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Obamacare is off to a very rough start. Not only has the federal Exchange software had significant problems, but if you have spent any time on Minnesota's Exchange entitled "MNsure", you know that they are having similar issues. Long phone waits, confusion, and frustration, are just a few descriptions you would hear from individuals who have tried to examine and possibly enroll in a health plan. Sadly, Minnesota's Mnsure may be one of the better Exchanges when compared to the federal exchanges. Folks who need to buy insurance because their plan was cancelled or they didn't have coverage prior to October 2013, or are just looking for a better deal, can work with their agent and buy directly from insurance companies. They can bypass the Exchange in Minnesota. If however, someone qualifies for a subsidy or premium discount, they do have to buy through MNsure and get through that ordeal. In many other states it is not an option to buy outside the Exchange, which has just compounded the problems. On top of the current debacle, is yet another major glitch for the Exchanges and that is the ability for them to send your medical plan order (if you're lucky enough to place one), from the Exchange to the insurance company. There appears not to be an effective software system in place to handle this transferral of insurance information, which currently has many people hanging in limbo; not very comforting.

Another concern is not only low enrollment numbers, but those enrolling through the Exchanges are older and with health issues. Why is that a concern you ask? If the Exchanges enroll mostly users and very few non-users (young and healthy), the overall pricing for everyone will go up, and substantially. It is called adverse selection. Health care users enroll, and healthier folks don't, causing insurance companies to need more premium to support the claims volume. Over time, healthier people in the system start dropping out due to increased cost of the insurance exacerbating the problem and eventually spiraling out of control. Some suggest then the federal government will just have to take over health care as they have in Europe and Canada. Just be clear
however, that health care will never be free. You will simply pay for it
through taxes rather than insurance premiums, and clearly not less. And, considering how the government (federal and state) has done to date, does it really make sense to give them the whole industry to manage? Keep in mind that costs have increased greatly for many current policy holders, higher deductibles and out-of-pocket maximums are prevalent, and plans must include coverage you may not want or ever use. It is also quite possible that your doctor may not be included in your new network. These are big changes for most of us. Yes, even insurance agents are paying more. Our agency's health insurance has increased 40% over what we paid in 2013, and we're the experts.

We will know more by the end of 2014. The enrollment numbers will be clearer as to makeup and total numbers. The insurance companies will have had an opportunity to assess their risk and decide if further increases will be needed. You will know if your doctor will be in your new network. You will have decided by then if the increase in your deductible and overall cost sharing was a smart choice. Also, Citizens will have had an opportunity to vote as to what they think is the best course for our country and that may cause further changes.

There has never been major entitlement legislation that was voted into law by just one political party. ACA (Affordable Care Act) is the first. From the start, that was a red flag. If things don't straighten out there will be further changes, and some may be significant. Our recommendation is to work with what you have and observe what is occurring in 2014. Don't make radical changes to your benefits programs and see where the legislature and executive branches take us, both federally and statewide. Also select your political representatives the best you can considering what you know at that time. Our guess is that you will have a better basis for decision making once 2014 has played out. Then decide what's next for you. As always please contact us with questions, concerns or if you need assistance.

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