Health Care initiatives in the world of the unemployed

Some of this is happy talk as nobody knows what the justices are thinking or how they will vote. But lets hope this is good kharma towards the goal of getting rid of this poc legislation .



http://news.yahoo.com/conservative-justices-insurance-mandate-152049742.html

The Prez promise to "bend the cost curve down" looks pretty lame here.......

http://www.democratandchronicle.com/article/20120408/BUSINESS/304080022/Health-insurance-costs-force-some-go-naked-?odyssey=tab|topnews|text|Home

The last paragraphs have a interesting analysis of what may happen to employer sponsored health insurance if the Obamacare law stands.


Health law aims to close gender gap
By Laura Green Palm Beach Post Staff Writer
Updated: 11:47 p.m. Saturday, April 7, 2012
Posted: 8:41 p.m. Saturday, April 7, 2012
Florida women who don't get health insurance through an employer can forget about finding a single comprehensive medical plan that will pay for their care while they deliver a baby.
It's one of 25 states in which there are no health plans that include maternity coverage on the individual market. A single carrier in the state offers maternity riders, separate plans a woman can buy in addition to her regular medical coverage. But she has to purchase it at least 18 months before she becomes pregnant.
While federal law requires nearly all employers who offer health insurance to include maternity coverage, there are no such rules governing the individual market.
Expanded access to maternity insurance is one of the provisions tucked into the 2,700-page law that is the Affordable Care Act. Maternity care grabbed few headlines as Congress spent 18 months wrangling over the legislation and when 26 states, led by Florida, challenged the law. But now the fate of that rule as well as dozens of others is unclear as the U.S. Supreme Court decides whether to strike down the law, which requires virtually every American to buy health insurance.
Florida women who want to be mothers and can't get insurance through an employer or qualify for income-based aid have no choice but to pay thousands of dollars out of pocket. A typical birth with no complications costs $8,000 to $10,000, according to Richard Bernstein, CEO and founder of a company specializing in health care and life insurance. A Caesarean section or delivery with complications can cost $20,000.
Women with no plans to have a child and no maternity coverage also pay far more for insurance on the individual market than men. The health care law also is aimed at stopping gender rating, the practice by which women are routinely charged more than men of equal health.
Insurance sold on the individual market costs women $1 billion more a year than men pay, according to a report from the National Women's Law Center.
Someone has to pay for the added costs women bill, said Bernstein, whose clients have included Donald Trump and the Trump Organization.
"It's really a matter of the math," he said.
When the government requires equal rating that means men have to pay more for services they don't need. Women typically cost about 18 percent more than men to insure, he said.
Fourteen states ban or limit gender rating on the individual market. In states where the practice is legal, 92 percent of best-selling plans charge women more than men, the National Women's Law Center found.
Even excluding maternity coverage, women are often expected to pay hundreds of dollars more than men for the same coverage. Researchers found a great deal of variation in rates charged to women across carriers and often within the same state.
In Florida, two best-selling plans with similar premiums, deductibles and copays and no maternity coverage charged women hundreds of dollars more than men of similar health, the Women's Law Center report found. One charged women $598 more a year than men. The other, with all the same features, charged $1,141 a year.
"That's why we think gender rating is not actuarially justified," said Danielle Garrett, a health policy analyst at the Law Center, and one of the authors of the report.
Maternity coverage is treated differently from other insurance for a reason, Bernstein said.
Typically, buying insurance is a risk both for the insurer and for the person buying it.
A consumer agrees to pay premiums not knowing whether or how much she will accumulate in medical costs that year. An insurer takes on the risk of having to pay hefty medical bills in the hope that the consumer will instead pay the premium and not need much medical care.
But with maternity insurance, there is no doubt the consumer will need medical care.
"It's a definite cost," Bernstein said. "They know the baby is going to come."
That's why many maternity riders require participants to pay premiums for one to two years before coverage kicks in, he said.
Another difference is that on the group insurance market, where employer-provided insurance is sold, insurers can spread their risk. They can require that 70 percent of employees take coverage, for example, ensuring that some on the plan will need maternity coverage and some will not, Bernstein said. In the same way, they can assure that some who sign up will be healthy and need little care while someone may develop cancer and need costly treatment.
But advocates of the health care law say that the high cost of maternity coverage may be depriving some women of prenatal care, which can result in higher-risk pregnancies, more complicated deliveries and more expensive care not only for the mother, but for the baby as well.
If a woman can't afford the treatment, those costs may be shifted to taxpayers.
Each year about 70,000 women go without any prenatal care, according to a report by Families USA. Among low-income women who receive no prenatal care, 41.5 percent say they have no insurance.
While Bernstein believes that women should have access to maternity insurance and prenatal care, he says the health care law could actually result in fewer women getting medical treatment through employer-based health insurance.
A provision of the Affordable Care Act that has not yet taken effect requires many employers to offer health insurance and fines them if they do not. The fine could make it easier for employers to get out of the business of providing health insurance, Bernstein argues.
If enough companies decided to get out of the insurance business because the fine is cheaper, the ever-increasing costs of health care could shift the culture.
"When they all pay the fine, no one is offering anything better than what you have," Bernstein said. "You just tell me, if you're the CFO and you could save 30 or 40 percent, what are you going to do?"

One might ask what the hec the IRS has to do with healthcare?


http://thehill.com/blogs/healthwatch/health-reform-implementation/220475-white-house-has-diverted-500m-to-irs-to-implement-health-law

I would add editorially I dont necessarilly agree with all of the premises stated in this article (which goes for all of the articles I post here) but I would comment on a few things in the article. It says that Obamacare is trying to address 50M uninsured. This may be technically correct but in reality mis-leading. We all know if you break your leg and you dont have health insurance, you can go to most emergency rooms and get treated (regardless of your economic status) . However I would argue that is not the case for 50M people. In Florida for example, if you got injured in a accident while driving your car, and you didnt have health insurance, your auto insurance PIP would pay for your treatment. If you simply decline to purchase health insurance and buy a mansion instead, and get treatment in a emergency room, they can launch a bill collection effort against you (just like any other business you would owe money to ) if you dont pay. When you boil that down it is about 15M people that dont have affordable access to health care. This begs the question , why are we screwing up our health care system to treat 15M (of 300M) people? If we are are serious about this , why not do something targeted at the 15M.

The article implies the court meekly upheld Social Security . However I would argue that Social Security is a TAX not a mandate. (Congress has the undisputed power to tax , you have to pay the tax but you dont have to participate in Social Security) . In the 1940s wheat growing case, it was prohibiting the wheat grower from doing something, NOT mandating him to do it. None of these examples are any type of precedent for a health care mandate. .



http://www.palmbeachpost.com/money/health-care-case-puts-congress-on-trial-2306966.html

Interesting discussion begining @ minute marker 5:40

http://video.cnbc.com/gallery/?video=3000085605&play=1