Health Insurance Blog

The struggling economy is causing significant issues for many states which provide health plans to assist low-income families.  Many states are being forced to pare back these health insurance programs at the worst possible time…when the number of unemployed Americans continue to rise and people need assistance the most.

The methods by which various states attempt to shave the costs of these programs range from cutting benefits, to freezing new enrollment, to raising the costs that must be picked up by the enrollee.

Among some of the state sponsored low-income health plans that are in trouble include:

• Washington Basic Health - Will fold in July unless $160 Million in additional Revenue.  About 300 Washington residents are added to waiting list each day.
• CoverTN - Tennessee’s state sponsored program.  Halted in December.
• CharterOak Health Plan - Connecticut’s program.  Must freeze enrollment this year unless lawmakers can find more money to keep it open.
• AdultBasic - Pennsylvania’s Program for low income adults.  Increasing fees.  Waiting list doubled in 2009
• General Assistance medical Care Program - Minnesota’s Program will end in March, existing members will be moved over to MinnesotaCare.

Among other viable options for low-income adults who are looking to lower their monthly health insurance costs, while insuring that they will be covered if they fall ill or are in a serious accident, would be to increase the deductible of their existing health plan.  This will keep monthly premiums down, but will require greater out of pocket costs if you should need to utilize medical care.

The article “Health Care Reform Would Help Insurers” by Gavin Magor on thestreet.com says insurance company stocks have risen in hopes that health care reform will come to a halt.  In actuality, reform could widen and increase insurers’ customer base while potentially increasing profits.

The House and Senate health care reform bills would promote some of the biggest changes in the industry in the last 40 years and provide millions of Americans with health insurance and an easier system to obtain affordable health insurance quotes.  The bills also include extensions of Medicaid and additional restrictions on insurance companies.

With reduced rates on Medicare some companies may struggle.  Humana Health Insurance is the largest Medicare Advantage provider so in order for them to remain profitable they would need to control expenditures.  It’s definitely possible as many health insurance companies have proven profits can remain during a recession by keeping costs down.

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.

As unemployment rises so does the number of people who need help finding health insurance.  A lost job usually means a loss in employer based health insurance as well.  According to the article on WISN.com, millions of Americans are an illness away from financial ruin because they are not protected by health insurance. 

Finding health insurance does not have to be difficult.  Consumer Reports supports checking to see if you qualify for Medicaid.  If you do not, another option is checking to see if your kids qualify for the Children’s Health insurance program (CHIPS). 

By visiting govbenefits.org you can see if there are any other government insurance programs you may be eligible for.  It’s important to shop around and educate yourself on the different types of health insurance options out there.

Despite the fiscal crisis being experienced nationwide, 14 states found money this year to increase health insurance coverage for an additional 250,000 children nationwide.

The states took advantage of $33 Million that was appropriated by Congress when it reauthorized the Children’s health insurance program (CHIP) back in February.

the 14 states that are expanding their children’s health insurance programs inlcude: Alabama, Arkansas, Colorado, Indiana, Iowa, Kansas, Montana, Nebraska, North Dakota, Oklahoma, Oregon, Rhode Island, Washington, and West Virginia

Since 2008, at least 21 other states have had to cut state sponsored health programs due to financial woes.  In addition the recession has caused at least 15 states to make cuts to Medicaid Programs during 2010-2011, and 8 states have made cuts to Medicaid benefits for 2009

According to the PRWeb article through medicaresupplementplans.com entitled “California Health Insurance Assistance Program Awarded 2009 Grant Funding”, California health insurance assistance programs are expected to receive about $3 million in grants to help Medicare beneficiaries in need of information on health insurance topics.

This is an ongoing effort to better assist these citizens who are often lacking comprehensive and accurate information about their health care options.  The funds being used are part of a $35.8 million grant from the Centers for Medicare and Medicaid Services.  The grants to California health insurance assistance programs are part of the 1st installment of funding that began in April ‘09 and will end in March ‘10.

Seniors often underestimate how time consuming researching and understanding their benefits can be.  And sometimes it gets really complicated.  These funds will support programs designed to make this process for them a little easier.  The assistance is personalized and local while providing a wide range of health insurance information best suited to each individual.

According to the Curt Woodward, an AP writer, the health insurance rates that Washington residents pay for the state subsidized Washington Basic Health Plan are set to rise sharply.  Monthly premiums will rise from around $37 to roughly $62.  In addition, annual deductibles will rise from $150 to $250.

About 100,000 Washingtonians are enrolled in the plan, which is an affordable health insurance option for the “working poor”.  Those that make too much to be eligible for Medicaid, but can’t afford to purchase Washington health insurance coverage otherwise.

The number of enrollees in the state subsidized health plan as well will shrink as well, which will help keep the plan solvent.  The 100,000 enrollees will be reduced to a projected 65,000 over time.  Part of the reduction will be driven by moving people who are eligible for Medicaid over to that plan (roughly 8,000).

More information about Washington health insurance.

According to Reuters, below is a list and description of the key players involved in the health care debate and subsequently shaping health care reform

• Kathleen Sebelius, Health and Human Services Secretary, leads Obama’s push to enact by the end of 2009 an overhaul of the $2.5 trillion U.S. health care industry. Previously served as the Kansas health insurance commissioner for eight years.
• Nancy-Ann DeParle, director of White House Office of Health Reform, is charged with coordinating reform efforts with Congress. A former Clinton administration official, DeParle headed the Health Care Financing Administration (now Centers for Medicare & Medicaid Services).
• Rahm Emanuel, White House Chief of Staff.   He was chairman of the House Democratic Caucus, fourth in the hierarchy of House Democratic leaders, was formerly a senior adviser to President Clinton.
• Senate Finance Committee Chairman Max Baucus, and the panel’s senior Republican, Sen. Chuck Grassley have taken the lead in the debate, playing key roles in writing legislation aimed at reducing soaring costs and expanding health insurance coverage to the estimated 46 million uninsured Americans.
• Senate Health Committee Chairman Edward Kennedy, has been a leader in the Senate on health care reform, pushing for a Patient’s Bill of Rights and an expansion of Medicare, to lower prescription drugs cost.
• Sen. Mike Enzi of Wyoming, senior Republican on the Senate Health panel, advocates for bipartisan support for health care reform.
• House Energy and Commerce committee chairman Henry Waxman, has championed reform efforts, including expand of health coverage for children, seniors, persons with disabilities, and low-income families.
• Joe Barton, the senior Republican on the House Energy panel, says ensuring that Americans are able to afford the health care they need is an important priority.
• House Ways and Means chairman Charles Rangel, supports an expansion of health care to include Americans who lack health insurance coverage. He says the United States must provide health coverage for children and working people the same kind of coverage Medicare provides for Seniors.
• Rep Dave Camp, the senior Republican on the House Ways and Means panel, says health coverage expansion can and should be done without making the government the sole health insurance provider.

More coveage of health care reform topics.

A recent Reuters article quoted these facts about our healthcare system.

1. According to US Government economists, public and private health care spending will hit $2.5 Trillion this year, 17.6% of GDP
2. Americans spend more per capita on health care than any other country at $7,421 per person, and receive poorer care than many other industrialized countries that have nationalized health care.  (Of the $7000 plus spent on health care per person…35% of this is paid by private health insurance companies, 19% paid by Medicare, 15% is paid by Medicaid and Children’s Health Insurance Programs, 12% from public funds, 7% private sources, and the remaining 12% out of pocket by patients.)
3. 15% of population (46 million people) have no health insurance coverage.
4. 63% of US companies offer health benefits to workers.
5. Growth in health insurance premiums has outpaced workers’ earnings and inflation since 2004 by a ratio of 4 to1.

Since the Healthy Indiana government-subsidized health care program was opened to adults without children in January 2008, it has given thousands greater access to Indiana health insurance. According to the Courier-Journal’s Leslie Stedman Weidenbener, the plan has been so successful that many people are on a waiting list to enroll (due to limited program funds). State legislators negotiated an exception to Medicaid regulations that limit the program to families. 34,000 out of 49,000 enrollees are adults without children who are unable to afford individual health insurance.

People covered under the Healthy Indiana program must pay a sliding scale monthly premium based on their income (from $20 to $75).

What’s included under the Healthy Indiana plan?

1. $500 in free preventative care each year
2. An annual health savings account (HSA) of $1,100
3. After the HSA is spent, there is a traditional health insurance plan without co-payments or deductibles.

To qualify for the Healthy Indiana program, Leslie writes that a childless adult must meet the following requirements:

• They must work for a company that doesn’t offer health insurance (so employers can’t drop them from their coverage and shift the burden onto the state)
• A single adult can make no more than $21,660 per year, or 200% of the poverty level
• They must have been without health insurance for at least six months.