Category Archive - Family

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Health Insurance Reform Promotes Breast Feeding

Monday, April 5th, 2010

(Image: Wha’ppen under CC 3.0)

A new study from the American Academy of Pediatrics has found that the nation could save up to $13 billion if 90% of mothers exclusively breast fed their babies for twelve months. It is thought to lower family health insurance costs, since breast-feeding has been associated with lower rates of stomach and ear infections, juvenile diabetes, asthma, and other common illnesses that often require treatment and hospitalization.

What does healthcare reform have to do with it? Many women resort to using formula due to work obligations. Hidden in the health insurance legislation is a requirement for large employers to offer a private room–not a bathroom–for women to pump breast milk.

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Health Insurance Companies Backtrack On Denying Children

Friday, April 2nd, 2010

(Image: D Sharon Pruitt under CC 3.0)

Good news for those seeking family health insurance: despite concerns that the language in the healthcare reform bill could be interpreted as allowing health insurers to continue denying coverage to children with pre-existing conditions until 2014–going against President Obama’s own statements, the insurers have decided to extend that coverage regardless.

Initially, some health insurance companies’ lawyers claimed that the immediate effect of the legislation in the next six months would solely prevent insurers from refusing to cover pre-existing conditions of children they had already decided to underwrite. After public controversy and negative publicity, they have backtracked on that view. Instead, they have agreed to abide by the clear intent of the law: that kids should have access to affordable health insurance.

A letter from America’s Health Insurance Plans’ president Karen Ignagni assures Health and Human Services Secretary Kathleen Sebelius that they will not seek loopholes. Rather, they will follow complementary regulations soon to be released by Sebelius’ office. Families can now breathe a little easier.

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Children’s Health Insurance May Not Cover Pre-Existing Conditions Yet

Tuesday, March 30th, 2010

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This is a big error in the healthcare reform bill: now, some health insurance companies are saying that they do not have to cover kids with pre-existing conditions!

That was supposed to be one of the main immediate benefits of the bill. Unfortunately, insurers believe that the language only requires them to cover pre-existing conditions for children already under a family health insurance policy. They still reserve the right to refuse to offer them a health insurance plan altogether, until 2014 (when the guidelines for adults take effect). Basically, their lawyers take the language to mean that if they extend coverage to a child under the age of 19, that coverage must encompass all of their health issues, pre-existing or otherwise; however, they can still deny the child coverage.

While still an improvement, it is a severe disappointment. The Obama administration is currently crafting an executive order with regulations that will clarify the issue, while Congress is working to resolve it.

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Family Health Insurance Loophole for Kids In Bill

Thursday, March 25th, 2010

Image: griffithchris under CC 3.0)

The health insurance reform bill attempts to help those seeking reliable coverage for their children. Unfortunately, there is a gap when it comes to kids.

It appears that some language in the bill makes it so that children can still be denied by family health insurance companies due to pre-existing conditions until 2014. Earlier statements from President Obama made it seem that the benefit was immediate. The administration believes it was still the intention, and they will later release new regulations clarifying that.

On the bright side, children with existing health insurance plans can no longer exclude specific conditions from their coverage under the policy. That provision is effectively immediate.

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Immediate Family Health Insurance Changes Post-Reform

Tuesday, March 23rd, 2010

(Image: Steve Polyak under CC 3.0)

With the passage of the healthcare reform bill comes many changes to family health insurance policies. Some of them occur immediately.

What significant impact will families feel now?

  • Children can no longer be excluded from health insurance plans due to pre-existing conditions.
  • Adult children can remain on your health insurance policy as a dependent until the age of 26.
  • There are no more lifetime or annual caps on health coverage, either per individual or per family.
  • Free preventative care will be offered with new health plans.
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Infants Charged Higher Family Health Insurance Rates!

Friday, February 26th, 2010

(Image: Pink Sherbet Photography under CC 3.0)

Over in North Carolina, health insurance company Blue Cross Blue Shield recently increased its health insurance rates. While rate hikes are common nowadays, this one is especially far reaching: it even hits babies!

Case in point: a nine-month-old infant’s family health insurance premium jumped by 55% on January 1st. According to BCBS, the higher premium is justified because infants use more health care services than older children. Now, they are classified in a higher-risk insurance pool.

This situation is absurd! Some may argue that many people with pre-existing conditions facing a dearth of affordable health insurance options brought the situation on themselves; that they neglected their health and had bad habits. While that can certainly be debated, a baby less than a year old has no choice in or responsibility for his or her health. Plus, this particular infant didn’t even have any conditions that would cost more to cover!

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North Carolina Family Health Insurance Rates To Rise

Thursday, February 25th, 2010

(Image: Ed Yourdon under CC 3.0)

As the second half of the bipartisan healthcare reform summit continues, a story out of North Carolina highlights why health insurance is such a vital issue.

The state’s Blue Cross Blue Shield was recently allowed to increase their health insurance rates by an average of 12%. Some policyholders have seen their premiums increase by 50% or more! North Carolina residents are in a tight bind, since Blue Cross Blue Shield makes up 97% of the individual health insurance market in the state.

Gender rating, an issue that has garnered attention during the summit, plays a role. BCBS of North Carolina had a standard policy of charging higher premiums to young women under a family health insurance plan once they turn 18, but cost increases have led to them lowering the age at which the higher premiums apply.

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Health Insurance and Rationing: Many vs. One

Monday, February 8th, 2010

(Image: tiarescott under CC 2.0)

How much would you be willing to pay for a couple to screen their child for a rare genetic condition? Would you want your medical insurance pay $4.7 million? That’s the amount it costs to prevent one child from being born with Spinal Muscular Atrophy (SMA). SMA is incurable and cannot be treated; a child born with it will never be able to move at all. There is an accurate test for it, but routine screening would end up costing your health insurance nearly $5 million to save one child from that fate. That’s because the SMA gene is carried by relatively few Americans and has no symptoms, meaning that the general population–as opposed to just those considered high-risk–must be tested. 11,000 women must be tested at $400 a pop to prevent one case (either by terminating the pregnancy, or using donated sperm or embryos to conceive). By contrast, it costs a relatively frugal $260,000 to provide a person with SMA lifetime care.

The idea of a single child being born with that condition is horrifying. Health insurance companies or the government using cost-effectiveness tests and rationing techniques to decide on health care is scary; cold, hard numbers hold a child’s fate in their hands. Decades worth of studies have shown that, perhaps counter-intuitively, the image of one individual’s suffering is more striking than the suffering of untold masses. Our minds find it easier to feel empathy on a smaller scale. A recent study from the American Journal of Public Health estimates that about 45,000 Americans die each year as a result of going without family health insurance, yet fewer people are willing to risk an increase in their medical insurance rates to prevent their deaths. Proponents of healthcare reform have an uphill battle psychologically; President Obama has attempted to give a name and face to the plight of several uninsured Americans in recent speeches, but his specificity appears to have had little impact.

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Family Health Insurance Steers Pregnant Women Towards C-Sections

Friday, February 5th, 2010

(Image: Andrea Fregnani under CC 2.0)

It was recently found that almost one-third of the pregnant women in the United States give birth by Cesarean section, a far higher rate than other developed nations. While C-sections are often necessary, they are nevertheless surgical procedures that can harm both mother and child. Many doctors believe that they be performed in only 10% of pregnancies at most.

A common misconception is that American women choose to have C-sections–sometimes even scheduling them–but that is actually relatively rare. Another explanation for the high Cesarean section rate in the U.S. may be our health insurance system. Unlike many other countries, family health insurance reimburses physicians and hospitals with a flat fee for the birth, regardless of how it is performed. Some doctors may unconsciously steer their patients towards a C-section, since medical insurance doesn’t offer an incentive for them to perform longer vaginal labor instead. To the contrary: some medical insurance companies actually have higher reimbursement rates for C-sections!

Meanwhile, most hospitals can charge far more for a Cesarean section birth, which gives them more opportunity to pad their maternity care profit margins. In addition, doctors may also be performing C-sections in order to lessen the risk of a medical malpractice claim being filed against them; physicians tend to be sued for failing to take action more often than taking the wrong action. Breech babies (which are in the wrong position for vaginal birth) can sometimes be turned around through changes in positioning and waiting, but time pressures and legal concerns reduce the likelihood that an obstetrician would take that risk. All of those factors combine, and the cost is passed onto the new mother through her family health insurance premiums.

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Don’t Put Your Girlfriend On Your Family Health Insurance!

Thursday, February 4th, 2010

(Image: Tambako the Jaguar under CC 2.0)

Family health insurance is often an affordable way to make sure your loved ones remain in good health. However, you have to make sure all of your legal paperwork is in order. Although cohabitation is more common, some benefits are only afforded to married couples (or those with formal domestic partnerships).

In New York, a man named named Robert M. Moore was arrested for fraud. His crime? Listing his live-in girlfriend as his wife in order to put her on this health insurance policy. She used over $13,000 worth of medical insurance, prescription drug coverage, and dental insurance. She hasn’t been arrested, whereas her lover is charged with third degree larceny and fraud.

People often do misguided things for love. It’s understandable that Moore wanted to care for his girlfriend, especially if she has pre-existing conditions that prevent her from buying individual health insurance coverage at an affordable price. Health is certainly more valuable than flowers and candy. Unfortunately, the State Insurance Department doesn’t agree. He faces up to seven years in prison. So think twice before giving your boyfriend or girlfriend a contract with their name on your health insurance policy for Valentine’s Day. If you’re worried about their access to health insurance, you might want to go ahead and put a ring on it instead.

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