ACA: premiums due

We’re told that with ACA all will be well once the non-essential but essential front-end portal is fixed.

Yes, that fixes the enrollment problem (in theory…).  But the website’s greater function is to marry the government’s payment of premium subsidies to the policy holder at the insurer of their choice.

Engineer / process guy that I am, I have been alert to commentary on this, and I haven’t heard any.  I’m not convinced that piece is finished.  I think the tell-tale signs are that it’s not finished.

I think ACA fails, and this has already started.  And for a lot of us each ACA screw-up is kind of a scrumptious affirmation of our insight and world view.  But it’s wise to note the most likely scenario with ACA is it staggers out of the gate here in 2014, but ultimately stands up and assumes its status in American life as an underperforming, economy killing, sclerosis inducing bureaucracy.  IE, the expectation of near term program collapse is probably too apocryphal.  ACA just never meets its goals, but it’s here to stay, with its supporters moving the goalposts and declaring victory.

But a boy can dream.  And the thing is, premium payments are where the rubber meets the road.

These exchange enrollees need to have their January premiums paid in December.  That means the full premium.  Whatever portion of that paid by the government as a subsidy also has to be remitted.  So whatever back end process that accommodates this off needs to be finished and working, because insurance has some qualities that are immutable to spin and douche-talk.  The big one being, no premium, no coverage.  It will bigger crisis yet if come January we have enthusiastic enrollees that can’t go to the doctor.  Maybe there is an Administrative remedy for it that forestalls a Congressional panic, but off the top of my head I can’t think of what it is.


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