Saturday, November 16, 2013

The good, the bad, and the ugly

The Good:

It turns out I have some options. First, my current insurance carrier - Blue Cross Blue Shield of New Jersey - will allow me to do an early renewal on my current plan. This means I can re-up with a start date of, for example, December 15 and keep my current insurance for a year. Since I like my plan, it’s nice to know I can keep it, at least for a while longer.

Second, although I originally thought I would not be able to find an ObamaCare-compliant insurance plan (a metallic) with any out-of-network coverage, it turns out that’s not the case. AmeriHealth is offering metallics in New Jersey that have out-of-network coverage: one Silver, one Gold, and one Platinum. The Silver is roughly comparable to my current coverage and is only $85 more per month than my current plan will be in 2014. Given my past medical history, I need out-of-network coverage; I am unwilling to risk financial ruin in the (I hope) unlikely event I need treatment at one of the big specialty medical centers outside of New Jersey.

The Bad:

Every rose has its thorns, of course, First, if I want to renew my current plan to reset my start date to December of 2013, I have to go without insurance for one day. That is, I would have to cancel my plan as of end-of-day on December 13; be without insurance on December 14; and would regain coverage on December 15. This is not a problem with regard to deductibles re-setting since I’m nowhere near mine anyhow. It is a little scary to think of being without health insurance, even briefly - and even scarier since December 13 is a Friday.

Second, although I am hoping to avoid any extensive interactions with my doctors, there is one doctor who is the hands down favorite to be involved in any (I hope) unlikely expensive encounter during the next year. Unfortunately, that doctor is one of my three doctors who are in the Blue Cross network but are not in the the AmeriHealth network.

The Ugly:

My first reaction to President Obama’s decision to not prosecute insurance companies that “extend current plans that would otherwise be cancelled into 2014” (provided their State regulators agree) was that it might open up another option for me: Assuming the State of New Jersey and Blue Cross were amenable, I could simply keep my existing plan until the current anniversary date in Spring 2014, renew it then, and have it in place until Spring 2015. After sleeping on it, however, I realized that would be a very risky path.

Imagine that the website is working reasonably well by, say, January 31; alternatively - and more believably - imagine that by January 31 the White House figures out a way for people to buy policies directly from insurance companies and still qualify for the subsides. It wouldn’t surprise me if the President declared that there is no longer a reason to allow insurers to renew non-ObamaCare compliant policies going forward because those who are losing their insurance can now find affordable alternatives. He would declare his November 14 statement no longer operable and announce that, henceforth, he will prosecute any insurance company that renews a pre-ObamaCare policy. Poof! When my anniversary date arrives on May 1, I have to go into the exchanges. I’d have to be as dumb as a whole yard of grass to trust my health to whatever the President says is allowable today when I know there’s a good chance it will be disallowed tomorrow.*

So if I want to hold onto my current health insurance, my only viable option is to take the 24-hour break from it. If I decide to go that route, I’ll be spending December 13th and 14th locked in my room with a box of saltines, a jar of peanut butter, a jug of water, and a pile of books.



* If I were a Republican Congresswoman, I’d introduce a bill that does exactly what the President’s November 14th statement does: allow insurance companies to renew non-compliant policies through (or perhaps it’s “up to”) October 1, 2014, while requiring that they provide all the information outlined in the CMS November 14 letter (pdf) to Insurance Commissioners. If Obama vetoes that, or threatens to veto it, that would tell me all I need to know about whether he’s committed to his decision to forgo enforcement.

And, no, “October 1, 2014” is not a typo. The President’s change is generally reported as allowing non-compliant policies to be renewed “through 2014” or “in 2014” but the wording of the letter is:

... health insurance coverage in the individual or small group market that is renewed for a policy year starting between January 1, 2014, and October 1, 2014, and associated group health plans of small businesses, will not be considered to be out of compliance with the market reforms specified below under the conditions specified below.

Which means I’ll probably be having a conversation with Blue Cross in August of 2014 about doing another early renewal. Time to stock up on saltines and peanut butter.

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