Posts Tagged - ‘health insurance plans’

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Will Student Health Insurance Survive?

Tuesday, October 12th, 2010

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The shape of health insurance plans is set to change due to healthcare reform. Health coverage for students is no different.

Colleges and universities all over the country are waiting with bated breath for new guidelines from the Department of Health and Human Services. They want to ensure that their offerings meet the minimum standard for adequate coverage as “Bronze Plans”. If not, such plans are in danger of disappearing: students with employed parents can stay on their health insurance until age 26, while others can buy coverage through the newly-created health insurance exchange markets.

Student health insurance is often maligned for charging high rates for inferior coverage–especially nonsensical given the generally young and healthy population. Moreover, many campuses have their own mandates.

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Should Pro Wrestlers Be Given Health Insurance Plans?

Wednesday, October 6th, 2010

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Although the story lines of professional wrestling are fake, the health risks are as real as can be. During the course of their job, wrestlers are often injured.

Strangely, in an industry that puts its workers at risk, they are not provided with health insurance plans. That is because pro wrestlers are generally considered independent contractors (although they cannot work for competing companies–this is especially the case under World Wrestling Entertainment). The biggest stars can afford to pay for their health care outright, but mid-card wrestlers will find it very difficult to find health coverage–due to their myriad pre-existing conditions and high-risk occupation. Former WWE executive Linda McMahon is currently running for the Senate in Connecticut; as a Republican, this status of her workers has been criticized.

Former WWE wrestler Mick Foley claims that being reclassified as an employee–and therefore having employer-sponsored health insurance–isn’t all positive. Currently, wrestlers receive potentially lucrative royalties for every usage of their image; WWE, especially, regularly releases DVDs and paid Internet and On Demand TV screening. As employees, they would lose that income stream. In other words, the grass always looks greener on the other side of the fence.

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Should Obama Use Executive Orders To Ban Health Insurance Plans From Increasing Rates?

Thursday, September 30th, 2010

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In preparation for healthcare reform regulations that will end up cutting into their profits, insurers are sharply increasing rates while they still can. While Department of Health and Human Services head Kathleen Sebelius has criticized their opportunism–which allegedly goes beyond the actual rise of health care costs–right now, her words have no teeth.

The increases are lowering already shaky public support for the law. What can the Obama administration do? A consumer watchdog group is recommending that the President issue an executive order to freeze health insurance plans‘ premiums until the rate review provisions go into effect in the next plan year.

According to the Supreme Court, presidents are allowed to do so. However, taking that course of action would be politically risky–many already believe that his administration is taking too much control over the health insurance industry.

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Health Insurance Plans’ Autism Coverage Under Fire

Tuesday, September 28th, 2010

Image: Bob Bobster under CC 3.0

Republicans running for Congress this year are touting their anti-Obamacare credentials. Nevada’s Sharron Angle is no different. Boosted by the tea party past a more moderate candidate in the GOP primary, she is going up against Senate Majority Leader Harry Reid in November. As one of the key architects behind the controversial healthcare reform law, Reid is in danger of losing his seat.

Angle is obviously against the individual coverage mandate, as well as health insurance plans being forced to cover certain conditions. She blames the latter for raising costs. Video from a speech last year on that issue has recently been released to controversy. In that speech, Angle railed against a state law that requires health insurers to cover early treatment for autism spectrum disorders. When she mentioned the word “autism”, she used air quotes, which some have interpreted as meaning that she doesn’t believe that autism is a legitimate condition that children’s health insurance should treat.

Not done offending people, Angle went on to say that maternity coverage should not be mandated, since she herself is done having children.

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Are Child-Only Health Insurance Plans Falling By The Wayside?

Thursday, September 23rd, 2010

Image: Pink Sherbet Photography under CC 3.0

Several health insurers, including Aetna and Anthem Blue Cross, will soon stop selling dedicated health insurance plans to children. These plans often appeal to parents who believe they cannot afford health insurance for the entire family, but decide to sacrifice for the sake of their kids. Still, children’s health insurance is a relatively small market by itself.

They blame newly effective provisions of the healthcare reform law that prevent them from denying coverage to children with pre-existing conditions, which means that those plans will no longer be cost-effective for them to offer.

Which states will lose this option? So far, they are:

  • California
  • Florida
  • Connecticut
  • Illinois
  • Virginia
  • Pennsylvania
  • Texas
  • Tennessee
  • Colorado
  • Arizona

Although there is a legitimate argument for the moral hazard of allowing adults with pre-existing conditions to forgo paying into the system when they are healthy and joining when they are sick, children have no choice in the matter. (The individual mandates that discourage this practice won’t go into effect until 2014–and may not survive a Supreme Court challenge.) Furthermore, unlike adults, children never contribute to their own health status by choice.

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Healthcare Reform Provisions and Obesity Treatment

Wednesday, September 22nd, 2010

Image: Combined Media under CC 3.0

Tomorrow, several of the earliest provisions of the healthcare reform law will go into effect. Many of these involve preventative care.

The paradox with a lot of health insurance plans is that they typically do not pay for medically supervised diets or nutritional counseling for the overweight and obese. (They may cover gastric bypass or other weight loss surgery, but some patients are not considered morbidly obese enough to be eligible for reimbursement.) However, they will cover the more expensive cost of treating related conditions like type 2 diabetes or sleep apnea when they are later developed.

The legislation looks to change that. Here is how it will change:

  • Recommended preventative care treatments are covered without co-payments or co-insurance percentages for policyholders, including behavioral counseling and obesity screening.
  • Public health initiatives will make calorie counts more visible, making it easier for people to eat healthily and lose/maintain their weight.
  • Comparative effectiveness research will be undertaken to determine if insurers will be required to cover gym memberships, therapy, or special meal programs.
  • An advisory group will look into the effectiveness and risks of weight loss drugs and surgery, possibly requiring coverage of those deemed more effective than harmful.
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Should Health Insurance Plans Cover Gastric Bypass Surgery?

Thursday, September 16th, 2010

Image: EmerandSam under CC 3.0

Obesity is a condition that impacts the health of millions of Americans. There are several options in dealing with it: diet and exercise is the most obvious. An increasing number of health insurers are encouraging the former through wellness programs.

However, success rates are relatively low. Some are proposing gastric bypass surgery as a solution. Some health insurance plans cover the $30,000 surgical procedure for the morbidly obese, but others believe that the investment in preventative care. Obese teenagers, especially, are increasingly taking advantage of it.

By no means is surgery a panacea: some people manage to regain all their weight (though fewer than the 95% who do so with diet and exercise), and up to a third of patients have medical complications. Still, in most cases gastric bypass seems to cure type 2 diabetes (which is expensive to treat for many years). The Atlantic‘s Marc Ambinder, himself a gastric bypass patient, speculates that paying for the procedure for all obese Americans would end up costing less than the medical complications associated with obesity. However, it is an extreme option of last-resort, and is an over $30 billion-worth pipe dream.

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Employer-Based Health Insurance Plans Providing Less Care for More Money

Friday, September 3rd, 2010

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When employees look at their health insurance plans today, they see more responsibility (and cost) on their end with fewer benefits. That’s according to a new survey from the Kaiser Family Foundation.

In a struggling economy, companies look for different methods of saving money. One of them is shifting the cost of health coverage to employees. Unfortunately, workers must pay for those costs with the same or even smaller (for those who have taken pay cuts) incomes! Wages have not grown with the cost of health insurance for several decades now.

The average employee is paying 14% more for health care in 2010.

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Healthcare Reform Lawsuit Arguments Continue

Tuesday, August 31st, 2010
health insurance plans
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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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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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