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Waiving Healthcare Reform Goodbye- Part Deux

March 9, 2011 in Affordable Health Insurance, Dependants, Employer Sponsored Plans, Grandfathered Health Plans, Group Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Exchange, Health Insurance Reform, Individual Health Insurance

Waiving Healthcare Reform Goodbye- Part Deux

By Ashley Ahle
March 7, 2011

As reported on March 2nd, President Obama has chosen to allow certain states and companies to opt out of the Patient Protection and Affordable Care Act. So far the number of waiver’s granted by the Department of Health and Human Services has reached above 1,000. Though these waivers aren’t exactly the same as the Waiver for State Innovation, they do act in the same way, as a stop gap for companies and firms unable to meet the minimum annual coverage limit for 2011.

Companies eligible for these waivers receive a one year grace period for meeting the $750,000 coverage limit. Providing these waivers minimizes disruption in the health insurance market by allowing people to keep their coverage until realistic options become available. A spokesperson for HHS said that these waivers will ensure that American’s can continue to access needed services with little impact on premiums while the transition to a new marketplace in 2014 is under way.

So far, these waivers are covering about 2.6 million American’s- less than 2% of privately insured individuals. Waivers have been denied to companies, however, that cannot demonstrate that their compliance with the annual limit requirement would significantly increase their premiums or decrease coverage.

An important question being raised right now, is how will granting these waivers affect the credibility of health care reform all together? According to Kaiser Health News columnist John McDonough– a professor at Harvard School of Public Health, these waivers “offer a useful window into the health law’s evolving politics and future bargaining likely to take place.”

Lawmakers opposing health care overhaul are using these waivers as examples of flaws in the reform by saying they make for too many loopholes. While at the same time, they are demanding more “transparency” from HHS regarding why companies are being denied.

In response, HHS has said they have already provided the information requested, to the House Committee on Oversight and Government Reform. However in a letter sent in February the committee had clearly stated that they wanted a defined method of how the HHS was processing waivers, and where in the PPACA did it give HHS the legal right to grant these waivers.

Most companies being granted the one year waiver, are companies offering the lower cost “mini-med” plans. House members in opposition claim that this prevents the 2.6 million Americans covered by these plans from receiving the health insurance coverage that “President Obama believes every American deserves.”

There needs to be an adjustment period for everyone while this policy changing, far reaching health care overhaul takes place. If passed, one cannot expect changes to come immediately. Much like holding the Presidential elections in November but having a change of office in January, this law will need time to meld with the current market. And in time, if granted, these wrinkles may be ironed out in a way that suits us all.

Waiving Reform Goodbye? For Some States It May Be Possible

March 7, 2011 in Affordable Health Insurance, Dependants, Employer Sponsored Plans, Grandfathered Health Plans, Group Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Exchange, Health Insurance Reform, Individual Health Insurance

Waiving Reform Goodbye? For Some States It May Be Possible

By Ashley Ahle
March 7th, 2011

On the eve of February 28th, President Obama announced his support of the Waiver For State Innovation bill, authored by Sen. Ron Wyden and Sen. Scott Brown. This bill is one of the first bi-partisan acts supported by the President in regards to health care reform.

First proposed back in November of 2010, this bill was only 200 words long, allowing States the Opt out option in 2014 instead 2017. This will eliminate any costs accrued for states already planning to opt out in 2017, by allowing them to avoid costs associated with implementing the Affordable Care Act mandates, IE: individual mandate, employer mandate, health insurance exchanges and the federal design of health insurance coverage.

These costs would potentially be avoided because the federal subsidies allowed to the States could be used to implement health reform how they see fit. Now, the states planning to opt out will have to come up with an alternative reform that meets the following requirements:

1. The State waiver ensures that individuals receive coverage that is at least as comprehensive as under the Federal law.

2. State waiver ensures individuals get coverage as affordable as under federal law.

3. State waiver ensures that as many people are covered as under Federal law.

4. State waiver cannot increase Federal deficit.

These waivers, when granted, will be valid for 5 years with the option to renew after. If states are seen not fulfilling any of the aforementioned requirements, then Federal Overhaul and reform will take effect.

The main problem seen from moving this opt-out up is that without 3 years of complete overhaul experience under their belts, the states may set their figures for grants too high, since there wouldn’t have been enough time to actually see what their costs will be related to insuring their own citizens.

This bi-partisan bill may be just what Washington D.C. needs in order to break the gridlock surrounding the Affordable Care Act. This plan would lessen the government’s rule over health reform (wanted by Conservatives) and would ensure reform happens for everyone (wanted by Liberals).

As stated in previous posts, repeal of reform is extremely unlikely. Many Republicans are still unwilling to ‘reform health reform’ strictly because they are holding out for a full repeal, while their counterparts are making efforts to ensure a bi-partisan agreement can be made. The only thing to do now is wait and see what changes will come. And hope for the best.

Oregon May Have the Answer for Child Only Health Policies

March 3, 2011 in Affordable Health Insurance, Child(ren) Only Health Plans, Dependants, Employer Sponsored Plans, Grandfathered Health Plans, Group Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Agent, Health Insurance Reform, Individual Health Insurance

Oregon May Have the Answer for Child Only Health Policies

By John Rueschenberg & Ashley Ahle of Coverage Point Insurance in Happy Valley, OR

The state of Oregon, a few months ago, restructured child only individual enrollments by switching to open enrollment periods, similar to that of a group open enrollment period. Child only applications are only accepted during the months of February and August of every year with effective dates of either March 1st or September 1st.

Congress Passed a law earlier this week allowing states to create similar laws that will close the loopholes in child only policies applications, which prevent insurance abuse of benefits. In order to keep insurance companies on board, regulation is needed to keep premiums from skyrocketing due people only obtaining coverage after they become sick and with no no consequences.

To simplify the process and reduce risk, annual enrollment periods across the industry, including enrollment for Medicare Advantage plans, should be changed to the month the eldest applicant was born. If this were to happen consumers, insurance companies, agents and the Federal Government would experience more ease when dealing with coverage.

Remembering the month you were born is far easier than researching the dates for the next enrollment period. Making this change would eliminate confusion that comes with purchasing an insurance policy. Enrollment periods that are lumped into a small time frame, like what currently happens for Medicare, group coverage and now child only policies in Oregon, increases the chances for error and reduces the quality of service, by creating an increased workload for the government, insurance companies and agents involved with enrollment.

Not only would changing the open enrollment period to the month of birth lessen the workload, it would also reduce the amount of SPAM email consumers receive year round. Instead of soliciting year round, agents and companies would only focus on the weeks leading up to the insureds birthday, making it easier for all parties involved.

Under health care reform, insurance companies are prohibited from denying any child with pre-existing conditions. Due to this change, many companies have either adopted the open enrollment periods or have stopped offering child only policies all together. Although companies are allowed to offer them outside enrollment periods, they are still prohibited from denying any child thus allowing people the opportunity to only gain coverage when an illness occurs, therefore driving up costs for everyone.

Not only would the birth month enrollment periods ease workloads across the industry, many more consumers would find it easier to obtain coverage and in turn, more people would be covered. Which is the goal of health care overhaul all together.

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