Who Can Afford A 51 Percent Rate Increase On Health Insurance Premiums?

By Coleen Elkins

If you are under age 65 and have health insurance you need to read this, share it and discuss it. 

No matter what state you live in you will see a substantial rate increase in your health insurance premium for 2016. So far New Mexico weighs in at 51 percent announced by Health Care Service Group. Wellmark of South Dakota has asked for a 43 percent rate increase. Assurant one of America's oldest insurers will either be sold or close their doors at the end of the year. 

It is uncertain if these rate increase will be approved by state and federal government. When carriers are reporting losses with like Blue Cross Blue Shield at $141 Million how can we not pay attention? The Obama administration can ask carriers to "explain their rationale" but if it is red ink what more do you have to explain? 

The carriers are citing higher costs for pharmaceuticals, and sicker patients for the rate increases. 

The "Affordable Care Act" had planned on attracting a younger healthier base of enrollees to support the expense of treating those that are chronically ill. That has not happened. In fact only one quarter of the enrollees fall into the younger healthier category. 

Not every state is going to face numbers referenced above but it doesn't matter, because this can not sustain itself. The question is how is the government prepared to sustain it or are they? 

This is a historical milestone and is going to heat up the debate over Obamacare on both sides of the isle over the next 18 months. 

The Elephant In Room.....Are You Being Crushed By Obamacare Taxes?

By Coleen Elkins

Are you on a Medicare Advantage Plan, Under 65 individual plan for yourself and your family or on group benefits plan at work? YOU ARE paying taxes accessed to your health insurance policy.  These taxes will increase each year!


There are six new taxes accessed by the law. These are taxes that did not exist on health insurance policies prior to March of 2010.

1. Patient-Centered Outcome Research Institute (Comparative Effectiveness) Fee

2. Annual Heath Insurance Industry Fee

3. Trhansitional Reinsurance Program Assessment Fee

4. Risk Adjustment Program User Fee

5. Marketplace ie: Exchange User Fees

6. Cadillac Excise Tax (for high cost plans)

What does this mean to you in cost?

Impact on individual market consumers: Increase premiums over a ten-year period for single coverage by an average $2,150, and for family coverage an average $5,080.

Impact on small employers: Increase premiums over a ten-year period for single coverage by an average $2,760, and for family coverage an average $6,830.

Impact on large employers: Increase premiums over a ten-year period for single coverage by an average $2,610, and for family coverage an average $7,130.

Impact on Medicare Advantage beneficiaries: Increase costs $16 to $20 per member per month in 2014 and will increase to between $32 and $42 by 2023.  The average expected increase in the cost of Medicare Advantage coverage over ten years is $3,590.

Is there relief in sight? Possibly!

There is a new bill House Bill that would repeal the tax. Representative Charles Boustany Jr. (R-LA)
he is joined by Representative Krysten Sinema (D-AZ) which is interesting. Krysten Sinema has been  an advid Obamacare supporter since she has taken office.

Rep. Boustany says the tax hurts individuals and businesses by increasing premiums and out of pockets. Boustany spent 30 years as a cardiovascular surgeon. In his comments to explain his actions he said this. "American families and small businesses are on the brink of being crushed under the weight of the Health Insurance Tax,” Boustany said in a statement, adding that the tax threatens “hundreds of thousands of lost jobs over the next decade.”The tax is an important revenue source for the Affordable Care Act, amounting to $8 billion in 2014 and rising to $14.3 billion by 2018, though the Congressional Budget Office has warned it would be “largely passed through to consumers in the form of higher premiums.”

Note: Open enrollment for Obamacare has ended for individual health insurance for those under age 65. Only those who have a qualified event can now enroll in health insurance. To learn about the law  visit our website http://www.yourhealthbenefitsmarketplace.com and to learn about Medicare and how to maximize your benefits at retirement visit our website http://www.yourmedicaremarketplace.com.

How Four Words May Impact Your Life Dramatically!

By Coleen Elkins

On March 4, 2015 The Supreme Court will begin hearing the lawsuit King vs. Burwell. The lawsuit boils down to four words written in the Affordable Care Act Law itself. Those words are beginning to echo repeatedly as the time approaches. The four words are "established by the state". When the Supreme Court hears a case they must rule on the law as it is written. The Court's job is not to find the intent of the author(s) of the law. 

If Court finds the law is held to those four words it may mean that the Federal Exchange was never intended to exist as part of the law. Thirty six states never created exchanges of their own and one more state dissolved their exchange after a disastrous failure and looked to the Federal Exchange to insure their subsidized residents for 2015. 

The law's top official Sylvia Burwell has refused to discuss "Plan B" in the event the law is ruled against. She is insistent President Obama is confident the Supreme Court will rule in the laws favor. They have not warned their customers their subsidies could be in danger. 

The new Republican Congress has drafted "Plan B" without the participation of Ms. Burwell. The proposal is not yet a bill, and would offer tax credits to people making up to 300 percent of the federal poverty level. Slightly lower threshold than currently in place. 

Preexisting medical conditions could not be denied when switching coverage as long as they have been continuously covered for at least 18 months. The uninsured would qualify to enroll for a onetime enrollment period. Health insurance could be purchased across state lines which would open up competition.

The Supreme Court decision is expected by the end of June. 

Read more: http://www.washingtontimes.com/news/2015/feb/4/republicans-release-obamacare-plan-b-in-case-of-re/#ixzz3QsgMXsEZ 

The deadline to enroll in health insurance under the Affordable Care Act for 2015 is February 15th. If you or someone you know has not enrolled in health insurance by then you will be unable to do so without a special election period or qualifying event. 

You can learn more by visiting our website: http://www.yourhealthbenefitsmarketplace.com 

Data Mining At Healthcare.gov?

By Coleen Elkins

The Associated Press revealed last week that those visiting Healthcare.gov to shop for or purchase health insurance are not doing so in complete privacy.

Fifty outside advertising and data-tracking companies were operating on the Obamacare website in order to track information about your shopping. This was done without your knowledge or consent.

The head of the House Science Committee Larmar Smith is demanding the Obama administration explain why companies were allowed to gather visitors information including name, zip code, pregnancy status and IP addresses.

Read more here

Preview Of Coming Attractions...... Is Your Legislator Preparing To Protect You?

By Coleen Elkins

Kuddos to Senator Brian Kelsey and State Representative Jeremy Durham of Tennessee. They filed legislation on Thursday to protect the citizens of Tennessee should The Supreme Court rule in favor of the plaintiff in King vs. Burwell. 

What is King vs. Burwell? It is a lawsuit sent to the Supreme Court to be heard.  This  means at the lower Courts there are mixed judgements (for and against) on the outcome and the case. The Justices agree the case has merit to be heard by the Supreme Court. 

Remember the Supreme Court must rule on "the letter of the law". In other words what it means exactly as it is written. 

In Senator Kelsey's words  "Plaintiffs in the lawsuit claim that the section of the law authorizing the government to distribute tax credits and assess penalties applies only when states choose to run their healthcare exchanges.  The law does not explicitly state that the tax credits and penalties apply when the federal government runs the exchange.  Tennessee is one of the 25 states that have chosen to force the federal government to run its exchange.  Senate bill 72 would prohibit Tennessee from running the exchange in the future if the plaintiffs receive a favorable ruling the case.  A decision on the case is expected by in June after the Tennessee General Assembly has adjourned. “This bill will stop the IRS from penalizing Tennesseans for not signing up for Obamacare,” said Senator Kelsey.  “It also prevents Tennessee from operating any Obamacare exchanges in the future.”

Hopefully legislators across the country have their fingers on the pulse of this case and are taking the necessary steps to be head of the outcome no matter what it is. We will be following this case weekly and monitoring what legislators are doing to protect their constituents. 

Proceeding begin the first week of March and a ruling is expected in June. 

You can visit the news pages of our websites http://www.yourmedicaremarketplace and http://www.yourhealthbenefitsmarketplace to stay in touch with the ever evolving changes in our healthcare benefits. 

Some Good News For Those On Medicare

By Coleen Elkins

Being in a situation where your doctors work together to coordinate your care can really give a patient peace of mind. For example if your Cardiologist communicates with your Pulmonologist also treating you could have healthier results.  Many hospitals and doctors are letting their patients know about their coordination of care services.

Beginning this month Medicare will pay primary care doctors a monthly fee to practice coordination of care for their chronically ill patients. The fee will be paid even if the doctor did not see the patient that month. Medicare feels this is a step to keeping patients healthier between doctor visits, and avoid costly hospital and nursing home stays.

Coordination of care could benefit patients of all ages. If the doctors practice receives extra funds to practice this way everyone will benefit. It will also help to lower the cost of medical care overall. Patients that have multiple illness often find themselves on several medications. If the doctors are working together and discussing medications etc the patient may end up with fewer monthly doctors visits. It will also lower costs by not repeating tests that may have been run by another physician.

The fee that will be paid is approximately $40 per month for each qualified patient. To earn the fee doctors will be required to come with a care plan for the qualified patients and spend time each month on coordinating their care with other providers monitoring and treating that patient. They will also have staff communicating with the patient with after care follow up calls etc.

Hopefully it will be found that this type of practice benefits everyone not just those at a high risk. Next time you visit your doctor ask them about coordination of your care.

Are You Ready To Talk Health Insurance On Your Tax Forms

By Coleen Elkins

It is the time of year when tax preparing companies remind us April 15th is approaching. The television commercials  are already beginning. Have you seen the green bowtie yet? Major tax preparing companies are warning you that there is an extra step on your taxes this year.


To help you get past the confusion the government is launching a new website. The website is a joint effort of Health and Human Services and the Internal Revenue Service. As of this writing the URL has not been published. The website will provide guidance in sharing your health insurance information and attesting to the fact that you do have health insurance. It will also help you determine if you qualify for an exemption from The Affordable Care Act.

A major tax preparing firm H&R Block has said up to thirty million people would be impacted by the filing changes. Those that have obtained a subsidy must file taxes to keep their subsidy even if they normally would not have to file.

Obamacare Approaches 5th Anniversary - Changes & Challenges Approaching For 2015 That May Impact You

By Coleen Elkins

On March 1st 2015 The Affordable Care Act also known as Obamacare will begin it's 5th year.

For those of you on Medicare your doctors may be sending you letters letting you know they may no longer participate in Medicare and this is why. Doctors and hospitals have been encouraged to participate in "meaningful use" of e-records and e-prescribing systems. This very expensive addition to a practice is meant to make the doctors office more efficient and cut down on communication errors that can harm patients. The cost average cost for a physicians office to implement this change is about $165,000.00 for a five person practice in just the first year.

You may have seen some dramatic changes in your Medicare provider network or received a letter from your doctor telling you that you will need to find a new doctor. More than 270,000 doctors and 200 hospitals nationwide will experience funding cuts from Medicare for failing to meet new government requirements. Some have just decided to no longer contract with Medicare and change the focus of their practice. This causing a very angry reaction amongst the Medicare community of those that have been impacted.

The employer mandate takes effect for the first time this year. Employers with 100 or more employees must provide health insurance to their workers. Next year the mandate will be impacting employers of 50 and more employees. Many employers are restructuring or relocating to other countries and cutting workers hours to avoid the mandate.

If you are under age 65 and did not purchase health insurance in 2014 and expecting a refund get ready. Each person without insurance will pay $95 or a one percent income penalty which ever is greater. That amount will increase to 2 percent for 2015. The cash strapped IRS is the appointed watch dog to collect the penalties and monitor insurance status of businesses under the employer mandate. 

Primary care doctors will face pay cuts in 2015. The funding given to states by the Federal Government to encourage them to beef up their Medicaid programs will be decreasing by an average of 43 percent beginning this month. Doctors will have no choice but to turn away patients because of the high cost of treating Medicaid patients coupled with the reduced pay.

Finally CHIP a funding program for children on Medicaid is reauthorized until 2019 but only funded through September of next year. Members of Congress although supportive of the program have failed to take steps to fund the program. They are receiving pleas from governors who want to know now if the program will end.

Continue to follow our blog in 2015 to stay on top of the changes that my impact you!