The Obamacare busy signal; are you having trouble with healthcare.gov? As many of you may have done today, and yesterday, I attempted to log on to the NJ area for the healthcare exchange. While most people who work for large companies are likely not lining up to check out the rates for insurance on the exchanges, others who run their own business are especially interested in finding out if the hype will indeed lead to lower healthcare premiums. Reports from other states say that consumers were able to find plans for the same price as they pay now with more robust coverage. Many of the states that set up their own exchanges were the ones who were able to view rates. In NJ, we are basically being blocked out by volume, which may of course be pent up demand for insurance coverage that is affordable. Affordability is in the eyes of the beholder, since many of us have different levels of income. The exchanges are designed to have something for everyone, allowing us to afford different levels of coverage. Those who are wealthy of course can choose plans that are quite comprehensive, while those who are on the lower end will likely be in a Medicaid network. As some doctors have warned about, there will be a huge volume of people looking to get Medicaid coverage, however, few doctors are signing up since the level of reimbursement for Medicaid is below the cost of care delivery, and since many doctors have had their reimbursements lowered by insurance carriers over the years, they are not feeling at all charitable. One of the representatives called us and asked me why we did not sign up for their plan, all I could say is that for 6 dollars a visit, I do not know anyone who would do it, and at a reimbursement level of $23.50 for an office visit for primary care, which is well under their cost of care delivery, few if any doctors will sign up in NJ which has one of the lowest levels of reimbursement for Medicaid in the country, even though it has one of the highest costs of living. If that sounds like a rant, it is more of a concern, since it will mean hospital based clinics will be even busier than before which is good for medical interns, but it will mean long waits for visits and care for those on the lower end of the financial spectrum. Hopefully we will see and improvement and we can report back on our experience with the system and rates. Unfortunately, right now, scoring healthcare coverage as an early adopter or early browser is like trying to score tickets on the floor at your favorite concert the minute the tickets go on sale. What do you think? As always, I value your opinion.