Navigator Vs. Insurance Broker: Who To Go To For Your New Affordable Care Act Health Insurance?

By Kenton Henry, Administrator

 
Let me preface this article with an admission. I am a health insurance broker and have been for 27 years. So consider that as you weigh the comparison suggested in the title of this piece.

 
Very shortly (October 1 to be exact) you are going to be able to enroll in a new Affordable Care Act (ACA) compliant health insurance plan to be effective January 1. Having health insurance at that time is no longer an option – it is a mandate. You probably know this by now and there is no need to review the details and I will not be addressing the penalties for not having coverage next year and beyond. Rather, I will be addressing your options for enrolling and factors you might want to weigh before electing the path you take to enrollment. I will strive to be as objective as possible in light of my preface.

 
First, let’s consider going through an insurance agent or broker like myself. Before I could consider selling my first health insurance policy back in 1986, I had to study for and pass my state’s insurance exam in order to obtain my license. I did this initially in Indiana and again in 1991 when I moved to Texas. While not the Bar Exam or Medical Board Exams – on both occasions they were comprehensive tests and I recall spending weeks of self-study in the quiet of the local library for the first and–after 5 years of experience–another week and a 40 hour prep course to boot for the second. They covered my knowledge of things not the benefit of common sense–and they were certainly not IQ tests–but measured my grasp of esoteric insurance laws, regulations, the principles and components of insurance and ethics among other topics. Next, I had to be appointed with an insurance company before I could represent their products. In addition to an application, an appointment entailed a thorough background and credit check. Approximately twenty years ago, every company with whom I applied to for an appointment made it mandatory I purchase errors and omissions coverage just as required of your attorney or doctor. Every person is fallible and the insurance makes certain an agent’s clients can be compensated for any negligence or unintentional mistake on the agent’s part resulting in the client’s harm. Fortunately, I have never had to file a claim with my E & O company nor have I had a complaint filed against me with a state insurance commission. I must also undergo and complete a minimum of 30 hours of continuing education every 24 months in order to keep my license. A record of this is made the State Insurance Commissioner. My license binds me to the same rules and regulations regarding my client’s privacy, confidentiality and personal information as the aforementioned professionals with whom you share the same type of information. Any compromise in it could result in revocation of my license not to mention civil liability on my part.

 
Who pays for these tests, licenses, continuing education and insurance? I do. It comes out of my personal income. Not to mention the cost of all my supplies, office overhead and gas utilized in seeing my clients at their convenience. Oh yeah . . . and I pay for my own health insurance. And I have never minded these expenses. These are merely the costs of doing business and I was happy to pay them when compared to the alternative which would have required being someone’s employee. So these are pretty much the facts as to my professional background, what is required of me and the protection afforded you by such.

 
Before contrasting this with the alternative – consider:
“The 2010 (ACA) law is intended to prod millions of Americans to buy health insurance, many for the first time. Those seeking coverage must provide details on citizenship, family size and income to determine whether they’re eligible for subsidies, and complete a form that can stretch to seven pages.” – Bloomberg 08.23.13

 
And the alternative to licensed agent or broker? As of October 1st, you will also have the option of going through a “Navigator” hired by your state and whose compensation will be subsidized with federal funds. (Clue: federal funds is code for your tax dollars). The Navigator’s job is to be educate you as to your options and help you elect one before being turned over to an enroller, otherwise known as a customer service representative. The latter will make this happen mechanically and it will most likely be accomplished by you going to a link and completing an electronic enrollment form estimated to be up to 21 pages or greater in length. (We don’t know yet. They and the premiums for coverage are yet to be released.)

 
While the requirements will vary from state to state, the federal requirements for Navigators are 20 hours of training. The federal health insurance exchange will apply in Texas, Indiana and Ohio. These are three of four states where I am licensed. There will be no background checks involved in the hiring process for Navigators as we are told there is no time for such. The administration says “we need to get as many people as possible to sign up as quickly as possible.” The Navigators will not be licensed. They will not pay for errors and omissions insurance. You will pay for their supplies, their insurance and their benefits.

 
I certainly don’t have to be your agent but these are factors you might want to consider before seeking assistance in enrolling in your new health insurance plan. If you feel I have unfairly or otherwise misrepresented things, please feel free to comment as much. In the feature articles below, some opposing or off-setting opinions are expressed–mostly by administration officials.

 

 

Admin. – Kenton Henry

 
************************************
Coming Articles: Biggest Traps of the Affordable Care Act for Medicare Recipients
************************************

 
Feature Articles:

 
BLOOMBERG August 23, 2013

 
State Laws Hinder Obamacare Effort to Enroll Uninsured
By Alex Nussbaum & Alex Wayne – Aug 23, 2013 2:32 PM CT

 
New laws passed by a dozen Republican-led states, the latest in Missouri last month, may make that harder, imposing licensing exams, fines that can run as high as $1,000 and training that almost doubles the hours required by the federal government. Republicans say the measures will protect consumers. Obamacare supporters say they’ll undermine the effort to get as many people as possible enrolled.
The rules are “like voter intimidation,” said Sara Rosenbaum, a health law professor at George Washington University in Washington, D.C., who supports Obama’s act. “In many, many cases these laws may be a direct interference with outreach assistance and that’s going to be quite serious.”
The Obama administration awarded 105 grants last week, steering money to hospitals, social-service agencies, local clinics and other groups. The navigators are meant to offer “unbiased information” to help people through the complexities of the new system, with its deductibles, copays, provider networks and tax credits, according to an Aug. 15 statement from the U.S. Department of Health and Human Services.
October Deadline
The grants were issued barely a month before the online exchanges are scheduled to open for enrollment on Oct. 1. The administration has said about 7 million people may enroll next year and it needs to motivate millions of young, healthy customers to sign up to keep the markets financially stable.
The state laws may complicate that task. The restrictions go farthest in a handful of states like Georgia and Missouri, where Republican legislators have already refused to set up the new insurance websites or spend money to promote the law.
In Florida this week, Governor Rick Scott told a Miami audience that federal privacy protections for consumers working with navigators were “behind schedule and inadequate.” He urged people to use brokers and agents instead.
Georgia Governor Nathan Deal, a Republican, believes navigators need state regulation because they’ll give advice on “a highly complicated and highly important topic,” his spokesman, Brian Robinson, said in an e-mail. They will also handle personal information that is open to abuse.
Consumer Protection
“This is a consumer protection issue more than anything,” said Kenneth Statz, an insurance broker on the legislative council of the National Association of Health Underwriters, a Washington-based group representing agents and brokers. “We just want to make sure that somebody who is sitting down with a consumer, trying to help them make this major decision, is going to be properly prepared.”
The state laws have passed with the backing of insurance agents and brokers, who view the online exchanges as competition and navigators as potential rivals with an unfair advantage absent new rules.
States require agents to be licensed and undergo periodic training, said Statz, who’s based in Brecksville, Ohio. He also has to carry insurance to protect clients who may be hurt by bad advice or malpractice, he said.
The 2010 law is intended to prod millions of Americans to buy health insurance, many for the first time. Those seeking coverage must provide details on citizenship, family size and income to determine whether they’re eligible for subsidies, and complete a form that can stretch to seven pages.
Federal Requirements:
While states controlled by Democrats such as Maryland, New York, Minnesota and Illinois have also passed rules, these generally follow federal requirements, said Mark Dorley, a health-policy researcher at George Washington University.
Other states have been more restrictive.
Georgia’s navigators need a license from the insurance commissioner. Each person assisting the uninsured has to pay a $50 application fee, complete 35 hours of training — 15 more than the federal requirement — pass an exam, and complete a criminal background check. Licenses must be renewed every year, requiring another $50 and 15 more hours of training.
Missouri defines navigators more broadly than the federal government, said Andrea Routh, executive director of the Missouri Health Advocacy Alliance in Jefferson City. Violating certification requirements risks a $1,000 fine.
Seeking License
Routh’s group, which seeks to educate people on the health law, didn’t apply for a grant. It may seek a license just to be safe, she said.
“Anyone who does outreach and education, or anybody who assists anyone with enrollment had better be checking that law to see if they need to be licensed,” she said.
Missouri voters approved a ballot initiative last year barring Governor Jay Nixon, a Democrat, from setting up the exchange without the assent of the Republican-controlled legislature, which has declined to act so far.
The rules may scare off churches, clinics or others who want to help, said Cindy Zeldin, executive director of Georgians for a Healthy Future. The Atlanta-based nonprofit was part of a group that won a $2.1 million grant.
Georgia’s law implies “navigators are somehow problematic,” she said in a telephone interview, “rather than that they’re groups that likely have a history of working in communities and are trusted.”
‘In Conversations’
The Obama administration has been “in conversations with states” to ensure their laws don’t hinder the effort, said Chiquita Brooks-Lasure, a deputy director at the federal health department, in an Aug. 15 conference call with reporters.
The federal law doesn’t require background checks, though navigators must provide quarterly reports and can lose their grants in cases of fraud or abuse. The administration is requiring them to undergo an initial 20 hours of training.
Some people opposed to Obama’s overhaul “want to see it fail,” said Missouri Health’s Routh. “If you put a lot of barriers in place that make it tough for nonprofits to go out and educate people and assist them in understanding the exchange, that may be one way to have it fail.”
******************************
The Washington Post
Health and Science
States scramble to get health-care law’s insurance marketplaces up and running
By Sarah Kliff and Sandhya Somashekhar, Published: August 24
With a key deadline approaching, state officials across the country are scrambling to get the Affordable Care Act’s complex computer systems up and running, reviewing contingency plans and, in some places, preparing for delays.
Oct. 1 is the scheduled launch date for the health-care law’s insurance marketplaces — online sites where uninsured people will be able to shop for coverage, sometimes using a government subsidy to purchase a plan. An estimated 7 million people are expected to use these portals to purchase health coverage in 2014.
The task is unprecedented in its complexity, requiring state and federal data systems to transmit reams of information between one another. Some officials in charge of setting up the systems say that the tight deadlines have forced them to take shortcuts when it comes to testing and that some of the bells and whistles will not be ready.
“There’s a certain level of panic about how much needs to be accomplished but a general sense that the bare minimum to get the system functional will be done,” said Matt Salo, executive director of the National Association of Medicaid Directors. “It will by no means be as smooth and as seamless as people expected.”
Oregon announced this month that it will delay consumers’ direct access to its marketplace, opening the Web site only to brokers and consumer-assistance agents in order to shield consumers from opening-day glitches.
“Even though we’re testing now, once you actually have the system up, you don’t know what the bugs will be,” said Amy Fauver, spokeswoman for Cover Oregon, the state agency implementing the law there.
In California, which has the nation’s largest uninsured population, health officials have begun hinting that they may have a similar problem.
“It’s a complex system, and there’s a lot of navigation that needs to happen,” said Oscar Hidalgo, a spokesman for Covered California. He said the agency will know by early September whether the system will be ready in time.
If not, he said, customers will still be able to log on to the Web site and peruse insurance plans and view prices. When they get to the final step, however, they will not be able to sign up. They will have to contact a customer service representative to complete the final enrollment step.
Officials with the District of Columbia’s Health Link decided to put off building a Spanish version of its Web site until later this year, giving its staff bandwidth to complete other tasks they see more critical to the launch.
Until then, the District will have bilingual call-center workers and in-person helpers who will be able to help Spanish speakers navigate the site.
The hiccups are troubling to advocates, who worry that there will be mistakes that result in people being erroneously rejected by Medicaid or denied subsidies to which they are entitled. They are concerned that impediments will discourage the uninsured from signing up for coverage.
“There will be something up and running, but there will be serious, serious difficulties with it” that could result in delays and errors initially, said Robert H. Bonthius Jr., a lawyer at the Legal Aid Society of Cleveland. “It’s an extremely ambitious program, well-intentioned, that is going to be very difficult to accomplish, and it’s going to be months and maybe years before it really gets sorted out.”
With a key deadline approaching, state officials across the country are scrambling to get the Affordable Care Act’s complex computer systems up and running, reviewing contingency plans and, in some places, preparing for delays.
Oct. 1 is the scheduled launch date for the health-care law’s insurance marketplaces — online sites where uninsured people will be able to shop for coverage, sometimes using a government subsidy to purchase a plan. An estimated 7 million people are expected to use these portals to purchase health coverage in 2014.
See how the states have sided on some of the key provisions of the Affordable Care Act:
The task is unprecedented in its complexity, requiring state and federal data systems to transmit reams of information between one another. Some officials in charge of setting up the systems say that the tight deadlines have forced them to take shortcuts when it comes to testing and that some of the bells and whistles will not be ready.
“There’s a certain level of panic about how much needs to be accomplished but a general sense that the bare minimum to get the system functional will be done,” said Matt Salo, executive director of the National Association of Medicaid Directors. “It will by no means be as smooth and as seamless as people expected.”
Oregon announced this month that it will delay consumers’ direct access to its marketplace, opening the Web site only to brokers and consumer-assistance agents in order to shield consumers from opening-day glitches.
“Even though we’re testing now, once you actually have the system up, you don’t know what the bugs will be,” said Amy Fauver, spokeswoman for Cover Oregon, the state agency implementing the law there.
In California, which has the nation’s largest uninsured population, health officials have begun hinting that they may have a similar problem.
“It’s a complex system, and there’s a lot of navigation that needs to happen,” said Oscar Hidalgo, a spokesman for Covered California. He said the agency will know by early September whether the system will be ready in time.
If not, he said, customers will still be able to log on to the Web site and peruse insurance plans and view prices. When they get to the final step, however, they will not be able to sign up. They will have to contact a customer service representative to complete the final enrollment step.
Officials with the District of Columbia’s Health Link decided to put off building a Spanish version of its Web site until later this year, giving its staff bandwidth to complete other tasks they see more critical to the launch.
Until then, the District will have bilingual call-center workers and in-person helpers who will be able to help Spanish speakers navigate the site.
The hiccups are troubling to advocates, who worry that there will be mistakes that result in people being erroneously rejected by Medicaid or denied subsidies to which they are entitled. They are concerned that impediments will discourage the uninsured from signing up for coverage.
“There will be something up and running, but there will be serious, serious difficulties with it” that could result in delays and errors initially, said Robert H. Bonthius Jr., a lawyer at the Legal Aid Society of Cleveland. “It’s an extremely ambitious program, well-intentioned, that is going to be very difficult to accomplish, and it’s going to be months and maybe years before it really gets sorted out.”
******************************************************************************


http://allplanhealthinsurance.com

Your More Affordable 2014 Health Insurance Exchange Plan is Likely to Work Like an HMO or Medicaid

By Kenton Henry

If you have ever been covered on an employer’s group health insurance plan, you may have had to select your medical providers from a Health Maintenance Organization (HMO). If you were enrolled in a plan of this type – it was probably because it was your only option or because you were young and thought yourself bullet proof. And the reason is – most older people would not elect an HMO if given a choice. Because if your plan utilizes one – you either see a provider within the network or you have no coverage at all. Most older people know that when your health problem is anything more than a common runny nose (which is all young people believe they’re ever going to suffer from) – a person wants to be able to select their own doctor or hospital.

 
Has your income ever been at the poverty level or below? If so then you probably qualified for Medicaid. That’s the government’s health plan administered by the states for the poor. And if you were covered by Medicaid, you know how difficult it was to find doctor’s to take Medicaid, get into an appointment or see a specialist.

 
Now comes Obamacare. And when the premiums for the new health care compliant plans become available for individuals and families to choose from October 1 for a January 1 effect date – be prepared for sticker shock. Without going into projections of an unknown quantity, suffice it to say, the word on the insurance street is the cost of these plans is going to make people in most states “have a cow”!

 
So naturally, you’re going to review the lowest cost plans – the bronze or “catastrophic” options and hope they meet your needs. And when you do – you best hope you ARE young and bullet proof because you are probably going to find your selection of providers is going to be what you had available in a larger group plan HMO divided by 10 . . . or more. Be prepared to wait a long time for appointments and heaven forbid you need to see a specialist or a special procedure because–if you do–you are probably going to have to get the President to issue another of his executive orders to make it happen.

 
And what if you’re not young and bullet proof? Get used to rationing. Because Obamacare doesn’t like specialists and who do you want to see when you have a serious problem? Who do you think is going to authorize a more sophisticated (expensive) procedure? I love my family doctor but when he thinks I need a more expensive procedure – he refers me to a neurologist or an orthopedic surgeon, etc. But be prepared for your new health plan pre-certification department to tell you – “There must be a pill for that.”

 
In conclusion, you’d better hope you qualify for the subsidy so you can add all or a portion of your premium to the national debt. If not . . . be prepared to pay Cadillac prices for what at best will be an Oldsmobile.

 
(For more a perhaps more objective take on this – go to:
THE WALL STREET JOURNAL; BUSINESS AUGUST 14, 2013:
Many Health Insurers to Limit Choices of Doctors, Hospitals
By Anna Wilde Mathews @ http://online.wsj.com/article/SB10001424127887323446404579010800462478682.html

 

http://allplaninsurance.com

What is Coming with Your Health Insurance Between Now and January 1!

Just Practical Information On What is Coming with Your Health Insurance Between Now and January 1!

08.12.2013
This is not an editorial. Today’s post is simply non-political, practical information regarding coming changes in health insurance between now and 2016 and beyond. The Patient Protection and Affordable Care Act (PPACA) is law and is on schedule to be fully implemented (for all but groups of 50+) January 1, 2014. For this reason it is my responsibility to inform my clients – and followers of this blog – of what they can expect in the coming months. Specifically, their insurance options and the mechanics involved in transitioning to health plans that provide minimum “essential benefits” that are in compliance with the PPACA. In this post, I will be addressing individuals and families which includes the self-employed and those who have a personal policy because their employer does not provide coverage. All others, including those covered by group plans for less than 50 employees will be addressed in subsequent posts.
First – those of you who currently have a personal or family policy will be allowed to keep your policy until your policy anniversary in 2014. You should check your anniversary date or–if you are my client–call me. Many companies have changed your anniversary date to December 1. This allows you to keep your current plan until December 1, 2014. After that, you must convert to a health care “compliant” plan which will be described below. I can simplify and assist you in this process when the time comes.
If you do not currently have health insurance you must purchase a health policy to be effective January 1 or pay a penalty on your tax return for 2014 and beyond. Another reason you may want to purchase a plan is if you have previously been unable to acquire a policy which covers your pre-existing health condition(s). Your new compliant plan must cover them and health issues will not factor into your cost.
When October 1 arrives (the earliest date you may apply for compliant coverage) I will provide you a link where you will enter your estimated income for 2014. It will instantly tell you whether you qualify for a subsidy. If you do – you are going to want to choose from and apply for plan options in your state health insurance exchange. If your state has not established a state exchange (as is the case in Texas) – you will select from plans in the Federal Health Insurance Exchange. If you do not qualify for a subsidy (which is the case if your income is 400% or greater than the Federal Poverty Level*) – you are probably going to choose a policy offered outside an exchange and direct from an insurance company. The reason being, it is anticipated these plans will offer the same benefits at a lower cost. I can assist you with this option as well.
Below, I will offer further and detailed information on exchanges, plan options and more. Please do not hesitate to call me for clarification or to discuss this information.

Admin. – Kenton Henry

*
FEDERAL POVERTY LEVEL GUIDELINES 2013
http://allplanhealthinsurance.com
*************************************
STEP 1:
Note these key dates and deadlines in your calendar:
If your employer offers health insurance, get key dates from your HR department. These are key dates if you’re planning to buy health care through your state’s Marketplace, which is available through a web site, a call, or an in-person visit.
• Oct. 1, 2013: First day you can enroll in a health plan on your state’s Marketplace
• Dec. 31, 2013: Last day you can enroll in a health plan and have your coverage start Jan. 1, 2014
• Jan. 1, 2014: First day you have insurance coverage if you buy a plan in the Marketplace — if, of course, you buy before this date
• March 31, 2014: The last date you can enroll in a plan on your state’s Marketplace to be covered for part of 2014
*************************************
Requirements:
* Be a citizen or legal resident.
• Buy your coverage through your state’s or Federal new health insurance Marketplace, also called an “Exchange”.
• Make about $11,490 to $45,960 a year if you are single – or $23,550 to $94,200 a year if you are in a family of four.
If you make less than the lowest amount, you may be eligible for Medicaid. Medicaid will cost you less than you’d save with a tax credit.
Unfortunately, if your state is not expanding Medicaid based on the guidelines in the Affordable Care Act, you may not be able to enroll in Medicaid or be able to get a tax credit. It’s possible that if you make less than $11,490 in 2013, which is the poverty level, you may not qualify for Medicaid if you live in a state that isn’t expanding Medicaid.
In general, you’re not eligible for the tax credits if you could get coverage through a workplace. However, the coverage offered by your employer must be considered affordable. If your company offers a plan that costs more than 9.5% of your income, or that does not cover at least 60% of the cost of covered benefits, you can look for a more affordable plan through your state’s Marketplace and may receive tax credits to lower your costs.
********************************
Insurance Exchanges
State Didn’t Set Up a Marketplace? Relax
You may have heard that not all states will have their own health insurance Marketplace, also called an Exchange. If your state doesn’t set up a Marketplace, what does that mean for you?
Rest assured that no matter which state you live in, you can buy insurance through a Marketplace starting October 2013.
The way you use the Marketplace will be similar in every state. You’ll access a web site, or call, or see someone in person. And you’ll have tools to compare health plans.
But Marketplaces won’t all be the same in every state. There are three ways your state’s Marketplace can be managed — and this affects your choice of health plans and coverage.
1) State-run Marketplaces
Seventeen states are creating their own Marketplaces. These states will have a lot of local control.
Each state will decide which insurance companies can sell policies on its Marketplace.
States also choose the core benefits each plan has to offer. They can set extra requirements for health plans, like benefits that are more generous or more affordable limits on your out-of-pocket costs.
The state is also in charge of getting people to use the Marketplace.
*Indiana and Ohio will have their own State Exchange. Residents of these states should call Kenton Henry @ 800.856.6556
2) Partnerships Between a State and the Government
A few states are teaming up with the federal government to develop Marketplaces.
The federal government:
• Sets up the Marketplace web site and in-person sites
• Decides which health plans will be sold in the partner state
• Sets the benefit levels
• Runs the Marketplace
The states:
• Monitor health plans
• Help people find the best insurance for their needs *(Call Kenton Henry @ 800.856.6556)
• Handle complaints
Federal-run Marketplaces
Some states decided not to set up their own Marketplaces. In those states, the federal government will step in to run the marketplaces directly. It will make all the decisions: how the Marketplace will work, what plans are sold, and how to promote the Marketplace. Each state is considered separately and has its own Marketplace web site. (Texas residents call Kenton Henry @ 800.856.6556)
**********************************************
Your Insurance Choices in a Marketplace: FAQ

A health insuranceMarketplace, also known as an Exchange, is a one-stop shop for affordable insurance in your state. Your state’s Marketplace has tools to make it easy for you to compare your choices and pick the best for your needs.
On a state Marketplace site, health plans are grouped by levels of coverage — how much the plan will pay for your health care and what services are covered.
Each level is named after a type of metal:
• Bronze
• Silver
• Gold
• Platinum
Bronze plans offer the least coverage and platinum plans offer the most.
How do the bronze, silver, gold, and platinum levels differ?
The metal plans vary by the percentage of costs you have to pay on average toward the health care you receive.
Here are the percentages of health care costs you pay for each type of plan:
• Bronze plan: 40%
• Silver plan: 30%
• Gold plan: 20%
• Platinum plan: 10% of your health care costs.
The way you pay your portion of these costs is in deductibles and copayments or co-insurance.
In general, the more you are willing and able to pay each time for health care service or a prescription, the lower your premium. A premium is your monthly payment to have insurance.
As an example, when you compare the bronze and platinum plans:
With a bronze plan: You pay the most each time you see your doctor or get a medicine. This is also called having higher “out-of-pocket” costs. But in a bronze plan you pay the least premium each month.
With a platinum plan: You pay the least each time you see your doctor or get a medicine. But in a platinum plan you pay the highest premium each month.
How does coverage from a metal plan compare to my current insurance?
The bronze through platinum coverage levels are new. So you probably don’t know how the benefits of the plan you use today compare to them. The coverage level you have now depends on whether you bought your plan:
• From an employer: Your coverage level is likely between a gold and platinum level.
• On your own: Your coverage level is likely between a bronze and silver level.
Having a sense of how the insurance you’re used to compares with the new plans will help you decide on a plan. You should compare the out-of pocket costs you are currently paying, the services provided (including prescription drugs), and anticipated changes in your health.
If you shop for insurance on your state’s Marketplace, you’ll see the health plans organized in this way:
• 1st by metal level: Bronze, silver, gold, or platinum
• 2nd by brand, such as Blue Cross, Cigna, Humana, Kaiser, United, and others
• 3rd by type of health plan, such as HMO, PPO, POS, or high-deductible plans with a health savings account.
The type of health plan affects how much choice you have in providers, the amount of paperwork you have, and your out-of-pocket costs.
**************************************
Tax Penalty At-a-Glance: Who Will Pay The Penalty & How Much Is It?
By law, you need to have health insurance by 2014. If you already get insurance through your employer or your partner’s employer, you’re all set. But what happens if you don’t follow this requirement from the Affordable Care Act?
If you can afford health insurance and don’t buy it, you’ll pay a fine when you file your 2013 income taxes in April 2014.
For the first year of the new law, 2014, the fine for not having insurance is the lowest it will be. After that, it goes up steeply in 2015 and again in 2016.
In 2014: There are two ways the government calculates what you owe. You have to pay whichever amount is higher.
• One way is to charge you $95 for each adult and $47.50 for each child, but not more than $285 total per family.
• The other way is to fine you 1% of your family income. If your family makes $50,000 a year, the fine will be $500.
In 2015: There will still be two ways to calculate what you owe. You have to pay whichever amount is higher.
• One way is to charge you $325 for each adult and $162.50 for each child, but no more than $975 total per family.
• The other way is 2% of your family income. If your family makes $50,000 a year, the fine will be $1,000.
In 2016 and beyond: There will still be two ways to calculate what you owe. You have to pay whichever amount is higher.
• One way is to charge you $695 for each adult and $347.50 for each child, but no more than $2,085 per family.
• The other calculation is 2.5% of your family income. If your family makes $50,000 a year, the fine will be $1,250.


http://allplanhealthinsurance.com

The Foxes Long Ago Took Over the Hen House

08.06.2013
Last Friday, the President met behind closed doors with Congress to grant they and their staff (who have incomes of $100,000 or more) a waiver from paying for participation in health insurance exchanges. Supposedly, 75% of their premium will be paid by us – regardless of their income.You already knew he had reserved the right to grant waivers to unions and donor corporations, correct? And he has done that over 1,200 times to date. Well now he has done it for our employees who ultimately determine their own salaries and benefits. News of this was not released until they had left town under cover of darkness for their month long recess.
It is anticipated this special dispensation will be formally acknowledged next week by President Obama’s Office of Personnel Management (OPM)–one in the same as the federal government’s H.R. department–which is charged with administering federal benefits within the government.

For a succinct and cogent summation of what the unintended consequences of full Affordable Care Act implementation mean to the quality of our nation’s health care, please view this video of Michigan’ Congressman Rodgers as he makes his opening statement to the Chair on health care reform:

http://safeshare.tv/w/zwhKdMtFHf
Admin. – Kenton Henry
****************************************************************
Feature Article

Grassfire

08.05.2013

Moments before shuttering Capitol Hill for a month-long recess, Congress exempted 11,000 members and staff from ObamaCare. News of Friday’s last-minute deal making is especially frustrating since part of ObamaCare’s original sell to the American people was that lawmakers and aides had to use the plan.
According to The Wall Street Journal, both parties went ballistic when they learned staff would incur dramatically higher healthcare costs. “Democrats in particular, begged for help,” and President Obama leapt into action telling them in a closed-door meeting that “he would personally moonlight as H.R. manager and resolve the issue.”

He did … for Congress.

“A behind-closed-doors deal announced after Congress is safely away from the crime scene. This is exactly why America rightly hates Washington,” charged Sen. David Vitter (R-LA) in a press release posted on his official website. “Obamacare’s a train wreck, even for Congress. So it gets fixed … FOR CONGRESS ONLY” (emphasis in original).
Vitter is right. All Americans should be extended the same “resolution” that Congress is getting.

But with Congress safely tucked away in their districts, the countdown continues for the “less fortunate” Americans who, on October 1, start enrolling in ObamaCare.

* Congress returns on Monday, August 9

Obama About To Do Another Side-Step?

08.01.2013
Obama About To Do Another Side-Step?
Op-Ed

Do you remember when the snidely Governor of Texas, played by actor Charles Durning, in the movie, The Best Little Whorehouse in Texas, croon’s …
” Ooh … I love to dance the little sidestep / Now they see me, now they don’t / I’ve come and gone / And ooh, I love to sweep around a wide step / Cut a little swath / And lead the people on!”?
This is exactly the image I have of the President so often but–most recently this morning–on hearing his plans to meet again with the federal Office of Personnel Management. The purpose will be to address their concerns about being forced to abandon their Cadillac federal health plans to enter the Federal Health Insurance Exchange like so many of the rest of us. While this mandate became law when the Senate surprisingly went along with the House vote to do so – now that the time for them to enroll in the exchange is rapidly approaching – they are beginning to balk. (I guess they didn’t read the bill till it was passed!) Now it seems they would like, at the very least, for their premiums to be subsidized by the taxpayers to the tune of (a minimum) 75% as is currently the case. This in-spite of the fact that low paid interns and aides can apply for a regular subsidy (just like you and I) while Rank and File Senators and Representatives receive $174,00 in annual salary; Senate Majority and Minority Leaders $193,400; and The Speaker of the House $223,500. Doesn’t your heart just bleed for them?
Rumor has it the President has promised to see what he can do about it and meet with them again soon. Hence, I hear the words …
” Ooh I love to dance a little sidestep, now they see me now they don’t-I’ve come and gone and, ooh I love to sweep around the wide step, cut a little swathe and lead the people on.
I’m a poor boy, come to greatness. So, it follows that I cannot tell a lie.”
Admin. – Kenton Henry
****************************************************************
FEATURED ARTICLE:

POLITICOPro
Lawmakers, aides may get Obamacare exemption
By JOHN BRESNAHAN and JAKE SHERMAN | 4/24/13 9:49 PM EDT
Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama’s health care overhaul, sources in both parties said.
The talks — which involve Senate Majority Leader Harry Reid (D-Nev.), House Speaker John Boehner (R-Ohio), the Obama administration and other top lawmakers — are extraordinarily sensitive, with both sides acutely aware of the potential for political fallout from giving carve-outs from the hugely controversial law to 535 lawmakers and thousands of their aides. Discussions have stretched out for months, sources said.
A source close to the talks says: “Everyone has to hold hands on this and jump, or nothing is going to get done.”
Yet if Capitol Hill leaders move forward with the plan, they risk being dubbed hypocrites by their political rivals and the American public. By removing themselves from a key Obamacare component, lawmakers and aides would be held to a different standard than the people who put them and aides would be held to a different standard than the people who put them in office.

Democrats, in particular, would take a public hammering as the traditional boosters of Obamacare. Republicans would undoubtedly attempt to shred them over any attempt to escape coverage by it, unless Boehner and Senate Minority Leader Mitch McConnell (R-Ky.) give Democrats cover by backing it.
There is concern in some quarters that the provision requiring lawmakers and staffers to join the exchanges, if it isn’t revised, could lead to a “brain drain” on Capitol Hill, as several sources close to the talks put it.
The problem stems from whether members and aides set to enter the exchanges would have their health insurance premiums subsidized by their employer — in this case, the federal government. If not, aides and lawmakers in both parties fear that staffers — especially low-paid junior aides — could be hit with thousands of dollars in new health care costs, prompting them to seek jobs elsewhere. Older, more senior staffers could also retire or jump to the private sector rather than face a big financial penalty.
Plus, lawmakers — especially those with long careers in public service and smaller bank accounts — are also concerned about the hit to their own wallets.
House Minority Whip Steny Hoyer (D-Md.) is worried about the provision. The No. 2 House Democrat has personally raised the issue with Boehner and other party leaders, sources said.
“Mr. Hoyer is looking at this policy, like all other policies in the Affordable Care Act, to ensure they’re being implemented in a way that’s workable for everyone, including members and staff,” said Katie Grant, Hoyer’s communications director.
Several proposals have been submitted to the Office of Personnel Management, which will administer the benefits. One proposal exempts lawmakers and aides; the other exempts aides alone.
When asked about the high-level bipartisan talks, Michael Steel, a Boehner spokesman, said: “The speaker’s objective is to spare the entire country from the ravages of the president’s health care law. He is approached daily by American citizens, including members of Congress and staff, who want to be freed from its mandates. If the speaker has the opportunity to save anyone from Obamacare, he will.”
Reid’s office declined to comment about the bipartisan talks.
However, the idea of exempting lawmakers and aides from the exchanges has its detractors, including Rep. Henry Waxman (D-Calif.), a key Obamacare architect. Waxman thinks there is confusion about the content of the law. The Affordable Care Act, he said, mandates that the federal government will still subsidize and provide health plans obtained in the exchange. There will be no additional cost to lawmakers and Hill aides, he contends.

Polls Clearly Indicate the Affordable Care Act Losing Popularity

07.30.2013

Polls clearly indicate that the Patient Protection and Affordable Care Act is losing popularity with not only Democrats and Republican politicians but the American public in general. In spite of the fact that no real costs of the Affordable Care Act to employers have been realized (other than those spent in attempts to decipher it through paid consultants or in house benefits directors and actuaries) popularity for the law continues to diminish. Much of this disenchantment could stem from the fact that more of us are realizing we really may lose our current health coverage and–perhaps more importantly–our providers. Others realize part-time employment may become the norm as employers attempt to avoid the mandate they provide health insurance to full time employees, i.e., those working 30 or more hours per week. It is a highly unpopular mandate with labor unions which have always supported a minimum 40 hour work week as the definition of full-time employment. It seems only logical many employers will restrict workers to less than 30 hours in attempt to avoid providing health insurance coverage. Another unintended consequence of government’s attempts to improve things.

Admin. – Kenton Henry

******************************

Featured Articles (Reprints June 30th and 26th Editions of the National Association of Health Underwriter’s Washington Update)

Is Health Reform Losing Its Base?

It is no secret that public support for health reform has always been mixed at best and that many Republicans have strongly disliked this law from the start. Now it seems like moderate Democrats are joining the pessimistic about health reform crowd. A recent poll conducted by the Washington Post and ABC News showed that moderate Democrats (who were previous PPACA supporters) are becoming lukewarm about the health reform law. When the law was initially passed in 2011, 74% of moderate and conservative Democrats were in favor of the law. Now, that number is down to 46%. Even more notable is that support is 11 points lower than what it was last year at this time. Liberal Democrats on the other hand still strongly support the law, with 78% of them still loving it to be exact. Among the public at large, 42% support and 49% oppose the law, retreating from an even split at 47% last July. On average, 56% of Democrats now support the law, according to the poll, down 10% from last year.
The same day these polling results were released, President Obama gave a speech out of Knox, Illinois on the economy. While the focus of the speech was the nation’s economy, President Obama unsurprisingly, given the magnitude of its economic impact, brought up the health reform law and tried again to raise support. This time, the president noted that the law is in fact working in the states that embrace it. Many of the states that have decided to fight the law are not seeing as many positive results. He cited states such as California and New York as proof that the law is driving costs down. The president also said that we are “well on our way” to full implementation of the law and that once implemented, the law’s benefits will provide security to middle class families.

*****************************

Legislation and Policy

Republicans Divided Over Threat To Defund ACA.
Many outlets, mostly out of the beltway, focus on the political machinations surrounding funding for the Affordable Care Act. The reports highlight a growing rift among factions of the Republican party: those who are pushing to defund the law using a spending bill, and those who believe the move, which could ultimately result in a government shutdown, would be politically dangerous.
Roll Call (7/30, Dennis, Fuller, Subscription Publication) reports that “with 60 Republicans already pushing…to defund Obamacare in any spending bill,” Speaker John Boehner “may not be able to cobble together a House majority” to stave off a government shutdown without courting Democrats. The article notes, though, that “several prominent Republicans” have spoken out against the effort, as this threat “would surely backfire on Republicans if they carry it out.”
FOX News (7/30) reports on the “divide” in the GOP, saying that the “aggressive” push to defund the Affordable Care Act is “increasingly pitting Republicans against Republicans.”
Indeed, several Republicans have spoken out against defunding the law. Politico (7/30, Arkin) reports that in an appearance on MSNBC Monday, House Deputy Whip Tom Cole (R-OK) warned that “shutting down the government to defund Obamacare is a ‘suicidal political tactic.’” Cole is quoted as saying, “Shutting down the government is a suicidal political tactic. Eventually it will be reopened, but the president will not have capitulated and you will have discredited yourself and along the way you will have hurt the American people.”
The Washington Examiner (7/30, Carroll) reports on another high profile Republican who is against defunding the Affordable Care Act, Oklahoma Senator Tom Coburn, who called the efforts “dishonest” and “hype.”
Also reporting on Republican opposition to the tactic are MSNBC (7/30, MacDonald) and the Tulsa (OK) World (7/30, Greene).
However, many Republicans are still pushing for the tactic, led Monday by Texas Senator Ted Cruz. Politico (7/30, Kopan) reports that in an interview with Glenn Beck Monday, Cruz argued that Republicans have the opportunity to can defund the ACA, but “‘scared’ Republicans are standing in the way.” Cruz said, “What I can tell you is there are a lot of Republicans in Washington who are scared. They’re scared of being beaten up politically.”
The Washington Examiner (7/30, Spiering) reports that Senator Marco Rubio (R-FL) “defended” the proposal, saying, “With all these problems why would anyone want to continue with this failed experiment? Only in Washington do people double down on their mistakes.”
Other outlets reporting on Republicans who support fighting for defunding the ACA include the Huffington Post (7/30, Schlanger), the NBC News (7/30, Hunt) website, the Deseret (UT) News (7/30, Askar), The Hill (7/30, Baker) “Healthwatch” blog, The Hill (7/30, Jaffe) “Ballot Box” blog, and the Washington Examiner (7/30, Spiering).
As one of the few Democrats inserting himself into the intra-GOP rift, Politico (7/30, Everett) reports that on Monday, Senate Majority Leader Harry Reid said, “If Republicans force us to the brink of another government shutdown for ideological reasons, the economy will suffer. I would suggest to any of my Republican colleagues that has this idea: Give a call to Newt Gingrich. … Ask him how it worked. It was disastrous for Newt Gingrich, the Republicans and the country.”
Commentary Considers GOP Rift Over Defunding ACA. In addition to accounts of the Republican rift over defunding the Affordable Care Act, several outlets carry analyses and opinion pieces reacting to the debate. Despite some maintaining sympathies for the Republican cause, all conclude that the tactic is certain to fail at the least, and potentially dangerous for the party at the most.
Well-known conservative blogger Jennifer Rubin, in her Washington Post (7/30) “Right Turn” blog, quotes various Republican leaders who are speaking out against the tactic, including Senator Richard Burr (R-NC), who called it “the dumbest idea I’ve ever heard.” Rubin concludes that it is a “certainty” that “the GOP is not going to defund Obamacare on its namesake’s watch.”
Sean Sullivan, in his Washington Post (7/30, Sullivan) “The Fix” blog, calls Cruz’s decision to call his GOP colleagues “scared” for not going along with his plan “a perilous move.” While he is confirming his “conservative bona fides,” Sullivan writes, Cruz is also highlighting his “willingness to be an antagonist at virtually every turn.”
Brent Budowsky, in a piece for The Hill (7/30) “Pundits Blog,” writes that as many Republicans agree, “threatening to shut the government down over healthcare is profoundly unwise policy for America and profoundly unwise politics for the GOP.”
Avik Roy offers a lengthy analysis of the tactic in his Forbes (7/30) “Apothecary” blog, saying that a one year delay of the ACA’s central provisions may be better than a complete repeal.
On the MSNBC (7/30) website, Geoffrey Cowley criticizes Senator Marco Rubio (R-FL) for doubling down on the “kill-it-at-all-costs rhetoric,” seeking to blame President Obama for a potential government shutdown.
Dennis Byrne, a Chicago writer, calls the plan “more than stupid,” in the Chicago Tribune (7/30). He argues that the tactic “will surely fail,” and could very well “cost the GOP in the 2014 elections, possibly including control of the House.” The only way to repeal the law, he concludes, is to “turn the spotlight on what they’d replace it with.”
Similarly, in an editorial, the Baton Rouge (LA) Advocate (7/30) criticizes Republicans for continuing to oppose the Affordable Care Act without coming up with a viable alternative. The paper argues that any sort of GOP-sanctioned replacement “requires legislative initiative, not just opposition.”
Syndicated columnist Jules Witcover writes in the Baltimore Sun (7/30) that despite continued unpopularity, the Affordable Care Act “will nevertheless prevail.”
House To Vote This Week To Repeal Part Of ACA For 40th Time.
The Hill (7/30, Baker) “Healthwatch” blog reports that this week, the House will vote “for the 40th time to repeal part of ObamaCare.” The bill, sponsored by Representative Tom Price (R-GA), restricts the IRS from implementing any part of the law. The article points out that this is part of the GOP’s “effort to keep up the negative pressure” following the employer mandate delay.
Republicans Seek To Change ACA’s Definition Of Full-Time Employment.
CQ (7/30, Attias, Subscription Publication) reports on the “ongoing debate” over whether Congress should revise the Affordable Care Act’s definition of full time employment. So far, “Republicans and business representatives” have voiced their support for “an effort to change the definition to 40 hours a week,” but Democrats aren’t behind it.
The Delmarva (MD) Daily Times (7/30, Gaudiano) also reports on the effort to change the full-time employment threshold.
ACA Call Center Under Fire For Not Offering Health Benefits To All Workers.
FOX News (7/30) reports that a call center set up to offer Affordable Care Act assistance in Contra Costa, California, is making news for not offering health insurance to all of its employees. The state’s budget “only allows for half of the customer service agents hired to work full-time,” which many in the community find “disappointing.”
Feds’ Marketing Of ACA To Young People May Violate Age Discrimination Act.
The Daily Caller (7/29, Howley) reports that the Obama Administration’s public relations campaign touting “the benefits of enrolling in Obamacare” to young people “appears to violate the federal Age Discrimination Act,” which “states that no program that receives federal money can discriminate with respect to age.” The Daily Caller notes that the “campaign-style demographic targeting” would “at least initially have the discriminatory effect of not equally promoting subsidized health care to older participants whose participation would not be as favorable for Obamacare’s convoluted apparatus.”


http://allplanhealthinsurance.com

No Joke! – IRS Employee’s Union Wants No Part of ACA Exchange Coverage

07.26.2013

No Joke! – IRS Employee’s Union Wants No Part of ACA Exchange Coverage
Op Ed:
In an ultimate case of hypocrisy (which would be hysterical were it not foretelling a travesty of monumental proportions about to be inflicted on the American people) the Union of IRS employees wants no part of the Obamacare and the Affordable Care Act (ACA)! The Union urges its members to write their congressmen expressing reservation about being forced out the Federal Health Benefits Program and into the insurance exchanges scheduled to be up and functional by October 1. The Federal Health Benefits Program is the “Cadillac” health plan we have always heard federal employees enjoy at our expense. In the meantime, many of us will be forced to give up our current health insurance and providers to acquire what they dictate is right for us. The very representatives who passed and will enforce the legislation and mandates say it is good enough for you and me while not wanting to accept it for themselves. They want no part of the very thing they are forcing down our throats!
We cannot make this up people! And you’re not outraged? Or are you?
(For more details, please see our first feature article below.)

Admin. – Kenton Henry
****************************************************************
FEATURE ARTICLES:
Washington Examiner
IRS employee union: We don’t want Obamacare
BY JOEL GEHRKE | JULY 26, 2013 AT 11:45 AM
TOPICS: ANALYSIS BELTWAY CONFIDENTIAL

National Taxpayer Employee Union officials are giving members a form letter expressing concern…
IRS employees have a prominent role in Obamacare, but their union wants no part of the law.
National Treasury Employees Union officials are urging members to write their congressional representatives in opposition to receiving coverage through President Obama’s health care law.
The union leaders are providing members with a form letter to send to the congressmen that says “I am very concerned about legislation that has been introduced by Congressman Dave Camp to push federal employees out of the Federal Employees Health Benefits Program and into the insurance exchanges established under the Affordable Care Act.”
The NTEU represents 150,000 federal employees overall, including most of the nearly 100,000 IRS workers.
Like most other federal workers, IRS employees currently get their health insurance through the Federal Employees Health Benefits Program, which also covers members of Congress.
House Ways and Means Committee Chairman Dave Camp offered the bill in response to reports of congressional negotiations that would exempt lawmakers and their staff from Obamacare.
“Camp has long believed every American ought to be exempt from the law, which is why he supports full repeal,” Camp spokeswoman Allie Walkersaid.
“If the Obamacare exchanges are good enough for the hardworking Americans and small businesses the law claims to help, then they should be good enough for the president, vice president, Congress and federal employees,” she also said.
“The NTEU represents Internal Revenue Service employees who have the responsibility to enforce much of the health insurance law, especially in terms of collecting the taxes and distributing subsidies that finance the whole system,” said Paul Kersey, director of Labor Policy at the Illinois Policy Institute.
“IRS agents will also collect data and apply penalties for those who fail to comply with many of Obamacare’s requirements,” Kersey said.
****************
Polls Identify Americans’ Disapproval Of ACA.
In continuing coverage, the Washington Times (7/26, Sherfinski) “Inside Politics” blog reports on a Fox News poll which shows that 53% of respondents would choose to repeal the Affordable Care Act, given the choice between keeping the law in entirety or overhauling it. The piece also reports on a separate poll, from CBS News, which found that “fifty-four percent disapprove of the law and 36 percent approve of it.”
The National Journal (7/26, Shepard, Subscription Publication) reports on the findings from the new United Technologies/National Journal Congressional Connection Poll which found that “opponents of President Obama’s health care law overwhelmingly believe the Affordable Care Act will worsen the quality of their care.” Further, more of the law’s supporters than not “don’t think it will improve their health care.”
Klein Extols Opportunities Brought By ACA. Washington Post blogger and MSNBC political analyst Ezra Klein writes about the coming “opportunity to change American health-care forever,” in a piece for Bloomberg News (7/26). He explains that the Affordable Care Act “carries the potential for both huge profits and huge social benefits,” as long as “Washington can stop bickering over the politics long enough to pay attention.”
Wonkblog Explores Former Republican Alternative To ACA. The Washington Post (7/26, Matthews) “Wonkblog” reports on a former Republican plan to “replace” the Affordable Care Act, proposed in 2009 by Sen. Tom Coburn (R-OK) and Rep. Paul Ryan (R-WI). Known as the Patients’ Choice Act, the law was “a credible way of covering almost all Americans,” picking up 13 co-sponsors in the House and seven in the Senate. After describing the central aspects of the bill, pointing out its similarities with the ACA.
Papers Offer Opposite Opinions On Repealing ACA. In an editorial, the Colorado Springs (CO) Gazette (7/26) encourages Republicans to work to defund the Affordable Care Act, because “most Americans don’t want” it. The paper argues that “perhaps nothing would give our country’s economy a greater jump-start than” stopping the law “in its tracks.”
However, in an opposing editorial, the Ogden (UT) Standard-Examiner (7/26) asks Congress to “respect” the Affordable Care Act. Although the paper has “problems” with the law, it argues that implementation “should not be hijacked through the inappropriate use of a filibuster, or the House refusing to vote for its funding.”

****************

Christie Slams ACA At GOP Governors’ Meeting.
The Newark (NJ) Star-Ledger (7/26, Portnoy) reports that in a discussion with fellow Republican Governors in Aspen, Chris Christie of New Jersey on Thursday called the Affordable Care Act a “sad legacy” for President Barack Obama. During the talk, Christie said that while he has expanded Medicaid under the law, “he twice vetoed health exchanges.” Criticizing the law, Christie said, “This is what happens when you use Parliamentary maneuvers to jam an absolute sea change in American life down the throats of the American people with bare majorities and not one Republican vote.”
Jindal, Walker Say ACA Is Not Workable. In an op-ed for the Wall Street Journal (7/26, Jindal, Subscription Publication), Louisiana Gov. Bobby Jindal and Wisconsin Gov. Scott Walker write that the ACA is not workable and predict chaos as the Oct. 1 deadline for health insurance exchanges to launch. The Governors argue that while delaying implementation off the ACA is a good idea, outright repeal of the law would be better.
New Jersey Policy Analyst Discusses ACA Benefits. NJ Today (7/26) carries video of an interview with New Jersey Policy Perspective Senior Policy Analyst Raymond Castro, who discusses the benefits of the Affordable Care Act to “New Jersey residents and business owners.” In the interview, Castro drew attention to the law’s subsidies, available to those purchasing insurance on the state’s exchange, calling them “the most important part of the reform.” Castro also pointed out that New Jersey stands to “save a lot of money” under the ACA, as the Federal government will take over a large chunk of costs.
Panels Answer ACA Questions In Utah And Alabama. The Salt Lake (UT) Tribune (7/26) reports that on Thursday, a “panel of Utah health care advocates, experts and state policy leaders answered questions” about the Affordable Care Act in “a televised town hall” event. The article links to recorded versions of the event.
Alabama Live (7/26, Berry) reports that the Chamber of Commerce of Huntsville/Madison County held a panel Thursday morning to inform “several dozen professionals” how the Affordable Care Act “will impact their small businesses in Madison County.” Led by Small Business Administration Alabama District Director Tom Todt, the Affordable Care Act 101 seminar “featured an overview of the Small Business Health Care Tax Credit, Small Business Health Options Program (SHOP) and Employer Shared Responsibility for Employee Health Coverage.”

****************

White Castle Considering Upping Part-Time Hires Due To ACA.
The Huffington Post (7/26) reports that in response to the Affordable Care Act’s employer mandate, White Castle “is considering hiring only part-time workers in the future,” its Vice President Jamie Richardson said in an interview Thursday. Richardson insisted, though, that “the restaurant chain has no intention of firing members of its current full-time staff or reducing benefits.”
The Los Angeles Times (7/26, Lopez) reports that in an interview with NPR Wednesday, Richardson further outlined his plan to deal with ACA implementation, saying, “As we look to the future, when the new healthcare law takes effect, we are considering at that point, for new hires, letting those people know upfront, ‘Hey, at this point we’re only able to hire part-time team members.’”
Brooks-LaSure Speaks At Senate Hearing On ACA. Bloomberg BusinessWeek (7/26, Clark) reports on Wednesday’s Senate Committee on Small Business and Entrepreneurship hearing on concerns about the Affordable Care Act. According to the article, “the big questions…didn’t have easy answers.” Will, when asked whether “all health exchanges will be up and running as scheduled on Oct. 1,” HHS Deputy Director Chiquita Brooks-LaSure “said she expects all exchanges will be up and running.”
Survey: Business Owners In New England More Optimistic About ACA. The Boston Globe (7/26, Reidy) reports that a new survey out of Deloitte LLP shows that “mid-size companies in New England seem to be more optimistic about containing health care costs than their national counterparts.” Overall, 60% of executives “cited rising health care costs as a major obstacle to US growth,” while only 46% did in New England.

http://allplaninsurance.com

What will my health insurance premiums go to January 1?

07.23.2013
****************************************************************
What will your health insurance premiums be come January 1? If you are covered by a small business (less than 50 employees)group plan – projections are you can expect your company’s premiums to increase by a minimum of 8%. If you are not covered by an employer group plan, you will be forced to buy from a federal, state or partnership (between the two) exchange or directly from the private market. While premiums are predicted to go down in as many as 10 states, that leaves 40 where potentially they will not. The question remains – what will your premiums go to? The federal exchange which–will be the source for plans in 34 states which are not creating their own exchange–is yet to release their premiums for the plans which must be available by October 1st. The word is that you better qualify for a subsidy or you are looking at rates at least 30% higher for those currently covered.
As our feature article details, the debate still continues as to how accurate and complete is the information we are being fed as to what our costs will be.
Admin. – Kenton Henry
****************************************************************
Feature Article:
GOP: Obama administration selective with health law data
By Tom Howell Jr. – The Washington Times
Congressional Republicans on Monday accused the Obama administration of withholding data on insurance premiums because it would undermine positive trends the White House touted last week while promoting the health care law.
Citing news reports, three senior GOP senators and the chairmen of House health-related committees said the administration has collected premium filings for 34 states that will use a federally run or federal-state partnership exchange — a market where those without employer-based insurance can buy coverage with the help of government subsidies — but it will not release the information until September as it negotiates the final rates.
________________________________________
SPECIAL COVERAGE: Health Care Reform
________________________________________
“We believe it is essential that the U.S. Department of Health and Human Services provide transparent pricing as soon as possible for the millions of Americans who will be impacted by this law,” they said in a letter to HHS Secretary Kathleen Sebelius, arguing many Americans’ premiums will rise under the Affordable Care Act.
They also accused the Obama administration of negotiating rates in secret, something the Wall Street Journal editorial page described as “running Obamacare as a black-ops mission.”
Supporters of the law have been buoyed by news out of New York, where officials last week said premiums on the state’s health care exchange in 2014 will be about 50 percent lower than last year’s direct-pay rates for individuals.
The Obama administration then released a report showing that, on average, premiums would drop by 18 percent in about 10 states and the District of Columbia. Those states have made information available for the individual market in 2014, when their health exchanges open under “Obamacare.”
Since then, Republicans have cited states where early data suggest that premiums will rise.
“Instead of selectively highlighting provisions and data that paint a rosy picture, we encourage the administration to give the American people as much information as possible so they can plan and prepare, and so that we can continue the necessary oversight,” the senior Republicans said in their letter.

http://allplanhealthinsurance.com

Health Insurance Premiums To Increase 72% in State Exchange

07.19.2013

So much for the “affordable” part of the Affordable Care Act. At least in some states, like Indiana, where along with Texas and Ohio, I have many clients. As October 1st winds nearer, the date when the Federal and State Health Insurance Exchanges must unveil the new health care compliant policies for 2014 that individuals, families and small groups must choose from – it is evident costs will skyrocket. According to the Indiana Department of Insurance rates there will increase 72%! (See Feature Article below.) In Texas–which is one of 34 states which elected not to establish a state exchange–the Federal Exchange will be the (default) exchange from which to elect coverage. It’s premiums are yet to be revealed but are predicted to be at least 30% higher than for those who currently have health insurance in Texas.

In conclusion, if you do not qualify for a federal subsidy for at least a portion of your coverage–prepare yourself for a significant rate increase. What does it take to qualify for a subsidy? Your annual reportable income must be less than 400% of the Federal Poverty Limit. *Refer to the chart below that limit, increasing increments and the accompanying subsidy.

Admin. – Kenton Henry

********************************

FEATURED ARTICLE:

In Indiana, Individual Health Insurance to Cost 72% More Due to Obamacare

8:15 AM, Jul 19, 2013 • By DANIEL HALPER

Obamacare will be costly for Hoosiers who already have health insurance, according to a report from Indystar.com.

“Insurance rates in Indiana will increase 72 percent for those with individual plans and 8 percent for small group plans under President Barack Obama’s healthcare overhaul, according to the state’s insurance department,” reads the report.

“The spike in costs is due primarily to new mandates under the law, which requires insurers to cover those with pre-existing conditions and to offer a minimum level of benefits, said Logan Harrison, chief deputy commissioner with the Indiana Department of Insurance under Republican Gov. Mike Pence. New taxes and fees under the law also contributed, Harrison said.

The Indiana governor tells the paper: “This new data regrettably confirms the negative impact of the Affordable Care Act on the insurance market in Indiana. … The Affordable Care Act requires many Hoosiers to purchase more comprehensive and more expensive health insurance than they may want or need. These rates call into question just how affordable health insurance will really be for many Hoosiers.”

Costs for individual plans is expected to increase from an average of $255 per member per month in 2012 to $570 in 2014, when the most aspects of the law go into effect.

***************************************

*2013 Federal Poverty Guidelines



48 Contiguous States and DC

Note: The 100% column shows the federal poverty level for each family size, and the percentage columns that follow represent income levels that are commonly used as guidelines for health programs.

 Household   Size

 100%

 133%

 150%

200%

 300%

400%

 1

$11,490

$15,282

$17,235

$22,980

$34,470

$45,960

 2

15,510

 20,628

23,265

  31,020

46,530

62,040

 3

19,530

 25,975

29,295

  39,060

58,590

78,120

 4

23,550

 31,322

35,325

  47,100

70,650

94,200

 5

27,570

 36,668

41,355

  55,140

82,710

110,280

 6

31,590

 42,015

47,385

  63,180

94,770

126,360

 7

35,610

 47,361

53,415

  71,220

106,830

142,440

 8

39,630

 52,708

59,445

  79,260

118,890

158,520

 For   each additional person, add

$4,020

 $5,347

$6,030

  $8,040

$12,060

$16,080


Alaska

 Household Size

 100%

    133%

 150%

200%

 300%

 400%

 1

$14,350

$19,086

$21,525

$28,700

$43,050

$57,400

 2

19,380

25,775

29,070

38,760

58,140

77,520

 3

24,410

32,465

36,615

48,820

73,230

97,640

 4

29,440

39,155

44,160

58,880

88,320

117,760

 5

34,470

45,845

51,705

68,940

103,410

137,880

 6

39,500

52,535

59,250

79,000

118,500

158,000

 7

44,530

59,225

66,795

89,060

133,590

178,120

 8

49,560

65,915

74,340

99,120

148,680

198,240

 For   each additional person, add

$5,030

$6,690

$7,545

$10,060

$15,090

$20,120


Hawaii

 Household   Size

 100%

 133%

  150%

 200%

 300%

 400%

 1

$13,230

$17,596

$19,845

$26,460

$39,690

$52,920

 2

17,850

23,741

26,775

35,700

53,550

71,400

 3

22,470

29,885

33,705

44,940

67,410

89,880

 4

27,090

36,030

40,635

54,180

81,270

108,360

 5

31,710

42,174

47,565

63,420

95,130

126,840

 6

36,330

48,319

54,495

72,660

108,990

145,320

 7

40,950

54,464

61,425

81,900

122,850

163,800

 8

45,570

60,608

68,355

91,140

136,710

182,280

 For   each additional person, add

$4,620

$6,145

$6,930

$9,240

$13,860

$18,480

Source: Calculations by Families USA based on data from the U.S. Department of Health and Human Services

Courtesy of All Med & Life Quote

http://allplanhealthinsurance.com

http://allplaninsurance.com

House to Vote on Affordable Care Act Individual and Employer Mandates

07.17.2013

Currently we have over 800,000 veterans awaiting decisions on their disability claims. The back log is so great–according to the most recent numbers available–the average wait time for a veteran is 15 months in Chicago, 16 months in New York and a year and a half in Los Angeles. Social Security’s disability program, which helps support 11 million Americans, will run through its trust fund in 2016, two years earlier than predicted. Couple this with the prediction Social Security, the fund that finances benefits for 44 million senior citizens and their survivors, will be exhausted by 2035 and Medicare, the health care program for those age 65 and over, will be have depleted its funds by 2024. Now consider a law has been passed which mandates health coverage for every American. Its objectives are largely, and initially, funded via subsidies from the federal government (you the tax payer). Can you possibly believe this is feasible given their track record? Given a federal debt of almost 17 trillion dollars? How long do you believe it will take before all private insurance companies are forced to withdraw from participation to be replaced by a single payer federally administrated program which can’t possibly be any more financially feasible than our government’s disability program, Social Security or Medicare?

Admin. – Kenton Henry

http://allplanhealthinsurance.com

****************************************************************

Today’s Feature Articles:

Legislation and Policy

House Votes To Target ACA Individual, Employer Mandates.

Coverage of the Obama Administration’s decision to delay the Affordable Care Act’s employer mandate continues Wednesday, the same day the House is set to vote to further capitalize on the weak position they believe the move has put Democrats in. Most reports, some national in scope, focus on the House votes to delay both the employer and individual mandates, while others focus on the implications of both of these provisions.

McClatchy                          (7/17, Kumar) reports that on Wednesday, the Republican-ruled House is expected to vote to delay key parts of the Affordable Care Act, a move that “is the latest in a sweeping legislative and political campaign to weaken the 2010 law and raise even more opposition in the eyes of an already skeptical nation, especially as it heads into 2014 elections that will decide control of the Congress and set the stage for the 2016 campaign for the White House.” The back-to-back votes will determine “whether to delay insurance mandates for both employers and individuals.”

The Washington Times

(7/16, Howell) reports that “President Obama has threatened to veto” the bills. Meanwhile, “the votes will force Democrats to align with the president or distance themselves from the overhaul in the wake of its recent stumbles.” In addition, it has put the “Office of Management and Budget in the awkward position of threatening, in the case of the employer mandate, to kill a bill that would reflect the White House’s own decision-making.”

CNN

(7/16, Walsh) reports that “most House Democrats are expected to oppose two House Republican bills on Wednesday that would delay key provisions of Obamacare,” according to House Democratic Whip Steny Hoyer (D-MD).

The Hill

(7/17, Baker) “Healthwatch” blog reports that the bill to delay the individual mandate “would cut the deficit, but would cause insurance premiums to rise,” according to the Congressional Budget Office.

Implications Of Employer Mandate Delay Still Unclear. The AP

(7/17, Alonso-Zaldivar) reports on the “domino effect” that is currently “undercutting” the Affordable Care Act: the Obama Administration’s delaying of the law’s employer mandate could “weaken” the individual mandate, because the requirement that companies report health insurance details for employers has also been pushed back. As the article explains, “without employers validating who’s covered, a scofflaw could lie, and the government would have no easy way to check.” The piece calls this yet “another incentive for uninsured people to ignore a new government requirement that for many will cost hundreds of dollars.”

****************************************************************

Not All Insurers Game for State Exchanges: The Consumer Impact

By Kate Rogers

Published July 11, 2013

FOXBusiness

As more insurers decide to pack up and leave certain states as health exchanges start to take form, experts say consumers are going to be left  feeling the pain.

Over the last few weeks, several departure announcements have sent a ripple through the health insurance industry, as companies weigh whether or not they want to play ball under Obamacare. So far, California has experienced the biggest migration  with Aetna (AET), UnitedHealthcare (UNH) and Cigna (CI) leaving the state’s exchange, Covered California.

Aetna also reportedly sent out a note to select customers last week, warning that the Patient Protection and Affordable Care Act is “changing health insurance.” Recipients were customers across the country with non-grandfathered health plans, meaning their plan was not in effect on March 23, 2010 and wouldn’t carry over under new state and federal exchange regulations under ACA.

“This includes adding preventative care and essential health benefits. The ACA also ends medical underwriting. Due to these and other changes, many people will pay more for their health insurance coverage in 2014 than they do today,” the letter stated according to the carrier.

Wellmark Blue Cross/Blue Shield also decided not to list on the individual exchange in Iowa for 2014, due to a lack of information available in the state, according to a spokesperson for the Iowa Insurance Division.

Fifteen states and the District of Colombia are in the process of creating their insurance exchanges before the 2014 deadline; when individuals must purchase insurance or face a fine for failing for comply with the individual mandate. The employer mandate has been pushed back to 2015, and some in the GOP including House Majority Leader Eric Cantor, (R-VA), are calling for the individual mandate to be rolled back as well.

More or Less Competition for Consumers?

Some experts say the recent departures hint consumers will have limited health-insurance choices thanks to the regulatory burdens of the law. Basic supply and demand dictates that with fewer insurers to choose from, consumers will have limited options and potentially higher prices, says Michael Cannon, director of Health Policy Studies at the CATO Institute.

A similar “exodus” occurred within the first six months of the implementation of the Affordable Care Act, Cannon says, when child-only care was enacted. Seventeen major insurers dropped child-only coverage, in an attempt to skirt the law’s new regulations and increased costs. The same may begin to take shape in the individual market.

“The program says you can’t charge higher premiums to the sick, so you have a situation where only low-risk consumers would be charged a premium much higher than their regular costs, so only people who buy it would be those who really needed it,” he says.

The employer mandate rollback is also a factor in the situation, says Grace-Marie Turner, founder of the Galen Institute, a health and tax policy research organization, as employers will now be incentivized to drop coverage and push their employees into the exchanges until 2015.

“It’s using employers to push more people into the exchanges,” Turner says.

Fewer insurers in state exchanges mean less competition, bottom line, she adds. “The whole point is we want more players, and more competition.”

Why California Matters

What happens in California is a big deal for the future of the Affordable Care Act, says Taylor Burke, associate professor and program director, MPH in Health Policy, at George Washington University.

“It’s an exit out the individual market, but [the insurers] only represent 8% of the individual market companies in the state,” Burke says. “California has the 7th largest economy on the globe, so whatever happens in California is a big deal for the stand up of the state exchanges.”

He points to two main reasons insurers leave a state: they don’t like the price points being offered in the exchanges nor the coverage they would have to offer under Obamacare’s 10 essential health benefits.

“In California, you can make the argument that there would be less choice, but if they stay in the market, their prices would be off the charts,” he says. “It would be a thing on the shelf, a high-ticket item that you couldn’t afford anyway.”

And if insurers take too long to make the decision, that may impact them negatively as well, he says.

“No one will want to buy their product. There’s a lot of hemming and hawing, but if the price point is too high, no one will buy it.”

But can consumers blame the insurer for higher prices? Turner says no, it’s the nature of the law’s regulations.

“Insurers can’t help the demands on the benefits they will have to cover—it will absolutely be more expensive,” she says. “It’s like going to buy a car with every accessory in the books—heated seats, fancy wheels, satellite radio, and saying you can’t charge more for it.”

What Insurers are Deciding

Robert Zirkenbach, spokesman for America’s Health Insurance Plans (AHIP), says each individual company will have to make their own decisions about which states to participate in as exchange bids come in.

“It will be based on a variety of reasons, but plans are offering coverage on the exchange, some will be outside the exchange—there will be options for consumers,” Zirkenbach says. “It will depend on the state and regulatory environment.”

He says the AHIP wants competition among insurers to keep consumer prices in check.  “Choice and competition is a good thing—when states have been setting up their exchanges, we are trying to encourage this,” he says.

The National Association of Insurance Commissioners says insurers who are leaving these markets are likely doing so because they have core businesses in other segments, including the large group market.

“The carriers we have seen exiting the individual market are not major players in that market segment, and therefore we don’t anticipate a major disruption of coverage for a large portion of the market,” a spokesperson said in an email statement. “Each insurance company is making decisions regarding its participation in exchanges based upon a number of factors.  Some are opting to participate in the exchanges, while others are not; however, nearly all of the requirements that apply to policies sold on the exchange also apply to policies sold outside the exchange, so insurers will not be avoiding a lot of requirements by opting out of the exchanges.”