Thursday, June 23, 2016

Do We Finally Have A Viable Alternative To Obamacare In The Making?

By Coleen Elkins    24-7 Health Insurance


Are we seeing progress? The House Ways and Means Committee has published an alternative to Obamacare that could improve our health insurance options. 

"In a nation of over 323 million people, each with different needs and circumstances, it makes no sense for one federal agency to dictate the contents of every American’s health insurance plan. And it makes even less sense to impose a tax agency to dictate the contents of every American’s health insurance plan. And it makes even less sense to impose a tax penalty on any American who chooses not to purchase that plan"

With 21 years experience and 6 years of watching our clients premium rise, carrier and network options diminish this proposal looks promising to us. 

You can read it in it's entirety here: A Better Way

Monday, June 20, 2016

Who Is Going To Insure America Now? United And Humana Say So-Long To The Under 65 Market For 2017

By Coleen Elkins 

Last week UnitedHealthcare mailed a letter to their under age 65 insureds in the individual market. This letter was to inform insureds UnitedHealthcare will NOT be participating in the individual market in 2017. Translation: You are going to become uninsured and will have to find new benefits for next year. 

Today June 20th 2016 Humana joined them announcing they are also leaving the under 65 market in 2017. The announcement from Humana was vague as to whether it will be in all states. We are waiting for clarification. 

Blue Cross Blue Shield of Arizona eliminated their PPO plans in 2016. That action was to stop the financial losses due to high claims and low government reimbursement for losses promised under Obamacare. Two weeks ago Blue Cross Blue Shield of Arizona announced a 65 percent rate increase on their HMO plans for 2017. 

Who does this impact? Everyone under age 65 individually insured. However hit hardest are those that do not receiving a premium assisted subsidy. Who is that? Anyone that earns over 400 percent of the Federal Poverty Level. 

After 6 years it is difficult to remember the promises made in the Healthcare Law aka Obamacare that is now nearly 20,000 pages. 

Below is a list of 10 Obamacare promises published by The Heritage Foundation on December 18, 2013. Pay special attention to #10.

The question is upon review of the promises has anything improved since 2013? Can the law financially sustain itself when it could not keep it’s commitment to pay, and only reimbursed health insurance carriers 12 percent of their sustained losses it promised for 2014?

Has the law come to a fork in the road? 

From: The Heritage Foundation December 2013

Promise #1: “If you like your health care plan, you’ll be able to keep your health care plan, period.”[2]

Reality: Millions of Americans have lost and will lose their coverage due to Obamacare.

Obamacare has significantly disrupted the market for those who buy coverage on their own by imposing new coverage and benefit mandates, causing a reported 4.7 million health insurance cancelations of an existing policy in 32 states.[3]

For those with employer-sponsored insurance in the group market, the Congressional Budget Office (CBO) projects that 7 million fewer people will have employment-based insurance by 2018.[4]

Moreover, the Administration itself has admitted that employers would not keep their existing health plans. Federal regulations written in 2010 estimated that 51 percent of small and large employers would lose their “grandfathered status” by 2013—meaning a majority of employers would not keep their existing health plans.[5]

Promise #2: “[T]hat means that no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period.”[6]

Reality: Many Americans might not be able to keep their current doctor without paying extra.

Many plans offered on Obamacare’s exchanges have very limited provider networks, decreasing the chances consumers will be able to keep their current doctor without paying more money.[7] Furthermore, many Americans who purchase coverage on their own have had their existing health plans changed or canceled due to Obamacare, resulting in some people being unable to keep their current doctors without paying additional money to do so.

Due to the significant payment reductions included in Obamacare, seniors with Medicare Advantage plans may be forced to find new doctors. The largest provider of these plans, UnitedHealth, has recently reduced its provider networks in several states.[8]

Promise #3: “In an Obama administration, we’ll lower premiums by up to $2,500 for a typical family per year.”[9]

Reality: Premiums for people purchasing coverage in the individual market have significantly increased in a majority of states.

A Heritage analysis shows that, on average, consumers in 42 states will see their premiums in the exchanges increase, many by over 100 percent.[10]

For people with employer-sponsored coverage, costs also continue to increase. For families, premiums from 2009 to 2013 have increased by an average of $2,976.[11]

Promise #4: “[F]or the 85 and 90 percent of Americans who already have health insurance, this thing’s already happened. And their only impact is that their insurance is stronger, better and more secure than it was before. Full stop. That’s it. They don’t have to worry about anything else.”[12]

Reality: Obamacare imposes certain new benefit mandates on those with employer-sponsored coverage—a majority of Americans.

These mandates increase the cost of coverage. In fact, federal regulations written in 2010 assumed “that the increases in insurance benefits will be directly passed on to the consumer in the form of higher premiums. These assumptions bias the estimates of premium changes upward.”[13]

But higher premiums not only cost people more money; they have other impacts on coverage as well. For instance, as a response to the direct cost increases associated with Obamacare, UPS dropped coverage for spouses of employees if they are offered coverage through their own employers.[14]

Promise #5: “Under my plan, no family making less than $250,000 a year will see any form of tax increase.”[15]

Reality: Obamacare contains 18 separate tax hikes, fees, and penalties, many of which heavily impact the middle class.

Altogether, Obamacare’s taxes and penalties will accumulate over $770 billion in new revenue over a 10-year period.[16] Among the taxes that will hit the middle class are the individual mandate tax, the medical device tax, and new penalties and limits on health savings accounts and flexible spending accounts.[17]

Promise #6: “I will not sign a plan that adds one dime to our deficits—either now or in the future.”[18]

Reality: Obamacare’s new spending is unsustainable.

Obamacare was passed into law relying on a wide variety of unrealistic budget projections. A more realistic assessment reveals that it will be a multi-trillion-dollar budget buster. The Government Accountability Office (GAO) estimated the cost of Obamacare over the long term if certain cost-containment measures were overridden. Under that alternative scenario, which assumes that “historical trends and policy preferences continue,” the GAO found that Obamacare would increase the primary deficit by 0.7 percent of gross domestic product (GDP).[19]

Senator Jeff Sessions (R–AL) and the Senate Budget Committee staff, who commissioned the GAO report, translated the 75-year percentage estimate into today’s dollar amount, which would be $6.2 trillion over the next 75 years.[20]

Promise #7: “[W]hatever ideas exist in terms of bending the cost curve and starting to reduce costs for families, businesses, and government, those elements are in this bill.”[21]

Reality: Health spending is still rising and is projected to grow at an average rate of 5.8 percent from 2012 to 2022.[22]

While growth in health spending has been slower recently compared to the past, that is largely due to the sluggish economic recovery. Indeed, Obamacare’s new entitlements will help drive greater health spending in 2014 and beyond.[23]

Promise #8: “I will protect Medicare.”[24]

Reality: Obamacare cuts Medicare spending.

Obamacare makes unprecedented and unrealistic payment reductions to Medicare providers and Medicare Advantage plans in order to finance the new spending in the law. The cuts amount to over $700 billion from 2013 to 2022.[25] If Congress allows these draconian reductions to take place, it will significantly impact seniors’ ability to access care.[26]

Promise #9: “I will sign a universal health care bill into law by the end of my first term as president that will cover every American.”[27]

Reality: Millions of Americans will remain uninsured.

Despite spending nearly $1.8 trillion in new spending from 2014 to 2023, the law falls far short of universal coverage. Indeed, Obamacare is projected by the CBO to leave 31 million uninsured after a decade of full implementation.[28]

Promise #10: “So this law means more choice, more competition, lower costs for millions of Americans.”[29]

Reality: Obamacare has not increased insurer competition or consumer choice.

In the vast majority of states, the number of insurers competing in the state’s exchange is actually less than the number of carriers that previously sold individual market policies in the state.[30] And at the local level, for 35 percent of the nation’s counties, exchange enrollees will have a choice of plans from only two insurers—a duopoly. In 17 percent of counties, consumers will have no choice—a monopoly—as only one carrier is offering coverage in the exchange.[31]

Thursday, June 2, 2016

Insuring Your Own Health And Under 65? Can You Afford Your 2017 Health Insurance Premium?

By Coleen Elkins   24-7 Health Insurance

The two questions in today's topic are something everyone insuring their own health needs to take a very hard look. What does the future hold?!?

Health insurance companies must file requested premium rates for the coming year with the Federal government. Blue Cross of Texas has requested nearly a 60 percent rate increase on multiple HMO plan offerings for 2017.

 A recent 2016 client proposal for a family of 3 in rural Texas with Blue Cross will cost $960.00 per month. A 60 percent rate increase will raise those rates by $576.00 a month in 2017.

Using the example of a 3 person household where one adult lost a job and obtained a health insurance tax credit or subsidy from the federal government their premium could be reduced up to 70 percent.

The tax credit shields those who are receiving it from the reality of the true cost of health insurance.

When that person seeks employment and finds a new job their income will go up. Perhaps the income will go up enough that when they report their income change they lose their subsidy. Can they afford paying $1476.00 a month for health insurance that offers a potential out of pocket of $6850.00 annually? Will they pay it or go uninsured?

In a statement, Blue Cross Blue Shield of Texas said its request is based on strong financial principles, science and data. "It's also important to understand the magnitude of the losses ... experienced in the individual retail market over the past two years," the statement said. The company says it lost $592 million last year and $416 million in 2014.

In some rural counties in Texas Blue Cross Blue Shield is the only option.

Hospitals across the country are now suing the poorest of people for non-payment. These are new problems for the Affordable Care Act.

In a statement, the Health and Human Services Department said the Texas rate request is just the beginning of a process. Consumers in Texas and other states will have lower-premium options when sign-up season begins Nov. 1. If they don't like what their current insurer is charging for 2017, they can switch.
"Consumers will have the final word when they vote with their feet during open enrollment," said the statement.

You can read more here.