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Covered California works really well, except for all the headaches

Headaches Persist As Covered California Enrollment Nears End

California Healthline, January 31, 2017

Covered California’s fourth annual open enrollment period, set to end Tuesday, has been rocky for many consumers.

During this period, two Covered California errors have affected roughly 50,000 policy holders, leading to higher-than-expected premiums or the potential loss of their tax credits:

  • Covered California discovered late last year that about 24,000 policy holders hadn’t provided consent for the agency to verify their income, even though the agency thought they had. Without that consent, thousands of consumers lost their 2017 tax credits, at least temporarily.
  • Covered California gave insurers the wrong tax credit information for about 25,000 policy holders, resulting in inaccurate bills. In most cases the recalculated premiums are higher than consumers had initially anticipated.

Those mistakes are in addition to ongoing challenges, including Covered California website glitches, complicated password resets and the often-fraught interaction between Covered California and Medi-Cal, the state’s health coverage program for low-income residents.

Covered California Executive Director Peter Lee said the agency is contacting enrollees to fix the problems. “No one’s perfect. Anything of the scale we’re doing is going to have some problems along the way,” he said at the agency’s most recent board meeting.

Emily Bazar, California Healthline columnist and senior correspondent, recently appeared on the “McIntyre in the Morning” show on KABC AM 790 in Los Angeles to discuss these problems and their effect on consumers.

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“McIntyre in the Morning” show on KABC AM 790

Doug McIntyre:  This story is so complicated, and I have a BA in English. I still don’t feel really competent of the facts on this so please be kind with me as we go through this because it’s complicated; it’s really complicated.

Emily Bazar:  You’re right. It’s incredibly complicated. It’s been very difficult for people since 2013, 2014 when this began - to figure out how to apply, how to use their insurance, what the requirements are to avoid the tax penalties - it’s been very complicated.

...

Emily Bazar:  It seems in the writing of these things that the day to day effect on people  - the effect that it has on their lives, their time, their pocketbooks - is not taken into account as much as it should be.

http://californiahealthline.org...

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Comment:

By Don McCanne, M.D.

Peter Lee and his staff at Covered California quite appropriately have received accolades for their great work in implementing the Affordable Care Act. It has not been without glitches, such as those in this article, but that should only be expected in a system with such great complexity. As Emily Bazar states, “It’s incredibly complicated.”

But wouldn’t an improved Medicare that covered everyone because of its massive size also be incredibly complicated? Actually not necessarily. A well designed single payer national health program is the epitome of simplicity in the financing of a health care system. The administrative complexity that uniquely characterizes our fragmented multi-payer system would be eliminated by the administrative simplicity of a single payer system. Improving Medicare includes revising administrative functions to operate smoothly within a single system as opposed to being only one player that cannot introduce efficiency into the infrastructure of our complex multi-payer system.

The large size - covering 324 million people - is not a reason to duck out of implementing a universal program. Rather our financing system screams out for simplicity and efficiency - precisely why we need to enact and implement an improved Medicare for all.

Size is not the problem. Design is. Emily Bazar says that we need to take into account “the day to day effect on people  - the effect that it has on their lives, their time, their pocketbooks.”