Insurance Companies Are Suing Trump!

When the Trump Administration announced a rule to stop cost-sharing subsidies to insurance companies, there were threats of lawsuits. The threats have now become a reality, with an insurance co-op recently filing a lawsuit against the federal government.

Cost-sharing reduction payments were set up under Obamacare to ensure that customers would be able to receive low deductibles and out of pocket costs. In return, the federal government would pay back the insurers. The Congressional Budget Office estimated that the government pays about $7 billion a year to all ACA insurers for cost-sharing reduction payments.

The federal government is now being sued by Maine Community Health Options, requesting the money owed to them by law. They are seeking $5.7 million in cost-sharing reduction payments. The insurance company did not raise premiums despite the end of the subsidy payments.

The co-op claims that they cannot change its health plan part way through the year to make up for the lack of reimbursements, and they took a financial hit.

Attorney Stephen McBrady of Washington, D.C. submitted the lawsuit that stated, ” “Section 1402 requires health plans to provide cost-sharing reductions to members, and then the health plans to be reimbursed by the U.S. government under the ACA. Insurers, in turn, are guaranteed by the ACA to be reimbursed by the government for the cost-sharing reductions they pay to their insureds. The law is clear, and the government must abide by its statutory obligations. Plaintiff respectfully asks the court to compel the government to do so.”

Since the ruling to halt the payments in October of 2017, 19 attorney generals filed a challenge against the president, but a federal judge denied the request. Many co-ops have closed because of financial losses due to the lack of reimbursements.

Community Health Options is the largest individual insurance provider in Maine. If they succeed in their lawsuit, they will receive the money from the U.S. Department of Treasury’s judgment fund.

Another lawsuit filed against the U.S. is by Common Ground Healthcare Cooperative of Wisconsin. If these co-ops win, it will no doubt open the door for other insurers to receive the reimbursements owed to them by the government.

The Maine co-op, Community Health Options, have yet to receive a hearing date; it will be a lengthy battle.


Five Ways To Get Better Health Plans At Lower Costs

Five Ways To Get Better Health Plans At Lower CostsHealth insurance premiums and deductibles can become costly, and continuously go u p every year depending on the plan. There are ways to help ease the burden of a high premium/deductible plan that is cost-effective while receiving the medical services you need.

Compare Plans

More than 90% of people end up not looking into their plan for the following year and renew last year’s plan by default. Not researching this can cost you greatly into the following year because your monthly premiums can increase, and/or what is covered can be changed.

Shopping around is probably the most important way you can save money. Prices can vary from not only plan to plan but from provider to provider. This is why it is important to not only shop around for price, but for the quality of services, and coverage also.

Plans with low premiums will have higher out-of-pocket expenses like deductibles and copays. These plans are more sensible for people who did not come close to meeting their deductible. Then there are plans with a higher premium and lower deductible that would be more sensible if you meet your deductible quickly.

Comparing plans with one company makes it easier. Every agency will give you the same plans, so EZ.Insure shows you all of your options in one place!

Shopping around and comparing different insurers and plans can become time-consuming, unappealing, and strenuous. EZ.Insure does all the work for you with our highly trained agents that specialize in your region. Your advisor will do the work for you and even sign you up for a plan that matches your criteria for coverage and price, all at no cost to you.

Use What’s Free

Free preventative care services are offered at no charge as long as you are within your insurance network. There are a lot of no-cost routine services to keep you healthy and catch problems early on before it becomes serious. Colonoscopies, mammograms, vaccinations, depression screenings are all free in insurance plans. Many people are unaware of these free services and thus avoided preventative tests. Make sure to go to the doctor and use these free services to stay healthy and prevent serious health issues and expenses later.

Choose Your Doctor

Make sure you choose a doctor that works with your plan. Some offices cost more than others, and some only accept a certain percentage of benefits!

A primary doctor can help you save money, which is why it is wise to do some homework an choose the right one. When you use a primary doctor who charges less then you can also find cheaper prices for outpatient services, specialist, and lab services. Talking to your doctor can lead to reliable information when it comes to quality care at a reasonable price. Your doctor can offer ideas on how to save money and help you find/refer you to less expensive prescription drugs, or diagnostic tests.

Avoid Unnecessary Bills

When talking to your doctor, there are questions to be sure to ask about medical tests and treatments that are overused. Many of them might waste your money. Some people choose to go to the hospital for an MRI or lab work which ends up costing you. Try to utilize Lab Corp or Quest Diagnostic independent labs to avoid high costs.  Hospitals will charge you double the cost of an independent provider.

Leverage Tax Breaks

Putting money into a health savings account (HSA) will help with high out-of-pocket medical costs. The account will let you put aside tax-free money to cover your medical costs. HSA allows you to put up to $3,400 for individuals and $6,750 for families within a year. You can use the money to pay for your deductible and other qualified medical expenses, and whatever you do not use will roll over into the following year tax-free.