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Archive for November, 2010

Stalled Negotiations Hinder Texas Health Insurance Network

Friday, November 19th, 2010

blue cross blue shield texas health insuranceOpen enrollment for 2011 is in full swing, and the largest provider of Texas health insurance in the state is still in contract negotiations with Texas Health Resources, the operator of Harris Methodist, Arlington Memorial and Presbyterian hospitals.

Blue Cross Blue Shield insures more than 25 percent of insured Texans, and if the company doesn’t reach an agreement with Texas Health Resources for 2011, then in six weeks 24 hospitals and 18 outpatient facilities will be considered out-of-network for consumers covered by Blue Cross Blue Shield of Texas.

The Fort Worth Star-Telegram reports that the holdup in negotiations is largely due to reimbursements that BCBS would owe Texas Health Resources’ facilities. According to Wendell Watson, a spokesperson for Texas Health Resources, the company is seeking a modest, single digit increase that is below the rate of medical inflation.”

Blue Cross Blue Shield spokeswoman Margaret Jarvis maintains that BCBS has made “every reasonable attempt to reach an agreement that will provide a balance of affordable healthcare options on behalf of our clients.” She notes that the company will continue to speak with Texas Health Resources in hopes of coming to an agreement, and said that their “biggest challenge is managing the rising cost of medical services today…which translates directly into higher health insurance costs.”

Consumers should note that as of now, nothing has changed. But come January 1, 2011, if an agreement isn’t reached, BCBS customers will see their in-network health care options become noticeably limited.

Fighting the Economic Perils of ObamaCare

Wednesday, November 17th, 2010

obamacare

As more conservatives flood into Congress next year, many are determined to repeal the health care bill, which may be the only way to get our federal deficits under control.  Obama’s administration continues to preach the positives of the bill, despite a general consensus that it’s too expensive and actually prohibits consumers from receiving affordable health insurance in Texas and across the country.

As the Heritage Foundation notes, much of the issue lies with the misinformation distributed by the government. For example, the former Director of the Office of Management and Budget under President Obama claims that leaving the legislation intact will cut costs, but the numbers just don’t add up.  A recent NY Times article claims that ObamaCare will cut the federal deficit and reduce Medicare spending.  But what’s left out is that, although spending on Medicare will be reduced by $575 billion over the next decade, the savings would be used to offset spending on new programs.  So in reality, no money is saved.

And to reduce Medicare spending, the new law plans to cut payments to providers, which only acts to decrease the number of doctors willing to see Medicare patients. That doesn’t save costs; it merely pushes the costs elsewhere. The administration also plans to make Medicare more efficient – which they say will reduce costs. But when’s the last time the government ever made something more efficient?  Efforts to increase efficiency from the top down usually result in price controls, which only disrupt the natural market forces.

Hopefully the newcomers to Congress will help to set our health care–and as a result, our economy–on the right track by addressing the irresponsible health care legislation and replacing it with reforms that actually work to lower costs. The Heritage Foundation sums up the issue with some clear thoughts:

The new law will be ineffective at increasing efficiency…The only way for the new Congress to eke out savings from health care is to repeal Obamacare and replace it with bottom-up, consumer-driven approach to reform.

Top 5 Open Enrollment Tips for Health Insurance in Texas

Thursday, November 11th, 2010

tips for texas health insurance enrollmentAs the end of the year approaches, people will begin renewing their Texas health insurance plans or enrolling in new plans.  And while renewing coverage can be quick and easy, it doesn’t mean the plan options and prices will stay the same.  So as you weigh your Texas health insurance options for 2011, be on the lookout for coverage and cost adjustments.

According to the National Business Group on Health, employer-sponsored health costs will rise nearly 9 percent in 2011, and these added expenses will likely be passed onto consumers via higher out-of-pocket cost and copays.  To assist consumers in navigating the impending changes and making the best choices for their health insurance, Fox Business suggests five useful tips:

1. Scrutinize higher copays and premiums, which will likely be more costly in 2011.  Save money by choosing another plan option—whether on the individual market or through your employer—researching wellness incentives, which can trim your plan costs, or switching to your spouse’s plan if it’s more cost effective.

2. Take advantage of free preventative services. Starting January 1, there will be more free preventive services than ever, per the terms of health care reform.  Some changes include free cancer screenings and weight-loss counseling.

3. Consider a high-deductible plan. If you’re healthy and don’t require frequent doctor visits and prescriptions, you can maintain health insurance with a very low monthly premium.  And if a major accident occurs or an operation becomes necessary, you’re covered.  Opting for a high-deductible plan also makes you eligible for a Texas health savings account, which is another great way to control your health care costs.

4. Note changes in drug coverage. Starting in 2011, you can no longer purchase over-the-counter medicines with HSA or flexible spending account dollars without a prescription from your doctor, so plan accordingly.

5. Keep your child on your health plan until they’re 26 if it makes sense for your family financially. The rules are lax, as your kids don’t have to live with you, and can even be married. It may be a great way to provide your son or daughter with solid coverage if they can’t obtain it on their own.

As open enrollment begins, keep the above tips in mind, and in general, ask a lot of questions to ensure you’re getting the best and most affordable Texas health insurance plan.  Otherwise, you may be blindsided by changes to your health plan once January rolls around.

Election Results are in: What’s Next for ObamaCare?

Thursday, November 4th, 2010

change is coming to texas health insuranceThe midterm elections are over. The ballots have been counted, and the results are in.  The Republicans won a sweeping victory in the House, one that political analysts are calling a referendum against the current administration.  So now that new blood’s being infused into our government, what’s next for ObamaCare, and how will it affect health insurance in Texas and across the country?

While job creation and the economy are still a huge focus, Republican leaders are determined to repeal ObamaCare, and to start fresh with a new plan that lowers costs and raises quality.  According to The Hill, Rep John Boehner said: “The American people spoke, and I think it’s pretty clear the Obama/Pelosi agenda is being rejected by the American people.”  Indiana Congressman Mike Pence said that “House Republicans will not rest until we repeal ObamaCare…”

Polls suggest that Republicans’ repudiation of the health care reform bill passed in March is in line with the feelings of the American public. Rasmussen Reports conducted exit polls, finding that 59 percent of those who voted on Election Day favor repealing ObamaCare.  While doing so won’t be easy, efforts have intensified, with lawsuits filed across the country challenging the constitutionality of the bill.  Jay Sekulow of the American Center for Law and Justice notes:

Our complaint specifically addresses the constitutional issues of concern:  ‘Mandating that individuals purchase health insurance is an unprecedented and unconstitutional expansion of congressional power, as Congress has never before required individuals to involuntarily buy a good or service under the guise of its Commerce Clause authority.’

This complaint—which hints at the frightening precedent such a measure would set, seemingly giving the government limitless power to dictate what individuals must purchase—and others are gaining momentum.  And whether it’s through legal posturing or legislation, ObamaCare seems to be in jeopardy.  Americans across the nation want change, and with a shift of power throughout Congress, it looks like change may be coming.

Open the Health Insurance Marketplace to Decrease Price, Increase Quality

Monday, November 1st, 2010

affordable texas health insuranceTomorrow’s elections may issue big changes to a variety of issues, including Texas health insurance, still reeling from national health care reform passed in March.  If Republicans win back a majority of seats in the House of Representatives, as many pundits are predicting, it will be interesting to see what they do about health care.

Last month, Republicans issued their Pledge to America, which included, among other initiatives, a plan to increase competition among health insurers by opening health insurance across state lines.  Opponents to this proposal claim that such a measure would result in consumers buying health insurance in the states with the lowest prices, and therefore, the fewest consumer protections.  But are state regulations for health insurance really geared toward consumer protection, or are they simply government-imposed mandates that do little more than raise the price of health insurance?

John Goodman of the National Center for Policy Analysis explores these regulations (the national average by state is 42), noting that most are the result of special interest lobbying, rather than measures to protect consumers.  This is why states with few regulations, like Idaho (13) and Iowa (26) don’t have higher reports of consumer abuses than states with more regulations.  So opening the market across states lines and allowing consumers to buy from states with cheaper prices would not subject patients to dangerous practices.  Instead, it would increase competition by allowing insurers to enter more markets, decrease the rate of uninsured residents and discourage states from imposing costly—and often unnecessary—regulations that would place them at a disadvantage to compete in the market.

A national health insurance market isn’t without problems, but increasing the availability of affordable health insurance in Texas and other states would be a huge win for consumers and businesses alike.  Hopefully tomorrow’s elections will put us on track to right some of the wrongs imposed by ObamaCare.