Posts Tagged ‘health care costs’

Rate Increase Accountability

Thursday, December 8th, 2011

In an effort to give consumers more knowledge when it comes to premium rate increases, the Department of Health and Human Services can now require that all insurance carriers file their rate increases online via a government website -http://companyprofiles.healthcare.gov. As of September 1, 2011 insurers who plan on raising their rates 10% or more must not only provide the rate detail, but the reasons justifying the need for such an increase. This information will now be made available to consumers, allowing them to not only be made aware of premium changes, but also allow them an option to add their questions, concerns, and comments – giving them a voice where previously they felt powerless to fight against the insurance companies. It also allows them to make more educated decisions when choosing to purchase a policy with a company, or move to another more competitive carrier. During a time when most Americans are struggling while big corporations continue to reap in big profits, holding them to some accountability is a big relief.

Assembly Bill 52 Hits a Roadblock

Thursday, December 1st, 2011

Assembly Bill 52, the bill that would allow California officials to regulate health insurance rates, did not gain enough support from the Senate, and has been put aside for now. Assemblyman Mike Feuer (D) said that he would wait until next year before trying to pass the bill again. Fears of AB 52 reigned mostly from health plans, doctors, and hospitals, fearing that the low premiums would mean lower reimbursement rates along with increased bureaucracy and red tape. The president of the California Association of Health Plans stated “AB52 hit a major roadblock because it’s flawed. It failed to address the underlying pressures that drive up the cost of coverage”.

The Autism Insurance Reform Bill

Thursday, November 24th, 2011
Recently, the autism insurance reform bill was passed, and SB 946 will be signed into law by Governor Jerry Brown. This means that as of July 1, 2012, services will be subject to the mental health parity law and require that health plans subject to this bill provide coverage for treatment to “develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism.” Such programs that will fall under behavior health treatment are applied behavior analysis, occupational therapy, and speech therapy. Benefits for such therapies cannot be subject to age limits or dollar limitations. 

Much of this is thanks to the organization called Autism Speaks, as they have been a strong force in pushing legislators to bring the law to fruition. While many families were faced with paying for medical care and much needed therapies out of their own pockets, this bill will help them get the care they need. Visit Autism Speaks to learn more, and urge Governor Brown to sign this bill as quickly as possible.

Obesity Rates Increasing in the U.S.

Thursday, November 17th, 2011
Alarming trends show that almost half the United States population will be obese by 2030. In California, rates have doubled in the last 20 years – resulting in over 20% of the State’s residents falling under the category of obese. With increasing size comes increasing health problems, such as diabetes and heart conditions. In 2009, obesity related medical costs were 15.2 billion in California, which is the highest in the country. The rest of the country in not far behind, however, and only further demonstrates a need for change.
According to a CDC report:
  • Obesity rates were higher among people ages 50 and older (most likely due to an aging population)

Health Insurance Regulation in California Under Health Care Reform

Tuesday, September 13th, 2011

Health care administration under the Affordable Care Act is tricky enough, but none more so than in California. Currently there are two options for the golden state – either consolidating into one regulatory agency or combining between two agencies, the California Department of Insurance (CDI) and Department of Managed Health Care (DMHC), to properly maintain a system that will ensure consumer protection. Those supporting consolidation believe that the fewer hands in the pot will avoid confusion and conflicting interpretations of federal laws. Oversight between two entities can also result in added government and administrative burdens, and difficulty in monitoring what is being purchased and sold in the marketplace.

Senior Citizen’s Facing Social Security Woes

Friday, August 12th, 2011
All of us are finding that our dollars are not going as far as they used to, but none are feeling the hit as much as senior citizens. It is shown that senior citizen’s expenses are rising twice as fast as their Social Security checks, and as many use this as their sole means of income, this is a frightening statistic. As a means to combat this gap in living expenses versus check totals, the Social Security Department created the Cost of Living Adjustment (COLA) in 1975. COLA was intended to be an automatic yearly increase based on the Consumer Price Index (CPI), and proved to be consistent until 2010. However, over the last two years, our senior citizens have received no COLA on their monthly checks. 

With cost of living expenses far outpacing the calculated percentage of the CPI, many are lobbying for a review on this process. Currently, the Consumer Price Index is calculated via urban wage earners for all age groups. However, this does not take into account the higher costs for health care and other expenses older Americans need. As a means to more accurately gauge COLA, it is proposed the government use the spending patterns of seniors by means of the CPI for Elderly Consumers, and use this information to balance their checks accordingly.

Blue Shield Cancels Rate Increases

Wednesday, April 27th, 2011
Even though a privately hired actuary deemed Blue Shield proposed rate hikes as “reasonable”, continued pressure from clients and state officials helped to convince the carrier to cancel their May 1st increase. Though citing a projected loss in the millions, consumers are looking at saving close to $40 million in premiums, which bring much needed relief after the two rate increases within six months – one in October and another January 1, 2011. Blue Shield of California’s CEO released a statement to include “…By agreeing not to raise rates this year, we are helping to make coverage more affordable for our members during tough economic times. It’s a financial risk for us, but a risk that’s worth taking.”

California Sees Rise in HMO Premiums

Friday, March 4th, 2011

Employers are constantly searching for ways to bring down the cost for group health insurance premiums. While the answer used to be “switch to an H.M.O”, this is no longer the case. While H.M.O. plans used to offer much lower premiums because patients were limited in where they could go for care, the rates for such plans have increased at such a steady pace, many of them have surpassed the PPO options in terms of monthly rates. The average increase for an H.M.O. in 2011 was 9.8%, the highest increase in five years.  

Many Children Going Without Mental Health Services

Thursday, January 27th, 2011

  As the number of uninsured children increases, a new study shows that many of these children have the added stress of an emotional, behavioral, or developmental disorder which is going untreated due to lack of access to medical care. Low income families tend to have children with higher rates of these conditions, such as ADD, autism, or depression, but do not have health coverage to assist with the mental health services they need – including counseling and medication. According to such reports as the one done by the Health Resources and Services Administration:

Long Term Care Costs Continue To Rise

Thursday, January 20th, 2011

  The good news? People are living longer. The bad? Costs for Long Term Care (LTC) are increasing steadily with each passing years, outpacing inflation. Should you need care after an accident or illness, you may find that savings can rapidly deplete when paying for the care you need. It is estimated that over two-thirds of the over 65 population will need some form of long term care, whether it is in as assisted living facility, adult day care facility, or home health services. Medicare offers some basic skilled care in a nursing home, but is limited to 100 days. When faced with a long term illness which impairs your ability to perform the basic activities of living, such as eating, bathing, or dressing, it is imperative to have access to continuous care. Long Term Care insurance helps you maintain your dignity and financial freedom and gives you the ability to contribute to the choices that affect your care — about the services you receive, where you receive them and who provides the care you need.  


© 2009 Abrams California Health Insurance Agency. All rights reserved.
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