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 Previews of the 2017 plans and premiums indicate most insurance companies have withdrawn from the market and those remaining are continuing to offer HMO coverage only.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

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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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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/

“Happy Anniversary Healthcare.Gov!” (Do We Want A Divorce?)

Op-ed by D. Kenton Henry

BIRTHDAY CAKE

 

Happy anniversary, Healthcare.gov! Today, October 1st, marks the first anniversary of the premier of the originally beleaguered Federally Facilitated “Marketplace” (FFM), the federal government website for the purchase of Affordable Care Act (ACA) compliant health insurance plans in states which did not implement their own. And what of it now?

After a rollout, which was anything but smooth, and a current expenditure of approximately $2.1 billion dollars (after a winning bid of $90 million) the site seems to have solved the majority of its “front- end” issues. These involve opening an account; verifying identity and plan selection. But in light of notice that the time has run out for those who did not succeed in providing adequate proof of income for subsidy (“Premium Tax Credit”) purposes thereby resulting in their loss of coverage or―at least the subsidy―one is left wondering what if anything will change relative to this “back-end” issue for 2015. According to a September 15th article in the New York Times, approximately half a million insured face a forced plan change. “363,000 could lose their premium subsidies due to an inability to verify income, while 115,000 more could have their policies canceled because they have not proven their immigration status. Federal authorities have been working for months to resolve both backlogs.”

My BlueCross BlueShield of Texas clients who have “grand-mothered” plans just received notice dated today that “The health plan you now have will no longer be available and cannot be renewed”. Grand-mothered plans are those which have been modified in anyway, such as a change in deductible, but purchased prior to January 1 of this year when all new policies were required to be ACA compliant. Termination will be effective the end of 12.31.2014 and the client, insured will have until that date to enroll in a new plan for seamless coverage beginning January 1. These policyholders are instructed to log in starting November 15th to review their options and elect new coverage through BlueCross BlueShield. What will the benefits look like and what will be the cost? Well, we won’t know until November 15th. The consensus seems to be that premiums in all but a few locations will be increasing somewhat across the market compared to this year’s ACA compliant plans but at less than the average rate of medical inflation in recent years. (Call me skeptical.) But what about compared to their grand-mothered plan? No way. By the time you add in the additional cost of mandated coverage for benefits such as pediatric dental and vision, maternity and the rest of the “minimum essential health benefits” along with guarantee issue for pre-existing conditions, there is no way these policyholders are going to be pleased with the premiums their new options will cost. If they had thought the marketplace offered better options, they would have elected them for 2014. I am certain the words, “If you like your plan, you can keep your plan. Period.” will be ringing in their ears as they peruse their new options.

On the upside, an estimated 25% additional insurance companies will be providing coverage for 2015 both in and out of the marketplace and state exchanges. This increased competition will give consumerd more options and will hopefully help offset some of the inflationary aspects of mandated coverage in future years.

On the downside, what of the “It’s a penalty … not a tax!” ― now known as the “Shared Responsibility Payment” ― for not having coverage in 2015? That increases to $325 per adult and $162.50 per child or 2% of household income ― whichever is higher. (Family maximum is $975.) It will increase every year hereafter, tied to the rate of inflation beyond 2016.

Additional variables remain to be seen such as “provider selection”. While pressure is being put on insurance companies to increase the number of in-network providers available to the insured, surveys seem to indicate more providers are electing not to join. They feel payments have dropped to low to make it worth their while to participate. Insurance companies are going have to find alternative ways to control costs and since they cannot control the risk they are forced to assume (elative to pre-existing conditions and the mandated “loss ratio”) they are going to ration our providers and our treatment.

On a final note, the enrollment period for 2015 plans will be half as long as for 2014 and will end February 15th. So get ready to be like the sheep, in the Wild Kingdom segment, passing through the anaconda. It’s going to be a tight squeeze! And once again . . . “Happy Anniversary to Healthcare.gov!”

By all means, please contact me if you feel I can make the celebration cake a little more palatable!

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FEATURED ARTICLE:

The New York Times

U.S. to End Coverage Under Health Care Law for Tens of Thousands

By ROBERT PEAR SEPT. 15, 2014

WASHINGTON — The Obama administration said on Monday that it planned to terminate health insurance for 115,000 people on Oct. 1 because they had failed to prove that they were United States citizens or legal immigrants eligible for coverage under the Affordable Care Act. It also told 363,000 people that they could lose financial aid because their incomes could not be verified.

The 115,000 people “will lose their coverage as of Sept. 30,” said Andrew M. Slavitt, the No. 2 official at the Centers for Medicare and Medicaid Services, which runs the federal insurance marketplace.

Some of them may be able to have their coverage reinstated retroactively if they produce the documents that they were repeatedly asked to provide in recent months, Mr. Slavitt said.

At the end of May, the administration said, 966,000 people were found to have discrepancies in their immigration and citizenship records. Most sent in documents as requested. In mid-August, the administration sent letters to about 310,000 people who had failed to respond. They were supposed to submit documents by Sept. 5, but the 115,000 consumers failed to do so, Mr. Slavitt said.

Many consumers and lawyers who work with them said that they had tried to submit immigration and citizenship papers, but that they experienced problems transmitting documents through HealthCare.gov. Other people said they sent the documents by mail to a federal contractor in Kentucky but never heard back from the contractor or the government.

“We heard from lots of consumers who told us they sent in their documents multiple times or tried to upload them through HealthCare.gov,” said Mara Youdelman, a lawyer at the National Health Law Program, an advocacy group for low-income people.

Jenny Rejeske, a health policy analyst at the National Immigration Law Center, which represents immigrants, said: “It is unduly harsh to terminate coverage while there are still technical problems with the federal system for verifying citizenship and immigration status. And there has not been adequate notice to people who speak languages other than English and Spanish.”

Florida leads the list of states whose residents are losing coverage because of immigration and citizenship issues, with 35,100. Federal officials said they were ending coverage for 19,600 people in Texas, 6,300 in Georgia, 5,300 in North Carolina, 5,200 in Pennsylvania, 4,000 in Illinois and 2,400 in New Jersey. The numbers released on Monday are for 36 states using the federal insurance marketplace. They do not include terminations in California, New York and other states running their own insurance exchanges.

Federal subsidies for the purchase of private insurance are a cornerstone of the Affordable Care Act. More than eight out of 10 people who selected health plans through the exchanges from October through mid-April were eligible for subsidies, including income tax credits. But in many cases, the government could not verify the incomes people reported when they applied for subsidized insurance.

This does not mean that they provided false information or were ineligible for assistance. The government tried to verify incomes by checking 2012 tax return information, but consumers may have switched jobs or received pay raises since filing those returns. As a result, officials said, the information in their applications may not match the data in federal files or in sources available to the government.

Mr. Slavitt said that on May 30 there were roughly 1.2 million households (and a total of 1.6 million people) with “data-matching issues.”

Since then, the government said, it has closed cases for 467,000 households with data discrepancies, and 430,000 cases are “currently in the process of being resolved.”

“There are still about 279,000 households with unresolved income-related data-matching issues that haven’t sent in supporting information, representing 363,000 individuals,” Mr. Slavitt said. They will soon receive letters from the government asking for proof of income, and if they do not reply by Sept. 30, they may lose some or all of their subsidies.

They would still be eligible for coverage, but in many cases could not afford it. In some cases, they would also have to repay some or all of the subsidies they received.

It is also possible that some people could receive larger subsidies if their incomes are lower than what they expected when they applied.

(A version of this article appears in print on September 16, 2014, on page A18 of the New York edition with the headline: U.S. to End Coverage Under Health Care Law for Tens of Thousands.)

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HEALTH INSURANCE “OPEN ENROLLMENT” PERIOD 2014 – 2015: DEJA VU ALL OVER AGAIN (AND THEN SOME)?

So you thought last year’s open enrollment period (the limited time frame in which an individual may enroll in a health insurance plan for the coming calendar year) was a fiasco? Consider the words of Kevin Counihan, head of the federal insurance marketplace who says 2015’s hurdles may outstrip 2014’s. “Part of me thinks that this year is going to make last year look like the good old days,” said Counihan in an interview with the New York Times. Now that’s a scary thought indeed.

No one expects the Federal Health Insurance Marketplace website, Healthcare.gov, to have all the technological problems it had last year. (Although this agent and editor experienced an exasperating number in attempting to enroll clients through the website just in the last six weeks.) Rather the problems will result from, among others, two things:

1) Price matters. And, in large part, premiums will not be going down. BlueCross Association plans, for instance, have requested steep increases in general, up to 17.6% for Florida Blue. Double-digit―up to 30% increases may be common among those competitive last year and others, previously not competitive, may offer equally lower premiums. In those states where prices will increase predominately, and the consumer does not qualify for a subsidy, affordability will be an issue and cost a deterrent to enrollment in spite of the penalty for not purchasing health insurance. The penalty will increase to 2% of family income or $325 per adult and $162.50 per child, whichever is higher. The reality is most insurers are filing their proposed 2015 health insurance premiums for approval now, even though claims experience for the current year remains unknown with four months remaining. Will premiums increases be warranted? Will decreases be mere wishful thinking? The good news is, the number of companies participating in the market is going up and there will be 1.6 times more plans to choose from.

2) The open enrollment period will be cut in half. Three months down from six to be exact. This period will run from November 15th to Febraury15th. What this means is, not only will all those who wish to enroll in a plan for the first time be attempting to navigate the system, but all those who wish to change plans will also. With the administration’s objective of signing up an additional 5 million subscribers this year, the process may end up resembling a stampede of cows all trying to enter the Fort Worth stock yard chute simultaneously. Let us hope the end result is more pleasant for the participants.

Actuarial concerns relative to the fiscal viability of the Affordable Care Act (of great concern to this editor) aside, the consumer can expect this fall, through February 15th, to present a host of challenges from knowing which plan is best for them to being able to afford it. All the more reason for the consumer to seek the counsel of an independent health insurance specialist who is licensed (passed their state’s insurance exam); maintains errors and omissions insurance for your protection; has met his or her state’s continuing education classes and may have (as in the case of this agent) decades of experience in the health insurance market. These qualifications as opposed to government enrollers or “navigators” for whom none of this may apply.

― D. Kenton Henry, editor, agent, broker

KENTON AT CAPITOL 2 (2)

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FEATURED ARTICLES:

The New York Times

Business Day |​NYT Now

Bracing for New Challenges in Year 2 of Health Care Law

By REED ABELSON SEPT. 2, 2014

The first year of enrollment under the federal health care law was marred by the troubled start of HealthCare.gov, rampant confusion among consumers and a steep learning curve for insurers and government officials alike.

But insurance executives and managers of the online marketplaces are already girding for the coming open enrollment period, saying they fear it could be even more difficult than the last.

One challenge facing consumers will be wide swings in prices. Some insurers are seeking double-digit price increases, while others are hoping to snare more of the market by lowering premiums for the coming year. At the same time, the Obama administration is expected to try to persuade about five million more people to sign up while also trying to ensure that eight million people who now have coverage renew for another year.

Adding to the complexity is the shorter time frame for choosing a new policy: three months instead of six.

“In some respects, it’s going to be more complicated,” said Kevin Counihan, the former chief executive of Access Health CT, Connecticut’s online marketplace, who was just named as the head of the insurance marketplaces for the federal government. Connecticut’s marketplace was among the most successful state-based exchanges, sharply reducing the number of uninsured in the state. “Part of me thinks that this year is going to make last year look like the good old days.”

Kevin Counihan, head of the federal insurance marketplaces, says 2015’s hurdles may outstrip 2014’s. Credit Christopher Capozziello for The New York Times

No one expects to face last year’s technological hurdles, in which consumers sometimes could not navigate the federal or state websites to buy a policy. HealthCare.gov is running relatively smoothly, and the states have been working to address technical problems with their marketplaces.

“The exchange can’t work worse than it did last year,” said Dr. Peter Beilenson, chief executive of Evergreen Health Co-op, an insurer in Maryland, where a faulty state-run marketplace prevented many people from signing up.

But the upheaval in insurance markets, with new carriers entering and the price of plans changing significantly, may make the coming year no easier than the last. While federal rules allow people to renew their coverage automatically for the next year in the same plan, many customers, especially if they were eligible for federal tax credits, will want to resurvey the landscape.

Just as there was an uproar when some people found out last year that their policies had been canceled, individuals this year may be surprised to find that they could be asked to pay much more for the same plan because their carrier is raising its prices or the amount of the federal tax credit they will receive is changing.

People will be renewing at the same time that others are enrolling for the first time, starting a week and a half before Thanksgiving, on Nov. 15. To ensure that they have a new plan by the beginning of the year, those who renew will have to sign up by Dec. 15. Exactly how the renewal process will work has not yet been determined.

“We’re still waiting on the details of the process,” said Paula Steiner, chief strategy officer for Health Care Service Corporation, which offers Blue Cross plans in five states. “We haven’t gone through any testing yet of any changes to the system for 2015.”

“I think there’s a possibility that there’s equal or more confusion this fall,” she said.

Those responsible for the federal marketplace say they are working hard to make the process as easy as possible. “We’re putting in place the simplest path for consumers this year to renew their coverage,” said Andrew Slavitt, principal deputy administrator for Medicare, which oversees the insurance marketplaces. Those who prefer to stay with the same plan will be able to renew their coverage automatically, as many do with employer coverage. People can renew by doing “absolutely nothing,” he said.

The federal online marketplace is being continuously improved, according to Mr. Slavitt, who said the government was updating the website to allow renewals. “We’re in a very different position than we were last year,” he said.

Dunia Padrino, left, with her sons Rolando Vega and Hanoy Castellon, learning about insurance under the Affordable Care Act last November in Hialeah, Fla. Credit Joe Raedle/Getty Images

Compared with this year, from the 19 states for which information is available, 30 carriers have requested entrance into the marketplaces for 2015 and 1.6 times more plans are being offered, with prices for 2015 likely to remain varied, as they were the previous year, according to McKinsey & Company’s Center for US Health System Reform, which is analyzing the insurance filings as they become available. Prices are rising about 30 percent for some plans, while decreasing by the same amount for others, depending on the market and policy. “We are definitely seeing a lot of volatility in pricing,” said Erica Hutchins Coe, a McKinsey expert.

Some of the large insurers, like some of the Blue Cross plans, have requested steep increases. Florida Blue, for example, expects to raise its rates by an average of 17.6 percent for 2015. Others, like some of the co-op plans, have been keeping prices low or even reducing rates.

Molina Healthcare, a company that has traditionally offered Medicaid coverage and now sells exchange policies, says its renewal strategy for the coming year is to emphasize that its members need not be concerned that the plan they selected will be more expensive. “One thing you can count on is the rates are flat or down,” said Lisa Rubino, senior vice president of exchanges for Molina.

In California, the state exchange is trying to get a step ahead by allowing people to begin renewing their plans Oct. 1. But anyone who wants to switch plans will still have to wait until Nov. 15, and many individuals may well want to shop around. In the Sacramento area, for example, someone who selected an H.M.O. plan from Anthem for 2014 faces a possible increase of nearly 17 percent, compared with a 2 percent increase for an H.M.O. plan from Kaiser Permanente in the same area.

Consumer advocates and others say nearly everyone with coverage should review their options ( https://www.brokeroffice.com/quote/quoteengine.jsp?login=insurnet) as well as whether their federal tax subsidy is likely to shift — either because their income may have changed or because the cost of the benchmark plan used to calculate the tax credit has changed.

Experts like Sabrina Corlette, a policy expert at Georgetown University’s Center on Health Insurance Reforms, say persuading those who did not sign up for coverage during the last open enrollment period to get coverage for 2015 will also present a significant challenge. People in this group were unaware they could get assistance with the cost of their premiums, decided the coverage was not worth the cost or simply found the process of enrolling too challenging.

“Most people assume in the first year they got the low-lying fruit,” Ms. Corlette said. Insurers and others “do have to widen the net,” she said, targeting hard-to-reach populations with what in the second year will often be “fewer resources and less time.”

Dr. Martin E. Hickey, chief executive of New Mexico Health Connections, a co-op that will rely on low prices to continue to attract members, said it was “a lot easier to retain a consumer than chase a new one.” In his state, many individuals failed to take advantage of the subsidies that reduced the cost of coverage substantially. “We didn’t communicate the affordability,” he said.

Even in California, which enrolled nearly 1.4 million people in its first open enrollment, there is acknowledgment that more effort is needed.

“We have a heavy lift again,” said Dana Howard, a spokesman for the state’s exchange, Covered California.

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THE HILL

Home | Policy | Healthcare

HealthCare.gov CEO sees challenges ahead

By Elise Viebeck – 09/03/14 10:50 AM EDT

The newly appointed CEO of HealthCare.gov is predicting fresh challenges for the system’s second enrollment period this November. Kevin Counihan, former head of Connecticut’s exchange, cited concerns such as the shorter sign-up period for 2015 plans that could create problems for officials and consumers alike.

“In some respects, it’s going to be more complicated,” Counihan told The New York Times in an interview. “Part of me thinks that this year is going to make last year look like the good old days.” The comment highlights the heady task facing federal health officials as they work to prevent a repeat of last year’s first enrollment period. Last year, technical flaws at HealthCare.gov and other exchanges plunged the enrollment process into chaos and created an enormous political headache for the Obama administration. Counihan did not indicate that his fears related to the technology, which has undergone extensive repairs since last October. The 2014 sign-up period was six months long, but with just three months to enroll more consumers, this year’s process could prove a tough climb as insurers and the government seek to convince hard-to-reach populations to buy health plans.

Existing policyholders are likely to encounter changes in their premium prices that could also cause confusion.

http://thehill.com/policy/healthcare/216496-healthcaregov-ceo-sees-challenges-ahead