Health Insurance Blog

According to the article “The Missing Link in Health Reform: A Guarantee of Good Coverage At Work” by Richard Kirsch on huffingtonpost.com, the new House bill will require all but very small employers to offer and help pay for good health insurance benefits.  They can also choose to pay a percent of their payroll to the government to assist with covering subsidies.

The Senate bill on the other hand doesn’t require employers to offer or pay for health insurance for their employees.  The Senate bill will require employers with 50 or more full time employees to pay a fine if their employees end up getting subsidies from the government.  What will actually end up happening depends on which bill gets implemented.

The article points out that currently 150 million Americans get health insurance through their work so there are a lot of people who need to understand the changes.  During the past 10 years health insurance at work has deteriorated and more consumers are turning to individual health insurance.  A study of employers released in the fall says the trend is likely to continue in 2010.  Health care reform is a key component to how it will all play out.

In what has been a roller coaster for all those involved and interested, the Wall Street Journal reports that the health overhaul bill once finalized need not include a Government-run health insurance option as long as other parts of the bill would fulfill the same goals.  However, one thing that will be required from the bill is the ability to hold health insurance companies accountable.

Keeping a public option out of the bill is a top priority for AHIP, whose members include CIGNA, WellPoint Inc. and Humana Inc. among other health insurance companies. The group also opposed the Senate bill because of new taxes on the industry, caps on administrative costs and other changes.

The WhiteHouse.gov website has information on the new health care reform bill.  They specifically discuss the changes being made to Medicare.  To pay for the health care reform bill there needs to be $313 billion in savings to create a deficit for an overall neutral plan.  The article says that America has the most expensive health care system in the world but points out that we do not get the best results.  Something new is needed to change this.

The majority of the savings which will help pay for the new bill comes from savings in the Medicare and Medicaid system.  There are 3 main points to saving in Medicare which include incorporating productivity adjustments into Medicare payment updates, reducing subsidies to hospitals for treating the uninsured as coverage increases, and pay lower prices for Medicare Part D drugs.

The pharmaceutical industry has committed to slowing the rate of increase of health care costs.  This will also help keep health insurance quotes down as most Americans will be required to carry health insurance coverage.  The Administration is continuously working with Congress to develop the best ways to achieve the necessary savings.

Upon the heels of the H1N1 virus outbreak, Geisinger Health Plan hospitals will continue to have visitation restrictions.  Geisinger Medical Center and Geisinger Wyoming Valley Medical Center will keep enforcing the visitor restrictions to help prevent the spread of H1N1 and other dangerous viruses.

Dr. Lisa Esolen, Medical Director for Infection Control at Geisinger Health System says that this has been an unpredictable flu season and they are committed to protecting patients.  Children under 12 are restricted from visiting all areas and everyone else will be screened for flu-like symptoms.  The H1N1 pandemic has slowed down but seasonal flu is starting up.  Past flu viruses have shown spikes in January through March.

Many people each year are hospitalized for the flu which is just one more reason to ensure you are protected with individual health insurance.  With the new health care reform bill which recently passed in Congress, most Americans will be required to carry health insurance coverage which will help cover costs for such flu pandemics.

According to the article “Americans Would Feel Varying Effects From Health Bill” by John Fritze for USA Today, the self-employed are among some of the most affected by the recent passing of the health care bill by Congress.

The article points out that those who buy their health coverage on their own, as opposed to through an employer, will feel some of the biggest changes under the new health care bill.  Along with most Americans, the new bill will require the self-employed and independent contractors to carry health insurance coverage by 2014 or otherwise face a penalty.  Health insurance quotes for the self-employed can be expensive and many choose not to be protected because of this.  About 1/3 of the 22 million self-employed Americans do not currently have coverage.  This number is bound to change in the coming years.

For those who are eligible to receive subsidies, health insurance rates will fall by about 59% on average, but this is only available to those making less than $43,320 per year.  The Congressional Budget Office estimates that the non-group insurance market prices may go up by as much as 13% and this will prove very challenging for the self-employed with slightly higher incomes as they are finding health insurance.

Texas insurance consumer advocate is looking to get rid of the blanket authority of health insurance companies to decide what their policies will cover according to the article “Texas Consumer Advocate Wants Ban on Health Insurers’ Blanket Clauses” by Terrence Stutz on DallasNews.com.  This would cause a big impact on individual health insurance in Texas.

Deeia Beck, the Public Insurance Counsel, asked the state’s insurance commissioner to stop provisions present in many health insurance policies, called discretionary clauses.  This gives health insurance companies the freedom to decide what benefits will get paid.  The health insurance industry strongly opposes this type of change being made.

There are currently 22 states who have banned this clause, and Texas may be next.  Insurance Commissioner, Mike Geesline, has held a hearing to consider whether or not to move forward with this proposal.  The National Association of Insurance Commissioners has urged its members to stop this practice.

Democrat Senate Majority Leader Harry Reid has thrown in the towel on the major facets of health care reform including the public plan as well as the expansion of Medicare to those aged 55-64.   What is left behind is no longer health care reform but is now health insurance reform.

The new bill will probably consist cutting health insurance costs by further regulating health insurance companies.

According to the article “Medicare ‘Buy-In’: A bargain or burden?” by Richard Wolf for USA Today, the latest health insurance proposal involves letting people use Medicare starting as early as age 55.

While this may sound appealing to many, the Medicare premium has not been determined and it could be costly.  Senate Majority Leader, Harry Reid, and other Democrats are considering expanding eligible consumers for Medicare and maybe Medicare supplement insurance plans.  This is an effort to break a deadlock between liberals and moderates who are unable to agree on a government run health insurance plan.

Details of this proposed plan are still pending an analysis completed by the Congressional Budget Office, who will project costs associated with the plan.  Those who are ages 55-64 who are uninsured or looking for more competitive premiums would likely be eligible.  Most consumers with employer based coverage would not be eligible for early Medicare coverage.  Finding health insurance for this age group may get easier if this plan is put into effect.

Blue Cross Blue Shield Medicare Supplemental Insurance is a very valuable type of coverage for those on Medicare.  According to their website, medicare does not cover all health care costs so having additional coverage can save you a lot of money.

Medicare coverage generally consists of Part A, which takes care of hospital and nursing facility care coverage, and Part B, which covers physician costs and other health care expenses.  Even with both of these coverages senior have to pay for other costs out of their own pocket.  Some of these include deductibles, copays, and coinsurance.  If someone doesn’t have Medicare supplement insurance, costs can be as high as $53,000 according to BCBS.  That is often beyond affordable for many seniors living off of social security.

Private insurance companies, such as BCBS medicare supplements, offer extra protection to fill in the gaps for medical expenses.  With health care reform still up for debate it’s hard to tell what will happen to seniors who are currently covered by Medicare and supplemental insurance.  It’s extra important that seniors have affordable health care, because not only do they need it more, but many are on fixed incomes, so a large increase in costs could be devastating.

The AARP recently announced they are supporting the idea of a government run health care system according to the article “Why Has the AARP Sold Out Its Members on Healthcare” by Al Ritter for the Baltimore Conservative Examiner.  This is interesting because the AARP is a self declared non-partisan group.

In 2008 AARP made about $653 million in royalties from insurance companies that sold products referred by AARP.  This is huge considering membership fees only brought in about $249 million that same year.  Seniors have two main choices for Medicare supplement insurance plans, Medicare Advantage and Medigap.  Medigap supplemental insuranceis endorsed by the AARP and they receive royalties from the company.  With Medicare Advantage health plans at risk with the new health care proposal, the hope is that more people will purchase Medigap and therefore AARP will make more money.

Section 1161 of the House bill cuts payments to the government run Medicare Advantage health plan which is used by about 20% of senior citizens.  It may cause them to lose some of their benefits such as health, vision and dental coverage and this is why they may be forced to purchase AARP Medicare Supplements.