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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.

Effect of Repealing the Individual Mandate

February 17, 2011 in Affordable Health Insurance, 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, Specialists

Effect of Repealing the Individual Mandate

By Ashley Ahle
February 17th, 2011

Deeming the individual mandate of the Patient Protection and Affordable Care Act unconstitutional has caused many people to question the need for it. As I have said in past posts, an individual mandate is necessary for the PPACA to be successful. Without it or something similar, the Health Care Reform would fail. That said, how can the individual mandate be altered to fit the needs of those fighting for repeal? And by piecing apart the PPACA, what will the costs be to the government and will a repeal actually solve anything?

According to the Congressional Budget Office, they estimate that a repeal of the mandate would bring in roughly $202 billion dollars between 2014 and 2019, while at the same time increasing the number of uninsured by 16 million people. It would also reduce the number of people on Medicaid and the Children’s Health Insurance Program by 6-7 million people; individual coverage by 5 million and employee sponsored coverage by 4-5 million people. The question is, then, is saving that $202 billion dollars more beneficial to the people of the country?

Alternatives to the mandate are out there, however people voting to repeal all of the Reform are unwilling to present these options due to the fear that they may actually strengthen the PPACA. Since the reform will fail without a mandate, there needs to be something in place that is strong enough to discourage people from buying coverage only when they are sick. Reform will prohibit risk adjustments from being made individually. Instead there will be a community rating; this is a way to calculate premiums by evaluating the risk factors of all persons in the market, instead of evaluating it individually like it is done now.

Under this community rating, it makes it so healthy and sick people pay virtually the same amount in premiums. If there were a repeal of the mandate, health costs would rise to such a crushing rate that we may face another government bailout like that of the auto industry. The aim in repealing the mandate is to lessen the government’s involvement and this would run the risk of increasing it.

Other options to the mandate that have been kicked around include the possibility of a small tax, limiting enrollment to once every two years, penalizing people who wait, and implementing a five year lock-out. The small tax would be set close to the amount proposed for the penalty. For people who go uninsured this would be a tax they would pay at the end of the year and for people who can prove credible coverage this would be a tax credit at the end of the year. The reason that Democratic politico’s didn’t propose this originally is because of the political fight over taxes that would ensue.

Limiting enrollment to once every two years would disable people who decide to go uninsured from buying coverage only when they are sick. It would act as a buffer, similar to the enrollment periods for Medicare. Penalizing people who wait for coverage is similar to the penalty on Medicare Prescription Drug Benefit. It would implement higher premiums for those who decided to wait. The five year lock out would prevent people who go without coverage, access to government subsidies and insurance protections for five years. Even if they wanted to buy coverage in the first place.

Here the problem lies with Congress. There has to be a middle ground at this point, that both Republicans and Democrats can meet. The way things are progressing, that ground may continue to elude all parties. Republican’s and Democrats fighting for a repeal will not vote for alternatives to the individual mandate because they don’t want reform at all, and those alternatives may actually strengthen the PPACA. If we all, in fact want the same thing, a system with lower costs and near universal care, there has to be compromise. Otherwise the amount of money wasted on arguing all facets of Reform will outweigh the benefits.

The New Republic: The Worst Case For Health Reform

January 21, 2011 in Affordable Health Insurance, Employer Sponsored Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Reform, Individual Health Insurance

The New Republic: The Worst Case For Health Reform

by Jonathan Cohn
January 20, 2011
Jonathan Cohn is a senior editor at The New Republic and a senior fellow at Demos

Steven Hyder, 40, runs his own legal practice out of a shared office in downtown Monroe, Michigan, a blue-collar town south of Detroit. Mostly he handles relatively routine, low-profile work: bankruptcies, personal injury claims, that sort of thing. But recently, he became part of a much bigger case. He’s a named plaintiff in a lawsuit challenging the constitutionality of the Patient Protection and Affordable Care Act….

Why Health Reform Won’t be Repealed

January 20, 2011 in Affordable Health Insurance, Child(ren) Only Health Plans, College Students, Dependants, Doctors, Employer Sponsored Plans, Grandfathered Health Plans, Group Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance, Primary Care Physician, Specialists

Why Health Reform Won’t be Repealed

By Aaron Carroll, Special to CNN
January 19, 2011 1:05 p.m. EST

Editor’s note: Dr. Aaron E. Carroll is an associate professor of pediatrics at the Indiana University School of Medicine and director of the university’s Center for Health Policy and Professionalism Research. He blogs about health policy at The Incidental Economist.

(CNN) — This week, the House of Representatives plans to vote to repeal the Patient Protection and Affordable Care Act. It will succeed….”

Myths — Ahem — Lies About Health-Care Reform

January 19, 2011 in Affordable Health Insurance, Dependants, Health Care, Health Care Costs, Health Care Reform, Health Insurance Reform, Individual Health Insurance

Myths — Ahem — Lies About Health-Care Reform

By Richard Cohen
Posted at 11:41 AM ET, 01/19/2011

The Post, enamored of euphemisms, calls lies myths. Thus the headline on a terrific article by Glenn Kessler entitled “Debunking common myths about health-care reform.”

The first myth is that “This is a ‘government takeover’ of the health-care system.” It is, of course, no such thing, unless the term “takeover” means the passing of some regulations. If that’s the case, then the government long ago took over the radio and television industry (the FCC and all of that), the drug industry (the FDA) and, of course, mining, what with all those pesky inspections and periodic indignation over the deaths of miners. In fact, as Kessler points out, the government did not take over the health insurance industry….

Administration: Health Repeal Could Cost Millions Coverage

January 18, 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 Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance, Specialists

Administration: Health Repeal Could Cost Millions Coverage

By the CNN Wire Staff
January 18, 2011 1:19 p.m. EST

Washington (CNN) — Nearly half of all Americans under the age of 65 have health conditions that could prevent them from getting insurance if the Republican effort to repeal health care reform is successful, U.S. Health and Human Services Secretary Kathleen Sebelius said Tuesday.

Sebelius said 129 million people — nearly half of all Americans under the age of 65 — have some form of pre-existing condition that could make them ineligible for coverage should they lose or change jobs, get divorced or face other changes that force them to seek new insurance….

Health Insurance Exchanges Should Not Be Like eHealthInsurance

September 20, 2010 in Affordable Health Insurance, eHealthInsurance.com, Health Care, Health Care Costs, Health Care Reform, Health Insurance Agent, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance

Health Insurance Exchanges Should Not Be Like eHealthInsurance
By John Rueschenberg
CoveragePoint.com

Two months ago, I had a meeting with Mary, a director at a reputable health insurance company. Mary’s name has been changed and her company’s name will not be disclosed to protect her identity. Mary and I were talking about the different insurance agencies and the amount of production that they bring to her company each year. Not at all to my surprise, her number one producer of individual health plans was and has been eHealthInsurance. eHealthInsurance is the largest online insurance agency, owned by publicly traded company eHealth Inc. We have all seen their TV commercials for affordable health insurance. The truth is that the rates are no different if you apply using eHealthInsurance, another agency or if you apply directly to the company by yourself. It will be the same rate no matter what, but keep in mind that an agent can help you and keep you from making a costly mistake, so that is why you should always use an agent.

Most will agree, the ongoing history of publicly traded companies is to make a huge profit and achieve excellent numbers so that they can keep their stock holders happy. While some publicly traded companies do care about customer service, many others don’t. I have never been to the eHealthInsurance’s headquarters before nor have I spoken to someone who works for, or previously worked for the company, therefore I don’t know exactly how they operate. What I do know and can share with you are the experiences of others who have dealt with the company at one time or another.

In my meeting with Mary, she described eHealthInsurance as her double edged sword. They continually have brought Mary’s company the most new individual health business, but eHealthInsurance has had an ongoing history of not providing adequate service to their clientele after the policy is issued. Mary also said of the people who applied for one of her companies health plans using eHealthInsurance.com, that ongoing for years now, eHealthInsurance has had the highest percentage of policies not taken after an application was submitted. “Not taken” is an insurance term meaning someone applied, but for one reason or another the policy was never issued. Similar stories are out there on websites such as Epinions.com and other product or service review websites. Interestingly enough, one of the automatically generated search terms that Google gives is “eHealthInsurance scam.” The Better Business Business Bureau of North Eastern California alone has received 22 complaints in the past 36 months for eHealthInsurance.

Ordinarily, I’m not about attacking someone or a company and pointing out their flaws, but this has changed because EhealthInsurance has made the recommendation that the new health insurance exchanges starting up over the next few years should operate similar to how eHealthInsurance.com does now. While lack of service does sound like how most government agencies have long been operating; such as the Department of Motor Vehicle, the Internal Revenue Service and Social Security Administration, the US population as a whole is not looking for health care to operate as another poorly serviced government agency.

There are other sites out there that do provide the same great online experience as eHealthInsurance, but also offer ongoing service for years to come. Websites like CoveragePoint.com give you the same great online service as eHealthInsurance.com does, but they instead have an ongoing reputation of being there for you when sticky situations come along. It is important that the example of the health insurance exchanges follow the examples of agents and agencies who have built a solid reputation of being there after the policy is issued. The agent is the person who is supposed to be there for you at the hardest time, such as when dealing with a difficult claim, especially if you have to deal with multiple insurance companies. An agent helps you during the application process, prevents you from making a simple mistake that would otherwise hold up your application in underwriting for days or weeks longer than necessary, or cause for you to receive a higher premium. An agent can help prevent a decline or a rider. An agents advice and experience are both invaluable and free to the consumer.

Circumstance and claims often do happen where you are dealing with your health insurance company, your auto insurance insurance company and Workman’s Comp; all three at once, or two at the same time for the same injury or claim. More than likely, each company wants the other to pay the claim, so often times none of them pay. Your agent is there to get you through these unfortunate circumstances as your personal representative. Your agent is supposed to be on your side. They should help you figure out the mess and point you in the right direction. The example of health insurance exchanges should not be eHealthInsurance, but instead the example should be that of agents and agencies who have built a solid reputation of being there for their clients when they are needed.

The Centers for Medicare and Medicaid Services(CMS) projects that the expense of health care would be 0.3% less by the year 2019 had the health care reform bill never passed. CMS also predicts health insurance exchanges are expected to cost roughly a total of $220 billion just to start up by 2014. Between 2014 through 2019, the health insurance exchanges are predicted to cost an additional $37.7 billion to operate. Roughly 85% of US health insurance policies are issued with the assistance of an agent. When you consider that about 85% of policies are issued using an agent, the duplicated efforts of exchanges will be a waste of taxpayer dollars. Eliminating the creation of the exchanges all together will save over $250 billion between now and 2019; health care savings would be seen and achieved much sooner. The creation of the health insurance exchanges will simply be a waste of time and taxpayer money, especially if they will be run like any other poorly serviced government agency. There is no reason to reinvent what has already been proven to work.

Health Reform News & Updates – Health Insurance Quotes & Affordable Health Insurance Plans – Compare Health Insurance Rates

June 9, 2010 in Affordable Health Insurance, Child(ren) Only Health Plans, Doctors, eHealthInsurance.com, Group Health Plans, Health Care, Health Care Costs, Health Insurance Agent, Health Insurance Exchange, Health Insurance Quotes, Individual Health Insurance, Life Insurance, Permanent Life Insurance, Primary Care Physician, Specialists, Term Life Insurance, Whole Life Insurance

Health Reform News & Updates – Health Insurance Quotes & Affordable Health Insurance Plans – Compare Health Insurance Rates.

Why Should I Work With An Agent?

June 7, 2008 in Affordable Health Insurance, Group Health Plans, Health Care, Health Insurance Agent, Health Insurance Quotes, Individual Health Insurance

The internet has made shopping for insurance easier. Instead of driving around town to meet with an agent, you can compare rates, benefits, and apply online. Some insurance companies even let you apply right from their website.

Does it still make sense to have an agent help you choose a plan? You bet.

Agents are insurance experts. It’s their job to help you shop plans from leading carriers so you can be confident you’ve found the best rates and benefits for you.

4 Reasons To Work With An Insurance Agent
When you consider all the benefits, working with an agent just makes good sense.

  1. Agents guide you through the process. Buying an insurance policy can be complicated. An agent walks you through each step of the process and helps you make sense of all the “insurance-speak”.
  2. Agents offer you choice. Your agent has a portfolio of plans to choose from, often from multiple companies. Your agent will know which policy will protect you the best. They’ll even know which company is most likely to accept your application.
  3. Agents troubleshoot mistakes. A mistake on your application can cause a company to raise your rates or even reject your application. Your agent will help you fill out your application correctly so you get the rates you deserve.
  4. It’s free. This is the best part about getting insurance through an agent. Agents collect payment from the companies they represent. So you get all the advice you want — absolutely free.

As professional agents, we’re happy to help you find the best plan. You can compare popular plans on our website, too. Get started now with your free online health insurance quotes.

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