Archive by Month - August, 2010

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Healthcare Reform Lawsuit Arguments Continue

Tuesday, August 31st, 2010
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Image: steakpinball under CC 3.0

When it comes to healthcare reform, controversy is never far behind. The federal government has continued to argue that the law is constitutional. In a district court, their lawyers claim that the burden of proof should be on the coalition of states suing.

Specifically, the states claim harm from the provision that mandates the purchase of health insurance plans. If a person or business does not comply, they are subject to annual fines of $695. However, the plaintiffs have allegedly failed to demonstrate imminent or actual financial injury, since that aspect of the legislation does not take effect until 2014.

Moreover, the federal government claims that even if the penalty (which would be collected by the IRS) is technically considered a tax, the Anti-Injunction Act prevents states from challenging it, since the individual mandate is considered integral to the structure of the bill.

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Most Health Insurance Plans Don’t Cover Fertility Treatments

Monday, August 30th, 2010
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Image: Daquella manera under CC 3.0

Treatments for infertility can be very expensive. The average cost of one round of in-vitro fertilization is $12,400; it often takes several cycles in order for it to be successful. Meanwhile, many women choose to implant multiple embryos for greater chances of success.

Not only are the actual treatments expensive, but they can lead to high-risk pregnancies and the complications that often result from multiple births. Due to the high cost, most health insurance plans don’t cover fertility treatments. The number of plans that include infertility coverage has decreased over the past decade.

Those that do are typically larger employers. In those cases, oral medications that promote fertility are more likely to be covered except for a nominal co-payment.

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Colorado To Vote On Health Insurance Plan Mandate

Saturday, August 28th, 2010
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Image: Paraflyer under CC 3.0

Like several other states, Colorado will have a healthcare reform-related question on the November ballot. Voters will be able to decide whether or not they want to legally challenge provisions of the law.

Similar to other states’ ballot measures, it would pass a law that prevents the federal government from enacting a health insurance plan mandate–one of the main provisions of the bill, intended to reduce the cost of health insurance by spreading the cost among more (typically healthy) people.

It remains to be seen if Amendment 63 is successful. Even if it passes, the federal law may still dominate state law. However, conservative groups are happy that the Colorado health insurance measure received enough signatures to reach the ballot.

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Health Insurance Plan Agents May Suffer Under Reform

Friday, August 27th, 2010
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Image: Jennifer Feuchter under CC 3.0

Although healthcare reform tries to help many, it will end up hurting at least some. For example, the business model of many health insurance brokerages and agencies is in danger.

Provisions involving medical loss ratios, which include agent commissions in the “administrative” category that will be regulated and limited, will have a negative effect. In addition, brokerages may be made redundant by the state insurance exchanges and accompanying websites that must be launched by 2014. On the bright side for them, the National Association of Insurance Commissioners passed a resolution that affirmed the importance of licensed insurance professionals.

With the possibility of a double-dip recession looming, more job losses is obviously a downside. However, industry experts predict that these companies have several options for adaptation. Hopefully, their experience in navigating the complexity of the market and helping people decide on a health insurance plan will still be in demand. Their compensation model may also be adjusted in favor of flat fees instead of commissions.

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Inflation of Health Insurance Plans Continued in 2009

Thursday, August 26th, 2010
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Image: Paolo Camera under CC 3.0

2009 had the American economy in the throes of recession. Inflation was very low, while the Federal Reserve cut the interest rate to almost zero. So why did the cost of health insurance plans continue to rise?

To be exact, United Benefit Advisors found that health insurance rates increased by an average of 7.3% for employers. That’s almost three times the inflation in general consumer prices.

Insurers tend to blame an increase in medical expenses. Meanwhile, companies are using consumer-directed health plans to pass more of the cost of group health insurance coverage onto their employees.

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No Fee on Health Insurance Plans to Pay For Okla. Medicaid

Wednesday, August 25th, 2010
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Image: KB35 under CC 3.0

Recently, the Oklahoma state legislature attempted to implement a one percent fee on the sale of health insurance plans. The proceeds were supposed to help pay for the state’s Medicare program.

However, the state’s Supreme Court just ruled that such a fee is unconstitutional, agreeing with Insurance Commissioner Kim Holland’s objections. Six out of nine justices decided that since the law was passed during the final week of the legislative session with less than three quarters of the legislature in favor, it could not stand.

The fee was to be charged to employers that offer health insurance coverage to their employees. It was supposed to raise $78 million for the fiscal year beginning July 1st.

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Grad Students’ Affordable Health Insurance Struggles

Tuesday, August 24th, 2010

Image: misspudding under CC 3.0

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Many students struggle with finding affordable health insurance. The situation for graduate students is even worse: they are often too old to be eligible to remain on their parents’ health insurance plans (even post-healthcare reform), and out-of-network co-payments are extremely high. At the same time, some graduate school programs require full-time hours, preventing students from finding a full-time job that offers coverage. They may also believe that their small stipends will not cover individual health insurance.

In the case of Purdue grad students, their premiums increased by over one quarter this year! Inferior coverage for dependents is the worst part of all. Spouses of international grad students, who normally don’t have work visas, are beholden to the university’s coverage. Unfortunately, the in-network health care facility does not provide essential services such as access to pediatricians or obstetricians, forcing family members to use expensive out-of-network care.

A study showed that other Big Ten universities provide superior health care for their graduate student populations, although they still have their pitfalls.

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Republicans Vow To Repeal Healthcare Reform If They Win Midterms

Friday, August 20th, 2010

Image: Republican Party of Shelby County under CC 3.0

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The heated midterm election battles are underway. Control of the House of Representatives and Senate is at stake in November. Democrats are looking to retain their majority, but what if they don’t?

Tennessee Republican representative Marsha Blackburn recently stated that the GOP will repeal the Obama administration’s healthcare reform law if they regain control. The law is controversial largely due to provisions that create a mandate for individuals and companies to buy a health insurance plan.

However, Rep. Blackburn’s promises may be more election rhetoric than reality. While the Republican party may take a few steps in the direction of eliminating the law, President Obama is guaranteed to veto any bill that would repeal it. Although political pundits predict that Republicans may win a significant number of seats, they may not reach the essential two-thirds of the Senate that would be necessary to override a presidential veto.

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Rate Hikes for Health Insurance Plans Requested in North Carolina

Thursday, August 19th, 2010
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In North Carolina, Blue Cross Blue Shield has asked to increase the monthly premiums of its health insurance plans by an average of 7 percent.

However, the rate hikes aren’t across the board. Some of the 300,000 individual health insurance customers in the state may actually end up saving money through cheaper rates, while a handful of others will experience severe premium jumps of 40 or 50 percent.

The insurer blames rising medical costs for the increase, and says that it would have been even higher without the limitations imposed by healthcare reform. It remains to be seen if the state will approve their proposal.

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Statistics About Massachusetts’ Uninsured

Wednesday, August 18th, 2010
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Image: David Paul Ohmer under CC 3.0

Largely due to the state’s first-in-the-nation healthcare reform, Massachusetts residents are the most likely in America to have a health insurance plan. Still, the expansion has not succeeded in providing universal coverage. Why?

A recent study from the Urban Institute and the Robert Wood Johnson Foundation’s State Access Reform Evaluation looked to identify the 4.1 percent who were still uninsured.

Here are their findings on the average Massachusetts resident without health insurance:

  • From 19 to 64 years old
  • male
  • an ethnic or racial minority (African-American, Hispanic, etc.)
  • unmarried
  • lack of proficency in the English language; either their own or that of an adult who lives with them
  • less educated
  • not a U.S. citizen
  • more likely to be unemployed
  • could be eligible for public Medicaid coverage

The study’s authors believe that the state’s message may not be getting across to its attempted demographic. Suggestions include rewriting the program information in order for it to be understandable with a 4th to 8th grade reading level.

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