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Three More Changes to Health Reform Law

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This was taken from a Humana email I received late yesterday.

Three more changes to reform law

In the past two weeks, the Obama administration has announced three major changes.

  • Consumers will now have until Dec. 23 to enroll in coverage to begin on Jan. 1. The deadline had been Dec. 15, “but since so many people have had difficulty buying coverage, they’re moving it back a week,” wrote Sarah Kliff in the Washington Post. “The key thing to watch here is how well the insurance companies are able to handle this compressed deadline.”

    AHIP spokesman Robert Zirkelbach says pushing the deadline back by eight days “makes it more challenging to process enrollments in time for coverage to begin on Jan. 1. Ultimately it will depend on how many people enroll in those last few days.”

  • The beginning of next year’s open enrollment period has been pushed back from Oct. 15 to Nov. 15. White House press secretary Jay Carney said this will help insurers: “This gives them more time to assess the pool of people who are getting insurance through the marketplaces and make decisions about what rates will look like in the coming year.”

    As many pundits and politicians have noted, however, pushing the date back a month also means starting enrollment after the November elections. “If Obamacare is so great,” said House Republican leader Eric Cantor of Virginia, “why are Democrats so scared of voters knowing its consequences?”

  • The launch of the online small business insurance marketplace, known as the SHOP exchange, has already had two delays. The administration further delayed its launch, announcing the day before Thanksgiving that online enrollment will be delayed for a year, until November 2014, in states where the federal government is running the exchange.

    The Washington Post wrote, “Administration officials characterized the decision as one made necessary as they prioritized fixes to the individual health exchange.”

    Small businesses can still get subsidized coverage, but instead of enrolling online through healthcare.gov, they have to “go directly to an agent, broker, or to an insurance company with plans certified by the marketplace,” a Q&A document from CMS explains.

    “This new delay announcement is a disappointment but not a surprise,” said the president and CEO of the National Federation of Independent Business. “Small businesses continue to be low on the priority list during the Obamacare implementation process.”

Kentucky Health Benefit Exchange

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We are a week away from the Kentucky Health Benefit Exchange.  I’m in the process of completing the training in order to sell in the exchange.  Hopefully rates will be available soon.

kynect.ky.gov

 

 

Modified Community Rating

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This week’s Business First of Louisville had an article about Modified Community Rating.  Director of Government Relations Lawrence Ford is quoted throughout the article.

Here’s the link:

http://www.bizjournals.com/louisville/print-edition/2013/05/24/modified-community-rating-system-is.html

Mr. Ford does a good job of explaining how this will impact Kentuckians rates.  He highlights two issues.  The first is younger people subsidizing the older population.  Insurance companies aren’t going to bring down older folks rates, they’re going to push the young population up to help offset the older population claims.  He also talks about the lack of a substantial penalty for those who don’t enroll.

Still something needs to be done about letting individuals buy whenever they get ill.  The way it’s currently set up that is what could happen.  I know there are talks about it, but we need something done soon before Jan 1, 2014.

Kentucky Expands Medicaid

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Yesterday Governor Steve Beshear announced Kentucky’s decision to expand Medicaid.  A link to the article in the Courier-Journal is below:

http://www.courier-journal.com/article/20130509/PRIME07/305090046

Figures from the 2012 U.S. Census Bureau tells us that 308,000 Kentuckians will now be eligible for this coverage.  The next step is for these newly eligible citizens is to enroll.  The National Association of Health Underwriters (NAHU) have always touted that many uninsured citizens could obtain coverage if they were to sign up for it.  Some citizens don’t even know that they’re eligible for “free” coverage.  Hopefully this will change.

Another point to keep in mind with this expansion is that hopefully Employer Based premiums will be lowered because these premiums have a “tax” included that helps offset the bills for the uninsured.  Hopefully that will be removed.

Let’s also hope that these newly enrolled citizens will start using their insurance.  One problem that uninsured people encounter is that they wait to get their healthcare.  By waiting, they’re more likely to seek service in the Emergency Room, which is the most costly place to seek service.  Now that they have Medicaid, hopefully they will seek preventive care and stay out of the Emergency Room.  Opponents have said this will flood doctor’s offices.  I guess we’ll have to wait and see.

The last point I’d like to cover is what kind of impact will this have on Employers.  Under this Expansion, a single person making up to $15,856 annually, will be eligible for Medicaid.  This is just a tick above the minimum wage level (assuming a 40 hour work week).  Something that I’d like to know is how many Kentuckians with full-time employment (under the new law that’s over 30 hours per week) would qualify for Medicaid.  These newly eligible citizens maybe considered a  “Qualified Waivers” to an Employer Sponsored Plan.  A Qualified Waiver is someone that has coverage elsewhere under another insurance plan.  An example would be someone today being covered under their spouse’s plan.  The employer doesn’t have to cover that spouse, and the employer isn’t harmed in their participation percentage with their health insurance company because the employee is covered under a spouse’s plan.  I know, it’s confusing.  The point is (and I’m still waiting for insurance companies to verify this, although today this is accurate) that these newly Medicaid eligible recipients will now be considered a qualified waiver in an employer sponsored plan.  How many new Medicaid recipients make this amount of money and work 30+ hours for one employer?

 

The Cost of Health Care

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On the front page of the Louisville Courier-Journal this morning (and the first story I heard this morning on CNN), the headline reads “The Cost of Health Care”.  Apparently hospitals try to make money, who knew?

In all seriousness, this is something that we’ve been talking to our clients about since 2003.  This is a huge problem that I’ve believed in for the last ten years.  Hopefully with this new published information, this will start us in the right direction in getting pricing out in public.  The medical industry is the only industry in the USA where you have no idea what something costs.  When you ask someone at the hospital/doctor’s office, you get a bewildered look, as in why are you asking, or how would I know?  It’s insane.  We as a society should have been demanding this time of open information for the last twenty years, it took the government to pass a over-reaching law to finally get this type of information.

Now, I could ramble on for the next twenty minutes about this, but I’m trying to keep it at a minimum.  I would like to know why hospitals charge what they charge.  Why does heart failure cost $10,000 at Baptist Hospital, but $16,000 at Norton’s?  What does that extra $6,000 get me?  Am I more likely to survive at Norton’s, or is it simply better food at Norton’s?

Here’s a link to the article:

http://www.courier-journal.com/article/20130508/BETTERLIFE05/305080118

Remember, especially for those with Health Savings Accounts, ask for a cost before having anything done to you.  You can do the same thing for prescriptions, call around to a few places before making a purchase.

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