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Posts Tagged ‘Health Care Reform’

Who’s Responsible for Messing with Texas Health Insurance?

Tuesday, August 24th, 2010

obamacare affects texas health insuranceLike the rest of the country, Texas health insurance is going through the ringer, facing austere regulations, threats to Medicaid and financial mandates passed down by the current administration.  While Texas has mostly opposed ObamaCare and the threat it poses to affordable Texas health insurance, it seems that now even the men and women who championed and passed the legislation are starting to back away from its spotlight.

In March, President Obama told House Democrats that he was confident that passing health care reform would be a smart political move.  But now, with the majority of Americans actually opposing the reforms, Democrats are hard pressed to find a sympathetic ear when extolling the virtues of ObamaCare. And many are even claiming now that the bill has taken a turn away from the legislation they initially passed.

In an attempt to smooth things over with voters prior to mid-term elections, Democrats are taking a new stance on their messaging surrounding ObamaCare.  Families USA, a liberal health care advocacy organization, hosted a conference call with Democrats and other allies, urging them to communicate the benefits of health care reform via personal stories, rather than facts and statistics.

The WSJ reports that Families USA advised democrats to “Keep claims small and credible; don’t overpromise or spin what the law delivers…’to don’t’ items include offering a long list of benefits or claims that the law will reduce costs and the deficit, even as voters are concerned about rising health care costs and believe that costs will continue to rise.”

That’s a far cry from last year and earlier this year when the administration rattled off facts and figures explaining how ObamaCare would insure millions more Americans while simultaneously lowering costs.  As more and more people reject this irresponsible legislation, the administration is forced to focus on human interest stories as a last ditch effort to swing some favor their way.  Human interest stories are nice, but they don’t lower costs, incentivize businesses to insure their employees or stimulate economic growth.

So now, like the rest of the country, Texans will witness the ObamaCare juggernaut steamroll their Texas health insurance, as Democrats attempt to remove themselves from the scene of the crime.

ObamaCare: Are the gains worth the pains?

Tuesday, August 10th, 2010

the pains of obamacareThe health care legislation passed back in March was monumental for a variety of reasons. For example, it was a long time in the making and was finally pushed through against the will of an entire political party; its breadth and cost are unprecedented; and after five months, the legislation is perhaps more unpopular than when it passed.   Apparently for good measure.

As the OC Register writes:

Obamacare was conceived around three goals: 1) providing health insurance coverage for all Americans, 2) reducing insurance costs for individuals, businesses and government, and 3) increasing the quality of health care and the value received for each dollar of health care spending…Just over 100 days after the law was signed, the evidence shows it is failing on each and every one of those goals.

The legislation does approach the first goal by expanding health coverage to millions more Americans, but this coverage is due primarily to the expansion of government subsidies and Medicaid.  Increases in private coverage will be shaky at best, and approximately 20 million Americans are still expected to be uninsured in 2019.

Things are even more daunting in terms of controlling costs and increasing the quality and value of our health care.  According to the OC Register, “The administration’s own chief health care actuary reports that the law will actually increase U.S. health care spending.”  ObamaCare is conservatively estimated to increase costs by $2.7 trillion over its first ten years, a scary number given our country’s already overextended deficits.  And these costs will be passed down to consumers, with average price increases for individual insurance plans estimated to rise between 13 and 17 percent.

On top of that, many Americans won’t be able to keep their insurance plans at all.  Thousands of businesses may drop their insurance plans and instead pay fines expected to be significantly less than the cost of insuring workers.

Do the math, and it just doesn’t add up.  Increasing the number of insured Americans is a good thing, but at what cost?  This expansive legislation favors draconian government intervention that kills consumer choice.  And ultimately, consumer choice, more than government-imposed mandates, keeps quality up and costs down.

Calculating the Value of Health Care

Thursday, August 5th, 2010

health insurance, obamacareThe health care legislation passed earlier this year will have a variety of effects, some starting this year and others rolling out through 2014.  One of the most noteworthy elements under the ObamaCare umbrella is the requirement that health insurance companies meet a specific “medical loss ratio.” This rule mandates that health insurance plans split the dollars they receive from insurance premiums into two categories.  According to the Wall Street Journal:

Depending on the type of insurance coverage, 80% to 85% of premiums must be spent on either medical services or “activities that improve health care quality.” This bucket includes everything from doctor visits, hospital stays and surgery to prescription drugs and medical equipment. It also includes programs to help patients cope with chronic diseases and reminders to take prescribed medications. The remaining 15% to 20% of premiums falls into a smaller bucket of “administrative” expenses like overhead, marketing, profits, compensation and agent commissions.

The ability of the government to dictate which activities fall into which category is an indirect way to cap insurer’s profits, but more than this misuse of government power, it has frightening implications for patients as well.  In order to meet federal requirements, health insurance companies will be forced to cut back on “administrative” tasks like working with doctors to reduce certain unnecessary tests, of which too many can be dangerous, and preventing fraud, which protects patients’ private information.

If crucial services like these are considered to be administrative expenses by regulators, even though they significantly improve quality of health care and lower costs, then health plans will lose their incentives to invest in and engage in these essential programs. As a result, costs will continue to rise, and the quality of health care will fall as health insurers struggle to stay afloat.

The article closes by noting: “Bureaucrats now have the power to force private health plans to make business decisions based on regulations rather than on what is best for company or customer health. This kind of governmental micromanaging of health care—seen nowhere else in our business sector—is anathema to the free market.  More importantly, it endangers the lives and well-being of millions of Americans.”

Federal Tax Credit May Bring Texas Health Insurance to 250,000 Small Businesses

Monday, August 2nd, 2010

texas health insurance for small businessesA recent report notes that nearly 250,000 small businesses in Texas will get help providing their employees with Texas health insurance via a federal tax credit as part of the new health care laws.  This credit may help to alleviate the startling fact that approximately one in four Texans is currently living without health insurance.

According to the Austin American Statesman, “The provision targets companies with 25 or fewer workers who earn an average of less than $50,000 a year. For Texas, the number of eligible businesses represents 81 percent of those with 25 or fewer workers.”

This tax credit is aimed at businesses that traditionally have the most difficulty providing employees with health benefits.  Nationally, 72 percent of businesses with 10 to 25 workers offer employee health plans, versus 95 percent of businesses with 50 or more workers. The percentage drops considerably for businesses with 10 or fewer workers; less than 46 percent of those small companies offer health insurance to employees.

Despite the credit, which ranges up to 35 percent of health coverage costs for qualifying employers, not all small businesses will be able to provide their workers with Texas health insurance plans.  Many businesses are simply trying to stay afloat and consider health coverage to be a luxury.  But regardless, the impact should prove significant enough to make a dent in the high number of uninsured workers in Texas.  And the more local employees with affordable Texas health insurance, the better.  Having health insurance in place saves money in the long run and prevents medical emergencies and operations from bankrupting one’s future.

Of course, like all programs being implemented as part of the new health care legislation, the tax credit will be paid for by the already overburdened American taxpayers, so there’s that to consider as well.

Texas Doctors Might Drop Medicaid

Monday, July 12th, 2010

texas medicaidMedicaid patients aren’t popular among doctors, who receive state-subsidized fees significantly lower than traditional market value for their services.  And with provider fees being trimmed another one percent on September 1st, the amount of doctors accepting Medicaid is expected to drop, damaging the state’s delivery of health care to the poor who rely on this form of Texas health insurance.

According to the Dallas Morning News:

The 1 percent trim to provider fees that starts Sept. 1 sounds modest. But doctors, insurance industry officials and health care experts widely see it as the first of many hits coming to doctors’ wallets as Texas’ fiscal woes deepen.  State leaders’ instructions for agencies to identify additional 10 percent budget cuts in the next two-year budget cycle mean more fee cuts may come next summer.

Industry experts believe that further budget reductions could drive doctors from the state and result in more patients seeking emergency room care.  This would be an inauspicious beginning to federal health care reform, which, starting in 2014 will create huge new demands for care by putting more poor adults and children on Medicaid.  This bit of legislation is conservatively estimated to add 1.5 million Texans to Medicaid by 2015.  The number currently stands at about three million.

Expanding the rolls of Medicaid while reducing doctor reimbursements simply won’t work, as fewer doctors will accept these patients.  At the same time, health care reform will expand Texas health insurance rosters in general without expanding the amount of medical professionals to service the newly insured.

Medicaid is a great resource for people who can’t afford traditional Texas health insurance plans, but without the necessary medical network to support these patients, expansion may overburden our already weakened state.

Legislation Likely to Increase Emergency Room Visits

Monday, July 5th, 2010

obamacare to increase emergency room visitsThroughout the administration’s posturing for the benefits of health care reform, a common theme was that the new legislation will allow uninsured individuals to seek less costly and more accessibly care, rather than turning to emergency rooms.  But a recent study by the National Center for Policy Analysis finds that emergency room costs will actually increase under the new health reform legislation.  According to the NCPA:

We find that emergency room costs will increase for two reasons: 1) about half the newly insured will enroll in Medicaid, and Medicaid patients seek emergency room care more often than the uninsured, and 2) while the newly insured will try to increase their consumption of care, the absence of any program to create more providers will force patients to turn to emergency rooms as the outlet for increased demand.

The recently enacted reforms will eventually add more than 30 million people to health insurance rosters, but no measures are being taken to expand the amount of doctors, nurses and medical support staff.  Naturally, this will lead to a severe imbalance in the demand for health care and the available supply.  Since it will be difficult for newly insured patients to see overworked doctors, emergency rooms will be the only place they can receive care.  Another consideration is that approximately half of the newly insured are expected to enroll in Medicaid.  Since many private practitioners do not accept Medicaid patients, the patients will again be forced to seek care at emergency rooms.

So rather than decrease our nation’s dependence on costly emergency room care, health reform legislation is likely to have the opposite effect.  The NCPA projects that “insuring between 32 million and 34 million additional people will generate between 848,000 and 901,000 additional emergency room visits every year.”  This is just another example of the negative impact ObamaCare may have on our already-overburdened health care system and economy.

Be Wary: Scammers Peddling Fake Texas Health Insurance

Saturday, June 19th, 2010

texas health insuranceHealth care reform has already caused mass confusion, and now scam artists are capitalizing on consumer uncertainty and making matters worse.  Unscrupulous individuals and businesses are offering fake Texas health insurance to the unsuspecting public.  Cases seen to date include nonexistent companies soliciting insurance and insurance being offered by companies not authorized to operate in Texas.  In April alone, 26 cease and desist orders were issued against entities engaging in such practices.

According to the Dallas Morning News, Kathleen Sebelius, U.S. Health and Human Services secretary, said in a letter to state insurance commissioners:

“Unfortunately, scam artists and criminals may be using the passage of these historic reforms as an opportunity to confuse and defraud the public…Media accounts indicate that fraudsters have gone door to door selling phony insurance policies,” she wrote. “Some have attempted to make dishonest profits by urging consumers to obtain coverage in a nonexistent ‘limited enrollment’ period that they falsely claim was made possible by the new legislation.”

Since these fake Texas health insurance plans are not backed by financial reserves, the insurers in question likely have no ability or desire to pay claims.  Consumers swindled by these scams may be left without insurance in a time of need.  To protect yourself from fraudulent insurance schemes, regulators have warned people to be wary of anyone claiming to be with the federal government and trying to sell you insurance.  Texas health insurance policies are sold and issued by companies, not government officials.  And be alert to sophisticated sales pitches. The Morning News notes that in some states, fraudulent sales representatives are attempting to sell a bogus product called an “ObamaCare Insurance Policy.”

Unfortunately, scam artists will always attempt to make a buck at the expense of confused consumers, so do what you can to protect your health and keep your finances secure.  If you have questions about health care reform, or need to obtain insurance, work with a licensed Texas health insurance broker, or contact a reputable, well-known health insurance carrier in your state.

Firms May Drop Texas Health Insurance, Pay Fines Instead

Friday, May 14th, 2010

texas health insuranceDuring Obama’s posturing for health care reform, one of his biggest sound bites was telling us that, if we like our current Texas health insurance, we can keep it.  It was a recurring statement meant to sooth some fears regarding such a massive overhaul to our health care system.  And while it may be true that the government won’t technically restrict us from continuing with our preferred health insurers, the reality is that some employers will simply end our coverage.

Under the new laws, many employers can save money by dropping the Texas health insurance plans they provide to their employees.  Rather than subsidize comprehensive group plans, employers can encourage their workers to find their own health insurance through the government-run exchanges.  This will result in fines for companies with more than 50 employees, but the fines are expected to be significantly smaller than the cost of keeping a workforce insured.

The Dallas Morning News reports that, “in the case of Dallas-based AT&T Inc., the move could mean saving billions of dollars per year.”  AT&T paid about $2.4 billion last year in health insurance costs for its 283,000 workers.  If the company were to push all those workers onto government subsidized exchanges, it would only have to pay an annual penalty of $600 million. Those are some serious savings for the company, which employs more than 14,000 workers in the Dallas area alone.

And the ramifications of the new health care law may become a big issue for taxpayers as well.  According to calculations by Fortune magazine, “if half of all people covered by company plans get bumped to the exchanges, it would raise the price tag of the new law by $160 billion a year.”  So adding insult to injury, it’s likely that we’ll have to pay a premium for losing our preferred Texas health insurance plan.

The True Cost of ObamaCare

Wednesday, April 28th, 2010

Cost of ObamaCareIt’s no secret that ObamaCare is going to be expensive.  And it’s no secret that cost estimates provided by the Congressional Budget Office are laced with hopes and dreams rather than common sense and responsible accounting.  But until now, most critiques of Obama’s health care reform legislation have come from republicans and concerned citizens.  Changing that is Rick Foster, the Chief Actuary of Medicare, a division within the nonpartisan Department of Health and Human Services.

Foster’s report details the costs, savings and coverage impacts expected as a result of health care reform.  The findings, which refute the Administration’s claims regarding improvements in care, cost savings and coverage, are not startling to most independent health care economists, but it’s surprising and refreshing that this 38 page report comes from a respected agency within the federal government.

John Goodman of the National Center for Policy Analysis provides some key summaries taken directly from the Actuary’s report:

Health care costs will increase, not decrease
National health expenditures will increase from 17 percent of GDP now to 21 percent under the new law and will be higher than without the legislation. Net federal spending on health care will also increase.

Expect health care shortages
Because of the increased demand for health care, “supply constraints might initially interfere with providing the services desired by the additional 34 million insured persons.”

14 million employees will lose their employer coverage
Under the new laws, many employers can save money by dropping their sponsored plans.  Employees of small firms are especially at risk.

A Medicaid insurance card is not a guarantee of care
An estimated 18 million people will be added to Medicaid, but because there is no corresponding increase in the supply of caregivers, “it is reasonable to expect that a significant portion of the increased demand for Medicaid would be difficult to meet, particularly over the first few years.”

Higher taxes will lead to higher premiums
The new taxes on medical devices, prescription drugs, and insurance plans “would generally be passed on through to health consumers in the form of higher drug and device prices and higher insurance premiums.”

The promise to those with pre-existing conditions is unfunded
“By 2011 and 2012 the initial $5 billion in federal funding [for those with pre-existing conditions] would be exhausted, resulting in substantial premium increases to sustain the program.”

That’s just a taste of what we can expect from ObamaCare, a massive piece of legislation that 58% of Americans want repealed.  It will be interesting to see the impacts felt by our country as these reforms roll out over the next few years.  Millions of Americans will experience cost and tax increases, and millions more will notice a reduction in the quality of their health care, so do what you can to prepare yourself and your family.

Health Care Reform Predicted to Cost Texas $27 Billion

Friday, April 9th, 2010

texas health insurance, texas health care reformIt’s no secret that health care reform is going to be expensive.  The majority of changes don’t go into effect until 2014, but states are already estimating the cost to implement reforms.  For Texas, that cost equals $27 billion over ten years, according to Health and Human Services Commission chief Tom Suehs.

Suehs told lawmakers that part of the price tag goes toward adding about 2.1 million Texans to Medicaid and the Children’s Health Insurance Program (CHIP), and about $5.5 billion will be allocated to paying doctors and other primary care providers more, so they’ll see these patients.   “We’ve got to make sure we have the physician community out there that’s willing to participate in Medicaid,” said Suehs.

Texas Senator Bob Deuell, a physician by trade, applauded Suehs’ emphasis on making sure doctors participate in Medicaid and CHIP.  “Having insurance doesn’t mean you have access to health care,” said Deuell.

But Democrats have balked at the $27 billion figure, calling the number “sticker shock” and an unrealistic overestimation of future costs.  Regardless of the final price tag, ObamaCare is going to cost Texas vast sums of money.  Citizens should expect to pay higher taxes to pay for impending reforms, as well as higher Texas health insurance premiums, as insurers look to offset the steep costs associated with covering a larger network of individuals.

All we can do now is take steps to prepare for the looming changes and cross our fingers that the benefits of health care reform might outweigh the financial burden being placed on states and citizens alike.

For more on this story, see The Dallas Morning News report.