Wednesday, September 4, 2013

Top Ten stupid things about the Delaware Insurance "Marketplace"

10.  The Federal government gave Delaware a $4 million grant to get people to sign up for insurance coverage.  We're hiring people to go out and convince people to pay money for premiums.  Ironically, that $4 million could have put another 526 Delaware children on Medicaid, but it won't.

9. In competition with itself, the Federal government gave yet another $550,000 grant to a Maryland-based company to help Delaware citizens "navigate" the insurance marketplace.  So 20% of the money for jobs signing up people in Delaware goes to a Maryland company?

8.  Everybody, from the News Journal to Rita Landgraf (DHSS Secretary) is emphasizing that they want to find everybody "eligible" for these "benefits" and "access."  Nowhere does anybody mention the stick with this particular carrot, that all of these wonderful eligible people will be charged $90/adult and $47.50/child if they don't sign up?  Congratulations, mom.  We're here to help you, but if you don't want our help we'll make sure you are on the list to be fined by the IRS.  Oh, and there is no mention in any of these articles about the exemptions, either.

7.  We are doing all this advance work, and none of the plans that are supposedly going into the marketplace have had their rates approved by the Federal government, and won't until sometime in October [whether this is before or after the marketplace is scheduled to open is not clear], which means that all these marketplace "navigators" will be out selling the uninsured on a product that nobody even knows the price of yet.

6.  The message will be quite confusing:  nearly half of the people they are reaching out to will, according to Landgraf, not be covered by the insurance marketplace policies, but by the state expansion of Medicaid.  Problem is:  they are trying to get people to go to the marketplace and sign up in October (where, hopefully, there will actually be prices with the policies), but the Medicaid expansion doesn't start till January.  So the people visiting the marketplace during October-December who have low incomes are going to be solicited to pay out for plans before they know if they are eligible for free coverage under Medicaid.  Got that?  I hope so.

5.  Uh, the advertising program is not exactly the most efficient way to reach these folks, anyway, which is something nobody appears ready to acknowledge.  All you need to do to find most of them is have the local hospitals and urgent care centers provide the state with a list of the names and addresses of all the people who, within the past 18 months, have shown up for medical treatment and have had no insurance.  Then you use those names and addresses to go find them.  Much simpler than billboards, but hey--who am I to talk?--I didn't get $4.55 million in Federal grants for this.

4.  The Federal government has decided that poor families can afford to spend 8% of their income on health insurance.  Or, for a family of four with an income of $50k, the Feds have decided that it is legal for the insurance companies to sock them for up to $4,000 in premiums per year.  Yep, I know plenty of struggling working poor people who can afford that.

3.  There is not really an insurance marketplace.  The only options that people visiting this website will have for health insurance are Highmark, Conventry, and ... Coventry.  Somehow when I visualize a marketplace I think about, you know, actual options and not the same corporate giants who have been rigging the system for decades to gouge consumers and government alike.  So much for the competitive power of free markets.

2.  The program is going to leave at least 25,000 Delaware citizens with no insurance after all that.  Landgraf estimates that she'll get 35,000 new suckers victims customers for Highmark and Conventry, and that 30,000 more will be signed up for Medicaid.  In other words, the State is admitting at the outset that it will fail to find and sign up nearly one-third of its target population.  So much for the power of advertising and "navigators."  Which leads me to ...

1.  Once more Insurance Commissioner Karen Weldin Stewart proves that not only can't she do her job, but she can't even give good quote:
“Our job is to enroll Delawareans that need health insurance, realizing that we won’t get all of them into it,” said Karen Weldin Stewart, commissioner of the Delaware Department of Insurance.
That's my job, says Karen, and I know before I start that I can't get it done, but you should keep voting for me forever because Highmark and Conventry really like me, and--after all--isn't that what matters?


delacrat said...

"Somehow when I visualize a marketplace I think about, you know, actual options and not the same corporate giants who have been rigging the system ...

"So much for the competitive power of free markets."


This supporter of Medicare-For-All thanks you.


Patt P. said...

Awesome – and thanks a lot! one night