Friday, November 1, 2013

Bumps in the Road? It can happen…


So I took last week off to be with my family, get away for some rest and relaxation and refill the tank a bit.  It seemed to help, and I think that perhaps my time away gave me a perspective that I was starting to lose with regard to what is happening in health insurance these days.  Therefore, I am going to try to bring some perspective to what we have heard in the news and on talk radio for hours on end. The Health Care Exchanges have gotten off to a rough start…
Let me say that those of us who actually make a living selling health insurance have seen this coming since the inception of this law.  Good, bad or indifferent, the regulatory decisions that have been made for the past two years have made this inevitable.  I am not saying that I told you so, but…many have in fact told anyone who would listen that this was going to happen.  Now that I have that off my chest, let’s move on. 
I, like many of you who read this blog, live in Kentucky.  We have Kynect as our state health insurance exchange.  It has performed rather well I must admit.  Our governor was even on national news exclaiming what a bang up job our state has done with its exchange.  Well done Governor, we do have a model that is workable, but what have we gained?  Reports that I have been reading have indicated that nearly 85% of the enrolled individuals through Kynect have gone to Medicaid.  My guess, and this is just a guess, is that the other 15% of those enrolling were previously enrolled in Kentucky Access (high risk pool) because their coverage will be terminating on January 1, 2014.  They have no other choice but to enroll in this plan.  But keep in mind, these people were already doing the right thing by being covered in the first place!!! 
My point is that nearly 100% of the enrollment in Kynect is comprised of people who qualified for Medicaid (and we should have been caring for all along) or people who could afford insurance in the high risk pool, and made health insurance a priority by actually purchasing a policy.  No where in this scenario do we find a mid income person who was previously uninsured suddenly finding that the premiums in the Kynect exchange have compelled them to purchase a policy.  Thus, those folks who make too much to have Medicaid assistance, but too little to feel compelled to spend discretionary dollars on insurance will remain uninsured.  I think that this will be the case across the nation. 
The federal exchange web site may be unreliable, but people’s behavior is predictable.  If something takes too long, costs too much, looks too cumbersome, feels too clunky, they just aren’t going to buy it.   While I do think that reform may have been needed for “health care” in general, I still feel that trying to fix one leg of a wobbly three legged stool still leaves you with a wobbly stool.  If our leaders don’t understand that premiums increase because the cost of the underlying services increase annually, your premise is flawed from the beginning.
So we are left with many unintended consequences that will be contrary to the intent of the act.  Blame will be flung far and wide.  Congress will have hearings, the spin will be incredible, the truth indistinguishable, the outrage indescribable and yet the costs will continue to rise, still uncontrollable.
Peace

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