Obama Promises Made Promises Broken

If you like your health care plan, tough luck – if you’re on a Medicare prescription drug plan:
More than 3 million seniors may have to switch their Medicare prescription plan next year, even if they’re perfectly happy with it, thanks to an attempt by the government to simplify their lives.

The policy change could turn into a hassle for seniors who hadn’t intended to switch plans during Medicare’s open enrollment season this fall.

And it risks undercutting President Barack Obama’s promise that people who like their health care plans can keep them….”As a result of this policy, there are going to be fewer plans offered in 2011,” said Bonnie Washington, a senior analyst with Avalere Health, which produced the study.

If you like your health care plan, better luck next time – if you’re a college student:

Along comes word that the bill “could make it impossible for colleges and universities to continue to offer student health plans.” That’s how the American Council on Education and a dozen other higher-ed lobbies put it in a recent letter to the Obama Administration, warning that the insurance coverage they offer may get junked by ObamaCare’s decrees.

Between 4.5 million to 5.5 million students annually are insured by short-term plans sponsored by their schools, which are tailored to upperclassman who have aged out of their parents’ coverage or to international and graduate students. These plans are very low cost because the benefits are designed for generally healthy young people and often organized around campus health services and academic medical centers.

All of which means these plans aren’t likely to qualify under ObamaCare’s “minimal essential coverage” rules that mandate rich benefit packages, even if colleges have the flexibility to make exceptions for special needs. And given that insurance must now be sold anytime to everyone, colleges may be required to continue to cover students after they’ve graduated-leaving this type of coverage unaffordable.

If you like your health care plan, cross your fingers and hope you’ll like your new one better – if your employer sponsored plan doesn’t meet the law’s strict grandfathering requirements:

While many U.S. companies initially hoped they could preserve much of their existing group health plans under the new grandfather provision, a new survey by Hewitt Associates, a global human resources consulting and outsourcing company, shows that almost all now believe they will not. Ninety percent of companies said they anticipate losing grandfathered status by 2014, with the majority expecting to do so in the next two years.

Under the “grandfather” provision of the U.S. Patient Protection and Affordable Care Act, companies can maintain many of their current health care coverage provisions and are required to make fewer changes to plan documents and administrative procedures in order to comply with the new law. Companies can lose their grandfather status if they take certain steps such as reducing benefits, significantly raising co-payment charges, significantly raising deductibles or changing insurance carriers.

According to Hewitt’s survey of 466 companies–representing 6.9 million employees–most companies expect to lose grandfather status because of health plan design changes (72 percent) and/or changes to company subsidy levels (39 percent).

None of this is exactly surprising—at least if you’ve been paying attention. Any health system overhaul as sweeping as the PPACA was bound to upset existing coverage arrangements, especially given the dominance of insurance in American health care. But given how disastrous the possibility of forced plan changes proved to HillaryCare in the 90s, the law’s supporters couldn’t admit that. So President Obama and congressional leadership and the progressive activist class had to promise, repeatedly, that no one would have to change plans if they didn’t want to.

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Please watch this… some insight on what is going on in Healthcare.

When are these changes effective?
The 2010 Medicare Supplement changes will be effective on any policy sold effective June 1, 2010.

When can I start marketing the new plans?
The new plans are effective June 1, 2010, so the kickoff for selling to those clients who will turn 65 in June will actually be January 1, 2010.

How competitive will the new plans M & N be?
We expect them to be very competitive. Co-Pays and Co-Insurance will always drop the premium.

Why were plans E, H, I and J eliminated?
Plan E was eliminated because the new Plan D would contain exactly the same benefits. Plans H, I and J were eliminated because with the other dropped benefits these plans would also duplicate other plans available.

What will happen in the plan your client has is dropped?
Any plan that was purchased prior to June 2010 will remain inforce. Keep in mind these new plans are for new issues with effective dates of June 2010 and beyond. Your clients’ current Medigap plan is guaranteed renewable for life. Even if their health changes, they cannot be terminated or forced to change to one of the new plans.

What is the new hospice benefit?
All plans will now include the Hospice Benefit as part of the “Core Benefits.” Medicare provides coverage for inpatient respite care up to 5 days less a co-payment amount of 5% of the daily benefit. The new Hospice benefit will pick up this 5% co-pay.

Why was the At-Home Recovery benefit dropped?
It was determined that the benefit was confusing and difficult to understand and administer.

Why was Preventive Care dropped from all plans?
Because Medicare Part B has changed to cover many more preventive benefits, effectively rendering this benefit redundant.

For Personal Advice or to talk to a Customer Care Consultant call 1-866-460-4321 or to e-mail us click here.

New Hospice Benefit
All plans will now include the Hospice Benefit as part of the “Core Benefits.” Medicare pays for all but very limited co-payments for outpatient drugs ($5). Included in all Medigap plans a benefit to pay this co-payment will be included.

Medicare provides coverage for inpatient respite care up to 5 days less a co-payment amount of 5% of the daily benefit. The new Hospice benefit will pick up this 5% co-pay.

New Plans
The new regulation also makes the following two new plan options available to beneficiaries, which have higher cost–sharing responsibilities and lower estimated premiums:

• New Plan M includes 50 percent coverage of the Medicare Part A deductible and does not cover the Medicare Part B Deductible. Plan M has all the core benefits plus the foreign Travel Emergency Benefit.
• New Plan N does not cover the Medicare Part B deductible and adds a new co–payment structure of $10 for each physician visit and $50 for each emergency room visit (waived upon admission to the hospital). Plan N has all the core benefits plus the foreign Travel Emergency Benefit.

Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010

*Plan F also has an option called a high deductible plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$1900] deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed [$1900]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan’s separate foreign travel emergency deductible.

For help understanding how this may impact your Medicare Plans or Health Care costs, please contact a representative at CATALIST HEALTH by calling – 1 – 866 – 460 – 4321 or by e-mailing info@catalistfinancial.com

Promises Made; Promises Broken. Senate Majority Leader Harry Reid is in full get-a-bill mode. Virtually every promise of reform has been thrown out the window, even as those willing to work with the president have been thrown under the bus. Just consider some of the promises broken.

Promises:

• Family health insurance premiums will drop by $2,500 a year by the end of the president’s first term.
• Everyone will be covered.
• If you like your current health insurance plan you can keep it.
• Electronic medical records will save significant amounts of money.
• The president will sit down with members of Congress and go over the legislation line by line.
• Discussions will be an open process that even C-Span could broadcast.
• Health care reform will cost about $60 billion a year (which would only be $600 billion over 10 years).

All those promises and more have been broken; they aren’t even considered serious anymore. And yet reform efforts move on. That’s one of the reasons those of us opposing the reform effort are so frustrated. No one — and certainly not the media — appears to be holding the president accountable.

Déjà vu. Actually, this effort isn’t all that different than the 1993-4 Clinton health care reform debate. When Clinton was elected there was also a sense of inevitability about the success of the bill. Most of the various trade associations — the AMA, PMA (now PhRMA), the AHA, the big business groups, and even HIAA — wanted to work with the administration and have a “seat at the table.”

It wasn’t until January or February of the following year (1994) — about where we are now — that many of the major groups started turning against the plan. The business groups have been turning, and some of the associations are turning.

Of course, there are differences. The Democrats are much further along this time than in 1993-4. And some of the trade associations have continued their support, even when it’s clear they will be hammered by the legislation.

But don’t let people tell you things are completely different this time. There are a lot of similarities.

No More Cards. Last week Senator John McCain (R-AZ) went on the floor of the Senate to complain that AARP has opposed every past cut to Medicare, even as it supports the proposed new cuts to Medicare — which are substantially larger than anything the Republicans ever proposed. And so McCain urged seniors to cut up their AARP membership cards.

It’s an important point. The media regularly refer to AARP as a seniors’ lobby or a consumer group. It’s not. It has effectively become an arm of the Democratic Party. Yes, AARP supported the Republican-led Medicare prescription drug legislation that passed in 2003. But Democrats roundly chastised AARP for doing so — even though several Democrats voted for the bill — and AARP apparently learned its lesson. If Democrats say something’s good, AARP must say something’s good. I just wish the media would recognize the relationship.

As these plans are still evolving, please visit us often for future updates.

Background

The changes to Medicare Supplement come as a result of HR 6331, the Medicare Improvements for Patients and Providers Act (MIPPA, passed on July 9, 2008), which authorized implementation of the NAIC’s proposed Medigap modernization changes, which were approved by the NAIC Plenary in March 2007.

Major Changes

The 2010 Medicare Supplement changes are an effort to modernize the Medigap Market by dropping some coverage options and adding others. See Below.

Summary of changes for 2010 Medigap plans purchased effective June 1, 2010:

• “At-Home Recovery” benefit will be dropped from all 2010 Medicare Supplement plans
• Preventative Care will be dropped from all 2010 Medicare Supplement plans
• Medigap Plans E, H, I and J will no longer be available for new sales
• Plan G will be modified to increase excess charges from 80% to 100%
• New Hospice Benefit will be added to all plans
• Two new Medigap Plans M & N will be available in 2010
• Insurance carriers will be allowed to offer plans that include “New” or Innovative Benefits, such as eyewear or hearing aid benefits. They may not include outpatient prescription drug benefits.

FOR HELP ON HOW THE PLANS AFFECT YOU OR WHAT OPTIONS YOU HAVE TO LOWER HEALTH COSTS PLEASE CALL (866) 460-4321 or e-mail info@catalistfinancial.com

One of the goals of health care reform is to make coverage more affordable, but the proposed annual $6.7 billion health insurance premium tax will have the opposite effect by increasing costs for families and employers across the country. The new health insurance premium tax will:

Increase premiums for families and small businesses: CBO has stated that new taxes on health plans will result in “higher premiums for private coverage.” These taxes would increase costs for families and employers at a time when they are already struggling with rising health care costs.

Cause immediate disruption for policyholders: While broader reforms will not begin until 2014, the new health insurance premium tax would go into effect in 2010 – after contracts have been negotiated and after individuals have enrolled in their plan for next year. Imposing new taxes next year that cannot be supported by current premium levels will cause significant disruption and higher costs for policyholders, and could impede the ability of health plans to meet promised benefits.

Create an unsustainable burden on health plans: Health plans will be required to pay a $6.7 billion tax beginning next year for the next 10 years, in addition to “stabilization‟ fees of $25 billion in 2013, 2014, and 2015. According to Fortune magazine‟s analysis of the companies listed under “Insurance and Managed Care‟, earnings in 2008 totaled $8.61 billion with a profit margin of 2.2% — ranking the industry 35th on the Fortune list.

The new tax is non-deductible and is layered on top of existing state and federal taxes paid by health insurance plans, including: premium taxes, assessments to support high risk pools, state and federal income taxes, employment taxes, sales and use taxes, and property taxes.

Put benefits at risk for families and employers: The new health insurance premium tax is assessed based on market share and is not tax deductible. As shown in this chart, the new tax will disproportionately impact health plans with the lowest net income, and for some health plans, could result in an effective tax rate of more than 100 percent. This would put at risk the reserves health plans are required by law to keep on hand to pay out benefits for families and businesses.