Why the new Obamacare enrollment numbers mean absolutely nothing

There’s a big conference call taking place as I write, with HHS Secretary Sebelius, over the announcement of the official Obamacare enrollment numbers.  And I’m sorry to say, the numbers don’t mean much, good or bad.

The official figures show around 106,000 people have enrolled for new insurance through the federal and state marketplaces.  But only about 27,000 did so via the federal exchange.

Now, first, I have a hard time with how HHS is talking about the data. They say that 1.5m people “applied for coverage.” No they didn’t. 1.5m attempted to browse the plans. They didn’t apply for anything. But HHS keeps calling this “applying for coverage.” It isn’t, and they need to stop saying it because it’s wrong and it’s going to come back and haunt them, just as “you can keep your plan” haunts them today.

This has been a pet peeve of mine since the exchanges were launched. With the DC exchange, which covers me, in order to browse plans all you had to do was come up with a username and a password, then give them your zip and your age. That’s it. The federal exchange, which covers my sister in Illinois, is a disaster. Forget the glitches that stopped people from accessing the site. I’m talking about the rather high hurdles you have to go through in order to just browse plans on the federal exchange. I was online entering the info for my sister, and it was pretty horrific. But what was worse was at the end of the process of simply applying for permission to browse the plans, they required me to sign a legal affidavit swearing the information was true. While the info was true, it was creepy as hell signing a legal document, holding me liable, for simply wanting to browse the plans.

hhs-obamacare-studyBut it got worse. It’s been a week and a half and my sister still hasn’t browsed plans because the site won’t let her. She got “approved” to browse, but they simply won’t let her. When we called the 800 number, we were told that “Homeland Security” had to check her application first. Really? Homeland Security didn’t have to check me out in order to browse the DC exchange. Why do they have to check my sister out on the federal exchange?

But putting that aside for a moment, here’s my concern about the “only 27,000” people actually enrolling in plans. I don’t think that figure says anything about the desirability of the program. It speaks volumes, however, about how hard it is to even browse the plans in the first place.

And even putting aside the legal affidavit, which is sure to scare some people off, or the arduous form you have to fill out to even browse plans, or the several day wait to get permission to browse AFTER you “apply,” there’s another rather obvious thing that’s going to stop people from even browsing. The entire federal site keeps calling the browsing process “applying” – and HHS Secretary Sebelius herself on a conference call with reporters today talked about people “applying” for coverage when they were simply trying to “browse” plans. I wonder how many people simply got scared off because they didn’t want to “apply” for coverage at all, they wanted to browse. I honestly worried, a lot, that I was “applying” for coverage for my sister and locking her into something before we even got to browse the plans. If I thought that, and she thought that, then others thought that too.

This is not to knock Obamacare. I have high hopes for the program, and it’s why I keep trying to get my sister to go through the federal exchange, because I’m hoping she’ll be pleasantly surprised.

I’m still not convinced that the people “fixing” the federal web site even understand what the problem is. On the media conference call with Sebelius this afternoon, one reporter said he still is having problems creating an account. They told him that he’s likely an exception, that the overwhelming number of people have had their applications approved. Yeah? My sister’s application was approved too, and she still can’t browse plans. If they think the simple fact that applications are “approved” is proof that the system is working, they’re sorely wrong.

There are some very serious problems with the way the federal exchange is set up, and it’s not just bad code, it’s bad design and bad decisions by the policy people. To reiterate, here’s what the federal site has to do, at a minimum, in order to fix the problems.

1. Stop calling it “applying,” and stop calling the forms they’re filling out “applications,” when people simply want to browse plans – you’re scaring them off.

2. Emulate the Washington, DC exchange and only require that people pick a username, a password, then enter their birthday and zip code before you let them browse plans. That’s it. And honestly they don’t even need a username and password. All you should need is their birthday and zip, unless they want subsidy info.

3. Browsing plans doesn’t mean showing people the name of the plan and the price for a 27 year old (which is what the federal exchange “browse plans” button does), it means showing them the details of the plans and how much it costs for someone their age.

4. No one’s account info needs to be checked by Homeland Security or anybody else. Give people immediate access to browse the plans.  Blue Cross Blue Shield let my sister browse the Illinois plans by simply entering her birthday and zip code on their Web site, why does her federal “application” have to go Homeland Security when BCBS doesn’t require those hurdles to simply browse the same plans?

5. Drop the affidavit, at least until people “pick” the plans they want. You don’t need to sign an affidavit in order to browse, that’s creepy, and you’re scaring people off.

Only then, when all of these things are fixed, will we have a true sense of whether Obamacare is a success or not.


(I’m told that in order to actually see my Facebook posts in your feed, you need to “follow” me – so say the experts.)

Here’s the document on the enrollment numbers that HHS released today:

Mid-Nov-Enrollment-ReportEMBARGOED-UNTIL-330PMNOV-13-2013-final.pdf


CyberDisobedience on Substack | @aravosis | Facebook | Instagram | LinkedIn. John Aravosis is the Executive Editor of AMERICAblog, which he founded in 2004. He has a joint law degree (JD) and masters in Foreign Service from Georgetown; and has worked in the US Senate, World Bank, Children's Defense Fund, the United Nations Development Programme, and as a stringer for the Economist. He is a frequent TV pundit, having appeared on the O'Reilly Factor, Hardball, World News Tonight, Nightline, AM Joy & Reliable Sources, among others. John lives in Washington, DC. .

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58 Responses to “Why the new Obamacare enrollment numbers mean absolutely nothing”

  1. Mark_in_MN says:

    A better health care reform law would make balance billing illegal in any case. Perhaps a better approach would be to set prices for procedures and types of care which providers must accept and insurance (be it public or private) must pay, in addition to moving standard office care to an annual capitation rather than a fee-for-service basis.

  2. Mark_in_MN says:

    The Congressmen are probably thinking of the majority of the US population, that has a set wage and changes irregularly or annually, and considered that the change in income would come from someone changing their jobs. That’s not living in the 1950s, that’s the world today for most people in our country. They did perhaps fail to really think through what that might mean for self-employed people with small business operations.

    Never-the-less, I can’t help but think that you and others are putting too fine a point on the income change thing, and go with normalcy for you business and regard the unexpected windfall or the bad month as an anomaly rather than something that might need to be reported each month.

  3. neroden says:

    That’s correct.

    If you get a plan with out-of-network coverage, the insurer only covers what *the insurer* thinks is reasonable…. and the rest of the astronomical, inflated bill you get from the out-of-network hospital is your problem (to pay, or negotiate, or fight in court, as the case may be). This is called “balance billing”.

    With in-network coverage, the in-network hospital is not allowed to charge you more than the insurance company’s allowed amount — the rest of the astronomical, inflated bill is purely fictitious.

    I’m not at all sure that out-of-network coverage is worth anything due to the inflated prices invented by the hospital cartels.

    The practice of doctors & hospitals charging fictitious, inflated prices ought to be banned outright, and I strongly suspect it constitutes fraud under common law, and a violation of the “reasonable and customary” regulations under state health insurance law.

    But nobody’s even tried to stamp it out yet.

  4. neroden says:

    Gah. Let me explain this again. What happens is that you GUESS your income at the beginning of the year. If your GUESS changes during the year, you’re supposed to report it.

    I often get windfall income unexpectedly. (Lucky me.) A more nasty scenario is someone losing their ability to work due to an illness.

    Anyway, I think the idiot Congressmen who wrote the law simply failed to comprehend the possibility of someone with an unpredictable and fluctuating income. The Congressmen are living in the 1950s.

  5. Duke Woolworth says:

    Enrollment won’t pick up until a deadline. Any student of human nature, and anybody who has studied the MA experience knows that. Continually moving the deadline guarantees failure.

  6. Yes, it was the in-network thing that I didn’t fully understand. So if I shift from a PPO to a POS, it’s still kinda sorta like an HMO because I’m basically stuck in the DC area, and with the doctors in their plan, for any and all of my medical expenses, lest I get stuck with the non-allowed amt from an out of netwk doctor.

  7. Will check, thx

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  9. trinu says:

    The proposal wasn’t even to go nuclear … it was to require filibusterers to actually filibuster. IE they would have to talk forever and not just vote no on cloture motions.

  10. Jhary says:

    Enrollment only means an end user created a user account. It does NOT mean they purchased an insurance policy…and they won’t tell you how many purchases were actually made, as very few people can afford even the cheapest policies available from O’Dramcare.

  11. basenjilover says:

    Singling out Sebelius is a good start. Then work way up to Pelosi, Feinstein and Obama. The truth is ACA is a bloody mess. Democrats seem to have penchant to blow away opportunities at every turn. While we’re at it, fix the damn fililbuster procedure as Reid promised. In other words, go nuclear and damn the Republicans and TeaPartiers.

  12. Whitewitch says:

    I think that is a huge point that should be made…Health Insurance is confusing and often you don’t know what you really have until you use it and find out the details. I have been in Insurance hell more than once over the years…thinking something was covered that was not…etc. etc. Single payor would solve all the ills (and hells).

  13. Whitewitch says:

    She clearly is not computer literate in the least…seems as if she should not have been placed in a position of power that required an understanding of computers.

  14. Whitewitch says:

    You don’t actually think the President listens to us do you John? Sadly, he is insulated and only listens to his peeps and most of them seem a bit simple – they can’t talk computer and should have gotten themselves a Computer Weenie to translate for them.

    Your ideas are great – I wish the President would listen to you…and had listened to us when we asked for single payor. Good article…great thoughts.

  15. ezpz says:

    The inability to browse plans on the federal site seems more a (political) feature than a bug…

    Jake Tapper:

    Obamacare ‘War Room’ docs: We’re concerned next media story is some consumers getting on website and finding fewer options, higher prices

    Washington (CNN) – Officials expressed concern that the next shoe to drop in the evolving story about the Affordable Care Act would be disappointment from consumers once they are able to get on the troubled HealthCare.gov website – disappointment because of sticker shock and limited choice, according to a new document obtained by CNN….

    http://thelead.blogs.cnn.com/2013/11/04/obamacare-war-room-docs-fewer-options-higher-prices/?hpt=hp_t2

  16. GarySFBCN says:

    Have each State copy and adapt the California website. It works well. And you don’t have to provide all your data to browse prices, plans, etc.

  17. SkippyFlipjack says:

    I might say that it sounds like the failure of the free market/government combo legislation that congress ended up popping out. Insurance companies don’t want you to comparison-shop — they want to be like mattress manufacturers, offering a variety of options that aren’t exactly comparable to what others offer, each with unique features (thrice-coiled reverse spring technology! full coverage for simple fractures but not compound ones!) to keep you confused. And in the end, they can just tell you that they’re not covering whatever illness you end up having. I’m looking forward to seeing if the ACA is able to simplify any of this. So far.. doesn’t seem like it.

  18. perljammer says:

    Great. Errors aren’t your fault. How does that help you get your insurance?

  19. SkippyFlipjack says:

    If the model didn’t work, insurance brokers wouldn’t be in business. An informed person — there’s the rub, of course — who can listen to your preferences and suggest a couple of matching plans can be a better experience than wading through reams of columnar data on a website. They’d still have to mail you stuff to sign so you’d be able to read the fine print. Personally I’d rather enroll on a website but the phone option isn’t necessarily bad.

  20. BeccaM says:

    ‘The self-employed’ are among one of the biggest pools of people who couldn’t get insurance before, either due to expense or pre-existing condition exclusions.

  21. BeccaM says:

    Mine changes constantly because I’m a self-employed consultant.

    I haven’t had a steady predictable income since the mid 1990s.

  22. BeccaM says:

    Maybe because according to the law we originally had 2 1/2 months to sign up, but now we’re down to just four weeks — with Thanksgiving holiday in the middle of that — and the process is still very nearly as FUBAR’d as it was on October 1st?

    As I mentioned in a comment above, I think maybe I completed enrollment as of last Wednesday. At least that’s what it says on Healthcare.gov. But I have no confirmation. No contact from my purported insurance provider. No clear instructions on what I’m supposed to do next to make this ‘initial enrollment’ insurance a reality.

  23. BeccaM says:

    You have all my sympathy and more. Apparently the rates aren’t so bad for folks in some states and locales, but for others, the premiums are quite literally out of reach.

  24. cold340t says:

    Stop conflating system problems with a single person. Did she write the program? No, fire the teabaggers that did.

  25. rhallnj says:

    They say the federal site can now handle 20-30k at a time, and if we assume 2 hrs per applicant, that’s over 125,o00 per day, 1 million per week, 4 million per month. Close to good enough.

  26. BeccaM says:

    One more thing: They also need to be way the hell clearer about what you’re supposed to do when you’re ‘enrolled.’

    Last week, I actually completed the application process (using a new email address and starting over from scratch), as far as Healthcare.gov was concerned. Well, almost. My ‘eligibility to enroll’ was approved. I browsed the plans available to me. I picked one. I completed the sign-up and it says “Initial enrollment complete.”

    But the very last thing that came up was a window saying I had to pay for my coverage for it to go into effect. Okay, I clicked the Pay Now button… and nothing happened. After that, what it says is the next step is for me to ‘contact my provider’ for details about my plan. Isn’t that rather backwards? I’ve applied. Shouldn’t the provider contact me with details and a bill to pay?

    So I did call the provider earlier today… and so far it’s the voicemail waiting game.

    I honestly don’t know what I’m supposed to do now or what happens next. You’d think they’d have sent some kind of email confirmation and instructions.

  27. fastneataverage says:

    I found this article at Daily Kos to be very enlightening. Jon, it may
    be that your sister needs to start over with a new email address, as it
    seems she is one of those that were stuck in la la land and can’t get
    out.
    http://www.dailykos.com/story/2013/11/12/1254621/-Meet-the-DeBuggers-An-attitude-adjustment-regarding-the-Fix-at-Healthcare-gov#

  28. Mark_in_MN says:

    I think that seasonal or occasional dips in revenue is not what they mean by changes in income.

  29. Nathanael says:

    We’re talking about fluctuations in SMALL numbers here. The different variants of the silver plans are for people from 100% – 400% of the federal poverty line (with one variant being for people doing better than that.)

    For people whose income dips that low sometimes, do you think the extra administrative overhead is going to seem like a good idea?

  30. Nathanael says:

    Ah. But over the phone you do NOT sign any affadavits. You know, I’m kind of relying on that. Any errors in the entry are not my fault, I said it correctly on the phone…

  31. Nathanael says:

    I had my local BCBS affiliate escalate to a supervisor, who then had to research and call me back a week later.

    Twice.

    The low-level people at the insurance company don’t know the answers to the subtle questions and so it’s been hard to get any information at all.

    This was after calling NY State of Health (the NY exchange) and discovering that the answer to nearly all my questions was “That depends on the plan. Call the insurance company directly”. At least they were able to give me the phone numbers for… two of the three insurance companies which supposedly offered plans in my county. The other company I never managed to reach on the phone so to hell with them.

    One of the promises of the “health care marketplace” was a “one stop shop” for health insurance.

    TOTAL FAILURE

  32. basenjilover says:

    Sebelius has been totally incompetent and needs to be shown the door. Why did Obama even appointed her as head of HHS? Was she a crony of his?

  33. Mark_in_MN says:

    Or you could form an LLC. That’s not at all unreasonable, and probably is a generally good idea.

  34. perljammer says:

    There’s the small detail that once the nice person at healthcare.gov takes your information over the phone, they still have to use the same damn website that didn’t work for you, to get the information into the system. All the phone call does is place an extra layer of potential errors and misunderstandings into the process, as well as giving the customer a possibly misplaced sense that all is well.

    As to whether total enrollments is the most important number — that depends on what it means to enroll. I don’t know what it means, do you? For it to be really meaningful, it seems like an enrollment should mean that someone has picked out a plan and made a submission that means, “This is what I want — sign me up and send me a bill.” But for all I know, it means “I’ve put a plan in my shopping cart; maybe I’ll buy it and maybe I won’t.” If you’ve seen a definition of the term, please do me favor and point it out.

  35. Mark_in_MN says:

    Sure, you have some months where your receipts are higher and some where they are lower, but that averages out to something unless you see very big shifts in traffic or how ads pay out. If someone is paid a regular paycheck every other week, there are two months where there are three pay periods, but that doesn’t change their income, just the distribution of it.

  36. Nathanael says:

    So, if your income varies from year to year, you predict your income for the upcoming year and tell the government. If you pick a silver plan, they put you in one of four “variants” of the silver plan, based on your income. (The variants for people with lower incomes are theoretically better, with lower deductibles etc.)

    If, partway through the year, you realize that you are *wrong* and your income is going to be different, you are supposed to contact the government to let them know. If you do this (which seems like a bad idea), then the government will determine that you belong in a different variant of the silver plan. Suppose you get switched from one variant to another in June. *Your deductible starts over from scratch* and the money you paid out of pocket before June doesn’t count towards the new deductible (or towards the new out of pocket limit).

    That’s gotcha #2.

    A friend of mine, upon hearing this, told me the nastiest scenario of all: suppose that you get a severe health crisis which lands you in the hospital and causes you to stop being able to work as much. Your income goes way down for the year. You report this to the government, and they put you in a “better” variant of the silver plan… and then, gotcha, your deductible starts all over again, midyear. The new plan’s “better”, but starting it halfway through the year *isn’t* because you still have to meet a full year’s deductible.

    —-
    Gotcha #1 is this. On SOME plans, you have a “individual deductible” (of, say, $1000) and a “family deductible” (twice that on all the NY plans I looked at, or $2000). So if ONE person gets sick and the other family members never goes to the doctor, your deductible is simply $1000. If everyone in family gets sick, your deductible is $2000.

    On SOME plans, the family plan has NO individual deductible. So if one person gets sick, the deductible is simply $2000, even if the other family members never go to the doctor.

    It’s very hard to tell the “better” type from the “worse” type by reading the “statement of benefits and coverage”, which all say “This describes individual / family plans” and then say “Individual deductible $1000, Family deductible $2000”. On the WORSE type, what that means is if you buy an individual plan the deductible is $1000 and if you buy a family plan the deductible is $2000. On the BETTER type, it means that if you buy a family plan, you have an individual limit of $1000 AND a family limit of $2000.

    You can’t tell the two types apart easily from any online information. Apparently the secret is the multi-letter acronym code in the top right corner of the Statement of Benefits and Coverage (HDHP, PPO, HMO, POS, etc.) Some code letters are “good type”, some are “bad type”. Real opaque.

    —-

    Regarding the out-of-pocket max: I think I have that figured out, and for plans offered on the “exchange”, the out-of-pocket max is almost as good as I thought it was. It does NOT count the premium, and it does NOT count out-of-network payments, but it DOES count everything you have to pay to “in-network” doctors, hospitals, and pharmacists. If you found out something different, let me know….

    So my spreadsheet has been describing the worst-case scenario as “out of pocket max plus premium”. Which works except for gotcha #2 regarding the silver plans.

    “I’m not entirely sure I understand it. Which is another problem. There
    shouldn’t have been a very long list of FAQs that they produced and had
    ready on Day One,”
    I seriously wish that they had a system which did not need this many FAQs; but I think with insurance companies scheming to find and exploit every possible loophole, the only way to have such a system is Single Payer.

  37. ex_brit says:

    This “roll-out” is going to make the ultimate Harvard Business School case! Something for everyone.

    As bad as the website problems and the Fed exchange numbers are so far, I think there’s a bigger issue with the low state exchange numbers. The forecasts were simply too high, and likely did not take into effect the following:
    – only early adopters buy on the spot. For most potential customers there is a gap between gleaning product information and making a purchase decision, especially on a service item that will be a large chunk of a family’s income. The demand is there and it will materialize, but the slope of the curve should have been much more conservative at the outset

    – forecasts should have been revised downwards in the weeks leading to the opening of the exchanges to reflect the MSM’s obsession with the Republicans’ attempts to block the law. This most certainly will have suppressed demand
    – forecasts should have been revised downwards to reflect that at the time of the launch, up to 80% of uninsureds still had not heard about the exchanges
    – forecasts should have been revised downwards to reflect the complete absence of the MSM in promoting and explaining the metal categories of coverage prior to launch

    – forecasts should continue to be lowered to reflect the reduced consumer confidence in the plans that is now being created by the Democrats’ circular firing squads

    I predict that demand will return and grow over time and will ultimately reach the original estimates. But until the entire program matures and settles down, this isn’t simply a problem of the customer’s experience on the websites. It is much more fundamental It needs the best professional management consulting firm in the country to take it out of the hands from the beaurocrats who, while well-meaning, are complete amateurs. To paraphrase Andy Grove, “the best predictor of success is past experience.” DHS had zero experience with a project this complex and the outcome to anyone with half a business brain should have been obvious.

  38. perljammer says:

    It is hard to imagine how this adminstration could have done a worse job of marketing this program. They have the terminology so screwed up it’s hard to tell what they’re talking about. Given the amount of trouble they have in clearly describing what’s going on, it’s no wonder that the actual website implementation is so bad.

    “Apply”? Shouldn’t that be “Create Account”? And that shouldn’t be required until you’re ready to say, “This is the plan I want to buy”. And while we’re on the subject of Applying, consider this: how many stories have we heard from people who have had to create multiple accounts before being successful at creating one they could actually use to log in and browse? Are all of those being counted as separate “Applications”?

    “Enroll”? WTF does that mean? I think it probably means, “Put a plan in your shopping cart”. I wonder what they call it when someone actually commits to purchasing a policy? Of course, my cynical side tells me that probably isn’t much of a problem at this point in time. Given the tendency of human beings to procrastinate, there will probably be a last-minute rush of Biblical proportions. God help the support staff come March, 2014.

  39. Fireblazes says:

    But at least BCBS can show you in writing on their website, what there plans are. The government can’t. Failing at what is basically 1990s technology.

  40. Nathanael says:

    Asking every self-employed person to incorporate is completely unreasonable.

  41. Fireblazes says:

    And then you go through all that BS and nothing shows up on the available plans page. Apply, request, submit or beg, it doesn’t matter if at the end of the process there are no plans to “buy”.

  42. I think it would be impossible by phone, but having said that, I still had to have several convos with BCBS to understand the plan I’m considering, and I still don’t fully understand it.

  43. That’s interesting, not sure if that’s in the report, it should be.

  44. I’m not entirely sure I understand it. Which is another problem. There shouldn’t have been a very long list of FAQs that they produced and had ready on Day One, including “what does the open period actually mean,” “what do you do if you make so little money that you should go on medicaid instead, where do you actually go,” if your kid is 22, but lives at home, does he go on your plan or his own plan (since kids up to 26 can go on the parents’ plan, or doesn’t that work here?)” I have lots of other questions too. Including how the out of pocket max work, which I think I just figured out, and which isn’t nearly as good as it sounds (and that’s not an obamacare problem, that’s an insurance problem that still isn’t explained well at all)

  45. Fireblazes says:

    So would you like the nice person at health.gov to describe the varying options and intricacies of several different plans and then describe the various pricing options, or would you rather look at the plans and numbers yourself? I cannot imagine trusting someone to tell me about the many different plans and their options.

  46. Mine changes every month, based on web traffic and ad sales.

  47. Because, as I explained in about 2,000 words, I was just on a conference call with the Secretary of HHS and she and her staff indicated the “application” process now works. And it doesn’t now work. And when a reporter said he still can’t get the thing to work, he was told he was an exception. The very fact that they’re continue to call these applications, and keep saying 1.5 million people applied for insurance which they are not and which they did not, is going to burn them when people finally realize that this is a lie, a misnomer, or whatever other phrase one prefers to call it. In addition, by saying that the “application” process now works, they’re suggesting that they’re not going to change the process, you’re still going to need to “apply” which will turn people away, they’re still going to require an affidavit, a check from Homeland Security, along application and more.

    I think that waiting until the fix doesn’t fix it is probably the worst time to weigh in. If this thing isn’t fixed shortly, I think the entire law is in danger, at the very least from some meddling congressional amendment that lets people “keep their plans” and kills the entire program.

    My entire life experience has been not waiting until things are messed up to speak up, because by then it’s too late. That call today gave me every indication that the specific problems I raise won’t be fixed, and that scares me.

  48. Mark_in_MN says:

    Another way might be to form your business as a separate entity, and have your business pay yourself more evenly.

  49. Mark_in_MN says:

    That’s not really a change in your income as it is a change in the cash flow or balance sheet of your business. It seems that your interpreting it too finally. A change in income is if you leave a job that gives you $29,000 a year for one that gives you $34,000. I don’t ink they are looking for monthly sales and cash flow reports for your business here (which would be kind of silly and unworkable from all sides of this).

  50. SkippyFlipjack says:

    How many people applied or enrolled over the phone? Isn’t total enrollments the most important number?

  51. Nathanael says:

    The issues arise mainly for the self-employed, obviously. Though people who are working casual labor jobs might have multiple income changes per year too.

    I suspect that the solution for most people will be to simply fail to report their income changes to the government each month, but I don’t feel comfortable with that given that I’m supposedly legally required to.

  52. Nathanael says:

    Windfall from a big contract? Sudden end of a big contract? Sale of a capital asset, followed by having the sale fall through and be reversed?

  53. Mark_in_MN says:

    Why would your income change more than once a month?

  54. Nathanael says:

    More detail on why the number 12: you’re only required to change plans once per month if your income changes.

  55. Nathanael says:

    John, if you want to promote this, and I would appreciate it if you did, you can credit me… or not, since this is something anyone could have figured out by spending 18 hours on the phone. I just want more people to know about the hidden traps in Obamacare.

  56. Nathanael says:

    Becuase it’s a goddamned disaster. I’ve spent 18 hours on the phone trying to get information (because the NY exchange has no “browse” option either).

    So far I’ve found out two major and very nasty “gotcha”s:

    —-

    #1:

    – Some, (though not all) family plans have no individual deductibles, meaning that a family plan for two people is much worse than two individual plans.
    – But if you’re married filing jointly, you can’t get the full tax credit for two individual plans.
    – You can’t tell which plans have this particular “screw married people” feature without making a phone call, or knowing what the secret code letters mean — it’s not described in the “Statement of Benefits and Coverage”.

    —-
    #2:

    The silver plans have “cost sharing reduction” versions based on your income. These are a TRAP. If your income changes during the year (which will be true for ALMOST EVERYONE on the individual market), you must report it. When you do so, you are shifted into a different “cost sharing reduction variant” plan. When you are shifted into a different plan, YOUR DEDUCTIBLE STARTS OVER and so does your out of pocket limit. You could end up paying 12 complete yearly out-of-pocket limits.

    This took me a lot of time on the phone to find out that it was actually this bad. If I hadn’t beeen completely paranoid, I would never have figured this out. Or the previous “gotcha”.

    Obamacare is a goddamn scam, run for the benefit of insurance companies, and apparently tied in with the government desire to spy on everyone (what the hell is the “Homeland Security” crap?).

    —-

    There is only one good thing to say for Obama. The premiums in NY State are cheaper, by about 50%. But the vast level of deception and abuse of consumers in the system is grotesque. Single payer NOW.

  57. Nathanael says:

    The New York exchange is equally bad about this; there is no “Browse” option, only an “Apply” option. As a result I’ve been on the phone trying to get information, because I refuse to apply until I know what I want. I was trying to decide whether it was affordable to get married.

    It isn’t, by the way. Obamacare still makes it completely unafforadable to be married in New York State unless you have Big Employer Insurance. Perhaps I’ll get some sympathy from Becca & company… 15 year engagement, still can’t get married.

  58. Carol says:

    why don’t you be more positive and see what happens? if there is need for pessimism later then fine, but for now leave it alone.

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