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One (1) Year Reprieve from Obamacare Ending in December for 70% of the U.S. - Online Enrollment Still Possible and Encouraged

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U.S. Citizens in 34 States, including CA and TX, plus Washington D.C., Still Eligible for December Online Enrollment in New, Less Expensive 2013 Health Insurance Plans Offering a 1 Year Reprieve from The Affordable Care Act, aka Obamacare, Thereby Avoiding the 2014 Tax Penalty. A New Website, InsureMyParts.com, Specifically Accomodates This Purpose.

Chula Vista, CA (PRWEB) December 06, 2013

The availability of a one (1) year reprieve from Obamacare, for U.S. citizens in need of new or less expensive health insurance, is coming to a quick close - Dec. 15 for some states, such as California, and Dec. 30 or 31 for other states including Texas. California based website InsureMyParts.com is uniquely positioned to help residents in all eligible states enroll online in the health insurance plan of their choice.

“To my knowledge, this is the only website in the nation whose primary focus is helping adults and families enroll themselves online in a 2013 health insurance plan with a one year extension of benefits,” says Mr. R. Girard, licensed insurance professional and co-creator of InsureMyParts.com. “Companies and plans vary by state, and some states have no health insurance plans with these extensions; however, approximately 70% of the U.S. still has this option.”

The option to enroll online is one the Federal Government has struggled with since the launch of its healthcare website, Healthcare.gov, in October of this year. Quotit®, a secure online quoting system used by InsureMyParts.com, is fully operational 24/7 despite ongoing modifications. Individual agent portals, run by the insurance carriers themselves, are also available on the website and fully operational.

Suffice it to say, the necessity of online enrollment is now firmly embedded in the collective minds of the general public. Therefore the need for Self-Serve Insurance®, the ability to compare companies, plans, and prices side by side from the comfort and convenience of home, then enroll online with a checking account or credit card, has never been greater.

Millions of residents in 34 states + Washington, D.C. now have mere days to learn about the full 12 month extension of benefits which count as creditable coverage, thus legally avoiding the IRS tax penalty. (1% of gross income in 2014 - $95 minimum). This should come as welcome news for those unable to afford the new PPACA "Affordable Care Act" plans, including the currently uninsured.

For those who are worried about switching doctors and/or hospitals, each major insurance carrier provides a "Doctor Finder" - an online search tool for all physicians and medical facilities within that company's network of providers, which can and should be used prior to submitting an online application.

In Conclusion: As long as legal U.S. Citizens are healthy enough to pass through underwriting, with an effective start date in December 2013, they need to know immediately that it is not too late to take advantage of this 1 year reprieve / extension of health insurance benefits.

“It hurts to think how many individuals and struggling families will not find out in time that they could have enrolled in a brand new health insurance plan that they could actually afford,” says Mr. R. Girard. “Unfortunately, the insurance companies are not going to advertise this - not while the Government is trying to usher the masses into the new Obamacare Plans.”

ABOUT

Providing Access to the nation's Top A-Rated Health Insurance Carriers, Mr. Réne “Rainy” Evan Girard, DBA Hesed Insurance Solutions, is a licensed Life & Health Insurance agent from Texas, now residing in California, whose Insure My Parts® website makes the process of enrolling online both easy and fun with informative videos, definitions of common insurance terminology, and Frequently Asked Questions and Answers. He also owns the registered trademarks for Self-Serve Insurance® and Self-Service Insurance®.

States Served: AK, AL, AR, AZ, CA, CO, CT, DE, FL, GA, IA, IL, IN, KS, KY, LA, MD, MI, MS, MO, NE, NC, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY + DC Reported by PRWeb 8 hours ago.

InCrowd Research Finds Millennials More Savvy When It Comes to Patient Engagement Than Their Gen X Counterparts

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62% of the Millennials surveyed indicated they were familiar with the term patient engagement versus only 40% of the Gen X health consumers.

Cambridge, MA (PRWEB) December 06, 2013

InCrowd, the only provider of real time market intelligence for the pharmaceutical industry, today announced the results of research with 330 Gen X and Millennial health consumers from across the United States. The findings suggest commonalities and differences between the two demographics. While the term patient engagement was not commonplace for both groups, the Millennials indicated greater comfort and familiarity with the term than the Gen X health consumers. Both groups placed high value on developing a health partnership with their physician.

“Our goal with the consumer health research was to understand how people under the age of 50 typically engage with their physicians and healthcare providers and what benefits they get from that engagement. We also wanted to understand what they need to be more involved in their care,” says Kathleen Poulos, Co-Founder and CMO at InCrowd.

InCrowd research also indicated that both Millennials and Gen X health consumers are interested in online tools and technology to enhance communication and engagement. Convenience and easy access to information were cited by both groups as important needs to be addressed when thinking about patient engagement solutions.

The health consumer research identified several opportunities for both the pharmaceutical and health insurance industries to amplify the voice of the patient as they develop programs and tools that will help drive patient engagement. Learnings from the InCrowd data helps companies empower patients under 50 to take charge of their health.

To learn more about InCrowd, real time market intelligence and the industry opportunities identified in the research, reserve your seat now for the second webinar in the series Pathways to Patient Engagement: Health Consumer Insights on December 10th hosted by KC Healthcare Communications LLC.

We invite you to listen to the first webinar Pathways to Patient Engagement: Insights from the Physician Community and join us on Tuesday January 14, 2014 for the third webinar in the series.

About InCrowd

InCrowd’s on-demand platform provides direct and immediate access to Crowds of screened and targeted healthcare professionals. Crowd queries are fast, easy and specialized for the healthcare industry. Micro surveys facilitate fast response rates, while specialized crowdsourcing provides answers within hours, even minutes. InCrowd is the only company offering healthcare focused real time market research. For more information, visit InCrowd, Inc.

About KC Healthcare Communications LLC

KC Healthcare Communications is a strategic marketing and communications firm that engages brands and organizations with patients, consumers, caregivers and health influencers, especially women. For more information about its webinars, Pathways to Patient Engagement, visit KC Health. Reported by PRWeb 8 hours ago.

Dynamic Healthcare Systems Partners with Peak Health Solutions to Provide Comprehensive Risk Adjustment Solutions

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Dynamic Healthcare Systems announced today that they have entered into an agreement with San Diego, CA-based Peak Health Solutions to support compliant outcomes and results for the complex administrative challenges faced by government-regulated health plans.

Irvine, CA (PRWEB) December 06, 2013

Dynamic Healthcare Systems announced today that they have entered into an agreement with San Diego, CA-based Peak Health Solutions to support compliant outcomes and results for the complex administrative challenges faced by government-regulated health plans. Dynamic Healthcare Systems’ subject matter experts and enterprise software solutions for encounter data processing and risk adjustment complement and will be integrated with Peak’s advanced risk adjustment analytics and medical records retrieval and coding solutions. Together, Dynamic and Peak will provide a comprehensive Edge Server offering for the Commercial Health Insurance Exchange Marketplace as well as solutions for Medicare Advantage plans starting with code capture to risk adjustment to EDPS/RAPS submission.

“Dynamic Healthcare Systems and Peak Health Solutions are working closely together to deliver a complete end-to-end Risk Adjustment solution for government health plans. This business model provides customers the opportunity to work with a consortium of subject matter experts dedicated to solving the complex compliance and administrative challenges of the Medicare and Exchange markets,” said Robert Dunn, President and CEO of Dynamic Healthcare Systems.

“Peak Health Solutions is excited to partner with Dynamic’s solutions to bring a unique full service offering to the Medicare Advantage and Health Insurance Exchange market,” said Gabe Stein, Executive Vice President of Peak Health Solutions. “Dynamic’s enrollment and submission solutions coupled with Peak Health Solutions risk adjustment, quality analytics, consulting and services will allow us to make a quick impact for our clients.”

For more information on the combined Dynamic/Peak solution, visit http://www.dynamichealthsys.com or call 949.333.4565.

About Dynamic Healthcare Systems
Dynamic Healthcare Systems, Inc. delivers comprehensive enterprise software solutions and services for Medicare Advantage health plans, Medicaid, and Exchange markets striving to succeed amid new and evolving regulatory requirements. Headquartered in Irvine, California, the company brings world-class innovations to companies serving the government-regulated healthcare population. For more information, visit http://www.dynamichealthsys.com or call 949.333.4565.

About Peak Health Solutions
Peak Health Solutions’ payer division delivers risk adjustment reporting and quality measurement (Stars) analytics on a single web-accessible decision support software platform. The PeakAnalytics’ software offers a superior set of solutions-- capturing and managing data for health plans; transforming the data into actionable information at the plan, provider and member level. Coupled with Peak’s comprehensive chart review and in home assessment capabilities, PeakAnalytics optimizes our clients’ risk scores and can close critical quality care gaps.

For more information, visit http://www.peakhs.com. Reported by PRWeb 8 hours ago.

Fact Checker: Obama’s claims on death rates and poverty due to a lack of health insurance

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“We believe we’re a better country than a country where we allow, every day, 14,000 Americans to lose their health coverage; or where every year, tens of thousands of Americans died because they didn’t have health care; or where out-of-pocket costs drove millions of citizens into poverty in the wealthiest nation on Earth.” Reported by Washington Post 5 hours ago.

Obama's Fixer-Upper Website Races to Catch Up

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Obama's Fixer-Upper Website Races to Catch Up Filed under: Health Care, U.S. Government, Internet, Barack Obama, Health Insurance

*Karen Bleier, AFP/Getty Images*

By RICARDO ALONSO-ZALDIVAR

WASHINGTON -- It looks as though President Barack Obama's fickle health insurance website is finally starting to put up some respectable sign-up numbers, but its job only seems to have gotten harder.

Two months in and out of the repair shop have left significantly less time to fulfill the White House goal of enrolling 7 million people by the end of open enrollment on March 31.

Signups were just over 100,000 nationally as of the end of October. The 36 states served by the federal government's website accounted for a paltry one-fourth of that, fewer than 27,000 people. But officials now say an additional 29,000 people enrolled through the revamped HealthCare.gov in just two days at the start of this week, despite heavy volume that not long ago would have caused the system to lock up.

HealthCare.gov is the online portal to subsidized private health insurance for people who don't have job-based coverage. Though it's too early to say whether the corner is being turned, Obama is inviting consumers to give the website a second chance. Here's a look at the changes you can expect:

*Speed and Availability*

Independent testers question the blazing Internet speeds claimed by techies at the Health and Human Services Department but say there's been noticeable progress.

"The trend is in the right direction ... but there are still things they can do to make the user experience better,"
said Michael Smith, a vice president of engineering at Compuware Corp. (CPWR), which helps companies monitor the technical performance of their websites.

As of Thursday morning, the number of states where consumers are experiencing unacceptably long wait times had been cut in half, down to 13 from 26 states in late October.

Compuware defines "unacceptable" as more than 8 seconds average response time to load the home page. The government claims a response time of less than 1 second. But Smith says that is likely being measured from computers with fast Internet connections and doesn't account for the experience of consumers with less than ideal access, which is incorporated in his company's testing.

HHS spokeswoman Joanne Peters acknowledged: "As with any website, the response times for individual consumers will vary depending on their computer's performance and the speed of their Internet."

Compuware says availability -- a measure of consumers' success accessing the site -- is up to 98 percent, close to the standard for commercial websites.

*Window-Shopping*

Many consumers were puzzled and frustrated when the federal website went live because it would not let them browse health plans without first setting up an account. That's the opposite of how e-commerce generally works. Most websites ask consumers to open an account after they're ready to purchase.

The flaw drove many people to an accounts creation page that turned out to be riddled with bugs and contributed to the system's early woes.

On Monday, HHS announced the deployment of a window-shopping function that lets prospective customers see plans and prices in their area, including previously unavailable details such as deductibles and cost-sharing, as well as provider networks.

*Reset Button*

People who got stuck in the system can now zap away their old applications and start over.

To do that, you log into your account, select the application in progress and hit "remove."

You have to follow that by closing and reopening your Web browser. Then you log back in and start a new application.

The reset process may not be entirely foolproof because HHS advises consumers to reach out to the call center at 800-318-2596 if they have trouble.

*Orderly Lines*

To help stave off problems during periods of high user volume, the website now has a queuing system. Consumers can request email notifications of when is a good time to come back. The feature kicked in this week as people flooded back to check out the revamped website.

The site can now handle 50,000 simultaneous users. Each visitor spends an average of 20 to 30 minutes on the site. In theory, the site will support more than 800,000 consumer visits a day.

The big spikes in traffic are still to come. Expect that to happen after the middle of this month, since Dec. 23 is the last day that people can apply for coverage that will take effect Jan. 1. Even heavier volume is likely toward the end of open enrollment March 31, as procrastinators jump in.

Confident that the site is stable, the government is emailing people who got stuck in the system and inviting them back.

Still, reaching the goal of 7 million sign-ups seems like a tall order. The government's initial projections estimated that 1.2 million people would have enrolled by the end of November, and the number is likely to be only a fraction of that.

And the March 31 deadline doesn't mean that enrollment comes to a full stop.

That's because under the law, people who experience a significant change in their life circumstances can still get coverage after the open enrollment period is over. Such changes include divorce, the birth of a child, loss of coverage, moving to another state or losing a job.

Rick Curtis of the nonprofit Institute for Health Policy Solutions estimates that as many as 20 million people could become eligible for coverage later in 2014, though it's not clear how many of those would enroll.

"About as many people will become eligible over the course of the year as are eligible now," Curtis said.
 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 5 hours ago.

Public Opinion On Obamacare Hasn't Changed

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Gallup is out with a new poll this morning on what respondents would like Congress to do with Obamacare. Despite the horrible launch of the federal exchange website, opinion over what to do with the site has barely budged in two years.

Take a look:

The percentage of people who want to keep the law or expand is the same as it was in January 2011. Support for repeal has grown slightly since the beginning of October, but is the same as in January 2011 as well.

The biggest threat to Obamacare the past few months has not been public opinion. It's been the website.

As long as the website worked, millions of Americans would have the opportunity to browse new insurance plans. Many of those who had their plans cancelled would find cheaper policies. Some would not. But the success or failure of the law would be based on its policy outcomes.

People are not going to care about a two month delay in the site if they can find less expensive, better health insurance. They also are not going to care about the website's launch if their premiums rise and they lose their doctor. They will care about how Obamacare affects their lives.

The only serious threat to the law was if the website proved entirely unworkable. This was a legitimate concern inside the White House. Even if they scrapped the website and using paper applications, officials would still have had to use the system to input information. There was no magic cure to the website's ailments.

Fortunately for the administration, that has proven not to be the case. Consumers seem to be having a much easier time navigating the site and signing up for plans. There are still serious concerns over the back-end errors, but it's unclear how significant those are since the Center for Medicare and Medicaid has been reluctant to comment on those issues.

None of this is to say that the website's problems have not hurt the president. The public no longer trusts him and his approval rating has plummeted. This makes sense. Obama's "if you like your plan, you can keep it" promise and the website's horrible launch were not failures of Obamacare. They were failures of the president.

For that reason, Americans have lost faith in the Obama administration. But their opinions on health reform have not changed since the law has not truly been tested yet. 

Join the conversation about this story »

 
 
 
  Reported by Business Insider 3 hours ago.

Obama's fixer-upper website races to catch up

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WASHINGTON (AP) — It looks like President Barack Obama's fickle health insurance website is finally starting to put up some respectable sign-up numbers, but its job only seems to have gotten harder. The 36 states served by the federal government's website accounted for a paltry one-fourth of that, fewer than 27,000 people. HealthCare.gov is the online portal to subsidized private health insurance for people who don't have job-based coverage. Independent testers question the blazing Internet speeds claimed by techies at the Health and Human Services Department but say there's been noticeable progress. "The trend is in the right direction ... but there are still things they can do to make the user experience better," said Michael Smith, a vice president of engineering at Compuware Corp., which helps companies monitor the technical performance of their websites. [...] Smith says that is likely being measured from computers with fast Internet connections and doesn't account for the experience of consumers with less than ideal access, which is incorporated in his company's testing. HHS spokeswoman Joanne Peters acknowledged: "As with any website, the response times for individual consumers will vary depending on their computer's performance and the speed of their Internet." On Monday, HHS announced the deployment of a window-shopping function that lets prospective customers see plans and prices in their area, including previously unavailable details such as deductibles and cost-sharing, as well as provider networks. Reported by SeattlePI.com 4 hours ago.

New 2014 Edition of Database Provides Overview of Managed Care Market

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The freshly updated 2014 edition of The National Directory of Managed Care Organizations Database has been produced. The latest mergers, acquisitions, promotions and appointments are included.The 2014 edition of the National Directory of Managed Care Organizations has been published by the Managed Care Information Center.

The unique database provides market intelligence information on more than 1585 managed care organizations representing 5,279 health insurance plans.

The new edition includes listings of all managed care companies including health maintenance organizations (HMOs), preferred provider organizations (PPOs), consumer driven health plans (CDHPs), health savings accounts (HSAs), point-of-service plans (POS), and several other types of managed care organizations.

The directory database also covers specialty HMOs and PPOs, and includes details on TPAs, PSOs, POSs, EPOs, Medicare and Medicaid health insurance plans, and Medicare Advantage Health plans and Medicare Part D prescription plans.

The directory is known for providing more "need to know" details in the managed care organization profiles presented.

Organization profiles include the health insurance company's main address, telephone, fax, web site address and key executive officers.

To help users 'size' a market, the directory includes the number of primary care physicians and specialist physicians in the managed care company network; and the number of hospitals with which the health plan has contracts.

The database includes such key contact names as CEO, CFO, COO, medical director, and CIOMIS director. Also, the name of the parent organization, the year the organization was founded, and its profit-not-for-profit status.

The National Directory of Managed Organizations Database is delivered on CD-Rom.

For complete details on the new edition visit: http://www.healthresourcesonline.com/payer-provider-data/the-national-directory-of-managed-care-organizations-database.html

Address: The Managed Care Information Center, PO Box 456, Allenwood, NJ 08720, 1-800-516-4343, fax 1-292-111, email: info@healthresourcesonline.com.

- 30 -

Contact:
Robert Jenkins
1- 800-516-4343

Company Contact Information
Managed Care Information Center
Robert Jenkins
PO Box 456
Allenwood, NJ
08720
732-292-1100

News and Press Release Distribution From I-Newswire.com Reported by i-Newswire.com 3 hours ago.

Illegal to Talk About Healthcare in Missouri? Healthcare Advocates File Suit

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Illegal to Talk About Healthcare in Missouri? Healthcare Advocates File Suit Illegal to Talk About Healthcare in Missouri? Healthcare Advocates File Suit
Health
Nation
Politics

The state of Missouri has gone to extreme measures to stop the Affordable Care Act from being implemented. Now physicians and community organizations are filing a lawsuit claiming that Missouri’s policies violate federal law and the U.S. Constitution.

Missouri’s “Health Insurance Marketplace Innovation Act of 2013” states that healthcare navigators, who are trained and certified by the federal government to help people in the community find insurance plans, cannot offer “advice concerning the benefits, terms, and features of a particular health plan.”

MSNBC reported that in addition to subjecting navigators to prohibitive regulations, Missouri’s policy also states that navigators cannot talk about other plans people might be qualified for, if they are sold outside of the state’s federally-operated insurance exchange.

Furthermore, the Missouri law prohibits anyone, not just navigators, from sharing health insurance tips without getting licensed as a navigator. Effectively, talking about healthcare, according to the lawsuit.

The lawsuit states that the laws “directly conflict” with the federal Affordable Care Act, putting groups like the nonprofit St. Louis Effort for AIDS and Missouri Jobs with Justice in an “untenable position,” restricting their constitutional rights to free speech, AP reported via CBS Local St. Louis.

The law, signed by Missouri Gov. Jay Nixon in July, was the initiative of insurance agents and brokers, who said that it would ensure that the healthcare information people received was correct and keep unqualified counselors from offering advice, according to the St. Louis Post-Dispatch.

The Missouri law requires navigators to advise people who bought their health insurance from an agent from the private market to consult with that agent, a protection against the ACA, which states that navigators must provide “impartial information” in order to “act in the best interest of the applicant.”

Missouri is one of 14 states that have passed restrictions on navigators’ abilities to execute the ACA. A similar lawsuit was filed in Tennessee earlier this year. The state had imposed similar restrictions to the rights of navigators, but was forced to drop them after health advocates filed suit in state and federal courts. A U.S. District Judge ruled that the rules likely violated both the First Amendment and the Affordable Care Act.

Sources: MSNBC, CBS Local, St. Louis Post-Dispatch

1 Reported by Opposing Views 28 minutes ago.

One Tweet That Shows Why You Shouldn't Complain About Obamacare 'Rate Shock'

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Hillary Rosner, a Colorado-based freelance journalist, tweets about her search for a post-Affordable Care Act health insurance plan:



Applied for new non-ACA health plan (ACA plans way too $ in CO). Insurer charging me 20% above quote bc I had a c-section. So fucked up.

— Hillary Rosner (@hillaryrosner) December 5, 2013


Here's the thing. You can have it one way on "rate shock" but you can't have it both ways.

There are, broadly, two ways that individual market health insurance could work. One is the situation we have now in most states, where it works more or less like homeowners' insurance: the insurer evaluates how many claims you're likely to make and sets your premium at expected claims plus a profit margin. If you have diabetes, you'll pay more, just like you'd pay more for homeowner's insurance if you lived on the beach.

Rosner is seeing a mild form of that problem. She's pricing out a policy that would start in 2013, meaning it's not subject to ACA rate setting rules. The insurer thinks her prior Caesarian section makes her likely to make somewhat more claims so it's adding 20% to her premium. Rosner thinks that's "so f---ed up," and a lot of people agree.

Which brings us to the other way you can price health insurance: Mandate that insurers charge the same price to everyone, regardless of health risk. The ACA does this, with the caveat that insurers are allowed a limited degree of age-based premium variation. Under ACA rules, the insurer wouldn't be allowed to raise Rosner's premium over a c-section.

But because insurers know they'll have to write a lot of policies to sick people at a loss, they're going to raise premiums across the board to make up the difference.

That's why ACA-compliant health plans are "way too $" in Colorado, as Rosner puts it. The pricing structure doesn't just protect people with modest claim-increasing conditions like a prior c-section, but people with very expensive pre-existing conditions like diabetes or cancer or HIV/AIDS.

That protection costs money. What Rosner is getting in exchange for a higher premium on an ACA-compliant plan is reassurance that insurance will be available to her, regardless of her future health condition.

That said, it's likely that Rosner has been personally made worse off by health plan switches induced by the ACA. Even before the ACA, federal law barred insurers from dropping their existing members for developing a new health condition, or raising their premiums as a result of that condition. This is a policy called "guaranteed renewal."

If Rosner had been able to stay on her old plan, she wouldn't face either a 20% c-section related premium hike or the need to pay to cross-subsidize people with more costly medical conditions. But that narrow protection for pre-existing conditions, often cited by conservatives as a reason to think the existing individual market is working, hasn't been working very well for very many people.

First, the value of the protection is limited. You can't change plans or insurers without subjecting yourself to a large premium increase or a coverage exclusion. The insurer can't raise your premium because of your personal health condition, but it can raise premiums based on the average claims filed by all the participants in your plan. To this end, the insurer can close your plan to new participants; over time, the healthier participants will tend to leave, driving up premiums for those who remain. And you're out of luck if you move to another state.

Second, this protection only works if you maintain continuous coverage in the individual market from the same insurer, and very few people are doing that. Over 80% of people who lack coverage from an employer or the government go uninsured rather than buying coverage through the individual market. Those who do carry individual coverage often do so for only a short time, such as during a gap between jobs that provide coverage.

Michael Cannon has noted that guaranteed renewal was a common feature of individual health insurance plans even before it was mandated by federal law, and it doesn't raise premiums nearly as much as the ACA's rules do. But that's actually a demonstration of how guaranteed renewal doesn't work: it's not very expensive for health insurers to offer because few insureds actually figure out how to turn it into effective coverage for expensive health conditions they develop.

This is a key difference in how liberals and conservatives view the health insurance market. Conservatives see a market that is working so long as you're responsible enough to keep yourself covered at all times so guaranteed renewal protects you from pre-existing condition exclusions. Liberals see a market that is stacked against people's efforts to access such protections.

Given how few people are making the protections of the existing system work, liberals have the better of this argument. They've found a way to make insurance available to the chronically sick that will actually work for most of the public. But they haven't been upfront about the fact that their fix will be paid for with higher premiums for lots of healthy people, including Rosner.

Join the conversation about this story »

 
 
 
  Reported by Business Insider 59 minutes ago.

Zane Benefits Publishes New Information on Defined Contribution Health Benefits

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The Top Questions on Defined Contribution Health Benefits - Answered

Park City, Utah (PRWEB) December 06, 2013

Today, Zane Benefits, the number one online small business health benefits solution, published new information on defined contribution health benefits.

According to Zane Benefits’ website, defined contribution health benefits are an employee health benefits strategy that are gaining popularity because of their affordability and accessibility.

Instead of offering a specific benefit, companies give healthcare allowances to employees. Employers - especially small and mid size employers - find this an attractive solution.

The term defined contribution has become a big buzzword this year in the health insurance industry. By using the term 'pure' we're referring to a defined contribution strategy that is not integrated with group health insurance coverage. Generally, the employer does not restrict the plans employees can choose from. With a 'pure' defined contribution approach, employees can be reimbursed for any qualified health insurance plan.

One of the primary reasons defined contribution health benefits are taking off is because of the built-in cost controls. There are no minimum or maximum contribution requirements, so companies can contribute any amount that fits the health benefits budget. Companies can also vary employee allowances based on job criteria.

Because of compliance with various regulations, most companies use a defined contribution software platform to administer the health benefits. There are no time-consuming annual renewals, and employees maintain a direct relationship with insurance company -- all of which leaves business owners and HR staff with more time for strategic work.

According to Zane Benefits’ website, whether the company currently offers health benefits or not, companies will want a thoughtful implementation process. For example, look for a defined contribution software platform with a dedicated implementation team to ensure a smooth and fast transition for the company and employees.

The idea behind 'pure' defined contribution health benefits is that it gives employees the most control and choice with their health benefits. It puts employees in the driver's seat. Employees use their healthcare allowance to select the health plan that best fits their families' needs, choosing any plan, from any carrier. They can keep their same network and doctors, and pick a coverage level that fits their health needs. Individual health plans costs 20-30% less than traditional group plans, and new tax credits are available to qualifying employees.

Click here to read the full article.

--
About Zane Benefits
Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHealth") for defined contribution health care. The flagship software provides a 100% paperless administration experience to small businesses and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about Zane Benefits, visit http://www.zanebenefits.com. Reported by PRWeb 1 hour ago.

Cancer-Stricken Boy Who Lost Health Insurance After Obamacare Inspires People to Turn to God

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A boy with a rare type of cancer who had his health insurance plan canceled after the Affordable Care Act took effect in October is inspiring many to turn to God. Reported by Christian Post 19 minutes ago.

Canceled In California: People Eye Health Plans Off Exchange

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Some Californians are choosing plans that don't comply with the Affordable Care Act to save money. They have only a few weeks left to pick coverage that will last a year. It will eventually be replaced by health insurance that includes a full range of essential benefits, but at a higher cost. Reported by NPR 3 minutes ago.

Obamacare

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America spends more on health care than any other country in the world, despite our uniquely non-socialized system, yet our health outcomes are at or below the bottom of the range for developed countries. Data from the OECD show that total health care spending in the U.S. amounts to $8,500 per person, more than double the $3,900 median value for health care spending in 21 other advanced economies. And what does all this extra spending provide U.S. residents? Fewer doctors (2.5 per 1,000 people vs. 3.5 elsewhere) and lower life expectancy (78.7 years vs. 81.2).

Why? Multi-payer profit-insurance adds about 40 percent to the total cost, due to the layer of bureaucracy required in the medical system to maneuver through the health insurance labyrinth. Because of the "lobbying" strength of the pharmaceutical industry, drugs sell for higher prices in America than anywhere else in the world, often by 100 percent or more. The U.S. government pays for more than half of all U.S. R&D to develop new drugs and treatment methods, but most of this research ends up profiting private medical firms. The uninsured, and more generally the poor, end up with grossly inferior care, which is often also more expensive because it is obtained at ill-equipped and underprepared emergency rooms. Unlike the rest of the world, most American doctors and health care providers are paid for the procedures they perform (diagnostic tests, surgery, etc.) compared to the fixed salary prevalent in most other countries. In the U.S. there are almost 32 MRI scanners for every million people, which compares to a median of only 13 for other advanced countries.

Obamacare addresses few of these problems, and only obliquely. The entire system is still conducted through multiple private insurance companies. NIH (National Institutes of Health) research and innumerable price protections for drugs and equipment are left undisturbed. So too the pay-for-procedure system of reimbursement, although there are provisions intended to encourage group medical practices with fixed salaries. These shortcomings reflect the Obama administration's respect for major funders of politicians along with its consistent reluctance to fight for underdogs against the rich and powerful.

During the debate over the Affordable Care Act in 2009 and 2010, AHIP (America's Health Insurance Plans, the industry group representing health insurance companies) donated more than $100 million to the Chamber of Commerce, according to the National Journal. The anonymity of the process allowed insurers to claim they were cooperating with the Obama administration's attempts to improve efficiency, rein in costs and expand access, while in reality their dollars were hard at work drumming up opposition to reform. This lobbying money was the key to keeping the "government option" -- in which the government would be a health care provider alongside the private sector -- out of the legislation. So far, socially responsible investors have been unsuccessful in persuading the majority of other shareholders to vote in favor of proposals to report on more complete accounting of spending to influence public policy, including indirect funding of lobbying through trade associations and tax-exempt organizations, such as the American Legislative Exchange Council (ALEC).

Like the failed Clinton health care reform effort, Obamacare picked a twisted path through a thicket of problems in order to avoid having the federal government pay for universal health coverage out of tax revenues. Like numerous other Washington initiatives in the past four decades, it sought instead to shift or mandate the cost onto employers, states and younger, uninsured citizens. The snafus that have accompanied the rollout of the health care exchanges may well be mostly due to carelessness on the part of the executive branch and its subcontractors in the implementation; but they are also due in considerable part to resistance from states, businesses and healthy young people who believe they do not need and cannot afford health insurance.

Amazingly, despite the ignominious beginning to open enrollment for Obamacare, U.S. health care spending has been growing less rapidly than nominal US GDP for about five years. The reasons for this are: a growing appreciation of the efficacy of more patient-centered, procedure-limited approaches which yield better outcomes at lower costs; the slow spread of fixed-pay group medical practices; and the increasing resistance from employers to rapidly rising medical costs. This in turn has led to pressure on the insurance companies to lower their premiums by lowering their payments to health care providers. Employers have also moved toward shifting more of the insurance premium to employees and increasing the costs for which employees were directly liable. It is possible that the Obamacare requirement for the electronic sharing of all medical records has also contributed to this trend in the last three years as doctors and hospitals moved into compliance. There are also some positive early indications for the rollout of Obamacare. Enrollment in Medicaid is growing rapidly in those states that have taken advantage of increased federal funding. States that built their own online exchanges for purchasing private insurance plans are seeing solid and growing enrollment. This suggests the most likely outcome is that once the federal website is repaired, millions of Americans will still gain access to insurance as the law intended.

Still other sources of improving health care outcomes and life expectancy are the twin revolutions in lifestyles and bio-genetic therapies, especially for cancers. The incidence of heart disease and death from cardiovascular causes has fallen dramatically in the last few decades. It is a common observation among the Baby Boomers that everyone looks ten years younger than their parents did at the same age, and that various diseases and disabilities seem to occur ten years later.

The new gene-based therapies for cancers and many other diseases are just in their infancy. There are many companies working on the frontier of genomics and other health care companies that are likely to benefit from the ultimately inevitable rationalization of the dysfunctional US system. Reported by Huffington Post 1 day ago.

Shopping Season

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The holidays are right around the corner. It's no wonder I've got shopping on the mind. And as with the contagion of Christmas music in a mall, I can't help but join the carol of intrigue surrounding the new health care marketplace.The health insurance exchanges are open. Unfortunately, we can't really shop there. No, I'm not jumping on the bandwagon and killing the government for 'technical glitches.' The exchanges' fits and starts may very well impact which party takes seats in the legislature and wins out in the court of public opinion, but will not likely be the undoing of the exchanges or their promise. However major, the kinks will be worked through and when thought about in the context of what has been spent to date in comparison to the size of the health care market itself, the dollars against the rework are pedestrian. The real reason we can't shop on the exchanges is because they are not true marketplaces with *choice*. In our normal everyday shopping experiences, American consumers are accustomed to choice. We can splurge for the deluxe version, or go for the budget option. We can buy from the local guy, or from our favorite national chain. With shopping, we can always go elsewhere, or if we're not satisfied with the options, we can give up on the shopping adventure entirely. These are the fundamental principles of shopping, and Americans have mastered them. So how can we have designed a national storefront for health care that offers no real choice or the freedom to navigate within a truly open market?On the plus side, with the insurance exchanges the government has dipped the health care industry's toe into shopping. Despite an inability for most to get from look-see to sign-up, HealthCare.gov has seen more looks than the most popular kitten video on YouTube. Any new online retailer would be thrilled to attract that traffic. Of course, having shoppers turn up en masse is certainly easier to achieve when the alternative is a federal fine. Regardless, the entire country is talking about HealthCare.gov (we are engaged), and the needle has been moved in the right direction in terms of focusing the American people on health care plans, policies, and enrollment. That's good news. However, the popularly-held belief that the "glitches" are the hurdle the exchanges need to overcome to truly be impactful is shortsighted. Sure, the glitches have prevented the all-important front-door from opening for too many, and there are back-end issues that need resolve; still, I can't help but focus on how we missed the mark on introducing the fundamentals of shopping. It's an opportunity wasted in the exchange setting, and as an example to be set for the broader health care marketplace. It is this - the lack of true shopping - that may prove the undoing of the exchanges, or in the very least will severely diminish their impact on reshaping health care.The limited choices offered within the exchanges remind me of Wendy's 1987 "Russian Fashion Show" commercial. Remember it? "Daywear!""Eveningwear!""Swimwear!" And they were all the same despite some cheesy accessory. The current reality of the insurance exchanges is a less humorous illustration of how illusory "choice" can be in an unimaginative and over-regulated environment. Government tells sellers what they can offer and what they can charge, and buyers what they are allowed to buy.To get shopping to work in health care, we need to create real market dynamics, with many sellers constantly bumping up against one another to compete for the customer. Right now, all four medal plans (bronze, silver, gold, platinum) that the government allows on the shelves are wearing the same gray uniform - all required to offer the same roster of "Essential Benefits." Everything looks the same because the scope of benefits is the same.In the rest of our dynamic economy, disruptive innovations frequently change the game, making incumbent players compete harder to sustain brand leadership and customer share. Until the exchanges can move beyond the government's oversight of who can sell what, to whom, and how, we'll never see truly disruptive health plan offerings that are necessary to stoke competition and change the landscape of shopping today. The role of government is to protect power from concentrating in market, not to define the boundaries and players of a market.For the exchanges to become 'true' marketplaces a few things need to happen. Neither of which expressly focus on getting the technology right. We will assume that happens on whatever timetable a mulligan of this magnitude takes, December 1 or thereafter.First, insurers must be allowed and incented to compete on policy design and on price. For that to happen, more variation in plans must be allowed. We need more players and products, which requires a reimagined definition of what an insurer is and can be. I am but one example, but I'd love the plan that doesn't cover in vitro fertilization (I have five kids), leaves me high-and-dry if I get stage four cancer (because I'd want to die at home), doesn't support primary care (because I'm willing to manage this on my own), but covers me from sunrise to sunset on pharmaceutical alternatives and natural remedies. I can't buy this today.Second, we need to get a handle on the subsidies. Right now the very subsidies that allow the masses to get insurance also obscure the total cost from too many consumers. As a result, "shoppers" on the exchanges behave much like "shoppers" before the exchanges, making decisions primarily on convenience rather than the ordinary metrics of shopping: price and quality. We need to arm patients (shoppers) with real data so they can direct where they go for care - where they send their health care dollars.Nobody who exists in our current economy today would argue with the proposition that technology can be a powerful enabler of shopping. And I'm willing to bet the majority of the millions of people who have tried to enroll or window shop in the insurance exchanges these last two months would agree that the intent of the exchanges is good, but the service delivery and product design is bad. I deeply admire the well-meaning social good and zealous intent of the exchanges, but if the exchanges are to survive and truly make a difference not only must the storefront improve (and it will), but as important, the merchandise must become distinguishable, the seller bench must grow, and buyers need a clear window into price and quality. By bringing these elements that revolve around creativity, personalization and 'informed' choice to the fore, we can make shopping for health insurance as American as shopping for cars, jeans or a new tablet computer. With any luck, by the time the holidays roll around next year, it will be easy for a loved one to give a custom gift of health insurance.Jonathan Bush is CEO and president of athenahealth, a provider of cloud-based services for electronic health records, practice management, and care coordination. Reported by Huffington Post 23 hours ago.

Barriers to health insurance: doubt, distrust and glitches

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A Florida woman has been trying desperately to log in to the new federal health insurance website but can’t get through. There’s the salesman in Indiana whose premiums have gone up but who’s afraid to try the website because of news coverage about its failures. Reported by msnbc.com 23 hours ago.

'Repeal and Replace' the Affordable Care Act? What, Exactly, Is Being Proposed?

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Opponents of the Affordable Care Act have said many times that the law needs to be "repealed and replaced." The natural follow-up is: "OK, replace it with what?"

Supporters of the ACA say that the opposition does not have an alternative plan. In fact, congressional opponents have offered alternatives, going all the way back to 2009. At least four pieces of legislation could be categorized as serious alternatives: Patient's Choice Act of 2009, Empowering Patients First Act of 2009 and 2013 and, finally, American Health Care Reform Act of 2013.

None of the bills was analyzed and scored by the Congressional Budget Office, however, so we do not have a long-term, non-partisan analysis of how much the proposals would cost, how much they would reduce or add to the deficit or how many uninsured Americans would be covered under them.

The bills offered various reforms, but to make a comparison to the ACA, we'll use the most recent proposal, House Resolution 3121, "The American Health Care Reform Act of 2013." It was drafted by the Republican Study Committee, sponsored by Rep. Phil Roe of Tennessee and co-sponsored by 107 (out of 240) House Republicans. The bill is divided into six sections:

*Section one: 'Repeal of Obamacare'*

H.R. 3121 would repeal the Affordable Care Act, using the language of a previous bill sponsored by Rep. Michelle Bachmann of Minnesota. All provisions of the ACA would be repealed, and existing law amended by the ACA would be restored to its original language.

That means some of the most popular reforms of the ACA, such as the expansion of Medicaid eligibility, requiring insurance companies to guarantee coverage, prohibiting insurance companies from dropping coverage based on health status and the ability of children under 26 to stay on their parents' insurance would be repealed or rolled back.
*
Section two: 'Increasing Access to Portable, Affordable Health Insurance'*
The bill would attempt to make insurance coverage more affordable by using tax deductions as opposed tax credits and cost-sharing subsidies under the ACA.

H.R. 3121 would replace the current tax exemption for employer-sponsored insurance and the self-employed tax deduction with a standard deduction for health insurance. It would be based on the amount paid for a qualified private insurance plan and would be adjusted each year according to changes in the Consumer Price Index. The bill's supporters say these tax deductions could equal $7,500 for an individual and $20,000 for a family.

The bill would also increase the allowable contribution for Health Savings Accounts (HSAs) and would allow employers to offer a greater benefit to employees who successfully completed a wellness program.

Under this approach, the value of employer-provided health insurance would count as taxable income and all taxpayers would receive a standard tax deduction to make the coverage more affordable. It strives to put those receiving employer-provided health insurance on equal footing with those who purchase it in the individual market. However, the tax deductions and other tax incentives in the bill may not be the most effective way to make coverage more affordable.

Generally, tax deductions and credits better serve-higher income earners because they have higher tax liability and can take advantage of the full value of deductions and credits. And unlike the ACA's subsidies, the standard deduction can be received only in a lump sum as part of regular tax filing and cannot be claimed in advance. This makes the initial purchase of coverage more difficult for those with very low incomes. Finally, increasing contributions to HSAs is of less value to low income Americans, who lack sufficient available income to take advantage of these provisions.

In fact, the biggest losers under the bill probably would be Americans under 133 percent of the federal poverty level (in 2013: $15,282 for an individual and $31,322 for a family of four), who are now eligible for Medicaid in 25 states because of the ACA. That provision would be rolled back by H.R. 3121, leaving states without the federal funding to make this expansion feasible. There is real doubt, even when coupled with high-risk insurance pools and tax deductions, that private insurance will be affordable for these vulnerable Americans.
*
Section three: 'Improving Access to Insurance for Vulnerable Americans'*
H.R. 3121 would deal with the problem of discrimination for pre-existing conditions in the individual market by appropriating $25 billion dollars over 10 years (or about $2.5 billion annually) to set up high-risk insurance pools in individual states. People with pre-existing conditions would buy health coverage through these high-risk pools, and the federal appropriation would subsidize part of the cost.

Premiums would be capped at 200 percent of the average premium rate in the state, although the bill is not specific on how that cap can be supported and maintained regardless of health status.

High-risk pools have been offered in many states for some time. The first such pools began in Connecticut and Minnesota in 1976. High-risk pools can vary substantially from state to state; some are hard to access, others impose waiting periods and some have premiums as much as 200 percent above the average paid in the individual market.

High-risk pool rates have proven to be unaffordable for many potential low-income enrollees. As a result, risk-pool enrollment rates have been historically low. Even though as many as 11.6 million Americans technically qualified for high-risk pool enrollment in 2012, only 226,000 Americans were able to enroll.

The Affordable Care Act used state-based high-risk pools as a temporary measure to insure people with pre-existing conditions before the elimination of the exclusion in 2014. The ACA appropriated $5 billion over three and a half years (roughly $1.4 billion annually) to cover those state-based efforts. However, the money essentially ran out at the beginning of 2013, and enrollment in those temporary pools for the most part ceased. This raises a question whether a $25 billion appropriation over 10 years would be able to do the job.

A 2010 article in National Affairs written by two conservative health experts concluded that covering pre-existing conditions would require "between $15 and $20 billion per year for a comprehensive set of high-risk pool programs."

*Section four: 'Encouraging a More Competitive Health Care Market'*

H.R. 3121 would attempt to increase competition by implementing three new reforms.

The first would be to allow individuals to purchase insurance across state lines. While there may be some competitive advantages in selling plans across states lines, there are issues that must be considered. Consumers might be attracted to the cheapest plans (with the least comprehensive benefits), leaving many of them underinsured when they actually need health care; this kind of competition could create a "race to the bottom" in terms of covered benefits between insurance companies. It could also destabilize state insurance markets by driving younger and healthier consumers into out-of-state plans. Finally, consumers could have more difficulty in resolving disputes, since the plans would be subject to the regulations of the issuing states, not where necessarily where consumers live. *

The Affordable Care Act allows states to form Health Care Choice Compacts to facilitate the interstate sale of individual policies. Those policies would be subject to the state regulations where the policy is issued. However, unlike H.R. 3121, they would require guaranteed coverage as well as the ACA's 10 essential benefits.

H.R. 3121 also would attempt to eliminate anti-trust exemptions for insurance companies. This provision could help prevent one insurance carrier from gaining a commanding majority of market share within a given state. However, all previous attempts to do this have failed.

Finally, the bill would fund an informational insurance website (or transparency portal) that would allow consumers to compare insurance plans. The portal, unlike the ACA's insurance marketplaces, would not allow people to enroll in insurance plans or Medicaid.

*Sections five and six: 'Reforming Medical Liability Law" and "Respecting Human Life'*

A major focus of H.R. 3121 is to reform malpractice laws. While it would not place a cap on economic damages in lawsuits, it would cap non-economic damages at $250,000 and would assign proportional responsibility. Courts would be allowed to restrict some attorney fees and limit punitive damages. Also, state medical liability laws would have priority.

A 2010 Harvard study indicated that annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion (2008 dollars), or 2.4 percent of total health care spending. The study concluded that reforms designed to reduce these costs "have modest potential to exert downward pressure on overall health spending. ... Reforms to the health care delivery system, such as alterations to the fee-for-service reimbursement system, ... (would) probably provide greater opportunities for savings." Those types of reforms are largely absent in H.R. 3121, compared provisions in the ACA.

Finally, the bill would prevent federal funding for abortions and would prohibit any federal law from requiring health plans to cover abortions. It would also guarantee that nothing in the bill would pre-empt state pro-life or conscience-protection laws.

*Final chapter not written*

The Affordable Care Act is the law of the land. However, it faces operational hurdles because of its balky rollout, and opponents will continue applying pressure to "repeal and replace."

Ultimately, Americans will have to decide if "replace" is an alternative that will provide adequate health insurance coverage and health security.* - Although regulations relating to consumer protection, fraud and abuse would be governed by the home state of the purchaser, other regulatory issues would be governed by the insurer's home state. Reported by Huffington Post 22 hours ago.

Dear President Obama: Payment Due Upon Receipt, Application Now Complete

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Dear President Obama,

As author of "The Clear Parent" Blog, it is typically not my practice to write political posts. However, the following invoice chronicles the time spent away from my search for "clear parenting" while dealing with shopping for individual family health insurance. Our policy was cancelled in October 2013, due to changes resulting from the Affordable Care Act (ACA), or as our family affectionately refers to as the "Unaffordable Care Act."

Before I itemize my bill for the hours spent researching, discussing, meeting with our insurance agent, and actually spending time applying for my family's individual health care insurance, I need to make a few things perfectly clear.

1. I am neither a "right-wing Republican" nor a "bleeding-heart liberal." A political party that matches my personal stance on issues of federal government/vs. states' rights, social issues, national security, and the environment is non-existent in this country.

2. Having worked for several years in the very low paying profession of public education, I hope that it is obvious that I care about the education and welfare of all children.

3. My strong belief is that we have the means in this country for each and every person to have access to affordable health care, adequate shelter, a quality education, and productive employment. However, I do not profess to know the means to this end.

Given the aforementioned personal information, it is my hope that you will read the following with an open mind, foregoing the inclination to stereotype me as "for" or "against" the ACA based upon my political leanings.

I have spent countless hours dealing with our need to purchase a new, "more adequate" individual health care policy. A gross approximation of these hours is listed below:
*My Expense Report for the Unaffordable Care Act*
*Description of Activity and Hours Spent on Task*

1. Losing sleep due to worrying about health care changes 22.0

2. Researching health care plans and reading publications 17.0
about issues related to changes in health care

3. Website navigating and attempts to navigate covered.ca.com 6.0

4. Travel and meeting with health care insurance agent 2.0

5. Reading and writing email to insurance agent 2.0

6. Navigating insurance provider website to apply for new policy 3.0

7. Time spent baffled by the fact that my husband and I need to 0.5
purchase "Pediatric Dental Care"

8. Conversations with health care professionals concerned about 3.0
implementation of ACA in January 2014

9. Online chatting with insurance provider representative regarding 0.5
misinformation sent to me

*56.0 TOTAL HOURS x $7.25* = GRAND TOTAL of $406.00*

*Federal Minimum Wage as of 12/5/13

Unfortunately, this $406.00 will barely make a dent in our new monthly "adequate" insurance premium to replace a policy which had a lower monthly premium, a lower deductible and coverage that was more than appropriate for our family (although I was not covered for prostate care).

Finally, please keep in mind that I have not included "pain and suffering" due to our family experiences with the National Healthcare "improvements." I plan to be a plaintiff in the soon to be filed Class Action against the Federal Government for the pain and suffering endured during this period of time. Our compensatory non-economic damages include body and headaches, potential shortening of life due to depression and emotional scarring, as well as permanent vision damage due to computer overuse and possible CVS (Computer Vision Syndrome).

Should you choose to share my invoice with other constituents who may be feeling "smug" that they are not dealing with this issue, please remind them that small and large businesses may be giving employees a fixed amount of money to "shop the marketplace" for adequate health care during 2014.

I can speak from first hand experience; it's not like going to the mall.

Respectfully,

Cate Pane
"The Clear Parent" Reported by Huffington Post 21 hours ago.

Guest Post: Obamacare Is A Catastrophe That Cannot Be Fixed

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Submitted by Charles Hugh-Smith of OfTwoMinds blog,

Obamacare is a catastrophe that cannot be fixed, because it doesn't fix what's broken in American healthcare.

*I just finished a detailed comparison of my current grandfathered health insurance plan from Kaiser Permanente (kp.org), a respected non-profit healthcare provider, and Kaiser's Affordable Care Act (Obamacare) options.* I reviewed all the information and detailed tables of coverage and then called a Kaiser specialist to clarify a few questions.

*First, the context of my analysis:* we are self-employed, meaning there is no employer to pay our healthcare insurance. We pay the full market-rate cost of healthcare insurance. We have had a co-pay plan with kp.org for the past 20+ years that we pay in full because there's nobody else to pay it.

What we pay is pretty much what employers pay. In other words, if I went to work for a company that offered full healthcare coverage, that company would pay what we pay.

Kaiser Permanente (kp.org) is a non-profit. That doesn't mean it can lose money on providing healthcare; if it loses millions of dollars a year (and some years it does lose millions of dollars), eventually it goes broke. All non-profit means is that kp.org does not have to charge a premium to generate profits that flow to shareholders. But it must generate enough profit to maintain its hospitals, clinics, etc., build reserves against future losses, and have capital to reinvest in plant, equipment, training, etc.

As an employer in the 1980s, a manager in non-profit organizations in the early 1990s and self-employed for 20+ years, I have detailed knowledge of previous healthcare insurance costs and coverage. As an employer in the 1980s, I paid for standard 80/20 deductible healthcare insurance for my employees. The cost was about $50 per month per employee, who were mostly in their 20s and 30s. In today's money, that equals $108 per month.

In other words, I have 30+ years of knowledgeable experience with the full (real) costs of healthcare insurance and what is covered by that insurance.

*Our grandfathered Kaiser Plan costs $1,217 per month. There is no coverage for medications, eyewear or dental. That is $14,604 per year for two 60-year old adults.* We pay a $50 co-pay for any office visit and $10 for lab tests. Maximum out-of-pocket costs per person are $3,500, or $7,000 for the two of us.

We pay $500 per day for all hospital stays and related surgery; out-patient surgery has a $250 co-pay.

So if I suffered a heart attack and was hospitalized and required surgery, I would pay a maximum of $3,500 for services that would be billed out at $100,000 or more were Kaiser providing those services to Medicare.

(Yes, I know Medicare wouldn't pay the full charges, but if Medicare is billed $150,000--not uncommon for a few days in the hospital and surgery-- it will pay $80,000+ for a few days in the hospital and related charges. All of this is opaque to the patient, so it's hard to know what's actually billed and paid.)

In other words, this plan offers excellent coverage of major catastrophic expenses and relatively affordable co-pays for all services.

*The closest equivalent coverage under Obamacare is Kaiser's Gold Plan. The cost to us is $1,937 per month or $23,244 a year.* The Gold Plan covers medications ($50 per prescription for name-brand, $19 for generics) and free preventive-health visits and tests, but otherwise the coverage is inferior: the out-of-pocket limits are $6,350 per person or $12,700 for the two of us. Lab tests are also more expensive, as are X-rays, emergency care co-pays and a host of other typical charges. Specialty doctor's visits have a $50 co-pay.

*The Obamacare Gold Plan would cost us $8,640 more per year. This is a 60% increase.* It could be argued that the meds coverage is worth more, but since we don't have any meds that cost more than $8 per bottle at Costco (i.e. generics), the coverage is meaningless to us.

*The real unsubsidized cost of Obamacare for two healthy adults ($23,244 annually) exceeds the cost of rent or a mortgage for the vast majority of Americans.* Please ponder this for a moment: buying healthcare insurance under Obamacare costs as much or more as buying a house.

*A close examination of lower-cost Obamacare options (Bronze) reveals that they are simulacra of actual healthcare insurance, facsimiles of coverage rather than meaningful insurance.* The coverage requires subscribers to pay 40% of costs after the deductible, which is $9,000 per family. Total maximum out-of-pocket expenses are $12,700 per family. This coverage would cost us $1,150 per month, and considerably less for younger people.

*How many families in America have $9,000 in cash to pay the deductibles, plus the $13,800 annual insurance fees?* That totals $22,800 per year. If some serious health issue arose, the family would have to come up with $12,700 (out-of-pocket maximum) and $13,800 (annual cost of insurance), or $26,500 annually.

*Is healthcare that costs $26,500 per year truly "insurance"?* I would say it is very expensive catastrophic insurance in a system with runaway costs.

*The entire Obamacare scheme depends on somebody paying stupendous fees for coverage which then subsidizes the costs for lower-income families and individuals.* How many households can afford $23,244 a year for Gold coverage plus $12,700 out-of-pocket for a total of $35,944 annually? How many can afford $26,500 for Bronze coverage?

Recall that the median household income in the U.S. is around $50,000.

How many companies can afford to pay almost $2,000 a month for healthcare insurance per employee? Even if employees pay a few hundred dollars a month, the employers are still paying $20,000 a year per (older) employee.

If an employer can hire someone in a country with considerably lower social-welfare/healthcare costs to do the same work as an American costing them $2,000 per month for healthcare insurance, they'd be crazy to keep the worker in America, unless the worker was so young that the Obamacare costs were low or the worker was a contract/free-lance employee who has to pay his own healthcare costs.

*Uninformed "progressives" have suggested that "Medicare for all" is the answer.* Their ignorance of exactly how Medicare functions is appalling; recall that Medicare is the system in which an estimated 40% of all expenditures are fraudulent, unneccessary or counter-productive, where a few days in the hospital is billed at $120,000 (first-hand knowledge) and a one-hour out-patient operation is billed at $12,000, along with a half-hour wait in a room that's billed at several thousand more dollars for "observation." (Also first-hand knowledge.)

Medicare is the acme of an out-of-control program that invites profiteering, fraud, billing for phantom services, services that add no value to care, and services designed to game the system's guidelines for maximum profit. If an evil genius set out to design a system that provided the least effective care for the highest possible cost while incentivizing the most egregious profiteering and fraud, he would come up with Medicare.

*Does Medicare look remotely sustainable to you?* Strip out inventory builds and adjustments from imports/exports and the real economy is growing at about 1.5% annually. As noted yesterday in What Does It Take To Be Middle Class?, the real income of the bottom 90% hasn't changed for 40 years, and has declined by 7% since 2000 when adjusted for inflation.

Here is Medicare's twin for under-age-65 care for low-income households, Medicaid:

*As I have observed for years, Obamacare and Medicare/Medicaid do not tackle the underlying problems of Sickcare costs in America.* If you haven't read these analyses, please have a look:

Why "Healthcare Reform" Is Not Reform, Part I (December 28, 2009)

Why "Healthcare Reform" Is Not Reform, Part II (December 29, 2009)

Type sickcare into the custom search box at the top of the left-hand column of the main blog page and you will find dozens of essays addressing what's broken with American healthcare.

*Obamacare is a catastrophe that cannot be fixed, because it doesn't fix what's broken in American healthcare.* It is a phony reform that extends everything that makes the U.S. healthcare unsustainable sickcare. Reported by Zero Hedge 21 hours ago.

Obamacare Glitches Hit 10 Percent Of Enrollments: Official

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As many as one in 10 enrollments through HealthCare.gov aren't accurately being transmitted to health insurance companies, a federal official disclosed Friday.

According to a preliminary assessment by the Centers for Medicare and Medicaid Services, the main Obamacare website is submitting accurate information about enrollees to health insurance companies about 90 percent of the time, agency spokeswoman Julie Battaile said during a conference call with reporters Friday. From Oct. 1 to Nov. 30, the error rate was closer to one-fourth, she said.

The administration is now working with health insurance companies to check all the reports submitted since the beginning of the enrollment period and to prevent future errors, Bataille said. "Our goal is to make sure that every consumer who enrolls in coverage is able to successfully complete that process," she said. The New Republic first reported on the agency's estimates of the error rates.

HealthCare.gov, the federal online portal for health insurance exchanges in more than 30 states, has performed better since the beginning of December, with usage and enrollment appearing to accelerate. But backend problems with the technology behind the website persist, jeopardizing health coverage for consumers who believe they are signed up and could be exposed to surprise medical bills because of the enrollment glitches.

When a consumer signs up via the federal exchanges, the system is supposed to submit their information to the insurance company. Instead, at times, it has failed to deliver any report, has sent duplicate forms, or provided erroneous information, such as not accurately representing the relationship between spouses or between parents and children, Bataille said.

Consumers who completed the enrollment process but aren't sure whether their benefits will be in effect in January should call the health insurance companies they selected, Bataille said.

Health insurance enrollments aren't complete until customers make a payment to the health insurer. HealthCare.gov prompts users to contact insurers about payments and the administration is reaching out to consumers to advise them on what final steps they should take, Bataille said. The deadline to choose a health plan that will be in place on Jan. 1 is Dec. 23, and consumers must pay their first health insurance premium by Dec. 31. The enrollment period runs until March 31.

Health insurance companies have reported flaws with these data transmissions since the beginning of the enrollment period. The Department of Health and Human Services has been aware of the issues since the exchanges debuted Oct. 1 but would not offer an estimate of how many consumers may face difficulty accessing their health benefits next year as a result until Friday.

The lack of disclosure partly was caused by uncertainty about the scale of the failures, Bataille said. "Because there have been a number of different problems associated with these transactions, it has made it difficult for us to easily quantify and categorize the total number of forms and the total number of errors seen over time. We are currently undertaking a very focused process to verify information," she said.

The administration and the private contractors that built HealthCare.gov established a dedicated team to work through faults in the 834 form submission process and to collaborate with health insurance companies to correct them. They are beefing up systems to track these forms rather than mostly rely on insurers' anecdotal reports of problems, Bataille said.

The Centers for Medicare and Medicaid Services and two industry trade groups, America's Health Insurance Plans and the Blue Cross Blue Shield Association, issued a rare joint statement Wednesday emphasizing their collaborative effort to secure the coverage chosen by users of the federal health insurance exchanges.

Some state-run health insurance exchanges are encountering similar difficulties, and the federal exchanges system also isn't providing complete information to state agencies on new Medicaid enrollees. Reported by Huffington Post 19 hours ago.
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