Gallup Poll: More Americans Buy Health Insurance on Their Own.

More and more U.S. adults get health insurance on their own or through a family member, a new Gallup poll finds.

The survey regularly examines the type of health care coverage chosen by Americans. Before open enrollment for the Affordable Care Act’s online insurance exchange, the survey shows, 16.7 percent paid for insurance plans on their own or were financed by a family member. That number grew to 20 percent by April.

Medicaid, the federal-state health program for low-income Americans, also rose:  9 percent of adults said they were on Medicaid compared with 6.8 percent before open enrollment.

The health law, known as Obamacare, expanded access to Medicaid by requiring all states to increase eligibility. After the Supreme Court struck down that requirement, several states opted to offer their programs to more residents.

Employer-sponsored insurance edged down from 44.4 percent of adults to 43.1 percent during the same period. Gallup said the decline could come from several factors, such as employers dropping coverage for employees, workers opting out of employer plans, or Americans leaving the workforce altogether.

Overall, the percentage of uninsured Americans dropped to 13.4 percent last month, Gallup noted.

Health Insurance Coverage for Children (Minors & Young Adults)

The Affordable Healthcare Act (ACA) includes provisions specifically designed to address the medical insurance needs of children and young adults. These changes extend health coverage to millions of previously uninsured young Americans and also guarantee insurance to children with pre-existing conditions. Several other changes are scheduled to take effect in 2014 that will expand coverage to those over 26 years of age.

Up to 17 million children under 18 may have some sort of pre-existing condition that could have prevented them from obtaining health insurance before the ACA took effect. Now insurance companies may not deny, exclude, or limit coverage to children with a pre-existing condition. This protection also extends to all individual and job-related policies that are grandfathered. In 2014, the prohibition against rejecting a health insurance application on the basis of a pre-existing condition will cover Americans of all ages.

The new insurance requirements created by the ACA also affect The Children’s Health Insurance Program (CHIP), which is the component of the Medicaid program that provides low-cost or free health insurance to children. The current eligibility standards for CHIP will remain in place through 2019 and financial funding for CHIP is now guaranteed through 2015. However, given health insurance subsidies from the government along with an expansion of Medicare eligibility, there are questions regarding how the CHIP program may need to evolve in the future.

Additional ACA changes increase the age at which young adults can be removed from their parents’ insurance plan. It is estimated that this policy has already enabled up to 3 million Americans between 19-25 that were previously uninsured to gain health coverage. Previously, insurance companies could require families to remove children from their plans at age 19. This limit is now raised to age 26 and applies to young adults across the board even if they are not living at home or are currently married.

This increased coverage for young adults also provides for those children in the foster care system over age 19 to remain eligible for the Medicaid program through age 26. There is one exception to the age limit increase. If a young adult is eligible for coverage through his or her employer and their parents’ plan is grandfathered, the parents’ insurance provider is not required to observe the new age limit increase. This exception will expire in 2014.

These age limit changes include tax benefits for those parents whose employer-provided health coverage includes their adult child in their insurance plan. Generally, healthcare coverage for adult children up to age 27 is now tax-free in most cases. These tax benefits currently extend to various workplace and retiree health plans and some self-employed consumers.

Employees with cafeteria plans, or plans that allow consumers to pick from a menu of tax-free benefit options and cash or taxable benefits, may now begin to make pre-tax payments for the health coverage of their young adult children. Since insurance plans usually expire at the end of the calendar year and coverage for adult children expires on their 26th birthday, these benefits are designed to ease the financial necessity of continuing to pay for a plan for which the adult child can no longer use.

Docs frustrated with PPACA.

Doctors aren’t thrilled about the way the health care landscape is changing.

In the face of health reform and other regulatory pressures, a survey reveals that a big proportion of doctors wish they could turn back time and choose a different career path. Forty percent of doctors said they wouldn’t become a physician again given the chance to rethink their career, according to research from the Physicians Practice, which surveyed 1,172 physicians.

Of those who said they wouldn’t become a physician again, 32 percent felt there was too much third-party interference in their practice operations. When asked to indicate the largest barrier to good health care for their patients, 37 percent of physicians identified a lack of adequate insurance coverage and 19 percent said they don’t have enough time to adequately educate patients on better health strategies.

Meanwhile, just 35 percent of respondents said they support the Patient Protection and Affordable Care Act or support it with minor changes.

PPACA has been a sore subject for many doctors, as research continues to find that PPACA could deepen the doctor gap. The influx of millions of newly insured Americans who gain coverage under PPACA next year, on top of the already growing physician shortage, will have profound implications for patient access to medical care, industry insiders warn.

“We are at a critical juncture,” Dr. Steven Wartman, president and CEO of the Association of Academic Health Centers, said earlier this year. “As the 2014 deadline for most Americans to have health insurance approaches, the health care workforce is not ready, and we are quickly running out of time.”

The Doctor Patient Medical Association has argued that PPACA will have little positive impact on patients’ access to medical care and will only create red tape for doctors.

Similarly, 45 percent of physicians surveyed by the Physicians Practice said that the re-election of President Obama “bodes poorly for the future of health care.”

Though the survey focused on the frustrations of doctors, the majority — at 60 percent — said they’d choose their career again. The survey also found that 46 percent of physicians said they will continue to practice the same way they do today over the next five years. Fourteen percent of those surveyed plan on retiring in that same time frame.

By  September 10, 2013

America’s biggest employers, from GE to IBM, are increasingly moving retirees to insurance exchanges.

(Bloomberg) — America’s biggest employers, from GE to IBM, are increasingly moving retirees to insurance exchanges where they select their own health plans, an historic shift that could push more costs onto U.S. taxpayers.

Time Warner Inc.  said Sunday it would steer retired workers toward a privately run exchange, days after a similar announcement by International Business Machines Corp. General Electric Co. last year said it, too, would curb benefits in a move that may send some former employees to the public insurance exchanges created under the 2010 Affordable Care Act.

While retiree health benefits have been shrinking for years, the newest cutbacks may quickly become the norm. About 44% of companies plan to stop administering health plans for their former workers over the next two years, a survey last month by consultant Towers Watson & Co.  found. Retirees are concerned their costs may rise, while analysts predict benefits will decline in some cases.

“Things are going to change dramatically,” said Ron Fontanetta, a partner at New York-based Towers Watson, which advises GE and other large companies. “Over the next two to three years, we see a much more aggressive rethinking of what employers are going to provide.”

The adjustments come as insurers have increased access the past few years to Medicare Advantage plans that provide benefits beyond the U.S. government health program for the elderly. Additionally, the health-care law promises to make it easier for those younger than 65 to buy insurance that’s guaranteed and subsidized by taxpayers.

Private Exchanges

The private exchanges are designed to join with companies to find the best deals for the former workers. The public exchanges established under ‘Obamacare,’ set to open Oct. 1, were created to provide insurance for millions of uninsured Americans. In both cases, enrollees will be able to select from a menu of private health plans.

Companies argue that many retirees can find more choice and a better deal on the exchanges, said John Grosso, head of the retiree health task force at Aon Hewitt LLC, a Chicago-based consultant. Instead of taking a one-size-fits-all company plan, a healthier retiree might find a less expensive policy with a higher deductible, or one that saved money by favoring generic drugs, he said in a telephone interview.

Less healthy workers or those who need more comprehensive coverage may not fare as well, Grosso said.

‘Gold-Plated’ Plans

“Some of them may not be as well off because they had a really gold-plated plan, but others who are paying a meaningful contribution to their own plan now can right-size the coverage,” he said.

At the same time, retirees have expressed concern that subsidies provided by companies in private exchanges may not keep up with rising medical costs, potentially putting them at financial risk in the future. And an influx of retirees could put added pressure on public exchanges that provide taxpayer-supported subsidies.

Retirees aren’t the only ones feeling the pinch. Last month, United Parcel Service Inc. told workers it would no longer provide health care for 15,000 spouses who can get benefits through their own employer. The company cited rising medical costs in general as well as the added expenses and new insurance options created by the health law.

IBM’s Decision

IBM said last week it will shift about 110,000 Medicare-eligible retirees to Tower Watson’s Extend Health, the largest private Medicare exchange. Former workers will find more options than the business could provide through its own plan, IBM, the third-largest U.S. employer according to data compiled by Bloomberg, said in a statement e-mailed Sept. 7. Caterpillar Inc. and DuPont Co. also have moved Medicare-age retirees onto the Extend exchange.

For most, coverage will come “at the same or lower cost” than they pay now. The Armonk, New York-based company will still make contributions to a tax-free health retirement account for the workers.

IBM capped its subsidies to retirees in the 1990s and “didn’t make this change to save money,” Doug Shelton, a spokesman, said in an e-mail. “It does not reduce our costs.” Rather, the company is making the change to help former workers, whose premiums and out-of-pocket charges are projected to triple by 2020 under the current plan, Shelton said.

Some unions now angry about PPACA.

WASHINGTON (AP) — When President Barack Obama helped push the Patient Protection and Affordable Care Act (PPACA) through Congress, he counted labor unions among his strongest supporters.

But some unions leaders have grown frustrated and angry about what they say are unexpected consequences of PPACA — problems that they say could jeopardize the health benefits offered to millions of their members.

The issue could create a political headache next year for Democrats facing re-election if disgruntled union members believe the Obama administration and Congress aren’t working to fix the problem.

“It makes an untruth out of what the president said, that if you like your insurance, you could keep it,” said Joe Hansen, president of the United Food and Commercial Workers International Union. “That is not going to be true for millions of workers now.”

The problem lies in the unique multiemployer health plans that cover unionized workers in retail, construction, transportation and other industries with seasonal or temporary employment. Known as Taft-Hartley plans, they are jointly administered by unions and smaller employers that pool resources to offer more than 20 million workers and family members continuous coverage, even during times of unemployment.

The union plans were already more costly to run than traditional single-employer health plans. PPACA has added to that cost — for the unions’ and other plans — by requiring health plans to cover dependents up to age 26, eliminate annual or lifetime coverage limits and extend coverage to people with pre-existing conditions.

“We’re concerned that employers will be increasingly tempted to drop coverage through our plans and let our members fend for themselves on the health exchanges,” said David Treanor, director of health care initiatives at the Operating Engineers union.

Workers seeking coverage in the state-based marketplaces, known as exchanges, can qualify for subsidies, determined by a sliding scale based on income. By contrast, the new law does not allow workers in the union plans to receive similar subsidies.

UPS ending health coverage for some spouses.

(Bloomberg) — United Parcel Service Inc.’s decision to drop health benefits for 15,000 of its workers’ spouses may be a sign of the future, as U.S. businesses grapple with rising medical bills and the added burdens of the Affordable Care Act.

The nation’s fourth-largest employer said yesterday that beginning Jan. 1 it will no longer offer health coverage to spouses who can get it through another company. UPS cited the ACA as part of its impetus, saying it would increase costs and provide other insurance options for spouses.

The shift is a sign of corporate America’s increasing willingness to make deep changes to benefits once taken as a given by U.S. workers. The health care overhaul, estimated to boost expenses for businesses by 2% to 4% next year, is adding to the momentum that already spurred higher deductibles and surcharges for covering dependents.

“The feeling is, drastic times call for drastic measures,” says Rich Fuerstenberg, a partner at New York-based benefits consultant Mercer Inc. “What employers are adopting today are strategies that were considered crazy or out of the mainstream just a few years ago.”

The benefits change will only affects workers in the U.S., according to a memo to employees published yesterday by Kaiser Health News. Spouses who don’t work or lack employer-provided insurance will still be covered by the Atlanta-based company’s health plan, as will children of workers, according to the memo. The change won’t affect 250,000 Teamsters union workers or employees in other countries.

Study: Navigators, Nonprofits Least Likely Sources of Health Insurance Guidance.

Across the country, the federal government is bestowing millions of dollars on a navigator program and an array of non-profits to help guide people through the new health insurance marketplaces. But a new nationwide survey raises questions about how readily consumers will turn to these groups for advice on health coverage.

The study, conducted by HealthPocket.com, a nonpartisan web site that compares and ranks health plans for individuals, families and small businesses, found that navigators and non-profits are the least likely sources for information about health insurance to which consumers will turn. According to the survey, consumers are far more likely to look to their doctors and pharmacists for advice, and even more likely to stand pat with the insurance they already have and not seek any sort of advice at all.

“The financial viability of the new health insurance exchanges is closely tied to the enrollment of younger, healthier individuals, and administration officials have stated that they would like to get 2.7 million enrolled from this age segment,” said Bruce Telkamp, CEO of HealthPocket, based in Sunnyvale, Calif. But “given that only 3 percent of consumers in the critically important 18 to 34 year age group indicated that they will use navigators or nonprofits as a primary source of advice, the administration will need to rely heavily on marketing channels outside of the navigator program and nonprofit outreach to meet its enrollment goals.”

Navigator is the term used by the Affordable Care Act to describe the health insurance councilors and customer service personnel who will help people enroll and sort through their health plan options on the new exchanges. Last week, the Obama administration announced it was awarding another $67 million in grants to non-profits and other community-based organizations to hire and train navigators. These awards come on top of the $150 million in government monies provided in July to nearly 1,200 community health centers nationwide for the same purpose.

 

Obamacare Navigators get $67 million in grants.

CHICAGO (AP) — President Barack Obama’s administration has announced $67 million in awards to organizations that will help people sign up for insurance under the new health care law.

Health and Human Services Secretary Kathleen Sebelius announced Thursday the Navigator grant awards to 105 organizations in states that are letting the federal government run their online insurance marketplaces.

The Navigator program will be particularly important to the health law’s success in some Republican-led states that aren’t doing any state-directed outreach to the uninsured.

The grant winners don’t have much time to hire and train outreach workers. Enrollment for the health law’s new coverage options starts Oct. 1, and benefits kick in Jan. 1.

Navigators must complete a training program developed by the federal government and pass an exam.

PPACA navigators to earn $20-$48 an hour.

Consumer Cost Protection in Obama Health Plan Is Delayed.

Federal regulators have delayed a consumer protection in President Barack Obama’s signature health law that limits the out-of-pocket costs of people with insurance.

The one-year postponement of the annual limit on costs that patients must pay above what their insurance covers is another setback for a health-care law that has met resistance from Republicans and faced delays in enforcement of other key provisions.

The White House announced on July 3 that it would postpone, also for one year, the so-called employer mandate, which requires companies with 50 or more workers to provide health insurance to employees.

The limit on out-of-pocket costs, such as deductibles and co-payments, was supposed to be $6,350 for an individual and $12,700 for a family beginning in 2014. Federal officials now will allow some insurers to wait until 2015 to comply with the consumer protection.

The one-year postponement applies only to group health plans such as those offered by employers and unions and only to plans which use independent managers to handle pharmaceutical or other benefits, said an administration official who asked not to be identified speaking about internal deliberations.

Individual policies sold in the new marketplaces created by the health care law still must comply on schedule with the overall limits on out-of-pocket costs included in the health care law, the official said.

Individual Health Insurance

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