Tag Archives: health insurance exchange

NY exchange scores F’s on some consumer features

The New York State of Health exchange lacks many of the features that other public Obamacare marketplaces, including Healthcare.gov, have added to make it easier for users to compare plans, according to a report released Tuesday by the Clear Choices Campaign, an advocacy group that seeks greater transparency in health care quality and pricing. Rather than just allowing users to compare premiums, for instance, some exchanges include tools that let users calculate their out-of-pocket costs and search for plans that cover their preferred drugs and providers. The scorecard accompanying the report gave New York an F in several categories. Although the pending repeal of the Affordable Care Act introduces uncertainty into the future of the Obamacare exchanges, a less standardized health insurance marketplace could increase the need for such comparison-shopping tools, said Joel White, president of the Clear Choices Campaign. White is also founder and president of the health care lobbying firm Horizon Government Affairs.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Senate Takes Major Step Toward Repealing Health Care Law

WASHINGTON — Senate Republicans took their first major step toward repealing the Affordable Care Act on Thursday, approving a budget blueprint that would allow them to gut the health care law without the threat of a Democratic filibuster.

The vote was 51 to 48. During the roll call, Democrats staged a highly unusual protest on the Senate floor to express their dismay and anger at the prospect that millions of Americans could lose health insurance coverage.

One by one, Democrats rose to voice their objections. Senator Maria Cantwell of Washington said that Republicans were “stealing health care from Americans.” Senator Ron Wyden of Oregon said he was voting no “because health care should not just be for the healthy and wealthy.”

The presiding officer, Senator Cory Gardner, Republican of Colorado, repeatedly banged his gavel and said the Democrats were out of order because “debate is not allowed during a vote.”

The final vote, which ended just before 1:30 a.m., followed a marathon session in which senators took back-to-back roll call votes on numerous amendments, an arduous exercise known as a vote-a-rama.

The approval of the budget blueprint, coming even before President-elect Donald J. Trump is inaugurated, shows the speed with which Republican leaders are moving to fulfill their promise to repeal President Obama’s signature domestic policy achievement — a goal they believe can now be accomplished after Mr. Trump’s election.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Failed Co-ops Add Ammunition to G.O.P. War on Health Law

New York is not alone in failed co-ops.

Washington — The financial failure of more than half the nonprofit health insurance companies created under the Affordable Care Act has handed Republicans a new weapon in their campaign against the health law, thrown the Obama administration on the defensive once again and left more than a half-million consumers in the cold.

“Any start-up faces the inherent risks of building a business from the ground up,” Dr. Mandy Cohen, the chief operating officer at the Centers for Medicare and Medicaid Services, told Congress on Tuesday at a contentious hearing of the House Ways and Means Subcommittee on Health. “As with any new set of business ventures, some co-ops have succeeded while others have encountered more challenges.”

So far, 12 of the 23 nonprofit insurance plans created as a result of President Obama’s signature domestic achievement have announced — voluntarily or under pressure from federal and state regulators — that they will not offer coverage next year. The most recent announcement came on Tuesday, just hours before the House hearing, when Consumers Mutual Insurance of Michigan posted a notice on its website saying it will not sell health plans in 2016 on the insurance marketplace.

New Yorkers were dismayed to receive notices over the weekend saying insurance policies from their co-op, Health Republic Insurance of New York, “will not be available after Nov. 30.” With more than 155,000 members, the New York insurer was the largest of the co-ops.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Supreme Court Rules in Favor of Obama Administration

The Supreme Court ruled in favor of the Obama Administration in the controversial King vs. Burwell court case.  The 6-3 decision confirms that the Affordable Care Act allows for tax subsidies to flow through both state-based marketplaces as well as the federally organized health insurance exchange.  While the political implications are significant, this ruling should have little impact on business as usual.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

 

NY health plans seek average 13.5% hike for 2016

Get ready to pay more for health care next year.

The battle over setting next year’s health insurance premiums in New York is underway after proposals seeking double-digit rate increases on average were submitted to state regulators.

Proposed rate adjustments vary widely, with an average increase of about 13.5 percent. While some health plans seek up to 30 percent rate increases, others have presented slight decreases, state records filed this month show.

Health insurance premium rates in 2016 for individual and small group plans — as opposed to larger employer-sponsored coverage plans — will ultimately be set by the state Department of Financial Services under the prior-approval process, which essentially gives the agency authority to approve or reduce the rates requested.

To read more, 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.

To read more, click here:

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

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

Nutrition: The Simple Rule for Eating

Over the past few months, I’ve written a number of times on how nutrition recommendations are seldom supported by science. I’ve argued that what many people are telling you may be inaccurate. In response, many of you have asked me what nutrition recommendations should say.

It’s much easier, unfortunately, to tell you what not to do. But here at The Upshot, we don’t avoid the hard questions. So I’m going to put myself on the line. Below are the general rules I live by. They’re the ones I share with patients, with friends and with family. They’re the ones I support as a pediatrician and a health services researcher. But I acknowledge up front that they may apply only to healthy people without metabolic disorders (me, for instance, as far as I know).

These suggestions are also not supported by the scientific weight of rigorous randomized controlled trials, because little in nutrition is. I’ve inserted links to back them up with the available evidence. They are not “laws” and should not be treated as such. No specific nutrients will be demonized, and none will be held up as miracles. But these recommendations make sense to me, and they’ve helped me immensely.

Full disclosure: I did not invent most of these. I’ve developed them from reading the work of others, including what may be the most impressive “official” nutritional guidelines, those of Brazil, as well as from earlier suggestions from readers, as in this great NYT interactive graphic. It captures readers’ responses to food rules by Michael Pollan. He is, of course, the promulgator of the well-known advice: “Eat food. Not too much. Mostly plants.”

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary