07 Aug 2017

Several US Governors Plead With Trump To Make Insurance Payments

Several US Governors Plead With Trump To Make Insurance Payments

There’s a new saga unfolding on Capitol Hill this week, as several politicians have engaged in a new dispute regarding health care. Democratic and Republican governors have started to plead with the President’s administration, as he withholds critical payments to the insurance industry. The payments are worth nearly $8 billion and are vital because they partially subsidize Obamacare plans for low-income Americans.

Trump despises Obamacare

In case you’ve been living under a rock for the last few years, it’s no secret that Donald Trump absolutely despises the Affordable Care Act. He’s made it his mission to dismantle and replace the bill but over the last few months, this has proven to be more challenging than previously thought. Trump and the ruling Republicans in Congress have tried and failed several times to pass a repeal-and-replace bill. This is due to the fact it’s difficult to achieve a consensus on the subject matter and even within the Republican party, there’s a massive schism.

If you can remember, we published an article last week detailing how the Senate began a continuous debate in order to achieve some sort of progress regarding the status of Obamacare.

There were three viable options on the table:

  • A partial repeal, keeping key aspects of the Affordable Care Act while replacing unpopular provisions
  • A complete repeal, meaning they would scrap everything
  • A repeal-and-replace strategy, which would involve drafting a new version of the BCRA, which would be approved by the Senate

The debate ended in a dramatic late-night vote where Sen. John McCain tipped the scales and voted down a partial repeal after the Senate debated and rejected the other two options. So, basically everything on the table was chucked out the door and they achieved nothing.

But what are CSRs?

This leads our conversation to the subject of federal funding. In order for Obamacare plans to be affordable, the federal government sends payments to insurance companies, which collectively reduce the monthly premiums for low-income Americans. The specific name for them is called cost-sharing reduction payments, and the federal government is seemingly withholding nearly $8 billion, creating an atmosphere of uncertainty and panic.

This is why several governors from both political parties have begun to plead with the Trump administration to facilitate these payments. In a statement provided by the Health and Human Services Committee of the National Governors Association, the government “has the opportunity to stabilize the health insurance market across our nation and ensure that our residents can continue to access affordable health care coverage.”

What does this mean for Americans?

Insurance companies are currently finalizing the premiums for 2018 and if they don’t receive these cost-sharing reduction payments, prices will likely rise. This would negatively impact low-income Americans who rely heavily on Obamacare plans due to the affordability factor. This in turn may force hundreds of thousands of individuals to switch over to Medicaid. This program is also in a state of limbo as many politicians have voiced their desire to reduce funding towards this vital lifeline.

This dysfunction has created a lot of anxiety in the hearts of Americans, but it’s important to remain calm and remain up-to-date with all this information. You can always rely on HealthQuoteInfo for trustworthy information and can speak to one of our agents if you have any remaining questions regarding this subject. Give us a call today at 855-614-5057.

 

03 Aug 2017

What Makes Covering Maternity Care So Unique?

What Makes Covering Maternity Care So Unique?

American women are more likely to die while giving birth than other women in any other developed country.  Further statistics are even more unnerving. American women die in pregnancy twice as often as Canadian women.. And, the United States is one of the very few countries, including North Korea and Zimbabwe, where the childbirth mortality rate has increased since 1990.

Why?

Access to quality healthcare is one major reason. Many poor American women can’t get it and they are the ones who need it the most. Such is not the case in many other countries, where health care is universal. Many pregnancies are unplanned, as many young girls and women are limited in their access to birth control and/or are unable to take care of a chronic health problem prior to their pregnancy.

There was a time when this country cared about its pregnant women. Nearly a century ago, in 1935, the government sponsored the Maternal and Child Health Services Block Grant Program, which strived to improve the health of women and children by affording access to prenatal and postnatal medical care. For the past thirty years, Medicaid covers pregnant women. And, the Children’s Health Insurance Program (CHIP) offers inexpensive medical services to expectant women.

This is an important distinction because it is a reminder that the intent of the coverage is to improve health outcomes for children.

The Affordable Care Act

The Affordable Care Act (ACA) or Obamacare, however, which lawmakers passed in March 2010, mandated all individual market health insurance plans to insure maternity care and newborns, as well as other essential health benefits.

If the ACA mandated maternity care, why are so many poor women still having difficulty accessing health care?

One of the ACA’s key coverage requirements is the expansion of Medicaid’s eligibility to low-income people. The expansion was supposed to be national, but a June 2012 Supreme Court ruling allowed the states to accept or reject it. As of April 2017, nineteen states had not expanded their programs, thereby leaving many adults and children ineligible.

Maternity Mandate

Many claim that the ACA requires more public funding for women and maternity related benefits and some argue that it’s unreasonable to men and women who do not plan on becoming pregnant. Are they correct? Is maternity care different?

Pregnancy

When an expectant woman receives proper medical care, she safeguards her baby’s health both before and after it’s born. That’s a given.

Proper prenatal care also safeguards a pregnant women’s health both before and after her pregnancy.  It looks out for remediable conditions such as gestational diabetes, post-partum depression, infection, ectopic pregnancies. The last two of which can be deadly.

Without Coverage

If a woman doesn’t not have health insurance when she’s pregnant, she may skip prenatal and postnatal care, which pinpoints possible problems for which her physician could help.

The world without proper maternity care would be scary. Less than ten years ago, there were no maternity or day care laws or regulations. In the individual insurance market, women in three-quarters of the states were often unable to find or afford maternity coverage.

Current Administration

Just a few days earlier, in July 2017, Republican lawmakers tried one more time to overturn the ACA.  Fortunately, they failed.  Hopefully, this will end their quest, but who knows. In addition, they agree with those who argue that the pregnancy mandate isn’t just and, like the ACA, would have allowed states to reject it. The pregnancy mandate remains vulnerable.

Current Situation

In many states, the only way to secure maternity coverage is by purchasing a rider as a supplement to a health insurance plan. Costs vary but generally can be in the thousands, sometimes more than the base premium.

What if the Pregnancy Mandate is Overturned

Should the pregnancy mandate ever be removed, what could a woman do? One alternative is to purchase a rider. A rider is additional insurance. The Congressional Budget Office (CBO) figured that they would cost more than $1,000. The CBO additionally estimated that the total cost of a pregnancy is $17,000 for women for women covered by private insurance. Without insurance, that number would double. And, if women had a C-section or later-term miscarriage. Without coverage, a woman could be in serious debt.

Since the ACA, there’s at least a path toward providing maternal care. Lawmakers have to fix it, not overturn it.  Recent decisions show promise, but, with the current administration, there will always be concern. We were headed in the right direction and now we stand in the right direction.  Abolishing the maternal mandate would threaten women’s lives and place families in financial hardship.

03 Aug 2017

Average individual health insurance premiums by state

Average individual health insurance premiums by state

The average cost of health insurance varies by state, just as it varies between insurance companies and the kind of policy coverage you want. There are many changes that are currently being made in the health insurance structure of the United States, many of which could affect how many people are able to find affordable health care coverage.

The cost of health care has changed over the years as the industry has evolved. The population of the United States is aging, which means the health insurance industry must create insurance policies that meet the needs and the budget of America’s elderly residents. Likewise, younger residents of the country are also looking for affordable health policies that they can use to protect themselves and their growing families.

State health insurance premiums

The cost of this care is perhaps the most prohibitive factor for people deciding if they can have insurance or not. Under the Affordable Care Act, or Obamacare, individuals must have health insurance or pay a penalty for not having the protection during the year. Obamacare has been widely criticized, although there has not been a suitable alternative offered to the American public so far.

There are a few factors that influence how much a health insurance plan costs. One of these factors is your location; local insurance companies compete on a local market where they can cater their policies to the people in their area. National insurance companies can influence local insurance policy prices and sales, but they can also work to destabilize the overall insurance industry by decreasing their policy offerings that are available as part of the state and federal health insurance marketplaces.

Health insurance policy premiums can also be affected by your age, pre-existing conditions you may have, whether or not you have insurance through your employer, or if you qualify for federal programs like Medicare or Medicaid. Each state has different health insurance subsidies that they offer, and some states are changing how their insurance options are structured in order to give their residents more affordable options that aren’t necessarily tied to the federal insurance structure.

State premium averages

Currently, insurance premiums and costs are based primarily on age and location because of how the insurance marketplace has been put together under the Affordable Care Act. Typically, older residents of the United States will pay more for their coverage. This is because there are more health issues that can crop up as people get older. On average, 30-year olds will pay 1.2 times more than 21-year olds will for their insurance policies; 40-year olds will pay 1.3 times more; 50-year olds will pay 1.8 times more than 21-year olds, and people aged 64-years and older will pay 3 times as much for insurance as a 21-year old would.

The second biggest factor regarding how much you may end up paying for your coverage is based on your location. Here is a breakdown of how much a 21-year old pays on average for their health insurance policy in the United States per month:

Alaska: $426
Alabama: $217
Arkansas: $236
Arizona: $247
Delaware: $255
Florida: $285
Georgia: $253
Iowa: $251
Illinois: $244
Indiana: $276
Kansas: $196
Louisiana: $284
Maine: $271
Michigan: $251
Missouri: $254
Mississippi: $234
Montana: $210
North Carolina: $270
North Dakota: $242
Nebraska: $243
New Hampshire: $246
New Jersey: $307
New Mexico: $211
Nevada: $279
Ohio: $258
Oklahoma: $209
Oregon: $206
Pennsylvania: $231
South Carolina: $249
South Dakota: $235
Tennessee: $225
Texas: $239
Utah: $180
Virginia: $222
Wisconsin: $280
West Virginia: $242
Wyoming: $366

The Healthcare Marketplace

There are different tiers of health insurance coverage that can be purchased through both state and federal health insurance marketplaces. These tiers range from catastrophic insurance, the cheapest level, and then move up from bronze to silver, gold to platinum. The lesser tiers tend to have higher deductibles, cover less, and have higher co-pays and coinsurance. Rates depend on what tier you purchase, what you want your deductibles and other costs to be, and how much overall coverage you need in a plan.

Prices for catastrophic health insurance for a 21-year old is about $197 per month, while the bronze to platinum tiers range from $200 to over $300. Of course, these rates can increase based on where you live, how old you are, if you have other insurance options, and whether or not you have pre-existing health issues. The average prices of health care insurance will continue to change as states take the reins on their own programs and as the federal government continues with their great insurance debate.

03 Aug 2017

What is “subrogation” in health insurance?

What is “subrogation” in health insurance?

If you have ever been accidentally injured, you may have noticed that your health insurer asked you questions regarding the circumstances of the incident. The odds are good that they were trying to determine whether someone else was responsible for causing the injury or the damages to you.

They must determine if the accident was your fault and how much they should raise your premiums, if necessary. However, the insurer also needs to know whether they can sue the other party on your behalf.

That’s right, if someone else is at fault for the injury or the damages your insurer has to cover, said insurer can in most cases sue the party at fault to recoup the losses. This is known as the insurer’s “right of subrogation.” Subrogation allows one entity to enforce the rights of another for its own benefit. By pursuing subrogation, insurers effectively assume your place in court: they possess the same legal rights as you would have and any legal defenses that could be used against you can also be used against them. Insurers may not ask for an amount greater than the one they paid to cover your expenses. Even though subrogation most often comes into play within the auto insurance sector and the health care insurance sector, it also comes up within real estate insurance, liability insurance, and other types of insurance.

The existence of subrogation is of great benefit not only to insurers, but also to the insured. Indeed, it allows insurers to keep policy costs at a reasonable level by providing them with some protection against accidents caused by a third party. Additionally, if the insurer is successful in suing the other party, they are required to reimburse any deductible you paid. The insurance company will notify you that they are pursuing subrogation, but the process occurs almost entirely between the insurer and the party responsible for the damages. As the injured party, you have little involvement in it.

Some contractual agreements with the party responsible for the damages may require you to sign a waiver of subrogation, which surrenders your insurance company’s right to sue said party for damages. Keep in mind that many insurance policies will not allow you to sign such a waiver, and if you do so anyway, the insurance company may refuse to pay your claim. And since waivers of subrogation also surrender your right to sue the other party for damages, it may be a good idea to consult an attorney before signing such a document.

Subrogation is just one of the many ways health insurance can make your life easier. To find health insurance that really fits your household’s needs at an affordable price point, visit HealthQuoteInfo.

28 Jul 2017

Breaking News: The Senate Rejects A Bill To Repeal Obamacare

Breaking News: The Senate Rejects A Bill To Repeal Obamacare

The mood is tense on Capitol Hill today as the Senate just voted to officially scrap an Obamacare repeal bill. This officially ends a seven-year vendetta against Barack Obama’s health care reform, and comes as a huge blow to President Donald Trump.

Keep in mind the President had previously campaigned heavily on a promise to officially repeal-and-replace the Affordable Care Act. Many Trump supporters will be upset with the news, as it’s now impossible to fulfill this promise. It’s also a massive defeat for the Republican Party, as it’s clear they cannot function as a cohesive unit to achieve anything remotely concrete.

The details are still developing, but here’s what we know so far:

As we reported earlier in the week, the Senate voted to begin a continuous debate regarding health care reform in this country. The reason behind this is due to the fact the Republicans tried to pass a bill called the Better Care Reconciliation Act (BCRA), which was scrapped because several senators refused to support it. So as a result, there’s a lot of pressure in the nation’s capital to come up with an alternative.

If you can remember, there were three viable options that could emerge from this lengthy debate.

  • A partial repeal, keeping key aspects of the Affordable Care Act while replacing unpopular provisions
  • A complete repeal, meaning they would scrap everything
  • A repeal-and-replace strategy, which would involve drafting a new version of the BCRA, which would be approved by the Senate

On Wednesday, it appeared the Senate was leaning more towards option number two, a complete repeal bill without a possibility to replace Obamacare. Although, support quickly waned and as the week progressed, things were steering more towards a ‘skinny repeal,’ as the media coined it.

This would entail keeping the bulk of the Affordable Care Act, but just trim off certain aspects the Republicans didn’t like. But if we fast-forward to 2 am on Friday morning and some drama was stirring in the shadows.

Senators were voting to enact this ‘skinny repeal’ as a last ditch effort to achieve some sort of progress. The vote was essentially tied, and the entire roster of Democrats had voted against it.

Two senior Republicans named Susan Collins (of Maine) and Lisa Murkowski (of Alaska) voted against the bill, expressing their skepticism towards this watered-down version and the uncertain ramifications on the American people. However, the pivotal deciding factor came as Senator John McCain (of Arizona) shocked the entire chamber by voting down the bill and therefore ending the tiebreaker.

McCain was just diagnosed with brain cancer last week and had been the target of several malicious Twitter attacks by the President in the past, which included ridiculing his decorated military career and questioning his decision-making capabilities.

What does this mean for Americans? Well, essentially the Affordable Care Act remains intact, so the general population can reap the benefits for the next few years. For example, this means it’s still illegal for insurance companies to discriminate based on your previous medical conditions and your age.

There’s also some good news for individuals and families who rely on Medicaid, which provides health coverage to those who fall into a low-income bracket. The program will continue to receive funding from the federal government, meaning millions of impoverished Americans will continue to get access to clinics, hospitals, and dentists.

Politically, this is a disaster for Donald Trump’s presidency and the Republican Party, as they’ve failed to achieve anything substantial within the first six months of power.

For all the latest health insurance news, consult HealthQuoteInfo and give us as call today at 855-614-5057 if you’re looking to purchase a plan in the near future.

28 Jul 2017

5 State Single Payer and Medicaid Buy-In

5 State Single Payer and Medicaid Buy-In

There have been many changes in the United States over the last few months and years about the health insurance structure that is currently in place. The Affordable Care Act, or Obamacare, is the current incarnation of a health insurance industry that has grown and evolved to meet the needs of the American people, generation after generation.
Although the Affordable Care Act has its downfalls, there is currently no suitable alternative being presented to stabilize or improve the health insurance industry in the United States. Individual states are taking matters into their own hands in order to secure their own insurance markets and provide viable health insurance options for their residents. Some large health insurance companies are reducing their policy options available as part of the health insurance marketplace set up under Obamacare, an action that ultimately reduces the number of affordable health insurance plans aimed towards individuals and families who were previously uninsured before Obamacare.
Single Payer Health Insurance
Some states are beginning to take action to prop up their own health insurance marketplaces. Each state has a health insurance marketplace that offers localized health insurance options for residents. Many of the marketplaces allow residents to apply for governmental health insurance subsidies or programs like Medicaid, which helps low-income residents afford a suitable health insurance plan. Unfortunately, changes to the existing federal health insurance structure may result in a lack of funding for these federal programs, leaving individuals and families across the country uninsured.
State single payer health insurance means that instead of having a health insurance marketplace with multiple companies offering competing health insurance plans, one overarching health insurance plan would be available to everyone. This single payer health insurance would eliminate Medicare, Medicaid, employer health insurance, and other current categories of health insurance in order to provide every resident of a state with free health care. Using money from the state budget and federally funded health insurance programs, states like California and New York are attempting to push through legislation that would enact a single payer structure in their states.
Of course, changes to the health insurance structure would take many years, even if the legislation being put forth in California, New York, and Nevada are accepted without changes. There will likely be a few years of struggle while the bill is being passed through the state legislature and is amended for the approval of the majority.
Medicaid Buy-In
Nevada is trying to put forward a health insurance structure that is different from the plans in California and New York. This health insurance restructuring would keep federal health insurance programs like Medicare in place, but would offer more people an affordable health care option under a similar program like Medicaid. Medicaid wouldn’t be offered to everyone, as some people would qualify for their employer’s insurance, other private insurance plans, and Medicare, but it would allow more people to purchase a health insurance plan that is equivalent to Medicaid in what it covers and how much it costs.
The states that are individually trying to change their health insurance structure, be it through a single payer system or Medicaid buy-in, will likely not see these changes for years to come. However, it is important that there is work being done to move towards a more stable and affordable health insurance system in the United States so that residents can benefit from reliable health insurance option for themselves and their families.
Health Insurance Options
Premiums are rising, plan options are few, and many states are struggling to provide their residents with affordable health care options that meet their health and budget needs. The health insurance industry is changing, but states are beginning to come around to the idea that they need to influence the health insurance industry without relying on the federal government for as much help as they were expecting.
States like California, New York, and Nevada are pioneering legislation that would change how their health insurance marketplaces are managed, while Alaska and Oklahoma have already created programs that have stabilized their insurance industries and given residents access to affordable, reliable health care options. There have been successes in health insurance reform from states in the past, just as there have been failures. Some states may choose to implement some aspects of a single payer system, while others may repeal their efforts altogether. Only time will tell how the health insurance industry in the United States will change to meet the needs of its residents.