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What Exactly are Reform Lawsuits Arguing?

February 24, 2011 in Affordable Health Insurance, College Students, Dependants, Employer Sponsored Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Exchange, Health Insurance Reform, Individual Health Insurance, Specialists

What Exactly are Reform Lawsuits Arguing?

By Ashley Ahle
February 24th, 2011

Lawsuits being filed against the Obama administration’s Patient Protection and Affordable Care Act (PPACA), have amounted to the unconstitutionality of the individual mandate, and whether the federal government has the legal power to enforce such a provision. Currently out of five lawsuits that have made it to the courts, two of them have passed while still three have been ruled constitutional.

Tuesday night, United States District Judge Gladys Kessler ruled in favor of health reform, stating that it does not violate the individual’s religious freedoms. She also stated that Congress is well within their means to penalize people who forgo insurance. under the Commerce Clause in the constitution.

A ruling in favor of a 26 state lawsuit against reform in Florida was upheld by Judge Roger Vinson. He dismissed the law in it’s entirety stating that picking apart the law and taking out the mandate would render it “toothless” anyway. The administration is asking Vinson to further clarify his ruling and will more than likely seek a stay of judgment, further delaying the case’s move to the Supreme Court.

When fighting the reform, the state’s main fear is that it would give the government too much power by allowing it to penalize individuals without, and force people to purchase health insurance. In defense, the government claims that everyone will buy health care at some point whether it’s with insurance or in an emergency. Without the mandate, premiums would skyrocket and no one would benefit.

Parts of the constitution that are being used in these cases are Commerce Clause, Supremacy Clause (states that federal power is supreme over state power), and the 10th amendment which leaves to the state “all powers not explicitly granted to the federal government go to the state.”

While it remains to be heard in the Supreme Court, it is also unclear if the PPACA can stand without the individual mandate. There may be too many other parts of the bill connected with the mandate that would have to be repealed or changed as well.

Don’t let any of this confuse you as these cases have yet to make it to the supreme court. As of now there has been no final decision about repeal and the cases are still being heard around the country.

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.

Health Insurance Exchanges, Part 2

February 9, 2011 in Affordable Health Insurance, 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 Reform, Individual Health Insurance, Primary Care Physician, Specialists

Health Insurance Exchanges, Part 2

By Ashley Ahle
February 9, 2011

Last week we left off talking about some of the costs related to insurance exchanges. What will directly cause insurance premiums to rise and how will exchanges help manage and keep them down?

Government money will be provided to help get the exchanges running, but what about after that? Well, subsidies will also be in place to help lower income families and individuals acquire coverage and pay for premiums.

The main reason people believe premiums will drop in price after the exchanges are in place, is because companies will be forced to have really competitive prices. These exchanges will need to be in the interest of the buyers, forcing the insurance companies to be very transparent about any rise in costs.

Insurance companies will still be setting their own prices, but within each state they can be rejected. Though the states can not set the premiums, they can however, reject certain plans if they think there is not enough justification for their cost.

Small businesses are concerned that exchanges will only complicate the process of insuring their employees because they would have to diversify their actual premium payments, rather than just writing one check. Though there will be significant tax deductions available for small businesses who opt into the exchange, the fear is that those deductions will not offset the cost of insures needing to meet certain plan standards.

For the small business owners, it may be difficult to make the change, however these exchanges would help make available millions of dollars for low-income and uninsured or un-insurable people. Not only will this help the US citizens, but the money will also help health insurers, hospitals, pharmaceuticals and physicians by reducing the amount of money each state spends on uncompensated care.

A Brief Look at the Impact of Health Insurance Exchanges (Part 1)

February 3, 2011 in Affordable Health Insurance, Employer Sponsored Plans, Group Health Plans, Health Care Costs, Health Care Reform, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance

A Brief Look at the Impact of Health Insurance Exchanges

By Ashley Ahle
February 3, 2011

Cutting costs and providing health insurance coverage to the many Americans who are currently uninsured are two huge focuses of health care reform. The plan to achieve both of these goals is to implement either a federal health insurance exchange, or a state regulated exchange.

Health exchanges are intended to create a more competitive marketplace for insurance companies. By competing against each other, the companies would be forced to lower prices for their more “cadillac” coverage plans.

Exchanges are also another way to universally regulate the insurance market by requiring companies to offer plans that meet minimum coverage requirements. These guidelines and regulations are created by the Health Choices Administration in an effort to federally oversee what happens inside the exchanges.

Although the exchanges are meant to provide an easily accessible and understandable way to shop for coverage, not everyone will be eligible to insure within the exchanges. Individuals must meet one or more of the following criteria in order to be eligible:

1. Must work for a company that employs 100 or less people.
2. Must work at a company that is not providing insurance.
3. Must be self employed.
4. Must be unemployed.
5. Must be retired but ineligible for Medicare.
6. Must be a small business.
7. After 2017 medium and large businesses will be eligible.

If one does not meet the above criteria , they will still be able to purchase coverage. Insurers involved in the exchanges will be required to offer the same plans with same premiums outside of the exchange so as to keep premium costs down.

Also, individuals who cannot afford to pay all of the premiums offered in the exchanges may qualify for Government funded subsidies to help pay for the premiums. This also directly ties into the individual mandate and the concern about low-income individuals not being able to pay for coverage.

Tune in tomorrow for Part two where we will discuss the costs and some Pro’s and Con’s.

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….”

Another Lawsuit Against ObamaCare Survives a Preliminary Challenge

January 20, 2011 in Affordable Health Insurance, Child(ren) Only Health Plans, Doctors, eHealthInsurance.com, 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, Life Insurance, Permanent Life Insurance, Primary Care Physician, Specialists, Term Life Insurance, Uncategorized, Whole Life Insurance

Another Lawsuit Against ObamaCare Survives a Preliminary Challenge
October 14, 2010 6:32 pm

The rulings keep rolling in on the constitutionality of the federal reform law. On Thursday, a federal judge in Florida refused to dismiss the lawsuit brought by a group of state attorneys general( led by Florida’s Bill McCollum), although he threw out several of the suit’s lesser claims. (Here’s the ruling, courtesy of the Wall Street Journal.) That’s the second such decision; a federal judge in Virginia held in August that the Commonwealth’s attorney general could proceed with a similar lawsuit. On the flip side, a federal judge in Michigan ruled earlier this month against a lawsuit that had been brought by the Thomas More Law Center, declaring that the law’s requirement to buy was constitutional….

— Jon Healey

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 Care Reform New health-care rules could add costs, and benefits, to some insurance plans

June 15, 2010 in Affordable Health Insurance, College Students, Dependants, Group Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance

Health Care Reform New health-care rules could add costs, and benefits, to some insurance plans http://ow.ly/17KFTo

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.

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