Your Voice: Covered California
Apr 18, 2014 | 5453 views | 12 12 comments | 146 146 recommendations | email to a friend | print
Clarifying Covered California

EDITOR,

In response to Diane M. Stone’s remarks regarding the Affordable Care Act (Your Voice, “Obamacare not a win,” April 4), the ACA protects patients and not insurance companies. It is my understanding that under the law, insurance companies are to publicly justify a premium increase and to spend 80 percent of premiums for health care. The cost for insurance has had its lowest increase in 50 years since the law took effect. Physicians and hospitals have a choice which contract they sign; hence, this may be the possible reason Ms. Stone found only one plan her physician participates in. It is unfortunate that Ms. Stone’s policy was canceled; however, I understand the administration has allowed a one-year extension for these policies and granted those affected to purchase a catastrophic plan. Canceled individuals may be eligible for Medicaid, tax credits and the possibility of obtaining a better plan or price through the marketplace. Because Ms. Stone paid her premium, her Covered California enrollment was a success. Enrollees are insured as long as they pay their premium. It is recommended that individuals with issues contact their health insurance company directly. Meanwhile, enrollees should be able to use their health insurance by providing their Social Security number if health care is needed. It is difficult to compare premiums with canceled policies, because they may not have met the new standards, such as insuring individuals with pre-existing health issues or having no lifetime limit. Although Covered California enrollment has ended for 2014, Medi-Cal enrollment continues year round. Open enrollment for the 2015 coverage year will begin in fall. For information, please visit the website: www.coveredca.com

Linda Jimenez, Tracy, Covered California volunteer

 
Comments
(12)
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KJeff95376
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May 01, 2014
I'm all for an Affordable Care Act, but I am 100% Opposed to forced requirements. I mean, I don't even need Auto-Insurance if I am licensed, yet choose not to drive, or own a car. It's still my choice. If the Government ever presents you with something that is not Optional, you should immediately push back. Good for the nation, or not - we lost when we allowed ourselves to be forced.
Wobbley
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April 23, 2014
I have a republican friend that is under employed. He had no health insurance and a lot of medical problems. He's MAD because he had to sign up for OBAMACARE. Now he has full coverage and has to pay $90 A YEAR. He thinks it's unfair.
KJeff95376
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May 01, 2014
It's unfair on a Socialist level if he did not want to buy Insurance.
warthog69
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April 22, 2014
I really wonder how many people who write letters and cry about Obama care actually voted for it? And Obama.
TracyBornAndTracyRaised
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April 23, 2014
warthog69, you are right that the people "crying about Obamacare" did not vote for it.

That would be because Obamacare was a bill passed into law, not a ballot measure put to the people. Therefore only the 535 members of the House of Representatives and Senate had the option to vote on it.
Seek_the_Truth
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April 21, 2014
Than you Linda Jimenez for "clarifying" the law, "...insurance companies are to publicly justify a premium increase and to spend 80 percent of premiums for health care." The fact that health care has had the lowest increase in cost in 50 years is no coincidence. The truth is, health care companies have to re-think their pricing strategy to keep competitive with their new mega-competitor - the US Government. This will mean dropping some plans, lowering rates on other and even increasing rates to make up for the spread. In the end, market pricing is disrupted. This is a BAD thing. Of course, I wouldn't expect someone who has been on the government payroll all her life to understand this.

LovelyTracy
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April 18, 2014
norcaldad,

Looks like you are placing blame on the wrong entity - Its seems like Covered California did its part: it set-up the state marketplace where you were able to select an insurance option based on your personal preference and what you could afford and if you received a subsidy it is paying it.

But - and this is huge part of our health care system that everyone needs to understand: We have a for-profit healthcare system and as such the insurance companies are beholden to their shareholders much more than to their customers they need to pay out the least amount as possible.

That is why the "Public Option" was so important: it would have competed directly with the for-profit health insurance companies and would have given you another option. But alas it didn’t come to be.

What you need to do now is complain to California's regulatory boards and let them know your insurance company is not providing the service you expect. http://www.dmhc.ca.gov/dmhc_consumer/hp/hp_agencies.aspx

I myself went with Kaiser and I have not had any trouble seeing a Doctor or making an appointment. Good Luck!
diane65
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April 23, 2014
Unfortunately the exchange in severely limited on choice of healthcare providers. As for the exchange doing its job, I encourage you to place a call or go online to Covered California. If you can get through or navigate the site you will quickly discover just how inept the California Health Exchange is. As for advice on complaining to the regulatory boards, try this as well. The Dept.of Managed Health Care has oversight for those companies and they refer you back to the insurance company you are complaining about to resolve their own problem. It is a joke.
TracyBornAndTracyRaised
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April 18, 2014
Ms. Jimenez has the right to provide information on the "Affordable" Care Act, as she has apparently signed up to do. However, some of these statements are extremely irresponsible and misleading.

Upon realizing that his oft-repeated promise of "If you like your plan, you can keep you plan" was ignorant at best, a lie at worst, President Obama did allow a one-year extension for the plans he promised would not be cancelled. However, insurance companies had already made arrangements to cancel these, and have no obligation to change their entire way of business for the President, yet again, and therefore cannot extend most of these policies. It is an empty statement by the President.

It is not Ms. Jiminez's place to call Ms. Stone's enrollment a success when Ms. Stone herself clearly did not see it that way. Merely "being insured" was not Ms. Stone's objective. She was insured before the "Affordable" Care Act. Success would have been improving, or at a bare minimum, maintaining her level of coverage.

Finally, praising the "success" of a law which threatened tax penalties and fines to those who do not comply is the most misleading and irresponsible behavior of all.
norcaldad
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April 18, 2014
Covered California hs been a failure so far. I am paying more for less. That is only if you can get the insurance providers to process your paperwork to sign up. It took months for us to get our cards. Then we find out our doctor dropped Covered California where he was on the plan 3 months ago. We had to switch plans for $200 more per month to get someone in Tracy who we can go to. If we could qualify for Medicaid then we could get better quality health care. This is just another political failure that is squeexpzing output the middle class.
rayderfan
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April 18, 2014
I agree that Ms. Jimenez can provide the information but unfortunately she has taken a large gulp of the "Obama Koolaid".

"The cost for insurance has had its lowest increase in 50 years since the law took effect."

This statement may be true but it is not what the President promised when he sold the plan to the nation. He said Obamacare would reduce the cost of health care by $2,500 per family per year.

"Canceled individuals may be eligible for Medicaid".

This may be true as well but if they are now eligible for Medicaid (MediCal here in California) they were probably eligible before Obamacare came along. Also keep in mind that if you qualify for Medi-Cal you then have to surrender your assets because you can only have the equivalent of $2,000 worth of assets. If your assets are more than this you get a "share of cost" requirement which means you pay a set amount out of your pocket every month before Medi-Cal kicks in.

If you are on Medi-Cal and you pass away, before your assets are distributed to your family Medi-Cal will seize them to recover their cost before your estate is distributed.

So for the record, Obamacare is not better for the you. That's a lie.


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