Today October 1, 2013 once again, if the Congress has
not faced with a shotgun marriage to keep the government running made another
adjustment to the AHC act, there will be a milestone reached in Obama Care; the
opening of the Insurance Exchanges.
Once again a well intended but not researched
government regulation will become the law of the land.
In New Jersey there are about 1.8 million uninsured of
whom 900000 are eligible for the present Federal sponsored exchange.If Medicaid
is expanded after Jan.1 more will be eligible perhaps about 80000.
There are only three participants; Horizon Blue Cross Blue Shield of New Jersey, AmeriHealth New
Jersey and Health Republic, and it has been reported that the Nj premiums are among
the highest in the country. The federal analysis finds that for a 27-year-old
with low-level catastrophic insurance, the monthly premium would be $129. For a
family of four with a better plan, it would be $943.
There is a penalty this year of $95.00 if an eligible
person does not become insured.
The success of the program depends on the
insurers making a profit. They will offer multiple plans and options from a
bare bones low premium restricted services and providers to a more expensive
more comprehensive program.
The carriers are relying on a high number of
young low risk individuals becoming insured, which may be so unlikely since the penalty this year is
minimal compared to the $1548 annual cost of the cheapest insurance for that age
group.
Aetna had originally announced participation,
but backed out recently having determined the risk for them was too great.
Horizon and the others in their low cost
programs are depending on a panel of “providers” who are willing to accept low
reimbursement.
Availability of specialists will be limited, and most likely
will not include those considered by their peers to be top quality. There will
also without question a smaller group of hospitals available to those who have
the cheapest plans.
