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.