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Sometimes you just have to share some advice with those who don't ask for it...

There are at least five options Ms. Bruenig could choose yet her solution to changing jobs is that we need Medicare for All.

1. COBRA - While the costs could be too high for her, this could be the best option for one wanting comprehensive coverage. Her insurance through The Washington Post (prior employer) would provide the least change. The plan she had the day she was last employed would continue. There would be no change in benefits or network. However, she would lose the employer contribution. Paying full boat is eye opening for most who leave employment and see their COBRA notice.
2. Special Enrollment Period (SEP) - Under PPACA a loss of coverage constitutes a qualifying event. She could easily create an account through the DC Exchange and purchase a plan. If her income is low enough (doubt it) then she could potentially qualify for an Advanced Premium Tax Credit.
3. Short Term Medical - This could be an affordable option. In DC these plans are limited to 90 days and have to cover pre-existing conditions. This could be viable because her new plan has to start on or before the 90th day of employment.
4. Christian Sharing Ministry - While she would have to apply and could be denied, it's still an option that could have appeal. Her bio says she's Christian so I would assume that she can meet the requirements for participation. The costs are low and with the limited amount of time she needs coverage this platform could fit the need.
5. Pay out of Pocket - Here's a novel idea...based on what premiums and benefits could cost it might make sense to pay for her healthcare costs directly to the physicians, labs, facilities, and pharmacies she uses during her period of time without coverage. Immunizations and a visit to the closest "minute clinic" for an ear infection may be less expensive than paying a month of premiums for COBRA or an individual plan. 

Maybe she should have consulted her health care reporter colleague Sarah Kliff? Or maybe not? Just sayin'.

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Computer programmers have a phrase, GIGO or Garbage In Garbage Out. If the data going in to the software is corrupt or faulty, the result will be useless.

The rocket surgeons that designed Obamacare failed to understand that the data they used was inexoribly flawed.

Their big idea to expand Medicaid resulted in folks that SHOULD be eligible either being denied coverage or they were kicked out.

Queue for Health Care . . . or Perhaps Not

Likewise, many able-bodied folks were able to jump line.

Unfortunately, many politicians have lost sight of Medicaid’s intended purpose. In doing so, they took limited resources meant for truly needy individuals and moved millions of able-bodied adults—the majority of whom do not work at all—to the front of the line instead. Meanwhile, hundreds of thousands of people with developmental disabilities and other conditions remain trapped on waiting lists, hoping to someday get access to desperately needed services. - Townhall

Why and how did this happen?

The architects relied on Census data without regard to Medicaid parameters.

First, the Census Bureau defines ‘households’ differently than the Medicaid program. For example, for an able-bodied adult who lives at home with his parents and does not work, Census data counts his parents’ income to determine his poverty status. The result is that Census data would indicate that he is not eligible for expansion. But after ObamaCare expansion, his state might learn the hard way that he is eligible because Medicaid eligibility is based on his personal income only. Oops. 

Abby Normal's Brain?

Oops indeed.

In other words, the right hand didn't know what the left was doing.

I suggest reading the article, but not on a full stomach. You might just toss your lunch.

#ObamacareSucks

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Got a call this morning from a nice gentleman whose wife, through whom the couple have their health insurance, is retiring, and due to the nature of the business (not-for-profit hospital system) said employer is not required to offer COBRA continuation. As such, they'll be losing this coverage when she pulls the trigger, and they're looking for an individual health insurance plan to be in place once that event occurs.

Regular readers know that, outside of Open Enrollment, there is no compensatoin available (at least here in The Buckeye State) for agents, and so there's really no way for us to help folks in these circumstances (I briefly considered, and quickly rejected, offering a Short Term Medical plan based on the caller's answers about their health). Now, I'll happily make an exception for existing agency clients, and those referred by colleagues, but I just can't afford to do so for call-ins.

I do feel bad about this, but the onus is on the carriers that choose not to compensate us for our efforts, and on the politicos and Departments of Insurance who turn a blind eye.

Shame on them!

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Colorado passed a similar bill in May 2019. The Illinois law limits out-of-pocket insulin costs to $100 for a 30-day supply.

"Health care is a right for all, not a privilege

https://www.newsweek.com/illinois-becomes-second-state-cap-monthly-insulin-prices-more-states-are-considering-it-1483987

Health care is NOT a right, but making health care affordable is an admirable goal. Problem is, when govt tries to dictate change in the private market it rarely happens as promised (and hoped).

Obamacare was supposed to "bend the curve" on health care and make it affordable for everyone while encouraging more competition and lower premiums. Buying health insurance would be as easy as buying an airline ticket.

And if you liked your doctor you could keep your doctor. If you liked your plan you could keep your plan.

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About 15 years ago, I wrote a Golden Rule (now UHC) Medicare Supplement policy on a nice lady, who subsequently suffered a fairly significant stroke, and whose daughter called me this morning with the sad new that her mother had passed away on the 15th. She had received the quarterly billing statement that would be due early next month, and needed advice on how to handle this.

My initial counsel was to simply write "Virginia passed on [DATE], please cancel as of that date" and send it in.

But on further reflection, it occurred to me that she would most likely be due a partial refund, and of course there would likely be some claims still pending.

So, I told the daughter to stand by, and that I would call her back after I'd had a chance to speak with the Home Office. After a brief hold, Elandra asked how she could help, and I explained our concerns to her. After she'd had an opportunity to confirm with her supervisor, she told me that everything was taken care of, the daughter would be receiving a partial refund (for premiums paid forward) and that she could disregard the bill, and that the folks at Golden Rule were sorry for her loss.

No additional paperwork, forms or death certificates necessary.

I am so impressed with how this was handled: professionally, courteously, compassionately and easily.

Kudos!

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From our friend Holly R:

Blue Cross insurers to help launch nonprofit drug company to lower prices https://t.co/sLJvW3IfIA pic.twitter.com/Mhf7nkrQfX

— The Hill (@thehill) January 23, 2020

BigPharma© has become quote the bugaboo of late, and of course the ever-increasing price of often life-saving meds has been an issue for quite some time. Nice to see one of the 800 pound insurance gorillas bringing its own guns to bear on the problem:

"Health insurers usually just pay for drugs that are made by drug companies, but now a group of 18 Blue Cross Blue Shield health insurers is helping to create a nonprofit drug company to make certain generic drugs itself, targeting medicines where there is a lack of competition and a need to bring down prices."

Of course, this is hardly an altruistic move (the carriers themselves acknowledge this), but at least there's some positive action being undertaken.

Kudos, BX!  

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From CMS in this morning's email:

[click to embiggen]

Pretty sure that ship has long since sailed:

I spoke with Medical Mutual about this a while back, and they assured me that the grace period only extends to in-force plans, and so if the initial premium wasn't paid by January 1, the plan would not, in fact, be put in-force.

Hmmm.

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