Medicare Part D Prescription Plans: What you Need to know

 

Greetings! To those of you who are current clients, thank you so much for your continued business. It’s that time of year again! Medicare’s Open Enrollment Period runs through December 7th. Most of you know, during this time, a Medicare recipient may analyze how their prescription drug usage or their current Part D Prescription Drug plan may have or will be changing for the coming calendar year.

2018 DEDUCTIBLE – INITIAL COVERAGE – GAP – CATASTROPHIC THRESHOLDS

Each year, virtually every drug plan changes something material about their coverage. It may be the premium, deductible, drug tiers, copays, or the drugs they cover or don’t cover. It could be all these things. If you don’t read your ANNUAL NOTICE OF CHANGE from your current Part D plan carrier (which you are due by September 30th each year) you could be in for some surprises with your coverage in the coming calendar year!

COMMONLY OVERLOOKED DETAILS:

a) Many people get fixated on the premium and go with the lowest. It’s easy to do. They do this without factoring in applicable deductibles and copays. My lowest premium Part D plan in 2018 is $16.70 per month. Most often, the plan with the lower premium has a higher deductible and copays, so―especially if you are using expensive brand name drugs―you end up paying more for your coverage, and drugs, overall. The same applies to the plans with no deductible.

b) While an annual deductible as high as $405 may apply before your Rx drugs are available for their copays, very often, the deductible does not apply to Tier 1 Preferred Generics and Tier 2, Non-Preferred Generics. That makes a big difference for most people. This is an example of where it pays to carefully review the plan’s SUMMARY OF BENEFITS.

c) When tempted to go with a Medicare Advantage Prescription Drug plan, keep in mind you will have to accept whatever drug coverage is tied to your Medical plan. If you are using expensive drugs, that means you may not necessarily end up with your lowest cost for your drugs. As you would when you let me identify that in the “stand-alone” Part D market.

d) As I explained in a previous post―especially when it comes to brand name drugs―it pays to always ask the pharmacist “what is this pharmacy’s lowest cost for this drug?”. Often that cash price is actually lower than your plan’s copay. In which case ― just pay cash!

Part of the service I provide my clients is running their prescription drug regimen through my a program to identify whether a superior Part D Drug plan exists for them for the coming year. My goal is to have you on a plan which results in all your prescription drugs being covered at your lowest total “out-of-pocket” (TOOP) expense. TOOP is the sum of your premium, any applicable deductible, and the copays you pay for your drugs at the pharmacy counter or through the mail. If we are fortunate enough that your current drug plan still results in meeting these objectives, you simply stay the course and let your plan roll right into 2017! If it no longer results in your lowest TOOP, I will identify the plan that is and (with your instruction) enroll you in it.

Some of you have already seen a version of this (and some of you have been preemptive) and provided me your regimen. For you, I have been working most nights and weekends since October 15th providing you 2018 plan recommendations. If you received one, you need read no further unless you are yet to request that I apply on your behalf. In which case – request the application be emailed to you or – in the case of Aetna and Humana applications – simply request I apply on your behalf with your information I have on record. Please do not apply without my involvement. Mine is a volume business, and I don’t stay in business without it going through me. Even Kenton has to eat! So your business is greatly appreciated!

To accomplish this, I need each of you (who have not already done so) to respond to this email with a list of current drugs and dosages. I am quoting each person’s plan in the order received. Remember, we have until December 7th but applying early is always better than later. So, please, forward your drug regimen, and I will quote you as soon as possible.

As to those of you with Medicare Advantage Plan, who like your coverage, you need do nothing. Just keep paying the premium and let your coverage roll right into the new year. Most of my clients have Medicare Supplement. For those whose policies are no more than two years old, you can be fairly certain it remains competitively priced, and there is little to regain in changing plans. For those of you whose policy is older than two or three years, I am volunteering to re-shop* your plan, beginning in mid-January when all my client’s Part D plans and Under Age 65 health insurance is put to bed. It is simply too much to address during the Open Enrollment Period for both Medicare and Obamacare! The government puts me in the untenable role of having to process 12 months worth of business in 8 weeks. There is no point in hiring additional help. By the time I got them trained, I would have to lay them off!

As my phones will be very busy, you may want to text me during this period if it is important you speak with me right away. My cell phone number appears below. I look forward to keeping you as a client and working to limit your medical and Medicare-related insurance expenses!

Thanks so much!
Kenton Henry
Office: 281.367.6565
Text my cell @ 713.907.7984
Http://Allplanhealthinsurance.com
Http://TheWoodlandsTXHealthInsurance.com

For the latest in health and Medicare relative news, follow my blog @ Https://HealthandMedicareInsurance.com

*Remember – because all of you are six months past your enrollment in Medicare’s Part B – it will be necessary for you to answer a series of health questions and qualify (based on your health) for a new, replacement, Medicare Supplement policy. When the time comes, I can email you sample applications so you may review those questions.

 

2018 Health Insurance Open Enrollment: Game On

Today is November 1, the first day of OPEN ENROLLMENT for Individual & Family 2018 health insurance coverage. This is not going to be my usual Op-Ed or commentary. Things are what they are for now, and I will let the numbers and the available benefits speak for themselves. We can go back to the dialogue once everyone has decided what is in their best interest for the coming year and elected a plan.

Because my phone ― and that of every agent and broker ― specializing in this market ― is going to be ringing off the hook the first few weeks, I am going to provide you some guidance to make this as easy as possible, on all of us.

Please go my quoting and application site. It has just been loaded with all your available plan options. Whether you receive a subsidy and have gone through Healthcare.gov and think you need to – or not ― you should begin here. You can get the quotes; estimate your applicable subsidy; and, seamlessly, enter into Healthcare.gov. Or, if you don’t qualify for or desire a subsidy, you may apply. If you need my assistance, you may save your work. I will see it and can pick up where you left off, to help you finish. You may email me and, if preferring to speak immediately and you cannot reach me on my desk phone, text me on my cell and I will get in touch with you, as soon as possible. If you need me immediately and cannot reach me on my desk phone, text me on my cell and I will get in touch with you, as soon as possible. My cell number is 713-907-7984. I will answer your questions and assist you in completing the process. (The voice-mail on the office line will be checked but, on the cell phone, will remain full.) It will help us both immensely if you review your options before contacting me.

CLICK HERE FOR 2018 HEALTH INSURANCE QUOTES AND PLAN OPTIONS:

https://allplanhealthinsurance.insxcloud.com/my-quote/individual-info

Here are the options I have to assist you from my quoting site:

(CLICK ON IMAGE TO ENLARGE)

Good luck and don’t hesitate to let me assist you with this year’s Open Enrollment!

D. Kenton Henry

Email: Allplanhealthinsurance.com@gmail.com

Office: 281-367-6565

Cell: 713-907-7984

https://allplanhealthinsurance.insxcloud.com/my-quote/individual-info

http://TheWoodlandsTXHealthInsurance.com

https://HealthandMedicareInsurance.com

THE FUTURE OF HEALTH INSURANCE IN 2018

Shortly after 1:30 a.m. Friday, July 28th, the U.S. Senate voted 49-51 to reject the Health Care Freedom Act (HCFA), a “skinny repeal” of the ACA. The pared-down version was attempted after previous efforts to pass a more sweeping repeal of the law have failed. Senate Majority Leader Mitch McConnell (R-KY) began floating the idea early in the week before ultimately releasing the text of the bill at 10 p.m. Thursday, just two hours before the vote. Republican Senators Susan Collins (ME), Lisa Murkowski (AK), and John McCain (AZ) joined all Democrats in voting no, while all other Republicans voted in favor. With the failure of this vote, congressional Republicans will no longer be able to use the budget reconciliation process to repeal provisions of the ACA until the next fiscal year and will instead have to move legislation under regular order that would require 60 votes for passage in the Senate. ― NAHU 7/28 (washingtonupdate@nahu.org)

Anyone who tells you they know what the next few months before health insurance OPEN ENROLLMENT  (OE)―the period during which individuals and families may apply for and obtain coverage for the coming calendar year―will produce definitively, is deluding themselves. OE is scheduled to begin November 1 and run through December 7th. At this point, the only safe prediction is the preservation of the status quo. In other words, premiums will increase another 15 to 25% minimum; there will be fewer options regarding carriers and plans and fewer in-network medical providers from which to choose. In some parts of the country, it will be even worse, with only one carrier to choose from and―in some cases ― none. Whether that will be the case in Texas remains to be seen.

Here is what we do know:

1) Premiums will increase significantly in most areas

2) In the area of Houston, one more carrier―Memorial Hermann Health Plan―has announced they are withdrawing from the market. All of their current policyholders must find replacement coverage for 2018.

3) Humana has canceled all their current individual and family plans effective July 1 and will not participate in the market in 2018. This is in addition to Aetna, Cigna’s and Unitedhealthcare’s withdrawal from the market in 2017.

4) Residents of Harris, Fort Bend, and Montgomery Counties will (hopefully) have only plans from BlueCross BlueShield of Texas, Community Health Choice, and Molina Healthcare from which to choose.

5) The only remaining network option available from the above-referenced carriers will be Health Maintenance Organization (HMO) plans where the insured individual must seek treatment within the network or have no coverage whatsoever.

Here is an important change this editor (who is also a health insurance broker) recently learned. Married couples who are small business owners seeking Preferred Provider Organization (PPO) coverage as a way of having access to providers and treatment―will no longer be eligible for coverage with most (if not all) small group carriers unless they had a minimum average of one W-2 employee in the previous calendar year. This new stipulation would have prevented many of my business owner clients from obtaining the group PPO health insurance they now have, had it been in effect before January 1 of 2017. A prospective client of mine whose family coverage was canceled by Humana, July 1―in the midst of cancer treatment―now finds himself denied covered access to his oncologist and hospital. It appears all ongoing medical treatment from those providers, at least through the remainder of the year, will be self-funded. If you are a small business owner considering moving to group insurance in 2108, bear this in mind and begin paying at least one employee W-2, full time, through the remainder of 2017.

Small business owners considering a move to small group coverage who can meet this eligibility requirement, please contact me for assistance in making the transition.

For individuals and families who do not have a business, or employer sponsored health insurance, I will have whatever health insurance options are available to residents of your county and will soon begin testing and certifying (as I must each fall) to market these plans for the coming calendar year. I will be able to assist you whether you qualify for a subsidy of your health insurance premium or do not. If you do, I believe it will be much easier to obtain your subsidy and health insurance through me than by dealing with the marketplace, Healthcare.gov. If you do not qualify for a one, I have a strategy for minimizing your premium while giving you access to the provider of your choice. It is not appropriate for everyone, but it has worked for many of my clients.

Please contact me at 281-367-6565; text me at 713-907-7984, or email me at allplanhealthinsurance.com@gmail.com

Though I see little reason to be optimistic for a solution to the aforementioned problems until the Patient Protection and Affordable Care Act (Obamacare) implodes entirely, and Congress is forced to unite to provide a workable solution, let’s hope enough reasonable minds prevail before it comes to that. In the meantime, I am here to assist in acquiring the best available option, as I have for the past 26 years.

―D. Kenton Henry, editor, agent, broker

http://TheWoodlandsTXHealthInsurance.com

https://healthandmedicareinsurance.com

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FEATURED ARTICLE

GOP leaders say it’s time for Senate to move on from health care

(Jenny Starrs/The Washington Post)

By Sean Sullivan By Sean Sullivan July 31 at 9:24 PM

Senate Republican leaders signaled Monday that they intend to move on from health care to other legislative priorities, even as President Trump continued to pressure lawmakers to repeal and replace the Affordable Care Act.

The discord comes amid uncertainty in the insurance industry and on Capitol Hill about what will come next after last week’s dramatic collapse of the GOP’s effort to scrap the seven-year-old landmark law. Trump on Monday threatened to end subsidies to insurers and also took aim at coverage for members of ­Congress.

But the White House insistence appears to have done little to convince congressional GOP leaders to keep trying. One after another on Monday, top GOP senators said that with no evidence of a plan that could get 50 votes, they were looking for other victories.

“We’ve had our vote, and we’re moving on to tax reform,” said Sen. John Thune (S.D.), one of Senate Majority Leader Mitch McConnell’s top lieutenants, speaking of the next big GOP legislative priority.

Sen. Roy Blunt (Mo.), another member of the Republican Senate leadership, put it this way: “I think it’s time to move on to something else. Come back to health care when we’ve had more time to get beyond the moment we’re in — see if we can’t put some wins on the board.”

McConnell did not address health care in his remarks opening Senate business on Monday afternoon. His top deputy, Sen. John Cornyn (Tex.), brushed back comments White House budget director Mick Mulvaney made on CNN on Sunday urging Republicans not to vote on anything else until voting on health care again.

“I don’t think [Mulvaney’s] got much experience in the Senate, as I recall,” said Cornyn as he made his way into the Senate chamber. “And he’s got a big job. He ought to do that job and let us do our job.”

Mulvaney was echoing what Trump tweeted Saturday: “Unless the Republican Senators are total quitters, Repeal & Replace is not dead! Demand another vote before voting on any other bill!”

On Monday, Trump tweeted: “If Obamacare is hurting people, & it is, why shouldn’t it hurt the insurance companies & why should Congress not be paying what public pays?” He was referencing subsidies that members of Congress receive to help offset their coverage costs purchased through the District’s exchanges, as required under the Affordable Care Act.

Sen. Rand Paul (R-Ky.) said Monday that based on a conversation he had with Trump, the president is considering taking executive action on health care, Reuters reported. A Paul spokesman did not immediately respond to a request for comment, and it was not clear what such an action could be. Health and Human Services Secretary Tom Price indicated over the weekend that he was considering using his regulatory authority to waive the Affordable Care Act’s mandate that all Americans buy coverage or pay a tax.

Some rank-and-file Republican lawmakers have used the collapse of repeal-and-replace to offer new fixes and improvements to health care, but there was no sign their leaders were engaged. On Monday, Price met with fellow physician Sen. Bill Cassidy (R-La.), who has proposed restructuring how federal money is distributed under the Affordable Care Act. Separately, a bipartisan group of 43 House members released details of their own plan.

“We had a productive meeting. All involved want a path forward,” said Cassidy in a statement after his White House meeting, also attended by several governors. In addition to turning over federal funds to the states, Cassidy and Sens. Lindsey O. Graham (R-S.C.) and Dean Heller (R-Nev.) have proposed repealing key mandates and a tax under the law.

But there are no signs that plan will be put to a vote any time soon. It has not been scored by the nonpartisan Congressional Budget Office. It’s unclear how many Republicans would vote for it. And McConnell is working on confirming Trump’s nominees this week.

A growing number of Republican lawmakers have raised the prospect of working with Democrats on health care. The collection of centrist House Republicans and Democrats unveiled a proposal Monday calling for revisions they said would help stabilize the individual insurance ­market.

Rep. Tom Reed (R-N.Y.), a co-chair of the centrist Republican and Democratic “Problem Solvers Caucus,” which released the plan, said he and his colleagues have been working on a draft for about three weeks, as they saw “the writing on the wall” that the Senate bill was likely to fail.

House Speaker Paul D. Ryan (R-Wis.) did not champion the plan. AshLee Strong, his press secretary, said in an email: “While the speaker appreciates members coming together to promote ideas, he remains focused on repealing and replacing Obamacare.”

Strong did not respond to a follow-up question about how that ought to happen. The House passed a sweeping rewrite of the Affordable Care Act this year, with only Republicans voting for it.

The Senate tried to pass its own version but was unable to reach an accord, even on a more modest bill that was meant to keep the talks alive in both chambers. That bill was rejected Friday when Sen. John McCain (R-Ariz.) joined two other Republicans to sink the legislation in a tension-filled vote that happened while most of the country was asleep.

In their outline, Reed and his colleagues said federal cost-sharing subsidies should be placed under congressional oversight and that mandatory funding should be assured. Now such disbursements are up to the Trump administration, which has been paying them monthly but has threatened to withhold them.

Top Democrats and Republicans warned against that.

“Right now, as insurers prepare to lock in their rates and plans for 2018, the Trump administration is dangling a massive sword of Damocles over the heads of millions of Americans — threatening to end payments the administration is supposed to make that would lower deductibles and out-of-pocket costs for so many Americans,” said Senate Minority Leader Charles E. Schumer (D-N.Y.) on the Senate floor.

Thune said he was “hopeful” the administration would keep making the payments.

After Friday’s vote, some Democrats have felt more empowered to talk about changes to the Affordable Care Act. The centrist House lawmakers want to repeal the 2.3 percent tax on medical device manufacturers and loosen the employer mandate under the Affordable Care Act. The law says companies with 50 or more full-time employees must offer coverage. They want to raise the threshold to 500.

They also said they want to create a state stability fund to reduce premiums and spur more innovation at the state level.

Getting health-care legislation backed only by Republicans to Trump’s desk by the end of August is all but impossible, even if they suddenly put aside their disagreements. The House is in recess until September. The Senate is scheduled to be in session the first two weeks of August.

The prospects of a bipartisan deal were just as doubtful, amid fierce partisanship that has gripped the Capitol in the Trump era, which has shown no signs of abating. Even those pushing for one were tempering expectations.

“We’re not stupid,” Reed said. “Those partisan swords — they’re going to be out there.”

Paige Winfield Cunningham contributed to this report

Health Insurance Plans and Premiums For 2017

health-insurance-premiums-2017

Well, here we are, two days from Obamacare Open Enrollment. Tuesday, November 1st, the starting gun goes off for Americans to shop for 2017 health insurance and we cross the finish line January 31st, at which point, our health insurance―barring a significant life change―will be locked in the remainder of the year. This month is my 30th year in the industry and it is my job to help you identify and elect your best health insurance option for 2017.

Here are the challenges ahead of us. As those of you who were in Under Age 65 health insurance market last year well know, you were forced off your PPO plan (assuming you were in one) and into HMO coverage. And you learned it was extremely difficult to find your doctors and hospitals in any HMO plan network. (In an HMO plan, you must utilize providers in your network or you have no coverage whatsoever.) Hence, you found your doctors, hospitals, and, effectively, your treatment rationed. Previews of the 2017 plans and premiums indicate most insurance companies have withdrawn from the market and those remaining are continuing to offer HMO coverage only. To add insult to injury, they are offering it at dramatically higher premiums. In Texas, premiums are 25% higher on average. And they are much higher in many other states.

As I write, plan and premium change notices are arriving in the mail and pushing the edge out of the sticker shock envelope. My own arrived, and while a 23% increase sounds good relative to what many of my clients are experiencing, the insurance company is also raising the deductible on my plan by a thousand dollars. A client left a message in my voicemail late Friday evening informing me his premium is increasing 58.9%. He went on to say, “That is unsustainable and I will pay the penalty before I pay that premium! We will have to find something else!” What he may not know yet―and what I will have to inform him―is that he will only have plans for two companies to choose from in his county. One is the company he is with. Regardless, all the options he will have are at significantly higher premiums than last year. Since 2014 (the first year Americans whose net income fell below a certain threshold were able to receive subsidies to offset a portion of their health insurance premium) I have said―if you qualify for a significant one―you may be happy with your health insurance premium. However, if you are one of the millions of hard working Americans making just above that threshold―in all likelihood―you are, like my client who left the voicemail, distraught over what is happening to your health insurance costs.

That being said, and as was already said, it is my job to help you identify your best option. And to do so without foregoing health insurance protection and paying the ensuing penalty for doing so. The strategy I employed for myself in 2016 is the same I will be utilizing in 2017. It is not what I would prefer, but what I would prefer is not an option. It is, however, the best option in light of the circumstances. Finances may not be your concern but access to your providers may be. Or, access to your providers may not be your concern but finances may be. Both may be your concern. My strategy may work for you or it may not. But I feel it provides the least compromise and is the best for adapting to this current state of affairs. At least until better options avail themselves in the individual and family health insurance market. Please contact me at 2813676565 to discuss it. If you feel it, or another approach, is the way you would like to proceed, I can make the application process go as quickly and smoothly as possible. And that is whether you qualify for a subsidy or not and without you having to personally deal with healthcare.gov.

ATTENTION SMALL BUSINESS OWNERS: You have possible recourse regarding the poor options in the individual and family health insurance market. If you are the owner of a legal business entity, e.g., LLC or corporation, you have an alternative. During the Small Business Open Enrollment Period (SBOEP)―from November 1 through December 15th―you may enroll your employer group and still have access to quality coverage and, more importantly, quality PPO provider networks where you are in control of who your providers are and, therefore, your treatment. During this SBOEP you will not have to meet the participation or contribution requirements which apply to small business group enrollment during the remainder of the year. In other words, you need only cover a minimum of two employees and you can require they pay 100% of their personal and family premium which will then be payroll deducted from their compensation. Please contact me if you have an interest in pursuing this strategy.

For those who are strictly in the market for individual and family health insurance, as of Tuesday, you may go to my website at http://TheWoodlandsTXHealthInsurance.com to review your options. While this site focuses on our hometown, it will provide quotes for residents of all 50 states. I can be the agent for residents of Texas, Indiana, Ohio and Michigan. Once there, you may apply online or call me to discuss the details of the options you see and I can submit your application for you. I the meantime (as of this moment), if you know―or believe―you qualify for a subsidy of your premium, you may go to my second quoting site where you may calculate the subsidy you qualify for or the penalty for not purchasing health insurance in 2017. You mag go on to obtain your quote and, if applying, log directly into healthcare.gov and apply. If doing so, when asked if you are working with anyone else on your coverage, select Agent or Broker and list my agent (legal) name, Donald Kenton Henry, and my National Producer Number (NPN) 387509. If you do this, I will be able to assist with any incomplete applications or outstanding requirements. If you become my client, in most cases, I can handle service related issues throughout the year without you having to deal with the personnel at healthcare.gov or an insurance company. The important thing I would like for you to appreciate is – you are charged not one penny more in premium by going through me for your health insurance than if you were to go directly through the front door of the insurance company whose product you wish to acquire and purchased it directly. And I charge no fee for my service. I only hope that, if I introduce you to a product you wish to utilize or a strategy, you wish to employ, you will acquire the product through me as your agent.

Click on this link to calculate penalties, subsidies and preview the plans available Tuesday, November 1: https://allplanhealthinsurance.insxcloud.com/my-quote/individual-info

I look forward to working with you and to, if becoming your agent, providing you the best of insurance service throughout the year. Again, please call me at 2813676565.

(Donald) Kenton Henry ― editor, broker

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FEATURE ARTICLE

The New York Times

Health Law Tax Penalty? I’ll Take It, Millions Say

By ROBERT PEAR OCT. 26, 2016

The decision by many healthy people not to sign up under the Affordable Care Act, even if it means a tax penalty, is undermining the plan. CreditKaren Bleier/Agence France-Presse — Getty Images

WASHINGTON — The architects of the Affordable Care Act thought they had a blunt instrument to force people — even young and healthy ones — to buy insurance through the law’s online marketplaces: a tax penalty for those who remain uninsured.

It has not worked all that well, and that is at least partly to blame for soaring premiums next year on some of the health law’s insurance exchanges.

The full weight of the penalty will not be felt until April, when those who have avoided buying insurance will face penalties of around $700 a person or more. But even then that might not be enough: For the young and healthy who are badly needed to make the exchanges work, it is sometimes cheaper to pay the Internal Revenue Service than an insurance company charging large premiums, with huge deductibles.

“In my experience, the penalty has not been large enough to motivate people to sign up for insurance,” said Christine Speidel, a tax lawyer at Vermont Legal Aid.

Some people do sign up, especially those with low incomes who receive the most generous subsidies, Ms. Speidel said. But others, she said, find that they cannot afford insurance, even with subsidies, so “they grudgingly take the penalty.”

The I.R.S. says that 8.1 million returns included penalty payments for people who went without insurance in 2014, the first year in which most people were required to have coverage. A preliminary report on the latest tax-filing season, tabulating data through April, said that 5.6 million returns included penalties averaging $442 a return for people uninsured in 2015.

With the health law’s fourth open-enrollment season beginning Tuesday, consumers are anxiously weighing their options.

William H. Weber, 51, a business consultant in Atlanta, said he paid $1,400 a month this year for a Humana health plan that covered him and his wife and two children. Premiums will increase 60 percent next year, Mr. Weber said, and he does not see alternative policies that would be less expensive. So he said he was seriously considering dropping insurance and paying the penalty.

“We may roll the dice next year, go without insurance and hope we have no major medical emergencies,” Mr. Weber said. “The penalty would be less than two months of premiums.” (He said that he did not qualify for a subsidy because his income was too high, but that his son, a 20-year-old barista in New York City, had a great plan with a subsidy.)

Iris I. Burnell, the manager of a Jackson Hewitt Tax Service office on Capitol Hill, said she met this week with a client in his late 50s who has several part-time jobs and wants to buy insurance on the exchanges. But, she said, “he’s finding that the costs are prohibitive on a monthly basis, so he has resigned himself to the fact that he will have to suffer the penalty.”

When Congress was writing the Affordable Care Act in 2009 and 2010, lawmakers tried to balance carrots and sticks: subsidies to induce people to buy insurance and tax penalties “to ensure compliance,” in the words of the Senate Finance Committee.

But the requirement for people to carry insurance is one of the most unpopular provisions of the health law, and the Obama administration has been cautious in enforcing it. The I.R.S. portrays the decision to go without insurance as a permissible option, not as a violation of federal law.

The law “requires you and each member of your family to have qualifying health care coverage (called minimum essential coverage), qualify for a coverage exemption, or make an individual shared responsibility payment when you file your federal income tax return,” the tax agency says on its website.

Some consumers who buy insurance on the exchanges still feel vulnerable. Deductibles are so high, they say, that the insurance seems useless. So some think that whether they send hundreds of dollars to the I.R.S. or thousands to an insurance company, they are essentially paying something for nothing.

Obama administration officials say that perception is wrong. Even people with high deductibles have protection against catastrophic costs, they say, and many insurance plans cover common health care services before consumers meet their deductibles. In addition, even when consumers pay most or all of a hospital bill, they often get the benefit of discounts negotiated by their insurers.

The health law authorized certain exemptions from the coverage requirement, and the Obama administration has expanded that list through rules and policy directives. More than 12 million taxpayers claimed one or more coverage exemptions last year because, for instance, they were homeless, had received a shut-off notice from a utility company or were experiencing other hardships.

“The penalty for violating the individual mandate has not been very effective,” said Joseph J. Thorndike, the director of the tax history project at Tax Analysts, a nonprofit publisher of tax information. “If it were effective, we would have higher enrollment, and the population buying policies in the insurance exchange would be healthier and younger.”

Americans have decades of experience with tax deductions and other tax breaks aimed at encouraging various types of behavior, as well as “sin taxes” intended to discourage other kinds of behavior, Mr. Thorndike said. But, he said: “It is highly unusual for the federal government to use tax penalties to encourage affirmative behavior. That’s a hard sell.”

The maximum penalty has been increasing gradually since 2014. Federal officials and insurance counselors who advise consumers have been speaking more explicitly about the penalties, so they could still prove effective.

Many health policy experts say the penalties would be more effective if they were tougher. That argument alarms consumer advocates.

“If you make the penalties tougher, you need to make financial assistance broader and deeper,” said Michael Miller, the policy director of Community Catalyst, a consumer group seeking health care for all.

http://www.nytimes.com/2016/10/27/us/obamacare-affordable-care-act-tax-penalties.html?smid=fb-share&_r=0

http://thewoodlandstxhealthinsurance.com

http://allplanhealthinsurance.com

https://allplanhealthinsurance.insxcloud.com/my-quote/individual-info

 

ON THE STATE OF OBAMACARE EXCHANGES AS 2017 OPEN ENROLLMENT APPROACHES

By D. Kenton Henry

As a health insurance broker the last thirty years, I have a vested interest in the state of the industry, and especially so since the Affordable Care Act (ACA) , commonly referred to as Obamacare, was passed in March of 2010. It has been a turbulent ride as I and my clients have struggled to adapt to each phase of the law’s implementation. This has been especially true, the previous three years, as I prepared―and now prepare again―for “Open Enrollment” (OE). OE is the period during which the Department of Health and Human Services allows people to acquire individual and family health insurance for the coming year. This year, it is scheduled to run from November the 1st through January 31st. I say “scheduled”, because they typically extend it in an effort to give people more time to enroll. And, apparently, the Department needs to give people as much time as possible because the latest numbers indicate Obamacare enrollment has fallen significantly short of expectations. (Refer to our feature article from The Washington Post below.)  As it explains, enrollment in the exchanges is less than half initially predicted. The success of the exchanges was predicated on the young and healthy enrolling in numbers sufficient to offset the sick and elderly who would naturally submit more and higher claims to the insuring companies. The young and healthy have largely declined enrolling―presumably and primarily because, well―they’re young and healthy. Had they enrolled, the theory was they would have diluted the claims (losses) with positive (no losses) premium dollars. Additional factors are that, unless someone qualifies for a subsidy, the premiums are high and, for the most part, going higher. The only cases where premiums seem to have gone down are where the insured members are forced into Health Maintenance Organization (HMO) plans where they find their providers and treatment rationed. Furthermore, the penalties (“Shared Responsibility Tax”) for not having insurance, relative to the premiums for having it, are so small as to be largely ignored. Yes, the penalties are increasing but not in proportion to the premiums. And word is, the premiums are only going higher in 2017.

*(CLICK ON THE GRAPHIC TO ENLARGE STATE BY STATE PROJECTED 2017 PREMIUM INCREASES.)

PREMIUM STATS 2017

As our feature article from the Wall Street Journal ( posted below) describes ―another factor detrimental to the success of the Act and the exchanges is decreasing competition among carriers. In spite of the high premiums they charge, insurers are experiencing losses too great to allow them to remain in the marketplace. As a result, they are dropping out in ever increasing numbers. These losses result, in part, because the government itself has cut the subsidies they originally promised insurance companies in order to offset the losses they anticipated. Obviously, companies have less money to pay the higher than expected claims they are experiencing. A Kaiser Family Foundation study, cited in the WSJ article, indicates exchange shoppers may have only one insurance company to choose from in 31% of the nation’s counties and the possibility of only two in another 31%. While many are quick to blame the “greedy” insurance companies, this editor feels the need to point out the reality that insurance companies are not charities. And even charities must operate in the black if they are to remain in existence. It is my opinion that only the government feels it is entitled to operate at a loss and, additionally, that, that is acceptable. Of course, when your are operating entirely with other people’s money―that is a much easier thing to do.

I will now put down my keyboard and go back to studying, testing and certifying to offer and provide the new Obamacare and Medicare related plans to both my clients and prospective clients for 2017. It amounts to an investment of many hours in order to remain informed and credible in an extremely complicated market. As in 2016, one key hurdle for those purchasing 2017 individual and family coverage will be to deal with the inability to find their doctors, and even their hospitals, in the HMO networks. I have developed a strategy for coping with this which I have utilized for myself. While it does not entirely eliminate the inconvenience of the aforementioned problem, it does soften the blow and in some cases―from a purely monetary standpoint―offset the loss in dollars a total and ideal solution would have cost.  Please call me at 281.367.6565 to discuss this and other strategies designed to minimize the difficulties and accompanying stress of identifying and acquiring 2017 health insurance.

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FEATURE ARTICLES

Wall Street Journal

Health Insurers’ Pullback Threatens to Create Monopolies

Analysis suggests ACA exchanges are likely to offer just one coverage option in 31% of U.S. counties

By Anna Wilde Mathews and Stephanie Armour

Updated Aug. 28, 2016 7:47 p.m. ET

Nearly a third of the nation’s counties look likely to have just a single insurer offering health plans on the Affordable Care Act’s exchanges next year, according to a new analysis, an industry pullback that adds to the challenges facing the law.

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THE WASHINGTON POST

Business

Health-care exchange sign-ups fall far short of forecasts

By Carolyn Y. Johnson

Business

August 27 at 8:10 p.m.

Enrollment in the insurance exchanges for President Obama’s signature health-care law is less than half the initial forecast, pushing several major insurance companies to stop offering health plans in certain markets because of significant financial losses.

As a result, the administration’s promise of a menu of health-plan choices has been replaced by a grim, though preliminary, forecast: Next year, more than 1 in 4 counties are at risk of having a single insurer on its exchange, said Cynthia Cox, who studies health reform for the Kaiser Family Foundation.

The debate over how perilous the predicament is for the Affordable Care Act, commonly called Obamacare, is nearly as partisan as the divide over the law itself. But at the root of the problem is this: The success of the law depends fundamentally on the exchanges being profitable for insurers — and that requires more people to sign up.

In February 2013, the Congressional Budget Office predicted that 24 million people would buy health coverage through the federally and state-operated online exchanges by this year. Just 11.1 million people were signed up as of late March.

Exchanges are marketplaces where people who do not receive health benefits through a job can buy private insurance, often with government subsidies.

Aetna, the nation’s third-largest health insurer, announced that it will pull back from Obamacare exchanges citing losses of more than $430 million since January 2014. (Daron Taylor/The Washington Post)

Aetna, the nation’s third-largest health insurer, announced that it will pull back from Obamacare exchanges citing losses of more than $430 million since January 2014. Aetna, the nation’s third-largest health insurer, announced that it will pull back from Obamacare exchanges citing losses of more than $430 million since 2014. (Daron Taylor/The Washington Post)

“Enrollment is key, first and foremost,” said Sara R. Collins, a vice president at the Commonwealth Fund, a nonpartisan foundation that funds health-care research. “They have to have this critical mass of people so that, by the law of averages, you’re going to get a mix of healthy and less healthy people.”

A big reason the CBO projections were so far off is that the agency overestimated how many people would lose insurance through their employers, which would force them into the exchanges. But there have been challenges getting the uninsured to sign up, too.

The law requires every American to get health coverage or pay a penalty, but the penalty hasn’t been high enough to persuade many Americans to buy into the health plans. Even those who qualify for subsidized premiums sometimes balk at the high deductibles on some plans.

And people who do outreach to the uninsured say the enrollment process itself has been more complex and confusing than Obama’s initial comparison to buying a plane ticket.

“This exchange will allow you to ‘one-stop’ shop for a health-care plan, compare benefits and prices, and choose a plan that’s best for you and your family,” Obama said in a speech in 2009. “You will have your choice of a number of plans that offer a few different packages, but every plan would offer an affordable, basic package.”

In some markets, a shortfall in enrollment is testing insurers’ ability to balance the medical claims they pay out with income from premiums. In an announcement curtailing its involvement in the exchanges this month, Aetna cited financial losses traced to too many sick people signing up for care and not enough healthy ones.

The health-care law has been a political lightning rod from the beginning, and Republican legislators have used insurance companies’ withdrawals from the exchanges to reignite calls for the law’s repeal.

Kaiser tracks public data on insurer participation in the exchanges to project how many options counties will have, but the numbers are not final. This year, exchanges in about 7 percent of counties had just one insurer. Earlier this month, Aetna announced that it will pull out of 11 of the 15 states where it offers coverage on the health-care exchanges. Humana made a similar decision weeks earlier, planning to exit several states. And last spring, UnitedHealth Group said it would remain in three or fewer exchanges next year.

Obama has used the health-care law’s challenges to issue a new call for a public insurance option.

“Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited,” he wrote in an essay published in the Journal of the American Medical Association. “Adding a public plan in such areas would strengthen the Marketplace approach, giving consumers more affordable options while also creating savings for the federal government.”

Chicago resident Eva Saur, 32, is exactly the kind of healthy person insurers would like to have on their rolls. Saur hasn’t had coverage in nearly a decade, but she takes good care of her health. For the handful of times she’s been sick, a walk-in clinic at a pharmacy has been sufficient.

“I was raised — not against the system — but we had a doctor who would prescribe us herbs before a prescription” medication, Saur said. “For me, monetarily, it makes way more sense to do this.”

Saur’s tax penalty for being uninsured was a bit more than $600 last year, while the cheapest health plan she examined cost about as much for three months in premiums — and came with a $7,000 deductible.

The penalty for not signing up is increasing. Still, some policy experts insist it is not enough motivation to buy insurance.

“It was basically no stick at all. This is the classic case of where Johnny marked crayon on the wall, his mother said, ‘Don’t do that,’ and then slapped his hand a day later,” said Joseph Antos, a resident fellow at the American Enterprise Institute. “The connection between the offense and the penalty is a little remote.”

The health-care law has had unequivocal successes. In some areas, lots of insurers compete on the exchanges, which helps keep premiums low. In Cleveland and Los Angeles, the average premium for a benchmark health plan actually declined in 2016. The number of uninsured Americans continues to shrink, hitting 9.1 percent last year — the lowest level ever.

The average premium for the people who receive tax credits – 85 percent of the people signed up through the exchanges — is just $106 per month. People who qualify for the income-based tax credits are largely sheltered from premium increases.

The first people to sign up for insurance through the exchanges were expected to be those with chronic diseases and high medical costs. Because insurers could no longer discriminate against those people, the law built in three mechanisms for the government to redistribute money from plans with healthier patients to those with sicker ones. Two of those programs expire at the end of the year. The third, called the “risk adjustment” program, transferred $4.6 billion between insurers in 2014.

Critics say there’s a fundamental problem with the system, and the risk-adjustment program needs to be fixed. But supporters of the law argue that the problem is temporary, the natural evolution of a nascent free-market system. Some of the first companies to enter the market made bad bets on how healthy customers would be, resulting in unprofitable health plans. Proponents say it’s natural for new entrants to replace them, with better information and more competitive plans.

Cigna, for example, has said it has filed to enter exchanges in three new states next year.

“There’s no bottleneck, this is just the natural growth pains of a new market,” said Jonathan Gruber, an economist at the Massachusetts Institute of Technology. “What happened is they set up this new market where insurers didn’t have experience; insurers made an estimate as to what people would cost and their estimate turned out to be too low.”

Supporters point to a recent government analysis that suggests the “risk pool” — the number of high-cost sick customers relative to healthy ones — is not worsening and could even be improving. Medical costs per enrollee in the marketplaces fell by 0.1 percent in 2015, while medical costs for people in the broader health-insurance market grew by at least 3 percent. In states with strong enrollment growth, there were greater reductions in members’ costs.

Everyone agrees that more healthy people need to sign up.

In June, the Obama administration unveiled its plan to target younger and healthier adults, including direct outreach to individuals and families who paid the penalty. It also released new guidance, encouraging insurance companies to communicate more with young adults being kicked off their family’s plan when they turn 26 years old.

Even older adults are taking their chances without health-care coverage.

Donte Fitzhugh, 55, of Charlotte was laid off last year from a job as a call-center operations manager. COBRA, which allows former workers to extend their employer-provided health insurance if they pay the full premium, was expensive, and Fitzhugh didn’t sign up for the exchanges for very human reasons: He figured he’d find a job faster than he did. He thought every penny counted when he was unemployed. He didn’t have major health problems, and he got a coupon to help cover the costs of his hypertension medicine.

As the window to sign up for health insurance passed without a new job, he kept procrastinating. Although health insurance from a new job will begin in October, he faces a penalty that will cost him hundreds of dollars.

“I believe in Obamacare. As an American, it’s my responsibility to have health insurance,” Fitzhugh said. “Since I didn’t have it, it’s going to impact me financially.”

Such are the barriers to insurance: Remaining uninsured can be more attractive or just easier than signing up to pay hundreds of dollars a month for something that many people don’t think they need.

Judy Robinson, a health insurance support specialist at the Charlottesville Free Clinic, has counseled hundreds of patients who are eligible for subsidized insurance on the exchanges but ultimately decide not to sign up. She said the subsidized insurance on the marketplace tends to be a good deal for those who make between 100 and 150 percent of the poverty level. But those who make more often are faced with large deductibles that don’t seem like a good deal to many people.

Beyond the sticker price, she said it can require a lot of paperwork to demonstrate the annual income required to qualify for tax credits if people are juggling multiple part-time jobs. And sometimes, people are simply mistrustful.

“There’s a lot of people that live sort of off the grid, sort of semi-off the grid and they just don’t go to the doctor,” Robinson said. “The hospital is the place where you go to die, and doctors are just going to try and make you do procedures and get money out of you. That’s how they think.”

There are also those who want insurance but are struggling — and find themselves trapped by the high cost of health care.

Donna Privigyi, 49, of Charlottesville has looked into insurance through the exchanges a few times. But over the past few years, much of her modest child-care salary and effort went toward trying to help support her adult son, Mark, who hadn’t been the same since the death of his younger brother. Donna was focused on trying to support her son. Health insurance — even rent — was an afterthought.

“With supporting my son, it didn’t matter,” Privigyi said. “I was just like, I can barely get by, just juggling the bills and taking care of him.”

Late last year, Mark died of a drug overdose, and Privigyi — consumed by grief — wasn’t thinking about insurance when the window to sign up opened and closed.

Then, in June, she got appendicitis. Her bills from two hospitals were $33,000.

The argument for having health insurance is the pile of bills she has been collecting — now with late fees added. The obstacle to getting health insurance is that same stack of bills.

“It’s such a gamble, you know, until I figure out what to do with these medical bills,” Privigyi said. “They’re just adding on late fees. How can I even afford to sign up?”

Juliet Eilperin contributed to this report.

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MEDICARE PREMIUM AND DEDUCTIBLE INCREASES AND BLUECROSS PPO ELIMINATION SLATED FOR 2016!

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By D. Kenton Henry

Clients and Friends of Kenton Henry and ALL PLAN MED QUOTE,

It is that time again. We are approaching the end of the calendar year and I write to thank you for your business and for the trust you placed in me to represent your health insurance needs to the best of my ability. This month marks my 29th year in the industry and that would not be possible without you.

Because there are so many changes coming your way-not only for Medicare recipients but for my Under Age 65 clients-following me here will be the easiest way to be informed of vital information affecting your coverage as it becomes available to me. This is your one source for the good, the bad and the ugly of the Medical insurance market. I will be posting the good part later when I determine what that is. Happy New Year.

BREAKING NEWS FOR MEDICARE RECIPIENTS: On Thursday, October 15, the Social Security Administration announced that there will be no cost of living adjustment (COLA) for 2016. At the same time, the Medicare Part B Premium and deductible is expected to increase significantly for some people next year. The Part B basic premium is expected to go from $104.90 to $159.30 per month Additionally, the Medicare Part B calendar year deductible is slated to also increase from $147 to $223! This latter increase would affect approximately the entire Medicare population of 17 million and will in turn trigger premium increases from the supplemental insurances such as Medicare Supplement and Medicare Advantage which pay that deductible for the insured person! Together, these increases could cause people to drop their Medicare Part B insurance resulting loss of coverage for doctors visits, diagnostic testing, lab work and out-patient surgeries. For more details and information on just who this affects please watch this video of a FOX NEWS LIVE report by Martha MacCallum video I recorded just today:

MEDICARE PREMIUM INCREASE 2016

https://youtu.be/9DVGiEa074E

  • Additionally, if you are Part D Prescription Drug Plan client of mine (or not) email me a list of your current prescription drug regimen (drug and dosage) and I will scan the market to identify your lowest total of pocket cost plan and make my recommendation. allplanhealthinsurance.com@gmail.com

UNDER AGE 65 INDIVIDUAL AND FAMILY NEWS:

Most relevant at this time for individuals and families under the age of 65 is the elimination of BlueCross BlueShield of Texas’s “Individual and Family” Blue Choice PPO network which over 370,000, insured members (including myself) utilize. I informed all my clients (sharing this coverage) in a letter mailed via the US Postal Service just a few days ago. I also addressed this issue in my latest blog post entitled “BlueCross BlueShield of Texas Tells Clients ‘Say GoodBye To Your PPO Plan’”. (The more sarcastic side of me considered entitling it, “Take A Bite Of This Sandwich” but my more professional self intervened.) In the letter and post, I informed those who have HMO coverage their policy would not be affected other than an anticipated rate increase. It turns out that is not the case as I was just informed that many who have HMO coverage will also have to select another version. And so it seems that, with my assistance, many of you will be seeking alternative coverage for 2016.

This begs the question: What will our options be with other insurance companies? Unfortunately, like BlueCross, most companies are yet to reveal the details of their policies. Within the next few days, I hope to have a quoting link available to you from which-in the very near future-you will be able to obtain all your 2016 options, subsidy or no subsidy, on or off the Federal Marketplace otherwise known as Healthcare.gov. Regardless, I will be introduced to these changes over the remainder of October and these, along with the quoting link, will be posted on my blog in real time. Rest assuredwhatever your best options are for 2016I will have them. And you will be able to elect them with the beginning of OPEN ENROLLMENT (OE) November 1st―through the end January 31st.

Do not hesitate to call me as we prepare for these changes. And to assure you will be informed of the latest information relative to your coverage – please click “follow” on my blog as I post all coverage changes and preview the options you will have.

If you are currently a client—thanks once again for your business. It is greatly appreciated  as will readership of healthandmedicareinsurance.com!

Sincerely,

BUSINESS PHOTO FINAL FOR BLOG 10 15 2015

Kenton Henry  Blog Administrator, Broker, Agent

Office: 281.367.6565; Toll Free: 800.856.6556

Email: allplanhealthinsurance.com@gmail.com

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AS YOU SLEEP THE FUTURE OF YOUR HEALTH INSURANCE SUBSIDY HANGS IN THE BALANCE

KENTONSBUSINESSWEBPHOTO

Op-Ed by D. Kenton Henry

While most Americans who receive a health insurance subsidy to offset the cost of the coverage they obtained from the federal website, Healthcare.gov, go quietly about their personal business―the future of that subsidy―and the very future of the Patient Protection and Affordable Care Act (PPACA) or Affordable Care Act (ACA) for short―which gave birth to said subsidies―hangs in the balance. And, for the most part, these same Americans remain blissfully ignorant that the future of their health insurance protection hangs with it also. Apparently sleeping as its fate is to be decided by the 30th of this very month when the Supreme Court releases its decision on King vs. Burwell.

King vs. Burwell contests the financial help available to some enrollees on  the federal insurance exchange in 34 states on the basis that the PPACA was not written to allow for the existence of subsidies provided by the federal exchange. In fact, the plaintiffs argue just the opposite―that only those exchanges established by the states could provide such. Should the court rule in favor of the administration, it will mean the law has survived one more effort to derail it and its future may well be assured. However, If the plaintiffs prevail, that leaves the estimated 6.4 million recipients of the subsidies in the thirty four states which did not with illegally subsidized health insurance. And, without subsidies . . . health insurance reform starts to fall apart. The majority of the recipients will drop their coverage and only the sickest―who bring the most expensive claims to the insurance companies―will remain on their plans. This phenomena is know within the industry as “adverse selection”. In reality, it means that the youngest and the healthiest, regardless of age, will flee their plans like rats off a sinking ship. And the sinking ship will be Obamacare. The law itself. This is because it is estimated that insurance premiums for these 6.4 million will increase an average 256%. A result which will single-handedly insert the substitution “Unaffordable” into the Affordable Care Act―Obama’s signature landmark legislation― sending it into a classic death spiral.

And what does the Supreme Court’s decision hinge on? Four key words: “established by the state”. As in the subsidies are to be available only to income qualified recipients in those exchanges established by the state. The four words are contained in that portion of the law which details how premium subsidies are calculated for health insurance policies. Plaintiffs argue thirty four states never established an exchange. Ergo, how can subsidies be provided for their residents? They argue the wording was constructed to serve as an incentive for the states to create own exchange; the states called the federal government’s bluff and the feds willy-nilly pulled a rabbit out of their head and provided federal exchange subsidies for which no provision within the law was made. To follow their argument to its logical conclusion, the Internal Revenue Service has violated the law by providing tax credits to individuals in these states.

The administration argues that exchanges were created by the states when they effectively opted to let the federal government do it for them. Therefore, their inaction became their action. This allows subsidies to be provided their residents.

As a health insurance broker with twenty-nine years in the industry, I have survived the inevitable ups and downs of the small business owner. I, and my practice, have survived Hillary’s attempt in the early nineties at health care reform and the deterring effect of ever increasing health care costs; the resulting sky-rocketing insurance premiums and the general turbulence of an industry which attempts to manage the costs of a sector which comprises an estimated twenty percent of our nation’s economy. I have survived the Affordable Care Act’s resulting cut in my compensation and the loss of hundreds of clients who were forced off their policies because they did not comply with the law’s mandates. Policies with which, for the most part, my clients were happy. Had they not been, they would have dropped them on their own. I now survive the effect of premiums which have risen on average fifteen percent each of the last two years and, in many cases, much, much more for those clients who do not qualify for the subsidy. The bottom line is, “if you qualify for a significant subsidy, you are probably happy with this law. If you qualify for a relatively small subsidy―or none at all―you are most likely very unhappy with it.” It seems everyone is judging it from the perspective of their own personal welfare. And that is human nature, is it not? And I reluctantly admit, I am no exception. And it is not without guilt I do so.

Because, if the subsidies are revoked, by my estimates, I stand to lose approximately two thirds of the new business I have written in the last two years since ACA plans were forced on the public under threat of penalty. Just last month I experienced the first and slightest increase in income since the act’s passage in March of 2010. My income had been decreasing precipitously since then, mostly due to the “minimum loss ratios” imposed on insurance companies resulting in maximum losses to the agent and broker. But I accepted these; remained committed to my industry and business and have survived. If King v. Burwell is decided in favor of the administration’s adversaries, my clients will let their coverage lapse and the resulting personal effect will be “two steps forward and three steps back”. Hence, the guilt. The guilt born of knowing the worst aspects of this law (unknown to average person) are yet to be implemented and only a minute portion of the resulting costs are currently apparent. Those forthcoming will have a devastating effect on our nation’s treasury which is already eighteen trillion in debt and rising “with a bullet”. I know that progression of this law and its mandates is already forcing rationing of our health care providers and further progression is going to result in ever increasing rationing of health care treatment available to each of us. And yet, for my own sake, I don’t want to experience more losses.

Please do not think I do believe there was no need for health care reform. When two of every five health insurance applications I submitted on behalf of clients was declined due to pre-existing conditions and another not taken due to “waivers” of such (prior to the law’s enforcement) I experienced the angst of my clients and my own.

And so I sit, in front of my computer desktop, on the edge of my seat monitoring each post from SCOTUSBLOG.COM and each editorial from the most liberal to conservative journalist (who knows much less about this law than I) attempting to predict as to which way this imminently pending decision will go. The patriotic conservative within me says, “for the welfare of my nation’s economy, this law should fail.” While the agent, broker, small business man within me who likes to eat, pay his bills, maybe put something away for retirement and doesn’t want to see any more of his clients lose their very necessary and greatly appreciated health insurance coverage says―”Please, oh, please. Let the Supreme Court of this United States of America, in all their supremacy, rule that the authors of the Patient Protection and Affordable Care Act didn’t really mean what they wrote. Let the subsidies stand.”

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http://healthandmedicareinsurance.com

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Related stories:

THE NEW YORK TIMES

Politics

Four Words That Imperil Health Care Law Were All a Mistake, Writers Now Say

By ROBERT PEAR MAY 25, 2015

http://www.nytimes.com/2015/05/26/us/politics/contested-words-in-affordable-care-act-may-have-been-left-by-mistake.html?ref=us

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MORNING CONSULT Burwell Draws Line On Health Subsidy Fix Jon Reid   |   June 10, 2015  http://morningconsult.com/2015/06/burwell-draws-line-on-health-subsidy-fix/