Another Runaway Roaring Down the ObamaCare Tunnel

Russ Vaughn
If the Obama administration thinks it has its hands full trying to create an effective system for enrolling participants, as the saying goes, "They ain't seen nuthin' yet."  Anyone with experience in the health care market can tell you that a far bigger problem than program enrollment or even delivery of services is billing and collections.

This ongoing train wreck of an introduction to the enrollment program has had many of us wondering how in the world these clowns will ever be able to handle the much more difficult issue of paying for it.  Even the Washington Post can see the pending problems as outlined in an article by the former boss of the Massachusetts forerunner of Obama's program.

Jon Kingsdale, who ran the Bay State operation from 2006 to 2010, correctly shows just how those billing and premium payment problems are going to be hugely difficult for ObamaCare.  Many of the very people whom ObamaCare was designed to insure are the very poor, and those folks share a common cultural trait that is going to guarantee that difficulty: they don't use banks, and most can't get credit cards.  Since virtually all health insurance billing and premium collection are done either by bank check or electronic transfer through a bank checking or credit card account, an administrative cost-saver for insurers, how are these folks going to make their payments?  According to this report by Jackson Hewitt Tax Services, the number of these "unbanked Americans" is just under 50 million and that:

More than one in four uninsured Americans eligible for the new premium assistance tax credits under the ACA does not have a checking account. Among the uninsured, non-elderly population with household incomes in the tax credit eligible range, 27 percent are effectively "unbanked."

The Jackson Hewitt report says the problem can be easily fixed simply by the government forcing insurers to accept debit card payments.  But they fail to note that this will require setting up another federal program akin to EBT, and doing it very quickly -- within weeks, in fact.  Good luck with that.

At WaPo, linking to the JH report, Kingsdale notes even more problems:

Enrollees are not covered until their first month's premium is received. In the individual insurance market, premium billing and collection is difficult to track. Folks frequently pay late or in weekly installments, or send too little or even too much. And when they stop paying, they often do not notify the insurer; the company must determine whether it is an intentional termination, an oversight, or a lost or late payment. Unlike most of today's 15 million direct enrollees, who pay premiums on their own, an estimated 27 percent of those who will be eligible for tax credits under the ACA do not have checking accounts. So they must use cash, money orders or prepaid debit cards to pay their share of monthly premiums.

Remember, enrollees remain uninsured until their first month's premium is received.  And until the exchanges begin to collect premiums, their operations remain underfunded -- a bit of a Catch-22.

This has all the appearance of a runaway locomotive roaring down ObamaCare's tunnel of troubles, headed smack into the caboose of the already derailed Enrollment Express.

You have to shake your head in wonder that ObamaCare's promoters failed to anticipate and address this payment train wreck.  It has to make you wonder just how well these liberal elites really understand the poor folks they profess to stand up for.

If the Obama administration thinks it has its hands full trying to create an effective system for enrolling participants, as the saying goes, "They ain't seen nuthin' yet."  Anyone with experience in the health care market can tell you that a far bigger problem than program enrollment or even delivery of services is billing and collections.

This ongoing train wreck of an introduction to the enrollment program has had many of us wondering how in the world these clowns will ever be able to handle the much more difficult issue of paying for it.  Even the Washington Post can see the pending problems as outlined in an article by the former boss of the Massachusetts forerunner of Obama's program.

Jon Kingsdale, who ran the Bay State operation from 2006 to 2010, correctly shows just how those billing and premium payment problems are going to be hugely difficult for ObamaCare.  Many of the very people whom ObamaCare was designed to insure are the very poor, and those folks share a common cultural trait that is going to guarantee that difficulty: they don't use banks, and most can't get credit cards.  Since virtually all health insurance billing and premium collection are done either by bank check or electronic transfer through a bank checking or credit card account, an administrative cost-saver for insurers, how are these folks going to make their payments?  According to this report by Jackson Hewitt Tax Services, the number of these "unbanked Americans" is just under 50 million and that:

More than one in four uninsured Americans eligible for the new premium assistance tax credits under the ACA does not have a checking account. Among the uninsured, non-elderly population with household incomes in the tax credit eligible range, 27 percent are effectively "unbanked."

The Jackson Hewitt report says the problem can be easily fixed simply by the government forcing insurers to accept debit card payments.  But they fail to note that this will require setting up another federal program akin to EBT, and doing it very quickly -- within weeks, in fact.  Good luck with that.

At WaPo, linking to the JH report, Kingsdale notes even more problems:

Enrollees are not covered until their first month's premium is received. In the individual insurance market, premium billing and collection is difficult to track. Folks frequently pay late or in weekly installments, or send too little or even too much. And when they stop paying, they often do not notify the insurer; the company must determine whether it is an intentional termination, an oversight, or a lost or late payment. Unlike most of today's 15 million direct enrollees, who pay premiums on their own, an estimated 27 percent of those who will be eligible for tax credits under the ACA do not have checking accounts. So they must use cash, money orders or prepaid debit cards to pay their share of monthly premiums.

Remember, enrollees remain uninsured until their first month's premium is received.  And until the exchanges begin to collect premiums, their operations remain underfunded -- a bit of a Catch-22.

This has all the appearance of a runaway locomotive roaring down ObamaCare's tunnel of troubles, headed smack into the caboose of the already derailed Enrollment Express.

You have to shake your head in wonder that ObamaCare's promoters failed to anticipate and address this payment train wreck.  It has to make you wonder just how well these liberal elites really understand the poor folks they profess to stand up for.