The Tribune Democrat, Johnstown, PA

Latest News

November 23, 2013

Health plans in limbo: Obama’s reversal leaves both critics, backers bewildered

— (First of a two-part series on local effects of President Barack Obama’s Patient Protection and Affordable Care Act)

 

The botched rollout of the federal health care website and complications associated with President Barack Obama’s direction to reinstate canceled policies has insurance providers reeling and reform supporters scratching their heads.

“We don’t know anything yet,” Joe Fortunato said at his business, The Health Insurance Place in Richland Township.

Any canceled policy must be reapproved by the state Insurance Department, Fortunato explained at the 508 Luray Ave. office.

The Health Insurance Place, associated with Fortunato’s American Insurance Marketing in the same location, serves as a broker for about eight different insurance companies, including both western Pennsylvania giants Highmark Blue Cross/Blue Shield and UPMC Health Plan.

Highmark and UPMC leaders say they are working to expand health care through the federal Patient Protection and Affordable Care Act while waiting for the state Insurance Department provide direction on the canceled plans.

“UPMC Health Plan is in the process of evaluating and reviewing the comments by the president as well as communication from the Centers for Medicare and Medicaid Services at this time,” spokesman William Modoono said in a statement.

“UPMC Health Plan is also working closely with the Pennsylvania Insurance Division and is awaiting final guidance from the state to determine its next steps.”

Highmark has been working to move those whose policies were canceled into new

policies that meet Affordable Care Act requirements, the company announced after Obama’s Nov. 14 address.

“The president announced that the federal government would employ its discretion to delay enforcement of Affordable Care Act market reforms in 2014 for plans that are currently in effect,” the company statement said.

“It is unclear how these proposed changes can be put into effect.”

The Insurance Department is developing its plans to respond to Obama’s directive, Insurance Commissioner Michael Consedine announced.

“The Affordable Care Act has created unprecedented confusion in the health insurance marketplace,” Consedine said. “(The Nov. 14) announcement by the president has served to heighten that confusion and has created more questions.”

“We are evaluating the president’s proposed ‘fix’ for consumers who have had their policies canceled. However, as Gov. (Tom) Corbett has stated, we don’t believe the ‘fix’ represents a real or permanent solution to the problems caused by the ACA. It is also unclear whether or not the federal government had the executive authority to institute the delays.

“I have reached out to the CEO of every major health insurance carrier in Pennsylvania to examine what they are able to do to ensure that individuals are not left without coverage.”

The Insurance Department expects to have more information in the next few days, Consedine said.

The good news is that those whose plans were canceled can probably save money by changing to new federally approved plans available now, Highmark says.

“These individuals will benefit from having a new health-care reform compliant plan because it will have additional essential health benefits, and the plans, in almost all cases, will be lower priced,” Highmark announced.

The bad news is that it’s still difficult for those eligible for a federal subsidy to enroll in the new plans because of the website debacle at healthcare.gov.

Because of website issues, The Health Insurance Place in Richland has not enrolled any clients who may be eligible for federal subsidy, agent Bobbi Farabaugh said at the Luray Avenue office.

Subsidies can help most people with incomes less than

400 percent of the federal poverty level, which is $45,960 for an individual and $94,200 for family of four.

Farabaugh said she can help people determine if they are eligible for the subsidy, which would decrease the monthly premium. She also can show them what plans are available, with what benefits and what the monthly premiums would be.

“But if they are eligible for the subsidy, they can’t get the subsidy except through the website,” Farabaugh said.

The Health Insurance Place is compiling a list of those who want to sign up for subsidized policies and will contact them for enrollment when the website issues are resolved.

Another option may come as early as Tuesday, the federal government announced last week.

Julie Bataille of the Centers for Medicare and Medicaid Services, the agency that oversees the government’s online insurance exchange, told reporters last week that the “direct enrollment” option should be functioning. The option should allow consumers to bypass healthcare.gov, sign up directly with companies such as UPMC Health Plan and Highmark and still receive the subsidized premium rate.

National reports show insurance companies are exploring the option. Neither Highmark nor UPMC has announced the enrollment option is available.

The continuing enrollment quagmire has frustrated even the most ardent health care reform advocates.

Dr. Matthew Masiello, director of the Centers for Health Promotion and Disease Prevention at Windber Research Institute, says the technology meltdown is inexcusable for a nation that prides itself as a leader in the digital realm.

“Needless to say, the most concerning of this whole thing is our technological inability to make this work,” Masiello said.

“That is very frustrating – especially with the overwhelming level of experience we have in this country – that we failed to make this happen.”

Opponents and supporters of the Affordable Care Act should be working together to solve the problems and work on improving the law, Masiello said, adding that political wrangling has confused the public about the new law’s actual requirements and benefits.

“Blame is on both sides, and they better accept the blame,” he said.

Randy Griffith covers health care for The Tribune-Democrat. Follow him on Twitter at twitter.com/photogriffer57.

1
Text Only | Photo Reprints
Latest News
  • Halfway house inmates can ease back into society

    Prison life can be a time warp.
    When inmates are locked away – for months, years, decades – society moves forward: Technology evolves, major events occur, pop culture changes. From a personal perspective, families and friends live their lives: weddings, funerals, graduations, births, retirements. All the while, criminals bide their time, existing in a regimented world of cement walls and metal bars.
    Almost all of them eventually rejoin society, though.

    April 19, 2014

  • Crime board took aim at house

    Johnstown’s unemployment rate is around 8 percent.
    One-third of the city’s population lives in poverty.
    Burglaries and assaults significantly increased between 2010 and 2012. There is a thriving illegal trade in heroin and prescription drugs.
    Given those conditions, it can be challenging for Johnstown Community Corrections Center residents to find jobs when living in the facility or to avoid falling back into a criminal lifestyle upon their release.

    April 19, 2014

  • Homicides linked to center

    Three homicides that took place in Johnstown last year involved either a suspect or victim who previously resided in the Community Corrections Center.
    Police Chief Craig Foust confirmed the name of one victim, who spent almost two months in the facility on Washington Street during 2007, a time period verified by the Pennsylvania Department of Corrections.

    April 19, 2014

  • bachota Volunteers helping to spruce up community

    Walls and ceilings inside the Cambria County Library look clean and bright with fresh new coats of paint on them.
    The work was recently done by inmates from the Johnstown Community Corrections Center.

    April 19, 2014 2 Photos

  • alanna Hartzok targets income disparity

    Alanna Hartzok described herself as being a conservative progressive.
    The Franklin County resident said she is in favor of conserving environmental resources, education opportunities, Social Security and Medicare, while wanting to progressively address wealth inequality, health care and taxation.

    April 19, 2014 1 Photo

  • Schools rise to leadership challenge

    Forest Hills and Cambria Heights high school students put the spirit of healthy competition toward a good cause and picked up some lessons in leadership along the way.

    April 19, 2014

  • KATEY LADIKA Student’s photos win awards

    A Forest Hills High School junior has captured several awards in a high school arts and writing contest that has identified greats such as Truman Capote and Andy Warhol.

    April 19, 2014 1 Photo

  • Local briefs 4/20/2014

    April 19, 2014

  • Biggest student loan profits come from grad students

    This week, the Congressional Budget Office projected that the federal government would earn roughly $127 billion from student lending during the next 10 years.

    April 19, 2014

  • Smartphone kill switches are coming

    Smartphones need kill switches. It's a relatively easy solution to the pricey (and irritating) problem of smartphone theft. But who would have thought that the big carriers would team up with Apple, Google, Microsoft, Nokia, Samsung and lots of other manufacturers to voluntarily begin adding the technology by July 2015? The cooperative spirit! It makes so much sense!

    April 19, 2014

Poll

Would you like to see the Johnstown Community Corrections Center remain open after its lease runs out on Oct. 11, 2015?

Yes
No
I'm not sure
     View Results
Order Photos


Photo Slideshow

House Ads