Affordable Care Act: Singing the blues

If you told most business owners who read Historic City News that they had to cut 80% of their customers, they would promptly hang up the “out of business” sign; but, that is exactly what Florida Blue has to do with 300,000 individual policyholders in order to comply with the Affordable Care Act, according to published reports.

Kaiser Health News reports that the new health exchange, an online marketplace through which consumers can purchase subsidized insurance, will offer coverage from Florida Blue and other carriers providing policies with 10 categories of “essential health benefits”. But, because the majority of the Florida Blue individual policies did not include all of the new services, those policies will no longer be available.

“We are going to do our best to migrate those cancelled policyholders to other products that meet all of the ACA requirements, but it takes time to do it correctly and that is something we’re a little short of, right now,” according to Florida Blue spokesman, Mark Wright. Florida Blue is the only insurer to offer plans on the exchange in all 67 of Florida’s counties.

That means high anxiety for policyholders who are getting their “pink slip” from the Blues and other healthcare insurers. That anxiety is compounded by the fact that because of unexpected technical problems, less than 1-in-10 people have been able to complete the enrollment process on the new federal marketplace website, www.HealthCare.gov.

Wall Street Journal is reporting that insurers have found flawed data generated by HealthCare.gov including duplicate enrollments, spouses reported as children, and missing data fields. Monday the president expressed his frustration and promised the website will be fixed. However, when that will occur is open for debate.

At first, it looked like the glitches besetting the federal health exchange were just a byproduct of high demand. Now it’s looking like those problems may be thornier and take longer to fix than first anticipated — and time is running out.

The New York Times reports that the administration’s request to fix problems by November 1 is unrealistic, according to people close to the project. In fact, some specialists working on the project predict it may not operate smoothly until after December 15 — the deadline for people to sign up for coverage beginning January 1.

In a statement from Wright today, he says Florida Blue is proactively communicating with members to help them understand how this transition affects them. “Prior to their 2014 renewal date, each member will receive a letter that instructs them to contact Florida Blue to review their migration options,” Wright said. “These new plans will offer members access to more comprehensive benefits in 2014.”

A person’s individual situation will be the key driver of what they will pay for coverage under the Affordable Care Act. Subsidies will be available in the marketplace to lower the cost of coverage for eligible individuals and the amount an individual will pay could vary significantly once his or her specific age, area in which they live, smoking status, family size, and income are factored in.