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

 

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

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

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

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

Sphere: Related Content

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

Older Adult Health Insurance Counseling

APPRISE

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

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

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

Health Insurance Coverage, Department of Human Services, Allegheny County

Sphere: Related Content

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

Sphere: Related Content

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

Sphere: Related Content

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

Sphere: Related Content

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

Sphere: Related Content

'Premium Shock' and 'Premium Joy' Under the Affordable Care Act - NYTimes.com Uwe Reinhardt

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

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

'Premium Shock' and 'Premium Joy' Under the Affordable Care Act - NYTimes.com

Sphere: Related Content

Market, insurers will keep premiums low, analysts say

Just how much premiums will change depends on the state you live in, Kingsdale said.
Individual premiums decreased when Massachusetts' health care took effect, he said, because the state already had high-priced and insurers were not allowed to turn away the sick and could not charge large premium differences based on age, gender and health.
"Other states will see exactly the opposite happen," he said. "Their premiums tend to be quite low, but they're getting skimpy insurance."
In Oregon, Ario said, large differences in premium prices have already appeared.
In one case, a 40-year-old non-smoker in Oregon could buy a low-cost or bronze-level plan for $162 a month from one company or the same plan from another for $400 a month, Ario said. Anti-trust laws prevented the insurers from comparing pricing before developing their premiums.
When the companies with the higher rates saw their competitors' lower premiums, he said, they asked the state to allow them to file for reduced premiums.
"The good news is that in most marketplaces, there will be some carriers that will be bold and price competitively to get more market share," Ario said.

Market, insurers will keep premiums low, analysts say

For a quick rundown on what the "gold, silver, and bronze" plans will cover, go here.

Sphere: Related Content

Eleven Alternatives to Obamacare's Individual Mandate - Businessweek

Eleven Alternatives to Obamacare's Individual Mandate - Businessweek

The short version:

1. Relabel the mandate to escape the high court’s scrutiny. Give people a tax credit if they do carry insurance, which is functionally the same as penalizing them if they don’t. Sound like a sly evasion? It’s essentially the approach advocated by House Budget Committee Chairman Paul Ryan.

2. Increase subsidies, such as the law’s existing set of tax credits for low-income Americans, to induce more people to sign up voluntarily. This would be along the lines of the enticements in Medicare Parts B (doctors’ and outpatient services) and D (prescription drugs).

3. Use government funds to compensate insurers for the cost of “adverse selection,” in which only sick people sign onto their plans.

4. Have the government and/or employers enroll people into health plans automatically, but with an option to drop insurance. Count on inertia and procrastination to keep them in the system.

5. Require people who go without insurance to sign a form acknowledging that they won’t be able to get back in for five years, even if they have an accident or contract a costly disease and want to get covered right away.

6. Leave it to the 50 states to enact their own mandates under state law, which would not be subject to Supreme Court review.

7. Penalize people who delay enrolling. Charge them more or strip them of the right to buy insurance at a standard rate regardless of preexisting conditions. There’s a precedent in Medicare: People who enroll in Medicare Part B after age 65 pay a 10 percent penalty on their Part B premium unless they have employer-provided health insurance.

There are more, but these are the more reasonable ones...

Sphere: Related Content

Small Business Majority | Small Business Owners’ Views on Implementing the Affordable Care Act

Small Business Majority | Small Business Owners’ Views on Implementing the Affordable Care Act

Key findings:

• Only a third of small business owners want the Supreme Court to overturn the Affordable Care Act; a plurality of 50% would like it upheld, with minor or no changes. This support grows after learning more details about the law’s key provisions:
  Only 34% of small businesses want to see the healthcare law overturned, while 50% want it to remain intact with, at most, minor changes. After learning more about its specifics, only 28% want to see it repealed and a 56% majority want it to be kept, as is or with minor changes. A 55% majority say they want it upheld because we need to make sure everyone has health coverage.
  
  Figure 1: After learning about the law, support for the Affordable Care Act grows
  

  There has been a lot of talk about the nation's health care reform law, the Patient Protection and Affordable Care Act. Which one of the following statements comes closest to your point of view when it comes to this law.

  
  
  
  

  After everything you read, which one of the following statements comes closest to your point of view when it comes to the nation's healthcare reform law, the Patient Protection and Affordable Care Act.

  
  
  
• By an 8:1 margin, entrepreneurs say they’d consider using a state health insurance exchange, and they favorably view many possible features of the exchange:
  A 66% majority of small business owners say they would use their state exchange or at least consider using it, compared to 8% who say they would not consider using it when they provide benefits. By wide margins, entrepreneurs find a host of possible features of the exchange very appealing. By a 2:1 ratio, small business owners support their state applying for federal funds to set one up.
  

Sphere: Related Content

Broccoli - Doctors for America

Broccoli - Doctors for America:

The health care market is unlike any other market because health care costs are unpredictable and are not meaningfully bounded on the upside. Break an arm and your costs could be in thousands of dollars. Have a heart attack and you’re in the tens of thousands of dollars. Get cancer and you could enter the hundreds of thousands of dollars category. There’s no way to prepare for such illnesses and their costs. That’s why health insurance exists, to smooth out these costs over a lifetime and to pool our resources to help those with catastrophic costs to pay for them. The purpose of mandating the purchase of health insurance is to have everyone pay into a system that they will eventually use. Equating broccoli and health insurance is specious and a sign of bad faith on the part of those making that argument. As far as I know, nobody has died because they couldn’t get their hands on some broccoli.

When broccoli is 1/6th of the economy of the nation, give me a holler. Maybe then it should be regulated.

In the meantime, what we are hearing is a deliberately misleading meme about 'limiting principles," AKA, "where do we draw the line?" My answer is that we don't draw the line at health care, a fundamental human need that now accounts for one sixth of all economic activity in the US. This is clearly NOT where to draw the line. We can argue about where TO draw the line when the Federal Government tries to mandate burial insurance or some other completely random pseudo-analogy thought up by Fox News and fellow travelers.

Sphere: Related Content

The ACP Advocate Blog by Bob Doherty: Irony

The ACP Advocate Blog by Bob Doherty: Irony

Good piece on the GOPs history of advocating for an individual mandate - until Democrats suported it:

In 1990, the conservative Heritage Foundation developed a plan for universal coverage that described the individual mandate as a “social contract” between the government and individuals:“Under this social contract, the federal government would agree to make it financially possible, through refund able tax benefits or in some cases by providing access to public-sector health programs, for every American family to purchase at least a basic package of, including catastrophic insurance. In return, government would require, by law every head of household to acquire at least a basic health plan for his or her family."
The individual mandate was then incorporated into bills proposed by GOP stalwarts Orrin Hatch (R-UT) and Chuck Grassley (R-IO) as an alternative to “Hillary Care.” It later became a lynchpin of the Massachusetts health reform plan championed by then governor (and likely 2012 presidential candidate) Mitt Romney (R-MA).
That was then, this is now.
The Heritage Foundation now argues that the individual mandate is “unprecedented” and “unconstitutional”- conveniently ignoring its own past ownership of the idea. A few days ago, Senator Hatch hailed the Virginia judge’s decision to overturn the individual mandate as “a great day for liberty. Congress must obey the Constitution rather than make it up as we go along. Liberty limits on government, and today those limits have been upheld.”

Sphere: Related Content

The Militia Act of 1792

The Militia Act of 1792:

Be it enacted by the Senate and House of Representatives of the United States of America, in Congress assembled, That each and every free able-bodied white male citizen of the respective States, resident therein, who is or shall be of age of eighteen years, and under the age of forty-five years (except as is herein after excepted) shall severally and respectively be enrolled in the militia, by the Captain or Commanding Officer of the company, within whose bounds such citizen shall reside, and that within twelve months after the passing of this Act. And it shall at all time hereafter be the duty of every such Captain or Commanding Officer of a company, to enroll every such citizen as aforesaid, and also those who shall, from time to time, arrive at the age of 18 years, or being at the age of 18 years, and under the age of 45 years (except as before excepted) shall come to reside within his bounds; and shall without delay notify such citizen of the said enrollment, by the proper non-commissioned Officer of the company, by whom such notice may be proved. That every citizen, so enrolled and notified, shall, within six months thereafter, provide himself with a good musket or firelock, a sufficient bayonet and belt, two spare flints, and a knapsack, a pouch, with a box therein, to contain not less than twenty four cartridges, suited to the bore of his musket or firelock, each cartridge to contain a proper quantity of powder and ball; or with a good rifle, knapsack, shot-pouch, and powder-horn, twenty balls suited to the bore of his rifle, and a quarter of a pound of powder; and shall appear so armed, accoutred and provided, when called out to exercise or into service, except, that when called out on company days to exercise only, he may appear without a knapsack.

Thanks to Ezra Klein, Joe Conason and others for pointing this out!

Sphere: Related Content