Thursday, March 29, 2012

Health Care Reform Mandate In Jeopardy

The initial arguments in the Supreme Court hearings about the individual mandate seem to indicate that the mandate will not be accepted. The general tone of the discussions had the 4 liberal Justices supporting the mandate, and the 4 conservative Justices against the mandate. Judge Clarence Thomas sat quietly and listened to the proceedings but did not ask any questions or make any comments. It is believed that Judge Thomas will not support the mandate, thus giving a 5 to 4 advantage to overturning the mandate.

The next step is to determine if the mandate can be severed from the remainder of the Affordable Care Act, and those discussions are underway.

Stay tuned for more.

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Tuesday, March 27, 2012

Supreme Court Begins Hearing Health Care Reform Arguments

Yesterday the legal boxing began with the first round being about the Anti-Injunction Act (AIA) of 1867 and whether or not the court could actually hear arguments about health care reform mandate if no penalties had been paid yet. The AIA is the basis of all tax collections which says that you have to pay the tax before you can challenge the tax in court. From the sounds of the arguments in hearing yesterday, it appears the AIA is a none issue for the rest of the week's health care reform arguments.

Today the Supreme Court will be hearing the first arguments about the ability of the federal government to impose a mandate to buy health insurance on all citizens.

Stay tuned for more.

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Sunday, March 25, 2012

California Hospitals Taking Action Before Health Care Reform Kicks In

Hospitals all around America are struggling to find ways to reduce costs and eliminate duplication of efforts. These cost cutting measures are part of the hospitals preparation to survive once health care reform fully begins in 2014.

In California, hospitals are trying to figure out how to make due with fewer patients, because the amount hospitals will be paid for providing medical services will be based upon keeping patients from returning to the hospital. This is a whole new world for hospital administrators, and on top of that they face significant cuts to Medicare and Medicaid, which make up over 50% of California hospital revenues.

Let's hope the hospitals figure this all out, because it would be a shame to only have a couple of hospitals left a few years after health care reform kicks in.

Stay tuned for more.

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Saturday, March 24, 2012

Republicans Plan To Use IPAB Against Democrats In November Elections

The Independent Payment Advisory Board (IPAB) was created as part of the Health Care Reform bill to force cuts to drug companies, insurers, and medical service providers if Medicare spending continues to climb. Republicans believe that the IPAB would squeeze payments to service providers and eventually stifle medical innovation and cause providers to see patients with non-Medicare coverage. Effectively rationing healthcare to those who can pay more, and making it difficult for Medicare patients to get the care they need.

The House of Representatives recently passed a symbolic bill to repeal the IPAB, but that bill is expected to stall out in Congress. Many Democrats would have also voted to repeal but the Republicans added additional caps on medical malpractice awards which Democrats oppose.

The Republican strategy is to make the IPAB an issue for the elections, but to wait until after the beginning of 2013 to get the IPAB repealed. Republicans are hoping that Seniors will see them as better stewards of Medicare.

Stay tuned for more.

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Thursday, March 22, 2012

Supreme Court To Hear Mandate Arguments Next Week

The US Supreme Court will begin hearing arguments about the Health Insurance mandate in the Affordable Care Act, and ultimately decide if the mandate is constitutional or if it oversteps the federal governments powers to control commerce. Some people want the mandate to be passed (the insurance companies and democrats) and other want the mandate to be struck down (republicans).

Either way, the decision will have major impacts of the future of health care in the US, so the outcome is very important for every US citizen.

Stay tuned for more.

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Wednesday, March 21, 2012

Health Care In The US Not As Bad As Believed

In a new research report Christopher Conover from Duke University's Center for Health Policy and Inequalities Research, the facts about how America's health care system compares to those of other countries is finally laid bare. The reality is that we've got it pretty good after all. (see the article in the Los Angeles Times: http://ping.fm/LH9VW)

Some examples are: Life Expectancy in the US is greater than in all other countries, instead of 39th, if deaths related to violence and automobile accidents are removed. This adjustment seems fair since we're looking for the effects of health care on life expectancy.

Another comparison is the quality of health care outcomes. People with cancer live longer in the US than in any other country. Many of the "avoidable deaths" that could be treated are in fact caused by the lifestyle choices of Americans, and thus make the numbers look like US health care is worse than other countries.

Stay tuned for more.


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Tuesday, March 20, 2012

California Facing a Shortage of Physicians

Thirty percent of California physicians are 60 years old or more, and more retire each year than the number of new physicians that start out. This doesn't bode well for what things will look like in 2014 when there are expected to be an additional 4 million Californians that will have health insurance.

The areas that will be hardest hit are the rural areas and the inland valleys. Primarily because doctors tend to gravitate towards the coast and the metropolitan areas. Many people in the central valley will find it harder to schedule an office visit after 2014 because of this shortage of doctors.

Stay tuned for more.

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Monday, March 19, 2012

Anthem Blue Cross of California Adjusting May 1st Pricing

Anthem Blue Cross members that have already received their letters describing a May 1st rate increase will get a little relief. Updated pricing shows a slightly lower rate change than what was originally put into the letters. The amount of change in the rates depends upon the family specific, and the plan the member is enrolled in.

This is welcome news to many Blue Cross members who were affected by the rate increase. Some members will wait to see the net result of the increase before deciding if they plan to change to a lower cost option.

Stay tuned for more.

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Saturday, March 17, 2012

What If the Mandate Is Struck Down? Will Health Care Reform Survive?

The US Supreme Court will hear arguments both for and against the individual mandate, which is the central figure in the health care reform bill. Insurance companies will argue that without the mandate, the ability to provide insurance for everyone goes away. The Obama administration says that without the mandate the reset of the health care reform rules should remain in place, except for 2 rules.

The two rules that would be removed from health care reform are the requirements that insurers cover everyone that applies, and that the insurance companies use a "community rate" instead of rates based upon the applicants health characteristics. Without these two provisions, the health care reform regulations just become "business as usual" but with more required benefits, and therefore, higher costs. The exact opposite of what health care reform was supposed to do.

If the mandate is struck down, then health care reform needs to be scuttled and a new plan created.

Stay tuned for more.

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Friday, March 16, 2012

Pre-Existing Condition Insurance Plan Enrollment Is Lower Than Expected

The PCIP was expected to have 375,000 new members, but so far only 50,000 have signed up for the insurance plan. Plus the costs for the people that did sign up are much higher than was expected when the PCIP was initially created.

The PCIP California program was meant to provide affordable health insurance to people with exiting health conditions that prevented them from being able to get regular underwritten health insurance. The premiums for the PCIP plan are less than what the expected costs are supposed to be, so the Federal government is subsidizing the program. In fact, the costs of the program are more than twice as much as was originally anticipated.

Stay tuned for more.

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Thursday, March 15, 2012

California Health Mandates Could Increase State Costs


California has 53 health insurance mandates that require specific benefits to be covered in health insurance plans that are offered in California. There are more mandate bills coming in 2012 as well.

The Affordable Care Act states that each State must offer a "minimum" set of health benefits in the plans that are offered in the Exchanges. However, the ACA says that if the state mandates additional benefit levels, then the state is responsible to pay for those additional benefits. The net result of this is that Californian's will either face higher insurance costs when 2014 rolls around because the only plans offered will have rich benefit levels, or the State will have to figure out how to generate more revenue to be able to pay for the extra benefits for every citizen in the health insurance plans.

Stay tuned for more.

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Wednesday, March 14, 2012

Health Insurance Exchange Conflict

CMS has stated that insurance brokers will be allowed to "interact with consumers on the exchanges in an automated way", but left the determination as to how for each State to decide. This will enable brokers to direct consumers to the exchanges to determine if they qualify for tax credits, but many health reform groups are concerned.

Health reform groups, such as Consumers' Union and the Multiple Sclerosis Society believe that allowing brokers to access the exchanges, the brokers will obscure the information and direct consumers to specific health insurance companies, while not letting consumers know about other options.

This is ridiculous. Independent brokers have long known that their best strategy is to not favor any insurance company, but present what is in the consumer's best interest. Having an exchange won't change that perspective. Cutting brokers out of the new exchanges will result in consumers not effectively using the new health reform features, and will probably slow down the sign up of the uninsured.

Stay tuned for more.

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Sunday, March 11, 2012

Finding Health Insurance in San Diego Can Be Challenging

When searching for good health insurance plans, San Diego residents need to find a good broker website that provide information and quotes from all the major insurance companies. That way you get plenty of choices, and also the necessary information to be able to compare plans and pick the plan that best fits your needs from over 150 different options. The second part of this is to make sure the website gives you a phone number so you can speak to a knowledgeable expert to get answers to any questions you have. Using these two tips will enable you to quickly find a great health insurance plan in San Diego, with the least amount of effort.

Stay tuned for more.

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Saturday, March 10, 2012

Americans Pay More for Health Care

A new report by the International Federation of Health Plans (IFHP) shows that Americans pay more for most medical service than people in other countries. The IFHP is composed of CEOs from various Health Insurance companies worldwide.

As an example, the average price for an MRI in the US is $1080. In France the same MRI costs $281 and in Germany the cost would be $599. The average US cost for a hospital baby delivery is $9280 and the cost would be $2536 in France and $2157 in Germany.

Even worse are the price differences for drugs. In the US, the average cost for Nexium is $193, and in France the cost is $23, while Canadians pay $36.

Stay tuned for more.

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Friday, March 9, 2012

All the Health Insurance Carriers Scramble To Keep Up

The changes due to health care reform and starting to come fast and furious, and this is making it hard for the insurance companies to keep up. In California, the state has added to the list of action items for insurance companies by requiring all health insurance plans to include maternity coverage starting July 1st.

Right now the big issue for insurance companies is the Medical Loss Ration (MLR) regulations, that require insurers to cut their administrative overhead and payout more in benefit claims.

Stay tuned for more.

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Thursday, March 8, 2012

Health Care Reform Subsidy Costs Explode

New data contained in the latest presidential budget proposal show the costs of providing subsidies to middle class citizens to help them buy health insurance in the new state insurance exchanges, have climbed by over 30% since last year. The new budget show expected costs of $478 billion over the period from 2014 - 2021.

This projected cost increase raises two concerns. First that the estimated cost of the insurance has gone up, and second, that the administration fears more employees will lose group coverage when the Affordable Care Act takes effect in 2014.

Stay tuned for more.

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Tuesday, March 6, 2012

Hospitals Will Have to Change Their Methods to Survive Health Care Reform

The new rules in the Affordable Care Act (ACA) are making hospitals look for ways to reduce costs and prevent duplicate efforts. The ACA moves the payments hospitals receive away from a fee for each service to a reward for keeping patients from returning to the hospital. This change is causing hospital administrators to begin looking for ways to streamline their actions.

This new payment methodology promotes higher-quality hospital treatment and prevents inadvertently subsidizing bad care to increase the hospital's revenue growth. These shifts will transform the hospital landscape by reducing the number of independent small hospitals, and the creation of larger hospital groups that will have more negotiating power with the insurance companies.

Stay tuned for more.

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Sunday, March 4, 2012

What Are The Top 3 Features Of A Great Small Business Wellness Program?

According to a Principal Financial Well-Beng Index, 41% of employees at small business say they would be more productive at work if their company offered a well-being program with the following 3 features:

1. Fitness Club discounts
2. On Site Preventive Screenings
3. Access to wellness experts such as nutritionists

45% of small business employees say they would participate in these well-being programs to improve their own physical health.

Stay tuned for more.

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Saturday, March 3, 2012

If you're pregnant without insurance check the information at SPF Insurance to find great solutions to get insurance coverage for your pregnancy. Pre existing condition insurance plan is a potential option.

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Anthem Blue Cross May Rate Increase Letters

The first clients with Anthem Blue Cross plans are beginning to call about alternatives to their Blue Cross plans. The rate increase will take effect on May 1st, so these subscribers are just now receiving the rate increase letters. For help finding good alternatives, contact:
SPF Insurance Services
17927 Sencillo Ct
San Diego, CA 92128
(858) 613-3628
http://spfinsurance.com

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