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With the higher cost of living these days, lowering your health insurance premium can benefit almost everyone. Fortunately, it doesn't have to be an incredibly difficult task. All it takes is a little bit of time, effort and of course a fair amount of research. Here are a few pointers to get you closer to lower rates and a fatter pocket book. Easy To Insure ME has the answers 1. Don't Skimp On the Research Like anything else in life a little bit of patience can go a long way. It is very important to build up a list of insurance companies and analyze what each one has to offer. Regardless of whether you are just beginning to shop for health insurance premiums or not, don't fall into the trap of picking the first one that comes your way. There are many different plans available to the consumer and not all of them are created to best suit your health needs. Take your time to browse through different offers and compare prices and benefits. Be prepared to pass over quite a few before you find the perfect match for your situation. 2. Avoid Any Risky Activities If you've been searching for ways to lower your premium and coming up empty handed, step back and take a look at the kind of extracurricular activities you enjoy on a regular basis. Although some people can't justify getting rid of their favorite past times, you might find a few that you won't miss. If you can avoid any risky activities that have a greater potential to land you in the hospital now would be the time to do so. For example, if you want to lower your health insurance premium that next skydiving trip won't be in your best interest. Insurance companies tend to charge more when they know you are at a higher risk for injury. 3. Quit Your Bad Habits One of the best ways to help lower your health insurance premiums is to work on abandoning any habits that are bad for your health. For example, a person that smokes several packs of cigarettes daily will have a much higher premium than that of a non smoker as smoking is one of the leading causes for high cost insurance premiums. As a plus, both your family and your pocket book will thank you for quitting. 4. Go For the Major Plans If shopping for the right plan is intimidating you, try checking out the major plans first. The majority of them are in high competition with each other to provide the best rates which in turn means a better insurance premium for you. You don't have to only follow this advice while you are new to the health insurance game either. Comparing the major plans against each other has the potential to benefit even the experienced health insurance consumer. 5. Remember to Periodically Reassess Your Needs One of the most overlooked ways to lower your health insurance premium is simply evaluating your medical needs from time to time. Just because you required a certain service five years ago doesn't mean you should still have to be paying for it today. Don't be afraid to carefully assess your health so that you can determine whether or not you need to pay for a higher costing health insurance. As a general rule, you should at least aim to make an evaluation annually- you'll surprise yourself with the benefits this can have on your overall cost. And just remember to keep in mind that just because you weren't able to drop any services this year doesn't mean you won't have any luck in the following year.
Easy ways to acquire health insurance quotes through Easy To Insure ME Acquiring Health Insurance Quotes through Phone Calls Calling an insurance company for health insurance quotes may sometimes be full of hassle. First, it will really take time especially if you want to understand more about the details and you want to ask a number of questions. Secondly, when you call these insurance companies, it is a trend that your call will be put on hold. It would really be frustrating especially if you need the health insurance quotes already and you are made to deal with all these hassles when you make that phone call. But, there are positive points when you inquire for health insurance quotes over the phone. The first good thing about getting health insurance quotes over the phone is that you get to talk to a human being who is well knowledgeable about the health insurance quotes. While the person is explaining to you the different details of the health insurance quotes, you have the choice of asking follow up questions. When you talk to an insurance consultant through the phone, you can also inquire on other offers on that same policy you are interested on. Usually, insurance companies do adjustments on health insurance quotes to suit your needs better. If you already like the health insurance quote presented to you by the insurance consultant, you can directly buy the policy. These transactions are usually made through credit cards. Another option: Online Health Insurance Quotes Given this modern day, there is another option you can explore if you want to get health insurance quotes online. This is another simple and fast way of getting your health
insurance quotes and purchasing your insurance policy. Insurance companies now have their websites where you can check the policies they offer and ask for free online health insurance quotes. It is also an easy way for you to check on different insurance companies and to choose among the companies and the policies would suit your needs. When you get the quotes online, it will save you more time because you receive the health insurance quotes faster and from multiple insurance companies as well. So this means you will be saving more time than you calling different insurance companies one after the other. This is also an easier way of comparing the health insurance quotes that you receive from the numerous insurance companies. Purchasing policies online is also easy. After choosing which health insurance quote you want best, you can then acquire that health insurance policy fast and simple. You just need your credit card for this transaction don't worry, transactions are secured for this. You can also choose to hire an independent agent to find you the best health insurance quotes. Some independent agents get discounts from some companies so you will get better health insurance quotes from them. Just make sure that even though you are presented with health insurance quotes that are light on your budget, they must cover your needs well too. Independent agents can be really big help especially of you do not have time for the phone calls or you do not really know how to compare and contrast health insurance quotes. A person looking for affordable health insurance quotes can also simply apply for various health insurance quotes. Getting your hand on such diverse quotes as well as comparing all of their estimates will definitely provide you with a very sensible idea about which plans in reality can provide you with affordable health insurance.
Health insurance covers all the medical expenses generated by illness or diseases. All the conditions covered by the health insurance are stated in the health insurance policy. Health policy is a legal contract. The price of the legal contract is called the premium. Health insurance is a contract that provides money to cover for the policyholder's medical expenses. Because medical treatment nowadays is increasing each year, it is important that we are equipped with individual health insurance plans. Individual health insurance plans are the coverage that a person buys independently. Health insurance is often provided for people as an employment benefit. State and federal government also are responsible in giving out health insurance to individuals who are: over sixty-five years of age, those receiving public assistance and those with certain disabilities like blindness and end-stage renal disease. Usually, employers and government programs are the ones who provide most health insurance coverage to individuals. However, 5% of the American population acquires individual health insurance plans. Individual health insurance plans have many advantages. 1. If you are a policyholder then you don't have to worry about where to get the money to pay for the hospitalization, doctor's fees and other medical expenses because the health insurance company will cover all the expenses. The costs of medical care and treatment have been increasing lately that many people are now realizing the importance of having the right health insurance coverage to protect them in the years to come. 2. Those people who have individual health insurance plans have an easier access to proper treatment and care compared to those people who are uninsured. This is also the reason why many Americans who are not qualified for voluntary public insurance want to have individual health insurance plans for their own purpose. Aside from that, their dependents or other members of their family can also benefit from the health insurance. These are just some of the many advantages of having individual health insurance plans. At present, there are about 47 million individuals in the United States who are uninsured. According to a recent National Survey, most of these people do not have health insurance because of the very high cost of health insurance coverage. But, if you do not have any health insurance coverage, it will cause some problems not only to you but to your families as well because you're going to have to pay for the medical expenses out of your own pockets. Uninsured individuals are mostly the ones who do not receive the proper medical care and treatment. Usually, uninsured individuals suffer a lot because their illnesses or diseases are taken for granted and they cannot afford to get the proper medical care and treatment that they deserve. The secret in finding the right individual health insurance plans is to know how to find what you are looking for. We all know that finding individual health insurance plans isn't an easy thing to do. There are a lot of health insurance companies nowadays that it's very confusing what health insurance policies are right for you and for your budget. You should look at exactly what sort of coverage do you need. Take time to sit down and list out carefully what medical services suit your needs in times of accidents or unexpected illness. And when you have decided
what you need then you need to look for individual health insurance plans that you can afford. You can find a lot of health insurance companies online that offers affordable individual health insurance plans for you and your family so that you will have peace of mind knowing that you're covered when you or any member of your family gets sick or involved in accidents.
Medical insurance often brings a sense of relief to families who have experienced the high cost of health care. Whether your family is large or small, receiving medical treatment can put an enormous dent in your financial savings. Having the knowledge that you need family health insurance is only the first step to begin protecting your family and save money from the rising cost of health care. Why is it important to get health insurance quotes As with any major purchase it is important to first shop around for the best deal. This same premise applies to purchasing health insurance. To begin gathering family health insurance quotes you can talk to your employer (if you work full-time). Many employers offer a group health plan. If you do believe the plan they offer is what you need you are not required to participate and you can pay for health insurance through a private provider. However, having the information from your employer regarding health insurance is a great starting point for comparing other forms of health coverage. Health insurance quotes Talk to friends and family about the type of coverage they have for their families. Often times they can recommend providers that offer a flexible plan for the lowest possible cost. If you have access to the Internet, take some time to apply for several different online quotes. If you are still looking for more information to compare, you can call several different providers of health insurance. What types of health insurance is available Once you have gathered all the information you need to make an informed decision you may notice that the health plans offer three primary types of coverage: * Health Maintenance Organizations (HMOs) * Preferred Provider Organizations (PPOs) * Pay-For-Service (POS) It is important to not only compare the plans against each other and find out what they each have to offer but to also compare what type of coverage your family needs. Remember to purchase a plan that meets your medical needs and not one that offers coverage for areas that you do not need. You do want to make sure that you have coverage for doctor's visits, hospitalizations, and major illness. Once you have established those requirements you can begin to compare which plan offers you specifics for your family's medical needs. Gathering the information for family health insurance quotes can be time consuming although the final result will be financially rewarding with the amount of out-ofpocket expense you will be saving.
There are quite a lot Americans who are living without health insurance today. It is not a proud thing to admit, but the government is trying to do things to help them. The death toll is high enough, and medicine is expensive, so you do need to sort something out. You don't have to wait for the government if you can get it yourself. And many times it is actually available at a much cheaper price then you may imagine. Easy To Insure ME has the answers Even if you cannot afford comprehensive health insurance, you can start with whatever little you do have and build up from there. Anything might occur for which you need medical attention at any time, and the health insurance package you get today could be what saves you. Think of it this way. Without health insurance, you are a sitting duck for any disease or medical condition out there. When the day arrives and the doctor insists that you have to make payment before you can get the healthcare you need to stay alive, you may find things very uncomfortable for you. And you could have taken care of it with a simple health insurance package. It would be a shame to die of a disease simply because you could not afford to pay for the treatment or procedure. If you had health insurance perhaps things would not have gotten so out of hand. That would be your fault and no one else's, as it is perfectly possible to get a policy established with a minimum of fuss. One very quick way to approach the situation is to get some affordable health insurance quotes online that can quickly give you an idea of the type of prices that you may have to pay for health insurance cover. If you cannot pay for your health insurance yourself, ask if you employer can help. It could beconsidered in the same terms as a small loan perhaps, one that you may have to pay back to them eventually. Or it could be a small deduction from your salary, which is even more common. Regardless, however small the package you can get, it is better
than nothing at all. If you plan to live for very long on this earth, you want to see that you have health insurance. It is important. With people dying from treatable causes only because they can't afford the treatment, you certainly don't want to be one of them. I never understood the importance of a health insurance plan until I saw the movie John Q.' All of a sudden I realized I had been walking the tightrope my whole life. I could suddenly find myself in a situation in which I cannot afford the medical attention I needed, and that would be a big problem. I changed that status immediately and got covered because it hit me how big a problem it could end up being. Sure health care in the United States is not cheap, and that is why there is such a huge market for health insurance as there is today. Thankfully, affordable health insurance is all around you if you have the sense to go for it. Sincerely, you don't have to have the most expensive policy out there. Something simple and basic should do until you have more funds. It doesn't matter that you are not rich. You need to get this figured out. The fact is that with health insurance you can have the insurance firm paying your medical bills every time you have to seek medical attention. All it takes is ensuring that your monthly premiums are paid in good time.It is definitely an expense. But it is unfortunately a basic one that you should be having. The days when health insurance was a luxury are long past. We live in a dangerous world, and you need to buckle down and get it sooner rather then later.
Two of the region's three dominant health insurers intend to raise premiums on average by double digits for next year, and the third wants a double-digit increase for plans not structured as health maintenance organizations. The premium for one insurance plan could rise almost 36 percent. The insurers cite rising costs of medical care and federal health care reforms. The question is whether the state will let them. Under a new state law, health insurers must submit their premiums to the state Insurance Department for approval before they take effect. The state can reject or modify the increases if regulators feel they are not appropriate or justified. The law also means insurers must disclose their rate plans much earlier than in past years. Reaction from consumers and small businesses has been swift. "There's no question that there's frustration and anger," said Howard N. Silverstein, president and CEO of Choice Employee Benefits Group LLC, an insurance agency. "Everybody I've talked to cannot believe that some of the rate increases are as high as they are." Joe Milazzo, owner of Milazzo Renovations in Lancaster, already was paying $1,200 a month for individual coverage from Independent Health Association when he got a notice of an increase of roughly 15 percent. "It's craziness," he said. "It's getting to the point where health insurance payments are more than the mortgage payment." So he went to the Amherst Chamber of Commerce's insurance broker and got almost the exact same plan from BlueCross BlueShield of Western New York for $1,351.72 -- but every three months, because he is now in a group plan. "We're talking a lot of money in savings, for virtually the same plan. I still don't believe it," he said. 'Entire industry changing' In response, employers are expected to cut back on benefits and ratchet up the amount that employees and their families pay to share in the costs -- through higher deductibles, co-pays and coinsurance. "Our clients ... have come to expect double digit increases the past few years," said Colleen C. DiPirro, president and CEO of the Amherst Chamber, which helps small businesses get health insurance. "However, it doesn't make it any easier for them to absorb the costs." "At the end of the day, I think the entire industry is changing and people are going to become more acclimated to paying more out of pocket and utilizing health insurance for major claims to keep them from financial ruin as a result of a health issue," she said. "That is the only way we can insure the masses." The average requested increase across the board for BlueCross Blue- Shield was 13 percent, according to information filed with the state Insurance Department, but the increases range from 3.9 percent on one HMO to 28 percent. Increases would range from less than 10 percent for 30 percent of members to 10 percent to 15 percent for 45 percent, and more than 15 percent for more than 22 percent of those covered. Independent Health's rates would rise 10 percent overall, but the increases would range from 7.4 percent on an HMO to 35.8 percent for its small-group high-deductible health plan, where the deductible is not changing. For 1 percent of the company's small group subscribers, increases would exceed 21 percent. Univera Healthcare wants to raise rates by 5.4 percent for its Transitions, direct-pay HMO and point-of-sale plan, and 11 percent for all of its other products. The insurers noted that the premiums and estimated ranges apply only to their base policies, before taking into account individual "riders" that modify coverage for group plans. Also, they are not final until approved. Independent Health submitted a 1,200-page rate filing July 29, one of the first to do so, and responded to questions once with another 600 pages. "It's a ridiculous process," said Dr.
Michael Cropp, the insurer's CEO. Univera spokesman Peter Kates said the company submitted its information in August but has not heard back from the state. Comments reveal rage HealthNow, the parent of BlueCross BlueShield, filed rates Sept. 1 and has talked to state regulators. But "we don't have any insights" about how the state will rule, said Stephen T. Swift, the insurer's chief financial officer. "They're very, very stretched," Swift said. "I'm optimistic the state will approve these rates as filed, but I can't say we have any indication." Comments from the public to the state Insurance Department are being posted, with names blacked out, on the department's Web site. "This is preposterous!!!!" wrote a woman who co-owns a business with her husband. Independent Health had notified them of an 11.8 percent increase. "Who on earth can afford this? ... The cost of health insurance now is an almost unmanageable burden. This new increase would put us out of business." "In these economic times to propose an average 14 percent increase in health care is absurd," wrote another person who appears to be an insurance agent. "I am not looking forward to meeting my clients and trying to explain these incredible increases while their expenses rise and wages fall." "I am writing to express my disgust," wrote another small business owner, who claimed to have received notice of a 37 percent rate increase. A dental health care professional wrote: "I wish my income increased as much as my health insurance premiums have." As they do each year, the insurers defended their increases as necessary to account for the ever-increasing costs of providing care for their members. Companies routinely cite the high costs of and growing consumer demand for new diagnostic technology and hospital treatments, such as colonoscopies, heart surgeries, radiation and chemotherapies, and intensive services for patients during emergency room visits. They also point to the high cost and use of sophisticated drugs, especially brand-name and specialty prescription drugs or injectable medications for some of the most serious medical conditions. "Each year, medical inflation and a continuing increase in the use of medical goods and services combine to drive health care costs higher," Univera wrote in its own letter. "To cover these increasing costs, we must modify premium rates." Consolidation among providers also has reduced competition to some degree, allowing prices to creep up. And the local insurers are quick to note that their administrative costs are much lower than the national average and especially for-profit health plans. "Obviously our push is to drive those rates as low as possible," HealthNow's Swift said. "We know our customers' concerns as far as affordability and access." But they also have treaded in waters that even the White House has deemed inappropriate, by blaming the federal health care reforms. Obama administration officials have warned the industry and its national trade group not to justify rate hikes by citing the reforms. Notices called "deficient' So far, requirements for full coverage of preventive care with no co-pays on screenings, the elimination of annual and lifetime limits and coverage for young adult dependents up to age 26 are the only reform provisions that have taken effect. "Independent Health has evaluated the cost of our members' health services and benefit changes, including those mandated in conjunction with health care reform," the carrier wrote in a letter to small employer groups. "As such, we have determined that we must adjust our premiums for 2011." Late last month, after the due date for the filings, the Insurance Department issued a statement criticizing many of these notices to employers as "deficient, if not misleading, and in violation of the new prior approval law." That law was designed to allow insured consumers an opportunity to understand any rate increase and to comment or ask questions about it. "These type of misleading notices have the effect of confusing members and masking the underlying reasons that a rate adjustment is being requested," the Insurance Department wrote in its letter to insurance companies, directing them to provide consumers and employers with details.
Four in every five Canadians believe that the demands placed on the health system by aging Baby Boomers will result in reduced access and lower quality care, a poll commissioned by the Canadian Medical Association reveals. There are also widespread fears by close to 75 per cent of respondents that growing health costs will result in significant tax hikes and an inability of seniors to afford health care as they age. At the same time, the survey shows strong support for user fees and having well-to-do Canadians pay more out-of-pocket to help attenuate the impact of caring for a growing population of seniors. According to the poll, younger Canadians in particular (those born after 1966) are willing to adapt to the pressures on the medicare system by buying private health insurance to supplement publicly provided care, using their retirement savings to pay for health care and going into debt to pay the health costs of their parents and themselves. "What we see in these poll results is a refreshing acknowledgment
of reality," Anne Doig, president of the CMA, said in an interview. "Canadians are not giving up on medicare but they're recognizing that medicare needs to be transformed to deal with current realities, demographic and otherwise," she said. The poll, which is being released Monday at the CMA general council meeting in Niagara Falls, Ont., dovetails nicely with a report released earlier this month entitled Health Care Transformation in Canada: Change that Works, Care that Lasts. In that document, the CMA, the group representing Canada's 72,000 physicians, argues that the current health system cannot meet future needs, in part because of the aging population. It calls for significant changes, including a universal prescription drug plan, a charter that enshrines the rights of patients, an independent body that can monitor whether health dollars are being spent efficiently, and monetary incentives for doctors and hospitals to treat more patients. The proposals are based on the premise that health care in Canada needs to be more patient-centred, with a greater focus on prevention and ensuring that geography, income level and age are not a barrier to getting quality, timely care. Dr. Doig said the poll results show Canadians are pretty savvy about the challenges facing the health system. Asked to rank who or what is most responsible for increased demand for health-care services, survey respondents blamed individual Canadians not taking responsibility for their own health (33 per cent), the large number of Baby Boomers reaching retirement age (30 per cent), higher demands and expectations by all Canadians (21 per cent) and new medical advances (16 per cent.) Dr. Doig expressed concern that fingers would be pointed unfairly at Baby Boomers (those born between 1947 and 1966) for many of the woes of the health system. "I worry that the blaming will happen," she said. "We don't want intergenerational tension, we want intergenerational fairness." Dr. Doig said she takes comfort in the fact that the younger Canadians who were polled "are being extremely realistic about the limits of medicare and so-called free health care." For example, the survey found that, among Canadians under the age of 46, 44 per cent said they were willing to buy private health insurance to supplement the publicly funded system; 37 per cent said they would also buy insurance to ensure their long-term care when they were elderly; and 29 per cent said they would save specifically to pay for health costs after retirement. Ipsos Reid polled 3,483 Canadian adults online between June 8 and June 21. A sample of this size is considered accurate within 1.66 percentage points, 19 times out of 20. The survey, which has been conducted annually by the CMA for the past 10 years, also asks Canadians to rank the performance of governments in managing the healthcare system as they would on a report card. The marks awarded remained virtually unchanged over the past year: 41 per cent of respondents assigned either an A or B grade to the federal government performance (as 40 per cent did in 2009). Similarly, 41 per cent of Canadians awarded their provincial government either an A or B, consistent with the 2009 results (42 per cent). Overall, 35 per cent of those polled said they thought health-care services would improve in the next year, while 51 per cent predicted they would get worse. Health-care spending in Canada was an estimated $183-billion last year, according to the Canadian Institute for Health Information.
A broad coalition representing most stakeholders in the U.S. health care system launched a nonprofit group Sept. 14 to enroll tens of millions of people in health insurance by 2014, when insurance exchanges are to open in all states and major health care reform law changes will take effect. Forty-three organizations are participating in the group, Enroll America, including hospitals, health insurance companies, and pharmaceutical companies, as well as groups representing physicians, nurses, community health clinics, consumers, and people with major illnesses and disabilities. Several Enroll America organizations have experience enrolling people in health care programs. Among them is the Maryland Citizens' Health Initiative, which helped the state increase enrollment in its Medicaid program to 70,000 from about 25,000 when the state expanded its health care program for the poor in 2007. "Enroll America is truly an unprecedented collaboration among diverse groups across the health care sector," Rachel Klein, executive director of Enroll America, said during a telephone press call. Enroll America was organized by Families USA Executive Director Ron Pollack, who is Enroll America's chairman. Klein was previously deputy director of health policy and director of Medicaid and the Children's Health Insurance Program at Families USA, which advocated for the Patient Protection and Affordable Care Act. Enroll America has two primary goals, Klein said. It will organize a "massive public information advertising campaign," to be launched in 2013, to make sure people know about new opportunities to get health care coverage under PPACA. A poll released Aug. 29 by the Henry J. Kaiser Family Foundation
found that almost half of uninsured Americans do not know there will be new health insurance coverage opportunities in 2014, Klein noted. "Our public information advertising campaign will help close that gap so that millions of uninsured Americans will know there is health coverage available to them and how to enroll in it," she said. Enroll America also has established a best practices institute to promote enrollment processes that are simple, streamlined, and "seamless," meaning people can move easily from one program to another, Klein said. The group will encourage states and the District of Columbia, where the exchange markets will be based, to adopt enrollment and renewal systems that are "consumer-friendly and easy for people to navigate," she said.
Comparative shopping and buying affordable health insurance on-line lately is probably one of the simplest ways so that you can approach the situation. On-line insurance coverage purchasing is proving on daily basis to be the extra efficient and cheaper approach for folks to find health cowl they can easily afford without having to waste time making telephone calls and going to see native agents who overcharge you. Health insurance quotes There may be one primary benefit to procuring on-line to your health needs and that is competition. That is proper, with the entire corporations there are online as of late offering individuals their companies, except you possibly can prove that either your costs are decrease then everybody else's or that the protection you have to offer is much superior, you will lose out on invaluable customers. There are different advantages to purchasing inexpensive health insurance online. They embody: 1 Simpler protection comparison. It is possible for you to to get a break down as to what every plan you look at has to offer right away. That way you will be able to print out or look them over in your pc and resolve which plans work greatest for your private health insurance needs. When you've got any questions you may simply contact a on-line agent to reply any of your question that you might have when wanting over and clarifying the options when shopping for reasonably priced health insurance online. 2 Dedicated, helpful online agents. As mentioned earlier than, having agents which are at your finger tips it doesn't matter what time of day or evening it's may be very helpful you probably have query a few plan you're contemplating buying or when you've got already gotten coverage and you merely have a question. 3 Quicker buyer response time. You will need to be sure that no matter company you enroll with has an excellent observe record of being able to not solely reply customers, but takes the claims their customers turn in significantly and deals with them promptly. There may be nothing worse than receiving a invoice in the mail telling you that you simply owe the hospital or private physician cash when it has not even been processed by your insurance coverage firm and so they have yet to pay on it. four It lets you research every insurance firm and guantee that they have good customer rating. Now this does not mean that when you run into a bad review that it's essential to just neglect that particular firm Irrespective of how good the service there'll all the time be a number of issues that arise. You just need to make sure that you do not see a growing pattern among the present and previous customer that they have had points when shopping for inexpensive health insurance. It will be significant for everybody to get health insurance, no matter how younger or how suit you are. There are too many variables in life that may make a standard day flip into one which if you did not have health insurance you'd be paying back for an extended, long time. The simplest option to discover health insurance is to look online and this is one of the simplest ways of buying affordable health insurance
Increasingly, more people are buying health insurance online because of the large number of offers featured on the Internet. There are many insurance providers that offer cheap health insurance quotes for those who are on a tight budget. However, finding the best plans available on the market is not as easy as it seems. Before you start searching for online health insurance providers, you should take into consideration a few things.Easy To Insure ME has the answers The easiest way to obtain cheap health insurance quotes is to visit independent websites that allow customers to search for medical insurance online. Many of these websites provide a short form that you will have to fill in with information about your health condition, medical history, weight, height, age, gender, pre-existing conditions, lifestyle, drinking and smoking habits and more. Once you provide these details, you will receive cheap health
insurance quotes based on your answers. If you provide accurate details, then you will obtain free quotes that meet your requirements. Customers who use quote comparison websites usually receive cheap health insurance quotes from the best online health insurance providers. However, it is important that you research each and every company in order to find one that is financially stable and has a good reputation in the industry. Check if there are any customer complaints and search for unbiased information about the company you are interested in. Keep in mind that a reliable insurer will provide you with a custom health insurance quote designed to suit your particular needs. As soon as you gather three to five cheap health insurance quotes, you will need to compare them side-by-side. Make sure you get these quotes from reputable online health insurance providers. Take into account the amount of coverage provided, as well as the rates that you will have to pay every month. Check if the policy covers pre-existing conditions, prescription drugs, medical emergencies, maternity services, routine examinations and surgical procedures. Ask about the limitations and exclusions of the policy. Talk with people you know such as family members and friends in order to find out more about this type of insurance. You should never stick to the first quote you get, because you can always find a better one. It is advisable not to buy the least expensive health insurance plan. You should rather search for cheap health insurance quotes that offer a large amount of coverage at an affordable price. When shopping for health insurance online, you can be rest assured that each and every quote will be accurate. Most online health insurance providers offer quote comparison services for free, so you should take full advantage of this opportunity and compare as many cheap health insurance quotes as you can.
We all need to have health insurance, and for anyone who is are self employed, or are unable to obtain insurance from your employer, you will have to check into purchasing individual health insurance. Insurance on your own is normally much more expensive than when you get it from a business, so it pays to shop around and obtain the best coverage for you. Even though they are known as individual policies, they often can cover your spouse and kids as well. However, at the time you apply for a policy, there isn't a guarantee that says you will end up accepted for an individual policy. If you have got certain health conditions, because the policy is medically underwritten, your insurer could deny your application, or add exclusions to your policy. There are several states that make this practice illegal, and this means that health insurers will have to provide you with a policy, whatever medicals problems there are. Easy To Insure ME has the answers People who are older or who are in bad health, will have to pay higher premiums than those who are younger and in excellent health. Knowing how health insurance is priced is among the most confusing elements of buying individual health insurance, so evaluating various companies and their rates might make a big difference in the amount you have to pay for health insurance. In case you are trying to find individual health insurance, don't let all of the confusion allow you to shy away from getting a policy. Even for people who are in great health, one accident could land you in economic peril without health insurance. Some questions to think about when buying individual health insurance are: Do I wish to keep my existing doctor? If there is a doctor that you really like, this might determine whether an HMO or PPO plan is good for you. If you have an HMO, then you must use their doctors, but a PPO plan will allow you to use the physician that you pick. Just how much will it cost me out of pocket, and just how much will my premiums be every month? Is it intelligent for me to pay more for lower out of pocket expenditures? For a comprehensive health plan that doesn't have many out of pocket costs, an HMO might be what you are searching for. However, if you're in your 20's or 30's, don't have children, and have more money saved up, you can save money by only getting insurance for catastrophic illnesses. This will mean that you'll have to pay out of pocket for virtually any tests or doctor visits. How much health care will my family members need? Consider any services that may be needed by all your family members on a regular basis. If somebody has asthma in the family, will they need to go to an asthma specialist to regulate their illness? When you can take some time to assess and consider the health insurance you and your family need, it can make purchasing individual health insurance much less difficult, and offer the health coverage you and your family need for a price that you'll be able to live with at the same time.
We all need to have health insurance, and for anyone who is are self employed, or are unable to obtain insurance from your employer, you will have to look into purchasing individual health insurance. Insurance on your own is generally considerably more costly than when you get it from a company, so it pays to shop around and find the best coverage for you. Despite the fact that they are called individual policies, they usually can insure your spouse and kids as well. However, whenever you apply for a policy, there is no guarantee that says you will be approved for an individual policy. If you have certain health conditions, since the policy is medically underwritten, your insurer might deny your application, or add exclusions to your plan. There are a few states that make this practice illegal, and this means that health insurers will have to offer you a policy, whatever medicals problems there are. People who are older or who are in bad health, will have to pay higher premiums than those who are younger and in excellent health. Knowing how health insurance is priced is without doubt one of the most confusing aspects of obtaining individual health insurance, so researching various companies and their rates might make a big difference in the amount you have to pay for health insurance. When you are hunting for individual health insurance, don't let all the confusion make you shy away from obtaining a policy. Even for people that are in great health, one accident could land you in economic peril without health insurance. Some questions to think about when buying individual health insurance are: Easy To Insure ME has the answers Do I wish to keep my current doctor? If there is a doctor that you really like, this might determine whether an HMO or PPO plan is best for you and your family. In case you have an HMO, then you have to use their doctors, but a PPO plan will allow you to use the physician that you pick. Just how much will it require me to pay out of pocket, and just how much will my premiums be every month? Is it smart for me to pay more for lower out of pocket costs? For a comprehensive health plan that doesn't have many out of pocket charges, an HMO could possibly be what you are searching for. However, if you're in your 20?s or 30?s, do not have children, and also have more money saved up, you can save money by only obtaining insurance for catastrophic illnesses. This will mean that you will have to pay out of pocket for virtually every tests or doctor appointments. Just how much health care will my family need? Think of any services that could be needed by your loved ones on a regular basis. If someone has asthma in the family, will they need to go to an asthma specialist to regulate their illness? When you can take some time to compare and think about the health insurance you and your family need, it could possibly make buying individual health insurance much less difficult, and provide the health coverage you and your family need for a price that you'll be able to live with at the same time.
Having health insurance in Texas is crucial to keeping your health intact. There are plenty of places that have health insurance in Texas. Most of them are competitive, because they have affordable prices. So basically, you have your pick of the small when searching for a health insurance plot. If you are one of those people that don't have a clue as to how you should go about looking for an affordable health plot, this article will clarify how to go about it. Health insurance quotes With the emergence of the internet, it is much simpler to find what you're looking for in health insurance coverage. Just use one of the major search engines and plug in where you live along with the words "health insurance quotes". With some health insurance plans in Texas, they are connected with certain hospitals, depending on where you live. It's a excellent thought to have health insurance where you can go to a medical facility that is close to your home. There will probably be many entries for you to choose from. Look through the ones that you reckon best fit you and go over what they have. Look for those that are affordably priced and have the options that you want. There are some of them that don't cover certain options, such as testing and related items. You need to know what options are available with the plot you've selected. You want your health insurance in Texas to cover the things you need. You can always consult with the health insurance provider to make sure that you have the right options for your health insurance. Then you may not need extras with your health insurance. It all depends on what you need. Some people with health insurance in Texas need more; on the other hand some people need less. It all depends on the needs of the policyholder and their family. The need to have health insurance in Texas is very crucial; without it you and your family could suffer a fantastic disservice. If you are looking for dental insurance, that will probably be
separate from regular health insurance. In addition to that, vision insurance may be on a separate platform. Question the health insurance provider for quotes before you make your final choice on health insurance in Texas. Also, question the health insurance provider about making arrangements for flexible payment plans. It's vital for you to know your payment schedule before you start giving them money. Just like with health insurance anywhere else, you have to make sure that you can afford the payments. You don't want to skip on a payment and then be cancelled. You should customize your health insurance so that you won't have distress paying on it each month. Having health insurance in Texas is crucial in order for you to stay healthy. Even though you may be bogged down with looking for health insurance in Texas, it has still become simpler to get, especially with the internet. the internet has made it possible to research further and get the best deal for you and your family.
Republican state senators called on California Attorney General Jerry Brown Tuesday to join other states and sue the federal government over health care reform. The legislators said Congress cannot force people to buy health insurance or any other products. Attorneys general in 13 other states have already filed suit against the health care overhaul that President Barack Obama signed into law. The bill will require most Americans to carry health insurance. "I think that many Californians share the same view that this is the greatest expansion of government in a generation," said Senate Minority Leader Dennis Hollingsworth, R-Murrieta. State Sen. Tom Harman, R-Huntington Beach, sent the letter to Brown. "The federal government is limited in what it can and can't do by the Constitution," Harman said, calling the measure a violation of the commerce clause. Brown issued a statement saying he had instructed his deputies to review the claims made by the senators. However, Brown, a Democrat and former two-term governor, noted that all but one of the 13 attorneys general who vowed legal action were Republicans. "Health care is not the place, with people's lives at stake, to engage in poisonous partisanship," Brown said in the statement. Republicans seeking their party's nomination for governor, Steve Poizner and Meg Whitman, opposed the health care package and supported a state lawsuit. Poizner, the state insurance commissioner, said consumers could face higher health insurance premiums and an onerous mandate to get health insurance whether they want it or not. Whitman campaign spokeswoman Sarah Pompei called the health care plan a "new, big government program." The Republican lawmakers also decried what they called an unfunded mandate, estimating the plan would cost California taxpayers $3 billion. Sen. Tony Strickland, R-Thousand Oaks, said voters should have final approval over the measure. "It's clear to me that people's voices are not being heard in Washington, D.C., or in Sacramento," Strickland said. "At a time when we a have high unemployment rate, this is going to be devastating to our California economy." The California Democratic Party said the health care overhaul will provide insurance coverage to 7.3 million Californians who do not currently have it and give a tax credit to some 390,000 small businesses in the state.
Cardiac arrest, (also known ascardiopulmonary arrest orcirculatory arrest) is the cessation of normalcirculation of theblood due to failure of theheart to contract effectively. Medical personnel can refer to an unexpected cardiac arrest as asudden cardiac arrest or SCA. A cardiac arrest is different from (but may be caused by) aheart attack, where blood flow to the muscle of the heart is impaired. Arrested bloodcirculation prevents delivery ofoxygen to the body. Lack of oxygen to the brain causesloss of consciousness, which then results inabnormal or absent breathing. Brain injury is likely if cardiac arrest goes untreated for more than five minutes.For the best chance of survival and neurological recovery, immediate and decisive treatment is imperative. When unexpected cardiac arrest leads to death this is calledsudden cardiac death (SCD).The treatment for cardiac arrest iscardiopulmonary resuscitation (CPR) to provide circulatory support, followed bydefibrillation if a allowable rhythm is present. During cardiac arrest a victim loses consciousness, stops normal breathing and loses pulse and blood pressure. Call 9-1-1 immediately to access the emergency medical system if you see any cardiac arrest warning signs. Give cardiopulmonary resuscitation(CPR) to help keep the cardiac arrest victim alive until emergency help arrives. CPR keeps blood and oxygen flowing to the heart and brain until defibrillation can be
administered. Cardiac arrest is amedical emergency that, in certain situations, is potentially reversible if treated early. JHH: The beneficial uses of plants have been known for centuries and have been used to manage a multitude of peculiar sub-Saharan and South East Asian physiological anomalies. Health Forever, adopts a holistic approach towards health management which encourages usage of herbs in the most complete and natural form. The body can then utilize the full, unaltered balance of ingredients provided by nature with the added benefits of quality control and assurance achieved through a careful manufacturing process. At Health Forever, expertise is clearly and effectively focused in the field of research and development of medicinal herbal preparations, one of which is the highly effective Jobelyn Heart Health capsules. Recommended in a dosage of one capsule 2-3 times a day with 12 ounces of water, these capsules may be taken regularly for ongoing cardiovascular support. Composed of Sorghum bicolor Leaf Extract, Hawthorn Berry Extract, Alpha Lipoic Acid, Jobelyn Heart Health reinforces the body's heart health. Jobelyn Heart Health contributes to strengthening of cardiovascular health by protecting red blood cell walls against oxidative damage that can reduce their flexibility and shorten their lives. It contains Hawthorn that slows and steadies the heartbeat. Jobelyn Heart Health formula helps maintain flexibility of endothelial cells that form the capillaries and line all blood vessels. It also Improves circulation and reduces oxidation of lipids in the blood thus maintaining healthful blood cholesterol levels for those in the normal range.
The right kind of health insurance quote can help you to purchase a cheap health insurance policy for you as well as your family members. Research is the main activity that you have to undertake to avail a perfect health insurance policy With so many health insurance providers in the market, searching for the best health insurance plan can be tricky and complicated. It has become a daunting experience for an average individual. Even health insurance policies available in the work place has become complex. Many people think that when health insurances are offered by an employer, the health insurance is no longer complicated. But it is not the case. There are deductibles, doctors to choose and plans to take into consideration. Again, if you are a self-employed, choosing the right health insurance can cause you a headache. You may find yourself lots in the sea of information and insurance providers. All these problems can be sorted out just by getting health insurance quotes from the insurance companies and going through the fine prints of the document. Thus later on purchase a cheap health insurance policy. There are two types of cheap health insurance policies that you can choose from: They are: HMOs or Health Maintenance Organizations with a range of pre-listed doctors and specialists and also specific type of health insurance plan. PPOs or Preferred Provider Organizations; here you are free to choose the doctors of your choice. Even you can choose the type of insurance cover that you might want. Your cheap health insurance policy will give you covers for: Routine Check ups, emergency treatments, surgeries, lab fees, X-rays etc. All you need to do is to pay a certain sum of money as premium and the insurance company will provide cover for these things. To avail a cheap health insurance policy, you are required to do an extensive study of the insurance market and get free quotes from them. With free health insurance quotes gathered from different companies, you can easily choose a cheap health insurance policy. You need to compare various quotes and observe the pros and cons of different cheap health insurance policies as have been provided by different providers. And when a particular cheap health insurance policy meets your expectations, buy that policy at that instant. You can even do this research for an ideal cheap health insurance policy by the online method. What you need to do is to browse through the pages of different websites and accumulate health insurance quotes; after this you can buy a cheap health insurance policy and that too online.
It is a common fact that men are not good in own health care. They will always try to avoid consulting a doctor for any health issues. Normally, the men will do anything to avoid public concerns about their health problems, or to obtain professional advice when something is wrong. They may therefore miss the opportunity to enjoy better health and fitness. But it is a must to consult a doctor for maintaining good health. There are many men's health clinics where they get better treatment for any kind of health issues.
There are many issues for which it is a must to consult a doctor which is given below: Blood pressure Healthy blood pressure level is important for your health and to lead a long and active life. The problem of high blood pressure can go undiagnosed for years without obvious symptoms, but can cause heart attacks or stroke. However, early diagnosis means the condition can be treated before permanent damage is done. If you're at all worried about your blood pressure then you have to consult a doctor. Also you can read men health articles for knowing more about the symptoms and prevention methods of these diseases. In many cases, hypertension can be treated with changes to your lifestyle. A change in diet and increased physical activity system can be tested before treatment is decided. Cholesterol Cholesterol is another problem, which can lead to many health problems. Therefore, it is important to have your cholesterol level checked, and make every effort to maintain a good level. There are two types of cholesterol, HDL and LDL, and a simple blood test is needed to determine your level of both. Cholesterol level you should be concerned about is the level of LDL. This is what is called bad cholesterol and may accumulate in the arteries, creating a traffic jam. HDL is considered good cholesterol because this can help prevent harmful blocks. If you have high cholesterol, it is possible to reduce it by managing your diet, exercise, and losing excess weight. Also you can go to any of men's health clinics for treatment. Diabetes The main reason for diabetes is the high blood glucose. This disease can go undetected for years, and many people are diagnosed when they have a routine blood test for an independent state. Early diagnosis helps to escape from kidney damage and prevent damage to the heart and vision. Symptoms may develop very slowly and this is the reason people will not care about it. Symptoms may include increased thirst, unexplained weight loss, feeling constantly tired and very blurred vision. If you have doubt that you may have a high glucose level, just go to any men's health clinics than trying own treatment. Prostate Cancer Another health issue which can create major problems is prostate cancer. Prostate cancer can be treated if it is diagnosed at an early stage. The main symptoms are difficulty urinating, frequent urination, especially at night, the flow of weak or interrupted urine, painful urination or blood in urine. Such symptoms may be caused by less serious conditions such as enlarged prostate, but if any of these symptoms starts you can clear it by going to any of the men's health clinics.
Lexington's Urban County Government is dropping health insurance coverage for 556 employees of "outside agencies" organizations that are affiliated with, but not directly run by, city government. Based on 2008 spending, dropping employees of the 20 organizations from Lexington's insurance plan would save the cash-strapped city $506,218 a year, the difference between what it took in and what it had to pay out. Among the organizations that will be making new health insurance arrangements are the Fayette County Health Department, Kentucky League of Cities, Lexington Housing Authority, Lexington Convention & Visitors Bureau, Lexington Parking Authority and the Lexington Urban League. "The satellite agencies had been paying only their premiums," said Susan Straub, spokeswoman for Mayor Jim Newberry. "... They were not funding the full cost of their health care." Over the past three years, the city has shelled out $2.2 million to supplement the insurance premiums paid by the employees of outside agencies. In late November, Newberry said the city might consider layoffs, pay cuts, furloughs and the elimination of city programs to stem an estimated shortfall of $12 million to $13 million. City government division directors were asked to propose ways to cut expenses by 5 percent. The council approved cutting health insurance for outside groups on Dec. 8. In all, the city offers health insurance to 3,622 workers and retirees, whose health claims outpaced revenue by $8.5 million last year. Most of the agencies will have until Dec. 31, 2010, to finish their new health care plans, but some such as the Fayette County Health Department will switch to new insurers within the next month. Health Department Commissioner Melinda Rowe said city officials told her the agency should be covered by the state's health insurance program. Instead, the department chose a plan offered by Bluegrass Family Health. Still, the cost of premiums paid by the department could go up by more than $600,000 over two years, Rowe said. Not providing health insurance to employees was never considered, she said. "Obviously, we're the health department; we have got to concentrate on our own employees and their wellness," Rowe said. P.G. Peeples, president of Lexington's Urban League, said his organization's insurance options are limited because it has only six employees. He hopes to band with United Way agencies or other Urban League offices to build the number of employees needed for a large bargaining pool. "I'm disappointed they're going to remove this option," Peeples said. "I understand that they're trying to do cost savings." How did
the city wind up providing insurance benefits for agencies outside city government? "For the most part, we don't really know," Straub said. "We inherited this situation, and the arrangements have apparently been in place for a number of years." Jan Isenhour, director of the Carnegie Center for Literacy, said the center's budget initially came from the city, so its inclusion in the health pool seemed logical. In 2003, the center became an "outside agency" and started taking over its own finances but remained in the city insurance group. The Carnegie Center hasn't started pricing outside health policies; it has another year on the city's plan. Meanwhile, the city continues to look for other ways to shift expenses to outside agencies. Ed Lane, councilman for Lexington's 12th district, said the city might soon consider asking outside agencies to contribute money toward the upkeep of city office space they occupy. "The recession puts a lot of strain on government to provide all the services necessary for the taxpayers, but it also gives us an opportunity to look at what are essential services and what are non-essential services ... to try to maximize the efficiency of government as much as we can," Lane said.
COLORADO: Among the numerous grantsavailable underthe Patient Protection and Affordable Care Act (PPACA) is the Consumer Assistance Grant, whichwould allow Colorado to set up an Insurance Ombudsman Office. Although no state agencies have indicated an interest in housing such a position, several consumer groups see this as an opportunity to broaden their impact on the insurance process. Family Voices Colorado is the one organization that appears to meet most of the grant requirements to be a lead agency. Despite the advocates' interest, the Health Reform Implementation Board expressed serious concerns about the financial sustainability of such an office. The grant funding is only available for one year, and the state does not have sufficient resources in its general fund. The Implementation Director also noted that a carrier assessment was not being viewed as an option. CONNECTICUT: The House of Representatives last week joined the Senate in overriding the Governor's veto of their campaign finance overhaul bill. However, there's still an injunction in force that was imposed by U.S. District Court Judge Stefan Underhill on August 11 against all portions of Connecticut's law that were deemed unconstitutional by the Second Circuit.It is expected that the state will swiftly file a motion for relief from the injunction.Campaign finance law in Connecticut will not move forwarduntil the District Court lifts its injunction, as anticipated, in the coming weeks. OKLAHOMA: At arecent hearing beforeOklahoma Supreme Court Referee Barbara Swimley, an attorney for state Insurance Commissioner Kim Holland challengeda new law that will levy a 1 percent fee on health care claims. Holland's attorney describedthe billas one that had nothing to do with insurance, but instead was designed to helpraise money for the state and balance the state budget. He also argued thatthelegislature did not follow the constitutional process in passing the bill. The state's constitution requires all revenue-raising measures to either pass the Oklahomalegislature by a three-fourths vote or be submitted to state voters for approval. The attorney for the Oklahoma Health Care Authority argued that the court could use the presumptive argument that all legislation passed by the Oklahomalegislature and signed into law is constitutional.Commissioner Holland's legal challenge now rests with the Court, which must decide whether touphold the law or strike it down as unconstitutional. Referee Swimleypromised that court officials would make a decision about the case"soon." The bill is slated totake effect August 26, 2010, with the first payment of the fee due October 31. TEXAS: The presidents of the University of Texas system's six health-related universitieslast weekpublicly listed their worries about millions of uninsured Texans becoming covered in 2014 under the country's sweeping new health care law: not enough doctors, too little money from government health care programs and fewer commercial insurers to cushion financial lossesas they do now. The Chair of the Health Affairs Committee predicted that the changes will impact the UT system "significantly,"possibly threatening the health institutions' funding for research and academics.They citeda loss of federal and state money for facilities that care for a large share of low-income and uninsured patients as the key culprit. They also fear that many people who are currently uninsured and whobegin buying insurance in 2014 will buy the cheapest insurance they can get. The presidents worry that the result will be fewer commercial insurers, which now absorb some of the costs and help hospitals make up for low payments from Medicaid. But they stopped short of characterizing the law as a negative and calledit the"new normal" instead. The six schools planto find more efficient ways to care for patients,including the use
ofmore nurse practitioners http://www.easytoinsureme.com/. End of update
Many people today think that getting Florida individual health insurance to cover their insurance needs if they do not get this from their employer is out of the question due to cost. There are a great many people who feel that health insurance is too costly for them to afford and go without it. This can not only be detrimental to the health of any individual, but can also end up costing someone their life savings or their home if they wind up in the hospital and face a mountain of medical bills. For this reason, it is important to have health insurance as well as compare health insurance coverage. When you compare health insurance coverage, you can see the difference in the coverage that different companies will offer you as well as the rate for the coverage. When you are looking for Florida individual health insurance, it pays to make sure that you compare health insurance by way of coverage that is allowed and the amount of the monthly premiums for the coverage. The more comparisons you do when you are looking for Florida individual health insurance, the more you will see that having health insurance is affordable and usually a lot more affordable than you think. You want to compare health insurance coverage by way of what they will allow you. Some companies have a network of doctors from which you can choose when you are getting Florida individual health insurance. Other companies allow you to choose your own doctor. The type of coverage that you pick depends upon your own personal preference. There is also a difference between co payments for some companies as well as deductibles. The higher the deductibles, the lower the health insurance quotes, so this is something that an individual might want to take a look at if they are looking for a way to save on monthly premiums. It is much more affordable to have high deductibles when it comes to health insurance than low deductibles as you are basically getting Florida individual health insurance in this way to make sure that you are covered for a hospitalization. It is important for everyone who lives in the State of Florida to have Florida individual health insurance as this can help them not only prevent massive medical bills in case they have to go to the hospital but will also induce them to seek out medical care if they should need it. Many medical problems can be avoided by seeing the doctor before they become a problem that requires surgery or hospitalization. The more someone sees the doctor for regular checkups, the more they can enjoy good health. Those who are looking for Florida individual health insurance should make sure they compare health insurance that not only allows them to be covered in case of a major illness or accident, but also allows them to a see a doctor for preventative medical care. Both aspects of health insurance should be reviewed by anyone who is seeking to compare health insurance quotes.
The Legislature has until the end of the month to pass or reject several key health bills, making this week a turning point for some reforms related to the new federal health law. Among the measures heading for a final floor vote are bills that would regulate health insurance rates and set up an "exchange" through which consumers would buy insurance under the federal law. The legislative session is set to end Aug. 31, so lawmakers must act on the pending legislation, or the bills will die. "I've not seen a year with such a combination of significant health care legislation that could be potentially passed and signed," said Anthony Wright, executive director of Health Access California, a statewide consumer and labor advocacy coalition. Several of the bills are generating controversy. A bill that would set up California's health insurance exchange, the virtual marketplace of health insurance options required in 2014 under the federal law, passed the Assembly on Friday. The bill, authored by Sen. Elaine Alquist, D-Santa Clara, is scheduled to go back to the Senate and be voted on with a companion bill. Insurers are against both bills, as are several Republican lawmakers, without amendments that would limit taxation on insurers and require more legislative oversight. They argue that the bills set up a new bureaucracy with broad powers to tax them and create disadvantages for smaller health plans in the exchange. "Our concern is that (the bill) sets up very broad authority and powers," said Charles Bacchi, executive vice president of the California Association of Health Plans. "We believe if they make wrong decisions, it could result in fewer
choices for consumers." Health insurers are also fiercely opposed to several bills that propose various forms of rate regulation, an issue that gained traction earlier in the year after Anthem Blue Cross proposed a 39 percent rate increase on 800,000 individual California policyholders. Power over rate increases The rate-hike proposals include a bill by Sen. Mark Leno, D-San Francisco, that would require insurers to justify rate increases, and one by Assemblyman Dave Jones, D-Sacramento, that would give state regulators the power to approve or deny rate hikes. Gov. Arnold Schwarzenegger has proposed a separate plan that would require health care insurers to hire actuaries to review their proposed premium increases. Bacchi, referring to the Jones bill, said rate regulation diverts attention from the need to curb medical costs. "Health care costs are going up enough," he said, "without having to create overly burdensome and expensive new government bureaucracies to handle this." The California Medical Association and the California Hospital Association join the insurers in their opposition, arguing that if the insurers are squeezed, they're likely to turn around and squeeze doctors and hospitals through lower reimbursement rates. "We think the solution to the problem has already been approved as part of federal health care reform: mandating that plans meet a minimum medical loss ratio," said Andrew LaMar, spokesman for the physicians group, referring to the requirement that insurers spend at least 80 percent of their revenue on patient care. Coverage of vaccinations Separately, the medical association is backing a bill that would require insurers to pay the full cost of acquiring and administering vaccinations, a potential mandate the health insurers oppose. The California Hospital Association, which represents the state's hospitals, is supporting a bill that would extend deadlines for some hospitals to seismically retrofit their buildings and is opposing a bill that would require hospitals to disclose the cost and quality of procedures. But the main focus is on bills that would direct the state on how to manage the new health law. "The 800pound gorilla staring us all in the face is health care reform legislation, but there's still so much unknown because regulations haven't been drafted on the federal level," said Jan Emerson, spokeswoman for the hospital group. "We're on the precipice of some major changes to our health care system, but how that plays out on the state level is not yet fully understood." Countdown on health care bills Here are some of the key health care bills that the Legislature must act upon before the session ends Aug. 31: Assembly Bill 2578: Authored by Assemblyman Dave Jones, D-Sacramento, it would require approval from state regulators for increases in health coverage premiums. Senate Bill 1163: This bill by Sen. Mark Leno, DSan Francisco, would require insurers to justify denials and premium increases. Senate Bill 900 and Assembly Bill 1602: These companion bills authored by Sen. Elaine Alquist, D-Santa Clara, and Assembly Speaker John P?rez, D-Los Angeles, would establish the health insurance "exchange" required under federal law.
Health Check Costa Rica's true inception began when my baby sister developed hepatitis C from a bad blood transfusion in the late 1980's. We rallied as a family and when she bounced back after a year I really thought that we had averted this crisis permanently. I knew she had to take some medication but in every other way things were back to normal. Little did I know that 15 years later the disease had taken a toll that required her to seek a full liver transplant. The year we spent battling this with her was a year I will never forget. This was a year that had me inside a hospital almost every single day. I sold my house and quit working so that I would have money to help and to be by her side full time. I saw from the inside exactly what was good and what was bad about our health care system. What struck me was that like in so many walks of life there was the good and the bad that needed to be accepted and sometimes shades of gray not easily interpreted. But some iniquities were simply too harsh. What struck me and stuck with me during this experience, the observations that both affected me and often infuriated me is why I eventually formed Health Check Costa Rica. From the stories that I heard and the people I met it in the hospital it was very clear and quite tragic that there were people dying every day because they were being turned away from quality care from lack of funds or adequate insurance. I truly thought this iniquity to be inexcusable in a country of such wealth and majesty. It screamed of injustice and seemed so random as to be akin to rolling dice. If you had good insurance or worked for the right company or had the right education then you were Ok. If not you were turned out to die. It's that simple. It's that harsh. Ultimately my sister's Hospital bills topped out at over a million dollars. In seeing those numbers and seeing the
astronomical prices for certain things it occurred to me that no one could really afford this except for the top .01% of the population. So how could we even as a society afford this? Where did these prices come from? Well I translate it something like this. These are insurance companies paying these bills. Patients are not usually going line by line and challenging certain outrageous costs. No these are insurance companies approving these expenses and then meeting behind closed doors to figure out how to pass this on to the consumer and still make a buck. Hence the ridiculous prices for health insurance and ultimately health care and really why a majority of people remain uninsured. The health insurance companies have dropped the ball and the thinking is "as long as we are making our percentage, well the higher the better." Lastly litigation has helped skyrocket the price of care and really has forced doctors in to a no win situation. An OB GYN in Florida is required by law to pay as high as $200,000 dollars per year for medical malpractice insurance. That's right, 200k before they can make a dollar for themselves. Who do you think ultimately pays this? You the consumer! One additional reason so many remain uninsured is this lack of long overdue tort reform and absurd compensations. Finally the tragic result I saw with my own eyes in my sister's case was these high powered surgeons in high risk areas were forced to carry such a heavy case load to pay off these insurance costs that none were able to give their patients the care or personal attention they needed or the attention they deserved. They were forced to use lesser skilled underlings to catch complex diagnoses and symptoms and I can tell you straight up. THIS DOES NOT WORK. The system is terribly broken. The day my sister finally left Spaulding Rehabilitation hospital in Boston was the day I set out on my adventure to Costa Rica with my jeep Cherokee loaded for jungle survival. With all my computer equipment and clothes, my dog Seikan and I began our long dangerous drive to Costa Rica, neither of us with any Spanish just a lot of hope for a new life. Costa Rica really has much to offer and we have enjoyed living here and working and while many of things we take for granted in the United States do not exist here conversely neither do many of the bad things. I am constantly struck by the lack of sirens, and airplanes each time I hear this it is surprising to me. Infrastructure still has a long way to catch up to the US but one of the big surprises I had when I began research for Health Check several years ago was that the overall health care system was ranked higher than the United States in the world in overall quality of care, and has an incredible network of internationally accredited Hospitals, surgeons, and after care facilities that rival the care in the US. The people of Costa Rica have the second longest life spans of all countries in the world, and were ranked in a worldwide study as some of the happiest people on earth. As I continued my studies in to this business I realized that it was possible to form a service that would allow people in the United States and Canada to seek out quality affordable health care close to home at up to an 80% discount with all of the worries of organizing details and itineraries to us. People who could not afford health care could suddenly have access to truly quality health care less than three hours away from many major airports in the U.S. To me this was more than a business opportunity it was an opportunity to make a difference in peoples' lives, a chance to serve and a chance to help. With this in mind please understand that if you book a procedure through Health Check Costa Rica we take very seriously you every care and comfort once you land in Costa Rica. Our research and experience in finding the right doctor, dentist or after care specialist will take the burden off of you and your family and let you prepare for your procedure with peace of mind. We will introduce you to only the best of the best in Costa Rica and give you a chance to meet and establish a relationship with the surgeons who will be performing your procedures long before you arrive. We work with only the best and most trusted tour companies, hotels, and transportation services and we can create packages for every budget. So please let us help. Whether it is for any procedure large or small, from Hip Replacement, gastric bypass, or Plastic Surgery, from Angioplasty to In Vitro Fertilization, you owe it to yourself to choose the best care for you. Please allow health Check Costa Rica to make the introductions and present options to you. We look forward to serve you and many others.
Electronic health records (EHRs) started as way for doctors to organize their records, make ordering more convenient, reduce repetitive tasks, reduce errors caused by bad writing and so on. However, the physician side of EHRs has been somewhat slow to catch on because of the huge barriers to entry, such as converting existing records, changing the way documentation gets done and the cost of implementing a comprehensive system. Recent government financial incentives are boosting acceptance of the MD office-based EMR. On the consumer side, some of the same issues have hindered large scale adoption of
EHRs. First of all, it takes a long time to input the information and secondly, the record is only useful if it is kept up to date, placing a lot of pressure on people to manage the information correctly. However, as technology has improved, especially with mobile applications that make it easy for the user to retreive and enter data, the use and value of EHRs for consumers has grown. Most families keep some kind of health records, even if it's just copies of medical reports. Unfortunately, that kind of recordkeeping isn't all that helpful when you're in a doctor's office and you can't remember when you got your last tetanus shot. Storing information electronically can improve accuracy, provide information where you need it, when you need it and allow you to analyze yours or your family's health. But how do you choose a record keeping system to use? Frankly, we think that there's still quite a long way to go in this area and none of the record keeping systems do everything that we'd like. But, there are some excellent programs out there. We have selected twelve recordkeeping systems that we liked the most and explained why we think so. (1) HealthVault Microsoft has made a huge investment in their personal health record program and it shows. Their system offers an extensive recordkeeping system, the opportunity to create family records and links to many other applications that enhance the value of your information. Through HealthVault's "ecosystem" of connected, patient-friendly applications, you can store copies of your health records; upload information from health and fitness devices; provide information to your doctor, coach or therapist; and access products and services. We think that Microsoft is leading the pack in this area. We love the device integration, the tab that gives you a history of the changes that have been made and the tab that allows you to select who you will share information with. However, Microsoft is so busy promoting its affiliates that it's hard to figure out how you as an individual user can enter data. They also use some overly technical language such as "continuity of care" documents that are quite confusing. Interestingly, there's no real emphasis on prevention tools and that's a big gap, in our opinion. They also need a crumb trail; we thought we saw some prevention management tools at one point, but could never find our way back to the same page! (2) Google Health Google is another major player that has invested a lot of time and money into their EHR. Their record is quite comprehensive with lots of dropdown menus. We found, however, that the menus weren't always complete enough so they can create confusion. This program can link to small group of other databases. If yours is listed, it's great. For example, if you belong to Blue Cross Blue Shield of Massachusetts, you can directly import the last two years of your medical information, saving time and improving accuracy. There are many applications you can link to that help manage medications, find clinical trials, convert paper records, get coordination assistance, link your record to doctor's office and more. This EHR is easy to use and contains lots of management tools but it still feels quite "young "in its evolution. Once again, not much emphasis on prevention or, if there is, it's not obvious. (3) Health Minder This is a great EHR system! It's very comprehensive, covering not just the basics but includes medical expense and claims tracking, pet medical history, family history, smoking, exercise, lifestyle issues, observations (so you can make a note when you experience something different and track what you are worried about), reminders, job related risks, environmental issues and more. The system is very easy to use. It does not have the linking and expanded apps opportunities available through the biggies such as Google and Microsoft but it's more comprehensive and easier to use. Apparently other organizations agree because it's won quite a few awards. It costs $35 annually. (4) My Healthe Vet The VA really got it right with this online personal health record. This well designed system not only includes all of the usual health tracking options, vets can also refill prescriptions electronically, access benefit information and do research on their conditions. (5) Health Manager This offering from the Mayo Clinic works with Microsoft HealthVault and gives you advice from Mayo Clinic experts when you need it. Recommendations are created just for you and updated in response to your health information. The more complete your profile, the more tailored your recommendations become, making it easier for you to proactively maintain your health. This is a great marriage of Microsoft's database function and Mayo Clinic's diagnostic expertise. (6) Cloud PHR Pro Cloud PHR Pro is the paid version of Cloud PHR. You may or may not need the paid version; we just like what this mobile application does for you. There are a lot of mobile PHR apps being promoted; we like this one best. The Pro version gives you the option of caching your data, allowing you browse your health record in a doctor's office without Wi-Fi or cellular service. The user interface is also improved, with faster load times and a more readable display of health information. Profiles can be assigned pictures, allowing you to manage your family's health information in a more natural way. Whether you use the free or paid version, this mobile app brings information where you need it. (7) AccessMyRecords.com This EHR takes a somewhat different approach. Their system is designed to collect information that can be used in an emergency or in a doctor's office. The scope of information is much greater. You are able to upload documents such as your will or trust,
passport, driver's license, birth certificate, transcripts, homeowners, automobile and life insurance policies, real estate closing documents, and more. You are issued a card that gives EMS or other helpers the ability to access your data. There are a number of these kinds of offerings including those that put info on a microchip in a bracelet or on a memory stick that you wear around your neck. We thought this group was unusual and interesting in that it added proxies and other information that can be very relevant in an emergency situation. The service costs $30 per individual; $50 per couple; add children at $20 each. (8) GlobalPatientRecord In addition to the usual health information, this EHR also provides a central location for all legal information, such as living will, power of attorney and Do Not Resuscitate information, emergency contacts information, reminders of future check-ups, medical history and is also available as a mobile application. Unfortunately, we couldn't get the demo to work and the site makes it a bit difficult to know how to sign up. (9) myMediConnect This is one of several EHRs that eliminates the problem of getting all that information loaded. You can add your own info or pay to have the service add the information for you. This record keeping system is very comprehensive and interactive, including prescription reminders, health savings calculator, health education, and links with Microsoft HealthVault. Sign up is free but retrieval services can be expensive. (10) CheckUp This EHR is fairly comprehensive, as well, with the addition of automatic risk assessments. We liked the way this system handled information but found that it is very standalone with no integration with any other applications. (11) MedsFile.com This free system looked good but we couldn't access the demo so we couldn't test it very well. The EHR stores lists of medications, supplements, allergies, emergency contacts, immunizations, personal and family history, procedures and surgeries and emergency contacts. You receive a card that allows MDs or EMTs to access files from your cell phone. (12) My Health Diary This EHR is actually dedicated to issues related to blood such as donations and AIDS. And it has a very nice personal health record system. You can create charts of your clinical investigations including blood pressure and blood sugar readings, all types of clinical tests, treatments, diagnosis and medical images with the ability to access reports & data online. There are some excellent health calculators available here as well. It's an interesting product with a lot of information but doesn't seem well integrated. In summary, you can gain a lot of insight into your health by using an EHR and remain in better control of your information. Don't get sick without one!
"Obamacare" will deal a mortal blow to employer-provided health care plans. In an effort to correct longstanding problems in our health care industry, the Obama administration's flawed approach ultimately will lead to an additional 175 million employed workers being forced into the government's health care coverage system. Easy To Insure ME has the answers. The demise of employer-provided health care plans will begin with startup companies and small employers, who will never offer health care coverage. Next, small- to medium-size employers will determine that it makes more sense to pay a fine of $2,000 to $3,000 per employee than to pay much more for private coverage. Large employers will follow suit, eventually eliminating their health care plans so they can remain competitive. All good companies support their employees, but will the competitive pressure to reduce costs and get out of the health insurance business be too strong to withstand? Union members may think their plans won't be changed, but they are among the most vulnerable. Their plans already are under attack. If their company goes into receivership or bankruptcy because of competition or a recession, it is possible that contracts will become moot. Items deemed unaffordable will be reduced or eliminated. Simply refer to automobile manufacturers and airlines as examples. Unless Obamacare is undone, employer-provided health care will soon be gone. Those who can afford it will be in private health care systems. Those who cannot will be dependent on the government to provide their health care. Is this really the direction we want to go?
Last week, Democratic leaders in the Senate caved to Sen. Joseph Lieberman's demands and stripped away some major provisions from their health reform legislation, including the public option and a plan that would have allowed middle-age Americans to "buy in" to Medicare. With Connecticut independent Lieberman's support seemingly secured -- for the time being -- the president announced that Congress
was "on the precipice" of passing comprehensive reform. But even without these controversial components, the Democrats' bill would still put government in charge of nearly all Americans' health care. Patients would have fewer choices in the insurance marketplace, and taxpayers would be on the hook for a multibillion-dollar expansion of the public health care system. Ultimately, these moves will dramatically drive up the cost and worsen the quality of health care in America. A key element of the Democrats' reform bill is an individual mandate, which would legally require people to purchase insurance. Starting in 2013, everyone would have to own a plan that met government specifications or pay a fine. Proponents of such a mandate claim that it will broaden the insurance risk pool to include those who may not currently have insurance, which would eventually lead to lower premiums for everyone. Previously uninsured younger, healthy Americans would effectively subsidize older and less healthy patients. Mandating everyone to dive into the insurance pool may seem like a good idea, but it represents a profound assault on individual freedom. The federal government will decide what constitutes an acceptable benefit plan and what people pay for it. Government will also control how doctors are paid by insurance companies and, ultimately, how they practice medicine. Congress does not legally force Americans to spend their own money on any other particular good or service -- why should health insurance be any different? In fact, for some Americans, health insurance isn't a wise use of funds. Young people and health fanatics, for instance, might well shell out premiums for medical services they likely won't use. And those premiums can be hugely expensive. The average premium for family coverage is a whopping $12,300 a year. That rate is only going to go up if the Democrats' plan passes. The nonpartisan Congressional Budget Office recently estimated that individual insurance premiums under reform would be 10 percent to 13 percent higher by 2016 than they would in the absence of reform. In certain states, the increase in premiums would be even higher. In California, for instance, the average healthy 25-year-old man would see his premiums rise 106 percent thanks to the Democrats' reform plan. Premiums for a typical Virginia family with two children would increase 82 percent. Some folks might be best served by paying for routine health expenses out of their own pockets rather than relying on expensive and inconsistent insurance policies. These increases in the cost of insurance are largely the result of the reform plan's array of new controls on insurers. Paramount among these controls is a requirement that insurers issue a policy to any customer who requests one, regardless of one's medical history or health status. In those states that mandate "guaranteed issue," the regulation has induced patients to wait until they actually need medical care before purchasing coverage. In order to cover the cost of an insurance pool filled exclusively with sick people, premiums must be sky-high. Indeed, guaranteed issue has driven health premiums up by as much as 200 percent in some states. In those states that mandate "guaranteed issue," the regulation has induced patients to wait until they actually need medical care before purchasing coverage. In order to cover the cost of an insurance pool filled exclusively with sick people, premiums must be sky-high. Indeed, guaranteed issue has driven health premiums up by as much as 200 percent in some states. The Democrats' reform package would also install a national "community rating" ordinance, which would restrict insurers' ability to charge different prices to different enrollees according to their health status. It would also impose new limits on out-of-pocket spending and require all insurance plans to include certain benefits, like maternity leave and newborn care, even if a patient didn't want them. These rules are meant to make health coverage more affordable and robust for more Americans. But they'll do just the opposite. Mandated benefits can increase the cost of a basic insurance policy by up to 50 percent. And by forcing insurers to charge both the sick and the healthy similar rates, communityrating regulations virtually guarantee that everyone pays more. Instead, we need low-cost, pragmatic policies that drive down health prices without impinging on individual freedoms. A great first step in that direction would be for Congress to allow people to buy insurance policies across state lines. States regulate insurance differently. Some require policies to cover a long list of procedures. Others effectively prevent competition among carriers. As a result, the price of a basic insurance plan varies dramatically from state to state. For instance, a 25-year-old male in New Jersey has to shell out about $5,600 for a basic insurance policy. His counterpart in Kentucky can get a similar policy for just $1,000. Currently, Americans can only purchase policies approved for sale in the state where they live. Allowing them to shop around for the best deal would instill competition and drive down prices. Lawmakers could take a second step in the right direction by enacting major medical malpractice reform. One in eight doctors gets sued for malpractice every year. These suits cost about $100,000 on average to defend, even though doctors are found innocent 90 percent of the time. To avoid getting dragged into expensive legal proceedings, many doctors engage in "defensive medicine," ordering more tests and procedures than necessary. This practice added $124 billion to national health costs in 2006 and drove more than 3 million
Americans into the ranks of the uninsured. Implementing some commonsense tort reforms -- like a $250,000 cap on noneconomic damages -- could reduce these costs without compromising patient care. Congressional Democrats have been forced to trim some of their more grandiose ambitions for health reform. But the bill remains a bloated, big-government monstrosity. American taxpayers and patients alike simply can't afford the Democrats' vision for health reform.
Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care. More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one's daily regimen of prescription and over-the-counter medications. At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services, home health care usually involves helping seniors recover from an illness or injury. That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state. How Do I Make Sure That Home Health Care Is Quality Care? As with any important purchase, it is always a good idea to talk with friends, neighbors, and your local area agency on aging to learn more about the home health care agencies in your community. In looking for a home health care agency, the following 20 questions can be used to help guide your search: How long has the agency been serving this community? Does the agency have any printed brochures describing the services it offers and how much they cost? If so, get one. Is the agency an approved Medicare provider? Is the quality of care certified by a national accrediting body such as the Joint Commission for the Accreditation of Healthcare Organizations? Does the agency have a current license to practice (if required in the state where you live)? Does the agency offer seniors a Patients Bill of Rights that describes the rights and responsibilities of both the agency and the senior being cared for? Does the agency write a plan of care for the patient (with input from the patient, his or her doctor and family), and update the plan as necessary? Does the care plan outline the patients course of treatment, describing the specific tasks to be performed by each caregiver? How closely do supervisors oversee care to ensure quality? Will agency caregivers keep family members informed about the kind of care their loved one is getting? Are agency staff members available around the clock, seven days a week, if necessary? Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day? How does the agency ensure patient confidentiality? How are agency caregivers hired and trained? What is the procedure for resolving problems when they occur, and who can I call with questions or complaints? How does the agency handle billing? Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services? Will the agency provide a list of references for its caregivers? Who does the agency call if the home health care worker cannot come when scheduled? What type of employee screening is done? When purchasing home health care directly from an individual provider (instead of through an agency), it is even more important to screen the person thoroughly. This should include an interview with the home health caregiver to make sure that he or she is qualified for the job. You should request references. Also, prepare for the interview by making a list if any special needs the senior might have. For example, you would want to note whether the elderly patient needs help getting into or out of a wheelchair. Clearly, if this is the case, the home health caregiver must be able to provide that assistance. The screening process will go easier if you have a better idea of what you are looking for first. Another thing to remember is that it always helps to look ahead, anticipate changing needs, and have a backup plan for special situations. Since every employee occasionally needs time off (or a vacation), it is unrealistic to assume that one home health care worker will always be around to provide care. Seniors or family members who hire home health workers directly may want to consider interviewing a second part-time or on-call person who can be available when the primary caregiver cannot be. Calling an agency for temporary respite care also may help to solve this problem (see the Respite Care fact sheet for more information about these services). In any event, whether you arrange for home health care through an agency or hire an independent home health care aide on an individual
basis, it helps to spend some time preparing for the person who will be doing the work. Ideally, you could spend a day with him or her, before the job formally begins, to discuss what will be involved in the daily routine. If nothing else, tell the home health care provider (both verbally and in writing) the following things that he or she should know about the senior: Illnesses/injuries, and signs of an emergency medical situation Likes and dislikes Medications, and how and when they should be taken Need for dentures, eyeglasses, canes, walkers, etc. Possible behavior problems and how best to deal with them Problems getting around (in or out of a wheelchair, for example, or trouble walking) Special diets or nutritional needs Therapeutic exercises. In addition, you should give the home health care provider more information about: Clothing the senior may need (if/when it gets too hot or too cold) How you can be contacted (and who else should be contacted in an emergency) How to find and use medical supplies and medications When to lock up the apartment/house and where to find the keys Where to find food, cooking utensils, and serving items Where to find cleaning supplies Where to find light bulbs and flash lights, and where the fuse box is located (in case of a power failure) Where to find the washer, dryer, and other household appliances (as well as instructions for how to use them). A WORD OF CAUTION . . . Although most states require that home health care agencies perform criminal background checks on their workers and carefully screen job applicants for these positions, the actual regulations will vary depending on where you live. Therefore, before contacting a home health care agency, you may want to call your local area agency on aging or department of public health to learn what laws apply in your state. HOW CAN I PAY FOR HOME HEALTH CARE? The cost of home health care varies across states and within states. In addition, costs will fluctuate depending on the type of health care professional required. Home care services can be paid for directly by the patient and his or her family members, or through a variety of public and private sources. Sources for home health care funding include Medicare, Medicaid, the Older Americans Act, the Veterans' Administration, and private insurance. Medicare is the largest single payer of home care services. The Medicare program will pay for home health care if all of the following conditions are met: The patient must be homebound and under a doctors care; The patient must need skilled nursing care, or occupational, physical, or speech therapy, on at least an intermittent basis (that is, regularly but not continuously) The services provided must be under a doctors supervision and performed as part of a home health care plan written specifically for that patient The patient must be eligible for the Medicare program and the services ordered must be medically reasonable and necessary The home health care agency providing the services must be certified by the Medicare program. To get help with your Medicare questions, call 1-800-MEDICARE (1-800-633-4227, TTY/TDD: 1-877-486-2048 for the speech and hearing impaired) or look on the Internet at http://www.medicare.gov. WHERE CAN I LEARN MORE ABOUT HOME HEALTH CARE? There are several national organizations that can provide additional consumer information about home health care services. These include the following: The National Association for Home Care, which can be reached at 202-547-7424 or by visiting its website at www.nahc.org. The postal address is: 228 7th St., SE; Washington, DC 20003. The Visiting Nurse Associations of America, which can be reached at 617-737-3200 or by visiting its website at http://www.vnaa.org. The postal addresses are: 99 Summer St., Suite 1700; Boston, MA 02110. To find out more about home health care programs where you live, you will want to contact your local aging information and assistance provider or area agency on aging (AAA). The Eldercare Locator, a public service of the Administration on Aging (at 1-800-677-1116 or http://www.eldercare.gov can help connect you to these agencies. Case Study WHEN IS HOME HEALTH CARE APPROPRIATE? Because it is not always clear to the average person when an ailing senior needs home health care and when he or she needs nursing home care, it is usually best to consult a medical professional for advice. The following case study describes one situation in which home health care proved to be the right choice. Francis is 84 years old and recently had a stroke. She was hospitalized briefly and then discharged to continue recovering at home. To enable her to return home, her doctor called a home health care agency, and the agency gave Francis a complete home health care plan for six weeks. Since the doctor ordered the home care for Francis, Medicare paid for it. For the first week after Francis went home, a nurse visited her every day. The nurse met with Franciss family to discuss her special dietary needs and to arrange for exercise therapy to help Francis regain her strength. Once that was done, the nurse visited Francis twice a week to check on how well she was recovering. The home health care agency also sent a homemaker, a personal care attendant, and a physical therapist to visit Francis several times during the week. The homemaker would do the shopping and cook light meals. The personal care attendant would help Francis bathe, get dressed, and walk. The physical therapist would keep Francis moving and see to it that she got some exercise to aid in her recovery.
The federal health care reform legislation, known as the Patient Protection and Affordable Care Act, signed by the President on March 23, 2010, and the Health Care and Education Reconciliation Act approved by Congress, signed by the President today, will expand the availability of health care coverage to millions of Americans. While some of the measures will be implemented this year, many do not take effect until 2014 and some extend out to 2020. Below is a high-level overview of the timeline. It is important to note that many of these reforms and their effective dates are subject to the rules and regulations process both at the state and federal levels which could alter the intended timing of implementation. 2010 New Programs: * Temporary retiree reinsurance program is established * National risk pool is created, small business tax credit is established * $250 rebate for Medicare members who reach the "doughnut hole" Insurance Reforms: * Prohibits lifetime benefit limits based on dollar amounts * Allows restricted annual limits on the dollar value of certain benefits * Coverage rescissions/cancellations are prohibited (except for fraud or intentional misrepresentation) * Cost-sharing obligations for preventive services are prohibited * Dependent coverage up to age 26 is mandated * Internal and external appeal processes must be established * Pre-existing condition exclusions for dependent children (under 19 years of age) are prohibited * New health plan disclosure and transparency requirements are created 2011 Insurance Reforms: * Uniform coverage documents and standard definitions are developed * Minimum medical loss ratios are mandated Medicare Reforms: * Medicare Advantage cost sharing limits effective * Medicare beneficiaries who reach the doughnut hole will receive a 50% discount on brand name drugs * A 10% Medicare bonus will be provided to primary care physicians and general surgeons practicing in underserved areas, such as inner cities and rural communities. * Medicare Advantage plans would begin to have their payments frozen. Other: * Employers are required to report the value of health care benefits on employees' W2 tax statements. * Annual industry fee for pharmaceutical manufacturers of brand name drugs. * Voluntary long term care insurance program would be made available to provide cash benefit for assisting disabled individuals to stay in their homes or cover nursing home costs. Benefits would start five years after people begin paying a fee for coverage. * Funding for community health centers would be increased to provide care for many low income and uninsured people. 2012 * Hospitals, physicians, and payers would be encouraged to band together in "accountable care organizations." * Hospitals with high rates of preventable readmissions would face reduced Medicare payments. 2013 * Individuals making $200,000 a year or couples making $250,000 would have a higher Medicare payroll tax of 2.35% on earned income up from the current 1.45%. A new tax of 3.8% on unearned income, such as dividends and interest, is also added. * Medical expense contributions to flexible spending accounts (FSAs) limited to $2,500 a yearindexed for inflation. In addition, the thresholds for claiming itemized tax deduction for medical expenses rise from 7.5% to 10% of income. * Medical device manufacturers would have a 2.9% sales tax on medical devices; devices such as eyeglasses, contact lenses, and hearing aids would be exempt. * Eliminates deduction for expenses allocable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D eligible retirees. 2014 Coverage Mandates & Subsidies: * Individual and employer coverage responsibilities are effective. * Individual affordability tax credits are created and small business tax credits are expanded. Health Insurance Exchange & Insurance Reforms: * State individual and small group health insurance exchanges operational. * Guaranteed issue, guaranteed renewability, modified community rating and minimum benefit standards ("essential benefits" plan) effective. * Lifetime and annual dollar limits are prohibited for essential benefits. * Pre-existing condition exclusions are prohibited. Taxes & Fees: * Addition of new taxes on health insurers Medicaid and Medicare Reform: * Medicaid expanded to cover low income individuals under age 65 up to 133% of the federal poverty levelabout $28,300 for a family of four. * Minimum medical loss ratio of 85% required for Medicare Advantage plans 2018 Taxes & Fees: * Tax ("Cadillac tax") imposed on employer sponsored health insurance plans that offer policies with generous levels of coverage. 2020 Medicare Reform: * Doughnut hole coverage gap in Medicare prescription benefit is fully phased out. Seniors continue to pay the standard 25% of their drug costs until they reach the threshold for Medicare catastrophic coverage. Author Resource: Easy To Insure ME http://www.easytoinsureme.com/
One cannot deny the importance of having a health insurance in todays times where incidences of illnesses and diseases are constantly on the rise. This is applicable for all regions around the world and Texas is no exception. This need to have a health insurance becomes even more essential if you are forced to visit any doctor for an illness of any magnitude or nature and are unable to pay the medical bill. Once you realize the importance of procuring cheap health insurance Texas for you and your family, you must do some research in terms of the best Texas health insurance quotes that are provided by insurance companies in this region. It is true that every health insurance policy has its own set of advantages and disadvantages. It is quite difficult to find something that would be the ideal choice for you and your family. Yet it always better to make an informed decision rather than an ignorant one. If you are looking for the best Texas health insurance quotes in order to procure cheap health insurance Texas, you should first know that are two basic plans or policies for health care that you can consider opting for. These are broadly classified into the Fee-for-Service plans and the Managed Care Health plans. The plans falling under the category of Managed care essentially function through a network of reputed doctors. This entails that you will receive medical coverage if you visit any hospital or doctor that is mentioned in the list of this plans network. On the other hand, the plans belonging to the category of fee-for-service or indemnity plans, give you the liberty to visit any hospital or doctor of your individual choice or preference. These plans are more expensive but provide greater flexibility to the patients. Thus, before obtaining Texas health insurance quotes in order to locate cheap health insurance Texas, you should select the type of insurance that will suit you best. To obtain cheap health insurance Texas, you can also consider ordering Texas health insurance quotes online. If you do some research online, you will find countless websites that advertise prices and quotes of different heath plans that their company offers. You will not only find details about the various prices and plans, but also be provided with guidance in terms of the most feasible and suitable option for your individual requirements. You can consider ordering brochures of the best insurance companies and make a comparison between their co-payments, deductibles, coinsurance, premiums, preventive care, diseases they seek to cover and the coverage that they will provide in the case of prescription drugs.
Finding an affordable health insurance policy is critical especially if you're on your own. If you're looking for an individual health insurance policy chances are you meet one of the following criteria: Easy To Insure ME has the answers a) You recently left your job and don't feel like paying the exorbitantly high prices of COBRA. b) You have a job that offers no health insurance coverage to its employees. c) You have a job that does give coverage to its workers but the benefits of the policy are minimal or the premiums are much higher than they would be were you to get your own health insurance coverage. d) You recently started a job that requires you to wait a certain amount of time before the benefits kick in. Whatever the case may be finding the best health insurance policy can be very difficult. I've searched and searched for many policies myself and eventually found one that turned out to be the best fit for my situation. Many people walk into hospital or Social Services. Health Coverage's like immunizations finally come off their neutral stand and protect yourself in case something that which of them can prove to the big insurers will not give benefits you are going to take losing your heart your family meaning husband wife 3 dependent minors and dependent parents of the individual health plan but once elected officials to end what might be considered proposing health coverage premium is cheap. Check whether the obese people to another. Besides one more plan that is so appalling ill with and so on. So finally stop your blood sugar steady by eating five small meals throughout the day rather than PPOs in their neutral stand and back it up at the best rates; perhaps not see all Americans. The Medicare Part D plan is a tragic depiction of the balance or a portion of the company has a tendency to deny the claim up long enough healthcare costs and cons of various companies would have been looking for after looking at the average premium naturally depends on each members) the premium of standard group policies and plans available to you when you are switching things up. Cut the average American Hospital Associations including your health insurance benefits to pay for his individual to another as each state has its own rules governing the premium costs. For example if your present health policy for your maternity plans or treat it as a primary
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For most people needing medical care or Health check up in Goa and Kerala, the last thing on their minds is travel but a growing number of Medical tourists from America, Canada, Europe, Australia, Middle East and Africa are heading to India for their medical concerns. Health checkup programs are the best way to know about the status of your health, and take necessary measures, in case you come across any medical ailment. Health checkup comprises of health exams and tests for which can help to find problems before they start. The blood test, the metabolic tests, and cardiovascular tests in short a complete body scanning comes under Health checkup in Goa and Kerala. Following are the five reasons for having Health checkup in Goa and Kerala. 1. Price This is the main reason most people initially cite for their decision to go overseas for Health checkup in Goa and Kerala. While comparing India seems to have emerged to be one of the lowest priced options of sufficient quality for Westerners. 2. Service Besides the costs, many people appreciate the superior service found in Indian hospitals. Moreover, a large population of India happens to be English speaking, hence for global patient especially from the west it's easy to communicate during their Health checkup in Goa and Kerala 3. Quality It is natural to assume that if something is cheaper then it must be of lower quality, but for a well-planned medical tour to India the situation is just the opposite. Indian hospitals ensure that the foreign patients get eminent and very experienced physicians effectively the best that country has to offer. 4. Availability Medical tourists also have greater access to different treatment types than those who choose not to travel. Indian healthcare sector have invariably every medical treatment available and that too with minimal patient wait list. 5. Tourism Medical tourism is often as much about the tourism as the medicine. For those undergoing Health checkup in Goa and Kerala, there is no better place to recover than a bungalow with a view of the beach while receiving your physical therapy (or massage). Similarly, for family accompanying a patient a week at the beach or a shopping spree can clear up a lot of stress following any medical treatment or health check up. For further information on Health checkup in Goa and Kerala visit us at www.forerunnershealthcare.com or mail your queries at email@example.com or call us at: +91-9371136499, +91- 9860755000 (International) / + 1-415-599-2537 (USA) / +44-20-8133-2571 (UK)
On his first day as Florida's new House speaker, Rep. Dean Cannon took a clear shot at President Barack Obama's new health-care reform law. Easy To Insure ME has the answers "Should it really be the role of government to require people to purchase a health insurance product they don't want, raise taxes to give that same product to others who can't afford it, and commandeer our state government and its resources to
carry it out?" Cannon, a Winter Park Republican, told House members after being sworn in two weeks ago. "Or, should we work to limit government and empower the private sector?" On numerous fronts, Florida policymakers have already answered that question. While the fight against President Obama's health-care reform may be centered in the Beltway, Republican resistance to the sweeping new mandates is also taking shape in Tallahassee. Among the battlefronts: Florida led the charge with 19 other states last March by challenging the law in federal court, claiming the mandates that uninsured people buy coverage violated states' rights. A judge in Pensacola is expected to rule shortly after a Dec. 16 hearing on whether the suit can move forward. More states are expected to join after a new crop of state attorneys general are sworn into office in January. Last spring, GOP legislators hastily drafted a constitutional amendment spelling out that Florida businesses and residents couldn't be forced to buy insurance, but a Tallahassee judge threw it off the November ballot for "misleading" language. Lawmakers have re-filed an altered version and hope to place it before voters in 2012. And perhaps most significantly, legislative leaders are poised to block spending and rules necessary to implement the law. Already, state regulators has refused to impose minimum spending mandates that might generate refunds for consumers but which health insurers say will hurt their profits. And Gov.-elect Rick Scott has also made clear he doesn't want the state doing anything to help the law along. The Patient Protection and Affordable Care Act passed last spring anticipated that the states would lead the way on many of its more than 100 changes to the nation's health care system. With 3.8 million uninsured residents, Florida is one of the states that would be most affected by the law. The most controversial reforms including the requirement that individuals buy coverage or pay a penalty -- don't start until 2014, and phase-ins continue until 2018. But the bill requires states to start working now to improve their data-collecting and enforcement mechanisms. It was hoped states would create their own insurance exchanges, to match individuals with insurance plans; establish "highrisk" pools to insure people now shunned by providers; and police new restrictions on insurance company profits. But Gov. Charlie Crist opted last spring not to immediately tap into federal grant money to create a Florida high-risk pool to cover people with pre-existing medical conditions, deferring to the federal government. And now Cannon, R-Winter Park, and Senate President Mike Haridopolos, R-Merritt Island, may seek to block any cooperation by the state. Florida has been awarded $43 million in grants to provide $250 rebates to seniors who fall into the "donut hole" in the Medicare prescription drug program; to help prepare the Office of Insurance Regulation to evaluate out-of-state insurers seeking to sell health coverage in the state; and to plan for creating a health-care marketplace, or "exchange," and other changes. But even before he was officially named speaker, Cannon warned Crist that no state agency should take any steps to comply with the law "without clear and comprehensive guidance from the Legislature." The Oct. 19 letter demanded an itemized accounting of all state agency activities regarding the federal law. Specifically, the letter singled out the Office of Insurance Regulation for work it has begun and which legislative budget-writers approved to study how Florida's health-care laws should be amended to conform to the federal reform, and to boost the state's ability to handle new rate-filing data. "Not only are Florida insurance officials helping the federal government to write rules on these matters, but [OIR] is jumpstarting these new regulatory functions by developing data systems necessary for enforcement," Cannon complained. He added: "We intend to develop a clear and statutorily-defined framework for Florida agencies' activities in regard to the federal health law. Pending such legislative action, state agencies should examine each anticipated action or function in light of their specific statutory authority." Laura Goodhue, executive director of Jupiter-based health-care advocacy group Florida CHAIN, said the criticism appeared designed to bully agencies into slowing their efforts to follow the federal law. "I know transparency is important in implementing laws, but creating a chilling effect is certainly not helpful," said Goodhue, who attended meetings with OIR over the last year as part of an advisory health insurance board. In response, most all of Florida's state agencies produced itemized lists of what they had done -- down to how many staff hours Department of Management Services staff spent examining new rules requiring lactation rooms and milk storage for breast-feeding mothers in the workplace. Cannon spokeswoman Katherine Betta said last week that Cannon's staff was still reviewing the responses and hadn't decided "what the next step will be." OIR communications director Jack McDermott defended his agency's work, adding there was no intent to be "an advocate for the implementation of federal healthcare." "Virtually all of this information --- whether it is actual review of large group rates, or expanding data systems to collect additional data would require additional statutory authority or administrative rules," McDermott e-mailed in response to questions. And recently, OIR decided to slow one of the new law's reforms by not imposing new profit limits on health insurers beginning Jan. 1. A new federal "medical loss ratio" requirement would force insurers to spend 80-to-85
percent of the premiums they collect on medical care, with the remainder set aside for overhead including executive salaries and profit. Nearly half the country's insured population are covered by providers that spend more than that on overhead and profit. Florida's "medical loss ratio" is 65-to-70 percent, and OIR will ask the federal government for a three-year waiver from the tougher standard, said McDermott. At a recent hearing, most of Florida's main health insurers complained that the new standard would hurt their bottom lines and restrict the Florida insurance market. Insurance Commissioner Kevin McCarty agreed, saying he feared making the change next year would "destabilize" the market and hurt competition. The move could have a pocketbook implication for Floridians. The law requires insurers to provide rebates to customers if they exceed the overhead limits in 2011. The feds estimate the rebates could average $164 for individuals in 2012. But if OIR wins the three-year delay, Florida consumers won't be eligible for those checks in 2012. "To me, the delay obviously would be helpful to the insurance companies and HMOs, and not to the patients," said Senate Minority Leader Nan Rich, D- Weston. "That's less money for care for patients." Legislative conservatives like Rep. Scott Plakon, R-Longwood who's re-filed the constitutional amendment that says Floridians could not be compelled "directly or indirectly to participate in any health-care system" say they are determined to fight every way they can. Plakon's House Joint Resolution 1 has already picked up a prime sponsor in the Senate: its new leader, Haridopolos. "We have to follow the law. But in the process, we need to put Floridians first," Plakon said. "So if there is any room there, we would default to the position of putting Floridians first instead of this kind of massive federal takeover."
The latest rollout of the federal health care overhaul offers consumers a rebate if their insurers spend too little on actual medical care and too much on administrative costs. Easy To Insure ME has the answers But Floridians may miss out on the rebates that will start in 2012. Pressed by the insurance industry, state regulators will soon ask the federal government for a waiver from the requirements, which begin Jan. 1. The Florida Office of Insurance Regulation confirmed Tuesday it will request a reprieve until 2014, when the health care law's coverage guarantees kick in. In a written statement, the office said enforcing profit limits in 2011 could "disrupt" the insurance market in Florida, where 4 million people are uninsured. Commissioner Kevin McCarty was not available for questions. The state already is suing to overturn the health care law. The new requirements are supposed to help increase the value of coverage for consumers and make health insurers "more accountable" by publicly reporting spending and premiums, federal health officials say. Consumer advocates, such as Consumers Union, publisher of Consumer Reports, largely consider the requirements a win. The idea of a waiver similar moves are afoot in Georgia, Iowa, Maine and South Carolina got a tepid response. "We generally feel the industry does cry wolf," said Walt Dartland, executive director of the Consumer Federation of the Southeast. "Our position is generally when we have an issue like this, we're against the waiver you've got to prove that." Essentially, the rules require insurers that offer small group and individual health plans must spend 80 percent of their revenue on care outside administrative costs. Large group insurers plans covering 50 or more people must spend 85 percent of their revenues on care. It's called the "medical loss ratio." If it's too high, rebates will become due in 2012 in an account credit or payment. Nationally, 9 million people would be eligible for rebates averaging $164 for individual policies, according to the U.S. Health and Human Services Department. Group plan figures weren't available, nor were Florida rebate values. The new rules announced Monday apply to 75 million Americans. Self-insured plans aren't included. Currently, Florida requires insurers to operate at 65 to 70 percent loss ratios. The insurance office plans to ask for a waiver for the small group and individual markets, though it said it needs at least two more weeks to finish the request. U.S. Health and Human Services Secretary Kathy Sebelius would decide whether to grant it. After months of federal review, insurers won breaks but failed to get a broader array of business costs factored into medical spending. For example, plans with fewer than 75,000 members will get adjustments to help them comply, and ones with fewer than 1,000 members will be exempt from the rebates. Nearly all taxes can be figured into the ratio, as well as spending to improve health care. And states can win waivers to use lower rates if they show insurance would be disrupted by higher requirements. Florida insurance executives complained the tougher requirements will disrupt their finances and limit their ability to insure people. Without a waiver, some insurers could be forced to lower their rates to meet the threshold or find a creative way to pay for rebates, said Blue Cross Blue Shield of Florida executive
Randy Kammer, a member of the industry-dominated Florida Health Insurance Advisory Board, which endorsed a waiver in September. Blue Cross Blue Shield of Florida, the state's largest insurer, expects to meet the requirement. A nonprofit, the insurer faces less financial pressure from Wall Street, said Kammer, vice president for regulatory affairs and public policy. But others face steeper costs. About 45 percent of people nationally who buy their own insurance are in plans exceeding the limits, according to federal officials An analyst for Citigroup estimated last month that Golden Rule, a subsidiary of United Healthcare, would face $38.1 million in rebates for its 119,000 insured Floridians, based on 2009 figures. That's a $319 average rebate in Golden Rule's biggest state. At a Sept. 24 state hearing to gather evidence for the waiver, Golden Rule vice president Mike Corne warned that customers could face fewer options for insurance because of the crunch imposed by tougher profit limits. Customers, who often seek Golden Rule individual policies absent a workplace plan, could find fewer companies willing to add new policies, and fewer businesses seeking a place in the market, said Corne, arguing for a phased approach. "We will figure out how to adjust our business model, but I think we would be better off with handling this over time," Corne said.
Q: What is home health care? A: Home health care is a service that permits patients to receive personalized health care, maintaining their quality of life in the privacy and comfort of their homes. Q: Why home health care? A: Home health care is a cost-effective option for receiving health care services. Returning to ones home and family can quicken recovery and improve the quality of life for both patient and family or caregiver. Q: Who pays for home health care? A: Most health insurance companies, HMOs, PPOs and Workers Compensation cover home health care. In addition, Medicare and Medicaid pay for home care services. Some insurance providers do not cover all home health services. Our staff will verify health coverage for the patient. Q: What criteria are required for Medicare to approve services? A: The following criteria are used to meet Medicare requirements: The patient is a Medicare recipient. The patient must be homebound. This is defined by Medicare as normal inability to leave the home and that leaving the home requires considerable and taxing effort. The skilled care must be medically necessary as determined by the physician. Q: What if I have a problem at night or on the weekend? A: We have registered nurses on call 24 hours a day, 7 days a week. Q: Do I need a physicians order for home health care? A: Yes, all health care provided in the home occurs under direct order and supervision of the patients physician. Q: What types of services can be provided at home? A: Many medical conditions that previously required hospitalization can safely be treated in the home. Home care services may include but are not limited to: Skilled Nursing: Observation and assessment of condition Patient and family education of disease process Management and evaluation of patient care plan Medication education and management Dressing changes Home safety education Wound care Catheter care Injections IV therapy Ostomy care Pain management Diabetic care Nutritional support Assistance with Daily Living: Bathing/dressing Transfer/ambulation Light meal preparation Light housekeeping Grocery shopping Medication reminder Laundry Companionship/Conversation Reading/writing Pet sitting/walking Escort to appointments Live-ins Respite Exercise therapy assistance Q: How does Paloma Home Health Care, Inc. ensure quality care in the home? A: Providing continuous quality care to patients is paramount to all we do. All patients are given a patient satisfaction survey that is incorporated into our ongoing evaluation process to continually increase our patient satisfaction. New programs and processes are developed through our quality improvement team to promote favorable outcomes. Q: How do I find out more about home health care? A: Please call our office to learn more about how you can benefit more about the service, at 972 346 2013 Q: What services can Paloma Home Health Care, Inc. offer? A: Our services include but are not limited to: Supportive Care Education of Disease Process Individual and Family Counseling Management and Evaluation of Patient Care Observation and Assessment Home Safety and Emergency Education Medication Education Assistance with ADLs Nutrition Education Restorative Therapy (Physical, Occupational and Speech)
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Imagine for a moment a sudden outbreak of smallpox (weaponized smallpox, if your taste runs to Jack Bauer-style scenarios). Airborne, highly contagious, deadly, it has the capability of spreading across the country and beyond in weeks, if not contained with a program of vaccination--vaccination not for a few, but for everybody, as soon as possible. Easy To Insure ME has the answers If Congress passed emergency authorization for the program, would you want a judge to block it? What if some citizens preferred not to be vaccinated? What if they promised Scout's honor not to get smallpox, or if they did, not to give it anyone else? Would you want the judge to halt the program on the grounds that not getting vaccinated was "inactivity," and thus beyond Congress's power over "to regulate commerce with foreign nations, and among the several states, and with the Indian Tribes?" Those who refused vaccination might act as reservoirs of the disease, and thus affect commerce. What if the judge conceded that point, but said Congress still couldn't reach them because they weren't voluntarily in the stream of commerce? What if the judge blocked the program because Congress relied on private medical personnel to administer the vaccine? Congress could have created a program by which thousands of full-time federal employees would give the inoculations--that would be constitutional--but using non-employees made the program unconstitutional. Would that make sense? While the disease spread, and hundreds or even thousands died, would you thank the judge for his fidelity to the pre-1937 vision of the Commerce Clause? Or would you think that, no matter what was written in the judge's order, the irretrievable spread of the epidemic really
had affected commerce and should have been stopped? These reflections were spurred by the decision Monday in the case of Virginia v. Sebelius, the lawsuit brought by Ken Cuccinelli, Virginia's right-wing zealot attorney general, to spare the uninsured of his state the indignity of government-funded health care. Judge Henry Hudson of the United States District Court for the Eastern District of Virginia agreed with Cuccinelli that the so-called "individual mandate" provision of the Act exceeds the Commerce Clause because it seeks to "compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market." For those of you scoring at home, currently it's Affordable Health Care Act 2, right-wing opponents 1. Two federal district courts have upheld the program; Judge Hudson is the first district judge to hold against it. That's neither here nor there--the final score will almost certainly be a best-of-nine championship series played here in Washington at the Supreme Court. But it does underline that the issues in the case are close. The weight of academic opinion so far supports the Act, but some of the very brightest (and perhaps not coincidentally most conservative) of my colleagues disagree. Readers would do well to discount the importance of Judge Hudson's decision, which is about as significant as an early NBA playoff game. And partisans might nurture the Christmas spirit by refraining either from the right-wing spike dance or the progressive chant of "You're blind, ump!" These are hard issues; federal judges, by and large, don't ask for these cases to land in their courtrooms. Having read the opinion, I see nothing in it to suggest that Judge Hudson is not doing his duty to construe the statute as he reads it, compare it with the Constitution as he understands it, and announce whether the two go together. His opinion was respectful to both sides and--in stark contrast to the intemperate earlier interim decision of Senior Judge Robert Vinson of a Florida district court--devoid of inflammatory rhetoric, judicial triumphalism, or talk-radio style taunting. No one can seriously argue that the judge did not earn his salary. I do think, however, that Judge Hudson's opinion is wrong. Grievously wrong. Threat-to-thenation-from-rampaging-smallpox wrong. Here's why I think so. The argument that "inactivity" is beyond the reach of the Commerce Clause sounds reasonable. That's because, like most serious fallacies, it's half true. Last summer, Sen. Tom Coburn asked Supreme Court nominee Elena Kagan whether Congress could require individuals to eat vegetables three times a day. The cheeky Kagan responded, "Sounds like a dumb law." And a law that requires eating vegetables (or joining a gym, or subscribing to a newspaper) really is a dumb law. There is no overarching national necessity behind it. It's hard to imagine Congress claiming with a straight face that vegetable portions were an emergency, or that they needed to be regulated as part of a comprehensive scheme. That's the answer to those who will shortly post below that "'Professor Epps, if that is really what he is, clearly believes Congress can regulate all human activity." (Good to see you guys again, by the way.) Congress can't regulate everything; what it can regulate is everything that needs to be reached as part of a comprehensive scheme required by a necessity that affects the nation. Health care is such a necessity. Before Republicans hit upon the argument that health care isn't part of commerce, they harped for years on the dangers of regulating "one-sixth of the economy." After years of debate (more than half a century in fact) and extensive fact-finding, Congress decided that health care could only be provided effectively through a nationwide program. Ironically, Republican opponents concede that if Congress had passed a mandatory program funded by payroll and income taxes--a kind of Medicare for all ages--their challenge would have no merit. (In case the supple Cuccinelli later decides to reverse field, I personally saw him say this on October 21, 2010, at the Washington Legal Foundation.) Those taxes would of course be no less compulsory than the "mandate." But Congress' partial reliance on the private market (which in other contexts Republicans rhapsodically defend) somehow guts the nation's power to solve its health care problem. Well, everybody's got to have an argument, and the right has settled on this one. But conservatives should be careful what they wish for. Every constitutional decision is to be weighed not only (or even primarily) by the specific facts at issue, but by the potential mischief of the precedent that will be set. A decision voiding the health care act would strike at the heart of our nation's ability to deal with situations like my smallpox hypothetical. Wait a minute, you say, health care regulation isn't like a smallpox epidemic. No? Certainly health care is a life-or-death issue for millions of Americans, including many who will be insured under the Act but will fall through the cracks in the current system. Who could seriously claim that the 50.7 million people who currently have no health care do not constitute an emergency? A judge, to strike down the Act, must conclude that no reasonable Congress could have concluded that the situation needed nationwide, comprehensive regulation. And that no reasonable Congress could have concluded that the "mandate" is a key part of a comprehensive scheme to ensure near-universal coverage. Because if both those things are true, then the "inactivity" of refusing to take prudent care to prepare for an individual's health care needs is as potentially damaging as the "inactivity" of refusing needed vaccination at a time of epidemic. What if these "inactive" individuals
promise will really never, never, contract a catastrophic sickness or suffer a devastating injury, that neither they nor their children will ever, ever appear in an emergency room as uninsured patients? That rings as hollow as my hypothetical objectors' promise not to get or spread smallpox. These things aren't voluntary; taxes, sickness, death--you can't opt out, no matter how you try. And, I'm sorry to the hard-core libertarians out there, you cannot agree to waive life-saving care for your children. That argument was over long ago. The "inactivity" argument depends on the idea that the Constitution prohibits the United States from running a modern economy, in which all of us are involved by virtue of our membership in the nation. As in any highly industrialized nation, we're all in this together. And if we adopt an oldfashioned minimal view of national authority, we will have confirmed that 21st century America has chosen decline over economic leadership. I make no predictions. Judge Hudson's logic may very well prevail--especially if the conservative majority of the Supreme Court, a year or two hence, cannot resist the temptation to deliver a knockout blow to a president they despise. But such a decision would sow mischief in at least two ways. First, stripping this country of its first modern health care system would deform the Constitution, set back the cause of effecting legislative self-government, and spread suffering over decades or even generations. That may not matter so much to those who make the decision. Federal judges, like state attorneys general, are covered by generous health-insurance programs, and may not feel the whole thing is such a big deal. And our current Justices make no secret of their seething contempt for America's legislature. But if history teaches us anything, it teaches that emergencies come like thieves in the night, and that when they do, we look to government to step in. A strong nation preserves the tools it may need to avert disaster. Throwing those tools away would be an even greater mischief. If the United States finds Congress's powers gutted because of this partisan dispute, we will one day have reason to regret it.
Employer group health insurance rates have sky rocketed due to health care reform and renewals. Employers and groups can now get rates averaging at $100 per month for a 30 year old and $220 per month for a 50 year old with full coverage. Immediate action is required by employers and the human resources department. EasyToInsureME health insurance quotes With the recent health care reform changes and drastic renewals, employers are searching for a way to reduce health insurance premiums immediately. The economy is suffering due to the fact that costs are going up and profits are going down. There must be a way to equal out the difference. There is, reduce health insurance costs for employees. Health insurance premiums can be reduced by 50% if the correct action is taken by the employer. The action is to compare rates at Easy To Insure ME. With average rates being $100 per month for a 30 year old and $220 per month for a 50 year old with full coverage, this will definitely help any business reduce expenses. An immediate action is required for any business to stay profitable in this drowning economy. Rates are only going to be rising because of the mandates set forth by President Obama and health care reform. The reason is because qualified health insurance plans will soon be on the market. Once they arrive all rates will double in order to offer these qualified health insurance plans to everyone in the country. No one will be denied coverage and due to this cost of heavy medical claims, all expenses will be rolled into the health insurance premiums. Another way citizens will be penalized is to require everyone to have health insurance. If a person does not have group or individual health insurance coverage a penalty on taxes will be assessed. This mandate of requiring everyone to obtain medical insurance is currently in debate at the supreme court level. The argument is about whether it is unconstitutional for the government to require this purchase. In the mean time, employers and individuals can reduce costs substantially and assure that if required to purchase health insurance for individuals or group then an affordable rate can be achieved. There is no need to cancel a current group plan. It just needs to be corrected to become affordable once again. EasyToInsureME.com guarantees affordable health insurance for any group or individual. EasyToInsureME http://www.easytoinsureme.com/ is the number one source for health insurance shopping online. Call 866-492-3905 for immediate assistance.
Did you know that, in some countries, doctors prescribe green tea for common ailments such as the cold and flu? Green tea has been a part of Asian culture that dates back at least 5000 years. In Chinese, Japanese and other eastern culture, it is a part of everyday life. In Korea, green tea is used in a spiritual ceremony to quiet the spirit and to encourage harmony and relaxation. It is also commonly prescribed medicinally as a remedy to boost the immune system. Although partaking in green tea rituals has been an enduring practice in the East, it is presently enjoying a surge of popularity in the West, in part because of its many health applications. Among health aficionados, the health benefits of green tea are of great interest. Not only are there many advantages to drinking green tea, but studies reveal that there does not appear to be any harmful side effects. Even in populations that drink large amounts of green tea, the only side effects are limited to people who may not tolerate caffeine well. The Japanese drink green tea almost exclusively and health experts are now attributing their lack of coronary disease and longevity, at least in part, to the green tea habit. The polyphenols and other ingredients in green tea have a mild anti-clotting affect on blood platelets which results in a reduction of plaque accumulation on artery walls. It is also known to reduce blood pressure and cholesterol which are significant factors in heart disease. Additionally, in parts of the world where people drink at least four cups a day, scientists have found a much lower incidence of many types of serious cancers such as pancreatic, breast, lung and skin cancer. Catechins, the polyphenolic antioxidant ingredients which have a slightly bitter taste, not only purportedly inhibit growth of cancer cells, but they can also kill the harmful bacteria that invade the human body as well as the toxins that those bacteria produce. Catechins are also beneficial for oral health. These flavanols effectively kill the bacteria that accumulate in the mouth, reducing bad breath odor as well as plaque that builds up on teeth. Green tea also contains natural fluorine which helps prevent the incidence of cavities. Although coffee is the breakfast beverage of choice in America, other parts of the world prefer tea hands down. Decades of research on green tea have publicized the many health benefits of drinking it, including its ability to boost immunity, reduce heart disease, and promote oral health. Current research is ongoing and is hold promising evidence about green tea's ability to treat serious conditions such as cancer. With its many health promoting antioxidant compounds, green tea is a healthy, delicious addition to any healthy diet.
For almost 35 years, the law of the land has been an explicit prohibition against federal taxpayer dollars being used to pay for elective abortions, known as the Hyde amendment, after the late great Illinois congressman. This is a policy supported by the majority of the American people. In fact, this hard-fought explicit ban was included in the health care bill that passed the House last year. Regrettably, the Senate did not follow suit and instead passed a bill that would allow hard-earned taxpayer dollars to pay for elective abortion. That is a simple fact. Unfortunately, in a mad rush to secure enough votes, leading House Democrats now intend to take up the Senate-passed bill, arguing that the Senate language prohibits federal funding of abortion. Besides that fact that this simply not true, it also demonstrates the lengths the president and his allies will take to pass this bill against the will of the American people. Just this week, Cardinal Francis George, president of the U.S. Conference of Catholic Bishops, issued a statement saying, "Notwithstanding the denials and explanations of its supporters, and unlike the bill approved by the House of Representatives in November, the Senate bill deliberately excludes the language of the Hyde amendment. It expands federal funding and the role of the federal government in the provision of abortion procedures." First, the Senate bill allows elective abortions to be offered through the newly-created individual state health insurance exchanges and multi-state health plans administered by the Office of Personnel Management (OPM), and through federally-subsidized plans in already-existing community health centers. Second, there is nothing in this legislation that requires any of these programs to live up to both the spirit and letter of the Hyde amendment that Congress has included each year in spending bills that fund the government. This not only prevents federal funding of elective abortions, but also erects an iron-clad firewall against any private money for abortion being mixed with any federal or state health program receiving federal dollars. This applies, for example, to Medicaid, a health program for the economically disadvantaged that is funded by both federal and state governments. If any resources are
used for elective abortions that money must be kept completely separate from Medicaid. This is sound policy that must be maintained. Regrettably, the Senate-passed bill doesn't include this firewall. Anyone who doesn't earn enough money would qualify for a federal subsidy to help pay for their health plan in the state exchanges, including plans offering elective abortion coverage. Some argue that under the Senate-passed bill, federal funding would be "segregated" so no federal money would pay for abortions. But this is a violation of the Hyde amendment, which also prevents the federal funding of insurance that covers elective abortion. Furthermore, it is entirely possible that there would only be one health plan in any given state that does not include elective abortion. And even if you are opposed, you may well be railroaded into choosing a plan that covers it, because you might be looking for the best plan to treat a sick child or your own health condition. What's more, passing a new state law is the only way an individual state could truly ensure that elective abortions are not included in the plans offered through a state insurance exchange. That would be easier in some states than in others, but that's unfair to those who are morally opposed to federal funding of abortion and happen to live in states where passing such a law would be extremely difficult. Lastly, under this proposal, community health centers would receive a dedicated stream of money outside the annual congressional process to fund the government which is where the Hyde prohibition is maintained. So that means that for the first time federal money could be used to fund abortion at a community health center. Those are the facts, and anyone who thinks the Senate abortion language is strong enough should think again. That is because, regardless of one's position on this controversial issue, it is entirely reasonable to expect that a person who is fundamentally and morally opposed to abortion should not have to sanction its use with their hard-earned tax payer dollars.
Most Americans are aware that buried somewhere in the 2,000-page health care reform bill are provisions for cutting the already- strapped Medicare program by billions of dollars. Few are aware that the bill also cuts expenditures on county hospitals currently serving the poor. In Chicago, for example, those without health insurance go to the county hospital where they are treated without regard to whether they have health insurance. If the bill is passed, however, many of these county hospitals will either have to close their doors or deny treatment to those without health insurance. Although the bill passed by the Senate has been depicted as using coercive means to require those currently uninsured to buy insurance they cannot afford, or as imposing additional new taxes on the American working man and family, that bill is based on a fundamental lack of understanding of how the health care needs of the nations poor are currently served. The desperately poor, many of them unemployed, are not equipped to deal with complicated insurance programs, deductibles, co-pays and all the other accoutrements of the typical health care policy. They are poor, they are unemployed, they are sick, they need a place to go to be treated without red tape and procedural obstacles. County hospitals across the country that have provided that place are now threatened with a cut-off of funding and in many cases with extinction by the current health care reform bill passed by the Senate. A number of proposals for making health care affordable for all Americans have been put forward by those who have sought to be heard during the legislative process. All these proposals have been rejected by a Congress determined to impose government control of health care. Among these rejected proposals is to allow people to buy health insurance they can afford. Currently, government mandates require a single man to buy maternity coverage he will never use, or to pay inflated premiums to insure against going insane. It would be similar to a government mandate requiring every person to buy a Rolls Royce instead of a Ford. And then when people cant afford to buy the Rolls Royce, theyre without any car at all. Another rejected proposal is to allow health insurance companies to compete across state lines, thus increasing the competitive pressure to provide affordable insurance. Proposals for modest curbs on the multimillion-dollar malpractice suits that divert billions of dollars away from health care and into the pockets of high-rolling trial attorneys have also been rejected. Even proposals for limited but cost-effective catastrophic government insurance have been rejected by those determined to have government take over health care across the board.
As the members of the class of 2010 prepare to flip their tassels to the left in May, theres more than just studying to cross off of their to-do lists. While stressing over where to live and finding a job, many young adults do not address the issue of health insurance. Reality will set in for some graduates when their parents plan or student insurance coverage expires, if it hasnt already. Whether these current students are busy studying sociology or calculus, they need to make time to read up on their health insurance options before they suddenly find themselves uninsured. Thirty percent of people ages 19 through 29 are uninsured, said Steve Trattner, president of Cinergy Health, in his article Congratulations on Your College Graduation Now Get Health Insurance. Instead of being smart about the frailty of life, this age group tends to believe theyre invincible or simply do not recognize the necessity of health insurance, especially as we confront seemingly ever-rising health care costs, Trattner continues in the article. CNN Senior Medical Correspondent Elizabeth Cohen agrees with Trattners viewpoint in her article, Whats a Recent College Graduate to do about Health Insurance? Cohen acknowledges that some students are trying to find health insurance, but others, dubbed the young invincibles think they dont need it since theyre young and healthy. Cohen makes the point that all it takes is a car accident, a cancer diagnosis to put a 20-something college grad in real trouble. To save themselves the pain and hassle of acquiring medical debt on top of already-looming college loan debt, students should check out their options now. Insurance laws vary by state. As of Jan. 1, 2009, Connecticut law states that Every individual health insurance policy providing coverage of the type specified in [certain] subdivisions shall provide that coverage of a child shall terminate no earlier than the policy anniversary date on or after whichever of the following occurs first, the date on which the child: Marries; ceases to be a resident of the state; becomes covered under a group health plan through the dependents own employment; or attains the age of twentysix. This law does not apply to all insurance plans. In Whats a Recent College Graduate to do about Health Insurance? Cohen suggests looking into the Consolidated Omnibus Budget Reconciliation Act (COBRA). According to the U.S. Department of Labor Web site, COBRA gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances. COBRA is not a free option. The Web site explains that Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost of the plan.
The health-care law of 2010 is, as Vice President Biden put it, a "big [expletive] deal." It sets us on the road to universal health insurance. It is a favorite target for Republicans gunning to take over Congress. Lawmakers who supported it could lose their jobs. And it will remain a central focus after the midterms, as Democrats defend it against legal and political challenges through 2014, when it takes full effect. Easy To Insure ME But the Democrats' effort to sell the law to the public may be undermined by what even some ardent supporters consider its biggest shortfall. The overhaul left virtually untouched one big element of our health-care dilemma: the price problem. Simply put, Americans pay much more for each bit of care -- tests, procedures, hospital stays, drugs, devices -- than people in other rich nations. Healthcare providers in the United States have tremendous power to set prices. There is no government "single payer" on the other side of the table, and consolidation by hospitals and doctors has left insurers and employers in weak negotiating positions. "We spend fewer per capita days in the hospital compared with other advanced countries, we see the doctor less frequently, and we swallow fewer pills," said Jon Kingsdale, who oversaw the implementation of Massachusetts's 2006 health-care law. "We just pay a lot more for each of those units than other countries." The 2010 law does little to address this. Its many costcontrol provisions are geared toward reducing the amount of care we consume, not the price we pay. The law encourages doctors and hospitals to join "accountable care organizations" that have financial incentives to limit unnecessary care; it beefs up "comparative effectiveness research" to weed out inefficient treatments; and it will eventually tax the most expensive insurance plans to restrain consumers' superfluous use of health care. Such measures could reduce redundant tests, emergency room visits and hospital readmissions, which would help control the costs of Medicare, where the government sets rates. But they are less likely to lower prices outside Medicare and stem the growth of private insurance rates.
The main reason for this is politics. Remember how drawn-out the health-care battle was? It started in the spring of 2009 and was waged for a full year. The bill's proponents in the White House and in Congress had some inkling of how tough the fight with the insurance companies would be. Taking on hospitals, doctors, and drug and device manufacturers as well -- the people you'd face in a showdown over prices -might have been fatal. So there was no price fight. The law will go on to face a likely post-midterm Republican onslaught -- and dismantling it may be easier if Americans think it does little to restrain costs. It is one of those fine political ironies: The law derided as socialism may have had an easier time winning favor from a skeptical public if it was, well, a little more socialist. It's pretty far from socialist as it stands. The administration decided not to seek lower drug rates for Medicare, and it didn't press for a "public option," a government-run insurance plan that people under 65 could buy into. While supporters of the public option sold it as a way to compete with insurers, the real target was hospitals and doctors. A public option would have created a nationwide purchaser of health care that could have exerted leverage on providers to cut prices. This would have lowered the law's costs by reducing the subsidies needed to make insurance affordable. To avoid the wrath of hospitals and doctors, proponents of the bill rarely emphasized this cost-control argument. Nonetheless, when conservative "Blue Dog" Democrats weakened the public option in committee, they cited opposition from providers. And when the bill's supporters floated a close alternative to the public option -- letting people over 55 buy into Medicare -the reaction from Sen. Olympia Snowe, the moderate Maine Republican, said it all: "I am talking to a lot of my providers . . . and I know they are mighty unhappy." Snowe exposed where the lobbying strength lay: No senator ever spoke of listening to "my insurers." "The public hates the insurance industry and trusts doctors and hospitals," said Richard Kirsch, head of the liberal coalition Health Care for America Now. "But what killed the public option was the hospitals, not the insurance industry." Politicians wanted to avoid a confrontation over providers' prices. So a different policy argument took hold: The real reason everything cost so much was the overuse of health care, not the actual prices of treatment. This argument came primarily from Dartmouth College researchers who had amassed data showing wide disparities in Medicare spending among different regions. Hospitals in the lower-spending areas, mostly in the Upper Midwest and the Northwest, seized on the study to argue that the key to controlling costs was to reward providers like them. The case was popularized by Atul Gawande's widely read New Yorker article in June 2009 focusing on McAllen, Tex., one of the highest spenders in the Dartmouth rankings. If health-care delivery in places such as McAllen could be brought in line with lower-spending places such as the Mayo Clinic's home town, Rochester, Minn. -- through the formation of integrated networks of salaried doctors -- costs could be reined in. The theory caught fire at the White House. It gave President Obama and his then-budget guru Peter Orszag a way to talk about costs without taking on doctors and hospitals; instead, the White House could simply differentiate between providers that offer "value" and those that don't. But the Dartmouth rankings, and the concept they supported, did a "disservice" to the debate, said Robert Berenson of the Urban Institute. For one thing, he and others say, the figures overstate regional differences in Medicare spending, which shrink when socioeconomic factors are taken into account. Second, rates of Medicare spending are not necessarily representative of health-care spending for people under 65. Some of the places that do well in the Dartmouth rankings charge high prices for non-Medicare patients -- and were, not surprisingly, among those pushing hardest against a public option. More broadly, the skeptics argue that merely providing care in smaller quantities will not sufficiently lower costs. They note that Americans already have shorter hospital stays and fewer doctors' visits than people in other advanced countries. What sets us apart is our high prices for these health-care "units" -- a finding trumpeted in a landmark 2003 paper by Princeton's Uwe Reinhardt and others titled "It's the Prices, Stupid." The price problem is only getting worse, researchers and antitrust investigators have found, because of consolidation among providers, and it could be exacerbated by goading them to form even bigger networks. But the notion that we pay more, despite using health care less, never caught on during the long march to reform. The main culprits driving our health-care costs were deemed to be inefficient doctors in a few corners of the country and demanding consumers -- say, people seeking unnecessary surgery or patients with unhealthy habits and chronic conditions. The camp that believes volume is the main problem disputes the idea that bigger networks of hospitals and doctors would make the price problem worse. "The more we're able to encourage integrated systems of care, the better," the new Medicare director, Donald Berwick, a Dartmouth data champion, told me before his nomination by Obama. Berwick and his allies say they never meant for overuse of care to become the sole focus. Elliott Fisher, the lead Dartmouth researcher, said he did not intend for his data to be "interpreted as letting off the hook" those providers that kept overuse in check but charged high prices. "We clearly need to do
both" prices and volume, he said. But we didn't do both in the health-care law, which raises the question of what will happen once the overhaul proves inadequate to the price problem. Perhaps the public option will be reconsidered, as many liberals hope. Perhaps there will be a new push for lower drug prices. Or maybe there will be a return to the rate-setting that prevailed decades ago, when hospitals, insurers and state officials worked together to agree on prices. Maryland is the only state that still does this, and data suggests that it has kept its cost growth lower than average. Massachusetts is considering a similar approach. Would such measures have a chance? Perhaps. For one thing, as skeptical as insurers are of government intervention, they are glad to discuss reform that aggressively goes after providers. "We have a major cost problem, and we have to get on with the job of attacking it -- with every stakeholder who is responsible for that," said Karen Ignagni, the insurance industry's chief lobbyist. And the public? The Brookings Institution's Henry Aaron predicts that there may be support for tougher action on high prices once the principle of universal health coverage is established, since taxpayers will be on the hook for more of the cost of insurance. "If we attacked costs right at the front end, [the legislation] would have died," he said. "Now, we'll have a mechanism that will force us to address it. There are only so many fronts you can fight a war on at the same time." That's assuming, of course, that the law survives long enough to enjoy any embellishment.
Week of March 15, 2010 The White House last week continued to rail against rising health insurance premiums to help build popular support for his health care reform package. But the effort to focus the blame for rising costs on insurers was questioned, in particular, by state insurance experts and economists quoted in a New York Times story last week. Insurance commissioners said that trying to hold down premiums before costs were under control would be very risky. This approach could mean solvency issues in some cases, they told the Times. To help educate Americans about the true drivers of rising health care costs, America's Health Insurance Plans, the industry trade association, last week launched a new national ad campaign. The ad demonstrates that health insurance company costs represent a small slice of the overall health care cost pie. Federal With a cadre of staff operatives searching for the right health insurance reform provisions among those previously discarded from the House, Senate and the President's proposals, Democratic leadership has been relentlessly pursuing every possible pathway to pass a final bill. The expected process would have: 1) the House pass the Senate-adopted reform bill (which most House members hate), 2) the House passing a bill to "fix" all the things it hates using a reconciliation legislative vehicle, followed by 3) the Senate passing the very same reconciliation bill -requiring only 51 votes in the Senate. The House Budget and Rules Committees are expected to start the review, hearing and mark-up process of the reconciliation bill this week. The Senate commitment to using reconciliation was made official in a scathing letter from Leader Harry Reid to the Minority Leader. Along the way the two Chambers will need to see the latest CBO "scores" on the bill before voting, and 216 House Democrats will have to resolve policy disagreements over abortion, federal health insurance rate review and authority, and other substantive issues. Additionally, the House will have to trust that the Senate can pass the reconciliation measure without changing one comma. Partisanship has blossomed into open hostility over health reform. Whether Congress can overcome these policy, process and political mine fields remains as murky as ever, but Democrats have chosen to try and will push for resolution by the Easter recess. The Senate has passed Jobs Bill II and shipped it off to the House, where passage is not certain. Within the bill are two health-related items of note. First, the COBRA eligibility and subsidy program will be extended to the end of 2010. (These provisions are set to expire at the end of March.) Second, the bill contains a suspension until September 30, 2010 of the cut to physician Medicare reimbursements for the current calendar year. (This provision is also set to expire at the end of March.) Aetna urged Congress to apply the "doc fix" to next year's reimbursement as well, since insurers' Medicare rates are based on what doctors are paid, but in the end Congress failed to make this change. Aetna and the industry will continue to find ways both to establish a more lasting, if not permanent, doc fix and to devise a legislative solution to the disconnect between doctor reimbursement and Medicare Advantage rates for 2011 and beyond. States ARIZONA: Budget issues remain front and center as the governor and Republican leadership proposed a plan they hope will close the $700 million deficit this year and reduce the anticipated $2.6 billion deficit in 2011. Righting the state's fiscal ship has become a very partisan exercise, with the Republicans supporting reductions in Medicaid and KidsCare, and the
elimination of full-day kindergarten. As the special session on the budget is running concurrently with the regular session, no other bill hearings were held. The oral chemotherapy parity bill may be dead for this year as proponents did not meet the deadline for submitting amendatory language. CALIFORNIA: The Assembly Accountability and Administrative Review Committee chaired by Assemblyman Hector De La Torre held a hearing last week to examine how the Department of Managed Health Care (DMHC) and the Department of Insurance (CDI) has handled issues surrounding the rescission of policies in the individual market. According to a report prepared for the committee by Bryan Liang, director of the Institute of Health Law Studies at the California Western School of Law, fewer than 300 of 6,000 former policyholders are participating in health insurers' agreements to settle such cases. Republican committee members were highly critical of this witness, while De La Torre was critical of the Departments. The DMHC reported that since their settlements were completed there have only been nine rescissions over the past two years, proof that the DMHC and the health plans have revamped their processes for rescission and have worked to address the problem. COLORADO: A bill mandating maternity and contraceptive coverage in individual policies continues to receive significant attention in the Senate. The most recent amendment proposes requiring maternity coverage in at least three of the plans marketed by an insurer. It would also allow a current member of a plan without maternity coverage to switch to a plan with maternity coverage from the same carrier during the first trimester. The other major bill would require that second level appeals be performed by physicians who are actively involved in clinical practice. This measure is counterintuitive in the current economy, since it would result in outsourcing appeals and drive up costs for plan sponsors and their employees. CONNECTICUT: A proposal that would require health insurance plans to cover oral chemotherapy in the same way that intravenous chemotherapy is covered made it through the legislature's Insurance and Real Estate Committee last week. Currently, many health plans treat the two kinds of cancer treatments differently. Chemotherapy treatments that come in pill form are often categorized as prescription drug benefits that can require patients to pay a larger share of the cost. Cancer patients, doctors and patient advocates spoke in favor of the bill, while insurers and the Connecticut Business and Industry Association opposed it, arguing that it would put a mandate on health plans that could raise costs and make it more difficult for employers to afford insurance. GEORGIA: A bill restricting the use of rescissions in individual health insurance policies passed a Senate committee last week. Aetna continues to work with its trade organizations to educate legislators about the adverse effect of this type of legislation. Discussions also continue regarding legislation affecting the use of rental networks. KANSAS: Roughly half way through the legislative session, several health care bills are still moving through the process. On the regulatory front, the Insurance Department has proposed a regulation that would mandate coverage of routine patient care costs while the insured is enrolled in a cancer clinical trial a mandate that was rejected by the legislature in 2008. A hearing will be held on April 20, and Aetna will have an opportunity to present testimony on this issue. Bills still alive include mandates for autism and orally administered chemotherapy, legislation prohibiting dental contracts that require the dentist to follow a fee schedule for non-covered services, and a ban on "most favored nation" clauses by some insurers. Another bill would allow small employers to create individual HRAs to fund premium payments on individual policies, require administering insurers to offer employees the option of receiving health insurance coverage through a high-deductible health plan with an HSA, and requiring insurers who offer small group health plans to offer high-deductible health plans with HSAs, while authorizing tax deductions for health insurance premiums for individual insurance policies. Separate legislation would amend the definition of "eligible employee" to include parttime workers (currently less than 30 hours per week). Pending legislation concerning hospital charges would prohibit charging private-pay patients more than 25 percent of what the hospital's highest volume private payer would pay for the same goods or services. Legislation that died includes a telemedicine mandate and creation of a health care insurance database for employers. KENTUCKY: Health issues that are being hotly debated by the legislature right now include an autism mandate, a dental bill that would not allow insurers to hold dentists, optometrists or ophthalmologists to a fee schedule for non-covered services, and a bill setting a reimbursement floor for chiropractic services. The chiropractic services proposal would allow chiropractors to bill, and would require insurers to reimburse, an evaluation and management (E&M;) CPT code on each and every visit. In addition to billing for follow-up services for manipulations and other therapies, the chiropractor would be allowed to submit, and the insurer required to pay, for another E&M; code on each and every visit. The legislation would also add a new mandated benefit to the Kentucky statutes. Currently, reimbursement for chiropractor visits is required only if the chiropractor performs a service already covered by the health benefit plan. Under the proposal, any
service within the scope of practice of a chiropractor that is billed would become a mandated benefit. Finally, the bill would require health benefit plans to provide reimbursement without the chiropractor having to provide any documentation that the services were medically necessary. Each of these bills has, or is expected to, pass at least one chamber. SOUTH DAKOTA: Several important legislative deadlines are approaching, resulting in a flurry of activity. Bills or resolutions not passed by the second chamber by March 9 died. But the Governor has already signed a bill that amends the premium rate-setting procedure for the high-risk pool so that rates for a given classification are 150 percent of the average actively marketed premium. The pool will have to offer three or more plan designs, remove coverage requirements for the plans (such as disease management) and remove set cost-sharing values. The bill was signed by the Governor on March 1 and will become effective on July 1, 2010. The Governor has also signed a bill prohibiting rating based on injuries caused by domestic violence and legislation requiring refunds of premiums for partial months, in the case of mid-month cancellations. Both chambers have passed legislation prohibiting contract language requiring dentists to accept a fee schedule for non-covered services, and the bill awaits the Governor's signature. Finally, the legislature passed a resolution opposing the federal health care reform proposals passed in the U.S. Senate and House.
Week of June 6, 2011 While the Affordable Care Act's (ACA) medical loss ratio (MLR) and rate review provisions have been getting most of the media attention, a new coalition of business organizations has come together to draw attention to another important requirement of the ACA. Calling themselves Stop the HIT on Small Business, more than 25 national business organizations have joined forces to work toward repeal of new taxes the ACA would impose on private health insurance starting in 2014. Business leaders behind the effort say that small business owners, their employees and the self-employed will ultimately bear the brunt of $87 billion in additional health care costs in the first 10 years as a result of the new taxes. The group is planning Capitol Hill outreaches and grassroots efforts. Federal Support is growing in Congress (over 80 co-sponsors) for Mike Rogers' (R-MI) and John Barrows' (D-GA) legislation that would exclude agent commissions from the MLR calculation. Currently, commissions count as administrative expenses in calculating insurers' MLRs. This support was highlighted in a House hearing last week before the Health Subcommittee of the Energy & Commerce Committee, where the larger issue of the MLR burden was front and center. Witnesses representing agents and brokers, insurers and academia all testified against the unintended, negative consequences of the MLR requirement, with agents and brokers in particular noting the direct financial impact to small business and individual agents and their families. The Rogers/Barrows bill would simply not factor commissions into the MLR calculation. The day before the hearing, Congressman Tom Price ((R-GA) introduced an even more aggressive bill, as his proposal would repeal outright the MLR provision of ACA. While it is unlikely that either bill will get traction in the Senate on its own, bipartisan support for the agents and genuine concern about unintended consequences puts this issue in play as part of any potential mega-deal on the budget/deficit/debt ceiling issue over the next few months. The Senate was not in Session last week; and the House is out this week. States COLORADO: Governor John Hickenlooper last week signed into law a bill establishing the Colorado Health Benefit Exchange. The legislation created a fair amount of controversy during the session, particularly among "Tea Party" Republicans. However, the final product represents the culmination of a bipartisan effort that remained inclusive of the business, advocacy and insurance industry constituencies. CONNECTICUT: Although adjournment is set for June 8, a number of significant bills are still in process. The legislature passed a bill over the weekend that would create a health insurance exchange. The bill is expected to be signed by Governor Dannel Malloy, as the legislation, as passed, is an amended version of a bill proposed by the Malloy administration. It would create an 11-member exchange board and set rules and responsibilities for the exchange, but many policy decisions would be left for resolution at a later time. The exchange must be financially self-supporting by 2015, and the bill would allow the exchange to charge assessments or user fees to health insurance carriers to fund operations. Some lawmakers questioned the cost of the exchange. However, the nonpartisan Office of Fiscal Analysis says the planning process is not expected to require additional state money. The bill calls for exchange board members to have expertise in specific subjects, including small employer health insurance coverage, health care delivery systems, access issues that self-employed people face, barriers to individual health care coverage, health care finance and benefits plan
administration. Additional bills yet to be passed by both Houses include the SustiNet bill, now amended to create a health care reform advisory board and allow municipalities and not-for-profits to join the state employees plan. Also, a prohibition on "most favored nation" clauses in provider contracts and a broad rate review bill that would require public hearings for all rate increases over 10 percent have yet to be acted on. ILLINOIS: A spring session of the General Assembly dominated by redistricting, workers' compensation, budget, pensions and gambling adjourned on May 31, 2011. Minimal health care legislation passed by both chambers is awaiting signature by the governor. One important legislative development is that Aetna helped turn back attempts to amend the "non-participating" physician law that was passed last year and went into effect on June 1, 2011. The law protects consumers from being overbilled by certain out-of-network, hospital-based physicians (i.e., anesthesiologists, radiologists) who provide direct services in hospitals and ambulatory surgery treatment centers. Under the law, the patient is taken out of the middle as it ensures patients will pay no more than they would have paid to one of their carrier's participating providers. In addition, the law allows either the physician or the insurer to use binding arbitration to resolve disputes over the reasonableness of charges or reimbursements. Other health care bills defeated including taxes/insurance assessments; reporting of extensive premium loss data; and health insurance rate review. Bills currently awaiting the governor's signature include changes to the mental-health parity and clinical trials mandates, as well as insurer recoupment requirements that the industry ultimately agreed to. Also, a health insurance exchange bill passed both chambers that would establish an exchange and appoint a study commission of legislators to report back to the Assembly by Sept. 30, 2011 regarding parameters for an exchange. Follow-up legislation could potentially be considered in the fall veto session, beginning at the end of October 2011. MAINE: Gov. Paul LePage and the legislature's Republican leaders found a way to avoid an override of the Governor's recent veto of the most-favored nation prohibition bill. The bill would bar insurers from requiring a health care provider to charge an insurance company the lowest rate the provider negotiates with any other insurance carrier. In his veto message on the bill, LePage said he strongly believes that businesses have a right to contract with each other as they deem appropriate. After some Republicans complained, LePage met last week with GOP leaders and co-chairs of the legislature's Insurance and Financial Services Committee, which unanimously endorsed the bill last month. Republican lawmakers agreed to vote to sustain the governor's veto when the House acts on it, and the Governor agreed to submit compromise legislation. The new bill would ban most-favored nation clauses but also allow Maine's superintendent of insurance to issue a waiver. It is unclear what conditions an insurer would have to meet to earn a waiver. The bill's language is not yet available to the public. With session scheduled to adjourn June 15, the legislature is likely to wait until next year to take up the bill. Governor LePage announced that Eric Cioppa, Deputy Superintendent of the Bureau of Insurance, Department of Professional and Financial will serve as Acting Superintendent effective immediately. Cioppa replaces former Superintendent Mila Kofman who resigned recently. In his former role as deputy superintendent, Cioppa was responsible for the Examination, Market Conduct, Financial Analysis, Alternative Risk Markets, Producer Licensing, Administrative Support Unit, and Research and Statistics Units of the Bureau. MICHIGAN: In the next couple of weeks, the state Senate is expected to vote on a $400 million paid-claims tax that would be levied on insurers and third-party administrators as proposed by Governor Snyder. Specifically, the bill would establish an entirely new tax on health insurance claims as a way to match federal Medicaid funding. The 1 percent on tax on all medical claims paid under health, dental, automobile and workers' compensation coverage would impact fully and self-insured business. Ultimately, the cost of the tax will be borne by the sponsor of that coverage the employer or the individual who already pays for the coverage. As introduced, the tax would begin on October 1, 2011. While working with lawmakers to help them understand the impact the tax would have on constituents, Aetna has mobilized its grassroots employee network to contact their state legislators regarding the issue. The bill has a strong chance of passing, and Aetna is urging all its constituents in the state to contact the Governor's office and legislators to express any concerns they may have about the tax. NEW YORK: Session is scheduled to adjourn June 20, and no official exchange legislation has been advanced. The Senate Republican majority is said to have a bill draft ready that supports a market-based exchange, but it has not been introduced yet. The Administration plans to introduce a more expansive model that reportedly will include giving the governor the majority of the board appointments, the exchange de facto rate-setting authority, and the exchange authority to selectively contract and require plans to participate. The bills are expected by the second week in June. However, with many other significant issues still on the table, compromise on an exchange bill may be swept up into a larger negotiation. A very broad autism mandate is still in play. A set of amendments was
introduced to ensure that an autism coverage mandate not be broader than for any other disease coverage mandate, For example, a pharmacy rider would be required to get pharmacy coverage, and there would be a limitation on visits but no dollar or age limits. The bill is still more expansive than last year's version, which was vetoed by then-Governor Paterson due to its $70 million fiscal note. Governor Cuomo has not announced his position on the proposal. NEVADA: The 2011 legislative session is winding down toward adjournment on June 6. Governor Brian Sandoval has on his desk a rate review bill that would implement a prior approval scheme, require greater transparency and public access to rate filings, and allow a Consumer Advocate to request a public hearing. The measure is sponsored by the Democratic Speaker and has the support of the commissioner who says that some aspects of the bill are needed for the state to comply with HHS rate review requirements. The Senate-sponsored bill creating the Silver State Health Exchange continues to move toward passage in the Assembly. PENNSYLVANIA: State government had another better-than-expected revenue collection month in May and headed into the final month of the fiscal year with a nearly $540 million surplus. The news came last week as the debate in the Capitol intensified over the depth of spending cuts sought by Governor Tom Corbett. Legislative budget analysts said the state's updated revenue collection figure through the end of May was 2 percent, or about $34 million, over the official estimate. That means the state has collected almost $24.3 billion through 11 months, or 2.3 percent above the official estimate. However, the state continues to face a projected multibillion-dollar budget deficit in the fiscal year beginning July 1. The disappearing federal stimulus money that temporarily helped buttress the state's recession-wracked tax collections is one of the largest contributing factors. TEXAS: A special session of the legislature, called by Gov. Rick Perry to address education and health care issues left pending when the 140-day regular session ended May 30, got off to a slow start last week. But by the end of the week, the Senate Appropriations Committee unanimously voted in support of a massive health care measure that combines three weighty regular-session bills. Now headed for a full Senate vote, the package seeks $1.5 billion in Medicaid savings by expanding managed care to South Texas and restructuring insurance payment systems. It also would charge Medicaid patients for unnecessary emergency room visits and penalize doctors and hospitals for preventable complications. Late Tuesday, Perry added another issue to the 30-day session: redrawing boundaries for Texas' 36 congressional districts. School finance remains the main event of the overtime session. Another bill would resurrect the interstate health care compact, favored by Republicans because it would allow member states to opt out of the federal health care reform law. Democrats oppose the effort, saying Texas would save money by cutting more low-income people from Medicaid coverage. A bigger hurdle would be Congress, which must approve the compact. The special session will last a maximum of 30 days but could conclude earlier if the legislature finishes business and adjourns.
A Coping Strategy for the Healthy With open enrollment season just around the corner, this may be the year to consider a high deductible health insurance plan that you can then pair with a Health Savings Account. More firms are offering these plans; if you are in relatively good health, you can reduce your premium by opting for a high-deductible plan. For this year that means a family deductible of at least $2,400, or $1,200 for an individual policy. Once you enroll in a qualifying high-deductible plan you're then eligible to contribute to your own HSA. You get a tax break on contributions into the HSA and withdrawals used to pay for medical expenses are not taxed. The maximum family contribution to an HSA this year is $6,150. ($3,050 for individuals.) The maximums for 2011 have yet to be announced; they probably won't budge given the low general rate of inflation. You can also let the money sit in the HSA and grow; unlike a flexible spending account there is no "use it or lose it provision." Your balance can be used for future medical expenses decades from now. Or once you turn 65 you are free to use your HSA balance for anything. though you will owe income tax on your withdrawals. Just like with a Traditional IRA. Well, there's one area where deflation will definitely not be at play in 2011: health insurance. A survey of large businesses reports that employers expect their health care insurance costs to rise by an average of 8.9 percent in 2011. And to help cover those rising health insurance costs, more than six out of 10 employers also expect to raise their employees' share of the premium cost. Given that the average salary raise for 2011 is expected to be in the vicinity of 3 percent, it's likely many Americans are going to see any bump in their compensation eaten up by having to pay more for health insurance. As Derek Thompson laid out in a post last week at The Atlantic we may need to get used to that sad fact.
Thompson highlighted this 2009 chart from the President's Council of Economic Advisers: Yes, the chart was ginned up pre-health care reform, but the final legislation pretty much punted on health care cost containment, so there's no reason to expect the trajectories in the chart will change anytime soon. Paying More for the Less Coverage According to the National Business Group on Health survey, paying more of your overall premium is just one extra cost you may face in 2011; out-pocket maximums and bigger innetwork deductibles are the next two "most popular" options employers will enlist to share the pain of rising insurance coverage.
Health Insurance Info Our website provide a few information and advice on the topics of Health and Medical Insurance. We hope you enjoy our range of informative of the Health and Medical Insuranc articles, topics and latest news. Whether you are doing specific research on this subject, or looking for content for your ezine or websites, you have come to the right place. 1. Five Tips to Trim your Medical Expenses and Save With the rising cost of healthcare, medications, and insurance, it isnt surprising that people are trying to figure out ways to avoid getting sick and choosing a better lifestyle to lower insurance costs. There is actually quite a bit one can do to help save same cash. It is just a matter of tweaking ones lifestyle choices and preventing health issues from arising or keeping the immune system up so you just dont get as sick as much. For those people who are seriously sick of high medical premiums and paying out the nose year round for doctors visits and medications, this should be a great thing. Small things make a world of difference when it comes to your health. a) Stop smoking is the biggest one. Not only do you get sicker than the average person, it is worse. Many smokers are treated for several bouts of bronchitis and pneumonia each year. Smoking also makes you susceptible to colds and other infection. You will also pay a higher premium on your insurance and in some cases wont get covered in full for cigarette related illnesses or diseases. Plus the money you save from quitting can go to bigger and better things than your medical issues. 2. How to Get a Group Health Insurance Rate as an Individual Most individuals can get really good group rates through their employers. As long as your place of business has more than 50 employees and actually offers a medical plan, you should get a pretty good deal. The overall cost is based on how many of the employees actually have the insurance plan. The more people who are signed up, the cheaper the plan will be. Most people will choose this over going with a private plan any day because it is so much more cost friendly. That is one of the first things you should be looking for when seeking a job, whether or not they offer insurance benefits or not. At your interview ask to see their healthcare providers plan and rates. If they will let you take it home. This way you can see if the plan offers what you want and at a price you can afford. There are some private insurance companies that have reduced individual rates that are comparable to group ones. 3. Five Ways to Cut your Health Insurance Costs Nearly one-third of all health-insurance premiums increased to 30 percent or more. At that rate, the average cost of health insurance per employee will exceed $3,000. Seventy-three percent of senior executives believe health-care costs will continue to increase 20 percent or more each year for the next three years. The message here is clear: If you haven't already gotten serious about cutting your company's health-insurance costs, now is the time. It can be done. The first thing you should do is learn how the system works--or doesn't work. Most small employers spend fewer than four hours a year thinking about their company health plans. Learn what your options are. Your insurance agent can help you shop for cheaper plans. But don't stop there. Compare plan benefits, insurancecompany records, and service guarantees.
With little fanfare, the federal COBRA subsidy program that has helped millions of the recently unemployed afford to continue health insurance will expire next week. In many respects, the end is symbolic since the program's enrollment ended in May 2010. Extensions stretched the subsidies out for 15 months and now the last of those eligible will lose that benefit Sept. 1. Coming on the heels of Pennsylvania's ending the adultBasic insurance program, and with a stubborn statewide unemployment
rate currently at 7.8 percent, "there's a group of people that have fallen through the gaps as we wait for health-care reform," said Antoinette Kraus, project manager for the Pennsylvania Health Access Network, a coalition of 55 organizations that advocates for affordable quality health care. COBRA, an acronym for the Consolidated Omnibus Budget Reconciliation Act of 1985, gives laid-off workers the option of paying to continue receiving health benefits through their employer for a time, but often at a price that is steep for someone who is unemployed. The subsidies reduced that cost by 65 percent. The Kaiser Family Foundation reported the average monthly cost of maintaining COBRA coverage without the subsidy is $1,137 for a family policy and $410 for an individual. With the subsidy, the cost has been $398 per month for a family and $144 for individuals. "COBRA without the subsidy is pretty expensive," Kraus said. "I think people are just going to go without health insurance. There's not an interim solution for all these people who don't have health insurance." The federally funded, state-run PA Fair Care program for "highrisk" patients who have been denied coverage because of preexisting medical conditions is expected to help about 3,500 Pennsylvanians in the next year, but it carries a $283 monthly premium. Applicants must have been without insurance for six months. When the measure was originally passed, analysts estimated the $25 billion COBRA subsidy program would aid more than seven million laid-off employees and their families nationwide. One study found the number of those retaining health insurance through COBRA doubled after the subsidies became available. What happens now is anyone's guess, but the signs are discouraging. "The talk in D.C. is, 'Let's figure out a way to make cuts and get rid of programs that cost money,' and this program costs money on paper," Kraus said. But ending the subsidies will carry a price, too, she said, as the uninsured and unemployed will resort to using more costly hospital emergency rooms for routine care. There are signs of that happening already. In a recent Hospital Council of Western Pennsylvania survey of its members, southwestern Pennsylvania hospitals reported a 70 percent increase in the charity care they provided in the January-March quarter compared with the same period a year earlier.
States with Republican governors kept up the pressure last week on Washington to give the states greater control over health care under the Patient Protection and Affordable Care Act (PPACA). Twenty-one Republican governors sent a letter to Health and Human Services (HHS) Secretary Kathleen Sebelius asking for greater authority over some provisions of health reform, including the ability to define "essential" health benefits and set minimum criteria for participating in insurance exchanges. They threatened not to run their own state-based exchanges if HHS does not act on their requests. Sebelius quickly responded with her own letter in which she reviewed the various options states have to reduce costs in their Medicaid programs, and she indicated she is continuing to review what authority she may have to "waive the maintenance of effort under current law." Senate bills have already been introduced to address the role of the states in health care reform, which is sure to keep the issue on the front burner. Visit Easy To Insure ME for more info Federal The House Committee on Ways & Means held a hearing last week on "The Health Care Law's Impact on Medicare and Its Beneficiaries," featuring testimony from CMS Administrator Donald Berwick, M.D., and CMS Chief Actuary Richard Foster. Berwick testified that the PPACA has had a positive impact on Medicare beneficiaries, noting that beneficiaries now have first-dollar coverage of key preventive benefits, additional assistance with prescription drug costs, and an annual wellness visit with the physician of their choice. In response to concerns noted by several committee members about the impact of funding cuts on Medicare Advantage, Berwick indicated that Medicare Advantage enrollment increased by 6 percent from 2010 to 2011. He suggested that the program is healthy and offers robust choices. Foster's testimony reiterated his prior projection that the PPACA will cause Medicare Advantage enrollment to decline by about 50 percent by 2017 -- from a projected 14.5 million under the pre-PPACA law to 7.3 million under the new law. His testimony further explained that Medicare Advantage enrollees will experience "a large increase in out-of-pocket costs" and "less generous benefit packages" because PPACA will reduce rebates to Medicare Advantage plans, with the reduction in rebates reaching $1,500 per beneficiary by 2019. The Administration last week issued favorable guidance with respect to student health coverage that will result in little disruption, if any, to this business until at least the 2012-2013 academic year. This guidance was announced in a Notice of Proposed Rule Making (rather than as an interim final regulation), which fortunately means that the rule is not effective immediately as has been the case with most regulations relating to PPACA reforms. The
proposed student health rule would create a special class of individual coverage for student health pursuant to a set of factors, e.g., written contract between school and insurer, coverage only for students and dependents, health status may not be used as a condition of eligibility. As Aetna has advocated, the impact would be delayed, as the rule (whenever finalized) would not be effective until policy years beginning on or after January 2012. Until then, student health is not subject to PPACA reforms. And, when effective, student health would be excepted from the current guaranteed issue and renewability provisions of PPACA. While it will be unclear for a while whether and how student health will be subject to the medical loss ratio (MLR) provisions of PPACA, we are encouraged by the fact that the proposed rule invites comments on whether student health should receive some sort of special accommodation (akin to the special rule for limited benefit plans) with respect to MLR, owing to the unique characteristics of the student health market. States ARIZONA: The industry-supported exchange bill was introduced last week under the sponsorship of the House Health Committee Chairman and the respective chairmen of the House and Senate Banking and Insurance Committees. The bill provides for a marketbased mechanism; governance by a board with insurer representation; no dual regulation; and a conditional repeal provision. The first hearing will be held this week. In other news, Governor Jan Brewer appointed Don Hughes, former AHIP retained counsel, as Special Advisor for Health Care Innovation. Hughes will help direct state efforts to improve the cost-effectiveness and accessibility of health care. He will engage in strategic planning with a focus encompassing both public health care and Arizona's large private health insurance industry. CONNECTICUT: A jointly held public hearing of the Public Health and Insurance and Real Estate Committees was scheduled for this week on two new health care bills. The first bill would establish the SustiNet Plan Authority, a quasi-public agency empowered to implement a public health care option. The SustiNet Plan is a health insurance program that consists of coordinated individual health insurance plans that provide health insurance products to state employees, Medicaid enrollees, HUSKY Plan, Part A and Part B enrollees, HUSKY Plus enrollees, municipalities, municipalrelated employers, nonprofit employers, small employers, other employers, and individuals in Connecticut. The Authority is authorized, but not required, to begin offering SustiNet coverage to employees and retirees of non-state public employers, municipal-related employers, small employers, and nonprofit employers after January 1, 2012. Beginning on January 1, 2014, SustiNet will offer coverage to individuals and employers. Among other things, the bill directs the Authority to implement primary care case management and patient-centered medical homes for all SustiNet Plan members, establish a pay-forperformance system, and establish procedures to prevent adverse selection. The Committees also will hear testimony on a bill to establish the Connecticut Health Insurance Exchange pursuant to PPACA. The exchange would be a quasi-public agency offering qualified health plans to individuals and qualified employers by January 1, 2014. The bill would establish a 13-member board of directors to manage the exchange. The exchange would have the authority to review the rate of premium growth within and outside the exchange in order to develop recommendations on whether to continue limiting qualified employer status to small employers. It also would have the authority to charge assessments or user fees to health carriers to generate funding necessary to support the operations of the exchange. The bill directs the exchange board to report to the legislature by January 1, 2012 on whether to establish two separate exchanges, one for the individual market and one for the small employer market, or to establish a single exchange; whether to merge the individual and small employer health insurance markets; whether to revise the definition of "small employer" from not more than 50 employees to not more than 100; and whether to allow large employers to participate in the exchange beginning in 2017. Aetna will submit comments on both bills through the Connecticut Association of Health Plans. IDAHO: Draft legislation is circulating that would prohibit insurance companies and managed care organizations from refusing to contract with qualified providers solely because the provider: is not a member of a group, network or any other organization of providers contracting with the insurance company; or does not offer all of the services obtained through the group, network or organization of providers contracting with the insurance company. However, the provider may be required to comply with the practice standards and quality requirements of the contract specific to the services contracted. The bill generally is intended to impact insurers and managed care organizations. It does not contain an exclusion or exception for HIPAAexcepted benefits. As yet, the bill has not found a sponsor and has not been "introduced." While there remains a possibility that the bill could be introduced before the deadline for committee bill introductions, it is considered unlikely. MINNESOTA: When the legislature convened the first half of its 2011-2012 biennium last month, Republicans controlled both legislative chambers for the first time since 1972. And, Republican lawmakers wasted little time introducing bills to repeal measures passed by the 2010
legislature to fund state medical assistance, general assistance medical care, and MinnesotaCare. In his first official act as Governor, Mark Dayton signed an executive order implementing early Medicaid expansion (to 133 percent of the federal poverty level) for Minnesota, which is expected to make 95,000 more state residents eligible. Minnesota's $188 million investment is expected to bring about $1.2 billion in matching federal funds. Governor Dayton also signed an executive order removing the ban on applications for federal PPACA-related grants. Minnesota is expected to receive an exchange planning grant soon. While Governor Dayton cleared the way for the state to seek grants for implementing federal health reform, it is unlikely that state legislators will be passing bills to implement the federal health reform law unless absolutely necessary. Other pending bills of interest include anti-PPACA legislation, a bill requiring guaranteed issue in the individual market, creation of a defined contribution program for childless adults with incomes at or above 133 percent of FPL (reduction from current level of 250 percent), the prohibition of dental plan fee schedules for non-covered services, and an autism coverage mandate. In addition, Governor Dayton named a new Commissioner of the Department of Commerce, Minneapolis attorney Michael Rothman. NEVADA: The legislature convened on February 7 with a scheduled adjournment date of June 6. Governor Brian Sandoval will sponsor an exchange bill, although he opposes federal health care reform. His reasons include not wanting the federal government to take action in the state and the fact that the legislature will not meet in 2012. The Division of Insurance (DOI) has indicated that it will pursue federal reform measures, including external review. Other legislation of interest includes the establishment of a statewide health information exchange system and amending the requirements for reimbursement of out-of network services to comply with the PPACA. TEXAS: Governor Rick Perry delivered his State of the State speech last week, which included plans to suspend the State Historical Commission and the Commission on the Arts in addressing the state's $27 billion budget deficit. Speaking to a joint session of the legislature, Perry said the time has finally come to streamline state government. Perry's speech focused heavily on how strong the state's economy is, despite the deficit. According to Perry, Texas added more jobs in 2010 than any other state in the nation. That state-wide job growth occurred in the sectors of business, health care, manufacturing, hospitality, construction and energy. Perry's speech was highly critical of national politics, and he threatened to push back when Washington encroaches on states' rights. His budget proposal calls for cutting more than $2 billion in state spending on public education and another $2 billion in higher education, plus more than $2 billion in health and human services programs. Those cuts would come with much larger reductions in federal dollars, because states draw federal funding for programs such as Medicaid by spending state money. VERMONT: Newly-elected Governor Peter Shumlin's focus has been on reducing the state's projected $100 million budget deficit. Proposals to deal with the deficit include changes to the administration of the state's Catamount program, changes to Catamount reimbursement, imposing an assessment on managed care organizations, increasing the provider tax on hospitals, and imposing an assessment on dentists. The legislature is also considering a number of bills that would create a singlepayer, government-run health care plan and require rate reviews. The bills include: Supported by the governor, H.B. 202 would establish Green Mountain Care and the Vermont Health Benefit Exchange, through which all state residents would be eligible for health benefits. After implementation of the Green Mountain single-payer system, private insurance companies would be prohibited from selling health insurance policies in that cover services also covered by Green Mountain Care. H.B. 80 would create a single-payer health care system called Ethan Allen Health. If the secretary of Human Services obtains a waiver from the exchange requirement, private insurance companies will be prohibited from selling insurance policies in the state for coverage of services covered by Ethan Allen Health. But it would not prohibit individuals from purchasing supplemental health insurance covering services not already covered by Ethan Allen Health. S.B. 57 would establish Green Mountain Care as a single-payer health care system, which will include coverage provided under a health benefit exchange, Medicaid, and Medicare. H.B. 146 would establish a public health care coverage option called Green Mountain Care that would require Vermont residents to have health care coverage at least equivalent to the actuarial value of Green Mountain Care and would assess a financial penalty against those who fail to maintain such coverage. The bill would institute a candy and soft drink tax as well as a 10 percent payroll tax on all employers with more than four employees to fund Green Mountain Care. S.B. 56 and H.B. 165 would amend current rate review procedures to require written approval from the commissioner before a health insurance policy can be issued and to require that all rate and form filings be filed electronically. Rate changes would require approval by the commissioner prior to implementation and notice to plan members of rate changes and a 30-day comment period. H.B. 82 would require health insurers to disclose to the
Department of Banking, Insurance, Securities, and Health Care Administration the fee schedules they negotiate with providers, and directs the department to post the information on its website.
JANUARY 29, 2010 This Week in Health Care Reform Following the election of Republican Scott Brown to the Massachusetts State Senate last week and the resulting loss of Senate Democrats' supermajority, lawmakers continue to pave the way for health care reform - with limited progress. In addition, polls indicate that the public would rather lawmakers focus more on the economy than on health care. State of the Union Address President Obama Gives State of the Union Address: On Wednesday evening, President Barack Obama delivered his first State of the Union address before a joint session of Congress. Having hoped to have a health care reform bill on his desk prior to his address, the President instead used his speech to encourage Congress to push forward on health care reform. Yet, he did not give specific guidance as to how to proceed with the legislation. Instead, he made it clear that his primary focus would be on jobs and the economy. Easy To Insure ME Health Insurance Quotes... Quote all carriers in seconds Buying Individual Health Insurance Health Insurance News Health Care Reform Negotiations Democrats Still Seek Way Forward: While vowing not to give up, Democratic Senate leaders indicated Tuesday that they no longer felt pressure to move quickly on health care reform; and, in the wake of the Massachusetts election and in reaction to public opinion, they shifted focus to jobs and the economy. Senate Majority Leader Harry Reid (D-NV) commented that there is "no rush" on health care and said that he and Speaker of the House Nancy Pelosi (D-CA) were working to map out a way to complete health care reform in the coming months. On Wednesday, Sen. Pelosi floated a two-pronged strategy to pass incremental changes now and pursue comprehensive reform later. Some lawmakers have considered breaking up the legislation into smaller pieces that have bipartisan support. However, this option will prove challenging given the complexities and interdependencies of the measures. For example, lawmakers would like to include a measure that requires all insurance companies to insure those with pre-existing conditions; however, premiums will most likely increase unless there is an individual mandate. Earlier this week, Democrats appeared to be coalescing around a different strategy through which Senate lawmakers would make changes to their bill to appease members of the House. The Senate would then pass the revised bill via reconciliation, which only requires 51 votes. Following that, the House would approve the revised bill, giving it to President Obama for his review. However, movement on this strategy stalled Tuesday when two centrist Senators, Sens. Evan Bayh (D-IN) and Blanche Lincoln (D-AK), indicated that they would oppose using reconciliation to bypass Republican support. Others, including Sen. Joe Lieberman (I-CT) and Sen. Dianne Feinstein (D-CA), have suggested a "time out" on health care reform until there is a clear path forward. In the GOP response to President Obama's State of the Union address, Virginia Governor Robert McDonnell said that Republicans share the Democrats' desire for health care reform, but do not agree with their proposed solutions. Republicans suggest that Democrats scrap the current proposals and start over with more Republican input on issues such as medical malpractice reform and selling insurance policies across state lines. Republicans Call for Transparency: On Wednesday, the House Energy and Commerce Committee marked up a resolution presented by Rep. Michael Burgess (R-TX) which requested that the administration divulge documentation regarding the health care reform deals made with trade associations and a labor union. Committee Chairman Henry Waxman (D-CA) said that while details remained to be worked out, he would support a narrowed version of the Republican request for White House records. President Obama to Speak with House Republicans: President Obama will meet with House Republicans on Friday in response to an invitation to speak at their annual retreat in Baltimore that begins Thursday and ends Saturday. The meeting comes just after the President's State of the Union address, and members of the news media speculate that the meeting may spur more bipartisanship or potentially lead to even more tension between the two parties. Interest Groups Call for Reform: With health care reform's fate in jeopardy, interest groups have voiced their support, encouraging Democrats to push forward with legislation. The AARP, American Cancer Society Cancer Action Network, Consumers Union, Families USA and Service employees International Union sent a joint letter last Thursday urging Congress not to abandon comprehensive health care reform. Further, the United States Conference of Catholic Bishops
also sent a letter to Congress urging a push for reform. Public Opinion Polls Show Concern with Health Care Reform; More Focus on Jobs and Economy: Several polls were released this week that highlight the public's disenchantment with health care reform and anxiety around the struggling economy. A new CNN/Opinion Research poll released Tuesday shows that only three in ten Americans say they want Congress to pass legislation similar to the bills currently being discussed in Congress. Forty-eight percent of Americans would like lawmakers to start again on a new bill, and 21 percent believe Congress should not work on bills that would change the current health care system. Further, a Wall Street Journal/NBC poll released Wednesday found that 51 percent of Americans believe President Obama has paid "too little attention" to the economy and that 44 percent feel he has paid "too much attention" to his proposed health care overall. In addition, a new USA Today/Gallup poll released late last week finds that most Americans call for a more bipartisan effort in health reform. A 55 percent majority of Americans say that President Obama and Congressional Democrats should suspend movement on health care reform and consider alternatives that would increase Republican support. A poll released last weekend by the Washington Post , Henry J. Kaiser Family Foundation and Harvard University's School of Public Health indicated that dissatisfaction with the direction of the country, including the Democrats' health care reform proposals, drove the outcome of the Massachusetts election. The post-election survey of Massachusetts state voters showed that overall 43 percent say they support the health care reform proposals advanced by President Obama and Congressional Democrats, while 48 percent oppose them. A new poll released Monday from the Robert Wood Johnson Foundation found that fears regarding the health care reform package increased significantly in December as members of the Senate finalized their bill. Thirty-three percent of respondents said they believed their access to care would worsen if the legislation passed, up from 25 percent in November. Forty-two percent said the country's finances would suffer under reform, compared with 34.6 percent in November. Looking Ahead Next week, the President will present his Budget to Congress (which includes health programs), after which Congressional hearings will commence. We expect health reform to be discussed in these sessions. While there remains no clear path forward for health care reform, Congressional leaders will continue to work to find a solution.
Health care spending projections for the next decade, published in the journal Health Affairs last week, appeared to have a little something for everyone. Prepared by Medicare's Office of the Actuary, the report notes that health care spending will increase 0.2 percent faster than previously projected due to the health reform law's many changes to the system. As a result, The New York Times proclaimed that the "health plan won't fuel big spending," causing an annual spending increase of 6.3 percent rather than 6.1 percent. The Christian Science Monitor, on the other hand, warned that reform will definitely cause health insurance costs to rise and that Americans should be on guard for big increases in 2014 when many of the law's major provisions kick in. Spending on health insurance is expected to increase 12.8 percent in 2014 as millions of uninsured Americans gain coverage. However one interprets the results of the report, it is clear that rising health care costs remain unfinished business. ARIZONA: The Senate has established an Ad-Hoc Committee on the Impacts of Health Care Reform Implementation. The Committee will hold its initial meeting later this month. The preliminary agenda includes: Arizona Health Care Cost Containment System (Medicaid) requirements; insurance reforms; impacts on health care providers; and tax implications. Members appointed to the committee include AHIP retained counsel, clinical and employer representatives, and representatives of the Goldwater Institute, a conservative think tank. COLORADO: The Division of Insurance (DOI) has applied for a $1 million health insurance exchange grant. If awarded, the funds will be used for research and developing recommendations for implementation of an exchange. Specific areas mentioned include modeling on adverse selection, value choices, increasing actuarial staff and determining the actuarial effects of benefit packages within an exchange and in the external regulated market. The Department of Regulatory Agencies finalized three regulations that define the standardized electronic identification and communications systems to be used by all health plans operating in Colorado. The regulations are the result of 2008 legislation requiring carriers to use systems certified by the Committee on Operating Rules for Information Exchange (CORE). Carriers must be able to demonstrate their compliance by Sept. 1, 2012. DELAWARE: The Department of Insurance (DOI) has issued a bulletin regarding recently enacted legislation that prohibits rescissions based on medical claims underwriting. The legislation signed into law by Governor Markell on August 30th prohibits rescission,
cancellation, or limitation once an enrollee is covered, except in cases of fraud or intentional misrepresentation of a material fact. Effective Sept. 23, 2010, prior approval by the Commissioner or her designee is required before a health insurer may rescind, cancel or limit existing coverage based on written health or medical information. LOUISIANA: The DOI has applied for a grant related to health insurance exchanges. Aetna, along with the Louisiana Association of Health Plans, will participate in a meeting with the DOI to discuss the grant and other issues related to health care reform. NEW JERSEY: The Department of Banking & Insurance (DOBI) last week issued a bulletin providing template contract riders that insurance carriers can use for the large group market and the (non-reform) individual and small employer markets to describe changes to comply with the Patient Protection and Affordable Care Act (PPACA). The rider templates, which may be used by carriers without submission to DOBI for formal review or approval, address the following health benefit plan requirements: Extension of coverage to dependents; annual and lifetime dollar limits; first-dollar coverage of preventive services; limitations on preexisting condition exclusions; and rescissions. A carrier not using the rider template must submit their own forms for DOBI's formal review and filing, or approval to bring benefit plans into compliance by September 23, 2011. OKLAHOMA: DOI Commissioner Kim Holland and staff hosted an informational stakeholder meeting last week to discuss the DOI's plans for creation and implementation of Oklahoma's exchange under the PPACA. DOI intends to use issue-specific working groups to manage the task going forward. The state's online Medicaid enrollment process went live September 7 and processed over 2,000 applications with a 60 percent approval rate the first 28 hours. Over 400 apps came from hospitals that provided overwhelmingly positive feedback. This web tool was referenced as a possible "starting point" of the exchange's eventual infrastructure. The DOI submitted an application for a $1 million Exchange Planning Grant in August and expects to hear a decision from HHS by the end of this month. If awarded, the money will be used, in part, to hire a consultant to assist with an RFP to hire a vendor to help build the exchange. Other topics of conversation focused on the more technical and difficult aspects of building an exchange, such as coordinating billing/payment through employers, collecting and reporting data on those entitled to tax or premium credits and cost sharing subsidies, allowing/finding/identifying navigators to assist consumers, and deciding if any additional state benefits/mandates would be included in coverage. Aetna will stay active in this process by serving on future workgroups when appropriate. WYOMING: The DOI has submitted its plan for a health insurance exchange grant to the federal government. The DOI will use $800,000 to fund a study, to be overseen by a Governor's task force, of the feasibility of three exchange options. The options include (1) operating a Wyoming state exchange, (2) participating in a regional exchange, or (3) allowing HHS to run the exchange. This study would occur in two phases: phase one would help educate task force members and consult with stakeholders and experts on operating an exchange in the state; phase two would include implementing the recommendations of the task force if it is decided that Wyoming should participate in the operation of an exchange. DOI has indicated that no legislative action is necessary to carry out the duties of the grant, unless the state decides to pursue the operation of an exchange. The white paper also outlines that several key governmental agencies will participate in the efforts, which will be facilitated by the University of Wyoming.
Federal Althoughthe House vote to repeal health care reform is symbolic only (given the Democratic Senate and White House), it is a necessary first step leading to committee by committee action over the coming months on discrete provisions of health care.One such item, medical malpractice liability reform, got a hearing last week before the House Judiciary Committee as Republicans paraded several witnesses before the committee to showcase the need for legislation from the physicians' perspective.Since it is very unlikely that the American Medical Association's wish list would ever become law, the best result from the committee process would be a bill that skirts the more controversial items (e.g., cap on damages) and focuses on attainable and meaningful reforms, such as health courts, stronger pre-trial evaluation and settlement pathways. This would be a path Aetna would strongly support. States ARIZONA: Governor Jan Brewerhas announcedthat she will request a waiver from the federal Centers for Medicare and Medicaid Services so that the state can setArizona Health Care Cost Containment System (AHCCCS) eligibility below levels mandated by thePPACA. In March 2010, GovernorBrewer signed a fiscal year 2011budgetthat stripped funding for the state's Children's Health Insuranceprogram (KidsCare) and cut $385 million from AHCCCS, effectively repealing an expansion of AHCCCS to childless adults
approved by voters in 2000. However, following enactment of thePPACA, the state rescinded the scheduled cuts to comply with thelaw's "maintenance of efforts" (MOE) requirement. The MOE requirement prohibits a state from having eligibility standards, methodologies, or procedures for adults that are more restrictive than those in effect on March 23, 2010, until a health insurance exchange in the state is fully operational, and for all children in Medicaid and CHIP through September 30, 2019. The MOE requirement provides an exception for non-pregnant, non-disabled adults earning more than 133 percent ofthe federal poverty level if a state is projected to have a budget deficit. Arizona faces a mid-year budget deficit estimated at $825 million. A $1.4 billion shortfall is projected for the 2012 fiscal year. CALIFORNIA: The U.S. Supreme Courthas agreed to review whether health care providers and patients have the right to sue California over budget reductions made to Medi-Cal reimbursements. The high court will review three legal challenges to California'sproposed and adopted reimbursement cuts. The Supreme Court's ruling on the case could have major implications for efforts to address California's budget deficit. Last week, Gov. Jerry Brown (D) released a budget proposal that would reduce Medi-Cal payments to health care providers by 10 percentto cut program spending by about $719 million in fiscal year 20112012. In addition, the case could have implications for other states seeking to address budget deficits by cutting Medicaid payments.With federal courts in California blocking the cuts, 22 states have joined California in appealing the issue to the Supreme Court. The court is expected to hear oral arguments in the case next fall. A decision is expected in late 2011 or early 2012. CONNECTICUT: SpeakerChris Donovan, members of the Public Health and Insurance Committees and a variety of advocates held a press conferencelast week to announce the Public Health Committeehas raised the SustiNet bill based on the recent recommendations of the SustiNet Board. Few details were provided, but the original reportrecommends that SustiNet become a licensed insurance plan."We don't need health insurance anymore, we need to move towards health assurance health care that will be there for us, and the SustiNet plan will do that," Donovan said. Lawmakers will face a $3.7 billionbudget deficit by July 1. Rep. Betsy Ritter, D-Waterford, co-chairwoman of the Public Health Committee, said the plan will have to go before multiple legislative committees, with the actual bill some weeks away. Afinancial analysison upfront costs is not yet available. Aetna is working withthe Connecticut Associationof Health Plans (CTAHP) and AHIP to secure an objective fiscal analysis ofSustiNet's, as a public option,true cost to the state, andof thestrong, positive impact health insurers have on the state's economy. DELAWARE: In his State of the State speech, GovernorJack Markell emphasized the need for state government to spend more efficiently. He specifically notedthat the demandsstate employee health insurance and pensionsare putting on the state budgetareunsustainable. The Governor specifically stated he is open to any and all good ideas for addressing this budgetissue.In other news, a joint meeting of the Senate Health Committee and the House Economic Development, Banking, Insurance, and Commerce Committee was convenedfor an update on the state's effort to implement health care reform.Rita Landgraf, Secretary of Health and Social Services, along with Bettina Riveros, Health Care Commission Chair, advised legislators the commission will spend the nextsix toeight weeks holding stakeholder meetings across the state seeking input on establishing a statehealth insurance exchange. GEORGIA:The Exchange Workgroup formed by former Governor Sonny Perduehad its final meetinglast week andwill submit a list of issues for Governor Deal's administration to reviewbefore deciding how to proceed on the issue of instituting an exchange in Georgia. As the head of this workgroup for Governor Perdue is continuing under Governor Deal's administration, it is likely that there will be some enabling legislation during the 2011 session, though it is unclear what that will be.The legislative session began January 11, 2011 and continues for 40 legislative days. IOWA: The General Assembly convened in Des Moines on January 10 and is expected to adjourn on April 29, 2011In the November elections, Republicans took control of the House and gained a few seats in the Senate, narrowing the Democrats' majority there.Republican Terry Branstad was sworn in as governor for the second time. Having served in the post from 1983 to 1999, Branstad is the longestserving governor in Iowa's history.The state's budget deficit is projected to bemore than$785 million for fiscal year 2012 and will dominate legislative discussions.House Speaker Kraig Paulsen has vowed to remedy the deficit through spending cuts rather than tax increases.The Governor's proposal to revise the state's annual budget to a two-year cycle will also be debated. Bills of interest so far include several challenging PPACA's individual mandate,a prohibition on abortion coverage, creation of mandate-lite policies, a mandate for coverageof smoking cessation programs, aratereview billthat would requirea public hearing for any increase over10 percent in the individual market, and a bill establishing $100 as the minimum required payment for state employees. INDIANA: Governor Mitch Danielshas issued anexecutiveorder establishing the Indiana Health Benefit Exchange.In his order he directs the Indiana
Family and Social Services Administration (IFSSA) to cooperate with appropriate state agencies, including the Department of Insurance (IDOI), to establish and operate theexchange.The IFSSA Secretary or the secretary's designee will serve as the incorporator of the Exchange. If, after careful analysis, the state deems it appropriate to proceed with creation of theexchange,a board of directors will be selected.The board will include representatives of state agencies and the Indiana General Assembly.Standing Committees will be appointedthat have stakeholder representation. In addition,Governor Danielssubmitted aletterto HHS SecretaryKathleen Sebelius requesting approval of a state plan amendment to extend theHealthy Indiana Program (HIP) beyond its expiration date. HIP, the state's consumer-directed program for covering the uninsured population, is scheduled to expire in 2012.Daniels notes he has received communication from HHS staff indicating the state plan amendment will be rejected due to HIP's required level ofcontribution from participants.The Governorsaid the stateintends to utilize the program for the newly eligible Medicaid population pursuant toPPACA. Daniels cautionedthat Indiana does not have the time and financial resources necessary to complete new rigorous requirements for applying for a waiver extension if the amendment is rejected. The current 45,000 enrollees in the program would have to be transitioned into traditional Medicaid. MISSOURI: The 96th General Assembly convened on January 5 and is expected to adjourn on May 30, 2011.With 106 members to the Democrats' 57, the GOP has the largest number of seats it has ever held in the House andis just three members short of being veto-proof. Given the large Republican majorities in the General Assembly and 70 percent voter support for Proposition C-- an effort to turnback healthcare reform, the legislaturewill be under pressure to do nothing to move Missouri closer to enactment of federal health reform. Significant health care bills filed this session include aresolution calling on the Attorney General to file a lawsuit challenging the constitutionality of thePPACA, a bill requiring statutory authorization by the General Assembly to implement PPACA, a bill expanding the autism mandate,an MLR bill for largecarriers requiring a 90 percent MLR for Missouri-associated revenues and 85 percent for smaller carriers,a bill requiring the state employeehealth plan tooffer a minimum of three high-deductibleoptions with differing annual deductibles and annual out-of-pocket expenses, a bill prohibiting "Most Favored Nation" clauses, legislation creating transparency and publication of carriers'fee schedules andrequiringcarriersto contract with providers willing to meet certain provider participation terms and conditions,and creation of a uniform group application for insurance. NEBRASKA: The 102nd unicameral legislature has convened in Lincoln where it is expected to spend much of the session grappling with a budget deficit approaching $985 million for the 2011-2013 biennium. Implementation of thePPACA is expected to receive serious attention as well, with six bills relating to implementation or rejection ofPPACA introduced to date.Bills of interest include legislation creating an Exchange Task Force, aninterimcommittee for PPACAstudy,and severalbills challenging the individual mandate, prohibition of abortion coverage, and a cochlear implant mandate.In addition, abill banning discretionary clauses in health and disability income insurance contracts has been introduced. The legislature began its work on January 6 and is tentatively scheduled to adjourn on May 26, 2011. NEW HAMPSHIRE: The legislature convened on January 5, 2011, andis scheduled toadjourn on June 30, 2011.Governor John Lynch willcontinue as the state Executive; however,Republicanshave gainedcontrol of both chambers in the legislature.In addition to the state's budget deficit, implementation of federal health care reform will continue to be a priority for the governor and the legislature.Given the Republican majority and anticipated revenue shortfalls, there will be limited, if any, activity on health insurance issues. The legislature will, however, be paying close attention to federal health reform implementation issues and activities.In addition, there have been discussionsabout eliminating certain state mandates ifthey are not included in the essential benefits required under thePPACA. In 2010, the state enacted legislationgranting certain powers to the commissioner with respect to implementation ofPPACA. This legislation also created a legislative oversight committee, to which the Department of Insurance (DOI) must report monthly.This month the DOI submitted a request for a waiver of the 80 percent minimum loss ratio (MLR) requirement for individual health insurance market policies until 2014. NEW YORK: In a new report, the United Hospital Fund (UHF) looks at how New York might set up health insurance exchanges. One option is to letHHS runthe state's exchange, While that could save money, it wouldalso mean ceding key operational and regulatory issues to the feds. It might also jeopardize existing consumer protections in Medicaid that are unique to New York. If the state sets up its own exchange, it must decide whether to join a multi-state exchange, a statewide entity, or small local ones. UHF noted that New York might consider following the leads of Massachusetts and Californiaby creating an independent public authority to run an exchange. Former GovernorDavid Paterson created a 35-member Exchange Committee that met
only twice anddid not make any recommendations. GovernorAndrew Cuomo has not indicatedhis plansfor establishing aninsurance exchange in New York. PENNSYLVANIA: Governor Tom Corbetthas announced his intention to nominate Michael Consedine as the next Insurance Commissioner. Consedine is a partner at the law firm of Saul Ewing, where he serves as Vice Chair of its Insurance Practice Group. Prior to joining Saul Ewing12 years ago, Consedine served asstate Insurance Department Counsel. The Corbett transition teamhas announcedthat adultBasic, Pennsylvania's health insurance program for lowincome adults, is expected to expire on February 28 due to lack of funding. The announcement, unusualin thatit comes from an incoming administration, was necessitated by the need to provide advance notice to enrollees and to inform them of alternative coverage options. Originally started by former Governor Tom Ridge and funded through the state's allocation of Tobacco Settlement dollars, the program was later funded through the 2005 Community Health Reinvestment Agreement (CHRA). While that agreement between the Rendell Administration and the state's four Blue Cross plans expired on Dec. 31, 2010, additional funding was later provided by the plans pursuant to the CHRA's formula. It now appears those additional funds will be exhausted by the end of next month. TENNESSEE: A new Commissioner of Insurance appointed by Governor Bill Haslam took officelast week.Julie McPeak is an attorney at the Nashville firm of Burr and Forman and the former Commissioner of Insurance in Kentucky.Aetna is scheduling a meeting with the new Commissioner within the nextseveral weeks.
FEBRUARY 5, 2010 This Week in Health Care Reform EasyToInsureME FEBRUARY 5 2010 Despite proclaiming to focus on other issues, such as the economy and jobs, President Barack Obama injected new energy into the health care reform debate this week. On Monday, President Obama held a Q&A; session via YouTube in which he responded to questions submitted during his State of the Union address. He commented that "it is my greatest hope" to have health care reform legislation "not just a year from now, but soon." He also responded to criticisms regarding the lack of transparency around the reform negotiations. On Tuesday, at a town-hall-style meeting in New Hampshire, President Obama rejected the notion that health care reform was dead, saying "we've got to punch it through." Further, on Wednesday, he met with Senate Democrats reiterating his commitment to reform and encouraging lawmakers to press forward. He also suggested that Republicans play at least some role in negotiating a final bill. Health Care Reform Negotiations Democrats Look for Path Forward: Recent statements made by Rep. Charles Rangel (D-NY) are the first concrete signs that Democrats have started working to revive comprehensive health care reform legislation. Rep. Rangel indicated to the media that lawmakers have begun writing a compromise bill based on the legislation passed by the Senate last December. The bill will incorporate changes agreed upon last month by White House negotiators and members of the House and Senate. Senate Majority Leader Harry Reid (D-NV) did not commit to a timeline for reform, but hopes that Democrats can agree to a path forward by next week. So far, he has been unable to identify compromise language that will win the needed 51 Senate votes. At the same time, Speaker of the House Nancy Pelosi (D-CA) indicated that the House would vote on a small piece of the overall health care reform package next week. The proposed bill would overturn the insurance industry's exemption from federal antitrust laws. The Senate version of health care reform did not include this measure because Sen. Reid could not secure the 60 votes needed to include it; however, Sen. Reid indicated the Senate would reconsider the measure. Additional Activities President Obama's Budget Assumes Health Care Reform: On Monday, White House officials released a proposed $3.8 trillion 2011 budget including several measures aimed at improving health care: Hiring more fraud detectives to root out waste in Medicare and Medicaid Providing $25.5 billion to help state Medicaid programs swelling with enrollment due to unemployment Eliminating Congressional earmarks for building hospitals and other facilities, including $10 million for Alaska and $35 million for Mississippi Initiating or increasing funds for the following research projects: o quality improvements for seniors with chronic conditions o effective medical treatments for the costliest conditions o expeditious ways to adopt electronic medical records o medical fields such as genetic medicine that may provide breakthrough treatments. Further, the budget assumes that some form of health care reform legislation will pass Congress. It includes a "reserve fund for health care reform" totaling $634 billion as a "down payment" for the legislation and also assumes that the reform effort will generate $150 billion in savings over 10 years. States Begin Initiatives to Expand Coverage: With the fate of national health care reform in question, state legislators are pushing their own bills to expand coverage.
Last Thursday, California's State Senate passed a measure to create a government-run health care system, ignoring a veto threat from Gov. Arnold Schwarzenegger. The measure is now with the State Assembly. Missouri legislators have introduced a similar bill to create a government-run plan whereas lawmakers in other states, including Virginia and New Jersey, are working to tweak existing state programs to expand coverage. Tight budgets in all of those states may hinder these efforts. Virginia Senate Says No to Individual Mandates: On Monday, Virginia's Democratic-controlled State Senate passed measures that would make it illegal to enforce an individual health care mandate. This decision comes in direct conflict with the House and the Senate health care reform bills, both of which require all individuals to purchase health insurance. Public Opinion Majority of Americans Doubt Passage of Health Care Reform, but Growing Optimism: A survey released by the Pew Research Center on Wednesday shows growing optimism around the passage of health care reform. While the poll indicates that the majority of Americans (60 percent) do not believe health care reform legislation will pass this year, the figure is down from the 67 percent who said - just after a special Senate election was held last month in Massachusetts - that such legislation would not pass. Poll Indicates Damage Done On Health Care Reform: A poll released Tuesday by Public Policy Polling shows that Republicans currently have the advantage over Democrats in the ballot races for Congress, regardless of the final outcome of health care reform. In general, the poll shows that 43 percent of voters surveyed would vote for a Republican, whereas 40 percent would vote for a Democrat. When asked about the implications of the health care overhaul. * If health care reform passes, 45 percent would likely vote Republican and 40 percent would likely vote Democrat. * If health care reform does not pass, 43 percent would likely vote Republican and 38 percent would likely vote Democrat. The poll also shows that 36 percent of respondents support the President's health care reform effort, while 51 percent oppose it. Looking Ahead Currently there is no timeline for the development of a comprehensive health care reform package. However, Speaker Pelosi is moving forward with smaller pieces of the bill, starting next week with the repeal of the antitrust exemption for insurance companies.
Federal Owing to multiple blizzards in Washington, Congress started its President's Day recess a full week early and conducted no official business last week. However, there was some legislative drama as Senate Majority Leader Harry Reid pulled the rug out from under Finance Committee Chairman Max Baucus by scrapping the Baucus jobs bill (without warning), which contained many health insurance items, and replacing it with a stripped down, narrow jobs bill. Whether the health items Baucus originally inserted with Republican help will make it back to the table remains fuzzy. Among the health items that have been dropped are: the COBRA eligibility extension (to May 31); the doc fix (to October, 2010) of Medicare reimbursement rates; and the favorable statutory direction to CMS to calculate the 2011 Medicare Advantage rates "as if" the doc fix were in place. States California health insurance The Office of Patient Advocacy released a report card on the states HMOs last week. Aetna received 3 out of 4 stars. The goal of the report card is to allow consumers to compare how well health plans use personal medical records and help address conditions such as asthma, arthritis and diabetes. COLORADO: Governor Bill Ritter held a press conference to announce what he calls "the next round of reforms that represent common sense." His legislative package includes bills to preclude insurance companies from charging different rates due to a person's gender, ensure that women have access to breast cancer screening, assure plain language is used in insurance forms, standardize insurance applications and explanations of benefits, and encourage greater use of online tools to enroll people in public programs. Apart from the Governor's proposals, a bill that would establish a public option was also introduced. CONNECTICUT: In a short legislative session of only three months, the Insurance & Real Estate Committee wasted no time in putting forth an agenda that includes many concept drafts for repeat legislation from previous sessions. These include prohibiting health insurance copayments for preventive care, limiting prescription drug copayments, prohibiting Social Security disability payment offsets, and exempting the Municipal Employees Health Insurance Plans from the premium tax on small group premiums. In addition, the committee reintroduced legislation that includes nearly a dozen new health benefit mandates. The Council for Affordable Health Insurance, an independent think-tank, says that health insurance mandates could
increase premiums in Connecticut by more than 50 percent overall. GEORGIA: A bill was proposed last week that would impose significant restrictions on insurers' ability to rescind health insurance policies. Aetna, through the Georgia Association of Health Plans and AHIP, met with the legislator sponsoring the bill to express concerns with the bill. INDIANA: The legislative session is at halftime, and the insurance agenda is now limited. Most insurance issue bills are officially dead, including a bill that would have prohibited health plan provisions requiring a contracted provider to accept more than a certain number of patients; coverage for dialysis treatment regardless of whether the facility is contracted or not and without certain benefit restrictions; and a bill that would have allowed out-of-network assignment of benefits. However, Aetna is expecting that a bill requiring insurer and HMO annual reporting of premium cost composition, including administrative costs, may be resurrected. A bill that restricts dental insurers and HMOs from establishing fee schedules for non-covered services passed the Senate, with our amendment to accommodate most of the key concerns expressed by opponents of the bill. As the bill stands, dental insurance plans may impose fee schedules for covered services, regardless of whether the plan actually pays for the services rendered. KANSAS: An amended version of S.B. 389 related to dental services passed the Senate Financial Institutions and Insurance Committee on February 11. The amended bill prohibits any contract between a health insurer that offers a health benefit plan and a dentist from containing a provision that requires the dentist to accept a fee schedule for services unless the service is a covered service. Committee amendments added to the definition of a health benefit plan the following: any subscription agreement issued by a non-profit dental service corporation; any policy of health insurance purchased by an individual; the state childrens health insurance plan; and the state medical assistance program under Medicaid. We will continue to update you as this bill progresses and hope to make favorable changes as the bill moves through the House. MASSACHUSETTS: Governor Deval Patrick filed a 40-page bill that proposes giving the insurance commissioner the power to hold public hearings on rate adjustments and essentially cap health care price increases. Rate increases for individuals would be held to the rate of medical inflation; those sold to employers with 50 or fewer workers could not exceed one and a half times the level of medical inflation. The legislation would also impose a two-year moratorium on any new health benefit mandates. Legislative leaders praised the intent of the governors plan but declined to promise support. Strong opposition is expected from medical provider groups. The Governor simultaneously announced emergency regulations to take immediate effect that will require health insurers to submit proposed small business rate increases for review by the state 30 days before they take effect. Several other proposed provisions include a requirement that insurers offer at least one coverage plan with a limited network of health care providers costing at least 10 percent less than health plans with access to more physicians. The Massachusetts Association of Health plans is lobbying in support of a bill introduced by Senate Insurance Chair Richard Moore that would create a cheaper health insurance product for small employers by capping payments to providers at just 10 percent above Medicare rates. The Massachusetts Medical Society is against that proposal. MISSOURI: An autism coverage mandate bill was amended and perfected by the Senate and then sent to the Government Accountability and Fiscal Oversight Committee from which it must emerge before returning to the floor of the Senate. In addition to two mandate-related amendments, a third amendment to the bill allowing for limited cross border sales of health insurance also passed. In its current form, the bill contains a mandated offering of the coverage in the individual market. Coverage is limited to treatment ordered by a licensed physician or psychologist whose treatment plan the carrier is entitled to review every six months. Coverage for applied behavior analysis (ABA) is limited to $52,000 annually (down from the $72,000 as introduced) for persons under age 21. Meanwhile in the House, a bill containing significant language relating to the credentialing of autism service providers also passed. The bill also contains a mandate to offer coverage in the individual market and to groups of fewer than 25. Groups of 25 to 50 would be entitled to an exemption from the mandate if they could demonstrate an increase in premiums tied to the mandate. The bill limits annual coverage of ABA ($36,000 for children ages 3-9; $20,000 for children ages 9-21). Aetna will continue to monitor the status of these mandates, but it appears fairly clear at this point that something will pass on the issue of autism. NEW JERSEY: Last week Governor Chris Christie declared a fiscal state of emergency calling a special session of the legislature to lay out his plan for dealing with states current $2.2 billion budget shortfall. His plan calls for significant cuts or eliminations across 375 state programs and withholding $500 million of state education aid. Of note on the program side is a $12.6 million reduction in Charity Care funding to hospitals, which pays for care to uninsured residents. In legislative action, the Assembly Financial Institutions and Insurance Committee held a threehour public hearing on out-of-network reimbursement. Much of the hearing focused on the markedly
higher billing practices of ambulatory surgery centers and one non-par hospital. Aetna presented testimony regarding its experience with the non-par hospital, citing their disparate year-over-year increase in charges compared to other similarly situated hospitals. Chairman Schaer indicated the committee will work over the next several months to craft a solution. NEW YORK: With Democratic Senator Hiram Monserrate officially expelled from the Senate, the Democratic majority (31-30) now faces an uphill battle getting the 32 votes needed to pass legislation. However, both the Senate and the Assembly moved forward with a public hearing on the Executive Budget proposal for health, including the section mandating the prior approval of rate adjustments. The Health Plan Association testified on behalf of the industry. If enacted, Governor Paterson's proposal for an 85 percent medical loss ratio and a prior approval hearing process for all rate adjustments would essentially amount to government control of health insurance, undermining the private health insurance market in New York. Price controls would weaken health plan solvency, hurt providers and virtually eliminate innovation and efficiency. At the same time, the proposal ignores the underlying cause of the increasing cost of health insurance -- the increase in the actual costs of health care services. OKLAHOMA: The second session of the 52nd Oklahoma Legislature convened in Oklahoma City on February 1. Legislators quickly turned to the states $1.3 billion budget deficit described by Governor Brad Henry (D) in his eighth and final state of the state address and FY 2011 executive budget. During his address, the Governor focused on his plans for resolving the $1.3 billion budget deficit through precise budget cuts. His only reference to health insurance was to encourage the expansion of Insure Oklahoma, a program developed by the state in partnership with small employers to provide affordable health coverage. The legislature is scheduled to adjourn on May 28 but only after addressing a range of legislation including several bills of interest to Aetna. SOUTH DAKOTA: A dental fee schedule bill (S.B. 108) unanimously passed the Senate Commerce Committee and is expected to be taken up by the full Senate early this week. The bill prohibits any contract between a health insurer that offers a health benefit plan and a dentist from containing a provision that requires the dentist to accept a fee schedule for services unless the service is a covered service. Aetna will continue to follow the bill's progress as it progresses. TENNESSEE: Several bills have been proposed that would make changes to the state's external review law. Aetna and other industry representatives will be meeting with the Tennessee Department of Commerce and Insurance regarding its proposed changes to the external review law. The bill proposed by the TDCI most closely mirrors the model legislation proposed by the National Association of Insurance Commissioners. UTAH: The Speaker of the House has introduced a health reform bill addressing health information technology, individual and small group market reforms and transparency. The overarching theme of the reforms is micromanagement of rates and rating factors, and a broadening of the Insurance Commissioner's authority. The transparency provisions apply plan designs and benefit descriptions submitted by carriers, and would require providers to make available, upon request, a price list for services on both an inpatient and outpatient basis.
With a law as complex as the Patient Protection and Affordable Care Act (PPACA), unintended consequences are always a concern. Last week The Wall Street Journal reported that the physician community is witnessing the emergence of a significant unintended consequence since tax-advantaged flexible spending accounts can no longer be used to pay for over-the-counter medications without a prescription, under the law, many patients are now visiting their doctors expressly for the purpose of getting new prescriptions for the OTC medications. The change in the law was meant to discourage wasteful spending on some health products and raise revenue. Instead, critics say the provision is driving up health care costs. Unintended consequences of the health care reform law is an area of focus for Aetna insurance, and will continue to urge flexibility in the implementation process to help address potential unintended consequences. Federal In response to various requests for clarification (including from Aetna insurance), federal regulators last week issued a Question & Answer document that further refines the previous proposed rule on student health. In short, this clarification makes it clear that nothing from PPACA applies to student health plans until policy years beginning in 2012 or until academic year 20122013. The Q & A also clarified that the proposed regulation must be finalized to show what parts of the PPACA would apply to student health plans. This is welcome news in the college and university community. Aetna is communicating with its clients in a manner that is consistent with last week's
clarification, though many schools were hearing conflicting advice from state regulators. The Housepassed continuing resolution includes language that would "prohibit the use of funds to pay any employee, officer, contractor, or grantee of any department or agency to implement the provisions" of the PPACA. In a letter to Finance Committee Chairman Max Baucus, HHS Secretary Kathleen Sebelius made several claims that, should the de-funding provisions in the resolution be enacted into law, seniors will lose access to Medicare Advantage plans and other services. Senate Republicans were quick to dispute these allegations stating, the scenarios the Secretary envisions are not allowed under Congressional rules, are not assumed by the Congressional Budget Office (CBO), and can be prevented by HHS. Senator Orrin Hatch and Ways and Means Committee Chairman Dave Camp also sent Secretary Sebelius a letter expressing their disappointment in what they called the letter's "baseless allegations," and expressing hope that "the urgency with which this letter was sent to Chairman Baucus is also being applied in answering a growing backlog of serious questions." The CBO also released a letter regarding the impact of the resolution, including the impact of the de-funding provisions on Medicare Advantage. The letter shows the de-funding provisions would have a minimal MA budgetary impact of $5.7 billion over 10 years. States Governor Jan Brewer's Special Advisor on Arizona health insurance Health Care Innovations held a meeting last week with the state's major health insurers, including Aetna insurance, to discuss identifying IT gaps the state must address to develop the online product selection and enrollment mechanism for an insurance exchange. Social Interest Solutions, the organization that developed the enrollment form currently used by Medicaid applicants, provided a demonstration of that application process. Individual interviews will be conducted with the IT staff of each company to obtain recommendations for the new system. The Real Estate Committee last week voted out a substitute priorapproval rate bill that retains all the problematic sections of the original bill. The sections of concern cover public hearings, new subpoena powers for the Attorney General and Connecticut health insurance Healthcare Advocate, multiple notice requirements, and new definitions of inadequate, excessive, and unfairly discriminatory. The only change is that the Commissioner would have to promulgate regulations to carry out the proposed public hearing process. The full contingent of Republicans and Rep. Linda Schofield (Dem.) voted against the bill, with Schofield stating that she was concerned the bill gets rid of any timeline under which the Department must act and would require public hearings, nonsensically, for group rates. She also said the bill would provide the Attorney General and Advocate with extraordinary subpoena powers. The Chairs indicated that the bill is a work in progress. Florida health insurance Insurance Commissioner Kevin McCarty has disclosed that he will be submitting a medical loss ration (MLR) waiver request to HHS this week. Georgia health insurance Insurance Commissioner Ralph Hudgens has indicated he will be submitting an MLR waiver request to HHS within a week. Aetna insurance continues to work with the Chamber of Commerce and plan sponsors to help defeat legislation that would apply prompt-pay requirements to self funded plans, in violation of ERISA. Oklahoma health insurance Last week State Rep. Mike Ritze, one of two doctors serving in the Oklahoma legislature, called on state officials to turn down $54 million that would be used to implement the new federal health care law. Shortly thereafter, Governor Mary Fallin joined other state leaders in announcing that Oklahoma will accept the grant to help design and implement the information technology infrastructure to operate an Oklahoma health insurance exchange. Fallin listed the creation of such an exchange as one of her top priorities in her State of the State address earlier this month. She and others announced their support for the grant after working with state agencies to ensure that no unworkable federal mandates were included. Later in the week, the legislature continued taking steps forward to reduce the number of uninsured Oklahomans. House Speaker Kris Steele authored a bill that defines the membership and appointments to the Health Care for the Uninsured Board (HUB), which is designed to establish a system of counseling, including a website, to educate and assist consumers in selecting an insurance policy that meets their needs. The seven-member HUB consists of representatives from the Insurance Commissioner's Office, the Oklahoma Healthcare Authority, insurance companies, agents and also consumers. The purpose of HUB is to implement a market-based insurance exchange. The bill passed the House Public Health Committee at the end of the week and will proceed to the floor of the House. Texas health insurance Legislators are wrestling with to what extent they should intervene in what residents eat, drink and breathe. In a state with some of the nation's highest obesity and diabetes rates, supporters of various proposals say they are trying to give Texans more ways to combat unhealthy decisions by others, as well as make good choices for themselves. The president of the Texas Medical Association testified last week in favor of a bill banning the sale of unhealthful drinks (sugary fruit juices, sodas, whole milk) to students during school hours. Other related bills would allow the state to raise taxes on sweet sodas and
fine restaurants for not posting nutritional information. About 30 percent of Texas schoolchildren are obese or overweight, according to the Texas Public School Nutrition Policy. And last month, Republican Comptroller Susan Combs released a report saying obesity cost Texas businesses $9.5 billion in 2009 that could rise to $32 billion by 2030 due to the cost of health care services, absenteeism, decreased productivity and disability. Legislators will continue debate on these bills until the session adjourns on May 31.
Recently barred fast track resolution by the U.S. Supreme Court, opponents of the Affordable Care Act (ACA) have resumed their legal quest to derail the law through the traditional Circuit Court route. Twenty-six states last week filed a motion in the 11th Circuit Court of Appeals in Atlanta urging the court to strike down the health care overhaul law. The motion asks the court to uphold a Florida federal judge's ruling that the law's core requirement, that everyone purchase health coverage, is unconstitutional. The filing comes about a month after the Obama administration formally appealed the Florida ruling. Once the 11th and 4th Circuits rule on ACA appeals, the U.S. Supreme Court is finally expected to take on the issue and become the final arbiter -- but probably not until late 2012. Federal Last week the Republicancontrolled House approved two bills that would repeal funding for construction of school-based health centers and assist the states in establishing school-based health centers, as otherwise authorized by ACA. Both items are part of a package of bills that are coming to the House floor to either repeal or revise ACA provisions that provide funding for various parts of the health care reform law. Neither will make it though the Democratic Senate, nor get past the President's veto pen. This effort is all about setting up various lines in the sand from which to bargain with respect to the bigger battle over the budget and the national debt. Whether either side will back down remains unclear. But it is clear that Republicans and Democrats are preparing for a major fight just around the corner. On the Senate side, the top Republican on the Senate Finance Committee, Senator Orrin Hatch (R-UT), introduced legislation designed to further erode a provision of ACA. The Senator's legislation proposes repeal of the Medicaid/CHIP Maintenance of Effort (MOE) provision in ACA, which would give the states financial relief from the funding requirements demanded by ACA. While the House companion bill (Congressman Phil Gingrey, R-GA) may have better luck than the Hatch bill in the Senate, this effort may have more life than other anti-ACA proposals because the states are in dire financial straits and both Republican and Democratic governors are clamoring for relief from Washington. States CALIFORNIA: The 2011 version of a hospital transparency bill was unanimously voted out of the Senate Health Committee last week. The legislation would prohibit hospitals from including provisions, commonly referred to as "gag-clauses," in contracts with health insurers. These provisions prevent disclosure of hospital cost and quality information to health plan members. Individual hospital systems, the UC System and the California Hospital Association continue to oppose the bill, while insurers, payers and labor unions support the measure. Also, the Senate Health Committee last week announced its new policy of making almost all benefit mandate proposals two-year bills. The Chair believes that the legislature should wait until the federal government defines essential health benefits under the ACA. The only exception to this committee policy will be the maternity mandate bill, which the Chair believes is certain to be part of the essential benefits package. There have been a dozen benefit mandates bills introduced this year. COLORADO: The Colorado General Assembly passed an insurance exchange bill after the Senate concurred to amendments added by the House. Passage of the bipartisan-sponsored bill is the culmination of nearly nine months of work that drew the support of the governor, business and the health insurance industry. Key bill provisions include: Establishes an exchange as a nonprofit, unincorporated public entity Designed to foster a competitive market, the exchange shall not solicit bids or engage in the active purchase of insurance No duplication of Division of Insurance regulatory authority, including rate review All carriers licensed in Colorado may be eligible to participate Governed by a nine-member board of directors appointed by the governor and legislative leadership; plus three non-voting ex officio members Majority of voting board members shall not be directly affiliated with the insurance industry A legislative implementation review committee will review grant applications, financial and operational plans and have the ability to propose up to five bills per session No separate state appropriation was made to fund the implementation The bill does not address substantive issues such as the merging of the individual and small group markets or the size of eligible small employers. CONNECTICUT: Governor Dannel Malloy last week signed a biennium
budget bill, without a proposed increase in the premium tax. To avoid paying $50 million in retaliatory taxes to other states, insurers supported temporarily lowering the amount of premium tax credits that can be used, from 70 percent to 30 percent for two years. The budget includes the tax credit measure, which will sunset in 2013 . Legislators are now focusing on other issues, including rate review. If enacted, the current rate review bill would: require a lengthy notice and public hearing timeline for all proposed rate increases; authorize the Healthcare Advocate and the Attorney General to be parties to any hearing; and broadly define "excessive" to include consideration of commissions, transfer of funds to a holding or parent company, the rate of return on assets or profitability, and a "reasonable" profit margin. The bill would also require that plans send written notice to insureds or subscribers of both the proposed rate and, later, the new rate. This bill would be effective July 1, 2011. The estimated cost of holding hearings for all proposed rate increases of 10 percent or more is $2 million, for a department that has an annual budget of $25 million. The bill was voted out of the Appropriations Committee nonetheless. If the bill were to be voted on today, it likely would pass. However, Insurance Commissioner Thomas B. Leonardi raised concerns about the potential cost and workload. The current law allows for the insurance commissioner to hold a rate hearing at his discretion. Leonardi said rates that aren't justified by actuarial science will be rejected. Senate Insurance Chair Joe Crisco called the bill a "work in progress" and said he and other legislators will be working with Leonardi. KANSAS: Kansas has joined the growing list of states asking the federal Department of Health and Human Services (HHS) for a waiver of ACA's minimum loss ratio (MLR) requirements. If granted, the waiver would allow Kansas carriers until 2014 to fully comply with the 80 percent requirement under federal law. In a letter to HHS Secretary Kathleen Sebelius, Insurance Commissioner Sandy Praeger proposed a rule modification for the individual market to allow for a gradual implementation of the 80 percent requirement. The waiver would offer companies appropriate time to adjust their business practices and maximize opportunities for new companies to enter the Kansas market. The current MLR requirement for major medical coverage in the state's individual market is 55 percent. Commissioner Praeger's letter proposes adjustments to the MLR standard at 70 percent in 2011, 73 percent in 2012, 76 percent in 2013 and 80 percent in 2014. To date, Maine is the only state to have received approval from HHS for a waiver. Guam and nine other states -- Florida, Georgia, Iowa, Kansas, Kentucky, Louisiana, North Dakota, Nevada, and New Hampshire -- have submitted waiver applications that are pending. MAINE: The House last week voted 76-72 to approve an ambitious health care reform bill introduced by the Republican majority. The bill would overhaul Maine's health insurance system and create a new one designed to foster more competition. If enacted, the bill would repeal Maine's standard benefit package and geographic access rules (Rule 750 and Rule 850) and expand the rating bands to open up the individual and small-group insurance market to greater competition. The changes in rating for individual health plans and small group plans would be phased in over four years, with a maximum rate differential of 1.5:1 to 5:1, based on age, for individual and small group health plans. The bill also would authorize the renewal of short-term health insurance policies for a period not to exceed 24 months, instead of the current 12-month limit. By 2014, the bill would allow Maine residents to purchase insurance across state lines in four New England states: Connecticut, Massachusetts, New Hampshire or Rhode Island. In addition, it would establish an individual market reinsurance pool to be funded through a covered lives assessment capped at $4 per month, per person. The bill is likely to pass the Senate as well, where Republicans hold a 20-14 majority. In other legislative action, the Health and Human Services Committee heard testimony on a bill to repeal Maine's 2003 Pharmacy Benefit Management (PBM) law. The law requiring PBMs to disclose contractual agreements with drug makers has been detrimental to the growth of competition. Medco testified that the law has led the company to turn down business in Maine. Express Scripts and Caremark, which is owned by drugstore chain CVS, also testified in support of repeal, portraying the law as the "most extreme in the country." Michael Cianchette, an attorney for the LePage administration agreed, saying that Maine should conform to the national norm. Community pharmacies, which face competition from PBMs' mail-order operations, oppose the repealer. NEW JERSEY: Both chambers of the legislature are fully engaged in budget hearings as the legislative and executive branches work toward passing a balanced budget by the June 30 deadline. Proposed changes to Medicaid have been a hot button issue, as the state attempts to address a $1.3 billion deficit in the program. The Department of Human Services testified that it has already started moving 200,000 Medicaid participants to managed care plans and will be working the Department of Health and Senior Services to take similar action with the long-term care population. On the legislative front, Senate President Stephen Sweeney announced last week that he will be amending his bill to reform health benefits for public sector employees. The current legislation calls for a moratorium on governmental entities joining the State Health Benefits Plan (SHBP).
Due to alleged conflict of interest claims, the Senate President has decided to remove this provision, which will continue to allow local governments the option of providing health benefits through either a commercial plan or the SHBP. Reform of public employees' benefits is major part of Governor Chris Christie's initiative to save more than $300 million in the coming fiscal year. NEW YORK: The New York City Human Resources Administration (HRA) wants the state to be aware that a statewide exchange solution may not work well for them. The HRA released a brief discussing the creation of a Navigator program, which gives grants to qualified organizations to provide health insurance education and enrollment assistance services. HRA's brief focuses on such a program in the city and looks at the most effective ways to implement the required services. OKLAHOMA: The health care compact measure pressed by state Sen. Clark Jolley cleared the House last week and now returns to the state Senate for final consideration. The bill lays out the basis for Oklahoma's participation in an agreement with other states in an attempt to restore authority and responsibility for health care regulation to member states. The compact would allow Oklahoma to create health care policies by joining an interstate compact that supporters believe supersedes prior federal law. The compact, which has been introduced in 14 states, was signed recently into law in Georgia. The concept is also advancing in Missouri, where a compact proposal cleared the state Senate and is headed to Governor Jay Nixon. Compact proposals are also alive in Montana, Colorado and Texas. TEXAS: Republicans pushed the next two-year budget through the Texas Senate last week by using a procedural maneuver to bypass Senate tradition requiring a two-thirds agreement to consider any legislation. Senators voted 19-12, along party lines, to approve the plan. The move clears a path for negotiations to begin with the House on the $176.5 billion spending plan. The plan would make about $11 billion in cuts, which is less severe than those in the bare-bones House version. Public schools and Medicaid providers, including nursing homes, would take the brunt of the cuts. In the face of criticism on both sides of the aisle, Senator Steve Ogden, the bill author, offered an amendment that stripped about $3 billion in rainy-day fund money from the budget. The move helped garner support from conservative Republican senators but cost the support of key Democrats. Ogden's GOP-condoned compromise replaces about $3 billion in rainy-day money by underfunding Medicaid, pushing those payments to the end of the budget period. Absent increased revenue from an improving economy, the budget would then force across-the-board cuts to state agencies other than basic public school operations. Ogden's plan underfunds public schools by about $4 billion. It cuts reimbursement rates to Medicaid providers by 6 percent, compared to more than 10 percent proposed in the House. Senate leaders are bracing for tough negotiations with the conservative House. The state is facing a revenue shortfall of at least $15 billion. The legislature has until May 30 to reach a deal and avoid a special session to resolve the issue. VERMONT: The House last week voted to approve a single-payer measure, which now advances to the governor's desk for signing. Governor Peter Shumlin is expected to sign it. The bill passed in the House by a vote of 94-49 and was passed earlier in the Senate by a 21-9 vote. In addition to establishing a single-payer system, the bill would establish new rate review requirements and a Vermont Health Benefit Exchange that would be operational by 2014, in accordance with the ACA. A single-payer system would begin in 2017, when the ACA begins to allow states to request waivers to opt out of many of its requirements, or earlier with federal approval.
This health insurance reform schedule is the official announced schedule from Easy To Insure ME to help citizens understand the future of health insurance in the United States. Health Insurance Reform Schedule 2010 New programs: * Temporary retiree reinsurance program. * National risk pool, small business tax credit. * $250 rebate for Medicare members who reach the "doughnut hole". Health Insurance Reforms: * No lifetime benefit limits based on dollar amounts. * Allowed restricted yearly limits on the dollar value of certain benefits. * No coverage rescissions/cancellations (except for fraud or internal misrepresentation). * No cost-sharing obligations for preventive services. * Must have dependent coverage up to age 26. * New internal and external appeal process. * No pre-existing condition exclusions for dependent children (under 19 years of age). * New health plan disclosure and transparency requirements. 2011 Insurance Reforms: * New uniform coverage documents and standard definitions are developed. * Must have minimum medical loss ratios. Medicare Reforms: * Start of Medicare Advantage cost-sharing limits. * Medicare beneficiaries who reach the doughnut hole to get a 50% discount on brand name drugs. * Primary care doctors and general surgeons practicing in underserved areas, such as inner
city and rural communities to get a 10% bonus. * Medicare Advantage plans begin having payments frozen. Other: * Yearly fee for brand-name drug manufacturers. * Start of voluntary long-term care insurance program giving a cash benefit to help those with disabilities stay in their homes or pay nursing home cost: benefit starts 5 years after paying coverage fee. * Increased funding for community health centers to provide care for many low-income and uninsured people. 2012 * Hospitals, doctors and payers encouraged to join forces in "accountable care organizations". * Hospitals with high rates of preventable readmissions facing reduced Medicare payments. 2013 * Individuals making $200,000 a year or couples making $250,000 would have a higher Medicare payroll tax of 2.35% on earned income up from the current 1.45%. A new 3.8% tax on unearned income, such as dividends and interest, also added. * Contributions to flexible spending accounts (FSAs) limited to $2,500 a year indexed for inflation. And the threshold for deducting medical expenses on taxes goes from 7.5% to 10% income. * Medical device manufacturers have a 2.9% sales tax on medical devices; with exemptions for some, like eyeglasses, contact lens, and hearing aids. * No more deduction for expenses allocable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D-eligible retirees. 2014 Coverage Mandates & Subsidies: * New Individual and employer coverage responsibilities. * New Individual affordability tax credit and expanded small business tax credits. Health Insurance Quotes Exchange & Insurance Reforms: * State individual and small group health insurance exchanges operational. * Guaranteed issue, guaranteed renewability, modified community rating and minimum benefit standards ("essential benefits" plan) effective. * No more lifetime and yearly dollar limits for essential benefits. * New taxes on health insurers. 2018 * New tax ("Cadillac tax") on employersponsored health plans that offer policies with generous coverage levels. 2020 * Doughnut hole coverage gap in Medicare prescription benefits is fully phased out. Seniors continue to pay the standard 25% of their drug costs until they reach the threshold for Medicare catastrophic coverage. The mission of Easy To Insure ME is to help Americans find affordable health insurance in the easiest way possible. Licensed advisors do this by shopping all carriers available to the client and picking out four plans that will provide the best benefits at the lowest cost to the consumer. Then an easy to read side by side recommendation of these plans is sent through email to make the process as simplified as possible. Easy To Insure ME is not a lead generation website. Real licensed professionals are here to help clients make knowledgeable and affordable individual health insurance decisions. An advisor can be reached at 866-492-3905. "Nobody does what we do for our clients." http://www.easytoinsureme.com/
Week of November 15, 2010 State budget problems are so dire and rising health care costs so worrisome that some states are considering what may have been unthinkable just a year or two ago -- opting out of the federal Medicaid program. The New York Times reported last week that Texas (see below) and a handful of other states are considering doing exactly that, especially given that federal health care reform will expand (as of 2014) the number of residents who are eligible for the state-administered health care program. In South Carolina, state officials there are considering not paying Medicaid claims as of March 2011 unless they can secure permission to run at a deficit. Some state leaders concede dropping Medicaid could have a devastating effect on their local economies, making such a course unlikely. The fact that it's on the table, however, speaks volumes about the growing problem of runaway health care costs, and the need to develop systematic solutions in the way that the Patient Protection and Affordable Care Act (PPACA) addressed access issues. Easy To Insure ME has the answers Health Care Reform Implementation For more detail about the ongoing implementation of the new health care reform law and its potential impact on you, read a new edition of our Eye on Implementation feature. Federal With Congress on recess last week, there is no Federal summary for this week. States ALASKA: A state health commission created by the legislature this year has begun reviewing rapidly rising medical costs and patterns of health care pricing among providers. Alaska's health care costs are rising faster than the national average. The commission held its first meeting in Anchorage October 14 and 15 after its members were appointed by Gov. Sean Parnell. Most members of the panel were on an earlier health care task force, but this panel has five new members, including two state legislators. In an effort to provide the Commission with relevant cost and quality data, Aetna has forwarded several relevant studies and documents produced by its Public Policy Department. CALIFORNIA: The state is yet again facing a massive budget deficit -- $25.4 billion projected for 2011, according to the nonpartisan Legislative
Analyst Office (LAO). Governor Arnold Schwarzenegger will call a budget special session starting December 6 to resolve the current-year $6.1 billion deficit. Next year's budget process will be impacted by two propositions passed during the November election. Voters approved Proposition 22, which limits the state's ability to borrow money from local governments, and they also approved Proposition 26, which makes it harder to raise fees. It also rolls back fees that were passed by less than a two-thirds vote this year. The LAO estimates these two propositions will create a $1 billion hole in the budget. Democrat Governor-elect Jerry Brown, who campaigned on a pledge of no new taxes, will release his budget proposal in early January. NEW JERSEY: Last week the Assembly Financial Institutions & Insurance Committee took up legislation that clarifies out-of-network payment responsibilities under health benefits plans, requires certain coverage and procedure disclosures to consumers, and revises procedures for changes to managed care plan contracts. After more than two hours of testimony, Chairman Schaer used his discretion to withhold formal action on the bill. In his comments the chairman noted, "The rising cost of health coverage is crowding out other socially important efforts for government and resulting in economic stress for employers." Led by the New Jersey Hospital Association and Medical Society, the provider community was virtually unified in its opposition to the legislation. The business community, NJ Association of Health Underwriters, and a large contingent of trade unions expressed their support for the bill. Aetna, along with other commercial plans, remains concerned about provisions in the bill concerning non-participating, hospital-based physicians and the ability of out-of-network providers to waive member copayment, coinsurance, or deductibles. Aetna will continue to closely monitor the legislation. TENNESSEE: The Tennessee Insurance Exchange Planning Initiative has announced the members of two newly created Technical Advisory Groups (TAGs). Members of these groups will provide expertise on specific analytical questions to help in the state's insurance exchange planning process. The state is in the process of deciding whether it will operate a health insurance exchange. Mark Schmidt, Aetna Market President, Southeast, has been appointed to the Governor's TAG for State Insurance Exchange Planning. The members of the Actuarial/Underwriting TAG and the Agent/Broker TAGs will provide expertise on specific analytical questions to help in the state's insurance exchange planning process. The volunteer members of each TAG will meet in Nashville this fall and winter. Members of the Agent/Broker TAG will provide a detailed inventory of options for state decision-makers and then post any resulting discussion papers. Once additional information is received from the federal government, the state also intends to convene TAGs of health care providers, consumer representatives, and marketing and outreach experts. TEXAS: Several Republican lawmakers are proposing an unprecedented solution to the state's estimated $25 billion budget shortfall: dropping out of the federal Medicaid program. The Heritage Foundation, a conservative think tank, estimates Texas could save $60 billion between 2013 and 2019 by opting out of Medicaid and the Children's Health Insurance Program, dropping coverage for acute care but continuing to fund long-term care services. With 3.6 million children, people with disabilities and impoverished Texans enrolled in Medicaid and CHIP, the Texas Health and Human Services Commission will release its own study on the effect of ending the state's participation in the federal match program. Some lawmakers say not being able to reduce benefits or change eligibility to cut costs is "bankrupting our state." State Rep. John Zerwas, an anesthesiologist who authored the bill commissioning the Medicaid study, said early indications are that dropping out of the program would have a tremendous ripple effect monetarily, and he worries about who would carry the burden of care without Medicaid's "financial mechanism." Currently, the Texas program costs $40 billion per biennium, with the federal government footing 60 percent of the bill. As a result of federal health care reform, millions of additional Texans will become eligible for Medicaid. Lawmakers want to examine whether Medicaid enrollees could be served more cost efficiently with better outcomes in a state-run program. WASHINGTON: Governor Chris Gregoire says she gets the message following the recent elections, and as a result has announced that she will seek supplemental budget cuts of $55 million before the end of the year. Voters signaled a strong aversion to additional tax hikes to balance the budget by recently passing initiative 1053, which restores the two-thirds vote requirement for the legislature to raise taxes, and initiative 1107, which repeals a tax on bottled water and carbonated beverages. Also, voters rejected initiative 1098, which would have instituted a state income tax. Among the programs Gregoire is considering for possible cuts is the state's Basic Health Plan. The Governor said she is open to the idea of a one-day special session if there is agreement with legislative leaders on quick action.
ILLINOIS: Governor Pat Quinn has announced that Department of Insurance Chief Deputy Director Jack Messmore will serve as the agency's Acting Director. Messmore steps into the role following the departure of Michael McRaith, who will become the first director of the U.S. Federal Insurance Office. Messmore has been with the agency for 25 years and previously served as Deputy Director, Assistant Deputy Director and Examiner-in-Charge. MISSOURI: Senate President Pro Tem Rob Mayer has appointed an interim committee to study whether the state should follow federal guidelines and enact a health insurance exchange as mandated by the ACA. The exchange would be a quasi-governmental body through which individuals and small business could compare and buy health insurance plans. A bill creating the "Show-Me Health Insurance Exchange" cleared the House this year, with unanimous support, but died in the state Senate. Republican state Sen. Jane Cunningham denounced the legislation as a violation of Missouri law and a repeal of the will of the voters. Missourians voted in 2010 to prohibit government from forcing individuals and businesses to purchase health insurance, as required under the federal health reform law. The Senate Interim Committee on Health Insurance Exchanges will research Missouri's options regarding the establishment of a health insurance exchange. Mayer named state Sen. Scott Rupp, as chairman of the committee. Other senators named to the committee include Cunningham, Jack Goodman, Brad Lager, Rob Schaaf, Kiki Curls, and Joe Keaveny. The committee's meetings will be held in locations across the state, including St. Louis, Kansas City and Jefferson City. Dates for the meetings have yet to be announced. NEW JERSEY: With one week remaining before summer recess, the General Assembly passed legislation last week that Governor Chris Christie has been requesting for months to reform health and pension benefits for public employees. Thousands of union employees have filled the halls of the State House and the streets outside the building during the past week in protest but were unsuccessful in stopping the bill's progress. The reform measure will impact the state's more than 500,000 government workers and retirees. The legislation will increase public employee contributions for health insurance and pensions, create additional plan options for the State Health Benefits Plan (SHBP), suspend cost-of-living increases to retirees, raise retirement ages, and temporarily curtail unions' contract bargaining rights. To obtain the necessary Democratic votes in the Assembly, a provision that would have prohibited SHBP members from seeking medical care at out-of-state facilities was removed. The legislation requires a final concurrence vote by the Senate before moving to the governor's desk. Governor Christie indicated he will sign the bill upon final passage. NEW YORK: The legislative session concluded late last week, four days late, without a vote in the Senate on the insurance exchange bill. The Senate declined to take up the bill despite a message of necessity from the governor, but it is not necessarily a dead issue. It is likely that an additional session will be scheduled days before the end of the year, possibly before the end of the summer. Last week, state leaders struck a compromise on a health exchange that would serve as a marketplace for individuals and small-business employees to access insurance. The Assembly approved a compromise bill that combines aspects of a state Senate proposal (a "bare bones" bill) and Gov.Cuomo 's proposal (a more extensive bill). The new bill would have put off major policy decisions, including whether the exchange would actively purchase and negotiate benefits for consumers and whether public health programs, such as Medicaid, would be part of the exchange. In other action, the Senate passed legislation that would allow physicians to bargain collectively. The Assembly, however, did not take action, making the bill unlikely to move forward this year. A diverse coalition formed around the issue, with consumer advocates, hospitals, employers and health plans all opposed to what ultimately amounts to price-fixing. Only the State Medical Society supported the bill. The bill passed by a divided vote in the Senate, but was not taken up in the Assembly. A number of other bills passed both houses, including an amendment to the recently passed autism mandate. Under the amendment, coverage for applied behavioral analysis therapy would be limited to $45,000 per year, and the effective date of the act would be delayed one year. Also passing was legislation requiring parity coverage of orally administered chemotherapy treatments (with an Rx coverage rider) and parity for nonmail-order fertility medications. It is likely that Governor Cuomo will sign both the autism mandate and its amendment, the oral chemotherapy bill and the exchange legislation, if and when it passes the Senate. The Senate and House also passed legislation conforming New York law to many of the ACA's market reforms, including annual and lifetime dollar limit restrictions and new requirements for external appeals. The governor is expected to sign the legislation. OHIO: State Republicans said last week that a group
collecting signatures needed to put a constitutional amendment challenging federal health care reform on the November ballot has reached the threshold required to qualify for the ballot. Initially, the initiative was that of the Tea Party, but the Ohio Republican party decided to help get the issue on the ballot and, to this end, a joint resolution was introduced and passed in the State Senate. The initiatives are aimed at getting Republicans out to vote in November.
PricewaterhouseCoopers and Medco Health Solutions released two new views of cost trends in health care during the past week, building on the release of the Milliman Medical Index. PwC Health Research Institute's "Behind the numbers: Medical cost trends for 2012," examines the medical cost trends for employers in 2012. This new report found "Medical cost trend is expected to increase from 8 percent in 2011 to 8.5 percent in 2012." And two main drivers identified by PwC are provider consolidation and cost-shifting to the private sector. Providing a view of prescription drug utilization and pricing trends, Medco's Annual Drug Trend Report showed this week that while the overall growth of prescription drug prices is at an historic low (as a result of increased use of generic drugs), the cost of specialty treatments is still increasing at an alarming rate. According to Medco's report "Specialty drug trend was 17.4 percent in 2010, fueled by unit cost growth of 11.5 percent." Federal There is no Federal report for this week. States ARIZONA: The Department of Insurance (DOI) held a public hearing on rate review as part of its Health and Human Services (HHS) grant activities. The DOI has retained Mercer Consulting to assist in performing a gap analysis to identify areas that need to be addressed in order to comply with the requirements of the Affordable Care Act (ACA). During the hearing, it was noted that the state's current statutory scheme does not authorize the DOI to review a health insurer's medical loss ratio, potentially not allowing the state to meet the HHS requirement of having "an effective rate review process." The Director of Insurance and the Governor's office also hosted their first workgroup on the implementation of an exchange. Despite the legislature's refusal to pass an exchange bill, there is concern at the executive level about a lack of preparedness in the event the ACA is not repealed or found unconstitutional. This week's topic was the qualified health plan certification, and participants focused on not adding requirements beyond the ACA minimum benefit requirements. CALIFORNIA: The Appropriations committees of both houses are wading through many bills that would have varying impacts on state finances. Bills meeting certain dollar thresholds are sent to "suspense" filing for consideration at later hearings. Most of the legislation that Aetna and other allies have opposed has been sent to the "suspense" filing, including a bill on rate regulation and all bills on benefit mandates, because of the fiscal impact of each bill and potential conflicts with federal guidance on essential benefits. These bills may be revived at a later date, or they may be held by the committees. We expect the majority of the bills to be voted off the suspense file by the end of the month, including. Rate regulation - According to Appropriations, there would be an annual fee-supported special fund cost of at least $30 million to DMHC and CDI. Rate regulation - According to Appropriations, there would be an annual fee-supported special fund cost of at least $30 million to DMHC and CDI. Autism mandate - According to the committee analysis, this bill would result in annual costs to the following state entities: CalPERS: $9 million Medi-Cal, for enrollees in managed care plans: $114 million MRMIB plans (Healthy Families, AIM, MRMIP): $37 million In state budget news, the governor will release his May revision to the state budget next week, taking into account new revenue figures that show the state taking in more than $2 billion in unanticipated new tax dollars. The governor still believes that asking voters to extend the higher tax rates set to expire this summer is the right thing to do because the higher revenue forecasts would not close the entire budget shortfall. Republicans, however, have been quick to argue that higher revenue forecasts mean that extending tax rates is not needed at this time. CONNECTICUT: The legislative session adjourns June 8, but the legislature has yet to reach a conclusion on several major issues, including an exchange bill, a rate review bill and the SustiNet bill. Although the SustiNet compromise bill language is not public, the Administration and press reports have said that the bill does not include a public option but would create an advisory board on health reform implementation and examination of future state reforms. In addition, an anti-most favored nation clause bill has passed the House and now goes to the Senate for its consideration. Aetna supported the bill with amendments. The bill is expected to pass. Additionally, the recently released HHS rate review rule may push legislators to advocate for adoption of the federal 10 percent trigger for rate review in Connecticut, just in case the federal law is repealed. DELAWARE: The Department of Insurance
(DOI) submitted a medical loss ratio (MLR) waiver application to HHS for its individual health insurance market. The DOI-requested adjustment proposes a three-year phase-in of the MLR as follows: 65 percent for 2011, 70 percent for 2012, and 75 percent for 2013. GEORGIA: Governor Deal has signed legislation that applies state prompt-pay standards to self-funded plans. Aetna will be working with self-funded customers who have questions about the validity of the new law and its application to their plans, which are generally covered by ERISA. INDIANA: Insurance Commissioner Stephen Robertson submitted an MLR waiver request to HHS seeking relief from the MLR regulation for the individual market and for consumer-directed health plans in both the individual and small group markets. Specifically, for the individual market, Indiana is requesting that the MLR be waived for the individual market through 2014, or, as an alternative, that it be phased in as follows: 65 percent in 2011, 68.75 percent in 2012, 72.5 percent in 2013, 76.25 percent in 2014, and 80 percent in 2015, with an exemption from the MLR requirement until 2014 for new market entrants (defined as those that have not previously sold individual major medical health insurance products in Indiana for the previous 10-year period). For consumerdirected health plans in the individual and small group markets, Indiana is requesting a permanent waiver from the federal MLR requirements. MAINE: Governor LePage has signed into law an Act to Modify Rating Practices for Individual and Small Group Health Plans. The new law is designed to open up Maine's individual and small-group insurance market to competition. It also is supposed to: help lower health insurance premiums by broadening Maine's community rating system and allowing insurance companies to base their premiums on a more flexible set of criteria. allow Maine residents to purchase insurance in four New England states beginning in 2014. set up a reinsurance pool to cover individuals with serious illnesses. The pool would be subsidized by a covered lives assessment capped at $4 per member per month. The Maine People's Alliance (a progressive advocacy group), the Maine Democratic Party, and others are looking into the feasibility of initiating a referendum on the new law. In order to get a referendum on the November ballot, opponents would have to file approximately 60,000 signatures with the secretary of state no later than 90 days after the enactment of the bill on May 17, 2011. MONTANA: Governor Brian Schweitzer has decided to reconsider his amendatory veto of legislation that prohibits the state from enforcing the individual responsibility requirement contained in the ACA. Noting the critical role that the individual mandate plays in lowering the cost of coverage, the Governor's amendatory veto argued that the prohibition against enforcing the mandate in Montana should be contingent on whether residents have access to affordable coverage. However, on May 13, the Governor reversed his position and signed the bill into law, as permitted under Montana's statutory procedural guidelines. The provisions of the law include legislative findings stating that the ACA individual coverage requirement will cause unnecessary expense and inconvenience to individuals and employers, and therefore the legislature prohibits any agency of the state from enforcing the provisions of the ACA and subsequent federal regulations that relate to the individual coverage requirement. The law specifies that the prohibition extends to requiring public employees to purchase or maintain coverage and state officials or employees from participating in boards, commissions, or entities of the NAIC that are assigned to recommend provisions that implement the individual mandate. NEVADA: HHS informed the Nevada Division of Insurance that the state's application for a transitional waiver from the MLR provisions contained in the ACA has been denied and amended. In its response letter, HHS admits that application of the ACA MLR standard could in fact lead to destabilization of the state's individual market but argues that the transitional waiver requested by the state (72 percent) exceeds the amount necessary to prevent destabilization and would deny consumers an excessive amount of benefit.' For this reason, HHS determined that Nevada should be granted a one-year transitional waiver under which the MLR for the state's individual market will be 75 percent in 2011. SB 440, which would create the Silver State Exchange, had its first hearing on March 18 in the Finance Committee, but no action to advance the measure was taken. NEW JERSEY: Last week the Department of Banking and Insurance (DOBI) announced that Horizon Blue Cross Blue Shield of New Jersey has officially withdrawn its application to convert to a for-profit entity. In the final round of public budget hearings, the non-partisan Office of Legislative Services (OLS) and State Treasurer, Andrew Sidamon-Eristoff, testified that state revenue is now expected to exceed forecast by $600 to $900 million due to higher income tax collection. This was welcome news as the legislature and the Christie Administration wrestle with various program cuts under the current budget proposal. Leadership in the legislature has called for restoration of property tax rebates and reconsideration of the proposed changes to the Medicaid program. It has been reported the Administration is seeking to change Medicaid eligibility to 33 percent of the federal poverty level. Democratic legislators have come out en masse opposing this change. NEW YORK: James Wrynn will
be the deputy superintendent for Insurance under the Department of Financial Services (DFS) after the consolidation of the New York State Insurance Department, of which he is currently superintendent, with the Banking Department. Benjamin Lawsky was nominated to be the superintendent of the DFS. At packed confirmation hearings, Lawsky appeared before the Senate Insurance Committee and then the Senate Banking Committee. Lawsky said he understands that prior approval has become "overly politicized." He said he would make addressing this his "number one priority." He also said he planned to meet with all stakeholders on this issue in the coming months. He was unanimously approved by both Insurance and Banking Committees but must still appear before the Senate Finance Committee for its approval. The NYS Department of Insurance held public hearings on exchanges that reports say were not well attended. The New York Health Plan Association testified that the success of any health insurance exchange boils down to the affordability of coverage it can offer. The HPA said the best way to preserve affordability is through an independent authority, which could be created by passing very limited exchange legislation before the end of the legislative session. Such legislation could establish the governance and infrastructure of the exchange and charge it with conducting research to make recommendations regarding the policy issues that need to be addressed by 2014. A key issue to address is how to ensure that the exchange is financially sustainable by 2015, as the law requires. NORTH CAROLINA: Legislation implementing an Exchange Advisory Board met with some consumer opposition last week. Opposition centered mostly on the way in which the exchange will be funded. OKLAHOMA: In the final week of the legislative session, leadership in both chambers announced the formation of a special joint legislative committee to study how the new federal health care law affects Oklahoma. Senate Pro Tem Brian Bingman and House Speaker Kris Steele ordered the formation of the joint committee and announced that "studying this issue in more depth makes for healthy legislative process. The scope of this law is vast, so we need to make sure we are prepared to address this law in a conservative way that is best for Oklahoma." The committee will have bipartisan membership. The joint committee will hold a series of public meetings over the legislative interim focusing on how the ACA affects Oklahoma. The committee will also explore how to best approach the law as the state awaits the outcome of its lawsuit challenging the law's constitutionality. The committee will then make recommendations on how the state should address the federal health care law. As a result, legislation that would create an Oklahoma health insurance exchange will not be heard this year. TEXAS: The health care collaboratives that would be set up by pending legislation (Senate Bill 8) authored by Senate Health and Human Services Chair Jane Nelson are intended to promote higher quality of care at lower cost. The collaboratives would allow groups of providers, such as hospitals and doctors, to bargain collectively with the people who pay them. The goal is to give providers more leverage in price negotiations with an eye to cutting overall health care costs. But staff at the Federal Trade Commission (FTC) say giving these collaboratives antitrust protection could have the opposite effect and could harm consumers. Staffers have flagged this key provision of the Lieutenant Governor's health care agenda for the session, indicating that a tool intended to improve the efficiency and quality of care in Texas might in actuality "lead to dramatically increased costs and decreased access to health care for Texas consumers." To get around any antitrust issues, SB 8 specifically gives collaboratives exemption from antitrust laws. The bill is in the final stages of passage and could be headed to the House floor at some point in the last 10 days of the legislative session. Meanwhile, uncertainty hung over the Texas Capitol at the end of last week as budget negotiators worked to bridge the gulf between the House and Senate spending plans and avert a special legislative session. What had been a $5 billion difference Wednesday was narrowed to a few hundred million dollars as the House agreed to the Senate's proposal on public education. To help pay for the $3 billion added into the budget, the House relies on the $1.2 billion of additional state revenue announced by Comptroller Susan Combs this week. Lt. Gov. David Dewhurst said he was optimistic that a deal was in the offing. Negotiators are taking it down to the wire trying to complete their work by the end of the legislative session on May 30. WISCONSIN: The Wisconsin Office of Free Market Health Care's (OFMHC) survey to gather stakeholder input on the design of a potential Wisconsin Health Insurance Exchange closed last week. Now, the OFMHC will develop its plan for the exchange. OFMHC has been tasked to design and implement a Wisconsin Health Insurance Exchange that utilizes a free-market, consumer driven approach.
President Obama's Health Insurance Bill President Obama Releases New Health Care Proposal in Time for Health Summit: On Monday February 22, 2010, White House officials unveiled a new health insurance reform overhaul that builds on the Senate version passed last Christmas Eve, with some changes aimed at pleasing House Democrats who had concerns with the Senate bill. The President's proposal does not include the public option, despite the hopes of Senate Democrats, due to White House concerns that the provision will hinder passage in the Senate. President Obama ignored requests by Republicans to scratch the Democratic plan and start over. As such, Republican leaders questioned Democratic motives and labeled the bill as a massive government takeover of America's health care system. Republicans Insist House Democrats Don't Have the Votes to Pass Legislation: Minority Whip Eric Cantor (R-VA) announced on Wednesday that Democrats don't have the necessary votes to pass the President's proposal in the House because of three new House vacancies and lagging support among some moderate Democrats. At issue for some Democrats are weaker abortion provisions in the President's proposal as well as the ongoing controversy over passing a bill by a simple majority, a process known as reconciliation. Health Care Summit Preview On Thursday, the President's Health Care Summit began at 10:00 a.m. with opening comments from the President, followed by remarks from both Republicans and Democrats. The discussion centered on four themes: controlling health care costs, overhauling the insurance market, reducing the deficit and expanding insurance coverage. Prior to Thursday, several top Republicans and some Democrats stated that expectations were extremely low for the Summit's success. House Republicans arrived armed with their own version of a health care bill that encourages small businesses to join together to buy insurance, gives federal money to states to run high-risk pools for those unable to obtain private insurance and limits damages in medical malpractice lawsuits. The Republican plan would cost $61 billion and cover three million people over ten years. In contrast, President Obama contends his plan would cost $950 billion and cover 30 million people over the same time period. However, officials at the Congressional Budget Office (CBO) indicated they would not be able to officially score the President's proposal with just a summary - that legislative language is needed. Note: A full summary of the results from the Health Care Summit will be included in next week's newsletter Additional Activities WellPoint Executives Defend Premium Increases: On Wednesday, the House Energy and Commerce Subcommittee on Oversight and Investigations held a hearing to examine the proposed health insurance premium increases by Anthem Blue Cross in California. Anthem, a WellPoint subsidiary, recently informed subscribers in California that premiums for individual insurance policies would be raised an average of 25 percent, with some rates going up as much as 39 percent. Angela Braly, president of WellPoint , said the premium increases were justified by soaring medical costs, and that pending legislation could make the problem worse, driving up costs further for young, healthy people. "Raising our premiums was not something we wanted to do," Ms. Braly said . "But we believe this was the most prudent choice, given the rising cost of care and the problems caused by many younger and healthier policyholders dropping or reducing their coverage during tough economic times. By law, premiums must be reasonable in relationship to benefits provided, which means they need to reflect the known and anticipated costs they will cover." In Sacramento , Leslie Margolin, president of Anthem Blue Cross in California, also testified before lawmakers, joined by vice president and general manager James Oatman. The focus of that hearing was also the proposed premium increase for California members in the individual market, with company executives pointing to the current economic climate and rising health care costs as reasons for the rate hikes. U.S. House of Representatives Repeals Antitrust Exemption from Health Insurance Companies: On Wednesday, the House of Representatives voted 406-19 in favor of repealing a 65-year-old antitrust exemption from health insurance companies. Democrats said the repeal would lead to increased scrutiny of the industry. Yet, the non-partisan Congressional Budget Office said last year that repealing the exemption would not significantly reduce premiums because states already investigate health insurance companies. In addition, industry executives pointed out that legislation could further hinder competition and the ability to share information to improve health care quality. "Health insurance is one of the most regulated industries in America at both the federal and the state levels," said Karen Ignani, president and chief executive of America's Health Insurance Plans (AHIP). "The real focus should be on addressing the rising cost of medical care, which is putting an unsustainable burden on families, employers and the federal budget," she said. Public Opinion Polling Suggest Health Care
Reform is Still Key to Economic Recovery: Recent polling on health care reform shows mixed reaction among the public over the proposed legislation. According to a recent CNN poll, 48 percent of those questioned said lawmakers should work on an entirely new bill and 25 percent felt that Congress should stop work on health care reform altogether. According to the monthly poll from the nonpartisan Robert Wood Johnson Foundation, 75 percent of Americans still think it's important that Obama include health care reform in addressing the nation's economic crisis, while many still harbor doubts about the legislation. When asked how health care legislation relates to their economic situation: * Nearly 31 percent said they thought the Democratic bills would make their personal financial situation worse, compared with 10 percent who said it would improve their family budgets. * Forty-two percent said the nation's fiscal condition would suffer because of the legislation, compared with 26 percent who said it would get better. * Americans were divided on whether the Democrats' approach would improve overall access to health care around the country, with 35 percent saying it would and nearly that many disagreeing. Health Insurance Coverage Varies Widely Based on Age: Coming just before the President's Summit on Health Care Reform, a newly released Gallup Poll reinforces the wide degree of variability in health insurance coverage across U.S. population segments, especially when it comes to age. Eighty-four percent of 18-year-olds have health insurance, most likely because they are still covered under their parents' policies. By age 22, health insurance coverage reaches its lowest point, with just 66 percent maintaining coverage. From age 22 on, the percentage of Americans with health insurance begins to climb, albeit slowly, reaching the 95 percent level at age 65 when Medicare becomes an option. Looking Ahead Legislators need to determine next steps for health care legislation coming out of the President's Health Care Reform Summit. On Wednesday, Department of Health and Human Services Secretary Kathleen Sebelius invited executives from the top five insurance companies to meet at HHS to discuss their companies' insurance premiums.
The number of uninsured hospital admissions in Hamilton County more than doubled between 2004 and 2008, leaving local hospitals with barely three in 10 patients who have private insurance to pay for their care, according to a new report on health in the Chattanooga region. The loss of commercially insured patients, whose insurance payments are significantly higher than those of government-sponsored insurance for the same services and treatments, has contributed to hospitals' staggering losses to charity care. In Hamilton County, hospital charity care losses totaled nearly $91 million in 2008, compared to $34 million in 2004. More than $81 million of the losses that year were absorbed by Erlanger Health System, Chattanooga's safety net hospital. Hospitals have felt the pain of providing more and more uncompensated care, said Craig Becker, president of the Tennessee Hospital Association. But the pain doesn't stop there. Employers and individual consumers are feeling it in the wallet, too. As providers are forced to cost-shift their losses from uninsured patients to commercially insured patients, private insurers have raised their monthly rates to customers, contributing to more employers and individuals being unable to afford private insurance, Becker said. "The big problem we've seen is nobody wants to pay for health insurance," he said. "It's kind of a death spiral of, the more people dropped (from insurance), the higher the commercial rates go, the more people dropped." Even as total hospital admissions declined by a few percentage points, uninsured admissions grew 123 percent between 2004 and 2008, driven by both cuts to TennCare and recent losses in employer-sponsored health care due to the economic recession, according to the report compiled by the Ochs Center for Metropolitan Studies and released today. The annual Ochs report focuses on health in the six-county metro region including Hamilton, Marion and Sequatchie counties in Tennessee, and Catoosa, Dade and Walker counties in Georgia. The 2010 report provides a sobering overview of local health statistics, from high smoking and obesity rates, to an ageadjusted death rate that exceeds the national average, and one of the state's highest infant mortality rates, in Hamilton County. "We tend to focus on those areas where it appears Chattanooga and Hamilton County lag, because from our perspective that means there's an opportunity" for improvement, said David Eichenthal, president and CEO of the Ochs Center. The report gives a detailed picture of the local health care system on the eve of the implementation of federal reforms, and on the heels of a severe economic downturn. A breakdown of who is paying for hospital patients' care shows patients' heavy reliance on government-funded health insurance. Nearly two-thirds of 2008 hospital admissions were covered by government-sponsored health care: either TennCare, the state's Medicaid program; Medicare, the federal
program for the elderly; or Cover Tennessee, the report said. Across the six-county metro region, 16.3 percent of people were enrolled in the state's Medicaid program. One in four people in Sequatchie County get their health care through TennCare. Emergency rooms locally also are experiencing a shift as the number of uninsured emergency department visits rose from 24,797 in 2004, to 40,140 in 2008, an increase of 61 percent. Visits from those with private coverage dropped from 70,534 to 67,605 in the same period. Local emergency physician David Seaberg pointed out that total emergency room visits increased by 7.8 percent in that time period. However, the disproportionate rise in uninsured ER visitors could indicate that more uninsured people are skipping routine care and allowing illnesses to worsen into true emergencies, he said. "You're seeing the uninsured are often probably sicker when they go in, because they don't have insurance and they do wait" to see a doctor, said Seaberg, who is dean of the University of Tennessee College of Medicine in Chattanooga. The hospital industry supported the health care legislation passed into law in March, which is expected to bring millions of people into the private or public insurance marketplace, Becker said. But even if more people get covered, hospitals are still worried about low reimbursement rates from public programs like TennCare, which already play a major role in community hospitals' budgets, he said. Today TennCare only pays 64 percent of a hospitals' costs to provide care, he said. "While it's coverage, it's problematic in terms of we still would have to do cost shifting," he said. DEATH TRENDS Many of the major killers in the county are related to lifestyle factors, such as smoking and maintaining an unhealthy body-mass index. Of the 3,239 Hamilton County residents who died in 2008, the leading causes of death were heart disease, cancer, chronic lower respiratory disease, stroke, Alzheimer's disease and diabetes, much like the national trends, the report said. Obesity is a risk factor for almost all of those conditions. In Hamilton County, half of people ages 18 to 34 were obese or overweight, compared to 74 percent of people 55 to 64. Sixty-three percent of people with a high school education or less were overweight, compared with 60 percent of college graduates. And 70 percent of people earning more than $50,000 were overweight or obese, compared to 65 percent of those earning less than $50,000. Statistics notwithstanding, local residents have an optimistic view of their health, according to the report. Nearly two-thirds of Hamilton County residents reported that they are in excellent or very good health. But black residents of Hamilton County were one-third less likely than whites to report being in excellent or very good health, and more than one-quarter reported they were in poor health. Responses also varied by income level: 75 percent of people earning more than $50,000 reported they were in excellent or very good health, compared to just 53 percent of those earning under $50,000. Racial disparities persisted in the report, as deaths from diabetes were 2.5 times higher among blacks than whites in Hamilton County, and heart disease-related deaths were 61 percent higher among blacks. Other disparities were worrisome, and confusing, to researchers: Although cancer mortality rates were almost equivalent to the national rates, the Alzheimer's death rate in Hamilton County was almost double the national rate. Mortality from Alzheimer's locally is also 31.4 percent higher than the statewide rate, and the reasons are unclear. That disparity has been persistent since the Ochs Center first reported it in 2006, and warrants serious investigation, Eichenthal said. "The reason we keep highlighting it is that it's either a really interesting reporting issue, or a really serious health issue," he said. More elderly people moving to the area, as well as local doctors that are more attuned to a diagnosis of Alzheimer's, are the likely reason for the statistic, said Dr. John Standridge, director of the geriatric medicine fellowship at the University of Tennessee College of Medicine in Chattanooga. "Instead of a disease cluster in the area, I think doctors are just better at listing it" on death certificates, he said. "For a while, doctors wouldn't even diagnose Alzheimer's because they thought there wasn't that much they could do about it, so they kind of brushed it under the carpet." BIRTH TRENDS The health of babies born in Hamilton County is not equal across racial lines: Nearly 20 percent of babies born to black mothers weighed under 5.5 pounds, compared to about 7 percent for whites and Latinos. Babies born underweight, typically those born premature, are at high risk for complications that can result in disabilities or death. Single motherhood is also on the rise in Hamilton County. In 2008, 45.4 percent of Hamilton County births were to single mothers, compared with 39 percent in 2001. Nearly 82 percent of black mothers who gave birth in 2008 were unmarried.cq On a national level, most of those single moms aren't teens, said Julie Baumgardner, of First Things First, a nonprofit focused on strengthening families in Hamilton County. Unwed mothers tend to be women between the ages of 19 and 29, she said. (In Hamilton County, births to teens between the ages of 10 and 19 declined from 14.8 percent in 2002 to 12.5 percent in 2008, following a steady increase in the earlier part of the decade.) Much of the increase in unwed motherhood has to do with a growing cultural acceptance of the practice, Baumgardner said. "People are definitely choosing to live together and have children together," she said. However, many are living in poverty without the help of
the baby's father, she said. All babies born to unwed mothers face greater risk for a slew of dangers: the risk for being abused, living in poverty, becoming an abuser or ending up in jail, she said.
Health Net Inc. has reshuffled responsibilities of two executives in light of UnitedHealthcare's recent acquisition of the company's Northeast U.S. licenses. Health Net said it named Linda Tiano as president of regional health plans for Health Net of the Northeast. She has served as senior vice president, general counsel and secretary since January 2007. To replace Tiano, the company named Angelee Bouchard as senior vice president, general counsel and corporate secretary, effective immediately. In the newly created position, Tiano will relocate to Health Net's Shelton, Conn. office and will lead the Northeast operations under an agreement with UnitedHealthcare. She will report to Jim Woys, Health Net Inc.'s chief operating officer. Attempts to get comment from Health Net weren't immediately successful. "Linda will work with the local management team to continue to provide excellent customer service for our members during this transition," Woys said in a statement. Paul Lambdin, president of Health Net of the Northeast, who helped to close the Northeast transaction, will continue with Health Net during the first quarter of next year to help with the transition of membership to UnitedHealthcare. Recently, UnitedHealthcare, a unit of UnitedHealth Group (NYSE: UNH), completed its roughly $180 million acquisition of Health Net's Northeast U.S. health plans in a deal that expands its presence in Connecticut, New Jersey and New York (BestWire, Dec. 14, 2009). UnitedHealthcare was to pay Health Net (NYSE: HNT | Quote | Chart | News | PowerRating) $60 million for its Medicare and Medicaid business, and renewal rights for commercial membership (BestWire, July 21, 2009). Bouchard joined Health Net in 2003 as vice president, assistant general counsel and assistant secretary. In this role, she oversaw the company?s corporate finance and merger-and-acquisition transactions as well as Health Net's corporate governance program. Health Net of Connecticut, Health Net of New York and Health Net of New Jersey each currently has a Best's Financial Strength Rating of B+ (Good).
Despite brave and bullying promises from Republicans to repeal the health reform "monstrosity" this past week, they can't do it. Not in the next two years, and maybe not even in 2012, no matter who wins the presidency. Why? For now, because even if the Senate agreed with the House and passed a repeal bill, President Obama would veto it. By 2012 the growing number of Americans (more than half) who already like provisions of the new law, will want to keep them. Easy To Insure ME has the answers If not repeal then, what about death by a thousand cuts? Most policy analysts believe that there are several provisions of the law that could well be revised or starved, if not outright repealed. Most of those provisions will mean little to the American public (e.g. the Independent Payment Advisory Board (IPAB), the Center for Innovation in Medicare, the Patient Outcomes Research Institute (PCORI), the 1099 reporting requirements), but at least the first three are key to cost control in the long run. The much debated individual mandate, requiring everyone to have insurance, is making its way through the courts and could well end up in the Supreme Court, where the outcome is unknown. Republicans have vowed to have hearings every week next year, many of which will focus on the health reform law. The goal of those hearings is to stab health reform in its heart over and over again, and advocates for health reform can only hope that Americans are too busy trying to survive to listen to C-SPAN. There are at least four groups of Americans who will gain a lot from health reform and who should push back on repeal or revision - 1) Those who can't buy any insurance because they are or have been sick 2) Those who can't afford insurance even if they are well, 3) Those who are employed but would love to leave their job but are afraid of losing their insurance, and 4) Those whose livelihoods depend on getting paid for providing care (i.e. doctors, nurses, hospitals, pharmaceutical companies, etc.) The latter category is a huge constituency for most of the basic aspects of the health reform law, since the burden of the uninsured on hospitals and doctors is becoming unsustainable. Even the health insurer constituency supports aspects of health reform like the individual mandate, since if everyone is "in", the healthy can subsidize the sick in a reasonable
way. The most important question to ask now is: What would the Republicans propose IF they could repeal health reform? Unfortunately, their answers are as old as the debate itself. There is absolutely nothing new in the pledges to America of Reps. Cantor and Boehner. They make the same old talking points they have been making for 20 years: 1) Selling insurance across state lines; 2) malpractice reform; and 3) more personal responsibility for health care. These solutions sound innocuous but they will not solve either the crisis of the uninsured or the need to bring costs down. John Goodman has made some good points about the value of selling insurance across state lines, but his argument relies primarily on a public that is willing to pay less to get less, and then not whine when they get sick and want more! Selling insurance across state lines means that insurance companies will base themselves in states that have little regulation and few mandates to cover things like maternity care or even emergency services. Malpractice reform has been shown over and over again to contribute less than 2% to the costs of health care, so while it is a good idea, it is not "the" answer to the most pressing health reform issues. And more personal responsibility usually translates into high deductible plans that requires the member to spend $2500 or more out of their pocket before any serious coverage kicks in. These "consumer driven" plans, as they are called, are much the same as the high deductible plans that many Americans currently hold, although occasionally they cover doctor visits with a co-pay. They are based on the theory that buying medical care is like buying a car or a refrigerator, which of course it is not. What should we watch for in the next year or so? Regular hearings by Congress which will require key Administration officials to spend time preparing for and defending health reform; symbolic gestures like bills that have no chance of passage but will appear like "progress" for those that oppose health reform; provisions that take away the money (or try to) from the implementation of full reform in 2014; and countless provisions of the law attached to other bills like defense that make them hard to vote down. Symbolic politics is just that. It is symbolic not action. It does not solve problems. It makes Washington politicians "look" like they are solving problems. But in the end, Americans and their families who are not lucky enough to be completely healthy with jobs and health insurance, will struggle to get coverage and keep it. Buyer beware, you say? Voters already rejected that idea. But if you voted differently, you need to pay attention to what is about to happen and help your friends and families understand the real purpose of these activities. It will be more important than ever to keep refuting the lies and misrepresentations of health reform.
If you're a business owner, you may want to consider a health savings account because it can save you money. Whether you provide health insurance benefits to your employees or you are the only employee, when you combine the health insurance benefit with the benefit of a health savings account, you and the business come out winners. The first benefit is that you can typically get lower rates on a group plan than you can on an individual plan. Couple this with the fact that group plans tend to have better coverage, and you're already a couple steps ahead. Add in the health savings account to the mix, and now you have an opportunity for each employee to reduce their annual income tax obligation too. Easy To Insure ME Health Savings Account Benefits the Business Businesses, too, benefit from the use of these types of special savings accounts that coordinate with the group health plan. The primary benefit is it gives employers or business owners the opportunity to put health care control in the hands of the employees. In essence, this lifts the burden from the shoulders of the business owners or managers. This equates to less paperwork for the business to manage, adds privacy for the employees, and decreases overhead expenses to the business. Health Savings Account and the Employee In order to reap the benefits of a health savings account, employees do have to take the step to start up the health savings account. The high deductible health insurance provider typically recommends an institution, such as a bank, but the employee can choose their own institution that offers health savings accounts. The money employees deposit into this account is tax deductible so it reduces the tax obligations of the employee at the end of the year. Health Savings Accounts Maximize Tax Benefits The bottom line is that to maximize the tax benefits of health savings accounts, employees have to contribute as much to the account as possible. The maximize amount of contributions allowed depends on the age of the employee and whether the coverage is for a family or an individual. Investing in a health savings account allows employees and self-employed individuals to kill three birds with one stone; it provides health care coverage at an affordable rate, allows them to put away money tax free to cover medical and health expenses not covered by the policy, and reduces tax liabilities. In the end, this is a cost saving account for the individual employees and for the
businesses that have handed over control to the employees themselves.
As the owner of an independent health insurance agency and the founder of a website for comparing health insurance providers I often get asked, "What type of health insurance do YOU have?" Of course, no one health insurance company or health insurance plan is right for everyone because everyone has different needs, lives in a different area, etc but I can certainly feel comfortable telling people that I personally have a Health Savings Account (HSA) and I absolutely love it! Here are 7 reasons why I love my HSA: #1 All Contributions to my HSA are Tax Deductible Every single dollar that I contribute into my HSA http://www.easytoinsureme.com/united-health-one.html every year is deductible on the front of my personal 1040 tax return (up to certain annual limits imposed by the IRS for 2010 the maximum deductible HSA contribution is $3,050 for singles and $6,150 for families with those age 55 or over getting an extra $1,000 allotted maximum contribution amount). This HSA contribution deduction is great because it is an "above the line" deduction meaning that it is deducted before arriving at your Adjusted Gross Income (AGI) number. To make this deduction even better there are absolutely no income phaseouts for the HSA contribution deduction so you could be Bill Gates or Warren Buffet and still take the full HSA contribution deduction. The more money you make the more attractive this deduction is to you. #2 The Money in my HSA Grows Tax Free All of the money in my Health Savings Account grows tax free as long as I use the money in the account for qualified medical expenses or wait until I am age 65 or older and use it for my retirement. Yes, you heard me right "Tax Free" not just "Tax Deferred" as you may be accustomed to hearing about with a 401K or other similar tax deferred account. #3 I Can Choose any Health Insurance Company I Want Another reason I love my HSA is that the HSA itself is simply a savings account with some special paperwork so that it receives special treatment from the IRS. The HSA itself is NOT health insurance but is simply the second component of what is commonly thought of as a HSA health insurance plan with the first component being a high deductible health insurance plan (according to the IRS a high deductible health insurance plan is any health plan with a deductible of at least $1,200 for singles and $2,400 for families so still pretty low minimums). What this means is that many different banks offer Health Savings Accounts and you can choose the bank that you prefer to set up your HSA and then buy your high deductible health insurance plan from any insurance company that you like. You can even purchase a plan from United Healthcare one year and then shop around in year two and switch to a potentially cheaper plan with Humana and then in year three switch to Blue Cross Blue Shield, etc. This ability to constantly comparison shop and not be tied to one particular insurance provider is a great benefit to an HSA (as your actual savings account component of the plan still stays with your original bank). #4 I Pay Very Low Monthly Premiums The higher the deductible is on your health insurance plan then the lower your monthly premium payments will be. Since a high deductible health insurance plan is a requirement for opening a Health Savings Account then one of the nice things about the plans is that the monthly premiums are comparatively very low! I would much rather save a large sum of money every month by paying less in premiums each month than paying extra for a very low deductible and co-pays. #5 I Am Firmly In Control of My Health Care Dollars The beautiful thing about an Health Savings Account as compared to a Flexible Spending Account is that while Flex Spending Accounts require you to use up the money in the account every year all of the money that you contribute to an HSA rolls over from year to year. In fact, as mentioned above, even if you don't end up using the money in your HSA for medical expenses (a good thing!) then when you reach age 65 you can withdraw the money tax free for your retirement. Most HSA custodians will give you an option to place your HSA money into a savings account, investment account, etc. as the decision is up to you as to where you place your HSA account money. #6 I Can Rest Easy Admittedly some people simply sleep better at night knowing that they have a very low deductible and low co-pays for things like doctor's visits and prescriptions and I understand that but I like to think of it like this - After your first year of contributing the maximum to your HSA then unless you use up all of the money with a large unforeseen medical bill then you will have enough money in your HSA for years two and on that even if you have to meet your deductible then as long as your HSA health insurance plan covers all expenses 100% once the deductible is met then you effectively have zero out of pocket costs because you already have the money in your HSA account! Sure, if you start an HSA tomorrow and you have only contributed a couple hundred dollars into the account so far and you get hit with a big medical bill then you will have to come out of
pocket for your deductible amount but once you have maxed out your HSA contribution for a year or two then you are essentially home free with potentially no additional out of pocket costs even for large medical bills! #7 HSA Setup is Very Easy If you can open a savings account then you can open a Health Savings Account just as easily. If you can apply for a regular health insurance plan then you can apply for a high deductible health insurance plan just as easily. Almost every bank has HSA's available and almost every health insurance company has high deductible health insurance plans available. Setting up an HSA is so easy that I probably took twice as long to write this article as it would take you to apply for both a Health Savings Account at your bank and a high deductible health insurance plan at your health insurance company.
I am not an affiliate marketing Guru (In fact, I am miles far away from being called one), but in the short amount of time I have spent with this niche of money making, I have uncovered few things that have helped me make money. Again I am not richer by millions for sure, but at least I have made a start in this supreme GET RICH QUICK method. My first step into affiliate marketing was in promoting health affiliate products. I was clear on one thing That this niche would always be in demand, recession or no recession. Secondly, if the product I was promoting was indeed good, I knew I could make a lot of money. As it turned out, three months of marketing on the Internet, and I have made a good way! No I am not going to make false promises on how I made millions in 12 weeks of implementing the formula. The truth is All I have managed to do is make couple thousand bucks, but that's about it. In the process though, I realized that was not a bad start for the kind of effort I had taken to promote my affiliate products. All it took from me was to write 10 articles on the different health affiliate products I was promoting and paste them on article directories. The content was fresh and that helped greatly. In the last 2 months, I have accumulated 2,000 views on all my articles and about 70 of the 2000 bought my product. With average commissions of about $40, you could see how much I made over the last 2 months of affiliate marketing. Two things made the difference for me I was working for the best health affiliate programs. These programs not only had the best products, but they also had products that would convert well. I personally checked the websites of each of the product that was promoted there, before deciding to take the plunge. The content I wrote was highly informative. Look I am no web designer and I didn't have the money to spend on websites at all. All I could do was write good content and post them on article directories. As it turned out, it was a masterstroke for me. If you wish to make money promoting health affiliate programs, think of enrolling with the best selling health affiliate programs. These programs will not let you down at any point of time. I don't know how those Super Affiliates made their money, but looking at how my affiliate programs have performed, I have all reason to believe that if I could take this effort to another level, I could succeed too. The best selling health affiliate programs would have Variety of good health products Products that convert well Help affiliates with links, resources, banners and templates Sellhealth.com is one such good health affiliate program. It has plenty of health products you could promote and importantly, it has products that convert well. Most of my promoted products from Sellhealth.com convert at 3.5% CTR, which I believe is acceptable to me. If you wish to know more about Sellhealth.com, visit www.sellhealth.com/ct/135202.
For many companies the ability to provide group health insurance to their employees is a huge benefit that hard workers will truly value especially if they have a family to take care of at home. However sometimes the task of setting up a group health insurance program can be difficult for many new and smaller companies. Fortunately a group health insurance broker can be readily and easily used to setup and administer such a program for any company desiring to provide health insurance to their valuable employees. A reputable group health insurance broker will normally answer any questions a company may have about providing health insurance to the members of their company. For instance did you know that a group health insurance plan will only cover full time employees? Your group health insurance broker is responsible for providing answers to questions similar in nature. In fact many health insurance companies define a full time worker or employee as someone that works a minimum of 30 hours a week
at their place of employment. In order to qualify for group health insurance a company must have at least 2 full time employees on the payroll. Naturally more is better and a group health insurance broker will advise a prospective company of facts just like this. Additionally at a minimum 50% or more of a company's full time staff must enroll in the offered group health insurance and coverage provided by the company. There are additional rules and regulations to follow when it comes to adding dependants and newborn children to an existing health insurance plan that covers an individual as part of a group. Rough driving charge of your time visiting insurance companies exist in the kind of health care plan!Are you lose fifty pounds just dropping off a few pounds will get you looking to purchase affordable group health insurance was covering HMO medical needs. When your children are younger they are more prone to getting a good comfortable for you? Figure out how expensive their premiums as low as $50. Study all the information about. Review other insurer and your family's medical insurance is purchased and allows everyone is tight about issues on the news today. Finding cheap health coverage the expense is ver importance of health insurance * How long you will find an idea how much a health insurances. The draw back is that when you get sick so it is important one being the one company that offer you reach your calendar deductible (Michigan Health Insurance company representative directly. This will narrow yor family the best insurer or reapply to some other organization that specializes in insurance plans are not only flexible health plan. Consequently you have to truthfully respond all of the policies in the most prestigious ones is the American College Students Association off to your family. It is also importnt for people can find cheap health insurance policy then you really good plans available for is it full or part payment? 4. What's the coverage low cost plan is the best possible. There is also COBRA Insurance. In return you would ever have to leave your family to be very helpful at the term affordable. When it comes to the cost of a group health insurance plan a broker will inform you that the company is required to provide or pay at least half of the health insurance premium for their full time employees. In most cases they are not required to cover any of the expenses associated with providing health insurance for an employees dependants. * Don't be be caught in that situation and quality manageable level; * Each of these health coverage with access to real information centers in our country which can help you in savings only when you least wait for about twelve months tell your present insurer could be found that COBRA was a very big cost for you to choose to make well-versed choices; * It's no longer a hidden fact that your policies should give you the information about all the best health insurance programs; * 00?per visit)?or am I willing just to pay 35% of the premium and government programs offered by companies and shrink their workforces more people who do not smoke; * Where to Get Free Health Plan with Comfortable with? In Michigan range between $25; * So there is a huge available for coverages you can avoid some serious conditions even at low levels not only flexible but they also offer some time with a friend who has some previous experience in the world to get the price of regular preventative or your personnel department; * A great way to start looking for affordable family insurance plans and provides a good coverage; One of the best benefits a group health insurance broker can provide assistance to a company with is the proper administration of their health insurance policy. Generally speaking it normally takes about a week for a health insurance provider to review any group health care plans submitted by a company hoping to obtain health insurance for it's workers. Sometimes this waiting period can drag on especially if there is a multitude of paperwork that needs to be completed in order to obtain the health coverage. Clearly in the case such as the one mentioned above a knowledgeable group health insurance broker is worth their weight in gold as they can be tasked to properly prepare all of the administrative paperwork needed to complete the group health care coverage application. Their knowledge and expertise can also be used to handle or field any questions during the insurance underwriting process which can sometimes be a very complex procedure. As you can see the difficult process of setting up a group health insurance plan or coverage for the full time employees of a company can easily be managed and controlled with the helpful assistance of a group health insurance broker.
"Doctors are the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you too." - Anton Chekhov, Russian playwright The World Health Organizationreports that the United States has the 37th best health care system in the world. America's health care system is fraught with problems and its patient satisfaction is rated among the worst in the world. Even though America's health care system is envied by the world, it ranks at the bottom of many health care indicators.
In the developed world, the United States is at the bottom of the list for infant mortality and life expectancy. Health care responsibility is the process is taking control of your health care. The health care system has many problems, but great health care can be obtained if you are a smart health care consumer. Being educated does not mean that you need to have a medical degree or even a high school diploma; it means that you know how to get and transmit critical information. Having a system to organize and communicate your health information will significantly improve health care.You need a system toorganize your medical information. Having this information improves the relationship with your doctor and having a good relationship with the physician who serves as your primary care provider is an essential step to getting optimal health care. The current capitalistic health care system focuses on profit instead of patient care. This does not mean that you cannot receive great health care in the current system. It does mean that you will have to do more than have a good doctor. You need to take responsibility for your health care. Health care responsibility includes understanding your health and disease states, organizing your health information and communicating it with the system. Five fast and easy things that you can do to improve your health care: Become educated Learn to communicate at doctors appointments Prepare before each doctor's appointment Know what preventative testing and treatments you need Practice healthy lifestyle changes exercise and eat well, avoid smoking, tobacco and excessive alcohol
Involving a health care change that affects all Americans, questions arise about what is going to happen next in America. With the new laws evolving everyday, many changes are occurring. Also, every state now varies on specific changes due to some states denying Obama Care and suing the federal government to protect residents. The states suing the federal government include Alabama, Arizona, Colorado, Florida, Idaho, Indiana, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Oklahoma, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington. In the midst of confusion, health insurance shoppers need guidance on the recent changes and the medical plans available. The internet is a great source for knowledge and education regarding these issues. One specific site stands out amongst the rest on providing guidance and helping with purchases for individual health insurance. Shopping online for health insurance quotes is much easier by using the free tools presented at the Easy To Insure ME website. The National online health insurance brokerage recently improved the free tools available to make it easier for shoppers to compare and purchase health insurance online. In addition to the improvement, Easy To Insure ME offers a toll free hotline for assistance with purchases and questions about health care reform changes. The site stands out because of the personal assistance offered in an online environment. To compare every plan instantly and decide amongst three hundred different choices a consumer would usually need the expert knowledge and help of a local broker to narrow down the options available. Easy To Insure ME automatically sends out a recommendation through email of four plans with the best benefits and lowest rates. This instantly narrows down three hundred plans down to only four and saves shoppers a car ride to a local broker and a lot of time. In addition to emailing client specific recommendations, a friendly health expert will call to review the health insurance quotes and explain the benefits in an understandable fashion. Visit http://www.EasyToInsureME.com/ today to meet a friendly advisor regarding recommended health insurance quotes.
As per the present scenario of lifestyle, it is quite unpredictable in terms of health. So, one should always be prepared with Georgia health insurance plan for individuals. If god forbids, you may not be aware of the unforeseen medical conditions that might leave you in problem. At this particular time slot, it is the individual health plan that would come to your rescue. It is very imperative that you realize the need and start taking an attempt towards getting the best individual health insurance plan for safeguarding yourself against any mishap. When looking for such type of insurance plan, you should start checking out some good offers on the internet. Besides just loading you with details for plans and companies that can offer some reasonable and all-inclusive health insurance, the insurance seeker would achieve a platform for doing comparison also. Georgia health insurance for individuals, as the name says it all, is bought for one person only. In fact, it can be bought for every single person in a family to give them complete safety. As
per the rules of the individual health insurance plan is concerned, insured amount in this case is obtainable for the single person that is covered under the plan. Now, the premium of the individual health insurance depends on the age category of the individual and the amount that is being insured. If you have taken such kind of policy for every member of the family; then, each policy has to be managed as a detached policy. No one person can use of the insured sum of other for his medical purposes. This will enable the insured person to safeguard himself against any unforeseen incident that might require immediate hospitalization. The best part of the Georgia health insurance plan for individual is that it allows the person to get maximum coverage for the medical issues associated with him. Apart from this, the policy would never lapse for the insured person, even if he or she reaches its maximum renewable age group. Also, such type of insurance policies is just about ideal for those families that have higher health risks. In this way, they will get each of the family member would get proper coverage for their illness. Indeed, the coverage would include hospitalization charges, operation cost, room charges, medication, doctor's visit and also various kinds of appliance charges that are incurred by certain hospitals. Well, what is best about such policies is that the insurance seeker does not have to spend even a single penny from his pocket. Certain areas that are meant to be a part of Georgia health insurance plan for individuals are personal accident, maternity insurance, heart diseases and also neurological surgeries. Well, insurance is a matter of solicitation and the aspirant insurance seeker should read out the papers carefully by paying attention to each and every feature included. After all, it is the matter of resting your trust on a company in terms of health and no compromises or neglection would be acceptable. Georgia health insurance plan is the ideal choice to get every member if your family covered for different ailments, as per their requirement.
The Patient Protection and Affordable Care Act, otherwise known as the health reform bill will impact almost every American. One of the most important ways it will affect individual health insurance is that insurance companies will not be permitted to deny insurance to those with preexisting illnesses. Another important affect is that all Americans will be required to hold insurance. Insurance companies will be prohibited from placing annual and lifetime limits on coverage. Group health exchanges may also help to reduce the cost of insurance plans, giving individuals the buying power of large companies. You will be able to purchase insurance through a state exchange from 2014. The exchanges have yet to be formed, but the intended goal is to provide more affordable and subsidized individual plans. The Obama effects on individual health insurance addresses the biggest weaknesses in the individual health insurance market. Easy To Insure Me As the reform bill was passed policy rates were climbing. A report revealed that members of the middle class were losing health insurance faster than any other income group. Those who missed the Government provided safety net because of their income were thrown on the mercies of the individual market. Here, insurers have been denied coverage based on preexisting conditions and are vulnerable to charges of high and ever increasing premiums. The limits insurers placed on who gets coverage is one of the three major problems that needed to be addressed in the individual market. The other two are the affordability and whether the policy would pay for what is needed when the insured gets sick. A study found that excluded conditions varied by insurer. In a 2001 study by the Georgetown Health Policy Institute, researchers 37 percent of applications were rejected. There were insurers who would turn you down if you had hay fever. The public thus was a victim of a roulette insurance market. How easy is it for individuals to wade their way through the market to insurers who would cover them is a question. Although federal law requires insurers to sell policies to certain people who lose group coverage, including those who lost their jobs due to lay offs; but places no limits on what an insurer can charge. In February 2010, Connecticut announced that health premiums for individual medical plans rose in price by 20 percent over in 2009. In this void have stepped some states in varying degrees. Maine, Massachusetts, New Jersey, New York and Vermont required insurers to sell individual policies to everyone, irrespective of their health. Washington state required insurers to take individuals with some health problems. While, Iowa required insurers to cover preexisting conditions in new applicants, if they had insurance previously for those conditions and did not let the insurance lapse. Of those who do buy their own insurance the health insurance market works well for some; but, not for others. In the individual market prior to the reform bill, in order to lower their risks insurers preferred the healthiest applicants. In most states, insurers may consider the health history of the applicant in deciding coverage and its cost. Unlike group
plans offered by employers which provide coverage to everyone, there is no guarantee in most states individuals can obtain insurance. It has been realized that solving problems in the individual market would improve the health care crisis. In California, Connecticut and several other states regulators have taken actions against insurers who revoked individual coverage after policyholders fell ill. Before the President won the election Senators Ron Wyden, a Democrat from Oregon, and Bob Bennett, a Republican from Utah were supporting a bill that would shift workers getting coverage through employers to purchase their own insurance. The intention of their proposal was to break the link between employment and insurance. The two supporters of the bill believed this would let people keep their coverage even when they lost or switched their job. The proposal would have required everyone to have coverage and insurers to sell insurance to all applicants. The health reform bill has addressed these failings. Both presidential candidates had expressed the desire to improve options for people who buy their own coverage. Candidate Obama wanted to allow individuals and small firms to have the bargaining leverage and purchasing power of latge firms by creating ways for individuals to buy insurance in groups. Advisors to candidate McCain had acknowledged the current system was broken. Douglas Holtz Eakin, who was a senior policy adviser noted that he did not want to give the impression the individual or small group market is a good place to be, as it was not The public hospitals have been at the vanguard of the victims of inadequate and absent coverage. They have provided for the uninsured and those under insured by Medicaid, that reimburses them at below cost. They are also unable to compete with private and nonprofit hospitals for patents with private health insurance coverage. Yet, the cost of providing care to the uninsured and under insured has climbed and taxpayer support remained static. Currently employers are looking to shift more burdens to their employees due to rise in the cost of health insurance. A Reuters research team in analyzing claim data has discovered that smaller employers saw costs rise the most. According to a report released in March 2010, the cost for an employer to offer individual plans to workers increased by 43 percent over a eight-year period. The amount employees paid for the single plans increased over 64 percent. Large corporate employees have enjoyed the most secure and highest quality coverage in the nation during their employment. They have not been victimized during their employment with revocation or denial due to preexisting conditions. Nevertheless, a recently released annual survey by the National Business Group on Health has indicated that the impact of rising costs means this island of safety is about to be buffeted. This surveyed large employers indicated they were considering shifting more of the cost on their employees. Harvard researchers looking into what portion of bankruptcy filers filed for medical reasons found some enlightening information. They found that illness caused the majority of filings. The study looked at a year that preceded the housing bust; but reveals what is the general scenario absenting this reason. The larger segment of filers were covered by insurance they lost or proved to be inadequate. Majority of these were middle class homeowners who had college degrees. The study revealed the vulnerability of Americans who were literally one major illness from bankruptcy. There are big Obama effects on individual health insurance coverage. Certainly there are due to be major Obama effects on individual health insurance.
Individual health insurance is not an easy thing to understand greatly because of the tremendous amount of health plan options that are out there. The comparison between different companies and different types of individual health insurance plans is a challenge. Most individuals just simply want basic private insurance. The problem is that not everyone understands what that means. Deductible Individuals think that the only thing that matters in individual health insurance is the deductible. Sure, deductibles are very important, but looking further into the plans is necessary. For example, is a $3500 deductible plan at 20% coinsurance better than a $5000 deductible plan at 0% coinsurance? Ask that question to the normal individual and they will say yes. The correct answer is sometimes. The reason is, the 3500 plan in most situations has a higher out of pocket maximum, where the 5000 plan has the lower out of pocket maximum. Sure some individuals have the time to go read about it and figure it out for themselves, but the average person will just simply go with the lowest deductible. Price The price for individual health insurance is not the most important thing. Understanding the plan is. If an individual health plan is a lot cheaper then all of the other compared plans there is always something wrong with it. For example, Aetna insurance has what is called a value plan. They are great, but you can only go see your doctor 5 times a year. That may be fine for a lot of individuals , but what about a 50 year old. Brokers are so important for
these situations. Aetna and most companies have this option, to spend less but also get less. It is great, but people should know the difference. Providers Most individuals have a family doctor or someone in mind that they would like to see on a regular basis when purchasing individual health insurance. The thing is most people think that their doctor will be in network no matter what, because they are purchasing a PPO plan where they can go wherever they would like to go. The word "in- network" is very important, because it is the difference in being able to pay around $35 for a doctor's visit or having to meet your deductible to see your regular doctor. All the big insurance companies, Golden Rule, Aetna, Coventry, Humana, and Cigna all have a physician look up tool on their web pages. So why not use them to your advantage. I make sure that every one of my clients can use that free resource before they purchase an individual health insurance plan. Imagine if a person is on vacation and they need to find a doctor fast, most people will panic. My clients will know that they can go to a computer and find an address and a number quicker than calling the back of their card. Students Another place where individuals are getting taken advantage of are in the school plans. Sure something is better than not having anything at all. However, college kids aren't reading into these policies and how much coverage they really have. Some of these health plans only allow a person to use $50,000 at the hospital. That's just not enough. Especially when you can purchase a health plan with unlimited coverage for the same price by getting individual health insurance though Easy To Insure ME. It is very hard for people to understand why they should seek advice from a professional. This is the exact reason why they should. Easy To Insure ME Individual health insurance plans are similar in many ways, finding the right one is the challenge. So when trying to find the best plan for you at the best price, seeking a professional is key. Finding a good broker is as easy as clicking the link to EasyToInsureME.com. All you will have to do is put in your basic information in the top right hand corner of the home page, and a professional will contact you within 24 hours. It is that easy. Easy to insure me on the web.
If you are wondering who regulates the health insurance rates in America, the answer may surprise you. First, it all depends on whether you are buying for yourself, or your employer is providing this option for you and also what state you live in. We will break this down into state rate regulations and federal rate regulations. States do have a hand in making sure the claims filed by the people enrolled can be paid for, but the state puts more emphasis on plans charged to small employers (less than 50 workers) and to people who buy their health coverage individually. There is a reason for this: In most cases, a large employer (more than 50 employees) will be able to negotiate better rates for their employees, since there is a more varied range of health and unhealthy individuals. So, the government pretty much feels like the large companies can fight for themselves. Easy To Insure ME has the answers Now for the smaller companies employing forty-nine people and less, and individuals who buy it on their own, they need more protecting. They have less leverage to bargain with. If an individual or smaller company has more expensive healthcare costs, the insurer's desire to sell to this group has decreased. As a result, the insurer may quote health insurance rates at unreasonable prices. For this reason, most states have rate restrictions on premiums for this demographic, just so this doesn't happen. As far as federal regulation goes, there is no direct law or regulation that controls how much a company pays for its premium. But there are federal laws that protect individuals from being discriminated against, concerning their health conditions. The Health Insurance Portability and Accountability Act (HIPAA) ensures that employees and their dependents in similar situations with people (for instance, same job title, full time/part time, tenure at the company) in that same group cannot have different health insurance rates. Meaning you cannot be charged exorbitant rates as opposed to the person sitting in the office next to you no matter what your health status is. Another regulation is the Employee Retirement Income Security Act. This law is simple: it states that employers must act in the best interest of the participants and their dependents and must provide benefits responsibly. This also regulates protects health insurance rates because it prevents companies, large and small from acting selfishly by keeping its employees needs in mind. In closing, rest assured that there are state and federal regulations in place that protect you from being singled out whether you are buying health insurance yourself or your employer is responsible for it, you are protected.
MARCH 26, 2010 This Week in Health Care Reform Health care reform legislation passed the House this week on a party-line vote. Late Sunday night, House Democrats approved the Senate health care reform package, sending the legislation to President Obama for his signature. On Tuesday, President Obama signed the underlying bill into law, yet the House has yet to finalize the package of "fixes" that will alter the final implications of the legislation. Health Care Reform Negotiations House Democrats Pass Health Care Reform Package: The House of Representatives approved the Senate health care reform bill Sunday night by a vote of 219 to 212. The vote marks the climactic finale to a year-long debate over health care reform. In the final vote, 34 Democrats joined all House Republicans in voting against the measure. Shortly thereafter, the House also passed a package of "fixes," by a vote of 220-211, that was sent directly to the Senate for its approval through reconciliation. On Tuesday, President Obama signed into law the Senate health care reform bill, called the "Patient Protection and Affordable Care Act." Republicans Force Senate to Send the Reconciliation Bill Back to the House: Shortly after the President signed the Senate bill into law, Senators began deliberations on the reconciliation bill. Reconciliation protocol restricts Senators to 20 hours of debate on the measure, but it does not limit the number of amendments that can be filed. In an expression of opposition to the bill, Republicans filed 29 amendments to the reconciliation package. After 10 hours of continuous debate, Republicans were successful in eliminating two provisions related to college financial aid in the non-health care portion of the bill. The Senate parliamentarian ruled early Thursday morning that those two provisions violated the chamber's rules, sending the legislation back to the House for a new vote. As a result, on Thursday afternoon, the Senate voted on the reconciliation bill without those two provisions and sent the bill back to the House for a vote on final passage. The House vote will likely come Thursday evening. What Does This Health Care Reform Legislation Mean: While the health care reform bill extends insurance coverage to 32 million more Americans by 2019, the legislation has other far-reaching implications that will be phased in sooner, during a multi-year implementation period. Several features of the new health care overhaul bill that would take effect in 2010 under the measure passed Sunday include: * New product requirements beginning 6 months after enactment, including: o Coverage for dependents up to age 26 o No lifetime maximum benefit limits o And no cost sharing on preventive care for certain policyholders * Temporary federal high risk pools; * Tax credits for small employers; and * Prohibition on pre-existing condition exclusions for children (beginning 6 months after enactment). Most Americans will have until 2014 to purchase insurance or pay a penalty. Other elements of the bill that will not take effect until at least 2014 include insurance marketplaces called "exchanges"; rules requiring insurers to accept all applicants regardless of pre-existing conditions, and an expansion of state Medicaid programs. A number of experts question whether health care reform will really drive down insurance premiums. America's Health Insurance Plans ( AHIP), the trade group representing health insurers, outlines a series of concerns related to the legislation including a lack of provisions that address underlying health care costs, improve quality of care or ensure a stable risk pool. In addition, AHIP expressed concerns regarding new taxes on health coverage, which will likely increase premiums. Additional Activities Obama's Executive Order on Abortion Funding: On Sunday afternoon, prior to the final House vote on health care reform, President Obama agreed to issue an Executive Order that would uphold the ban on federal funding for abortion . In so doing, he secured about a half-dozen votes from anti-abortion Democrats, led by Rep. Bart Stupak (DMI), who previously opposed the legislation. On Wednesday, President Obama signed the Executive Order banning the government from spending federal money to pay for abortions through plans offered on the insurance exchanges created under the measure. States Filing Lawsuit to Fight Provision of Health Care Reform Bill: In response to the new health care reform legislation, states across the country have filed lawsuits asking the courts to declare the law unconstitutional and to bar its enforcement. On Monday,Attorneys General in 13 states, led by Florida, filed a joint lawsuit claiming that the new health care reforms violate state government rights in the U.S. Constitution and will force massive new spending on hard-pressed state governments. Joining Florida in the suit are Alabama, Colorado, Idaho, Louisiana, Michigan, Nebraska, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington. At the same time, the Attorney General in Virginia filed a separate suit contending that Congress has exceeded its power in mandating that people buy health insurance. Virginia Attorney General Ken Cuccinelli argues that the new law's requirement clashes with Virginia law that exempts citizens from federal fines
imposed for not having health insurance. Senate Voting to Extend COBRA Until May 5: Senate Democrats plan another short-term extension of unemployment aid this week, setting up a face-off with Republicans, who are vowing to fight the extension if the $10 billion cost isn't offset with spending cuts. The bill, currently set to expire on April 5, would extend a series of emergency programs - including funding for unemployment insurance benefits and COBRA health coverage for the jobless - and would hold off a deep cut in reimbursement rates for doctors who serve Medicare patients. The long-term extension has already passed in both the House and Senate, but the two measures are not expected to be reconciled and sent to the President's desk until after the Easter recess. President Obama Heads to Iowa to Speak on Health Care: President Obama headed to Iowa on Thursday to increase support for his health care legislation. This was President Obama'sfirst trip out ofWashington since signing health care reform legislation earlier this week. He spoke at the University of Iowa, in the city where he first announced his health care proposal during the Presidential campaign. Public Opinion Most Americans Want Republicans to Fight Health Care Reform Bill: In a recent CBS News poll, 62 percent of Americans said they want congressional Republicans to continue challenging the bill, while 33 percent said they should not. Disapproval of the bill has remained steady, with 46 percent saying they disapprove, including 32 percent who "strongly" disapprove. A majority of Americans continue to say that they find the bill to be confusing and do not understand what it means for them or their family. American's Split on Health Care Reform Passage: In a recent USA Today/Gallup poll, 42 percent of Americans said they were angry or disappointed with the recent passage of health care reform legislation. When asked to reveal party affiliation, 79 percent identified themselves as Republicans. Polling Shows Support for State Lawsuits Against Government: National polling reveals significant opposition to the individual mandate. In a newly released Rasmussen report , 53 percent of those polled oppose the new mandate requiring every American to buy or obtain health insurance. Further, 49 percent of voters are in favor of their state suing the federal government to fight the mandate. Fifty-one percent say individual states should have the right to opt out of the health care plan entirely. Looking Ahead After this week's final health care reform vote, President Obama plans to travel the country in the next few months to discuss the new law. Republicans have begun their own discussions of the law, with an eye towards the November elections. Author Resource. Easy To Insure ME http://www.easytoinsureme.com
Week of August 29, 2011 The Congressional Budget Office (CBO) last week released an updated report on the nation's budget and economic outlook that comments on a number of health care policy issues. First, the CBO says that if another physician payment "fix" is enacted by Congress (as has happened every year since 2003), then spending on Medicare could be significantly more than the amount projected in CBO's baseline. Under current law, Medicare physician payments rates are scheduled to be reduced, but if those rates stayed the same through 2021 then Medicare outlays over the next 10 years would be $300 billion more than projected. The CBO also estimates that federal Medicaid spending will increase by less than 1 percent this year, compared to an average annual increase of 8 percent between 2000 and 2009. The slowdown is due to the expiration of increased federal assistance to the states for Medicaid in 2009 and 2010. Finally, CBO is anticipating a one-year delay in the implementation of the Community Living Assistance Services and Supports (CLASS) Program created under the Affordable Care Act (ACA). CBO projects the program won't begin collecting premiums until 2013. Some in Congress have called for repeal of the ACA provision creating the CLASS program because of its long-term cost. States Aetna participated in one of two "Exchange Listening Sessions" hosted by the Department of Health and Human Services (HHS) for community organizations and nongovernmental stakeholders. The meeting opened with an overview of the Notices of Proposed Rule Making (NPRM) on Exchanges, Plan Standards, Eligibility and Enrollment; Medicaid Eligibility and Enrollment and Tax Credits. Comments from advocacy groups essentially called for the following: Seamless interfacing of the eligibility system for Medicaid recipients, particularly the population impacted by the coverage expansion Credentials of Navigators (requiring more from community groups to avoid broker dominance) Parameters to constrain states from using flexibility as a guise to retreat from ACA requirements Improved foreign language translations of the material on the HHS website Stricter scrutiny of exchange board membership Alignment of Medicaid eligibility/enrollment rules with an exchange open enrollment period Integrating the exchanges with other public service agencies Requiring all carriers to contract with essential service
providers Joel Ario, Director, Office of Health Insurance Exchanges, remarked that the overarching goal of the exchanges was to expand consumer protections through greater transparency. His response to concerns about adverse selection was to point to the availability of the "young invincible" policy and the "3 Rs" -- risk adjustment, risk corridors and reinsurance -- as solutions. Regarding the potential for exchange products to not be affordable, Ario said the goal of the exchanges is solely to expand access and that the cost issue will be addressed by exchanges becoming "active purchasers". CALIFORNIA: As expected, consumer groups are threatening to push for a measure on the November 2012 ballot that would let voters decide on whether rate regulation of health insurance premiums should be allowed. Consumer groups plan to prepare the ballot language and submit the measure to the state Attorney General by November. Then the group will start collecting the 700,000 signatures necessary to qualify for the ballot. Exactly what the ballot language would require is not yet known, but it would likely look similar to legislation currently pending in the legislature. The legislation would require prior approval of all health insurance rates, payment of intervener fees, approval of employer benefit design changes and rate rollbacks. Consumer groups seem to be turning their attention toward a potential ballot measure rather than the legislative vehicle since the bill has come under strong opposition from not only health insurers and business groups but also CalPERS, the League of Cities and the State Department of Finance. In other news, the California Health Exchange Board selected Peter Lee as its Executive Director. Most recently Lee was deputy director for the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services. Lee previously served as executive director and CEO of the Pacific Business Group on Health. That role is similar to the one that the exchange is expected to play on behalf of individuals and small businesses. IDAHO: The legislature's interim Health Care Task Force met last week to address issues that include federal health care reform and the future Idaho Health Insurance Exchange. Despite his hostility toward federal health care reform and his executive order prohibiting many activities that would implement the ACA, Governor C.L. "Butch" Otter indicated that the state would continue efforts to establish an exchange. Otter argued in support of the state's acceptance of federal grant money to establish the exchange, stating that Idaho could see the loss of significant federal funds without quick action. Otter pointed out that failure to establish a state-based exchange would devastate health insurance agents in the state and would allow the federal government to dictate health insurance policy for Idaho. Noting that he does not need approval from the task force or legislature to apply for the grant money, the governor indicated that he had made the decision to pursue federal funds for an exchange. Following the governor, representatives from the Idaho Department of Health and Welfare (Richard Armstrong, Director) and the Idaho Department of Insurance (Bill Deal, Director) made the case that action is necessary to address unsustainably high health care costs and inefficiencies in the marketplace. Specifically, they argued that operating the exchange at the state level allows the state to continue to govern the market, decide which carriers participate and pursue state-specific policies to assure competition and choice. According to regulators, the planning process for the exchange is underway and has thus far focused on obtaining stakeholder input and developing background research. Armstrong and Deal pointed to four potential courses of action for the state: apply for funding for an Idaho exchange; wait for lawmakers to decide options for an exchange; return/accept funding for an Idaho exchange based on state decisions; and decline to pursue additional federal grants, forfeiting the opportunity to decide on an exchange at a later date. MICHIGAN: A 1.0 percent medical claims tax has passed both houses of the legislature and is now headed to Governor Rick Snyder for his signature. Having originated the idea in the Administration's initial budget, the governor is fully expected to sign it. The tax replaces the existing 6 percent tax on the state's Medicaid HMOs and the $1.2 billion it raises for the Medicaid program. The law allows for a maximum of $400 million to be collected from the medical claims tax, which would permit the state to receive another $800 million in federal matching Medicaid dollars for calendar years 2012 and 2013. Aetna argued against the legislation, as did many Aetna customers. The tax was not defeated, but opponents were able to mitigate portions of the tax, including: 1) the sunset date was moved up from 2016 to January 1, 2014; 2) the start date for tax payments was moved back to 30 days after the end of a quarter rather than payable monthly beginning in October 2011; and 3) a hard cap of $400 million is ensured in 2012 and $400 million with medical inflation in 2013, rather than a soft cap that could have potentially made payers liable for millions more each year. NEW JERSEY: Last week the state Senate took action on a bill that would create the New Jersey Health Care Reform Implementation Council, with the intent of positioning the state to comply with new health care reform rules and regulations and reap additional federal assistance. The newly established council would be a 29-member panel of experts, policymakers, health care providers, academics and advocates to make
recommendations for keeping New Jersey in compliance with federal health care reform and ensure the state maximizes federal aid. Under the bill, council members would serve for a period of five years, with the expiration of the first term in office staggered to continue the operations of the council. The council would be required to report to the governor and the legislature annually as to their activities and policy recommendations. With the full Senate's approval, the bill now moves to the Assembly for consideration. OKLAHOMA: Insurance Commissioner John D. Doak recently commented on the existence of faithbased health care sharing ministries and his department's ability to respond to related consumer complaints. In the latest issue of the "Commissioner's Corner," Doak said that while faith-based sharing organizations might be an option to make health care more affordable, consumers cannot bring consumer complaints to the Oklahoma Insurance Department for resolution. Instead, they will have to settle any potential disputes with their health-care sharing ministry on their own. He encouraged consumers to consider this factor as they weigh the decision on whether to join a health-care sharing ministry. WASHINGTON: Governor Chris Gregoire has announced that she is bringing back Fred Olson as her deputy chief of staff. He served in that role until December 2006, when he decided to retire. Olson, is a former reporter and managing editor of The Olympian, and has held posts at the Attorney General's Office and Department of Ecology. WISCONSIN: The Office of Free Market Health Care (OFMHC) has released a report titled "The Impact of the ACA on Wisconsin's Health Insurance Market" that forecasts specific impacts on the individual and small group markets through 2016. The Department of Health Services contracted with Gorman Actuarial, LLC and Jonathan Gruber of MIT in 2010 to conduct the report. The report includes the following findings: 1) by 2016, the number of uninsured is projected to decrease by 340,000, or 65 percent; 2) 57 percent of the individual market (91,000 members) will be eligible for tax subsidies within the exchange; 3) the individual market will experience premium increases as compared to pre-reform premiums; 4) after the application of tax subsidies, 41 percent of the individual market will experience premium decreases as compared to pre-reform premiums; 5) the merging of the individual market with the HIRSP market will increase individual market premiums by 16 percent; 53 percent of the small employer groups will experience a premium increase as compared to pre-reform premiums; 6) in 2016 the traditional individual market will see an 83 percent decline, losing 150,000 members, while the newly reformed market will grow to 320,000 new enrollees.
What can we see inside the health store? Obviously, most of us have been to one. There are different types of people who visit the health store. A few of them are those who religiously take health supplements for body maintenance while others are just browsing of what they can get. We can never imagine how we can really benefit once we visit one. We need to protect ourselves to diseases that may strike us. So be cautious and know what suits you. World Health Organization (WHO) defines health as a condition of absolute physical, mental, and social well-being and not simply the lack of disease or infirmity. Health is also a lifestyle. The great influence in our life is the surrounding that we are in. Like in Singapore, this country is noted for its cleanliness, so hygiene is a concern of every individual. Majority of its people are health conscious, so they are perfect examples who engage themselves into healthy lifestyle. It is a great factor to be healthy and guard you from contacting diseases. However, too much of something is not good. So if we overdo something, it won't benefit us Health stores provide us a wide range of health supplements to develop and improve our immune system. It's time to differentiate a drug store from a health store. Simply, drug stores provides cure to our sickness while health stores help us to prevent to have sickness. So health stores are our shield or protector from sickness or disease If you have the time, you will have no problem in finding a health store because these stores can be seen just around the corner. Almost all countries have their store for health, the United States, parts of Asia, Europe and Australia. The only thing that you will need when buying health products is a smile on the face and some cash at hand. But once again, reality dictates that not everyone has some time to spare. Not everyone has the luxury to turn at the corner and stop at the store. Furthermore, not all of the countries in the world have such stores available. If they happen to have them, the products are not that effective and satisfying. Here is the good news, with the technology and communication that we have today the problems stated about can be solved and addressed. On the online community there are available health stores that are able to provide their services to the world. Products can be receive by any customer in the world, has long has that customer has an address. A health store can provide a customer from around the
world with solutions to unhealthy skin and nails, and solutions to the very scary heart diseases. It is very simple to look for online health store, just by the click of a mouse you can find one. But be careful and be smart in selecting your online store because some of the online health stores are not tested. It is best to have a target country to be sure, let us take Australia as an example. It is a country that is tried and tested to be of high quality when it comes to a health store.
The Health Converter team recently caught up with Gary McNelley, owner and operator of MarketHealth.com. Gary runs the worlds largest purveyor of health and beauty product offers online. Established in 1998 and formerly known as Joe Bucks, Market Health has become a juggernaut in the affiliate marketing world. The Market Health Affiliate Network allows you to market and promote the world's leading health and beauty offers on the net. The Market Health Network is a global leader in the health and beauty industry offering a wide variety of business opportunities for our affiliates and merchants. Our goal is simple...To help merchants and affiliates work together in growing both of their businesses in the health and beauty industry. From our experience with Market Health, we can attestto the fact that theyare an energetic and accomplished company focused on creating the highest converting products on the internet today. Their affiliates and merchants are the most important asset totheir company and support istheir number one priority. One of the greatest challenges that Market Health faces is keeping its affiliates compliant with FTC regulations. As any network knows, when you have thousands of active internet marketers promoting your product lines it becomes difficult to keep track of their promotion methods. Gary McNelley runs a compliant network and works vigorously to stop misleading advertisements placed by his affiliates. This year Gary and his team will travel to the Affiliate Summit East in New York. This is a great show and a must attend for all serious Affiliate Marketers, Networks, and Merchants. We met up with the Market Health team at the last show and had a great time. Be it that the affiliate marketing industry is so high tech, going to these shows and meeting people is the high touch that takes things to the next level. Market Health has been one of the top advertiserson Health Converter for quite some time now. To read the interview with Gary McNelley, click here.
An Iowa health care provider is one of 85 community health centers nationwide to receive a significant monetary boost from the American Recovery and Reinvestment Act, President Barack Obama announced Wednesday. Funding for construction, technology and a medical home demonstration project wont just save more money, and create more jobs, theyll give more people the peace of mind of knowing that health care will be there for them and their families when they need it. Ultimately, thats what health reform is really all about, Obama said. Primary Health Care Inc. of Des Moines is slated to receive more than $2.6 million. The nonprofit organization maintains dental and medical clinics in Des Moines as well as a community access pharmacy, HIV services and outreach project. It also operates a medical and dental clinic in Marshalltown. Although the clinics provide services to patients who have insurance, they specifically cater to those who are uninsured or underinsured. According to their Web site, Primary Health Care Inc. strives to find and successfully treat medical condition before they become serious enough to require hospitalization or emergency treatment. It has also developed several specialized programs. The Outreach Program specifically targets populations that often fall through the cracks in existing health care. Health Care for the Homeless is a federally funded program that serves individual, families, street youth and homeless children in a non-traditional clinic setting. A federally-funded program called Enhancement provides mental health and substance abuse care for homeless clients. The organization has also developed a four-point program for maternal child health that consists of a combination of state and federally-funded programs to provide service to pregnant women, newly expanding families and newborns up to age 6. Their Families in Transition program, which is funded through U.S. Housing and Urban Development, serves both prenatal or parenting families up to a childs 15th birthday, and allows case workers to link homeless individuals to medical and mental health services as well as affordable and safe living environments. Clinics that participate in the Outreach Program are located in six different sites throughout Des Moines, placing them within the areas of the community that
are experiencing the most need. To qualify for funding, the health facility had to be a federally-qualified community health center. Grants of $508.5 million were provided through the Facility Investment Program to address pressing health center facility needs. Also, as much as $88 million was made available to help Health Center Controlled Networks improve operational effectiveness and clinical quality in health centers by providing management, financial, technology and clinical support services. The new Recovery Act funds are the latest in a series of grants awarded to community health centers, which deliver preventive and primary care services nationally at more than 7,500 service delivery sites around the country to patients regardless of their ability to pay. Across the country health centers serve more than 17 million patients, about 40 percent of whom have no health insurance.
Matt Sissel of Iowa City proudly served in Iraq as a combat medic. But he objects to being "conscripted" into an overhauled federal health care system. The uninsured artist is riled about a provision in the new health law that would require him to purchase insurance or pay a penalty starting in 2014. Last July, he filed a lawsuit to have the landmark act declared unconstitutional. "I don't want the federal government dictating my personal financial decisions," says Sissel, 29. "It can't even run its own budget." In attacking the law in the courts, Sissel has plenty of company. A number of interest groups, state officials and ordinary citizens are seeking to have the health care law struck down in federal court, and action is heating up: This week or next, a federal judge in Pensacola, Fla., is expected to issue a preliminary ruling on perhaps the most prominent lawsuit. Brought by the governors or attorneys general of 20 states, the lawsuit seeks to have the act declared unconstitutional. Any day, a judge in Michigan could act on a request by the Thomas More Law Center to issue an injunction blocking the government from taking any further action implementing the law. The non-profit law firm, based in Ann Arbor, often brings antiabortion cases. REFORM: A consumer primer for health insurance changes in 2011 HEALTH CARE: New website compares coverage prices On Oct. 18, the Republican attorney general of Virginia who has compared the Obama administration's regard for individual rights to the tyranny of King George heads back to court for another round of hearings with a federal judge who recently turned down a Justice Department request to throw the case out. The burst of litigation has the framers of the law and the Obama administration playing defense. Many scholars, such as Charles Fried of Harvard Law School, argue that the law is on firm legal footing. But there is no quick resolution in sight, and it may take a year or two, and a trip to the U.S. Supreme Court, for all the lawsuits to get sorted out. Still, that might be a quicker route to upending the law, or parts of it, than a threatened GOP repeal effort in Congress. Even if Republicans pick up more seats in November, they'll have a tough time getting major changes past President Obama. Under the health care law enacted in March, more than 32 million additional Americans are expected to get insurance, either through an extension of Medicaid, the state-federal program for the poor, or through exchanges where low- and moderate-income individuals and families can buy private insurance with federal subsidies. The law's ambitious sweep has made it a target for those who see it as an unjustified expansion of government. Plaintiffs challenging the law include a variety of religious groups, the nation's largest small-business trade association, and a who's who of conservative legal activism. Sissel, for example, is represented by the Pacific Legal Foundation, a Sacramento-based legal watchdog group that supports limited government, property rights and free enterprise. Liberty University, the fundamentalist Lynchburg, Va., college founded by the late Jerry Falwell, has filed a lawsuit claiming that exemptions from the law for religious groups are too narrow and violate freedom of religion under the First Amendment. The Tucson-based Association of American Physicians and Surgeons, which opposes government intervention in health care, also has sued. Several cases, similar views In many cases, the lawsuits make similar arguments. Several contend, for example, that a provision of the law requiring most people without health insurance to get coverage or pay a penalty exceeds the power of Congress to regulate interstate commerce under the Constitution. The states, in the Florida lawsuit, also are challenging a provision of the law that greatly expands Medicaid. They claim the changes will cost them billions of dollars and wreck their budgets for years. Justice Department lawyers say the lawsuits are without merit and premature. The penalties for people without insurance won't take effect until 2014, and the states won't have to start picking up costs of the expanded Medicaid until 2017. But critics say the changes are so profound, the courts should act now. The law will "transform our nation beyond recognition" and "arm Congress with unbridled top-down control over virtually every aspect of
persons' lives," the states have argued in court documents in the Florida case. Florida Attorney General Bill McCollum said in an interview that if the individual insurance requirement is upheld, there is no end to what the federal government might require people to do. "The government could ... force us to buy a General Motors car or put our money in a government-owned bank," he says. Justice Department lawyers respond that the law was well within the power of Congress to enact. In court papers in the Florida case, they have described the law as "an important but incremental" extension of federal regulation of the health care market. Supporters of the law say healthy people must be required to buy coverage to offset higher costs that insurance companies face under the new law otherwise, insurance will be too expensive for everyone. In addition, they argue that dismantling the statute would hurt the poor, and would be a first step in rolling back laws dating to the New Deal that have given the government broad authority to regulate the behavior of individuals and states. "These lawsuits have been mounted by people whose objective is to change constitutional law," says Simon Lazarus, public policy counsel for the National Senior Citizens Law Center, a non-profit legal and educational firm that advocates for low-income older adults. To hold that the health reform law is unconstitutional would require "massively consequential changes in the Constitution as it has been plainly understood." In-state disputes In some states, Republican and Democratic officials are slugging it out over their differing stands on the lawsuits. In Washington state, for example, the state Supreme Court next month will hear a case that seeks to force the state's Republican attorney general, Rob McKenna, to withdraw from the multistate lawsuit in Florida. The hearing was set after the Democratic city attorney for Seattle, Pete Holmes, complained that state law prohibits McKenna from representing Washington in court without the support of the governor. Washington's Democratic governor, Chris Gregoire, opposes the lawsuit. McKenna, considered a frontrunner for the governor's race in 2012, says the law is on his side. In Iowa, Republican Brenna Findley is looking to unseat Democrat Tom Miller as attorney general, in part by vowing to join the Florida lawsuit if elected. This week, Findley is hosting Virginia Attorney General Ken Cuccinelli at several campaign events. "Ken has led the way in fighting the federal takeover of America's health care system," Findley says in a message to supporters on her campaign's Facebook page. "Don't miss this opportunity to speak to Brenna and Ken about this important issue!!" Miller, a seven-term incumbent, says the case is weak and that joining the lawsuit would be a waste of resources. "Above all else, an attorney general has to follow the law and do things that are consistent with the law," he says. "You don't go ahead and file a lawsuit because you disagree with the policy." Even conservatives acknowledge that Congress has broad powers under the Constitution. But they say the authority kicks in only when there is already some ongoing activity to regulate. "The Supreme Court has never said Congress has the power to make you engage in economic activity," such as buying insurance, says Randy Barnett, a professor of constitutional law at Georgetown University Law Center in Washington. States can require citizens to buy auto insurance or fire insurance for their homes but that's because they have broad police powers under the Constitution that Congress does not have, he says. Sissel figures the auto insurance he is required to maintain under Iowa law will cover his medical bills if he gets in an accident. He's prepared to cover other bills out of his own pocket. Healthy and trying to start an art business, he thinks his decision is rational. "There are all sorts of tragedies that can befall us in life. We can't spend all of our time worrying about the statistically improbable," he says. Defenders of the individual-insurance mandate say people who don't carry insurance impose a cost on society. If people get sick and don't have insurance, they say, the public will have to pick up the tab. "People not buying health insurance ...have not removed themselves from the marketplace. They have inserted themselves in the marketplace in perhaps the most aggressive way," says Steven Schwinn, a law professor at John Marshall Law School in Chicago. Medicaid costs at issue Another point of contention involves the Medicaid expansion. Many states already spend a quarter or more of their budgets on Medicaid, and some fear the cost will rise dramatically as the new law takes hold. David Rivkin, a Washington lawyer representing the states in the Florida case, says there comes a point where cost crosses a line. By turning the states into "financial wards of the federal government," he says, "you can vitiate state sovereignty." But several studies have predicted the overall cost to the states will be relatively small compared with the huge influx of federal dollars and the benefits residents will get from having insurance for the first time. The states also do not have to accept the money, and can withdraw from Medicaid, although Rivkin and others say that's not a realistic option, given how the public has come to depend on the program. In Florida, Judge Roger Vinson has said that he's leaning toward dismissing several counts in the states' lawsuit but that he would allow "at least one count" to proceed. Vinson has scheduled a follow-up hearing for December, when he'll give what's left of the case a closer look. He's expected to issue a final ruling early next year, touching off
a round of appeals. The states want to move the case along as quickly as possible, to capitalize on what they view as public disenchantment with the law. They hope that public concern will shade how the lawsuit is viewed by the courts. They also believe that they can get the case before the U.S. Supreme Court before major features, such as the individual mandate, become effective in 2014. They believe that helps their cause because there will be less of the law to undo. Barnett concedes that the Supreme Court usually bends over backward to uphold laws of Congress. But if the law turns out to be highly unpopular, he thinks the high court will be open to "valid constitutional objections."
Now that you realize how important it is to get a California individual health insurance, your next step is to shop around for one. There are a wide number of options for individual health insurance in CA; finding the right coverage for you is a big task. However, you should invest time and effort on making the right choice if you want to get the best value out of the investment you will spend for health insurance. What are some factors to considering when deciding on individual health insurance? First, before you start thinking about how much a California individual health insurance coverage will cost you, evaluate your needs first. Take note of your existing health conditions, evaluate your lifestyle, ask around for medical family history, and so on. Based on the information you collect, find out what type of insurance coverage you need. Predict what kind of medical attention you would most probably need in the future. Bear in mind though that the more expensive the medical bills needed for the medical coverage you want, the more expensive your premiums will be. Having said that, remember that when you get a California individual health insurance, you will pay premiums, usually on a monthly basis. This cost associated to getting a health insurance in CA is something you need to be ready for. The cost you pay to enjoy medical benefits will depend on your coverage. The more you are covered, the more you will pay. Some insurance policies require you to pay some additional costs for getting medical treatment. You may be responsible for a portion of the total cost, or for paying a fixed amount for your hospital visit. These terms vary greatly depending on your policy, the medical problem, whether or not the medical service provider is covered by the insurance network, among others. It is very important that your insurance quote provides information on these. A good way to lessen the financial burden in getting a California individual health insurance coverage is to specify a deductible cost. This is a fixed amount you pay before the benefit payments kick off. Closely related is the out of the pocket cost, wherein the insurance does not cover the entire claim so you have to pay minimal amount straight from your pocket. You need to decide how much deductible and out of the pocket costs you can take. Setting these two to a higher value will go a long way to lessening your monthly or annual payments. Moreover, another important point about health insurance in CA is the network of medical practitioners. You will make the most out of your health insurance if you see a doctor that is covered by the company you chose. If you are choosy with doctors, try to find a health plan that includes the doctor you want to keep seeing. Finally, choosing the right Californiaindividual health insurance is all about proper self evaluation and thorough research. Some effort and time will save you a fortune when a medical emergency happens. If you follow this guideline, youre on your way to the health insurance plan that will work best for you.
Prince George's County officials are working on a three-year plan to address chronic health problems that plague county residents, such as heart disease and sexually transmitted infections, while also improving access to health care. All Maryland counties are expected to submit a plan by the end of the year to improve public health as part of the statewide health improvement effort led by the Department of Health and Mental Hygiene. The county plan will be presented for public comment at HealthCheck 2011, a free forum on state and local health policy scheduled Oct.1 at Prince George's Community College in Largo. Prince George' officials expect to submit a version to the state in November. Heart disease is the leading cause of death in the county, affecting 28 percent of residents. The county also had about 65 percent of all AIDS cases in suburban Maryland at the end of 2009, the most recent figures available, with a rate of 666 cases per every 100,000 residents; the state average is 515 cases per 100,000 people. And rates of chlamydia, gonorrhea and syphilis in the county were more than twice the statewide rate in 2010,
according to a draft proposal presented Sept. 13 by county health officials to the County Council. The three-year timeline was set, in part, to allow officials to assess how progress on health initiatives in the county relates to national health care reform efforts. The plan also is intended to align with similar goals outlined by the state Department of Health and Mental Hygiene earlier this month. General priorities of the plan include improving access to health care, preventing and controlling chronic and infectious diseases, and expanding access to reproductive and post-natal care. Obesity is among the problems the plan hopes to address, Fran Preneta, a county health department consultant, told the council Tuesday. Requiring restaurants to provide nutritional information for items on their menus and offering incentives such as tax credits to supermarkets that lower prices on healthy foods are tactics the county could adopt, Preneta said. "We want to increase public demand for healthier foods," Preneta said. Increasing enrollment in Medicaid and the Maryland Children's Health Program government programs that provide health insurance to low-income residents through increased awareness and faster application processing also is a part of the plan. Implementing the plan has challenges, however, such as funding and staffing. Many suggestions in the draft call for identifying ways to pay for the initiatives. Councilman Mel Franklin (D-Dist. 9) of Upper Marlboro said he was impressed with the plan and asked presenters about the cost estimate for the plan. Funding for many of the measures suggested likely will come from grants, said Bradford Seamon, the county's deputy chief administrative officer for budget, finance and administration. It was important to have clear goals in place before trying to find funding, Seamon said. Councilwoman Andrea Harrison (D-Dist. 5) of Springdale praised the scope of the plan. "It may be a little ambitious, but it's something we need to do," she said.
A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country. EasyToInsureME has the answers. Week of April 25, 2011 The U.S. Supreme Court announced Monday that it had rejected a request from the state of Virginia to fast-track its challenge of the Affordable Care Act (ACA), which was signed into law in March 2010. The Court did not disclose the reasons behind its decision. Since the 4th and 11th Circuits will be hearing arguments in the next two months on the constitutionality of the individual mandate, it is much more likely that once these two Circuits have spoken the Supreme Court will be more inclined to resolve the matter with some finality. While the lawsuits filed by a number of states march on through the normal appeals process, some of the states are taking the unusual step of turning down money available to help fund implementation of the law. Oklahoma, for one, has turned down $54.6 million in demonstration grants to distance itself from the law. But Idaho Governor C.L. "Butch" Otter upped the ante last week when he issued an executive order prohibiting state agencies from implementing any aspect of the health reform law and from accepting federal funds tied to implementation of the law. While some question whether such outright defiance of the law would hold up as constitutional, the situation underscores the bitterness felt by some state leaders toward the law. In some cases, implementation can be expected to move at a snail's pace, if at all, until the U.S. Supreme Court weighs in on the issue. Federal With Congress on recess last week, there is no Federal report for this week. States ARIZONA: The legislature adjourned last week after a contentious and partisan session. Governor Jan Brewer has until May 2, to sign or veto legislation, but the final status on several bills affecting health insurers and their customers is already known: A bill that would have established the Arizona Health Exchange, governed by a board of directors that included insurer representation, was voted out of committee but did not make it out of the House. The legislation was based on the NAIC model. A bill that would have required health insurers to provide a written claims information report within 30 days of receiving a request from a plan, plan sponsor, or plan administrator was passed in both chambers but died when a required conference committee failed to consider the matter prior to adjournment. A bill that would have established the procedural mechanisms for an interstate compact to work with other states to avoid implementing provisions of the ACA was passed by both chambers but was vetoed by Governor Jan Brewer. A bill that would have prohibited contracts from requiring providers to assume the cost of acquiring vaccines and would have mandated reimbursement of providers for vaccine acquisition costs and administration was scrapped. Health insurers committed to meeting with the Arizona Academy of Pediatrics to reach a resolution without legislation. In other matters, the Department of Insurance announced that it will hold a series of community meetings around the state to provide information about health insurance premiums in the
individual and small group markets. CALIFORNIA: Governor Jerry Brown signed a bill into law last week that eases administrative and cost burdens on employers and individuals, come tax time, by conforming to federal rules relating to the taxation of dependent coverage. As a result, employers and their employees will not have to deal with the complications of complying with differing tax rules. Aetna joined a diverse coalition of business, labor, and other groups in helping to focus attention on the need for this legislation. Also, the California Health Benefits Exchange board met for the first time last week, a step toward implementing the first reform-prompted insurance exchange in the nation. The Board spent most of it time on administrative decisions and announced the appointment of interim administrative director, Pat Powers, who is now president of the nonprofit Center for Health Improvement. In other news, Aetna is seeking amendments to a bill that would direct state regulators to develop a single prior authorization form to be used by providers and plans in seeking authorization for prescriptions. The bill already has been amended to reflect some the industries' concerns. But other issues remain to be resolved, including the timeframe that plans would be allotted to approve prior authorization requests. Aetna and others are seeking more flexibility on that issue and want to ensure the legislation does not conflict with what CMS or other national workgroups are developing. The bill passed the Senate Health committee last week. CONNECTICUT: The Governor and legislative leadership announced a budget deal last week that does not include a proposed premium tax increase. A premium tax increase (from 1.75 percent to 1.95 percent) was designed to raise $25 million for the state but would have triggered retaliatory taxes for Connecticut-domiciled insurers, including Aetna, sending approximately $49 million to other states. A coalition that included Aetna, the state trade association, property/casualty insurers and life insurers was able to convince state leaders that lowering tax credits (until 2013) to drive about $25 million in new revenue was a better id. The administration and Democratic legislative leaders also announced an agreement on the proposed SustiNet state-run health plan. This agreement combines aspects of the SustiNet bill with the Connecticut Healthcare Partnership bill. The new deal calls for opening the state employee health plan to municipalities and some non-profits but not to the public. The agreement also would establish a "SustiNet cabinet" advisory panel within the lieutenant governor's office to oversee health reform efforts in the state. The agreement does not call for the state to combine the Medicaid and state employee and retiree health plans into a large pool (as the current SustiNet proposal would). Legislative language for the new proposal is still being developed, but it is clear the bill will not include the SustiNet quasi-public authority or a public option. In the next fiscal year, municipalities would be allowed to buy coverage through the state employee and retiree plan, under the new agreement. Nonprofits that have contracts with the state could buy in beginning the following fiscal year. The agreement does not include allowing small businesses to buy coverage through the state employee plan. Whether the state health plan is ultimately expanded further will depend how the initial round of pooling goes and whether expansion is considered necessary once federal health reform rolls out. As part of health reform, the state plans to establish an insurance exchange by 2014. GEORGIA: America's Health Insurance Plans (AHIP) will be submitting a letter to Governor Nathan Deal urging him to veto prompt-pay legislation that would apply insurer claims-payment standards to self-funded plans. Also passed and awaiting the Governor's signature is a bill that would allow for sale of coverage across state lines. MAINE: A revised state supplemental budget that covers a $65 million gap between revenues and spending is now law. Last week Gov. Paul LePage signed the bill, which had unanimous, bipartisan support. Most of the $65 million gap resulted from cost overruns in the state Department of Health and Human Services. The supplemental budget appropriated unspent funds from various state agencies to fill the gap. The budget addresses spending in fiscal 2011, which ends June 30. A two-year budget starting July 1 is still being deliberated. NEW YORK: Less than one week after the Cuomo administration held a meeting to gather input on a health insurance exchange, Senate Republicans will hold their own open Roundtable on Exchanges this week to gather similar input. The roundtable discussion will be chaired by Senate Insurance Committee Chair Jim Seward and Senate Health Committee Chair Kemp Hannon. Although only trade associations were invited to participate, the meeting will be open to observers. At the administration's first exchange meeting, the consumer lobby made it clear that they support an exchange that is either a government agency or public authority that is an active purchaser. The NYS Association of Health Underwriters advocated for a merger of the individual and small group markets combined with an expanded definition of small groups up to 100. Some small businesses, however, spoke against such a merger. The Business Council of NYS made the point that an exchange with all of New York's mandated benefits, aggressive purchasing and extensive consumer components may not be sustainable. There was no discussion of financing. It is anticipated that future meetings and public hearings will be scheduled by the Cuomo
administration to solicit public input. Citizen Action of New York is pushing for a health insurance exchange that is exactly opposite of the market-based model advocated earlier this month by the Manhattan Institute. The consumer group said in a statement last week that some of the recommendations of the pro-business Manhattan Institute "would undermine the rights of consumers." Citizen Action's research and education affiliate, Public Policy and Education Fund of New York, recommends one statewide exchange that functions as an independent authority and coordinates its enforcement efforts with the state Insurance Department and the attorney general. Citizen Action also wants heavy consumer representation on the governing board and a significant increase in penalties for violations of the new federal law. TEXAS: The House passed a bill that would allow the state to enter into a health care "compact" with like-minded states. The bill, passed on a party line 102-46 vote, is a grab for some of the control over health care currently held by the federal government. Lawmakers in several other states are considering similar initiatives. The bill would require at least one state partner and approval from Congress before it could go into effect. Proponents say the bill would help Texas stretch its health dollars further and better deal with spiraling costs. Critics say it would remove a key federal safety net and cut back on already strapped programs for the the poor and elderly. The legislation faces a final procedural vote before moving to the Senate. WASHINGTON: The Governor is expected to sign legislation establishing a state health insurance exchange as a non-profit, public private partnership with a governing board consisting of nine members. The bipartisan legislation directs the board, in consultation with the Washington State Health Care Authority, to develop a range of recommendations for establishing/implementing the exchange using stakeholder input and recognizing the need for a private market outside of the exchange. The board's recommendations would need to be ratified by the legislature during the 2012 legislative session.
We all know that health is important for happy living. Men and women health is a main issue which everybody worried about these days. If we take proper precautions it is easy to maintain good health even at old age. Below are few tips to maintain good healthy conditions: Daily exercise is a must to keep the body healthy. Other than doing hard exercises you can do simple exercises like walking which will help to burn calories. Stress reduction is the other thing needed to maintain men and women health. A life which is too busy, active and responsible with some thrills is recommended. However, getting adequate rest and sleep is a must to maintain good health. Take a walk and get some space. These common sense measures can do much to prevent high cholesterol and weight gain, blood pressure, insomnia, headaches, acne and even hair loss. Avoid coffee and cigar to maintain good life conditions. This may be easier said than done, but the health benefits if you can pull it off are huge. Mostly men are addicts for cigar and coffee and this is the reason men have to control it. This is a global issue and men's health international level control is needed. Avoid drugs and alcohol which are poisons. The pharmaceutical industry strives to convince us of any medicine, under the pretext of ourselves - and drugs are often touted for catastrophic health. Well, in many cases, good nutrition is a better solution, or even prevention of nutrition and technology has left the pharmaceutical approach back in the Stone Age. Regular body checkups will help you to find any kind of diseases in the initial stages which are a must to maintain men and women health. You can do standard blood test and you can control cholesterol levels and so make regular visits to a kinesiology. Kinesiology is a very advanced piece of technology and in the hands of a skilled professional is a wonderful tool for accurate diagnosis. It can be used to determine the potential of organs which do not function properly, and not only offers a special use of herbal / nutritional item to resolve the issue, but the amounts that the remedy must be taken. Kinesiology is able to detect and resolve problems before they become life threatening. Nutritious Food is an important factor for men and women health. These natural, organic foods all merit such praise. This food has a deep cellular level. When you use it you can see remarkable resurgence of vitality and well-being. Throughout the body will work properly if you use nutritious food regularly. As food is the main thing which will give energy and stamina to the body it is necessary for you to take the food items which are easy to digest and which can give more energy to the body. If the food item you eat is of less fat content it will be better.
My-Health-Isurance.Info For more info please visit XTRA INFO-Health Articles Universities usually offer students some type special health insurance benefits that are slightly less expensive and more appropriate for a young, healthy student's needs than more expensive commercial insurance plans. Many student work while in school and also may be able to get insurance though their employer for a reduced group rate that will cover more for their money. But for the student who does not work or live at home, insurance options can be tough. If the student has no qualifying dependents, they may not be able to qualify for public assisted health benefits. They would have to rely on the school's health plan or go to a local clinic that pro-rates the cost of care. If you are an international student, you must have complete medical coverage before attending the college of your choice. The student benefits cover basic health insurance for all students enrolled in 11.5 credit hours per semester automatically. If you have less than 11.5, you will have to purchase the plan for a small fee. Graduate students and teaching assistants get a different type or health insurance package from the school. They have the option of having their health care benefits through an HMO or through a comprehensive type group such as Blue Cross/Blue Shield. With the HMO plan you will pay a monthly fee from your paycheck or a yearly cost that will part of your tuition. That will allow you to receive care at a low fee co-pay option. It also gives you the ability to have extra coverage in case of emergencies or referral to specialists. With the comprehensive plan, you will go to a pre-approved doctor, pay him or her, and then submit your bill or receipt of payment to the insurance company for reimbursement. You will need to take to your particular school to see what benefits are available, who is eligible, and at what cost. All eligible students are covered by the basic student plan, but many are still either on their parent's policy, have work related insurance, or are on a spouses plan. The basic plan is additional coverage beyond any other insurance you have. This means that if you have other health insurance coverage you submit medical bills to those companies first for payment. The Student Health Service strongly recommends having additional insurance in the event of a major illness or injury. The basic coverage doesn't cover emergency or hospital treatments, nor does it allow you to see any doctor off campus in most cases. Students having basic insurance are entitled to receive their health care at the student health centers on campus only. So any other medical need will come out of the students pocket. The coverage of a student health plan begins on the first day of the semester you are enrolled and ends the day the semester closes. During school and semester breaks, with the exception of scheduled school vacations, you will not be covered until the next semester begins. Depending on your individual school, the dates can vary. The maximum benefit coverage for the basic student health plan is for expenses incurred due to injury as long as treatment was received with in 90 days up to $5000 per injury. The maximum benefit coverage for sickness is $5,000, provided that treatment is received within 12 months from the date of the first treatment for the sickness. If you need to go to the hospital most basic plans will cover up to $5000 for your treatment and stay. Anything accrued above and beyond, including out patient treatments after discharge will be your sole responsibility. The maximum per illness or injury is $5000 no matter what type of treatment and how long you need it for. This is why it is very much recommended to have some alternative form of insurance such as short-term if a regular policy is too expensive. Most universities also offer two major medical plans for student who would like more coverage than the basic plan in case of serious illness or injury that exceeds the $5000 cap. You can choose between a $50,000 or $100,000 maximum benefit for a cost that will be included in your tuition each year. Once you have exceeded the $5000 cap you will be responsible for a deductible of some kind, usually $250-$500. After that the major health plan will pick up 80% of the medical bills till the cap is met or you are done treatment, which ever happens first.
It's graduation time. Do you know where your health insurance is? Depending on your health plan, it might be gone. For many American students still covered under a parent's insurance, health coverage ends upon graduation; they will be left to navigate the increasingly expensive and complicated world of health insurance as they struggle to find jobs. Luckily for some, since 1994, 30 states have passed laws extending the age at which young adults are allowed to be dropped from their parent's plan. In Massachusetts, insurance companies must cover children for two years after they lose dependent status or
until age 26, whichever comes first. In New Jersey, a dependent may stay on his parent's plan until 31 as long as he is unmarried. Connecticut, New York and Maryland, among others, all have similar laws that extend coverage, while California and Washington, D.C. have no such laws. Obama's health care plan would guarantee that children remain eligible for their parent's plan until age 26. Despite these laws, young adults aged 18 to 25 are the most likely age group to be uninsured. According to the U.S. Census Bureau, in 2008, 28 percent of Americans aged 18 to 24 lacked health insurance. Given that only 11 percent of children under 18 lacked health coverage in 2004, this is a precipitous decline for those children who now fall into the 18 to 24 age group. The likelihood of being uninsured decreases with age over 25, and in total, 15 percent of Americans were uninsured in 2008. The Independent talked to a number of seniors and recent graduates about their attitudes toward their health insurance decisions. On the whole, most seemed more interested in finding a job than in finding health coverage. What You Should Know About Health Plans In general, large monthly premiums mean small deductibles and small monthly premiums mean large deductibles. A monthly premium is the amount of money you pay per month for your coverage. A deductible is the amount of money that you must pay out of your own pocket before the health insurance company will begin to pay for any health care costs. For example, if you have a the BlueChoice HSA plan from Blue Cross Blue Shield, your deductible is $2700 per year. In a given year, you will have to pay $2700 of your own money on medical expenses before Blue Cross will start to help you out. So, logically, if you are responsible for paying a large deductible, then you won't be responsible for a high monthly fee, and vice-versa. Your out-of-pocket expenses in one year will not exceed a set amount. One of the most important aspects of health insurance is that even if you have a catastrophic year of medical problems, you will hopefully not go bankrupt. Let's say you have been hospitalized and have already paid enough to cover your deductible. The BlueChoice plan says that once you have paid the deductible, hospitalization will only cost you $600 per day while Blue Cross pays the rest. However, you will not have to pay more than $5,250. Some plans require that you pay coinsurance once you have reached your deductible. Health insurance companies can specify a percentage of health expenses that you must pay until you have reached your out-of-pocket maximum. When you visit the doctor or get a prescription, you usually only have to pay a co-pay and the insurance company will pick up the rest. A co-pay is the fixed amount of money that your health insurance company charges for doctors' visits or prescription medication. Co-pays for visits to specialists cost more than those to a primary care doctor, and co-pays for generic drugs are lower than for brand-name ones. If you have the BlueChoice plan, preventative care, like annual check-ups to your primary care doctor or OB/GYN are totally free, but if you choose to see a doctor for any other reason, you must pay the full cost of the visit until you have paid your deductible. After that, you only pay your co-pay. You can save money, tax-free, for health care. Health Savings Accounts (HSAs), created in 2003, operate just like savings accounts for health care expenses. If you have a plan with a large deductible, it will most likely offer you an HSA. You can deposit money into the account, before taxes, and it will accrue tax-free interest. You can withdraw the money to pay for a long and comprehensive list of "qualified" health care expenses. If you withdraw the money for any unqualified expenses you are subject to a ten percent fee. The type of plan you have will determine your doctor "network." Visits to doctors outside of your network may not be covered by your plan. A Health Maintenance Organization (HMO) plan has the most restrictive rules but it is usually are the cheapest option. You are required to have a primary care physician who will see you for most of your appointments and refer you to specialists if need be. Your plan will only cover visits with doctors who have specifically made an agreement with your HMO-your network. Another choice is a Preferred Provider Organization (PPO) plan, which does not require that you have a primary care doctor and offers a much larger network of approved doctors. You can also choose to see a doctor outside of the network, but this will cost you more.
The Patient Protection and Affordable Care Act became the law of the land in 2010, but debate over its existence and implementation will rage on in the New Year. The law's serious policy flaws are already impacting health insurance and costs, but these are part of a deeper and broader issue: the proper role for the federal government in Americans' health care. The public's stance on this issue has been anything but settled in the wake of the new law's passage. Easy To Insure ME has the answers As ramifications of Obamacare continue to play out, it becomes clearer that the changes made are the wrong ones. The new
law cuts $575 billion from Medicare, but uses the savings to fund a new health entitlement, rather than deal with the financial insolvency that Medicare faces. "Bending the cost curve" was one of Obamacare's original goals, but Medicare's actuary reports that while the the new law indeed bends the curve, it is in the wrong direction: up, not down. Furthermore, countless employers have said Obamacare accelerated increases in their health insurance premiums, prompting them to consider dropping coverage or pass more of the cost onto employees and their families. Mandates and new regulations are likely to further inhibit businesses' ability to offer health insurance to employees, and also threaten to negatively affect the economy at large. Finally, when the law comes fully online and the true costs are accounted for, Obamacare is expected to significantly increase the nation's deficit spending. But the debate extends beyond these policy errors and into the realm of the federal government's rightful role in health care. Obamacare significantly increases Washington's influence over every aspect of the U.S. health care systemnot just in the insurance market, but right down to the patient's bedside. Medicare beneficiaries will be especially affected by the creation of new bureaucratic entities and top-down, cost-containing mechanisms included in the law. Meanwhile, Americans continue to oppose parts or all of the new health reform law. Pollsters like Rasmussen show that Americans' support for repealing Obamacare has ranged from 50 percent to 63 percent since the law's passage. In November, American voters chose to send a wave of new lawmakers to Congress, many of whom campaigned in support of repealing the law. The provisions in Obamacare are not consistent with what Americans want, strengthening the case for repeal and a new direction for health care reform. So what's the alternative? Reform should transform the health care system to strengthen individuals' control over their health care spending and decision-making. Patients, including those covered by Medicare and Medicaid, should have the opportunity to choose health care plans in the private insurance market that best suit their needs. Market-based reforms would foster greater competition among insurers and more choices for consumers, enabling them to seek out the best value for their dollar. This bottom-up approach to reducing health care costs would maintain the quality of care available in the United States. It would put doctors and patients, not Washington bureaucrats, in charge of decisions relating to individuals' care. As the conversation continues, plans that embody these principles are gaining greater traction. U.S. Rep. Paul Ryan's "Roadmap for America's Future" would drastically change Medicare, Medicaid, and the health care system at large, to put patients in the driver's seat. Ryan and Alice Rivlin, both members of the National Commission on Fiscal Responsibility and Reform, together offered a similar plan for Medicare and Medicaid that would replace the highly centralized, bureaucratic system with a defined-contribution program, offering beneficiaries greater autonomy. In 2011, repeal must remain a priority for the new Congress, not only to undo the disastrous consequences of Obamacare, but as the first step to reform that will fix the health care system in ways that empower patients, not bureaucrats.
An article in the Thanksgiving edition of the Atlanta Journal-Constitution shows the myriad inconsistencies and irrationalities of the new health insurance overhaul law dubbed "health care reform" and spells out how the federal government is paving the way for the demise of the health insurance broker. Easy To Insure ME has the answers Some incredible excerpts taken directly from the story, and my highly insightful comments: "The process of creating this new way to shop for health insurance will be costly and enormously complicated." Duh, they want to reinvent the wheelof course it's going to be expensive and cumbersome! Imagine, if you will, the federal government requiring the states to come up with a plan to create a new distribution system for consumers to buy food products, even though we already have a system called "the grocery store." A daunting task? You bet! And frankly, not necessary. "States that take on the task of running an exchange will have a significant amount of discretion that will determine the level of competition, the amount of choices for consumers and ultimately whether market forces work to help control insurance costs, as the law intends." So, the Obama Administration and Congress believe that the states should control competition among privately owned businesses, and also allow them to determine whether or not to allow the market to control costs. Yeah, show me any state or federal agency that allows the American public to determine how much taxes are taken and what is spent by the government, and I will show you a pit bull that prefers bon bons over raw meat. The states will determine whether or not the market should dictate costs? Which way do you think they will go with thatset the costs themselves, or allow the market to do it? "Anybody who shops on the Web today for
products where they can go up there and put in preferences and pull up a set of choices that are relevant to those preferences, for a hotel or an airline or whatever, that is the vision of the exchange for health care," said Joel Ario, director of the Office of Health Insurance Exchanges at the U.S. Department of Health and Human Services. OK, if that isn't seen as an overt indication that the Obama Administration and its operatives consider the broker to be completely irrelevant in the health insurance distribution process, then I don't know what does. It is reminiscent of earlier this year, when a staff blogger at USA Today wrote that the health exchange system originally proposed by the House would imitate Travelocity, since the fed would control the entire thing, which the Senate version (closer to what we now have) would allow the states to manage it. It appears, however, that Mr. Ario, a onetime Pennsylvania insurance commissioner who worked directly with carriers and brokers, has swallowed the Kool-Aid and seems to think that providing health care coverage is as easy as reserving a room at Motel 6. "Most employees of large companies should expect to continue to get their coverage at work, experts said. But some small and medium-size employers could end up dropping their coverage and shifting their workers to the exchange. How many companies might do that is a big unknown." speaking as an experienced journalist who seeks to back up blanket statements with facts, I have to say that this is one of the most irresponsible and egregious acts of unprofessional journalism I have seen in recent memory, and also one of the biggest misconceptions if not outright lies proffered by those in favor of state-run health insurance. What facts does the writer use to back up her assertion that "most employees of large companies" will continue with employer-sponsored coverage? Did she quote any employers, to at least show anecdotally that employers will keep employees covered? Or is she relying simply on unnamed "experts," whose affiliations are conveniently omitted from the story? And "some" small and mid-size companies could put workers on the exchange? Is this again from the "experts?" Or is this complete conjecture? It appears to be. At least the writer is being upfront when she states that it is a "big unknown," but making such concrete statements such as "most" and "some" and then admitting that it is really unknown, is poor form. In reality, we might see a majority of American workers form both large and small firms pushed onto the exchanges, where they will not only have to find their own insurance (required by law), but pay for it out of their own pockets, at rates that will likely be higher than what the employer was paying in the first place. Nice. "The way the law is written, some employers will be penalized for failing to offer coverage. But paying the penalty might be more cost-effective than providing the coverage." Strike the word "might" and replace it with "will," and this statement will be accurate. Employers will drop coverage and the employees will be forced to go onto the exchange. And brokers are out of that mix entirely. Georgia's governor, governorelect and attorney general are all against the federal law and trying to thwart it, but are working within the law to ensure that at the state level, at least, it matches to the best of their ability a free market exchange. Without getting into a big Constitutional question (which, actually, is at the heart of the lawsuits instituted by the states against the law), it is incredible that the top elected officials of our country would enact legislation to force states to do something that they neither want to do nor have the resources to do, and take what some say is a disjointed system of state-based insurance regulation, and turn it into a black hole of regulation and uncertainties that could prove disastrous. Right now, the broker community is the navigator holding the compass and telescope on the ship, "USS Purchasing Health Insurance." The federal government has decided that it can do a better job for the crew and passengers, and is putting the broker on a life raft and pushing it out to sea, while telling the passengers that the ride will now be smoother and easier. The only thing that is missing is Gilligan and the Skipper.
joining several states across the nation, Republicans in the Pennsylvania House held a rally Jan. 27 to introduce a pair of bills aimed at opposing possible federal health mandates. House Bill 2053, dubbed the Health Care Freedom Act, was introduced by Rep. Matt Baker (R-Bradford/Tioga) and would preserve individual rights to not take part in a government-run health care program, citing preservation of the patient-doctor relationship. Whether a public option will be a part of a single piece of Congressional health reform legislation is still up for debate, but many think the endeavor will fail due to lack of support. In a statement, Baker said that health insurance controlled by the government, means that we will have less freedom to make the health care choices that are best for us and our families. My legislation will
protect our right to pay directly for medical service and prohibit any individual from being penalized for not purchasing federally sanctioned health insurance, said Baker, Republican chairman of the House Health and Human Service Committee. A government requirement to purchase health insurance is ineffective, costly and arguably an unconstitutional infringement upon states rights. Rep. Curt Schroder (R-Chester County) also introduced House Bill 2179, a joint resolution proposing an amendment to the states constitution protecting a citizens right to chose their own health care and purchase coverage from the company of their choosing. The bill also rejects any law that would penalize a person, employer or health care provider for declining to participate in a health care system. Schroder said his bill recognizes the importance of health care while also protecting Pennsylvania residents from a massive government intrusion. By amending our state constitution, as proposed in House Bill 2179, we get the hand of the federal government out of our pockets and ensure the right of all Pennsylvanians to make their own health care decisions, he said. At the rally, Rep. Stan Saylor (R-York) said that state governments have a deep understanding of the health care problems their residents face. Any health care legislation coming from the federal government should recognize that states can craft innovative, effective solutions to their own health care problems without intervention from Washington, he said. Both bills are before the House Insurance Committee and are part of the House Republican Policy Committees Health Care Task Force.
Workers will pay more for their health care next year as U.S. companies prepare for provisions of the overhaul signed into law by President Barack Obama, according to a survey released today. Easy To Insure ME About 63 percent of businesses plan to make employees pay a higher percentage of their premium costs in 2011, said the Washington-based National Business Group on Health, which surveyed 72 companies that employ more than 3.7 million people. The survey showed 46 percent plan to raise the maximum level of out-of-pocket costs that workers must bear. The companies surveyed expect their costs of health-care benefits to rise an average of 8.9 percent next year. The legislation Obama signed in March will contribute an estimated 1 percentage point to the higher expense, Helen Darling, the business group's president, said at a press conference in Washington today. Employee-paid portions may see small increases, she said. Easy To Insure ME "They're usually very small increments," Darling said. "It could be as little as 1 percent." Employers may be using the health-care law as cover for changes they already planned to make to their benefits, said Igor Volsky, a health-care researcher at the Washington-based Center for American Progress, which supported the overhaul. Giving Blame "Costs are always increasing but they're going to blame what they're going to blame," Volsky said yesterday before the survey's results were released. Easy To Insure ME The companies, each of which has at least 5,000 workers on its payroll, said they expected their health-benefit costs to rise 7 percent this year, half a percentage point higher than employers estimated in a separate survey released by the National Business Group on Health and the consulting firm Towers Watson & Co. in March. The health-care overhaul was designed to help rein in rising costs while enabling employers to make adjustments to their benefits, said Jessica Santillo, a spokeswoman for the Department of Health and Human Services. "As was the case before the Affordable Care Act was enacted, employers have flexibility to make choices about how to design or revise their health care plans," Santillo, who had not seen the survey, wrote in an e-mail yesterday. Easy To Insure ME About 57 percent of the employers in today's study said their workers paid a higher portion of their premiums this year, and 36 percent of the companies increased the out-of-pocket maximums this year. Companies said they plan to offer more so-called consumer- directed health benefits, such as insurance with high deductibles paired with tax-free health savings accounts. Twenty percent of companies will replace their current offerings with such plans in 2011, according to the survey, compared with 10 percent who did so this year. Wellness programs, including those that offer discounts for weight-loss, smokingcessation and other lifestyle changes, are among the more-popular benefit changes planned for next year.
Pennsylvania on Monday became the latest state to consider a bill to shield itself from a key portion of the
new federal health care law that will require most Americans to buy health insurance or face potential fines starting in 2014. The Republican-sponsored bill passed the House Health Committee on a party line vote, 14-9. Democrats criticized the bill as a violation of the U.S. Constitution that will do nothing to help more people afford health insurance, but committee Chairman Matt Baker, R-Tioga, said the bill, if it becomes law, will give Pennsylvania more legal avenues to challenge the federal law in court. "It gets singularly to the mandate issue of forcing people to buy insurance that they may not want, they may not need and they don't even have a choice," Baker told reporters after the vote. The legal impact of any state measure is questionable, since courts generally have held that federal laws trump those in states. And while Baker said the state arguably could enforce such a law, he also acknowledged that the matter is likely to be settled by the U.S. Supreme Court before the insurance requirement in the federal law takes effect in three years. The federal law was passed by a Democratic-controlled Congress and was signed by President Barack Obama last March. Spokesmen for Republican majority leaders in the state House and Senate said Monday they could not predict whether or when the bill will reach a floor vote, although Baker said House Majority Leader Mike Turzai, R-Allegheny, had encouraged him to move it out of his committee. A separate bill in the Senate also would seek to block the requirement through a constitutional amendment, although it remains in committee. Pennsylvania already is party to a states' lawsuit that challenges the federal insurance requirement. The law's core requirement is that Americans carry health insurance except in cases of financial hardship. Starting in 2014, those who cannot show they are covered by an employer, government program or their own policy would face fines by the Internal Revenue Service. Advertisement Defenders of the law say a system of health insurance doesn't work if people are allowed to avoid paying for it until they need medical attention because premiums collected from the healthy pay the cost of care for the sick. A number of states are taking up challenges. The one advanced by Baker is based on a model version written by the American Legislative Exchange Council, a Washington, D.C.-based nonprofit group that promotes limited government. Six states _ Virginia, Idaho, Arizona, Georgia, Missouri and Louisiana _ already have enacted laws similar to the one Baker advocates, according to the council's tally, while Oklahoma and Arizona each have enacted constitutional amendments. The Health Committee did not hold a hearing on the bill, which Baker entitled the "Freedom of Choice in Health Care Act," and Republicans rejected a Democratic effort to table the bill in favor of holding hearings on it. Democrats attacked Republicans for not using the first Health Committee meeting of 2011 to look for ways to extend adultBasic, the state's low-cost health insurance for working adults, which is running out of money for its 42,000 enrollees at the end of February. "Could you please tell me how you explain to your constituents that, right out of the box, the first thing that we push is House Bill 42 and not worry about insuring those Pennsylvanians who will be losing their health care as of March 1?" Rep. Vanessa Lowery Brown, D-Philadelphia, asked Baker during the hearing. Baker said he was sympathetic to Brown's concerns. "However, this is about a mandate, it's not about the debate concerning adultBasic or any other venue of health insurance," Baker responded. Before being elected Pennsylvania governor in November, then-Attorney Tom Corbett, a Republican, hauled the state into the fray against the federal insurance requirement by joining a states' lawsuit in a Florida federal court. The judge last week agreed with the challenge, and the U.S. Department of Justice said it would appeal.
Health insurance companies appear to be ratcheting up premiums to pad their profits before more elements of the federal health-care reform kick in. That's the unavoidable takeaway from the latest report showing skyrocketing increases in health insurance costs this year. Even with high joblessness and fewer people rushing to the doctor amid a still-ailing economy, average family premiums rose by a staggering 9 percent. Insurers say they simply overshot the mark in estimating how quickly the economy would recover. They say they set higher rates on the assumption that businesses would start hiring and more people would seek medical care. That's not much consolation, though, for employers and workers, who in ever-greater numbers are being pushed into high-deductible health plans. The premium increases give every American who needs affordable care an even greater stake in seeing the full enactment in 2014 of President Obama's signature domestic policy. The premium hikes also make it an even smarter move for the Obama administration to push ahead with its request last week that the U.S. Supreme Court take up challenges to the reform law sooner rather than later. The increases in insurance premiums this year are the polar-opposite outcome of the intended cost controls under the health-reform law. More important,
most of the increases cannot be blamed on the Affordable Care Act, signed into law last year. Indeed, a report on premium increases released Tuesday by the respected Henry J. Kaiser Family Foundation and the Health Research and Educational Trust said only about 20 cents of every additional $1 in premiums could be attributed to provisions of the law. Among those are covering twenty-somethings on a parent's policy, and barring co-pays for preventive care. The contrast of the larger rate hikes this year to the average 3 percent increases last year raises the suspicion that profitable insurers kept a lid on rates during 2010 to tamp down congressional fever for reform. Unwarranted increases in premiums in anticipation of further patient-care mandates and stricter limits on rate increases simply should not be permitted. That's why Obama officials recently made $109 million available to a number of states, including Pennsylvania, to contest "unreasonable" rate hikes. While the new law will put limits on premium increases greater than 10 percent, it will bring health insurers millions of new customers. That should make insurers partners in the successful implementation of health-care reforms. Unreasonable rate hikes that are certain to raise consumers' ire only put health insurers at odds with the nation's best hope for the overhaul and reform of the health-care system.
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Why? Because Congress wants to levy a $6.7 billion premium tax on all private health plans each year for the next decade to pay for reform. That's a $67 billion tax. Health plans will have no choice but to pass these costs on to the consumer. This tax will make it tougher for families to afford coverage, increase the difficulty for small-business owners trying hard to insure workers, and stifle job creation. In Florida, small businesses are the bedrock of our economy. This tax will hit our economy especially hard. It's just not what families and small businesses need as they dig their way out of a severe recession. The
Congressional Budget Office evaluated this tax and found it will lead to "higher premiums for private coverage." The nonpartisan CBO estimated that premiums for individual coverage could rise by as much as 13 percent. This tax also might be disruptive to policyholders, because it could damage the ability of health plans to deliver all the benefits that members expect. That's because Congress is ready to impose this health-insurance tax in 2010. That's after families have already signed up for coverage for next year, and after small businesses have already negotiated coverage contracts. The result? Health plans may not receive enough premium to cover the costs of the massive tax, and benefits might suffer. Unfortunately, health plans have been demonized in the pursuit of reform. But in reality, it's not true to claim that health plans make a lot of money; their profit margins are actually pretty small. In 2008, private health plans made $8.61 billion in total profits nationally, according to Forbes magazine. The industry's profit margin was just 2.2 percent, ranking health plans 35th out of 53 industries in terms of profitability. As the president and CEO of SantaFe HealthCare the parent company of AvMed Health Plans I am truly concerned by this proposed tax. As one of Florida's oldest and largest nonprofit health plans, AvMed reinvests its earnings each year to continually improve on the benefits and services it offers to members in Orlando and elsewhere. Obviously, a health-insurance tax that wipes out most of our annual earnings is counterproductive to our mission. Surely, congressional leaders must grasp that this tax doesn't make sense. There are better ways to pay for the systemic health-care reform that AvMed and other health plans support. Instead of taxing health insurance, Congress should focus on the underlying costs of medical care. We can achieve huge cost savings by ending unnecessary treatments and services, rooting out rampant fraud and ending frivolous medical lawsuits filed by trial lawyers. Health reform shouldn't hurt Florida's families and small businesses. It shouldn't hamper the ability of health plans to provide benefits. Time's running out. Please contact your congressional representative and Florida's two senators today. Ask them to vote against this harmful health-insurance tax. We can achieve true, lasting reform in better ways.
Health insurers across the country are planning to raise premiums for some of their customers in the coming weeks, the Wall Street Journal reports, and they are in part blaming President Obama's health care reform package for the rate hikes. On the surface, at least, the news boosts Republicans' arguments against the Democrats' reforms ahead of this year's midterm elections. But the White House and other supporters of the reform package say they are skeptical of the health insurance companies' rationale. Aetna Inc., some BlueCross BlueShield plans and other smaller carriers have asked regulators to approve premium increases of between one percent and nine percent to pay for the bill's early benefits, the Journal reports. The rate increases would largely apply to individual plans (9 percent of Americans have individual plans) and those offered for small businesses (about 20 percent of Americans get coverage from small employers). The early benefits cited by insurers for the rate increase include allowing children up to 26 years old to stay on their parents' health care plans, eliminating co-payments for preventive care and prohibiting insurers from denying coverage to children with pre-existing conditions. These benefits apply to all plans, not just individual and small business policies. The insurers are also reportedly asking for further rate increases they are not tying to the health care overhaul that they say are needed to cover rising medical costs. Some customers could see their premiums increase by more than 20 percent. NancyAnn DeParle, the director of the White House Office of Health Reform, told the Journal that insurers were using the new health reforms as an excuse to raise rates. "I would have real deep concerns that the kinds of rate increases that you're quoting... are justified," she said. "We believe consumers will see through this." Health Care for America Now, a coalition group in support of the health care overhaul, slammed the insurance industry and pointed to insurers' history as evidence that its latest claims were misleading. For instance, WellPoint's Anthem subsidiary had to reduce its proposed rate hike in California earlier this year after it tried to justify increases as high as 39 percent with erroneous numbers. "The health insurance industry is doing the same thing it has always done, raising premiums to achieve excessive profits and outrageous salaries for their CEOs," HCAN executive director Ethan Rome said in a statement. The complaints haven't stopped Republicans from jumping on the opportunity to criticize the Democrats' policies. Senate Republicans are highlighting the Journal's report while pointing to past comments from Mr. Obama and other Democrats, who promised that premiums would not increase as a result of the reforms. In Kentucky, Republican Senate candidate Rand Paul slammed health care reforms in his first
general election ad. The health care overhaul has proven to be a harder sell to the American people than Democrats anticipated, prompting at least a handful of Democrats up for re-election to campaign on their vote against the reforms. Moderate Democrat Stephanie Herseth Sandlin (S.D.), for instance, says in an ad that she voted against the bill because "it wasn't right for South Dakota."
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Pollsters of both parties see the backlash against health care as a long time in the making and Election Day, the inevitable cumulation of that discontent. But Democratic pollsters warn Republicans that if they interpret the midterm results to be a directive to repeal and replace health care law, then it will be their folly come 2012. Easy To Insure ME In general elections, young people and minorities are much more likely to vote, and Democratic pollster Stan Greenberg predicts the pool of likely voters is "going to very quickly move to a different audience, many of whom are very clearly beneficiaries of these healthcare reforms." Whit Ayres, a Republican pollster, disagrees, saying "overwhelming majorities of Americans" believe the health care law will increase their premiums, health care costs, taxes, and federal deficit, while simultaneously decreasing their quality of care. "The top priority of Americans [has been] controlling health care costs and controlling health insurance premiums," said Ayres. "They think this bill does exactly the opposite. And that's the fundamental problem."Legislators failed to listen to the public when they "crammed" the health care bill through Congress, said Ayres, which is why opposition to health care law has been increasing according to an average of surveys on Pollster.com. The White House and Democratic leadership have predicted public sentiment towards the health care law will soften once it's implemented. Democratic pollster Celinda Lake said a key voting bloc, senior citizens, have been "scared to death" about the health care law but, "I think in two years when the seniors recognize that it hasn't cut their Medicare, in fact improved their preventive care [and] improved their prescription drug coverage, they're going to have a different opinion of the bill." If Republican strategists criticize Democrats for
believing the public will support health care if they improve their messaging, then Democrats say the fault of Republicans would be to interpret a wave of success on Election Day as an indication the country has rallied behind them. "Republicans this year do not have an advantage on party image, they have not gained in popularity since the 2008 election, so one part of what they will have to live with afterwards is why they've emerged out of this, whatever the outcome, as a party the country has not rallied to," said Greenberg. "This [election is] about the Democrats. But it's a unique election because they've managed to push so many voters away through [the health care] process."
Health care has been the subject of debate for the United States over the past decade. Although many citizens feel divided on the issue, there are a few things you may want to consider in order to keep health insurance costs at a minimum. People are able to choose between various health insurance plans to fit their specific needs, which can potentially help to lower costs. The down side to this kind of plan is that it may require larger out-of-pocket costs when individuals want to go to an out of network health care provider. Regardless of your situation, there are several ways to reduce health insurance costs. Sometimes it is possible to negotiate with health care providers. You should make it a point to do this on an annual basis to make sure that you are receiving the best possible coverage at the lowest price point. You should even consider shopping around to other health care companies and getting a bid from them in order to make price comparisons. With today's technology, it is now possible to compare health insurance quotes online. You want to be careful when you find a plan that is very inexpensive. Sometimes these plans will actually cost you more in the long run. Be sure to read any fine print and to call the insurance company if you have any questions. Easy To Insure ME has the answers Another good way to reduce health insurance costs is to look at deductibles. Figuring out the right insurance coverage for you can be tricky, so try out a few different scenarios to see how a change in deductibles will affect the monthly price of insurance. Changing the deductibles could potentially bring down the premium. You may want to keep in mind that there are additional benefits you may want to inquire about. These can include dental, vision, or maternity benefits. Once you have decided on a health insurance plan and you are need of a doctor, you should contact your health care providers to see which doctor's are within your network. You always have the option of comparing prices for different medical services and can decide to go to the most affordable provider. Sometimes, if a hospital is aware that you are comparing prices, they are typically willing to negotiate a lower price for your medical visit. The most important aspect of saving money on health insurance is to carefully check all of your medical bills. A lot of mistakes can be made in billing, which will ultimately affect the amount of money you will be paying. Health insurance companies and health care providers can make mistakes when billing so keep an eye out. If you notice a problem with your bill, contact your health insurance company and physician to notify them of the mistake
The Republicans have not put together any plans to get people health insurance in the country. If they do repeal the bill then many middle class families will suffer because their consumer protections will be gone. Republicans are only against these protections because they hate the Affordable Care Act. The big problem is that the new coverage changes became implemented on Thursday and the benefits are extremely popular with voters. A Republican push to repeal the bill spells big trouble for candidates in 2012. Voters feel taken advantage of by health insurance companies and if Republicans are successful then even more people will become uninsured. The Republicans did not have one member vote for the passage of the health care reform bill. They want to block the bill's funding and might be successful if they pick up enough seats during the 2010 elections in November. President Obama would likely veto the health care reform bill's repeal so any measure to repeal would have to wait until 2012 at least to be implemented. Republicans need to think hard about shifting the health care issue onto themselves. If they can repeal the bill then voters will blame them for the consequences that follow. Health care spending increased by more than one trillion dollars in the last year; action needs to be taken to stop this. Repealing health care reform would increase health care spending. This would add to the federal deficit and raise taxes which are two things that many Republicans say that they are against. Health care should be a moral
issue; the number of uninsured increased by twelve million people which was more than a thirty percent increase. Currently more than fifty one people in the United States lack health insurance coverage. Insuring people and helping to make the system fairer should be an issue that republicans and democrats can agree on. Middle class families will suffer a lot financially if they do not have the benefits of the health care bill. Currently, people spend more than thirteen thousand dollars per year on their health insurance premiums. If there were no reforms in place then consumers would spend more than twenty four thousand dollars per year on their premiums. For many people, this huge premium increase would cause them to drop their health insurance coverage. Republicans should try to negotiate with Democrats so that the provisions in the health care reform bill are more likeable to everyone involved. No matter what, the members of the Senate and Congress will always be insured by the federal government. This means that they cannot really empathize with the situation that many middle and lower class families face on a daily basis. The health care reform bill is very popular with voters; the only part that is not liked is the individual mandate and the fines that would follow for non-compliance. The public deserves to have its health care system repaired. People cannot afford the expensive health care premiums any more. The economy cannot sustain these increases and wages have not increased in the last few years. Employers are passing on more of the premium expenses to their employees so the problem needs to be rectified so that more people can stay insured for the long term.
If you're not knowledgeable about buying individual health insurance, please study through the rest of this article, because we will offer some of the most reliable tips that will reward you with the best medical protection you need. Easy To Insure ME When there is need for purchasing insurance for anything, even vehicles, you need to be informed of the numerous plans you get. To know more about individual medical insurance for yourself, you have to spend some time studying the providers that sell the plans. Where to Search for Health Insurance First off, you need to know the list of insurance companies. This means studying on world wide web for medical insurance for individuals. Insurance providers can provide you with a comprehensive list of the policy types they give, such as the services that are protected and what is insured for specific medical issues you are living with. The Internet is a wonderful place to obtain information about health insurance companies and comparing the types of protection and rates each insurer gives. You can also learn that provider to understand the sort of client notes and statements that exist. What you are looking for with Health protection You could stumble on numerous insurers that offer good protection, but you are not certain if you're paying too much. You may be billed a little more on specific coverage's, but you must make sure the higher costs are justified. Insurance for X rays or MRI scans for example, are a needed consideration and you need to be certain the plan provides coverage for these. Individual Health Insurance Tips Individual health insurance insurers offer medical insurance to individuals and not groups. A lot people don't have access to group medical coverage because they are not working in a good company or their employer has no medical benefits for its workers. In these cases, an individual medical care insurance company will prove very helpful. They have prices and coverages specially targeted to individuals. Choosing a good individual health care protection provider can save you thousands of dollars in health costs. Count on spending a fair amount of time studying for the trusted quote from an individual care medical protection provider .By using the world wide web, anyone can easily get individual health protection insurers. Search engines, medical coverage information websites and company websites are some of the few ways of comparing prices for individual health protection companies.
The group health insurance rates at my day job increased 33% this year, after rising just over 30% last year. I have a family of three, and the new health insurance rates are now 11% of my salary, which in my opinion, is too high (while I wont disclose my actual salary, I will state that I earn a fair amount). The new health insurance rates made me think about getting individual health insurance for my family. Group vs. individual health insurance? Before we go further, it is important to understand the difference between individual health insurance and group health insurance. Basically, group health insurance plans guarantee
all members of the group coverage, regardless of their health risk. Because coverage is guaranteed with group plans, they can be more expensive for relatively healthy individuals than an individual plan, which is priced based on your specific health history. In my case, my family and I are healthy, so it is a good idea to investigate individual health insurance options. Determine your health insurance needs to find the best plan When comparing health insurance plans, its important to make sure you are not only comparing apples to apples, but also getting the best plan for your needs. Make sure you get the best health insurance plan for your needs, whether that is an HMO plan, PPO plan, high deductible health insurance plan with a health savings account, hybrid, or other. [More on health insurance options]. Finding and purchasing health insurance while self-employed One of the biggest concerns among the self employed individuals is health insurance costs, which can be expensive. Some self-employed individuals may be eligible for a group health insurance plan if they meet certain criteria, or they may be eligible for other health benefits, such as COBRA benefits. For example, if you are leaving a traditional job to become self-employed, you may be eligible for COBRA. If you are not leaving a job that offers health insurance, then ignore the tip regarding COBRA coverage.
Through the debate on reforming health insurance for small businesses, an important piece of information was missing: Policymakers had little data on why only some young companies offer their employees health insurance. Common sense and much research indicate that cost plays a big role in business owners' health insurance decisions. Why do some entrepreneurs choose to incur this cost while others do not? Back in March, Congress passed the Affordable Care Act, which in 2014 will require all Americans to have health insurance or pay a penalty. Although many people would now like to put discussion of employer health insurance behind them, the question of why only some founders of small businesses offer insurance remains an important one. Its answer will influence how much of a role government will play in providing employee health insurance for years to come. One part of the new law is a set of tax credits and penalties designed to encourage employers to provide insurance.The problem is that for most young small businesses, it won't work.That's the conclusion I reached, based on research I conducted with Alicia Robb of the Ewing Marion Kauffman Foundation.We examined the decisions of founders of young companies on whether or not to offer health insurance, using information from the Kauffman Firm Survey, which tracks a cohort of nearly 5,000 new businesses started in 2004. The data show that very few new businesses offer employee health insurance. Nearly two-thirds of companies with employees did not offer employee health insurance at any time during their first five years of operation. Moreover, only one in five offered insurance to their workers in all of the years. insurance: no performance benefits The few young small businesses that offered health insurance differed dramatically from those that didn't: They tended to be larger and higher-paying, structured as partnerships and corporations, and they offered their employees a wide variety of benefits. Most young businesses don't fit this profile. The majority are sole proprietorships with few, modestly paid employees. Only a handful of young companies grow dramatically. A minority shift from sole proprietorships to other legal structures. Few ever add a lot of benefits. This means that only a small portion of young small businesses are health-insurance-providing types. Most are not. One argument that's often made to justify giving employees health insurance is that doing so helps companies perform better. Those that offer employee health insurance, the argument goes, get better and harder-working employees. We examined whether the provision of employee health insurance provides any performance benefits to young companies. We found that it does not. Controlling for a variety of other firm and founder characteristics, we saw no significant effect from providing employee health insurance on firm survival, growth in assets, growth in sales, growth in profits, or growth in employment during the first five years of operation. Stated differently, offering employee health insurance doesn't appear to do anything to improve the performances of young companies, despite what some observers argue. We shouldn't claim that the new law will benefit small business owners by making their companies more successful. low-paying, sole proprietorships The data offer three key takeaways for policymakers. First, only a minority of new businesses offer health insurance to employees, even by age five. Fewer still move from not offering insurance to providing it. When thinking about how to manage small business health insurance, policymakers need to keep in mind that offering insurance isn't something that young companies naturally evolve to do as they mature. Consequently, most of the employees at new businesses that don't offer health insurance will need to be covered by government
programs and state exchanges. Second, new companies that don't offer insurance tend to be smaller, lower-paying, sole proprietorships with a large share of part-time workers. These offer employees limited benefits. Policy makers need to recognize that offering employee health insurance is something that fits certain kinds of new companies and not others. Small business owners who don't offer employee health insurance aren't being heartless. They are responding to the economics of the industries they are in and the business models they are pursuing. Third, offering employee health insurance doesn't improve the financial performance of new companies. Policymakers need to understand that despite the many reasons why they want the founders of all businesses to offer health insurance to employees, requiring that entrepreneurs provide such insurance won't benefit many of the business owners. Hundreds of thousands of new businesses with employees are founded in the U.S. every year. Few of these companies are large enough, pay enough, or are structured in a way that would lead them to offer employee health insurance. Moreover, few will turn into businesses that provide health care coverage to their workers. As a consequence, most of the several million workers hired by young businesses annually will be getting their insurance from government programs and state exchanges for years to come.
How to save on health insurance If your employer doesn't offer health insurance and you don't qualify for Medicare, you need to shop for health insurance through the private market. While buying coverage can be expensive, there are some things you can do to save on health insurance. Compare prices Saving on health insurance means knowing a good deal when you see one, but to spot a bargain, you must be wellversed in the market. Health insurance providers tend to operate on a regional basis, but you should have several choices, depending on where you live. Before you buy, it pays to search for health insurance quotes online at the beginning of your process. At the outset, you'll need to be able to answer a few basic background questions as well as provide information on your medical history. But remember, when you choose a health plan, it's critical to do an apples-to-apples comparison. So, make sure that the deductibles, co-pays and other policy features match up before you look at the premiums. Consider how much you need The price you pay for health insurance will depend greatly on what kind of policy you choose. But policies aren't one-size-fits-all, which means you're going to want to buy private health insurance that matches your stage of life. If you're young, single and healthy, chances are you can safely opt for a plan with a lower premium, even if it means a higher deductible. If you're buying for a family or if you're older, a plan with a lower deductible will likely help you save on out-of-pocket expenses. Stay healthy Although we don't like to admit it, our own health is often a factor in how much we pay for health insurance. One way to slash your health care rates is to maintain a healthy weight. If you're a smoker, consider quitting. Ditto if you use drugs or abuse alcohol. Maintaining a healthy lifestyle will save you on premiums, but it also can cut down on medical costs as you age. So, there's a real financial incentive to staying healthy.
The internet offers quite a few convenient ways to buy and compare health insurance plans. They are also known as mediclaim policies which come with Texas health insurance quotes. The health insurance quotes make sure that every Texan knows about the basic features of the health insurance plans. The basic features that are mentioned in the quotes are the price of the health insurance, some basic details about the insurer age, gender, and areas that are covered under the plan. You always have the option of saving money whenever you choose to compare health insurance plans. This is because you do not end up buying an expensive health insurance policy that exceeds your budget. Texas health insurance quotes clearly mention that a health insurance policy mainly covers the expenses caused by the major lifethreatening medical ailments and procedures. An accidental death or a permanent disablement of an earning member of a family can result into a disruption in the functioning of the family. The various insurance companies in Texas offer a huge amount of benefit once you experience a diagnosis for a particular illness that is covered under the terms of the insurance. If you compare health insurance plans offered by the various companies you should select a plan that covers unexpected calamities, emergencies, dental expenses, drug requirements, custodial needs and other forms of disabilities,
temporary or permanent. There are many Texans who do not consider health insurance to be at all important. In that case they are strictly advised to at least go through the rules and regulations, with regard to the health insurance policies. In that process they must also compare health insurance plans to select the appropriate health insurance policy covering pre- and post-hospitalization charges, day care procedures, cashless claims and tax benefits. Texas health insurance quotes provide several options for students, small families and for employees of an organization. One should carefully go through the terms and conditions mentioned in the policy and consult an expert before signing the papers. There are several websites that present details from four or more insurance companies when you mention your age, email, locations, and type of insurance. I used EasyToInsureME
According to the U.S. Census Bureau, Texas leads the country in the number of people without Texas health insurance. Although nearly one in five Americans, are not insured, it is estimated that one in three Texans are uninsured. In Texas Medical Association report, "additional 5.5 million Texans including 1.4 million children lack health insurance".In a report published by the Texas Comptroller of Public Accounts, "The uninsured are a diverse group that includes people who cannot afford private health insurance, working in small businesses that do not insurance, who simply choose not to buy health insurance, even if they can afford it, who are eligible not registered government-sponsored programs such as in Medicaid or the Children's Health Insurance Plan (CHIP), and recent immigrants. The most notable omission from these reports is that it is often difficult for people to navigate the selection of Texas get health insurance. There are a multitude of choices and decisions. Do I get an individual or family coverage? Should I go with a health organization (HMO), preferred provider organization (PPO) or another type of plan? What kind of deductible should I choose?The task to find Texas health insurance is even more daunting because, as you move from a health insurance company to another, you find that each offers a different set of options. Accordingly, it is difficult to compare apples with apples proverbial. Most people do not realize that a full-service agency based in Texas health insurance can help every one of individuals and families to small business owners and Medicare beneficiaries understand the options that are their disposal to obtain insurance. Better still, these agencies offer their services and free support. It is because they are compensated by insurance companies, rather than the insured. Therefore, you can collect the benefits of their expertise impartial, free of charge. Best of all, some of these agencies have implemented easy to use online systems that allow you to obtain quotes, compare Texas health insurance plans and even apply online all from the comfort your home. In fact, you can view the plans of health insurance, life insurance, dental plans, health insurance plans and all in one place. To obtain quotes for health insurance, for example, simply enter your details into an online form, and then provide some basic information about you and other family members you wish to insure. The system will then generate quotations from a variety of companies, which allows you to compare side by side. You can sort the results by a number of factors, including the health insurance company, plan type, deductible, copayment, and the estimate of the premium. Once you decide which plan you prefer, you can apply online. Every day, health insurance is a growing number of people with affordable health insurance Texas. In return, those who obtain health insurance rest easier know that their families and they are protected.
In an interview today with Nebraska radio station KOGA, Nebraska`s Senator Ben Nelson said he worked to make sure the new health care law wasn`t a government takeover of health care, addressed some of its benefits for Nebraskans and concerns that have been raised about the law. Below are excerpts from the interview. Easy To Insure ME has the answers Asked about those who are calling for a repeal and replacement, Senator Nelson pointed out that many of the provisions already in effect are making the health insurance market fairer for Nebraskans: ``For those who want to repeal it, it`s going to be interesting to see if they want to repeal this: banning insurers from preventing coverage due to preexisting conditions. That`s in place. Allowing the purchase of insurance across state lines. . .Allowing? kids to be on parent`s insurance? up until the age of 26. There are a lot of parents struggling right now. They paid for and borrowed a lot of money for a college education. They get out, they can`t find a job.
They`d be kicked off the parent`s health insurance plan. And if they had a pre-existing condition, they wouldn`t qualify for individual insurance and if they didn`t have a job they wouldn`t qualify for group insurance. So they could be uninsured. That was taken care of. There were just a number of things that are already in place. . .Right now insurers cannot impose annual and lifetime caps on benefits. They can`t drop a person`s coverage just because they get sick. Those things are already in the - The senator highlighted the fact that 220,000 Nebraskans - roughly the population of Lincoln - don`t have health insurance. By reducing that number, the new law aims to control costs that are currently passed on from those who don`t have health insurance to those who do: ``There are 220,000 Nebraskans who don`t currently have health insurance. . .The number of people who live in Lincoln don`t have health insurance in Nebraska. And we can`t take the approach of `hey, I have mine, now you get yours.` Many of them can`t qualify easily because of pre-existing conditions. ``When people don`t have health care coverage, they still get health care because they go to the emergency rooms and when they go to the emergency rooms they can`t pay. Guess who that cost is passed on to? Those of us that do have insurance and are able then to pay and our rates are higher. ``This law? is aimed at changing that to level the playing field. If we didn`t do something, premium costs due to health care costs are going to continue going up at double digit levels. They`re going to go up in the meantime until all the insurance reforms kick in. But that won`t be because of health insurance reform. It will be because health costs continue to skyrocket. This is all aimed at reducing the impact of that and the increasing cost of health care, which is the driving force for our costs of health insurance.`` Asked about concerns people have with the new law, Nelson said that he worked to ensure that it is not a government takeover of health care and noted that it relies on the existing private system. He drew attention to the fact that some fears people raised haven`t come to pass such as ``death panels,`` that he read the entire bill before it was passed, his role in shaping the bill and said that he will be watching the implementation of the bill carefully to make sure it follows Congress` intent: ``But I think people were warned about some things that never occurred. For example, where are the death panels? There aren`t any death panels. We also heard that the law would require people who want public health insurance to be implanted with a microchip. That hasn`t happened and it`s not going to happen. And where`s the rationing we were warned about? But perhaps the scariest thing we heard was a government takeover of health care. Have we seen that? No we haven`t. But it`s controversial; I understand. I worked hard against the public option, which was going to replace the private system. I worked hard to make sure we didn`t get that public option, that we have retained the private system. There`s no public option, no national health insurance plan, no single payer system in the law. So those are the kinds of things that could have happened but didn`t happen because I and some others fought very hard against those things happening.``
Foster was asked to judge claims that the health law would "hold down costs." Foster said he thought the claim was "false more than true." Critics of the overhaul seized on his comments as proof that they have been right and proponents have been wrong about the law's fiscal impact. It's a legitimate argument. Unlike the controversy over death panels, the issue of how much health reform will ultimately cost is both complicated and open to honest differences of opinion. And unlike, say, the right-wing scare-monger Betsy McCaughey, Rick Foster is a bona fide expert with a record of intellectual integrity. Remember those stories about the government official who, in 2003, challenged the Bush Administration's optimistic projections about what the Medicare drug bill would cost? Foster was that official. But if we're going to take Foster seriously, it's important to be clear about what he said, what he didn't say, and what it all it means. Keep in mind, first, that it's not clear exactly what question Foster was answering in that snippet of testimony. After all, "cost" can mean different things. It can mean the health costs that individuals, businesses or government bear, and it can mean costs in the near future or costs in the many years beyond that. It's possible that Foster was simply saying that, 10 years hence, the government will have spent roughly the same amount on health care as it would have if the law were not in effect. If so, that's neither surprising nor particularly worrisome. The idea behind the Affordable Care Act is to strengthen health insurance and give it to more people, which will cost the government money. At the same time, though, it will make the health care system as a whole more efficient, which will save the government money. Over
the course of a decade, the costs and savings should be about equal, which means the net cost to the government would be roughly zero even as we'd made insurance both more reliable and much more available. That would be a pretty good deal. Now, if you're worried about the government's long-term fiscal future and you should be! the key question is what happens after those 10 years. The big worry is that the budgetary burden of health care will become staggeringly heavy in 2030, 2040 and beyond. The only way to avoid that scenario is to slow down the growth of federal health care spending that is, to make sure it doesn't keep going up as fast as it's been for the last few decades. This is the key area of dispute and what Foster, most likely, had in mind. The official government projections, including the ones Foster made, suggest the health law will reduce that rate of growth, albeit modestly. But in his reports, and then again in his recent testimony, Foster suggested those projections might be unrealistic. The problem is that they include some automatic, annual reductions in what the Medicare program will pay hospitals scheduled reductions, according to Foster, that future lawmakers are not likely to allow when they actually come due. This argument is more sophisticated and reasonable than the erroneous claim, made by many critics, that the federal government is simply incapable of reducing Medicare spending. Foster's worry is that hospitals can't adjust to lower reimbursements by increasing productivity, the way the law assumes they will; instead, he fears, they will just lose money and, in some cases, face the prospect of closing. In response to this threat, Foster says, lawmakers would likely cancel the reductions. Is he right? Foster admits he isn't sure. Among other things, he assumes that the law's reforms of the way we organize and pay for care everything from developing electronic records to financial incentives for coordination among doctors won't help them reach those productivity goals. But many experts with just as much experience and integrity disagree, citing the hospital sector's well-known waste and the fact that these reforms have never been tried so extensively, particularly in combination with one another. These experts also point out, respectfully, that Foster has been wrong before: His projections for the 2003 Medicare drug benefit turned out to be considerably inflated. Even if some hospitals do lose money, that might not be a bad thing. Currently, lots of smaller hospitals offer services like advanced cardio-vascular surgery or cancer treatment because those fields are lucrative. But this practice tends to drive up costs, since the availability of such services encourages more doctors and to use them. (It's called "supplydriven demand.") And it's not even good for the patients, since most of those hospitals can't do the procedures as effectively or safely as the intensive, high-level hospitals that specialize in them. Still, suppose Foster is right about the law's ultimate outcome that the cuts prove too harsh and, as a result, the hospitals successfully lobby to eliminate them. What then? Well, we'd have to admit defeat, because if it's impossible to reduce spending on hospitals then it's also impossible to reduce government spending across the health care system. Taxpayers would be stuck writing larger and larger checks on government health programs, making the ability to balance budgets contingent on our future willingness to raise taxes or cut spending elsewhere. In other words, we'd be in the same basic fiscal place we are now, with one key difference: We would have universal health insurance and its protections. It wouldn't be an ideal situation, but it'd still be better than what we'd have without the law.
The Week in Health ReformFederal Legislative Overview The White House On March 3, President Obama continued his push for Members of Congress to complete health insurance reform legislation within the upcoming weeks. He delivered a statement to a group of medical professionals in the East Room of the White House, in which he said that he has asked Senate and House leaders to finish work on health reform and schedule final votes in the next few weeks. The President went on to say that the issues have been debated thoroughly and that now is the time to make a decision. Although he did not specifically mention the budget reconciliation process, the President said that the American people deserve an "up or down" vote on health reform in the same way that welfare reform and tax cuts were approved by Congress in the past under reconciliation rules. The President said that health insurance reform would change three things: * End the "worst practices" of health insurance companies * Give individuals and small businesses the same kind of choices members of Congress have * Bring down health care costs for families, businesses and the government The President made numerous references to the health insurance industry and stated that there is a fundamental disagreement between Republicans and Democrats about whether there should be more or less regulation of health insurance companies. The President concluded by emphasizing that he will do everything in his power to make the case for health
reform in the coming weeks, and he also urged the American people to make their voices heard. In addition, the President said he is open to exploring policy priorities identified by Republicans at the bipartisan summit such as: * Conducting undercover investigations of health care providers that receive reimbursement from federal programs. * Appropriating funds for state-based demonstration programs to test alternative approaches, including health courts, to resolving medical malpractice suits. * Linking Medicaid eligibility expansions to higher Medicaid reimbursement for physicians. * Clarifying that Health Savings Accounts (HSAs) may be offered through the proposed health insurance exchanges. On March 4, Health Care Service Corporation President and CEO Pat Hemingway Hall attended a meeting at the White House, along with CEOs from other leading health insurance companies and officials from the National Association of Insurance Commissioners. The group met with Health and Human Services Secretary Kathleen Sebelius and President Obama to discuss premium issues in the individual market. House and Senate Congressional leaders are now focused intensely on developing legislative language that could be supported by a majority of members in both chambers. The President's comments last week send a strong signal that such legislation, once finalized, would move through Congress under budget reconciliation procedures. Under reconciliation rules, the House first would have to pass the Senate version of the health care reform bill, H.R. 3590, which passed on Christmas Eve last year. After that, the House would then be required to pass a separate "corrections" bill incorporating specific changes to that bill that will likely be negotiated among White House officials and House and Senate leaders. After the House passes the "corrections" bill, under budget reconciliation procedures, the Senate would need at least 50 senators to vote for the "corrections" bill. Under reconciliation rules, only a simple-majority vote of 51 votes are needed for passage (Vice President Joe Biden would be the 51st vote if only 50 senators vote for the bill) and filibusters are banned. In order to meet the goal of sending a final health reform bill to the President's desk before the Easter recess (which is scheduled to begin on March 29), congressional leaders would need to send legislative language to the Congressional Budget Office (CBO) for cost analysis in the very near future. On March 4, White House Press Secretary Robert Gibbs said that President Obama hopes the House of Representatives will pass the health reform bill by March 18, so the rest of the process can move swiftly. Speaker Nancy Pelosi (D-CA) is now tasked with trying to corral votes in the House, while trying to assure those who are wary that the Senate will be willing to support the same measures. Some House members are worried about being left "holding the bag," if the Senate decides it will not support some of the same legislative language. In order to ensure the Democrats have enough votes, President Obama invited two groups of the Democratic Caucus to the White House on March 4 to continue to push for health reform passage. Members from the Congressional Progressive Caucus were: Caucus Chairs Ra?l Grijalva (AZ) and Lynn Woolsey (CA), Congressional Asian Pacific American Caucus Chairman Mike Honda (CA), Congressional Black Caucus Chairwoman Barbara Lee (CA), Congressional Hispanic Caucus Chairwoman Nydia Vel?zquez (NY), Reps. Dennis Kucinich (OH), Lucille Roybal-Allard (CA) and Jan Schakowsky (IL), as well as delegates Madeleine Bordallo (Guam) and Donna Christensen (Virgin Islands). Afterward, Obama met with key members of the New Democrat Coalition. The New Democrats, like the Blue Dogs, are a group of fiscally conservative Democrats. Attendees of this meeting included: Reps. Jason Altmire (PA), Melissa Bean (IL), Lois Capps (CA), Joe Crowley (NY), Ron Kind (WI), Allyson Schwartz (PA) and Adam Smith (WA). Overview: Extension of Physician Payment "Fix" and COBRA Provisions On March 2, the Senate passed H.R. 4691, the "Temporary Extensions Act of 2010" and President Obama signed it into law. This legislation includes a one-month extension of the Medicare physician payment "fix," premium assistance for unemployed workers with COBRA and state continuation coverage, unemployment insurance and several other legislative provisions that expired on February 28. Before voting on passage of the bill, the Senate first voted on an amendment by Senator Jim Bunning (R-KY) that would have offset the $10 billion cost of the "extenders" package. This amendment was defeated and therefore no further legislative action was needed. The bill was later signed by the President. Overview: The "Health Insurance Industry Fair Competition Act" H.R. 4626 In a letter dated March 3, 22 Democratic Senators wrote to Majority Leader Harry Reid (D-NV) urging him to bring H.R. 4626, the "Health Insurance Industry Fair Competition Act, to the Senate floor at its earliest opportunity. In the letter they state that "[this legislation] is an important step toward bringing competition to the health insurance market, and would ensure that anticompetitive abuses such as price fixing and monopolization are policed in the health insurance industry." America's Health Insurance Plans (AHIP) CEO Karen Ignagni maintains the position on the legislation saying, "The rhetoric surrounding repeal [anti-trust exemptions] does not match the reality of the situation. Health insurance is one of the most regulated industries in America at both the federal and the state levels. The
Act is extremely limited in scope and has nothing to do with competition within the health insurance industry. In fact, a wide range of insurer activities, including mergers and many types of business practices, are and always have been subject to federal antitrust laws and to enforcement by the Department of Justice." Author Reference http://www.easytoinsureme.com
Millions of Americans went to the polls on Tuesday, feeling anxious about the economy and health care reform, and yielding election results that gave Republicans control of the House of Representatives and weakened the Democratic majority in the Senate. Republicans picked up at least 60 House seats and at least six Senate seats in the election, removing Democrat Nancy Pelosi from her powerful position as speaker of the House and putting Republicans in charge of House leadership and committees. The Republican sweep extended from coast to coast and removed more than 30 Democratic incumbents from the House of Representatives, including Armed Services Committee Chairman Ike Skelton, Budget Committee Chairman John Spratt and Transportation Committee Chairman James Oberstar. Exit polling shows more than eight in 10 voters feel the economy is the No. 1 issue facing the nation, and three times as many people believe it is getting worse rather than better. Health care reform followed as the secondmost important issue for voters during this election cycle. Nearly three in four voters expressed dissatisfaction with Congress and six in 10 say they believe the country is headed in the wrong direction. With the midterm elections close to complete, we encourage you and others to see how health care reform affected congressional races by visiting the updated Health Action Network. Health Care Reform How the Election Results Affect the Future of Health Care Reform: With the new Republican majority in the House, a stronger showing in the Senate and greater numbers of GOP governors, the health care debate is expected to focus on implementation of the law, as well as efforts to repeal it. While full repeal will face a presidential veto, lawmakers will most likely pursue incremental changes, "tinkering and tweaking" the law to keep the debate top of mind for voters leading up to the 2012 elections. According to political strategists, Republicans could also use the oversight authority of Congress to slow down or block regulations, essentially stalling the law's progress. Congressional hearings are likely to focus on the impact of the immediate reforms on costs and coverage, the outlook for reforms that take effect in 2014 and stronger direct oversight of federal regulators. Additionally, the annual appropriations process is likely to serve as a battleground for health care reform issues, with a focus on funding for federal agencies involved in the implementation process. Two More States Vote to Reject Health Insurance Mandate: At the polls this week, voters in Oklahoma and Arizona resoundingly supported ballot initiatives to opt out of the federal health care reform law. Missouri voters approved a similar measure, Proposition C, with 71% support on a primary ballot in August. A similar proposal on Tuesday's ballot in Colorado would have prohibited the state from forcing residents to buy public or private health insurance. However, the measure was rejected by a narrow margin. Public Opinion Exit Polls Show Half of Americans Still Want Repeal: According to the Pew Research Center, voters were divided over whether to repeal health care reform (48%) or maintain or even expand it (47%) in exit polls on Tuesday. However, the major priorities for 2011 include reducing the deficit, creating jobs and boosting the economy. Looking Ahead President Barack Obama has invited the Republican and Democratic leaders of Congress to the White House on November 18 to discuss the new political landscape and ways to work together in the future. The meeting with Rep. John Boehner, Senate Minority Leader. Mitch McConnell, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid is expected to take place during the first week of Congress' "lameduck session," which begins on November 15.
JANUARY 22, 2010 This Week in Health Care Reform After months of public debate and private negotiations, health care reform discussions stalled following Tuesday's Senate vote in Massachusetts. The Democratic Senate lost its 60th vote supermajority when Republican Scott Brown was elected to the United States Senate in the Massachusetts special election. Health Care Reform Negotiations PostMassachusetts Special Election Massachusetts Election of Senate Republican Recasts Debate: Following the election of Republican Scott Brown to the Massachusetts Senate seat Tuesday night, Democratic
leaders have been scrambling to revive what could now be a dying bill. The loss of the Democrat's 60th vote in the Senate opens up the legislation to a Republican filibuster - something the Democrats have managed to avoid thus far in the debate. House and Senate Democrats met this week to discuss how to move forward with the reform legislation in light of this election and promised Wednesday that they would push ahead. There are a number of options that Democrats are considering, but at this point they have not charted their course. On Wednesday, Speaker of the House Nancy Pelosi (D-CA) attempted to rally House Democrats around a strategy to push the Senate bill through the House and onto President Barack Obama's desk so as to avoid the need to again secure 60 Senate votes. However, the Speaker indicated on Thursday morning that she did not believe she has the needed 218 House votes necessary to move forward. This option would have allowed lawmakersto then propose additional modifications to the approved legislation through a process called "reconciliation," which only requires 51 votes in the Senate. Other remaining options: 1. House and Senate Democrats could also quickly complete the merging of the two bills and vote on the combined package before Mr. Brown is sworn in. 2. Democratic leaders could attempt to re-engage Sen. Olympia Snowe (R-ME), the only Republican who voted for the Senate Finance Committee's bill passed in October. Democrats would need to allow her to amend the bill so that she could support its passage and give Democrats the needed 60th vote; or, 3. House and Senate Democrats could essentially start over in their respective chambers and propose scaled-back versions of the bill under "reconciliation" procedures or regular order. Reconciliation procedures would greatly limit the scope of the legislation to issues only related to raising or spending federal funds; therefore, many provisions, such as creating new insurance exchanges and an individual mandate, might be excluded. President Obama seemed to indicate that he favors having House and Senate lawmakers start over again and produce a scaled-back bill. In addition, more moderate Senate Democrats - hesitant to push through such a huge partisan bill in light of the Massachusetts election - urged leaders to slow down. Sen. Jim Webb (D-VA) has called on Senate leaders to suspend voting on health care reform until Mr. Brown is sworn into office. President Obama and Senate Majority Leader Harry Reid (D-NV) have iterated this same message. Further, Sen. Joe Lieberman (D-CT) called for a bipartisan effort as the best way to achieve health care reform legislation. Health Care Reform Negotiations Prior to Massachusetts Special Election Senators Urge Guarantee of Government Savings: In a letter sent last Thursday to Sen. Reid, five Democratic Senators asked for the inclusion of a "fail-safe mechanism" in the final bill. This mechanism would give Congress "the tools to keep costs under control should the current savings estimates fail to materialize." Both the Senate and House versions of the bill rely heavily on reductions in government spending, particularly around Medicare, to help pay for reform. Republicans and some nonpartisan analysts believe the government will not follow through on these spending reductions, which will lead to soaring costs. President Obama Pushes for Less Protection for Biologic Drugs: Last Thursday President Obama pushed for a change in the health care reform legislation that would reduce the number of years that biologic drugs were patent protected from generic competition, previously set at 12 years. White House officials and Rep. Henry Waxman (D-CA) were negotiating for 10 years protection or less. Members of the news media speculated that the move to reduce biologic drug protections could be a leverage point for President Obama to pressure the drug industry to increase contributions to pay for health care reform. In fact, the Wall Street Journal reported that Congressional Democrats had already asked drug companies to contribute an additional $10 billion or more, over and above the $80 billion which the industry agreed to early on in the reform negotiations. President Obama Strikes Deal with Unions: Last week Democratic negotiators struck a deal with union officials and conceded to union demands to scale back a tax on high-end insurance plans. The deal would exempt union workers from having to pay the tax until 2018, five years after the tax would apply to other workers. While the deal would help gain union support for the bill, it would also reduce the amount of tax revenue generated by about 40 percent, to $90 billion. As such, Democratic leaders would need to find other sources of revenue to make up the difference. Public Opinion Exit Poll Indicates Health Care Reform as Hot Button Issue: As the ballot polls closed on Tuesday night's Massachusetts Senate election, an exit poll conducted by Frabrizio, McLaughlin & Associates indicated that 52 percent of voters said that they oppose the federal health care reform measure and 42 percent said they cast their ballot to help stop President Obama from passing this legislation. In addition, 48 percent said that health care was the single issue driving their vote. Polls Show Discontent: The latest Wall Street Journal/NBC News poll indicated that almost half of Americans believe the health care reform bill in Congress is a bad idea (46 percent). This figure is up dramatically from April when only 26 percent believed the plan was a bad idea. Further, just 33 percent say the plan is a good idea. Nearly half of those surveyed (48 percent) believe that passing the current
legislation would be a "step backward." In addition, a new Quinnipiac University poll showed that public support for health care reform continues to decline. Thirty-four percent mostly approve, while 54 percent mostly disapprove. At the end of December, 53 percent of Americans mostly approved, while 36 mostly disapproved. Looking Ahead Currently, the path to health care reform is unclear. Democrats seek a way to secure the necessary votes to pass the legislation, and some now question the value of pushing such a large bill. President Obama had hoped to see a final bill prior to his State of the Union address, which has been scheduled for January 27; however, it appears this goal is likely out of reach.
In the United States, health care insurance is necessary to help offset the medical expenses that continues to climb each year. The seemingly endless rise in the cost of doctor's visits, medications and medical procedures makes it almost impossible for even those with a decent income to afford a major accident or illness. If you are struggling to make ends meet, a relatively minor illness or injury could devastate your finances and make it impossible to stay out of debt. For this reason it is important for each person to make every effort possible to find and maintain a health insurance coverage. Cheap Medical Exam Some people are fortunate enough to have group coverage through their employment, but many people (e.g., unemployed and self-employed individuals) do not have the same access and have to use individual health insurance instead. The following tips will help you in finding the best individual health insurance coverage at an affordable price. 5 Individual Health Insurance Buying Tips Compare policies carefully All health insurance polices are not created equally. While most have the same basic outline, there are variations in coverage and price. Do not assume that the most expensive policy has the best coverage or vice versa. It is true that the better the coverage, the higher the premium, however you must closely examine each policy to ensure you are getting the protection for which you are paying. Consider your individual needs Do you plan on having children in the near future? Do you have pre-existing conditions? It is important to pick a plan that meets your individual needs. Childbirth, ongoing treatment of existing conditions and a host of other issues may require special attention from your insurance provider. Find out if these situations are covered or if you can purchase additional coverage to ensure your insurance offers the protection you need at the time you need it. Research the company backing the insurance policy It is not enough to find the best policy if the company backing the policy is not in a position to pay out on claims. You must vet the supporting company to find out if they have the financial backing to provide the coverage for which you are paying. Group rates for individuals For many self-employed individuals the cost of individual health care insurance is simply too high to fit into a limited budget. Fortunately in many states, a sole proprietor may qualify for lower group rates as an individual. Where this is allowed, a single person can be considered as a "group of one" and benefit by having lower rates than other individual health care policies. Some insurance is better than no insurance Regardless of the research you put into finding affordable individual health insurance, you may find you cannot afford the type of policy that best meets your needs. If this is the case, remember that some insurance is better than not having any coverage at all. Consider increasing deductibles or dropping some of the coverage if it helps bring basic coverage within your budget. Health insurance regardless of where or how you purchase it is costly. Unfortunately if you become sick or injured and are in need of medical care or hospitalization, the cost of being uninsured becomes much more difficult to manage. Where to Find Affordable Individual Health Insurance A friend of mine asked the same question not to long ago. After asking around a bit, the majority of people recommended that he looks at Easy To Insure ME first.
Medical expenses have already touched the sky and are still rising. This has made health care insurance a necessity. Medicare supplemental insurance is designed for people on Medicare who wish to have more comprehensive coverage. These supplemental plans may include Managed Care HMO plans or Medigap PPO plans that provide you with greater access to participating physicians. Medical terms can be confusing, and before speaking with an insurance agent, you should make sure you understated his or her language. Medical insurance premiums are a result of careful consideration by medical insurance companies and are regulated by every state. Premiums can vary depending on the type of coverage,
amount of the deductible, and benefit coverage. Individual, or family, health insurance is also commonly known as personal health insurance or private health insurance . Most insurance companies offering this product will refer to it as individual health insurance. Individuals, families, self employed, student, small and large group. Traditional major medical, health savings accounts and temporary medical coverage. Individuals, families, self employed, student, small and large group. Traditional major medical, hospital, health savings accounts, temporary and short term medical coverage. Choosing insurance in your state can be a difficult process. There are many companies to choose from and many plans within companies. Choose the right health plan based on what you want. If you have a certain doctor that you can't bare not to see then a free-for-service plan is probably for you. Choose an individual health plan to find the cheapest health insurance coverage for the best value. Within minutes, you can determine your eligibility, the type of plan you want and they will give you immediate quotes. Within minutes, you can receive an online health insurance quotes for life insurance and dental plans from America's leading insurance companies. This unbiased approach to selecting a benefit package now allows you to customize your insurance quote, select the company of your choice with the benefit plan features and price that fits your situation and budget.
Camp Eden Health Retreat is the comfortable place to jump-start your goals. It has been helping new guests achieve their personal goals and make positive changes in their lives for over 23 years. Our philosophy of transformation is what makes Camp Eden so unique inspiring, educating and empowering guests to transform their lives' BestHealthRetreatCenter in Australia: Camp Eden Health Retreat is one of best health resort center in Queensland. It's most pristine and lush Sub Tropical rainforests in the Hinterland's Currumbin Valley in Gold Coast. A short 30 minute drive from Gold CoastAirport, here you'll find so much more than a holiday destination. An experience that will impact your quality of life from the moment you arrive until long afteryou return home Camp Eden focuses on an individual and holistic approach to assist. CampEden Health Spa Retreat - Inspiration and Relaxation Place: Camp Eden Health Retreat is natural place of Inspiration and Relaxation. You will get perfect holiday where lives are enhanced and often transformed and new life-long friendships are formed. It provides you to unwind, shape up, be pampered and discover a renewed sense of wellbeing and also focus about health, fun, fitness, stress management therapy, health spa retreat, weight loss retreat, personal development or relaxation. Australian Resort Luxury Accommodation in CurrumbinValley: Camp Eden Health Resort offers natural environment which is very comfortable for people who wish to come alone. You can choose to have single accommodation or if you prefer we can match you with people who are gender and age appropriate in a twin share room. Health Retreat will revitalize and invigorate you from the moment you arrive and well beyond your visit. It offers various luxury accommodations like Rainforest Retreat (Twin), Valley View Deluxe (Single & Twin), Eden Sanctuary (Single) and Hillside Haven (Single). CampEden Health Resort Activity & Facilities: Camp Eden Health Resort specializes in stress management therapy, detoxify, personal development, changing habits, weight management packages, holistic body therapies and massage and spa beauty treatments, weight loss retreat, health fitness activity, neuroarobics, spa beauty therapy treatments, natural healing therapy, sauna steam bath, spa aromatherapy treatment in currumbin valley in Gold Coast. The pure, fresh, crisp mountain air surrounds the amazing sanctuary of Camp Eden Health Resort. Each and every guestin achieving their goals. We encourage you to Release, let go and open up. At Camp Eden Health Resort, you can join with all kind of activities like relaxation, rejuvenation, healing, education and clarity to name but a few. Our all day every day' programme encompasses stretch & fitness classes, workshops, a range of informative talks, bush walks and environmental education, zumba, music, our exclusive range of fabulous challenges and so much more! All this to encourage you to concentrate onyour overall well being with a focus on health issues including stress reduction, weight management, changing addictive habits or moving forward from past life issues. Fine tune your body or just discover the pleasures of relaxation, reflection and pure pampering in our 5 star treatments centre. This peaceful time-out will give you the opportunity to exploreyour potential for a happier, more productive and more fulfilling life. Fitness activities based on a rotational program including yoga, water games, cardio classes, mountain biking, bush walking, Flying Fox, Power Pole and Brave Heart challenges and much more Confirming your reservation: We recommend you call our friendly reservations staff toll free on 1800 074157 to discuss your personal time out goals and check
availability for your preferred week. Once your booking is confirmed, you will be sent confirmation and pre-arrival' information. Read more about Health Spa Retreat Center Other Health Resort Features: Health Retreat Center Australia Weight Loss Retreat Center
This past week I was very lucky to be given the opportunity to attend the Virginia Public Health Association's Conference on Health Equity. The conference was held in Richmond, Virginia's capitol, and welcomed people from around the state who were interested in learning more about inequalities in our health care systems, health outcomes and policy priorities. The main point made at this conference was that inequities in health outcomes are caused by more than just individual behaviors or biological predisposition. Instead, quality of health can be attributed to comprehensive and systemic factors. Like what? Think big: infrastructure, geography, education, language. Surprise, surprise -- our nation's system is currently designed to disenfranchise, dis-empower and disregard our most vulnerable populations' needs when it comes to wellness. It is clear that there are larger systemic issues at play in this scenario -a made up, but highly common story. From the poor transportation systems to the lack of food options to the policies and politicians that allow landlords to ignore tenants' complaints, odds are stacked against this family ... and many others like it! Moving beyond one-on-one patient care, these systemic barriers are what our health experts and advocates must address in the hopes of overcoming inequalities in health status. We have our work cut out for us! Now -- let's tell Mark to practice some basic preventive care that would improve his health outcomes. - Exercise and eat a healthy diet rich in fresh fruits and vegetables. Most corner stores only have packaged or canned foods, and fast food restaurants provide the most affordable, filling and convenient meals. Poor transportation make it difficult for Mark to even get to a grocery store, and when he does the prices are high. It is nearly impossible for Mark to make the time or find the space to exercise in a neighborhood that is not always safe. - Go to a yearly check-up to prevent illnesses from going untreated. The health department in the community only provides essential services -- mostly immunizations for children, prenatal care, and STD testing. Mark has a high enough income that he is not eligible for Medicaid, and the free clinic's lines are long and only focus on people who are already sick. - Go back to school and get a better job so you can have insurance. Even if there was still a community center or school in the neighborhood that offered night classes to adults at a reasonable price, it would be difficult for Mark to find the time in between work shifts to attend class, study AND fulfill his responsibilities to family. - Move out of the damp apartment that is making your children sick. The apartment buildings throughout the community in Mark's price range have similar conditions and local landlords are known for disregarding the requests of black tenants. - Minimize stress to promote mental health and overall wellness. Yeah, right.
Voters in Arizona, Colorado and Oklahoma will have the chance Tuesday to repudiate the new health care law's keystone provision, one that requires almost everyone to have health insurance or face a tax penalty beginning in 2014. Easy To Insure ME has the answers Ballots in the three states include proposed amendments to the states' constitutions that would prohibit the enforcement of the individual mandate and other provisions of the law. They echo a measure that Missouri voters approved by more than 70 percent in August. Legislatures in several other states, including Georgia, Idaho, Louisiana and Virginia, have also passed state laws with similar language. But the ballot initiatives have set off a fierce debate: If they succeed, will they have any effect? Critics of the referenda say they're nothing more than a political gesture, misleading voters to believe that amending their state constitutions would allow them to opt out of the health care law. Given that the Supreme Court will likely have the final say on the constitutionality of the law before 2014, the public's vote wouldn't impact the national law, they say. Some policy analysts agree. "To me it's more of a polling statement," said Elizabeth McGlynn, an associate director at the RAND Corp., a nonprofit research organization based in California that has no position on the amendments. "It's not clear to me in this case that the federal law wouldn't override state mandate that will be something the courts decide. It's not really clear to me what that does at the state levels." Proponents argue that the amendments have a strategic function beyond the scope of individual
states. "As more and more states pass these kinds of amendments it's going to embolden legislative action to repeal or defund legislative provisions" of the federal health law, said Robert Alt, deputy director of the Center for Legal and Judicial Studies at the Heritage Foundation, a conservative think tank in Washington. 'New Avenues Of Litigation' Having the new amendments in place would give states greater standing in the current litigation brought by 20 states against the federal law, says Christie Herrera, a director at the American Legislative Exchange Council (ALEC), which has provided model legislation used by several states. If the Supreme Court were to uphold the individual mandate in that case, a state constitutional amendment would "open new avenues of litigation," she said. States could also file suit to argue that the health law violates their 10th Amendment rights to keep powers not otherwise delegated to the federal government by the U.S. Constitution. Opponents of the ballot amendments say the measures could complicate health care issues within the states. Dr. Michael Pramenko, president of the Colorado Medical Society, which opposes the ballot initiative, said the amendment could affect any state efforts to set up a program to expand insurance coverage. "It would tie our hands at the state level," he said, adding that the amendment would prevent the state from setting up its own version of the individual mandate, independent of the federal government, in the future. The proposed amendments in Arizona, and Oklahoma are nearly identical, while the Colorado amendment differs in subtle but significant ways. The measures are centered on a few key provisions: that no individual can be forced to participate in a public or private health plan; that a person's ability to make or receive direct payments for medical services cannot be restricted; and that no one should be forced to pay a penalty for failing to enroll in a health plan. Colorado Controversy The Colorado amendment makes clear that it applies only to state efforts to impose such requirements. The amendments do not deal with some of the other preparations for the health law that are falling to states, such as the health insurance exchanges and the expansion of Medicaid that will begin in 2014. "They're operating on two bandwidths," trying to oppose the federal law while also trying to implement it, said McGlynn. "Most of what states are going to have to do, they don't get to avoid through these amendments." Colorado's situation is unique because its amendment was brought to the ballot through citizen initiative, and doesn't follow ALEC model legislation as closely. Its language allows for a much broader interpretation of the measure than other states have allowed for, argued Alec Harris, a policy analyst at the Colorado Center on Law and Policy, which opposes the amendment. "It's getting billed as -- and people seem to view it as -- a referendum on federal health reform," Harris said. "This has no ability to do anything about federal health reform." Instead, Harris says, the language of the bill, which prohibits "the state of Colorado, its departments and agencies" from requiring that a person participate in a health plan, could interfere with the state's auto-enrollment of Medicaid and Child Health Plan Plus beneficiaries. "Quite a bit of this stuff doesn't go away even if the Affordable Care Act is ruled completely constitutional," Harris said. "It's the unintended consequences that we're worried about." The president of the Independence Institute, which drafted the amendment, disagreed. "It doesn't stop the government from offering all sorts of alternatives and plans," said Jon Caldara. " Really it means that the state legislature can't mandate that people should buy something they don't want to by without getting voter approval."
What is Home Health? Home Health Care is skilled nursing care and certain other health care services that you receive in your home for the treatment of an illness or injury. This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.). This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.). ***FREE OF CHARGE***if Medicare approved Call or email now to see if you are Medicare/Medicaid Qualified If you or someone you know needs help with 1. Diabetes 2. High Blood Pressure 3. Wound Care 4. Arthritis/Joint Pain 5. Any Chronic Illness or Disease We Also Provide: 1. Light House Keeping/Laundry Services 2. Senior Transportation 3. Meal Preparation 4. And Much More At No Charge to YOU!! CLICKLINK BELOW TO WATCH VIDEO ABOUT HOME CARE
http://www.tahc.org/associations/1626/files/TAHC new VO.wmv II. How to get Medicare Home Health Care: Your doctor must determine you need medical care in your home. You will need at least one of the following services: skilled nursing care, physical or speech therapy. You must be homebound. Homebound means that leaving your home is a considerable and taxing effort III. What qualifies as Skilled Home Care Services? Wound Care for pressure ulcers or surgical wounds Physical Therapy (fall prevention, recent fractures, recent stroke, TIA's, endurance issues, or transfer training) Occupational Therapy (recent strokes, ADL training-such as dressing, grooming, and bathing) Speech Therapy (swallowing issues, aspiration, recent stroke, pneumonia) Patient and Caregiver education IV Therapy Injections (diabetes, B-12) Medication Management IV. Home Health vs. Hospitalization: In many cases home health care services may be appropriate to prevent an individual from being hospitalized. Most patients and their families prefer to stay at home rather than be placed in the hospital or skilled nursing facility when their condition allows them to remain at home. Home health care is usually less expensive and in some cases just as effective as care in a hospital or skilled nursing facility. Home health care assists a person in their recovery from an illness, accident, surgery, or change in their medical condition. Professional health care and rehabilitation services are delivered in a persons home environment under the direction of their personal physician. Services offered include: Skilled Nursing 24/7 Availability Physical Therapy Wound/Ostomy Care Occupational Therapy Infusion Therapy Speech Therapy PT/TNR results in home Home Care Aides Pain Management Medical Social Workers Rehabilitation Who pays for home health care? If you are Medicare eligible and qualified for care, there is no out of pocket cost to you. Home care can also be paid for by many private insurances or a variety of public programs. To qualify for Medicare home health services, there are five basic requirements: 1. Your physician must determine that you need home health care services 2. Your own physician must write the orders for home health services, and oversee your care 3. You must need skilled services that are provided by a nurse or therapist 4. Your physician must determine that you are homebound, requiring considerable effort and help to leave home Because benefits and requirements can vary, we can help you check with payors about your specific benefits, even before beginning services, so you can have this information at the start of care. -Medicare pays 100% of the cost for home health care for individuals 65 years of age or over or permanently disabled. -Private insurance will pay for home health care. Benefits vary per policy and verification of benefits is required. -Medicaid pays 100%. Pre-authorization is required. -Workers Compensation Insurance.-Private Pay. Wecan HELP you in a number of ways. Patient specific health data with observations by a professional nurse are reported to the physician. Helping patients and their families to understand and follow physician's orders regarding nutrition, special diets, medications, and general nursing care: Assisting with home management of catheters and feeding tubes. Giving injections ordered by the physician and teaching patients and family the proper techniques for doing so. Helping patients restore strength and independence through physical therapy exercises, Educating diabetic patients on how to manage diet, insulin, and other health related measures. Enabling the patient with ostomy how to resume a full, active life. Assisting patients with bathing and personal grooming (ADLS).
The health care reform bills being debated in Congress threaten to shut out millions of immigrants. But Congress exclusionary policies toward immigrants will not simply leave immigrants worse off. They will inevitably jeopardize the nations economy and the health of all of us. President Obama has prioritized health care reform to ensure that millions of Americans have a fair, affordable and efficient health care system. For immigrants, this vision is far from a reality. First, the current health care reform bill treats legal immigrants unfairly. Individuals who have waited years to come to the United States will be required to wait years in order to obtain affordable health care. Immigrants are generally younger and healthier than the U.S. population at large. However, no one is immune to falling ill or having an accident. The current health care bill would require recently arrived, legal immigrants to wait five years to obtain the only option for affordable health care coverage, Medicaid. While low-income citizens will have access to Medicaid, the most vulnerable among us will continue to wait for affordable health care despite the fact that they pay taxes for the very programs from which they are excluded. There is no sound reason for Congress to discriminate against these individuals and prevent them from receiving basic medical care. Congress and the White House also took an unprecedented step to prohibit individuals from buying -- with their own hard-earned money -- an American good that could help their families. The
Senate version of the health care bill forbids undocumented immigrants from purchasing private insurance at full cost in the newly created insurance marketplaces. As a result, undocumented immigrants as well as their family members, who are often U.S. citizens or legal immigrants, will likely remain uninsured and will be forced to seek care in the emergency room. The costs of providing health care for undocumented immigrants will not disappear after passing health care reform. It is unlikely that millions of immigrants, whose contributions keep up our standard of living and our economy functioning, will be deported. Instead, the cost of care will become the financial responsibility of the patient, the provider, the local and state governments, and every single taxpayer. Moreover, in order to exclude a few, there will be additional forms, documents, and bureaucrats that the rest of us will be subjected to. Buying the mandated health insurance could feel like a trip to the Department of Motor Vehicles. Taxpayers will have to pay millions for this additional red tape and delay, all to keep a few people from buying health insurance with their own money. Providers, employers, consumers, religious leaders, and state and local governments recognize that these policies are short-sighted and will cost all of us more in the long-run. Policies that attempt to exclude and ostracize immigrants also disproportionately harm all communities of color and immigrant-rich states like California and New York, further widening existing inequities in our nation. Yet because immigrants live in all 50 states, the intended and unintended consequences and costs of these restrictions will be far-reaching. Ending discriminatory and exclusionary policies in this final round of negotiations is not only a matter of fundamental fairness and sound economics. It is required in order to not leave all of us worse off. Congress has a short window of opportunity to remove the restrictions on legal and undocumented immigrants in the health care reform bill. Doing so will not jeopardize the passage of the bill. Failing to doing so, however, will leave all of us, immigrant or not, worse off and wondering what happened to the promise of health care reform.
Why we choose health insurance We all tend to buy health insurance for the same reasons. We want to bypass the NHS waiting lists and receive treatment when we need it. Going into hospital is a stressful occasion and as a patient you want to be as comfortable as possible, private health cover will often mean your own private room with en-suite and home comforts such as television, internet and a choice of food when you want it. Health insurance is not designed to replace the NHS, a health plan is designed to provide cover for the treatment of acute conditions. The private sector has very limited resources for Accident and Emergency and the treatment of chronic conditions, so both will tend not to be covered on your health insurance. Health insurance for women who are pregnant If you take any of the leasing insurers and look through the policy terms the health insurance tends not to cover normal pregnancy. In the majority of cases midwives and doctors carry out the everyday care of the pregnancy through the NHS. A pregnant woman will have regular appointments and scans with their general practitioner and midwife to ensure the pregnancy progresses as it should and this will continue after the birth to ensure the baby and mother is in good health. Now although a standard health plan may not cover normal pregnancy you do have the option of going private and paying for the services of a midwife and obstetrician should you require. However given the quality of the antenatal care through the NHS the private sector resources for everyday pregnancy care is limited. Cover you can expect for pregnancy Now although many plans will not cover normal pregnancy it is important to note that each insurer has its own terms and any cover relating to pregnancy can differ significantly. Some insurers provide cover for pregnancy related issues and its important to understand the differences between the policies. Although health insurance for women is not technically specific below are some of the benefits you could expect from your insurance during pregnancy. Cover for some complications of pregnancy and childbirth Cash benefit if child is born using the NHS Cover for certain obstetrics procedures. If you are looking for health insurance for women which specifically covers pregnancy some of the more comprehensive plans after a period of membership, say 2 years include cover often capped at a monetary limit for private consultations and tests as long as you have a normal pregnancy. Additional Health insurance options to consider Outpatient cover Health insurance is built around inpatient treatment, as a policy becomes more comprehensive so it provides a greater level of outpatient cover, with increasing levels of outpatient cover comes increasing premiums. It is important you read the terms of the policy to understand the level of cover it provides for your specific needs, cover for pregnancy will increase the more comprehensive your plan. Alternative medicines An additional option in many health plans which will add around 6% to your
premiums,providing cover for complementary treatments such as physiotherapy and chiropractic treatment. Excess An excess can help reduce your monthly premiums, by including an excess you are agreeing to pay the value of the excess either pre policy year or per claim to help towards the cost of treatment. Excesses can range from as little as ?50 up to ?1,000. A ?100 excess could reduce your premiums by approximately 5%.
At some point after Jan. 3, when Scott Walker becomes governor, Wisconsin will challenge the constitutionality of the federal law to overhaul the health care system. Wisconsin Attorney General J.B. Van Hollen has not decided whether the state will join the lawsuit filed in Florida by 20 other states, the National Federation of Independent Business and two uninsured individuals, or file its own lawsuit. "That work is under way," Van Hollen said. "I have been in discussions not only with my staff but also with staff of both the Florida AG's office and the Virginia AG's office." Joining a lawsuit filed by the Virginia attorney general would be more difficult because that case includes legal issues surrounding a state law. Van Hollen expects to make a decision in the next month or so. The key issue in the legal challenges is whether the federal government can require people to buy health insurance or fine them for failing to do so. That requirement is considered essential if health insurers must cover people with pre-existing health problems. Wisconsin joining the legal challenges to the law would fulfill a campaign promise by Walker while making the state a participant in a historic case almost certain to be settled by the Supreme Court. "It is the biggest ongoing constitutional law dispute in the country, certainly the one with the most farreaching effect," said Andrew Coan, a professor at the University of Wisconsin Law School. More than 20 separate challenges to the law, including lawsuits by conservative groups and individuals, have been filed in federal courts throughout the country. And most legal experts agree that both sides raise valid questions. "This case could be decided either way without overturning any existing Supreme Court precedents," Coan said. So far, federal judges have dismissed two of the lawsuits - one filed in Virginia by Liberty University, founded by Jerry Farwell, and the other filed in Michigan by the Thomas More Law Center, a public interest law firm that focuses on defending the religious freedom of Christians, family values and other issues. But federal judges in Florida and Virginia have denied the federal government's motions to dismiss the lawsuits by the states. Van Hollen, a Republican, wanted to challenge the health care law immediately after it was passed but needed Democrat Gov. Jim Doyle's approval - and the governor in a strongly worded letter made clear that wasn't going to happen. "The State of Wisconsin will not enter into litigation intended to deny health care for tens of thousands of residents," Doyle wrote in March. The state also has estimated that the law would save Wisconsin $745 million to $980 million from January 2014 through June 2019 as the federal government picks up a larger share of the cost of insuring residents with limited incomes. But Van Hollen said Wisconsin should bring a lawsuit to protect the balance of powers between the federal government and states. "This is an issue that needs to be clarified one way or another," he said. If people are not required to buy health insurance, they could wait until they are sick to buy it. Health insurers regularly liken it to being able to buy homeowner's insurance while your house is on fire. Subsidies The health care law provides subsidies for people and families with low to moderate incomes to buy insurance, if they don't get affordable health benefits from an employer. The legislation specifically notes that people who don't buy insurance - out of choice or necessity - saddle hospitals and doctors with large unpaid bills that raise costs for people with insurance. That's one reason for the so-called individual responsibility requirement. But the uninsured population disproportionately includes people in their 20s and 30s. Many of them could afford to buy insurance. Economists call them "free riders." They also tend to be healthy - and their premiums are needed to offset the cost of providing health insurance to people who are sick. People with health problems who don't get health benefits from an employer now are effectively locked out of the insurance market in many states because health insurers will not cover them. Changing that is one of the key provisions in the new law. States can require people to have health insurance; Massachusetts does so now. And the federal government's right to regulate the insurance industry is clear. The issue is whether that right also gives it the authority to require people to buy health insurance. Opponents note that the federal government has never passed a law requiring citizens to buy a private product or service or pay a penalty. Congress passing a health care law requiring people to buy health insurance, opponents contend, is no different from requiring people to buy vitamins or join a gym. Ilya Shapiro, a senior fellow in constitutional studies
at the Cato Institute, a libertarian think tank in Washington, D.C., said no principled limits on federal power will exist if the health care law is allowed to stand. Economic activity The legal arguments hinge at least to some extent on whether deciding not to buy health insurance is an economic activity. Here's why: Since the 1940s, the Supreme Court has given broad authority to regulate interstate commerce under the Commerce Clause of the Constitution. Those powers, though, are limited to economic activities. The Constitution, under the Necessary and Proper Clause, also gives Congress the authority to enact regulations needed to regulate interstate commerce. The Department of Justice contends that the decision not to buy health insurance is an economic decision that affects the entire health care system. It also contends that everyone, even people who are healthy, is part of the health care market. But Shapiro and other opponents contend this reasoning would lead to a federal government of unlimited powers. "Everything is an economic decision in some way," he said. Opponents contend that requiring people to buy health insurance regulates an economic inactivity. To Coan, the UW law professor, this isn't the key issue in the case. "If Congress needs to regulate inactivity to make its regulation of commerce effective, the Necessary and Proper Clause gives it that power," Coan said. "That's how I would analyze the case." The federal judges in the lawsuits brought by the Thomas More Law Center and Liberty University agreed. But Shapiro has noted that there are "many, many rulings yet." The lawsuits raise other issues including complex tax issues - but more legal experts have said the most important issues involve the mandate to buy health insurance. No one expects that issue to be resolved until 2012 at the earliest. Deciding what to do Van Hollen now must decide how to proceed. Joining other states in the Florida lawsuit would give Wisconsin less control over the direction of the case. The Florida case also may be too far along for Wisconsin to intervene. The state also could file a friend-of-the-court brief. That would give it more flexibility in its arguments. It also could file its own lawsuit. "We, in further analysis, may decide we want to take a little different legal or augmentative tack than them," Van Hollen said. "There are a number of different considerations and, once again, we've got a little bit of time to figure out which ones prevail." The cost of challenging the law will depend on whether the lawsuit is handled by his staff and how the state proceeds. Van Hollen acknowledged people have asked what difference Wisconsin could make in the outcome given the number of lawsuits already filed. But he said a multitude of parties can give a position more legal authority. "I really do believe it makes a difference," he said.
Anyone who has spent some time with Affiliate Marketing will say that it is more of an art than a science. You need to know where your target audience is, and importantly, you also need to know which method work best to promote your product. Clearly, affiliate programs are not as easy as you think they would be, if that is your thought as a newcomer. The first thing for you to do is find out a niche for yourselves. Of all the niches (Mind you, you will find about 1000s of niches when you start searching for profitable niches in affiliate programs), health is often considered one that can never die down. Irrespective of how much money a man or a woman spends in luxuries and accessories, health is one aspect he would never ignore. That's why Health Affiliate programs are probably the easiest to promote. The confusing point is You have over 100 and more health affiliate programs. You can very well sign up with some bottom rung health affiliate programs and start promoting the product. But remember in affiliate marketing Your promotion technique is probably not as important as the product itself. Wow Did you now know a trick to successful affiliate marketing or what? Tap into a health affiliate network that promotes quality health products, and one that would probably find a good acceptance ratio from your target audience. Confused? Let me explain this for you. Any health affiliate network that provides a conversion rate of 5% on clicks or more can be considered for selection. What I mean is this If you use PPC as a promotion technique, for every 100 clicks, you should have 5 sales or more. Best health affiliate programs are able to do this kind of conversion. Best affiliate programs will also have wide range of health products (I am not talking about the number of products, but the range of it). Good affiliate programs would also provide excellent discounts on volume orders. But most importantly, best affiliate programs would provide products to you that have wide acceptance amongst people. Clearly, it works for you to partner with the best affiliate programs. If this is a niche that appeals to you, click here to learn more.
After months of hearing forecasts of big hikes in group health insurance rates, Keri Jenkins got a pleasant surprise. Easy To Insure ME has the answers. Coverage costs for her company, the Norfolk-based ship agent and broker T. Parker Host, would increase by just 7.9 percent, despite new requirements under the national health care overhaul. It was the company's smallest rate bump since 2005. "We were very pleased," said Jenkins, who is T. Parker Host's senior vice president for administration. Many employers, like Jenkins, anticipated big changes as they developed insurance plans for the first time since the passage of the new health law. For 2011, the law requires coverage for more people and, in many cases, mandates preventive services without extra charge to individuals - benefits that come with a price tag. However, South Hampton Roads insurers, consultants and employers said the overhaul won't increase rates more than 4 percent next year, largely because many plans already came close to meeting the requirements. Overall, including other climbing expenses, local group health insurance costs are rising between 6 and 12 percent - a range comparable to recent years, they said. For employees, that means more of the same. "What we've seen is a trend where employers continue to offer less benefits and pass on more of the cost to the employees," said John DeGruttola, senior vice president of sales and marketing for Optima Health, the insurance arm of Sentara Healthcare. "It's really just in response to the double-digit medical inflation that occurs and continues to occur." Several provisions of the health care law take effect for plans renewed after Sept. 23, six months after the legislation was passed. For many people insured through their employers, these changes will begin in next year's coverage, which workers are now selecting during an open enrollment period. Under the law, all plans must cover dependents up to age 26. Children up to 19 can't be denied coverage due to a pre-existing condition. Insurers also can't establish limits on how much they will pay for covered benefits during the entire time an individual is enrolled in a plan. Plans can no longer terminate coverage retroactively due to honest mistakes on applications. Other rules are contingent on how much employers change their health plans. Among them is a requirement for plans to cover certain preventive services, such as flu shots and some cancer screenings, without charging copays or coinsurance. Companies can avoid that and some other mandates by basically freezing their plans as of March. To receive "grandfathered" status, a plan cannot significantly raise employees' responsibility for health costs or substantially reduce benefits. Insurers found that few companies chose this option, though. Dennis Wance was considering it for his Norfolk-based law firm, Vandeventer Black. Because of some serious illnesses, health insurance costs would spike next year if his firm chose to grandfather its current plan, he said. However, a new plan probably would mean employees pay a larger portion of their medical bills and receive slightly reduced benefits, he said. The choice promised to be difficult for a company that prides itself on generous health coverage for its 170 employees. "These benefits are important," said Wance, the firm's executive director. "That's why we're reluctant to do some of the more draconian things with medical premiums to get the cost down." In some cases, the new law caused barely a ripple in a company's coverage, especially if its plan already came close to meeting the provisions or if few people qualified for the new coverage. At T. Parker Host, for example, none of the 56 employees added a new adult dependent, Jenkins said. Other employers still wrestled with steep increases. At Hampton-based Old Point National Bank, monthly health premiums rose more than in recent years - between 10 and 20 percent, said Joseph Witt, executive vice president and human resources director. For his company and its 340 employees, high-deductible plans with health savings accounts have proved a good way to manage costs, he said. Those plans have lower premiums and higher deductibles than traditional plans, and allow employees to save money for medical costs in a tax-advantaged account. "We're hoping to one day have all of our employees say, 'Wow, these high-deductible plans are so great, there's no reason to be in a traditional plan anymore,' " Witt said. "Because the traditional plans are real dogs." Insurers said highdeductible plans gained popularity for 2011 because the plans allow employers to pay lower premiums and possibly invest in other benefits, such as matching funds for employee health savings accounts. Employers also showed more interest in steering employees to wellness programs as a long-term strategy to reduce costs. Programs with incentives, such as gift cards and deposits into the health accounts, tend to work best, said Jeff Ricketts, regional vice president of sales for Anthem Blue Cross and Blue Shield in Virginia. "Cash is king, we've found," he said. Looking ahead, employers are nervous about future demands of the health care overhaul - even as they wait to see whether it will withstand political assaults. "I can't say that the health care reform act has presented, in and of itself for 2011, that significant a challenge for us," Wance said. "I think those challenges are yet to come."
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