Posts Tagged ‘deductibles’

Sick Americans Worry About the Cost of Their Healthcare

Tuesday, June 5th, 2012

Many Americans who have been sick or injured over the last year worry about the high cost of healthcare, and struggle to ensure that their care is appropriate, according to a new poll by the Robert Wood Johnson Foundation (RWJF), National Public Radio (NPR) and Harvard School of Public Health.  RWJF commissioned the poll to enhance understanding of Americans’ experiences and attitudes towards the cost and quality of medical care.

Fully 87 percent think the cost of care is a serious problem.  Approximately two-thirds – 65 percent — believe the cost of care has soared over the last five years.  In addition to the general public, the poll studied sick Americans’ experiences with and perceptions of the costs and quality of medical care.  “Sick Americans” (27 percent of adults surveyed) are defined as those who said they had a serious illness, medical condition, injury, or disability requiring significant medical care or who had been hospitalized overnight in the past year.

Many sick Americans had problems with the cost of their own medical care.  More than 40 percent reported that the cost of their medical care has caused a “very serious” (20 percent) or “somewhat serious” (23 percent) problem for their finances.  They also reported that expensive healthcare costs affected their ability to access care.  One in six sick Americans could not get the medical care they needed (17 percent).  Among the sick Americans who could not receive care, 52 percent report that it was because they could not afford the needed care, and 24 percent say it was because their insurers refused to pay for it.  Finally, 11 percent of sick Americans said they had been turned away by a doctor or hospital for financial or insurance reasons when they tried to receive care.

One of those people is Fresno, CA resident Amber Cooper, who has health insurance from her job in the accounting department of a small manufacturing company.  Then the company changed their insurance plan.  According to Cooper, “We were in a conference room…and I had heard rumors but didn’t know if it was true, and I started crying in front of everyone and actually had to excuse myself to gather myself together and go back in.  Unfortunately, the rumors had come true with potentially devastating consequences for Cooper, who had a liver transplant at the age of 10 and takes a medication twice a day so her body won’t reject her liver.

Every year my company changes the insurance.  And instead of giving us three different choices for insurance plans, they were changing to one, which was a high-deductible plan with no prescription coverage,” she said.  Cooper was devastated.  Her anti-rejection medicine costs more than $1,000 a month, a price that she could not afford to pay on her own.

Cooper found help at the HealthWell Foundation, which pays for her medication.  Still, she can’t afford the $300 monthly blood test to make sure she’s not rejecting her liver.  “It is scary because the only way to tell if you’re going to go into rejection is by the blood work.  Your numbers will be a little bit crazy, and then the doctors will be like, ‘OK, you need to get in and we need to check you out and make sure you’re OK.’  So I really took a risk not getting that blood work done.  But I couldn’t afford to get it done. I really couldn’t,” she said.

Cooper isn’t alone.  Health insurance has been changing noticeably “beneath the surface,” said Drew Altman, president and CEO of the Kaiser Family Foundation, a private, nonprofit, nonpartisan research group. “In plain language, it’s becoming skimpier and skimpier and less and less comprehensive.  This affects not only how people seek healthcare — they’re more reluctant to get it if they can put it off.  But it also affects family budgets in a very real way, especially as we’re still coming out of recession and families are still crunched by a weak economy,” Altman said.

Paul Fronstin of the Employee Benefit Research Institute says this is a national trend.  “Deductibles have gone up. Co-pays have gone up.  You see cost-sharing for out-of-network services have gone up,” Fronstin said.  “It seems to have accelerated in the last few years.  Healthcare is just continuing to take a bigger bite out of take-home pay.”  According to Fronstin, the economy is causing more companies to cut back on coverage because of the math: It’s the only way they can keep up with rising healthcare costs.  “Employers are trying to manage those costs.  They’re trying to keep those cost increases as close to inflation as possible.  And they’re doing everything they can to get their workers to think twice about the healthcare that they are using,” Fronstin said.

Consumerism Comes to the Healthcare Market

Wednesday, May 2nd, 2012

While the nation waits for the Supreme Court to hand down its decision on the constitutionality of the Patient Protection and Affordable Care Act (ACA), businesses and their employees are voting with their wallets for one approach that’s already available: Account-based health insurance plans (ABHPs), which combine lower premiums in exchange for high deductibles.

Consumer-directed health insurance is the foundation of market-oriented health reform solutions and will be offered as an option in the public health insurance exchanges if the ACA is found to be constitutional.  At present, 59 percent of major employers have an account-based health plan option, an increase of 53 percent when compared with last year, according to a survey by Towers Watson and the National Business Group on Health.  More importantly, employee enrollment in ABHPs has risen at companies offering them as a choice.  This year, 27 percent of eligible employees are enrolled, a 35 percent increase over 2011.  That finding is similar to a Fidelity Investments report showing a 61 percent surge in sign-ups for health savings accounts (HSAs) among its client companies — the largest one-year gain on record.  ABHPs are linked to tax-advantaged HSAs, because contributions can be used to accumulate funds to pay costs not covered by the high-deductible plans.  Reduced premium costs are the key driver.

Employers anticipate that their healthcare costs to rise 5.9 percent in 2012, according to the Towers/NBGH survey.  Total yearly premiums paid by employers and workers for high-deductible plans in 2011 were 10 to 19 percent lower than for managed care or traditional point-of-service plans, according to a Kaiser Family Foundation study. According to Kaiser, the average annual cost for individual coverage through a high-deductible plan last year was $4,793 — 15 percent lower than for a PPO managed care option.  “Everyone saves some money, and that really matters in tough economic times,” said Helen Darling, president and CEO of NBGH.

The downside is that high-deductible accounts shift much of the burden to the employee.  Out-of-pocket expense can be painfully high in the event of illness.  By law, there is a maximum yearly out-of-pocket liability of no more than $5,950 for single coverage and $11,900 for family coverage, although the Kaiser survey reports that the average maximum out-of-pocket cost in plans for single coverage was $3,304.  Supporters of ABHPs say that a higher out-of-pocket responsibility will create smarter, more careful healthcare consumers — which is expected to slow the rapid growth of healthcare spending.

As some employers adopt health plans that require patients to pay more out of their own pockets, demand for medical pricing information is on the rise.  In response, a new crop of entrepreneurial companies is providing price transparency tools to self-insured employers.  “The consumerism movement is finally getting wired,” said Cyndy Nayer, president, CEO and founder of the Center for Health Value Innovation in St. Louis, who believes pricing transparency in health care will lower costs by fostering competition.  “This is one of the best disruptive technologies.”

The dearth of price information in healthcare has been a major driver of ballooning costs, medical cost containment experts say.  Managed care had made pricing of individual medical services unknown to health care consumers.  Providers participating in HMOs had traditionally been paid on a per-head-per-month — basis, while insurers’ negotiated discounts off fees charged by doctors participating in their preferred provider networks were rarely disclosed to patients.  Because health insurance has been primarily paid for by employers, employees had little incentive to shop around for medical care.

Medicare Times Are a Changing

Monday, January 16th, 2012

Baby boomers may not like it — and whoever wins the White House this year — but the Medicare that our parents knew and love is destined to change. And it’ll be like it or lump it.

With more than 1.5 million baby boomers enrolling in Medicare every year, the program’s future is one of the most crucial economic issues for anyone who currently is 50 or older. Healthcare costs are the most erratic part of retirement expenses, and Medicare remains a great deal for retirees, who often get benefits worth significantly more than the payroll taxes they paid while working.  “People would like to have what they used to have.  What they don’t seem to understand is that it’s already changed,” said Gail Wilensky, a former Medicare administrator. “Medicare as we have known it is not part of our future.”

Consider these numbers.  Medicare’s giant trust fund for inpatient care is expected to run out of money in 2024.  When that happens, the program will collect only enough payroll taxes to pay 90 percent of benefits.  Additionally, researchers estimate that as much as one-fifth and even two-thirds of the more than $500 billion that Medicare now spends every year is spent on treatments and procedures of little or no benefit to patients.

Representative Paul Ryan (R-WI), chairman of the House Finance Committee, is leading the charge on changing Medicare.  Ryan’s current proposals will not impact people now 55 or older would not have to make any changes.  But how would it work?  Would it save taxpayers’ dollars?  Would it shift costs to retirees, who are least able to afford it?   Will Congress ultimately end traditional Medicare?  These questions are still waiting for answers.  “I’m not sure anybody has come up with a formula on this that makes people comfortable,” said health economist Marilyn Moon, who formerly served as a trustee overseeing Medicare finances.

The White House’s preference is to keep the existing structure of Medicare while “twisting the dials” to control spending, said Medicare trustee, economist Robert Reischauer of the Urban Institute think tank.

Ryan’s original approach would have put 100 percent of future retirees into private insurance.  His most recent plan, written with Senator Ron Wyden (D-OR), would keep traditional Medicare as an option, competing with private plans.

Writing for AARP, Ricardo Alonzo Zaldiver says that, “This could mean more Medicare recipients joining private insurance plans (currently, only about 25 percent of Medicare recipients are in private ‘Medicare Advantage” plans, while the other three-quarters participate in the traditional, government-run Medicare program).  A new voucher-for-private-Medicare plan would be available to anyone currently under 55.

“It could also mean keeping the existing Medicare structure but making certain tweaks to control spending.  Under President Obama’s healthcare overhaul, the Independent Payment Advisory Board could force Medicare cuts to service providers if costs rise above certain levels and Congress fails to act.  Obama has said he’ll veto any plan to cut Medicare benefits without raising taxes on the wealthy.  During failed budget negotiations last summer, he indicated a willingness to gradually raise the Medicare eligibility age to 67, revamp co-payments and deductibles in ways that would raise costs for retirees, and cut payments to drug makers.  ‘For the 76 million baby boomers signing up over the next couple of decades, it will pay to be watching.’”  President Obama has promised that he will veto any plan to cut Medicare benefits without raising taxes on the wealthy.

The Chicago Sun-Times offers this sage advice: “Fix Medicare, ignore scare talk.”  According to writer Steve Huntley, “I’ve contributed to Medicare every year of its existence. Yet, it’s a myth that seniors have paid the costs of their Medicare services, as demonstrated by the research of economists Eugene Steuerle and Stephanie Rennane of the Urban Institute think tank.  Their study showed that a two-income couple earning $89,000 a year would pay $114,000 in Medicare taxes during their careers but could expect to receive $355,000 in medical care in retirement. They could get prescriptions, doctor visits and hospital services valued at three times their contribution to Medicare.

“Medicare combined with Medicaid and Social Security add up to an entitlement time bomb –  they’ll consume all tax revenues by 2052, according to a Heritage Foundation analysis –  for the people who’ll be stuck with the bill: working Americans.  In 1950, there were 16 taxpaying workers for each retiree; by the time the baby boomers all retire, there will be two workers for each retiree. Entitlement reform has to happen.”

Medicare Advantage Premiums to Fall Four Percent in 2012

Tuesday, October 4th, 2011

The Obama administration’s announcement that Medicare Advantage insurance plans premiums will decline in 2012, at a time when enrollment is expected to rise, is good news for the leading health insurers in that segment.  Wall Street analyst Ana Gupte said that the announcement suggests strengthening support in the administration for the privately-run versions of the government’s Medicare program, which covers the elderly and disabled.  Medicare Advantage plans offer basic Medicare coverage with extras like vision or dental coverage oratremiums lower than standard Medicare rates.  Health and Human Services Secretary Kathleen Sebelius said that Medicare Advantage premiums will average four percent less in 2012, and insurers running the plans believe that enrollment will rise by 10 percent.  “Overall, we were very encouraged by the announcement and see this as reinforcing our bullish thesis on the Medicare Advantage and (prescription drug coverage) segments,” according to Gupte.

It’s highly unusual to see healthcare insurance premiums falling. Reduced premiums and growing enrollment are the opposite of what insurers and Republicans predicted would happen to Medicare Advantage after the passage of the Patient Protection and Affordable Care Act (ACA).  The ACA cut payments to fee-for-service Medicare Advantage plans by about $136 billion over the next 10 tears.  Right before the law passed, American’s Health Insurance Plans predicted that “millions of seniors in Medicare Advantage will lose their coverage, and millions more will face higher premiums and reduced benefits.”  So what accounts for the drop?  The decrease in premiums doesn’t have a lot to do with policy decisions made in the ACA.  It’s three outside factors that are putting downward pressure on Medicare.  One is that Medicare costs are growing more slowly.  Both in Medicare and in private insurance, the recession has seen patients using fewer medical services.  This looks to be especially true in Medicare, where seniors might have more limited resources because they tend to live on a fixed income.  The latest S&P Healthcare Economic Indices data indicates that Medicare spending appears to be rising at a slower rate than just a few years ago.

Jonathan Blum, director of the Centers for Medicare and Medicaid Services (CMS) Center for Medicare, said the more affordable costs and growth forecasts demonstrate that companies are still interested in offering such plans despite new consumer protections under the healthcare law and payment caps to insurers.  According to Blum, “We can say with complete accuracy that despite projections in 2010 that the program will decline, the program has grown and will continue to grow.  The plans have made a very strong statement that they intend to commit to the program.  Plans that do a better job serving the needs of their Medicare members should be rewarded and all plans should be encouraged to improve their performance.” 

Healthcare insurers warned that seniors can expect more costs and receive fewer benefits from their Medicare Advantage plans after payment cuts take effect.  They point to projections from the Congressional Budget Office, which predicted Medicare Advantage enrollment would fall to just 7.8 million participants in 2019.  “Medicare Advantage plans remain committed to the program and are doing everything they can to preserve benefits and keep coverage as affordable and possible for beneficiaries,” said Robert Zirkelbach of America’s Health Insurance Plans (AHIP).  “However, as these cuts take effect in the coming years, Medicare Advantage beneficiaries will face higher out-of-pocket costs, reduced benefits, and fewer health care choices.”  The group and its insurer members, who opposed many of the healthcare reforms before they passed, are now committed to implementing the law.

“Many people raised fears that under the Affordable Care Act, beneficiaries would see their Medicare Advantage options shrink and their premiums rise,” Sebelius said.  “Instead, we have seen just the opposite.”

Some in the industry are looking at other ways to bring Medicare costs down.  According to the Fierce Pharma website, “Healthcare industry leaders are poised to make their own deficit-reduction suggestions — including some that might not win them points in a popularity contest.  Uncertain what budget cuts the deficit-reduction committee might propose, the Healthcare Leadership Council has come up with its own proposal that would ask Medicare beneficiaries to endure more belt-tightening themselves.  The group is aiming to put forward an alternative more palatable than across-the-board Medicare cuts mandated by the deficit-reduction bill if the “supercommittee” doesn’t agree on its own plan.  And it’s betting that its proposal will be easier to bear than budget-cutting ideas floated in the past, such as drug re-importation.  The council, which includes Big Pharma executives, hospital companies and insurers, crafted a plan that would raise the Medicare-eligibility age little by little to 67 from 65, beginning in 2014. It would hike co-pays and deductibles.  It would require well-off seniors to pay higher premiums.  And it would add private-sector competition to traditional Medicare coverage, pitting government-subsidized private insurance plans against regular Medicare.  Requiring seniors to pay more might be considered a non-starter; after all, consumer groups, particularly AARP, have vociferously fought against such moves in the past.  But the council figures that provider-based Medicare cuts will end up costing beneficiaries when all is said and done.  ‘This thinking that we’re protecting beneficiaries because we’re only cutting providers — that’s mythical,’ said Mary Grealy, the council’s president.”

200 Economists Come Out in Favor of ObamaCare

Monday, April 25th, 2011

Approximately 200 healthcare economists are urging Congress to reject a premium support model for Medicare and instead “support vigorous implementation” of last year’s health reform law.  The economists – who are primarily academics – sent a letter to Congressional leadership saying there are two general strategies to Medicare spending and the “right” approach can be found in the Patient Protection and Affordable Care Act (ACA). “It supports research on identifying those procedures that work best,” according to the letter.  “It emphasizes payment reforms and new ways of organizing delivery of care to slow spending growth while improving care,” it said, adding that the Congressional Budget Office (CBO) projects that the Affordable Care Act will decelerate annual growth of per-person Medicare spending over the next 10 years below the rate of overall economic growth.

House Republicans recently released their fiscal year 2012 budget, which seeks to convert Medicare to a premium-support system.  Patients would be given a list of health plans from which to choose, and Medicare would subsidize the premiums.  In their letter to congressional leaders, the healthcare economists said the term “premium support” mislabels a voucher program, which they say will end up forcing consumers to pay more.  Citing CBO statistics, the economists expressed concern that current proposals link voucher payments to growth in the Consumer Price Index adjusted for population growth.  “Because medical care costs are rising much more rapidly than the CPI, this guarantees that the value of the proposed Medicare vouchers would erode over time,” according to the CBO.

Some believe that forcing people to pay more out-of-pocket expenses will make them better healthcare consumers.  Writing in The New Republic, Jonathan Cohn says that “The solution, as this argument goes, is to redesign insurance so that it forces people to pay more out-of-pocket expenses.  And, within reason, it’s not a bad idea.  Most economists, even those on the left, would agree that excessive coverage leads to higher health care spending.  But redesigning insurance in a way that actually lowers spending and, by the way, promotes good health, is a lot more complicated than merely giving people “more skin in the game,” as conservatives like to put it.  A new study by researchers affiliated with the Rand Corporation suggests why.

“The study, published in the American Journal of Managed Care, compares trends in medical spending by two groups of people — one group with traditional insurance and one with newly purchased high-deductible coverage,” Cohn notes.  “It appears to be the largest study of its kind, and the three authors did their best to adjust for factors like age, occupation and underlying medical conditions.  The result? People with high-deductible plans spent substantially less on their medical care.  That’s good news.  Or is it?  Giving people more skin in the game has distributional consequences.  It shifts the burden of medical expenses onto those people with the most serious medical problems, which is, arguably, what insurance is designed to prevent.  In addition, discriminating medical consumers are not always intelligent medical consumers.  People may decide to skimp on useful medical care rather than the superfluous kind.”

According to White House press secretary Jay Carney, healthcare savings are necessary to control the deficit. Carney said that the president would build on the work of his debt commission, whose recommendations he initially refrained from endorsing.  Carney also praised a small group of senators from both parties, known as the “Gang of Six”, which is establishing a framework where a sharply divided Congress can compromise on deficits.  “The president understands very well that healthcare spending is a major driver of our deficit and debt problem,” Carney said.  “He believes we can achieve those savings in ways that protect the people that these programs are supposed to, and were designed to, support and help.”

Nine Million Americans Lost Healthcare Coverage During the Recession

Monday, April 4th, 2011

The financial crisis not only robbed nine million Americans of their jobs – but also their healthcare insurance. According to a new study by The Commonwealth Fund, only 25 percent of Americans who lost employer-sponsored healthcare coverage succeeded at finding another source.  As a result, an estimated 52 million Americans did not have healthcare coverage in 2010.  Even though the federal government provides a subsidy, just 14 percent of people who lost their jobs continued their coverage through COBRA.

According to The Commonwealth Fund Biennial Health Insurance Survey of 2010, “Using data from The Commonwealth Biennial Health Insurance Survey of 2010 and prior years, this report examines the effect of the recession on the health insurance coverage of adults between the ages of 19 and 64 and the implications for both their finances and their access to healthcare.  The survey of 3,033 adults, conducted by Princeton Survey Research Associates International from July 2010 to November 2010, finds that in the last two years a majority of men and women who lost a job that had health benefits became uninsured.  Adults who sought coverage on the individual insurance market over the past three years struggled to find plans they could afford and many were charged higher premiums, had a health condition excluded from their coverage, or were denied coverage altogether because of a pre-existing condition.  Meanwhile, Americans with health insurance had higher deductibles and consequently greater exposure to medical costs.  And millions were struggling to pay medical bills, facing cost-related barriers to getting the care they need, or skipping or delaying needed care, including prescription medications, because of the cost.”

Just 50 percent of adults aged 64 or less are current with preventive care.  Fully 49 million employed Americans spent 10 percent or more of their yearly income on out-of-pocket costs and insurance premiums, a sharp increase from the 31 million reported in 2001.  Once the Patient Protection and Affordable Care Act (ACA) goes into full effect in 2014, the situation is likely to improve dramatically.  “These reforms have enormous potential to begin solving the problems identified in this report,” said Sara Collins, vice president of The Commonwealth Fund, a private foundation that promotes a high performing healthcare system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, children, and the elderly.

“The report tells the story of the continuing deterioration of healthcare accessibility, efficiency, safety and affordability over the past decade,” said The Commonwealth Fund president Karen Davis. “All this despite the fact that the United States spends more than any other country on healthcare.  Most recently it has failed the millions of Americans who lost their jobs during the recession and lost health benefits as well, leaving them with no place to turn for affordable healthcare coverage.  The silver lining is that the Patient Protection and Affordable Care Act has already begun to bring relief to families,” Davis said.  “Once the new law is fully implemented, we can be confident that no future recession will have the power to strip so many Americans of their health security.”

Of those people who attempted to buy an individual plan during the study’s timeframe — 19 million individuals – or 71 percent found it difficult or impossible to locate a plan they could afford and met their needs, were denied coverage or charged extra because of a pre-existing medical condition.  Adults with family incomes of less than $22,050 for a family of four were hardest hit with 54 percent having no healthcare insurance.  An additional 41 percent of families with incomes of between $22,050 and $44,100 had no coverage.  Of higher-income families, just 13 percent lacked healthcare coverage in 2010.

Conservative groups such as the Heritage Foundation are critical of the healthcare reform law.  The Washington, D.C.-based think tank wants changes made to the healthcare system to make it less reliant on government and to have individuals “own and control their own healthcare policies.”  Additionally, Heritage believes that the healthcare law will increase government spending.  “Of course there’s some people who will benefit from the law, but just focusing on individuals with benefits is misleading,” said Brian Blase, a policy analyst in health studies.  “You have to look at the law in its totality.”

Healthcare Reform May Not End Medical Bankruptcies

Monday, March 21st, 2011

Is healthcare reform a cure-all for the issue of medical bankruptcy?  Depends.  Bankruptcies occur when a person has a serious illness and cannot keep up with paying the bills.  Since RomneyCare became law n Massachusetts, the number of medical-related bankruptcies fell from 59.3 percent to 52.9 percent between 2007 and 2009, according to a recent study.

“Health costs in the state have risen sharply since reform was enacted.  Even before the changes in health care laws, most medical bankruptcies in Massachusetts — as in other states — afflicted middle-class families with health insurance.  High premium costs and gaps in coverage — co-payments, deductibles and uncovered services — often left insured families liable for substantial out-of-pocket costs.  None of that changed.  For example, under Massachusetts’ reform, the least expensive individual coverage available to a 56-year-old Bostonian carries a premium of $5,616, a deductible of $2,000, and covers only 80 percent of the next $15,000 in costs for covered services,” according to the researchers.  According to the authors, an insured couple earning more than $44,000 a year – a level that is higher than the eligibility requirement for subsidies – might pay as much as $20,512 a year for medical services.  “Massachusetts’ health reform, like the national law modeled after it, takes many of the uninsured and makes them underinsured, typically giving them a skimpy, defective private policy that’s like an umbrella that melts in the rain: the protection’s not there when you need it,” lead author Dr. David Himmelstein said in a Physicians for National Health Reform news release.  The organization’s goal is a national single-payer healthcare system.

The study’s results, which were published in the American Journal of Medicine, suggest “that reducing medical bankruptcy rates in the United States will require substantially improved – not just expanded – insurance.” http://www.latimes.com/health/boostershots/la-heb-obamacare-insurance-costs-03082011,0,7832154.story To determine if RomneyCare had cut the number of bankruptcies, the research team examined a random sample of Massachusetts bankruptcy filings from July of 2009.  After sending surveys to 500 households, they compared the results to national and Massachusetts data assembled during 2007.  The Massachusetts healthcare law went into effect in 2008. According to Dr. Steffie Woolhandler, one of the study’s authors, health insurance in Massachusetts has risen since RomneyCare was implemented.  “It’s really too much money for the average family – especially if the breadwinner is the one who gets sick,” she said.  “We need to reduce limits on deductibles and out-of-pocket costs.”

“People think they have reasonable insurance until they try and use it,” said Dr. David Himmelstein, another study author.  “You are carrying an umbrella and it starts to rain and you put it up and it’s full of holes.  For most people, it just hasn’t rained yet.”  High premiums, large co-payments and deductibles mean that even families with insurance have to pay substantial out-of-pocket costs, said Himmelstein, a professor of public health at City University of New York.  Himmelstein said his survey’s findings suggest that the national health overhaul — which was modeled on the Massachusetts law and takes full effect in 2014 – is unlikely to ease the number of medical bankruptcies, either.

Sally Pipes, a conservative healthcare expert, is a long-time critic of the Massachusetts healthcare law.  “In fact, a substantial portion of Massachusetts’ newly insured still can’t afford to purchase even basic medical services, and are effectively no better off than before the law’s passage. Meanwhile, government health spending is spiraling out of control, adding to the state’s already massive public debt.  Nearly 30 percent of Massachusetts residents report that their medical costs have increased since MassCare’s implementation.”

Employer Healthcare Coverage Costs Americans More and Offers Less

Wednesday, December 15th, 2010

American families with employer-sponsored health insurance are paying more for inferior coverage, according to a new study from the Commonwealth Fund

According to the study, premiums for family coverage rose 41 percent between 2003 and 2009, more than three times faster than median incomes.  Deductibles on a yearly basis rose 77 percent.

According to the study’s authors, “Fortunately, the Affordable Care Act (ACA) contains a significant number of coverage and delivery system reform provisions designed to reduce cost growth and provide financial protection, while improving the quality of healthcare.  The creation of state-based health insurance exchanges, the introduction of new market rules and consumer protections, and the expansion of state and federal oversight of industry practices will begin to increase value in U.S. health insurance markets.  Further analysis suggests that the incentives for administrative efficiency and modernization included in the ACA have the potential to save businesses and families $2,000 or more in premium costs by 2019.”

Whether you live in Montana, Texas, or New York, private insurance costs have been increasing faster than working family incomes,” said Commonwealth Fund Senior Vice President Cathy Schoen, the study’s lead author.   “For more than a decade, families with job-based insurance have been sacrificing wages to hold on to health insurance. The good news is that the Affordable Care Act reforms provide a foundation to improve coverage and slow healthcare cost growth in the future.”

“Health insurance is increasingly unaffordable for families, and benefits are being scaled back as employers and workers struggle to keep up in a difficult economy,” said Commonwealth Fund President Karen Davis.  “If implemented well, provisions in the Affordable Care Act — including some starting this year, such as tax credits for small businesses to provide coverage, dependent coverage for young adults up to age 26, and elimination of co-payments for preventive care — have the opportunity to reverse these unsustainable increases and ensure that families in every state have access to affordable, comprehensive health insurance.”

Why Russ Feingold Voted No

Monday, December 14th, 2009

One of the most surprising votes in the process to pass comprehensive healthcare reform is Senator Russell Feingold’s (D-WI) vote against an amendment sponsored by Senator Barbara Mikulski (D-MD) to fund women’s preventive health services.  The amendment, which will eliminate deductibles and co-payments for screenings like mammograms, passed by 61 – 39, with two Democrats voting “nay” and three Republicans voting “yea”.

Writing on AlterNet, a syndication service and online community of the alternative press, featuring news stories from alternative newsweeklies, magazines and the web, Daniela Perdomo notes that the amendment “guarantees that all women will receive a free annual gynecological exam, which would include screenings for the leading killers of women – breast, cervical, ovarian and lung cancers; heart disease; and chronic illnesses such as diabetes.  It also requires insurance plans to cover a whole slew of comprehensive preventive care and screenings specific to women, with no copayments.”

Feingold’s official statement says that he cast his “nay” vote to assure fiscal responsibility.  According to Congressional Budget Office estimates, the amendment will cost $980 million over the next 10 years.  Feingold has a history of voting for fiscal responsibility, Perdomo notes.  “I can’t rail against Feingold and say that he’s shown little fiscal restraint when voting for other measures.  He voted against the bailout giveaway to the banks.  In other words, I think Feingold’s votes are often sound.  But I do think he is wrong on this one, and I pick on him because he’s normally so level-headed.”

The other Democrat who voted against the Mikulski amendment was Ben Nelson (D-NE).  Republicans voting in favor were Olympia Snowe (R-ME), Susan Collins (R-ME) and David Vitter (R-LA).

Senator Mikulski herself sums it up the best:  “Simply being a woman is a pre-existing condition.”

Healthcare Costs Rise 5.7 Percent During 2009

Tuesday, November 17th, 2009

Healthcare costs are rising at a faster pace than inflation or wages.  Healthcare insurance costs have increased at a rate of 5.7 percent this year,  both for employers and employees.  This follows increases of 5.7 percent in 2008 and 6.1 percent in 2007.  The study also found that 59 percent of companies raised their employees’ deductibles and co-pays to fund the increase.

Although the increase isn’t in the double digits as it was a few years ago, it still outpaces the rate of inflation or workers’ incomes.  “It’s not something to cheer about, especially since costs are getting passed on to employees,” said Blaine Bos, the survey’s author.  From 2003 to 2007, the average individual deductible grew from $250 to $400.  For families, the deductible rose from $1,000 to $1,500, according to the Mercer study.

According to the study, 47 percent of companies are encouraging employees to enroll in plans with lower premiums and higher deductibles.  Another 19 percent of employers are offering consumer-directed health plans.  These have high deductibles and let employees control spending accounts.  “They encourage employees to consider costs when by letting them save account money they don’t spend for future needs,” the study concluded.