Monday, December 16, 2013

Backdating ObamaCare

A last-minute HHS rule orders insurers to pay for the law's blunders.

Click here to go the this WSJ editorial.
"the government is now forcing the insurance industry to cover everyone retroactively and also to waive the contractual terms of that coverage—or else.

"new regulation that explains "there have been unforeseen barriers to enrollment on the exchanges."

"unilaterally ordering plans to backdate all exchange applications. People can sign up for a plan on the exchange as late as Dec. 23. If an application winds up in some technology void, or it is passed to the insurer inaccurately or too late to process, that coverage nonetheless begins on Jan. 1."

"Simply selecting a plan is sufficient as long as buyers eventually make a "down payment," however much that might be. Upon receipt, the insurer is responsible for all medical claims incurred that month."

"hundreds of thousands of patients may soon discover that they face gaps in coverage through no fault of their own, but because their old plan was canceled and the exchanges malfunctioned."

"The regulatory fine print reveals that HHS intends to kick insurers off the exchanges if they don't obey. Having destroyed the old individual market, HHS will only certify the new "qualified health plans" if insurers "adopt policies to prevent disruptions in treatment of episodes of care.""

"HHS is also mandating that insurers treat out-of-network doctors and hospitals as in-network providers."
"The exchanges are supposed to publish searchable online provider directories so patients can call up their physicians, but those functions are still down or not built. Enrollees may only learn that their providers don't belong to their new plans only after they are billed for the full freight as if they were uninsured."

"The new HHS rule commands insurers to refill any prescription, no questions asked."

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