ObamaCare Archives - Page 3 of 4

Cheaper Short Term Plans Can Now Last Up To 3 Years

The Trump Administration has finally finalized expanding insurance companies ability to sell short-term health insurance plans for up to 3 years (36 months). This will allow consumers to buy less expensive and less comprehensive insurance policies for a longer time. The old rule for short-term health insurance was that it cannot last for more than three months. This new rule will open these policies to consumers for up to 36 months, in hopes that more healthy people will utilize them. These plans may offer less coverage, but will be there for those who can not afford or do not feel that they need extensive coverage.

“We want to open up affordable alternatives to unaffordable Affordable Care Act policies,” said Health and Human Services Secretary Alex Azar. “Americans need more choices in health insurance so they can find coverage that meets their needs. The status quo is failing too many Americans who face skyrocketing costs and fewer and fewer choices. This is one step in the direction of providing Americans health insurance options that are more affordable and more suitable for individual and family circumstances.”

In 2016, Obama restricted these plans by limiting them to just three months of coverage from 12 months. Back in October, Trump issued an executive order to cut back the restrictions on these plans that limited them to three months. By removing these restrictions, Trump gave the public the ability to decide for themselves whether they need a more committal plan, or a short term plan for the next year. This is one of Trump’s first steps to achieving his promise of dismantling the ACA once and for all.

Some skeptics worry that the more healthy people leave the marketplace, the more expensive premiums will be for those still in the market. The premiums would increase and cause subsidies for policyholders to rise which in turn would cost the government more money.

When asked about the concerns that the proposed rules would destabilize insurance markers Seema Verma, the administrator of the federal Centers for Medicare and Medicaid services said, “we don’t think there’s any validity”. She continued to state that federal officials believe that between 100,000 and 200,000 healthy people now buying insurance through those federal exchanges would switch to the short-term plans, as well as others who are now uninsured.

Once someone signs up for a short term plan for a year, they can now continue to renew it for up to three years. Insurers can ask medical questions and possibly reject consumers due to pre-existing conditions for a short-term policy. Once approved for the plan, if a consumer develops a ‘pre-existing condition’, then they can be rejected when it is time to renew.

*Short term plans do not cover maternity care, so if you are considering getting pregnant you should take into consideration how much out of pocket costs you can handle.*

Short term plans are less expensive, because they cover less, for example, maternity care and preventative care are not covered. It is ideally for those who are relatively healthy and do not need a lot of coverage. The hope is that the new rule will be more appealing for younger and healthier people.

The Trump Administration believes this will bring in an increase in premium revenues and profits because more people would sign up for a short-term insurance plan. This will allow the insurers to set prices to reflect a customer’s health risk of high medical costs. Trump believes that this 36 month extension is important because premiums more than doubled from 2013-2017 for health plans in the federal Marketplace Insurance exchange.

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Medicare Prices Steadily On The Rise

Details have emerged after a report was released on the investigation into Medicare drug prices. The report “Manufactured Crisis: How devastating drug price increases are harming America’s seniors,” and its findings were released by U.S. Sen. Claire McCaskill, Democrat-Missouri. This report talks about the hiked up drug prices for senior citizens and how it needs to be further investigated. Medications for seniors have gone up nearly 10 times more than the annual inflation rate.

The report stated that “Soaring pharmaceutical drug prices remain a critical concern for patients and policymakers alike. Over the last decade, these significant price increases have emerged as a dominant driver of U.S. health care costs — a trend experts anticipate will continue at a rapid pace.”

The cost of about 20 of the most prescribed drugs for Medicare have gone up significantly from 2012 to 2017 according to the report. The lowest increase being Zostavax going up 31%, to the largest increase being 477% for the drug Nitrostat. Twelve of the drugs investigated, increased over 50% during the five-year time span, while six of them increased over 100%. The rise has gone up so much that some Medicare enrollees are unable to pay for their meds.

Some Medicare Drug Prices Have More Than Doubled Each Year!

The Pharmaceutical Research and Manufacturers of America did not agree with the report and followed up with comments reported by CNN. “This is yet another misleading report that ignores the robust negotiation that occurs between Medicare Part D plans, middlemen, and biopharmaceutical companies,” Juliet Johnson, a spokeswoman for PhRMA, said in a written statement. “Negotiated rebates can reduce list prices by as much as 30 to 70 percent for medicines used to treat diabetes, high cholesterol, and chronic respiratory illnesses. Notably, half of the 20 brand medicines in this report are used to treat these chronic conditions.”

As stated, the medicines are used to treat chronic conditions, but the reality is that many seniors need these medications. A lot of Medicare enrollees have some sort of health issue, whether chronic or not that requires treatment and medication to stay healthy.

Juliet Johnson later stated “we agree more can be done to make Part D more affordable and predictable for seniors. One way to do that is to ensure seniors benefit from the significant negotiated savings when they pick up their medicine at the pharmacy.”

The prices of pharmaceutical drugs for seniors has been an ongoing issue, they are becoming more expensive every passing year. It can become too much for seniors to include in their budgets, which can be very harmful to their health. Medicare enrollees can purchase a Medicare Advantage plan or Medicare Part D plan to help pay for pharmaceutical drugs needed. But as drug prices continue to rise, the premium costs will go up as well to pay for the difference.

By law, Medicare is not allowed to negotiate drug prices, which is something Democrats have tried to change for a long time. Some sort of change or assurance must be given to seniors that these prices do not continue to climb and become unattainable. During Trump’s State of the Union address, President Trump states he will fight to make the drug prices go down. This will hopefully put a resolution of the soaring drug prices, and provide relief for seniors.

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$25 Billion Medicare Cuts Possible Due To Republican Tax Bill

The GOP tax bill that the Republicans have been working on, can lead to major cuts in Medicare funding and spending in 2018. The bill is estimated to cut $25 billion from Medicare starting 2018, and resulting in $400 billion over the next ten years.

The Congressional Office has estimated a $1.5 trillion deficit to over the next 10 years due to the tax bill.

In 2010, Washington passed a “pay as you go” rule which requires any new laws to be deficit neutral. Basically if there is not enough economic growth to balance the money lost, then the Office of Management and Budget has to cut spending. Unfortunately, it is likely that one of the spending cuts will be to Medicare.

The tax bill does not exactly say that it will cut spending on Medicare, it will be an unintended result. Some Republicans stated that the cuts would affect doctors, health providers, and hospitals, not Medicare beneficiaries. They have also had talks to try and change the Medicare eligibility age from 65 to 67.

House Speaker Paul Ryan seems to threaten cuts to Medicare saying “we’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit. I think the President is understanding choice and competition works everywhere, especially in Medicare.”

A major issue with the possible cuts is that Medicare beneficiaries could end up being kicked off of their current Medicare plan, or receive fewer benefits.

Juliette Cubanski, associate director of the Program on Medicare Policy at the Kaiser Family Foundation says, “these cuts could be one bad side effect of this tax legislation. Many providers may be able to absorb the payment reductions if they have a very diverse patient base. But others who rely primarily on Medicare may find this cut really difficult to deal with.”

While many are uneasy with the possible cuts, House Majority Leader Kevin McCarthy says that it is all a scare tactic by the Democrats, and that Medicare cuts will not occur. He states “the Republicans have been wanting to have this fixed for quite some time. When Obamacare went in, it cut Medicare. We have been trying to make our entitlement sustainable into the future.”

Roughly 54 million Americans currently receive Medicare benefits. Many fear the cuts will leave many Americans without coverage or unattainable expense to have coverage. However, McCarthy claims lawmakers will find a way to avoid the Medicare tax cuts.

Healthcare Rates to Rise in 2019

In 2017 when President Trump did away with cost-sharing subsidies, it forced insurers to raise premiums. The cost-sharing subsidies helped pay back insurers for giving customers lower premiums due to their income status. Due to the halt in the subsidies, health-insurance premiums have been rising for those who have to buy their own insurance, approximately 34% in 2018 for silver plans. Insurers are now brainstorming what they will charge and if they want to participate in the ACA exchanges for 2019.

Insurers have been participating less and less in the market exchange, leaving customers with fewer choices. If more insurance companies decide to pull out of the exchanges, it will mean that customers will have even fewer choices available to them, at higher costs.

Premiums will continue to keep growing without the cost-sharing subsidies to help with the costs impacted on insurers. The hike in premiums could be as much as 30% for 2019. It is projected that those that will be impacted the most are those who make too much money to qualify for premium support subsidies.

Eyles and Ceci Connolly, president and CEO of Alliance of Community Health Plans both voiced their disappointment of Congress failing to take action to fund cost-sharing subsidies.

“What’s happened is that several pieces of the puzzle have been pulled away. It is hard for me to isolate CSRs, what we are looking at now is a puzzle that is falling apart piece by piece,” Connolly said. “Losing the individual mandate, losing the cost sharing reduction subsidies and losing any hint of reinsurance, not to mention the risk corridors that were already gone, you’re just running out of options to manage the cost of this program.”

Midterm elections are approaching which brings up the issue of health care. While both political parties will be criticized, the polls have shown that voters hold Republicans more responsible for the high costs. Both parties have come to an agreement to include health insurance funding in the spending law, but could not agree on the details of what to fund exactly. Republicans are pushing for abortion restrictions stating insurers can cover abortions but cannot use federal funding for them, while Democrats do not agree.

Lawmakers are hoping the stabilization effort of adding funding to the bill to offset the costs of insurance, but health-policy experts disagree on how much it will help. Health experts state that the higher premiums will be offset for people by other subsidies they will be qualified for.

Republicans are not thrilled to stand behind the idea of the stabilization funding because they view it as saving the insurers of a health law, ACA, which they promised voters they would repeal. They blame the ACA’s regulations which stopped competition and drove up premium costs. Congress is leaning towards unlikely passing the stabilization bill.

Insurers are expected to announce the premium price hike sometime in the fall.

Plans Rates to Increase in 2018: Silver Costing More than Gold

Plans will be at least 34 percent higher in 2018 due to Trump’s decision to halt cost-sharing subsidy payments to insurers.

Because the Trump administration ceased these cost-sharing payments to insures, insurance companies raised premiums to compensate for the loss of these reimbursements. This termination of subsidies has also caused some insurers to drop out of the marketplace, leaving regions with only one insurer.

The changes

Silver plans pay for about 70 percent of customers’ health costs, with the remainder of payment left for the customer. These plans are purchased by nearly 80 percent of customers. The cost of silver plans is increasing an average of 34 percent next year.

Bronze plans, the second most popular plan, covers 60 percent of customers’ health costs. These plans are purchased by about 23 percent of customers. The cost of bronze plans is increasing an average of 18 percent in 2018.

Gold plans are usually the priciest, covering 80 percent of customers’ health costs. These plans are purchased by about 3 percent of customers. This year, the cost of gold plans are increasing an average of 19 percent.

Platinum plans are the most expensive plans, covering 90 percent of customers’ health costs. These plans are purchased by less than 1 percent of customers. The cost of platinum plans is rising by an average of 24 percent next year.

Gold plans usually have higher monthly plans and lower out of pocket costs than silver plans, but that has now changed. Now silver plans are more expensive than the gold plans that have lower deductibles.

Who this will affect

Customers who will be affected by these price increases are those who must purchase Obamacare because they do not have insurance through employers or Medicare. People who qualify for government subsidies will benefit from the premium increase of silver plans. As the premium increases for next year, enrollees will receive higher premium tax credits, allowing them to have a plan with a lower deductible, copays, and less out of pocket spending.

However, people who do not qualify for government subsidies will have to pay more for a silver plan. The least expensive gold plan for next year will be cheaper than the least expensive silver plan. So many people will probably opt to purchase the bronze or gold plan next year.

If you make more than the poverty line, in some states, a gold plan will cost less and have a lower deductible. Also, a high deductible bronze plan will have lower premiums. For example, a 40-year-old individual making $30,000 and eligible for a tax credit will pay 54 percent less in 2018 for their premium of the lowest-costing bronze plan, 9 percent less for the lowest-costing silver plan, and 16 percent less for the lowest-costing gold plan.

Gold plans are a better option in some states such as Pennsylvania, Wyoming, New Mexico, Kansas and Texas. Below is a map of highlighted states where gold plans are lower than silver plans by $25 or more.

Need Help?

Comparing plans for the upcoming year, and choosing one can be difficult. EZ.Insure can help you compare all the plans in your area, and assist you in choosing the ideal plan. Whether gold or silver is the cheapest, or bronze or platinum will suit you, EZ.Insure will make it an easy decision. Enter your zip code in the bar above to receive instant quotes in your area. You can also email replies@ez.insure or call 888-350-1890 to get started!

Senate GOP Planned on Getting Rid of Healthcare Mandate, With No Success

Republicans have been working to get rid of the individual mandate from the Affordable Care Act. The reason is to not only save the government money, but to “provide more tax relief to middle class families.” However, they have failed repeatedly to get the tax reform bill passed, leaving the mandate applicable, and the penalty that follows if it is disregarded.

The individual mandate is the requirement for people to buy health insurance or pay a fine. This was intended to have people buy coverage, especially those that are healthy, in order to keep insurance costs lower for everyone. When healthy people are part of the insurance pool, it helps fund the treatment costs of sicker people.

The Congressional Budget Office estimates that by repealing the mandate, the government will save about $330 billion over the next ten years. The money the government would save is the money spent on insurance premiums because people would drop their insurance or opt out of having one. The Congressional Office also estimates that there will be 13 million people uninsured in the following ten years. Without the mandate, fewer people will sign up for insurance, especially healthy people. What will then happen is the costs of treatment for the sicker people would sky rocket.

There have been many arguments as to whether the mandate encourages or discourages people from buying health insurance. Republicans argue that the mandate discourages people from buying insurance that costs just as much as the penalty they would receive if not being insured. But, studies have shown that more Americans over the years have been signing up for insurance because of the law. Paying a penalty that can cost more than paying for insurance is poor financing and illogical.

Republicans claim that repealing this mandate would mainly help the middle class. “Eighty percent of the people who pay the mandate tax make less than $50,000 a year, and a third of those who pay the tax make less than $25,000 a year,” said Sen. John Thune. However, the issue is that the ones who will suffer the most are the middle class. When premiums increase even more, only those who qualify for subsidies will be able to afford coverage. People who earn too much to qualify for a subsidy, and want to buy insurance will have a hard time with medical costs, because coverage will be too expensive.

There is some support behind the mandate repeal amongst Americans, while others think it’s a bad idea after hearing that many Americans will be uninsured, causing premiums to rise. Despite the support or lack of from the American people, the mandate is here to stay and you will be penalized if uninsured.

Get Help Making Sense Of All Of This

The Senate’s continuous failed attempts prove that this reform bill will not pass, leaving the individual mandate the current law. If you do not sign up for health insurance, you will pay a penalty up anywhere from $695 to $2,085. It is important that you teach an agent to find a plan as soon as possible. EZ.Insure’s agents are highly knowledgeable about all the plans in your region. You will be assigned your very own agent that can help you compare plans and pick which is best for you and your family at an affordable price. No bouncing from agent to agent. Contact one now at replies@ez.insure. To get an instant quote, you can enter your zip code in the bar above. Do not wait and end up having to pay a penalty that could cost more than monthly premiums.