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September 19, 2007

Governors Push for Insurance Change

California Gov. Arnold Schwarzenegger lobbied the Bush administration Monday to roll back rule changes that limited the scope of a popular children's health insurance program.

In a letter to Health and Human Services Secretary Michael Leavitt, the governors said 28 other governors had joined their effort to pressure the administration to reconsider changes to the State Children's Health Insurance Program.

"The requirements amount to a unilateral restriction on state authority to provide health insurance coverage for children and undermine the foundation of the state-federal partnership upon which SCHIP was built," Spitzer and Schwarzenegger wrote to Leavitt.

Under the program, the federal government and the states subsidize the cost of health coverage.

The new guidelines, issued in August, are designed to keep families from dropping private health insurance in exchange for cheaper or better coverage through public programs.

Under the new guidelines, when a state expands eligibility to higher-income children, it has to show it has enrolled at least 95 percent of eligible poor children in public health programs.

Democratic lawmakers and governors from both parties have said the rules are misguided and will result in more uninsured children. The administration says the rules will refocus the program on the low-income people it was intended to serve.

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Posted by healthinsurance at 04:26 PM | Comments (0)

September 16, 2007

Health Insurance Premiums Vault Past Inflation

Health insurance premiums rose 6.1 percent this year — the lowest rate of increase since 1999 — but that fact offered little solace to employers and workers, who have seen overall premium increases rise far faster than wages or inflation during that same period.

The average cost of a family plan purchased by employers this year hit a new high, $12,106, according to a detailed annual survey of nearly 2,000 employers by the non-partisan Kaiser Family Foundation, a research group based in Menlo Park, Calif. Individual coverage premiums averaged $4,479.

“Health insurance is becoming increasingly unaffordable for many employers and working people in the country,” says Drew Altman, president of the foundation. “We’re seeing this more and more every year.”

While the percentage of the premiums paid by workers stayed about the same as last year, the dollar amount paid by workers toward their share of family coverage rose $308 to $3,281. Single employees paid an average of $694 toward their coverage, up $67.

The 6.1 percent increase in premiums was more than twice the annual rate of inflation in July of 2.4 percent.

Sharing The Pain

Premiums are just one part of the cost. Many workers also have annual deductibles they must meet before coverage kicks in. Those ranged from an average of $401 for individual workers in HMO-type plans to $1,729 in high-deductible plans.

Increasing those deductibles helped some employers keep costs down.

At Econ-O-Line Abrasive Products, a 23-employee shop that manufactures sandblasting equipment, owner Dan DePottey says his premium increases have averaged less than 5 percent in both of the past two years. During that time, the firm went from a zero-deductible HMO plan to one with a $1,000 deductible. To soften the blow, DePottey told employees they would be on the hook for only $250 of that deductible: The company would pick up the rest. So far, not very many of his workers have needed to take him up on the offer.

“I actually got lower costs this year than last,” says DePottey. His total health insurance premium bill fell from $147,000 last year to $141,000.

The number enrolled in high-deductible policies, which are often coupled with special tax-free savings accounts, did not increase in a statistically significant way, the survey found. Such plans cover about 5 percent of insured workers, or about 3.8 million people, up from 4 percent in 2006. Premiums are generally lower for such plans.

At The Community Builders, a non-profit company based in Boston that builds affordable housing, few workers signed up for a newly offered high-deductible plan, says Judy Lauch, who oversees benefits for the 500-worker firm.

The plan, with a $1,000 deductible for individuals and $2,000 for families, was offered to counter a steadily rising cost of the more traditional coverage.

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Posted by healthinsurance at 01:32 AM | Comments (0)

September 10, 2007

Employers Scrutinize Health Insurance Eligibility

If you're one of the millions of Americans who receives your health insurance through your employer, you would be wise to read the small print before signing up family members for coverage this enrollment season.

And if you've signed up your girlfriend as your "spouse," now's the time to cut her coverage.

Faced with rising medical costs, U.S. employers are starting to scrutinize the eligibility of dependents, such as spouses and children, who are covered under their health plans. Traditionally, employers relied on an honor system to manage enrollment. But now, in an effort to restrain rising health spending, a growing number of employers are requiring employees to provide documented proof.

Workers should be prepared to dig out copies of birth and marriage certificates, root around for tax returns and obtain a letter from their child's college. Employees who fail to provide supporting documents when asked risk losing health coverage for their loved ones and, in rare cases, their jobs -- if they knowingly seek coverage for family members they know to be ineligible. In cases of clear fraud, an employer may also seek to recoup plan-paid medical and prescription costs.

Large auto makers such as General Motors Corp., Ford Motor Co. and Chrysler LLC have dropped tens of thousands of ineligible dependents from their health plans by using audits. Now banks, hospitals and hotel chains -- where staff turnover can be high and benefits a major attraction of the job -- are following suit.

"It's an issue that's top of mind for employers," says Susan Johnson, a senior consultant at Watson Wyatt Worldwide in Chicago who oversees audits carried out by the consulting firm.

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Posted by healthinsurance at 10:56 PM | Comments (0)

September 09, 2007

U.S. eyes California’s universal health care plan

The prognosis for universal health care in California is grim this year, and experts say a failure could set back similar efforts nationwide for years to come.

Unions, doctors and other powerful interests are arrayed against Gov. Arnold Schwarzenegger's $12 billion-a-year plan to make medical insurance mandatory. He has threatened to veto the Democrats' less ambitious alternative and take his plan to the ballot instead.

A showdown could come as early as Thursday, when the Democrats plan to put Schwarzenegger's proposal to a vote in the state Assembly. The aim is to show how little support it hasA record 6.8 million Californians, nearly 1 in 5 of the state's residents, went without health insurance at some time during 2006, according to figures released Tuesday by the U.S. Census Bureau.

Nationally, a record 47 million Americans, including 8.7 million children, lacked health coverage, the report said.

With the campaign for the White House under way, what happens in America's most populous state could have especially wide repercussions.

"If we fail, it will have the effect of a wet blanket on health reform nationally," said Robert Ross, president of the California Endowment, a foundation devoted to health care. "I think the presidential candidates will all look with a very watchful eye at what happens in California."

Following the lead of Massachusetts, which passed universal health care last year, Schwarzenegger announced his own plan last January to provide health insurance to all California residents.

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Posted by healthinsurance at 04:57 PM | Comments (0)

September 06, 2007

California Measure To End Retroactive Cancellations Of Health Plans

The California Department of Managed Health Care on Tuesday said new rules to prevent HMOs from retroactively canceling individual policyholders' coverage are taking longer than expected to draw up because of the variety of plans involved, the Los Angeles Times reports. In January, the agency, which regulates California HMOs, said it would introduce in the spring regulations to stop the practice of HMOs retroactively canceling coverage because of a failure to disclose pre-existing medical conditions.

DMHC spokesperson Lynne Randolph said the delay in issuing the new rules is a result of the time required to survey the plans to make sure the rules fit them all. "These regulations need to get out in a timely way, but we also feel that consumers deserve to have regulations that will be able to be quickly adopted so that thousands of people who are now being denied health insurance or are afraid of obtaining health insurance because of possible rescission can get relief," Randolph said.

A survey of Blue Cross of California was the first to be completed in March, but the company is disputing the findings, as well as the department's decision that the HMO routinely violated state law by rescinding policies. Surveys of other plans are ongoing.

Proposed rules could take up to a year to be made public and then approved, revised or discarded. Randolph said rescission regulations would be sought even if Gov. Arnold Schwarzenegger's (R) health reform proposal is approved because major changes to the state's health care system would take a long time to implement and could face legal hurdles. Schwarzenegger's (R) plan would require that insurance be sold to all residents, regardless of medical history.

Jerry Flanagan of the Foundation for Taxpayer and Consumer Rights on Tuesday in a letter to DMHC criticized the delay, writing, "Patients cannot afford for you to allow another company's rescission policy to leave more Californians uninsured, uninsurable and facing unpayable medical bills."

Chris Ohman, executive director of the California Association of Health Plans, said the state's efforts to pursue the regulations are "kind of silly," adding, "Let's focus on issues that are going to be relevant to health care reform" (Girion, Los Angeles Times, 8/29).

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Posted by healthinsurance at 02:18 PM | Comments (0)

September 04, 2007

Health insurance debate: 47 million Americans at risk?

Thanks to a combination of laziness, incompetence with numbers and (especially) ideological crusading, we are in the middle of a stretch of the most pervasive and dishonest bad journalism I have ever seen in the United States. I refer to the stories which assert that 47 million Americans (or 6.8 million Californians) are without health insurance.

No, they're not.

At some point over the past 12 months, an estimated 47 million people in this country and 6.8 million people in California have been without health insurance. At any single point in time, the number of people without health insurance has been estimated at 5 million for California. I haven't seen a national figure, but if the California ratio works nationally, that would mean about 34.5 million people are without health insurance at this moment.

Are they all Americans? Do you consider illegal immigrants and resident aliens to be Americans? There are some people out there who will see this as racist. There are more people who will see this as common sense.

Page 29 of this Census Bureau report shows that 10.2 million of the 47 million people who at some point within the past year didn't have health insurance are noncitizens.

OK, so we're down to 36.8 million Americans who at some point within the past year didn't have health insurance. The snapshot in time number, if the California ratio held up: 27 million Americans are, at this moment, without health insurance.

Sure seems less scary than 47 million Americans, huh?

But let's take it further. According to the research of one of the biggest advocates of expanding health coverage in the nation -- the Henry Kaiser Family Foundation -- 19 percent of the uninsured have family incomes more than triple the federal poverty level but choose for their own reasons to go without health insurance.

19 percent of 27 million is 5.13 million.

The Kaiser research also documents that 25 percent of the uninsured are eligible for Medicaid or the State Children's Health Insurance Program but do not sign up. This is the single part of the health insurance debate that drives me most bonkers. A gigantic hunk of the problem is oblivious individuals -- and irresponsible parents. How often do you hear about this? Never.

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Posted by healthinsurance at 12:05 PM | Comments (0)