>\n\u003cfigure id=\"attachment_16097\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/153494074CROP-e1383673996387.jpg\">\u003cimg class=\"size-large wp-image-16097\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/153494074CROP-640x433.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"433\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Charles Ornstein,\u003c/strong> \u003ca href=\"http://www.propublica.org/article/loyal-obama-supporters-canceled-by-obamacare?utm_campaign=bt_twitter&utm_source=twitter&utm_medium=social\" target=\"_blank\">ProPublica\u003c/a>\u003c/p>\n\u003cp>San Francisco architect Lee Hammack says he and his wife, JoEllen Brothers, are “cradle Democrats.” They have donated to the liberal group Organizing for America and worked the phone banks a year ago for President Obama’s re-election.\u003c/p>\n\u003cp>Since 1995, Hammack and Brothers have received their health coverage from Kaiser Permanente, where Brothers worked until 2009 as a dietician and diabetes educator. “We’ve both been in very good health all of our lives – exercise, don’t smoke, drink lightly, healthy weight, no health issues, and so on,” Hammack told me.\u003c/p>\n\u003c/div>\n\u003cdiv>\n\u003cp>The couple — Lee, 60, and JoEllen, 59 — have been paying $550 a month for their health coverage — a plan that offers solid coverage, not one of the skimpy plans Obama has criticized. But recently, Kaiser informed them the plan would be canceled at the end of the year because it did not meet the requirements of the Affordable Care Act. The couple would need to find another one. The cost would be around double what they pay now, but the benefits would be worse.\u003c/p>\n\u003cp>“From all of the sob stories I’ve heard and read, ours is the most extreme,” Lee told me in an email last week.\u003c!--more-->\u003c/p>\n\u003cp>I’ve been skeptical about media stories featuring those who claimed they would be worse off because their insurance policies were being canceled on account of the ACA. In many cases, \u003ca href=\"http://www.newrepublic.com/article/115457/obamacare-victim-florida-happy-she-can-get-real-coverage\">it turns out\u003c/a>, the consumers could have found cheaper coverage through the new health insurance marketplaces, or their plans weren’t very good to begin with. \u003ca href=\"http://www.latimes.com/business/hiltzik/la-fi-mh-debunked-20131030,0,6010994.story#axzz2jnQTZ53H\">Some didn’t know they could qualify\u003c/a> for subsidies that would lower their insurance premiums.\u003c/p>\n\u003cp>So I tried to find flaws in what Hammack told me. I couldn’t find any.\u003c/p>\n\u003cul>\n\u003cli>The couple’s \u003ca href=\"http://www.propublica.org/documents/item/815690-kaiser2013benefits\" target=\"_blank\">existing Kaiser plan was a good one\u003c/a>.\u003c/li>\n\u003cli>Their new options were indeed more expensive, and the \u003ca href=\"http://www.propublica.org/documents/item/815691-kaiser2014benefits\" target=\"_blank\">benefits didn’t seem any better\u003c/a>.\u003c/li>\n\u003cli>They do not qualify for premium subsidies because they make more than four times the federal poverty level, though Hammack says not by much.\u003c/li>\n\u003c/ul>\n\u003cp>Hammack recalled his reaction when he and his wife received a letters from Kaiser in September informing him their coverage was being canceled. “I work downstairs and my wife had a clear look of shock on her face,” he said. “Our first reaction was clearly there’s got to be some mistake. This was before the exchanges opened up. We quickly calmed down. We were confident that this would all be straightened out. But it wasn’t.”\u003c/p>\n\u003cp>I asked Hammack to send me \u003ca href=\"http://www.propublica.org/documents/item/815690-kaiser2013benefits\" target=\"_blank\">details of his current plan\u003c/a>. It carried a $4,000 deductible per person, a $40 copay for doctor visits, a $150 emergency room visit fee and 30 percent coinsurance for hospital stays after the deductible. The out-of-pocket maximum was $5,600.\u003c/p>\n\u003cp>This plan was ending, Kaiser’s letters told them, because it did not meet the requirements of the Affordable Care Act. “Everything is taken care of,” the letters said. “There’s nothing you need to do.”\u003c/p>\n\u003cp>The letters said the couple would be enrolled in new Kaiser plans that would cost nearly $1,300 for the two of them (more than $15,000 a year).\u003c/p>\n\u003cp>And for that higher amount, \u003ca href=\"http://www.propublica.org/documents/item/815692-kaiser2014lee\" target=\"_blank\">what would they get\u003c/a>? A higher deductible ($4,500), a higher out-of-pocket maximum ($6,350), higher hospital costs (40 percent of the cost) and possibly higher costs for doctor visits and drugs.\u003c/p>\n\u003cp>When they shopped around and looked for a different plan on California's new health insurance marketplace, \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, the cheapest one was $975, with hefty deductibles and copays.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/18/why-some-are-seeing-premiums-go-up-as-affordable-care-act-goes-into-effect-obamacare/\" target=\"_blank\">Why Some Are Seeing Premiums Go Up As ACA Goes Into Effect\u003c/a>]\u003c/p>\n\u003cp>\u003ca href=\"http://www.whitehouse.gov/the-press-office/2013/10/30/remarks-president-and-governor-deval-patrick-affordable-care-act\" target=\"_blank\">In a speech in Boston last week\u003c/a>, President Obama said those receiving cancellation letters didn’t have good insurance. “There are a number of Americans — fewer than 5 percent of Americans — who've got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident,” he said.\u003c/p>\n\u003cp>“Remember, before the Affordable Care Act, these bad-apple insurers had free rein every single year to limit the care that you received, or use minor preexisting conditions to jack up your premiums or bill you into bankruptcy. So a lot of people thought they were buying coverage, and it turned out not to be so good.”\u003c/p>\n\u003cp>\u003cstrong>Seems like lose-lose situation\u003c/strong>\u003c/p>\n\u003cp>What is going on here? Kaiser isn’t a “bad apple” insurer and this plan wasn’t “cut rate.” It seems like this is a lose-lose for the Hammacks (and a friend featured in a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/04/obamacare-downside-reports-of-premiums-going-up/\">report last month\u003c/a> on this blog.)\u003c/p>\n\u003cp>I called Kaiser Permanente and spoke to spokesman Chris Stenrud, who used to work for the U.S. Department of Health and Human Services. He told me that this was indeed a good plan. Patients in the plan, known as 40/4000, were remarkably healthy, had low medical costs and had not seen their premiums increase in years. “Our actuaries still aren’t entirely sure why that was,” he said.\u003c/p>\n\u003cp>While many other insurance companies offered skimpier benefits, Stenrud said, “our plans historically have been comprehensive.”\u003c/p>\n\u003cp>Kaiser has canceled about 160,000 policies in California, and about one third of people were in plans like Hammack’s, Stenrud said. About 30,000 to 35,000 were in his specific plan.\u003c/p>\n\u003cp>“In a few cases, we are able to find coverage for them that is less expensive, but in most cases, we’re not because, in sort of pure economic terms, they are people who benefited from the current system ... Now that the market rules are changing, there will be different people who benefit and different people who don’t.”\u003c/p>\n\u003cp>“There’s an aspect of market disruption here that I think was not clear to people,” Stenrud acknowledged. “In many respects it has been theory rather than practice for the first three years of the law; folks are seeing the breadth of change that we’re talking about here.”\u003c/p>\n\u003cp>That’s little comfort to Hammack. He’s written to California’s senators and his representative, House Minority Leader Nancy Pelosi, (D-CA), asking for help.\u003c/p>\n\u003cp>“We believe that the Act is good for health care, the economy, & the future of our nation. However, ACA options for middle income individuals ages 59 & 60 are unaffordable. We’re learning that many others are similarly affected. In that spirit we ask that you fix this, for all of our sakes,” he and Brothers wrote.\u003c/p>\n\u003cp>Consumer advocate Anthony Wright said it’s important to remember the way the insurance market worked before the act was passed, when insurers could deny coverage based on pre-existing conditions. “It’s impossible to know what the world would have looked like for these folks in the absence of the law,” said Wright, executive director of the group Health Access.\u003c/p>\n\u003cp>“We certainly had an individual market, especially in California which was the Wild Wild West, where there was huge price increases, cancellations, a range of other practices.\u003c/p>\n\u003cp>“That doesn't mean that there were certain people who lucked out in the old system, who wound up in a group with a relatively healthy risk mix and thus lower premiums,” he added. “The question is: Is health insurance something where people get a rate based on the luck of the draw or do we have something where we have some standards where people who live in the same community, of the same age, with the same benefit package are treated equally?”\u003c/p>\n\u003cp>Wright said discussions should focus on how to provide consumers like Hammack with assistance if they barely miss qualifying for subsidies.\u003c/p>\n\u003cp>So what is Hammack going to do? If his income were to fall below four times the federal poverty level, or about $62,000 for a family of two, he would qualify for subsidies that could lower his premium cost to as low as zero. If he makes even one dollar more, he gets nothing.\u003c/p>\n\u003cp>That’s what he’s leaning toward — lowering his salary or shifting more money toward a retirement account and applying for a subsidy.\u003c/p>\n\u003cp>“We’re not changing our views because of this situation, but it hurt to hear Obama saying, just the other day, that if our plan has been dropped it’s because it wasn’t any good, and our costs would go up only slightly,” he said. “We’re gratified that the press is on the case, but frustrated that the stewards of the ACA don’t seem to have heard.”\u003c/p>\n\u003cp>\u003cem>Editor's note: Ornstein posted this follow up story \u003ca href=\"http://www.propublica.org/article/answered-why-two-obama-loyalists-lost-their-health-policies\" target=\"_blank\">Answered: Why Two Obama Loyalists Lost Their Policies\u003c/a>, explaining much more about the couple's situation.\u003c/em>\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Why Insurance Commissioner Can Delay Only Blue Shield's Cancellations",
"title": "Why Insurance Commissioner Can Delay Only Blue Shield's Cancellations",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_16103\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/174426822-e1383684544419.jpg\">\u003cimg class=\"size-large wp-image-16103\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/174426822-640x423.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"423\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California's insurance commissioner Dave Jones announced an agreement with Blue Shield on Tuesday morning that will mean some 113,000 people who had their policies cancelled will now be able to keep them through March 31, 2014.\u003c/p>\n\u003cp>If you're one of those 113,000 people, you now have the option either to hold onto your policy into next year or to shop on the Covered California marketplace where you might qualify for a subsidy.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Blue Shield warned that extension is not without risks.\u003c/aside>\n\u003cp>Jones says Blue Shield of California Life & Health agreed to send letters on Wednesday to its policyholders, informing them of the extension. If you've received a cancellation notice from another health insurance company, it is highly unlikely you will get an extension, as we detail below.\u003c/p>\n\u003cp>Blue Shield warned that extension is not without risks. Spokesman Steve Shivinsky says that policyholders who decide to stay with their current plan must still enroll in a new plan that complies with the Affordable Care Act by March 15, 2014. Otherwise, they risk a coverage gap. In addition, if people extend their current policy, they may have to pay a deductible twice in 2014 after they enroll in a new plan.\u003c!--more-->\u003c/p>\n\u003cp>\"It's confusing,\" Shivinsky said. \"It's bad for consumers that we have to mail these letters out and provide even more confusing information when they're trying to sort through their options.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Jones said that consumers must carefully consider their options. \"If these consumers anticipate a major health expense in the first three months of next year,\" Jones said, they should move to a new policy now. He also stressed that people should \"look at all your options,\" especially if they might qualify for a subsidy.\u003c/p>\n\u003cp>\u003cstrong>Blue Shield only, not other carriers\u003c/strong>\u003c/p>\n\u003cp>Jones could take this move with Blue Shield only because of what he called a \"rather complicated series of facts.\" California, he says, is the only state in the nation that has two separate regulators of health insurance products. Jones regulates policies that fall under the Department of Insurance. The Department of Managed Health Care (DMHC) regulates HMO products and other kinds of health plans.\u003c/p>\n\u003cp>Because of a special loophole in California law, Jones says, Blue Shield has the option to move its insurance products from the Department of Insurance to DMHC. Jones says that move between regulators requires Blue Shield to provide 180 days' notice of cancellation, but Blue Shield only provided 90 days. Blue Shield disagrees and argues that 90 days' notice was sufficient. Nonetheless it is complying with the Department of Insurance and allowing those 80,000 policyholders — covering 113,000 people — the option to extend.\u003c/p>\n\u003cp>In any case, an additional 90 days is the maximum extension. \"Three months is exactly what we could get\" under state law, Jones says.\u003c/p>\n\u003cp>Shivinsky said that Blue Shield elected to make the move to DMHC to \"consolidate its business\" under one regulator. He said the company already had about 80 percent of its business in DMHC. It will reduce the \"administrative burden,\" he said.\u003c/p>\n\u003cp>Jones says he had lobbied Covered California to allow all consumers to renew their individual policies through 2014. But Covered California, he says, determined that all individual policyholders must move to ACA-compliant plans on Jan. 1, 2014.\u003c/p>\n\u003cp>For all these reasons, if you've received a cancellation notice from any other carrier besides Blue Shield, you should not expect to get an extension.\u003c/p>\n\u003cp>\u003cstrong>ORIGINAL POST:\u003c/strong>\u003c/p>\n\u003cp>California's insurance commissioner, Dave Jones, is holding a press conference Tuesday morning to announce a deal the Department of Insurance has reached with what it terms a \"major health insurance company\" to delay the cancellation of more than 115,000 insurance policies statewide.\u003c/p>\n\u003cp>The San Francisco Business Times\u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2013/11/blue-shield-has-deal-with-state-to.html?ana=RSS&s=article_search&page=all\" target=\"_blank\"> confirmed\u003c/a> that the insurer is Blue Shield of California from the company's spokesman, Steve Shivinsky. The Business Times described Blue Shield as not \"necessarily happy\" with this change. From the Business Times report:\u003c/p>\n\u003cblockquote>\u003cp>Blue Shield officials said Monday evening that the Department of Insurance had required them to take this step, on threat of a lawsuit compelling the insurer to delay the cancellations. The department declined official comment ahead of the insurance commissioner's press conference.\u003c/p>\n\u003cp>The extensions can't last more than three months, and must end March 31, Blue Shield said. Consumers need to be aware that taking advantage of the delay could come with downsides, including the possibility of being liable for two sets of deductibles and possibly missing out on tax credits and cost-sharing subsidies available only through the \u003ca href=\"http://www.bizjournals.com/profiles/company/us/ca/sacramento_/covered_california/3327461\">Covered California\u003c/a> exchange.\u003c!--more-->\u003c/p>\n\u003cp>\"We had a disagreement with the state over the 90 day notice we gave to ... policyholders and we were faced with a lawsuit if we did not agree to their requirement for the 90 day extension,\" Shivinsky clarified. He said 80,000 policyholders are being notified of the new course of action that regulators are requiring.\u003c/p>\n\u003cp>The deal has the look and feel of \u003ca href=\"http://www.usatoday.com/story/opinion/2013/11/03/obamacare-coverage-cancellations-president-obama-promise-editorials-debates/3426681/\">a political retreat \u003c/a>by Democratic officeholders worried about the recent outcry about cancelled individual policies.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>State of Health will have update this post after Jones' press conference.\u003c/p>\n\n",
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"excerpt": "California's insurance commissioner Dave Jones is holding a press conference Tuesday morning to announce a deal it has reached with what the press release terms a \"major health insurance company\" to delay the cancellation of more than 115,000 insurance policies statewide.\r\n\r\nThe San Francisco Business Times confirmed that the insurer is Blue Shield of California.",
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"description": "California's insurance commissioner Dave Jones is holding a press conference Tuesday morning to announce a deal it has reached with what the press release terms a "major health insurance company" to delay the cancellation of more than 115,000 insurance policies statewide.\r\n\r\nThe San Francisco Business Times confirmed that the insurer is Blue Shield of California.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16103\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/174426822-e1383684544419.jpg\">\u003cimg class=\"size-large wp-image-16103\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/174426822-640x423.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"423\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>California's insurance commissioner Dave Jones announced an agreement with Blue Shield on Tuesday morning that will mean some 113,000 people who had their policies cancelled will now be able to keep them through March 31, 2014.\u003c/p>\n\u003cp>If you're one of those 113,000 people, you now have the option either to hold onto your policy into next year or to shop on the Covered California marketplace where you might qualify for a subsidy.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Blue Shield warned that extension is not without risks.\u003c/aside>\n\u003cp>Jones says Blue Shield of California Life & Health agreed to send letters on Wednesday to its policyholders, informing them of the extension. If you've received a cancellation notice from another health insurance company, it is highly unlikely you will get an extension, as we detail below.\u003c/p>\n\u003cp>Blue Shield warned that extension is not without risks. Spokesman Steve Shivinsky says that policyholders who decide to stay with their current plan must still enroll in a new plan that complies with the Affordable Care Act by March 15, 2014. Otherwise, they risk a coverage gap. In addition, if people extend their current policy, they may have to pay a deductible twice in 2014 after they enroll in a new plan.\u003c!--more-->\u003c/p>\n\u003cp>\"It's confusing,\" Shivinsky said. \"It's bad for consumers that we have to mail these letters out and provide even more confusing information when they're trying to sort through their options.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Jones said that consumers must carefully consider their options. \"If these consumers anticipate a major health expense in the first three months of next year,\" Jones said, they should move to a new policy now. He also stressed that people should \"look at all your options,\" especially if they might qualify for a subsidy.\u003c/p>\n\u003cp>\u003cstrong>Blue Shield only, not other carriers\u003c/strong>\u003c/p>\n\u003cp>Jones could take this move with Blue Shield only because of what he called a \"rather complicated series of facts.\" California, he says, is the only state in the nation that has two separate regulators of health insurance products. Jones regulates policies that fall under the Department of Insurance. The Department of Managed Health Care (DMHC) regulates HMO products and other kinds of health plans.\u003c/p>\n\u003cp>Because of a special loophole in California law, Jones says, Blue Shield has the option to move its insurance products from the Department of Insurance to DMHC. Jones says that move between regulators requires Blue Shield to provide 180 days' notice of cancellation, but Blue Shield only provided 90 days. Blue Shield disagrees and argues that 90 days' notice was sufficient. Nonetheless it is complying with the Department of Insurance and allowing those 80,000 policyholders — covering 113,000 people — the option to extend.\u003c/p>\n\u003cp>In any case, an additional 90 days is the maximum extension. \"Three months is exactly what we could get\" under state law, Jones says.\u003c/p>\n\u003cp>Shivinsky said that Blue Shield elected to make the move to DMHC to \"consolidate its business\" under one regulator. He said the company already had about 80 percent of its business in DMHC. It will reduce the \"administrative burden,\" he said.\u003c/p>\n\u003cp>Jones says he had lobbied Covered California to allow all consumers to renew their individual policies through 2014. But Covered California, he says, determined that all individual policyholders must move to ACA-compliant plans on Jan. 1, 2014.\u003c/p>\n\u003cp>For all these reasons, if you've received a cancellation notice from any other carrier besides Blue Shield, you should not expect to get an extension.\u003c/p>\n\u003cp>\u003cstrong>ORIGINAL POST:\u003c/strong>\u003c/p>\n\u003cp>California's insurance commissioner, Dave Jones, is holding a press conference Tuesday morning to announce a deal the Department of Insurance has reached with what it terms a \"major health insurance company\" to delay the cancellation of more than 115,000 insurance policies statewide.\u003c/p>\n\u003cp>The San Francisco Business Times\u003ca href=\"http://www.bizjournals.com/sanfrancisco/blog/2013/11/blue-shield-has-deal-with-state-to.html?ana=RSS&s=article_search&page=all\" target=\"_blank\"> confirmed\u003c/a> that the insurer is Blue Shield of California from the company's spokesman, Steve Shivinsky. The Business Times described Blue Shield as not \"necessarily happy\" with this change. From the Business Times report:\u003c/p>\n\u003cblockquote>\u003cp>Blue Shield officials said Monday evening that the Department of Insurance had required them to take this step, on threat of a lawsuit compelling the insurer to delay the cancellations. The department declined official comment ahead of the insurance commissioner's press conference.\u003c/p>\n\u003cp>The extensions can't last more than three months, and must end March 31, Blue Shield said. Consumers need to be aware that taking advantage of the delay could come with downsides, including the possibility of being liable for two sets of deductibles and possibly missing out on tax credits and cost-sharing subsidies available only through the \u003ca href=\"http://www.bizjournals.com/profiles/company/us/ca/sacramento_/covered_california/3327461\">Covered California\u003c/a> exchange.\u003c!--more-->\u003c/p>\n\u003cp>\"We had a disagreement with the state over the 90 day notice we gave to ... policyholders and we were faced with a lawsuit if we did not agree to their requirement for the 90 day extension,\" Shivinsky clarified. He said 80,000 policyholders are being notified of the new course of action that regulators are requiring.\u003c/p>\n\u003cp>The deal has the look and feel of \u003ca href=\"http://www.usatoday.com/story/opinion/2013/11/03/obamacare-coverage-cancellations-president-obama-promise-editorials-debates/3426681/\">a political retreat \u003c/a>by Democratic officeholders worried about the recent outcry about cancelled individual policies.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>State of Health will have update this post after Jones' press conference.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_16085\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Carolyn-Senger-doctor-outreach-ORIGINAL-1-e1383602096347.jpg\">\u003cimg class=\"size-large wp-image-16085\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Carolyn-Senger-doctor-outreach-ORIGINAL-1-640x426.jpg\" alt=\"San Diego physician Carolyn Senger explains the Affordable Care Act to a patient (Anna Gorman/KHN).\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">San Diego physician Carolyn Senger explains the Affordable Care Act to a patient (Anna Gorman/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/November/04/doctors-patients-obamacare-advice-outreach.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Carolyn Senger, a preventive medicine doctor, regularly treats uninsured patients, coaching them how to stay healthy.\u003c/p>\n\u003cp>Now she is teaching them one more thing -- how to sign up for insurance under the nation’s Affordable Care Act. “Not only can I help you with your health, but I can also help you get some coverage,” Senger says to her patients.\u003c/p>\n\u003caside class=\"pullquote alignleft\">But like everyone else, physicians have differing opinions on the law.\u003c/aside>\n\u003cp>Despite the ongoing controversy over the website and the rocky rollout of the law, the Obama administration still hopes that millions will sign up for new insurance options before the March 31 deadline. To make that happen, health officials are counting on physicians to shift the conversation from the online problems to the benefits of coverage. They are motivated by a longstanding principle: People trust their doctors.\u003c/p>\n\u003cp>But like everyone else, physicians have differing opinions on the law, with some enthusiastically promoting it and others ardently opposing it. In fact, both sides of the political debate are using healthcare providers to get their message out.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There are some doctors who think this is a half-baked and terrible idea,” said Lucien Wulsin, executive director of the Los Angeles-based Insure the Uninsured Project. “But there are a bunch who think this is going to be beneficial to helping their patients get care and afford coverage.”\u003c/p>\n\u003cp>Ori Hampel, a urologist in Houston, is one of a cadre of physician opponents meeting with legislators and speaking out against the law. Hampel said he feels a duty to warn patients they could end up with more expensive care and less access to doctors under what he calls the “unaffordable care act.”\u003c/p>\n\u003cp>Hampel and others are part of an organization called Docs 4 Patient Care, which has a strong presence in Texas, Georgia and Michigan and has challenged health reform since before it passed. “We think it’s a dangerous law and it is an intrusion on the doctor-patient relationship,” said Hal Scherz, a Georgia physician and president of the organization.\u003c/p>\n\u003cp>\u003cstrong>Differing Opinions\u003c/strong>\u003c/p>\n\u003cp>Doctors have also become messengers for the conservative group Americans for Prosperity. In one television ad, a Virginia doctor says Obamacare has her worried about having to navigate a complicated system rather than help patients. “Can I still work with parents to decide what’s best for their kids or will the government be in the middle of things?” she asks.\u003c/p>\n\u003cp>Whatever their views, physicians are expected to play a crucial part in patients’ understanding of the law and their willingness to enroll. The federal government is partnering with physician groups like the American Medical Association to educate doctors. Covered California, the state's insurance marketplace, awarded more than $3 million out of a total of $40 million in outreach grants to medical groups.\u003c/p>\n\u003cp>A recent Kaiser Family Foundation \u003ca href=\"http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-august-2013/\" target=\"_blank\">tracking poll\u003c/a> showed that doctors and nurses are the most trusted sources for people seeking information about health reform. Nevertheless, patients get more of their information from the news media, family and friends.\u003c/p>\n\u003cp>That is in part because physicians’ knowledge about the Medicaid expansion and insurance marketplaces varies widely. Doctors unsure about the details of the law may be more reluctant to talk about them.\u003c/p>\n\u003cp>To help, physician organizations are putting information on their websites and offering training sessions. The AMA prepared a fact sheet for doctors, a brochure for them to give patients and a flier for their waiting rooms: “Need affordable health insurance? New coverage options coming soon!”\u003c/p>\n\u003cp>\u003cstrong>'This Stuff Is Complicated'\u003c/strong>\u003c/p>\n\u003cp>The American College of Physicians posted an online state-by-state guide for doctors and a list of questions and answers about health reform. Charles Cutler, a Pennsylvania doctor who heads the organization’s board of regents, said several of his patients have already come to him with questions about insurance, benefits and prescription drugs.\u003c/p>\n\u003cp>“I don’t have all the answers,” Cutler said. “This stuff is complicated.”\u003c/p>\n\u003cp>Senger, the San Diego doctor, is the state director of an organization called Doctors for America, which is reaching out to physicians and patients with the motto “Coverage is Good Medicine.”\u003c/p>\n\u003cp>“Even if you don’t like this provision or that provision, getting patients insured is universally helpful” in ensuring they can seek regular care and their doctors can get reimbursed, said Alice Chen, executive director of the group and a UCLA assistant professor.\u003c/p>\n\u003cp>At a free health fair last month, Senger explained the changes to several patients, including Apolinar Recendiz, a 55-year-old uninsured housecleaner.\u003c/p>\n\u003cp>Senger told Recendiz that she may be eligible for insurance in January under the Affordable Care Act, despite having diabetes. “They’ll try to find what options will work best for you, and also for your family,” she said. “And they’ll try to make it affordable for you.”\u003c/p>\n\u003cp>Recendiz, with greying hair and a thick accent, nodded and smiled. “Imagine,” she said. “I didn’t know.”\u003c/p>\n\u003cp>Senger’s outreach didn’t end with the patients. Later, she met with a group of residents and medical students, running through the specifics about the state’s insurance marketplace. Veronica Villareal, a medical resident, said by learning “the nitty, gritty details” about Obamacare, she is more equipped to talk to her patients and direct them toward coverage.\u003c/p>\n\u003cp>\u003cstrong>Obamacare 101\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The Service Employees International Union also recently unveiled ads with doctors urging consumers to apply. In the ads, two New York doctors tell people in both Spanish and English they have “exciting news” – that consumers can get new, affordable coverage starting next year. \u003cspan style=\"text-decoration: line-through\"> \u003c/span>\u003c/p>\n\u003cp>With enrollment already underway, doctors need to get up to speed so they know what to tell patients, said Richard Baker, an ophthalmologist in Los Angeles.\u003c/p>\n\u003cp>“These are the new rules,” he said. “Physicians need to be educated.”\u003c/p>\n\u003cp>That’s what Insure the Uninsured Project is doing with a presentation entitled “Obamacare 101.” Just a few days before enrollment began on Oct. 1, doctors, medical assistants and health clinic personnel in Los Angeles spent hours learning about both the Medi-Cal expansion and the insurance marketplace. They repeated questions that they had already gotten from patients – about penalties, co-pays and benefits.\u003c/p>\n\u003cp>Howard Kahn, chief executive of L.A. Care Health Plan, which organized the session, said there is nobody better to educate patients than the person holding the stethoscope to their heart. “A doctor’s message counts more,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Carolyn Senger, a preventive medicine doctor, regularly treats uninsured patients, coaching them how to stay healthy.\r\n\r\nNow she is teaching them one more thing -- how to sign up for insurance under the nation’s Affordable Care Act. “Not only can I help you with your health, but I can also help you get some coverage,” Senger says to her patients.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16085\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Carolyn-Senger-doctor-outreach-ORIGINAL-1-e1383602096347.jpg\">\u003cimg class=\"size-large wp-image-16085\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Carolyn-Senger-doctor-outreach-ORIGINAL-1-640x426.jpg\" alt=\"San Diego physician Carolyn Senger explains the Affordable Care Act to a patient (Anna Gorman/KHN).\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">San Diego physician Carolyn Senger explains the Affordable Care Act to a patient (Anna Gorman/KHN).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Anna Gorman,\u003c/strong> \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/November/04/doctors-patients-obamacare-advice-outreach.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Carolyn Senger, a preventive medicine doctor, regularly treats uninsured patients, coaching them how to stay healthy.\u003c/p>\n\u003cp>Now she is teaching them one more thing -- how to sign up for insurance under the nation’s Affordable Care Act. “Not only can I help you with your health, but I can also help you get some coverage,” Senger says to her patients.\u003c/p>\n\u003caside class=\"pullquote alignleft\">But like everyone else, physicians have differing opinions on the law.\u003c/aside>\n\u003cp>Despite the ongoing controversy over the website and the rocky rollout of the law, the Obama administration still hopes that millions will sign up for new insurance options before the March 31 deadline. To make that happen, health officials are counting on physicians to shift the conversation from the online problems to the benefits of coverage. They are motivated by a longstanding principle: People trust their doctors.\u003c/p>\n\u003cp>But like everyone else, physicians have differing opinions on the law, with some enthusiastically promoting it and others ardently opposing it. In fact, both sides of the political debate are using healthcare providers to get their message out.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There are some doctors who think this is a half-baked and terrible idea,” said Lucien Wulsin, executive director of the Los Angeles-based Insure the Uninsured Project. “But there are a bunch who think this is going to be beneficial to helping their patients get care and afford coverage.”\u003c/p>\n\u003cp>Ori Hampel, a urologist in Houston, is one of a cadre of physician opponents meeting with legislators and speaking out against the law. Hampel said he feels a duty to warn patients they could end up with more expensive care and less access to doctors under what he calls the “unaffordable care act.”\u003c/p>\n\u003cp>Hampel and others are part of an organization called Docs 4 Patient Care, which has a strong presence in Texas, Georgia and Michigan and has challenged health reform since before it passed. “We think it’s a dangerous law and it is an intrusion on the doctor-patient relationship,” said Hal Scherz, a Georgia physician and president of the organization.\u003c/p>\n\u003cp>\u003cstrong>Differing Opinions\u003c/strong>\u003c/p>\n\u003cp>Doctors have also become messengers for the conservative group Americans for Prosperity. In one television ad, a Virginia doctor says Obamacare has her worried about having to navigate a complicated system rather than help patients. “Can I still work with parents to decide what’s best for their kids or will the government be in the middle of things?” she asks.\u003c/p>\n\u003cp>Whatever their views, physicians are expected to play a crucial part in patients’ understanding of the law and their willingness to enroll. The federal government is partnering with physician groups like the American Medical Association to educate doctors. Covered California, the state's insurance marketplace, awarded more than $3 million out of a total of $40 million in outreach grants to medical groups.\u003c/p>\n\u003cp>A recent Kaiser Family Foundation \u003ca href=\"http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-august-2013/\" target=\"_blank\">tracking poll\u003c/a> showed that doctors and nurses are the most trusted sources for people seeking information about health reform. Nevertheless, patients get more of their information from the news media, family and friends.\u003c/p>\n\u003cp>That is in part because physicians’ knowledge about the Medicaid expansion and insurance marketplaces varies widely. Doctors unsure about the details of the law may be more reluctant to talk about them.\u003c/p>\n\u003cp>To help, physician organizations are putting information on their websites and offering training sessions. The AMA prepared a fact sheet for doctors, a brochure for them to give patients and a flier for their waiting rooms: “Need affordable health insurance? New coverage options coming soon!”\u003c/p>\n\u003cp>\u003cstrong>'This Stuff Is Complicated'\u003c/strong>\u003c/p>\n\u003cp>The American College of Physicians posted an online state-by-state guide for doctors and a list of questions and answers about health reform. Charles Cutler, a Pennsylvania doctor who heads the organization’s board of regents, said several of his patients have already come to him with questions about insurance, benefits and prescription drugs.\u003c/p>\n\u003cp>“I don’t have all the answers,” Cutler said. “This stuff is complicated.”\u003c/p>\n\u003cp>Senger, the San Diego doctor, is the state director of an organization called Doctors for America, which is reaching out to physicians and patients with the motto “Coverage is Good Medicine.”\u003c/p>\n\u003cp>“Even if you don’t like this provision or that provision, getting patients insured is universally helpful” in ensuring they can seek regular care and their doctors can get reimbursed, said Alice Chen, executive director of the group and a UCLA assistant professor.\u003c/p>\n\u003cp>At a free health fair last month, Senger explained the changes to several patients, including Apolinar Recendiz, a 55-year-old uninsured housecleaner.\u003c/p>\n\u003cp>Senger told Recendiz that she may be eligible for insurance in January under the Affordable Care Act, despite having diabetes. “They’ll try to find what options will work best for you, and also for your family,” she said. “And they’ll try to make it affordable for you.”\u003c/p>\n\u003cp>Recendiz, with greying hair and a thick accent, nodded and smiled. “Imagine,” she said. “I didn’t know.”\u003c/p>\n\u003cp>Senger’s outreach didn’t end with the patients. Later, she met with a group of residents and medical students, running through the specifics about the state’s insurance marketplace. Veronica Villareal, a medical resident, said by learning “the nitty, gritty details” about Obamacare, she is more equipped to talk to her patients and direct them toward coverage.\u003c/p>\n\u003cp>\u003cstrong>Obamacare 101\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The Service Employees International Union also recently unveiled ads with doctors urging consumers to apply. In the ads, two New York doctors tell people in both Spanish and English they have “exciting news” – that consumers can get new, affordable coverage starting next year. \u003cspan style=\"text-decoration: line-through\"> \u003c/span>\u003c/p>\n\u003cp>With enrollment already underway, doctors need to get up to speed so they know what to tell patients, said Richard Baker, an ophthalmologist in Los Angeles.\u003c/p>\n\u003cp>“These are the new rules,” he said. “Physicians need to be educated.”\u003c/p>\n\u003cp>That’s what Insure the Uninsured Project is doing with a presentation entitled “Obamacare 101.” Just a few days before enrollment began on Oct. 1, doctors, medical assistants and health clinic personnel in Los Angeles spent hours learning about both the Medi-Cal expansion and the insurance marketplace. They repeated questions that they had already gotten from patients – about penalties, co-pays and benefits.\u003c/p>\n\u003cp>Howard Kahn, chief executive of L.A. Care Health Plan, which organized the session, said there is nobody better to educate patients than the person holding the stethoscope to their heart. “A doctor’s message counts more,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Voter Registration Advantage for Democrats Because of Obamacare? Could Be…",
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"content": "\u003cfigure id=\"attachment_15996\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/12218772@N00/3002399585/in/photolist-5zj5N6-oNvuW-5rc2XF-93tt9r-5rPt2K-5kU9St-rMpNV-93wzGL-93wypN-4Ae9o8-pZZFf-5qS9Zz-5sZtiY-regKk-4TXvXB-8THMFw-dmYem3-eFnQCf-72ni6e-8LwYp9-4EDaYV-FKuED-aypMek-arM7xS-5sV9QX-arM8AA-arM7sy-arJsY2-arM8fd-arM8vj-arM8j9-arM8y9-ayFpMH-5ziB39-de9j9j-de9jB4-4U1XSx-4rKm56-5yrWZe-55NECD-5oauft-4zrgTF-4qMkBq-4SuG3a-B5kpm-5h1Bis-5h1AUJ-5gWfc2-5gWeHz-5h1BaA-5h1ARU\">\u003cimg class=\"size-large wp-image-15996\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/3002399585_fdfd1b2117_b-640x426.jpg\" alt=\"(JasonLangheine/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(JasonLangheine/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Scott Shafer, KQED\u003c/strong>\u003c/p>\n\u003cp>The floundering roll out of the federal government’s health care exchange has given Republicans plenty of reasons to criticize the Affordable Care Act. But setting aside the online train wreck of healthcare.gov and the cost of expanding health care to millions of Americans, there may also be political reasons the GOP hates Obamacare: Voter registration.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The majority of California's 5.5 million uninsured are Latinos -- who tend to register and vote Democratic.\u003c/aside>\n\u003cp>It goes back to the 1993 National Voter Registration Act -- a.k.a. the Motor Voter act. It requires that state agencies providing public assistance must also offer voter registration materials to anyone they help. The most recognized place this happens is the DMV, hence the nickname \"Moter Voter.\" The Obama Administration says the law also applies to federally run exchanges in states (mostly with Republican governors) that decided \u003cem>against\u003c/em> having their own online health insurance marketplace.\u003c/p>\n\u003cp>Republicans in Congress have been railing against this, although the issue has taken a back seat to other concerns, notably the technological shortcomings of healthcare.gov. But to quote conservative talk show host Rush Limbaugh, Obamacare is really\u003cem> \u003c/em>“about building a permanent, undefeatable, always-funded Democrat majority.\"\u003c!--more-->\u003c/p>\n\u003cp>Surprisingly, California has never fully implemented Motor Voter. Pete Wilson was governor when the law was enacted and he objected to it being an “unfunded federal mandate.” A lot has changed since then. For starters, Californians can register to vote at the DMV as well as \u003ca href=\"http://registertovote.ca.gov\" target=\"_blank\">online\u003c/a>, and last year State Senator Alex Padilla \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120SB35\" target=\"_blank\">authored SB 35\u003c/a>, which required that all state agencies designate a Motor Voter coordinator.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Kim Alexander, president of the California Voter Foundation, notes that Secretary of State Debra Bowen \u003ca href=\"http://blogs.sacbee.com/capitolalertlatest/2013/05/states-new-health-exchange-to-serve-as-voter-registration-hub.html\" target=\"_blank\">recently declared \u003c/a>that Covered California is covered by the Motor Voter act, although the California Health Benefit Exchange Board is apparently taking a “phased in” approach to voter registration, presumably making sure the health insurance part is working well first.\u003c/p>\n\u003cp>Alexander sees tremendous potential to expand voter registration in the state via CoveredCA.com.\u003c/p>\n\u003cp>“There are 5.8 million Californians who are eligible to vote but are not registered,” says Alexander, “and there are 5.3 million who are uninsured. We expect many are one in the same.”\u003c/p>\n\u003cp>Alexander notes that health advocates see a direct correlation between health status and voting.\u003c/p>\n\u003cp>“They know that promoting health involves promoting civic engagement,” says Alexander, adding “when people feel they have a say in their lives through voting and civic participation, it has a positive effect on their physical and mental health.”\u003c/p>\n\u003cp>\u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/C/PDF%20CaliforniaUninsuredQuickRefGuide2011.pdf\" target=\"_blank\">Nearly 60 percent \u003c/a>of the 5.5 million uninsured California officials hope will get insurance through the new health care marketplace are Latino. Overwhelmingly, they tend to register and vote Democratic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So, at least in California, maybe Rush Limbaugh has a point.\u003c/p>\n\n",
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"excerpt": "The floundering roll out of the federal government’s health care exchange has given Republicans plenty of reasons to criticize the Affordable Care Act. But setting aside the online train wreck of healthcare.gov and the cost of expanding health care to millions of Americans, there may also be existential political reasons the GOP hates Obamacare: Voter registration.\r\n\r\nIt goes back to the 1993 National Voter Registration Act -- a.k.a. the Motor Voter act. It requires state agencies that provide public assistance, such as the DMV, must also offer voter registration materials to anyone they help. ",
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"description": "The floundering roll out of the federal government’s health care exchange has given Republicans plenty of reasons to criticize the Affordable Care Act. But setting aside the online train wreck of healthcare.gov and the cost of expanding health care to millions of Americans, there may also be existential political reasons the GOP hates Obamacare: Voter registration.\r\n\r\nIt goes back to the 1993 National Voter Registration Act -- a.k.a. the Motor Voter act. It requires state agencies that provide public assistance, such as the DMV, must also offer voter registration materials to anyone they help. ",
"title": "Voter Registration Advantage for Democrats Because of Obamacare? Could Be… | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15996\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/12218772@N00/3002399585/in/photolist-5zj5N6-oNvuW-5rc2XF-93tt9r-5rPt2K-5kU9St-rMpNV-93wzGL-93wypN-4Ae9o8-pZZFf-5qS9Zz-5sZtiY-regKk-4TXvXB-8THMFw-dmYem3-eFnQCf-72ni6e-8LwYp9-4EDaYV-FKuED-aypMek-arM7xS-5sV9QX-arM8AA-arM7sy-arJsY2-arM8fd-arM8vj-arM8j9-arM8y9-ayFpMH-5ziB39-de9j9j-de9jB4-4U1XSx-4rKm56-5yrWZe-55NECD-5oauft-4zrgTF-4qMkBq-4SuG3a-B5kpm-5h1Bis-5h1AUJ-5gWfc2-5gWeHz-5h1BaA-5h1ARU\">\u003cimg class=\"size-large wp-image-15996\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/3002399585_fdfd1b2117_b-640x426.jpg\" alt=\"(JasonLangheine/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(JasonLangheine/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Scott Shafer, KQED\u003c/strong>\u003c/p>\n\u003cp>The floundering roll out of the federal government’s health care exchange has given Republicans plenty of reasons to criticize the Affordable Care Act. But setting aside the online train wreck of healthcare.gov and the cost of expanding health care to millions of Americans, there may also be political reasons the GOP hates Obamacare: Voter registration.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The majority of California's 5.5 million uninsured are Latinos -- who tend to register and vote Democratic.\u003c/aside>\n\u003cp>It goes back to the 1993 National Voter Registration Act -- a.k.a. the Motor Voter act. It requires that state agencies providing public assistance must also offer voter registration materials to anyone they help. The most recognized place this happens is the DMV, hence the nickname \"Moter Voter.\" The Obama Administration says the law also applies to federally run exchanges in states (mostly with Republican governors) that decided \u003cem>against\u003c/em> having their own online health insurance marketplace.\u003c/p>\n\u003cp>Republicans in Congress have been railing against this, although the issue has taken a back seat to other concerns, notably the technological shortcomings of healthcare.gov. But to quote conservative talk show host Rush Limbaugh, Obamacare is really\u003cem> \u003c/em>“about building a permanent, undefeatable, always-funded Democrat majority.\"\u003c!--more-->\u003c/p>\n\u003cp>Surprisingly, California has never fully implemented Motor Voter. Pete Wilson was governor when the law was enacted and he objected to it being an “unfunded federal mandate.” A lot has changed since then. For starters, Californians can register to vote at the DMV as well as \u003ca href=\"http://registertovote.ca.gov\" target=\"_blank\">online\u003c/a>, and last year State Senator Alex Padilla \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120SB35\" target=\"_blank\">authored SB 35\u003c/a>, which required that all state agencies designate a Motor Voter coordinator.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kim Alexander, president of the California Voter Foundation, notes that Secretary of State Debra Bowen \u003ca href=\"http://blogs.sacbee.com/capitolalertlatest/2013/05/states-new-health-exchange-to-serve-as-voter-registration-hub.html\" target=\"_blank\">recently declared \u003c/a>that Covered California is covered by the Motor Voter act, although the California Health Benefit Exchange Board is apparently taking a “phased in” approach to voter registration, presumably making sure the health insurance part is working well first.\u003c/p>\n\u003cp>Alexander sees tremendous potential to expand voter registration in the state via CoveredCA.com.\u003c/p>\n\u003cp>“There are 5.8 million Californians who are eligible to vote but are not registered,” says Alexander, “and there are 5.3 million who are uninsured. We expect many are one in the same.”\u003c/p>\n\u003cp>Alexander notes that health advocates see a direct correlation between health status and voting.\u003c/p>\n\u003cp>“They know that promoting health involves promoting civic engagement,” says Alexander, adding “when people feel they have a say in their lives through voting and civic participation, it has a positive effect on their physical and mental health.”\u003c/p>\n\u003cp>\u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/C/PDF%20CaliforniaUninsuredQuickRefGuide2011.pdf\" target=\"_blank\">Nearly 60 percent \u003c/a>of the 5.5 million uninsured California officials hope will get insurance through the new health care marketplace are Latino. Overwhelmingly, they tend to register and vote Democratic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So, at least in California, maybe Rush Limbaugh has a point.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How the Medicare Part D Rollout Was the Same -- and Different -- From the ACA",
"title": "How the Medicare Part D Rollout Was the Same -- and Different -- From the ACA",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_15957\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/85501576-e1383155435404.jpg\">\u003cimg class=\"size-large wp-image-15957\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/85501576-640x426.jpg\" alt=\"Medicare Part D is also known as the Medicare prescription drug benefit. It went into effect on January 1, 2006. (Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Medicare Part D is also known as the Medicare prescription drug benefit. It went into effect on January 1, 2006. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Dan Diamond\u003c/strong>,\u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/what--medicare-part-d-can-and-cant-teach-us-about-the-affordable-care-act\" target=\"_blank\"> California Healthline Contributing Editor\u003c/a>\u003c/p>\n\u003cp>With the possible exception of one phrase -- \"it's a marathon, not a sprint\" -- defenders of Obamacare have repeatedly invoked the same warning:\u003c/p>\n\u003cp>Don't be too critical of the Affordable Care Act's new marketplaces. Medicare Part D had a rocky rollout, too.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"The level of frustration for those using [medicare.gov] was pretty high in 2005, just like today.\" \u003c/aside>\n\u003cp>\"In terms of confusion, lack of knowledge, and misinformation, the current situation with exchanges resembles the situation that prevailed when Part D enrollment opened,\" Daniel McFadden, a UC-Berkeley\u003cstrong> \u003c/strong>economist and Nobel laureate, \u003ca href=\"http://online.wsj.com/article/SB10001424052702303492504579111060370752416.html\" target=\"_blank\">told\u003c/a> the \u003cem>Wall Street Journal \u003c/em>earlier this month.\u003c/p>\n\u003cp>Part D, \"at the time that it was passed was actually less popular than the Affordable Care Act,\" President Obama said in an \u003ca href=\"http://www.npr.org/2013/10/01/227916696/transcript-and-audio-npr-interview-with-president-obama\" target=\"_blank\">NPR interview\u003c/a> on Oct. 1, the day the new marketplaces launched.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There \u003cem>are \u003c/em>similarities between the two programs, from the political fight over their enactment to the difficulties in making the laws a reality. But the laws differ in some important ways, too, including ones that supporters haven't fully acknowledged.\u003c/p>\n\u003cp>So what can we take away from Part D? Here's a quick guide to lessons from the drug plan's rollout.\u003c/p>\n\u003cp>\u003cstrong>Websites' Difficulties\u003c!--more-->\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>How they're similar\u003c/em>: Both launches were filled with glitches. The Medicare Prescription Drug Plan finder's launch in November 2005 was about a month behind schedule. That website also was slow, missing key information, and took time to fix, notes Georgetown health scholar Jack Hoadley, who \u003ca href=\"http://ccf.georgetown.edu/all/how-does-acas-first-week-compare-to-medicare-part-ds/\" target=\"_blank\">has\u003c/a> \u003ca href=\"http://ccf.georgetown.edu/all/how-does-enrollment-in-aca-exchanges-compare-to-medicare-part-d/\" target=\"_blank\">blogged\u003c/a> about lessons from Part D's implementation.\u003c/p>\n\u003cp>\"The level of frustration for those using the site was pretty high in 2005, just like today,\" Hoadley told \u003cem>California Healthline\u003c/em> earlier this month.\u003c/p>\n\u003cp>\u003cem>How they differ\u003c/em>: In many respects, Medicare.gov was less important to Part D than healthcare.gov is to the ACA.\u003c/p>\n\u003cp>The new insurance exchange websites are seen as a key linchpin of the law; they're intended to allow millions of Americans to browse different coverage options, see their subsidies and check if their preferred providers are included.\u003c/p>\n\u003cp>That personalized shopping experience is one reason why the online features are so crucial and call centers aren't a perfect substitute. As the \u003cem>Huffington Post\u003c/em>'s Jeffrey Young recently reported, the ACA wasn't really designed for \u003ca href=\"http://www.huffingtonpost.com/2013/10/22/obamacare-phone_n_4144951.html\" target=\"_blank\">shopping over the phone\u003c/a>.\u003c/p>\n\u003cp>And it's also a major departure from 2005, when most seniors didn't turn to the Part D website on their own. Surveys suggested that nine out of 10 seniors went through brokers, family members or other helpers to select their new prescription drug plans, according to \u003ca href=\"http://chir.georgetown.edu/pdfs/Medicare%20Part%20D%20and%20the%20Exchanges.pdf\" target=\"_blank\">one report\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>The Urgency of the Problem\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>How it's similar\u003c/em>: Both high-profile laws came under widespread scrutiny, with front-page stories and network news reports devoted to their rocky launch.\u003c/p>\n\u003cp>\u003cem>How it differs\u003c/em>: While criticism of Part D did focus on the law's unexpectedly high cost and troubled launch, there was also a public health component: Seniors were \u003ca href=\"http://www.nytimes.com/2005/11/07/business/07drug.html\" target=\"_blank\">increasingly nervous\u003c/a> that they wouldn't get their drugs.\u003c/p>\n\u003cp>Current challenges with the ACA, meanwhile, center on the political and policy implications. Many of the nation's poorest and sickest patients already are being helped by provisions in the law that expand Medicaid and bar insurers from excluding customers based on pre-existing conditions.\u003c/p>\n\u003cp>\u003cstrong>The Political Environment\u003c/strong>\u003c/p>\n\u003cp>\u003cem>How it's similar\u003c/em>: Just as Democrats fiercely resisted Republicans' efforts to enact a Medicare drug benefit, the GOP refused to support the Democrat-led ACA.\u003c/p>\n\u003cp>\u003cem>How it differs\u003c/em>: While Part D is seen as successful today -- 90% of seniors were satisfied, according to a \u003ca href=\"http://www.krcresearch.com/news_seniorsMedicare.html\" target=\"_blank\">2009 survey\u003c/a> -- Democrats say that their party deserves some credit.\u003c/p>\n\u003cp>\"We lost the policy fight, and what did we do?\" \u003ca href=\"http://www.cnn.com/2013/10/29/politics/5-things-tavenner-obamacare-hearing/\" target=\"_blank\">asked\u003c/a> Rep. Bill Pascrell (D-N.J.), at a hearing on Capitol Hill on Tuesday. \"We went back to our districts and we told our seniors although we voted no, we … will work with the Bush administration to make it work,\" Pascrell added.\u003c/p>\n\u003cp>\"And how many of you stood up to do that\" for the ACA, Pascrell asked his GOP colleagues. \"None. Zero. Zero.\"\u003c/p>\n\u003cp>\u003cstrong>How the White House Is Managing the Situation\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>How it's similar\u003c/em>: Both administrations were forced to scramble to address the dual problem of fixing the program while managing public perception.\u003c/p>\n\u003cp>\u003cem>How it differs\u003c/em>: The Bush administration quickly implemented a policy of \"almost over-sharing information,\" one former official told \u003cem>California Healthline\u003c/em>; for example, CMS officials held regular meetings with industry stakeholders throughout the fall and winter of 2005, with daily updates on the state of the Part D rollout.\u003c/p>\n\u003cp>But the current White House adopted a \"bunker mentality\" for weeks, \u003ca href=\"http://www.politico.com/story/2013/10/obamacare-bunker-mentality-white-house-98648.html\" target=\"_blank\">David Nather writes\u003c/a> at \u003cem>Politico\u003c/em>, offering few details over what went wrong and how soon it can be fixed. While officials are now shifting gears and offering \u003ca href=\"http://www.reuters.com/article/2013/10/26/us-usa-healthcare-obama-idUSBRE99P02S20131026\" target=\"_blank\">more transparency\u003c/a>, NBC's Chuck Todd on MSNBC's \"\u003ca href=\"http://www.nationalreview.com/corner/362576/todd-white-house-bunker-mentality-over-obamacare-andrew-johnson\" target=\"_blank\">Morning Joe\u003c/a>\" on Wednesday morning said that the White House remains hunkered down. The Obama administration is nervous, Todd said, that \"their entire second term is going to be judged on the implementation of health care.\"\u003c/p>\n\u003cp>\u003cstrong>What We Still Don't Know\u003c/strong>\u003c/p>\n\u003cp>By the end of November 2005, about two months after its original scheduled launch, medicare.gov was \"well-designed and easy to use,\" one \u003cem>New York Times \u003c/em>\u003ca href=\"http://www.nytimes.com/2005/11/24/business/24dad.html?pagewanted=all\" target=\"_blank\">reporter concluded\u003c/a>.\u003c/p>\n\u003cp>Will healthcare.gov follow a similar timetable? Obama administration officials have pledged that the exchange websites will be mostly working by late November, which would still allow for a four-month open enrollment period.\u003c/p>\n\u003cp>That gets to another interesting comparison: how will sign-ups through the ACA compare to Part D?\u003c/p>\n\u003cp>Obama administration officials acknowledge that early enrollment numbers will be low -- HHS Secretary Kathleen Sebelius on Wednesday morning told a House committee that the figures will be \"very small,\" largely because of problems with the exchange website.\u003c/p>\n\u003cp>But Georgetown's \u003ca href=\"http://ccf.georgetown.edu/all/how-does-enrollment-in-aca-exchanges-compare-to-medicare-part-d/\" target=\"_blank\">Hoadley notes\u003c/a> that the decision to purchase health coverage is a complicated process, pointing to the slow uptake for Part D: about 8 million seniors waited to sign up until after Jan. 1, 2006.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Modest enrollment numbers in the first month, let alone the first week, mean little as an indicator of eventual success,\" Hoadley concludes.\u003c/p>\n\u003cdiv>\u003c/div>\n\n",
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"excerpt": "With the possible exception of one phrase -- \"it's a marathon, not a sprint\" -- defenders of Obamacare have repeatedly invoked the same warning:\r\n\r\nDon't be too critical of the Affordable Care Act's new marketplaces. Medicare Part D had a rocky rollout, too.\r\n\r\n\"In terms of confusion, lack of knowledge, and misinformation, the current situation with exchanges resembles the situation that prevailed when Part D enrollment opened.\"",
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"description": "With the possible exception of one phrase -- "it's a marathon, not a sprint" -- defenders of Obamacare have repeatedly invoked the same warning:\r\n\r\nDon't be too critical of the Affordable Care Act's new marketplaces. Medicare Part D had a rocky rollout, too.\r\n\r\n"In terms of confusion, lack of knowledge, and misinformation, the current situation with exchanges resembles the situation that prevailed when Part D enrollment opened."",
"title": "How the Medicare Part D Rollout Was the Same -- and Different -- From the ACA | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15957\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/85501576-e1383155435404.jpg\">\u003cimg class=\"size-large wp-image-15957\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/85501576-640x426.jpg\" alt=\"Medicare Part D is also known as the Medicare prescription drug benefit. It went into effect on January 1, 2006. (Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Medicare Part D is also known as the Medicare prescription drug benefit. It went into effect on January 1, 2006. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Dan Diamond\u003c/strong>,\u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/what--medicare-part-d-can-and-cant-teach-us-about-the-affordable-care-act\" target=\"_blank\"> California Healthline Contributing Editor\u003c/a>\u003c/p>\n\u003cp>With the possible exception of one phrase -- \"it's a marathon, not a sprint\" -- defenders of Obamacare have repeatedly invoked the same warning:\u003c/p>\n\u003cp>Don't be too critical of the Affordable Care Act's new marketplaces. Medicare Part D had a rocky rollout, too.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"The level of frustration for those using [medicare.gov] was pretty high in 2005, just like today.\" \u003c/aside>\n\u003cp>\"In terms of confusion, lack of knowledge, and misinformation, the current situation with exchanges resembles the situation that prevailed when Part D enrollment opened,\" Daniel McFadden, a UC-Berkeley\u003cstrong> \u003c/strong>economist and Nobel laureate, \u003ca href=\"http://online.wsj.com/article/SB10001424052702303492504579111060370752416.html\" target=\"_blank\">told\u003c/a> the \u003cem>Wall Street Journal \u003c/em>earlier this month.\u003c/p>\n\u003cp>Part D, \"at the time that it was passed was actually less popular than the Affordable Care Act,\" President Obama said in an \u003ca href=\"http://www.npr.org/2013/10/01/227916696/transcript-and-audio-npr-interview-with-president-obama\" target=\"_blank\">NPR interview\u003c/a> on Oct. 1, the day the new marketplaces launched.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There \u003cem>are \u003c/em>similarities between the two programs, from the political fight over their enactment to the difficulties in making the laws a reality. But the laws differ in some important ways, too, including ones that supporters haven't fully acknowledged.\u003c/p>\n\u003cp>So what can we take away from Part D? Here's a quick guide to lessons from the drug plan's rollout.\u003c/p>\n\u003cp>\u003cstrong>Websites' Difficulties\u003c!--more-->\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>How they're similar\u003c/em>: Both launches were filled with glitches. The Medicare Prescription Drug Plan finder's launch in November 2005 was about a month behind schedule. That website also was slow, missing key information, and took time to fix, notes Georgetown health scholar Jack Hoadley, who \u003ca href=\"http://ccf.georgetown.edu/all/how-does-acas-first-week-compare-to-medicare-part-ds/\" target=\"_blank\">has\u003c/a> \u003ca href=\"http://ccf.georgetown.edu/all/how-does-enrollment-in-aca-exchanges-compare-to-medicare-part-d/\" target=\"_blank\">blogged\u003c/a> about lessons from Part D's implementation.\u003c/p>\n\u003cp>\"The level of frustration for those using the site was pretty high in 2005, just like today,\" Hoadley told \u003cem>California Healthline\u003c/em> earlier this month.\u003c/p>\n\u003cp>\u003cem>How they differ\u003c/em>: In many respects, Medicare.gov was less important to Part D than healthcare.gov is to the ACA.\u003c/p>\n\u003cp>The new insurance exchange websites are seen as a key linchpin of the law; they're intended to allow millions of Americans to browse different coverage options, see their subsidies and check if their preferred providers are included.\u003c/p>\n\u003cp>That personalized shopping experience is one reason why the online features are so crucial and call centers aren't a perfect substitute. As the \u003cem>Huffington Post\u003c/em>'s Jeffrey Young recently reported, the ACA wasn't really designed for \u003ca href=\"http://www.huffingtonpost.com/2013/10/22/obamacare-phone_n_4144951.html\" target=\"_blank\">shopping over the phone\u003c/a>.\u003c/p>\n\u003cp>And it's also a major departure from 2005, when most seniors didn't turn to the Part D website on their own. Surveys suggested that nine out of 10 seniors went through brokers, family members or other helpers to select their new prescription drug plans, according to \u003ca href=\"http://chir.georgetown.edu/pdfs/Medicare%20Part%20D%20and%20the%20Exchanges.pdf\" target=\"_blank\">one report\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>The Urgency of the Problem\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>How it's similar\u003c/em>: Both high-profile laws came under widespread scrutiny, with front-page stories and network news reports devoted to their rocky launch.\u003c/p>\n\u003cp>\u003cem>How it differs\u003c/em>: While criticism of Part D did focus on the law's unexpectedly high cost and troubled launch, there was also a public health component: Seniors were \u003ca href=\"http://www.nytimes.com/2005/11/07/business/07drug.html\" target=\"_blank\">increasingly nervous\u003c/a> that they wouldn't get their drugs.\u003c/p>\n\u003cp>Current challenges with the ACA, meanwhile, center on the political and policy implications. Many of the nation's poorest and sickest patients already are being helped by provisions in the law that expand Medicaid and bar insurers from excluding customers based on pre-existing conditions.\u003c/p>\n\u003cp>\u003cstrong>The Political Environment\u003c/strong>\u003c/p>\n\u003cp>\u003cem>How it's similar\u003c/em>: Just as Democrats fiercely resisted Republicans' efforts to enact a Medicare drug benefit, the GOP refused to support the Democrat-led ACA.\u003c/p>\n\u003cp>\u003cem>How it differs\u003c/em>: While Part D is seen as successful today -- 90% of seniors were satisfied, according to a \u003ca href=\"http://www.krcresearch.com/news_seniorsMedicare.html\" target=\"_blank\">2009 survey\u003c/a> -- Democrats say that their party deserves some credit.\u003c/p>\n\u003cp>\"We lost the policy fight, and what did we do?\" \u003ca href=\"http://www.cnn.com/2013/10/29/politics/5-things-tavenner-obamacare-hearing/\" target=\"_blank\">asked\u003c/a> Rep. Bill Pascrell (D-N.J.), at a hearing on Capitol Hill on Tuesday. \"We went back to our districts and we told our seniors although we voted no, we … will work with the Bush administration to make it work,\" Pascrell added.\u003c/p>\n\u003cp>\"And how many of you stood up to do that\" for the ACA, Pascrell asked his GOP colleagues. \"None. Zero. Zero.\"\u003c/p>\n\u003cp>\u003cstrong>How the White House Is Managing the Situation\u003cstrong>\u003c/strong>\u003c/strong>\u003c/p>\n\u003cp>\u003cem>How it's similar\u003c/em>: Both administrations were forced to scramble to address the dual problem of fixing the program while managing public perception.\u003c/p>\n\u003cp>\u003cem>How it differs\u003c/em>: The Bush administration quickly implemented a policy of \"almost over-sharing information,\" one former official told \u003cem>California Healthline\u003c/em>; for example, CMS officials held regular meetings with industry stakeholders throughout the fall and winter of 2005, with daily updates on the state of the Part D rollout.\u003c/p>\n\u003cp>But the current White House adopted a \"bunker mentality\" for weeks, \u003ca href=\"http://www.politico.com/story/2013/10/obamacare-bunker-mentality-white-house-98648.html\" target=\"_blank\">David Nather writes\u003c/a> at \u003cem>Politico\u003c/em>, offering few details over what went wrong and how soon it can be fixed. While officials are now shifting gears and offering \u003ca href=\"http://www.reuters.com/article/2013/10/26/us-usa-healthcare-obama-idUSBRE99P02S20131026\" target=\"_blank\">more transparency\u003c/a>, NBC's Chuck Todd on MSNBC's \"\u003ca href=\"http://www.nationalreview.com/corner/362576/todd-white-house-bunker-mentality-over-obamacare-andrew-johnson\" target=\"_blank\">Morning Joe\u003c/a>\" on Wednesday morning said that the White House remains hunkered down. The Obama administration is nervous, Todd said, that \"their entire second term is going to be judged on the implementation of health care.\"\u003c/p>\n\u003cp>\u003cstrong>What We Still Don't Know\u003c/strong>\u003c/p>\n\u003cp>By the end of November 2005, about two months after its original scheduled launch, medicare.gov was \"well-designed and easy to use,\" one \u003cem>New York Times \u003c/em>\u003ca href=\"http://www.nytimes.com/2005/11/24/business/24dad.html?pagewanted=all\" target=\"_blank\">reporter concluded\u003c/a>.\u003c/p>\n\u003cp>Will healthcare.gov follow a similar timetable? Obama administration officials have pledged that the exchange websites will be mostly working by late November, which would still allow for a four-month open enrollment period.\u003c/p>\n\u003cp>That gets to another interesting comparison: how will sign-ups through the ACA compare to Part D?\u003c/p>\n\u003cp>Obama administration officials acknowledge that early enrollment numbers will be low -- HHS Secretary Kathleen Sebelius on Wednesday morning told a House committee that the figures will be \"very small,\" largely because of problems with the exchange website.\u003c/p>\n\u003cp>But Georgetown's \u003ca href=\"http://ccf.georgetown.edu/all/how-does-enrollment-in-aca-exchanges-compare-to-medicare-part-d/\" target=\"_blank\">Hoadley notes\u003c/a> that the decision to purchase health coverage is a complicated process, pointing to the slow uptake for Part D: about 8 million seniors waited to sign up until after Jan. 1, 2006.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Modest enrollment numbers in the first month, let alone the first week, mean little as an indicator of eventual success,\" Hoadley concludes.\u003c/p>\n\u003cdiv>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New ACA Fracas: Did the White House Know People Would Face Insurance Cancellations?",
"title": "New ACA Fracas: Did the White House Know People Would Face Insurance Cancellations?",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>\u003cscript type=\"text/javascript\" src=\"http://platform.twitter.com/widgets.js\">\u003c/script>\u003c/p>\n\u003cfigure id=\"attachment_15926\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/186114457.jpg\">\u003cimg class=\"size-large wp-image-15926\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/186114457-640x443.jpg\" alt=\"President Obama makes remarks during a ceremonial swearing-in of FBI Director James Comey. (Alex Wong/Getty Images)\" width=\"640\" height=\"443\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama makes remarks during a ceremonial swearing-in of FBI Director James Comey. (Alex Wong/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\"if you like your health plan, you will be able to keep your health plan.\"\u003c/p>\n\u003cp>That's been President Obama's talking point since 2009, before the Affordable Care Act was passed in 2010.\u003c/p>\n\u003cp>But millions of Americans are receiving notices of policies being cancelled, \u003ca href=\"http://investigations.nbcnews.com/_news/2013/10/29/21222195-obama-administration-knew-millions-could-not-keep-their-health-insurance\" target=\"_blank\">NBC reported\u003c/a> on Monday night and — citing four unnamed sources \"deeply involved in the Affordable Care Act\" — further argued that the administration has known this would happen for the last three years.\u003c/p>\n\u003cp>From NBC:\u003c/p>\n\u003cblockquote>\u003cp>None of this should come as a shock to the Obama administration. The law states that policies in effect as of March 23, 2010, will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date — the deductible, co-pay, or benefits, for example — the policy would not be grandfathered.\u003c!--more-->\u003c/p>\n\u003cp>Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. And because many policies will have been changed since the key date, “the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range.”\u003c/p>\n\u003cp>That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.\u003c/p>\u003c/blockquote>\n\u003cp>All of the sources said that many of those who receive cancellation notices will experience sticker shock when migrated to a new policy. State of Health has reported on these situations, including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/18/why-some-are-seeing-premiums-go-up-as-affordable-care-act-goes-into-effect-obamacare/\" target=\"_blank\">Mark Brown of San Jose \u003c/a>who is seeing an increase of 90 percent.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>(Just to reiterate -- this is the individual insurance market. In California, that's about two million people or about 6 percent of the population.)\u003c/p>\n\u003cp>Meanwhile, the White House is firing back. Josh Earnest, special assistant to the president, said on Twitter:\u003c/p>\n\u003cblockquote class=\"twitter-tweet\">\u003cp>NBC \"scoop\" cites \"normal turnover in the indiv insurance market\". That's a) not new b) not caused by \u003ca href=\"https://twitter.com/search?q=%23ACA&src=hash\">#ACA\u003c/a> c) the problem \u003ca href=\"https://twitter.com/search?q=%23ACA&src=hash\">#ACA\u003c/a> will solve.\u003c/p>\n\u003cp>— Josh Earnest (@jearnest44) \u003ca href=\"https://twitter.com/jearnest44/statuses/394953060692160512\">October 28, 2013\u003c/a>\u003c/p>\u003c/blockquote>\n\u003cp>Politico added nuance to the story, saying that while many consumers will see their policies cancelled, \"how directly that's related to the law can be debated.\"\u003c/p>\n\u003cp>More from \u003ca href=\"http://www.politico.com/story/2013/10/white-house-rejects-nbc-obamacare-report-99001.html\" target=\"_blank\">Politico\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The law requires insurance plans to meet basic standards after 2014. If they don’t meet those standards, insurers can no longer sell those plans unless they are “grandfathered” – or they existed before 2010 and haven’t changed at all since then.\u003c/p>\n\u003cp>So, if an insurer changed a premium or a deductible in 2013, the plan is no longer grandfathered under Obamacare and can’t be renewed in 2014.\u003c/p>\n\u003cp>The White House says it’s not forcing anyone off those plans – the insurers are if they change their policy and it loses its grandfathered status.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"http://thinkprogress.org/health/2013/10/28/2850061/wrong-story-obama-knowing-health-care-policy-cancelled/\" target=\"_blank\">ThinkProgress \u003c/a>notes that \"40 to 67 percent might lose their grandfathered status\" sounds \"ominous\" but:\u003c/p>\n\u003cblockquote>\u003cp>The debate was \u003ca href=\"http://www.nypost.com/p/news/opinion/opedcolumnists/you_re_losing_your_plan_O2H1EFmYlHSoQmqp48uDHI#ixzz0qr6NMGi1\">widely\u003c/a> \u003ca href=\"http://www.nytimes.com/2010/06/14/health/policy/14health.html?tntemail0=y&_r=0&emc=tnt&pagewanted=print\">covered\u003c/a> in \u003ca href=\"http://articles.latimes.com/2010/sep/22/nation/la-na-health-new-benefits-20100923\">the press\u003c/a>, so it’s unclear what exactly the NBC investigation unit has uncovered.\u003c/p>\n\u003cp>The goal of grandfather regulations is to allow a consumer to keep their existing policies, while also ensuring that there are some basic patient protections built into these plans. If insurers make changes that significantly burden enrollees with lower benefits and increased costs they have to come into compliance with all consumer protections. Therefore, policies lose their grandfathered status if insurers cancel coverage when a person becomes ill, impose lifetime limits on benefits, eliminate all benefits for a particular condition and reduce the cap for covered services each year, among other changes. (In fact, in November of 2010, the federal government \u003ca href=\"http://thinkprogress.org/health/2010/11/16/171787/grandfather-update/\">loosened some of these standards\u003c/a>.)\u003c/p>\n\u003cp>So yes, individuals can keep the plans they have if those plans remain largely the same. But individuals receiving cancellation notices will have a choice of enrolling in subsidized insurance in the exchanges and will probably end up paying less for more coverage.\u003c/p>\u003c/blockquote>\n\u003cp>Yes, many people will be eligible for subsidies. In California, \u003ca href=\"http://kff.org/health-reform/issue-brief/quantifying-tax-credits-for-people-now-buying-insurance-on-their-own/\" target=\"_blank\">as many as half\u003c/a> of the two million people currently buying insurance on the individual market will be eligible. What's unclear is what happens to the other million Californians.\u003c/p>\n\u003cp>As noted above, Mark Brown's policy was cancelled and the new one offered by Kaiser has essentially the same benefits — but for nearly double the price.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"There are going to be winners and losers whenever they deploy something like this, and I’m in the loser category at this point,\" Brown said.\u003c/p>\n\n",
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"excerpt": "\"if you like your health plan, you will be able to keep your health plan.\"\r\n\r\nThat's been President Obama's talking point since 2009, before the Affordable Care Act was passed in 2010.\r\n\r\nBut millions of Americans are receiving notices of policies being cancelled, NBC reported on Monday night and -- citing four unnamed sources \"deeply involved in the Affordable Care Act\" -- further argued that the administration has known this would happen for the last three years.",
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"description": ""if you like your health plan, you will be able to keep your health plan."\r\n\r\nThat's been President Obama's talking point since 2009, before the Affordable Care Act was passed in 2010.\r\n\r\nBut millions of Americans are receiving notices of policies being cancelled, NBC reported on Monday night and -- citing four unnamed sources "deeply involved in the Affordable Care Act" -- further argued that the administration has known this would happen for the last three years.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cscript type=\"text/javascript\" src=\"http://platform.twitter.com/widgets.js\">\u003c/script>\u003c/p>\n\u003cfigure id=\"attachment_15926\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/186114457.jpg\">\u003cimg class=\"size-large wp-image-15926\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/186114457-640x443.jpg\" alt=\"President Obama makes remarks during a ceremonial swearing-in of FBI Director James Comey. (Alex Wong/Getty Images)\" width=\"640\" height=\"443\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">President Obama makes remarks during a ceremonial swearing-in of FBI Director James Comey. (Alex Wong/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\"if you like your health plan, you will be able to keep your health plan.\"\u003c/p>\n\u003cp>That's been President Obama's talking point since 2009, before the Affordable Care Act was passed in 2010.\u003c/p>\n\u003cp>But millions of Americans are receiving notices of policies being cancelled, \u003ca href=\"http://investigations.nbcnews.com/_news/2013/10/29/21222195-obama-administration-knew-millions-could-not-keep-their-health-insurance\" target=\"_blank\">NBC reported\u003c/a> on Monday night and — citing four unnamed sources \"deeply involved in the Affordable Care Act\" — further argued that the administration has known this would happen for the last three years.\u003c/p>\n\u003cp>From NBC:\u003c/p>\n\u003cblockquote>\u003cp>None of this should come as a shock to the Obama administration. The law states that policies in effect as of March 23, 2010, will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date — the deductible, co-pay, or benefits, for example — the policy would not be grandfathered.\u003c!--more-->\u003c/p>\n\u003cp>Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. And because many policies will have been changed since the key date, “the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range.”\u003c/p>\n\u003cp>That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.\u003c/p>\u003c/blockquote>\n\u003cp>All of the sources said that many of those who receive cancellation notices will experience sticker shock when migrated to a new policy. State of Health has reported on these situations, including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/18/why-some-are-seeing-premiums-go-up-as-affordable-care-act-goes-into-effect-obamacare/\" target=\"_blank\">Mark Brown of San Jose \u003c/a>who is seeing an increase of 90 percent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>(Just to reiterate -- this is the individual insurance market. In California, that's about two million people or about 6 percent of the population.)\u003c/p>\n\u003cp>Meanwhile, the White House is firing back. Josh Earnest, special assistant to the president, said on Twitter:\u003c/p>\n\u003cblockquote class=\"twitter-tweet\">\u003cp>NBC \"scoop\" cites \"normal turnover in the indiv insurance market\". That's a) not new b) not caused by \u003ca href=\"https://twitter.com/search?q=%23ACA&src=hash\">#ACA\u003c/a> c) the problem \u003ca href=\"https://twitter.com/search?q=%23ACA&src=hash\">#ACA\u003c/a> will solve.\u003c/p>\n\u003cp>— Josh Earnest (@jearnest44) \u003ca href=\"https://twitter.com/jearnest44/statuses/394953060692160512\">October 28, 2013\u003c/a>\u003c/p>\u003c/blockquote>\n\u003cp>Politico added nuance to the story, saying that while many consumers will see their policies cancelled, \"how directly that's related to the law can be debated.\"\u003c/p>\n\u003cp>More from \u003ca href=\"http://www.politico.com/story/2013/10/white-house-rejects-nbc-obamacare-report-99001.html\" target=\"_blank\">Politico\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>The law requires insurance plans to meet basic standards after 2014. If they don’t meet those standards, insurers can no longer sell those plans unless they are “grandfathered” – or they existed before 2010 and haven’t changed at all since then.\u003c/p>\n\u003cp>So, if an insurer changed a premium or a deductible in 2013, the plan is no longer grandfathered under Obamacare and can’t be renewed in 2014.\u003c/p>\n\u003cp>The White House says it’s not forcing anyone off those plans – the insurers are if they change their policy and it loses its grandfathered status.\u003c/p>\u003c/blockquote>\n\u003cp>\u003ca href=\"http://thinkprogress.org/health/2013/10/28/2850061/wrong-story-obama-knowing-health-care-policy-cancelled/\" target=\"_blank\">ThinkProgress \u003c/a>notes that \"40 to 67 percent might lose their grandfathered status\" sounds \"ominous\" but:\u003c/p>\n\u003cblockquote>\u003cp>The debate was \u003ca href=\"http://www.nypost.com/p/news/opinion/opedcolumnists/you_re_losing_your_plan_O2H1EFmYlHSoQmqp48uDHI#ixzz0qr6NMGi1\">widely\u003c/a> \u003ca href=\"http://www.nytimes.com/2010/06/14/health/policy/14health.html?tntemail0=y&_r=0&emc=tnt&pagewanted=print\">covered\u003c/a> in \u003ca href=\"http://articles.latimes.com/2010/sep/22/nation/la-na-health-new-benefits-20100923\">the press\u003c/a>, so it’s unclear what exactly the NBC investigation unit has uncovered.\u003c/p>\n\u003cp>The goal of grandfather regulations is to allow a consumer to keep their existing policies, while also ensuring that there are some basic patient protections built into these plans. If insurers make changes that significantly burden enrollees with lower benefits and increased costs they have to come into compliance with all consumer protections. Therefore, policies lose their grandfathered status if insurers cancel coverage when a person becomes ill, impose lifetime limits on benefits, eliminate all benefits for a particular condition and reduce the cap for covered services each year, among other changes. (In fact, in November of 2010, the federal government \u003ca href=\"http://thinkprogress.org/health/2010/11/16/171787/grandfather-update/\">loosened some of these standards\u003c/a>.)\u003c/p>\n\u003cp>So yes, individuals can keep the plans they have if those plans remain largely the same. But individuals receiving cancellation notices will have a choice of enrolling in subsidized insurance in the exchanges and will probably end up paying less for more coverage.\u003c/p>\u003c/blockquote>\n\u003cp>Yes, many people will be eligible for subsidies. In California, \u003ca href=\"http://kff.org/health-reform/issue-brief/quantifying-tax-credits-for-people-now-buying-insurance-on-their-own/\" target=\"_blank\">as many as half\u003c/a> of the two million people currently buying insurance on the individual market will be eligible. What's unclear is what happens to the other million Californians.\u003c/p>\n\u003cp>As noted above, Mark Brown's policy was cancelled and the new one offered by Kaiser has essentially the same benefits — but for nearly double the price.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"There are going to be winners and losers whenever they deploy something like this, and I’m in the loser category at this point,\" Brown said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Health Law Nudges Therapists Toward Group Practice",
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"content": "\u003cfigure id=\"attachment_15838\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/148129971.jpg\">\u003cimg class=\"size-large wp-image-15838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/148129971-640x494.jpg\" alt=\"\" width=\"640\" height=\"494\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Because mental health is one of the ACA's required benefits, many therapists are now having to deal with insurance contracts for the first time. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Sarah Varney\u003c/strong>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/October/24/Health-Law-Changes-Therapy-Business.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>In the corporate world of American health care, with its consolidating hospital chains and doctors’ groups, psychologists and other mental health therapists are still mostly Mom-and-Pop shops; they’ve built solo practices, hanging their own shingles, not unlike Lucy in the Peanuts gang: “Psychiatric Help 5¢, The Doctor Is In.”\u003c/p>\n\u003cp>But that business model is shifting from solo practices toward large medical groups, say mental health experts. The shift is propelled by the Affordable Care Act, which mandates mental health benefits in insurance coverage, and the 2008 mental health parity law, which requires private and public insurers to cover mental health needs just as they do medical conditions by charging similar co-pays, for example.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“It’s a big change for us. There is a loss of autonomy that a lot of therapists are frightened about.” \u003c/aside>\n\u003cp>“It’s a big change for us,” said Barbara Griswold, a marriage and family therapist in San Jose. “I spent all of my life setting up this practice where I choose my clients, I choose my hours.”\u003c/p>\n\u003cp>In just the last few months, Griswold has weighed a new contract with a giant health insurer, warned other therapists to watch what they’re signing in payment negotiations and considered the extinction of her own solo practice. “The idea of me moving into an interdisciplinary practice where somebody else is taking care of my billing, and someone is choosing my clients for me —there is a loss of autonomy that a lot of therapists are frightened about,” Griswold said.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Organizations that advocate for mental and behavioral health, groups that long complained they were treated as second-class providers, have applauded the federal laws. “Some people have paid for mental health out of pocket because they didn’t have mental health insurance,” said Dr. Katherine Nordal, executive director for professional practice at the American Psychological Association. “I think now they’ll expect their providers to accept insurance.”\u003c/p>\n\u003cp>But inclusion into the mainstream has come with some unhappy caveats: Cash was simple. Patients used to paying $150 in cash for a therapy session will, with some limitations, be covered by their health plan.\u003c/p>\n\u003cp>That means many therapists will have to figure out innumerable insurance plans and byzantine billing codes for the first time. “A lot of people come to me and they’re almost falling apart,” said Griswold who wrote a book called, “Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance – and Whether You Should.” “It’s almost like a therapy session with these therapists. Seriously! I had a woman cry on my couch. She was like, ‘I don’t know how to do this!’”\u003c/p>\n\u003cp>Therapists who already accept insurance typically take a big pay cut since insurers negotiate fees that are about half of what they charge for cash visits. Blue Shield of California, for example, recently asked Griswold to accept a 10- to 30-percent discount off of her already discounted rate for patients who will buy health plans through the new online insurance marketplace. She refused and then wrote about the negotiations in her popular newsletter. “I put out in my newsletter, ‘Do you even know what you signed?’ And people wrote back, ‘Oh my God, I had no idea!’”\u003c/p>\n\u003cp>In many ways, therapists are encountering what medical doctors have complained about for years: the confusing and confounding – some say hostile – insurance bureaucracy that providers must tangle with in order to get paid. Therapists are expected to invest in expensive electronic billing software and electronic health records and comply with a tome of regulations.\u003c/p>\n\u003cp>“Just keeping up with all of that quite frankly is exhausting,” said Erica Savino Moffatt, a psychiatric nurse practitioner in Boston. “If you’re Jane Therapist hanging her shingle down the office from her home, it used to be the benefit was a better work-life balance and control over your immediate work environment. But a lot of that is lost in trying to track all of these logistics.”\u003c/p>\n\u003cp>The dizzying complexity of running a practice has meant more therapists are taking down their shingles, and consolidating with each other to share the burden, executives at national mental groups say. Or they are joining large medical groups in which mental health services are part of a continuum of care.\u003c/p>\n\u003cp>The changes are part of a remaking of a system that has long treated the mind as separate from the body. “If you look how many airlines there are today versus 10 years ago; if you look at hardware stores versus Home Depot and Lowe’s; it’s really a monopoly economy,” said Linda Rosenberg, president of the National Council for Behavioral Health. “And I think solo practitioners are going to be employees of big systems.”\u003c/p>\n\u003cp>In Tacoma, Wash., Dr. Barry Anton works as a clinical psychologist at Rainier Associates, an outpatient mental health clinic staffed by 17 therapists. Solo practitioners “might find it difficult to succeed in the new environment because the health care delivery system is evolving,” Anton said.\u003c/p>\n\u003cp>As insurance companies look to provide mental health care on a large scale, clinics like Rainier Associates are attractive partners. “It’s been very convenient and efficient for the insurance company to work with a bigger group,” said Anton. “We only have one tax ID number; we take care of all the credentialing; we take care of all the billing. They cut one check. It’s just more efficient for them.”\u003c/p>\n\u003cp>Psychologists, psychiatrists and other therapists in larger groups gain bargaining power as well and can demand higher reimbursement rates from insurance companies. “For those mental health practitioners who can develop group practices where they can provide a full range of services – from psychotherapy to family therapy to marriage therapy to medication management – they are going to be in a much better position to negotiate not only with commercial carriers but also with the federal government,” said Nordal of the American Psychological Association.\u003c/p>\n\u003cp>In addition to super-sizing mental health practices, mental health providers are beginning to play a bigger role at primary care clinics.\u003c/p>\n\u003cp>Savino Moffatt is a newly minted graduate who, instead of starting her own practice, saw where the future was headed: She works as a psychiatric nurse practitioner at a large clinic in Boston that is well positioned for the era of integrated medicine. She sits alongside internists and pediatricians who previously didn’t know where to turn \u003cspan style=\"text-decoration: line-through\">to \u003c/span>for psychological help with their patients. Now, Savino Moffit is just down the hall. “Once you say, ‘Hey, I’m here! I do psychiatry.’ And they kind of look at you like, ‘Oh thank goodness! I have a patient and I’m so worried!’”\u003c/p>\n\u003cp>Savino Moffit says she can identify mental health conditions like depression that might be masquerading as physical symptoms and which allows physicians to better serve their patients. It also can save the clinic from ordering costly and unnecessary tests, an important consideration for large medical groups that receive a set amount of money each month to cover all the needs of their patients.\u003c/p>\n\u003cp>Mental health experts say setting up these new business models will take time; that it’s a marathon, not a sprint. Barbara Griswold, sitting in her therapist’s chair at her office in San Jose, says that’s about the right speed. “I tend to think therapists overreact about change. We’re not really good with change, which is funny because we help people with change.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv>\u003c/div>\n\n",
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"excerpt": "In the corporate world of American health care, with its consolidating hospital chains and doctors’ groups, psychologists and other mental health therapists are still mostly Mom-and-Pop shops; they’ve built solo practices, hanging their own shingles, not unlike Lucy in the Peanuts gang: “Psychiatric Help 5¢, The Doctor Is In.”\r\n\r\nBut that business model is shifting from solo practices toward large medical groups, say mental health experts. The shift is propelled by the Affordable Care Act.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15838\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/148129971.jpg\">\u003cimg class=\"size-large wp-image-15838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/148129971-640x494.jpg\" alt=\"\" width=\"640\" height=\"494\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Because mental health is one of the ACA's required benefits, many therapists are now having to deal with insurance contracts for the first time. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Sarah Varney\u003c/strong>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/October/24/Health-Law-Changes-Therapy-Business.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>In the corporate world of American health care, with its consolidating hospital chains and doctors’ groups, psychologists and other mental health therapists are still mostly Mom-and-Pop shops; they’ve built solo practices, hanging their own shingles, not unlike Lucy in the Peanuts gang: “Psychiatric Help 5¢, The Doctor Is In.”\u003c/p>\n\u003cp>But that business model is shifting from solo practices toward large medical groups, say mental health experts. The shift is propelled by the Affordable Care Act, which mandates mental health benefits in insurance coverage, and the 2008 mental health parity law, which requires private and public insurers to cover mental health needs just as they do medical conditions by charging similar co-pays, for example.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“It’s a big change for us. There is a loss of autonomy that a lot of therapists are frightened about.” \u003c/aside>\n\u003cp>“It’s a big change for us,” said Barbara Griswold, a marriage and family therapist in San Jose. “I spent all of my life setting up this practice where I choose my clients, I choose my hours.”\u003c/p>\n\u003cp>In just the last few months, Griswold has weighed a new contract with a giant health insurer, warned other therapists to watch what they’re signing in payment negotiations and considered the extinction of her own solo practice. “The idea of me moving into an interdisciplinary practice where somebody else is taking care of my billing, and someone is choosing my clients for me —there is a loss of autonomy that a lot of therapists are frightened about,” Griswold said.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Organizations that advocate for mental and behavioral health, groups that long complained they were treated as second-class providers, have applauded the federal laws. “Some people have paid for mental health out of pocket because they didn’t have mental health insurance,” said Dr. Katherine Nordal, executive director for professional practice at the American Psychological Association. “I think now they’ll expect their providers to accept insurance.”\u003c/p>\n\u003cp>But inclusion into the mainstream has come with some unhappy caveats: Cash was simple. Patients used to paying $150 in cash for a therapy session will, with some limitations, be covered by their health plan.\u003c/p>\n\u003cp>That means many therapists will have to figure out innumerable insurance plans and byzantine billing codes for the first time. “A lot of people come to me and they’re almost falling apart,” said Griswold who wrote a book called, “Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance – and Whether You Should.” “It’s almost like a therapy session with these therapists. Seriously! I had a woman cry on my couch. She was like, ‘I don’t know how to do this!’”\u003c/p>\n\u003cp>Therapists who already accept insurance typically take a big pay cut since insurers negotiate fees that are about half of what they charge for cash visits. Blue Shield of California, for example, recently asked Griswold to accept a 10- to 30-percent discount off of her already discounted rate for patients who will buy health plans through the new online insurance marketplace. She refused and then wrote about the negotiations in her popular newsletter. “I put out in my newsletter, ‘Do you even know what you signed?’ And people wrote back, ‘Oh my God, I had no idea!’”\u003c/p>\n\u003cp>In many ways, therapists are encountering what medical doctors have complained about for years: the confusing and confounding – some say hostile – insurance bureaucracy that providers must tangle with in order to get paid. Therapists are expected to invest in expensive electronic billing software and electronic health records and comply with a tome of regulations.\u003c/p>\n\u003cp>“Just keeping up with all of that quite frankly is exhausting,” said Erica Savino Moffatt, a psychiatric nurse practitioner in Boston. “If you’re Jane Therapist hanging her shingle down the office from her home, it used to be the benefit was a better work-life balance and control over your immediate work environment. But a lot of that is lost in trying to track all of these logistics.”\u003c/p>\n\u003cp>The dizzying complexity of running a practice has meant more therapists are taking down their shingles, and consolidating with each other to share the burden, executives at national mental groups say. Or they are joining large medical groups in which mental health services are part of a continuum of care.\u003c/p>\n\u003cp>The changes are part of a remaking of a system that has long treated the mind as separate from the body. “If you look how many airlines there are today versus 10 years ago; if you look at hardware stores versus Home Depot and Lowe’s; it’s really a monopoly economy,” said Linda Rosenberg, president of the National Council for Behavioral Health. “And I think solo practitioners are going to be employees of big systems.”\u003c/p>\n\u003cp>In Tacoma, Wash., Dr. Barry Anton works as a clinical psychologist at Rainier Associates, an outpatient mental health clinic staffed by 17 therapists. Solo practitioners “might find it difficult to succeed in the new environment because the health care delivery system is evolving,” Anton said.\u003c/p>\n\u003cp>As insurance companies look to provide mental health care on a large scale, clinics like Rainier Associates are attractive partners. “It’s been very convenient and efficient for the insurance company to work with a bigger group,” said Anton. “We only have one tax ID number; we take care of all the credentialing; we take care of all the billing. They cut one check. It’s just more efficient for them.”\u003c/p>\n\u003cp>Psychologists, psychiatrists and other therapists in larger groups gain bargaining power as well and can demand higher reimbursement rates from insurance companies. “For those mental health practitioners who can develop group practices where they can provide a full range of services – from psychotherapy to family therapy to marriage therapy to medication management – they are going to be in a much better position to negotiate not only with commercial carriers but also with the federal government,” said Nordal of the American Psychological Association.\u003c/p>\n\u003cp>In addition to super-sizing mental health practices, mental health providers are beginning to play a bigger role at primary care clinics.\u003c/p>\n\u003cp>Savino Moffatt is a newly minted graduate who, instead of starting her own practice, saw where the future was headed: She works as a psychiatric nurse practitioner at a large clinic in Boston that is well positioned for the era of integrated medicine. She sits alongside internists and pediatricians who previously didn’t know where to turn \u003cspan style=\"text-decoration: line-through\">to \u003c/span>for psychological help with their patients. Now, Savino Moffit is just down the hall. “Once you say, ‘Hey, I’m here! I do psychiatry.’ And they kind of look at you like, ‘Oh thank goodness! I have a patient and I’m so worried!’”\u003c/p>\n\u003cp>Savino Moffit says she can identify mental health conditions like depression that might be masquerading as physical symptoms and which allows physicians to better serve their patients. It also can save the clinic from ordering costly and unnecessary tests, an important consideration for large medical groups that receive a set amount of money each month to cover all the needs of their patients.\u003c/p>\n\u003cp>Mental health experts say setting up these new business models will take time; that it’s a marathon, not a sprint. Barbara Griswold, sitting in her therapist’s chair at her office in San Jose, says that’s about the right speed. “I tend to think therapists overreact about change. We’re not really good with change, which is funny because we help people with change.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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},
"radiolab": {
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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},
"science-friday": {
"id": "science-friday",
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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