Topic: health insurance
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November 15, 2013 at 7:16 PM
Late Friday, interview requests were still pouring in for State Insurance Commissioner Mike Kreidler, who turned down President Obama’s rule change to allow insurers to keep discontinued individual health insurance plans.
The old plans were discontinued by insurers because they didn’t include a variety of benefits required by the Affordable Care Act, or in other ways didn’t meet the standards of the federal law.
Calls came in all day, and there were plenty of questions on the “Ask Mike” feature on the commissioner’s website. Many were from people unhappy with Kreidler’s stand, but nobody threw rocks or picketed the office, said his spokeswoman, Stephanie Marquis, who was half-expecting something unpleasant. “We’re so polarized as a nation. It’s a little bit unnerving.”
What made people mad were those notices from insurers that their plans had been scrapped, she said. Some of the letters simply told people their plans would be replaced with a more expensive one, but didn’t let them know that taking that plan wasn’t their only choice, and that they might find a less expensive option on the Washington Healthplanfinder exchange site.
“I wish we could have required the companies to send a particular letter,” Marquis said. But Kreidler’s office doesn’t have the authority to do that, she noted.
Most people who had been in the individual market for some time might well believe that the replacement offered was their only choice. “In the past, you had to take that,” she said. “But now you don’t.”
After Kreidler made his announcement Thursday morning, news organizations lined up for interviews, including The New York Times, The Washington Post, NPR, local TV, radio and newspaper outlets, and, late on Friday, Al Jazeera America, she said.
Kreidler’s two cents, Marquis said, went roughly like this: “He understands the president was put in a very hard place. And of the bills before Congress, the proposal Obama made was the least egregious. But even that couldn’t be done without tremendous upheaval in (Washington’s) market. And even if they say ‘you can keep your plan,’ that doesn’t mean your rates don’t go up — just like they have every other year.”
The one call Kreidler didn’t get? President Obama.
“I was hoping the president would call and thank him,” Marquis said. “Why not? He’s standing up for the law!”
November 14, 2013 at 5:23 PM
President Obama came out with the surprising decision this morning to allow insurance companies to revive health plans that have already been canceled. But he left it up to state insurance commissioners to decide whether to resurrect these policies — which don’t comply with the Affordable Care Act — or continue as planned and encourage people to buy new coverage with a broader range of benefits.
Washington’s commissioner Mike Kreidler opted to stay the course, and he didn’t mince words in making his choice:
I understand that many people are upset by the notices they have recently received from their health plans and they may not need the new benefits today. But I have serious concerns about how President Obama’s proposal would be implemented and more significantly, its potential impact on the overall stability of our health insurance market.
In Washington state, most of the 290,000 people with individual policies already have received letters from their insurance companies telling them their plans are being canceled at the end of the year. These plans failed to meet all of the new health insurance requirements, including providing 10 “essential benefits” such as maternity care, prescription drugs and preventive care, and limiting out-of-pocket expenses at $6,350 per person.
All 90,181 people with insurance coverage from Regence BlueShield have learned their plans will be canceled, as did all 60,000 people covered by Group Health Cooperative. Some 77,000 people with LifeWise Health Plan, a subsidiary of Premera Blue Cross, also learned their plans were being scrapped.
An additional 24,000 people with LifeWise are covered under “grandfathered” plans that predate the act and will not be canceled, though members will be getting letters this month informing them they can move to another plan if they would like to.
Some have already started looking for or even signed up for new plans either through the state’s Healthplanfinder insurance exchange, where they could be eligible for tax breaks, or outside of the exchange.
So what was Kreidler thinking when he decided to reject Obama’s offer? We at HealthCare Checkup had the chance to talk to the commissioner on Wednesday when it was just Congress kicking around ideas for bringing back the canceled plans. Already Kreidler was worried that lawmakers would reverse direction because of the huge amount of uncertainty it would create. Here were his main concerns:
How would the resuscitated plans be priced?
The plans could be offered for the same price, or a higher rate. In recent years, individual insurance premiums in the individual market have increased on average anywhere from 8 to 18 percent a year.
How long would the plans last?
Would they be valid for a year, two years, indefinitely?
Would people be able to jump between plans?
The Affordable Care Act guarantees health insurance to people who are sick and currently denied coverage. But the system is not designed to allow people to stay with bare bones plans, then jump to better coverage when they have an emergency. For insurance to work, some people have to pay more and use fewer medical services.
What would insurance companies do?
The insurance companies struggled to put prices on the 2014 individual market plans, given that no one knows for sure who will be signing up – namely, will young and healthy people join the insurance pool in meaningful numbers? Changing the rules midstream disrupts their projections and adds a large dose of uncertainty for pricing decisions. Additionally, companies are supposed to propose their 2015 prices in the spring, a process that becomes doubly difficult if the old plans live on.
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In this state, where by last count 77,000 residents have enrolled in Healthplanfinder, “we are in a unique position,” Kreidler said on Wednesday. “We were smart enough to set up our own exchange and expand the Medicaid program. We’re having a relatively high degree of success.”
Before today’s announcement, Kreidler had this message for Congress — which now applies to the president: “Please don’t mess it up for us. We’re doing the right thing for the citizens of our state.”
September 18, 2013 at 10:03 AM
The 15 percent of Washington households that lack Internet access might be missing out on trivial matters such as videos of the latest celebrity gaff or Facebook updates from nearly forgotten high school friends. But come next month, these residents are also going to have a harder time signing up for health insurance available as a result of the Affordable Care Act, or Obamacare.
In Washington state, new insurance plans for residents who are uninsured or who don’t get health insurance through work will only be available through an online portal called the Washington Healthplanfinder.
While much of the state struggles to remember which of their passwords goes with which email address, others don’t have a single email account — a requirement of enrolling in the insurance exchange.
“First we need a list of free emails,” said Carol Allen, a community health educator with King County, during a recent Healthplanfinder training session in Seattle. Luckily, free email is readily available through Google, Yahoo and others.
But you still need to get these folks aboard the Internet (And, of course, if you are reading this blog, you are.)
A report called “Exploring the Digital Nation” released this summer by the U.S. Commerce Department found that:
“Compared to the national adoption rate, white and Asian American households, and high-income and highly educated households, had higher computer ownership and broadband adoption rates in both urban and rural areas. Rural African American and Hispanic households with low incomes reported the lowest computer and broadband adoption rates.”
And as Seattle Times health reporter Carol Ostrom recently blogged, Washington ranks high nationally for the percentage of under-age-65 Hispanics without insurance, and the percentage of people under age 65 living at or below the poverty level without insurance — just the people who have a harder time getting online.
What to do? It seems reasonable to send folks online to register for health insurance, particularly given that they need to be able to compare more than 40 plans to figure out which one they want, and they need to do things like enter income information to calculate what their insurance would cost or if they qualify for Medicaid or tax credits.
So local governments are partnering with community groups, health clinics, libraries and other services to provide in-person help for people who might struggle to navigate this system (see this story I recently wrote about the issue). In King County, 23 community groups will help educate and recruit uninsured residents. One partner is Sea Mar Community Health Centers, which has about 60 health facilities across the Puget Sound region.
To bridge the digital divide, Rudy Vasquez, director of Sea Mar’s managed-care operations, said they’ll be installing computer kiosks at many of their health clinics so patients can research and enroll in health insurance plans onsite.
“It’s trying to create a smooth pathway for them to access assistance,” Vasquez said.
August 29, 2013 at 7:24 PM
With about 16 percent of its residents uninsured, Washington state falls solidly in middie of the pack, with Texas having the highest percentage of residents without health insurance: more than 25 percent. Massachusetts, where a state health-insurance mandate has been in place for years, has the smallest percentage of uninsured residents at just under 5 percent.
But in one way, and not a good one, Washington nearly led the nation, a recent report revealed. From 2008 to 2011, the state’s increase in the number of residents without insurance was second-highest.
The latest numbers come from the U.S. Census Bureau’s recently released 2011 Small Area Health Insurance Estimates for counties and states.
Washington ranked ranked high in two other measures: the percentage of under-age-65 Hispanics without insurance, and the percentage of people under age 65 living at or below the poverty level without insurance.
Only Tennessee had a higher rate of growth in uninsured residents from 2008 to 2011. Some states stayed virtually the same, and some had decreases.
The Census Bureau’s report also looked at counties. In Washington, the county where the percentage of uninsured residents grew the most from 2008 to 2011 was San Juan with an increase of 4.3 percent. It was followed by Mason and Whatcom counties. King County had an increase of 2.5 percent.
August 26, 2013 at 11:48 AM
Welcome to HealthCare Checkup, a new blog intended to get us all better acquainted with the Affordable Care Act. We’ll keep you updated on health-insurance changes in Washington state and around the country that could affect you.
We’re pretty sure you’ve got questions about the federal health-care overhaul. Here, in just a few words — and a short animated video — is the quick overview you will need to wow your friends.
Basically, one major aim of the ACA is to pull everyone into one big insured pot by 2014. Most people are already there, because they’re insured through their workplace, through federal or state programs such as Medicare or Medicaid, military benefits or tribal health plans. But about 16 percent of the the people in Washington are uninsured, many because they can’t afford the premiums. That’s more than 1 million people in our state, so it’s likely that even if you’re already insured, you know someone who isn’t.
The law, which requires most people to have health insurance or pay a penalty, has two major ways to help people who don’t have insurance: One, Medicaid eligibility is being expanded, and federal dollars pumped in, so many more people at the very lowest income levels will qualify for the first time. Two, putting faith in the power of competition, the law creates an online marketplace (the “exchange”) to make it easier for people to compare insurance plans and, if their incomes are low enough, get a subsidy so they can afford to buy.
Now that you’ve slogged through the words, here’s the fun — such that it is: A quick video version to help cement your new-found knowledge.
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