California Now Requiring Discount Health Plans Providers Obtain License

California Now Requiring Discount Health Plans Providers Obtain License in Politics and Legislation

California regulators are now requiring discount health plan providers to obtain licenses to conduct business within the state. The state has already licensed three providers. The new licensing regulations come in response to the number of complaints the California Department of Managed Health Care has seen over the past four years about the discounted health plans according to the Los Angeles Times.

Consumers complained that the discount plans exaggerate the benefits included when it comes to savings and health care provider networks. They are also blindsided by the fact the discount plans accept members with pre-existing medical conditions but only cover a percentage of total health care costs. At times, discount plans don’t provide any coverage, depending on the terms and health care services needed.

Shoppers need to be careful of these discount plans. It’s very important to realize that these types of plans are not like regular health insurance nor should they replace lost insurance.

But because California currently has 7 million uninsured residents, many are desperate for any type of “coverage” even if it’s not right for their needs. The danger with discount health plans is that they seem affordable at the time of purchase, but often result in enormous medical bills.

Maybe the new regulations are a good thing. Discounted health plans are offered in every state but only 21 states require licenses leaving a lot of room for improvements to be made across the country. If you’re considering a discount health plan, you should consult first with a licensed agent to first explore your individual health insurance options.  

Comments[0]

Most Americans Using Internet for Health Care Questions

Most Americans Using Internet for Health Care Questions in General Healthcare

The Center for Disease Control and Prevention conducted the National Health Interview Survey to collect data on the use of health information technology. The survey found that 51 percent of adults between the ages of 18-64 used the Web to find health information over the past year.

But the use of the Internet was mostly limited to research. According to the survey, just three percent of adults used an online chat group to learn about health topics and only five percent emailed a health care provider.

When it comes to using the Internet to manage personal health care, not many take advantage — only six percent requested a prescription to be refilled over the Internet and less than three percent made an appointment online.

So, we have to ask: does this survey show that health care providers aren’t meeting the demand of patients online?

The industry doesn’t think so. Health providers say they feel that using the Internet lacks privacy measures. Also, many are unsure how to bill for time spent answering emails. But to keep patients and remain competitive, it’s hard to see how doctors and hospitals can avoid adapting to the changes and start using health information technology to provide more effective and efficient care. 

By the way, more people are using the Internet these days for buying health insurance as well. Last year, over a million consumers used GoHealthInsurance.com to shop for a plan.

Comments[0]

More Children Receiving Health Insurance Benefits

More Children Receiving Health Insurance Benefits in Individual Health Insurance

Yesterday marked the one year anniversary for the signing of Children’s Health Insurance Program Reauthorization Act (CHIPRA) by President Obama. 

Since the signing of the legislature, an additional 2.6 million uninsured children have gained coverage through the state health programs. Kaiser Health News reports there are currently 40 million children that have coverage through Medicaid and CHIP programs.

There is, however, one slight problem. Some states are finding it hard to maintain current levels of coverage for children, let alone expand the program.  There were a total of 19 states that extended their Medicaid and SCHIP programs, but 15 states had to make cuts to their programs.

Even more troubling, Families USA found that 39 states are planning to cut or freeze public program rates in 2010. Fifteen states will increase cost-sharing for Medicaid recipients.  And eight states are even considering cutting 1 million people from their programs completely. States alone just cannot handle the financial load of providing for all of the uninsured.

A total of $87 billion in funds was allocated to states for these health care programs from the American Recovery and Reinvestment Act last year, but only $25 billion of that is coming out of President Obama’s budget plans this year. That’s not going to be enough to prevent these budget cuts from happening, unfortunately.

Still, adding 2.6 million children onto the ranks of the insured certainly seems like a success — at least politically for President Obama.

Comments[0]

Illinois Supreme Court Overturns Ruling on Medical Malpractice Caps

Illinois Supreme Court Overturns Ruling on Medical Malpractice Caps in Politics and Legislation

The Illinois Supreme Court overturned a medical malpractice law on Thursday which was met with quick opposition from health care providers. The law put limits on the amount injured patients could receive for pain and suffering damages.  Critics of the ruling acknowledged that the caps curbed elevated health care costs and made health insurance plans more affordable in Illinois.

The prior Illinois legislation put caps of $500,000 for non-economic damages filed against doctors and $1 million against hospitals. The Illinois Supreme Court believe that the law was in violation of the states constitution; specifically the constitution’s “separation of powers” clause that does not allow the court to determine appropriate damages in cases.

The Chicago Tribune notes that the overturned law could make future health care rulings quite murky. And with looming health care and health insurance reform, who knows what factor yesterday’s ruling will become.

Critics disagree with the decision because they cite data which shows the malpractice caps kept health care costs low over the past few years. For example, before 2005, the costs of medical-liability insurance for health care providers kept escalating due to malpractice lawsuits. Physicians were leaving Illinois because they could not afford malpractice insurance. But since the law was enacted, the number of malpractice claims filed has declined — and believe it or not, so has the price of Illinois health insurance.

It’s also apparently a budding national trend — 11 out of 30 states have already overturned similar rulings according to The New York Times.

Comments[0]

How the Government is Becoming Health Care's Biggest Consumer

How the Government is Becoming Health Care's Biggest Consumer in General Healthcare

Recent projections by the Centers for Medicare and Medicaid Services estimate that the government will be paying for half of all health care services by the end of next year. 

In 2008, public funds accounted for 47 percent of the $2.34 trillion spent on national health services. By 2012, it is estimated that the government will pay for at least 50.4 percent of the nations total spending on health care. 

There is little to slow the increasing need of government help in purchasing health care — especially since just about all of the Baby Boomers will become eligible for Medicare in 2011.  And until the economy starts doing better, many lower-income Americans will continue to receive financial assistance for government-run health care programs like Medicaid. 

The federal government can keep offering short-term fixes for keeping these public health insurance programs afloat, but will have to consider a better option for the future. 

Comments[0]

Universities Requiring Health Insurance for Students

Universities Requiring Health Insurance for Students in Individual Health Insurance

In order to get coverage to students, universities are now making health insurance mandatory. The University of Massachusetts requires that every student purchase some form of insurance, whether it is an individual health insurance policy or through the university. 

Also, the University of Minnesota goes so far as audit 15 percent of their student population for proof of insurance every semester.  Students who do not provide the proof within three weeks time of the audit will receive a $907 fee for that semester and is automatically covered under the universities group plan.

But after graduation, things change.

Not surprisingly, young adults are more likely to go without health insurance than any other age group.  According to the U.S. Census Bureau people between the ages of 18 to 24 had the highest rates of uninsured in 2008, reaching 28.9 percent. People between the ages of 25 to 34 years of age held the second highest rates of unemployment at 26.5 percent.

A big part of it is the fact that when a young adult graduates from college, he or she loses a parent’s coverage. So to get coverage, the grad has to find a new job or purchase an individual health insurance plan. But many young people just go without insurance coverage — because they don’t yet have a job, don’t believe they can afford coverage on their own, or don’t believe they need it.

Comments[1]

Lots Happening in the World of Health Care and Health Insurance Policy

Lots Happening in the World of Health Care and Health Insurance Policy in Politics and Legislation

Today, a Pew Research Center poll was released showing the majority of Americans believe the health reform effort is not going to happen.

About 60 percent believe health care and health insurance reform in Washington will not pass; 30 percent believe it will become law.

But surprisingly, these aren’t at their worst. Just after Senator-elect Scott Brown won the special election in Massachusetts for Senator Edward Kennedy’s seat, almost 70 percent of America thought health reform was done for.

Also, as we’ve blogged about before, Virginia lawmakers are very close to passing a state law that would ban a federal health insurance mandate. Problem is, the state law wouldn’t hold up against a federal statute.

Finally, President Obama included an extension to the COBRA subsidy for laid-off workers to the end of 2010. The program can definitely be considered a success and is very popular with Americans. (Premiums for COBRA coverage can be hundreds of dollars, though an individual health insurance policy can be as low as $50 per month.)

So lots of things are happening for the middle of the week and we’ll see what happens next.

Comments[0]

Health Insurance for Uninsured in Florida Lacks Demand

Health Insurance for Uninsured in Florida Lacks Demand in Individual Health Insurance

Florida legislature established a program in January 2009 to help uninsured residents purchase affordable health insurance.  Governor Charlie Crist pushed for this law, which offers stripped down health plans that aren’t subject to certain state-mandated benefits. The program, Cover Florida, was considered a political victory by Crist but has not enjoyed such success among uninsured residents.

Cover Florida offers private health insurance for residents that do not qualify for public programs and have been without insurance for 6 months.  There are 27 plans that can be purchased averaging $50 a month.  Residents with pre-existing conditions cannot be turned down for coverage but have to wait a year before their conditions can be covered. 

According to the American Medical Association, the program only had 5,246 people enroll in Cover Florida over the year. With 3.8 million uninsured adults still remaining, the program seems to be a bit of a failure.

So why did so few purchase this policy?

For starters, the state had almost no funds to promote the program to uninsured residents.  Also, insurers that sold the policy received little compensation for selling Cover Florida, giving agents little motivation to offer the program. 

Finally, the Cover Florida health insurance plans are more appealing for those who have trouble finding insurance, turning off consumers who are eligible for other private insurance policies. 

It seems that the Florida legislature is realizing that passing the bill was only half the battle. 

Comments[1]

State Lawmakers Across Country Push Against Federal Health Insurance Mandate

State Lawmakers Across Country Push Against Federal Health Insurance Mandate in Politics and Legislation

Last month, the Virginia State Senate sent a (political) message to Washington with its committee approval of a bill to block any federal law that would force Americans to purchase a health insurance plan.

Now lawmakers in 35 other states around the country have introduced proposals to block a potential federal mandate, reported the Associated Press and ABC News.

Many of these proposals are from Republicans, who have been steadfast in their effort to kill health care and health reform entirely. But the public seems to agree with reform’s critics, as most recent polls have shown that a majority do not support an overhaul.

As we’ve written before, many state lawmakers are also questioning the constitutionality of a federal health insurance mandate; even naming their measures against a mandate the "Freedom of Choice in Health Care Act."

Still, constitutional experts believe a mandate would actually be legal — and enforceable.

"[These state proposals] are merely symbolic gestures. If this Congress were to pass an individual mandate, and if it is constitutional — which I believe it is — the express rule under the supremacy clause is that the federal law prevails," said Michael Dorf, a Cornell University constitutional law professor.

Comments[0]

Fighting Health Insurance and Medicare Fraud

Fighting Health Insurance and Medicare Fraud in Individual Health Insurance

Yesterday, the Obama Administration met with insurance industry representatives, law enforcement and other government officials on Thursday to discuss legislature to fight Medicare and health insurance fraud. 

According to Attorney General Eric Holder, Medicare fraud costs the government $60 billion a year. Holder and the Obama Administration say current efforts to stop fraud have not been effective enough.

The USA Today article seemed to indicate a productive meeting, which the public and private sectors agreed to proactively share data and improve coordination.

Obama also plans to expand the Health Care Fraud Prevention and Enforcement Action (HEAT), which will ramp up law enforcement efforts against fraud.  HEAT has shown that collaboration between the public and private sectors helps combat health insurance fraud and has recovered $2.2 billion in the last year. 

Some main action items in this “fraud summit” include using less-sensitive identification numbers instead of Social Security numbers and educating families about keeping information private. A “pre-payment” system has also been proposed. When fraud is suspected, the government would delay Medicaid payments to ensure its validity rather than “pay and chase” the perpetrator as it currently operates.

Holder believes coordination between HEAT and the health industry will make processes smoother and easier to enforce.

Because Medicare fraud costs the government and families so much money every year, it’s a good thing the Obama Administration is cracking down.

Comments[0]

Gallup Poll Finds More Americans Have Government-Sponsored Health Insurance, Fewer Have Employer Coverage

Gallup Poll Finds More Americans Have Government-Sponsored Health Insurance, Fewer Have Employer Coverage in Group Health Insurance

Remember the public health insurance option that much of America and all Congressional Republican lawmakers were against? Well, a new Gallup poll found that more Americans actually jumped on a public health plan in 2009 than 2008.

According to the poll, 24.6 percent of insured Americans in 2009 had coverage through a government plan such as Medicaid, Medicare or a military or veteran’s health insurance plan.

In 2008, 23.3 percent of insured Americans were covered with a government-sponsored plan.

The poll also found that employer coverage is waning. In 2009, 46.8 percent of the insured population had employer-based group health insurance — 49.2 percent had employer coverage in 2008.

More Americans also were uninsured in 2009 than 2008 — 16.2 percent and 14.8 percent respectively.

With the poor economy and unemployment as high as it is right now, this data really isn’t a huge surprise. But it does highlight the fact that when people can’t afford health insurance, which many can’t, they turn to the government.

Comments[0]

Pet Health Insurance to be Included in Group Benefits

Pet Health Insurance to be Included in Group Benefits in Individual Health Insurance

Here’s some interesting news: This year, Purinacare.com has recently launched  a “Group Benefits Department” which will give discounts to employers and associations for pet insurance. 

It’s an interesting play on a budding market. Pet health insurance has been gaining recent popularity as the cost of maintaining a healthy pet has increased.  Believe it or not, pets can now receive many of the same treatments as their owners. 

Pet health insurance policies are basically individual health insurance policies that require annual deductibles and monthly premiums to keep coverage.

If you’re interested in pet insurance, just make sure you know what you’re getting. Depending on the insurer, some pets might not have certain care covered based on their breed. But many policies will cover routine veterinarian trips, vaccinations, surgeries and even grooming.  You can also find policies with less coverage may only include emergency care.

For years, veterinary medicine was one of the only health fields without the financial support of insurance.  But now, pet owners are realizing health insurance  for their pet is a good idea. And it definitely can be.  

Comments[0]

Two Senate Democrats Come Out Against Budget Reconciliation for Health Reform

Two Senate Democrats Come Out Against Budget Reconciliation for Health Reform in Politics and Legislation

So, health care and health insurance reform is up in the air. Senator-elect Scott Brown is coming to Washington and Democrats are suddenly a vote short of filibuster-proof.

One option for Democrats is a legislative procedural loophole called budget reconciliation that requires only a majority vote in the Senate. With this, Democrats could pass the health reform bill with only 51 votes.

But two Democratic Senators, Blanche Lincoln of Arkansas and Evan Bayh of Indiana, have already come out against the idea.

Senator Lincoln said that she doesn’t want the reform effort rushed and would fight against use of the tactic.

“I will not accept any last-minute efforts to force changes to health insurance reform issues through budget reconciliation,” said Senator Lincoln.

Also, we can’t forget that Senator Lincoln is still considering a tough re-election race this year in the very red state of Arkansas.

Senator Bayh had a bit of a more calculated answer, saying that pushing reconciliation could hurt relations with Congressional Republicans for future legislation.

Both points are salient, but that doesn’t mean the Democrats won’t use their ultimate health reform trump card.

Comments[1]

Virginia Committee Bans Federal Health Insurance Mandate

Virginia Committee Bans Federal Health Insurance Mandate in Politics and Legislation

Today, the Washington Post reported that the Virginia state Senate Commerce and Labor Committee approved a measure that would ban a federal health insurance mandate if passed in Washington D.C.

Though, the provision still has to make it past the full Virginia Senate where Democrats hold a small majority, this committee vote should make the ears of lawmakers on Capitol Hill perk up.

The president and Democrats in Congress have been fighting back waning public support of the health reform and this surely won’t help. Many pundits and critics of the current legislation are saying the gubernatorial losses for the Democrats in New Jersey and Virginia, and most recently the election of Senator Scott Brown in Massachusetts, are a sign that the public is turning on the Democrats’ health reform efforts.  

It could just be further proof that the pundits, this time, are right.

But it wasn’t all bad news today for the Democrats. A recent Kaiser Family Foundation poll found that when the public were informed of specific provisions in the current health care and health insurance legislation, their support significantly improved.

From a press release of the poll:

“Sixty-seven percent said they were more supportive [of the health reform bill] when they heard that the legislation included health insurance exchanges, and 63 percent felt that way after being told that people could no longer be denied coverage because of pre-existing conditions. Of the 27 elements of the legislation tested in the poll, 17 moved a majority to feel more positively about the bills and two moved a majority to be more negative.”

Based on this poll, it sounds like the Democrats aren’t doing such a great job pleading their case.

Comments[0]

California Democrats Try to Pass Single-Payer Health Care

California Democrats Try to Pass Single-Payer Health Care in Politics and Legislation

In the wake of Senator-elect Scott Brown and the stand still on the health care debate in Washington, California Democrats have decided to take matters into their own hands.

Democrats have again proposed to implement a single-payer health care system and get rid of the California health insurance industry, which the California Senate will vote for a single-payer system next week. The cost of creating this universal health care system would cost around $210 billion in just one year, which would double California’s state budget according to The New York Times.

California Republicans are shocked that the Democrats are still proposing this bill after what they perceive to be a referendum on health care in Massachusetts and with California’s surmountable debt.

Governor Arnold Schwarzenegger has already vetoed a single-payer bill twice and has unsuccessfully tried passing his own health care bill. So it’s not like the political environment in California is ripe for major health care change.

Democrats certainly have plenty of hurdles ahead if they want to pass this unrealistic bill. For one, they can’t answer the question of how single-payer health care would be financed. The flimsy California Democrats have come up with so far is to tax individuals and employees.

With the governor hard-nosed on opposition to this bill and without the votes to overturn a veto, this bill has absolutely no chance.  

Comments[0]