Archive by Month - June, 2010

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How To Prevent Short Term Health Insurance Buyers From Gaming The System

Wednesday, June 30th, 2010

Image: MNgilen under CC 3.0

With reform beginning to take effect, subsidized guaranteed issue insurance for people with pre-existing conditions is set to become available. Unfortunately, there is a serious concern: the issue of people gaming the system.

In some places, such as Massachusetts, people will buy short term health insurance when they are knowingly sick and cancel shortly after they receive treatment (under one year later). Insurers pay for their treatments, while receiving little in premiums for reimbursement. Therefore, the costs are passed onto steadily insured consumers.

The prevalence of this practice has skyrocketed over the past several years. Legislators are proposing several solutions, including an open-enrollment period that would allow individuals to buy temporary coverage solely during one or two months out of the year. There would be exceptions included for major life changes.

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Virginia Health Insurance Company Abandons Patients

Wednesday, June 30th, 2010

Individuals in one state now have one less option for health care. UniCare has decided to pull out of the Virginia health insurance market, due to competitive pressure from larger insurers.

Some of their nearly 3,000 patients are eligible to switch to Anthem Blue Cross Blue Shield, but others don’t live in Anthem’s coverage area. They will need to search for new health insurance coverage by January 1st, when UniCare’s plans will expire.

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Can Online Chat Make For A More Affordable HMO?

Tuesday, June 29th, 2010

Health insurers want to save money on customer service. At the same time, policyholders are increasingly connected. The UPMC Health Plan is a health insurance company that believes live online chat can do both.

Employees will be trained to handle policy and claim questions through their website. They hope that the technology will make it easier to provide affordable HMO products.

If their innovation is more successful than previous Internet attempts in terms of customer satisfaction, it could spread across the industry.

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Will Healthcare Reform Help Part-Time Employees?

Tuesday, June 29th, 2010

Image: The Consumerist under CC 3.0

Many supporters of healthcare reform have pointed to the benefits that it can bring to part-time workers. In most cases, companies do not offer health coverage to employees who work under a certain number of hours per week. Some businesses even intentionally schedule employees just under the threshold, in order to deny them health care.

During the recession, many people have been juggling multiple part-time jobs. Although they end up working full-time hours or longer, they are eligible for health benefits from none of them.

Affordable individual health insurance is the solution in this case, but it may not be available to everyone. The exchange markets that the law establishes in 2014 are hoped to help in this regard.

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High-Risk Health Insurance Pool D-Day

Monday, June 28th, 2010

Image: katietower under CC 3.0

Today is the deadline for states to decide whether or not they will participate in one of the initial changes of healthcare reform: they need to tell the federal government if they are planning to create new health insurance pools for high-risk patients with pre-existing conditions.

So far, 18 states have flatly refused. Qualified uninsured people from those states will buy into a national pool, which will open on July 1st. Utah and Texas are still undecided, but they’re running out of time.

The states that will create new temporary pools for high-risk health insurance plans will receive part of a $5 billion grant set aside in the law for that purpose.

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Democratic Governors Fight Back Against Healthcare Reform Lawsuit

Monday, June 28th, 2010

While several lawsuits contending that healthcare reform is unconstitutional are currently pending, supporters of the legislation are stating their arguments in favor of it.

A small group of Democratic governors are now defying their Republican attorney generals, by filing a friend of the court brief defending the federal government.

The states involved:

  • Washington
  • Colorado
  • Pennsylvania
  • Michigan

Their filings will explain what benefits they believe affordable health insurance reform will have for their states, bolstering the defendants’ case for any future Supreme Court hearings on the topic.

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Health Insurance Rate Cap Denied In Mass.

Friday, June 25th, 2010

Consumers looking for affordable health insurance on the open market won some and lost some today. This is an example of the later: a state insurance appeal board just overturned a cap on rates that was set by Gov. Deval Patrick in Massachusetts.

The rate cap was intended to put a lid on seemingly endlessly rising health insurance rates. Massachusetts health insurance companies claimed that the cap would irreparably damage their businesses.

The appeal board sided with Harvard Pilgrim Health Care, which was worried that increasing health care costs combined with the cap would make them insolvent. That insurer’s proposed rate increases were considered reasonable given those concerns. They are now free to implement the premium hikes, initially scheduled to become effective on April 1st. However, the three-month period they were meant for is about to finish–although they may charge the higher rates retroactively.

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Math Errors Torpedo California Health Insurance Rate Increases

Friday, June 25th, 2010

The state of California has been a battleground for health insurers recently. First, WellPoint was heavily criticized for proposed small group and individual health insurance increases of over 30%. The highest premium jumps were later withdrawn after the insurance commissioner found mathematical errors. (Smaller increases were eventually approved.)

Now, it looks like history is repeating itself. Aetna had asked for increases that averaged nearly 20% for its California health insurance customers. It has withdrawn its request upon discovering a “human error” in its calculations.

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Adult Stepchildren Can Be Covered By Family Health Insurance

Thursday, June 24th, 2010

As a result of the healthcare reform law, people will soon be able to cover their adult children under their family health insurance policies.

In an era of blended families, it is of serious concern that the same benefits are extended to stepchildren. Fortunately, that is the case. The stepchild of any half of a married couple will indeed be eligible for coverage under their stepparent’s plan until the age of 27. (The same is true for adopted children.)

Under healthcare reform, the same limitations for biological children apply to stepkids. Namely, that they can’t partake in it if they are offered acceptable health coverage by their employer.

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Americans Spend Double On Health Insurance, With Worse Results

Thursday, June 24th, 2010

A study from the Commonwealth Fund compared the health care systems of several developed nations. Unfortunately, the United States was again ranked at the bottom.

The survey found that, on average, Americans spent over $7,000 on health expenses in 2007. Still, their quality of care was not the highest. The authors blame the inequitable patchwork of individual, employer-provided, and public health insurance plans that leave millions uninsured.

So if the USA isn’t on top, who is? The Netherlands had the highest overall score. Maybe our health insurance system could learn from the Dutch.

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