Posts tagged with Health Insurance

Governor: No state-federal health care partnership

TOPEKA (AP) — Gov. Sam Brownback says Kansas will have a federally run health insurance exchange, after he declined to support Insurance Commissioner Sandy Praeger's application for a state-federal partnership.

Brownback had said months ago he would wait until after Tuesday's election before moving forward on health care. He announced his decision Thursday after meeting with Praeger, who sought the governor's signature on a letter of support for a state-federal exchange.

Brownback's decision illustrates the divide over the federal health care law between the conservative Republican governor and the moderate Republican commissioner.

States have until Nov. 16 to inform the federal government if they plan to create their own health insurance exchanges, partner with the federal government or have their exchanges run by federal agencies.

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Brownback asked to set health exchange ‘benchmark’

By John Hanna, Associated Press

TOPEKA (AP) — Kansas' insurance regulator is asking Gov. Sam Brownback to spell out the requirements for health coverage to be sold in a new online marketplace mandated by the federal health care overhaul, but Brownback still plans to make no decisions until after the presidential election.

Insurance Commissioner Sandy Praeger made her recommendations public Tuesday, a day after she sent the conservative Republican governor a letter containing her proposals for the "benchmark plan" that companies must offer to participate in the online marketplace. The federal health care law says such marketplaces, known as exchanges, will start operating in 2014.

Praeger's proposal calls for requiring companies to offer the same coverage Blue Cross Blue Shield of Kansas does in its comprehensive plan for small groups, along with additional coverage for children's eye and dental care. The commissioner noted in her letter that if Brownback does not set the state's requirements by the end of September, the U.S. Department of Health and Human Services could do it for the state.

Brownback has strongly criticized the federal health care law, enacted in 2010 and championed by President Barack Obama. Praeger, a moderate Republican, has praised the law as an important step toward providing universal access to health insurance, and she and Brownback disagree over how aggressive the state should be in setting up an exchange.

"My administration will not make any decisions regarding the implementation of Obamacare until after the November elections," Brownback said in a statement Tuesday, reiterating the stance he's long held.

States have until Nov. 16 to declare whether they still want to be partners in running an exchange or leave it entirely to the federal government. Kansas hasn't started to set one up because Brownback and Republicans who control the Legislature oppose the law. Brownback has argued that if Republican Mitt Romney defeats Obama, many requirements in the law are likely to be waived.

Praeger's proposal for the exchange's benchmark plan is designed to give consumers who use the online marketplace familiar coverage at competitive prices, said Linda Sheppard, the Insurance Department's project manager for the health overhaul.

"That does help the market stay stable," Sheppard said.

The federal government limited Kansas and other states to setting their benchmarks based upon 10 health plans already widely available to their consumers.

Blue Cross Blue Shield of Kansas provides coverage for about 900,000 Kansans, and Praeger is proposing that the exchange benchmark be tied to its most popular small group plan. At the end of March, more than 30,000 people were enrolled in it.

"Selecting this plan will allow for the most continuity in the marketplace as a large number of Kansans already have these benefits through their small business employer or as individuals," said company spokeswoman Mary Beth Chambers.

HHS has already said it would base its benchmark for Kansas on the same plan.

But the federal health care law requires that the benchmark include coverage for children's eye and dental care, and the biggest health plans in Kansas generally don't, except through supplemental policies. Praeger proposes that coverage for those plans mirror what's available through the state for children of working-class families that can't afford private insurance.

Sheppard said that if HHS sets the benchmark for Kansas, it could mandate different coverage for such services, as well as coverage for services such as speech and physical therapy.

"This is all kind of coming together in a really short time frame," she said. "The companies are obviously really anxious to get the benchmark set as early as possible."

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U.S. Census Bureau report finds more people have health insurance

A look at health insurance coverage. Uploaded

A look at health insurance coverage. Uploaded by Karrey Britt

The U.S. Census Bureau announced today that in 2011 median household income declined, the poverty rate was not statistically different from the previous year and the percentage of people without health insurance coverage decreased.

Here’s a look at the statistics:

$50,054 — median household income, a 1.5 percent decline from 2010 and the second consecutive annual drop.

46.2 million — people were in poverty in 2011, or 15 percent of the population.

48.6 million — uninsured, down from 50 million in 2010.

These findings are contained in the report “Income, Poverty, and Health Insurance Coverage in the United States: 2011.” The results were compiled from information collected in the 2012 Current Population Survey Annual Social and Economic Supplement.

Here’s more data on heath insurance coverage:

• The number of people with health insurance increased to 260.2 million in 2011 from 256.6 million in 2010, as did the percentage of people with health insurance.

• The percentage of people covered by private health insurance in 2011 was not statistically different from 2010, at 63.9 percent. This was the first time in the last 10 years that the rate of private health insurance coverage has not decreased. The percentage covered by employment-based health insurance in 2011 was not statistically different from 2010, at 55.1 percent.

• The percentage of people covered by government health insurance increased from 31.2 percent to 32.2 percent. The percentage covered by Medicaid increased from 15.8 percent in 2010 to 16.5 percent in 2011. The percentage covered by Medicare also rose over the period, from 14.6 percent to 15.2 percent. The percentage covered by Medicaid in 2011 was higher than the percentage covered by Medicare.

• In 2011, 9.7 percent of children under 19, or 7.6 million, were without health insurance. Neither estimate is significantly different from the corresponding 2010 estimate. The uninsured rate also remained statistically unchanged for those age 26 to 34 and people age 45 to 64. It declined, however, for people age 19 to 25, age 35 to 44 and those age 65 and older.

• The uninsured rate for children in poverty, 13.8 percent, was higher than the rate for all children, which was 9.4 percent.

• In 2011, the uninsured rates decreased as household income increased from 25.4 percent for those in households with annual income less than $25,000 to 7.8 percent in households with income of $75,000 or more.

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State increases scrutiny of some insurance rates

TOPEKA (AP) - State insurance regulators are complying with part of the federal health insurance reform law that requires more scrutiny of health insurance rate increases above 10 percent at a time when Gov. Sam Brownback's administration is strongly opposing other provisions of the law.

The Kansas Department of Insurance has added more steps to increase scrutiny of requests for increases of 10 percent or more, which has been required by the federal Affordable Care Act since September. In the past, the state would conduct more stringent reviews of rate increase proposals of 12 percent or more.

"Kansas always looked very, very closely at rate increase filings," said Linda Sheppard, the state insurance department's director of the accident and health division and Affordable Care Act project manager. "If we decide we don't think it's a reasonable rate, we will work with the company to try to get it adjusted down."

The insurance department is led by an elected commissioner, Republican Sandy Praeger, who isn't part of the executive branch, The Topeka Capital-Journal

Brownback has said the state would wait until after the November election to determine if it must comply with a separate provision of the law requiring states to set up a statewide exchange to help consumers comparison shop for health insurance. Brownback also said the state should not expand Medicaid programs as part of the federal health insurance overhaul.

He has said if President Barack Obama is not re-elected, all or part of the health care reform act could be repealed.

Sheppard said the state insurance department was using part of a $1 million federal grant to assess Kansas' rate evaluation process.

"We're looking at practices in other states. We are doing a full-blown, very thorough look at our process," she said.

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Supreme Court upholds key part of Obama health law

Claire McAndrew of Washington, left, and Donny Kirsch of Washington, celebrate outside the Supreme Court in Washington, Thursday, June 28, 2012, after the courts's ruling on health care.

Claire McAndrew of Washington, left, and Donny Kirsch of Washington, celebrate outside the Supreme Court in Washington, Thursday, June 28, 2012, after the courts's ruling on health care.

By Mark Sherman, Associated Press

WASHINGTON — The Supreme Court on Thursday upheld the vast majority of President Barack Obama's historic health care overhaul, including the hotly debated core requirement that virtually all Americans have health insurance.

The 5-4 decision means the huge overhaul, still taking effect, will proceed and pick up momentum over the next several years, affecting the way that countless Americans receive and pay for their personal medical care.

The ruling hands Obama a campaign-season victory in rejecting arguments that Congress went too far in approving the plan. However, Republicans quickly indicated they will try to use the decision to rally their supporters against what they call "Obamacare."

Stocks of hospital companies rose sharply, and insurance companies fell immediately after the decision was announced that Americans must carry health insurance or pay a penalty.

Breaking with the court's other conservative justices, Chief Justice John Roberts announced the judgment that allows the law to go forward with its aim of covering more than 30 million uninsured Americans.

The justices rejected two of the administration's three arguments in support of the insurance requirement. But the court said the mandate can be construed as a tax. "Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness," Roberts said.

The court found problems with the law's expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states' entire Medicaid allotment if they don't take part in the law's extension.

The court's four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.

Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.

Kennedy summarized the dissent in court. "In our view, the act before us is invalid in its entirety," he said.

The dissenters said in a joint statement that the law "exceeds federal power both in mandating the purchase of health insurance and in denying non-consenting states all Medicaid funding."

In all, the justices spelled out their views in six opinions totaling 187 pages. Roberts, Kennedy and Ginsburg spent 57 minutes summarizing their views in the packed courtroom.

The legislation passed Congress in early 2010 after a monumental struggle in which all Republicans voted against it. House Majority Leader Eric Cantor, R-Va., said Thursday the House will vote the week of July 9 on whether to repeal the law, though such efforts have virtually no chance in the Democratic-controlled Senate.

GOP presidential candidate Mitt Romney has joined in calls for complete repeal.

After the ruling, Republican campaign strategists said Romney will use it to continue campaigning against "Obamacare" and attacking the president's signature health care program as a tax increase.

"Obama might have his law, but the GOP has a cause," said veteran campaign adviser Terry Holt. "This promises to galvanize Republican support around a repeal of what could well be called the largest tax increase in American history."

Democrats said Romney, who backed an individual health insurance mandate when he was Massachusetts governor, will have a hard time exploiting the ruling.

"Mitt Romney is the intellectual godfather of Obamacare," said Democratic consultant Jim Manley. "The bigger issue is the rising cost of health care, and this bill is designed to deal with it."

More than eight in 10 Americans already have health insurance. But for most of the 50 million who are uninsured, the ruling offers the promise of guaranteed coverage at affordable prices. Lower-income and many middle-class families will be eligible for subsidies to help pay premiums starting in 2014.

There's also an added safety net for all Americans, insured and uninsured. Starting in 2014, insurance companies will not be able to deny coverage for medical treatment, nor can they charge more to people with health problems. Those protections, now standard in most big employer plans, will be available to all, including people who get laid off, or leave a corporate job to launch their own small business.

Seniors also benefit from the law through better Medicare coverage for those with high prescription costs, and no copayments for preventive care. But hospitals, nursing homes, and many other service providers may struggle once the Medicare cuts used to finance the law really start to bite.

Illegal immigrants are not entitled to the new insurance coverage under the law, and will remain one of the biggest groups uninsured.

Obama's law is by no means the last word on health care. Experts expect costs to keep rising, meaning that lawmakers will have to revisit the issue perhaps as early as next year, when federal budget woes will force them to confront painful options for Medicare and Medicaid, the giant federal programs that cover seniors, the disabled, and low-income people.

The health care overhaul focus will now quickly shift from Washington to state capitals. Only 14 states, plus Washington, D.C., have adopted plans to set up the new health insurance markets called for under the law. Called exchanges, the new markets are supposed to be up and running on Jan. 1, 2014. People buying coverage individually, as well as small businesses, will be able to shop for private coverage from a range of competing insurers.

Most Republican-led states, including large ones such as Texas and Florida, have been counting on the law to be overturned and have failed to do the considerable spade work needed to set up exchanges. There's a real question about whether they can meet the deadline, and if they don't, Washington will step in and run their exchanges for them.

In contrast to the states, health insurance companies, major employers, and big hospital systems are among the best prepared. Many of the changes called for in the law were already being demanded by employers trying to get better value for their private health insurance dollars.

"The main driver here is financial," said Dr. Toby Cosgrove, CEO of the Cleveland Clinic, which has pioneered some of the changes. "The factors driving health care reform are not new, and they are not going to go away."

Justice Ginsburg said the court should have upheld the entire law as written without forcing any changes in the Medicaid provision. She said Congress' constitutional authority to regulate interstate commerce supports the individual mandate. She warned that the legal reasoning, even though the law was upheld, could cause trouble in future cases.

"So in the end, the Affordable Health Care Act survives largely unscathed. But the court's commerce clause and spending clause jurisprudence has been set awry. My expectation is that the setbacks will be temporary blips, not permanent obstructions," Ginsburg said in a statement she, too, read from the bench.

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No surprise — Census Bureau finds income drop, poverty rate increase

The U.S. Census Bureau announced today that in 2010, median household income declined, the poverty rate increased and the percentage without health insurance coverage was not statistically different from the previous year.

Its findings were released in a report "Income, Poverty and Health Insurance Coverage in the United States: 2010." The information was complied from information collected in the 2011 Current Population Survey Annual Social and Economic Supplement.

Here's a look at 2010 and how it compared to 2009:

Median household income — $49,445, a 2.3 percent decline from the 2009 median.

Poverty rate — 15.1 percent, up from 14.3 percent in 2009 ─ the third consecutive annual increase in the poverty rate. There were 46.2 million people in poverty in 2010, up from 43.6 million in 2009 ─ the fourth consecutive annual increase and the largest number in the 52 years for which poverty estimates have been published.

Health insurance — The number of people without health insurance coverage rose from 49 million in 2009 to 49.9 million in 2010. The percentage without coverage −16.3 percent – was not statistically different from the rate in 2009.

The Census Bureau will release state and county data next week.

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Hundreds rally against closing SRS office

Hundreds of people showed up in South Park on Saturday, July 16, 2011, to rally against the closing of the Social and Rehabilitation Services office in Lawrence.

Hundreds of people showed up in South Park on Saturday, July 16, 2011, to rally against the closing of the Social and Rehabilitation Services office in Lawrence. by Richard Gwin

Ray Cho, of Lawrence, works at a local engineering firm, somewhat removed from the social services community.

But he said he values the services provided by the Lawrence branch of the Kansas Department of Social and Rehabilitation Services, and he joined hundreds Saturday morning to protest the local office’s announced closure.

“I see the need,” said Cho, holding a sign that read, “10,211 use the Lawrence SRS office.”

Since the recent announcement by Gov. Sam Brownback and SRS Secretary Robert Siedlecki Jr. that the Lawrence office would be closing as a cost-saving measure, many in Lawrence have expressed shock and disbelief at the decision. More than 600 people attended a town hall meeting Monday to discuss the closure, and community members have started a Twitter and Facebook campaign to “Save Our SRS.”

According to state officials, closing the Lawrence SRS would save $413,000. In the future, those currently receiving SRS services in Lawrence would need to travel to other offices, such as SRS facilities in Topeka, Ottawa or Overland Park.

Advocates and consumers of SRS services — which include food stamps, general assistance and vocational rehabilitation — expressed determination at the rally that they would fight the closure.

“We will not sit back,” said Peter Luckey, pastor at Plymouth Congregational Church. “We will not stop.”

Despite the recent controversy about the closure, Siedlecki has not backed off of the decision, said rally organizer Abbie Hodgson.

“Secretary Siedlecki is holding strong,” she said.

Numerous local politicians, including State Sen. Tom Holland, D-Baldwin City; State Rep. Paul Davis, D-Lawrence; and Douglas County District Attorney Charles Branson, spoke at the rally in support of keeping the Lawrence SRS office open. The speakers highlighted the hardships many in Lawrence will face if the local branch shuts down. A date has not been set for a possible closure, but a general timeline of several months has been given by state officials.

Still, organizers remained optimistic that the office will be saved.

“I’m hopeful,” said organizer Jacob Beaumont, who along with volunteers scoured South Park with petitions. “I wouldn’t be doing this if I didn’t believe we could save the office.”

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Kansas families can now buy child-only health insurance

In the last quarter of 2010, most insurance companies in Kansas stopped selling child-only health insurance. They said the federal government's Patient Protection and Affordable Care Act provisions allowed families to wait until children became sick to buy coverage, which made sales of the policies unprofitable. The exception is in Johnson and Wyandotte counties where one insurance company continues to offer the policy.

Now, for families living in Kansas other counties, an amendment to the state's Uninsurable Health Insurance Act allows Kansas children under age 19 who were unable to buy or obtain child-only health insurance to apply for coverage under the state's high risk pool. This pool is operated by the Kansas Health Insurance Association (KHIA).

All this came about because the Kansas Insurance Department proposed the legislation, which became House Bill 2075. The bill was passed by the Kansas Legislature and signed by Gov. Sam Brownback.

The amendment gets rid of a Catch-22 in the act. Before the new rules, families could apply for the KHIA pool, but they were required to obtain denial of coverage from two companies first. When the companies pulled their coverage in all but two Kansas counties, families in 103 counties could not obtain any denials.

In Johnson and Wyandotte counties, where one insurance company still offers child-only coverage, families can show eligibility for the KHIA plan by proving they've been denied coverage by that company, or show that the premium quoted was higher than the KHIA rate.

Families need separate child-only policies for a couple of reasons, says Linda Sheppard, director of the state Insurance Department's Accident and Health Division:

  • Parents may have coverage offered by their employer, but the employer offers employee-only coverage. If the parents want health insurance for their children, they must buy a separate policy.
  • A grandparent or another adult who has taken responsibility or custody for a child needs to purchase separate insurance because they're in the middle of the process of taking custody, or their own insurance doesn't cover the child.

"We had that situation happen to one of the employees in our department," said Sheppard. "They were taking custody of their teenage grandchildren. They were over 65 and already on Medicare, and they were not able to purchase coverage for their grandchildren in the county in which they lived."

Sheppard doesn't know how many children are eligible or will take advantage of the new coverage. "We did a quick review when companies started notifying us that they were withdrawing the coverage," she says. "It's probably in the hundreds of people. I don't know that the number is huge."

After companies no longer provided child-only policies, the Insurance Department's consumer assistance division received some calls, "so we knew there's a need out there."

For more information on the KHIA plan for child-only policies, call 1-800-362-9290 or go to the KHIA website.

“The new law provides a temporary solution until 2014, when all health plans are required by law to provide coverage without consideration of health status,” said Insurance Commissioner Sandy Praeger.

Kansas Insurance Commisioner Sandy Praeger, left, participates in an online chat Wednesday, Jan. 26, 2011, in The News Center while public information officer Bob Hanson is on the phone. Praeger will be answering questions about insurance and health reform during another chat Aug. 1.

Kansas Insurance Commisioner Sandy Praeger, left, participates in an online chat Wednesday, Jan. 26, 2011, in The News Center while public information officer Bob Hanson is on the phone. Praeger will be answering questions about insurance and health reform during another chat Aug. 1. by Kevin Anderson

Just for review, this is what's occurred since the Affordable Care Act went into effect in March 2010:

  • The creation of a new high-risk pool for uninsured Kansans who can’t get coverage anywhere else.
  • Dependent coverage extended to age 26.
  • Preventive services now included in your policy.
  • No canceling of policies (rescissions) for mistakes made on applications.
  • Small business tax credit.
  • Early retiree reinsurance.
  • Additional consumer education assistance.
  • Information available on www.healthcare.gov as well as the Kansas Insurance Department website.

In 2014:

  • Almost everyone will be required to have health insurance or pay a penalty.
  • Insurance exchanges will be set up to help people choose the coverage they want if they need insurance or do not purchase insurance through a local agent.
  • The high-risk pool will be eliminated.
  • Guaranteed Issue and no pre-existing condition exclusions in all markets; this makes coverage accessible to everyone, regardless of health status.
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Kansas Insurance Department to host public meetings about health reform

The Kansas Insurance Department will host three public meetings this fall about health insurance.

The meetings will focus on the new federal health reform law, health insurance regulation and how health insurance rates are determined.

Commissioner Sandy Praeger, of Lawrence, and others from the department will give presentations, followed by a question-and-answer period.

Kansas Insurance Commissioner Sandy Praeger

Kansas Insurance Commissioner Sandy Praeger

“With the federal health reform law now in effect, it’s important for Kansas consumers, health providers and insurance agents to understand the changes and how the department must deal with them. We also want to explain how health insurance companies arrive at the premiums for their customers, and how Kansas law determines our regulation of those rates.”

— Insurance commissioner Sandy Praeger

The meetings will be:

Wednesday, Nov. 10 — 1 p.m., Hays Medical Center, Hadley Conference Rooms, 2220 Canterbury.

Tuesday, Nov. 23 — 9 a.m., Kansas University Edwards Campus, Regnier Hall Auditorium, 12600 Quivira Road.

Thursday, Dec. 9 — 1 p.m. Wichita State University Metropolitan Complex, Sudermann Commons, 29th and Oliver.

Kansas consumers with questions now can call the Consumer Assistance Hotline at 800-432-2484.

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One in 7 were denied insurance

...according to a congressional investigation. An article by the Wall Street Journal about the findings, said:

Two top House Democrats said the findings covered 2007 to 2009 for Aetna Inc., Humana Inc., UnitedHealth Group Inc. and WellPoint Inc. In total, the carriers denied coverage to more than 651,000 people due to pre-existing medical conditions over the three-year period.

In 2014, the health care reform act won't allow people to be denied coverage because of a pre-existing condition.

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New web site shows health insurance prices

Found this on USAToday last week, an article by Alison Young: "New website shows prices for individual health coverage".

A web site that will be VERY useful for those of you looking for your own policies. Lest you think that's only a handful of people, consider this: 16.7 million people younger than age 65 have individual policies.

Millions of consumers who shop for health insurance policies in the individual market will get a tool today that will help them compare prices and see inside information on how often insurers deny applications for coverage.

Check the USAToday.com article out for a great overview of why the U.S. Department of Health and Human Services put the site together.

Unfortunately the article didn't have the link to the site, but I tracked it down (not that it was so difficult) at Healthcare.gov. Right there on the upper left of the main page is "Explore your coverage options", where you can select the state you live in, and start the process.

Here's a tutorial provided by Healthcare.gov on how to use the new Insurance Finder.

According to a message from HHS Secretary Kathleen Sebelius:

The Insurance Finder is designed to make it easy for you to see many of the things you need to know to make a decision about your insurance coverage. It includes helpful features that let you see specifically what benefits are excluded under the plan you’re considering, including benefits like maternity care and prescription drugs. To break through all the “insurance speak,” you can click on terms to see important cautionary notes and definitions. And you can select up to three plans and select “compare these plans” to see all their details at once.

I'll post in the Nosurance resources section, too.

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Consumers think they have no control over health care costs

From Marketing Daily comes this article about a survey of 1,500 people who say they feel helpless about controlling health care costs, think that health insurance companies are responsible for lowering costs, and don't know much about health care reform.

They also think that the media doesn't present the issues in an unbiased way. From a journalists' point of view, that's interesting and dismaying. At WellCommons, we strive to provide the best information and links to the best information about health care and health care reform.

Please be sure to let us know if we're missing anything that should be included, or if you think our coverage is biased.

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Can we learn lessons from health care for dogs?

That's what Dr. Danielle Ofri considered, after wading and slogging through the health insurance maze just to get approval for a standard procedure, and then compared it to the care for her dog.

She tells the very poignant tale in today's Well column -- Quality Health Care? Ask Your Veterinarian -- on the NYTimes site.

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Health insurance and the self-employed

This NYTimes article by Lesley Alderman says people who are self-employed won't benefit from the new health care act until 2014, and explains how some, who were paying more than $1,000 a month, are successfully using experienced insurance brokers to find lower cost health insurance.

“Our member brokers are reporting that the number of calls they receive has quadrupled since the president signed the health reform bill in March,” said Janet Trautwein, chief executive of the National Association of Health Underwriters, which represents nearly a third of the estimated 500,000 to 600,000 active health insurance brokers in the United States. More than a third of individuals who purchase insurance on their own use a broker, according to a recent survey by the Kaiser Family Foundation.

When I was self-employed, a local insurance broker helped me find health insurance that was reasonable and had good coverage.

If there are self-employed people out there who are having trouble finding health insurance, are there any insurance brokers in Lawrence who can help out?

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Report finds 89 percent of Kansas small businesses eligible for health care tax credits

Four million small businesses will be eligible for new tax credits this year to help pay for health insurance for their employees.

The tax credits are part of the Patient Protection and Affordable Care Act and target businesses with 25 employees or fewer.

A report released Wednesday by two advocacy groups quantified the new legislation’s impact.

In Kansas:

• 51,600 — businesses with 25 or fewer workers.

• 88.9 — percent of businesses that will be eligible for tax relief.

• 45,800 — businesses will qualify for a tax credit up to 35 percent of the cost of coverage. These are businesses that employ 25 or fewer workers who earn an average wage of less than $50,000.

• 13,100 — businesses will qualify for the maximum tax credit of 35 percent of the cost of coverage. These are business that employ 10 or fewer workers who earn an average wage of less than $25,000.

In Douglas County:

• 2,400 — businesses have 10 or fewer employees, according to Roger Zalneraitis, the city’s economic development coordinator. He used information from the U.S. Bureau of Labor Statistics and youreconomy.org It is unclear how many would qualify for the credits or how many offer health insurance.

Nationally, percentage of businesses offering health coverage:

• 46 — with three to nine employees.

• 72 — with 10 to 24 employees.

• 95 — with 50 or more employees.

“Health care costs are absolutely the single biggest issue facing small businesses. They pay 18 percent more than big businesses for their insurance, only exacerbating this crisis and this problem.”

— John Arensmeyer, CEO of Small Business Majority

Higher costs:

• Businesses with 10 and fewer workers pay about $350 more for each employee’s health insurance than businesses with more than 50 employees.

• Small businesses pay more because they don’t have the size to leverage better prices. Also, rates can skyrocket if just one worker becomes sick or has a pre-existing condition.

• 86 — percent of small businesses that don’t offer health insurance cite cost as the reason.

• 72 — percent of small business owners are offering coverage, but say they are struggling to afford it.

The tax credit:

• Tax credits are based on number of employees and their average wages.

• Employers can count two half-time workers as one full-time worker and, therefore, qualify.

• Small nonprofit employers also benefit with a maximum credit of 25 percent.

The report:

“A Helping Hand For Small Businesses: Health Insurance Tax Credits,” issued by Families USA, a consumer health organization, and Small Business Majority, a small business advocacy group.

"Employers have been willing to provide health coverage for their employees, but economies of scale have made this almost impossible for many small businesses. Starting this year, they will have access to a new tax credit to help provide this essential benefit, enabling them to hire and keep good workers who want and need health coverage.”

— Ron Pollack, executive director of Families USA

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There’s a difference between co-pay and co-insurance

And NYTimes reporter Walecia Conrad explains the difference in "When Choosing Health Care, Know What You’ll Owe".

It's worth a read, for this reason alone:

Co-insurance is common in the individual insurance market. And as companies head into this fall’s open enrollment season, many are considering a switch from co-pay to co-insurance as a way to increase employee cost-sharing and contain rising health benefit expenses, said Tom Billet, director for health and group benefits at the consulting firm Towers Watson.

Because of the confusion involving co-pay and co-insurance, many patients don’t realize just how much it may cost them until they become seriously ill or are hospitalized, said Lynn Quincy, a senior policy analyst at Consumers Union. “Ten or 20 percent may not sound like much, but 20 percent of a $100,000 surgery is a lot of money,” she said.

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Got questions about new U.S. health insurance site? Here are answers.

http://www.flickr.com/photos/mmjourno/4754642131/

Phil Galewitz at Kaiser Health News put together a very useful Q-and-A about the new U.S. health insurance site, www.healthcare.gov. The health care reform legislation required creation of the site, whose goal is to help people shop for a plan.

Federal health officials say the website - which cost $3.5 million to build - will work as a bridge to help consumers until 2014 when much of the new law takes effect, including provisions that bar insurers from discriminating against people with pre-existing conditions and establishing new health insurance exchanges, the marketplaces that make it easier for consumers and small business to buy insurance.

Among the six questions and answers:

So how does the website work?

The site takes you through a checklist: state, age range, whether you are disabled, healthy or have a medical condition. The web site asks if you are losing coverage from work or if you have any coverage. Then, you're given the choice to learn more about private health plans, along with other options such as Medicare, Medicaid, COBRA coverage and the high-risk insurance pools being set up by states and the federal government this month for people who have not been able to get insurance because of preexisting medical conditions. You enter your ZIP code to get a list of plans in your area.

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If air travel worked like health care

This is an eye-opener. http://www.youtube.com/watch?v=5J67xJ...

It's a dramatization of an article of the same name that Jonathan Rauch, a senior writer and columnist for the National Journal, wrote last September. It starts out like this:

"Hello! Thank you for calling Air Health Care, the airline that works like the health care system. My name is Cynthia. How can I give you travel care today?"

"Hi. My name is Jonathan Rauch. I need to fly from Washington, D.C., to Eugene, Oregon, on October 23."

"Yes, I'd be happy to assist you with that. It does look like we can get you on a flight on January 23 at 1 p.m. or February 8 at 3 p.m. Which would you prefer?"

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