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Posts Tagged ‘Universal Health Care’

Many Important Health Care Reform Changes for Young Adults

Thursday, June 17th, 2010

While many young adults faced losing coverage as they aged off their parent’s plan, had no coverage in the case of an unexpected pregnancy, or merely had the bare necessities covered by their school plans, all can breathe a sigh of relief as health care reform promises to end their fears.

As mentioned in earlier posts, the most immediate change is coverage will be extended to overage dependents, as long as they are not offered other employer sponsored coverage, up through their 26th birthday. This helps ease the burden of uninsured claims, as many of these adult children would wait over two years before attempting to obtain their own coverage.

Another helpful option for these previously uninsured individuals is the fact that more than half of them will be eligible for either Medicaid in 2014, as their income is expected to be less than 133% or qualify for government subsidies if they decide to purchase private insurance through an exchange if they are earning 400% of the poverty level.

More relief serves in the fact that maternity coverage will be a mandatory inclusion on the plans, something that is either excluded completely or greatly restricted, depending on what state you reside in. This is most important during young adulthood, as is the need for access to contraceptives, which will also be covered.

The fact that lifetime maximums will be eliminated also sheds light on the current state of most university based plans. Many tend to cover only the most basic of health needs, and offer only limited protection for conditions that are considered eligible medical expenses. With the implementation of comprehensive coverage for all adult children, in spite of of any pre-existing conditions, we can breathe easy that coverage is in place should they need it. Regardless of how you feel about health care reform, we can all agree that all youths of our nation deserve health care coverage!

Tags: children's health, group health, health insurance, heath insurance, Universal Health Care
Posted in Employees, Employers, Family, Federal, Laws | No Comments »

Lack of Pediatric Specialists a Growing Concern

Wednesday, May 12th, 2010

Health Care Reform promises to ensure that all Americans have access to medical coverage. The most pressing concern is the fact that many children are without coverage and the care they need now, so the bill states that by September 23rd, 2010, no child can be denied coverage due to pre-existing conditions. While this is well needed, it does bring to light the fact that there is an increasing shortage of Pediatric Specialists. With an influx of new patients entering the system, and the demand for both medically necessary and non-medically necessary treatments rising, will there be enough physicians to handle the load?

The problem lies in the way these specialists are compensated. Since the majority of their reimbursement comes from Medicaid, and is only covering about 67% of the cost, many new physicians decide to pursue alternate fields of specialty. With limited doctors, the average wait time to see a specialist can be as long as 114 days. This may cause parent’s to turn to the emergency room instead of waiting for a pediatric visit, putting the child at risk with inferior medical care. Hope lies in requiring Medicaid to pay Medicare rates, assisting new doctors with outstanding medical school loans, and funding for continued training. If we lose our pediatric specialists, we put our future at risk.

Tags: children's health, health insurance, pre-existing, Universal Health Care, wellness
Posted in Family, General, Individual, Resources, Tools | No Comments »

The First Year for Health Care Reform – Step One

Thursday, March 25th, 2010

Though some fine tuning will be taking place, the plan for implementing the Health Care Reform Bill during the first year will (most likely) look something like this:

Dependent children will be eligible to stay covered under their parent’s plan until their 26^th birthday. The House is still pushing to make this coverage last through their 26^th birthday.
Insurers can no longer impose exclusions on pre-existing conditions in children. Children are considered exempt from this until their 19^th birthday
Lifetime maximums on benefits and annual limits on coverage will be discontinued
A “high risk pool” will be created for people who cannot otherwise obtain individual coverage due to pre-existing conditions
Seniors will receive a $250 rebate for help them cover the costs of their medication while in the “doughnut hole” (between $2700.00 and $6154.00)
The implementation of covered preventative care services requiring no co pays

Though the final outcome is still yet to be known, these are some of the highlights of the plan of action for health care reform in 2010. Though changes will be made, and battles will be fought, we can expect some of these changes to take shape in less than 6 months from now. From then on? No one knows for sure. We do know, however, that every American will be watching and waiting to see what happens next.

Tags: doughnut hole, health care reform, health insurance, pre-existing, preventative care, Universal Health Care
Posted in Federal, General, Government Run Health Plan, Laws | No Comments »

Health Care Reform is here! What does this mean for you?

Monday, March 22nd, 2010

No one really knows! It seems that revisions are made by the hour, and nothing is quite set in stone as of yet. Also (as of this hour) 11 states have filed lawsuits stating that the bill is unconstitutional, in that it forces people to pay for coverage or face financial penalties. Does it promise to cover all Americans? Supposedly, by 2014, after spending the next few years inching towards this goal by means of guaranteed issue policies, no lifetime maximum amounts, the cessation of policy rescission’s, etc. Once this is in place, individual policies would be purchased via an exchange:

Health Benefit Exchanges. Effective in 2014, state-based American Health Benefit Exchanges and Small Business Health Options Program (SHOP) Exchanges are established, administered by a governmental agency or non-profit organization, through which individuals and small businesses with up to 100 employees can purchase qualified coverage. States are permitted to allow businesses with more than 100 employees to purchase coverage in the SHOP Exchange beginning in 2017. States may form regional Exchanges or allow more than one Exchange to operate in a state as long as each Exchange serves a distinct geographic area. (Funding available to states to establish Exchanges within one year of enactment and until January 1, 2015)

We will see some changes right away, such as offering coverage to all children regardless of pre-existing conditions, and the creation of high risk health pools. Others will take more time, such as the adult pre-existing conditions being a non-issue when it comes to obtaining medical coverage.

Proponents of the bill claim this will save us trillions over the years, while opponents can’t see how that is possible. Guaranteeing and requiring that all obtain health insurance coverage cannot be without a hefty price tag, can it?

Stay tuned………

Tags: health insurance, individual health, pre-existing, underwriting, Universal Health Care
Posted in Federal, Government Run Health Plan, Laws, Resources, Tools | No Comments »

Brown’s Victory & What it Means for Health Care Reform

Tuesday, February 2nd, 2010

Health Care reform faced yet another setback as Massachusetts State Senator Scott Brown received 51.9% of the vote needed to fill late Senator Kennedy’s seat in the US Senate. This now makes the Republican head count 41, thereby bringing the 60-count Democrats were relying on to pass the health care reform legislation to an end. Brown’s strong statements regarding the negative portions of the bill, such as higher taxes and the destruction of jobs, played a major role in his political success. However, ironic that he fills the seat of a major proponent of universal health care, many are breathing a sigh of relief as the thought is while health care reform is much needed, it is something that needs to be dealt with carefully – not a “fix it later” attitude.

While Brown’s win does not mean this legislation is dead in the water, it will mean that it goes back to the drawing board, where hopefully a system that works for all will come to light.

Tags: health insurance, individual health, Universal Health Care
Posted in Federal, Government Run Health Plan, Laws, State | No Comments »

Oppose the Public Plan NOW!

Friday, July 10th, 2009

As you all are aware, the debate regarding the future of our nation’s health care system is raging in Congress right now.

On behalf of our agency, we have dedicated extensive time to educate ourselves and our clients about the most effective ways to improve the health care system. We strongly feel that a public plan will not increase competition in the health insurance industry because it can never occur on an equal playing field. We also feel that the role of the agent is critical, and that to overlook the services that agents provide is a mistake. Our clients have enjoyed over thirty years of superior customer support from our agency, and to take that away would be detrimental.

Nonetheless, recently introduced legislation includes a public plan option and Insurance Exchanges (Gateways) that are devised in a manner that could effectively eliminate the role of the agent. Please take part in our effort to make certain that your Congressman and Senators know your opinions on health reform and the invaluable role of insurance agents.

All you need to do is refer below for our sample letter

I am writing to you today as a concerned constituent. As Congress considers comprehensive health reform, I am very concerned about a proposed employer mandate to provide health insurance coverage. A legal mandate to force employers to provide health insurance to their employees, while well-intentioned, would actually hurt American workers and health insurance coverage by placing a significant burden on American businesses and in turn decreasing jobs and economic growth while doing little to help reach currently uninsured Americans.

While I believe we should build on the successful employer-based system through which most Americans receive quality and affordable health insurance coverage, the employer-based system is not suited for everyone’s health insurance needs. There are obvious problems and questions that would arise were the government to force the employer system on populations that do not naturally belong to it. How do we deal with part-time workers, workers who change jobs frequently, low-wage workers and workers in small firms?

Small businesses and companies are not social experiments. Most employers voluntarily offer health coverage for a somewhat simple reason: a healthy workforce is directly linked to healthy productivity. Thus, employers’ ability to offer incentives to differentiate nonwage-related benefits helps them to attract the best workers and remain competitive. We should be looking to craft policies that encourage more employers to offer coverage, though not mandate it.

Throughout the years, numerous organizations have conducted studies that indicate an employer mandate for health care expenditures will only prove to have a negative impact on wages, job creation and general economic growth. A study conducted by the National Federation of Independent Business (NFIB) concluded that an employer mandate would cause the economy to lose 1.6 million jobs within the first five years and that smaller business would be disproportionately affected because of the increase cost associated with an employer mandate. The cost burden that an employer mandate would place on small businesses would impact their ability to stay in business in the future and disproportionately affect them as they would account for 66% of the lost jobs. When America is faced with a tough economic growth and a historically high unemployment rate why would you create a mandate that would only further perpetuate that problem and in turn force more individuals out of employer-sponsored coverage.

- An employer mandate would not only increase unemployment, but also do little to reach the currently uninsured. In 2007, Richard Burkauser and Kosali Simon of Cornell University examined who would benefit from an employer mandate and found that among workers making $15 per hour or less, the mandate would still leave over half of them without insurance, while 46% of workers earning below the federal poverty level would still be uninsured.

- A recent Federal Reserve Bank of San Francisco study found that mandated employer-provided health insurance in Hawaii increased coverage while employers responded by shifting to more part-time workers who are exempt. Economists looked at employer-based coverage in Hawaii (mandated since 1974) from 1979 through 2005 during which coverage rates rose for workers who were unlikely to be covered absent the law. But the report concluded that an employer mandate to increase coverage may not be an effective means to achieve universal coverage in part because of labor distortions, such as employers expanding the use of part-timers. Hawaii’s law does not cover workers employed fewer than 20 hours weekly.

Imposing an employer mandate, although well-intentioned, would severely hurt American business and the economy and cause countless unintended consequences. While we should encourage more employers to offer health insurance coverage, it would be misguided to mandate such coverage. Once we go down the path of some government mandate on employers for coverage, it will be forever consumed by the political whims and budgetary picture of the day. I urge you to oppose the creation of an employer mandate for health insurance coverage, and look forward to hearing your views on the matter.

and the necessary link to identify and contact your federal elected officials. We urge you to call their offices, e-mail or fax a letter. These are the quickest ways to reach members of Congress. If you e-mail or fax a letter, please be sure to change the sample letter into your own words, as form letters have less credibility. Please be sure to send the letter under your own signature and on your letterhead.

Thank you for your continued support!

Tags: agent, health insurance, Universal Health Care
Posted in Government Run Health Plan | 1 Comment »

SB 810 (LENO) The California Universal Healthcare Act

Wednesday, July 1st, 2009

Senate Bill 810, the Universal Health Care Act, proposes methods to provide affordable and attainable healthcare to all Californians. In a time where there are more uninsured individuals than ever before, and more stringent medical underwriting requirements (leaving those with pre-existing conditions ineligible for coverage), this bill could bring some much needed relief to our strained economy.

Under SB 810, eligibility would be based on residency. All residents would be covered, regardless of health status, employment status, or income level. Would this mean an increase in taxes? Well, theory states that over $200 billion dollars were spent in California on healthcare last year. By utilizing this enormous cash flow already being spent on healthcare by Federal, State, and County funds, such a plan is possible. By changing the way the funds are directed, such as purchasing prescription medication and durable medical equipment in bulk, California can save billions in the first year alone.

Ensuring fair reimbursements to providers, allowing consumers to choose their own doctors, and relying on a shared source of financial support, may be the answer to one of the biggest issues facing our State and Nation as whole.

Tags: health insurance, pre-existing, Universal Health Care
Posted in General, Laws, Resources, State | No Comments »

The Argument Against Government Run Health Plans

Sunday, June 14th, 2009

While many people think the answer lies in a Government run health insurance plan, but there is also a negative side to the theory. While the idea of health coverage for all is a dream worth pursuing, we need to make sure the quality of coverage is not sacrificed in doing so.

Currently, there are state and government run plans in place, such as Medicaid and children’s health insurance. While these programs benefit many people who would normally not have any coverage at all, concerns lie in the fact that there are lower reimbursement rates to providers, thus resulting in less access to doctors.

Obama’s plan is to allow those who have a plan they already like to keep their current coverage. However, should Employers have the choice between current higher premiums, or a lower cost option of the Government run plan, the lesser of the two would be elected. Therefore, employees would now be subject to a plan with more limited access to providers, and could possibly lose their current doctors altogether.

In terms of the doctor’s themselves, they may refuse the low reimbursement rates altogether and decide not to accept any insurance. Lower compensation would also means cuts in care and staff at your doctor’s office. Would-be physicians may decide to pursue more lucrative careers, instead of dealing with the red-tape of a government dictated medicine.

Tags: health insurance, Universal Health Care
Posted in Federal, General, Laws, State | No Comments »