By Mina Kim
(Justin Sullivan/Getty Images)
Gov. Jerry Brown’s revised budget plan is a mixed bag for health advocates and some county officials.
Brown said the state would take the lead on a key provision of the federal health law — expanding Medi-Cal to more than one million Californians. Brown scrapped earlier plans to consider a more complicated, county-based system.
But Brown anticipates recouping more than $300 million from the counties next fiscal year – money that pays for public health programs and care for the uninsured. Brown’s rationale? With the full implementation of federal health reform next year, more people will enroll in Medi-Cal and fewer people will show up to county emergency rooms.
Farrah McDaid Ting with the California State Association of Counties says Brown’s proposal makes no sense. She says plenty of people will still rely on county services in 2014.
They are “people who qualify for Medi-Cal but don’t sign up, people who have a hard time signing up or staying on programs, the undocumented in our communities and those who are in between private health plans,” McDaid Ting said. “We need to retain enough funds to serve those people.” Continue reading
Covered California, the state’s health insurance exchange, announced the recipients of $37 million in education and outreach grants on Tuesday. It’s a critical step in the drive toward the full implementation of the federal health law on Jan. 1. “This program now belongs to California … and to Californians, and we have to make it work,” said Dr. Robert Ross, a Covered California board member.
The grants were awarded to 48 lead organizations, which will be supported by 226 community partner groups. They will focus on education and outreach to the 5.3 million Californians the exchange seeks to enroll, with an estimated 2.6 million of those people eligible for subsidies to help them afford insurance. Five of the recipients will target their outreach to small businesses.
Californians will be able to shop for insurance on the new marketplace starting Oct. 1, with coverage going into effect on Jan. 1. Most people must have insurance or pay a penalty. In 2014 the penalty is $95 per person or 1 percent of income (whichever is greater), and the penalty rises to $695 or 2.5 percent of income (again, whichever is greater) by 2016. Continue reading
For you wonks out there, Kaiser Health News has a fascinating Friday afternoon read for you.
In a piece titled “Bloggers See Own Reflections in Oregon Medicaid Study,” reporter Jordan Rau describes how this week’s news about Oregon’s Medicaid Experiment quickly became “a Rorschach test for how partisans and health policy wonks view the health care law.”
With no money for better food, no money for good shoes to go on walks, no rain gear, no walkman for listening to music as a distraction while walking, change is harder.
To quickly recap, in a New England Journal of Medicine study researchers analyzed how 10,000 people who won Medicaid coverage have fared since they gained insurance. The highlights were: no apparent affect on physical health; rates of depression 30 percent lower than those without coverage; catastrophic out-of-pocket medical expenses essentially eliminated.
In his piece, Rau publishes excerpts from seven blogs, each with a different take on the study’s highly nuanced results. But he closes with something I hadn’t seen elsewhere: a view of the experiment by someone who says he was one of the winners of the Medicaid coverage. Rau found the post on the blog Robert’s Stochastic thoughts.
Here’s the post in its entirety:
I am one of the winners in the Oregon lottery [winners could get Medicaid]. Going from no insurance to insurance is very confusing. When you have no money every health question starts with “would I rather live with this problem and have electricity, or treat this problem and keep my milk in a cooler for a month or so?” Stepping back into healthcare was like Continue reading
Confusion about the health law reigns for many small businesses
By Kelley Weiss, CHCF Center for Health Reporting
Tax credits for small businesses offering health insurance have been available since the health law was passed in 2010. (Photo/Getty Images)
With less than a year to go before the full rollout of Obamacare, many business owners are still scratching their heads over what it will mean for them.
In fact, most still wrongly believe they’ll have to offer health insurance to their employees, according to a recent eHealth survey. While businesses with 50 or more full time employees will have to pay a $2,000 penalty per worker if they do not offer health insurance, there is no penalty for smaller businesses.
Another commonly misunderstood part of the health care law is the role of the tax code. John Gonzales [also with the Center for Health Reporting] has more details about how paying your taxes and Obamacare works. It’s the bedrock of enforcing the law and subsidizing premiums for people to buy insurance.
At an event about taxes and Obamacare, UCLA health care economist Dylan Roby gave a somewhat grim picture. He says widespread ignorance and varying degrees of hostility towards the health care law persist among business owners.
“Many of these employers, especially on the smaller level, are not that great about maintaining a relationship with the government,” Roby says. Continue reading
The president talks up the health care overhaul at Tuesday’s press conference
The health care overhaul is “a big complicated piece of business,” President Obama told reporters during Tuesday’s news conference. (Alex Wong/Getty Images)
If you’re one of the millions of people confused about Obamacare, the president took a few minutes on Tuesday to reiterate his main messages about the federal health law.
“For the 85 to 90 percent of Americans who already have health insurance, they’re already experiencing most of the benefits of the Affordable Care Act even if they don’t know it,” the president said.
He called insurance “stronger, better, more secure,” for people than before the law’s passage. ”Full stop. That’s it. Now they don’t have to worry about anything else.”
President Obama specifically mentioned three benefits of the ACA already in place:
- Children can stay on their parents’ plan until age 26
- Your insurance company cannot drop you if you get sick
- You get free preventive care with no co-pay and no deductible (including many cancer screening tests)
The law also has banned lifetime caps on coverage. For people who have employer-based insurance or Medicare, most of the changes required by the law are already in place.
For people who do not have insurance — or who buy insurance for themselves or their families — “implementation issues” remain, the president said. Continue reading
By Stephanie O’Neill, KPCC
(Dale M. Moore/Flickr)
Perhaps the most popular provision of President Obama’s federal health law is that people cannot be turned down or charged a lot more because they are sick. Obamacare also reduces how much more older people can be charged for insurance.
But the president’s health law permits one group to be charged more — a lot more: smokers. States can allow health plans to charge tobacco users up to 50 percent more for their health insurance premiums.
The provision allowing for a “tobacco surcharge” was designed in part to encourage smokers to quit a habit that often leads to major illness.
The Centers for Disease Control puts the nation’s annual price tag for smoking at more than $190 billion in both medical care and lost productivity.
It’s that price tag that prompts some to support higher health care premiums for smokers. Micah Weinberg is a senior fellow with the Bay Area Council, which researches public policy issues that affect businesses and the local economy. While he says caution is needed to avoid premiums so high that they are unaffordable to smokers, ”I think that we need to make sure that there is a strong financial disincentive for people to smoke.” Continue reading
By Stephanie O’Neill, KPCC
Federal tax credits designed to make health insurance more affordable, starting next year, will help nearly 3 million Californians buy health insurance, according to a study issued Tuesday.
The report commissioned by Families USA – a supporter of President Obama’s health care reforms — says that more than 85 percent of all Californians who qualify for the federal tax credits live in families with at least one full- or part-time worker who doesn’t receive employer-sponsored health insurance.
It also finds that 52 percent of Californians expected to qualify for the sliding-scale tax credits will come from middle-class families who earn up to $95,000 a year. Continue reading
By Phil Galewitz, Kaiser Health News
Vermont may not see rate shock, but its insurance market is strikingly different from that in California. (herzog/Flickr)
After years of anticipation, Vermont became the first state Monday to publish proposed 2014 individual health insurance rates under the federal health law. Despite Republican and insurers’ predictions, there was no “rate shock” in the new premiums, according to the Vermont governor’s office and insurance representatives.
That state may not be the best barometer of the impact of the heath overhaul on premiums, however, because it already prohibits insurers from using health status to determine an individual’s premiums. It is one of only seven states in the country which have so-called community rating regulations.
Unlike California, Vermont already prohibits insurers from using health status to determine an individual’s premiums.
California does not currently have community rating regulations. A major study last week
concluded that individual premiums will likely go down substantially for many Californians and up for others on the individual market, once the new online marketplace for health insurance opens later this year. Premiums are expected to be announced for California in several weeks.
Vermont also requires prices to be the same regardless of person’s age. Two of the health law’s biggest changes include prohibiting insurers from using health status to determine premiums and prohibiting insurers from charging older people more than three times the rates of younger people.
A major new analysis shows that hundreds of thousands of Californians will see their monthly insurance premiums fall an average 47 percent under President Obama’s health care overhaul, in large part due to tax credits and subsidies. It is the first detailed look at how health insurance premiums could change under President Obama’s Affordable Care Act, which goes into effect on Jan. 1, 2014.
Covered California, the agency charged with creating the state’s new health insurance marketplace, commissioned the analysis. The report looked at the individual market only and did not examine the small or large group market.
Under the ACA people with incomes up to four times the federal poverty level (about $94,000 for a family of four; $46,000 for an individual) will be eligible for subsidies from the federal government. That’s about 570,000 people, Covered California said.
Major findings from the study include:
- Individuals with incomes less than four times the poverty level are “likely to pay” 47 to 84 percent less for their monthly premium compared to this year
- Premiums would have increased 9 percent in 2014 because of health care inflation, even without the ACA Continue reading
Now the actuaries are weighing in.
In a new analysis, the Society of Actuaries says insurance companies will pay an average 32 percent more for medical claims under the health care overhaul.
That means premiums could go up, especially in the individual market.
The Obama Administration isn’t convinced, though, saying the report didn’t consider all the ways in which the administration says the Affordable Care Act will reduce costs.
More from the AP: Continue reading