Health Insurance Blog

A Health Insurance Bill that for the first time would use federal money to cover children and pregnant women, was overwhelmingly approved by the senate yesterday.  Eleven million children without health insurance and from low-income households will receive health insurance coverage as a result of this bill.

Until now, health insurance was provided for families who made too much to receive Medicaid, but yet couldn’t afford private health insurance by The State Children Health Insurance Program (SCHIP).

More information about existing children’s health insurance programs at the state level.

Due to economic struggles and the rising cost of health insurance, many small businesses have eliminated or cut back their coverage of employees. Eve Tahmincioglu of MSNBC has reported on the trend of employers dropping their health coverage. Small businesses are suffering from decreasing sales from customers who are struggling financially. With lower profit margins, it has become virtually impossible for these businesses to pay ever-increasing premiums for their employees.

Employers that haven’t yet resorted to eliminating health care coverage altogether are taking other cost-cutting measures. Popular options, according to Eve, are increasing the cost of family members’ coverage and raising deductibles. These actions pass more of the costs of health care onto the consumer.

A recent survey claims that 85% of small business owners do not offer medical coverage to their employees, and 36% of those that do are thinking about dropping it. That figure was 74% in January 2007 and 77% in January 2008. As a result, more people will have to fend for themselves in the health care marketplace. Workers whose companies no longer offer health insurance benefits should look into buying individual health insurance policies, although that may not help employees who can’t get it due to pre-existing conditions.

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The city of San Francisco has filed suit against California insurance regulators alleging that they have approved a health insurance rating system that allows California health insurance companies to charge women more than men for health insurance coverage.

In the state of California, gender rating is permitted in setting health insurance rates, which allows a customers gender to be used as a rating factor in determining their health insurance premium.  A practice that has resulted in women paying on average 39% more than men for identical coverage.

Currently 10 states outlaw the practice of gender rating with regard to individual health insurance rates, however California is not one of them.

Blue Shield of California representatives have claimed that their actuaries crunched the numbers based on healthcare data and indeed found that women are more injury prone than men and more likely to break bones or become sick, thus justifying the relevance of using gender as a rating factor.

Blue Cross and Blue Shield of North Dakota (BCBSND) has come to an agreement with local hospitals that they will not lower reimbursement payments, reports Retha Colclasure of KFYR Bismarck. In order to save money, the insurer had sought to reduce payments to health care providers without contract renegotiations. The North Dakota Insurance Department blocked such a move.

Decreased payments from insurance companies make hospitals tighten their budgets, possibly resulting in fewer services being offered. For example, St. Alexius hospital would have suffered a $300,000 monthly deficit, Retha claims. Sometimes, hospitals may even refuse to treat patients under certain insurers because of what they consider inadequate compensation. Thankfully, North Dakota health insurance customers will no longer have to worry about that.

The Fort Mill Times is reporting that two state congresspersons have proposed expanding Minnesota health insurance to more children through the state’s MinnesotaCare program. MinnesotaCare is aimed towards working poor individuals and their children. The possible costs of such a move have not been detailed.

These proposed changes would no longer require parents to pay premiums for their child’s health care if they fall below a certain poverty level. The program has also been opened up to families unable to afford private health insurance, regardless of whether their incomes are above that level. In addition, the enrollment waiting period has been eliminated, so kids can be covered immediately.

Senator Linda Berglin and Representative Paul Thissen, both Democrats, are co-sponsors of the bill. Their goal is for needy individuals to have greater access to children’s health insurance.

COBRA health insurance coverage is becoming more and more out of reach for Americans who lose their jobs, according to a report by Families USA.   According to the report, Americans who become unemployed and receive unemployment benefits received on avg. $1,278 per month in federal benefits, COBRA health insurance coverage would devour more than80% of that to cover a family.  Needless to say, spending more than 80% of your income on health insurance doesn’t make sense, and doesn’t leave enough money behind for other basic family needs.

The full report from Families USA is online an can be found at www.familiesusa.org/resources/publications/reports/cobra.html.

for information about affordable health insurance plans as an alternative to COBRA.

Following up on a post from Wednesday, Highmark and Independence Blue Cross have decided to abandon their plans for a merger, says Martha Raffaele of the Associated Press. The Pennsylvania health insurance companies did not want to agree to give up either the Blue Cross or Blue Shield trademark, which the Insurance Department was requiring.

Highmark is dominant in western Pennsylvania, while Independence Blue Cross is mainly in Philadelphia. A merger would have made the combined insurer the largest health insurance provider in the state. Insurance commissioner Joel Ario believes that a merger would have a negative impact on consumers’ health care access and choice unless another competitor was allowed to enter the market with a Blue name.

The top four providers of Florida health insurance recently met to discuss health care under a Barack Obama administration, says Jeremy Cox of the Jacksonville Times-Union. Representatives from Humana, UnitedHealth, Blue Cross Blue Shield of Florida, and Aetna were in attendance.

The insurers believe that President Obama should enact a health insurance mandate for all Americans if, as they predict, he will require insurers to cover individuals with pre-existing conditions. They think that the cost will be prohibitive for carriers otherwise. At the moment, Obama has not publicly supported a mandate, and how exactly one would be carried out is unknown. He has supported a role for the private sector in universal health care, but that role will most likely be a change from the current market.

Instead of the plans Obama and congressional Democrats have proposed for health care reform, the insurance companies would prefer that the government focus mainly on enrolling eligible but currently uninsured individuals in federal-run programs like Medicaid and Medicare, Jeremy says. While the insurance companies agreed that greater coverage is a priority, they claim the task of covering other Americans should be left to them through innovative new plans.

The top five Tennessee health plans (based on prevention, treatment and customer assessment) according to US News and World Report’s annual rankings were as follows:

UnitedHealthCare Plan of the River Valley - Also rated as the #1 overall health plan for the Medicare market

CIGNA Healthcare of Tennessee - ranked #1 in Tennessee on the customer assessment measure.

Cariten Health Plan

UnitedHealthcare of Tennessee

Aetna Health of Tennessee

More information about Tennessee health insurance plans.

According to Jane M. Von Bergen and Angela Couloumbis of the Philadelphia Inquirer, Pennsylvania’s insurance commissioner has set a condition that must be met for the state to approve a merger of two major Pennsylvania health insurance companies: Highmark and Independence Blue Cross. 

The deal will require that the combined company give up the right to the Blue Shield trademark, currently used by Highmark. They will be allowed to retain the use of the Blue Cross trademark, while the former could then be used by another competitor to market themselves statewide. 

It is unknown whether the two companies would accept such a provision, say Jane and Angela. The state is mostly worried about the impact a merger would have on competition. This decision, rumored to occur next week, could jepoardize a merger that has been in progress since early 2007. 

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