Daily Archives: August 13, 2013

Latest Obamacare Carve Out a Boon to Big Insurance

Latest Obamacare Carve Out a Boon to Big Insurance | Fox News.

One of the key selling points in Obama’s populist push was that the bill would set annual caps on out-of-pocket expenses demanded by insurers. Starting in 2014, the law sets the limit at $6,350 for individual policies and $12,700 for family plans.

But through a regulatory re-write slipped into the rule book in February, but first publicized in today’s New York Times, the administration has given big insurance companies a one-year delay on the caps.

The reason cited is a technical problem in getting new and existing computer systems in synch. But the move will also help prevent more rate shocks. Insurance premiums are set to rise precipitously next year as insurers are required to begin accepting patients with pre-existing conditions.

It’s my understanding that this only affects group plans. As the dust clears on this latest Obamacare delay it will become clearer.

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Most support higher premiums for smokers

Most support higher premiums for smokers | LifeHealthPro.

A decade ago, the survey showed that 65 percent thought smokers should pay more. Now, that’s down to 58 percent. The Gallup folks shrugged off the drop, saying it was “down modestly.”

Yet people’s attitudes about obesity and insurance rates haven’t really budged. In 2003, 43 percent thought “significantly overweight” people should pay more, and now, 41 percent say they should.

This more tolerant attitude toward the obese could be partly because there a lot more overweight Americans than smoking Americans. Of those surveyed, 45 percent self identified as being significantly overweight. Only 19 percent said they were smokers.

Then there were the “tell-me-something-I-didn’t-know” stats from the survey. Smokers by a wide margin (70 percent to 28 percent) said it was unjustified to charge higher rates for smokers, while for nonsmokers, it was just about the reverse (65 percent justified).

People who were overweight weren’t quite so opposed to higher rates — 63 percent of them felt they shouldn’t have to pay more for insurance.

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Yet Another White House Obamacare Delay: Out-Of-Pocket Caps Waived Until 2015

Yet Another White House Obamacare Delay: Out-Of-Pocket Caps Waived Until 2015 – Forbes.

Notes Pear, “Under the [one-year delay], many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.”\

Perhaps affected individuals that have high medication costs should drop out of their group plans and purchase an individual plan on the exchange?

This article is also a great summary of other “amateur hour” implementation issues of Obamacare.

First, there was the delay of Obamacare’s Medicare cuts until after the election. Then there was the delay of the law’s employer mandate. Then there was the announcement, buried in the Federal Register, that the administration would delay enforcement of a number of key eligibility requirements for the law’s health insurance subsidies, relying on the “honor system” instead. Now comes word that another costly provision of the health law—its caps on out-of-pocket insurance costs—will be delayed for one more year.

Another nugget on subsidies….

The progressive solution to expensive problems? More subsidies. But subsidies don’t reduce the underlying cost of care. They only excuse the high prices that manufacturers and service providers already charge.

 

You can’t make this stuff up.

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Obamacare amateur hour: Consumer cost cap delayed

A Limit on Consumer Costs Is Delayed in Health Care Law – NYTimes.com.

Under the policy, many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.

Some consumers may have to pay even more, as some group health plans will not be required to impose any limit on a patient’s out-of-pocket costs for drugs next year. If a drug plan does not currently have a limit on out-of-pocket costs, it will not have to impose one for 2014, federal officials said Monday. (emphasis added)

There really is no excuse for this. Remind me again, how long have they know this was coming?

Prediction Chaos.

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Low-premium, high-deductible health plans are endangered by Obamacare

Endangered, more like headed for extinction: Low-premium, high-deductible health plans are endangered by Affordable Care Act : Stltoday.

Rod Coons and Florence Peace pay $403 a month for a family health plan that covers barely any medical care for either of them until he or she reaches $10,000 in claims in a given year. And that’s just the way they like it.

“I’m only really interested in catastrophic coverage,” says Coons, 58, who retired last year after selling an electronics manufacturing business in Indianapolis. Beyond their premium, the couple typically spends no more than $500 annually on medical care, Coons says. “I’d prefer to stay with our current plan.”

That won’t be an option next year. In 2014, plans sold on the individual and small-group markets will have to meet new standards for coverage and cost-sharing, among other things. In addition to providing 10 so-called essential health benefits and covering many preventive-care services at no cost, plans must pay at least 60 percent of allowed medical expenses and cap annual out-of-pocket spending at $6,350 for individuals and $12,700 for families. (The only exception is for plans that have grandfathered status under the law.)

Mr. Coons is obviously unenlightened. No doubt he will be much happier with an Obamacare Bronze plan.

Also, I take issue with the preventive care at no cost. That is simply untrue. There IS a cost to preventive care and it’s covered in two ways:

  1. It is embedded into your premium
  2. Cost sharing with other plan members.

Remember this: NOTHING in Obamacare is “free” or at “no cost”. There may be no DIRECT charge but you or your “health insurance neighbors” are paying for it. Neither the insurance companies or the doctors are printing money and the money has to come form somewhere.

Related: You can keep your doctor and your can keep your plan. Period.

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