Health Care Changes in the US, Truth vs Scare

August 26, 2010 Update July 30, 2014

The Affordable Care Act, also known as Obamacare is working.

Insured Americans numbers are at an all-time high. Health insurance companies are facing what they dreaded all along; they must be fair, they are required to insure everyone, regardless of their histories, and the latest news is that the Insurance Companies are required to refund the excess amount of fees collected for premiums, that was not used.

The increase in insured individuals has also caused several other phenomenon that one rarely hears on the news:

1. Many students who attended private colleges for studies in the medical field, who could rarely find jobs after spending an arm and leg for an education, are being snatched up, left and right.
2. Pharmacies are doing booming business, requiring more employees to be hired.
3. Clinics are busy, and again, more jobs.
4. Americans who are insured are catching health problems earlier, and with a focus on wellness are avoiding late-stage diseases.
5. In States with expanded Medicaid, more jobs were added for workers in these states to educate people, and help them get enrolled.
6. Premium refunds, for those paying the higher premiums.
7. A healthier population.

Remembering back to 2007, when all of the Presidential Candidates were running for President in the 2008 Election Race, the then Senator Hillary Rodham Clinton, asked a Question on Yahoo Answers, She asked:

"Based on your own family's experience, what do you think we should do to improve health care in America?"

38,020 Answers were given in the 2 week period the Question was open . I will post the link below so that you can read for yourself all of the Heart Breaking and Horror stories of People and Families affected by no Insurance, or dealings with Insurance Companies. Any politician who did not respond to the boisterous cry from Americans and fight to get them the Care they need, does not have a heart, and likely never had to worry about Affordable Health Care either.

(See Link Below)

TIME Magazine today published an important article on how the Health Care changes that will occur in 2011 will harm Insurance Agents and Brokers.

One of the rules of new Health Care legislation is that 85% of premiums must go toward actual Health Care Expenses. This has the Insurance Industry Trolling the State Insurance Commissioners - They have 25, in their court now. Since the Insurance conglomerates could not win in Congress, they are going from State to State. They have pushed Legislation on States levels that will guarantee their Importance and continued toe-hold on the Insured!

If your Insurance Commissioner has acquiesced and pushed for the Insurance Industry, it seems to be a conflict of interest. The Insurance Commissioners have always been the one place those harmed or abused by Insurance companies could to to for help. Are we now living in lulu world?

According to Ms. Pickert, 'Agents and brokers are so concerned they will be viewed as redundant under the new law that they successfully lobbied to get state insurance commissioners to publicly acknowledge their importance. At a meeting of the powerful National Association of Insurance Commissioners (NAIC) last week in Seattle, 25 commissioners sponsored a resolution stating that implementation of health reform should "recognize and protect the indispensable role that licensed insurance professionals play in serving consumers."

The resolution was passed just as the NAIC was debating a much-anticipated set of recommendations on how insurance companies should calculate their medical and administrative expenses, known as medical loss ratios. Under the Affordable Care Act, beginning in January, plans sold to individuals and small groups must spend 80% of premiums on actual medical care (as opposed to administrative costs); the figure is 85% for large group plans. Plans that spend less will be required to send rebates to customers. The NAIC counted agent and broker commissions, which can make up 5% to 20% of premiums, in the administrative category. Most experts, therefore, predict these commissions will be on the chopping block as insurers scale back administrative expenses to comply with the new rules.'"

Are you kidding me?

1). The fact that TIME.com/CNN seems sympathetic to this group of "Important Industry" shows the exact reasons that Health Care Reform was needed, and was loudly cried for.

The Will of the People was done . There is no such thing as "serving customers" in the Insurance Industry. It is the "Insured" who serves the Insurance Industry, Boards and Stock Brokers. Those who pay Insurance Premiums, are "the Insured" and little more.

According to this article, this recent activity between the States' Insurance Commissioners and The Insurance Industry , gets to the source of the problem. Instead of acknowledging they lost this battle in Congress, on State levels, they are determined to continue practices that have plagued the American Insured for 50 years.

2). They are not more important than Grandma Smith, or Baby Jimmy, or Leland born with a Hole in his Heart. These Industry giants, who claim to have the best interest of their "customers", are once more hurting the very ones who need relief from past Insurance company practices. The way the Insurance Industry changed after 1997, created even a different Physician. This is when PPO's and HMO's began to dictate "what was a disease", "what was covered under the Insurance", "if the patient should have such extras as anesthesia or go into a heart surgery cold turkey".

3). These Brokers and Agents only have profits in mind when it comes to Insurance. Do like the rest of the country. Get an honest job, cut "administrative costs". Quit paying yourselves so many perks, or get in the unemployment line like the other million people who certainly lost their standing with you when they lost their jobs....Unless they could afford your Cobra payments.

Redundant, I'll say...

When I worked for a State Agency between 2007 - 2009, I was given two choices for Insurance Plans. After studying the plans offered, the benefits, and trade-off's, this is what I learned.

HSA accounts and High Deductible Choices.

One Plan was the Regular low deductible plan the general employee opted for.

• This was a low deductible $500.00 for an Individual plan with a premium of about $78.00
• Twice per month for an Individual.
• The co-pays were anywhere from $50.00 to $25.00 per visit.
• The co-pays on prescriptions was fairly low.
• Anything but a regular check-up needed to be approved by the provider,
• Many drugs and treatments that did not fall under the coverage of the Insurance.
• opt in for a type of Health Savings Account, but it was a reimbursement plan.

The Heath Savings Account that rolls over to an interest bearing account, then to an IRA forever is a model that should be used Nationally. Each account has a certain amount per pay period put onto the card. This card can be used for anything medical. This includes, IRS approved over the counter drugs, and medical supplies.

Having that pre-tax money go specifically for Health Care needs, helps people and their families to be healthier. Office visits, drugs, diabetic supplies.

The Second Plan, was amazingly affordable. This type of plan is especially for those are healthy, and rarely, if ever use their Insurance at all.

In years past, I lost thousands in premiums paid for nothing, because the insurance was too expensive to use. It is the "just in case" scenario, that keep the Insured, shelling out. Although the deductible was low, $500.00 is steep to many workers. After a lot of calculating, several phone calls and a one hour meeting with her HR person, this is what I learned about the Second Plan.

• Deductible $2,500.00
• One Free Wellness Check-Up per Year (changed to twice per year)
• If you are hospitalized from an ER Room visit, the Deductible is waived
• The Premiums for the first year were $15.00 every two weeks
• The Second year of Healthful Living lowers the premiums each year to Free
• HSA Account - Draws Interest after it reaches $100.00 balance,
• HSA Account - After it reaches $1,000.00 has option to convert to a Roth IRA
• HSA Account - Rolls over, year after year, until retirement.
• The Insured chooses the amount that comes out each pay period
• The account holder is issued a "Credit Card", good at almost every pharmacy and medical provider, Including Medical Collections, E.R.s, Hospitals and Dr's Offices (some dental)
• The amount contributed is Pre-Tax Dollars, allowing you more net of your paycheck.
• The HSA /IRS rules allow the Insured to buy most OTC drugs, and remedies. Birth Control, First Aid Kits, Heating Pads, Ice Pack, Diabetic Supplies, the list is long, and grows longer. These are all things that will help a person get better without having to see a physician, or even get advice of remedies over the phone without going to the medical provider.
• The more Healthy people within a Health Program, the more people will enroll, giving a wider base to cover those who are riddled with Health Problem
• The Health Care Reform Act is pushing more employers to offer better HSA plans for employees.
• The high deductible, combined with the HSA Account for healthy people, or those on the road to a healthier lifestyle - A Person with a Healthy Lifestyle, in essence, Pays Their Self for being Healthy. [I guess that is why it is called "Smart Choice"]

Hopefully this Hub has been some help in giving you real facts about the Health Care Reform Act, and how it will affect Employers and Employees.