NV Obamacare Insurance Exchange Reduces Target 60%

[tskeeter]

Yesterday Nevada, a state reported as having among the highest level of residents without medical insurance, reduce the 3/31/14 enrollment targets for it's state insurance exchange by nearly 60%.  From 118,000 enrollments to 50,000 enrollments.  While , at the same time, reporting 20,000 enrollments during the first four months of operation.  (The program to date enrollments have been running about 167 per day.  To meet the new target, enrollments would have to increase to 714 per day.  Making even the reduced target look quite ambitious.)  (Personal note:  The NV exchange didn't experience the problems that the national exchange had.  The second week of operation, I was able to log on and quickly get information I wanted.  No wait time, no mysterious error messages.  An "as expected" experience.)

So what gives?  Why is enrollment so low?

Were reports of lack of access to medical care grossly overstated?  Did we put in place laws that will spend millions and millions of dollars to solve a problem that doesn't exist?  Or, at the minimum, exists on a fraction of the scale that we were told?

Do many of the people who were reported as lacking insurance lack insurance by choice?  Have we forced a solution on people who don't believe they have a problem? 

Are people who want insurance finding that the government mandated insurance is just too expensive, so are choosing to continue without insurance?

[Rocky Mtn Saver]

It's been a combination of things, as I understand.  Signing up the young,healthy people has always been expected to be a hard sell.  And it's turned out to be so.  Lack of good, coordinated consumer education has been, in my opinion, perhaps the biggest problem in luring people to the new offerings.  (I've talked to numerous people in conversation - many in the target groups - and they have no clue what 'Obamacare' is about or how to figure it out.)  Of course, the website issues have been common knowledge.  I'm guessing even in places where the website hasn't been so bad, people are expecting problems and are avoiding it. 

I'm sure there have been other obstacles, but those are the ones I know are kerfluffing the new effort. 

[Deleted]

Feb 13, 2014 11:44:26 GMT -5 Rocky Mtn Saver said:

It's been a combination of things, as I understand.  Signing up the young,healthy people has always been expected to be a hard sell.  And it's turned out to be so.  Lack of good, coordinated consumer education has been, in my opinion, perhaps the biggest problem in luring people to the new offerings.  (I've talked to numerous people in conversation - many in the target groups - and they have no clue what 'Obamacare' is about or how to figure it out.)  Of course, the website issues have been common knowledge.  I'm guessing even in places where the website hasn't been so bad, people are expecting problems and are avoiding it. 

I'm sure there have been other obstacles, but those are the ones I know are kerfluffing the new effort. 

I also know a ton of young people (22-25) that are switching back on to their parent's insurance.

[Rocky Mtn Saver]

Well, that's good!  (for them, if not for the ACA's exchanges) 

[dancinmama]

I really don't believe that the legislators that wrote the law are all that bright.  On the one hand, you need A LOT of young and healthy people to sign up to make it fly; on the other hand, it mandates that those same people that you NEED to sign up be allowed to stay on their parents' policy until they are 26.  It doesn't take a rocket scientist to figure out that those two things are in direct conflict with one another.

It's becoming apparent that young and healthy people are NOT interested in paying premiums for a service that they are the least likely to need in order to pay for older, sicker people.  And I don't think that most of them can afford the premiums unless they qualify for subsidies and in that case they're not PAYING for the older and sicker people, are they?

It's also become painfully obvious that we were lied about how the law was going to effect those who already had insurance.  Why?  Because if people had known that they would lose their insurance as a result of the law, it would never have passed in the first place.  So it's become a credibility issue with the American people - even those who voted for the President and thought the concept of the law was a good idea.

And can anyone follow all the illegal changes that have been made to the law because it wasn't and isn't going to work as passed?  This whole thing is one big and VERY EXPENSIVE cluster f@*^#!!

[Rocky Mtn Saver]

On the upside, I think they mentioned that they've seen an uptick in young people signing up recently.  Still not as many as they'd like, but perhaps a shift?

www.nytimes.com/2014/02/13/us/3-3-million-enrolled-in-health-care-marketplaces-more-young-people-signing-up.html?_r=0

[souldoubt]

When politicians trying to sell Obamacare to the public tell us we need to pass it to see what's in it there's something wrong.  I think like most things politicians try to accomplish this will fall back most on the middle class as others have mentioned on here.  Those who make a certain amount won't qualify for much of a break yet they're forced to pay for insurance or the penalty and most people don't have extra cash sitting around.  My gf signed up through covered CA and is in the process and it's been a joke.  I know someone else who has spent hours on the phone sometimes getting transferred to a call center in another part of the world because his insurance cards were supposed to be sent out weeks ago yet he still hasn't received them.  Calling it a clustherf*ck is an understatement considering how many changes they've made and setbacks they've had.    

[dancinmama]

And that's the problem in a nutshell.  The AFFORDABLE Care Act is NOT affordable for the government and the majority of American people and, now, everyone knows it.  The question is, how long will we be made to suffer through this and how many more BILLIONS of dollars will be added to the national debt as a result of it before the politicians that passed this piece of crap agree to come to the table and work on legislation that will actually work with input from both sides of the aisle.

[Nazgul Girl]

The website is very tricky, and I don't know of anyone in my DD's age group, or younger, who has managed to navigate it.   I'm supposed to help one of her friends who has some cognitive issues sign up, if the friend ever calls me.   Hopefully, she will.  

[Ava]

It's not affordable, and it's not the solution to our healthcare problem.
I went on my state's website to see how it worked. I have insurance through my job, but I wanted to see what was out there.
My state's website has been up and running correctly from day 1.
For me, a non-smoking 41 year-old female, the monthly premium was $300 a month (after a $56 subsidy) for a silver plan.
Then you have deductibles and out of pocket expenses. My income in October was 38K a year.
It's too expensive, I think.

The ACA has some excellent changes to what we had before; you cannot be denied health insurance, and insurance companies cannot put lifetime or yearly limits to your coverage. The law also tries to focus more on prevention. Those are excellent points.

On the other hand, the real issue here is that healthcare in the U.S. is a for-profit enterprise.
Until we come up with a plan to cap costs and cover EVERYBODY, we won't have a solution to our healthcare crisis.
Healthcare is a right, not a privilege.

[Deleted]

Feb 13, 2014 15:08:24 GMT -5 Nazgul Girl said:

The website is very tricky, and I don't know of anyone in my DD's age group, or younger, who has managed to navigate it.   I'm supposed to help one of her friends who has some cognitive issues sign up, if the friend ever calls me.   Hopefully, she will.  

I did covered Ca with no problem for my mom and looked at the overall US site for myself, I am 29, I don't know what age your DD is but most young people are very computer savvy.  The numbers were about what the combined self & employer paid. 

[Rocky Mtn Saver]

Feb 13, 2014 15:08:33 GMT -5 Ava said:

It's not affordable, and it's not the solution to our healthcare problem.
I went on my state's website to see how it worked. I have insurance through my job, but I wanted to see what was out there.
My state's website has been up and running correctly from day 1.
For me, a non-smoking 41 year-old female, the monthly premium was $300 a month (after a $56 subsidy) for a silver plan.
Then you have deductibles and out of pocket expenses. My income in October was 38K a year.
It's too expensive, I think.

The ACA has some excellent changes to what we had before; you cannot be denied health insurance, and insurance companies cannot put lifetime or yearly limits to your coverage. The law also tries to focus more on prevention. Those are excellent points.

On the other hand, the real issue here is that healthcare in the U.S. is a for-profit enterprise.
Until we come up with a plan to cap costs and cover EVERYBODY, we won't have a solution to our healthcare crisis.
Healthcare is a right, not a privilege.

LOL, but it's a right none of us wants to pay for! 

One problem is that we really don't know how to properly value health care in our experience.  It might be that $300 is indeed too expensive or it might be that it's actually cheap - we don't as a group have any way to really judge.  Many of us have either been (a) receiving subsidies from our employer who pays a goodly portion of our premiums or (b) not been paying anything.  So, yes, asking a person to begin paying $300 premium when they've been paying $0 premium or their employer has been paying much of it is always going to seem ridiculously expensive.  We've as a community been accidentally burying the true costs of our healthcare and coverage for a long time and now we have no real sense of what we should or should not be contributing toward it. 

[tskeeter]

Feb 13, 2014 15:08:33 GMT -5 Ava said:

It's not affordable, and it's not the solution to our healthcare problem.
I went on my state's website to see how it worked. I have insurance through my job, but I wanted to see what was out there.
My state's website has been up and running correctly from day 1.
For me, a non-smoking 41 year-old female, the monthly premium was $300 a month (after a $56 subsidy) for a silver plan.
Then you have deductibles and out of pocket expenses. My income in October was 38K a year.
It's too expensive, I think.

The ACA has some excellent changes to what we had before; you cannot be denied health insurance, and insurance companies cannot put lifetime or yearly limits to your coverage. The law also tries to focus more on prevention. Those are excellent points.

On the other hand, the real issue here is that healthcare in the U.S. is a for-profit enterprise.
Until we come up with a plan to cap costs and cover EVERYBODY, we won't have a solution to our healthcare crisis.
Healthcare is a right, not a privilege.

While you make some very valid points, Ava.  There are a few issues with nationalized heathcare that cause me concern.  The first is the cost.  We have several examples where unlimited, no additional cost to the patient, healthcare has dramatically increased the consumption of services.  The most recent example of this is the experience reported by Oregon.  I don't think we, as a country, can afford to fund unlimited consumption of medical services.  My second concern is the potential impact of illegal immigration on the consumption of taxpayer funded medical care.  There has been discussion in federal government circles about providing medical care to everyone who is in the US, legally or illegally.  Can you imagine what would happen if non-citizens were gauranteed unlimited, no cost medical care to everyone who could find a way to get across our borders and into the US?  Every potential immigrant with a serious medical problem would be trying their hardest to get into the US any way they can because they could get free, unlimited medical care here.  Sounds like a really quick way to backrupt the country, to me.  My third concern is that, in response to the skyrocketing cost of a national medical care system, medical care will be rationed.  I have seen the British model of national health care in action, and in my opinion, it's a big, big step down from what most people in the US get today.  Hospitals look like US hospitals in the 40's and 50's, with large wards of patients, no private/semi private rooms, and a single bank of pay phones to serve an entire hospital of patients.  Eldery people who need care for conditions that are not immediately life threatening, such as cataract caused blindness or joint replacement, are put on a several year long waiting list and often die before they get the treatment they need, seriously compromising their quality of life during the last 5 - 10 years of their lives.

Today, our healthcare system gaurantees treatment for any immediately life threatening conditions in emergency rooms across the country.  But, I'm not convinced that what I have seen of nationalized heathcare is an improvement for all but a very small portion of the population.   

[alabamagal]

I think the enrollment numbers will go down even further when the people who signed up have to start PAYING their premiums.

[buystoys]

We had to pay our premiums before the insurance became effective.

I was against the legislation, but it passed, so I am taking advantage of it.  We are paying less for medical coverage that is comparable to the COBRA/open enrollment plan(s) we had reviewed prior to making the final decision to retire.  The web site wasn't user friendly, but it can be navigated.  I think a lot of people using the national site (I can't speak for the individual state sites) are not savvy enough to understand that not all plans are equal and you still have to crunch some numbers to determine what is best for your own situation.  When you know you have a pre-existing condition, you want to look at the overall deductibles in addition to the monthly premiums and I think a lot of people either don't think about that or just forget about it....

[Deleted]

ACA puts me in the same shitty place.  I either have income low enough for Medicaid coverage or my income will still qualify but I will not due to other factors they consider. When this happens I am not eligible for a subsidy because my income is too low....

[buystoys]

Shasta, my heart goes out to you!    We are fortunate enough that I can manipulate our income via Roth rollovers to keep us at the low end of the subsidized rate.  I realize not everyone is in our position or can afford the actions we are taking.  If I had to use our actual planned earned income for this year, we would be at the Medicaid level, which changes the game considerably.

[Deleted]

They raised my taxes to fund this shit, I hope it helps enough people to make it worth it.