Last night, while watching the Sox trample the Cards, I dropped a comment amid the usual ROX/SUX banter. What's important is the last line which I thought was obvious when I wrote it.
No one picked up on it but I see that Howard Fineman writing for Huffington Post did report out on the trouble ahead which is going to hit at a very inopportune time. Try to look past the obnoxious headline.
I don't think I need to elaborate on Fineman's article. I would just fine tune one point. October 1 is the traditional start of open enrollment in the health insurance industry. It has been so since the beginning of time. That's why it's entirely predictable that we will see something like a repeat of the "cancellation letter" controversy this time next year. There's a potential for serious backlash against the law and the Democrats with the usual suspects on the right wing exploiting the situation.
I know that this subject is bewildering and opaque to people. I'm tired of watching the Democrats blindsided again and again with no choice but to roll with the punches because they're unprepared. I'll stick around and answer questions and comments to the best of my ability.
There's an underlying issue that I believe is important. We the People are our own guardians. Waiting around for someone to save you is like waiting for Trickle Down. It ain't happening.
12:29 PM PT: I think this diary would have been better if I had explained more about the basis for my concern. I was writing in response to one of the comment below, and decided that it really belongs up here in an Update, instead. Here it is:
Start with the original model for the healthcare system under the Affordable Care Act.
316 million Americans are supposed to have equal access to the healthcare system which is expected to provide the same level of care to all of them regardless of ability to pay because everyone is insured.
(I'm not being crass. The ACA is expected to control costs based on this model but the reality deviates from the model. That means different results from what was expected. Your mileage may vary. )
The 316 million consumers include individuals who are in the gap where there is no coverage because certain states didn't participate in Medicaid expansion. In the past, the uncollected cost of treatment provided to the uninsured resulted in a two-tier fee structure designed to shift costs to the insured. As a result, annual cost increases are also shifted to the insured, instead of being distributed equally to all consumers. The concentration exaggerates premium increases from year to year. It is assumed that this practice will continue because "those who would have been eligible for Medicaid under the health law's new rules but whose states chose not to expand their programs, also are exempt"from the individual mandate penalty.
The expected cost shifting wouldn't be a reason for the kind of concern I have except for the existence of dual marketplaces.
As of October 1, 2013, consumers could buy insurance from:
1) the ACA exchanges offering group policies with cost-savings based on income eligibility standards,
2) the individual market which existed before the ACA and continues to operate.
What's the difference between plans offered by each market?
Minimal difference according to the info at the linked Healthcare.gov page. The ACA's subsidized cost-savings are only available through the exchanges. Does that mean that consumers will gravitate to one or the other market based on their need for subsidies?
Going back to the unified whole that includes all 316 million consumers, what justifies the existence of two markets? Why is it preferable for insurance companies to operate an individual insurance market instead of combining it with the exchanges? Will all consumers receive equal treatment or will cost-shifting be applied only to the exchanges? How will the performance of the two markets compare between now and Open Enrollment 2014?
It's funny that HHS Secretary Sebelius was expected to answer for notification letters sent to policyholders by the insurance companies that operate in the private sector. Why weren't there any representatives from the insurance companies at the hearing to testify about their business practices?