Obamacare - Part 1- Implementation

The Patient Protection and Afforable Care Act signed in 2010 dubbed the ObamaCare.

The concept is to increase the size of insurance pool money (to everyone) easing  premium price and everyone enjoys insurance coverage.

People denied coverage due to existing medical conditions or high insurance premiums will benefit from ObamaCare.

Obamacare was launched simultaneously on 1st January 2014 and insurers were required to amend customer's existing healthcare to Obamacare.

BIG-BANG APPROACH FOR A LAUNCH PLAN

What happens when you launch a plan using the Big-Bang approach? 

Insurance companies have always faced processing matters like timely issuance of Medical Cards to customers and issurance of Guarentee letters for patience without proper IDs.

Likewise with the ObamaCare, pharmacies & hospitals are dealing with customers without sufficient plan identification or have yet to pay their first month's premiums by still providing prescriptions nevertheless.

"Some pharmacies, such as Walgreens and CVS, are taking the unprecedented steps of providing January prescriptions for customers who signed up for health plans on the federal exchange even if they have yet to receive their insurance cards or pay their first month's premiums."

Source:- http://www.detroitnews.com/

On the other hand, insurance companies are extending the deadline for premium warranty period.

"Many — but not all — insurance companies are trying to make it easier for recent enrollees to gain coverage by extending the deadline to pay their first month's premium for a week, or in some cases, until the end of the month."

Source:- http://www.detroitnews.com/

Interesting to observe whether the processing issues are sorted out in the next quarter otherwise the gap between uncollected premium and unidentified patient making claims will become wider.

 INSURANCE FOR EVERYONE

With Obamacare, there are no more uninsured people but a new gap in the "Underinsured category"

Insurance plans have Excess (The minimum medical costs incurred before insurance starts paying) and Loadings ( additional premium based on customer's profile) to help fight high claims ratios.

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People with high-costs chronic illnesses or low income will still feel the burden paying the medical costs before the insurance kicks in. Reason being they have to bear the medical expenses from their own pocket before being eligible to be covered by insurance.

Only time and data can help address these gaps when data on claims ratios based on customer profile starts to trickle in. Only then sound adjustments can be made.