Health Care initiatives in the world of the unemployed

I saw a couple of posts on the other topic threads on Health Care. Since UIO has generously configured an off-topic board for such discussions I thought I might give it a try.

I’ve (unfortunately) had time to watch and read a lot of reporting on this and went to a town hall meeting on the pending Health Care initiatives this past Tuesday.

This seems to be an awfully emotionally charged issue for some people. I hope we can take a factual unemotional approach to this.

What has prompted me to look at this is I have been able to take advantage of the current law to maintain affordable health insurance for myself. I would like to see what ever is done in Washington to not disrupt this.

It’s a complicated issue. The main source of information that is written down is the bill that has come out of committee in the US House of Representatives (HR 3200). You can go on line and read it (rest up because its ~1070 pages of legalese).

I have read some sections of it.

I will subsequently post some info on this subject. I will try very hard to post factual information. If I state an opinion or conclusion vs. a fact I will say so.

If something I post were factually incorrect, I would welcome data to the contrary. Obviously I’m sure many of you have input on this. I look forward to reading it.

We'll see how it works
Thanks!

To make this somewhat relevant, I wanted to relate my experience in maintaining my health care coverage while unemployed and what may possibly happen to it under the pending initiatives.

Just some background on me: I’ve been unemployed for a few years and was formally employed in Corporate Marketing. When I was laid off I thought it was important to maintain health care coverage. (It’s my understanding that it is easier to purchase coverage if you are already insured vs. if you are not insured).

The next logical step was to purchase insurance via COBRA (which is essentially purchasing your former employer's insurance at their rates). Given being laid off was a life changing event for me, I immediately subscribed to COBRA, my old company's plan was a almost a "Cadillac" of plans, it had modest co-pays and a deductible but it covered Medical, Dental, and Vision and had a $1M lifetime benefit. In my world it was somewhat expensive (this was before the stimulus package and thus I had no government assistance in paying for it).

I continued on COBRA for the full 18months. After that I purchased coverage via a "high deductible" insurance plan (medical only) in conjunction with a Health Savings Account (HSA). This plan had a $3M lifetime benefit[at a 36% discount from what Cobra had cost]. The way this works is you trade a higher deductible for a lower premium, and your medical and dental out of pocket expenses are tax deductible (similar to a Flex Spending arrangement that some of you may have had with your employers)

After 1 year my insurer announced that they would raise their rate by 30%. I did my research on the web, fired my insurer and purchased new (high deductible-HSA) insurance for 10% cheaper than my previous plan’s initial cost (with a $5M lifetime benefit).

This plus a discount on dental insurance I receive from a trade group allows me to access affordable health care coverage.

All the insurance companies I am referring to here are household names in the industry.

Given thus far Ive been able maintain some level of health insurance without the assistance of the taxpayers (if you dont count my unemployment benefits) , I follow the health care initiatives debate with great interest. The people in power who advocate reform insist that you will be able to keep your own insurance. When I heard that I thought "great", this doesnt impact me. However I started to read reporting that this was not necessarily correct. Ive pasted a article below (the link is gone) from Investor's Business Daily which explains this in not really the case in the House Bill (HR 3200). I subsequently read this section of the bill on the web and what the article states is correct. (see below). I would encourage you to read the article then pull up page 16 on the bill and read it .


It's Not An Option
Posted 07/15/2009 06:46 PM ET

Congress: It didn't take long to run into an "uh-oh" moment when reading the House's "health care for all Americans" bill. Right there on Page 16 is a provision making individual private medical insurance illegal.
When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.
It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of "Protecting The Choice To Keep Current Coverage," the "Limitation On New Enrollment" section of the bill clearly states:
"Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law.
So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won't be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.
From the beginning, opponents of the public option plan have warned that if the government gets into the business of offering subsidized health insurance coverage, the private insurance market will wither. Drawn by a public option that will be 30% to 40% cheaper than their current premiums because taxpayers will be funding it, employers will gladly scrap their private plans and go with Washington's coverage.
The nonpartisan Lewin Group estimated in April that 120 million or more Americans could lose their group coverage at work and end up in such a program. That would leave private carriers with 50 million or fewer customers. This could cause the market to, as Lewin Vice President John Sheils put it, "fizzle out altogether."
What wasn't known until now is that the bill itself will kill the market for private individual coverage by not letting any new policies be written after the public option becomes law.
The legislation is also likely to finish off health savings accounts, a goal that Democrats have had for years. They want to crush that alternative because nothing gives individuals more control over their medical care, and the government less, than HSAs.
With HSAs out of the way, a key obstacle to the left's expansion of the welfare state will be removed.
The public option won't be an option for many, but rather a mandate for buying government care. A free people should be outraged at this advance of soft tyranny.
Washington does not have the constitutional or moral authority to outlaw private markets in which parties voluntarily participate. It shouldn't be killing business opportunities, or limiting choices, or legislating major changes in Americans' lives.
It took just 16 pages of reading to find this naked attempt by the political powers to increase their reach. It's scary to think how many more breaches of liberty we'll come across in the final 1,002.

Below is a link to the best summary Ive found of the current Health Care reform bill (HR 3200) that is before the House of Representatives. Ive not verified every item by cross checking it with the actual bill but I have no reason to believe its inaccurate. The most disturbing part that impacts me (and anybody else that is using Health Savings Accounts [HSA]) is that it states that Sec 122 of the bill will outlaw high deductible Health Insurance Plans , and I would thus conclude that Health Savings Accounts would be eliminated as well (they are only allowed now with High Deductible Health Plans)

http://sweetness-light.com/archive/what-the-health-care-bill-actually-says

Thank you for your post. I agree that this is an "emotionally charged" topic and frankly, I do not understand why.

I have to admit, that I have never been one that ever cared for politics. I never followed what was going on in my local Government or Nationally. I am one of those that believed it was the Congressman's problem, that was their job, that is what they were paid to do. When I would vote, I would vote for who I "liked", without bothering to learn the pros and cons of the "issues". I know this sounds terribly ignorant, but it is the truth. And, my source for determining who I "liked" was the news media.

But since I have been on unemployment, which has been for over a year now, I have been forced to deal with these real life issues that are hitting home with me now. I had worked for years for a large defense contractor and had always taken it for granted. Prior to that, I was always blessed to find very good jobs with similar corporations. Which also means, I had always had very good health care.

I have a special needs child and what was so wonderful, was that even when I changed jobs and health care coverage changed, I was still able to keep his physicians.

But now? I wasn't as fortunate as some, to be able to afford COBRA, so when I was laid off, I immediately lost all health care. I simply did not fall into the same class of people that I believe that is intended and designed for. So overnight, I had nothing. I had a small severance to delay the impact of my income being cut in half for about 6 weeks.

I went from having a wonderful job to a potential welfare mom. But, I had found there were some serious problems within that system. I had always thought the welfare system was set up for people such as me, for people who have paid into the community. To offer a hand up while you looked for work. Not so. I discovered endless rules and regulations that seem very unreasonable and illogical at times. I have often sat in waiting rooms watching others come in and out and receive everything offered and yet over and over I was denied. I found I was just a number...a faceless number. Circumstances were not considered. No one explains, you are just told. I don't know who has come up with the so-called guidelines to determine who gets what, but I can tell you first hand, it doesn't seem fair.

My children and I have gone from July 2008 to present without any health care. I cannot afford even the smallest of premiums from any of the other programs the state of Florida has offered. I have looked them over and normally, I would say it is nice and reasonable, but again, for certain people. Perhaps for people who have two income coming into their home. A wife still works and the husband was laid off, vice versa. But as a single mother, when my income is cut, I don't have a back up or another resource.

But what baffles me, is how in the world, when my income has been cut by 50% with children, how in the world can the welfare system, the state of Florida say I do not qualify? Believe me I have asked, but seemingly not deserving of an explanation. After reapplying for one year, I was finally approved of 153.00 per month in food stamps a couple weeks ago. That figure is almost insulting to me. I was also sent an application to apply for Kidcare. I have yet to hear from them. Of course, I will have to pay a premium and I do not know the rules as far as preexisting conditions. This is a valid concern of mine for my son. Since it has been one year since my son has seen his physician, he has been removed as a patient, as his doctor is very popular and he explained many others are on a waiting list to get in and it isn't fair for my son, who is not seen to keep his spot anymore.

Yet, after saying all of this. You would think I am for the new proposed health care bill. I looked into it. On the surface, the way it is presented it seemed exactly what someone like me needed. It sounded like it was the answer to my problems. But, unlike before, this time I have chosen to engage myself and look into it. I have already seen enough going on in this country through this new administration that I did not approve of, so this led me to investigate, thoroughly. I have to say, I do not like what I have found. In fact, it also seems to violate our constitutional rights. It seems to go way beyond the issue of health care and goes off into other avenues that are just as serious. It also seems to open a pandora's box, if you will. While some things within the bill sound ok, I also see, how legally, there are loopholes which, if the wrong person desired to do something we would deem as unethical or immoral, would be allowed because of the way the bill is skillfully worded.

I have also learned a lot about government and history. I admit, and I am ashamed, I really didn't know as much as I thought I did. I don't know what my teachers taught me in high school, or whether I was just asleep in class when government and history were taught, but I have learned a lot lately. And I think this is the case for a lot of Americans. I also see many elderly standing up. They are not given the credit and respect they deserve either. I do not view being elderly as a person who is not useful anymore. But I see them as someone who has a lot of wisdom and much to offer. Many of them do understand government and history and the Constitution. Many of them lived through wars and the Great Depression and many know what caused the Great Depression and they are seeing history repeating itself.

So even though I would be considered one who would "benefit" from this new reform? I do not want it. I value my freedom more. And you can't put a price on that. I do believe there needs to be a change, as I have just conveyed to you how messed up the system is, just in my little world here in the state of Florida. But I do not believe that this new proposed bill is the answer.

Now this is my opinion, but I believe, that only God can solve the turmoil that is going on in our state and country.

Mary

Thanks for sharing that Mary, I sure hope things work out for you for the better. This whole health care deal I think can be summed up by the phrase "knowlege is power".

In my opinion where most of the hot feedback has come from at these town hall meetings is from people who have read the bill (HR 3200), much of it just doesnt jive with what its advocates are saying. (and thus people may conclude its a scam with a ulterior agenda)

In your case, I would have no problem with some kind of saftey net so you and yours could access the health care system. I just dont think (in my opinion)that we should gut the existing system to achieve this. I would think simply giving you something like a Debit card that a Doctor or clinic would accept would go a long way (and cost a lot less than a $Trillion that these people are talking about. )

I know nothing about what benefits are available to you. But if you havent already, I would look into a program call SCHIP (sp?), they passed this in Congress last year and made a big deal about saying it covered children. I assume that you have looked at Medicade.

I wish you the best of luck, thanks for your post!

I agree as well.

I think in cases of those who are laid off, there should be another reasonable alternative offered. Obviously, this would be on a temporary basis, until you found employment. I see how Governor Crist has things offered, and that is nice, but only for those, again, who are in a particular class, who can afford it.

Yes, I have applied several times for Medicaid to no avail. I obviously need health care for myself, but my primary concern is for my little boy. I have never heard of the SCHIP program but will look into it, thanks.

Yes, I agree, there are many other ways to improve health care and I agree that it doesn't mean the present system should be done away with. My personal opinion has always been that private insurance companies have been given too much authority..dictating to doctors and overriding what the doctor deems necessary. So what are people going to do when the Government starts doing that? I believe insurance companies should be regulated and more power given back to the doctors.

Mary-

I stumbled on to this link on SCHIP (below). I remember there was some controversy about it when the Congress supposedly enhanced it last year, the issue was they made faimilies with over $60K a year in income eliglible for it. If thats true, you may have a shot at it.

Good luck

http://healthinsurance.about.com/od/medicaid/a/SCHIP.htm

Sc4ram, thanks for moving this conversation over here I appreciate your respect to stay on topic in the other threads

U bet UIO, good idea to have a off topic forum

This article appeared in the Orlando Sentinel today under the title shown as subject for this post, it wasnt available via the Sentinel website at time of post.


http://azdailysun.com/articles/2009/09/10/news/20090910_front_203419.txt

The Washington Post

Health-Care Math
Mr. Obama says he won't add one dime to the deficit, but a lot of dimes remain unaccounted for.

Sunday, September 13, 2009

WHEN POLITICIANS start talking about paying for programs by cutting "waste and abuse," you should get nervous. When they don't provide specifics -- and when the amounts under discussion are in the hundreds of billions of dollars -- you should get even more nervous.
President Obama outlined, in his speech to Congress last week, a sensible framework for health-care reform. But here are a few questions he has yet to answer:

-- What exact combination of new revenue and spending cuts is the administration proposing?

-- Will that financing be adequate to underwrite the cost of expanded coverage -- not only within the 10-year budget window but beyond?
-- What mechanisms does the administration envision, if any, to control costs if they are greater than anticipated or if projected savings don't materialize?

One approach the president endorsed Wednesday night was to tax insurance companies that offer excessively generous plans, although he did not offer details of the threshold at which this would apply. The administration apparently would set the allowable limit higher -- and therefore bring in significantly less money -- than the plan being crafted by Senate Finance Committee Chairman Max Baucus (D-Mont.). Mr. Baucus, whose proposed tax is estimated to reap $200 billion over 10 years, would tax plans exceeding $21,000 for a family of four. He would index that cap to the regular consumer price index, not the far higher rate of inflation in medical costs. The lower the initial limit and the lower the inflation index, the more effective the tax would be in restraining health costs, so to the extent that the administration and Mr. Baucus diverge, the Baucus plan is preferable.

Beyond the insurance tax, Mr. Obama was vague about where the money would come from, and administration officials have since declined to provide specifics. Previously, the administration outlined $635 billion in Medicare and Medicaid savings, but it is not clear what it now envisions beyond cutting payments to Medicare Advantage plans that receive higher payments than regular Medicare providers and reducing subsidies to hospitals for treating the uninsured as that population diminishes. Squishy talk about cutting "hundreds of billions of dollars in waste and fraud" isn't enough.

One idea that, like the Monty Python parrot, is not dead yet is some version of the administration's proposal to limit the value of deductions for the highest-bracket taxpayers. The administration originally proposed generating more than $300 billion in revenue by limiting the wealthiest taxpayers, who pay marginal tax rates of 33 and 35 percent, to deductions worth 28 percent. One tweak might be to leave the existing value of deductions in place but not allow the deductions to rise when the Bush tax cuts expire and the highest tax rates revert to 36 and 39.6 percent.

The president has staked out two principles with admirable firmness: Health reform must not add to the federal deficit, and it must slow the rate of health cost inflation. Now he needs to support the detailed measures that will fulfill both pledges.