Parts of health-care law to take effect

[dnf777]

I forgot to mention that work pays 50%. So the total cost is around $600. Thank goodness for work place insurance!

My point was that the prices have already increased significantly and I am not looking forward to seeing what happens this November during open enrollment.

Call me socialist, but I'm beginning to wonder if "promote the general welfare" should be construed to mean the gov't should manage health insurance or financing? We all accept the socialist structure of the gov't "providing the common defense" as necessary, when it is such a huge beast. Is healthcare not just as large? Like the DoD, should a DoH similarly run contracting and oversight of private providers? (health contractors...like defense contractors)

I'm sure I'll take some jabs for my opening line, but has the thought crossed anyone elses mind, in the context of the current system is failing, and a half-assed reform bill is not likely to salvage it? If the dire predictions are true, then NOBODY should be comfortable even if they have insurance at the moment.

And if you reject that notion, and want to repeal the health law........what are ya gonna do instead? Please note, insurance rates were increasing exponentially BEFORE this law ever took effect or was even a twinkle in anyone's eye.

[Gerry Clinchy]

Profit in insurance is not needed.

Not sure what business you're in ... but I think that a farmer might take exception to the fact that profit in food is not needed, since it might deprive some people of food they need.

Your statement would imply that any service or product that is considered a "need" should be non-profit, i.e. paid for by taxes and overseen by the govt? We could start with health care, include food, clothing, home heating, electricity, public transportation ... probably a lot of other things people could add to the list.

[M&K's Retrievers]

Please note, insurance rates were increasing exponentially BEFORE this law ever took effect or was even a twinkle in anyone's eye.

I'm afraid you aint seen nothing yet. Those of us dumb enough to still be in the business are just now starting to get emails from our carriers laying the groundwork for major rate increases in the offing due to Obamacare mandates. They can't do this crap for free. My guess is after the first of the year we will see companies withdrawing from the health care industry by either canceling their business or selling it to other companies. In either case the result will be less carriers competing for your business. The remaining companies-mainly The Blues and United Health Care- will hang around awhile hoping for a shot at administering the only game left in town - the government health plan. Me and thousands like me will be out of business not to mention thousands of support people from insurance companies, agencies, state insurance departments, etc who will be jobless. Don't forget the loss of state income in the form of premium taxes. And Dave, you will be a salaried government employee working long hours and being underpaid for your services.

Someone said earlier "Does Obamacare?" No. He doesn't but we had better care or an outcome similar to the one described above will ensue.

Pretty picture regards,

[depittydawg]

Not sure what business you're in ... but I think that a farmer might take exception to the fact that profit in food is not needed, since it might deprive some people of food they need.

Your statement would imply that any service or product that is considered a "need" should be non-profit, i.e. paid for by taxes and overseen by the govt? We could start with health care, include food, clothing, home heating, electricity, public transportation ... probably a lot of other things people could add to the list.

Not at all. The decision on whether or not to a service should be profit or non-profit rests solely on the merit of selecting the most effective method of delivery. Most countries in this world do not have profit driven health insurance industries. They deliver a better product at a lower cost. Examples are Canada, England, France, Germany, Japan ....
We have public roads. We have a Public Military. We have Public Schools. We have Public Police, fire etc. etc. We have had all of these for more years than any of us have been alive. And we still have a Private Economy.

The models of public healthcare in almost every other modern country have evolved. Ours has not. We spend the most, by far, on healthcare of any nation on the planet and we rank 32nd, (last time I looked) in delivery. What benefit has Profit driven health insurance provided to America?

[Gerry Clinchy]

Some other Obamacare facts:
http://www.pbs.org/newshour/rundown/...ges-begin.html

Free preventive care: New policies must cover preventive care -- such as immunizations, mammograms and colonoscopies -- without charging a deductible or co-payment. (Even a modest co-pay would help keep costs down).

The provisions will go into effect for plans issued or renewed after Sept. 23. So you'll see the changes the next time you buy a new plan, or when your new policy year begins. For many large employers, that's Jan. 1. For others, it could be sooner or later than that.

Higher annual limits on coverage: Plans will still be allowed to place annual dollar limits on coverage, but those annual limits must be at least $750,000. Annual limits will be banned completely by 2014.

Are there any exceptions to some of these rules?
Yes. Some of the changes will not apply to "grandfathered" plans -- plans that existed before the law was signed on March 23 and that haven't made significant changes since then. This is particularly true for individual insurance plans.

For both group and individual grandfathered plans, the changes providing free access to preventive care and expanded access to ob-gyn's and emergency care will not apply. Individual plans that are grandfathered do not have to accept children regardless of pre-existing conditions, and also do not have to comply with the new $750,000 minimum for annual limits.

Even if your plan is a grandfathered one, however, there's a good chance it won't stay that way long. That's because in order to keep the status, the plans cannot make any significant changes, such as raising premiums, co-pays or deductibles.
"Over time plans are going to need to do those things to keep up with inflation," says Sara Collins, vice president of the Commonwealth Fund. By 2013, she says, the government estimates that 60 percent of large employer plans and 45 percent of small employer ones will lose their grandfathered status. (So, it's not quite true that if you like your present plan, you can keep it. Small changes in the plan could trigger requiring the plan be changed to conform to the new law.)

The government also estimates that up to 88 million people will be affected by the provisions that mandate free access to preventive care, more access to emergency care, and a more extensive appeals process.

These numbers all come from estimates prepared by the Department of Health and Human Services as part of regulations issued for the new law.

http://spectator.org/archives/2010/0...-at-six-months
A perfect example is the uproar over recent reports that insurers were citing the new health care law as part of their rationale for raising premiums.

In response to the news, Health and Human Services Secretary Kathleen Sebelius sent a threatening letter to the insurance industry lobby, America’s Health Insurance Plans (AHIP), warning that there will be “zero tolerance for this type of misinformation and unjustified rate increases.” Sebelius also added that, “I want AHIP's members to be put on notice: the Administration, in partnership with states, will not tolerate unjustified rate hikes in the name of consumer protections.” (Seems to me that when more services are expected to be coverred, it would be "justified" to raise rates to cover those costs?)

It’s no surprise that the new health care law, which requires insurers to offer more generous benefits, would make premiums go up. In the pre-ObamaCare health care system, state regulators already created over 2,000 benefits that insurers were mandated to cover, according to the Council for Affordable Health Insurance -- and those benefits drove up the cost of health insurance by 20 percent to 50 percent. It’s one reason why coverage in highly-regulated New York costs more than double what it does in neighboring Pennsylvania, according to data from eHealthInsurance.com.

ObamaCare adds a raft of new mandates on top of existing state mandates. The Congressional Budget Office determined that an earlier version of the law would increase premiums in the individual market by 10 percent to 13 percent over where they would be without the law’s passage.

http://health.usnews.com/health-news...e-changes.html

Also not necessarily covered: family planning services like a vasectomy or insertion of an intrauterine device; weight loss counseling, and smoking cessation programs. These may be covered at some point in the future after a federal health board comes up with recommendations on mandatory coverage. (Kind of interesting what's not covered.)

Watch out for rising premiums. While the health reform law makes it tougher for insurance companies to hike up premiums, they can still implement rate increases when justifiable and, yes, premiums may rise on employee group plans to absorb extras like adding in your co-workers' college-age kids.

Don't assume it's cheaper to add a grown child to your plan. It may cost you more to add, say, your 23-year-old daughter to your plan than to buy her an individual policy. "Our latest report shows that the average premium for individual adults ages 19 to 24 is about $107 per month," McLean says. If your premiums rise by more than that when you add a child, it may better to explore other options. (I guess you could have done that before Obamacare as well if you had the $ and wanted to provide that for your kid?)

http://blog.heritage.org/2010/09/23/...Morning%2BBell

Before Obamacare was passed six months ago today, former President Bill Clinton promised a leftist horde at the Netroots Nation convention: "The minute the president signs the health care reform bill, approval will go up, because Americans are inherently optimistic." Fast forward to last Sunday, when, after Meet the Press host David Gregory played a clip of Clinton's promise, the former President responded: "I was wrong."

Doctors: In order to make a trillion dollar new entitlement look deficit neutral, you have to game the system. Obamacare accomplished this by pretending to cut doctor Medicare reimbursement by 23%. Congress already added to the deficit by delaying these cuts through this December. But a massive pay cut is just the beginning of the pain Obamacare has inflicted on physicians. The law also makes it next to impossible for doctors to establish their own hospitals, burdens them with thousands of hours of new reporting requirements and overburdens emergency rooms. Then there is the massive expansion of Medicaid which reimburses doctors at only 56% the rate in private practice. No wonder studies show that Obamacare will be 300,000 nurses and 100,000 doctors short of what is needed by 2020.

Consumers: Remember President Obama's promise, "If you like your health care plan, you can keep your health care plan"? Don't believe it. Do you like your health savings account (HSA) or flexible spending accounts (FSAs)? Well those provide you with too much economic health care freedom for Obamacare to work, so Obamacare regulates both out of existence. Do you like your current employer coverage? Sorry, studies show that Obamacare's regulations are likely to incentivize employers to dump 35 million Americans out of their current health care plan. And once they are in the new marketplace, other Obamacare regulations and mandates are already sending health insurance premiums through the roof.

States: Medicaid spending already represents on average about 21 percent of the typical state budget. Obamacare will significantly expand that number. Of the 34 million Americans who gain health insurance through Obamacare, over half (18 million) will receive it through the welfare program, Medicaid. This impending state budget crisis was what the Cornhusker Kickback was all about. Obamacare attempted to appease states by bailing them out through 2016. But by 2017, state taxpayers will be on the hook for an ever-expanding share of Medicaid dollars. If state Medicaid spending increases by 41 percent as projected, then by next year Medicaid could end up consuming nearly 30 percent of the average state budget. Already, 44 states report that they have exceeded projected Medicaid enrollment and spending targets for this year, and Obamacare will only make those numbers worse.

Seniors: : The President's own Medicare Actuary projects that the record-breaking payment reductions due to hit hospitals, home health agencies and nursing homes will make 15 percent of these providers unprofitable and possibly "jeopardize" seniors’ access to care. On top of that, payment cuts to Medicare Advantage plans will hit seniors especially hard. Enrollment in these plans is expected to drop from 14.8 to 7.4 million. By 2017, the average annual per-capita cuts for Medicare Advantage enrollees will be about $3,700 -- a 27 percent reduction from today’s levels.

[Gerry Clinchy]

And more ...

http://blogs.forbes.com/merrillmatth...mepagechannels

At least ABC News White House Correspondent Jake Tapper is doing his job.

Tapper asked President Obama how he reconciled his claim before ObamaCare passed that reform would lower health care costs with the fact that a new government report—plus, I might add, every news story on the topic—says health care costs are rising.

Good question that; wish the answer had been also. The president replied, “I said at the time, it wasn’t going to happen tomorrow, it wasn’t going to happen next year.”

No, Mr. President, that’s not what you said. You claimed repeatedly that by the end of your first term a family health insurance policy would cost $2,500 less.


Obama added, “as a consequence of us getting 30 million additional people health care, at the margins that’s going to increase our costs, we knew that.” But what you said last March was, “[M]y proposal would bring down the cost of health care for millions—families, businesses, and the federal government.” Unfortunately, Tapper didn’t get to follow up and demand that the president answer the question truthfully, but maybe other journalists will.

Is the health insurance mandate a tax or not? In a lively exchange, ABC’s George Stephanopoulos asked President Obama last fall if the mandate to have health insurance was a tax. “[F]or us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase,” the president replied. And the legislation concurs; it never refers to the mandate as a tax.

Except that the Obama Justice Department now says it absolutely is a tax. At least it’s making that claim before judges considering the constitutionality of the mandate.

The reason Justice is calling the mandate a tax is Congress has the constitutional authority to levy taxes; it does not have any constitutional authority to tell people they have to buy health insurance.

So if the administration can convince the judges—and eventually the Supreme Court—the mandate is a tax, the mandate may have a better chance of being ruled constitutional.

But it would sure be nice if someone in the media would ask the president, yes or no, whether he still believes the mandate is not a tax. And if it isn’t, why is he letting Justice claim it is? (Catch 22?)

For one thing, some health insurers are dropping out of the traditional health insurance market. Others are dropping some of their current offerings. For example, Wellpoint, Cigna and CoventryOne have decided to stop offering child-only policies because of new rules going into effect this week forcing them to accept any child applicant (separate from a family policy).

There's no such thing as a free lunch. If you're going to require insurers to cover more expensive customers and provide more benefits, it's going to cost more -- and those costs are going to be passed on to customers in the form of higher premiums. When New York implemented many of these same insurance rules in 1983, premiums rose by nearly $500 per policy -- resulting in nearly 500,000 New Yorkers dropping their insurance. (Dropping coverage won't be an option with Obamacare, though.)

Today, the president will almost certainly highlight projections that health-care reform will eventually provide coverage to some 30 million more Americans. He won't note that that's years off -- or that roughly half of those newly insured are merely being dumped into the Medicaid system, with all its problems in access and quality.

You also won't hear much about the fact that the government's own actuaries have now concluded that the health-care law will actually increase health-care spending, contrary to the president's promises before the bill passed. Nor will you hear that outside experts now predict that ObamaCare will cost as much as $2.7 trillion over its first 10 years of actual operation, adding more than $350 billion to the deficit over that period despite massive new taxes.

For example, we've now learned that college students receiving limited-benefit policies via their universities won't be able to keep those. (I guess it's a good thing they'll be able to go back on their parents' plan.) Similarly, at least a million seasonal workers will lose their plans because they fail to meet the government's new benefit requirements.

http://www.heritage.org/Research/Rep...rance-Premiums


Individuals who do not have co-payments or deductibles lack “skin in the game” and thus have less incentive to economize on their use of health care services. This results in higher premiums for their health insurance. The CBO concludes that a 10 percent decrease in cost-sharing typically increases health care spending by 1–2 percent.[3]

The average 60-year-old consumes about six times as much health care as the average 20-year-old, but Obamacare mandates that insurers charge the oldest individuals in the risk pool no more than three times the lowest rate. As a result, young individuals will pay much more than the actuarially fair amount for their premiums. Management consulting firm Oliver Wyman estimated that premiums will rise by 45 percent for those age 18–24, 35 percent for those age 25–29, and 26 percent for those age 30–34.[4]

According to an analysis by Wellpoint, a health benefits company, the guarantee issue provisions in Obamacare will be mostly responsible for the rise in premiums.[6] Furthermore, a recent academic paper found that the existence of guarantee issue regulations more than doubled premiums for individual policies and nearly doubled premiums for family policies.[7]

Obamacare is set to reduce the reimbursements doctors and hospitals receive for Medicare. A 2006 Health Affairs piece finds that a 1 percent relative decrease in the average Medicare price is associated with a 0.17 percent increase in the corresponding price paid by privately insured patients.

The study found that cost shifting from Medicare and Medicaid to private payers accounted for 12.3 percent of the total increase in the price of private insurance from 1997 to 2001.[8]
Proponents of Obamacare argue that the individual mandate is the glue that holds the legislation together. Because the mandate was so unpopular, however, Congress gave the IRS limited ability to enforce it. It is unlikely, therefore, that the mandate will be effective at encouraging healthy individuals to purchase coverage and cross-subsidize the premiums for the old and the sick.

According to Oliver Wyman, a weak mandate would cause “the average medical claims of members in the reformed individual market [to] be 50 percent higher than the average in the market today (not including medical inflation). This would translate into premium increases of approximately $1,500 for single coverage and $3,300 for family coverage in today’s dollars.”[11]




Increased Demand for Health Care
The expansion of insurance coverage through Obamacare will increase the amount of health care that previously uninsured people demand. CBO predicts that a major coverage expansion would cause total demand for health care services to increase by 2–5 percent.[12] Oliver Wyman estimates that the average uninsured will use about 20 percent more in health care services than the average individual, which will raise premiums in the individual market.[13]

[Gerry Clinchy]

Most countries in this world do not have profit driven health insurance industries. They deliver a better product at a lower cost. Examples are Canada, England, France, Germany, Japan ....

You may want to re-check some of this ... UK is having problems with its health care system. Lack of timely care has been a problem for a long time; and more recently denial of care if it can't give at least "x" amount of time of life extension. Lack of timely care has also been a problem in Canada. I'm not up-to-date on France, Germany and Japan.

In all of these countries, those who can pay for care privately get care in a more timely fashion ... or they have the $ to go to another country where they can get care.

There were some articles in the NY Times quite a while ago about how US seniors are finding care in Mexico. Yet other articles also note that indigents (illegal immigrants here to the US) from Mexico don't want to go back home for dialysis because they say that it would be a death sentence.

Many millions are being spent giving free care to illegal immigrants who can't get care in their home countries. As far as I know, Obamacare will not change that. Especially since illegal immigrants will not be able to get subsized coverage ... and there seems to be little effort by the govt to send illegals home. Catch 22?

[depittydawg]

You may want to re-check some of this ... UK is having problems with its health care system. Lack of timely care has been a problem for a long time; and more recently denial of care if it can't give at least "x" amount of time of life extension. Lack of timely care has also been a problem in Canada. I'm not up-to-date on France, Germany and Japan.

In all of these countries, those who can pay for care privately get care in a more timely fashion ... or they have the $ to go to another country where they can get care.

There were some articles in the NY Times quite a while ago about how US seniors are finding care in Mexico. Yet other articles also note that indigents (illegal immigrants here to the US) from Mexico don't want to go back home for dialysis because they say that it would be a death sentence.

Many millions are being spent giving free care to illegal immigrants who can't get care in their home countries. As far as I know, Obamacare will not change that. Especially since illegal immigrants will not be able to get subsized coverage ... and there seems to be little effort by the govt to send illegals home. Catch 22?

No system is perfect. I'm sure they have problems. And no doubt they will solve their problems So do we. And by the numbers, we pay more, and get less. For 30 years I've paid healthcare premiums. Now, I'm over 50 and no insurance company will sell me a policy. I'm lucky. I have a job with a group plan.
Couple of years ago I was sweating bullets, not for myself, but for my family. I was unemployed and using half my unemployment money to pay for COBRA. At that time it was about 600 a month for my family. Now its well over a thousand.
There is also the fact that the most common cause of bankruptcy in the US is healthcare costs. And more often than not, those going bankrupt have insurance.
People allowed themselves to be duped by the millions the industry threw into (and continue to) a media blitz of mis-information. Here it is in its simplest form.
Heard a testimony from an American living in England. Same job, same company, different country. His paycheck has a deduction for health insurance. According to him, it's about the same as his deduction was here in the US. In England his healthcare deduction goes to the government. In the US it goes to an Insurance Company.
The difference is, when he got sick, broken leg I believe. He had the surgery and all the follow up care. Never spent a dime of his own money. Everything, medications, hospitalization, surgery, physicians services, all of it was 100% covered. Remember, same deduction from his paycheck.
I had a nasty broken leg a few years ago. I also had a very good policy here. I got great treatment. 25K for the surgery, lots of meds, physical therapy, etc. Besides my insurance premiums I also had to fork out several thousand for co-pays, deductibles, medications, etc. In this case, same services, only mine cost me a lot more. Why? So United Healthcare could make their profit. An anecdote to this story is that the year I broke my leg, the CEO of United Healthcare received compensation of about half a billion dollars.

[dnf777]

I'm afraid you aint seen nothing yet. Those of us dumb enough to still be in the business are just now starting to get emails from our carriers laying the groundwork for major rate increases in the offing due to Obamacare mandates. They can't do this crap for free. My guess is after the first of the year we will see companies withdrawing from the health care industry by either canceling their business or selling it to other companies. In either case the result will be less carriers competing for your business. The remaining companies-mainly The Blues and United Health Care- will hang around awhile hoping for a shot at administering the only game left in town - the government health plan. Me and thousands like me will be out of business not to mention thousands of support people from insurance companies, agencies, state insurance departments, etc who will be jobless. Don't forget the loss of state income in the form of premium taxes. And Dave, you will be a salaried government employee working long hours and being underpaid for your services.

Someone said earlier "Does Obamacare?" No. He doesn't but we had better care or an outcome similar to the one described above will ensue.

Pretty picture regards,

I hear what you're saying. I already am essentially a gov't employee. Over half of my income is derived from medicare or state med-assist...and a few private insurance carriers.....all of whom pattern compensation off medicare rates. Why not just eliminate the middle man? The defense industry seems quite happy indeed with their arrangement. And due to the sheer size and overall dollar amount of the health care industry, its almost on par with the defense industry. There will always be a demand and market for private pay health care and insurance. But to ensure the masses have some form of care, maybe a two-tiered, gov't run health industry would be the way to go. Just a thought.

[M&K's Retrievers]

The primary purpose of manufacturing is to distribute a product over a large percentage of the population, NOT to make profit. When Profit became the single objective of manufacturing Companies, our costs began to go through the roof and our product rankings began a freefal that continues to this day. Profit in manufacturing is not needed. maximizing Profit for the manufacturing equation adds 30% more cost, and deprives millions of product when they need it.

There I fixed it.