Monday, September 30, 2013

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

Older Adult Health Insurance Counseling
APPRISE 412-661-1438 or
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
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 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
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

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Friday, September 27, 2013

Kasich makes faith argument for Medicaid | The Columbus Dispatch


Talking to reporters, Kasich pleaded for legislators to approve the expansion.

“The most-important thing for this legislature to think about: Put yourself in somebody else’s shoes. Put yourself in the shoes of a mother and a father of an adult child that is struggling. Walk in somebody else’s moccasins. Understand that poverty is real.”

Kasich continued: “I had a conversation with one of the members of the legislature the other day. I said, ‘I respect the fact that you believe in small government. I do, too. I also know that you’re a person of faith.

‘Now, when you die and get to the meeting with St. Peter, he’s probably not going to ask you much about what you did about keeping government small. But he is going to ask you what you did for the poor. You better have a good answer.’ ”

Kasich makes faith argument for Medicaid | The Columbus Dispatch

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Wednesday, September 25, 2013

What Do PPACA Standards Mean for Employers’ Health Plans? | Towers Watson - Towers Watson


Large employer and self-insured plans

Employers with 101 or more employees may not purchase coverage for their employees through the state insurance exchanges, at least until 2017.6 Employer plans need not cover all 10 essential benefits or classify their plans into actuarial value tiers. Nevertheless, the PPACA requires large-employer-insured plans and all self-insured plans, whether offered by large or small employers, to meet similar standards for benefit generosity and plan affordability:

  1. Actuarial value: Under the PPACA’s employer pay-or-play mandate, employers with 51 or more full-time employees must offer at least one plan with an actuarial value of at least 60% or face potential penalties. Employees of large firms that fail this “minimum value” standard may become eligible for federal premium assistance tax credits to buy coverage in the exchanges. When employees qualify for these credits, the employer must pay a penalty of $2,000 per full-time employee or $3,000 per full-time employee receiving a premium assistance tax credit, whichever is less. Large firms that do not offer a health plan to all full-time employees also face a penalty of $2,000 per full-time employee.7
  2. “Core” benefits: Most plans offered by large employers already include benefits similar in scope to the 10 statutory essential health benefits, but the law does not require large-employer-insured plans or any self-insured plans to satisfy this standard. The Internal Revenue Service (IRS) has proposed basing actuarial value calculations for these plans on four “core” categories of health services: physician and midlevel practitioner care, hospital and emergency room services, pharmacy benefits, and laboratory and imaging services.8 The four core categories include 95% of the charges covered by a benchmark plan with broad coverage.9 In practical terms, this difference is likely to have little material impact on actuarial value estimates.
  3. Employer premium contributions: Employees of large firms that offer coverage meeting the minimum value standard are not eligible for premium assistance tax credits or cost-sharing subsidies in an exchange unless their share of the employee-only premium in the employer’s lowest-cost plan exceeds 9.5% of family income. Employers whose coverage does not meet this affordability standard must pay the same financial penalty as firms that fail the minimum value requirement. The IRS proposed regulation applied the affordability standard only to single coverage, but the final regulation suggested that future guidance will address family affordability. The regulation could make nonemployee family members eligible for premium tax credits where the self-only coverage is affordable but the family coverage is not.
How do current employer plans compare with exchange standards?

Figure 1 depicts key cost-sharing provisions for prototypical plans that might be offered in the four exchange tiers in the individual market. These plan designs are largely similar to plans that employers currently offer with the exception of the bronze plan, which has considerably higher cost sharing than most current employer plans. The $3,000 deductible is about $1,100 higher than the average deductible for an account-based health plan (ABHP) in 2010.10 The PPACA might cap deductibles for all employer-sponsored plans at $2,000 (see sidebar), potentially making it difficult for employers to design a plan with a 60% actuarial value.11

Figure 1. Prototypical health plans in each exchange tier

Towers Watson Media

What Do PPACA Standards Mean for Employers’ Health Plans? | Towers Watson - Towers Watson

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Who Will be Uninsured After Health Insurance Reform? - Robert Wood Johnson Foundation


  • The ACA would reduce the number of nonelderly people without health insurance by 28 million—from 18.9 to 8.7 percent.
  • Of the 23 million still uninsured, 40 percent would be eligible for, but not enrolled in, Medicaid or the Children’s Health Insurance Program (CHIP). A further 22 percent would be undocumented immigrants.
  • The majority of those uninsured—19 of the 23 million—would be nonelderly adults:
    • Thirty-seven percent—mostly young singles without dependents—would be eligible for Medicaid, but not enrolled.
    • Twenty-five percent would be undocumented immigrants.
    • Sixteen percent would be exempt from the individual mandate because they would not have an affordable insurance option.
    • Eight percent would be eligible for affordable subsidized coverage in the health benefit exchanges.
    • The remaining 15 percent—most higher-income families with dependents—would likely be subject to the mandate, having an affordable private insurance option despite not qualifying for a subsidy.
  • Who Will be Uninsured After Health Insurance Reform? - Robert Wood Johnson Foundation

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    Michigan's Approach to Medicaid Expansion and Reform — NEJM


    Five core principles are evident in Michigan's approach to expanding and reforming Medicaid under the ACA. First, the state must achieve sufficient savings to offset its contributions for the Medicaid expansion when federal funding drops from 100% to 95% in 2017 and to 90% in 2021. Medicaid coverage of some state-financed health services, including mental health and prison health programs, is expected to result in approximately $200 million in savings for the state budget in 2014. If the state's costs are not offset by such savings, Michigan will withdraw from the Medicaid expansion in 2017 or later years. But current projections indicate that the state's cumulative savings should cover the additional costs through 2027.5

    Second, Michigan will introduce financial incentives for new Medicaid enrollees to control their use of health care services and to maintain healthy behaviors. For 150,000 new enrollees with incomes between 100% and 133% of the federal poverty level, cost sharing amounting to as much as 5% of their annual income (approximately $580 to $775 for a single adult) is slated to begin 6 months after Medicaid enrollment. After 48 months of Medicaid coverage, cost sharing for these new enrollees will increase to 7% of their annual income, or they can choose to enroll in subsidized private insurance offered through the state's health insurance exchange. A system resembling health savings accounts will be created for individuals or their employers to deposit funds to cover copayments for health care services. Cost sharing can be reduced to 2% of annual income for new enrollees who demonstrate that they engage in healthy behaviors.

    Third, the state will enroll newly eligible adults in private health plans rather than in traditional fee-for-service Medicaid. Health plans will be eligible for financial bonuses for effectively managing enrollee cost sharing required by the state and for achieving cost and quality targets. Health plans will also be directed to implement value-based insurance design by varying cost sharing according to the clinical value of services provided.

    Fourth, Michigan's new law addresses health care delivery by requiring that new enrollees have access to primary care and preventive services. New enrollees will also be offered the opportunity to complete advance directives for end-of-life care when they enroll in Medicaid — part of a broader state initiative to encourage residents to express their preferences regarding end-of-life care.

    Fifth, Michigan's new Medicaid law enhances the state's capacity to monitor the costs and quality of health care. The Department of Community Health, which oversees the Medicaid program, will assess opportunities for improving the Medicaid program and make Medicaid data available to outside vendors that can help participating health plans to pursue innovations in the program. The Department of Insurance and Financial Services will evaluate the effect of the Medicaid expansion on private insurance premiums in the state; some reduction in these premiums is anticipated.3,5 A new Health Care Cost and Quality Advisory Committee will be created to promote greater transparency with respect to the costs and quality of care.

    Michigan's Approach to Medicaid Expansion and Reform — NEJM

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    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

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    Monday, September 23, 2013

    Primary Payer Status Affects Mortality for Major Surgical Operations

    This is the famous “Medicaid is worse than no insurance” study. It’s worth jumping to the full study and reading the Discussion section, as the authors do a pretty good job of pointing out why Medicaid patients, like the uninsured, are so darn sick and do so poorly in the health system. But, it does not say what they (the Right) think it says!


    In this study, we conclude that Medicaid and Uninsured payer status confers increased risk adjusted in-hospital mortality compared with Private Insurance for major surgical operations in the United States. Medicaid is further associated with higher postoperative in-hospital complications as well as the greatest adjusted length of stay and total costs despite risk factors or the specific major operation. These differences serve as an important proxy for larger socioeconomic and health system-related issues that could be targeted to improve surgical outcomes for US patients.
    Primary Payer Status Affects Mortality for Major Surgical Operations

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    What is Medicaid’s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence – Issue Brief | The Henry J. Kaiser Family Foundation

    Finding #1:  Having Medicaid is much better than being uninsured.

    Consistently, research indicates that people with Medicaid coverage fare much better than their uninsured counterparts on diverse measures of access to care, utilization, and unmet need. A large body of evidence shows that, compared to low-income uninsured children, children enrolled in Medicaid are significantly more likely to have a usual source of care (USOC) and to receive well-child care, and significantly less likely to have unmet or delayed needs for medical care, dental care, and prescription drugs due to costs.3 4 5 6
    The research findings on adults generally mirror the patterns for children. A synthesis of the literature on the impact of Medicaid expansions for pregnant women concluded, “…the weight of evidence is that expansions led to modest improvements in prenatal care use, in terms of either earlier prenatal care or more adequate prenatal care, at least in some states and for some groups affected by the expansions.”7 Mothers covered by Medicaid are much more likely than low-income uninsured mothers to have a USOC, a doctor visit, and a dental visit, and to receive cancer screening services.8 Nonelderly adults covered by Medicaid are more likely than uninsured adults to report health care visits overall and visits for specific types of services; they are also more likely to report timely care and less likely to delay or go without needed medical care because of costs.9 Projections from a recent analysis show that, if Medicaid beneficiaries were instead uninsured, they would be significantly less likely to have a USOC and much more likely to have unmet health care needs; except for emergency department care, their use of key types of services would also drop significantly. At the same time, their out-of-pocket spending would increase dramatically – almost four-fold on average.10 Other research provides evidence of increased access to care and health care utilization for previously uninsured low-income adults who gain Medicaid coverage under state expansions of eligibility.11
    Keep reading! (link below)
    What is Medicaid’s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence – Issue Brief | The Henry J. Kaiser Family Foundation

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    Sunday, September 22, 2013

    JAMA Network | JAMA Internal Medicine | Medicare Payment for Cognitive vs Procedural Care: Minding the Gap


    Importance Health care costs in the United States are rising rapidly, and consensus exists that we are not achieving sufficient value for this investment. Historically, US physicians have been paid more for performing costly procedures that drive up spending and less for cognitive services that may conserve costs and promote population health.

    Objective To quantify the Medicare payment gap between representative cognitive and procedural services, each requiring similar amounts of physician time.

    Results The revenue for physician time spent on 2 common procedures (colonoscopy and cataract extraction) was 368% and 486%, respectively, of the revenue for a similar amount of physician time spent on cognitive care.

    Conclusions and Relevance Our analysis indicates that Medicare reimburses physicians 3 to 5 times more for common procedural care than for cognitive care and illustrates the financial pressures that may contribute to the US health care system’s emphasis on procedural care. We demonstrate that 2 common specialty procedures can generate more revenue in 1 to 2 hours of total time than a primary care physician receives for an entire day’s work.

    JAMA Network | JAMA Internal Medicine | Medicare Payment for Cognitive vs Procedural Care:  Minding the Gap

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    JAMA Network | JAMA | Views of US Physicians About Controlling Health Care Costs


    Physicians’ views about health care costs are germane to pending policy reforms.

    Objective To assess physicians’ attitudes toward and perceived role in addressing health care costs.

    Results A total of 2556 physicians responded (response rate = 65%). Most believed that trial lawyers (60%), health insurance companies (59%), hospitals and health systems (56%), pharmaceutical and device manufacturers (56%), and patients (52%) have a “major responsibility” for reducing health care costs, whereas only 36% reported that practicing physicians have “major responsibility.” Most were “very enthusiastic” for “promoting continuity of care” (75%), “expanding access to quality and safety data” (51%), and “limiting access to expensive treatments with little net benefit” (51%) as a means of reducing health care costs. Few expressed enthusiasm for “eliminating fee-for-service payment models” (7%). Most physicians reported being “aware of the costs of the tests/treatments [they] recommend” (76%), agreed they should adhere to clinical guidelines that discourage the use of marginally beneficial care (79%), and agreed that they “should be solely devoted to individual patients’ best interests, even if that is expensive” (78%) and that “doctors need to take a more prominent role in limiting use of unnecessary tests” (89%). Most (85%) disagreed that they “should sometimes deny beneficial but costly services to certain patients because resources should go to other patients that need them more.” …

    JAMA Network | JAMA | Views of US Physicians About Controlling Health Care Costs

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    Sunday, September 8, 2013

    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

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    Thursday, September 5, 2013

    Uninsured in Texas and Florida -


    A new Census Bureau report documents the alarming percentages of people in Texas and Florida without health insurance. Leaders of both states should hang their heads in shame because they have been among the most resistant in the nation to providing coverage for the uninsured under the Affordable Care Act, the law that Republicans deride as “Obamacare.”

    Uninsured in Texas and Florida -

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    “Secretary of ‘splaining” -


    “I have agreed to give this talk today because I am still amazed at how much misunderstanding there is about the current system of health care, how it works, how it compares with what other people in other countries pay for health care,” Mr. Clinton told the crowd assembled in a hall around the corner from a montage of black-and-white photographs of the 1992 presidential campaign. The audience of about 250 included Gov. Mike Beebe, a Democrat, and Speaker Davy Carter of the Legislature and Michael Lamoureux, president of the State Senate, both Republicans.

    Despite the bipartisan show, health care is a contentious topic in Arkansas politics that conservatives have seized on in local campaigns. Mr. Pryor did not attend the event for risk of being too closely associated with the health care law, according to one person with knowledge of his plans, but who was not authorized to discuss them publicly. A campaign spokesman has said that Mr. Pryor had a scheduling conflict.

    With the new insurance markets set to open on Oct. 1 for an initial six-month enrollment period, the White House has asked cabinet officers and other presidential appointees to step up efforts to promote the law. The administration has also recruited actors and entertainers and is seeking athletes and disc jockeys to whip up enthusiasm. Last week, the singer Katy Perry retweeted a Twitter post from President Obama encouraging young people to sign up for coverage. He responded, “Thanks for spreading the word.”

    Mr. Clinton’s speech, which the White House broadcast live on its Web site, was not the first time that the former president, whose own attempt to sell a universal health care law failed drastically in his first term, has stepped into the debate over the new law. At the Democratic National Convention last September, Mr. Clinton delivered an endorsement of Mr. Obama that included concrete, well-received explanations of his policies, including on health care. That speech in particular signaled to the White House that Mr. Clinton could be an effective surrogate to sell the highly complicated Affordable Care Act.

    On Wednesday, the former president carefully laid out Mr. Obama’s plan without delving into politics. But his mere involvement in selling the law provides him with a platform to reframe the failed battles of “Hillarycare” from his own administration.

    “It would not be in her interest to be running for president and have this be a huge controversial issue in 2016,” said Robert J. Blendon, a professor of health policy at Harvard who closely follows public opinion of the law. “The Clintons have a lot of interest in getting this up and working and making it a legacy for the Democratic side.”

    Reading glasses perched on his nose, Mr. Clinton struck a professorial tone as he explained in extensive detail the intricacies of the act. He laid out who would qualify for federal subsidies to help pay for the cost of coverage through the new markets and even ticked off Web addresses and phone numbers where Americans could find information.

    Clinton Urges Americans to Sign Up for Health Care Exchanges -

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    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

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    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

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    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

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    Sunday, September 1, 2013

    Doctors and Their Medicare Patients -

    In the critics’ most dire scenarios, baby boomers nearing retirement age could find that their current doctors are no longer willing to treat them under Medicare and that other doctors are turning them down as well. Those concerns have always been greatly exaggerated. Now a new analysis by experts at the Department of Health and Human Services should demolish that mythology for good.
    The analysts looked at seven years of federal survey data and found that doctors are not fleeing Medicare in droves; in fact, the percentage of doctors accepting new Medicare patients actually rose to 90.7 percent in 2012 from 87.9 percent in 2005. They are not shunning Medicare patients for better-paying private patients, either; the percentage of doctors accepting new Medicare patients in recent years was slightly higher than the percentage accepting new privately insured patients.
    Medicare patients had comparable or better access to medical services than the access reported by privately insured individuals ages 50 to 64, who are just below the age for Medicare eligibility. Surveys sponsored by the Medicare Payment Advisory Commission, an independent agency that advises Congress, found that 77 percent of the Medicare patients — compared with only 72 percent of privately insured patients — said they never had an unreasonably long wait for a routine doctor’s appointment last year.
    The findings from this survey and others can be sliced and diced in many ways. But the overall picture is clear: nationwide there is no shortage of doctors for Medicare patients. It is likely to stay that way, because Medicare is a big insurer that few medical practices can afford to ignore.
    Doctors and Their Medicare Patients -

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