Parents tell their sons and daughters that they remember when medicines were really inexpensive. But anyone who has recently visited the pharmacy to fill prescriptions realizes that those days are long gone. My own drugs have become pricier, and the deductibles and copayments for the medicines are higher. How can we get affordable drugs for our illnesses?

Even generic pills have increased in cost. Augmentin antibiotic pills, commonly used for infections, which cost about $400 for brand-name medicine, still cost $80 to $120 for generics. Inhalers, blood pressure medicines, anti-diabetic drugs and cholesterol-lowering medicines have all become more expensive.

If you need injected medicines, you are likely paying more. For arthritis, medications are remarkably effective at reducing pain, improving mobility and function, and improving quality of life, but at high cost. Phil Mickelson's golf success despite his psoriatic arthritis is an example of how effective these drugs (such as etanercept) can be.

In the treatment of cancer, we have made enormous progress, with reduced cancer deaths. But the cost of anti-cancer drugs has ballooned to many thousands of dollars per month. The average costs of such medications has doubled to $10,000 per month in the last decade, and 11 of 12 drugs approved in 2012 cost over $100,000 per year.

The effect of the Affordable Care Act on drug costs is good news and bad news. As for the good news, the reduction of the donut hole of personable responsibility for drug fees is lowering costs for Medicare patients. But the bad news is that, compared with last year, the deductible amount on health plans (which only sometimes includes drug expenses) has increased by 43 percent on average for bronze plans, to $5,031, and total out-of-pocket costs have increased to $6,350 for individuals, and up to $12,700 for families. Since the average household income is a median of only $53,046, health care is rapidly becoming unaffordable for many families, and the cost of drugs has become a big burden on family finances. Health insurance, once thought to be a protection against personal bankruptcy, now may no longer have that role for many people.

Other countries are also trying to deal with the high cost of medications. In England, access to expensive drugs is often denied based largely on cost (but also on only marginal improvement from some medicines). In India, the courts and government allow generic equivalents of drugs, still protected elsewhere by patents, to be produced and sold, often at only one tenth of the price of the brand-name drugs. India's solution is not allowed in the United States, where courts protect patent holders. But an English-type approach might actually be adopted in America by the Independent Payment Advisory Board, created by the Affordable Care Act, to reduce escalating Medicare costs.

What can you do to find affordable medications? Here is a long list of my tips:

• When your doctor is prescribing medicine for you, ask what the cost of those drugs will be and if a generic drug is available that will work as well. Generics are less expensive than brand-name proprietary medicines.
• When you are going to fill the prescription, compare prices at your usual pharmacy, and also with other in-store pharmacies and even online pharmacies. In my experience with my patients, you could save up to 75 percent by comparative shopping.
• Check with the pharmacy to be certain if your prescription is a brand-name drug or a generic, and if it is on the regular formulary (cheaper and more available) or if it is now considered a specialty pharmacy drug (which is not only more expensive but may require pre-authorization due to the high cost).
• If your medication is too expensive, ask your doctor if a less-expensive medicine can be prescribed instead.
• Also ask your physician if she/he has free samples available for you.
• Since pharmaceutical manufacturers know their drugs are very expensive, many of the companies provide patients with discount cards, which can reduce your out-of-pocket costs. Some also have free drugs available for patients if their incomes are limited (but those limits can be as high as $100,000 income annually!). Ask at your doctor's office if they have discount cards. If they do not know about any discount programs, contact the drug manufacturer or ask the pharmacist.
• If you are on Medicare and are receiving an expensive medicine, ask your doctor, your pharmacist, or the drug company if there is a foundation that can reduce your copayments for the treatment. Then apply for a grant from the foundation (this is very easy, and if you need help, check with your doctor's office staff).
• When it is time to re-enroll in a Medicare Part D program, shop carefully on the Medicare.gov website, where you can list all your medications and determine the best value plan. Remember, each plan is still allowed to change costs of drugs at any time, so a good choice right now might not be the best later in the year. Companies can also change the tier status of drugs (higher tiers have larger copayments and prices) at any time.
• If your medications are still too expensive, price shop on the Internet from Canadian or other foreign online pharmacies. To understand details, pros and cons of ordering drugs in this manner, see the chapter "Finding Affordable Medications" in my book Surviving American Medicine.
• If your doctor is planning to use injected therapies, such as anti-arthritic drugs, immune-modulating therapy or chemotherapy, discuss with your doctor what the costs will be, what your copayments will be, and whether there are less-expensive or less-toxic therapies with similar outcomes and disease control.

Is this too much work for you to have to do? Well, when you are going to buy a home, a car, or even a major appliance such as a video system, you usually spend a little time researching so that you don't get the wrong house, auto or TV. But more important than buying those is getting the wrong medication, or one you cannot afford. Start being a smart shopper for drugs and treatments by asking for the right help and information from your doctor, pharmacist and insurance company. Use your team to win the game of finding affordable medications. Reported by Huffington Post 1 day ago.

February 14th is the last day to switch your Medicare coverage, if you are enrolled in a Medicare Advantage plan. From January 1st through February 14th, Medicare beneficiaries can switch from a Medicare Advantage plan back to Original Medicare. Contributing Editor: Jim Verville - MMAP Counselor, Area Agency on Aging of Northwest Michigan

Lansing, Michigan (PRWEB) February 07, 2014

If you switch to Original Medicare during this period, you’ll have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month.

The Michigan Medicare Medicaid Assistance Program, also known as MMAP, reports that some beneficiaries have determined that they simply do not want to continue their Medicare Advantage policy. They have decided that this type of coverage does not work for them, or perhaps they are not sure what to do. They have an out. Medicare beneficiaries can either cancel their Advantage plan completely, or switch to a stand-alone Medicare Prescription Drug Part D plan. The disenrollment/enrollment must take place no later than February 14th. Beneficiaries electing to do this will return to Original Medicare on March 1st. Those who elect to do this are not permitted to enroll in another Advantage policy, but they can apply for a Medicare supplement plan. Also, if they do not enroll in a stand-alone Part D drug plan, they will be subject to a penalty.

MMAP counselors are available to help beneficiaries compare their options.

“We have received calls from people who want to make the switch, and calls from some folks who aren’t quite sure,” said Jim Verville, the MMAP Regional Coordinator Region 10 in Traverse City. “Anyone who needs help with their Medicare benefits can call 1 – 800 – 803 – 7174 for free counseling.” Verville runs the MMAP program for the ten counties in Michigan’s Northwest Lower Peninsula.

About Michigan Medicare/Medicaid Assistance Program (MMAP)
MMAP (pronounced “map”) provides free health benefits counseling services for Michigan’s Medicare beneficiaries, including younger adults who have Medicare due to a disability and Medicare beneficiaries who may also qualify for Medicaid. MMAP counselors provide personalized counseling to help beneficiaries understand and make informed decisions about their Medicare benefits and plan options. MMAP also promotes Medicare Fraud Awareness and works to educate beneficiaries on how to detect and report suspected Medicare Fraud.

MMAP is part of the national networks of State Health Insurance Assistance Programs (SHIP) and Senior Medicare Patrols (SMP). It is dedicated to providing objective and confidential health benefits counseling services and is not affiliated with nor does it receive funding from the insurance industry. Funding for MMAP comes from grants from the Michigan Office of Services to the Aging and the U.S. Department of Health and Human Services.

Beneficiaries who would like to talk with a MMAP counselor should call 1-800-803-7174. Reported by PRWeb 18 hours ago.

Armed with an Apple laptop and a pile of fliers, he's part of the army of workers and volunteers fanned out around the country trying to enroll young — and probably healthy — people in health insurance available through President Barack Obama's signature law. Run largely by groups with close ties to the White House, the on-the-ground recruiting effort is based in part on lessons learned from Obama's two presidential bids, which revolutionized the way campaigns tracked and targeted voters. With Chapman's personal information now in Enroll America's system, volunteers will almost certainly keep tabs on her enrollment status through the March 31 deadline, mirroring the way the Obama campaign kept track of likely Democratic voters. [...] outside groups are compiling their own databases through contacts their volunteers make while they're promoting the health law at colleges, bars, church youth group events, even laundromats. Komongnan thought he had health insurance, but when a bad ear infection brought him to the emergency room last year, he was told he no longer had coverage. Because his school requires students to have health insurance, he had to sign up for coverage through the college that costs nearly $700 per semester. While Komongnan's health insurance costs will be reduced dramatically, he doesn't count toward the pool of young and healthy people the White House is courting since he's getting coverage through Medicaid, not the new private marketplace. Reported by SeattlePI.com 17 hours ago.

* House Republicans struggle with conditions for debt limit hike
* Scale of demands far less ambitious than watershed 2011 battle
* Some conservatives advocate sitting this one out
By David Lawder
WASHINGTON, Feb 7 (Reuters) - The U.S. debt limit suddenly looks a lot less threatening as Republicans in the House of Representatives struggle to choose from a diminishing list of minor conditions for an increase needed by the end of this month.
Both House Republican leadership and some of the conservatives who voted against the deal to end a government shutdown last October are taking a more pragmatic approach that includes no talk of brinkmanship. As a result, financial markets are far from panicking.
The conditions under discussion by Republicans were shrinking in scale on Thursday after party leaders opted not to attach changes to "Obamacare" insurance provisions nor approval of the Canada-to-Texas Keystone XL oil pipeline.
Republican lawmakers and aides said possible debt limit conditions still under discussion included the restoration of military pension cuts that many Republicans had just supported in December, as well as adjustments to doctor payment rates in the Medicare health care program for the elderly.
These would be a far cry from Republicans' ambitious demands for trillions of dollars in spending cuts in 2011 during a bitter debt limit fight that brought the United States to the brink of default.
House Speaker John Boehner said no decisions had been made on whether to attach any conditions to an increase in the $17 trillion borrowing cap. But he repeated what has become a new mantra on the issue: "We do not want to default on our debt and we're not going to default on our debt."
It remained unclear how he will come up with conditions that Democrats can accept or engineer House passage of the "clean" increase sought by President Barack Obama.
"The Republicans have been negotiating with themselves, and the demands keep getting smaller," said Jim Kessler, a co-founder of Third Way, a centrist think tank in Washington. "They are trying to find some face-saving gimmick rather than something with real substance."
He said the Democrats who control the Senate are likely to reject any substantial conditions and send back a straight increase, putting Republicans in the position of capitulating or holding out and risking market turmoil and a potential voter backlash in November mid-term elections.
Time is running short. A temporary extension of the debt limit nominally expires on Friday and the Treasury has said it expects to exhaust all remaining borrowing capacity by the end of February.
Expressing frustration at Boehner's indecision, Democratic Senator Patty Murray on Thursday accused Republicans of "just throwing ideas against the wall to see what sticks and creating more uncertainty."
Some Republican lawmakers have advocated sitting out this debt limit round and allowing an increase to be passed with Democratic votes only. Raul Labrador, an Idaho Republican backed by the conservative Tea Party movement said that would be better than making some half-hearted demands likely to fail.
"The Democrats can own it," said Labrador, who voted against the shutdown deal, which also extended U.S. borrowing authority.
Such a move could be accomplished by a significant number of the majority Republicans voting "present," which would exclude their votes from the majority needed for passage.
Democrats would happily push a clean increase into passage, said Representative Steny Hoyer, the No. 2 House Democrat, who said he could easily deliver more than 180 "yes" votes towards a 218 majority.

BACK IN THE (DEBT LIMIT) DAY
The 2011 budget fight is viewed by many Republicans as their finest debt-limit hour because it led to the Budget Control Act, which cut discretionary spending by about $2.1 trillion over 10 years, including the painful, across-the-board cuts known as "sequestration."
But the episode also cost the United States its top-tier credit rating from Standard & Poor's and caused widespread financial market turmoil as investors feared a first-ever default on U.S. debt.
Another debt limit increase that was needed in mid-October last year was hijacked the government shutdown on Oct. 1, a fight that was waged over conservative demands to deny funds to President Barack Obama's signature health insurance reform law.
Investors and the public conflated the two events, and Republicans never got an opportunity to use the debt limit to make coherent demands for deficit reduction.
The shutdown paved the way for a modest compromise to set spending levels for government agencies and the military through September 2015, and the debt limit rhetoric has since cooled.
Financial markets are also somewhat more sanguine. Interest rates on one-month Treasury bills are somewhat elevated, but not to the extent they were last October.
And Moody's Investors Service said this week that failure to raise the debt limit by March or April would not lead to a U.S. credit downgrade because the government could more easily cut other expenses to maintain debt payments.
Steven Hess, Moody's lead U.S. sovereign credit analyst said he nonetheless expected Congress to pass a borrowing cap increase "certainly during the month of February."
Some House conservatives who fought hard last year over the government shutdown say they won't give up their desire to use the debt limit to reduce deficits, but they are taking a more pragmatic approach this year.
Representative Rob Woodall of Georgia said he doesn't think House Republicans want to try to "bulldoze" their demands on Senate Democrats and the White House.
"I don't think that's where folks are, I don't think we have the votes to get that done," said Woodall, first elected in the Tea Party wave of 2010. "What we're trying to do is coalesce around something that the Senate would be an enthusiastic partner on."
Woodall voted against the deal last to end the October shutdown and in 2011 declared that "the days of blindly increasing the debt limit without spending cuts are over." Reported by Huffington Post 14 hours ago.

KENNEBUNK, Maine--(BUSINESS WIRE)--Mark Farrah Associates: Latest Reports Assess 2014 Strategies of Health Insurance Industry Leaders Reported by Business Wire 13 hours ago.

Brokers Who Adapt to Changing Market Will Thrive in 2014

Park City, UT (PRWEB) February 07, 2014

Today, Zane Benefits, the #1 Online Health Benefits Solution, published a new information on increasing health insurance policy sales.

According to Zane Benefits’ website, many health insurance brokers feel uncertain about the health insurance market post-ACA. However, for brokers who are willing to adapt, there is tremendous opportunity.

Zane Benefits offers ten trends in how health insurance brokers are increasing health insurance policy sales in 2014.

1) Dust Off Individual Product Lines

2) Register with the Public Health Insurance Exchanges

3) Offer Defined Contribution Solutions

4) Incorporate a Private Health Exchange Solution

5) Think Voluntary

6) Focus on Your Target Markets

7) Utilize Internet Inbound Marketing

8) Be the Go-To Person for ACA (aka ObamaCare) Questions

9) Become a Trusted Advisor

10) Ask for Referrals

Click here to read the full article.

--

About Zane Benefits
Zane Benefits, the #1 Online Health Benefits Solution, was founded in 2006 to revolutionize the way employers provide employee health benefits in America. We empower employees to take control over their own healthcare, while helping employers recruit and retain the best talent. Our online solutions allow small and medium-sized businesses to successfully transition to a health benefits program that creates happier employees, reduces costs and frees up more time to serve their customers. For more information about ZaneHealth, visit http://www.zanebenefits.com. Reported by PRWeb 12 hours ago.

House Budget Committee Chairman Paul Ryan's claim that health reform creates a "poverty trap" that discourages poor families from working has it backwards, as my colleague Jared Bernstein notes.  Chairman Ryan's proposals to repeal health reform and block-grant Medicaid would more likely increase work disincentives, particularly among poor parents with serious medical conditions and other ongoing health care needs.

To see why, let's consider a hypothetical Jane -- a very poor working parent with two children and with income of 60 percent of the poverty line (about $11,875).
· If Jane lives in a state taking up health reform's Medicaid expansion, she can significantly expand her hours or take a much higher-paying job, earning up to $27,310, and still retain Medicaid.  Even if her income rises above $27,310, she can get subsidized coverage through the new health insurance marketplaces (also known as exchanges).

As the Congressional Budget Office (CBO) states, "some people who would have been eligible for Medicaid under prior law -- in particular, working parents with very low income -- will work more as a result of the [Affordable Care Act's] provisions."· Before health reform's major coverage expansions took effect this year, Medicaid eligibility for working parents ended at just 61 percent of the poverty line in the typical state.  So, if health reform (including the Medicaid expansion) were repealed, which Chairman Ryan supports, Jane would lose Medicaid if she worked more hours or took a higher-paying job (though her children would still be eligible for Medicaid or CHIP).

She could receive transitional Medicaid for a limited time but would likely end up uninsured if her employer didn't offer job-based coverage (very low-wage jobs mostly don't come with health coverage) or she couldn't afford that coverage.

If Jane has a serious medical condition or other health needs that require ongoing treatment, she might feel that she had to retain Medicaid, even if that meant giving up a higher-paying job.  She could thus be "trapped," in Chairman Ryan's words, but this would result from health reform's repeal, not its enactment.
Converting Medicaid to a block grant, which Chairman Ryan also favors, would only worsen the impact on work incentives.  Chairman Ryan's 2013 budget plan would have cut federal Medicaid funding by one-third, likely forcing all states to sharply cut eligibility, benefits, and/or payments to health care providers.  The Urban Institute estimated that 14 to 20 million people would lose Medicaid under an earlier Ryan block-grant proposal, and this estimate doesn't count the millions who would lose coverage from repealing the Medicaid expansion.

Medicaid income limits for working parents would likely be even lower under a block grant than they were before health reform.  That would worsen the problem that Chairman Ryan expressed concern about because Jane would have an incentive to cut her hours and earnings in order to retain Medicaid.

But what about poor, non-disabled adults without children, who generally weren't eligible for Medicaid before health reform?  Now that they can get Medicaid (if they live in an expansion state), will they work significantly less?  The evidence to date says there will be, at most, a small effect.

As we have pointed out, researchers using data from the Oregon Health Study -- a landmark, ongoing study of the state's Medicaid program -- found that enrolling in Medicaid did not discourage people from working.  The data showed no statistically significant difference between a group of low-income adults selected for Medicaid and a control group that remained on a waiting list, either in the share with earnings or in the amount of earnings.

A study of Tennessee's Medicaid program found increases in employment among some adults after losing Medicaid, which might suggest that expanding Medicaid reduces work.  But Urban Institute researcher Austin Nichols points out that the study doesn't have the same unbiased experimental evidence as the Oregon study, since the comparison group used in the Tennessee study were adults who lived in neighboring states.  And when he tried to replicate its findings, he found no significant effect of the Medicaid eligibility reduction on employment.

After examining the research literature, Nichols concludes: "The best guess is that Medicaid expansions have no effect on labor supply."  Even CBO concludes that, on balance, health reform's Medicaid expansion will have only a relatively modest impact on labor supply.
Related Posts:

· Oregon Medicaid Study Strengthens -- Not Weakens -- Case to Expand Medicaid· Ryan Budget Again Includes a Medicaid Block Grant That Would Add Millions to the Ranks of the Uninsured and Underinsured· Ryan Budget, Not Medicaid, Creates a Two-Tiered Health Care System Reported by Huffington Post 11 hours ago.

Opponents of the Affordable Care Act have used the most recent Congressional Budget Office (CBO) report on the nation's economy to claim that the health care law "kills jobs" and forces people out of the labor market.

Those claims, along with botched headlines and erroneous reporting, ignored important details in the report. Confusion about the report was evident in the halls of Congress.

During testimony about the report, Rep. Paul Ryan (R-WI), chairman of the House Budget Committee, stated, "Obamacare is clearly part of the problem. It adds trillions of dollars in government spending, and it has made things worse for our economy and for working families. By 2017, CBO projects that people will be working fewer hours precisely because of the incentives created in this law ... and these changes, they disproportionately affect low-wage workers. Translation: Washington is making the poverty trap much worse."

The CBO report is clear that employers will not eliminate jobs. Rather, it says that Americans might choose to work less. Does the report suggest that the ACA will create more hardship for working families and harm the economy? In a word, no.

The CBO says that, as a result of the ACA, lower-wage Americans have a greater opportunity to work fewer hours or not seek additional employment in order to afford health insurance. Additionally, some older Americans might transition from full-time to part-time work, or they might choose to retire since they would no longer have to rely on employer-sponsored insurance.

These conclusions are not new. In its initial scoring of the ACA, the CBO projected that individuals would voluntarily leave the labor market or would reduce working hours because of more affordable insurance coverage.

The CBO's latest report sees that effect as part of a larger trend. It says that participation in the labor force has been declining and is expected to continue to decline. Between 2007 and the fourth quarter of 2013, the participation rate dropped by about 3 percent. About half of that decline was the result of baby boomers moving into retirement or reducing work hours. This trend will continue and will be the largest factor, by far, in reducing the number of workers in the labor force over the next 10 years. Additionally, the economic downturn and limited job opportunities caused many frustrated job-seekers to leave the job market. This accounts for one-third of that 3 percent decline. By the end of 2017, labor participation is projected to drop by another 0.4 percent.

Between 2017 and 2024, the CBO estimates, the number of work hours in the total economy will be 1.5 to 2 percent lower than what would have occurred in the absence of the ACA. That translates to 2 million to 2.5 million full-time-equivalent employees over that seven-year period. Most of this drop will be in low-wage sectors of the economy. Since premium and cost-sharing subsides under the ACA decrease as individual income increases, this can create a disincentive for low-income workers to expand working hours or work another job.

But is that all bad? Is it better for low-income Americans to work longer hours (in many cases more than the traditional 40 hour work week), hold down more than one job, or continue working into older age simply to have access to affordable health insurance? Is it better to have the option of working fewer hours to take care of children or an elderly parent? Workers would still have the option to increase their take-home pay, give up some subsidies, and pay a greater share of the cost of their health insurance.

According to Doug Elmendorf, director of the CBO, "These subsidies, of course, make these lower-income people better off ... By providing these people a subsidy, these people are better off, but they do have less of an incentive to work."

There were other key points in the report that did not find their way into headlines and news stories. Part-time employment has not increased as a result of the Affordable Care Act. This is directly contrary to predictions of the law's opponents, who claimed that the employer-responsibility provisions in the ACA would lead employers to convert full-time jobs into part-time ones.

Also, the CBO reduced its estimate of the net cost of the ACA by $9 billion through 2024, in part because of the number of states that have refused to implement the law's Medicaid expansions. And the CBO still maintains that, over the 10-year window of its analysis, the ACA will reduce the federal deficit. In fact, that trend is expected to increase in subsequent years, with the ACA leading to greater deficit reduction.

On premiums, the CBO found that rates in the insurance exchanges are projected to be 15 percent lower in 2014 than earlier projections.

The CBO and the Joint Committee on Taxation estimate that the number of non-elderly people who have health insurance will increase markedly -- by about 13 million in 2014, 20 million in 2015, and 25 million in each of the subsequent years through 2024. They also suggest that enrollment in the individual insurance market will reach about 6 million people in 2014, about 1 million people fewer than originally estimated. However, the CBO says enrollment may jump as the April 1 deadline for open enrollment nears, which may put the figure closer to 7 million.

Finally, according to the CBO report, "On balance, the CBO estimates that the ACA will boost overall demand for goods and services over the next few years ... the net increase in demand for goods and services will in turn boost the demand for labor over the next few years." In everyday language, that means the ACA will boost the economy and, in turn, create jobs.

Ultimately, legislation and laws are about more than labor-participation numbers and budget projections. They are also about the quality of life in America. Medicare and Social Security became law to provide older Americans security and dignity in old age. Medicaid became law to ensure that very low-income parents, children and people with disabilities have access to care that they otherwise could not afford. As a society, we undertook the burden of supporting these programs because of the degree to which they improved the lives of our fellow citizens. It is all too easy to forget this in our current political environment. Reported by Huffington Post 10 hours ago.

Republicans were, as usual, hysterical in their lies and distortions about the Congressional Budget Office's report on Obamacare's effects on jobs and the economy. Various GOP leaders or groups falsely cited CBO as saying the law would have a "devastating impact on jobs;" that it would result in "even more pink slips," and was "bad for the economy," by "destroying fulltime jobs."

Nor will the media win any medals for their coverage of the report. Both the New York Times and the Washington Post initially headlined that CBO estimated a loss of some two million jobs, before making corrections. CNN made the same mistake at first, as did others. In fact, the budget office report said no such thing about Obamacare killing jobs. What it said was that the number of workers, not the number of jobs, would be reduced.

The distinction is important. The CBO pointed out that by separating health insurance from employment, Obamacare makes it possible for people who choose to swap their full-time jobs for part-time, or to quit and retire early, or leave to start a new job or business, to do so without having to worry about not having health insurance. So there may well be fewer workers, but not necessarily fewer jobs. And those same jobs can then be filled by other, often younger, workers who might otherwise be unemployed.

The worst offender I saw in the press was the Washington Post columnist Dana Milbank. I found him terribly hypocritical because he offered two almost completely contrasting takes on the CBO report on successive days, without ever admitting he'd done so. In his Wednesday column, Milbank wrote, referring to the non-partisan budget office employees, that "the government's green eyeshades had bestowed a big gift on the law's Republican critics."

In that column, Milbank embraced the Republican argument that the report "wasn't pretty for Obamacare." The reduction of 2.3 million full-timers in the workforce by 2021, he wrote, "will inevitably be a drag on economic growth," which is "grim news for the White House and for Democrats on the ballot in November." And, Milbank added:
This independent arbiter [CBO], long embraced by the White House, has validated a core compaint of the Affordable Care Act's (ACA) critics: that it will discourage work and become an ungainly entitlement. Disputing Republicans charges is much easier than refuting the federal government's official scorekeepers.
Milbank went on to dismiss the White House's effort to paint the report as mostly good news, by saying that effort was contradictory and irrelevant. He never bothered to mention the administration's best argument, made by Jason Furman, chairman of the president's Council of Economic Advisors. Furman compared Obamacare's potential effect on the labor market to that of two legendary government programs that gave millions of Americans a new freedom of choice about whether and how much to work. And he ridiculed GOP efforts to repeal the new healthcare law, telling reporters:
I have no doubt, if for example, we got rid of Social Security and Medicare, there are many 95-year-olds who would choose to work more to avoid potentially starving or to give themselves the opportunity to get health care, I don't think anyone would say that's a compelling argument to eliminate Social Security and Medicare.
But, while not calling for repeal, Milbank was having none of Furman's argument. He simply ignored it. His column concluded: "Obamacare has been undermined by the very entity they had used to validate it."

That was Wednesday. A day later, Milbank appeared on Chris Mathews's MSNBC program "Hardball" and took the opposite tack.

Mathews began the segment by quite properly attacking the GOP's lies about the CBO reporting that Obamacare would cost jobs and hurt the economy. Mathews then played a clip of CBO director Douglas Elmendorf testifying before Congress that Obamacare would boost demand for labor and reduce the unemployment rate.

Totally abandoning the case he made Wednesday against Obamare's allegedly disastrous effects, Milbank first replied to Mathews by hedging:
You could make a case based on actual things in that CBO report that were damning about Obamacare. On balance, it was fairly mixed.
"Fairly mixed," not virtually all bad, as he wrote just the day before.

Milbank then went further, criticizing Republicans for making the same case that he himself made the day before, saying that the GOP was "arguing something that is completely made up out of whole cloth," something, Milbank said, that was "completely untethered from the facts."

He never bothered to mention that he had put forth this same Republican argument "completely made up out of whole cloth," only the day before.

I wish Milbank would make up his mind. He gets my vote as hypocrite of the month. Reported by Huffington Post 9 hours ago.

Business liability insurance cost tool is now activated online at the Cherry News company. This independent rates tool is producing 2014 liability plan costs at http://cherrynews.com/business-insurance.

Louisville, KY (PRWEB) February 07, 2014

Owners of a small businesses can now seek different insurance products online using an automated tool. The Cherry News company has introduced its business liability insurance cost tool that is activated for use at http://cherrynews.com/business-insurance.

The direct access provided to this open system for pricing online is offering insight into the types of policy pricing that agencies are offering to business owners in 2014. The liability plans that are underwritten are each provided through rated U.S. agencies to help maximize the coverage available.

"All liability plans that our system presents online can be purchased instantly from each requested provider to expedite proof of coverage after purchase," said one CherryNews.com company source.

The insurer system online includes multiple variations of insurance products that are underwritten exclusively for businesses. The liability plans, worker compensation and other coverage types popular with companies can be explored when using the rates finder system online.

"Business owners who are unable to find inexpensive rates using local insurers could find our system to be a useful source to locate discounts and other price markdowns for insurance plans," said the source.

The CherryNews.com company has also created a business health insurance policy finder for this year. This different search platform at http://cherrynews.com/health-insurance is meant to help companies explore the types of coverage pricing available for companies of any size online.

A direct search of these systems uses the mailing address zip code of each small business owner to introduce the most accurate pricing for this year. This zip code search platform is allowing faster online research of agencies.

About CherryNews.com

The CherryNews.com company now offers consumers in the U.S. easy methods for looking up insurance prices that national companies provide for policies. This company has expanded its public access tools in 2014 to include these insurance lookup options. The CherryNews.com company also provides retailer information to help Internet shoppers to find discounts and other markdowns online. The price guides, special reports and other content this company continues to syndicate online help to educate U.S. consumers about the products and services industry. Customer support services are now installed on the company website. Reported by PRWeb 9 hours ago.

The Obama administration is looking at extending the president's move to allow individuals to keep their health insurance plans even if they do not meet the requirements of the healthcare law. Reported by Newsmax 7 hours ago.

It's time for some straight talk. Will President Obama's Affordable Care Act (ACA) reduce health care costs for millions of consumers across the country? The answer, based on hard evidence, is a resounding "no."

I don't believe any of the measures in the ACA designed to decrease costs will be effective. For example, one theory is that providing health care coverage would reduce visits to the emergency room, but the data shows the opposite. In fact, The New York Times reported this week that after obtaining insurance coverage, the number of patients treated in ERs actually increased. The same article showed that another idea, that using non-physician health care coordinators such as nurses and physician assistants would cut costs by $3 to $7 for each dollar invested, was inaccurate; a randomized study found costs actually rose by 4 to 11 percent.

This is not to imply that the ACA is all bad. Allowing children to stay on their parent's plan up to the age of 26, eliminating restrictions on those with preexisting conditions from getting coverage, and increasing the total number of people with health insurance are all positive changes. But contrary to the assertions of the administration, the ACA will increase costs.

In view of this, we have to look for equitable ways to provide high-quality care without further bankrupting the system. As I see it, there are two choices: We can either ration care, or be smarter about how we utilize expensive therapies or do both.

Rationing care would include cost-saving measure such as not offering dialysis for those over 65, limiting MRIs for certain indications, and restricting chemotherapy in cases where it would add less than a year to one's life.

Though unpalatable, these cuts would address the escalating health care costs caused by the implementation of the ACA. We must stop misleading the public: Although the ACA will improve coverage for many, it cannot be everything for everyone. Now that we've vastly increased the number of insured Americans, we cannot afford to provide expensive therapies to everyone. It's as simple as that. To claim that the ACA will decrease costs while increasing coverage is both illogical and untrue.

The second approach is to increase investments in clinical studies that explore alternative approaches to health care spending. While the Health Resources and Services Administration deals with that question, and has a grant program to do that kind of research, it has been relatively underfunded. For example, the U.S. spends about $2.4 billion a year on defibrillator implants but hasn't been willing to allocate $50 million to proposed studies that would consider the cases in which the implants are truly necessary. Such research could potentially save hundreds of millions of dollars, and yet the amount of money the ACA allocates for this and similar projects is embarrassingly small. We need to invest a great deal more into research that will show which treatments are beneficial, and which are extraneous.

It seems reasonable to restrict access to therapies that are not effective or cost-effective. If we are going to do any kind of rationing, then we need to ration the ineffective treatments or expensive therapies that do not do any better than cheaper ones. This may be politically incorrect, but Americans spend billions a year on supplements that may be useless or even harmful.

In a report released this week, the Congressional Budget Office estimates that the ACA would reduce the workforce by 2.5 million jobs. Many men and women, the analysis found, continue working primarily to maintain the health care benefits, and may decide to drop out if the ACA coverage is better than that offered by their employers. The analysis projects that employment will rise over the next decade, but "that increase will be smaller than it would have been in the absence of the ACA." Insurance costs for these Americans will now be subsidized by the taxpayer instead of by employers. Is this really progress?

However you slice it, ACA will not cut costs for the vast majority of working Americans, and it's time we acknowledge that unfortunate fact. Instead of burying our heads in the sand we should be putting them together to look for a viable solution. Reported by Huffington Post 7 hours ago.

Community Health Center of Central Missouri adds two new dentists to its oral health team.

Jefferson City, MO (PRWEB) February 07, 2014

The Community Health Center of Central Missouri has added two new dentists to its team of preventative and emergency care physicians. Dr. Tyler Slaughter joined the team in January, while Dr. Ashwini Bichu will join him in February.

Dr. Slaughter is practicing at CHCCMO’s Truman Clinic in Jefferson City on Wednesdays. Slaughter has a Bachelor of Science in fisheries and wildlife from the University of Missouri School of Natural Resources. He also has a doctoral degree in dental surgery from the University of Missouri School of Dentistry, Kansas City.

Dr. Bichu has a Bachelor of Dental Surgery degree from the University of Mumbai, as well as the New York University College of Dentistry. She is the newest dentist to join the CHCCMO team and will practice at the Fulton Clinic as well as the Truman Clinic in Jefferson City.

CHCCMO also recently received two grants to help them provide top-notch dental care for patients young and old in the Show Me State. CHCCMO received a $138,000 oral health grant from the Missouri Foundation for Health for dental equipment. They also received a $36,158 Outreach and Enrollment Grant from the U.S. Department of Health and Human Services’ Health Resources and Services Administration for Health Insurance Marketplace, which is the new way to find and apply quality health coverage on the HealthCare.gov website.

Contact the CHCCMO for quality primary care services without worrying about the ability to pay. They have four clinics in Jefferson City, Linn, California and Fulton. Visit http://www.chccmo.org to find out more.

About the Company:
Established in 1995, the Community Health Center of Central Missouri strives to provide the primary healthcare needs of the residents of central Missouri. Since the establishment in 1995, CHCCMO has grown to include four locations: Jefferson City, Fulton, California and Linn. Community Health Center of Central Missouri offers preventative, functional, restorative and emergency dental care for patients of all ages. They believe in primary care for the whole family and every family. Reported by PRWeb 7 hours ago.

Should we care if people decide to work less because they get more government benefits? Writing at Salon Brian Beutler says we should focus on the benefit to individuals who are no longer indentured at jobs they don't want because of health care costs.

Beutler's headline says conservatives have rediscovered their "love for indenture." If you look up "indenture" the definition will be something like "A contract binding one party into the service of another for a specified term." In this case, he's talking about people being bound to jobs because of insurance costs.

The whole debate is based on a new CBO report released this week which showed that the equivalent of 2.5 million people would choose not to work thanks to Obamacare. This estimate is based on working hours so the actual number who choose not to have a job at all will be much lower and the number who choose to simply work fewer hours will make up the rest. In any case, Beutler asks us to imagine two people and then judge which one is deserving of "government intervention."



Imagine someone who’s been employed consistently for 25 years. He doesn’t earn big wages, but he’s frugal and would have enough money saved for a modest retirement but for the fact that insurance on the individual market will cost him $1,500 a month — or simply won’t be made available at all.

Now imagine someone else who’s been employed consistently for 10 years and thinks it’s time for a change. She wants to join a new start-up, which is offering her a decent salary bump, but won’t provide health insurance, or the insurance they will provide will place her pediatrician out of network, and her child has a preexisting condition.



Of course Beutler's answer is that they both deserve a hand from the government. That means the guy who worked for 25 years and wants to retire at, say, 53 will be able to do so. Obamacare subsidies will cover the majority of his insurance costs until Medicare and Social Security kick in at age 65. That's great news for him. He can focus on his stamp collection, or whatever, instead of schlepping to work every day.

The second person is an example of someone who wants to stay in the work force but move jobs. Since she's getting a big salary bump it's a safe bet she's not going to be working fewer hours. So she's not really one of the people CBO was discussing in its report. She's not pulling back, she's leaning in.

Let's imagine a bit more about her. She's 34 years old with a college degree. Been working 10 years as Beutler suggested. And let's assume she'll be making $43,000 a year at her new, higher paying gig. That means she's not going to get any help in the form of a subsidy. She'll pay around $2,700 a year in premiums. She won't use nearly that amount in services which is good because money saved on her policy (and people just like her) is needed to subsidize Mr. Early Retirement's decision to redirect his energy into philately.

Is this really a good thing? Even Beutler admits there is a danger lurking here. He writes "If Congress gave me $100,000 a year for nothing, I’d probably never hold down a job again." But that insight is hard to square with the left's response to the CBO report.

Obamacare isn't killing jobs, the left argues, it's only decreasing the hours people choose to work. How can that be a bad thing? And of course it's not a bad thing for the people working less (excluding, for simplicity, any moral argument about work). It's all good for them. They get to knock off early or retire early. Few of them, if any, will complain.

The real question is this: Do we want a system where some millions of working age people choose to work less because other working age people are forced to subsidize them doing so? Is this fair to the people who pay the bills? Even the example Beutler offered suggests it's not. Why should a 34 year old woman working her way up be asked to subsidize the early retirement of a 53 year old stranger?

And here's where I think there is a broader question that goes beyond one CBO report or even beyond Obamacare to "government intervention" in general. The welfare system in many parts of the country is fairly generous. The CATO institute examined this issue last year and found that the "In 11 states, welfare pays more than the average pre-tax first year wage for a teacher." The report adds "In 39 states it pays more than the starting wage for a secretary."

Granted, $35,287 (the amount one can "earn" on welfare in California) isn't $100,000 a year but not everyone has Beutler's high expectations. For some people, $35k is enough to discourage them from taking a job where they would work a lot more for very little change in their standard of living. Why bother?

Generally speaking, the decision to work less at others people's expense does not seem like something we ought to be defending, much less celebrating. And, getting back to Obamacare, it's pretty silly to label the working age people who cut their hours "indentured" when you are asking other working age people to take home less money in order to cover their subsidies. Who is really being locked into a contract of service to someone else, Mr. Early Retirement or Ms. Young Worker?

 
 
 
  Reported by Breitbart 4 hours ago.

What right does the government have to make you buy health insurance?

That's the question that riles Obamacare critics the most. It's not the premiums or the website or the dropped coverage. It's the infringement on their liberty.

You hear it all the time: "This is a free country!" That's what everybody says. But what do they really mean? Do they know what freedom is?

It seems obvious at first. Freedom is lack of coercion. Therefore, anything the government makes you do infringes on your freedom.

But there are different types of coercion, and the government isn't the only one doing the coercing.

Let's say that you want your daughter to attend the best school in America. But you can't afford the tuition. Do you really have freedom of choice? If you choose the school you want, they won't let you through the front door. If you force your way in, they'll arrest you.

So you "choose" a more affordable school. You wanted a better school, but they forced you to settle for a different one. Sounds like coercion to me.

Let's consider another example. You want to retire at the age of 65. You've worked hard throughout your entire adult life. Unfortunately, wages haven't risen, and the bills kept piling up. You saved as much as you could, but it's only enough to live off for a couple years. Oh, and one more thing: Social Security and Medicare don't exist.

If you "choose" to retire, you'll go broke. You'll go without preventive health care. Your chances of dying early will increase significantly.

So you have a choice: Keep working or die young.

In this case, you actually have less freedom because the government is less involved. Without Social Security and Medicare, you do not have the freedom to choose a long, healthy retirement.

Freedom requires more than the absence of laws and taxes. True freedom of choice requires the capability to make that choice -- and the free market doesn't always give us that capability.

Jobs are scarce. Most of us don't have the freedom to work anywhere we want. We take what we can get. For many of us, that means working at a company that doesn't pay for our health insurance so we "choose" to buy insurance on the individual market.

Before Obamacare, the individual market charged really low rates to healthy people and really high rates to sick people. So the people who needed insurance the most couldn't afford it. They didn't have the capability -- and therefore the freedom -- to buy it.

Obamacare outlaws that kind of discrimination. It requires insurers to charge the same rates to healthy and sick people alike, and that means that healthy people will have to pay higher rates. Some of them won't want to, so they'll stop buying insurance. When they drop out, they leave behind the sicker people who are most costly to insure, forcing insurers to raise rates even more. It's a vicious cycle, a "death spiral," that results in almost everyone being priced out of the market.

Virtually no one will have the freedom to buy health insurance on the individual market.

And that's why we have an individual mandate. If the healthy people don't drop out, there's no death spiral, and the insurance remains affordable for the people who need it the most.

The government gives them a freedom that the free market cannot. It gives them the capability to purchase health insurance.

If we choose not to buy insurance, we pay a penalty. As Supreme Court Chief Justice John Roberts has written, "It makes going without insurance just another thing the Government taxes, like buying gasoline or earning income." Those taxes pay for our roads and Army and Navy and Social Security and Medicare -- and those things give us the freedom to live a life that we often take for granted. Without those taxes, without those government-funded investments, we could not call ourselves a free country.

In the same way, without Obamacare, without the government making us buy health insurance, we would be condemning millions of Americans to lives without health care. We would be restricting their freedom. And what right do we have to do that?

--

This op-ed was published in today's South Florida Sun-Sentinel. Reported by Huffington Post 4 hours ago.

*How to pick a health insurance plan*

Health care can be very expensive. Having a baby costs about $30,000, and so does the average three-day hospital stay.  Health insurance is a way to reduce those costs to an amount that you can manage by sharing the risk with others. That works because most people are mostly healthy most of the time, so their premiums help pay for the expenses of the small number who are sick or injured.

Here are the three major questions you need to ask when picking a plan. 

Before health reform, companies could sell plans that didn’t cover all types of medical care. For example, some might not cover doctor visits, or prescription drugs, or maternity care.
 
That was bad for consumers because no one can predict what kind of medical care they might need in the future. The only way to protect yourself financially is to have health insurance that covers every kind of health care.
 
*The new health care law has fixed this problem.*
 
Insurance sold to individuals and small businesses must now cover 10 “essential health benefits."

· Emergency services
· Hospitalization
· Laboratory tests
· Maternity and newborn care
· Mental health and substance-abuse treatment
· Outpatient care (doctors and other services you receive outside of a hospital)
· Pediatric services including dental and vision care.
· Prescription drugs
· Preventive services (such as immunizations and mammograms) and management of chronic diseases such as diabetes
· Rehabilitation services

The rules for insurance provided by large employers are a little different but most of them will cover the same set of benefits. To make sure, ask your employer for the Summary of Benefits and Coverage, a standard form that will state exactly what the plan covers and doesn't cover. 

* *

Get health insurance rankings

Click on the image at right for rankings of health insurance plans nationwide. Use the tool to:

· Choose a plan category such as private HMO or PPO, or Medicare HMO or PPO.
· Choose a state.
· Customize your search to compare plans' scores and their performance in measures such as consumer satisfaction and providing preventive services.

*You pay for health insurance in two ways:*

· The monthly premium that you pay to purchase your plan.
· The share of costs you pay out of your own pocket when you receive medical care. Those are some combination of deductibles, coinsurance, and copays.

In general, if you pay a higher premium upfront, you will pay less when you receive medical care, and vice versa.

If you purchase coverage through your state's Health Insurance Marketplace, you may be eligible for income-based subsidies that lower the cost of your premium.*To make comparison easier, the plans sold in state marketplaces are grouped in standardized “metal tiers” with various combinations of premiums and cost-sharing:*

· *Bronze* plans will cover 60 percent of the average member's total health care costs and thus have the lowest premiums.
· *Silver* plans will cover 70 percent.
· *Gold* plans will cover 80 percent.
· *Platinum* plans will cover 90 percent and have the highest premiums.

*Which of those plans is right for you depends on your health and your financial situation:*

· If you already know you have an expensive medical condition, consider a plan with a higher premium that covers more of your costs.
· If you are generally healthy you might come out ahead paying a lower premium and a bigger share of your health costs, because those costs are most likely not going to be that high. Of course, you need to be prepared to pay more if you do unexpectedly become sick or injured. 

-*Your out-of-pocket expenses*-

The terms “cost-sharing” or “out-of-pocket costs” refer to the proportion of your medical bills you will be responsible for paying when you actually receive health care. Cost-sharing never includes your monthly premium.

If you buy insurance through your state marketplace, you’ll be able to see and compare the cost-sharing structure of plans before you buy. If you get insurance through a job, the information will be on the Summary of Benefits and Coverage form.

These are the four cost-sharing terms you will see.

*Deductible. *The amount you pay every year before the insurance company starts paying its share of the costs. If the deductible is $2,000, then you would pay cash for the first $2,000 in health care you receive each year, after which the insurance company would start paying its share. In every plan you can buy, preventive services will be covered in full even if you haven’t used up your deductible for the year. Some plans will also pay a portion of your costs for a few other services, usually doctor visits and prescription drugs, even before your deductible has been met. In general plans with higher premiums have lower deductibles, and vice versa.

*Copay. *A fixed dollar amount you pay for certain types of care. You might pay a $20 for a doctor visit and the insurance company will pick up the rest. Plans with higher premiums generally have lower copays, and vice versa. And some plans do not have copays at all. They use other methods of cost-sharing.

*Coinsurance. *A percentage of the cost of your medical care. For an MRI that costs $1,000, you might pay 20 percent ($200). Your insurance company will pay the other 80 percent ($800). Plans with higher premiums generally pick up a larger portion of the bill.

*Out-of-pocket limit. *The most cost-sharing you will ever have to pay in a year. It is the total of your deductible, copays, and coinsurance (but does not include your premiums). Once you hit this limit, the insurance company will pick up 100 percent of your costs for the remainder of the year. Most people never pay enough cost-sharing to hit the out-of-pocket limit but it can happen if you require a lot of costly treatment for a serious accident or illness. Plans with higher premiums generally have lower out-of-pocket limits.

The new health law says that in 2014, the out-of-pocket limit for plans sold to individuals and small groups cannot be more than $6,350 for an individual or $12,700 for a family.

Some plans may have lower out-of-pocket limits than that.

Every health insurance plan has a network of providers—doctors, hospitals, laboratories, imaging centers, and pharmacies that have signed contracts with the insurance company agreeing to provide their services to plan members at a specific price.

If a doctor is not in your plan's network, the insurance company may not cover the bill, or may require you to pay a much higher share of the cost. So if you have doctors you want to continue to see, you will want them to be in the plan's network.

Most state Health Insurance Marketplaces, including the ones operated through the federal HealthCare.gov site, have links to provider directories that you can see before you buy. But it's best to cross-check with the doctor's billing office, as directories can be inaccurate or out of date.If you are considering insurance through a job, you can obtain provider lists from participating insurance companies, or from the company’s employee benefits department.

*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*

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Update your feed preferences Reported by Consumer Reports 3 hours ago.

*Managing Medicare*

Medicare offers comprehensive health insurance coverage to people 65 and older. But the decisions and choices you face can be confusing and overwhelming. Here's our step-by-step guide for getting the most out of Medicare.

-*What's covered by parts A, B, C,and D*-

Medicare comes in three parts:

· *Part A* covers hospital inpatient care, some types of home health care, hospice care, and care in skilled nursing facilities. There is no premium for Part A if you or your spouse has earned at least 40 Social Security work credits.
· *Part B* covers doctor services, outpatient hospital care, preventive care, and some types of home health care. You have to pay a monthly premium for Part B. In 2014, it's $104.90 for individuals with an income of less than $85,000 a year and couples with an income of less than $170,000. Higher-income beneficiaries pay more.
· *Part C*, also known as Medicare Advantage, is an alternate way of getting your Part A and Part B benefits. Instead of the government paying your provider directly, Part C plans are run by Medicare-approved private insurance companies. If you elect to get your benefits through Part C, you must also be enrolled in Part A and Part B.

· *Part D* covers prescription drugs. This is an optional benefit that is only available through private insurance companies. Most Medicare Advantage plans include Part D. For details on exactly what each part of Medicare covers, see Medicare's website.

No matter how you choose to receive your Medicare benefits, you will receive certain preventive services for free, such as immunizations and screening tests for breast and colon cancer.

Get health insurance rankings

Click on the image at right for rankings of health insurance plans nationwide. Use the tool to:

· Choose a plan category such as private HMO or PPO, or Medicare HMO or PPO.
· Choose a state.
· Customize your search to compare plans' scores and their performance in measures such as consumer satisfaction and providing preventive services.

**Signing up for Medicare for the first time**

The "initial enrollment period" for Medicare consists of the three months before, the month of, and the three months after your 65th birthday.

If you already receive Social Security, Medicare will automatically enroll you. If not, you must enroll on your own either online through Medicare.gov or at a Social Security office.

Nearly everyone who becomes eligible for Medicare should enroll in Part A immediately, because it has no premium. (If you do not have enough Social Security credits to qualify for premium-free Part A, you should defer enrollment until you quit working.)**When to sign up for Part B**

If you don't sign up for Part B when you should, you will be hit with a harsh penalty: a permanent increase in your premium of 10 percent for every year that you should have been enrolled but weren't. In 2014 the standard Part B premium is $104.90 a month.Most people should sign up for Part B either when they turn 65 or when they or their spouse stop working, whichever comes later. Sounds simple, but no one is going to come after you to enroll, there are some exceptions, and it's easy to make a mistake. Here are the rules for people in the following situations:

· *You receive a subsidy to purchase an individual health plan through your state's Health Insurance Marketplace.* Once you become eligible for Medicare, you are no longer entitled to this subsidy. You should enroll in all parts of Medicare as soon as you are old enough, and cancel your marketplace plan.
· *You have an individual health plan but don't receive a subsidy to help pay for it. *If you keep this plan instead of enrolling in Medicare when you should have, you'll be hit with the late enrollment penalty. Cancel it and enroll in Medicare.

· *You are still working at a large employer.* You can delay Part B enrollment without penalty if you have health insurance through your own or a spouse's current job at a workplace with 20 employees or more. Once the last working spouse leaves his or her job, even if they're getting COBRA or retiree insurance, it's time to sign up for Part B. You have eight months, starting the month after the job ends, to get this done without penalty.
· *You are still working at a small employer.* If your workplace has fewer than 20 employees, sign up for Part B at 65. Your employee health plan then becomes a secondary plan that kicks in after Medicare has paid its share of the bills. Workplaces this size are allowed to drop you from their employee plan after you reach 65, something that's against the law for larger employers. If you ignore this rule, and your group health plan finds out you're over 65, it may refuse to pay claims that Medicare would have paid.

· *You or your spouse is on COBRA.* Even though the COBRA plan is exactly the same as your former group health plan, once you turn 65 you must switch to Medicare. But COBRA can still function as the main insurance for the younger spouse, and you can keep parts of your COBRA plan that Medicare doesn't cover, such as your dental benefit. Learn more about Medicare and COBRA.
· *You have a retiree plan.* If you have a retiree plan from your old job, you must sign up for Part B when you turn 65, even if your retiree plan doesn't change at all. After you go on Medicare, the retiree plan becomes a secondary plan (but may still function as the main insurance for your younger spouse). If coverage is meager and premiums high, compare the cost of keeping and using it the cost of a Medigap or Medicare Advantage plan instead. Also ask your retiree plan's administrator if you can rejoin the plan later if circumstances change; sometimes plans allow this and sometimes they don't.

· *You receive veteran's benefits.* The Department of Veterans Affairs and Medicare operate independently of each other for the most part. Medicare won't pay for care you get at a VA facility, and the VA won't help you with your Medicare co-payments and deductibles (except if the VA authorizes you to get care at a non-VA hospital). The VA encourages veterans to sign up for Medicare A and B to have the flexibility to seek care at non-VA facilities if need be. Moreover, if you are not in one of the VA's higher priority groups, you could lose your coverage suddenly if Congress decided to cut back the VA's budget. At that point, you would have to pay a penalty for late enrollment in Medicare Part B. Learn more about VA and Medicare.
· *You have TRICARE for Life.* If your military service entitles you to TRICARE for Life, you must sign up for Part B when you turn 65, regardless of whether you are working or have other sources of coverage. If you don't, you lose your eligibility for this valuable benefit. Learn more about how TRICARE works with Medicare.
· *You are on the Federal Employees Health Benefits Plan (FEHB).* FEHB will continue to cover you after retirement, even if you don't take Medicare at all. But if you delay enrollment in Part B after retiring, and then change your mind later, you'll be hit with the Part B late-enrollment penalty. Because FEHB premiums can be substantial, you need to consider your options carefully. Learn more about how FEHB works with Medicare.

**When to sign up for Part D
**

You should sign up for Part D when you first go on Medicare unless you have equivalent drug coverage from another source, such as a retiree plan (your plan administrator can tell you whether your coverage is equivalent to Part D.)You may be tempted to skip Part D if you don't take any prescription drugs on a regular basis. That would be a big mistake. There's a penalty—1 percent extra on your premium for every month you could have signed up, but didn't—for enrolling more than three months after your 65th birthday month. So if you are a year late enrolling, your premium will be 12 percent higher than it would have been otherwise. Instead, if you aren't on any regular medications, buy the cheapest plan available in your area. You can switch to another at open enrollment every year if your prescription needs change.-*Protecting yourself from high out-of-pocket costs
*-

As soon as you have Part B, your next step is to figure out how to protect yourself from high out-of-pocket Medicare costs.

Original Medicare is the familiar program that's been around since 1965, in which the government pays Medicare's share of your medical bills directly to providers of Part A and B services. You can go to any doctor or hospital anywhere in the country that accepts Medicare reimbursement.

But Original Medicare has some substantial deductibles and co-insurance (for example, a $1,216 deductible for every hospital stay and 20 percent of outpatient doctor visits). And unlike the private insurance you're used to from your working years, Medicare does not have an out-of-pocket limit. Those deductibles and coinsurance payments can add up fast, especially if you need costly treatments like outpatient chemotherapy.

You may have a retiree plan (a health plan provided courtesy of your former employer) that helps pick up some or all of these costs.

If not, you have two options for limiting your exposure to excessive out-of-pocket costs.

*Medigap. *These private supplemental plans cover most or all original Medicare's out-of-pocket costs. If you select this option, you will continue to be covered by original Medicare. After Medicare has paid your claims, it will automatically forward them to your Medigap plan, which will then pay its portion of the bill. Learn more about Medigap.Since Medigap plans do not cover prescription drugs, you must also purchase a  standalone Part D plan if you want drug coverage.

*Medicare Advantage.* This is a private health plan that substitutes for original Medicare. These plans now cover nearly 3 in 10 Medicare recipients. Every Medicare Advantage plan offers Part A and Part benefits, and most also include Part D. You continue to pay your Part B premium as usual and may also pay an extra premium for the plan itself.

Medicare Advantage plans typically come with deductibles and copays, but unlike Original Medicare, they have an annual out-of-pocket limit. Once your share of the costs of your care hits that amount, the plan will pick up 100% of your bills for the rest of the year. You are not allowed to have a Medigap and Medicare Advantage plan simultaneously.Medicare Advantage plans work like the managed care plans you may have had during your working years. You will have to receive your care from doctors, hospitals, and other providers within the plan's network or the plan won't pay.If you have a retiree plan, check with your plan administrator before signing up for a Medicare Advantage plan because it may affect your eligibility for your retiree benefits.

Read more about Medicare Advantage below.Here's a chart that summarizes the two choices:

 

*Medigap*

*Medicare Advantage*

*How it relates to Original Medicare Parts A & B*

Private supplemental coverage that pays all or most Part A & B deductibles and co-insurance.

Private health plan that provides Part A & B benefits directly in place of Original Medicare.

*Premium*

Average of about $150 to $200 a month. Can vary by age, health history, or both. $0 to more than $100 a month depending on the plan. All plan enrollees pay the same regardless of age or health history.

*Out-of-pocket costs*

Low to none (not counting premium).

In-network medical deductibles and  copays of up to $3,400 to $6,700 a year, depending on the plan.

*Choice of doctors and hospitals*

Any that participate in Medicare.

HMOs: Plan providers only.

PPOs: Any provider,  but out-of-network providers cost more.

*When you can buy*

First six months after you sign up for Part B and are at least 65 years old. After that, in most states you can be turned down or charged extra for pre-existing conditions.

When you first enroll in both Medicare A  and B and annually thereafter during Open Enrollment (Oct. 15-Dec. 7).

*Part D (drug) coverage*

Not included. You must buy a separate Part D plan for this.

Most plans include a Part D coverage.*Quality information available*

No. There are no standardized ratings for Medigap plans. Yes. Medicare.gov has star ratings (5 stars are the best). Consumer Reports has Medicare Advantage quality rankings from NCQA.

*Cards in your purse or wallet*

Three. 1. Red, white, and blue Medicare card. 2. Medigap card. 3. Part D card. Usually just one Medicare Advantage card. The red, white, and blue Medicare card can stay in your desk drawer.

*Paperwork*

Little to none. Medigap almost always automatically cuts a check to providers after Medicare pays its share.

Some, because you pay deductibles and copays directly to providers.

*Changing to a different plan*

Once you are enrolled in Medicare, you can join, switch, or drop a Medicare Advantage or Part D plan once a year during the annual open-enrollment period, which runs from Oct. 15 through Dec. 7.  

Which Medicare plan do you have?

You may be uncertain whether you have original Medicare or a private Medicare Advantage plan. The name on your insurance card probably doesn't say "Medicare Advantage." Instead, it might list a plan name, like "Secure Horizons." Here's how to find out which Medicare plan you have:
1. Call 800-MEDICARE (800-633-4227).
2. The system will ask you to say your "Medicare number." That's the number on your red, white, and blue Medicare card (see example). Everyone has this card, even those enrolled in Medicare Advantage plans.
3. The system will give you some options. Select 0 for a customer service representative.
4. When the representative comes on the line, you will be asked for your Medicare number again, as well as some other identifying information such as date of birth and full address.
5. Once your identity has been confirmed, ask the rep: "Could you tell me whether I have original Medicare or Medicare Advantage"? You will be told either: "There's no Medicare Advantage plan on file" OR the name of your Medicare Advantage plan.

Caregivers can make this call on behalf of a Medicare enrollee, if they have the identifying information.

Your mailbox may be overflowing with sales brochures from Medicare Advantage plans, but our advice is to ignore them. Instead, use the government's Medicare plan finder and NCQA's rankings of Medicare HMO and PPO plans. We also recommend checking out MedicareRights.org. That site has an excellent tool that will walk you through a comparison of original Medicare and Medicare Advantage.

*Choose carefully*

Before you choose a plan, make sure you understand these key points.

· Understand the difference between a PPO and an HMO.  In general, in an HMO it is very difficult to get care out of network. In a PPO, it's allowed but you will have to pay more of the cost yourself.
· Find out which doctors and hospitals are in the plan's provider network. Ask your doctors which Medicare Advantage plans they take part in, and which they would recommend.
· If you regularly take prescription drugs, check the Medicare plan finder to see whether they are on the plan's formulary, its list of preferred drugs. But before you sign up, double-check with the plans themselves to be sure.
· Look at all expenses you'll be paying, not just premiums. Deductibles, co-insurance, co-payments, and out-of-pocket maximums can vary greatly from plan to plan. Because you're not allowed to purchase a Medigap supplement plan alongside Medicare Advantage, you'll be responsible for paying those expenses out of your own pocket.
· If you have retiree coverage from an employer, do not sign up for a Medicare Advantage plan without checking first with your plan administrator. In some cases, it could void your retiree coverage.
· Find out what coverage you will have outside the plan's service area. Many HMOs and PPOs will only pay for emergency care when you are away from home. That is an especially important consideration if you, for example, spend the winters or summers in different locations, or pay extended visits to your adult children.

Here's what you need to know about Medigap.

*Medigap plans come in standardized varieties*

In most states, Medigap plans are available in 10 standardized benefits packages, which vary according to how much of your expenses they will pick up. The more generous the plan, the higher the premium.

The most popular plan is F, which pays for pretty much everything Medicare doesn't, including the 15 percent excess charge that you can be billed by doctors who don't accept Medicare as payment in full. Here's a chart of the various Medigap plans.

You can find a complete list of Medigap carriers in your area on Medicare.gov.

The search engine will give you a range of prices for each category of plan, and the names and contact information for companies that sell them. But it's up to you to contact the carriers directly to get their specific pricing information.

*The type of premium pricing method you choose will affect your future costs*

A policy that looks inexpensive when you first buy it at age 65 could end up being the most expensive when you hit 80.

Carriers use three pricing models (though in some states you may have a choice of only one or two):

· Community-rated (also called no-age rated). The same premium is charged to everyone, regardless of age. Medigap experts say these plans are the least expensive over time, though not necessarily when you first purchase them.
· Issue-age-rated. The premium is based on your age when you buy the policy. It won't go up as you age, but will increase due to cost inflation.
· Attained-age rated. The premium starts low but goes up as you get older. Over time, this type of policy is the most expensive.

Learn more about policy pricing.

*Medigap plans can turn you down or charge you more for pre-existing conditions at certain times*

In every state, you have a guaranteed right to buy a Medigap policy for six months starting the first day of the month you are at least 65 and enrolled in Part B.

After that, you're only entitled to guaranteed issue Medigap in specific situations, such as:

· Your Medicare Advantage plan shuts down or you move out of its service area.
· Your retiree plan shuts down.
· You joined Medicare Advantage at 65 but decide to switch back to original Medicare within a year.
· Your Medigap plan shuts down.

The minimum rules for when Medigap must sell you a plan are explained in this publication from Medicare. But some states have chosen to go beyond these minimums, for example, by requiring insurers to sell Medigap plans to applicants at any time. Your State Health Insurance Assistance (SHIP) program or state insurance department can give you information on your state's rules.

*Signing up*

You can sign up for Medicare Part D, which helps cover prescription drug costs, along with other components of Medicare starting three months before your 65th birthday. It's important to be prompt because there's a permanent premium surcharge for enrolling more than three months after your 65th birthday if you don't have equivalent drug coverage from another source, such as a retiree plan. (Your plan administrator can tell you whether your plan is equivalent.)If you are already enrolled in a Part D "standalone" plan or a Medicare Advantage plan that incorporates drug coverage, you can switch plans during theopen-enrollment period, which runs from Oct. 15 to Dec. 7 every year.

*Making Part D work*

In 2014 the maximum allowable deductible for a Part D plan is $310, though many plans have lower or even no deductibles.

During your initial coverage period, you will pay an average of 25 percent of the costs of your medications until you and Medicare together have spent $2,850. At that point, you will enter the "doughnut hole" and will have to pay a larger share of your drug costs.

Inside the doughnut hole, you will pay 47.5 percent of the cost of brand-name drugs and 72 percent of the cost of generics until the TOTAL cost of your brand-name drugs and YOUR share of the cost of generic drugs together add up to $4,550. At that point, you will exit the doughnut hole and enter the "catastrophic coverage" period, which lasts until the end of the year, during which you will pay only 5 percent of the cost of your drugs.

For more information on the closing of the doughnut hole, download this guide from Medicare.

*Choosing a good plan*

Depending on where you live, you might have dozens of private plans to choose from, with different premiums, co-payments, and levels of coverage, including which drugs are covered. Choosing a plan that is right for you can save you thousands of dollars per year in premiums and out-of-pocket drug expenses. It pays to review your Part D coverage every year, especially if you have started taking new drugs.**

· *Start at Medicare.gov.* You can find the basics about the benefit and Part D plans at Medicare's website. There's a link to the Medicare Part D Plan Finder, which allows you to compare offerings and coverage options in your area and includes a helpful formulary finder that allows you to compare plans based on their coverage of your personalized list of drugs. It will even show you your monthly out-of-pocket drug cost for the year.
· *Ignore sales pitches.* Print, TV, and radio ads and plan brochures are unlikely to offer enough information for you to make a wise choice. Avoid selecting a plan just because it has a familiar name or brand. If possible, consult a trusted broker.  But watch out for brokers pushing plans from just one carrier.
· *Learn more.* We recommend consulting the website of the nonprofit Medicare Rights Center. There you can find in-depth information on Medicare Part D.

-Getting financial help-

Individuals with annual incomes of less than $17,235 and financial resources of less than $13,300, or married couples with incomes of less than $23,265 and resources of less than $26,580, might qualify for Extra Help from Medicare to pay their Part D premiums and out-of-pocket drug costs. Download Medicare's instructions on applying for the Extra Help program.

Getting Medicare help from your state

For information and free counseling about Medicare, Medigap, Medicare Advantage, and long-term care, contact your State Health Insurance Assistance Program (SHIP). These federally funded programs are not connected to any insurance company or health plan. SHIPs were established to help beneficiaries with plan choices, billing problems, complaints about medical care or treatment, and Medicare rights.

Alabama 800-243-5463

Alaska 800-478-6065 or 907-269-3680

Arizona 800-432-4040 or 602-542-4446

Arkansas 800-224-6330 or 501-371-2782

California 800-434-0222

Colorado 888-696-7213

Connecticut 800-994-9422

Delaware 800-336-9500 or 302-674-7364

District of Columbia 202-739-0668

Florida 800-963-5337

Georgia 866-552-4464

Hawaii 888-875-9229 or 866-810-4379 (TTY)

Idaho 800-247-4422

Illinois 800-548-9034 or 217-524-4872 (TDD)

Indiana 800-452-4800 or 866-846-0139 (TDD)

Iowa 800-351-4664

Kansas 800-860-5260

Kentucky 877-293-7447

Louisiana 800-259-5301

Maine 800-262-2232 or 800-606-0215 (TTY)

Maryland 800-243-3425 or 410-767-1100

Massachusetts 800-243-4636, 617-727-7750, or 800-872-0166 (TDD/TTY)

Michigan 800-803-7174

Minnesota 800-333-2433

Mississippi 800-345-6347 or 601-359-4929

Missouri 800-390-3330

Montana 800-551-3191

Nebraska 800-234-7119, 402-471-2201, or  800-833-7352 (TDD)

Nevada 800-307-4444 or 702-486-3478

New Hampshire 866-634-9412

New Jersey 800-792-8820

New Mexico 800-432-2080 or 505-476-4846

New York 800-701-0501

North Carolina 800-443-9354 or 919-807-6900

North Dakota 888-575-6611, 701-328-2440, 800-366-6888 (TTY)

Ohio 800-686-1578

Oklahoma 800-763-2828

Oregon 800-722-4134

Pennsylvania 800-783-7067

Rhode Island 401-462-4000

South Carolina 800-868-9095

South Dakota 800-536-8197

Tennessee 877-801-0044

Texas 800-252-9240

Utah 800-541-7735

Vermont 800-642-5119

Virginia 800-552-3402 or 804-662-9333

Washington 800-562-6900

West Virginia 877-987-4463 or 304-558-3317

Wisconsin 800-242-1060

Wyoming 800-856-4398

*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*

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Update your feed preferences Reported by Consumer Reports 3 hours ago.

Health insurance industry insider Bob Laszewski asks today whether Obamacare is beginning to unravel. His question is prompted by word yesterday that the Obama administration is considering a 1-3 year extension of rules which allow people to keep their "old" plans rather than buy a new one on the exchange.

Yesterday we learned the administration was considering extending their one year grace period for insurance plans as a way to increase rate stability. What this suggested is that the administration is very concerned about the possibility the rate increase announce this May will be bad news.

Laszewski argues the administration's desire to constantly put off bad news means the policy is unraveling piecemeal.



This might be one of those you can't win for los'en moments for the administration. Stay on the cancellation track and make lots of people mad one more time on election-day or grant another three-year reprieve and make the people you forced to buy the new plan wonder why they can't have the policy their neighbor across the street has.

When the President last October called on health plans and insurance commissioners to defer the cancellations for one more year, was it the beginning of the unraveling of all of the stringent individual health insurance market requirements in Obamacare? Would this new change to defer these cancellations for another three years just be step number two in that process?



Remember, back when this change was announced, Ezra Klein called it the "first crack in the individual mandate." He also said that if it led to a further delays it would be "a very big problem for the law." Lazewski actually disagrees that the policy is in danger. Thanks to risk corridors and reinsurance, the policy will continue one way or another, at least until Obama leaves office. The real problem is political. It's possible the President will decide to leave the uproar associated with implementing his own health care mandate to his successor rather than add it to his own troubles.

Speaking of troubles, there is more news in Laszewski's post. He says the final percentage of people who will see their plans cancelled for non-payment is going to be close to 20 percent. There have been suggestions this was the case but now the books are closed. That means (as I said here) many more people are going to be dropped from the official HHS count than enrolled in October and November combined. We heard a lot about the "November surge" a few months ago, but relatively little about the void rate which turns out to be much larger.

This adjustment to the enrollment numbers means that the current total is closer to 2.5 million. Instead of being 1.1 million behind projections, HHS is closer to 1.7 million behind. It's going to take a huge surge in March to get to the revised (lowered) CBO estimate of 6 million overall.

But don't expect to see HHS update the numbers to reflect reality any time soon. Why? Because the portion of the website which allows HHS to delete someone has not been built. That should give the administration all the excuse it needs to keep putting out inflated paid plan enrollment numbers to match their inflated Medicaid enrollment numbers.

 
 
 
  Reported by Breitbart 3 hours ago.

We’re used to making a big fuss over children’s birthdays, but this week child advocates and families across the country are celebrating CHIP, the Children’s Health Insurance Program, on the fifth anniversary of its reauthorization. One family who lives in the working-class Germantown neighborhood of Philadelphia with their six-, four- and three-year-old children told us they celebrate and are grateful for CHIP every day. The husband is a talented freelance videographer and the wife cares for the children. CHIP has been a lifeline for the family, providing stability with health and dental coverage for the children. With CHIP coverage, she gets regular phone calls reminding her it’s time for appointments or letting her know a dental van is in the area. CHIP has opened doors to high quality child-appropriate providers at the Children’s Hospital of Philadelphia and the University of Pennsylvania Health System when needed and provided peace of mind for the hardworking father, whose income can vary wildly from month to month and year to year. CHIP has given him security knowing his children are getting the care they need without breaking the bank. The wife says, “The kids wouldn’t have had health insurance if it wasn’t for CHIP.”

There are more than eight million children with stories like this. To survive and thrive, all children need access to comprehensive, affordable health coverage that is easy to get and keep. Unmet health and mental health needs can result in children falling behind developmentally and having trouble catching up physically, emotionally, socially, and academically. And it can mean life or death for children from preventable disease and illness. Our hearts at the Children’s Defense Fund (CDF) are so often broken with stories of children dying for lack of timely, affordable health care and CHIP plays a critical role in the American health care system in decreasing their numbers. It has strong bipartisan roots. It was created in 1997 when Democrats and Republicans, led by Senators Orrin Hatch (R-Utah) and Ted Kennedy (D-Mass.), came together to create a system of health coverage for children whose families earned too much to qualify for Medicaid but too little to be able to buy health coverage that today costs on average more than $16,000 a year for a family of four in the individual market. CHIP continues to provide crucial support for millions of working families: 92 percent of all children enrolled in CHIP had at least one parent employed during the last year. Since its creation CHIP has helped cut the number of uninsured children in half, to the lowest level on record, while improving child health outcomes and access to care.

Health coverage for CHIP children is more affordable for families than private insurance and its benefits are generally more comprehensive and child-appropriate than private insurance. CHIP’s benefits and provider networks are specifically designed to make sure children have access to child-appropriate services, providers, specialists, and facilities.* *

CHIP is an essential part of the health system for children. By preserving and strengthening CHIP and Medicaid and creating new coverage options for parents, access to health coverage is now available for 95 percent of all children in America. But eligibility and access to coverage do not guarantee enrollment. While 42 million children are enrolled in CHIP and Medicaid, more than 8 million in CHIP alone, more than 7 million children under 19 are still uninsured. Nearly 70 percent of these uninsured children are eligible for but not enrolled in CHIP or Medicaid. More than a third of the eligible but unenrolled children live in just three states—California, Florida, and Texas. The Children’s Defense Fund is making and all of us must make every effort to enroll every child to save child lives.

We know health-related problems can lead to poor academic performance and that uninsured children are more likely to perform poorly in school than children with coverage. CDF has partnered with AASA, The School Superintendents Association, to link uninsured children with health coverage by adding a question to school enrollment forms asking whether children have health coverage and helping connect uninsured students with coverage. One school administrator put it simply, “As superintendent, I care about the young people we serve. If they are ill and miss school, we miss opportunities to promote their learning.” School-based outreach is an important tool in connecting eligible children to CHIP and we urge every school official to take steps to make sure all their children are enrolled in health programs for which they are eligible.

CHIP has strong bipartisan support among Americans across the political spectrum and has been a bright spot in health coverage since its creation. Although CHIP is authorized through 2019, its funding is running out and will virtually disappear by October 2015 unless Congress takes immediate action. If funding is not continued, millions of children would lose health coverage and millions more would likely receive less comprehensive coverage at significantly higher cost. Either would be an enormous step backwards for children. Congress must act this year to keep CHIP funding for millions of families and prevent uncertainty and discontinuity for children, parents, or states about CHIP’s future.

When CHIP was reauthorized in February 2009, President Obama correctly said: “No child in America should be receiving her primary care in the emergency room in the middle of the night. No child should be falling behind in school because he can't hear the teacher or see the blackboard. I refuse to accept that millions of our kids fail to reach their potential because we fail to meet their basic needs. In a decent society, there are certain obligations that are not subject to tradeoffs or negotiations – health care for our children is one of those obligations.” I could not agree more. CHIP remains a critical piece in the puzzle of connecting millions of children to health coverage. We’ve made tremendous progress and must continue to move towards the finish line so that every child in our country has access to comprehensive, affordable, and easy to get and keep health coverage. Let’s celebrate CHIP’s track record of success the common sense way by acting now to ensure CHIP in states across the country can continue the good work. Reported by Huffington Post 3 hours ago.

When AOL CEO Tim Armstrong explained this week that the company was rolling back a key retirement benefit for employees, he said, essentially, that he was just doing what everyone else was doing.

Instead of matching employees' contributions to their 401(k)s every pay period, AOL is now making those contributions once a year. While the difference may seem inconsequential, the change is expected to cost departing employees hundreds or even thousands of dollars in lost retirement savings. Current employees will also lose out on any investment returns those matching contributions would have generated throughout the year.

"All companies are going in this direction," Armstrong said at a town hall meeting with employees Thursday.

Yet AOL is the only large public company aside from IBM known to have made the shift. And in a 2013 survey of 400 companies, 93 percent said they were "unlikely" to change to an annual contribution plan, Rob Austin, director of retirement research at the benefits consulting company Aon Hewitt, told HuffPost back in December.

"Anecdotally, some companies have explored this," he said. However, most seem reluctant to follow through, and on Friday, Austin stressed that his previous comments applied to annual contributions as a whole, not AOL's decision.

Armstrong said the move was due in part to Obamacare, claiming the health care law increases AOL's costs by $7.1 million, but without explaining how. In addition, he cited $2 million the company spent caring for two "distressed babies" born to AOL employees in 2012, although one-time extraordinary expenses typically don't have a lasting impact on employers' insurance costs.

Those comments stirred controversy and sparked broader worries that more companies would follow AOL's lead. AOL, which is the parent company of The Huffington Post, has not responded to multiple requests for comment about the benefits changes or Armstrong's remarks.

Armstrong also described the decision to delay matching 401(k) contributions as the best of two options: AOL could either require employees to pay hundreds of dollars more each month for health insurance, or require departing employees bear the brunt of increased costs.

Brigitte Madrian, a professor of public policy and corporate management at Harvard University's Kennedy School of Government, said AOL's move will affect retirement wealth accumulation for everyone in the long run. "This is not good public policy," she said.

All told, about 9 percent of employers pay out their 401(k) match once a year, according to Aon Hewitt. Most of these employers have older plans that always functioned this way.

When IBM changed up its 401(k) policy, it did not cite rising health care costs or Obamacare, as Armstrong did.

Other companies are using the health care reform law as an excuse to make different kinds of cuts. Target, Home Depot and Trader Joe's, for example, all have ended health benefits for part-timers, many of whom can actually get a better deal on the exchanges via Medicaid coverage or heavily subsidized private insurance plans -- though that won't be the case for all the affected workers.

However, it's not clear whether these changes are actually a result of new costs under the law, or if companies simply view Obamacare as a convenient excuse to trim benefits and save money.

Obamacare mandates that employers offer coverage to more workers and dependents, include richer benefits in their insurance plans and pay taxes and fees to finance the law. All of these requirements could lead to higher costs for companies. Yet health care spending overall is growing at a historically low rate.

What is clear is that rather than shouldering whatever extra costs they do incur, businesses will almost certainly foist them on workers, as they've done for years. Employers may be accelerating these trends in response to Obamacare, but companies have long sought to constrain their own health care costs by shifting an ever-increasing share of the burden to employees.

A survey last year by the International Federation of Employee Benefit Plans revealed that as the Affordable Care Act goes into effect, more job-based health plans will carry high deductibles and more cost-sharing when employees receive medical care, and workers will be made to pay a larger share of the premiums. Wellness programs aiming to improve employees' health, meanwhile, should offer bigger discounts on insurance premiums for participants.

More employers are also eyeing privately run health insurance exchanges, where employees get a flat amount of money to apply to a variety of available health plans. Walgreens and Sears are among the firms that already have adopted this strategy.

The biggest change for employers won't come until next year, when Obamacare's so-called employer mandate goes into effect. Under these provisions, companies with at least 50 full-time workers are required to offer health coverage that meets the law's standards for affordability and benefits, or face financial penalties if employees obtain subsidized coverage on the exchanges.

A large company like AOL, which already provides insurance, however, won't be affected by this change. Reported by Huffington Post 3 hours ago.