Jan 13, 2014|
A health checkup on Affordable Health Care. The first deadline to sign up for Obamacare has come and gone. The new health care law is reportedly rebounding from a rough start, but while many Americans signed up, overall participation is dismal compared to expectations. Many who signed up and those attempting to do so--are still frustrated with the process. Some say it’s all too confusing …others warn they’re being counseled into policies they would not have chosen…and industry leaders worry the system is being flooded with unhealthy people and seniors while young so-called “invincibles” remain elusive. We have the latest on sign ups, payment plans, extensions, improvements and glitches. And, we’ll have experts on hand to take your calls. Angela spoke with Patrick Taylor with Benefit Planning Group and Gabe Janusa, President of Demand Insurance & Benefits.
We're discussing the hot topics of the day with co-host of First Take, Todd Menesses.
Angela discusses the shooting in Lafayette and says farewell to WWL as she hands her timeslot off to Scoot.
What's trending in sports, news, and entertainment?
Angela talks with WWL-TV investigative reporter Katie Moore and Tulane law professor Tania Tetlow about the city's backlog of uninvestigated rape cases.
Automatically Generated Transcript (may not be 100% accurate)
The Affordable Care Act was a major major events in the life of this country really and it is still affecting many people as we try to grasp. What it means and who is eligible and how you get it -- an etc. and we are. Always so grateful to experts Patrick Taylor president of benefit planning group. And -- genius president of demand insurance. And I want to mention that both of these men are independent insurance people they -- they do not work for the government but they certainly have. Made it their mission to understand. This act and I also one thing to delightful people for holding on number gonna. We're gonna get to Patrick and gave -- other questions but first let's go to Joseph in Marrero thank you for holding on -- And it happened and I Pataki. Economic initiatives that the real quite yummy in my life views on you what you count your watch NG it just sadly. And count federal policy and your audio and now. We get out there are even. I momma put that in general for you -- thanks ready and you can't. The cut debt. My objectives you know since. Our governor Bobby Jindal. A huge. Obama expansion you know health care expansion. Not all the cool about -- and other -- days. That people who are on Medicaid -- had disabled the age of 4045. He didn't actually you know call. Certain there are searching for additional. Tentacles that we all have kids so -- it's fast. The people who are on Medicaid. They cannot get enough Caldwell gave him physical therapy particularly media to keep -- moving you know. So obvious that the little deal. Okay thank you I think wouldn't yes in other words this is not going to affect someone who was already on Medicaid. Medicaid is an entity unto itself that any adjustments. That are going to be made it to remain independent of the Affordable Care Act that's correct. So that isn't gonna help those people it was interesting it was a very interesting article in the Washington Post in disgust. They took the states. That signed up to expand Medicaid vs those who did not we did not Louisiana ground and it showed that. Those that did expand Medicaid. And those who created their own marketplaces. Signed up significantly more. And with greater ease than those states that did not I just thought that was an interesting. Now -- and the pendant in percentage of people that enrolled in those states were Medicaid. Enrollees exactly not -- and not private church enrollees you correct Medicaid rolls with higher than dual mines -- on the private market through the exchange. Yes. OK we do have another caller Phyllis from Metairie thank you so much for holding on. Hello hello hello. Matt Matt turned 53 year old son is unemployed and get it done what I'm planning chest. And he tried it but he couldn't say how much he's gonna make it here. And so the -- plate that make the big numbers again -- again just so he couldn't get insurance but it is precedent. There I hate to say this spent their ride if you can SE give them some sort of an estimated number then he would have to pay for the insurance in the many thousands taxes and 2015. Further attacks -- 2014. Then he would get a tax credit. Pumped for any of those dollars but he can't projected because he doesn't have a job. -- definitely can happen and it. -- -- try it one -- -- but I think it sir. Is there -- things aren't done overly I have other any prospects for work for this gentleman is elected and who we he will get you know re employed somewhere. If not. Can he started -- can start his own business Amin. Well he may be honest folks enemies he has the right to buy insurance coverage but he may not qualify for a subsidy if he's not alone project what does income is then the government can use any information to make a projection so that information he can't do anything. So it's not just remodeled the fact that the government this marketplaces is going -- honour system so. Whatever information he he says is his income -- 2040 projects debate. That's a number they're getting used to. Was this trade get ready physically you can say try that that -- the -- and it's the lowest but then this person don't make it in Harrison I think it's -- Well you know you if if if that happens and you look at look look at really -- and today in dispersant had an interest free loan on his tax credit for a period of maybe sixteen months. It be ascertained that when I'm December's tax credit he received he said to get the credit for the next twelve months talking about the credit ma'am I think also what I'm hearing them say has. If your son I hear what -- saying he's making 220 dollars a week in unemployment. But insurance is an important and he wants to spend that toward that he could do it and not get the tax credit. You can get insurance can't you you can get the insurance and it but it. Terry Terry download the product. Well that's a possible on the most tragic to apply for coverage prior to January 1 of them hate it could it would sure it would get if he's got that the. About and that is one of the benefits of this -- -- try to do they cannot be denied that's correct that's correct the the application is as simple as your name address Social Security number date of birth sign here. It is that simply doesn't ask one medical questions guaranteed issue. May I ask how long he's been without work. It hit three. Three months are you hopeful that something will come out. Yes so -- for them. Helping the -- is that's. When you know you just need to hear that and -- -- it's a reality today. You know along during his situation but anyway okay. -- no thank you very much for holding we appreciate it feels a lot. Let -- talk about. Something that you would mention -- very important that sometimes what you see on the marketplace. Is not what is. Real it's not reality unfortunately. You know depending on who's walking you through these plans that are available once you go through the through the marketplace through the process. What you find is at the the information -- shares to the government that the government is now sharing with individuals and viewing their screen. Isn't always the case for example you may be an individual maybe you're married to you -- your spouse had to supply for coverage. You may see a number of different plants remembered different -- scariest and it's probably showing you the Stanley deductible not the individual deductible. So you may be making a decision. Based on a false reality. Against you know you're not gonna know what the actual specifics of the plan are unless you dig in to the deet -- There's there's a link the you can click on that -- populated the summary of benefits and coverage for that specific plan. All also like to -- that. Sometimes it's she's in the Arab network deductible and out of network Matt out of pocket Max and their listing that number on the marketplace. Double making decisions saying you know 121000 pound duffel that's impossible it -- is no way to get -- 121000 dollar deductible. On on this web sites and I was on for two people or single person want to say for a single person or two people can't he can't be that high. It's something family of five or six well depending on the policy that's available. In those situations it's it's a traditional POS plan. There's an -- to do deductible for each person up to a Max of three. And but if you look in at one of those eight to say qualified plans like pat what saga to earlier. You deal with the filming deductible for everybody says one doubtful for the whole family so you're not gonna know that a -- you are privy to the information. That an insurance agent would likely have access to a non insurance -- may be walking through the process doesn't have access to it. And it's also extremely important understand the cost sharing benefit. For those people that are under the 250 percentile. The federal poverty level. They can participate are have the benefits of cost sharing and that you have to buy a silver level plan in order to do that -- -- sharing -- cost sharing means that there reducing the deductible or reducing the co insurance. To the individuals so let's go back to one of those HSA plans on this not seen a lot. Plane may have a 2800 dollar deductible which is at 5600 dollar to -- before family. On the on a silver level I'm -- -- the details. It may only have a 400 dollar deductible. Which is really great and then it's a 100% coverage however. The maximum out of pocket says 101000. Well if it's a 100% coverage after the 28 of the 5600. Awareness of 101000 come from where -- -- well you've got to pay out 20% for prescription trucks over and about the deductible. But that's when those little deet tails you know that people are going to see on in the -- -- a note to look for that -- -- think people gonna get their. Policy in the mail and likely to -- this is not up on most of these already happening. Guess it's already happening -- people -- people who are doing this on the around the not really -- me with insurance that they they could just wing it and in go to the process from start to finish. And not -- what's gonna happen next week or mommy upcoming month they're gonna get their policy that ambulance Weytman. I didn't I didn't I did purchase is pulses is not what I thought it was going to be he can create a whole another. Around the issues yes if they're unhappy with their policy can they change it. Well I imagine -- can always remove their application during open enrollment they can always buy new policy during that timeframe but after that time frame is expired after march 31 that'd be stuck with that he election. For the rest of the year. Now and November and again. Thomas to give them. A job or they -- with the employer offers insurance in the future that's fine only on the way to get out of that plan but you know I'm gonna ask why is it's and to have gone. Convoluted why is only just simple ABC want another problem I had is to have seen some people they wanna buy coverage now. I'll watch it say they wanna apply now. But they don't want the cover to go into effect until April 1 on March 1 but. The timing of your applications based on when you actually crisis might buy coverage today to the fifteenth they're coverage is gonna start February 1. You can't check the box. On the west and say you know what I want my plan to start over the first and one I want to start. May first there's no option for that it's frustrating that means. The people that come into office have to come and timely based on the premise of the government has set for us we can't check a box and say. That's a deadly element plan to start. -- gonna take some callers Nora from Metairie thank you for holding on. Hello -- I and bullets forever to com. Why I did everything -- supposed to do we feel that -- November. They'd help those who have been have coverage by January 3. As of now I haven't even gotten a letter they -- a pop in number is an -- -- saying. You know. Awhile wait awhile column on the way. On what what insurance company if you don't mind that you -- put. Across lacrosse. They they've had a few glitches. We'll tell you were getting policy numbers every day it's getting a little bit better every day. Would call blue cross and had had they cast had a cast your check. Then that's that they happen but. That they can't detect but they have intent. Well that's that's a good sign. We call health care dot -- just to make sure that your -- You're enrollment was confirmed I'll tell you that I had a case the other day. We couldn't find him in the blue cross system for all the money in the world -- back to health -- dot gov opened up their application and it was never confirmed in the reason why. Was back in early November and December they had a glitch in the system. And even though you press confirm it didn't confirm. And attacked at the end of that conversation we wound up confirming it however she didn't have coverage now -- you don't have covers now to February the first. Solid called blue cross again and cause health care and act out. Thank you very I'll just ignore for calling -- you look. -- I'm so sorry who. Thanks to take my. You know been listening to -- and it's making my head then it's truly I said. And the conversation. Really is about employment opportunities. Policy. And what you would get them out for this policy in the continent on the but it really didn't confirm -- guarantee you. Actual care health care health care and and sufficient and that they provide this service that they decided to they're going to go into. And that's called healing people. When I have something wrong -- may. And I was raised not to go to the doctor unless absolutely have to do and I would think most people are and that's how -- people -- -- it's and that's a necessary thing in and and it's really not. You know voluntary and you'd just you'd just needed you need to have your fingers so I'm in need to have -- -- job beaver check in now. And I need to go to my doctor that's right down the street. Let them vivid and Matheson did not -- -- -- in Baton Rouge or somewhere happen and not. Wherever this health insurance companies that this and an Indio whatever they're doing business. And need to have them provide that health care provided in my community what I have access to us that have been discussed none of that has been discussed that leads me to believe. There's going to be a lot of people. That are going to doctor of their children at home and and and take care of their own -- -- up and make mamma wanna sell my finger back on when and I'm told. The engine company can tell me they only have to sell on half of my finger because I only -- for the bonds. Plan because that's not health -- in my opinion and I'm at and where are com. It didn't really make a wonderful point in -- I hear what you're saying. I think even before the Affordable Care Act I think there were some deep concerns what was happening in medical the medical world about who's in control of what. I wanna have that relationship with the doctor I want the doctor and I'm comfortable with who will get to know me understand my issues and we have that relationship. And and by -- to do what's the best thing not dictated by some person in -- room someplace. It's the that is alliance -- is so important for people to understand what plan their buying. And what is the network so many people are going on health care -- out by themselves they see a cheap plan. And because it has co pays they buy it. They're not really focusing on while it is this a PPO network is that an HMO appoint a service network what kind of network is that. I can tell you that you know if you want really good kid and -- you want access to the majority of the doctors in this world don't go on an HMO or point a service plan. Need to go on a PPO plan. If you're gonna stay in your community and you never care about. You know me going out of the city or and you just on staying in neighborhood well on HMO plan might work that you have to understand the reason those plans are cheaper. Is because they're restricting the network the more they restrict the network the -- the premiums are going to be. OK. I think I understand a little bit that. But it is complex and I do I do hear what she sang from and what we're watching is a real revolution and health care. Not just this act but even prior to I think I'd be more concerned about. The then one Payer system in five or six years from now -- the event that our country can't afford this plan Morse at in the care today two wonderful guys Patrick Taylor. President of benefit planning group and gave -- noose up with demand insurance I'm thinking about their numbers because. They've helped an awful lot of people. Gave genius is number is 504309. 0060. And Patrick Taylor's is 504. 8333434. I'm gonna give those out hopefully before we finish as well so if we're not asking the right questions please please give us a call. At 2601878. Or give them McCall. We were talking about there are some exemptions. What does this. There are thirteen hardship exemption these are the folks that will not pay a penalty for not owning insurance for example if you're homelessness number one. He would not pay a penalty. Number two if you ever -- that if you were evicted in the past six months or you're facing eviction or foreclosure. You'll not. I'll pay that only. If you receive the shut off in addition your utility company that's another exemption. If you recent experienced domestic violence. That's another one you recently spread to death of a close family member can be many people. You experience a fire -- or other natural or human caused disaster that caused substantial damage to your property. If you filed bankruptcy in the last six months. He had a medical expense do you couldn't pay in the last 24 months. So give you a hardship exemption. Media experience -- unexpected increase in necessary expenses due to caring for the ill disabled or aging family member. Number ten we -- here is you expect to claim the child is a tax depended who's been denied coverage in Medicaid for -- chip. Another person. Is required by court order to give medical support to that child. On number eleven as a result of an eligibility appeals decision you're eligible for -- and a qualified health plan through the marketplace. I'm number twelve you were determined ineligible for Medicaid because you state like Louisiana. Didn't expand eligibility for Medicaid under the Affordable Care Act in the classroom which is recent and it due to. Always cancel plans indeed the initiation -- a pivotal bitten and offer an exemption is -- thirteen. He individual insurance plan was canceled -- you believe that other market clients and other Barclays plans unaffordable -- that are available to you. There's other thirteen hardship exemptions. So if you have insurance to work for company the company dropped it. You're saying that you would not have to pay the thing if you go on the marketplace and can't afford any of them. That's correct. But in that situation what what I found is that. People that eligible for these exemptions for examine him at thirteen if they were held before this catastrophic policy before. All these canceled policy notices people under the age of thirty would only public and by catastrophic policy. Now what always happens and now they're -- for people over the age of 32 by a catastrophic option. And now what I've found is that. Those people are likely to be able to get a bronze plan or civil plan for very very you know. Lowell out of pocket cost. Which will be much better and cash for the option. I would think that the iris is going to go back to those people that it stated that it's unaffordable at some point in time. And audit them and make them prove that it was on affordable and since they had the catastrophic plan now available to everyone. -- this can be pretty challenging for months folks -- other way and one of the thing to remember you mentioned Colin was talking about. The 95 dollar -- 1% of your income. In my calculations no one's going to pay 95 dollars because 1% and you've got to be making at least 11100470. In order be eligible for the subsidy. That's over a hundred dollars as far as apparently its concerns if you make it 20000 dollars a year you gonna pay a 200 dollar penalty not money five dollars. If you're making 30000 dollars a year he'll pay 300 dollars for a right now I think that's a very important addition to. If people are people are focusing on money -- money I don't think habitually the greater of 21% income 95 miles. We have a caller Jack on the -- Jack. Yeah. -- -- Yeah he and how would the government going to know whether we hail they have not insurance. The insurance carriers actually gonna sending notice to the IRS verifying. They -- covers that you don't month to month essentially. So hopefully you'll be content on the course -- we don't know what's gonna happen for that respect. They're gonna copy of our old. I'm hoping that's the case but we're we're not clear -- that we just know that. Well -- we'll find out. We're learning day by day let me say I think this is a real statement that. Let us all sit here one year from now and see what the issues that sort of fell through the cracks. What do we all learned from that but thank you very much Jack for calling we have somebody who has sent Texas. What if you lost your job in November and coverage ended in December and couldn't afford the continuation coverage due to no job. Well you can still go on the market places and buy that coverage so it's still isn't too late because the next one says what if you have insurance -- your job -- resign or laid off. Would you be able to enroll mid year or would you have to go to cope you had to believe the you know thirty or sixty days to buy coverage on the exchange if not. Eating a chance to do that hopefully you've had a chance to 22 cover to cope or stick continuation. The -- and at march 31 is a cutoff date correct yes to get into the marketplace correct right. But as this person sank in June they -- lose their job whatever. Now they have to go and get a new. Yet they have these can do that -- sixty days okay once you lose your job which dropped -- to be Politico in sign on to the marketplace. Our. We were talking earlier about. Let's go back and let's go forward a year. Do you think these rates are gonna stay the same. Whether it's bronze silver platinum. I think that's impossible while you not think there's some protections for consumers that -- the rates can increase for more than 10%. Right so I'm home I don't know what the new rates are going to be but I imagine -- feature actors to wanna go through additional scrutiny -- may just keep or cabinet of 10% to war. We just below that. I think it so we can and -- expected at 10% in congress they sell but I think the federal government's going to look at the average age throughout the country. And and see how much you know what the average ages and I think that that's gonna dictate part of the future rate increases also because right now the average age is around fifty. When he needs to be somewhere in the neighborhood of 3839. That's gonna create a problem in the future I think apple app for say is that we're gonna have the younger people coming in maybe not this year but the next two years that they will have boy they surged from younger folks buying insurance through the exchange. Because they're going to be Don Mathis a cheaper for me to buy coverage on the exchange or pay the pounding the telling may be -- fatigue issue now on 26 -- to be two and a half percent of your income. So just do the -- And then as we speak in many candidates two and a half percent of your income times. Up to three people and the fans. And so if your penalty is 200 dollars and there's three people on the family that 600 dollars. Now that gets up there and and but what about it as we have here from somebody out. This -- just what about somebody who usually doesn't have an extra 220 bucks. That's that's going to be a problem. He dove on insurance and you're not qualify for the one of these hardship exemptions and you'll be one of those folks that are payment don't you don't have coverage. What is what is your greatest concern today. My greatest concern is that. My belief is this is gonna work for the next. Couple of years may be 45 years but my concern is that you have people there then. Addicted to these affordable insurance premiums cable but never -- -- -- -- yet -- of the subsidies so. Now the reason in my opinion they called the April Carrick is because it becomes affordable for a lot of people that. I had no problems in struggling to make those payments for the cost insurance. And what happens is that what you have people that are basically. Mary to that low cost of the government steps in and -- those subsidies away than what we have. Yet unaffordable premiums. That you can't make the case you can't afford it. And then maybe we moved to a single Payer system that almost forces us to a single Payer system at some point so basically you're putting Bob by buying a policy on the exchange unfortunately Europe through putting. Yourself and a weak position for the years to come. Unless you're really looking forward insulting a waste of money in one of these. Plans other plants. You know -- let's go back to the questions he that you get a minute ago for those people they can't afford it. I would stress to those people to call us. Because I have talked to so many people that can't afford it and by the time we got finished talking to -- They were spending fifty year eighty dollars a month for a very very good health insurance plan I -- planned -- we saw twenty years ago remember the hundred dollar deductibles and -- 200 dollar deductibles. We're seeing and that again in I'm seeing people with premiums I've seen premium as low as a dollar fifty or 46 cents. There's a -- there's a policy out there that you can afford and that we don't have enough time today to give all the examples but I promise she just about everybody can afford it. Let me -- about the numbers for Patrick Taylor. 8333434. Danger -- -- 3090060. And they have helped an awful lot of people is they help us learn the system I'd love listening to Patrick Taylor in game genius because. From the last time you were here in December. What I'm hearing is that there is it's a little easier getting on. And that a lot of people are finding some great benefits. Yes. And vote on a walk and I'll mind my office for the the biggest smile you ever seen. And keep in mind it's just not the people that are getting subsidies Angela. People are are able to buy health insurance now that weren't able to buy health insurance plans before people are able to change their health insurance finally. You know they've got preexisting conditions guess what that doesn't matter we can now changing to another plan and possibly save you money on scene and every single day. So it's just not the subsidies that are Macon smiles. Just remember the last day to officially -- is march 31 and when you do that coverage would not begin until May first. So get in touch with an agent. Or brokers synergy can. Bring all your information. Let's go ahead and not ask and which you which you can -- 12014. Analysts have you at least valuing some Clancy over specially family and please don't wait till the last man on them because -- that happened on Christmas Eve of the day before Christmas Eve and we just couldn't see everybody and we had to turn people away. Start doing that planning now please please it takes time. I wanna give up their numbers one more time gave to a new set up 309 it's 0060. Patrick Taylor 8333434. I always want -- -- -- Give you another invitation to come back in the studio because we learn something every time you're here and perhaps will wait until went. To see how things pan out because you're still asking some very serious questions. About in the early march yeah when this thing really kicks in and people get their policies and then they'll look and say gee I thought it was something else but it's this. There are some more hurdles down the road no doubt about it and I think early march would be great idea because we can that alert. The end of the population that hey you've only got thirty days to get this done and Arnold the first 31 is the absolute deadline let's also be model that this is the first time that all these insurance carries an operating on -- off the exchange -- face -- these types of challenges. So let's try to bear with golf we possibly can. And Russia's priorities patients we possibly can and there's a medical emergency. You know reach out to your agent or broker reverend rolled Jew or return directly to the insurance carried seeking get anything she possibly can one more real quick. Quick point if you don't have an agent if you did it on line and you want an agent you give us a call and we can become the -- and it doesn't cost you a penny and it's and we can be there to be represented at all music to many people's ears. Thank you gentlemen as always we will see you in March thank you.