New Health Incsurance

Understanding New Health Insurance

Week of August 26, 2013

Visit USA.gov's Health Insurance webpage to learn about the new Health Insurance Marketplace and other types of health coverage. Starting October 1, 2013, you can fill out an application for health insurance through the Health Insurance Marketplace. You will be able to compare your options side-by-side and enroll in a plan that fits your budget and meets your needs. Coverage takes effect as early as January 1, 2014.

MEDICARE SAVINGS HEALTH CARE LAW

For Immediate Release:	Thursday, May 24, 2012
Contact:	CMS Office of Public Affairs 202-690-6145

HEALTH CARE LAW SAVED PEOPLE WITH MEDICARE OVER $3.5 BILLION ON PRESCRIPTION DRUGS
IN THE FIRST FOUR MONTHS OF 2012, MORE THAN 416,000 PEOPLE WITH MEDICARE SAVED AN AVERAGE OF $724 ON PRESCRIPTION DRUGS AND 12.1 MILLION USED A FREE PREVENTIVE SERVICE

Under the new health care law – the Affordable Care Act -- seniors and people with disabilities in Medicare have saved a total of $3.5 billion on prescription drugs in the Medicare drug benefit coverage gap or “donut hole” from the enactment of the law in March 2010 through April of 2012. The Centers for Medicare & Medicaid Services (CMS) released data today showing that, in the first four months of 2012 alone, more than 416,000 people saved an average of $724 on the prescription drugs they purchased after they hit the prescription drug coverage gap or “donut hole,” for a total of $301.5 million in savings. These savings build on the law’s success in 2010 and 2011, when more than 5.1 million people with Medicare saved over $3.2 billion on prescription drugs.

In addition, CMS announced that this year, from January through April, 12.1 million people in traditional Medicare received at least one preventive service at no cost to them – including over 856,000 who have taken advantage of the Annual Wellness Visit provided in the Affordable Care Act. In 2011, over 26 million people in traditional Medicare received one or more preventive benefits free of charge.

“Thanks to the health care law, millions of people with Medicare have paid less for health care and prescription drugs,” said CMS Acting Administrator Marilyn Tavenner. “The law is helping people with Medicare lower their medical costs, and giving them more resources to stay healthy.”

People with Medicare who hit the coverage gap “donut hole” in 2010 received a one-time $250 rebate. In 2011, people with Medicare began receiving a 50 percent discount on covered brand name drugs and 7 percent coverage of generic drugs in the “donut hole.” This year, Medicare coverage for generic drugs in the coverage gap has risen to 14 percent. Coverage for both brand name and generic drugs in the gap will continue to increase over time until 2020, when the coverage gap will no longer exist.

For more information on how the Affordable Care Act closes the Medicare drug benefit coverage gap “donut hole,” please visit: http://www.healthcare.gov/law/features/65-older/drug-discounts/index.html.

Prior to 2011, people with Medicare faced cost-sharing for many preventive benefits like cancer screenings and smoking cessation counseling. Now, many of these benefits are offered free of charge to beneficiaries, with no deductible or co-pay, so that cost is no longer a barrier for seniors who want to find and treat problems early.

For more information on Medicare-covered preventive services, many of which are now provided without charge to beneficiaries thanks to the Affordable Care Act, please visit: http://www.healthcare.gov/law/features/65-older/medicare-preventive-services/index.html.

To learn what screenings, vaccinations and other preventive services doctors recommend for you and those you care about, please visit the myhealthfinder tool at www.healthfinder.gov.

Health Care Cost Increase Is Projected

By ROBERT PEAR
WASHINGTON — A government analysis of the new health care law says it will not slow the overall growth of health spending because the expansion of insurance and services to 34 million people will offset cost reductions in Medicare and other programs.

The study, by the chief Medicare actuary, Richard S. Foster, provides a detailed, rigorous analysis of the law.

In signing the measure last month, President Obama said it would “bring down health care costs for families and businesses and governments.”

But Mr. Foster said, “Overall national health expenditures under the health reform act would increase by a total of $311 billion,” or nine-tenths of 1 percent, compared with the amounts that would otherwise be spent from 2010 to 2019.

In his report, sent to Congress Thursday night, Mr. Foster said that some provisions of the law, including cutbacks in Medicare payments to health care providers and a tax on high-cost employer-sponsored coverage, would slow the growth of health costs. But he said the savings “would be more than offset through 2019 by the higher health expenditures resulting from the coverage expansions.”

The report says that 34 million uninsured people will gain coverage under the law, but that 23 million people, including 5 million illegal immigrants, will still be uninsured in 2019.

Republicans said the report vindicated their concerns about the law, which was approved without a single Republican vote. The White House pointed to bright spots in the report and insisted that the law would help bring down costs. In 2004, when Mr. Foster raised questions about cost estimates by the Bush administration, Democrats lionized him as a paragon of integrity.

Mr. Foster says the law will save Medicare more than $500 billion in the coming decade and will postpone exhaustion of the Medicare trust fund by 12 years, so it would run out of money in 2029, rather than 2017. In addition, he said, the reduction in the growth of Medicare will lead to lower premiums and co-payments for Medicare beneficiaries.

But, Mr. Foster said, these savings assume that the law will be carried out as written, and that may be an unrealistic assumption. The cuts, he said, “could become unsustainable” because they may drive some hospitals and nursing homes into the red, “possibly jeopardizing access to care for beneficiaries.”

Nancy-Ann DeParle, director of the White House Office of Health Reform, said that fear was unfounded.

Mr. Foster’s report, which analyzes the effect of the law on national health spending of all types, has a different focus from studies by the Congressional Budget Office, which concentrated on federal spending and revenues and concluded that the law would reduce budget deficits by a total of $143 billion over 10 years.

In his report, Mr. Foster made these points:

¶The government will spend $828 billion to expand insurance coverage over the next 10 years. Expansion of Medicaid accounts for about half of the cost. The number of Medicaid recipients will increase by 20 million, to a total of 84 million in 2019.

¶People who go without insurance and employers who do not provide coverage meeting federal standards will pay $120 billion in penalties from 2014 to 2019. Individuals will pay $33 billion of that amount, while employers pay $87 billion.

¶The law will reduce consumers’ out-of-pocket spending on health care by $237 billion over 10 years, to a total of $3.3 trillion.

Cuts in federal payments to private Medicare Advantage plans will “result in less generous benefit packages,” the report said. By 2017, it said, “enrollment in Medicare Advantage plans will be lower by about 50 percent, from its projected level of 14.8 million under the prior law to 7.4 million under the new law.”




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Health Care Reform hold Insurance Companies Accountable

If Congress now creates new exchanges, as seems increasingly likely, it must prevent this phenomenon by setting two national rules: Insurers have to accept everyone and have to charge everyone the same rates regardless of health status.

Such rules would force insurers to spread risk. But enforcement would also be difficult. Every aspect of health insurance — from the rules for underwriting and setting premiums to the marketing of policies — would need to be monitored stringently to prevent companies from steering all bad risks to the exchanges.

It would be smarter for Congress to revisit the idea of creating a public plan that could provide an attractive choice for consumers and real competition for private insurers, to give them the incentive to offer good coverage at affordable prices.

But without a public plan, tough rules and restrictions on insurance companies will be essential. Otherwise, Americans will never be able to count on good, affordable health care.

Tort Refom 0n Health Insurance Reform

If a so-called "reform" bill comes up with these elements - no employer mandate, strong individual mandate, market rates for everything, no real insurance reform - there is no reason to vote for it. It is worse than no bill at all.
I reviewed your comments closely and what I have not seen or heard is anything that includes tort reform. We know that this bilks out billions of dollars that could be used toward delivery of care. Among the issues are costs for repetitive tests, astronomical premiums for malpractice insurance to all providers, not just doctors. All nurses, therapists, hospitals,outpatient service entities must pay these premiums BEFORE the FIRST patient receives any services. In the mix of all those to be paid in the health care delivery/provider cycle is the amount of money that is frittered away to cover litigation costs for this very sophisticated system we call health care. YES, DEFINITELY, we NEED a way to protect patients from unscrupulous practices. BUT, let us LOOK how this present system of "protection" is SUCKING the life out of the costs reduction efforts. A better approach is to put before PEER review entities outside local care to look at complaints, rather than to allow juries that are not knowledgeable about health care practices to make decisions that are just. It could require practitioners to participate on a fair rotation so that no one gains too much power over this entity. And it also has the benefit of being a continuing educational tool for those serving on it. I can tell you that I learn as much from my journals in the review of cases as I do in reading dry research projects. It puts a human face on the case at hand. This takes litigation OUT of the third parties with the possibility of great financial gain! Claims looked at for Buffalo, NY could be reviewed by a PEER Panel in Omaha. Omaha's claims could be reviewed by PEER review panel in Miami. Miami could be reviewed by PEERS in Denver. If all these claims were done ANONYMOUSLY and without monetary gain by the reviewers, but the insurer would have to pay for the costs of helping the patient pay for his health care that was required for "fixing" the error and an award for pain and suffering that could be reasonable for both, we would see very few of these "jackpot" awards going to attorneys and little to the clients. Frivolous suits would be kept to a minimum, especially if appeals were allowed a LIMIT in terms of restitution. This is a huge part of costs and it could be a substantial reduction in pay outs by insurance companies, dollars that would go to payments of real services. Third party rewards for health care that they do not deliver is like a leach sucking the blood out of the host. It did take a while for health care to document this, my God George Washington even used leeches in times of illness, but we have come a long way since then! It is time for the health care system to document this for the health of patients, the delivery system and the economy so that we can use those dollars to deliver health care to the people, who need it and not dollars to those who stand by watch to see if a mistake is made. That is a diagnosis we can make and we can cure it. Other suggestions we have been hearing are not conclusive. Let us get STARTED on the problem we know we can help.
There are needs that require insurance reform, those have a whole host of problems that ARE being talked about, but the tort reform issue seems totally neglected. A neglected patient can not get well, nay the patient who is neglected, has no hope of surviving.
When a very sick patient comes to the hospital with many illnesses, the most manageable problems are tackled first, so that the others CAN be addressed. Let us NOT obfuscate the whole system, when there are AREAS to BEGIN the process. This is a journey, this not parking lot.

Posted by: Lauragail

SEE THE CONECTION WITH AARP HEALTH CARE PLAN

The truth: Daschle is cashing in mightily on his role as "the architect of President Obama's health care plan" in the private sector — and evading lobbyist disclosure by reinventing himself as a highly paid "senior adviser" to D.C.-based law firm/influence-peddling shop Alston & Bird.

Daschle represents mega-insurer UnitedHealth, which opposes the pure public option, and Alston & Bird represents a total of 31 clients from the health care sector. According to D.C. watchdog OpenSecrets.org, "Of the $2,730,000 reported income received from clients, nearly 50 percent of that, $1,070,000, comes from these 31 health care clients."

Medicare Hospital Discharge

Pinpoint another serious problen confronted by members of Mass Senior Action.
Hospitals discharging older patients without any follow up or "transitional" services.
One of every five Medicare beneficiaries is readmitted within 30 days of discharge and one of every three, within 90 days--often becuase of poor communication between patients, care givers, and health care providers.
We need a benefit in Medicare to help people safely transition to home or another setting to prevent costly and unnecessary hospital re-admissions