Posts Tagged - ‘affordable health insurance’

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Are Health Insurance Brokers An Endangered Species?

Tuesday, November 30th, 2010

Image: H. Michael Karshis under CC 3.0

In many states, regulators fear that health insurance brokers are falling by the wayside. The healthcare reform law passed this year requires that a certain percentage of premiums be spent on providing medical care, as opposed to being spent on administrative costs.

Some consider brokers as middlemen, standing in the way of affordable health insurance by creating yet another level of bureaucracy. However, they can help people navigate the confusing variety of plans available and shop around–although that purpose may become irrelevant once states get their own health insurance exchanges up and running.

In addition, many brokers may end up out of work if they cannot adapt to the changes in the market and regulatory environment.

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Florida Rep. Tries Anti-Health Insurance Mandate Amendment Again

Wednesday, November 24th, 2010

Image: turtlemom4bacon under CC 3.0

Last year, State Representative Scott Plakon (R-Florida) attempted to put a measure that would amend the state’s constitution to forbid mandating the purchase of health insurance on the ballot. That time, a judge rejected it due to what was considered overly political and misleading language.

Undaunted, Plakon is trying again. House Joint Resolution 1 would challenge the Obama administration’s healthcare reform legislation, which will eventually fine certain individuals and employers for failing to purchase affordable health insurance. It would give Florida more legal standing in its lawsuit against the federal government’s provision.

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Health Insurance Reform: Healthcare Mergers Coming Up?

Monday, November 22nd, 2010

Image: Frits Ahlefeldt-Laurvig under CC 3.0

The healthcare reform law may end up having an unfortunate side effect: although one of its stated goals is to help make affordable health insurance more widely available by spurring competition, several health care providers are considering merging.

According to many groups of doctors, hospitals, and clinics, the alliances and joint ventures are necessary in order to maintain their profit margins and take advantage of the potential savings of the law while avoiding the additional costs. However, consumers may suffer as a result.

The industry’s lobbying groups also want the Federal Trade Commission and the inspector general of the Department of Health and Human Services to give them exceptions from antitrust and Medicare fraud laws. This could potentially be dangerous. On the positive side, it can force medical service providers to coordinate care, leading to better health outcomes for patients.

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Which Country Has The Most Disputes with Health Insurance Companies?

Friday, November 19th, 2010

Most people agree that health care is an essential good, though they may disagree on how to go about providing it. Yet, a recent survey shows that millions the world over are forced to skip it because of the high cost. In order to maintain profitability, health insurers want to keep costs down. However, this often results in disputes between patients and health insurance companies over coverage.

According to the Commonwealth Fund’s findings, one nation sees more of these battles than others: the United States. Other industrialized nations, such as Germany and Switzerland, are believe to have less complex systems. Some have more private sector involvement than others, but the survey’s authors generally believe that they manage to provide more affordable health insurance (America has the highest per-capita spending on it) without as much hassles.

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Another State to Join Healthcare Reform Lawsuit?

Tuesday, November 16th, 2010

Image: davis.jaque under CC 3.0

Although the very first challenge to the Obama adminstration’s affordable health insurance reform law was rejected by the Supreme Court, that isn’t stopping states from continuing to oppose it. Over 20 attorney generals launched a lawsuit over the individual mandate provision earlier this year; it is predicted that arguments will be heard sometime in 2011.

Now, Kansas is mulling over the possibility of becoming yet another plaintiff in the large Florida-led case. The Republicans recently elected to state office, Governor-elect Sam Brownback and Attorney General-elect Derek Schmidt, have vowed to mount legal challenges. However, it will most likely take awhile for them to gear up for it.

Ironically, former Kansas Governor Kathleen Sebelius, who retired in order to become the Secretary of Health and Human Services, is in charge of promoting and implementing the healthcare reform legislation.

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Texas Medicaid Health Insurance in Danger

Tuesday, November 9th, 2010

Image: jpo under CC 3.0

Across the country, states are struggling to balance their budgets. (Unlike the federal government, they don’t have the luxury of running a deficit.) This generally requires some combination of raising revenue through taxes and cutting spending programs.

The Republicans that triumphed in the midterm elections are adamant about only using the former. In Texas, they are even considering cutting the affordable health insurance program for the poor, Medicaid. Although the program itself is largely run by the federal government, state governments contribute.

According to supporters of the withdrawal, Texas would launch its own health plan for the impoverished. Many aren’t holding their breath. There is also speculation that the proposal is at least partially intended to spite the Obama administration in Washington for getting involved in individual Texas health insurance matters.

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Obama Didn’t Realize Affordable Health Insurance Reform Would Be So Hard

Monday, November 8th, 2010

Image: Beverly & Pack under CC 3.0

After his party’s drubbing in the midterm elections, President Obama is Monday-morning quarterbacking. In an exclusive interview with 60 Minutes, he admitted that he didn’t expect the passage and implementation of affordable health insurance reform to have such a high political cost.

Many would consider this view naive, given that presidents have struggled with the complex system for decades. Also, there are many interest groups heavily involved, with a major stake in the issue.

According to Obama, he assumed that his incorporation of proposals previously advanced by Republicans such as Mitt Romney would help bring about some compromise with the GOP. As it turns out, the final product ended up pleasing few: progressive Democrats wanted more, while conservatives wanted far less.

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IRS’ Affordable Health Insurance Reform Implementation in Danger

Wednesday, October 27th, 2010

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Understandably, most people aren’t huge fans of the IRS. For the most part, Americans communicate with them when they’re taking money out of their pockets during tax season. However, a provision of the new healthcare reform law has the Internal Revenue Service actually attempting to give money back!

The law is meant to make affordable health insurance more widely available through tax credits to small businesses that provide coverage to their employees. Doing so will require more manpower and resources for implementation and enforcement of the program. Some Republican candidates are considering defunding the IRS and other agencies involved to stifle healthcare reform, since it is predicted to take $5 to $10 billion for each agency to fully implement it.

Congress has the power to do so, and does not require President Obama to sign off on a repeal he would be guaranteed to veto. Ironically, one of the most business-friendly provisions may suffer as a result.

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Stay Vigilant With Your Health Insurance Benefits

Monday, October 25th, 2010

Image: Mike Sansone under CC 3.0

If you have generous health insurance benefits provided by your employer, you may not think about it that often. For the most part, you choose the most affordable health insurance option that fits your needs during the open enrollment period and then run on autopilot.

Unfortunately, it seems that sticking your head in the sand isn’t good enough. Teachers in several school districts in New Jersey were recently uninsured for several months. A clerical error meant that although premiums were taken out of their paychecks, premiums were not paid to the insurers for four months.

Teachers in Newark still haven’t had their coverage restored. However, Paterson teachers are luckier–all covered expenses that occurred during that period will be paid for, and their coverage was reinstated.

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State Health Insurance Commissioners To Rule on Medical Loss Ratios

Thursday, October 21st, 2010

Image: turtlemom4bacon under CC 3.0

All eyes are on Orlando today, but not because of anything Mickey Mouse has done. Rather, it is a meeting of several states’ insurance commissioners. Their topic: coming up with the rules that insurers will have to abide by post-healthcare reform.

Specifically, they are responsible for calculating minimum medical loss ratios. MLRs are also known as the percentage of premiums spent on providing health care, as opposed to profits and administrative expenses. Proponents of the limits believe that they will result in more affordable health insurance for consumers. However, some are worried that the new rules will make some niches and entire markets–such as small groups–less appealing, and that people will become uninsured as a result.

The group’s recommendations will become effective next year. Although the already-determined limits are 85% for large group plans and 80% for small groups and individuals, the commissioners will consider tax exemptions and a longer phasing-in period. Most significantly, they will help determine what counts as a medical expense. Insurers obviously want a wider definition of qualified medical costs.

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