Health Insurance Blog

No matter what you celebrate, we at Health Insurance Sort wish you a peaceful holiday.

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Kay Lazar from the Boston Globe is reporting that the Massachusetts Department of Revenue is raising the monentary penalties charged to individuals without Massachusetts health insurance.

The fines are levied monthly. If an adult over the age of 27 and earns over $31,212 per year, as of 2009 they will now have to pay $1,086 per year for being uninsured. An uninsured adult from 18 to 26 years of age making that amount must pay penalties totaling $624 per year. There is a sliding scale for individuals with lower salaries; people making less than $15,612 are eligible for health care subsidized by the state and therefore don’t have to pay any penalty.

The state of Massachusetts passed a 2006 law that requires all adults (age 18 or over) to have health insurance if the Commonwealth Health Insurance Connector Authority determines they can afford it. The policy is intended as a way to transition the state to universal healthcare. Kay quotes a Dept. of Revenue commissioner, who says that last year, 5% of adults that are required to buy health insurance didn’t obtain coverage.

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RedOrbit recently reported that after many states have seen a significant increase in Medicaid enrollment since the beginning of the recession (Connecticut has seen a 6% increase this year), governors have asked Congress and President-Elect Barack Obama to help them pay for the publicly funded health insurance plan. The governors are petitioning for $40 billion to cover a shortfall in projected tax revenues, which would be a two-year long increase in the percentage Washington D.C. kicks in for medical funding. As of the 2007 fiscal year the federal goverment covers 57% of Medicaid costs while individual states cover the rest.

Medicaid is offered to children and the extremely poor; about 1 in 6 low income individuals in America are enrolled. Rising unemployment has resulted in more people being eligible for Medicaid, while at the same time state governments are suffering from lower tax revenues. Unlike the federal government, states aren’t allowed to run a budget deficit. If the states don’t recieve this funding, they will either have to cut programs or raise taxes in order to balance their budgets. While most unemployed individuals can buy into group health insurance plans, the majority cannot afford the premiums without an employer paying some part of them.

The National Business Coalition of Health just released a study based on data from its eValue8 comparison tool. The study’s findings include great news for individuals with chronic conditions and employer-based health insurance. The average health insurance plan is doing more to cover the medication and equipment needed, due to higher employee demand. The result is less expensive co-payments for consumers.

Visible Trends in 2008:

• Asthma. 32% of insurance plans reduce co-payments for treatment, and 19% eliminate them entirely.
• Diabetes. 33% of insurers reduce co-payments, and 27% waive them.
• Hypertension.  20% of insurers waive co-payments, and 28% reduce them.

According to the Phoenix Business Journal, seven Arizona health insurance companies are working together to create the Arizona Association of Health Plans Inc.

The Seven health plans include:

• Arizona Physician’s IPA
• Mercy Care Plan
• Care1st Arizona
• University Family Care
• Phoenix Health Plan
• SCAN Long Term Care
• Health Choice AZ

The Association hopes to add more commercial health insurance carriers to their membership as they strive to work with AHCCCS administration as well as legislators, government agencies and health care providers to improve the quality, availability and cost of health care delivery in Arizona.

Autism affects thousands of American families every day. In most cases, families must go into debt to pay for the comprehensive therapy they feel their children need; behavioral therapy is not covered by most insurance. Utah state senator Howard Stephenson and state representative Roger Barrus (both R) plan to change all that. In January, they will introduce a bill in the state legislature that would mandate providers of Utah health insurance to cover treatment for autism.

In the Salt Lake Tribune, Heather May outlined the provisions of this bill:

• The bill will only cover treatment for autistic children under 5 years of age, because that’s when therapy is said to have the greatest impact.
• The type of treatment covered by the bill is most likely to be ABA therapy (applied behavior analysis), which consists of up to 40 hours a week of one-on-one therapy that helps autistic children learn to communicate and teaches them appropriate social skills. ABA is widely considered to be effective, but it has been criticized by some for being an unproven method.
• Companies that are self-insured, as well as the federal government, will be excluded from the health care coverage mandate.
• The insurance will have a $30,000 annual cap, as well as a lifetime cap.
• The bill will also require families to contribute financially.

California’s state sponsored health insurance program for working poor and uninsured children received a last minute contribution from First 5 California.  The $16.8 Million contribution will allow Healthy Families California to continue accepting new members through June of ‘09.  Without this last minute lifeline, an estimated 162,000 California children would have went without health insurance for at least the next six months.

The Managed Risk Medical Insurance Board, which runs the Healthy Families program, had scheduled a meeting for today December 17th  to limit new enrollments into the health care program, which currently provides California health insurance for 900,000 children who would otherwise be uninsured.

First 5 California is an organization that is tasked with improving the healthcare of young children in California.

Ohio is one of only two US states that are planning on expanding their publicly funded health insurance programs (such as Medicaid and Healthy Start Ohio).  The other state planning to do so is West Virginia.  19 Other states are making cuts to their programs, or are considering doing so.

Although the state hasn’t made a firm spending commitment, they have received approval to expand the children’s health insurance program in 2009.

Golden Rule, a United HealthCare company, is offering a unique insurance product.  The plan allows workers, who fear that they might get laid-off and subsequently lose their employer-sponsored health coverage, to pay a fee in order to be covered by a Golden Rule health insurance policy in case they lose their job and become uninsured.

The cost savings for the member would come into play when the monthly premiums required to be covered by Golden Rule would be substantially less than health coverage from COBRA.

For Example, COBRA replacement coverage for a husband and wife could cost $500-$800 per month, whereas similar coverage via the Golden Rule health plan would cost $385 per month once enrolled + $77 per month now for the right to access the plan later.

The plan is called UnitedHealth Continuity.  It is currently available in 25 states, and over time, Golden Rule plans to make it available in all 40 states where they currently do business.

The cost savings seem pretty speculative unless you would expect to be on COBRA for several months.  If you didn’t get laid off, you would be spending $77 a month for nothing, although I guess that is what insurance is all about….peace of mind.

Women of child-bearing age (19 to 55 years old) pay more for health insurance than men, says Linda A. Firestone, Ph.D in the Sun-Sentinel. A typical woman’s policy includes maternity coverage, which accounts for the gender disparity in insurance rates. Since the majority of American adult women eventually have children, health insurance with maternity coverage makes sense for them–especially if there are pregnancy or birth complications.

Group health insurance plans (for example, those provided by employers) in Florida do not allow women to opt out of maternity coverage. If a woman does not plan to have children, she can choose to buy one of many individual health plans, which allow her to opt out of maternity coverage. In fact, many insurance providers (such as Humana), no longer offer maternity coverage in their plans. Insurance specialist Larry Wides says the cost savings from a group plan tend to cancel out the reduced premiums resulting from the elimination of maternity coverage.