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Archived Articles - 2

Health Coverage for All – Who Wins and Who Loses

As the health care debate heats up it is important to take a step back and look at the facts as they exist right now. With several competing bills making their way through the House and the Senate, and with President Obama presenting his own ideas for reforming health care, it is a good idea to look at the proposals as they have been laid out. Understanding each proposal and how it will affect individuals employers and the country as a whole will help to put things in perspective.

With so much shouting on both sides of the aisle the real facts are easily obscured, but it is up to every American to do his or her own homework and determine whether or not to support the health care reform proposals as they exist today.

Mandatory Health Insurance Coverage
One of the hallmarks of the health coverage reform measures as they exist today is mandatory health insurance coverage. The proposals now under consideration mandate that every individual who can afford health insurance coverage purchase a policy to protect themselves. Under the bill making its way through the Senate finance committee individuals who refuse to purchase affordable health insurance coverage will face a fine ranging from $750 for individuals to over $3,000 for high income families.

It can be a bit hard to determine the winners and losers under this scenario, but it may be safe to assume that young healthy workers who choose to forgo health insurance coverage may end up on the losing side of the equation – at least from their own point of view. Many young workers, even those who earn a good living, often choose to go without health insurance – essentially rolling the dice and assuming that nothing bad could happen to them. Of course when a health crisis does arise those young healthy workers may find themselves facing financial ruin – or passing the burden of their care on to the rest of the taxpayers.

A Public Option
There has been a great deal of debate over the so-called public option in health care reform. The public option as envisioned by President Obama and the Democrats in Congress would consist of a government run program that competes with private health insurers. The idea behind the plan is that competition will help to drive prices down and prevent some of the most egregious abuses of the health care industry.

The winners and losers in the public option can be a bit difficult to sort out as well, but many people feel that private insurers will lose out to the public plan because the government plan will not have to turn a profit. Many who are opposed to health care reform feel that the inclusion of a public option will eventually drive private health insurers out of business. On the other hand a public option can help to make health insurance more affordable for individuals, and those who are in favor of such a plan feel that the public option will help to keep health insurance costs under control.

Coverage for Preexisting Conditions
Many observers on both sides of the aisle feel that the exclusion of preexisting conditions places an unfair burden on individuals who need to purchase their own health insurance coverage. Many consumers find themselves unable to change jobs or strike to on their own because a preexisting health problem prevents them from buying health insurance coverage on the open market. Many people with health conditions like diabetes, heart disease and a history of cancer find themselves unable to buy health insurance at all, and even when insurance is available it is often prohibitively expensive.

The plans under consideration would all prevent insurers from refusing coverage for those with preexisting conditions, and unlike many parts of the health care reform plan this change seems to have strong bipartisan support. With this proposal, the winners and losers are quite clear. Individuals with preexisting health conditions will be the winners under this scenario. And since they will no longer be permitted to refuse coverage or charge more for riskier individuals health insurance companies stand to lose – with lower profits and more risk.

Expanded Eligibility for Medicaid
Another hallmark of the health insurance reform plans making their way through Congress is expanded eligibility for Medicaid. This government program currently provides health coverage for the poorest Americans, but under the new health insurance plans eligibility would be expanded to more people. The exact requirements vary from plan to plan, but expanded eligibility for Medicaid is a big part of the health reform measures under consideration.

This expanded Medicaid eligibility will offer benefits to individuals who would otherwise be eligible for government subsides. By expanding eligibility requirements the government will provide assistance to more individuals, including those who currently make too much to be eligible but too little to afford health insurance coverage on their own. Expanded Medicaid eligibility will also be a boon to companies who provide coverage to Medicaid patients. Some of the largest health insurance companies compete in this area, and the proposed changes could offer expanded opportunities to the biggest players in this marketplace.

Some health care providers, including medical clinics, hospitals and individual doctors, could end up losing if Medicaid eligibility is expanded, especially if reimbursement levels remain at their current levels or go down. The reimbursement levels for Medicaid are already quite low, and expanded coverage could place additional downward pressure on those reimbursement rates.

No matter which side of the aisle you find yourself on, it is important to understand the proposed changes to our health care system. Listening to the pundits can provide an unrealistic idea of what is – and is not – included in the bills, so it is important for every American to do his or her own research to determine exactly what health care reform will mean if and when a bill is passed by Congress and signed by President Obama.

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Is your COBRA about to expire?

See below for information about your CALIFORNIA INDIVIDUAL HEALTH INSURANCE coverage rights under the federal HEALTH INSURANCE Portability and Accountability Act (HIPAA).

HIPAA (HEALTH INSURANCE Portability and Accountability Act)

HIPAA is a Federal law that does three things:
1) it makes it easier to take your HEALTH information with you when you change employers,
2) it sets very strict rules about the privacy of your medical records, and
3) it gives you the right to purchase INDIVIDUAL HEALTH INSURANCE after you've used up your COBRA benefits (see "COBRA").
It was also very difficult to obtain insurance after COBRA benefits ran out. HIPAA improved these shortcomings.
If you have been covered by health insurance including COBRA and have exhausted all COBRA/CalCOBRA benefits with no break longer than 63 days, HIPAA gives you the right to buy INDIVIDUAL HEALTH coverage with few or no limits on pre-existing conditions.

COBRA

COBRA (Consolidated Omnibus Budget Reconciliation Act)Have you recently left your employer? COBRA allows former employees, retirees, and their dependents to temporarily keep their health coverage at group rates. It is more expensive than group insurance. Why? When you are employed, your employer usually pays some or all of the premium for your health insurance. COBRA participants pay the entire premium themselves.
You have responsibilities to make sure your COBRA coverage goes into effect and stays in effect. You must decide to accept or reject COBRA during a certain time period (usually 60 days away notification from employer). Your former employer's plan administrator must mail you the COBRA information and forms within 14 days after receiving notification from your former employer of the qualifying event. If you do not ask for COBRA coverage before the deadline you may lose the right to COBRA coverage. You must also be sure to pay your monthly premiums or you can lose your coverage.
You may be entitled to obtain an extension of coverage under CalCOBRA. When all COBRA/CalCOBRA extensions are exhausted, you can obtain individual health insurance under HIPAA (see "HIPAA").

HMO

HMO (Health Maintenance Organization)
An HMO is a collection of hospitals, doctors, and other health services all organized under one network. HMOs keep costs down while providing a full range of health services. You usually pay only small co-pays when using services, no matter how many or what kind of services you use. In return, though, you must usually use the hospital(s), doctors, and other health providers in the HMO's network. In an HMO, you select a primary care physician. If you need a specialist, the primary care physician must first refer you to that specialist before you can see them.

PPOs

PPO (Preferred Provider Organization)
In a PPO, insurance companies contract with doctors, hospitals, and other providers to form a "network."
You can sometimes get health care outside the network (someone or someplace not included in the network) but you will have to pay more. Unlike an HMO, you also have to pay a deductible and coinsurance.
Yyou usually can see a specialist without first being referred by your primary care physician, and you have much more freedom in choosing a doctor or hospital. PPOs in California are regulated by both California Department of Insurance (CDI) and Department of Managed Health Care (DMHC).

Choosing Your Doctor

If you like your doctor and he or she is not a member of the HMO network, you will probably want to choose a PPO so that you can continue seeing him or her.
It will be better than having no HEALTH INSURANCE at all.

HSA

HSA (Health Savings Account)
In an HSA, you contribute money to a special bank account to be used for medical bills. You get a Federal tax deduction on the money you contribute to your HSA, and if you use the money for medical expenses, you pay no Federal tax or penalty on it.
The HSA account can also earn Federal tax-free interest. Note: there is no California tax exemption for your HSA contribution, or for the interest the account earns.
HSA's always go along with a high-deductible HEALTH INSURANCE plan -- a $1,500 deductible, for example.

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