WWL>Topics>>6-11-14 2:10pm Angela: on Obamacare

6-11-14 2:10pm Angela: on Obamacare

Jun 11, 2014|

Angela talks with Patrick Taylor of Benefit Planning Group and Gabe Janusa of Demand Insurance and Benefits about the Affordable Care Act.

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Automatically Generated Transcript (may not be 100% accurate)

I certainly appreciate if you want to listen to our show on. Of the advent of Bloomberg into the community. Deep concerns by the taxi and limo -- companies. And that we had much to learn and I think a lot can happen between now in reality. But -- gonna follow up on that for sure because. You know there's good and bad in and we just need to. We need to feel right about it I think that's the war. Anyway we will we will visit that again we are moving on though it has been several months since we've checked in on the Affordable Care Act. On their continues to be a few kinks in the system but eight million people have signed up have you. What's your experience been -- save money. Are you able to go to the doctors you want we'd really like to know to give us -- call at 2601870. Meanwhile are two different to -- help guide this that this transition are here for the next hour. Patrick Taylor president of benefit planning group and game -- president of demand insurance and benefits. Two wonderful friends in our lives we have missed you so much -- we have two chairs dedicated to these -- I don't know how many hours we dedicated once we started on. The obamacare in the affordable care because there it was a confusing. Transition. And you helped guide this through. So where are. Well at this stage probably what a lot of people are reading now on the application inconsistencies. -- -- is about two million people. Of the seminary million and actually rolled it had these applications inconsistencies. And now the troubling part about this is and I believe a lot of these two -- people mean need to be aware that they have this application inconsistency. For example if people didn't had a email address and -- Purchase insurance through the exchange of the marketplace and they never checked that email address and name form during the application process to remarkably silly -- to receive communications. Via email but they never checked email when they're not aware of that application inconsistency. For the problem may be if they don't provide that data within a ninety day period they need to lose. Their coverage. Now I believe the administration. Has the ability to extend their nine day period. But down I think a lot of people that are. Upright happy to see this information and be aware of are people that selected the box that they wanna be communicated via mail itself in that case of they receive an actual correspondent today can review and respond to. And keep in mind they -- actually lose their coverage. They they stand losers subsidy. Oh OK some of the discrepancies let's talk about what they couldn't. Income information needs to be verified citizenship information. Immigration status is on a three. Main pillars if you will. Of information that is. Missed or inaccurate they see the government's information is not lining up with information that the applicant is providing. So there's a discrepancy or inconsistency. That's what's happening and they want proof of what. They're actually income or other if. Nation is so the website actually asked for very minimal information. On and a lot of cases they've gone back in news 2012. Then com. For a lot of these individuals where you can imagine how many individuals income has changed since 2012. -- for those people that are self employed. That big big discrepancies with with self implementing come over the years because in 2012. You may have made 45000. And then in thirteen maybe drop down 22000. There's so they're looking at those that did -- or someone and they'll present for the opposite exactly. And so for those who got the extra break. What does that term. The subsidy with subsidy to those that the subsidy. If you under reported during the coming your income came in higher. Then you would have to pay back that subsidy. The -- that's correct it for what we've been told and -- correct me penis and the different. The federal government the three income tax returns can collect back up to 2500 dollars. And in subsidy dollars if you weren't eligible for a subsidy however. You know you receive your receiving a 5000 dollars a year subsidy in the federal government comes back and as well you know you're really not eligible for that they can only take back at this point 2500. Of that 5000 dollars. So I changed any. China's -- due a refund more that refund can be wiped away pretty quickly. A lot they'll take it right from the refund that was the shocker room will we're we're going to learn a lot -- -- seasons -- -- season inches again the government still hasn't issued this checklist or document saying okay what the actual amount will be repaid if some money under reports over reports there income. You know they got too much of the -- ZR two little you know again the government. That's something that we mentioned a program following him when those out of state -- consultants call in Texas Virginia. He said you know we had this information -- and when he that we do need to -- so. There's no worksheet. You think about it as complicated movement of an issue is this is there's not an -- worksheet. So once again income tax season is going to be quite interesting action right so when you look at it Turbotax software your tax act well I don't have anything yet. But they will next year -- Wilson. OK a lot of the CPA set -- talked to have not. Taken any classes. Or webinars. On anything having to do with -- obamacare yet as -- -- is that because the rating for the dust to settle. That it probably haven't put the educational programs together yet. You know have an iris worksheet you can't really put together an educational program from one another -- -- does seminars for Steve did you at least in terms of how to not educate employers in terms of their reporting but. To the individual consumer of the individual taxpayer. Is -- much information out there. I I remembered in our last. Meeting here that. Your concern Wallace yes they have signed up eight million people roughly eight million people but how many people have paid paid into it. We had. Jim O'Donnell in here yesterday. And I asked him -- -- things going in the state and he said that he felt. I don't know I cannot remember the exact you're but he felt about 80% had paid which is pretty content that's who we've heard about 80% via. So what happens to those who don't pay it just drops. Well it if -- subsidy eligible. What happens or they received I should say something illegal if they actually received a subsidy when he applied purchase coverage. They have next in ninety day grace period -- she repay or pay their their back premiums. It's of people that bought insurance off the exchange that don't have -- additional I don't had a nine day grace period in that situation and a thirty day. Grace period. So a lot of people that are popular dad bought through the exchange in got a cents a they have a little more flexibility. Okay. Well we have a caller let's go to David in Kenner David. Don't. Bet against. -- It -- into buying in. Until. How many went willingly. But. If you like insurance -- -- All of that. And yet. I don't believe sir that anybody held somebody's arm behind their back in May demand role by the. Yeah. And I went on body it's good to I don't believe that but he's putting the everybody. Really. Has. You holding. We know that if you wanna look at a smoking gun in might be that penalty that people may have to pay it on reclining your chair. This is why do you do you know what you guys. Are. That's what. Unknown that is -- around and -- and I know now. On these guys were like dogs they've helped us a lot. And that is that the case and all the bottom line is. On Rangel who lost their parents were both. I don't like we each have our own radiation. I loved Italy and the real arena like events yeah. Anyway we appreciate all callers and I I do believe that but let's address a very quickly. Everybody who didn't have insurance -- said he got to get insurance and you don't get insurance you're gonna pay a penalty and that's that is the threat if there is a threat right okay. And and there are some exemptions and you know some people don't really fond of that. That category but generally yes that's correct okay now if you think that's -- remembered next time we have Oprah material should be between November 15. To February. Fifteenth 2015. Will be next year's open enrollment period for 2015 coverage once that time is going to be 82% county. Flashy or is it there was a 1% now it's doubled to 2% so if people aren't rolling before the deathly may be thinking in general and this time. Well in David was thinking that was the arm twisting. And that's one thing but if he sang that people who lost their insurance. That had nothing to do that was everything with their own company's decision to drop it right. So be angry at your own company for doing that okay all right let's take a deep breath everybody could -- We'll be right back let's take a break I'm Angela under the that -- -- We are back with Patrick Taylor -- president of benefit planning group engage in -- president of demand insurance. And we are updating ourselves on the latest on the Affordable Care Act which again to a lot of our time in. To learn what was going on when it hit last fall with the open enrollment. In the commercial they bring up a very good point. The next open enrollment is November 15 through February 15. But from if you don't have insurance now. You're saying if you wanna pick up the call to an agent you can't buying -- that's correct. That is I think surprising. Well that's what the open enrollment period is all about -- because. It was the major change for the obamacare was all the insurance companies have to cover preexisting conditions right there we we don't have medical questions any longer and applications. The only way to an insurance companies can semi afford to do this is to have an enrollment period -- close at enrollment period until the following year. -- But over the limit later on in the Russians let me point out though that people can buy health insurance during the course of the year after open enrollment. Only if they experience it's called a special enrollment period so they get married -- advocate divorce of the gave birth to a child. Maybe they lose coverage through an employer they'll open up they wind of that person to buy new coverage but if you don't buy coverage of the -- sixty day timeframe. And you're out again you're gonna have to wait until you either get the job. Through and new employee work. Or four or the next open enrollment. Period. I can say though that the self employed people do you have someone in an advantage over the rest of the population and at least two. Or more employees they can always at any time. -- or start a group health plan for the company. Okay well as the issue that this shop. For so what does that stand for it was a small business correct what is the issue that. Was being faced with that well over. With a development of the shop. Basically they wanted to all the insurance carriers that are gonna participate on it had at least two options for employees to enroll. While Louisiana being one in the states that I guess is. I decided not to. Often it to a table will roll and apple will only offer of one option to the employees OK so it was just limiting choice for folks -- Louisiana is here it Louisiana's among eighteen states that's what it is. When you say two options. Regular obamacare had multiple options. Or -- might as an actual -- choice so employer would choose maybe one or two options the rollout for their employees to choose under the shop exchange. But if you buy a shop eligible plan you can only -- one option to those employees it's only one person -- buying. You know a basically only if one person chose a PPO -- you -- a person choose appeal as planned or H -- selling a roll out one option. -- parliament about what's important meal to have options because keep in mind the employers. Can't charge more than nine and a half percent of the employees income for health insurance you've got to have. A bronze level -- a candidate cheap -- level plan and it may be a gold or platinum level plan. And because -- Louisiana can only offer one planned. People are really going to war we don't think that they're going to be going to the shop to be nine group health insurance and not only that they have to go through -- nation anyway. They need a broker an alternative. -- okay let's talk about what's happening in your world of a brokers. With this and they were the navigators that we're helping people that the government sponsored navigators. And then you'll. Were offering your services as well you were not making money office. Or were well below the insurance companies -- it right. But -- charge -- -- okay what is the it is there a concern in your industry that the brokers will not be needed to in the future. A lot -- from day one we've been concerned about that one Payer system. -- that we may wind up in and fire -- years from now -- insurance agents won't be needed in longer. Sure am -- -- been fearful of that from day one. Think about the term life insurance industry for example I mean you can go online get a quote and purchase coverage. And what's happening Mary yes you know there are there is an agent behind the scenes you may never meet this really associate with the contract but as you introduce technology. You know basically people are buying direct and but they're losing that. That to add value and service of you know what what what did you think what should I do highlight duo what do Michaels before what am I missing you know what's the work well for my family. Say I think that's the whole thing I think that not just to your industry but to others the elimination of people. Is we are now having to be our own doctors were having to be our -- this and that that and that's what we're not here that's why people are expert at something. I'll go to my grave not understanding why we are losing that. When in fact we need more and more. What that lives in the art of communication skills. Rapidly. When you when you sit back and you look at how complicated Obama careless or it is and will continue to be. And all of the variables in the equation surrounding this law in the decisions that people have to make. On the concerning their health care how opinion not do that with a specialist. If you're 25 years old in your single and you need to go on the exchange by policy that's one thing. But you when you're 45 Beers on your own your own business he has three children you may or may not have employees this becomes a very complicated. And that's where we earn our money. I think that that's who will stay in the business as long as there's the ability for us to be in the business and help people. I'm looking at that sparkle in game John you know it's just it it is complicated and I think my hearing from you that. You think five years from now will be one Payer system. I don't know how we can afford to to do when -- look at how many of our clients in just my firm are receiving subsidies and the amount of those subsidies. It's it's an unfathomable -- money. And that's just what are firm date there's there's thousands of us out there. Out of the game mean people that are on the exchange. That you you know and I'm not that these non -- numbers -- I'm not sure but I would imagine 60% percent of those people are receiving subsidies. And when you say that to remind people it is. They're getting a tax break -- -- not getting money they're getting a tax break that's correct and that then is not going into the coffers that's right okay. So that's what's costing so the federal government is paying a good portion of their insurance premiums I have done the math and my firm and it. I remember correctly seventy to 75%. Of the premium dollars or -- paid by the federal government for the people that purchased insurance on the exchange okay I'll certainly after reminder for the federal government decides. Yeah -- Israelis expect that it's a transfer of wealth from individual taxpayers. To the government in in the government's writing a check to the insurance companies. If it becomes you know what we have to go to newsroom but only combat I do wanna know if we should go to a single Payer. What will that -- stay with this on in July and I didn't do well and stay with this okay. Our guest today Patrick Taylor engage in -- sort of our authorities on helping us through the Affordable Care Act or Obama care. And I can't help you call back sorry mr. call. We were talking about what will it mean. If what -- saying. Patrick is that it's what we have is unsustainable. Financially. So going to wait one Payer or the government is being so low pay year. How would that make it cheaper. Are there would make it seem to answer any of the L one are higher the of one buyer of goods. -- means so much competition involved not that naturally going to make it cheap purchase and give the government all the control. For your health care and I think a perfect example -- one Payer system is the VA hospital. Look and see what's happening with the VA hospital system right now. And look at what happens with Medicaid patients you know they may sit back and wait for a month Bertuzzi is specialists were you have health insurance policy today. You're probably not -- -- More than 23 weeks disease. Us. It's interesting we have from -- two programs. In the last month one is on concierge medicine. Which of the doctors who. Say we're no longer gonna take 25 to 3500 patients were gonna limit ourselves to 600. We're going to be able to see each patient at least thirty minutes. And I asked clearly you just taking well people -- not -- not at all the majority of them are Medicare drug found very interesting. You do pay for that survey should pay 1679 dollars a year. And do you have a doctor 24/7 in your life. And but the the message from those doctors and then we did another show more recently which is really a movement. Of -- a nationally. Our doctors who are against Obama here. But it's it's brought -- from that the man I interviewed -- at nine years ago gave up taking insurance. Very risky thing to do he is not alone there are others. And he's able to keep -- costs down people pay out of pocket this is not for catastrophic things this is clearly for -- everyday thing. And he has kept his practice going for nine years. I called it this is finally the voice of doctors we've heard everybody else we've not heard the doctors. And these are their voices they're not going to be -- all of them are going to be some of them but it is interesting to me to see as we are evolving. That this is happening. And two up to a doctor that I talked to it is this is why we went to med school. It was to help people to help people stay healthy and get health. And in the systems and are now too often it's the five minute visit it's the ten minute that visit it is I can't see for three weeks. Maybe all of this is happening now. -- talking about that there's there's a lot to say about the way about that concierge service I've been it's part of that now for about ten years. And it's an incredible surface but not everybody can afford that. But it is nice to know that when you call your doctor he's there -- and on it to Sunday afternoon or whether or not you're -- And the Atlantic Ocean and you need to make sure there's an antibiotic waiting for you -- you come home. You know we're always going to have doctors you know we're there always going to be students med students that are learning. -- always going to be teaching facilities that will be able to help those people that can't pay for the health insurance that they'd like to pay for. In a bit if. I just enough Hamas a lot of money on how to -- because sustain themselves and me if you look at the Medicare reimbursement rates for hospitals. He moved to a single Payer system I mean you pretty much bringing everybody to Medicare status. -- and if they can't survive off of Medicare you know they're going to private insurance carriers that to make up the difference. So I don't think there's enough money out therefore to really survive either under a single Payer system. And I'm still very curious suffered a myriad of answers but when it. When did all of this cost become. You know so. It wasn't gradual -- was boom all of a sudden we're paying out the nose. I think -- to look at the whole pot. In this high has all these pieces. You've got. Your attorneys you capture drug company's chief cultured doctors you've got your hospitals you have insurance companies. The only thing Obama -- did. Was attacked insurance companies at the end of the day. They really didn't do much more than that and if I'm incorrect somebody correct -- On I believe that this this whole system has been evolving for decades. And we just gotten to a point were rated critical mass. And where we have to make more changes are what make and it's not just to fix insurance companies. And some of those needed -- it -- Well that it. We are gonna. Get to some of our caller let's go to -- in -- -- -- Yours. And struck. Central. -- -- Oh. And what you. Are sure. They are. So. For. Without insurance company. So. In -- for. Oh. -- And strictly. On. The insurance companies. Should. It. Should do. -- -- -- Here. And -- in church eight. -- really. Sure. Where they're almost out. -- -- -- -- Chill out it will. Ensure. -- -- -- -- -- -- run off the bat nominal at Patrick explain but I think we all agreed early on that one of the great benefits of Obama care. Was covering people who were not able to get -- -- that was. Wrong from the get go so that is a positive. But Patrick your. -- -- We we don't have enough hours of the day to talk about the things that we don't like about obamacare will say there are some things about obamacare that I love. Now a -- also say that. As an insurance agent is my client's account was not drafted and they lost their health insurance policy that would have been fixed. And that's where we -- an -- -- a year insurance -- should fix that problem because legally the insurance company didn't have a right to do yet. -- -- -- -- -- -- -- I'll leave it alone from there it shouldn't have happened on this -- -- pointing out does sir is absolutely correct I mean now I'm. Part of that 15%. Is going to the administrative cost in part of that 15%. Is getting paid to the eight it's actually -- pol but you know even if you don't use an agent. -- portion of that 15% is either going. It's go into the coffers of insurance company so lot and by the way if he's -- navigator yeah he may not be paying. For that service -- -- tax dollars are paying them directly salary to survey issues -- one way or the other you're gonna be paying. For that. Now what's been fortunate with our industries that you know they may be eight. A substantial on Wednesday substantially in mediocre upfront for -- commission to the -- but on the second year. It mean I'd be even in our interest even work with the -- In the future because the commission rates are very very low and we would have to see virtually. Maybe a thousand people a year and and help them -- to actually make. A a normal -- so you're criticizing us as if we're taking them on the money for a cells and actually not the case. So but I'll be there are cement that you're exactly right yes we are affected by that. And we're hoping that senator Mary Landrieu will take the insurance commissions outside of that medical loss ratio so we can had a more. Notify relation with the clients that is meaningful and a win win situation global parties. I -- He's saying that we're sure sure sure. But right now. It will -- our current. We have to thank for people ought to ask -- what are so other people were archer -- People can't. We and we -- is sir we are still subsidizing for that and that and we will always be subsidizing for those people as well. I appreciate your call -- very much let's go quickly to Jack in the quarter. -- Outstanding point. Before I argue in favor of the single Payer system I'd like to compare and contrast. A Republican program called Medicare Advantage George Bush introduced it. Medicare Advantage is essentially a partnership between government and private insurance and that's exactly what obamacare it. President Obama did not have the votes in the support. The pass a single Payer system so he compromised they gave us Obama yeah now how the Republicans can support Medicare Advantage in the polls Obama here. I do not understand. But -- -- that it was supposed to be a cost saving measure. And the -- be substituted -- traditional fee for service Medicare which is essentially a single Payer system now. To no surprise to me Medicare Advantage of according to Paul Krugman. An economist. It's 12% more expense of the Medicare Advantage as opposed to traditional fee -- service. Now at -- let -- in the article whip a comprehensive study has been done if we would go to a single Payer system. Spoke with says he has the taxpayers can save one point seven trillion dollar because it's that simple. It eliminates that the huge bonuses were executives with insurance companies. Traditional Medicare doesn't have to pay. Dividends to shareholders they don't have to advertise. So there are many get it get tremendous cost saving measure. First we -- limit date. Medicare Advantage and then go to a single Payer system and substitute that Obama yeah. And let it be based on a person's means an income is about to pay the appropriate premiums and essentially as Medicare work. -- and I think he can work quite well we extend and hope. Jack I want you to send that to me here at 400 pointer street in my name thank you for your call we got to take a break we'll be right back. Over talking about health insurance and let's go quickly to Stephen Metairie state. Irons well wanted to ask all we hear a lot of the concierge care if you have a primary care physicians. You would keep telling him. To be here are here positions. And right on that -- OK now when you get referred by year. Primary care physician specialists say cardiologist. How does work you know longer. Under the broad cross your hair from his primary position correct. That's correct however you know let's say -- the doctor today something's wrong with Manny because he has specialist. Our doctor has relationships with specialists they called they schedule the appointment and I may -- indices that specialists in three days from now. Whereas without the concierge service. It's pretty much up to me on my shoulders to -- to go out there and find the specialist. Get the upon with the specialists and it's just about it's all about convenience and time at all. Literally when your primary care physician knows and Lee partners where if you will. That you won't be able to get to see a special place market cardiologist. Yes yes and out because of -- seeing cases where. Somebody wanted to -- see a doctor that had no relationship to the concierge physician. But that physician was still -- to make the phone calling it that person and -- the the the specialist pretty quickly. But again when you have concierge medicine you still have to have your insurance is absolutely and that's that's the big deal but it is you now have. A one on 1247. Doctor in your life -- cons here's a fee. Is not tax deductible and can be paid out of NH assay canny about -- okay. We learn but thank you very much -- for the call. I've loved this hour I -- the update. And it's one that will continue may be in the fall after the things real -- visit to again but thank you both. Patrick Taylor and game -- thank you very much -- stay with this will be right back. Trichet to joining us on about our talk about what's happening with think -- with Obama. -- and we're changing gears -- percent are very special guest for the next hour. Colin talked to the councilman.