American Workers' Health Care Costs Increase Again - MUST READ!

Health care expenses grew more than wages this year - 2013

     

 

 

The family health care tab shows no sign of shrinking. On average, according to the latest Milliman Medical Index (MMI), a family of four covered through a typical employer health plan will pay out $9,144 this year in premiums and out-of-pocket expenses. That's up about 6.5 percent over 2012, though not as much as the prior year's increase of 7.2 percent. The 2013 rise translates into slightly more than $45 a month in higher monthly premiums and out-of-pocket expenses.

A significant reason for the jump, based on today's figures from Milliman, a health care consultancy, is that employees are shouldering a greater share of the cost of health insurance. Families are paying 8.4 percent more than last year toward insurance premiums, while employers are paying 6.1 percent more. Between 2010 and now, employees have seen yearly increases of 8 percent to 9 percent in their average monthly premium; increases in the employer contribution have averaged less than 7 percent. Private-industry wages, by contrast, have risen less than 2 percent in the last year, according to the Bureau of Labor Statistics.

Families with coverage like the one built into Milliman's assumptions will pay an average of $5,544 in monthly premiums through payroll deductions and $3,600 out of pocket for doctor visits, medications and other medical bills. Such figures are national averages; the most expensive 10 percent of patients run up more than seven times the average individual's expenses, according to Milliman.

"Average" means a family with two kids, enrolled in a company's standard preferred provider organization, which is the most widely used form of group coverage. The family pays about 41 percent of the actual cost of health care, according to the Milliman index. Employers pay the other 59 percent.

About half of Americans are insured through their employer; about 15 million people buy individual health insurance, according to the Kaiser Family Foundation, and are therefore responsible for all of their care.The Milliman report did not examine cost trends for such plans or for Medicare plans.

Original Article By Chris I. Young via http://health.usnews.com/health-news/health-insurance/articles/2013/05/22/american-workers-healthcare-costs-increase-again

 

Is the future of American health care in Oregon? --- MUST READ

 

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“The governor has a notion that you can move away from medical billing and towards a more flexible approach to health-care spending that makes more sense for the community,” John McConnell, a health economist at Oregon Health and Science University, is telling me. Then he stops. “You’ve heard the air conditioner story, right?”

Oregon Gov. John Kitzhaber has a plan to save Medicaid. (Robbie McClaran)

 

As it turns out, I have heard the air-conditioner story. Oregon Gov. John Kitzhaber (D) loves to tell the air-conditioner story. He loves to tell it so much, in fact, that it has become something of a running joke in Oregon health-policy circles. At this point, even Kitzhaber is in on it. Before he repeats it to me, he says, “I probably shouldn’t bore you with my air conditioner story.”

Here’s the air conditioner story: There’s a 90-year-old woman with well-managed congestive heart failure who lives in an apartment without air conditioning. That’s actually the whole story.

Kitzhaber, a former emergency room physician, sees this as the perfect example of what’s wrong with our health-care system. “A hot day could send the temperature in her apartment high enough that it strains her cardiovascular system and kicks her into full-blown congestive heart failure,” he said. “Under the current system, Medicare will pay for the ambulance and $50,000 to stabilize her. It will not pay for a $200 window air conditioner, which is all she needs to stay in her home and out of the hospital. The difference to the health-care system is $49,800. And we could save that $49,800 without reducing her benefits or her quality of life.”

Oregon’s Two Experiments

The past few years have seen two remarkable health-care experiments in the Beaver State. One is the Oregon Health Insurance Experiment, the first randomized, controlled trial comparing Medicaid — or any kind of health insurance — with being uninsured. The other is Kitzhaber’s effort to rebuild the state’s Medicaid program around community health rather than individual fee-for-service treatments. The health-insurance experiment has gotten all the attention. But it’s the Medicaid reforms that really matter.

The Oregon health insurance experiment didn’t begin as an experiment. It began as a budget cut. From 2002 to 2008, Oregon threw 93,000 people out of its Medicaid program. In 2008, the state found it had enough money to add 10,000 of them back. The only fair thing to do, state officials figured, was draw straws. So 90,000 of the poorest residents of the richest country the world has ever known entered a lottery to win health insurance.

The 10,000 Oregonians who got Medicaid weren’t the lottery’s only winners, though. Early on, a group of eminent health economists realized the lottery offered a chance to conduct a study no one in their discipline had ever managed but everyone had always wanted: a randomized, controlled experiment comparing those who received Medicaid with those who remained uninsured. This would enable researchers to isolate the effects that insurance — at least as delivered by Oregon’s Medicaid program — had on the uninsured.

“It’s hard to overstate how excited we were,” said Amy Finkelstein of the Massachusetts Institute of Technology. “We thought it was a once-in-a-lifetime opportunity to bring the gold standard of experimental design to this question.”

Two weeks ago, the group reported the data from the first two years of the study. They found that Medicaid coverage increased the amount of health care people used, offered almost total protection against catastrophic health expenses and reduced depression by 30 percent, but it didn’t show a statistically significant effect on blood pressure, cholesterol or blood sugar.

Statistical Questions

The study has come under fire from health researchers who think the sample of sick people was too small to show statistically significant improvements in those measures. “What I don’t get is if you look at the table in their study and look at baseline blood pressure it was like 119 over 76,” said Aaron Carroll, associate director of Children’s Health Services Research at Indiana University’s School of Medicine. “That was normal. You wouldn’t expect it to go down by nine. It would be a bad thing for normal blood pressure to drop that much. All we should care about is blood pressure in the small subset that had high blood pressure. But they don’t present that.”

It’s a critique that Katherine Baicker, a Harvard health economist who was one of the principle authors of the study, partially accepts. “Our power to detect changes in health was limited by the relatively small numbers of patients with these conditions,” she said. “Indeed, the only condition in which we detected improvements was depression, which was by far the most prevalent of the four conditions examined.” She also noted that the diabetes results were consistent with the improvements one would expect from the clinical literature but the number of people with diabetes was too small to establish significance.

However, she said the sample size was large enough to rule out large improvements in blood pressure and cholesterol, at least over the first two years.

All this might make for an interesting academic panel on Medicaid. But the results were quickly conscripted into the war over President k Obama’s health-care reforms. “Today, the nation’s top health economists released a study that throws a huge ‘STOP’ sign in front of ObamaCare’s Medicaid expansion,” wrote Michael Cannon, director of health policy studies at the libertarian Cato Institute. Perhaps the law’s supporters oversold what is really just “a $1 trillion program to treat mild depression,” wrote the Daily Beast’s Megan McArdle.

I would be more favorably inclined toward such commentary if the authors followed their analysis to its logical conclusion and turned in their own health-insurance cards. “My daughter needs private coverage,” says Ezekiel Emanuel, an oncologist and chairman of the Department of Medical Ethics and Health Policy at the University of Pennsylvania who worked on the Affordable Care Act. “Do I say to her the health-care system in the U.S. won’t necessarily do a great job managing your blood pressure so don’t get health insurance? No way in hell! And if that wouldn’t be my response for my daughter it shouldn’t be my response for poor people.”

 

The study’s bottom line is that Medicaid worked. It performed the core functions of health insurance. It got people access to health care and protected them from catastrophic expenses. “We can reject the ‘Medicaid does nothing’ hypothesis,” Finkelstein said. “Medicaid had impact. It increases their use of preventive care. It increases their outpatient visits. It increases their health-care utilization.

What the study called into question is the next step in the health chain: How much healthier, really, does the care we’re buying make us? And I use the term “us” advisedly. “Medicaid is a financing tool,” Kitzhaber said. “Once people get on Medicaid they are bought into the same hyperinflationary, inefficient, backloaded medical system as everyone else.” That’s the system Kitzhaber wants to change.

Oregon’s gamble

In 2012, Kitzhaber struck an audacious deal with the Obama administration. If the federal government would give Oregon $1.9 billion to remake its Medicaid program, Oregon would put Medicaid on a tight budget, guaranteeing $11 billion in savings over the next decade. If the savings don’t materialize, the funds dry up and Oregon is left with a huge budget hole.

“The fundamental problem with our health-care system is the growing discrepancy between the cost of care, the resources available to pay for it and the tenuous connection between that expenditure and actual health,” Kitzhaber said. “What we’re doing is instead of putting our budget into the ER and paying for congestive heart failure after congestive heart failure, we’re putting it into care coordination and community health workers. We’re investing in health. It’s just a paradigm shift.”
At the core of this shift are Oregon’s 15 “coordinated care organizations.” What makes them different from accountable care organizations or managed care is that they’re responsible for more than the health of their members, which now include 94 percent of the state’s Medicaid population. They’re also responsible for the health of the communities they’re in. They have to run regular community health assessments, and the results influence their pay.

This is a potentially transformational notion, based on a belief that the health-care system doesn’t decide or drive health, even that individuals don’t particularly drive their own health. If you live in a community where the streets are dangerous and the health of your neighbors is poor, you’re probably going to be unhealthy — and there’s little or nothing your local hospital can do about it.

Privately, many who are enthusiastic about Oregon’s effort to reimagine its health-care system admit that it’s not exactly clear how CCO’s will begin transforming whole communities.

The biggest change relates to the air conditioning story. Kitzhaber has given the CCOs radical flexibility in what they can purchase with Medicaid dollars. They can buy an air conditioner for a 90-year-old woman in a hot apartment. They can also try to improve outcomes by investing in “upstream” preventive care; one CCO is paying pregnant women to stop smoking. They’re also integrating with other public services.

“Six months ago,” said Oregon Health and Science University’s McConnell, “if you were a Medicaid patient who came to ER 20 times you’d get treated on your 21st time and go home. Now you come in and there’s a social worker with a list of names and they work with you when you leave to connect you with outpatient care and other resources.”

All that might be an improvement, but it’s a long way from a revolution. “I’m obsessed with what they’re doing in Oregon,” says Jeffrey Brenner, head of the Camden Coalition of Healthcare Providers, one of the country’s most innovative community-health efforts. (Do you remember that Atul Gawande article in the New Yorker about the doctor pioneering “hot spotting” in health? That was Brenner.) “But the problem you can run into with this population health stuff is people don’t know how to connect it to a change strategy that’s incremental. They get paralyzed by the vision and they don’t know where to start. You need small victories.”

Obamacare gives almost every American health insurance. That’s a necessary but not sufficient condition for making them healthier. Oregon’s experiment may or may not work, but it’s the right next step. “Medicaid can be improved,” Carroll said. “But we need to differentiate between the way we deliver care and the way we design insurance. Giving people insurance just gives them the access to the care itself. Denying them Medicaid deprives them of simply accessing the system. But if we want to improve quality, we have to change how we deliver care.”

In Oregon, at least they’re trying.

Original Article By Ezra Klein, Published: May 20, 2013 at 9:20 amE-mail the writer

Health Plans Cautious On Where To Sell Obamacare Coverage - A SOLUTION IS OFFERED!

National health plans so far have announced participation in “fewer than 15 states” to provide benefits under the Affordable Care Act. (Photo credit: Wikipedia)

Health insurers are being selective about which insurance exchanges they will offer products on with national health plans so far announcing participation in “fewer than 15 states,” a health plan chief executives and a new report indicate.

Health insurance companies like Cigna Cigna (CI), Aetna Aetna (AET), Humana Humana (HUM) and UnitedHealth Group UnitedHealth Group (UNH) are so far staying in familiar territory where they already have business as they decide where to offer health insurance products to uninsured Americans via the so-called exchanges or online marketplaces that will open for business this fall as part of the Affordable Care Act. At that time, uninsured consumers will be eligible for federal subsidies of up to $5,000, depending on income to buy any number of private health insurance options. Benefits kick in in January 2014.

“The health plans are being very selective about entering markets,” Dan Mendelson, chief executive officer of Avalere Health, a research and advisory services firm on health policy issues tracking development of the exchanges, said in an interview.

Avalere’s latest report, issued this month, said “national payers are entering exchange markets cautiously in 2014, with national carriers announcing participation in fewer than 15 states.”

Health insurance companies are being cautious about the poor population of customers that will be buying benefits, perhaps for the first time. Therefore, they aren’t going into many new markets to sell coverage other than the states where they sell individual and small group coverage now.

“Seven out of eight people who purchase coverage are going to be poor or near poor,” Mendelson said. “If you don’t understand those populations, there is a higher risk. (Health insurers) are looking to mitigate risk by going into markets that they understand.”

The uninsured will still have plenty of choices among health benefit firms, but there are unlikely to be new players other than what the already-insured population has.

Health plans reason it makes sense to offer products in the markets they are already in because they already have preferred lists of medical care providers known as networks. Thus, they already have doctors and hospitals for new customers to choose.

Humana chief operating officer James Murray, for example, told Wall Street analysts and investors earlier this month on the company’s first quarter earnings
call that they were looking at “aligning around participating on 14 exchanges in various — of the states that we have significant network strength.” Humana has not disclosed the states it plans to enter with products on exchanges.

Meanwhile, Cigna chief executive officer David Cordani told analysts on his company’s first-quarter earnings call earlier this month that the insurer was “sharply focused on a limited number of markets.” It did not disclose the markets.

Aetna is targeting 14 markets to sell products on exchanges, but isn’t ruling out backing out of discussions in states where terms aren’t adequate, executives have said. “We are entering these exchanges very carefully,” said Mark Bertolini, Aetna’s chief executive officer, told analysts April 30 on the company’s first quarter earnings call.

Perhaps the safest bet for long term commitment to exchanges in their markets will be the Blue Cross and Blue Shield plans, analysts say.

“The Blues are in these markets forever,” Mendelson said. “They are not going to leave.”

But experts caution consumers on if the "Blues" are really the best choice. There are Assurants, Humana, Cigna, Aetna, etc. but none come close to the exceptional coverage being offered in today's market with USHealth Group. "The company's concept is simply - head-to-toe coverage, consumer payback and your very own health insurance advisor. Not to mention for better coverage than currently being offered in the market today, USHealth Group benefits generally save consumers between 10% -30% annually. They approach the market as financial advisors to their customers and in essense, that is what they really are to a degree," said Micheal Deer, expert health insurance advisor.  

Contact A USHealth Advisor Today!

Original Article: ByBruce Japsen, via http://www.forbes.com/sites/brucejapsen/2013/05/18/health-plans-cautious-on-where-to-sell-obamacare-coverage/

Here's What The GOVERNMENT Expects Health Insurance Premiums To Increase By - MUST SEE

http://www.obamacareamplified.com/heres-what-the-government-expects-health-insurance-premiums-to-increase-by-per-state/

Visit us online at: http://insurance-penniesfordollars.webs.com/contact-us 

 

RATES GUARANTEED FOR 3 YEARS!

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Forbes Reports: Ray Of Hope For Affordable, Convenient, Quality Health Care

Steven Brill’s recent 24,000-word cover story in Time captured, in demoralizing detail, all that’s wrong with America’s bloated, dysfunctional health care system. How about a ray of hope?
It’s called telemedicine. Say you have symptoms of a sinus infection or the flu, or even need a trip to the emergency room. Rather than wait days for a diagnosis from your primary doc, a telemedicine service can get a bona fide physician on the phone, by email, or on a video screen via Skype in 60 minutes or less—24 hours a day, seven days a week.
“Our health care system is broken in many ways, but telemedicine is a game-changer,” says Daniel McGugin, partner at Virtus Benefits, an employee benefits provider in Nashville, Tenn.
Good Medicine For Small Business
McGugin shared one case study involving a 150-person trucking company he’ll call “Abecee Transportation.” (Virtus won’t release real client names.) This month Abecee faced a 17% increase in its health insurance premiums. To ease the pain, the company considered switching to a plan with a higher deductible. That would have saved $150,000 a year in premiums; it also would have aggravated Abecee’s employees who would be forced to pay a bigger portion of their medical bills from their own pockets.

Enter telemedicine. In 2012 Abecee paid $120,000 in claims for “non-emergent” doctor visits (the sniffles and such), including expensive trips to the ER. According to a recent study by AmeriDoc—a leading telemedicine provider, along with Teledoc and Consult A Doctor—17,000 patients with access to a telemedicine plan reduced their number of visits to doctors’ offices by 30%, and to hospitals by 60%. At those same proportions, Abecee would save roughly $65,000 in claims. Cost of AmeriDoc’s telemedicine plan: $24,000.

As for Abecee’s employees, they’d get to keep their health benefits while not wasting productive hours schlepping to a doctor’s office or an ER. A 2010 report by Press Garney, a health care consultancy in South Bend, In., found that the average ER wait time is a little over 4 hours. AmeriDoc guarantees that doctors in its network respond within an hour.

“Health premiums are only going higher and employers will continue to shift the burden to employees through high-deductible plans,” says McGugin. “We’re telling all of our clients to take a hard look at telemedicine.”

To be clear, telemedicine is no substitute for traditional insurance. Nor is it particularly cheap for individuals buying it in the open market. Individual telemedicine plans cost roughly $120 a year (including dependents), plus a $30 “consult fee” per call. (Employer-sponsored plans generally don’t charge a consult fee.)

If you’re a healthy male, have no preexisting medical conditions and are willing to take chances, you might want to pair telemedicine service with a super-high-deductible insurance plan that has a rock-bottom premium. That combo provides access to affordable treatment for non-emergencies while cushioning the financial blow of a catastrophic illness or accident. Other target customers include those who simply can’t afford traditional insurance but want access to basic care.

You can sign up for telemedicine service by calling a provider directly or working through a broker like McGugin. The cost is the same—providers pay the broker fee, not you.

Point Of No Return

While telemedicine isn’t new (hospitals have used phones to serve remote rural areas for 40 years), less than 1% of Americans have access to it. Expect more to join the ranks—and soon—thanks to affordable high-speed Internet connectivity and, of course, rocketing health costs.

The Society of Actuaries just released a study estimating that premiums on individual health plans will jump 32% over the next three years. Towers Watson, an HR consulting firm, found that 70% of companies with more than 1,000 employees will offer high-deductible plans ($1,250 minimum deductible) this year, up from 59% in 2011. And Rand Corp. estimates that, within a decade, half of all workers with employer-sponsored health care (including government employees) will have high-deductible plans.

All that bad news is good for David Lindsey, CEO of AmeriDoc. Founded just five years ago, the Dallas company has quietly amassed 1.3 million paying patients (not including dependents). That number is on track to triple by the end of the year, says Lindsey.

AmeriDoc’s network includes 290 doctors (some licensed in multiple states) who agree to be on call when they aren’t seeing patients on-site. Lindsey claims he has enough capacity to handle current members, though he looks to add more white coats all the time. “Doctors inquire every day about joining the network,” he says. A big reason: more patients per hour with little additional overhead. “They hate dealing with insurance companies. [Telemedicine] is how they’re going to get paid in the future.”

To control quality (and avoid malpractice suits), AmeriDoc records all visits electronically and stores the data for seven years. Customer-service staffers review random samples of calls every week; they also call every patient within two days after a consultation. “We call three times,” says Lindsey. “If [the member] doesn’t respond, we assume all went well. We’ve never had a malpractice claim.”
Lindsey concedes that, thus far, a lot of subscribers use telemedicine to “shop for prescriptions” without having to visit a doctor. Viagra is a big request—one that AmeriDoc’s physicians routinely deny without the requisite heart-rate and blood-pressure tests.

Meanwhile, AmeriDoc’s remote-delivery menu of services is expanding. The company created a finger-prick blood-testing pack that lets patients take their own samples and mail them in sterilized packs to a lab to measure testosterone, cholesterol and glucose levels. Next month AmeriDoc will roll out another self-blood test that aims to detect future cardiovascular disease.
Bottom line on telemedicine, says Lindsey: “It would be irrational if you did not call it a ray of hope for American health care.”

Contact Us Today For A Personalized No-Obligation Quote: USHealth Plans Have Existing TeleMedicine Features www.insurance-penniesfordollars.webs.com

Original Article:http://www.forbes.com/sites/brettnelson/2013/03/28/a-ray-of-hope-for-affordable-convenient-quality-health-care/  By: Brett Nelson

Health Insurance Tax ‘Scares The Daylights’ Out Of Some Small-Business Owners - MUST READ

 

Many small-business owners worry that a new tax on insurance providers in the health-care law will mean higher premiums for them, undermining the law’s capacity to lower their health-care costs.
Starting next year, the federal government will charge a new fee on health insurance firms based on the plans they sell to individuals and companies, known as the fully insured market. Meanwhile, the provision exempts health-insurance plans that are set up and operated by businesses themselves (the self-insured market).

Revenue from the tax will help pay for the health-care overhaul, which is expected to extend coverage to millions of uninsured or underinsured Americans.

However, because most large corporations self-insure their workforce, experts warn that insurance companies will pass the costs directly to small businesses. The vast majority purchase coverage in the fully insured market.

“Insurers have confirmed back to me that the tax will be passed down to consumers, and the direct impact will be staggering,” Ryan Thorn, owner of a small insurance planning firm near Salt Lake City, told lawmakers during a congressional hearing Thursday. “It disproportionately hits individuals and small-business owners, the people who have been hurt most by these challenging times.”

 

During his testimony, Thorn read letters from his small-business clients about the likely impact of the new health insurance tax. One wrote that the tax “scares the daylights out of us,” while another warned that it would likely “hasten the decision to move away from providing group coverage for our employees.”

The Department of Health and Human Services reports that among private businesses that offer health insurance, three of every four firms with between 100 and 500 employees purchase coverage in the fully insured market. The number jumped to 87 percent for firms with fewer than 100 workers.
On the other hand, 82 percent of large firms (500 or more employees) run their own health insurance programs.

Robert Zirkelback, a spokesman for America’s Health Insurance Plans, a trade group for insurance providers, acknowledged that small firms will likely “shoulder most of the burden” of the tax. Meanwhile, a new minimum-coverage requirement for employers with 50 or more workers will be broader than what some of them already offer, he said, which could further increase their costs as they are forced to supplement their current plans.

A new study by the National Federation of Independent Business, which has long pushed back against the health-care law, suggests that the health-care tax could reduce private-sector employment by several hundred thousand jobs over the next decade, more than half of which would come from small businesses. Based on its forecasts, the toll on gross domestic product could reach as high as $185 billion.

Paul Van de Water, an economist with the Center on Budget and Policy Priorities, took issue with parts of the study, saying that the model does not account for higher compensation for employees in the form of better health coverage. He disputed the claim that the tax would eliminate jobs, too, citing estimates from the Congressional Budget Office that any changes in employment because of the health-care law will be negligible.

But even if the tax has some negative side effects, he said, that is the price the country must pay to improve the health-care system.

“No one likes taxes, per se, but we raise taxes to raise revenues to pay for things that we want to pay for,” Van de Water told members of the House Small Business Committee. “In this case, we are paying for an expansion of health-care coverage to 27 million Americans.”

Nevertheless, the concerns from small-business owners and insurance companies have prompted lawmakers to introduce bills that would repeal the health insurance tax — one from Sens. Orrin G. Hatch (R-Utah) and John Barrasso (R-Wyo.) and another from Reps. Charles W. Boustany Jr. (R-La.) and Jim Matheson (D-Utah).

Business lobbying groups from the manufacturing, construction and farming sectors have supported those efforts, citing similar concerns about the likely impact on their health insurance premiums.

Original Article By J.D. Harrison via http://articles.washingtonpost.com/2013-05-12/business/39210827_1_health-insurance-plans-insurance-providers-insurance-companies

Morning Bell: Obamacare Is About Power MUST READ!

Photo: Michael Sandoval

 

Members of the House of Representatives are scheduled to vote Thursday to repeal all of Obamacare. Given that the House voted to repeal the law last year, some commentators and observers have questioned the need for another repeal vote.

However, the scandals coming to light over the last week perfectly make the case for why Congress must eradicate the law from the statute books.

On Friday, the Internal Revenue Service finally disclosed that it had spent years targeting tea party and other conservative groups, delaying their applications for non-profit status and giving those applications additional scrutiny — solely because of those groups’ political beliefs.

Also on Friday, The Washington Post revealed that Health and Human Services Secretary Kathleen Sebelius personally asked health industry groups to contribute to Enroll America, a pro-Obamacare front group working to “educate” the public about the law’s supposed benefits.

While we don’t yet know all the details about these scandals, we do know that the IRS grossly abused its power at a time when Obamacare grants it massive new authority. The Treasury Department’s Inspector General has said Obamacare represents “the largest set of tax law changes in 20 years,” with at least 42 provisions adding to or amending the tax code.

Obamacare taxes most people with health insurance, and most people without health insurance. Likewise, the law taxes many employers who provide health insurance, and most employers who don’t provide health insurance.

Obamacare’s heavy reliance on the IRS seems somehow fitting, as the entire law relies on a scheme of government controls and regulations to work its will on the health care system. The law imposes price controls on insurance companies and extends a system of price controls for pharmaceutical companies. Obamacare also places a board of unelected, unaccountable bureaucrats at the center of its plans to control health care costs.

A 2010 Congressional Research Service report found that the number of new bureaucracies “that will ultimately be created” by Obamacare “is currently unknowable.” Little wonder that Vice President Biden boasted shortly before the law was passed, “We’re going to control the insurance companies.”
That’s what Obamacare is about. It’s not about health care. It’s about government control and power. And the record of this Administration shows its willingness to use this power in arbitrary and harmful ways.

Secretary Sebelius’s recently disclosed fundraising campaign tried to make an end-run around Congress, forcing private companies to give money for a pro-Obamacare marketing campaign that Congress itself has refused to fund.

It isn’t the first time the secretary has skirted the law, either. HHS’s infamous waivers, the majority of which went to individuals in union health plans, weren’t mentioned in Obamacare. And in recent weeks, Democrats who support the law have criticized the secretary for taking funds from other programs to fund Obamacare implementation.

Just like the IRS, HHS has also targeted the First Amendment rights of private organizations. In 2009, the department applied an infamous “gag order” on Medicare Advantage plans, ordering them not to communicate with seniors about how Obamacare’s cuts to Medicare Advantage would affect their coverage.

If past experience is any guide, IRS and HHS could use their newfound Obamacare powers to target their political opponents. Will individuals who choose not to buy insurance under Obamacare’s mandate find themselves subjected to government audits?

Will corporations who choose not to “donate” to Sebelius’s fundraising campaign find themselves targeted by Obamacare regulators — or even the IRS itself? Given the events of the past week, few can answer these questions with an unequivocal “no.”

There’s one easy way to stop the rot, and that’s to repeal Obamacare once and for all. At a time when this week’s revelations show how the government has abused its existing powers, it’s exactly the wrong time to give the government yet more authority. Congress should instead focus on repealing Obamacare and restoring freedom.

Original Article: By Jim DeMint via http://blog.heritage.org/2013/05/16/morning-bell-obamacare-is-about-power/

The New Obamacare Insurance Is Looking More Like Medicaid - MUST READ!

There’s an astute article in today’s edition of the Wall Street Journal by veteran healthcare reporter Anna Mathews. It outlines the scope of health plans that will be offered on the new exchanges taking shape this fall. And why Obamacare is looking more and more like Medicaid.

Mathews notes that hospitals are giving up discounts to the new exchange-based health plans. In turn, the hospitals plan to make up these discounts through the narrow networks of providers that consumers will be able to choose from. The bet that these hospitals are making is that they can offset the discounts by getting more volume. They can then limit what they pay for services by getting better control over the providers through the same sort of narrow contracting. In other words, if the health plans and hospitals contract with fewer providers, they can exert more leverage on doctors to limit services and keep costs down.

Ideally, plans would be able to compete on a range of things, with network design being just one variable. But Obamacare largely prescribes the benefit design and limits cost sharing, leaving networks one of the few levers that plans have to manage costs and competition.

The article plays off of news that hospital chain Tenet Healthcare (NYSE: THC) made earlier this week on its earnings call. Tenet announced that they had signed exchange-related contracts covering about 15 of their existing hospitals (about 30 percent of the chain’s portfolio). The contracts reportedly pay Tenet at about a 10 percent discount to traditional commercial contracts. In exchange for the discount, the contracts are offering narrower networks to the plans’ members — ostensibly to send incremental volume Tenet’s way. In other words, the members will be steered to the Tenet hospitals.

By way of background, a 10 percent discount off of commercial hospital rates would be better than Medicaid in most markets. It is also somewhat better than Medicare in many markets. These discounts are real.

This is a risky bet for Tenet, because it’s not clear what the exchange-based clientele will look like. Beneficiaries, who are sicker than folks in an average insurance pool, could dominate the exchanges. Such adverse selection would increase costs to Tenet.

This is exactly what has happened with Medicaid, which treats many indigent Americans who are in poor health. Yet the higher costs of taking care of the Medicaid population hasn’t been made up with more funding, but fewer services that these patients are able to get access to. The same thing is likely to hold true in the exchanges. If the exchanges are favored by sicker patients, this outcome will occur even sooner.

Medicaid pays the full freight for most healthcare services (with few out of pocket costs) but compensates by sanding down the rates paid to providers. The result is that the Medicaid benefit has been hollowed out over time. Fewer doctors are willing to see Medicaid patients, making it hard for patients to get appointments and schedule needed services. The Medicaid benefit is great on paper, but often stingy when you try to use it.

This similarity between the exchange coverage and Medicaid was highlighted by another point made on the Tenet call, first noted by UBS analyst A.J. Rice. Tenet said that co-pays and deductibles associated with buying insurance through the exchange are going to be substantially less than is the case for traditional commercial health insurance. The hospital chain said that since the provider will be responsible for collecting a much smaller portion of the bill from the patient directly (and risk not getting paid), the net effect of the 10 percent discount from traditional commercial rates may be fully mitigated. This is even before taking into consideration the question of whether Tenet has picked up any incremental share from the arrangement. The upshot was that the financial impact of these reduced co-pays may be part of Tenet’s business gamble.

If Tenet’s analysis is right, it underscores the magnitude and the impact of reductions in out-of-pocket costs under Obamacare. But with fewer out-of-pocket costs, consumers will also have far less skin in the game. In turn, they will have less incentive to constrain their demand for services.

That constraint will instead be applied by the providers themselves, through the limitations that they place on access. Not by outright denying care, but by funneling patients into overworked networks that make it much harder to actually get appointments and schedule needed services. This is exactly how rising demand is managed under Medicaid. It’s one more reason why Obamacare coverage is likely to resemble Medicaid over time.

Original Article By: Scott Gottlieb via http://www.forbes.com/sites/scottgottlieb/2013/03/01/the-new-obamacare-insurance-is-looking-more-and-more-like-medicaid/

The IRS Is Accessing Your Health Records. You Trust Them? --- A MUST READ!

So how do you feel about turning over access to sensitive healthcare information to the Internal Revenue Service?

In the wake of running disclosures of the agency’s nefarious snooping and political targeting, its new role as chief health insurance enforcer should give us heartburn.

Under Obamacare, responsibility for verifying eligibility for the healthcare program, and monitoring whether you carry “qualifying” health coverage (and are exempt from the law’s penalties) falls principally to the IRS.

The IRS was given expansive, new powers to execute these goals. That includes more authority to share your personal information — not only about your income, but also your healthcare.

And the agency’s reach only grows: Former IRS Commissioner Douglas Shulman told Congress last year that the agency would need another $13.1 billion to implement Obamacare in 2014, on top of the billion it has already spent.

Officials at the U.S. Treasury, the parent of the IRS, have estimated that the IRS now has about 700 full-time staffers working on Obamacare implementation.

Estimates say that eventually, the IRS will need a minimum of 5,000 and perhaps as many of 16,000 additional employees to carry out the new law’s many mandates.

The IRS is under fire this week, after its Director of Exempt Organizations Lois Lerner admitted on Friday that the agency targeted conservatives for special tax-exempt scrutiny during the 2012 election season. IRS targeted tea party types and groups that specifically opposed the Obama Administration.
This abuse should give everyone pause heading into the fall, when the IRS assumes the lead roll in monitoring what kind of health insurance we carry, whether we are eligible for Obamacare, or subject to the legislation’s myriad list of financial penalties.

A link to more than 75 regulations, notices, guidance documents, and other public directives on how the IRS will implement various provisions of the Affordable Care Act can be found HERE

These are just some of the ways that the IRS will regulate your healthcare.

1. The IRS is responsible for implementing 47 new healthcare tax provisions under Obamacare. These include the right to levy a penalty against businesses and individuals who don’t provide or acquire insurance, determining how to distribute annual subsidies to those qualifying for subsidies to buy the Obamacare coverage, and deciding how to deliver tax credits to small businesses that buy coverage for workers.

2. The IRS will also include new paperwork with everyone’s’ tax returns starting next year, to monitor the decisions all of us make with respect to our health insurance. This tax document must contain sufficient information for taxpayers to prove that they purchased qualifying health insurance under Obamacare.

According to American’s for Tax Reform, at a minimum, the form will need to contain: the name and health insurance identification number of the taxpayer; the name and tax identification number of the health insurance company; the number of months the taxpayer was covered by this insurance plan; and whether or not the plan was purchased in one of Obamacare’s “exchanges.”

You can view the projected IRS form at www.ObamacareTaxForm.com. On the form, lines 3-4 show where taxpayers will disclose their personal health ID information.

3. The IRS will also have to actively share with other agencies, state exchanges, and maybe even individual health plans; the financial information of folks purchasing coverage on the Obamacare exchanges (and qualifying for subsidies). Right now, there’s no other way to make sure people qualify for the federal money.

The new enrollment form unveiled two weeks ago – for people to use in applying for the Obamacare subsidies — failed to ask the relevant and probing questions that the government will need to know in order to verify financial eligibility.

The Obama White House probably wanted to stoke a perception that the application will be simple. They had been criticized for the form’s first iteration, which ran dozens of pages.

But the shorter that form is, the more burden the government assumes on itself to cross reference the application with income information maintained by the IRS. It’s now clear that the IRS will be heavily involved in vetting eligibility for the subsidies and the new exchanges.

4. Among other things, the IRS is now requiring employers to report the cost of the healthcare coverage you get at work under an employer-sponsored group health plan on an employee’s Form W-2, Wage and Tax Statement, in Box 12. The IRS says that this reporting is for informational purposes only, to show employees the value of their health care benefits. But it could be a first step to taxing those benefits.

5. Obamacare also creates a new definition of income – “household income” — that could be used to change tax liability down the road. Household income is meant to include not only the income of the family principals such as a husband and wife, but also the income of all other members of the “household” who live with the family.

This is not limited to children. According to the Tax Freedom Institute, any person who qualifies as a dependent under code section 151 is included in household income. This might be a grandparent, for example, or a grandchild. Measuring household income is a way to determine eligibility for Obamacare’s subsidies.

6. Under Obamacare, the government has also expanded who the IRS can share your information with, although prior laws don’t seem to have constrained the agency.

Under Code 6013(j)(21), among other things, your tax information can now be disclosed to the exchanges set up under Obamacare, as well as others with a need to know your tax information in order to carry out provisions of the new health law.

Finally, the IRS isn’t merely the Obamacare toll collector. The agency also has discretion to shape how the law gets implemented.

The IRS has already flexed its political muscle. The agency has a lot of leeway under the law. It has used that influence to pursue political ends that the Obama team wasn’t able to get into the original legislation.

Just this week, the IRS ruled (in a proposed regulation) that health plans can’t count activities that “improve the quality of care” toward the amount of money they’re required to spend on delivering healthcare services to beneficiaries.

This is a way for the Obama team to squeeze health plans financially.

Many folks already complain about the access that our employers have to information on our health. You can thank a quirk of tax law that, years ago, made it more affordable to buy health insurance at work, rather than on our own.

If most of us had our druthers, the workplace would be the last place we’d want to get health coverage. Well, maybe the second to last place.

The last place we’d want to buy our coverage is through the IRS.

Original Article By:  Scott Gottlieb via http://www.forbes.com/sites/scottgottlieb/2013/05/14/the-irs-is-accessing-to-your-health-records-but-you-can-trust-them/

California Health Insurance Exchange Announces Grants - Is TN Next ??

Covered California issues $37 million in grants to 48 organizations to help educate Californians about the new healthcare law.

Covered California, the state's health insurance exchange, announced $37 million in grants Tuesday to begin the massive task of educating millions of Californians about the new healthcare law.

The grants will go to 48 organizations, including universities, nonprofit groups, health foundations and unions. They will help state officials explain the new benefits, show people how to access insurance, and encourage small businesses to enroll.

Covered California's executive director, Peter Lee, said Tuesday that getting the word out will require collaboration and partnership across the state.

"There is a lot to learn, there is a lot to explain and not a lot of time to do it," he said at a news conference at First 5 LA in downtown Los Angeles. "Covered California can't deliver this message from behind the desks in Sacramento."

In October, enrollment will begin in the state's exchange, through which people will be able to purchase insurance with federal subsidies. Consumers will be able to enroll by phone, online, in person and by mail. The benefits will take effect in January.

Covered California board member Robert Ross said the law is now in the hands of Californians and the clock has begun to tick toward implementation. "We are the ones who have to make it work," he said. "It is not going to be perfect on Jan. 1. We will have bumps. We will have bruises. But we will continue to move forward."

Of the grant funds, $34 million will target consumers and $3 million will reach out to small businesses, Lee said.

The organizations cover all 58 counties and have employees who speak dozens of languages. They include the Asian Pacific American Legal Center, Planned Parenthood, California Rural Indian Health Board and the UC Regents.

Original Article By Anna Gorman via http://www.latimes.com/health/la-me-grants-20130515,0,4661979.story

Employers Penalizing Spouses For Health Insurance --- Their Are Options!

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Here’s a dose of medicine women might not want to swallow: It’s getting more expensive for a wife to get health insurance through her husband’s plan.

Employers, it seems, are madly seeking ways to put a tourniquet on their escalating health care costs. “They’re well aware that in 2014, when the health reform law’s provisions kick in, they will be asked to cover more employees and face added cost pressure,” said Julio Portalatin, president and chief executive of benefits consultant Mercer. “They’ve taken bold steps to soften the impact and it’s paying off already.”

One of those bold steps recently caught my eye.

Are Bosses Dumping Wives’ Coverage?

I read a fascinating, if unsettling, piece by MarketWatch’s Jen Wieczner called “Why Your Boss Is Dumping Your Wife,” whose premise was that companies are dropping health coverage for spouses to cut costs.

While titillating, based on my reporting, the article turned out to be somewhat hyperbolic.
It seems that it’s not so much that companies are suddenly dumping coverage for spouses. (They’ve never been required by law to provide that coverage, although many do; nor have they been obligated to insure employees.) What is happening is that firms are increasingly tacking on spousal surcharges that can run as much as $3,000 a year. And more companies are planning to do so next year.

Surcharges of Up to $3,000 a Year

In a recent survey conducted by the National Business Group on Health, a membership group that advises large employers about health benefits, and the consulting firm Towers Watson, 20 percent of respondents said they now levy a surcharge of roughly $100 per month on wives who decide not to take advantage of their own employer’s insurance and instead opt for coverage through their husband’s policy.

An additional 13% said they plan to do so in 2014. These types of surcharges typically range from $500 a year to $3,000.

More Firms Slap on Spousal Surcharges

In 2012, 18% of employers with 5,000 or more employees had some type of spousal surcharge provision, up from 15 percent in 2011, according to the Mercer 2012 National Survey of Employer-Sponsored Health Plans. The employers either imposed a surcharge on spouses who had access to other coverage or in rare instances (4% of employers) denied coverage entirely.

A few years ago, these types of clauses were practically nonexistent.

Companies often find that spouses are more expensive to insure than their own employees, says Helen Darling, president of the National Business Group on Health.

That’s because, Darling and other the benefits experts I interviewed say, covered spouses are often women. As a group, women spend more on health care than men because of childbearing and having more free time, which results in additional doctor’s visits.

Health insurance surcharges can have serious financial repercussions for women in their 50s and older.

If you’re hit with a spousal penalty, I suggest taking matters into your own hands and compare your alternatives.

If you’re currently on your husband’s policy but work full-time for an employer that offers health benefits, check with your human resources department for details on enrolling. You might find that your employer provides a larger subsidy.

Before switching over to your employer’s plan, though, scrutinize the benefits of both choices. Your coverage might not be as generous as your spouse’s and paying a surcharge might be worth it.
You might also want to stay on your spouse’s plan and pay the piper just to keep life simple. Being covered by the same insurer can make paperwork less complicated for filing and tracking medical expenses. And you’ll avoid the potential hassle of needing to switch doctors when you change insurers if your plan has a different set of care providers.

Remember to factor in the tax savings when reviewing the surcharge; the penalty may not be as big as you think.

The health insurance premium and any surcharge is paid pretax, Darling says. So if you’re charged $100 extra and are in the 30% bracket, you’ll only effectively be responsible for 70% of the extra cost.

My advice may not eliminate the sting entirely, but perhaps it will numb it a bit.

Also try looking at the options that USHealth Group via Nannette Bean of MDBean Insurance Agency of TN has to offer. This company offers Individual Plans that are customized to fit an individual's needs.

Original Article By: Kerry Hannon via http://www.forbes.com/sites/nextavenue/2013/04/25/employers-penalizing-spouses-for-health-insurance/

10 Things Major Medical Health Insurers Won't Tell You --- You Must Know Your Options!

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1. "Your deductible is only the beginning."

Ellen Stephenson, 57, was fully insured when she was diagnosed with an aggressive form of breast cancer eight years ago, so she never imagined she would be on the hook for $100,000 in medical bills. But after meeting her plan's $3,500 annual deductible, she has to pay another $40 for each doctor visit and another $250 for each test. Over years of treatment, those extra costs have added up, and there's no end in sight. She's still being treated for the cancer, which has spread to her pelvis, spine, brain and lungs. "It's a challenge," says Stephenson, who was the director of a nonprofit before her illness. "I don't know what will happen, but right now my physician's office is very, very kind and is working with me."

Consumers typically assume that once they meet their health plan's annual deductible, the plan pays the rest. Not true, says Nancy Metcalf, a senior program editor at Consumer Reports Health, who notes consumers still often have to kick in thousands of dollars in co-pays and other expenses. And those costs seem to be rising. The average out-of-pocket medical costs hit $3,091 in 2006 (the most recent data available), up 26% from 2001, according to the Center for Studying Health System Change in Washington. And workers will likely shoulder an even bigger chunk of their health bills in the future. A report last year by consulting firm Mercer found that 57% of the 1,100 employers it surveyed planned to shift "a somewhat greater share" of the health care cost in 2011 to workers. Many plans don't cover seemingly common care such as fertility treatments.

2."You MUST look into the individual market as an option."

Buying individual health insurance isn't as easy as having a clean bill of health and enough cash. Insurers can and often do refuse to sell policies to individuals with existing conditions, says Wendell Potter, a senior analyst at the Center for Public Integrity. Those "preexisting conditions" aren't limited to serious illnesses like cancer or diabetes seemingly minor ailments like corns or cataracts might also be grounds for disqualification. The Affordable Care Act, the health insurance legislation signed into law a year ago, would prohibit the practice, but it doesn't take full effect until 2014. Until then, consumers are on their own unless you contact a USHEALTH Advisor such as Nannette Bean of MD Bean Insurance Agency when guaranteed health plans are offered.

3."If you fight hard enough, we'll back down."

Don't assume that because your insurer initially rejected a claim that it won't eventually pay up. You just need to fight harder. In fact, many companies routinely reject claims, while others regularly turn them down on a technicality. "If the treatment is denied, and you and your doctor think it was necessary, you definitely should appeal," says Cheryl Fish-Parcham, deputy director of health policy at Families USA, a nonprofit health-care advocacy group. A few areas are responsible for most of the appeals, according to a study in the 2003 Journal of the American Medical Association. The report found that more than a third of all disputes were about whether treatment was necessary and more than a third were over the contractual agreement of the plan.

Persistence often pays off. About a third of the contractual disputes were overturned, and about half the medical necessity disputes were reversed. One biomedical engineer, who asked not to be identified, spent more than a year battling his insurance company to get his wife's physical therapy covered. The insurer was paying for her expensive MRIs and genetic tests but not physical therapy because the doctors had a hard time diagnosing the neuromuscular disease; without a clear diagnosis, the insurer was unwilling to pay for coverage. Another glitch the insurance company was using outdated research on medically appropriate treatment, so physical therapy wasn't even included on its list. "You really need to know the science of your disease because they don't," says the husband, who did much of his own research. Some, but not all policies and states, allow for an appeal outside of the plan. The Affordable Care Act will provide consumers with a formalized way to appeal and will create an external review process.

4."We will pay out-of-network expenses."

Yes, there are times when insurance companies will completely cover care even if it's provided by an out-of-network provider. That typically occurs when a plan covers the treatment but an in-network provider often a specialist is not available close to home or when there's an emergency and you have to get care at an out-of-network hospital. If you know ahead that you're going to an out-of-network provider because no one is available in your community, get the insurance company's permission in writing, says Helen Darling, president of the National Business Group on Health, a nonprofit association of large employers. That way, months later if the insurer disputes the claim, there's proof of the agreement.

5."We won't cover therapy. And how does that make you feel?"

The Mental Health Parity and Addiction Equity Act of 2008 was supposed to improve mental health coverage by requiring companies with more than 50 workers that offer mental health benefits to have the same deductibles, co-pays and treatment limitations for mental health and substance abuse care as they do for medical or surgical treatment. The law, however, doesn't require mental health coverage so some plans responded by dropping it completely. "In mental health, people assume certain things are covered and they're actually not," Allison Wishon Siegwarth, a policy analyst at The Bazelon Center for Mental Health Law in Washington.

Nearly one-third of employer-provided plans with more than 50 workers changed their mental health benefits, according to the Kaiser Family Foundation/Health Research & Educational Trust 2010 annual survey of employer benefits. Of that group, about two-thirds raised or eliminated the limits on coverage for this care, but 5% dropped it. Wishon Siegwarth warns consumers to check even if they are covered because many plans don't include treatment for conditions such as eating disorders.



6. "Go ahead, buy the brand-name drug."

The pharmaceutical industry spends billions to get consumers to ask for drugs by brand name, and the insurance industry certainly isn't standing in its way. Insurers and employers have increasingly shifted the costs of prescriptions to patients. As it is, the average co-pay for so-called "fourth tier" medications the most expensive was $89 in 2010, up 20% from 2005. Ten years ago, the fourth-tier didn't even exist the most patients would pay for medication was typically $29.

Compare that to the price of generic drugs, which work just as well as brand-name medications. The average co-pay for a generic prescription is $11. But the insurance companies won't be the one to tell you. Jackie Kosecoff, CEO of Prescription Solutions, says insurance companies do make generics significantly less expensive than brand name drugs but it may not be enough: "People get conditioned by the advertising that they brand-name is the latest, greatest and best." Another problem the doctors continue to prescribe them.

7. "Our reputation isn't what you think it is."

A brand name or a national presence may not mean much when it comes to health care coverage. Because plans vary by state, an insurer's plan may be radically better in one area of the country than another. Or so says the nonprofit National Committee for Quality Assurance, which accredits and ranks health insurers. Companies like Aetna, Kaiser, and Group Health, which administer plans across the country, are highly-rated in some states, poorly evaluated in others. Meanwhile, some of the top-ranked insurance plans - like Capital Health Plan, Geisinger Health Plan and Tufts Associated Health Maintenance Organzation aren't nationally known at all.

"There's more variation in terms of how health plans take care of their patients than people realize," says Andy Reynolds, a spokesman for NCQA. The ranking is based on several factors including how often insurance companies use scientifically-supported care to prevent or care for medical conditions. Patients also have a say in the rankings by rating customer service and how well doctors communicate. There's also a score for how well the plans verify providers' credentials and safeguard privacy. Married couples who are trying to decide between his plan or hers may find it particularly useful as a starting point.

8. "We don't speak your language."

Yes, many insurers offer customer service in languages other than English, but the only language in which it's truly critical to be fluent is insurance-speak. That means understanding Current Procedural Terminology (CPT) and diagnostic codes from the International Classification of Diseases (ICD),says Jane Downey, a speech- language pathologist in Albany, N.Y. and president-elect of the New York State Speech Language Hearing Association. It might not seem fair to ask consumers to understand all that, but experts say it could make the difference between getting coverage or not.

Fortunately, the internet is a wealth of resources for patients trying to get information. That means understanding the technical codes and avoiding words that raise red flags for the insurance companies, says Lisa Geng, co-author of "The Late Talker," about caring for her speech-delayed son: "Do not use the words 'childhood development' or 'delay.' The insurance company will think the child will outgrow it." But the words "developmental disorder" rather than "development delay" may unlock the door. "You really have to indicate it's a treatment and not enhancing," says Downey.

9. "We'll do anything to keep you in network."

Your favorite doctor is out-of-network, but you don't want to end up with a bill the size of your first mortgage. Finding out the actual cost, however, can be difficult, say consumer groups: When patients call and ask how much an out-of-network procedure will cost, insurers will typically cite the plan's general benefits. If you actually want to know what you'd end up paying, it will take more work -- probably CPT codes for the exact procedures you'll need, plus a strong sense of determination and a fondness for hold music.

In-network doctors are simply less expensive for the insurance company. Robert Zirkelbach, a spokesman for America's Health Insurance Plans, says insurance companies want consumers in the plans because it's less expensive and the insurers have screened the providers to ensure quality. "Health plans are able to negotiate significant discounts," he says. Members' going outside the plan can also be bad publicity, indicating they may not be satisfied with the doctors in the plan, Darling says.

10. "You'll get your rights -- eventually."

Assuming the Affordable Care Act remains in place, consumers will be entitled to a number of new protections and coverage. For example, the Patients' Bill of Rights is expected to address some of the most challenging obstacles for many consumers. For example, consumers in health insurance plans will no longer have to pay for routine screenings and check-ups provided in network including routine immunizations and cancer screenings. Insurance companies are required to notify consumers of the changes as they go into effect some don't begin until 2014.

But it will still be up to consumers to learn the details of the plans. As it is, many are confused. A February Kaiser Health Tracking Poll found that nearly half of Americans are confused about the status of the Affordable Care Act. Fifty-two percent think the law still exists, but 22% think it has been replaced and another 26% aren't sure. "I think a lot of people don't know what they have a right to and aren't asking to get them," says Fish-Parcham at Families USA.

Original Article By JILIAN MINCER via http://www.smartmoney.com/plan/insurance/10-things-your-health-insurance-company-wont-say-1299280540906/#articleTabs