Friday, September 1, 2017

Will Obamacare Really Fail? 

We are carefully following all writing regarding the future of health insurance in America.

Senator Bernie Sanders is touring the country rallying for Medicare for all. It is very doubtful Medicare for all would pass any CBO analysis.

Today we would like to share with you one of the most comprehensive articles we have received from our business partner AHCP Sales. 

By now, everyone’s heard the news: the Republican efforts to repeal and replace the Affordable Care Act have failed in the Senate. After three unsuccessful votes—first on the Better Care Reconciliation Act, then on a repeal and delay bill, then on a skinny repeal—majority leader Mitch McConnell declared on July 27 that “it’s time to move on.” For now, repeal & replace is dead, though the efforts could certainly be revived sometime in the future.

While there is much disappointment among Republicans and their supporters at this apparent failure, members of both parties are now saying that they need to work together on a bipartisan solution. Of course, time will tell whether this can really happen, but many lawmakers are saying that they’re willing to give it a try. In fact, as USA Today reports, a bipartisan Senate panel will be holding hearings on September 6th and 7th on stabilizing the individual insurance market.

Meanwhile, President Trump is calling for his party to continue with the repeal efforts; after all, he says, Republicans have promised voters for the past seven years that they have a much better plan, so they shouldn’t give up so easily. His criticism of Majority leader Mitch McConnell has also increased in the past few weeks, leading to a rift that some worry will derail the GOP’s other legislative priorities.
Please continue reading here

Saturday, July 29, 2017

The Health Care Freedom Act Has Failed

By Coleen Elkins                  24-7 Health Insurance

A 48 hour attempt by the United States Senate to obtain a “skinny" version of the repeal of The Affordable Care Act also known as Obamacare failed by one vote.

This is what the Health Care Freedom Act would have accomplished. It would have eliminated the individual mandate penalty and temporarily repealed the employer mandate penalty and medical device tax along with providing states flexibility on certain ACA requirements. Earlier in the week, separate votes on the Better Care Reconciliation Act (the Senate’s alternative to the American Health Care Act) and the Obamacare Repeal Reconciliation Act (the “repeal and delay” option) also failed.

As of today over 80 insurance companies have left the individual market. The market is extremely unstable. Insurance companies have until September to notify CMS (Centers for Medicare and Medicaid Services) if they intend to leave or stay for 2018. Currently forty five counties in the United States will have zero insurance options in 2018. This number could increase. 

Note: This does not mean Medicare Plans are leaving. If you are on Medicare you may still be impacted. The rules in the Affordable Care Act will change Medicare over time if it is not revised or repealed. Such rules included bundled payments for providers. This is where providers would receive and share a bundled payment for a single episode of services provided by each of them to a patient. 

Both parties have indicated next steps may include bipartisan efforts to fix the ACA and stabilize the market. Specific plans and a timeline have not been discussed yet.

Republican leadership in Congress or the Administration may also pursue other ways to dismantle, replace or reform the ACA including regulatory action, regulatory non-enforcement or other options

Our office supported efforts that would bring bipartisan support to help stabilize the health insurance marketplace. We encourage you to reach out to your legislature and tell them what is important to do. You can achieve that in 10 minutes or less by visiting their website or getting their contact information HERE 

Our health insurance and Medicare insurance agency is a Member of the National Association of Health Underwriters and we are following legislative changes daily. We remain hopeful that resolution will come in time for the 2018 market to offer options to consumers. 

Please stay in touch with us as we do currently have options and ideas to help people find health insurance plans that meet their personal needs. 

Coleen Elkins 
Peace Of Mind For Your Health Since 1995 through ongoing customer service to our clients 
Individual, Small Business, and Medicare Specialist

Friday, June 16, 2017

Health Insurance Market Update

Offered by 

Health Insurance is in a delicate state right now. Inaction is causing reaction on the part of insurance companies. The bottomline is the market is extremely unstable. 

This article is focused on the state of Texas, but it is a snap shot of what is happening in EVERY STATE. If you are reading this and are concerned please share the information and consider taking a simple action of contacting YOUR Senator's office via email or telephone to let them know your concerns. It will take you less than ten minutes.

Use this link:

Eight health insurers have formally exited Texas’ individual market for health coverage, a blow to competition in the Obamacare insurance exchange north of Dallas, in Cooke, Fannin and Grayson counties along the Texas-Oklahoma border.

Statewide, though, the eight companies comprise only 4 percent of the individual market, said Texas Department of Insurance spokesman Ben Gonzalez.
Still, because the withdrawals are effective for at least five years, they amount to a near-permanent shunning of a potentially lucrative book of business, both inside and outside the exchange, in the nation’s second most populous state.
The exits are likely to stoke the already sky-high anxiety of consumers and providers as well as insurance company officials about which insurers will remain in Texas’ individual market, to what extent and at what cost.

Blue Cross Blue Shield of Texas is the anchor of the state's Obamacare exchange -- and appears to be sticking, despite questions about continued federal subsidies for low-income customers.

Secretive talks in the U.S. Senate over the American Health Care Act, the proposed bill to replace Obamacare, and uncertainty about whether President Donald Trump’s administration will continue paying subsidies for low-income purchasers’ out of pocket costs have raised many questions about market stability.

Insurers have already begun scaling back options in other states, once again citing millions in losses from the Affordable Care Act.

Experts said Texas, where state GOP leaders have staunchly opposed the law and refused to run or encourage residents to buy in the exchange, is not immune to the attack of nerves.

The 'blues' are sticking

However, in a boost to the Texas exchange’s stability, it appears that the largest player, Blue Cross Blue Shield of Texas, which is the only carrier selling in every county, will remain in the Marketplace.

Blue Cross has submitted proposed products and rates for 2018 to the state insurance department, though it won’t finalize decisions on them until “early fall,” company spokesman Gustavo Bujanda said.
“We hope to again participate in the individual market, but haven't made any final decisions concerning our level of participation,” he said in a written statement.

However, top Austin health insurer lobbyist Jamie Dudensingstrongly signaled Blue Cross will be back.
In a statement decrying how the eight carriers’ formal withdrawal notices “demonstrate deep instability in the individual market,” she noted the situation could be worse.

“Unlike some other states, every county in Texas will have at least one health insurance option,” said Dudensing, who is chief executive of the Texas Association of Health Plans.

Bujanda, asked if the carrier will sell exchange products in all 254 Texas counties next year, declined to comment.

Continued participation by Blue Cross is vital, said Cynthia Cox, who conducts economic and policy research on the Affordable Care Act for the nonpartisan Kaiser Family Foundation.
She noted that 45 counties in Ohio, Missouri and Washington face the prospect of having no insurer in those states’ exchanges next year.
In Texas, only two of the eight departing insurers, Humana and Prominence HealthFirst of Texas, were still selling in the state exchange this year, Cox noted.

No 'zero-insurance counties’

Assuming Blue Cross keeps selling border to border and no other insurers bail, there would be 97 counties with just one insurer in 2018 — up from 94 this year, she said. But there are no "zero-insurance counties" on the horizon yet, Cox said.

Along the Red River, Cooke, Fannin and Grayson counties would have just Blue Cross. Fourteen other counties, in the Panhandle and South Texas, would go from having three insurers to two, she said.
"It's a mixed bag, but it still would be a better situation than some other states are in," she said.

Potentially more than offsetting the recent departures is the prospect that two insurers, Centene Corp. and Oscar Health, will expand their Texas footprint. Both have indicated they will, though vaguely.

On Tuesday, St. Louis-based Centene said despite market uncertainty, it is seeking regulatory approval to sell health plans in Texas and a handful of other targeted states in 2018. About 90 percent of its key demographic is eligible for subsidies, the announcement said. Nearly a year ago, when it appeared Fort Worth would have just one insurer in the exchange, Blue Cross, Centene expanded into Tarrant County.

New York-based Oscar, which was co-founded by the brother of White House senior adviser Jared Kushner, withdrew last year from the individual market in the Dallas-Fort Worth area. But it continued to operate in San Antonio and is scrutinizing new Texas markets.

Dudensing, the industry’s state trade group chief, said the individual market supplies coverage for about 1.5 million Texans. About two-thirds of them buy in Obamacare’s federally run Marketplace, she said. The rest purchase policies that comply with the federal health law but outside the exchange. In addition, there’s an unknown number of Texans with “grandfathered” policies they began buying before the federal law passed in 2010.

Some brokers say carriers such as Humana no longer will offer the old, pre-Obamacare policies. The brokers complain they have too few exchange plans to offer customers. In no Texas county is more than four offered; and in 219 counties, just one or two, according to Kaiser’s Cox.
On Monday, the federal Centers for Medicare & Medicaid Services, which run the Obamacare exchanges in most states, reported that about 963,000 Texans enrolled in a Marketplace plan late last year or early this year and have followed up by paying their premiums.

Of them, 86 percent received a premium tax credit to assist with payments. Sixty-three percent received “cost sharing reductions” — the subsidies for low-income consumers that U.S. House Republicans have contended lack explicit legal authorization. Their future under Trump has been unclear.

Sticker shock

Last year, several Texas health insurers requested steep rate hikes for 2017. Blue Cross sought increases of 56 percent to 59 percent on exchange products, while another insurer’s increase exceeded 70 percent. Because of the federal subsidies, most though not all consumers didn't feel the higher premiums' bite. 

With continued federal funding of the cost sharing reductions uncertain, some states such as Iowa have requested waivers to revamp their Obamacare exchanges. Others such as Alaska and Minnesota are pushing ahead with state “reinsurance” programs that would limit rate increases. Texas leaders continue their hands-off approach, irking Dudensing and other industry figures.

Conservative Dallas health economist Devon Herrick, meanwhile, has predicted more trouble ahead for the Texas exchange.
“It’s essentially a poor risk pool, and with poverty comes health issues,” said Herrick, a senior fellow with the National Center for Policy Analysis. “So you have some populations that are inherently unprofitable.”
No one state has the entire solution, Herrick said.

"The overarching problem is that the current market is very unstable," he said.

Liberal health insurance expert Stacey Pogue of the Austin-based Center for Public Policy Priorities said Washington is responsible for the turbulence.

“Uncertainty being sown at the federal level — by the Senate writing a health care repeal bill in secret and the Congress and administration’s unwillingness to ensure payments due to insurers — is hurting consumers in Texas,” she said.

Find your county

To see which insurers participate in each county in the Obamacare exchange, by year, click on this Kaiser Family Foundation tool and select Texas and the year. "HCSC" is Chicago-based Health Care Service Corp., which owns Blue Cross Blue Shield of Texas.
EPO is exclusive provider organization. Like a preferred provider organization or PPO, it lets you seek services without going through a gatekeeper doctor, which is the hallmark of a health maintenance organization or HMO. But a PPO can cover some out-of-network visits, while an EPO and HMO do not, except in an emergency.
In 2016, there was one complete withdrawal, by Humana Insurance Co., and five “partial” withdrawals, in which the carrier pulled off the Obamacare exchange but did not make a full exit from the Texas individual insurance market. The partial withdrawals were by Aetna, Allegian, All Savers, Southwest Life & Health Insurance Co. and United Healthcare Life Insurance Co.

What they said …

Kaiser Family Foundation analyst Cynthia Cox: "It's a large number of companies exiting. Even if they are small companies, it's significant. It could be worse.”

Blue Cross Blue Shield of Texas senior media manager Gustavo Bujanda: "We're working with regulators at the state and federal level to achieve a stable and sustainable market.”

Centene Corp., on its expansion plans in Texas and four other states: "We are still working through the filing and review process. We will not have specific details until the review is complete.”

Oscar Health chief executive Mario Schlosser: "We're confident that in the end, there will be a stable individual market next year. We're actively looking for ways to serve more members in new markets, including in the state of Texas.”

Texas Association of Health Plans chief executive Jamie Dudensing: "Other states are proposing state-based solutions to address the stability of the market before the market goes from bad to worse. ... Moving forward, state policymakers need to examine state-based solutions in the wake of the federal government's inability to act.”

Center for Public Policy Priorities senior policy analyst Stacey Pogue: "The companies that have announced plans to stop selling insurance to Texans not covered through their jobs cover a small share of the market today. But we may not yet know the full extent of how uncertainty caused by federal inaction will weaken the Texas market.”

National Center for Policy Analysis senior fellow Devon Herrick: "The architects of the Affordable Care Act and the American Health Care Act are trying to fix the market. It's in our best interest to have a functioning market. We all have the same goal. But we have different ideas for how to achieve it."

Monday, May 8, 2017

American Health Care Act Phase One

By: Coleen Elkins            24-7Healthinsurance


For those of you that wish to read a summary of the entire bill passed by the House of Representatives last Thursday you can read it here:  Kaiser Foundation Summary

The next step is the bill heads to the Senate where the U.S. Senators vow to rewrite the bill.

The bill needed to pass and this is why. In 2018 many of those with pre-exisiting conditions won't have health insurance under Obamacare NOR will others. Many health insurance carriers have announced their departure from the current individual market. In Iowa Medica the last insurer has announce it is most likely leaving the market. Des Moines Register

If you are one of those that believe it is time for a single payer plan or "Medicare for all" think again. According to the CBO the Medicare Trust Fund is projected to be insolvent by 2028. $716 Billion dollars was taken from Medicare to fund Obamacare. More about that here: Modern Healthcare Remember we said "Trust Fund" because while we are working we are paying into Medicare to enjoy it once we reach 65. Read more here: Ask Heritage 

Once the Senate completes their writings and pass a bill a committee will be formed. The committee of both Senate and House members will convene where the bill will be legislated the old fashion way. If they are successful the official bill will be voted on again by both the House and the Senate. Ultimately it will be presented to President Trump for signing. If they are not successful ????

If you are reading this AND have read the provided links and are feeling concerned PLEASE reach out to your state Senator tell them your thoughts and concerns they need to hear it from YOU.     Contact my Senator of the 115th Congress.

If you feel better informed please share this post.

Thursday, May 4, 2017

House Votes To Repeal and Replace Obamacare

By Coleen Elkins 

It was a narrow margin today when the House of Representatives passed the vote to repeal and replace Obamacare. We will post details of the new law within the next 48 hours. The next step is the bill goes to the Senate.

Friday, April 21, 2017

Will There Be A Vote On Obamacare Next Wednesday?

By Coleen Elkins

Every morning we read bit of legislative news we can find providing a progress report on the repeal and replace of Obamacare.

This article addresses every aspect of what has gone wrong so far and what might possibly make it work this time around.

If you have an opinion as you are reading PLEASE take a moment and let YOUR representative in the House and Senate know what you are thinking! Google them and go to their website it is that simple!

Click below to read the article.

Published by Dan Calabrese o
Published by: n Friday April 21st, 2017

Tuesday, March 7, 2017

Obamacare Repeal And Negotiations Underway

From The House Ways and Means Committee   3-6-2017


The amount a household is required to pay towards their premiums is based on income. If a household’s income increases during the tax year, excess premium tax credits may result. Under current law, for households with incomes less than 400 percent of the federal poverty level there are certain limits on the amount the household is required to repay the federal government for the excess premium tax credits. For tax years 2018 and 2019, this section requires any individual who was overpaid in premium tax credits to repay the entire excess amount, regardless of income.

Under current law, qualified health plans must meet certain requirements for households to be eligible for the premium tax credit. This section amends those requirements to make available premium tax credits for the purchase of “catastrophic-only” qualified health plans and certain qualified plans not offered through an Exchange. Additionally, this section prohibits premium tax credits from being used to purchase plans that offer elective abortion coverage. Lastly, this section revises the schedule under which an individual’s or family’s share of premiums is determined by adjusting for household income and the age of the individual or family members.

This section repeals Obamacare’s premium tax credit beginning in 2020. SECTION_04: SMALL 

This section repeals Obamacare’s small business tax credit beginning in 2020. Between 2018 and 2020, under the proposal, the small business tax credit generally is not available with respect to a qualified health plan that provides coverage relating to elective abortions.

Under current law, most individuals are required to purchase health insurance or pay a penalty. This section would reduce the penalty to zero for failure to maintain minimum essential coverage; effectively repealing the individual mandate. The effective date would apply for months beginning after December 31, 2015, providing retroactive relief to those impacted by the penalty in 2016.

Under current law, certain employers are required to provide health insurance or pay a penalty. This section would reduce the penalty to zero for failure to provide minimum essential coverage; effectively
repealing the employer mandate. The effective date would apply for months beginning after December 31, 2015, providing retroactive relief to those impacted by the penalty in 2016.

Obamacare imposed a 40 percent excise tax on high cost employer-sponsored health coverage, also known as Cadillac plans. Under current law, the tax will go into effect in 2020. This section changes the effective date of the tax. It will not apply for any taxable period beginning after December 31, 2019, and before January 1, 2025. Thus, the tax will apply only for taxable periods beginning after December 31, 2024.

Under current law, taxpayers may use several different types of tax-advantaged health savings accounts to help pay or be reimbursed for qualified medical expenses. Obamacare excluded over-the- counter medications from the definition of qualified medical expenses. This section effectively repeals the Obamacare tax on over-the-counter medications. The effective date begins tax year 2018.

Distributions from an HSA or Archer MSA that are used for qualified medical expenses are excludible from gross income. Distributions that are not used for qualified medical expenses are includible in income and are generally subject to an additional tax. Obamacare increased the percentage of the tax on distributions that are not used for qualified medical expenses to 20 percent. This section lowers the rate to pre-Obamacare percentages. This change is effective for distributions after December 31, 2017.

Obamacare limits the amount an employer or individual may contribute to a health Flexible Spending Account (FSA) to $2,500, indexed for cost-of-living adjustments. This section repeals the limitation on health FSA contributions for taxable years beginning after December 31, 2017.

Obamacare created a new 2.3 percent excise tax on the sale of certain medical devices. This section repeals the medical device tax beginning after December 31, 2017.

Prior to Obamacare, as an incentive for employers to offer retiree drug coverage, employers who offered sufficient prescription drug coverage to their employees qualified for the Retiree Drug Subsidy to help cover actual spending for prescription drug costs. Obamacare eliminated the ability for employers to take a tax deduction on the value of this subsidy. This section repeals this Obamacare change and re-instates the business-expense deduction for retiree prescription drug costs without
Prepared by the Committee on Ways and Means Majority Staff March 6, 2017
reduction by the amount of any federal subsidy. This section applies to taxable years beginning after December 31, 2017.

Taxpayers who itemize their deductions may deduct qualifying medical expenses. The medical-expense deduction may be claimed only for expenses that exceed a certain percentage of the taxpayer’s adjustment gross income (AGI). Obamacare increased the AGI percentage threshold from 7.5 percent to 10 percent if the taxpayer or spouse was aged 65 or older. This section restores the pre-Obamacare AGI percentage threshold to 7.5-percent for all taxpayers beginning in 2018 and extends the special rule for those aged 65 or older through this year.

Obamacare imposed a Medicare Hospital Insurance (HI) surtax based on income at a rate equal to 0.9 percent of an employee’s wages or a self-employed individual’s self-employment income. This section repeals the additional 0.9 percent Medicare tax beginning in 2018.

This section creates an advanceable, refundable tax credit for the purchase of state-approved, major medical health insurance and unsubsidized COBRA coverage. To be eligible, generally, an individual must not have access to government health insurance programs or an offer from any employer; and be a citizen, national or qualified alien of the United States, and not incarcerated. The credits are adjusted by age:
  • Under age 30: $2,000
  • Between 30 and 39: $2,500
  • Between 40 and 49: $3,000
  • Between 50 and 59: $3,500
  • Over age 60: $4,000
    The credits are additive for a family and capped at $14,000. The credits grow over time by CPI+1. The credits are available in full to those making $75,000 per year ($150,000 joint filers). The credit phases out by $100 for every $1,000 in income higher than those thresholds.
    The Secretary of the Treasury is empowered to create a systembuilding upon already developed systemsto deliver the credit. Eligibility determinations will continue to be conducted by the federal government, while insurers and licensed agents and brokers will be able to do more of the consumer- facing actions currently performed in 39 states by
    The program also calls for simplified reporting of an offer of coverage on the W-2 by employers. Reconciliation rules limit the ability of Congress to repeal the current reporting, but, when the current reporting becomes redundant and replaced by the reporting mechanism called for in the bill, then the Secretary of the Treasury can stop enforcing reporting that is not needed for taxable purposes.
Prepared by the Committee on Ways and Means Majority Staff March 6, 2017

This section increases the basic limit on aggregate Health Savings Account contributions for a year to equal the maximum on the sum of the annual deductible and out-of-pocket expenses permitted under a high deductible health plan. Thus, the basic limit will be at least $6,550 in the case of self-only coverage and $13,100 in the case of family coverage beginning in 2018.

This section would effectively allow both spouses to make catch-up contributions to one HSA beginning in 2018.

This section sets forth certain circumstances under which HSA withdrawals can be used to pay qualified medical expenses incurred before the HSA was established. Starting in 2018, if an HSA is established during the 60-day period beginning on the date that an individual’s coverage under a high deductible health plan begins, then the HSA is treated as having been established on the date coverage under the high deductible health plan begins for purposes of determining if an expense incurred is a qualified medical expense.

Obamacare imposed a 10 percent sales tax on indoor tanning services. This section repeals the tanning tax starting in 2018.

Obamacare imposed a net investment tax, applying a rate of 3.8 percent to certain net investment income of individuals, estates, and trusts with income above certain amounts. This section repeals the net investment tax starting in 2018.

Generally, employers may deduct the remuneration paid to employees as “ordinary and necessary” business expenses. Obamacare added a limitation for certain health insurance providers that exceeds $500,000 paid to an officer, director, or employee. This section repeals the limit on the deduction of a covered health insurance provider for compensation attributable to services performed by an applicable individual starting in 2018.
Prepared by the Committee on Ways and Means Majority Staff March 6, 2017

Obamacare imposed an annual fee on certain brand pharmaceutical manufacturers. This section repeals the tax on brand pharmaceutical manufacturers such that the it would not apply for years beginning after December 31, 2017.

Obamacare imposed an annual fee on certain health insurers. The proposal repeals the health insurance tax beginning after December 31, 2017.
Prepared by the Committee on Ways and Means Majority Staff March 6, 2017