Posts Tagged ‘Affordable Care Act’

Health Insurance Premiums Have Been Increasing for Years

Saturday, June 7th, 2014

A recent study done by the Commonwealth Fund found that health insurance premiums have been increasing for years.  The nonprofit group performed this study to determine what had been happening in the health insurance industry before the implementation of the Affordable Care Act changes.  They wanted to show the public the whole picture so that people aren’t blaming all of the health insurance increases on Obamacare.  This information comes from Maggie Fox’s NBC News article, “Health Insurance Premiums Have Been Increasing Since 2008.”  They studied health insurance premiums in the private health insurance markets.  Those are the individual and family health insurance plans that Americans find and pay for out of their own pocket, not through a group or employer.  The study found that health insurance premiums have been steadily increasing since 2008.

Individual insurance premiums increased by at least 10% per year from 2008-2010.  We are still waiting to see what the premium prices will be for 2015, but most experts agree that they will be higher than this year’s prices.  The study results point out that premium increases really cannot solely be attributed to mandatory changes brought about by the Affordable Care Act because premium prices were rising 10% per year before the law took effect.  Premiums almost have to increase because health insurance companies have to cover much more than they covered before the ACA took effect.  Insurers can no longer deny coverage to people with preexisting conditions either, so it costs them much more money to offer insurance plans.  They can’t exclude maternity coverage from plans or charge cancer patients more for their insurance policies, so premium prices across the board are likely to increase.

State and federal run health insurance exchanges started offering plans this year.  Before these exchange plans were an option, an estimated 14 million people bought individual health insurance plans outside of the workplace.  This is either because they don’t have a job or their employer doesn’t offer them health insurance coverage.  Eight million people have bought insurance plans through the exchanges this year, according to the President’s administration.  A Gallup poll found that the number of Americans without health insurance went from 18% in December to 13.4% in May.  It’s going to take years before we know the true effect of the Affordable Care Act on the health insurance industry, especially because of the plans that have been allowed to continue offering sub-standard policies for two more years.  It will just be important to keep in mind that health insurance plans were rising before the ACA as well.  Increases in 2008, 2009 and 2010 were 9.9%, 10.8% and 11.7%, respectively.

Large Employers May Stop Offering Health Insurance Plans

Wednesday, May 21st, 2014

A lot of people who get their health insurance from their large group employers might just be searching for insurance coverage elsewhere soon.  While it certainly wasn’t the intention of the Affordable Care Act to make it more difficult for employers to offer insurance to their employees, that has been an effect of the health insurance mandate often referred to as Obamacare.  In the Forbes article, “Obamacare Increases Large Employers’ Health Costs“, Sally Pipes tells us about recent study findings.  S&P Captial IQ’s study determined that 90% of workers in America who currently have health insurance through a large employer will be searching for a policy in the government exchanges by 2020.  That figure seems extreme, but the harsh reality is that the taxes, fees, and added insurance mandates placed on large employers are hurting them.  Many of these employers simply don’t think that they can afford to offer health insurance if something doesn’t change.  They are currently mandated to offer you health insurance plans, so that is something that will have to be considered as well.

Group health plan sponsors pay a new fee to help fund the government sponsored Patient Centered Outcomes Research Institute (PCORI).  This organization tests the effectiveness of certain medical treatments and Medicare uses the results to determine what they will cover for their patients.  Some skeptics worry that results could be twisted to support lower cost treatments over more effective, but higher cost ones.  Another fee that large employers have to pay is a Temporary Reinsurance Fee.  This fee is supposed to stabilize premiums in the individual health insurance marketplace.  The American Health Policy Institute estimates that $15.3 million will be collected by this fee in just two years.  In 2018, large employers will start paying a 40% excise tax on health insurance plans that are deemed “expensive”.  Individual premiums above $10,200 and family premiums above $27,500 are considered “expensive”.  One company estimates that this excise tax will cost them $378 million over the course of five years.

In addition to the direct taxes, there are indirect tax increases for employers as well.  There is the mandate for companies to offer health insurance to full time workers within the next year or two.  If they don’t, they will pay a fine.  Companies also have to allow children to remain on their parents’ health insurance until the age of 26 now.  That last mandate alone has increased employer insurance costs between 1 and 3%.  Mandating full coverage of preventative care services, such as immunization and birth control is drastically increasing employer health care costs as well.  The AHPI survey estimates large employer health care costs to rise by 4.3% in 2016, by 5.1% in 2018, and increase by 8.4% in 2023.  This equates to hundreds of billions of dollars extra that large employers will have to shell out over the next decade or so.

Unfortunately, what this means to Americans with health insurance from their large employer is that their costs will likely increase as well.  More than 80% of large employers have already increased their employees’ deductibles, or plan to do so soon.  Some employers might stop offering health insurance altogether and pay the fine for not offering plans.  They might actually save money by doing that, although employee morale could decrease from such a move.  Companies may also offer incentives for sick employees to search for health insurance in the exchanges instead of using the company plan, saving both the employer and employee money.  But if all of the sickest employees head into the health insurance exchanges, costs within those will increase for everyone.  The potential destruction of employer health insurance plans was certainly not a goal of the Affordable Care Act, but it might just be a consequence.  If you are worried about losing your employer health insurance, you can compare health plans and rates here.

Pregnant Women Have More Maternity Health Insurance Choices

Tuesday, May 13th, 2014

There was a time, not very long ago, that you were hard pressed to find health insurance as a pregnant woman.  This pre-existing condition was the only reason needed for a health insurance company to deny a pregnant woman’s application for coverage.  The Affordable Care Act has changed this former reality, according to “Health law gives pregnant women more options“.  In the Associated Press article, it says that Medicaid will help to supplement private insurance plans bought in health insurance exchanges.  Pregnant women who recently purchased private health insurance plans through the government exchanges will also be able to access Medicaid coverage from their state as well.  This applies to lower-income women, but the income limits vary significantly from state to state.  Some state limits are close to the poverty level, while others are more like a middle class income.

Did you know that Medicaid already pays for almost half of the births in the United States?  This new expansion of Medicaid services to pregnant women will be effective in every state, even if they have not opted to expand their overall Medicaid system under the Affordable Care Act.  Unfortunately the logistics of this Medicaid expansion are fairly complicated.  States and the federal government are trying to iron out the details, so it is still complex for consumers to navigate.  Overall though, it’s a good thing for women because they will end up paying less out of pocket.  They have the option of using only their private health insurance, only Medicaid, or a combination of both plans if that is what will be best for their pregnancy scenario.

While the cost of insuring more women is going to be higher, there are anticipated lower costs overall.  Taking care of a woman and her unborn child with good prenatal services helps to avoid the larger expense related to premature births and birth defects.  Pregnant women without health insurance often don’t seek prenatal care and can’t be treated for problems that they don’t know exist.  The Affordable Care Act made it so that health insurance companies must offer maternity coverage, even if the woman is seeking health insurance while she is already pregnant.  For those lower-income women who bought private plans in the health insurance exchanges using federal subsidies, the original law stated that they were no longer eligible for Medicare.  Then there was a ruling that said Medicare coverage did not meet the “minimum essential coverage” that the law requires because it is temporary and states can deny certain services.  Now they can use their private plan along with Medicaid coverage.  A woman might benefit from using both plans because her coverage will continue after she has the baby, but the Medicaid coverage could help with cost-sharing.

If you are looking for health insurance with maternity coverage, you can find affordable health insurance in any state.

Pennsylvania Health Insurers Offer Low Cost Non-Compliant Plans Through 2017

Sunday, April 27th, 2014

Pennsylvania is one of nine states that is giving health insurance customers a break before forcing them to adhere to Affordable Care Act guidelines.  According to the Pittsburgh Business Times’ Kris B. Mamula, Highmark health insurance is the latest company offering renewals that don’t meet all of the new insurance mandates.  In “Highmark prepares new renewal plan health insurance,” we learn that Highmark is following in the footsteps of UPMC Health Plan with their new renewal options.  UPMC was the first company in western Pennsylvania to offer these non-compliant health insurance plan renewals that are lower cost.  They started offering these plans four months ago.  Highmark Inc. will be offering new renewal plans to employers who provide health insurance coverage.  The options will be available during both the July and December enrollment periods.

Plans were introduced during an insurance broker meeting last week.  Although minor details were not yet given to the public, Highmark is calling the plans “grandmothered plans”.  These lower cost plan options do not meet the requirements of the Affordable Care Act.  Insurance companies in Pennsylvania and eight other states have a three-year window where they can continue to offer their existing health insurance plans without penalty.  They will have to meet the Affordable Care Act guidelines in 2017, but the added three years gives employers some time to plan out their course of action.  More details are expected to be released by Highmark soon.

When UPMC started offering their lower cost plans, premium increases were between 0 and 48%.  Plans that incorporate the mandated coverage from the ACA had premium increases 100% and greater.  Insurance brokers who were at the recent meeting said that Highmark will be offering more flexibility with their non-compliant health insurance renewal plans.  Highmark is also likely to see a large increase in sales of their Community Blue plans, which limit the network of providers available.  It’s good news to employers and others who will benefit from the three year reprieve given in Pennsylvania and eight other states.  But eventually they will all have to meet the new guidelines put into place by the Affordable Care Act.  They will save money and have added time to determine their best plan options starting in 2017.  But in other states, health insurance companies will already be settled into their new health plans and insurers in these nine states will have to play catch up.

Hard to Find Health Insurance Anywhere After March 15 Deadline

Thursday, April 24th, 2014

The deadline to sign up for health insurance and meet the Affordable Care Act requirements has come and gone.  Health insurance exchanges will not start offering plans until later this year for the next enrollment period.  But most people were not expecting some private health insurance companies to stop selling health insurance plans after March 31 as well.  According to Health Day’s Karen Pallarito, “Suddenly Health Insurance Is Not For Sale“.  One Tennessee insurance broker said that many health insurance companies in her area are not selling insurance plans until the exchanges open again later this year.  One of the main reasons that some health insurers have made this decision is because they believe they will attract healthier, younger people when the government exchanges are open as well.  Insurance companies can no longer reject sick people or those recently diagnosed with a disease.  They are hoping that they will be able to attract the young, healthy individuals that will keep their costs lower.

For coverage that will start in 2015, the next open enrollment period starts on November 15.  Penalties for not obtaining insurance coverage yet won’t be issued until tax time next year, but those who waited might just be ready to purchase insurance come November.  Healthy and young individuals are most likely to plan in advance when shopping for health insurance.  That is why it makes sense economically for health insurance companies to only offer plans during open enrollment times.  Individuals who have recently become sick or need some type of care right away are the most likely to search for health insurance at any time of the year.  Open enrollment periods were designed to deter people from waiting until they are sick to shop for health insurance.  When that happens, insurance can become unaffordable all around.

Health insurance companies offering plans outside of the exchanges can choose whether or not to sell health insurance year round or not.  One survey of 180 health insurance companies found that one or more health insurers will be offering plans after March 15 in only 14 states.  Some of those plans will only be offered through the end of April.  You will be able to find health insurance in some places though.  Arizona’s non-profit insurer Meritus plans to continue offering health insurance plans year round.  They are currently working with the Arizona Department of Insurance.  In Nevada, their Health Coop will continue offering insurance plans to consumers around Las Vegas.  There may be some states where it is difficult to find health insurance before November 15.  If you are looking for a plan, you will probably have to work a little harder than before the deadline.

High Number of Americans are Underinsured

Wednesday, March 26th, 2014

The country has been very focused on uninsured Americans over the past couple of years.  Another important issue that is rarely discussed is how many people are actually underinsured.  U.S. News & World Report’s Kimberly Leonard discussed research from the Commonwealth Fund in her article, “Report Highlights Underinsured by State”.  The Commonwealth Fund’s report is called “America’s Underinsured: A State-by-State Look at Health Insurance Affordability Prior to the New Coverage Expansions”.  When looking at Americans under the age of 65, one out of every eight is underinsured.  This means that although they do have health insurance, they still pay a high percentage out of pocket for health care costs.  Many underinsured Americans end up filing for bankruptcy because of their health care bills.  They are also at a high risk of ignoring symptoms and avoiding the doctor.

States with the lowest rates of underinsured Americans were in the Northeast and the upper Midwest.  The Southern and Western states had the highest rates.  New Hampshire’s underinsured rate of 8% was the lowest in the nation.  Some of the other states with low rates include Minnesota, Maryland, and Massachusetts.  The highest underinsured rate of 17% belongs to both Idaho and Utah.  Both Tennessee and Mississippi had underinsured rates of 16%.  When the report looked at the combination of uninsured and underinsured Americans, the highest numbers of uninsured and underinsured Americans were in New Mexico and Texas.  Middle income Americans in Wyoming and Alaska suffer the most from being uninsured or underinsured.  One-third of the middle income population in those states falls into the uninsured or underinsured category.  The lowest uninsured and underinsured rates were in Connecticut, Massachusetts, Minnesota, and the District of Columbia.  These states had combined rates less than 20%.

Deductibles, premiums, household income, and insurance status were taken into account for the report results.  Lower income households, earning less than $47,000 per year for a family of four, are considered underinsured if they spend more than 5% of their yearly income on health care costs.  Middle income households, earning between $47,000 and $95,000 per year, are underinsured if more than 10% of their annual income is spent on health care.  The Commonwealth Fund report found that $32 million Americans are underinsured, $4 million of whom come from middle income families.  It also showed that 47 million Americans were uninsured in 2012.  Obviously this data was collected before the Affordable Care Act went into effect.  It will be a good comparison for the next few years to see if the ACA makes the changes that it set out to make in “fixing” our health care system.  The number of uninsured Americans has certainly gone down, and the number of underinsured Americans should as well.  Since insurance companies can no longer discriminate against those with preexisting conditions and they must offer affordable plan choices, fewer Americans may be underinsured in the future.

 

Individuals Paying More for Health Insurance Without Government Subsidies

Friday, February 28th, 2014

On the heels of the Office of the Actuary of the Centers for Medicare and Medicaid Services report detailing premium increases for many small businesses, there is another report saying that individuals are paying more for health insurance as well.  According to The Business Journal’s Kent Hoover in his article “Take out subsidies and Obamacare is Really Expensive,” those Americans who are not receiving government subsidies are paying significantly more in health insurance costs.  Some Americans qualify for government tax subsidies when they buy an individual or family health insurance plan in the health insurance exchanges.  Low and middle income Americans can buy insurance plans through the government website or individual state health insurance exchanges and receive a tax break based on their income level.

But eHealth Inc. just performed a study to see how much health insurance plans cost for those who don’t qualify for the government subsidies.  They compared data from before the Affordable Care Act went into effect with plan costs as of February 24 of this year, after the ACA prices took effect.  Average individual health insurance plans now are $274 per month.  That is a 39% increase from average plan costs before the ACA requirements changed health care.  Family plan monthly average costs increased to $663 per month.  This is up 56% from the same time last year.  The company performing the study sells an array of health insurance plans and wants to highlight what they perceive as the negative changes brought about by the Affordable Care Act.  Those who already had affordable health insurance may be negatively affected, while those people who didn’t have health insurance or with very high plan costs receive the benefits of the health care law.

Compare health rates from multiple insurance companies to find the most affordable premiums for you or your family.  If you don’t qualify for a government subsidy or have health insurance through your employer, there are countless health insurance plan options available from an array of health insurance companies.

Many Target Employees Now Searching for Health Insurance

Tuesday, January 28th, 2014

Part-time employees working at Target stores are searching for new health insurance policies right now.  As of April 1, Target’s part-timers are no longer eligible for the company’s health insurance plan.  This information comes from Bloomberg’s Alex Wayne in the article “Target to Drop Health Insurance for Part-Time Workers.”  They are following in the footsteps of Trader Joe’s, Home Depot, and other large retailers in the U.S.  Last year, the company had more than 361,000 workers.  They would not specify how many of those workers are part-time, which means that they work fewer than 30 hours a week.  But Target did say that only 10% of their part-time employees actually opted to take the health insurance offered to them.  This could be because they are students on their parents’ plans, have a spouse with health insurance, or forgo having insurance altogether.

Target is making these changes because of President Obama’s U.S. Patient Protection and Affordable Care Act.  Companies with more than 50 employees must offer health insurance plans to their full-time workers or they will be penalized.  Most Americans will also be penalized if they are not insured.  But Target insists that their part-time workers will be better off searching for their own health insurance plans.  If they qualify for a government subsidy, they can buy a plan from a health insurance exchange and pay less than they would with Target’s plan, according to the company.  This allows both the employee and the company to save money.  It’s not apparent how many of these Target workers will qualify for a subsidy though.  Those who don’t qualify might end up paying more for their health insurance than they did with Target.  If you are looking for a cheap health insurance plan, you can receive affordable quotes here.

Employees shopping in the health insurance exchanges have until the end of March to meet the open enrollment deadline.  This lines up with the end date of Target’s insurance plan for their part-time workers.  Target insists that people will not have their hours cut just so that the company no longer has to offer them health insurance plans.  They say that this will only apply to those who are already part-time, but only the employees will know if this holds true.  If it’s true that only 10% of their part-timers opted for company health insurance anyways, this change may not make a large impact overall.  But with the company withholding figures on the number of part-time workers and those close to the cusp of 30 hours, I’m not sure how many people truly will be affected by this health insurance change.

If Aetna Leaves the Exchanges, Others Likely to Follow

Thursday, January 23rd, 2014

With all of the ruckus over the Affordable Care Act, there is one aspect that we haven’t considered yet in this blog.  Health insurance companies might start backing out of the exchanges if things don’t go as planned with enrollment.  So far, not enough young and healthy people have purchased insurance through the exchanges.  This puts the entire plan out of balance because young people help to keep the costs down for everyone involved, including the insurance companies.  According to CNBC’s Matthew Belvedere, “Aetna could be forced out of Obamacare: CEO.”  Aetna’s CEO, Mark Bertolini, worries that the age of enrollment and Medicare changes could force his company out of the health insurance exchanges.  They have to publish their health insurance rates in the exchange for 2015 by May of this year.  As of now, they don’t have enough information to decide whether they will have double digit gains, smaller gains, or have to leave the program altogether.

According to Aetna’s CEO, the majority of people who have bought health insurance in an exchange already had individual health insurance.  They just switched to an exchange to save money because of the available federal subsidies.  Right now, 11% of the people buying in exchanges were fully uninsured before the Affordable Care Act.  That statistic isn’t promising to support the claims that this act would help insure nearly all Americans in an affordable way.  Mr. Bertolini says that the exchanges need more choices in them.  More insurance companies need to offer plans in the exchanges in order for them to actually function like the marketplace they were supposed to.  This will bring more Americans into the exchanges to search for health insurance.  This could also bring more younger, healthier people into the exchanges.  These young Americans help keep rates down for everyone.  Plans from the Afforable Care Act only make up 3% of Aetna’s revenue, so they aren’t concerned about it making or breaking them.  It seems to me that the process is more of a headache to Aetna as it stands now.  Aetna’s CEO forecasts a large number of people using exchanges over the next 6 years, but says the majority of those will be in private exchanges rather than public.

 

How Children’s Health Insurance Differs From Adults

Tuesday, January 7th, 2014

The new health insurance laws affect children differently than adults.  U.S. News & World Report’s article “How Obamacare Affects Children” discussed the differences so that parents know what to expect.  Kimberly Leonard got information from the Urban Institute, Georgetown University’s Center for Children and Families, First Focus and the American Academy of Pediatrics for this list of how children’s insurance will be different from adults.  First of all, children did not have to wait to shop for health insurance in the new health insurance exchanges.  They were already eligible through Medicaid and the Children’s Health Insurance Program (CHIP).  This program has been available to uninsured children at either no cost or a very low cost.  This federally or state run program drastically lowered the number of uninsured children to a number that is still a record low.  But even though the number of uninsured children is at a record low, one in ten kids in the United States was uninsured before the Affordable Care Act took effect.

Now that millions of parents will be getting health insurance because of the Affordable Care Act, many of the 7.6 million uninsured children will also get health insurance coverage.  Parents may be shopping in the health insurance exchanges or comparing health insurance from companies so that they will not be penalized for not having coverage.  Some parents whose children qualify for public health insurance plans might be better suited signing their kids up for that then adding them to their new private health insurance plan.  Compare the benefits and costs and make sure that your child’s current pediatrician is covered if you want to stay with them.

The biggest news for children under the Affordable Care Act is the large amount of services that private health insurance plans must offer, many of them for free.  There are 26 preventative services that are now covered without the payment of a copay, deductible, or co-insurance.  Kids with pre-existing conditions can no longer be denied health insurance coverage because of their disability or health issue.  There are also 10 Essential Health Benefits services that have to be covered by private plans and health insurance exchange plans.  These include vision and dental coverage for kids, emergency services and more.  Kids over the age of 19 don’t have to be covered with vision and dental, so consider that when shopping plans.  One of the biggest benefits to parents and older children was the inclusion of kids under their parents’ insurance until the age of 26.  Some young adults aren’t offered health insurance at their first jobs, so being able to maintain coverage through their parents is the only way for them to have health insurance.  This list includes many of the ways that health insurance for children is different than insurance for adults and the added benefits that kids can receive.