Tag Archives: Health Care Compliance

Immigrants, the Poor and Minorities Gain Sharply Under Health Act

LOS ANGELES — The first full year of the Affordable Care Act brought historic increases in coverage for low-wage workers and others who have long been left out of the health care system, a New York Times analysis has found. Immigrants of all backgrounds — including more than a million legal residents who are not citizens — had the sharpest rise in coverage rates.

Hispanics, a coveted group of voters this election year, accounted for nearly a third of the increase in adults with insurance. That was the single largest share of any racial or ethnic group, far greater than their 17 percent share of the population. Low-wage workers, who did not have enough clout in the labor market to demand insurance, saw sharp increases. Coverage rates jumped for cooks, dishwashers, waiters, as well as for hairdressers and cashiers. Minorities, who disproportionately worked in low-wage jobs, had large gains.

The health care law was one of the most bitterly contested pieces of legislation in the country’s history. It remains controversial because of its costs to both taxpayers and insurance customers. The high premiums and high deductibles of many plans still make coverage a crushing financial burden for some families.

And the law is not close to achieving the goal of universal coverage, in part because 19 states have declined to expand their Medicaid programs for the poor, an option the Supreme Court granted them in a landmark 2012 case. Nevertheless, the Times’s analysis shows that by the end of that first full year, 2014, so many low-income people gained coverage that it halted the decades-long expansion of the gap between the haves and the have-nots in the American health insurance system, a striking change at a time when disparities between rich and poor are growing in many areas.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Poll: Americans Largely Oblivious to Supreme Court Case on Obamacare’s Future

7 in 10 Americans have heard little or nothing about the case

A great deal of Americans will be taken by surprise should the Supreme Court rule against the Affordable Care Act in the coming weeks — a new poll finds seven in ten Americans say they’ve only heard a little or nothing at all about the pending case.

According to a new poll by the Henry J. Kaiser Family Foundation, 44% of Americans haven’t heard anything while 28% have heard only a little about King v. Burwell, a case due to be heard within weeks that could cause millions to lose federal subsidies for health insurance.

Though more people report knowing about the case than did when the Court announced it would take it up, the lack of knowledge isn’t a good sign given the impact the case could have on health insurance for low and middle-income Americans.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Poll Marks a Love/Hate View of the Affordable Care Act

Public support for Obamacare tied its all-time low in the latest ABC News/Washington Post poll – even as most Americans say the Supreme Court should not block federal subsidies at the heart of the health care law.

With the high court set to rule on the latest challenge to the ACA, the poll reflects the public’s split views of the law – criticism of its insurance mandate, yet support for extended coverage.

Overall, just 39 percent support the law, down 10 percentage points in a little more than a year to match the record low from three years ago as the Supreme Court debated the constitutionality of the individual mandate. A majority, 54 percent, opposes Obamacare, a scant 3 points shy of the high in late 2013 after the botched rollout of healthcare.gov.

In spite of majority opposition overall, however, 55 percent think the Supreme Court should not block federal subsidies that help some low and moderate income Americans pay for their health insurance. Many fewer, 38 percent, would like to see the Court strike down those subsidies.

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary

 

 

 

 

Managing Your Medicare’s Out-of-Pocket Expenses

Medicare beneficiaries need to pay for a sometimes significant portion of their health care costs. Just like private health insurance, Medicare requires beneficiaries to pay premiums, deductibles and coinsurance. But there’s a lot you can do to keep these costs manageable. Here are some steps to minimize Medicare’s out-of-pocket costs.

Premiums.
Most people aren’t charged a premium for Medicare Part A hospital insurance. The standard monthly premium for Medicare Part B medical insurance is $104.90 in 2015. This amount is typically deducted from your Social Security check if you are already receiving payments, but those who have not yet claimed Social Security will receive a bill. Retirees with modified adjusted gross incomes above $85,000 for individuals and $170,000 for couples are charged higher Part B premiums.

It’s important to sign up for Medicare Part B during the initial enrollment period, which is a seven-month window that begins three months before your 65th birthday. Your Part B premiums will increase by 10 percent for each 12-month period you were eligible for Medicare Part B but didn’t sign up for it. “If you are 68 when you sign up for Medicare Part B, you will be hit with a 30 percent premium increase every year for the rest of your life,” says Ronald Kahan, a medical doctor and author of “Medicare Demystified: A Physician Helps Save You Time, Money, and Frustration.” If you didn’t sign up for Medicare Part B at age 65 due to participating in group health insurance through your job, you should sign up within eight months of leaving the job or the coverage ending to avoid the penalty.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Employers Urge Repeal of Small Group Expansion

The Affordable Care Act’s mandated expansion of the definition of the small group market would limit employers’ health plan options, according to employer groups who are urging the repeal of the mandate before it takes effect in 2016.

Expanding the small group market to include groups up to 100 would not only reduce choice for this segment of the market, it means some employers would be unable to keep the insurer they currently have, according to the Society for Human Resource Management and the National Association of Health Underwriters. The industry groups and more than a dozen other employer organizations are applauding efforts to repeal the ACA mandate through legislation called the Protecting Affordable Coverage for Employees Act (PACE).

The expansion is intended to make insurance more affordable for the smallest employers by expanding the risk pool to include larger companies. It also aims to increase the number of participants in the ACA’s Small Business Health Options Program, also known as the SHOP exchanges.

The PACE bill would maintain the current definition of a small group market as 1-50 employees and give states the flexibility to expand the group size if they feel the market conditions in their state necessitate the change.

“It is in the best interest of employers and their employees that states determine the definition of their small group market,” the groups argue in a recent letter to the bill’s sponsors, Senators Tim Scott (R-SC), Jeanne Shaheen (D-NH), and Michael Bennet (D-CO).

“Repealing the ACA-mandated expansion and returning to the historical role of state determination would allow flexibility and ensure a broad array of coverage options and mitigate dramatic premium increases,” they add.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Amenities, Perks, and Bonuses Trump Salary Raises

Yacht-size bonuses for Wall Street big shots and employee-of-the-month plaques for supermarket standouts are nothing new, but companies’ continued efforts to keep costs down have pushed employers to increasingly turn to one-off bonuses and nonmonetary rewards at the expense of annual pay raises.

“There is a quiet revolution in compensation,” said Ken Abosch, a partner at Aon Hewitt, a global human resources company. “There are not many things in the world of compensation that are all that radical, but this is a drastic shift.”

According to Aon Hewitt’s annual survey on salaried employees’ compensation, the share of payroll budgets devoted to straight salary increases sank to a low of 1.8 percent in the depths of the recession. It dropped to 4.3 percent in 2001, from a high of 10 percent in 1981. It has rebounded modestly since the recession, but still only rose 2.9 percent in 2014, the survey of 1,064 organizations found. (These figures are not adjusted for inflation.)

Aon Hewitt did not even start tracking short-term rewards and bonuses — known as variable compensation — until 1988, when they accounted for an average of 3.9 percent of payrolls. Ten years later, that share had more than doubled to 8 percent. Last year, it hit a record 12.7 percent.

Of course, companies have long rewarded top executives and rainmakers with bountiful bonuses — and that continues to be true — but compensation experts say the prevalence and types of one-time rewards and perks have spread further down the ranks than ever before. Although pay-for-performance rewards for top achievers and signing bonuses to attract talent account for most of the one-shots, they also include company wide amenities and targeted perks, like lunches out with the boss or Visa gift cards.

“It affects the C.E.O. all the way down to the guy who sweeps the factory floor,” Mr. Abosch said. Ninety-one percent of the companies surveyed have at least one broad-based reward program, up from 78 percent in 2005 and 47 percent in 1991.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

The ACA Incentives People to Attain Health Insurance

Obamacare’s big stick doesn’t seem to be scaring many people into buying health insurance.

The health law includes many inducements for people to obtain health insurance — including free Medicaid coverage for many low-income Americans and subsidies for those with moderate incomes. But it also includes the notorious “individual mandate,” a fine for those who can afford insurance but don’t buy it.

Because the law, and the fine, are new, many policy experts expected that some people would decline to sign up for insurance until they were hit with a penalty at tax time. Forecasters have estimated a big bump in marketplace enrollment next year, the first sign-up period after people have been fined. The Congressional Budget Office, for example, estimates 10 million more people will have Obamacare plans next year. The law’s structure relies on even healthy and otherwise disinclined consumers to enter insurance markets to help stabilize prices.

Certainly, some people who might otherwise go uninsured have been persuaded by the penalty. Polls have shown that it is a well-known provision of the law. And studies of the uninsured have shown that mentioning the penalty changes some people’s thinking about health insurance. At the end of the normal enrollment period in February, about 11.7 million people had selected marketplace health plans or renewed their plans from 2014, according to the federal government.

But the Obama administration just conducted a small experiment into how much the penalty would affect the behavior of the remaining uninsured. And the results leave some experts concerned that next year’s sign-ups will come in below expectations.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Average Americans Can’t Afford Insurance Deductibles

Just because you have health insurance doesn’t necessarily mean you can afford all your medical bills, especially if you have a high deductible. So sometimes, it pays to negotiate.

A Commonwealth Fund study released this week found that nearly a quarter of working-age Americans who had health insurance in 2014 were “underinsured.” The report cited rising deductibles — the amount you must pay for care before insurance coverage begins — as a growing factor.

More people than ever before have health plans with deductibles, the report found, and more people have deductibles that are high relative to their incomes. Half of those who were underinsured reported problems paying medical bills or said they were paying off medical debt, the report found.

High deductibles squeeze many families because most Americans lack significant savings to help cover sizable bills. “Most Americans don’t have that much money in the bank,” said Karen Pollitz, a health policy expert with the Kaiser Family Foundation.

So consumers may be interested to know that the amount of a medical bill is not necessarily set in stone, said Erin Singleton, chief of mission delivery for the Patient Advocate Foundation, which assists people with chronic conditions. You can ask whether a discount can be applied, or whether the hospital has funds available for patients with a financial hardship.

Often, people are embarrassed to talk to professionals about discounting their bills, said Martin B. Rosen, a co-founder of Health Advocate, which helps patients with employer-based coverage. But, he said, “There’s no harm in asking” — just be polite.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Republicans Proposed Plan to Replace The ACA

The Washington Times reports that the list of Republican plans “to deal with the potential fallout” from King v. Burwell “is growing longer, although Republicans have yet to coalesce around a game plan with just six weeks before the court is expected to rule.” Rep. Tom Price (R-GA) unveiled a “revamped version” of his ACA replacement bill last week. The proposal would repeal the health law in its entirety and offer tax credits to people to purchase insurance on their own. Another plan, from Sen. Bill Cassidy (R-LA), would allow states three ways to respond to a Supreme Court ruling against the ACA’s subsidies: “States could set up exchanges under Obamacare, do nothing and lose federal support or – and this is what the senator wants – opt into a third path titled the Patient Freedom Act.”

The Hill reported in a similar article that Republican lawmakers “are all over the map about what to do about the millions of people who could lose” subsidies if the Supreme Court rules against the ACA next month. Although Republicans agree that “they need a plan if the high court strikes down a subsidies next month,” they do “not agree about how to help people who’d lose access to healthcare – and even whether to help them at all.” Currently, “there are more than half a dozen plans floating around, with varying degrees of details.”

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

What Don Draper taught us about the Modern Man

Don Draper is the ultimate 1960s ad man from AMC’s Mad Men, which came to end today.  Don is a man with perfect style. He is supremely confident, cool under pressure, and admired by everyone for his creative genius and ability to close a deal.

Don’s ambition and drive overcame a traumatic childhood and a less than honorable tour of Korea with the US Army. At the height of Don’s success he had everything – a beautiful wife and children, a Manhattan apartment and the ultimate job, a successful leader of his own agency and a legend of his industry.  Don was a perfectionist, which seemed to be driven more by what he thought other people expected of him than his own priorities. With that, people came to expect perfection from Don. He was “the man.”

Don, however, was also a man whose emotions were in lockdown, as he obsessed with being successful and in control. As seen in the show’s opening credits, after his success came his spiraling downfall, triggered by a series of events: the loss of his second marriage to Megan, a daughter who disowned him, the decline of his agency, and eventually, the loss of his job.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary