Posts Tagged ‘coverage’
Health Care News
Not all surprises are good. When it comes to Obamacare, the original projections are turning into unfortunately different realities. For the next six days, Heritage is going to highlight one of the various changes in Obamacare projections (e.g., cost, enrollment, etc.) from when the law first passed until now.
Under Obamacare, most employers will either provide government-approved health coverage or drop coverage, pay a penalty, and send their employees to the new government-subsidized exchanges.
In 2010, the Congressional Budget Office (CBO) estimated that by 2019, three million fewer individuals would have employer-sponsored insurance (ESI) due to Obamacare’s impact.
In March 2012, the CBO updated its estimate to show that by 2016, six million fewer Americans would be enrolled in employer coverage.
In a separate report, the CBO projected the loss of ESI under different scenarios, one of which showed a loss of ESI coverage for 20 million Americans by 2019. The CBO reports show that businesses are less likely to offer coverage to employees under Obamacare.
Surprise: If you like your coverage, Obamacare might prevent you from keeping it. While estimates vary on exactly how many people will lose their coverage, it’s clear that it will be millions. Obamacare is the gift that keeps on giving—results that Americans don’t want.
12 Days of Obamacare Surprises:
6. A 50/50 split on enrollment estimates…
5. More uninsured Americans…
4. Increased exchange subsidies…
3. Big tax increases…
2. The small business tax credit…
1. And the individual mandate.
Health Care News
Medicare is shaping up to be a deciding factor in the debate over our nation’s future.
As Heritage’s Bob Moffit and Alyene Senger explain in a recent paper, “Why Traditional Medicare Must (and Will) Be Reformed,” the status quo in Medicare is unsustainable and unacceptable due to the program’s structural and financing flaws.
Here are a few reasons Medicare needs to be reformed:
- Medicare spending is growing faster than any other federal program. Medicare spending has reached unsustainable levels and is contributing to our budget deficits more quickly than any other program. Further, over the long term, Medicare has made $37 trillion worth of benefit promises to future seniors that are simply not funded. The hospital insurance trust fund is projected to be insolvent by 2024.
- While seniors have paid for their benefits, their payments do not cover the costs of the program. In 2011, approximately 88 percent of Medicare’s spending was funded by taxpayers. A large part of the problem is the erroneous belief that seniors have fully paid for their benefits. In fact, Moffit and Senger explain that, “on average, a one-earner couple who retired at age 65 in 2011 and earned an average wage will have paid just $60,000 into the program but will receive an estimated $357,000 worth of benefits.”
- Medicare enrollment is set to skyrocket. Baby boomers have already begun to retire. At the current rate of retirement, the program will enroll 10,000 beneficiaries into Medicare every day from 2011 to 2030. Moffit and Senger explain that “enrollment is expected to jump from 48 million beneficiaries in 2011 to 81 million by 2030.” This is coupled with a 50 percent decrease in the proportion of workers contributing to the hospital insurance trust fund over the same period. The outlook: more beneficiaries and fewer workers paying taxes to support them.
Health Care News
Officials in California plan to use popular network television shows to market the state’s new health care exchange, established as part of Obamacare, according to a marketing plan drafted in June.
“Individuals from California’s robust entertainment industry will be approached at the most senior levels to engage in California’s effort, to enroll residents in coverage, many for the first time,” the report states.
It continues, “A number of popular television programs and personalities such as Grey’s Anatomy, Modern Family, the Biggest Loser, Dr. Oz and others will be approached and pitched to incorporate story lines or mentions of health care reform that would reinforce campaign messages.”
Health Care News
Since Obamacare was enacted into law, different organizations have come out with different estimates of how many employers will drop health coverage for their employees. This week, the health care consulting firm Deloitte released a new survey that found that around 10 percent of employers would drop coverage and send their employees into the new government-run exchanges.
Although still ominous, Deloitte’s results significantly differ from previous studies by other organizations. Here are a few of the prominent examples:
Health Care News
Obamacare requires health insurance companies to produce a summary of benefits and coverage (SBC) based on a government-imposed template and glossary. Below is a sampling of the requirements (70 pages) concocted by the Departments of Health and Human Services, Labor, and the Treasury to simplify the task.
- The summary of benefits and coverage “must be presented in a uniform format, cannot exceed four double-sided pages in length, and must not include print smaller than 12-point font.” It also must “replicate all symbols, formatting, bolding, and shading.”
- Plans and issuers must provide the summary of benefits and coverage in a “culturally and linguistically appropriate manner.” (The government’s template and glossary are available in “Spanish, Tagalog, Chinese, and Navajo.”)
- “The items shown on page 1 [of the template] must always appear on page 1, and the rows of the chart [in the template] must always appear in the same order. The chart starting on page 2 must always begin on page 2, and the rows shown in this chart must always appear in the same order. However, the chart rows shown on page 2 may extend to page 3 if space requires, and the chart rows on page 3 may extend to the beginning of page 4 if space requires. The Excluded Services and other Covered Services section may appear on page 3 or page 4, but must always immediately follow the chart starting on page 2. The Excluded Services and Other Covered Services section must be followed by the Your Rights to Continue Coverage section, the Your Grievance and Appeals Rights section, and the Coverage Examples section, in that order.”
- “The footer must appear at the bottom left of every page.”
- “The uniform glossary of health coverage and medical terms may not be modified by plans or issuers” (e.g., “Emergency Room Care” is to be defined as “Emergency services you get in an emergency room”; “Physician Services” is to be defined as “Health care services a licensed medical physician provides or coordinates”; and “Prescription Drugs” is to be defined as “Drugs and medications that by law require a prescription.” The glossary is intended to be educational in nature and the definitions may not be the same as definitions used by a plan or issuer.”)
Health Care News
Is Granny “disposable”? Some seniors may get that impression once Obamacare kicks in.
As noted in a recent Wall Street Journal article, the new law cuts $200 billion from Medicare Advantage, a public-private “hybrid” of Medicare. As a result, more than 11 million seniors will likely see their Medicare Advantage premiums rise significantly or their benefits noticeably lessened. Either way, it will violate President Obama’s promise that all who liked their current coverage would be able to keep it under Obamacare.
But Obamacare giveth what it taketh away. And the $200 billion it takes away from the seniors’ program will go to finance new entitlements for younger, healthier Americans. (more…)
Earlier this morning the Senate Finance Committee, during its markup of the “Chairman’s Mark” of the America’s Healthy Future Act of 2009, voted down an amendment that would have helped ensure that Americans can keep their current coverage.
The amendment offered by Senator Orrin Hatch (R-UT) stated the following:
“The implementation of Americas Healthy Future Act of 2009 shall be conditioned on the Secretary of Health and Human Services certifying to Congress that this legislation would not cause more than 1,000,000 Americans to lose the current coverage of their choice.”
The intention was to put into law President Obama’s oft repeated promise that “If you like your health insurance, you can keep it.” However the amendment failed on a party line vote.
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