MUST READ!!! - Best Individual Health Insurance Policies

8 Keys to Picking the Best Individual Health Insurance Policy

Following these steps could save you tens of thousands of dollars if illness strikes.

By Megan Johnson, Steve Sternberg

Choosing the right individual health insurance plan just got a lot easier with the help of U.S. News’s Best Health Insurance Plans. Our user-friendly plan finder lets you zero in on a plan with the coverage you need at a price you can afford. To make a good choice and avoid some common traps, however, you need to keep a few basics in mind, starting with the meaning of such terms as premium, deductible, copay, and coinsurance. Then go through the checklist provided here, with your likely medical needs and how much you can pay a month as the backdrop. With the right insurance, you could save thousands, perhaps even tens of thousands, if you or a family member gets sick. 

1. Identify the “must-haves.” You can’t foresee a sudden injury or illness, but some medical needs can be anticipated. Maternity coverage, for example, is an obvious must-have if you’re starting a family, and not all policies offer it. If you have a family history of heart disease, you may want to make sure your coverage includes the cost of cardiac screening tests and cholesterol-lowering drugs. Under the Affordable Care Act, individual insurance plans must cover the full cost of more than two dozen preventive services for men, women, and children, including vaccinations and tests for high blood pressure, cholesterol, colon cancer, and diabetes, as long as they’re provided by a practitioner in the plan’s network.

2. Don’t overbuy. Would you buy a luxury car with a monthly payment as big as your mortgage? There’s not much point in thinking about a Cadillac insurance policy your budget can’t handle, either. If you’re relatively young and healthy, consider choosing a policy with a high deductible, the amount you must pay out of pocket before certain benefits kick in. A plan with a deductible of $5,000 or more is likely to cost you considerably less per month, and could save you money in the long run.

3. Check the network. If you have a primary care physician and specialists you like, be sure they’re in the network of any plan you consider buying. Policies generally cover a lower share of the cost of out-of-network care—or none at all. For each plan U.S. News has rated, we supply links to the insurance company’s website. There, you should find a directory of doctors in the company’s network.

4. Know your share of the costs. This isn’t crystal-ball gazing. Plans are required to state how much you’ll pay out of pocket, through flat fees called copays and through coinsurance, a form of “cost-sharing” in which you pay a percentage of a medical service. When you’re sick, seemingly small copays can add up. And an expensive procedure could leave you obligated to pay thousands in coinsurance.

5. Make sure your drugs are covered. You’ll want to make certain that the plan’s formulary, or list of covered medications, includes those you take regularly, especially if they are expensive. Or at least make sure the plan has a great alternative for prescription drugs.

6. Look into annual limits on coverage and services. Thanks to health reform, annual dollar limits on coverage will disappear entirely in 2014. For now, any individual policy you buy cannot impose a limit of less than $1.25 million, an amount that will rise to $2 million on September 23, 2012. But the Affordable Care Act still allows plans to impose limits on services not deemed “essential” and, in some cases, to obtain a waiver allowing them to retain an annual limit.

7. Factor in your dependents. If you have children under age 26 without health insurance coverage through an employer, the law permits them to be on your insurance. Policies also can no longer exclude kids under age 19 from coverage because of pre-existing conditions.

8. Walk through several plans. It only takes a few minutes to review the main benefits associated with each plan, and some plans that look appealing at first glance may turn out to have cost-sharing features that could burden you with heavy medical costs. Each plan rated by U.S. News displays this information on a single page on usnews.com. A live person will walk you though the messier details if you contact the National Association of Health Underwriters, which can put you in touch with licensed local agents and brokers.

Article via: http://health.usnews.com/health-news/health-insurance/articles/2012/08/07/8-keys-to-picking-the-best-individual-health-insurance-policy

INSURANCE Companies THANK FAST FOOD FOR YOUR HEALTH ISSUES!!!!! A Must Read!

DID YOU KNOW??? Study Shows:           Insurance companies hold billions in fast food stock

Researchers say there's a "potential disconnect" between insurance companies' mission and unhealthy food options.

 

Article By: By Sarah Klein, Health.com

 

The fast-food industry has long been under fire for selling high-fat, high-calorie meals that have been linked to weight gain and diabetes, but the financial health of the industry continues to attract investors -- including some of the leading insurance companies in the U.S., a new study reports.
According to Harvard Medical School researchers, 11 large companies that offer life, disability, or health insurance owned about $1.9 billion in stock in the five largest fast-food companies as of June 2009.

The fast-food companies included McDonald's, Burger King, and Yum! Brands (the parent company of KFC and Taco Bell). Companies from both North America and Europe were among the insurers, including the U.S.-based Massachusetts Mutual, Northwestern Mutual, and Prudential Financial.
The researchers say insurance companies should sell their fast-food stock or use their influence as shareholders to make fast food healthier, by pressuring big restaurant chains to cut portion sizes or improve nutrition, for instance.

There's a "potential disconnect" between the mission of insurance companies and the often-unhealthy food churned out by companies like McDonald's, they write.

"The insurance industry cares about making money, and it doesn't really care how," says the senior author of the study, J. Wesley Boyd, M.D., an assistant clinical professor of psychiatry at Harvard Medical School, in Boston. "They will invest in products that contribute to significant morbidity and mortality if doing so is going to make money."

Boyd and his colleagues used a database that draws on financial filings and news reports to estimate the fast-food investments of the 11 companies. Their findings appear in the American Journal of Public Health.

Massachusetts Mutual and Northwestern Mutual -- which both offer life, disability, and long-term care insurance -- owned $367 million and $422 million in fast-food stock, respectively, much of it in McDonald's, the authors report. Prudential, which offers life insurance and long-term disability coverage, held $356 million in fast-food stock, according to the study.

Insurance companies disputed these figures. Andrea Austin, the assistant director of corporate relations for Northwestern Mutual, in Milwaukee, says the company's investment in fast-food companies is only about $250 million, and was at the time the study was conducted. That amounts to about one-fifth of 1 percent of the company's portfolio, she adds.
Austin also disagrees that the company's fast-food investments represent a disconnect with its mission. "We have to determine what's going to give our policy owners value," she says. "We have to make sure we fulfill our obligations to them, and to do that we invest in a wide variety of industries. It's that diversification that enables us to return value to them."

In an e-mail, MassMutual spokesman Mark Cybulski called the study's findings "absolutely incorrect" and said that as of December 31, the company's holdings of fast-food-related stock amounted to just $1.4 million, which represents less than one-hundredth of 1 percent of the company's $86.6 billion in cash and total invested assets.

Austin says she has "no idea" why the figures differ and says that Northwestern Mutual doesn't use subsidiaries.

Theresa Miller, the vice president of global communications for Prudential Financial, said in an e-mail that she could not discuss the specifics of the company's portfolios. But she noted that the investments in the report are within index funds, and that "a large portion" are managed on behalf of third-party clients.

MassMutual, Northwestern, and Sun Life (another insurer mentioned in the report) have contested Boyd's findings in the past. Last year Boyd led a similar analysis, published as a letter to the editor in the New England Journal of Medicine, that found that seven insurance companies held some $4.5 billion in tobacco-company stock. Then, too, Cybulski said that MassMutual's holdings were just a fraction of what Boyd and his colleagues claimed.

According to Boyd, the discrepancy in his figures and those cited by MassMutual may be due in part to two factors: Insurance companies may invest in fast-food stocks through subsidiaries over which they have limited oversight (and therefore may not consider them direct investments), and some of the investments may be in index funds, a type of mutual fund tied to the collective performance of a large group of stocks, such as the S&P 500, which may include those of fast-food companies.

The database used in his analysis provides only the aggregate of a company's holdings, Boyd says.
Austin says she has "no idea" why the figures differ and says that Northwestern Mutual doesn't use subsidiaries.

Boyd and his co-authors emphasize that fast food -- unlike cigarette smoking -- can be safe in moderation.

However, a growing body of research has linked frequent fast-food consumption to weight gain, obesity, and type 2 diabetes.

As a result, the study notes, several cities and towns have restricted fast-food restaurants via zoning laws. And under the health-care legislation passed by Congress in March, chain restaurants will have to post calorie information on their menus, as is already required in New York City.

In their 2009 paper on tobacco, Boyd and his colleagues suggested that insurance companies profit twice over by investing in tobacco stocks, since they can charge higher premiums to smokers and also profit if the stock rises. A similar dynamic may be at work with fast food, according to Boyd.

"They can charge you more for life insurance if you have these negative health outcomes that people have as a result of eating fast food," he says.

But investing in unhealthy industries such as fast food and tobacco isn't necessarily a win-win for insurers over the long term, especially for health insurers, says Sara N. Bleich, Ph.D., an assistant professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.

"Health insurance companies get profits if they invest in tobacco and fast food, [but] these are some of the top drivers of mortality in the country," says Bleich, who researches obesity policy but was not involved in the current study.
 
"They are essentially killing off their consumer base, so it's not a sustainable model in the long-term. Long-term goals should be consistent with health, because that ensures a large population from which to draw consumers."

Robert Zirkelbach, the press secretary for America's Health Insurance Plans, a national association representing health insurers whose Web site lists three of the companies named in the study, declined to comment on the specifics of the study. "Our industry is strongly committed to prevention and wellness," Zirkelbach said in a statement.

"Health insurance companies are doing things across the country that are working to address obesity, to promote prevention, and to encourage people to live healthier lifestyles."

Gigi Kellett, the director of the anti-tobacco campaign of Corporate Accountability International, a Boston-based watchdog group, says that both tobacco and fast food are inappropriate investments for insurance companies.

"Tobacco remains the leading cause of preventable death around the world, and there is growing research that diet-related diseases could soon surpass tobacco," she says. "It's irresponsible for insurance companies to invest in companies that make people sick."

Corporate Accountability International recently launched a "Retire Ronald" campaign to pressure McDonald's to discontinue the Ronald McDonald clown character and rein in its marketing to children, Kellett adds. For her part, Bleich says that while health insurance companies, specifically, should be encouraged to divest their fast-food investments, encouraging self-regulation and competition in the fast-food industry may be a more effective way to make the industry healthier.

 

 

 

Where Does Your Current Health Insurance Rank???--- A MUST KNOW!

 

 

FBIC( Fight Bad Faith Insurance Companies) Ranks 100 Insurance Companies From Bad To Good

TOP 10 BAD Faith Insurers:

1. Allstate (US Boycott... Worst Do Not Buy)
2. State Farm (US Boycott...Worst Do Not Buy)
3. The Hartford (US Boycott... Worst Do Not Buy)
4. Unum (Disability, LTC, Life)
5. Farmers/ Zurich
6. Lloyds
7. MetLife
8. Liberty Mutual
9. American Family
10. Auto-Owners (aka Owners)

25. United Healthcare

27. BlueCrossBlueShield

Read more of the WORST at http://www.badfaithinsurance.org/indexdetaillist.html

Top 10 GOOD Faith Insurers:

1. Amica (Ok, Best To Buy)
2. Chubb (Ok, Best To Buy)
3. Allianz (Ok, Best To Buy)
4. Coventry Health
5. Kaiser Permanente
6. Credit Suisse - USHealth Group
7. Royal & Sun Alliance
8. GMAC
9. Swiss Re America
10. FairFax Financial

12. Aetna Health

17. Humana Health

40. Alfac

41. Farm Bureau

45. USAA

Read more of the BEST at: http://www.badfaithinsurance.org/indexdetaillist.html

Next ObamaCare Deadline: State Health Exchanges---A MUST KNOW!!

States have until Friday to say whether they'll set up health exchanges under President Obama's health reform law.

NEW YORK (CNNMoney) -- States have until Friday to decide whether they will set up health insurance exchanges, a key provision of President Obama's controversial health reform law.
The health exchanges, which are scheduled to open their doors in 2014, will create online marketplaces where individuals and small businesses can find more affordable insurance plans. Uninsured Americans whose incomes range from 100% to 400% of the federal poverty level will be eligible for federal subsidies.

Between 23 million and 25 million people will receive coverage through the exchanges from 2016 on, according to estimates from the Congressional Budget Office.
  
Since health reform remains a political flashpoint, many states were waiting to see who won the presidential election before deciding whether to set up an exchange.
  
Residents in states that choose not to create exchanges will be able to participate in a federal exchange. A few states may opt for state-federal partnerships, in which states operate certain customer assistance and plan management functions.

Most Americans must have health insurance starting in 2014 or face fines.
  
Some 15 states and the District of Columbia have established state exchanges so far, with four others planning to set up the partnerships, according to the Kaiser Family Foundation. Traditionally blue states, including New York, Maryland and California, are among the ones that have created exchanges.
  
Another 11 states -- including Texas, Florida and South Carolina, where the governors have come out strongly against the president's initiative -- have decided not to create exchanges. Another 14 states are studying their options and six have done virtually nothing to prepare.
  
Arizona is one of the states still weighing the choices. The Grand Canyon State received a $30 million grant to study the issue and Governor Jan Brewer, a Republican, will make her decision this week, said Matthew Benson, her spokesman.

Recognizing that creating exchanges can be a heavy organizational lift, the federal Department of Health and Human Services announced last week that it would give states additional time to submit details of their plans for an exchange. While states still have to tell regulators whether they plan to implement an exchange or not, they don't have to provide specifics until December 14.
  
There are pros and cons to creating exchanges, said Alan Weil, executive director of the National Academy for State Health Policy. Creating them involves financial, operational and political risk.
  
The exchanges have to be self-sustaining after the first year. If they are not, states may be on the hook or may have to charge fees to the insurers, Weil said. And they can also be complicated to set up since states have to establish rules regarding offerings and pricing, as well as meet various marketing requirements to make sure the sick and the poor are not shut out. They must also establish call centers and websites to assist people in picking plans.
  
Also, some state officials may face a political backlash since Obama's health care reform is deeply unpopular in many locations.

But establishing an exchange allows states more control over which plans are allowed to participate, how the insurance options are structured and how quality of care is measured. Also, it makes it easier to coordinate with the state's Medicaid system, which will be expanded in many states to cover all adults up to 133% of the poverty line.
  
But even the states that are embracing the exchanges are scurrying to get the system ready by the 2013 open enrollment deadlines, which begin in October.
  
"There are some states that may simply run out of time to have everything ready to go," said Jen Tolbert, director of state health reform for the Kaiser Family Foundation.

Update On Health Care Reform - 2010 Reforms Already In Effect TODAY

Reforms already in effect

 

More young adults with insurance. All health plans must allow young adults to remain as dependents on their parent’s health plan until they turn 26, whether or not they live at home or can be declared as dependents on the parent’s income tax return. An estimated 6.6 million young adults who would otherwise be uninsured have gained coverage during the first year of eligibility, according to a recent analysis by the Commonwealth Fund, a nonprofit health policy think tank.

 

Cheaper drugs for people on Medicare. Seniors who reach the “donut hole” – the point when they have to start paying prescription drug expenses themselves – now get a 50 percent discount when buying brand-name drugs and a 14 percent discount on generic drugs covered by Medicare Part D. More than 5 million older adults and people with disabilities have saved $3.5 billion in prescription costs since the law was passed. The donut hole will continue to shrink until it disappears completely by 2020.

 

Temporary help for people with pre-existing conditions. To tide people with health problems over until 2014, the law created temporary Pre-existing Condition Insurance Plans in all 50 states plus the District of Columbia. Thanks to federal subsidies, people who have been denied coverage or quoted outrageous premiums because of their health history can buy these comprehensive health plans for about the same price as a healthy person their age would pay for a private plan. The catch is that to qualify for the program, the law says people must have gone without insurance for at least six months. Even so, 67,482 Americans had enrolled in these plans as of April 30, 2012. This program is scheduled to expire in 2014, when people with pre-existing conditions will no longer be locked out of the health insurance market.

 

Free preventive care. New private health plans must cover and eliminate cost-sharing (co-payment, co-insurance or deductible) for proven preventive measures such as immunizations, Pap smears, and screening colonoscopies. Beginning August 2012, private health plans must provide additional preventive measures to women, including free well-woman visits, screening for gestational diabetes, domestic violence screening, breastfeeding supplies, and contraception. Workplaces run by religious organizations that object to birth control are to receive a special accommodation: their health plans must still offer the coverage, but the cost of it will be borne entirely by their insurance companies.

People on Medicare are also now entitled to the same free preventive coverage, and in addition get a free annual “wellness visit.”

 

More consumer protections. Health insurers can’t set lifetime limits on your coverage or cancel if you get sick. Annual limits on coverage in job-related and individual plans are now restricted to a minimum of $1.2 million, which will increase to $2 million beginning Sept. 23, 2012, before being completely phased out in January 2014.

 

Article via: http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm

Update On Health Care Reform- Happenings in 2012; 2013

Happening in 2012 and 2013

 

Premium rebates. Nearly 12.8 million Americans will receive more than $1.1 billion in rebates in August, 2012, from insurers who didn’t spend enough of their 2011 premium income on health care. By August 1, 2012, insurers must issue rebates—either as reduced premiums or refunds directly to individual customers or employers—if they spend too much of their revenue on administrative, marketing or other business expenses instead of medical care and quality improvement activities.
Insurers must spend at least 80 percent of premiums on medical care and quality improvements for customers in their individual and small-group (under 50 employees) plans. The cut-off is 85 percent for large group plans.

The rule does not apply to self-insured plans offered by employers who pay employee health expenses on their own. The only way to know if you are self-insured is to ask your employer. You can’t tell just by looking at your insurance card.

Standard disclosure forms. Beginning in September, 2012, all health plans will have to use a standardized, consumer-friendly form to provide a uniform summary of benefits and coverage, including information on co-payments, deductibles, and out-of-pocket limits. This will make it easier for you to compare plans. Insurers will also have to calculate and disclose a patient’s typical out-of-pocket costs for two medical scenarios: having a baby and treating type 2 diabetes. See a sample form (PDF).
Caps on Flexible Spending Accounts (FSAs). Employers can still set their own limits (usually $2,500 to $5,000) on FSAs in 2012. But in 2013, the most you can set aside tax-free for medical expenses not covered by insurance will be $2,500, with the cap increasing by the annual inflation rate in subsequent years. Plus you can no longer use FSAs to pay for over-the-counter drugs unless you have a doctor’s prescription. The cap takes effect January 1, 2013. For people with 2012-2013 health care plans that run on a fiscal (rather than calendar) year, the cap kicks in July 1, 2013. Read more about FSAs.
New Medicare tax for high earners. Two Medicare-related taxes will impact high earners in 2013. Individuals earning over $200,000 (or $250,000 for couples who file jointly) will see their Medicare payroll tax rate increase from 1.45 percent to 2.35 percent. They’ll also pay a new 3.8 percent Medicare tax on unearned income, including investments, interest, dividends, annuities, rent, royalties, certain capital gains and inactive businesses. Read more about Medicare.
Exceptions to the unearned-income tax. It does not apply to the sale of your principal residence—unless your capital gain on the house is more than $250,000 for single filers and $500,000 for married couples filing jointly. And even then, it applies only to the capital gain in excess of those amounts. So, for instance, a single filer who made a $300,000 profit on a house sale would only pay the tax on $50,000. Also exempt from the new tax: income from tax-exempt bonds, veteran’s benefits, and qualified retirement plan distributions such as those from an IRA or 401(k).

Article via: http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm

Update On Health Care Reform--- Major Changes Come In 2014

Update on health care reform

Many changes are already here, though major ones come in 2014

The Affordable Care Act started changing the country’s health-care system almost from the moment it was signed into law in March 2010. It has already expanded coverage of young adults by allowing them to stay on their parents’ plans until they turn 26, outlawed lifetime limits on what insurance will cover, lowered the cost of drugs for seniors on Medicare, caused up to 12 million consumers to get premium rebates totaling some $1.1 billion, and expanded access to free preventive care for patients of all ages. Last summer it survived a challenge in the U.S. Supreme Court.

But all that is prelude to the transformation coming in 2014, when almost all Americans will have access to affordable health insurance that covers essential care.

2014: A new system begins

A set of rules that take effect Jan. 1, 2014, will make shopping for health insurance a completely different experience for those who buy it on their own—or are uninsured today. These are the biggies:

Guaranteed issue. This is the most popular part of health reform: Health plans must sell coverage to everyone, regardless of pre-existing conditions, and can’t charge more based on health or gender.

Exchanges. By this time next year, every state must have an insurance exchange— an organized marketplace where individuals and small-business owners can view, compare, and purchase qualified private health plans. It’s expected that most consumers will shop on their state’s exchange online, but they can also shop by phone or through brokers.

States have the option of setting up exchanges themselves or allowing the federal government to do the job. It’s expected that the federal government will operate exchanges in as many as half the states. (To see what an exchange looks like, visit the Health Connector run by Massachusetts, which has had a mandate since 2007.) About 20 states are expected to be ready to operate their own exchanges by late 2013. In other states, the federal government will step in to do the job.

Individual mandate. Everyone will be required to have health insurance or pay a penalty. Almost any sort of legitimate coverage will satisfy the mandate: private insurance obtained on your own or through a job, Medicare, Medicaid, CHIP, Veterans Affairs, or Tricare.

Penalty. If you don’t have health insurance, you’ll have to pay a tax penalty, starting at $95 per individual, $285 per family, or 1 percent of income, whichever is greater, for 2014. (That rises to $695 per individual, $2,085 per family, or 2.5 percent of income in 2016.)

Because the vast majority of people will already have qualifying health insurance, few will confront the choice of buying a plan or paying a penalty. Moreover, you won’t have to pay it if you make too little money to file a federal tax return or would have to spend more than 8 percent of your household income on the cheapest qualifying plan, even including subsidies. Americans living abroad, and those in prisons, are exmpt from the mandate and associated fines.
Individual subsidies. Afraid you won’t be able to afford insurance? If you buy on an exchange as an individual, you may qualify for a subsidy in the form of an advance tax credit if your household income is between 100 percent and 400 percent of the federal poverty level. (The tax system already subsidizes people who have coverage through a job by excluding the cost of their health plan from income taxes.)

For instance, a family of four with an income of 200 percent of poverty, or about $46,000 in 2012, will pay no more than $235 a month for health insurance. People with household incomes of less than 250 percent of poverty will also get subsidies to reduce their out-of-pocket costs, such as deductibles and coinsurance. You’ll learn whether you qualify for a subsidy when you shop on the exchange.

Medicaid expansion. The health care law was intended to expand the government-run health program for low-income Americans to cover up to 16 million more people with household incomes up to 133 percent of the poverty line ($14,856 for an individual and $30,657 for a family of four). That includes many at or below the poverty line who aren’t currently eligible. Read more about how to navigate Medicaid.

 

Article via: http://www.consumerreports.org/cro/2012/06/update-on-health-care-reform/index.htm

 

 

 

What Obama's Re-Election Means For Health Care

Despite the Affordable Care Act's more certain future under an Obama second term, controversy over the law isn't over.

 

(TIME.com) -- Liberals feared that a Mitt Romney presidency could mean the end of the most significant piece of social legislation in half a century.

Conservatives feared a second Obama term would allow implementation of another massive entitlement program.

 

But for hospital administrators and businesses like health insurance companies and drug makers, the biggest fear on election night was that they would be left with an enormous mess to clean up.

 

Although the Affordable Care Act, passed in 2010, won't be fully in place until 2014, billions of dollars have already been distributed and the wheels of reform have begun to turn.

 

Seniors with Medicare prescription drug coverage are getting cash rebates. Young adults have joined their parents' insurance policies. Uninsured Americans with pre-existing conditions are getting health coverage through Obamacare programs. Some states are setting up health insurance consumer assistance bureaus and drawing up the architecture for new exchanges where private health insurance will be sold and regulated.

Stopping all of that, which Romney vowed to do if not by edict then by throwing truckloads of sand in the government's regulatory gears, would have created chaos.

 

TIME.com: Obamacare's 'health panel'

 

The ability of critics to challenge the law's legitimacy was drastically reduced with the Supreme Court upholding its constitutionality earlier this year. But it is also important that Obama administration officials will be in charge during the law's full implementation. Hospitals, insurers, drug companies and patients can now expect a more orderly rollout of the Affordable Care Act over the next few years.

 

As Jennifer Haberkorn reported in Politico last week, the Obama administration recently reduced the flow of new regulations defining precisely how the legislative language of Obamacare would work in practice. The purpose of holding back new rules was to avoid controversy close to the election.

 

As Haberkorn reported, there's now a backlog of new regulations that are expected to be unveiled soon, including some that could affect wide swaths of the population. We still don't know, for example, what health services and expenses insurers will be required to cover under Obamacare.

 

At the same time, governors will soon decide whether to set up their own health insurance marketplaces to regulate individual and small business health plans. Many Republican governors had held off making this call until after the election. States that opt not to set up exchanges will open the door for the federal government to run them instead.

 

Thanks to a part of the Supreme Court Obamacare ruling that left the law's large Medicaid expansion as optional instead of mandatory for states, governors and state legislatures will also have to decide whether to widen eligibility for the public insurance program.

 

(Here's a reliable timeline of Obamacare provisions and when they are scheduled to go into effect.)

As Phil Galewitz reported for Kaiser Health News, some state-based Republicans may be persuaded to get on board with such pieces of the law now that it's definitely staying on the books:

"Mike Fasano, a Republican and one of the longest serving Florida lawmakers, said with the president's win, the GOP-dominated state legislature would 'take a hard look' at expanding Medicaid — despite the opposition of Republican Gov. Rick Scott.

 

"Fasano, who is moving from the state Senate to the state House next year, said Florida can't afford to miss out on new revenue without having its own plan to help more than 4 million residents who lack health insurance. He acknowledged that challenging Scott would be an uphill battle but said the governor's waning popularity might embolden lawmakers."

 

TIME.com: What the health care decision means for the country

 

Despite the Affordable Care Act's more certain future under an Obama second term, controversy over the law isn't over. The public is still largely split on its merits. Republican state lawmakers and governors won't suddenly and universally back the law. Republicans in Congress still have say over funding for some of its programs.

 

But the health care industry is now free from a great deal of uncertainty. Or at least it's free from this round of uncertainty. Any policy, business sector or law that's tangled up with politics will always retain a tinge of the unknown. See here.

Obama's Re-election Secures Health Care Reform

By Emily Jane Fox @CNNMoneyNovember 7, 2012: 10:19 AM ET via http://money.cnn.com/2012/11/07/pf/health-care-reform-obama/index.html

Most of health care reform's changes, including the new penalty on those who don't have insurance, won't go into place until 2014. But several key pieces will take effect next year.

NEW YORK (CNNMoney) -- The battle over health care reform is over.
President Obama's re-election will neutralize efforts to overturn the Affordable Care Act, the health care reform law passed in 2010 and one of the signature policy changes of his first term.

The law -- controversial since it was first proposed in 2009 -- requires most Americans to have health insurance and subsidizes coverage for low- and middle-income people.

The fate of health care reform hung in the balance throughout the election campaign, since Republican challenger Mitt Romney vowed to repeal it if elected. Obama won his first big fight over the ACA in June, when the Supreme Court upheld the law.

Several provisions have already gone into effect, including one that provides patients with pre-existing conditions access to insurance and another that allows young adults to stay on their parents' insurance plans.

The country is already feeling the impacts of the law. The number of Americans without insurance this year fell for the first time in four years, according to a U.S. Census Bureau report.

More than 3.1 million young Americans ages 19 through 25 who would otherwise be uninsured now have insurance, according to the Department of Health and Human Services.
  
Most of the changes, including the new penalty on those who don't have insurance, won't go into place until 2014. But several key pieces of the law will take effect next year.
  
Starting in 2013, Americans will see two big Medicare taxes that were enacted to help pay for new federal subsidies that millions of people will get when they buy health insurance.
  
The health reform law adds a surtax on wage income above a certain level and creates a Medicare tax on investment income.
  
The Medicare tax increases will apply to people making more than $200,000 a year, or $250,000 for married couples.
  
Those with investment income also could be subject to a new 3.8% tax on at least a portion of their capital gains and dividends.

Roughly 4 million households -- or 2.4% -- will be affected by the surtax initially, according to estimates from the Tax Policy Center. By 2022 that number will grow to 8.3 million, or 4.6% of households.
  
Also set to roll out next year: The tax-deductible amount a worker may contribute to a flexible spending plan will be set at $2,500 and adjusted for inflation thereafter. As it stands now, there is no official limit, but employers set one for each plan.
  
By 2014, companies with 50 or more full-time workers must provide health insurance that the government deems affordable and fair, or else they will be subject to fines. Fines are $2,000 per worker, but don't apply to the first 30 workers.     

5 Secrets To Decreasing Your Health Insurance Premium Costs!!

FiveWays to Save on Health Insurance

General Article Originally Written By Donna Fuscaldo via http://smallbusiness.foxbusiness.com/entrepreneurs/2012/05/29/four-ways-to-save-on-health-insurance/

Despite efforts to lower the cost of health care, small businesses are still struggling to cover the expense.

According to the U.S. Small Business Administration, small businesses pay premiums that are 18% higher on average than large businesses pay for the same coverage. What’s more, the SBA says small businesses have higher administrative costs to set up and maintain the plans and less bargaining power in negotiating with insurance companies.

On top of that, health-care reform, which was supposed to save small businesses money, hasn’t helped, according to John Cerasani, president of insurance brokerage Northwest Comprehensive.  “The fact of the matter is health-care reform didn’t do anything to address the rising costs small business owners have,” he says.

Given these challenges, here are five ways to save on rising health-care costs.

Shop Around

A common misconception among small business owners is that once they take out health insurance they are locked in for a period of time. But according to Anthony Lopez, small business consumer specialist at eHealthInsurance, health insurance can be a month-to-month expense, which means you can change plans at any time.

“There’s a lot of different options,” says Lopez. He says to shop around at least once every six months to make sure you are saving as much as possible.

Decide On A Major Medical Comprehesive Plan

Major Medical Comprehesive Plans offer all of the same components as a major medical plan only with more benefits through one company, USHealth Group. Through this approach, the specific needs of it's customers are met both insurance-wise and financially. So, in general, you only pay for what you need oppose to paying for the extras you do not.

Offer High Deductible Plans

These plans have lower premiums, but require the plan holder to pay a higher out of pocket deductible, which could motivate your employees to take better care of themselves.

“High deductible health plans put the onus more on employees to take care of themselves in terms of managing expenses and costs,” says Cerasani of Northwest Comprehensive. While high deductible plans may face resistance at big companies, Cerasani says small businesses are increasingly turning to high deductible plans as a way to offset costs.

eHealthInsurance’s Lopez says that offering multiple plans, including one with a high deductible, will also save the small business owner money. And small business owners looking to offer medical, dental and vision may save more by bundling them together. “It reduces costs overall” by bundling it with one company versus using multiple carriers, says Lopez.

Another way to save: offering employees health savings accounts, which are like personal savings accounts that can only be used for qualified health-care expenses. Typically HSAs have lower premiums, says Lopez.

Consider HMO Plans

Health maintenance organization or HMO’s are plans in which prices are negotiated by the participating doctors and typically cost less than other plans. “Certain HMOs are extremely strong and have considerably lower premiums,” says Cerasani.

Tier the Amount of Contributions

Another thing small business owners can do to save money, while a little less traditional, is to tie the amount an employee pays for health care to their salary, says Cerasani. For example, employees making $20,000 to $45,000 would pay a certain amount while those making $45,000 to $60,000 pay more, and employees earning more than $60,000 pay the most.

“The higher compensated folks pay more of the employee contribution,” says Cerasani. “It saves the small business owner money to make the costs cheaper overall.”

Baby Boomers' Health Insurance At Stake--- A Must READ!

Nov. 1, 2012, 6:00 a.m. EDT

Boomers’ health insurance at stake at the polls

Medicare isn’t the only major health program in play. The future of the “Obamacare” reforms could have a big financial impact for some older workers

By Elizabeth O'Brien  via http://www.marketwatch.com/story/boomers-health-insurance-at-stake-at-the-polls-2012-11-01

We’ve heard a lot this campaign season about proposed changes to Medicare, and indeed there are big differences in the presidential candidates’ visions for that program for anyone age 54 and under. But for some older Baby Boomers—particularly the self-employed and early retirees—possible changes under the Affordable Care Act, otherwise known as “Obamacare,” could be a much bigger deal.

 

And no matter who wins Nov. 6, how Obamacare is handled by the federal government and the states will have big implications for boomers’ health and financial security.

Republican challenger Mitt Romney has vowed to repeal the Affordable Care Act right away if he’s elected. But many experts say a Romney victory wouldn’t derail the law in its entirety, at least not right away. “Forget about the politics, certain provisions are popular,” said Gary Lauer, CEO of eHealth, an online health insurance provider.

For example, consumers have embraced the provision, already implemented, that lets children stay on their parents’ plans until age 26. And while it hasn’t taken effect yet, a separate provision that will prohibit insurers from denying coverage or charging more to adults with pre-existing conditions will likely prove equally popular, Lauer said. That element of the law is a major boon to hundreds of thousands of older folks who don’t have job-based coverage and are not yet eligible for Medicare—especially for those who currently struggle to get insurance because of pre-existing conditions.

According to Census Bureau data, 16.3% of people age 45-64 were uninsured in 2011, compared to 15.7% of Americans overall. And in 2008 (the most recent year surveyed), 29% of individuals age 60 to 64 who applied for non-group insurance were denied coverage based on their health status, according to the Kaiser Family Foundation.

But many analysts say that extending more insurance coverage to those older Boomers will depend heavily on another major element of the Affordable Care Act: The implementation of health insurance exchanges, currently slated to take effect at the beginning of 2014. Many states have already begun laying the groundwork for these exchanges. (If a state decides not to establish an exchange, under the law the federal government will step in and run it for them.)

In general, states run by Democratic governors have shown more commitment towards implementing the exchanges than their Republican counterparts, said Lauer, who has consulted with states on the technology infrastructure needed for the exchanges. Many Republicans have opposed the exchanges as a federal intrusion into their state operations, and leaders of some states have balked at the estimated cost of implementing the Affordable Care Act.

The exchanges will likely run more smoothly, at least initially, in the states that have gotten an earlier start in establishing them, experts say—some cite California and Maryland as examples. But whether “smoothly” also means “affordably” is a different question altogether. Gene Zaino, CEO of small business service provider MBO Partners, said his discussions with insurance companies and brokers suggest that insurance provided through the exchanges will be expensive, because those seeking coverage through them will be the sickest and most costly to insure.

Supporters of the exchanges counter that if effectively implemented, the individual mandate, which requires everyone--including healthy young people-- to either buy insurance or pay a fee, will balance out the system’s costs and risks. Stephen Shortell, professor of health policy and management at U.C. Berkeley, said the way the individual states structure the exchanges will factor into the cost for their residents, although it’s too early to predict exactly how.

As for Romney’s vow to repeal the law, doing so would be complicated. For starters, would need the cooperation of a majority of both houses of Congress. If that’s not possible, Romney could find other ways to impede the act’s implementation, such as denying funding under the federal budget.

Even then, there’s the chance that some of Obamacare would be left standing. There is some talk, for example, that under a Romney administration, the no-coverage-denial provision would stand—though, with no individual mandate or exchanges, coverage for older boomers would still be expensive. And Romney, who famously enacted a precursor to Obamacare while serving as governor of Massachusetts, has also been also a vocal proponent of states’ rights. As such, Shortell said, he’s more likely to support state-by-state differences in healthcare delivery—even if that means letting them implement elements of Obamacare.

The bottom line? No matter what happens on election day, the state where you live will likely play an increasingly important role in how you get health insurance and how much you pay for it.