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From top carriers

What is the future of the health care bill in the Senate?

Right before the House vote on the new health care legislation, the Senate approved a $1.1 trillion spending bill that will finance the government until September and prevent a government shutdown. The approval of the spending bill allowed the House to safely pass the American Health Care Act (AHCA).

While House Speaker Paul Ryan is hopeful that the Senate can pass a bill meant to replace the Affordable Care Act (ACA) in a couple months, this is highly unlikely. The Senate, which moves more slowly than the House, will now begin work on creating a health care plan that will be acceptable by all the factions of the Republican party. This could mean that the Senate will need to write a new bill all together.

Because the members of the GOP are divided on the issue of a new health care bill it may prove to be a challenging task to pass it. Furthermore, the Senate needs a 51-vote majority to pass the bill, which allows them only two defections. The Senate is expected to take until August to push a bill through with the needed support. When the Senate produces a new or updated bill it will return to the House for a vote.

Until the Senate and House agree on a new health care bill, the ACA remains in place. Thus, those selling and buying health insurance will be adhering to the rules and regulations already in place.

Posted on Tuesday, May 30th, 2017. Filed under Health Insurance.

The proposed GOP healthcare plan and what it means for the ACA

Until Congress passes the proposed American Health Care Act, the current rules and regulation regarding the ACA remain in place. This means that the following aspects of the ACA must still be complied with for the duration.

Some of the rules and regulations that must still be followed include, but are not limited to:

  • Anti-discrimination rules related to transgender benefit protections and their enforcement
  • Individual and employer mandates and fines/taxes for non-compliance
  • Market reform mandates and IRS tax enforcement from large employers whose self-insured group plans do not satisfy market reform rules
  • Reporting obligations/IRS tax enforcement of dues from large companies failing to accurately and in a timely manner report coverage offered to workers/dependents

The rising opposition to the proposed American Health Care Act, is likely going to cause a delay in the ability for the Act to pass through the House and Senate. Many voices of opposition are voicing their concerns that rushing through this healthcare act and not allowing it to be properly vetted will have the potential to adversely affect many Americans.

The next few months or years are likely to be confusing and frustrating. Insurance agents, brokers and carriers are going to be doing their best to stay on top of the latest changes.

Posted on Friday, March 31st, 2017. Filed under Health Insurance.

How the executive order affects larger employers?

Late January, President Trump signed a healthcare executive order that could impact employers, even if it did not specifically mention them.

The executive order instructed federal agencies to, “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement that would impose a fiscal burden,” on states, health care providers or individuals. The order can undo individual mandates to purchase insurance and other mandates placed on employers, like providing full-time employees with coverage.

The employer mandates may be regarded as a fiscal burden, according to the wording of the executive order. The employer mandate may become questionable if there is no tax on individuals who do not have minimum essential health insurance.

Nonetheless, it is advisable for all employers to continue complying with the established rules by the ACA until the GOP proposed American Health Care Act (or another act) is implemented.

The transition from the ACA to the proposed American Healthcare Act may be painful and prolonged. Stay on top of what is happening in the industry and understand your existing health coverage to be able to evaluate what may replace it.

Posted on Monday, March 27th, 2017. Filed under Health Insurance.

What you might not know about the ACA?

Many Americans are hoping for a reform in the health insurance system. They are hoping that the Trump administration delivers on its promises regarding health care. People want choices and perhaps that is what the incoming administration is planning to accomplish. It is not clear what changes may be made yet.

What most do no know is that in many states people only had one choice for their health insurance. What is worse is that in other states people had no choice in health insurance. Moreover, many of those who did sign up for insurance through the ACA, were unable to pay their premiums. Many people who qualified for the ACA, did not qualify for government subsidies.

The idea of the ACA was to get the young and healthy people to sign up to provide a cushion for those older Americans who do need health insurance more often. This, however, was not very successful. Young people were priced out of the market, as current wages do not keep up with the rising cost of living.

Obviously the health care system is incredibly imbalanced and a ponderously expensive entity that needs work to make it function well. Much like immigration reform, a replacement for the ACA is going to take some foresight and careful consideration.

Posted on Tuesday, February 28th, 2017. Filed under Health Insurance.

What Does the Affordable Care Act Really Mean?

With the United States facing significant changes in many areas, including health care, trying to understand what the Patient Protection Affordable Care Act (ACA) may evolve into is an unknown.

According to many industry watchers, since the ACA was enacted, over five millions people saw their health insurance policies discontinued because they did not meet ACA standards. Those plans were labeled as being unsatisfactory. However many scrapped plans offered more and were more valuable to customers than what was being sold under the auspices of the ACA.

What are the possible differences between the ACA and what may happen if it is repealed?

  • The ACA plans are focused on preventive care
  • According to the law, many of the services are covered without co-pay
  • Many of the services are not subject to co-insurance
  • Many of the services do not have a deductible
  • These services are supposedly free, but as benefits, they add to premium costs
  • Added premium costs are paid for by policy holders on the front end
  • Health Savings Account-like plans are in the Bronze category under the ACA with a family deductible of over $12,000

The number of claims an insurance carrier gets determines premium costs. There is no underwriting under the ACA, which increases an insurance company’s claim expenses. Increased costs for the increased risks translate into higher premiums. To bring costs down many carriers have restricted their networks of hospitals and doctors — a turn of events that means Americans may have to change doctors or change insurance carriers.

If the ACA is repealed and a different kind of health care system comes into play, such as the system in existence before the ACA was passed into law, the following may be implemented:

  • Insurance plans would focus on major medical
  • Health Savings Accounts with a High Deductible Health Plan or plans similar in nature may return
  • Prescription drug coverage and doctor visit co-pays were applied to the deductible
  • Monies in the savings account could pay for drugs and doctor visits
  • Many people can pay $100 to $200 to visit a doctor

The possible repeal of the ACA and what would replace it is unknown. If the old system is revitalized, consumers may well see more choices and competitive rates and plans.

While the repeal of ACA is ongoing, the prospect for more fair insurance rates and a return to better plans may be hovering on the horizon.

Posted on Monday, February 20th, 2017. Filed under Health Insurance.

What Health Care in the United States May Look Like in the Future

According to president-elect Donald Trump, Americans have suffered under the weight of a massive economic burden brought about by the Affordable Care Act (ACA).

Apparently the Affordable Care Act was passed into law without much foresight, resulting in out-of-control costs, non-functional websites, higher premiums, less competition in the insurance industry and a greater rationing of care. As a result of the legislation, every American was allegedly faced with uncertainty of the ACA collapsing, causing even greater economic concern and hardship when it came to health care.

President Donald Trump’s administration suggests that on day one of a new administration free market reforms would be introduced into the health care industry by completely repealing the ACA. Replacing the repealed legislation would be the next task and the administration indicates it would have such reforms ready that closely follow free market principles geared to restore certainty and economic freedom to all Americans. Free market principles combined with sound public policy are intended to broaden health care access, improve the quality of care and make it more affordable.

The proposed seven-point plan touted by president-elect Donald Trump to make health care more affordable for all Americans will allegedly:

  • Lower health care costs for every American
  • Remove uncertainty about health care
  • Offer financial security for Americans
  • Tackle other policy revisions to lower the cost of health care
  • Enforce immigration laws to relieve economic pressures on Americans in health care
  • Stop fraud and waste and energize the American economy
  • Reduce the number of people accessing programs such as Children’s Health Insurance, Medicaid
  • Work on growing the economy by bringing jobs and capital back to the United States
  • Reform mental health services

It appears that the plan to reform health care in the United States is ambitious and may result in some significant changes for Americans. While it is not precisely clear how many of the proposed reforms are to be implemented and what may be designed to replace existing health care legislation, there are many industry pundits who feel that change may be a good thing to stimulate the economy.

The country is on the brink of a new era and it appears that approaching health care with a different point-of-view may produce some interesting results, not only for the people, but also for the insurance industry as a whole.

Posted on Tuesday, January 31st, 2017. Filed under Health Insurance.

Health care support may be based on age

There is a good possibility that the new form of health care for the nation may provide health support based on age. As explained by House Speaker Paul Ryan, the idea would be that older Americans who are very ill would get more support, as would lower income individuals. Those with higher incomes would thus not receive the same kind of support since they could afford to pay for it.

The new administration has plans to make significant changes to Medicare. Many incoming politicians feel Medicare is responsible for a huge hole in the budget due to the misuse and abuse of the program. Having said that, Speaker Ryan also pointed out that the longer Medicare runs without any changes or pending changes in place, the delay just makes things worse.

Americans who use Medicare are advised to be aware of any potential changes that may affect them. It is hard to predict what changes may be proposed and how they would benefit Medicare recipients, and whether or not those suggested revisions may come to pass.

Posted on Tuesday, January 24th, 2017. Filed under Health Insurance.
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