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TONY WILSON: Some gain coverage, while others lose it under Affordable Care Act

Tony Wilson

Tony Wilson

A new year always brings with it reflections on where we’ve been and a sense of excitement about where the new year may lead.

This new year brings an additional level of excitement for me because I’ve found out at various holiday parties and gatherings that more people than just my better half are reading this column. And they (not Shelly) are doing so because they enjoy it.

I know — I was shocked, too. I asked many if they were sure they weren’t confusing my column with Darrell Huckaby’s.

So, after a brief holiday hiatus, I’m back and ready to guide you into 2014 with more information about health care reform along with an ample dose of opinion and, at times, a bit of sarcasm. (Like the T-shirt says: “Sarcasm, just one of the many services I offer.”)

First, let’s assess where we are, particularly in the area of the individual mandate, and what’s happened since we last checked in.

You’ll recall under the Affordable Care Act that virtually every American must obtain qualified coverage in 2014 or face a penalty at tax time next year.

To accomplish this requirement the federal government has spent, as my Granny would say, bookoos of money on the healthcare.gov website to assist people with the purchase of health insurance coverage.

I use the technical term “bookoos” because we don’t know how much the feds actually spent and continue to spend on healthcare.gov because the feds won’t give us the exact amount despite the administration’s stated goal of being “transparent.”

The administration also had a stated goal of signing up 7 million people for coverage via the healthcare.gov website — at least I thought that’s what the goal was since Department of Health and Human Services Secretary Kathleen Sebelius has stated this as a goal since as far back as June.

She announced last week that the 7 million number was not a goal of the administration and never has been. She says she and other administration officials were quoting a number thrown out by the Congressional Budget Office.

Oh, my bad.

That’s how transparency works: you state your goal for at least seven months and then when you are in danger of not meeting the goal you say that it wasn’t your goal.

If teenagers perfect this type of “transparency,” household chores around the country will go undone as they say to parents in unison, “Washing the dishes was not one of my goals despite the fact I’ve told you all day, Mom, that I would wash the dishes.”

To date, a little more than 2 million people have signed up for coverage through the exchange website since Oct. 1, the date the exchange opened. I’ll admit I’m a little skeptical of this number since just a few weeks ago the number was hovering below 500,000 enrollees.

However, maybe, with the number of people losing their coverage due to the non-ACA compliance of their current plans, many people enrolled by the December deadline so that they could obtain a Jan. 1 effective date, ensuring that their families would not have a gap in coverage.

(I am still a little amazed by the number of people that were able to obtain coverage when at the time of the deadline the healthcare.gov website was down for “scheduled maintenance.” That’s like the post office closing on April 15 for scheduled maintenance while a line of people wanting to get their tax returns postmarked forms out front.)

Let’s give Secretary Sebelius the benefit of the doubt and say the number is 2 million. How many of those 2 million are those who could not obtain coverage due to a pre-existing condition or due to affordability?

If this is a goal of the ACA and the administration (see previous commentary on goals not being goals) then we are making steps in the right direction, although far more enrollments are needed to make the insurance model work.

I do wonder, however, how many of the 2 million enrolled are actually some of the estimated 6 million people who lost their coverage as a result of their plans not meeting the ACA plan requirements.

Only Washington, D.C., politicians would consider enrolling 2 million while 6 million lose their coverage a win.

Over the next few weeks I’ll outline for you some of the changes you can expect to see in your coverage in 2014 along with some of the new fees and taxes heading our way. I’m going to get started on next week’s column right after I do the dishes.

Questions or comments? Feel free to email me at twilson@nfp.com.

Tony L. Wilson is a partner with NUVISION Financial Corporation based in Conyers. NUVISION is a subsidiary of National Financial Partners Corp. (NFP), which provides benefits solutions for companies.