HHS Leaves Autism Hot Potato In State Hands

Kathleen Sebelius (AP photo/Charles Dharapak)

A state can decide for itself how it wants its official "essential health benefits" (EHB) package to handle services for children with developmental disorders.

A state also will have at least two options for deciding how it wants to handle pediatric dental and vision benefits in the EHB package.

The U.S. Department of Health and Human Services (HHS) has confirmed that it will be taking that approach to running the EHB program in an advance version of a new final rule, "Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation" (CMS-9980-F).

The final rule is set to appear in the Federal Register Feb. 25. The rule will take effect 60 days after the publication date.

PPACA

PPACA opponents are still trying to repeal PPACA or block implementation of the law, and HHS or other departments could postpone implementation of parts of the law. If the law takes effect on schedule and works as expected, it will create a new system of exchanges, or Web-based health insurance supermarkets, starting Oct. 1.

In an effort to help consumers shop for coverage on an apples-to-apples basis, PPACA will require all non-grandfathered individual or small group insurance plans to cover the EHB package.

The plans will have to cover the EHB package whether the plans are sold through an exchange or outside the exchange system.

The EHB package requirements will not apply to grandfathered plans, self-insured plans or large group plans.

HHS is giving each state some ability to adjust its EHB requirements, by creating a state EHB benchmark based on the list of benefits offered by a popular plan sold in that state. But a state's EHB benchmark also must meet PPACA guidelines. PPACA requires each EHB package to include 10 classes of benefits.

Consultants at Milliman found that most EHB benchmark candidate plans offer similar benefits, and benefits similar to those required by PPACA, with three major exceptions: pediatric vision benefits, pediatric dental benefits, and "habilitative benefits," or rehabilitative benefits for children or adults with developmental delays who may need help with acquiring basic life skills.

The sponsors of many benchmark candidate plans have offered pediatric dental and pediatric vision benefits through separate insurance policies, analysts have found.

States, insurers, employers and groups representing parents of children facing developmental delays have spent years fighting emotional battles over whether states should mandate that plans provide coverage for expensive habilitative services, such as applied behavioral analysis (ABA) for people with autism. ABA therapy and similar types of therapy can cost $30,000 a year or more.

EHB

In an EHB bulletin issued in December 2011, and in documents released in January 2012, February 2012 and July 2012, HHS suggested that it would let states decide to handle habilitative services for themselves.

HHS has proposed letting states handle gaps in a proposed benchmark plan's pediatric and vision benefits by adopting either the benefits that federal employees who pay for dental and vision coverage get, or the dental and vision benefits that the state's Children's Health Insurance Plan program provides.

HHS received about 11,000 comments on the proposals.

Many commenters asked HHS to use a state's Medicaid plan as the benchmark for habilitation, pediatric dental and pediatric vision benefits.

"In order to maintain the states’ role in defining required benefits in their markets, we will finalize the regulations to provide for state flexibility in determining how to define habilitation services and to offer other options for supplementing based-benchmark plans that do not include coverage for pediatric dental and vision services," officials said.

If the EHB benchmark plan a state chooses does not cover habilitative services, the state can use the Medicaid definition of habilitative services or the National Association of Insurance Commissioners definition.

If a state chooses not to define habilitative benefits, the issuers can choose how to define the term, officials said.

"This is a transitional policy," officials said. "HHS intends to monitor available data regarding coverage of habilitative services."

Mental parity

In another section, officials have stated that HHS Secretary Kathleen Sebelius will use PPACA authority to require that any insurance plan subject to the EHB requirements must meet the mental health and substance abuse treatment parity standards included in the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

MHPAEA itself applies only to employers with 50 or more employees that choose to offer mental health or substance abuse benefits. If an employer offers mental health care benefits, the coverage rules can be no more restrictive than the typical requirements for other types of care.
PPACA will require states that impose extra benefits mandates to cover any costs associated with providing the extra mandated benefits. Some PPACA watchers have speculated that states that required individual and small group plans to comply with MHPAEA to cover the cost of MHPAEA compliance.

"Because compliance with EHB would requirement compliance with the parity standards, states would not have to defray any costs associated with bringing plans into compliance, because any benefits added to ensure parity would be considered part of the EHB package," officials said.

Actuarial Value

The EHB program is just one of many parts of the Patient Protection and Affordable Care Act of 2010 (PPACA).

In addition to the section on the EHB program, the upcoming final rule also includes regulations on calculating a plan's minimum value and actuarial value.

PPACA will require large employers to offer a health plan that covers a minimum percentage of the value of the EHB or else pay a penalty.

Issuers that sell individual or small group coverage will have to classify their plans in one of four "metal levels" -- bronze, silver, gold or platinum -- based on actuarial value, or the percentage of the EHB that the plan covers.

HHS released a preliminary version of an actuarial value calculator months ago,
HHS said in the preamble to the new final rule that it has tried to use technical comments on an actuarial value calculator it created to improve the calculator. If the calculator does not accommodate a plan's cost-sharing structure, the plan can use another method along with actuarial certification of the results, officials said.

HHS also reported that it has developed the long-awaited minimum value calculator.

 

The minimum value calculator is similar to the actuarial value calculator, but issuers cannot simply use the actuarial value calculator to determine minimum value, because the actuarial calculator is based on individual and small group claims data, and the minimum value calculator is based on employer-sponsored plan claims data, officials said.

In a discussion of the value regulations, officials noted that HHS, the U.S. Labor Department and the U.S. Treasury Department believe that self-insured plans are exempt from a new PPACA limit on deductibles.

But the departments believe self-insured plans do have to comply with a new PPACA annual limit on total cost-sharing amounts, or the total cost of the deductibles, co-payments and coinsurance amounts that enrollees must pay.

"The departments are concerned about the operational and timing issues raised by commenters, and find that some transitional relief is appropriate," officials said in a preamble to the final rule.

"Accordingly, the three departments are issuing concurrent sub-regulatory guidance identifying an enforcement safe harbor for large and self-insured group health plans to address those operational concerns."

Other matters

Also in the preamble to the final rule, officials said:

- They will let plans tinker with the EHB by substituting benefits, or sets of benefits, that fit into one of the 10 PPACA EHB categories and are actuarially equivalent to the benefits being replaced.
- A plan with a provider network can exclude out-of-network bills when determining whether an enrollee has reached a PPACA deductible or cost-sharing limit. But a plan can voluntarily establish cost-sharing limits for out-of-network care, and a state can require issuers to do so, officials said.

Read More: Original Article: http://www.lifehealthpro.com/2013/02/20/hhs-leaves-autism-hot-potato-in-state-hands?eNL=5125339aca9f8086530000e3&utm_source=HCRW&utm_medium=eNL&utm_campaign=LifeHealthPro_eNLs&_LID=141697675&t=employee-benefits

BCBS Rate 2-Digit Increases For 2013 In NY, CA, TX, PLUS ...IS TN and MS Next??

Health Insurers Raise Some Rates by Double Digits

 

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.       

 

Bob Chamberlin/Los Angeles Times

Dave Jones, the California insurance commissioner, said some insurance companies could raise rates as much as they did before the law was enacted.                           

 

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

      

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

      

In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

       

The proposed increases compare with about 4 percent for families with employer-based policies.

Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators’ evaluations.

      

The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.

      

New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.

      

The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.

      

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

      

“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.

      

While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.

      

The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. “We need these rates to even come reasonably close to covering the expenses of this population,” said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.

      

Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.

      

“There’s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,” said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.

      

Federal officials say the law has resulted in significant savings. “The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,” said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.

      

“Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,” he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.

      

As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.

      

In New York, for example, state regulators recently approved increases that were much lower than insurers initially requested for 2013, taking into account the insurers’ medical costs, how much money went to administrative expenses and profit and how exactly the companies were allocating costs among offerings. “This is critical to holding down health care costs and holding insurance companies accountable,” Gov. Andrew M. Cuomo said.

      

While insurers in New York, on average, requested a 9.5 percent increase for individual policies, they were granted an increase of just 4.5 percent, according to the latest state averages, which have not yet been made public. In the small group market, insurers asked for an increase of 15.8 percent but received approvals averaging only 9.6 percent.

      

But many people elsewhere have experienced significant jumps in the premiums they pay. According to the federal analysis, 36 percent of the requests to raise rates by 10 percent or more were found to be reasonable. Insurers withdrew 12 percent of those requests, 26 percent were modified and another 26 percent were found to be unreasonable.

      

And, in some cases, consumer advocates say insurers have gone ahead and charged what regulators described as unreasonable rates because the state had no ability to deny the increases.

       

Two insurers cited by federal officials last year for raising rates excessively in nine states appear to have proceeded with their plans, said Carmen Balber, the Washington director for Consumer Watchdog, an advocacy group. While the publicity surrounding the rate requests may have drawn more attention to what the insurers were doing, regulators “weren’t getting any results by doing that,” she said.

      

Some consumer advocates and policy experts say the insurers may be increasing rates for fear of charging too little, and they may be less afraid of having to refund some of the money than risk losing money.

      

Many insurance regulators say the high rates are caused by rising health care costs. In Iowa, for example, Wellmark Blue Cross Blue Shield, a nonprofit insurer, has requested a 12 to 13 percent increase for some customers. Susan E. Voss, the state’s insurance commissioner, said there might not be any reason for regulators to deny the increase as unjustified. Last year, after looking at actuarial reviews, Ms. Voss approved a 9 percent increase requested by the same insurer.

      

“There’s a four-letter word called math,” Ms. Voss said, referring to the underlying medical costs that help determine what an insurer should charge in premiums. Health costs are rising, especially in Iowa, she said, where hospital mergers allow the larger systems to use their size to negotiate higher prices. “It’s justified.”

      

Some consumer advocates say the continued double-digit increases are a sign that the insurance industry needs to operate under new rules. Often, rates soar because insurers are operating plans that are closed to new customers, creating a pool of people with expensive medical conditions that become increasingly costly to insure.

      

While employers may be able to raise deductibles or co-payments as a way of reducing the cost of premiums, the insurer typically does not have that flexibility. And because insurers now take into account someone’s health, age and sex in deciding how much to charge, and whether to offer coverage at all, people with existing medical conditions are frequently unable to shop for better policies.

      

In many of these cases, the costs are increasing significantly, and the rates therefore cannot be determined to be unreasonable. “When you’re allowed medical underwriting and to close blocks of business, rate review will not affect this,” said Lynn Quincy, senior health policy analyst for Consumers Union.

      

The practice of medical underwriting — being able to consider the health of a prospective policy holder before deciding whether to offer coverage and what rate to charge — will no longer be permitted after 2014 under the health care law.

 

Original Article: http://www.nytimes.com/2013/01/06/business/despite-new-health-law-some-see-sharp-rise-in-premiums.html?pagewanted=all&_r=0

How To Find Affordable Private Health Insurance --- BCBS, Aetna, Humana, etc. Aren't The ONLY RIGHT Answers ---FIND YOURS!

The Patient Protection and Affordable Care Act

In March 23rd, the US health care system underwent the beginning of a major reform, which may have changed the way many people go about getting health cover. The Patient Protection and Affordable Care Act included a mandate that every American must have medical provision, or pay a fine. Some details of the Act are still awaiting a Supreme Court ruling.

The provisions of the Act roll out over the next few years. Some provisions came into effect within months of the Act being signed into law. Most of the changes so far have affected seniors, children, those with pre-existing conditions, and young adults. Within the next few years, there will be new programs that include co-ops and online exchanges.

In 2014 a provision comes into effect, called Promoting Individual Responsibility, which says that the majority of citizens must purchase health insurance - if they don't, they could face having to pay a fine.

Buying Health Insurance On Your Own

 

If you are not covered through your employer, or part of a COOP, and are not eligible to state funded programs, you will probably have to buy health insurance as an individual.

When selecting the right insurance option, the purchaser needs to be aware of various factors. For example, should the plan include prescription coverage or not? A female of childbearing age is more likely to opt for a plan that covers pre-natal visits.

Pre-existing conditions - there are now government-assistance programs, as well as new provisions in the new legislation to help those with pre-existing conditions get cover. Pre-existing conditions, for people aged under 19, are no longer permissible reasons refuse coverage in family plans. If you want to enroll somebody under 19 on their own, in some cases they need to be part of an open enrollment period.

Major insurance companies today are required to spend a good portion of the money they collect from their insured contributors on health care.

For those who cannot afford the price of health care insurance, there is currently financial assistance.

How To Find Private Health Insurance

Private health insurance is the main source of health coverage for the majority of people in the United States. Approximately 58% of all Americans have private health care coverage. For elderly citizens and eligible children and families from low-income households, public programs are the primary source of health cover. Public programs include Medicare, Medicaid, and SCHIP. TRICARE and the Veterans programs also provide some coverage.

If you are not covered by a publicly funded program, or if your coverage is only partial, you will need to have some kind of private health insurance. Such companies as USHealthGroup, America's Choice For Health Insurance, BCBS, Aetna, United Health Care, etc. 

Since the turn of the millennia, millions of Americans have found themselves with no health cover at all. Most studies place the number of "uninsured" at over 46 million. Tens of millions more have inadequate insurance.

---

Source: US Census Bureau

Offspring over the age of 19 and under 26 may now be added to their parents' insurance plan.

Matching Your Needs With What Is Available

Deciding on what best suits you, your current circumstances, plus those of your family's, may seem confusing and daunting. Experts advise purchasers to think carefully about what is ideal for them before proceeding with a purchase. The following points need to be considered carefully:

• One plan or separate plans - adding a spouse or offspring to a plan may be ideal, but not always so. In some cases, shoppers may find better deals by checking what is around first. It is important to balance to benefits offered against the amount that has to be paid out in premiums, in every case.
• Is your doctor included? - if you are considering an interesting plan, make sure your doctor or clinic is listed in their network of healthcare professionals. Otherwise, you may either have to change doctors, or pay out-of-pocket for the one you prefer.
• Only choose relevant options - do not choose a plan with options you do not need, in order to keep your premium costs to a minimum. If the purchaser or spouse is a female over 45, it is unlikely maternity coverage is a top priority. Even prescription plan coverage most likely will not cover all drugs, especially the newer, more expensive ones.
• Big premiums today, or in the future? - if you have little disposable income and enjoy good health, you might find it more convenient to opt for a high-deductible plan to start with, that has progressively lower monthly premiums with the passing of time. If your health care requirements are high now, a low-deductible plan to start with may be a better choice.

An important decision as such should not be handled alone unless you fully understand what you are getting for you and your family. Consider an advisor with USHealth Group, America's Choice For Health Insurance. Nannette Bean is an award-winning insurance advisor with USHealth Group.

Original Article Comes From:http://www.medicalnewstoday.com/info/health-insurance/find-private-health-insurance.php

FoxNews Reports: ObamaCare's "affordability glitch" Could Leave Your Family Without Health Care!!--- Stay Informed-MUST READ!

Could ObamaCare's 'affordability glitch' leave your family without health care?

 

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The “Affordable Care Act” is turning out to be anything but. Slogans reminiscent of the government doublespeak of George Orwell’s 1984 are taking the place of real access to real care.

Advocates for the poor are now suddenly concerned about a new oxymoron, the so-called “affordability glitch,” where your employer can no longer afford to cover you and your family, and you will be forced to go to the state exchanges for your health insurance only to discover that you can’t afford the rising premiums there and don’t qualify for a federal subsidy. The only “good news” about this glitch is that new IRS regulations may exempt you from paying the 2.5% tax for non-compliance, which is hardly a consolation when you still lack insurance.

Employers simply can’t afford to pay these health insurance premiums, especially for family plans, and remain in business. And you are no longer allowed to pick up the slack. Consider that ObamaCare will allow you to pay only 9.5% of your income towards an employer plan.
 According to new estimates just released by the Congressional Budget Office, at least 7 million people who now receive health insurance from their employer will not be covered by their jobs a decade from now. This is double the number the CBO previously predicted.
So what will your employer do? It is becoming more and more likely that he or she will drop your policy and pay the penalty, or reduce you to part time hours to avoid the penalty. According to new estimates just released by the Congressional Budget Office, at least 7 million people who now receive health insurance from their employer will not be covered by their jobs a decade from now. This is double the number the CBO previously predicted.

Twenty-three million of us will go to the state exchanges, according to the CBO, leaving 30 million non-elderly people still lacking health insurance by 2023.

How ironic are these estimates when you consider that ObamaCare’s stated purpose is to provide affordable insurance for all. So why the glitch? The answer is that premiums are rising to the point of unaffordability, something that the new law should have anticipated given its taste for comprehensive plans with low co-pays and limited deductibles ($2000 for an individual, $4000 per family maximum).

Consider the state exchanges, where beginning this October ObamaCare will offer four basic types of plans; Bronze, Silver, Gold, or Platinum. Bronze is considered a basic, catastrophic-type plan, but this is simply false advertising by the Obama administration when you consider what the plan must cover; ambulatory and emergency patient services, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitation, laboratory, preventive and wellness services and chronic disease management, and pediatric services including oral and vision care.

Sounds great until you consider the cost of all these non-catastrophic services. Traditionally, high deductibles have kept premiums down by promoting cost-sharing; you pay out of pocket for basic well care and utilize a health savings accounts to provide you with a tax deduction for most or all of these payments. ObamaCare doesn’t believe in this kind of common-sense cost sharing and is trying to decrease out of pocket payments. When you take away these proven disincentives for overuse, you are left with an entitlement behemoth.

Rising premiums automatically accompany comprehensive insurance plans in an age of expensive medical technology. Insurers transfer costs to the consumer. The bronze and silver plans on the state exchanges will limit the amount you can pay for premiums to 9.5% of your income if your income is 300-400% of the poverty line, but on average, the IRS estimates that a family of 5 will be paying $20,000 for a bronze plan. This is simply unaffordable to most families.

There’s that glitch again. And here’s the main oxymoron; The unaffordable affordable act.

Read more: http://www.foxnews.com/opinion/2013/02/11/could-obamacare-affordability-glitch-leave-your-family-without-health-care/#ixzz2KtNMUcsw Original Article By Dr. Marc Siegel; Published February 11, 2013 via FoxNews.com

ObamaCare policies will cost MORE; Cover far fewer than promised!! - MUST READ!!

Wheels coming off... LITERALLY!

 

 

The central parts of ObamaCare don’t roll out until 2014, but the wheels are already falling off this clunker. The latest news from four federal agencies is that 1) insurance will be a lot less affordable than Americans were led to expect, 2) fewer people than promised will get insurance and 3) millions of people who have coverage through a job now will lose it, thanks to the president’s “reforms.” Oh, and children are the biggest victims.

The Affordable Care Act is looking less and less affordable.

Start with the IRS’s new estimate for what the cheapest family plan will cost by 2016: $20,000 a year to cover two adults and three kids. And that will only cover 60 percent of medical bills, so add hefty out-of-pocket costs, too.

The next surprise is for parents who thought their kids would be covered by an employer. Sloppy wording in the law left that unclear until last week, when the IRS ruled that kids won’t be covered.
Starting in 2014, the law will require employers with 50 or more full-time employees to offer coverage or pay a penalty. “Affordable” coverage, that is — meaning the employee can’t be told to contribute more than 9.5 percent of his salary. For example, a worker earning $40,000 a year cannot be required to pay more than $3.800.

But the law doesn’t specifically mandate family coverage — and now the administration says that won’t be required.

You can see why: If the lowest-cost family plan (again, two adults and three kids) is to run a whopping $20,000, and if the employee’s contribution is limited to $3,800, the employer’s tab would be $16,200 — adding about $7.40 an hour to the cost of that employee. Wisely, the IRS announced on Jan. 30 that employers won’t have to pay for dependents.

But the Congressional Budget Office’s much-cited prediction that ObamaCare would leave only 30 million people uninsured by 2016 was based on the assumption that kids would be covered by employers. At the very least, employers insuring their workers for the first time to avoid the penalty are unlikely to do that.

So how will the kids be covered? They won’t. The IRS shocked the law’s advocates by announcing that the insurance exchanges won’t provide subsidies for a child whose parent is covered at work.
Nor will these parents be penalized for not insuring their children — the IRS will kindly consider the kids exempt from the mandate.

Also exempt are millions of people who’ll stay uninsured because their state is wisely choosing not to loosen Medicaid eligibility.

Some background: Despite President Obama’s promises to help solve the problem of the uninsured by making private health plans more affordable, the law expands coverage mainly by forcing states to loosen their Medicaid eligibility rules. But the Supreme Court ruled that the feds can’t command states in this way.

At first, the CBO said that ruling would only prevent 4 million people from gaining coverage — but more states than it expected are refusing to go along; it could well be 8 million more without coverage.

Oh, and the CBO last week also doubled its previous estimate on how many people will lose the health coverage they now get through work, upping the figure to 8 million by 2016 and 12 million by 2019. Several top consulting firms put the figures even higher.

Yet the biggest setback is that most states are refusing to set up insurance exchanges. The exchanges are supposed to sell the government-mandated plans and hand out taxpayer-funded subsidies to most enrollees.

Here’s the glitch. The law says that in states that refuse, the federal government can set up an exchange. But the law empowers only state exchanges, not federal ones, to hand out subsidies. The Obama administration says it will disregard the law and offer subsidies in all 50 states anyway, but the case will likely go to the Supreme Court.

If the courts uphold the clear language of the law, then some 8 million people in the affected states won’t be eligible for subsidies to cover that $20,000 (or more) insurance bill. That’s another 8 million without coverage.

All in all, at least 40 million people could be uninsured in 2016, only 9 million fewer than before the law was passed.

Expect the momentum for repealing this law to grow as its flaws, perverse incentives and faulty predictions come to light.

Betsy McCaughey is the author of “Beating ObamaCare.” Article from: http://www.nypost.com/p/news/opinion/opedcolumnists/wheels_coming_off_QPojjZX0Bd8BU80hDpcKZP

Feds Reject Mississippi's Plan For Insurance Exchange

 

The heath exchange Mississippi Insurance Commissioner Mike Chaney had in mind got turned down by the federal government.Rogelio V. Solis/AP

 

The heath exchange Mississippi Insurance Commissioner Mike Chaney had in mind got turned down by the federal government.

Rogelio V. Solis/AP

 

Mississippi Insurance Commissioner Mike Chaney, who has been the driving force behind the creation of a state-based exchange, got his answer from the feds: Sure can't.

The U.S. Department of Health and Human Services rejected the plan Thursday, making Mississippi the only state to have its exchange blueprint nixed by the federal government.

Instead, Mississippi will have a federal exchange, just like more than two dozen other states that balked at implementing the health law provision on their own.

The decision follows more than a month of delay from the federal government over the future of Mississippi's proposal. Chaney pushed ahead even though Mississippi Gov. Phil Bryant opposed a state-based exchange.

That infighting proved to be a big problem. The federal government said the split between Chaney and Bryant is at the heart of its decision.

Chaney began building the exchange in Mississippi based on his authority to run the state's high-risk insurance pool. One problem with that approach: It has nothing to do with Medicaid, only subsidized private insurance.

Chaney said the state had taken the federal agencies overseeing the exchanges at face value. "But I fear that we have been unable to trust them at this point. And Americans need to be able to trust their government. I feel that I have been betrayed at this point," he said during a news conference Thursday evening.

The Affordable Care Act says that the exchanges have to be one-stop shops for both private insurance and Medicaid. As insurance commissioner, Chaney doesn't have authority over Mississippi's complicated Medicaid enrollment processes.

Gov. Bryant sent letters to HHS expressing his opposition to state-based exchanges and questioning the commissioner's legal authority to run one. Chaney insisted he had the authority and was backed up in a ruling by the state's Democratic attorney general.

In a statement, Bryant praised the ruling from the federal government. "I have said repeatedly that the health insurance exchanges mandated by Obamacare are not free-market exchanges," he said. "Instead, they are a portal to a massive and unaffordable new federal entitlement program. They trigger new taxes on businesses and will ultimately drive more people onto Medicaid rolls. I firmly maintain my position that Mississippi will not willfully implement a mechanism that will compromise our state's financial stability," Bryant said.

Mississippi would have been the only Republican-led state in the South with a health insurance exchange not run by the feds.

But a spokesman for HHS said the state's approach wasn't feasible. "With the Governor's refusal to work with us or the insurance commissioner, there is no way to coordinate strategy with other agencies that he's in charge of," an HHS spokesman told KHN.

Work has been underway on an insurance exchange for years, and Chaney isn't sure what will become of it. The Web portal for the state's exchange already exists at OneMississippi.com.
The commissioner is leaving the door open for Mississippi to run a state-based exchange exclusively for small businesses. HHS wants Mississippi to consider a partnership.

"Given the work the insurance department has done, Mississippi is an excellent candidate for a state partnership marketplace. We encourage Mississippi to apply to operate parts of its marketplace by the February 15, 2013 deadline," the HHS spokesman said.

This story is part of a collaboration that includes Mississippi Public Radio, NPR and Kaiser Health News. by Jeffrey Hess February 08, 2013 2:06 PM fromMPB via http://www.npr.org/blogs/health/2013/02/08/171485790/feds-reject-mississippis-plan-for-insurance-exchange

Health Insurance for New Startup Businesses

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“I’m think about getting a first time health insurance policy, where do I start?”

 

Purchasing a health insurance policy for the first time can appear to be very overwhelming, especially in today’s marketplace. Below are some key points to keep in mind to help you simplify and better manage the process to ensure the best results possible in today’s market.

 

Before you even pick up the phone to call a broker, you must make sure to gather the following information:

• Census of your current employees – This means collecting the name, home zip code, date of birth, and coverage status of the employee (employee only, employee spouse, employee children, and family - ages, current health conditions and previous health related issues is information that would need to be gathered for all members). All brokers will need this information in order to get back rates from the carriers.
• Know your budget – Figure out how much money you are looking to spend on a health insurance policy for your business. Knowing how much you want to send allows you to work with the broker to find a policy and/or supplemental health products that can help you meet your objectives.
• Familiarize yourself with plan options – Have an idea of what types of plans you would like to offer your employees. Even if these plans may not be feasible, they will allow you to frame the conversation with your broker. Make sure to check out our blog post on which plan options may be best for your business.
• Know what you currently have when comparing – If you are looking to match benefits or to an existing or previous plan, make sure to provide this to your broker as well. This will help streamline the options that your broker brings back streamlined options that look to meet your objectives.
• Identify your long term goals – You expect your clients, and employees to work with you for a long time, and you should make sure to lay out a comparable plan for your benefits. Figure out the average age of your group, what you want to offer them in future years, and what information you think you will need to provide them in order to understand your vision.

• Try a Comprehensive Health Insurance - These plans are almost the exact mirror imagine of a traditional major medical plan, only the coverage is head to toe, tons of health relate freebies and the customer receives tons of payback from one company. With these plans, it is very important to check the PPO network because this could be the fine line between your plan being trash or treasure.

Original Article can be viewed at: http://www.forbes.com/sites/thesba/2013/02/08/health-insurance-for-new-startup-businesses/