S&S Benefits.....Opinion, Hearsay & News Review

HHS continues to make PPACA even more costly by proposing that each state can make choices as to what they wish to define as essential health benefits for their exchange plans (in addition to the HHS definition of the same). States can choose from a number of options designated by HHS from existing plan models that HHS has decided are worthwhile. Thus, the state exchanges will continue with the patchwork of laws that already complicate the insurance market and raise costs due to state mandated benefits. Not quite the simple plans originally promised with easy to compare features. But look at the bright side, the  all powerful HHS has been kind enough to approve options.

Costs under health reform will go up next year when the feds will start collecting a new tax on medical devices, from tongue depressors to artificial hips. The tax will be 2.3% of sales and the Medicare chief actuary has estimated that the tax will raise national health costs by $18.2 billion in 2018.

Something to reduce costs. In 1993, Michigan passed medical malpractice reform. Michigan has 23,000 physicians and 144 hospitals. In 2002, the number of malpractice cases was 1,501. By 2009 there were less than 800 claims and malpractice insurance premiums have been significantly reduced.

PPACA health cost reporting in 2012 for  W-2s (issued in 2013) will not include separate dental and vision plans. Employee expenditures for FSA plans are also not included. Employers who issue less than 250 W-2 forms are excluded until at least 2014.

The CMS reports that healthcare spending edged up from 3.8% in 2009 to  3.9% in 2010 and amounts to $2.6 trillion, or $8,402 per person. The federal government's share of $743 billion represents 29% of total spending.

The Agency for Healthcare Research and Quality reports that just 1% of Americans accounted for 22% of health costs in 2009 (about $90,000 per person). In 1996, the 1% accounted for 28% of spending. In the top 10% of spending, 60% were women, 40% were 65 or older, 3% were age 18-29 and 80% were white.

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Aetna is joining Best Buy to sell four of its most popular wellness kits to Best Buy customers. The retailer has created a new "health technology" department in three of its suburban Chicago stores where it will stock cards for a $20 purchase for limited-time access to Aetna's online programs.

HHS is now picking on Trustmark for raising rates by 13% in September for 10,000 people in Illinois, Alabama, Pennsylvania, Virginia and Wyoming.. Trustmark disagreed that the rates hikes were unreasonable.     Also making the list of HHS non-compliant carriers are United Security Life (which lost money on its small block of business), John Alden Life and Time Insurance. These smaller insurance companies don't have large enough blocks of business in any one state to sustain losses, but that doesn't stop HHS from condemning any carrier that requests more than a 10% increase on a block of business so that the company can stay in business.

Kaiser Health news reports that Alaska will spend $200,000 per year for each high risk pool member under PPACA. The pool for the uninsured with pre-existing conditions will cover about 50 members at a cost of $10 million. Alaska is asking for additional federal funding along with 8 other states. Congress allocated $5 billion for the programs which will operate until 2014, when insurers will be required to take all applicants and not charge higher premiums based on health status. As of Dec.1, about 45,000 people have signed up for the programs, far less than the 200,000 anticipated.

While these PPACA exchange pools are going broke, the CMS is looking for reinsurers to  protect against the obvious anti-selection for the next three years of these pools. CMS has requested RFIs about organizations that will reinsure these exchanges.  If they do find a reinsurance carrier, they won't like the price. Will HHS then limit the rate increase requested by a reinsurer? Or are they just asking if some company will lose money for three years on behalf of Obamacare? Just goes to show that the insane are running the asylum in HHS.

The U.S. Conference of Catholic Bishops is promising a legal challenge to the part of Obamacare requiring contraceptive coverage begnning August 1st for contraception services. The rule does not apply to churches, but does apply to religious universities and hospitals. Religious institutions that are not exempt from the rule will have until August 1, 2013 to comply.

The U.S. Bureau of Labor Statistics  reports that in March 2011, more than two-thirds of private industry workers had access to medical care benefits and 51% of all workers participated in a medical care plan. Employers paid an average of 80% of premiums for single coverage and 69% of premiums for family coverage.