Heath Care Reform- Will it be good for us?

On the surface, comprehensive health reform sounds like a fabulous idea. Why wouldn’t Americans want everyone to have guaranteed health care coverage? However, insurance for everyone comes with a price tag that isn’t only about the approximately $1 trillion (yes, with a TR) that it will cost to implement over the next 10 years.

All of the bills under active consideration require people to obtain health insurance coverage, known as an individual mandate. According to the Senate Health, Education, Labor, and Pensions (HELP) Committee’s health reform bill, by 2013, all individuals would be required to have health insurance coverage. Those who don’t will be assessed a tax up to the cost of the minimum benefit plan.

Other proposals require employers with more than 25 employees to provide qualified health insurance coverage. One bill being considered requires employers with more than 25 employees to provide coverage and requires them to pay 72.5 percent of each employee’s premiums for “acceptable” coverage and 65 percent of the cost of those employees’ family coverage premiums. What is deemed “acceptable” is up for discussion, too.

Additionally, the bill mandates coverage for part-time employees and requires employers to pay for a portion of the costs on a pro-rata basis. Many employers now can’t afford such contributions to their employees’ health plan costs. Employers that fail to comply would incur a penalty of eight percent of the company’s payroll, along with the potential for additional payments and penalties down the road.

“President Obama waxed enthusiastic about countries that 'spend less' than the US on healthcare. The Journal explored the United Kingdom's National Institute for Health and Clinical Excellence, or NICE, which has become in practice....a rationing board. As health costs have exploded in Britain as in most developed countries, NICE has become the heavy that reduces spending by limiting treatments. Obama and Democrats claim they can expand subsidies for tens of millions of Americans, while saving money and improving the quality of care. It can't possibly be done. The inevitable result of their plan will be some version of a NICE board that will tell millions of Americans that they are too young, or too old, or too sick to be worth paying to care for,” according to a July 7 editorial in The Wall Street Journal.

The HELP Committee’s bill also proposes the establishment of a National Health Insurance Exchange by 2013 to replace the current individual health insurance market and provide an option for employers and public program enrollees in Medicaid. The bill also proposes expanding Medicaid eligibility for all individuals to 133 percent of the federal poverty level ($14,000 for an individual) and requires an 85 percent medical loss ratio for Medicaid managed care organizations. It also establishes new preventive services benefits, increases payments for primary care, and implements a medical home pilot project to reduce costs and improve outcomes through use of preventive services and care coordination.

Additionally, by 2013, DHHS would develop and offer a public plan through the exchange to compete with private insurers. The public plan would comply with the same requirements as private health plans, but provider payments would be similar to Medicare rates and providers participating in Medicare would be required to participate in the public plan for five years.
However, a government-run public plan would not be subject to the same rules for financial solvency and would not be required to pay taxes. Because these plans would operate with advantages unavailable to private plans, that could eventually force everyone into the government plan, which could result in long lines and rationing such as in Canada and Great Britain, according to the National Association of Health Underwriters.

Medicare Advantage Plan Changes Expected

Medicare reform is also part of the bill restructuring provider payment rates and requiring the Department of Health and Human Services (DHHS) to develop new payment methods to promote coordinated care and reward quality and efficiency in areas such as hospital readmissions, post-acute care, imaging, and primary care. The bill reduces payment rates and establishes an 85 percent medical loss ratio for Medicare Advantage plans. The legislation also eliminates the coverage gap in Part D by 2023 and reauthorizes Special Needs Plans (SNPs) that integrate care for beneficiaries with coverage through Medicaid and Medicare.

The reduction in Medicare Advantage plans payment rates could have a significant impact on people over 65 that are currently enjoying the low monthly premium costs for their existing plans. The advantage plans for next year could change, either by providing reduced benefits or higher monthly rates or both. The millions of seniors now covered by the Advantage plans could be forced to seek other supplement plans or live with reduced benefits.

Our team of professional agents at Insurance Connection USA will continue to provide you with details on all the available plans and options and will be prepared to meet with you and review your individual situation and benefit needs.

The Insurance Connection offers Medicare Supplemental Insurance to Seniors in Denton, Texas

For Immediate Release:

Denton Texas - The Insurance Connection an independent insurance agency plans to expand their offices in Denton with a goal of serving the senior community.

"Our dedication to superior customer service and prompt attention to client requests has made us one of the leaders in the insurance agency business", said Robert Garrison, Managing Director of the Insurance Connection.

"We intend to bring our vast experience in helping families and businesses with their health insurance needs to focus on helping the senior community fully understand the various options that are available to them. The change in Medicare has brought several new options available to Medicare eligible people and our agency has the experience and trusted reputation to assist seniors in making the right choice for them", said Marianne Montoya, Medicare Specialist. "We have two agents who will devote full time to working with the senior community", said Montoya.

The Insurance Connection is a company that specializes in assisting individuals and small companies locate appropriate and affordable insurance for their Health, Life, Home and Auto. Our mission is to provide our clients accurate information they can use to choose the insurance plan that best serves their individual requirements.

Contact Marianne Montoya at 940-382-4700 for more information.

Insurance Connection
1204 W University Suite 206
Denton, Tx 76201

Can You Afford to be Without Health Insurance?

Has anyone ever said to you, "I plan on getting appendicitis next week"? Of course not! Nobody plans on getting sick. But unfortunately, our personal health is often beyond our control. A bacterial infection, a nasty car wreck, broken ankles during a soccer match, an emergency appendectomy-the world is a dangerous, unpredictable place. And without affordable health insurance, a major illness or accident could result in serious financial losses.

Don't roll the dice with your health. Investing in a health insurance policy is a crucial step toward protecting yourself and your finances in the event of a major illness or accident. Affordable health insurance that provides the coverage you need is possible.

Millions of Americans Lack Affordable Health Insurance

The reality is harsh: according to the U.S. Census, 47 million Americans were without health insurance in 2006. That's almost one sixth of the population. Even worse, AARP.org reports that 78 percent of the uninsured are employed.

In all, almost 90 million citizens-roughly one-third of the entire population-spent a portion of 2006-2007 without health insurance.

The Cost of Being Uninsured

Before you think about the cost of a health insurance policy, ask yourself how much it may cost to be without one. HealthAffairs.org estimates that Americans without health insurance pay $30 billion in out of pocket medical costs every year. In a good year when you don't get sick, your medical costs may be zero. But if you should fall ill and require surgery, you'll be faced with tens of thousands in medical bills.

The price tag for an ambulance ride alone is enough to bleed your bank account dry. If your ailment is serious enough to keep you in the hospital for a few nights, you can expect to be hit with an astronomical bill upon your release.

Here are a few examples of the cost of being uninsured:

A 3-day hospital stay - $27,984

Burst appendix - $48,151

Knee surgery and aftercare - $48,302

Source: Blue Cross

Contact Marianne Montoya at 940-382-4700 for more information.

Insurance Connection
1204 W University Suite 206
Denton, Tx 76201