Today is Thursday, May 17, 2012

Small Groups

Small business groups, WSJ finally find their voices on health spending bill HR 3962

The National Federation of Independent Businesses (NFIB) and the National Small Business Assn. (NSBS) suddenly are finding their voices on ObamaCare (HR 3962). But they and The Wall Street Journal still have to discuss the huge costs small employers would incur in an effort to comply with the bill and to qualify for tax credits provided for under the bill.

Impact graphs:

 

Karen Kerrigan: ObamaCare (HR 3962) burdens small employers with higher costs, crushing taxes

Karen Kerrigan, president of the Small Business & Entrepreneurship Council,  writes in Politico’s Arena:

Colorado health insurers mislead legislators on community rating, small business premiums

Back in 2003, Colorado’s health insurers fooled naive state legislators into enacting a bill that ended community rating of health insurance risks for small employers. They said rate increases would slow. They soared.

Insurance brokers and insurers are trying to roll back the reinstatement of modified community rating, which cuts their commissions and profits. Insurers want premiums to rise because they get their 4% take regardless. And apparently brokers and agents make more money when there is medical risk rating instead of community rating. It’s obvious that this isn’t about those who pay the premiums.

One of the smartest, most pro-small business moves that Governor Bill Ritter and Democrats in the General Assembly have done was the enactment of House Bill 1355. It reinstates community rating, which makes health insurance less expensive for small businesses that have older and sicker employees while increasing costs for those that have younger, healthier employees. Most small businesses are owned by people over 40, and most have older, less healthy workers. Or, as anyone who’s been in business knows, an employee can have an accident or get cancer tomorrow. And when that happens, you’re no longer a healthy employer.

Under today’s community rating system, your rates won’t go up because an employee or family member suddenly begins filing financially catastrophic claims on an insurer. Both for-profit and not-for-profit insurers want to be able to screw their consumers with medical risk rating of small groups. Even though most of the insurers’ customers in the state are small employers and their employees, insurers want to be able to take them to the cleaners.

At this point, the Democrats are the pro small business party in Colorado because they support community rating. Republicans killed modified community rating in 2003 when it passed HB03-1164, and the GOP was the anti-small business party until several Republicans supported HB 1355.

Now, Colorado’s health insurers are trying to mislead small employers and legislators again. I hope that Ritter and the GOP’s gubernatorial candidates, Scott McInnis, Josh Penry and Dan Maes, don’t take the bait.

Impact graphs and links back to 2003 on this issue:

How Pelosi health insurance deform bill (HR 3962) gets small employers

Speaker Nancy Pelosi’s health insurance deform and pork for everyone bill (HR 3962) clearly is written to drive individuals into a government-run HMO/PPO. One small employer’s reaction to the fines for small employers is that he’ll pay the fines, which will be cheaper than private health insurance premiums under Pelosi’s health care Canadianization bill:

Wellpoint (WLP): Health reform will hike costs for Colorado’s young, lower costs for high risks

Wellpoint (WLP), which operates Blue Cross and Blue Shield plans in Colorado, Missouri, California and other states, is circulating reports on the impact of the two Senate and the three House health insurance and spending bills (most importantly, S 1796 and HR 3200). In a 17-page (single spaced) report on Colorado, Wellpoint concludes that without high enough penalties and fees for those who don’t buy health insurance while insurers are required to sell to all applicants (guaranteed issue), premiums would jump 20% to 80% for some customers.
Read more.

Congress must set rules for selling health insurance across state lines, McInnis says

Republican gubernatorial candidate Scott McInnis said in an interview Friday that he supports making it possible for health insurance across state lines, but the former Congressman and state legislator warned that Congress must pass health reforms that create uniform regulations in all of the states.

I asked:

 

Rep. Mike Coffman opposes ObamaCare, but his solutions are off

Rep. Mike Coffman (R-CO) opposes ObamaCare for some pretty good reasons, but his solutions are a bit off.

His column, which apparently was published in the Denver Post as well as on his web site, concludes:

If the Democrats want to provide real reform and pass a bill that accomplishes the goals they espouse ‚Äî increased coverage and reduced, sustainable costs ‚Äî they should take a cue from their Republican colleagues’ health care reform priorities and do the following:

‚Ä¢ Increase access to care by providing tax incentives for individuals to purchase their own health care and provide relief for those who are working but can’t afford health care;

Pretty broad generalizations. But he had limited space. I think the GOP is too hung up on tax incentives for people who don’t pay income taxes. Maybe nobody should get tax incentives for buying health insurance. Give them tax incentives to buy preventive and wellness care as well as prescription drugs and prescribed medical devices with their credit cards.

• Build on the proven employer-based system and require health insurers to cover those with pre-existing conditions;

Employer-based health insurance is a disaster. It denies insurance portability to workers, locking them into jobs that don’t allow advancements in responsibility or incomes. To me, this shows how Coffman and the GOP are owned by insurers, brokers and agents who make a living selling insurance and consulting services to employers.

• Enable small businesses to reduce health care costs through group purchasing and make all policies portable;

Ironically, Coffman helped create a Colorado purchasing coop for small employers when he was in the state senate. And when insurers moved to kill that coop, he backed them and opposed community rating. This, again, shows he’s listening to his contributors, not small businesses.

and

• Include medical malpractice reforms in order to reduce the costly practice of defense medicine.

Ok. I agree with this, but the GOP makes too much of it. There are bigger reforms that would work, as I’ve outlined many times here over the last 6.5 years.

House Democrats are presenting the American people with a false choice by comparing their current plan to the alternative of doing nothing. We deserve better. We deserve real reform.

Yep.

 

What large employers can do to fix health insurance markets

The Wall Street Journal published a PR piece about how CEOs can fix health care. I think the piece is off base and posted the following reply:

How large employers can help fix health care:

 

Posted by Donald E. L. Johnson on 07/28/09 at 07:51 PM
Books • Health insurance • Community Rating • Health Insurance Reform • Preventive Care • Small Groups • Read More

How to buy health insurance

Shopping for health insurance probably is more difficult than buying a car or a house because you have to be very good at finding a reliable agent, comparing plans and reading the fine print, which can be a challenge for lawyers.

About 202 million Americans have private health insurance. By 2010 about 20 million people will buy health insurance through insurance agents and insurers rather than through their employers. In 2007, according to the Census Bureau, 177.4 million people were covered by employment-based insurance. Please note that Census Bureau figures are very questionable, but these are the best figures I can find at the moment.

In the June 24, 2009, edition of The Wall Street Journal, Anna Wilde Mathews’ article, Going it alone when buying a health policy, explains how to research the health insurance markets.

Since you may spend $5,000 to $20,000 a year, or $25,000 to $100,000 over five years, on health insurance, it pays to learn how to play the health insurance markets. Nobody will look after you, your family and your money as carefully as you will, especially if you know what you’re doing.

Simply put, the first step is to read her article and the some 55 comments on the article. (Paid subscription required, and it’s worth it if you’re about to spend $10,000 to $20,000 for a year’s worth of health insurance.)

The second step is to talk to, say, half a dozen insurance agents. Get names of agents and brokers from friends. The more agents you visit with, the more you’ll learn about the agents and about your options. Look for an agent who represents several insurers and works for you as well as for commissions. Those commissions range from 3% to 20%, Mathews reports. So, be careful.

Mathews recommends that you talk to agents who specialize in health insurance, not new agents nor agents who also sell property and casualty or life insurance. Understanding and keeping up with health insurance is a full time job.

Third, visit online insurance sites and brokers. Web-based brokers suggested by Mathews include:

www.eHealthInsurance.com
http://www.HealthPlanOne.com
http://www.HealthInsurance.com
http://www.InsureMonkey.com

Other resources include:

www.healthinsuranceinfo.net
http://www.familiesusa.org
http://www.healthcarecoach.com

Impact graphs from Mathews:

Some consumers choose plans based solely on online research. But without guidance, it can be tough to fully understand the nuances of a plan and how it compares to other options. First, make sure you’re actually buying insurance, not some other product such as a discount card. Don’t just look at premiums. Figure in other fees you will face, such as a percentage of the cost of doctor visits. Make sure you understand the policy’s annual out-of-pocket maximum, meaning the most you might have to spend in a year, since certain charges might not count toward the total.

Also, watch out for benefit limits or exclusions. If you focus just on price, “on the back end, you’re going to get stung,” says Ida Schnipper, founder of patient-advocacy firm Health Champion LLC.

Before making a final decision to purchase a policy, closely review the full plan explanation, sometimes called the certificate of coverage or the evidence of coverage, and seek help from the Web brokerage’s agents or other experts if you don’t understand it. Insurers may let you review this document only after you tentatively choose a plan.

If buying health insurance looks like a lot of work, it is.

We’ve been buying health insurance for ourselves and employees since 1986. And despite our expertise in insurance and health care, we always depend on our health insurance broker for information and guidance. But it helps to know what questions to ask, and you can save a lot of money and grief by asking good questions.

Do your home work.

Posted by Donald E. L. Johnson on 06/27/09 at 05:34 AM
Health insurance • Buying Insurance • Individuals • Small Groups • Small Business • Permalink

How Colorado’s health insurance cooperative for small businesses died; lessons for today

Health insurance buying cooperatives for employers still are under consideration even though it is clear that such cooperatives won’t work, as I blogged Monday.

This debate prompted me to search for my previous blog on health care cooperatives.

One of my first posts, if not the first, was Susan J. Alt’s testimony before the Colorado legislature in her futile attempt to save the Alliance, which was the state-sanction cooperative for small employers. She was chair woman of the Alliance. The link is here.

I also blogged on testimony against HB03-1013 by Tim Jackson, the then executive director of the Colorado chapter of the National Federation of Independent Businesse (NFIB) here.

The bottom line is that after years of nit picking away at the Alliance, lobbyists for health insurers succeeded in killing the Alliance. I sat on the Colorado Assn. of Commerce and Industry’s health insurance committee for several years. We met weekly and I learned a lot about how lobbyists and legislators work.

The work is tedious, the lobbyists are smart and have the institutional memories and the legislators barely have a clue.

In a related blog posted at the end of 2003, I noted that our firm’s experiences with health insurance were profiled by http://www.bloomberg.com. The link no longer is available. I’m glad we don’t have employes today.

This bill killed the Alliance.

Co-ops gain backing as alternative to government insurer. wsj.com.

Posted by Donald E. L. Johnson on 06/19/09 at 09:32 AM
Health insurance • Health Insurance Reform • Small Groups • Small Business • Uninsured • Permalink

How to reform health insurance markets

For years, a few people have been pointing out that there are only 6 to 8 million uninsured American citizens. As George Will pointed out on “This Week” Sunday, millions have not signed up for programs for which they are eligible. Millions (14.5 million to be exact) earn more than $50k a year but don’t buy insurance. Some 10 to 15 million of the so-called uninsured are not American citizens. The left’s lame reply is that “we have to pay for them anyway,” but that’s not true.

When uninsured illegal immigrants and

Posted by Donald E. L. Johnson on 06/15/09 at 05:50 AM
Health insurance • States' Health Legislation • Community Rating • Health Insurance Reform • Risk Rating • Small Groups • Read More

HUM: Humana turns in strong first quarter; earnings rise 13%; beat estimates

Humana Inc. (HUM), which last month lowered its estimates for 2008, reported a 13% gain in first quarter earnings, beating analysts’ estimates by two cents per share, Bloomberg reports in a very comprehensive story. One reason HUM beat estimates is that its income tax rate fell to 35.3%. HUM closed Monday at $46.38, up 3.34% on the day.

In its earnings announcement, Humana said:

Posted by Donald E. L. Johnson on 04/28/08 at 08:25 AM
Health insurance • Individuals • Medicare • Small Groups • Healthcare Providers • Hospitals • Read More

Mark Hillman bill rigs market for Anthem Blue Cross

The Mark Hilllman bill (or, the Anthem protection act of 2003), HB03-1164, is a form of socialism and anti-competition legislation because the legislature is being used by the insurance industry to rig the market in its favor.

 

Posted by Donald E. L. Johnson on 05/02/03 at 08:07 AM
Colorado • Legislation • Health insurance • States' Health Legislation • Community Rating • Health Insurance Reform • Risk Rating • Small Groups • Small Business • Read More

Colorado fight over small business health insurance and community rating continues

Colorado’s legislators are doing a better job of sorting out a raft of poorly conceived health care reform measures than the editorial page of The Rocky Mountain News, which appears totally confused in this editorial, “Small-group insurance market still ill.”

Posted by Donald E. L. Johnson on 02/28/03 at 02:54 AM
Colorado • Legislation • Health insurance • Community Rating • Health Insurance Reform • Small Groups • Small Business • Read More

Florida’s new risk rating system fails to help small employers

Florida dropped its modified community rating system in favor of rate bands and risk rating by health insurers, but this has failed to help small businesses buy insurance for their employees, according to the Palm Beach Post. In its news report, fewer Florida firms offering health insurance, the Post reports on a Chamber of Commerce survey that shows premiums are rising and more employers are being forced to drop coverage.

 

Posted by Donald E. L. Johnson on 02/11/03 at 01:26 AM
Health insurance • States' Health Legislation • Community Rating • Health Insurance Reform • Risk Rating • Small Groups • Small Business • Read More

Page 1 of 2 pages  1 2 >