Health plans that require consumers to spend thousands of dollars before insurance kicks in are more common than ever before.

About 40 percent of Americans have health plans with $1,200 or more in deductibles.

The plans are meant to push consumers to make smarter health care choices, but a new study from USC has found they put some people at greater financial risk. 

The research, in the April edition of the American Journal of Managed Care, shows people with chronic health conditions, and those with lower incomes, are the most likely to be impacted by a high medical bill stemming from the deductible.

"When they face this bill, it has a serious consequence for them. Not every family can absorb a $2,000 bill without changing their lifestyle," said Neeraj Sood, Director of Research at the USC Schaeffer Center for Health Policy & Economics.

"The most vulnerable populations are the ones who are going to face the highest risk."
​​
To see how a high deductible plan might affect you, here's a breakdown of how they work - and what to look out for:

WHAT DOES HIGH DEDUCTIBLE MEAN, EXACTLY?

The premium is your monthly payment that keeps your name on the health insurance rolls. The deductible is the amount you have to pay before the health insurance kicks in. It could be anywhere from $1200 to $2000 or $3000 -- even up to $10,000.

Keep reading at 89.3 KPCC....

A top executive at the trade group representing health insurers on Monday warned of premium increases for ObamaCare plans next year, saying the situation is “not a pretty picture right now.”
​
Matt Eyles, senior executive vice president of America’s Health Insurance Plans (AHIP), said that insurers “want to make sure people have access to coverage at the most affordable price, but that also has to reflect what the reality is right now and it’s not a pretty picture right now.”

Eyles, who will become CEO of AHIP on June 1, blamed several policies advanced by Republicans in Congress or the administration for the problems.Speaking at an event hosted by The Atlantic, he noted the repeal of the individual mandate in the tax bill in December, which is expected to lead to less healthy people signing up, as well as initiatives from the Trump administration to expand access to cheaper, skimpier plans known as short-term plans, which have also raised fears of siphoning away healthy people and causing an increase in premiums.

Continue reading at The Hill....

Between a third and a half of people age 45 to 59 and a quarter of those 60+ went without needed health care in the past year due to its cost, according to a troubling new survey from the West Health Institute and NORC at the University of Chicago.

“We were surprised by the magnitude of the findings,” said Dr. Zia Agha, chief medical officer at the West Health Institute, a nonprofit applied medical research organization based in San Diego. “And 80% of the people we surveyed had health insurance, so just having insurance does not make you immune to health care costs.”

The researchers at West Health Institute and NORC at the University of Chicago (a nonpartisan research institution) interviewed 1,302 adults. Their findings were released at the American Society on Aging’s 2018 Aging in America conference in San Francisco.

​Age 45 to 59 skipping health care

Specifically, the survey found these results for people age 45 to 59 (members of Generation X and boomers) as a result of health care costs:

• 49% didn’t go to the doctor last year when they were sick or injured
• 45% skipped a recommended medical test or treatment
• 43% didn’t go to a dentist when they needed treatment
• 40% went without a routine physical or other preventive health care
• 30% didn’t fill a prescription or took less than the prescribed dose of medicine

Age 60+ skipping health care

​The percentages were less dramatic for people 60 + (boomers aged 60 to 72 and Americans older than 72) — perhaps partly because those 65 and older have Medicare. But they are still concerning:

• 30% didn’t go to a dentist last year when they needed treatment
• 27% went without a routine physical or other preventive health care
• 25% didn’t fill a prescription or took less than the prescribed dose of medicine
• 25% skipped a recommended medical test or treatment
• 24% didn’t go to the doctor when they were sick or injured

Younger Americans were even more likely to go without health care due to costs last year, the survey found.

Continue reading at MarketWatch....

Healthcare matters can involve a whole host of medical and legal complications. At best, these issues may affect you financially; at worst, they could mean the difference between life and death. Whether you go to the hospital for a routine procedure or an emergency, there are steps you can take to help avoid complications. 

1. Have an up-to-date Medical Power of Attorney or Advanced Medical Directive (“Living Will”). In the event you cannot make medical decisions yourself, these documents entrust decisions about your care to a person you designate. Advise your family of your designation so that person is notified when decisions must be made.

2. Make sure your name, identifying information and all other information is completely accurate at each doctor’s appointment, outpatient surgery and hospitalization. Serious problems involving medical care sometimes begin as simple clerical errors. A small error can create a major treatment crisis. Reduce the chance of error by carefully reviewing all your doctor’s office or hospital admissions paperwork. During hospitalization check your hospital wristband for errors. 

Continue reading at LegalShield.com....

By David Ross

You may think health insurance is too expensive for you.

And it is true that health insurance policies offered in the Obamacare Marketplace ("Affordable Care Act" policies) are astronomically expensive, have ridiculously high deductibles, and are only available from a dwindling number of companies. This recent article reports rates for ACA coverage are expected to jump another 90% in the near future.

What the mainstream news doesn't tell you is this: LOW-COST HEALTH INSURANCE IS AVAILABLE!

You cannot afford to NOT have health insurance.

Just because you consider yourself “healthy” doesn't mean you can afford to go uninsured.

I recall a man who told me just that a few years ago. He was hesitant to buy insurance, being a 40-something who never went to the doctor. He finally decided to get coverage for himself and his new wife, mostly out of concern over the then-existent tax penalty for not having coverage.

He went the next year-and-a-half paying his premiums, but never even going to the doctor.

And then – he was shot. A totally random event put him in the hospital with serious injuries and serious medical bills.

Another client, a sixty-year old man, the owner of an auto body shop, didn't have coverage when I met him. His reason for not having health insurance? He said his insurance had gotten too expensive so he had dropped it for himself and his employees. When I told him about our low-cost policy, he jumped at the chance to sign up.

Seven months later he had a heart attack, and almost immediately had over $75,000 in medical expenses. His new insurance plan, the new one I helped him get, covered his expenses, and all he had to worry about was getting well.

Not all stories end as well.

Recently a friend on Facebook posted a link to a GoFundMe page, asking for donations to help pay medical bills for her uninsured daughter-in-law who had been severely injured in an automobie accident. The post said the hospital had dismissed her after only four days because she didn't have insurance, though she still needs additional care and therapy. Why didn't a young mother have health insurance? Did she think she couldn't afford to be covered, or did she think she would never need health insurance?

She could have had a great health insurance plan for about $120 a month.

The man who got shot had coverage – including dental insurance plus an extra critical illness rider that would pay him $50,000 should he be diagnosed with a critical illness – for about $220 a month. That includes both him and his wife.

The 60-year old's coverage cost him about $400 a month, and saved him over $75,000.

These are incredibly low rates, and are certainly affordable for most people. Of course, no one likes paying for something they aren't “using.” Heck, I don't like paying for things I do use, like cell phone service and gasoline.

But like cell phones and gasoline, in today's world, health insurance is a necessity.


For details about our Expected Benefits health insurance plan, visit our site.

Hooray! The "individual mandate" that required that you have ACA-compliant health insurance or pay a hefty tax penalty is no more!

You can now buy or not buy whatever health insurance you want, instead of feeling forced to choose between Bad and Worse on the Obamacare Marketplace.

My Expected Benefits Plan has always been, and still is, the best choice for covering yourself, your family, and your employees if you're a small business owner.

And it costs about half what you'd pay for an Obamacare plan without subsidies.
​
The Expected Benefits Plan has a zero deductible, and is part of the MultiPlan/PHCS Network. It's accepted by over 900,000 medical doctors and chiropractors, and at over 4,000 hospitals nationwide.

This coverage is currently available in AL, AR, AZ, GA, IA, ID, IL, KY, LA, MI, MO, MS, NE, NM, NV, OK, SC, TN*, TX, UT, WI, WY, and is coming soon to IN, MD, and PA.
​
For more details, visit my website.

*Slightly different coverage in TN.

Cara Pressman sobbed in the big red chair in her living room. The 15-year-old tried to absorb the devastating news relayed by her parents: that their insurance company, Aetna, denied her for a minimally invasive brain surgery that could end the seizures that have haunted her since she was 9 years old.

"When my parents told me, I went kind of blank and started crying," she said. "I cried for like an hour."

Her friends had been lined up to visit her in the hospital for the surgery three days away, on Monday, October 23. Between tears, she texted them that the whole thing was off.It was supposed to be a joyous weekend. Cara's grandparents had come to town to celebrate their 90th birthdays, a jubilant party with more than 100 family and friends crowding her home. The party did go on -- just with a lot more stress.

Cara had multiple complex partial seizures that weekend. When the seizures strike, her body gets cold and shakes, and she zones out for anywhere from 20 seconds to two minutes, typically still aware of her surroundings. Her seizures can be triggered by stress, by being happy, by exerting herself -- almost anything. "It's like having a nightmare but while you're awake," she said.

In the six weeks since the denial, Cara has had more than two dozen seizures affecting her everyday life. Her message to Aetna is blunt: "Considering they're denying me getting surgery and stopping this thing that's wrong with my brain, I would probably just say, 'Screw you.' ''

Keep reading at CNN.com....

By Chris Conover

A headline this week in The Hill shocked me: "ObamaCare enrollment strong in third week of sign-ups." The Hill is a serious, well-respected, non-partisan news source. But any reader taking this headline at face value would be seriously misled about what is really going on with Obamacare enrollments during this fifth open enrollment season.

The Hill's reporter correctly notes that "the pace of sign-ups has exceeded last year: In the first 26 days of last year's open enrollment period, 2.1 million people signed up compared to the 2.3 million people who signed up the first 18 days of this year's period."

Those figures imply that the daily rate of sign-ups this year is outpacing last year's rate by 58% [originally reported as 28%: Update #2]. Surely that is evidence of strong enrollment, no?

The reason it is not is buried at the tail-end of the story where the reporter notes "the enrollment period ends Dec. 15, which is about half as much time as people had to sign up last year."

Yipes! If enrollees have only half the time to sign up, then by pure arithmetic, the daily enrollment pace needs to be double last year's in order for total enrollment at the end of the enrollment period to match the level reach at the end of last year's enrollment period: 12,216,003.

But if current enrollment is 158% [originally reported as 128%: Update #2] of last year's when it needs to be 200%, a more accurate way to frame this year's performance would be to say that Obamacare is on track to sign up 21% [originally reported as 36%: Update #2] fewer enrollees than last year (i.e., 158/200=79% which would mean signing up 21% fewer). [originally reported as 128/200=64% which would meaning signing up 36% fewer: Update #2]. That's a pretty bad news story rather far removed from the rosy picture painted by The Hill's headline.

Read more at Forbes....

As a business owner, you have enough on your plate without having to worry about what's become for many a confusing and sometimes complicated health insurance maze.

I'm here to un-complicate things and show you how to protect yourself, your family, and your employees from unforeseen health care costs.

Low-cost health insurance is available, at 30-50% less than what's on the Obamacare Marketplace.

Do you find ACA plans unaffordable? Is your subsidy too small to offset the cost of Obamacare plans? Did you lose dependent coverage at work? Do you want to offer your employees truly affordable benefits?

Our Expected Benefits Plans are accepted throughout the PHCS/Multiplan network, which includes over 900,000 doctors and thousands of hospitals.

These plans provide up to $1,000,000 coverage per year. They have zero deductibles. Our plans include Teledoc services, $50,000 in critical illness protection, dental coverage, and even a concierge-type service to help you find and schedule recommended surgeries and procedures.

Once you're covered, you never have to re-apply or re-qualify. You can keep these plans until you reach age 65, no matter what future health issues may arise.

Details about our Expected Benefits Plan can be seen here.

Call me today!

Regards,
​
David Ross 
678-654-9500

PS: The Expected Benefits Plan is currently available in AL, AR, GA, IA, KY, LA, MI, MS, NE, OK, SC, TN, and TX. Coming soon to AZ and NC.

By David Ross

Every American under age 65 has one of three kinds of health insurance. Either you have government health insurance, private health insurance, or you're self-insured.

What does it mean to be self-insured? It means if you have a medical bill, you're expected to pay it. If you don't have cash to pay the bill, or can't get a loan to pay the bill, then your assets – house, car, whatever you own – can be taken from you in a lawsuit. Bankruptcy may be your only means of eliminating your medical bill debt.

The whole point of health insurance is this: To transfer risk from you to an insurance company, in exchange for a certain sum of money, known as the premium. You pay a small amount now so you won't have to pay a large amount later.

If you don't have health insurance, you're liable.


“Government Insurance”

By government insurance, I'm not talking about health insurance provided by a federal or state agency to its employees.

I'm calling “Obamacare” government insurance. Through the misleadingly-named Affordable Care Act, the federal government has mandated certain requirements and coverages by health insurance policies that are offered through the federal or state “exchanges,” now known as “The Marketplace.”

Policies offered through The Marketplace are required to provide certain services, known as the 10 Minimum Essential Benefits. Don't be fooled by the phrase – there's nothing “essential” about some of the benefits. Since the law doesn't allow for any kind of discrimination, maternity coverage, for example, is required for males and post-menopausal women. Pediatric services must be included, even if the policyholder has no children. Coverage is required for substance use disorder services, including behavioral health treatment, counseling, and psychotherapy... even if you don't want or don't need such services.

Additionally, government insurance – Obamacare – forbids the rejection of any applicant. It's guaranteed-issue health insurance, which means that already-sick people must be accepted. While this may be great for already-sick people, it drives the cost of the policy to astronomical heights. This is why so many insurance companies have abandoned selling through the Marketplace. The “risk pool,” i.e, the group of people being insured, has become heavily weighted with people who are running up high medical bills because of their pre-existing conditions.

Insurance companies must charge higher premiums so they have money to pay the claims of so many sick people. In every year since the ACA went into effect, premiums have risen by double-digit percentages, and each year, fewer and fewer insurance companies are selling their policies in The Marketplace.

Contrary to popular belief, insurance companies aren't “getting rich by jacking up prices.” As part of the ACA law, insurance companies that sell in The Marketplace must return 80% of the premiums they receive in claims benefits. That leaves a 20% gross profit, from which they must pay salaries and other business expenses. Can your business thrive on a 20% gross profit?

Many people get “tax subsidies” which reduce their cost of Obamacare health insurance. When asked what the true cost of an Obamacare policy is, they usually have no real idea. They think that the $75 or whatever they actually pay is what the policy actually costs. In reality, it costs (and taxpayers are paying) five to ten times what the policyholder pays.

Obamacare policies also usually have very high deductibles that people don't figure into their “low-cost” insurance. If you have to pay $5,000 to $7,500 of your medical expenses before the policy begins to pay anything, how much is the insurance really costing you?


Stuck in the Middle

Many Americans feel “stuck in the middle,” wanting health insurance but not being able to afford it. Small business owners, especially, are feeling the pain. Owners earn too much money to qualify for government subsidies to help pay the high price of an Obamacare policy. If you don't qualify for subsidies, the price of insuring yourself and your family with government insurance is truly staggering. A family of four may have a monthly premium of $1,400-$1,800 or more a month for a basic Obamacare plan! That is not “affordable health care” for very many people. Many of these people have said “no more!” and have by default become “self-insured,” risking their assets and their future on the hope they will never get sick or be involved in an accident that requires medical care.


Private Health Insurance

There are at least two alternatives to Obamacare and to being “self-insured” — group health insurance and personal health insurance. Both are referred to as private insurance, to distinguish them from government-mandated Affordable Care Act policies.


Group Health Insurance

If you're employed by a midsize or large company, chances are that you have or have been offered group health insurance. By law, in most cases, if a company offers group health insurance, the employer must pay at least 50% of the premium for the employee. Some employers also help pay for some or all of the coverage for employee's families.

The amount paid per person on a group policy is determined by how healthy or how sick the group is, on average. One person who has had a high claims can raise the rates for the entire group when it's time for a renewal. Already-covered employees can't be bumped from a group plan, but their being in the group does indeed affect rates for everyone.

With group health plans, there is but one policy covering all participating employees. Each member of the group is insured under one policy. New employees can be added to the policy, and retiring or terminated employees are usually dropped from the policy. Coverage is not portable; you can't take it with you, except under COBRA laws, which allow an employee who leaves the company to be covered for up to 18 months. The downside here is that the employee must pay the entire premium without contributions from the employer.

Group plans usually have deductibles, and may or may not allow you to see certain doctors or have certain treatments. The guidelines are spelled out in the policy, and depend on agreements between the insurance carrier and the employer. Some of the requirements are mandated by state or federal laws, but not to the extent that individual Obamacare policies are.


Individual Health Insurance

Personal health insurance has been around a long time. The idea is simple. You pay a certain amount each month to an insurance company in exchange for the company accepting the risk that you will have medical expenses. It's a contract between the customer and the carrier. What is or is not covered is spelled out in the policy, and prices are set based on your age and health status.

The insurance company evaluates the risk of covering you. It can decline to accept you, or charge you more, or “rider out” (not cover certain health conditions), based on your health status. Certain pre-existing conditions may make you uninsurable, because the risk to the company is more than they are willing to accept.

Many people are offended by the above paragraph, or think it's “unfair.” Those people forget that insurance – health insurance, life insurance, homeowners and car insurance – is a business, not a birthright.

Personal, private insurance is much less expensive than insurance policies sold in the ACA-compliant Marketplace. It usually costs 30-50% less. Why? Because the risk pool — people covered by a certain company — are healthier and will have statistically fewer claims, costing the insurance company less money. Why are they healthier? Because unhealthy people weren't accepted as policyholders.

Contrast that with ACA-compliant Obamacare policies that by law must accept anyone who applies. With Obamacare, the insurance companies have a huge risk pool of already-sick people, running up massive healthcare bills. This is why so many insurance companies have pulled out of The Marketplace. Obamacare just isn't a good business model.


My Recommendations

If you work for a company that offers group health insurance, take it. Consider yourself one of the fortunate ones. Keep in mind that you may lose coverage if you leave your employer.

If you have pre-existing health conditions that would keep you from being covered under private health insurance, or if you have a low income which qualifies you to get subsidies, then sign up for Obamacare. You may still have to meet a high deductible before you can actually get any useful benefits from the policy, but at least you're covered in the event of a major medical catastrophe. Consider also buying a private supplemental plan, also known as a GAP Plan, to help cover your deductible.

If your income is too high for subsidies, or if you're fundamentally opposed to socialized health care a.k.a. Obamacare, get a private health insurance policy.​

Here's the takeaway from your having read this far: Do not let yourself be self-insured. Unless you're a multi-millionaire, an unexpected sickness or accident can bankrupt you.


David Ross is a licensed life and health insurance agent providing both group and individual health insurance policies, as well as supplemental GAP plans, cancer plans, life insurance, and dental insurance. Call 678-654-9500 or email him at david@davidrossandassociates.com. Visit his website at http://davidrossandassociates.com.

With the writer's permission, I just added to the testimonials page  this thank-you email I received today from one of my health insurance customers, who has recently renewed their health policy with me for the third year.

+ + +

We would like to take the opportunity to thank you for all of the hard work that you have done for our family.

Since you have mostly dealt with my husband, Chris, I usually contact him with any questions that I may have about our insurance. Whenever I do so, he usually calls you and I have the answer to my question within hours. In a time where customer service seems to be fading quickly, I certainly feel like we receive great customer service from you. It may not be important to everyone, they may just be concerned with the end results. But in a customer service-driven business like insurance, it is very important to me and my family. We feel like you have gone above and beyond to answer our questions and service the needs that we have.

​As we all know insurance is a very delicate subject these days, and to navigate through it with a consummate professional is appreciated.

— Shana & Chris Stephens, Mr. Pawn, Lilburn GA, Sept. 2017

According to recent data released by the Centers for Medicare and Medicaid Services (CMS), in 2018, 1,332 counties in the United States will have only one health insurer operating on the Obamacare exchanges and 49 will have none.

The data comes from the Health Insurance Exchanges Issuer County Map, which shows projected issuer participation on the Health Insurance Exchanges in 2018 based on the issuer public announcements made prior to late July of 2017.

"The map currently shows that nationwide 49 counties are projected to have no issuers, meaning that Americans in these counties could be without coverage on the Exchanges in 2018," a press release for the agency states. "It's also projected that 1,332 counties—over 40 percent of counties nationwide—could only have one issuer in 2018."
​
The data also show that at least 27,660 Americans currently enrolled for health coverage on the Exchanges live in the counties projected to be without any coverage in 2018 – but, because of the Obamacare individual mandate, those who live in areas with no insurers offering health coverage will still be forced to buy coverage.

Read more at CNS....

By Michael F. Cannon

I receive lots of daily health-policy newsletters. This morning, one of them exhibited an all-too-common misunderstanding and bias about how health-insurance markets work.

The setting is the “Consumer Freedom Amendment” Sen. Ted Cruz (R-TX) has offered to the Senate GOP’s bill to rewrite ObamaCare. Contrary to what the Republican Party has pledged for seven years — a pledge that presidential candidate Donald Trump even put in writing — the Senate bill would not repeal the health-insurance regulations that are behind ObamaCare’s rising premiums, race-to-the-bottom coverage, and collapsing insurance markets. The Cruz amendment would keep those regulations on the books, but allow consumers to purchase insurance that does not include all of ObamaCare’s hidden taxes and coverage mandates. In effect, it would separate the market. Currently healthy enrollees would opt for the lower-cost “Freedom Option” coverage, which would stay with them once they developed expensive illnesses. Currently sick enrollees would opt for ObamaCare-compliant plans. Premiums for ObamaCare-compliant plans would rise even more than they already have, essentially turning ObamaCare’s Exchanges into high-risk pools that would require lots of government subsidies to keep afloat.

Enter one of my daily newsletters, which matter-of-factly reported:

Of course, everyone paying into the system for those who most need care is the way insurance is fundamentally supposed to work.

Of course! I hear this sort of thing all the time. Now, there is a charitable interpretation that would render this particular phrasing just barely true, but I am fairly sure that interpretation is not what the author intended to convey. Instead, the sentence glosses over a distinction so crucial that entire insurance markets hang in the balance. And it does so in a way that presents the (legitimately disputed and controversial) pro-ObamaCare ideology as an of-course-this-is-fundamentally-true fact.

Fundamentally, insurance markets are a system of subsidies. People with the same ex ante (i.e., before-the-fact) risk of needing medical care pay into the system to subsidize the few in that group who will develop expensive medical needs. We know insurance is supposed to work this way, because of what happens when you try to pool together people with different ex ante health risks at the same premium: the system of subsidies collapses. (See: state-level experiments with community rating, ObamaCare’s CLASS Act, the child-only market under ObamaCare, U.S. territoriesunder ObamaCare, and Exchanges in dozens of counties). Risk-based premiums, exclusions for preexisting conditions, and other measures that ObamaCare supporters hate are actually consumer protections. They exist to keep that system of subsidies stable, so it can keep doing the most good possible by subsidizing people who become sick.

The idea that everyone should pay the same premium regardless of risk arises because left-of-center folks want to cram additional, hidden subsidies into the insurance system. They want to do this rather than create explicit taxes and transfers because, as Jonathan Gruber taught us, there is not sufficient political support for explicit taxes and transfers. But again, when you force insurers to cover unlike risks at the same premium, insurance markets collapse. So ObamaCare throws tons of money at insurers — with everything from the individual mandate to risk-adjustment — in the hope of preventing a collapse. Sometimes it prevents a collapse. Sometimes, not so much.
The above sentence therefore amounts to saying, “Insurance is fundamentally supposed to work exactly like ObamaCare supporters want, with mandates and lots of government subsidies, not like its opponents say.”
​
That’s what the news tells me, anyway.

Reprinted from the Cato Institute, July 10, 2017

We all know that it's important to have health insurance. And if it were free, we'd all sign up and get some. But health insurance is the opposite of free -- it's expensive. And that means that inevitably, a large number of us get priced out.

So just how bad is the problem? According to the Gallup-Sharecare Well-Being Index, 11.7% of Americans were uninsured as of the second quarter of this year. That's a 0.8-percentage-point increase from the end of 2016, at which point 10.9% of the population was without insurance. All told, an estimated 2 million Americans seem to have dropped their coverage between then and now.

Why the change? For one thing, premiums rose significantly across the board this year for those who don't qualify for federal subsidies, and many folks just couldn't afford them. Furthermore, a large number of insurers pulled out of the open exchange, leaving consumers with a narrower range of choices for coverage. And let's not discount the role the Trump administration's healthcare bill may have played in all of this. With uncertainty about the future of healthcare abounding, many folks have probably just given up, figuring they're better off saving their money for medical emergencies than struggling to pay the premiums they can barely afford to keep up with.

Still, pricey as today's health plans might be, going without health insurance could wind up being a very costly mistake. And if you're not careful, you might end up spending far more money on healthcare than you ever expected.

Pay now, or pay later

It's easy to see why so many Americans would rather go without health insurance than cough up those monthly premiums. Though insurance costs vary based on a number of factors, including age and geographic location, according to eHealth, the country's largest private online health insurance exchange, the average cost of an unsubsidized individual monthly premium this year is $393, which is 22% higher than the average $321 premium during 2016's open enrollment. The average unsubsidized monthly cost for a family plan, meanwhile, is $1,021, which represents a 23% increase since 2016's open enrollment.
​
Clearly, that's a lot of money to spend. But there's a reason many of us pay an arm and a leg for insurance, and it's to protect ourselves from the unknown. According to Healthcare.gov, the average cost of a three-day hospital stay is around $30,000. Now imagine you're currently forking over $393 a month for health coverage, or $4,716 a year, and you never use that insurance once -- until you suddenly get injured and are rushed to the hospital, where you're forced to camp out for several days. Suddenly, that insurance more than pays for itself. Even once we factor in a deductible, which this year is $4,328 on average, and a copay, you're still coming out a good $15,000 to $20,000 ahead.

Read more at Madison.com....

​The closely guarded Senate health care bill written entirely behind closed doors finally became public Thursday in a do-or-die moment for the Republican Party's winding efforts to repeal Obamacare.

The unveiling of the legislation marks the first time that the majority of the Senate GOP conference gets a comprehensive look at the health care proposal. With Majority Leader Mitch McConnell pressing ahead for a vote next week, senators are likely to have only a handful of days to decide whether to support or vote against the bill.

A draft circulating late Wednesday showed the Senate legislation would still make major changes to the nation's health care system, drastically cut back on federal support of Medicaid, and eliminate Obamacare's taxes on the wealthy, insurers and others. The Senate plan however would keep Obamacare's subsidies to help people pay for individual ​coverage.

McConnell's decision to keep the details tightly under wraps until Thursday was intentional and aimed at winning over his colleagues out of the public spotlight, but the secretive process has infuriated Democrats -- and aggravated plenty of Republicans, too.

"I need the information to justify a 'yes' vote. I have a hard time believing that we would have that in such a short period of time," Sen. Ron Johnson, R-Wisconsin, told CNN on Wednesday.
​
Read more at CNN....

By Andrew P. Napolitano

Last week, the U.S. House of Representatives crafted a partisan compromise bill that endorsed and reinforced the Affordable Care Act, or Obamacare. This was done notwithstanding claims to the contrary by President Trump and the House Republican leadership, who want us to believe that this bill, if it becomes law, will effectively repeal and replace Obamacare.

Obamacare is a stool with four problematic legs. The constitutional leg is the premise that the federal government has the lawful power to regulate the delivery of health care. The legal leg is the premise that the federal government is obliged to provide health insurance to everyone in America. The economic leg commands that everyone in the U.S. purchase and maintain health insurance. And the Orwellian leg says that every physician in the U.S. shall retain all patient records digitally and that federal bureaucrats shall have access to all those records.

None of that is changed in the House-passed bill. Here is the back story.

The original Obamacare proposal had the taxpayers foot everyone’s medical bills through a series of taxes, regulations and controls. That is the so-called single-payer system that former President Obama dreamed of. It would have been much like the systems in place today in Great Britain, Canada and Australia, where one waits for months to see government-employed physicians who are stingy with government-owned medications and mired in red tape and long lines over government-financed medical procedures.

Even many of the Democrats who controlled both houses of Congress during Mr. Obama’s first two years in office were unable to accept that idea. In its place, they produced a 2,700-page piece of legislation, which candidate Donald Trump vowed to dismantle — saying he favored a market-based, state-regulated system with no federal involvement, the kind we knew in the pre-Obamacare era.
​
None of those goals is reached by the House-passed bill.

Keep reading at the Washington Times....

House Republicans are shopping around a new ObamaCare replacement plan, amid pressure to deliver a legislative win as President Trump nears the end of his first 100 days. 

“We have a good chance of getting it soon. I’d like to say next week, but I believe we will get it” eventually, Trump said Thursday at a White House press conference. 

“We’re very close,” House Speaker Paul Ryan, R-Wis., said a day earlier at an event in London.

Fox News is told they hope to have revised legislative text in the coming days, and lawmakers are set to discuss the proposal on a conference call this weekend. But it’s unclear when such a plan could hit the House floor or what level of support it might have – Congress is currently on recess, and lawmakers won’t return until next week.

Fox News is told that leaders have not yet tried tallying support for the document on Capitol Hill.

"The question is whether it can get 216 votes in the House and the answer isn't clear at this time,” a senior GOP aide said. “There is no legislative text and therefore no agreement to do a whip count on."
​
A White House source said they could potentially have a vote by the end of next week, though they put the chances at 50-50.

Read more at Fox News....

The White House prodded House Republican leaders to make last-minute tweaks to their Obamacare replacement bill Thursday aimed at protecting high-cost patients before lawmakers leave Washington for their two-week spring break.

The House Rules Committee will meet later in the day to consider an amendment offered by two House members to create a new risk-sharing fund for the seriously ill, House Speaker Paul Ryan told reporters at a news conference.

"Their amendment makes this a much better bill," Ryan said. "This amendment alone is real progress and it will help us build momentum toward delivering on our pledge to the country" to repeal and replace Obamacare.

The effort by the Rules Committee to rush to adopt an amendment to a bill -- without time for anyone to read it or any immediate intent to take the measure to the House floor -- is highly unusual. But it reflects the strong desire by the White House to demonstrate that the effort to repeal Obamacare isn’t dead, despite the embarrassing setback last month when Republican leaders had to pull the bill from the House floor right before a scheduled vote.
 
The provision is sponsored by Representatives Dave Schweikert of Arizona and Gary Palmer of Alabama, both members of the House Freedom Caucus, the conservative group that some other House Republicans have been blaming for blocking a deal on a final bill.

While the amendment "was offered by two of our most conservative members," it is embraced by a broad part of the Republican conference, Ryan said. Lawmakers will continue working on further revisions, he said.
The proposal would give health insurers $15 billion in government funding to subsidize the care of high-cost patients from 2018 through 2026, helping lower premiums for others.

It would give Health and Human Services Secretary Tom Price broad authority in determining how the payments are handed out, including which patients insurers would be reimbursed for and how much. Many aspects of the program would be worked out by HHS and aren’t detailed in the four-page amendment. In 2020, the program’s operation would be handed over to the states.

Freedom Caucus Chairman Mark Meadows of North Carolina said Thursday morning at an event hosted by Politico that if the offers made over the last few days are in the final bill, then “the majority, if not all of the Freedom Caucus will vote for this bill.”

Continue reading at Bloomberg.com....

Parts of the country are in jeopardy of not having an insurer offering Obamacare plans next year.

Many counties already have just one insurer offering health plans in the Obamacare marketplaces, and some of those solo insurers are showing signs that they are eyeing the exits.

Humana announced this year that they’d be leaving the markets altogether next year. That means there are parts of Tennessee that will have no insurance options unless another insurer decides to enter.

And Anthem, which operates in 14 states, is getting nervous, an industry analyst told Bloomberg News this week. Its departure would be a much bigger problem. According to an analysis of government data by Katherine Hempstead at the Robert Wood Johnson Foundation, Anthem is currently the only insurance carrier in nearly 300 counties, serving about a quarter of a million people.

As you can see on our map of those counties, an Anthem departure could leave coverage gaps in substantial parts of Georgia, Missouri, Kentucky, Ohio and Colorado, as well as smaller holes in other states. In places where no insurance company offers plans, there will be no way for Obamacare customers to use subsidies to buy health plans.
​
Without an option for affordable coverage, they would become exempt from the health law’s mandate to obtain coverage. A result could be large increases in the number of Americans without health insurance.

Continue reading at the New York Times....

With Republicans’ ObamaCare overhaul sidelined on Capitol Hill, the Trump administration is vowing to use its full legal authority to “immediately” help Americans and mitigate the health care law’s “harmful effects.”

That means that as congressional Republicans regroup on strategy for pursuing future legislation, it will fall to Health and Human Services Secretary Tom Price and other administration officials to pursue changes to the Affordable Care Act for now. These potential changes would not be as sweeping as those contained in the failed GOP legislation, but range from cutting government costs to providing relief from certain requirements to customers and insurers.

“Secretary Price is, and always will be, focused on patients,” agency spokeswoman Alleigh Marre told Fox News on Wednesday. “He and the HHS team will continue to pursue actions to mitigate the ACA’s harmful effects and protect patients.”

Though President Trump has threatened to let ObamaCare “implode” on its own, his administration has several options to try to improve the 2010 law absent new legislation – and already has used one.

Trump signed an executive order in January directing federal agencies to easy some of ObamaCare’s regulatory burdens -- resulting in the IRS processing tax refunds for Americans who violated the law and failed to provide the agency with proof of insurance.
​
Additional options for the HHS secretary include tweaking what types of coverage insurers are required to offer, pulling back on the mandate to buy insurance and cutting federal subsidies that help low- and middle-income customers afford ObamaCare coverage – which likely would prompt a backlash.

Continue reading at Fox News....

By John Stossel

President Trump and Paul Ryan tried to improve Obamacare. They failed.

Trump then tweeted, "ObamaCare will explode and we will all get together and piece together a great healthcare plan for THE PEOPLE. Do not worry!"

But I do worry.

Trump is right when he says that Obamacare will explode.

The law mandates benefits and offers subsidies to more people. Insurers must cover things like:

• Birth control.
• Alcohol counseling.
• Depression screening.
• Diet counseling.
• Tobacco use screening.
• Breastfeeding counseling.

Some people want those things, but mandating them for everyone drives up costs. It was folly to pretend it wouldn't.

Insisting that lots of things be paid for by someone else is a recipe for financial explosion.

Medicare works that way, too.

When I first qualified for it, I was amazed to find that no one even mentioned cost. It was just, "Have this test!" "See this doctor!"

I liked it. It's great not to think about costs. But that's why Medicare will explode, too. There's no way that, in its current form, it will be around to fund younger people's care.

Someone else paying changes our behavior. We don't shop around. We don't ask, "Do I really need that test?" "Is there a place where it's cheaper?"

Hospitals and doctors don't try very hard to do things cheaply.

Imagine if you had "grocery insurance." You'd buy expensive foods; supermarkets would never have sales. Everyone would spend more.

Insurance coverage -- third-party payment -- is revered by the media and socialists (redundant?) but is a terrible way to pay for things.

Today, 7 in 8 health care dollars are paid by Medicare, Medicaid or private insurance companies. Because there's no real health care market, costs rose 467 percent over the last three decades.

By contrast, prices fell in the few medical areas not covered by insurance, like plastic surgery and LASIK eye care. Patients shop around, forcing health providers to compete.

The National Center for Policy Analysis found that from 1999 to 2011 the price of traditional LASIK eye surgery dropped from over $2,100 to about $1,700.

Continue reading at Reason.com....

So. What comes next on repealing ObamaCare?

The TrumpCare bill (AHCA) was a disaster. It was not a vote to repeal ObamaCare, but rather a vote to keep it, and tweak it. That’s not what Republicans promised to do, and it’s not good enough. We should not mourn its passing, but celebrate it. The defeat of the bill was glorious, and the members of the Freedom Caucus who opposed it are heroes.

The reason fans of the free market are angry is not because TrumpCare failed — but because of the statements by Paul Ryan and Donald Trump that they are done with trying to repeal ObamaCare. Those statements are wrong and dangerous. As Ted Cruz once said:

First principle: Honor our promise. When you spend six years promising, “If only we get elected, we’ll repeal Obamacare,” you cannot renege on that promise. Failure is not an option. Breaking our word would be catastrophe. The voters would, quite rightly, never again trust Republicans to deliver on anything.

Amen.

The response to the defeat of TrumpCare is not to pick up the ball and go home. It must be to draft a bill that actually does what Republicans promised, and drives down costs through market-based mechanisms.

What should such a bill look like? As it turns out, Ted Cruz had a proposal that outlined an answer to that question. I blogged that op-ed before, but with the defeat of the AHCA, Cruz’s op-ed has renewed relevance, as a blueprint that could bring Republicans together and actually repeal ObamaCare. I think it’s worth giving his proposal another detailed look.

Keep reading at Red State....