Sunday, February 9, 2014

ACA: The Informed and Web Savvy Consumer Purchases Health Insurance?

The Affordable Care Act was supposedly aimed at insuring the previously uninsured. Unfortunately a woefully low percentage of previous uninsured are attracted to ACA whereas the vast majority of applicants are the previously insured merely looking for a tax credit to lower rates [subsidy]. (1)

Moreover, regarding the uninsured or the previous insured seeking subsidy, an implicit assumption by the central planners of ACA is that potential health insurance consumers are web savvy and informed consumers of health insurance. Maybe not so much regarding the uninsured which is the supposed target market of ACA.

Lower middle income and lower income people, making up a large segment of the previously uninsured, are not exactly the segment of the population with computers, computer skills and web savvy. Hence the central plan designers of the ACA have designed a delivery system known as the market place exchange web site that does not match the target market’s access point and skill set.

The same population that makes up the uninsured market, if they manage to find a computer, acquire computer skills and navigate the web site, are further assumed to be informed consumers by the central planners. Would an uninsured person or an insured person be more informed regarding health insurance? Would a person consistently uninsured in the realm of health insurance over long periods, in the main, be familiar and informed regarding health insurance?

One ends with a mismatched delivery system regarding its target market with the target market being additionally populated with uninformed market participants. Central planning at its zenith!

What are the results? Abysmal. However, highlighting two of the uninformed results may be of interest:

(a) when comparing seemingly like-kind insurance plans on the ACA web site the consumer defaults to lower price. Unfortunately the lower price many times means the consumer has purchased the ultra-narrow or narrow provider network. Hence when the time comes to use the insurance the consumer finds few takers. One might call this procedure being “informed” the hard way, (2)

(b) the supposed informed consumer will realize, without any doubt, that once his or her policy is issued they will need to request a HIPPA Release Authorization Form from their insurer, sign such form, and return it post-haste. Huh? Without the form only the named insured can access insurance information, claims paid or pending information, etc. A single person without a HIPPA Release Authorization Form filed will find no outside person can help. If a spouse is involved, sorry no information unless the form is on hand. Yes, one spouse is considered the named insured and the other spouse can only gain access if the named insured submits the HIPPA Release Authorization Form. Of course the model informed consumer of the central planner surely knows this information without a second thought. (3) (4) (5)

The plans differ; the planners are all alike... - Frédéric Bastiat



(1) Aetna could be forced out of Obamacare: CEO, CNBC, 01/22/2014


(2) Marketplace Plans’ Networks Are Very Small, Study Finds. Kaiser Health News, 12/12/2013

(3) Authorization Use and Disclosure FAQs

(4) HIPAA Release Form

(5) HIPPA Release Authorization Form

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