Tag Archives: Why is Health Insurance Going Up

Even Insured Can Face Crushing Medical Debt, Study Finds

Here is the surest way to enjoy the peace of mind that comes with having health insurance: Don’t get sick.

The number of uninsured Americans has fallen by an estimated 15 million since 2013, thanks largely to the Affordable Care Act. But a new survey, the first detailed study of Americans struggling with medical bills, shows that insurance often fails as a safety net. Health plans often require hundreds or thousands of dollars in out-of-pocket payments — sums that can create a cascade of financial troubles for the many households living paycheck to paycheck.

Carrie Cota learned the hard way that health insurance does not guarantee financial security. Ms. Cota, a 56-year-old travel agent from Rosamond, Calif., learned she had the autoimmune disease lupus in 2007. She ran up thousands of dollars in medical and dental bills and ended up losing her job, and eventually her house.

“I had to move in temporarily with my ex-husband,” she said in a recent interview. “I’m staying with him until I can figure out what to do.”

In the new poll, conducted by The New York Times and the Kaiser Family Foundation, roughly 20 percent of people under age 65 with health insurance nonetheless reported having problems paying their medical bills over the last year. By comparison, 53 percent of people without insurance said the same.

These financial vulnerabilities reflect the high costs of health care in the United States, the most expensive place in the world to get sick. They also highlight a substantial shift in the nature of health insurance. Since the late 1990s, insurance plans have begun asking their customers to pay an increasingly greater share of their bills out of pocket though rising deductibles and co-payments. The Affordable Care Act, signed by President Obama in 2010, protected many Americans from very high health costs by requiring insurance plans to be more comprehensive, but at the same time it allowed or even encouraged increases in deductibles.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Companies continue chipping away at health insurance benefits

Companies’ health care costs in 2015 rose at the lowest rate in at least 20 years, a report out Thursday shows, but workers’ share of costs continue to skyrocket.

The average health care rate increase for mid-sized and large companies was 3.2% this year, the lowest since the consulting firm Aon started tracking it in 1996.  Despite this, the average amount workers have to contribute toward their health care is up more than 134% over the past decade and that trend will accelerate.

“Our clients say, ‘I can’t keep paying more and more of these ever-rising health costs,’ ” says Craig Dolezal, a senior vice president of Aon’s health practice.

Employees on average contributed $2,490 toward premiums and another $2,208 in out-of-pocket costs, such as copayments, coinsurance and deductibles in 2015, the report shows. The amount of employees’ premium and out-of-pocket costs combined was just $2,001 in 2005.

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

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

Health Care Spending Down, Cost Sharing Up

The growth in health care spending is slowing down, and one reason might be that cost sharing is rising.

The proportion of insured workers with at least a $1,000 deductible was 41 percent in 2014, quadruple that in 2006. Hidden in the numbers is the fact that increasing cost sharing for patients with chronic illnesses can backfire, causing their health care spending to go up, not down.

When patients face higher cost sharing for prescription drugs, they tend to cut back on them. That’s a finding from a recent study from the National Bureau of Economic Research by Peter Huckfeldt and colleagues, who examined employer-based health plan enrollees who use drugs to treat high cholesterol, hypertension and diabetes. They even found that patients cut their drug use when drugs were exempt from the deductible. Perhaps they did so because they did not understand the drugs had no deductible. They may also have cut back on visiting the doctor to get a prescription because the visits were subject to the deductible.

These kinds of cuts in care can be especially problematic for patients with more severe illnesses. A number of studies document the adverse effects of cost sharing on sicker patients. When applied indiscriminately, cost sharing can hurt the sicker patients by prompting them to delay or avoid the preventive care they need. A 2012 study showed that higher cost sharing reduces spending on physician visits and drugs, but can increase hospital spending. When Medicare beneficiaries face higher cost sharing, hospitalizations go up, not down, especially for those with chronic illnesses.

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

OSHA Releases New ‘It’s The Law’ Poster

The Occupational Safety and Health Administration (OSHA) has released a new version of its “Job Safety and Health – It’s The Law!” poster.

Background
Under the Occupational Safety and Health Act (OSH Act), employers have certain responsibilities, including the obligation to:

  • Provide their employees with a safe workplace;
  • Follow all relevant safety and health standards;
  • Find and correct safety and health problems in the workplace; and
  • Inform employees about workplace hazards.

Content of New Poster
The newly designed poster informs employers of their legal obligation to provide a safe workplace. It also informs workers of their right to request an OSHA inspection of their workplaces, receive information and training on job hazards, report a work-related injury or illness, and raise safety and health concerns with their employer or OSHA without being retaliated against.

Additionally, the poster has been updated to include the new reporting obligations for employers, who must now report every fatality and every hospitalization, amputation and loss of an eye. It also informs employers of their responsibilities to train all workers in a language and vocabulary they can understand, comply with OSHA standards, and post citations at or near the place of an alleged violation.

Posting and Size Requirements
Employers must display the poster in a conspicuous place where workers can see it. Reproductions or facsimiles of the poster must be at least 8 1/2 by 14 inches with 10 point type. According to OSHA,previous versions of the poster do not need to be replaced.

Note: Employers in states operating OSHA-approved state plans should obtain and post the state’s equivalent poster.

The poster is available by clicking here. Multiple languages and resolutions are available for download.

To learn about other federal notices required to be displayed in the workplace, please visit our section on Federal Poster Requirements.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

ACA Rules for Foster Children

Nathan Cox-Reed has a toothache.

He thinks he needs a root canal, but the full-time student, 22, is uninsured. He can’t afford a trip to the dentist.

“I’m only working 30 hours a week. I wouldn’t have enough money to do something like that,” said Cox-Reed, a film and video student at Columbia College in Chicago.

While many young adults are now covered by the Affordable Care Act, able to remain on their parents’ insurance until age 26, the rules are different for those like Cox-Reed, who grew up in the foster care system.

There are more than 400,000 children in foster care in the United States, the Department of Health and Human Services said last year. All are provided with health care coverage as long as they are wards of the state.

When foster kids turn 18, they age out of the system and instantly lose their coverage.

That’s about to change, when another part of Obamacare takes effect on January 1, 2014. Medicaid coverage will be extended for former foster youth until they reach 26, as long as the individual was in foster care and enrolled in Medicaid until the age of 18.

“I definitely think it would be a big relief, and I would definitely feel more secure as far as my health goes,” Cox-Reed said.

But there’s a catch. Cox-Reed has dreams of traveling across the nation and becoming a filmmaker. A future relocation could jeopardize his medical coverage.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary