Category: Insurance Exchanges

Geisinger Health Plan enrolls more than 20,000 through Obamacare – themorningcall.com

 

Geisinger Health Plan, a health insurance company serving Lehigh, Northampton and 39 other Pennsylvania counties, added more than 20,000 members during the first open-enrollment period under the federal Affordable Care Act, the company announced Monday.

"We are extremely happy with the number of individuals who selected Geisinger Health Plan for their health insurance coverage," says David Brady, vice president of health care reform and commercial business development. "We felt it was important to offer individuals who were shopping on the marketplace a choice of coverage options that focused on quality and customer service. Based on our results, Pennsylvanians agreed."

Geisinger Health Plan offered 26 plans on the federal marketplace and GeisingerMarketplace.com, its private site, the company said in a statement.

Geisinger Health Plan enrolls more than 20,000 through Obamacare – themorningcall.com

Rooting for Failure – NYTimes.com

 

It’s hard to remember a time when a major political party and its media arm were so actively rooting for fellow Americans to lose. When the first attempt by the United States to launch a satellite into orbit, in 1957, ended in disaster, did Democrats start to cheer, and unify to stop a space program in its infancy? Or, when Medicare got off to a confusing start, did Republicans of the mid-1960s wrap their entire political future around a campaign to deny government-run health care to the elderly?

Of course not. But for the entity of the Obama era, Republicans have consistently been cheerleaders for failure. They rooted for the economic recovery to sputter, for gas prices to spike, the job market to crater, the rescue of the American automobile industry to fall apart.

I get it. This organized schadenfreude goes back to the dawn of Obama’s presidency, when Rush Limbaugh, later joined by Senator Mitch McConnell, said their No. 1 goal was for the president to fail. A CNN poll in 2010 found 61 percent of Republicans hoping Obama would fail (versus only 27 percent among all Americans).

Wish granted, mission accomplished. Obama has failed — that is, if you judge by his tanking poll numbers. But does this collapse in approval have to mean that the last best chance for expanding health care for millions of Americans must fail as well?

Does this mean we throw in the towel, and return to a status quo in which insurance companies routinely cancel policies, deny health care to people with pre-existing conditions and have their own death panel treatment for patients who reach a cap in medical benefits?

Rooting for Failure – NYTimes.com

APPRISE: Older Adult Health Insurance Counseling, Allegheny County, Pennsylvania

Older Adult Health Insurance Counseling
APPRISE

APPRISE 412-661-1438 or APPRISE@fswp.org. 
APPRISE offices are open Monday through Friday from 9:00 a.m. to 4:00 p.m.
SeniorLine 412-350-5460, toll-free 1-800-344-4319, TTY 412-350-2727 or SeniorLine@alleghenycounty.us
APPRISE is a free health insurance counseling program designed to help Pennsylvanians, age 60 years and older. APPRISE volunteer counselors are specially trained to answer consumer questions and offer education about Medicare, HMOs, long-term care insurance, supplemental insurance, and Medicaid benefits. APPRISE services are free, objective and completely confidential.
APPRISE counselors are available to assist an individual in the following ways:

  • Determine if a Medicare HMO is right for the individual by explaining the way Medicare HMOs work.
  • Understand Medicare benefits by explaining what services are covered under Medicare Parts A and B and the Medicare Summary Notice.
  • Select a Medigap insurance policy by explaining the benefits in each plan and providing a list of companies that sell these plans.
  • Obtain assistance to pay for prescription drugs through government and private programs that offer this service, and explain the eligibility requirements and how to apply.
  • Find government programs that will pay Medicare deductibles, co-payments, and Part B premiums and assist consumers with the paperwork.
  • Understand long-term care by explaining eligibility requirements for government long-term care programs and explaining private long-term care insurance and how to select the best policy.

APPRISE services are free and all information is kept completely confidential. To contact a counselor, contact the APPRISE coordinator at 412-661-1438 or APPRISE@fswp.org. For general information on this and other services for older adults, you may contact the DHS AAA SeniorLine at 412-350-5460, toll-free 1-800-344-4319, TTY 412-350-2727 or SeniorLine@alleghenycounty.us.
Pennsylvania Health Law Project (PHLP)
PHLP 1-800-274-3258 works to overcome barriers to accessing health care coverage and services. They provide:

Health Insurance Coverage, Department of Human Services, Allegheny County

Final Word On Obamacare Coverage: Cheaper Than Expected

 

It’s the definitive look at the insurance market with less than a week to go until the marketplaces open for enrollment.

"We’ve done a pretty good job of getting affordable options on the shelves," Jeanne Lambrew, deputy assistant for health policy to Obama, told reporters Tuesday in advance of the report’s public release. "That is success that we’ve gotten to the point where we can say that."

On average, people will have a choice of 56 different insurance plans — depending on which state you live in, though, that figure could range from seven (in Alabama) to 106 (in Arizona). The average number of insurers in a state is eight, though that again ranges from one to 13 in different states.

As for premiums, before tax credits kick in, they will average 16 percent below the Congressional Budget Office’s original estimates for a silver-level plan (which covers 70 percent of costs). The number of insurers in a state is directly tied to how low premiums will be, Lambrew noted. Arizona, with an average of 106 plans to choose from, had the second-lowest average premiums for a 27-year-old adult: $166 a month. Wyoming, with an average of 16 plans, had the highest average premium at $342 a month.

But then the tax credits take effect. Those knock the premium for that 27-year-old, projected to earn $25,000, down to $145 in most states. For a family of four making $50,000, the credits take the premium price down from more than $1,000 in some states to $282.

The numbers before and after tax credits drop even further for bronze-level plans (which cover 60 percent of costs), often below $100 on average when tax credits are accounted for. White House officials routinely note a recent study that found 6 in 10 uninsured Americans will be able to purchase coverage for less than $100 a month.

Some might still find it preferable to pay the individual mandate penalty ($95 for the year or 1 percent of their income, whichever is greater), as Kaiser Health News reported Tuesday.

Final Word On Obamacare Coverage: Cheaper Than Expected

10 companies submit health insurance product applications in Pa. – Philadelphia Business Journal

 

Ten insurance companies have submitted products to be included in the Pennsylvania health insurance marketplaces set to open Oct. 1.

• Aetna Health Ins. Co.

• Aetna Life Ins. Co.

• Capital Advantage Assurance Company

• Capital Advantage Insurance Company

• First Priority Life Ins. Co.

• Geisinger Health Plan

• Geisinger Quality Options

• HealthAmerica PA

• Highmark

• HM Health Ins. Co.

• Keystone Health Plan Central

• Keystone Health Plan East

• QCC Ins. Co.

• UPMC Health Network

• UPMC Healthplan Inc.

Keystone Health Plan East and QCC are affiliates of Independence Blue Cross, the Philadelphia region’s largest health insurer.

 

10 companies submit health insurance product applications in Pa. – Philadelphia Business Journal

Community groups feel heat of D.C. health-care battle

 

The letter from Washington arrived on Laura Line’s desk Wednesday, three weeks after her nonprofit won a federal grant to help consumers make sense of the health-insurance marketplaces created by the Affordable Care Act and four weeks before they were to open for business.

It gave her nine days to provide Republicans on the House Committee on Energy and Commerce with all details and documents, electronic and paper, in her possession and not, involving the $953,716 her organization is getting to assist with health-insurance enrollment in 10 Pennsylvania counties.

"The letter doesn’t concern us; it just adds to our workload," said Line, corporate assistant director for health care at Resources for Human Development, a national social services organization based in Philadelphia. "We are working at an incredible pace to try to be ready for Oct. 1," she said. "It will definitely distract us from what we are trying to do, which is to get health-insurance coverage for uninsured and underinsured residents who qualify in the marketplace."

Republicans said the letter was an attempt to protect tax dollars and personal medical information. Democrats said it was intended to sow confusion and undermine health reform.

The vitriol and hyperpartisanship that accompanied President Obama’s health overhaul at first seemed to be largely rooted in Washington, where it was passed on party-line votes in 2010 and largely upheld by the Supreme Court in 2012. When that decision made optional the law’s main provision for insuring low-income people – an expansion of Medicaid – much of the battle shifted to state capitals.

Now, with the six-month open-enrollment period approaching for the insurance-exchange marketplaces, opponents are aiming at community organizations that will be working with consumers.

Community groups feel heat of D.C. health-care battle

Navigators Say GOP Lawmakers’ Information Requests Are ‘Shocking’ – Kaiser Health News

 

Organizations that received the latest round of health law navigator grants say last week’s letter from House Republicans could have a chilling effect on efforts to hire and train outreach workers to sign up Americans for health insurance by Oct. 1, the opening day for  new online insurance marketplaces.

The letters were signed by 15 Republican members of the House Energy and Commerce Committee and requested that the organizations provide extensive new documents about their participation in the program and schedule a congressional briefing by Sept. 13.  The letters went out to 51 organizations–including hospitals, universities, Indian tribes, patient advocacy groups and food banks—out of 104 that shared $67 million in grants. 

"I find the letter quite offensive," says Lisa Hamler-Fugitt, executive director of the Ohio Association of Foodbanks, which received a $1.9 million grant. "It is shocking. It is absolutely shocking."

The organizations, all in states where the federal government will be setting up insurance marketplaces, are already under a difficult time crunch, with just six weeks from the time they received the grants to hire, train and prepare outreach work forces.

"Was this an attempt by members of the committee to basically stop and slow down the navigator process?" Hamler-Fugitt says. "We’re going to stop now and pull together voluminous documents to provide back to the committee?"

Some of those documents don’t yet exist, she says. "We weren’t required to provide position papers, salary ranges, privacy policies or procedures. You don’t do that until you know that you got the award."

The Obama administration used stronger language in describing the letter last week, characterizing it as a "blatant and shameful attempt to intimidate."

Navigators Say GOP Lawmakers’ Information Requests Are ‘Shocking’ – Kaiser Health News

Major New Study On Obamacare Premiums Should End The ‘Rate Shock’ Hysteria Once And For All | ThinkProgress

 

The most comprehensive study on Obamacare to date finds that Americans’ insurance premiums under the health law will be “lower than expected.” Many Americans will pay even less than the top-line rates after factoring in government subsidies for their health coverage, with some paying nothing at all for crucial medical coverage.

The Kaiser Family Foundation (KFF) looked at individual policy prices in the 17 states, plus the District of Columbia, that have released comprehensive numbers for their Obamacare insurance marketplaces. Since premiums under the law will vary based on factors such as age and geographic location, KFF chose to examine how much the second-least expensive “Silver” mid-level plan and the least-expensive bare-bones “Bronze” level plan would cost for 25-year-old, 40-year-old, and 60-year-old Americans in those 17 states’ largest cities. The report includes both the top-line prices for those demographics, as well as what their costs would be after factoring in government subsidies based on varying income levels.

According to KFF’s findings, a single 40-year-old in Los Angeles could buy the second-cheapest mid-level plan for $255 per month — but if that person makes just under $30,000 per year, he or she will only have to pay $193 per month after receiving a government subsidy.

Strikingly, in every city analyzed, a family of four with two 40-year-old adults and a household income of $60,000 per year would pay $409 per month for the second-cheapest Silver plan after receiving subsidies. That’s more or less in line with the average $4,565 per year that workers currently contribute towards their employer-sponsored health insurance plans.

The report also finds good news for younger and older Americans. In Seattle, a 25-year-old making $28,725 per year will pay $193 per month for a Silver plan after subsidies and $138 per month for the cheapest Bronze plan after subsidies. For a single 60-year-old with the same income, those number would be $193 per month and $44 per month, respectively, after factoring in subsidies. And in Burlington, Vermont, both a single 25-year-old making $25,000 per year and a 60-year-old couple making a combined $30,000 per year would pay nothing at all for the cheapest, bare-bones Bronze plan.

While the KFF researchers emphasized that there will be significant variation in Obamacare premiums depending on geographic location, they concluded that premiums would be lower than what the government expected, writing, “the latest projections from the Congressional Budget Office imply that the premium for a 40-year-old in the second lowest cost silver plan would average $320 per month nationally. Fifteen of the eighteen rating areas we examined have premiums below this level, suggesting that the cost of coverage for consumers and the federal budgetary cost for tax credits will be lower than anticipated.”

Major New Study On Obamacare Premiums Should End The ‘Rate Shock’ Hysteria Once And For All | ThinkProgress

The Affordable Care Act And People With Disabilities – Forbes

 

“ACA changes the world for persons with disabilities and funds who will now have a choice between public or private health insurance. For significant financial as well as health reasons, we believe that private health insurance, not Medicaid, will be soup d’jour for the vast majority of (Special Needs Trusts) SNT clients. We cannot know for certain, but I would not be surprised to see persons with disabilities leaving public health insurance (Medicaid) for the private market in January, 2012.

The most obvious and most significant health industry reform important to our SNT clients is the elimination of pre‐existing conditions as a bar to purchasing private health insurance. However, ACA also eliminates annual or lifetime caps, rescission of insurance policies, non‐renewability, and higher premium costs for persons with pre‐existing conditions. For individuals with significant medical problems, elimination of cost‐containment ceilings is just as important as access to the door of private medical care. It is not unusual to see clients who have maxed out their lifetime cap and are now seeking public health insurance.

Why would clients opt to pay for private health insurance rather than “free” Medicaid? The two major reasons are first, securing health insurance without a payback on death and second, access to significantly better medical care…

Change makes most of us uncomfortable, but change is a constant in our lives. This is one time when special needs attorneys can both lament the negative impact of national legislation on our personal financial well‐being, but rejoice in the concomitant good fortune of our clients with disabilities who can now join the private health insurance market with the rest of us as equal citizens with their dignity intact.”

The Affordable Care Act And People With Disabilities – Forbes

‘Premium Shock’ and ‘Premium Joy’ Under the Affordable Care Act – NYTimes.com Uwe Reinhardt

Community Rating Under the Affordable Care Act
Under the law, an individual health plan selling policies in the small-group and nongroup market — whether it sells policies through the state’s exchange or not — will be free to set its own premium for a given policy. But within a given age group, it must apply the same premium to all comers, regardless of their health and their gender. Furthermore, the health plan cannot reject any applicant willing to pay that premium, a provision called “guaranteed issue,” or cancel existing policies.
In other words, the Xi based on the individual’s health status in the equation above will be replaced by the average expected health spending per insured, with the average calculated over the insurer’s entire anticipated risk pool of insured members of a given age. To calculate the average, the insurer must consider as one single risk pool all enrollees in all health plans offered by the insurer, whether or not they are offered on the exchange.
This form of premium setting is known as “community rating.” Because it forces healthier individuals to subsidize sicker individuals through the community-rated premiums, it has been much debated.
Community rating invites “cherry-picking” by insurers — i.e., attempts to attract mainly low-risk applicants. To limit the profit potential from cherry-picking, there will be post-enrollment risk adjustments through which funds are transferred from insurers ending up with relatively healthier risk pools to those ending up with relatively higher risk pools.
The community rating under the law is not the pure version found in the social insurance systems of Europe (e.g., Switzerland, the Netherlands and Germany) or Asia, where even age is not considered in setting premiums. Rather, the American version is called adjusted community rating, because it does allow insurers to adjust the community-rated premium for the age of the applicant.
Age-adjusting is done by multiplying the community-rated premium for the youngest members in the expected risk pool by a standard, multiplicative age ratio to be used by all insurers. Thus the quoted premium can increase step by step with age, but only up to a multiplicative factor of 3. At a given age, smokers can be charged up to 1.5 times the regular premium.
The change from what was in place before the Affordable Care Act to post-law arrangements in the nongroup market can be illustrated graphically. In the chart below, we assume initially that all members of a given population are covered by either medically underwritten or community-rated health insurance, with a given package of covered health benefits. The white line represents the premium individuals would have to pay under medical underwriting. The dashed segment of that line is meant to show the actuarial cost and the premium range in which insurers in the real world would reject applicants outright. The green line shows the community-rated premium for this same population. We assume here that age is either not factored into the premium or the population in question is all of the same age, which is why the green line is horizontal.

Premium Shock
As the chart illustrates, a switch from medically underwritten premiums to community-rated ones raises the premiums for the relatively healthier members of the insurer’s risk pool. Many of them will suffer what has come to be called premium shock.
Younger and healthier members of the pool should realize that, in effect, they are buying a call option that allows them to buy coverage at a premium far below the high actuarial cost of covering them when they are sicker. The price charged the healthy for this call option is the difference between the premium they must pay and the current lower actuarial cost of covering them.
Furthermore, for Americans in households with incomes below 400 percent of the federal poverty line, the green and red lines exaggerate the impact of the law on their spending. These Americans will be granted often quite generous, income-dependent federal subsidies toward the premiums they face on the exchanges and their out-of-pocket costs for health care. This makes it well-nigh impossible to make general statements, based on averages, about the net after-subsidy impact of the law.

‘Premium Shock’ and ‘Premium Joy’ Under the Affordable Care Act – NYTimes.com