As I listened in my car this morning that Individual Mandate tax in the Healthcare Reform Bill had been upheld by the Supreme Court, I sighed and kept driving. There are positives and negatives to this Bill, but I fear that the negatives & cost outweigh the positives. And yes, I have read the Healthcare Reform Bill...have you?
Are the new benefits in this Bill evil? Not exactly. However, I'm extremely upset that I will be paying a percentage of the premiums for someone's abortion, but that's another article for another time (Insurance companies should only have to cover Medically Necessary abortions for pregnancies that are threatening the life of the mother, not Whoops-I-had-a-one-night-stand Abortions). But I digress.
The biggest problem I have with Healthcare Reform is that there is a reason why the provisions below haven't been covered by insurance companies before. Forcing insurance companies to cover a multitude of new benefits, and forcing individuals to purchase Healthcare or pay a penalty is also wrong.
Will children grow up wanting to be doctors? Probably not. They'll want to be entrepreneurs. More profit, less mandates, more freedom.
Let me explain my relationship with Healthcare Reform. I am a licensed Insurance Broker, and I work mainly with Group Health Plan clients. Therefore I am not only training my clients on the changes we are facing, but I study Healthcare Reform weekly, if not daily.
Also, if I am the person that enrolls individuals and companies in their health insurance, then what happens to my job & all of the other brokers out there when people are forced to go to the Exchanges? I thought jobs were the biggest priority for our president (not capitalized on purpose, capitalization is for important things).
The changes that have already been implemented are not terrible things, but they do bring an increase in cost. It's like going to a fancy restaurant and having them force you order the filet, a bottle of Cabernet, 3 sides, and dessert in order to eat there. Those things are great, but they will increase your bill. Oh wait, this restaurant has a group mentality, so other people's bills will be averaged into yours. Enjoy.
Here are some of the changes that have been implemented so far that have increased the average Insurance Plan renewal rates 15 - 17% each year (Not my opinion, actual numbers from insurance carriers I work with like Blue Cross Blue Shield, Health Net, Cigna, etc.):
- Dependents Coverage to Age 26
- Adult/married children can be enrolled under the parent's group health plan regardless of full-time student status
- Pre-Existing Conditions waived for Children under 19
- Life Benefit Limits Removed
- Health Insurance plans used to have Lifetime Benefit limits of $5,000,000 (we've only had 2 clients max this out, out of the hundreds we work with), now have an Unlimited Maximum (insurance company liability).
- Preventive Services Covered in Full
- Your Well Woman, Well Man, Well Baby, etc. exams are now covered in full...whereas before it would be subject to your PCP copay, usually $20, $30, maybe $45.
(Don't be fooled, this cost is now built into your insurance rates.)
Is individual insurance for families without Group Health Coverage a bad thing? Absolutely not. What concerns me is Government Mandated insurance. Are four tiers of coverage enough to choices for all the families in America? I doubt it.
The Individual Mandate (you know..the one that the Supreme Court ruled on today) states that "U.S. Citizens and legal residents are required to have "minimum essential coverage" or else face a tax penalty...The tax penalty for noncompliance is the greater of $695 per person per year, up to a maximum of $2,085 per family, or 2.5% of household income."
If your employers don't provide enough health benefits, they get financially penalized (Employer Mandate). If your employers provide too much health benefits, they will be financially penalized (Cadillac Excise Tax).
So you'll probably have to go to the Exchange since your employer might opt to pay those taxes (which are lower than the cost of providing Health Insurance for you) instead of providing a Group Health plan. Of course, then they will have to increase your pay in order to compensate for not providing Group Health Coverage, and pay the increased payroll taxes that come with it, which lowers their profitability from when they were paying pre-tax dollars to your health plan. It seems that the Government has created a jumbled mess with intended & unintended consequences.
Guaranteed Issue, is guaranteed to raise costs. "Carriers must accept all applicants regardless of pre-existing condition & health status and must use adjusted community rating." This applies to the Exchanges too...claims costs from everyone else in your state, possibly even country, are now being added to your monthly premium.
The Exchange - January 1, 2014
If you do not have minimum essential coverage (which is yet to be determined, of course), whether through your coverage at work or individually, you will be forced to go to the Exchange.
"There are four tiers of coverage. Each tier covers the following minimum actuarial value of covered benefits. Coverage in each metal category must include essential benefits and have out-of-pocket maximums no greater than HSA limits ($5,950 for individuals, $11,900 for families in 2011)."
- Bronze - 60% Coverage
- Silver - 70% Coverage
- Gold - 80% Coverage
- Platinum - 90% Coverage
Since the only say I really have here is on who I will vote for to be our next President, all I can do is educate myself on current issues & pray that God will be with our country during this time of turmoil, confusion, and debt.
