A year ago, I tried to imagine how the start of major Patient Protection and Affordable Care Act (PPACA) coverage expansion programs and health insurance rules would change the health insurance community. I compared the new PPACA World to a hammer that was about to fall on the old U.S. health insurance world.
“PPACA might come and smash Managed Care World as we know it to bits Jan. 1, or a few weeks or months later, or it might just blow away, or something else,” I wrote.
I now think the best description of what PPACA World did is “something else.” The hammer still…seems…to…be…falling. Ever so slowly toward our heads. Someone else has a PPACA public exchange plan. Someone else has doctors struggling with the new narrow provider networks. But many people, including me, are still in some kind of grandfathered plan, grandmothered plan, or other non-PPACA plan that’s operating pretty much the same old way it always has.
This is getting to be the time of year when reporters like me write our forecasts for 2015. Before I do that column, here’s a self-evaluation of how I did with the predictions I made for 2014.
1. For some, PPACA World will be heaven.
This is not the case for most of the people reading this.
PPACA World has not been easy on health insurance brokers, benefits compliance specialists, or the many conscientious people who are now paying more for less coverage.
PPACA has been great for the sick people who were shut out of the commercial health insurance system for years.
Their coverage may not work all that well, but at least they have coverage to complain about.
2. Exchange managers will get into brutal court fights with the vendors that designed, built and integrated balky exchange enrollment systems.
This seems to be happening, or on the verge of happening, in a number of states.
3. In states that have relatively low exchange plan enrollment because of exchange enrollment system problems, doctors, hospital executives, insurers and insurance regulators will send thank-you notes and bouquets to the information technology companies that caused the system problems that held down enrollment.
I can’t yet tell.