Here's the bottom line, folks. Until now, we've been at the mercy of health insurers who raised their rates at whimsy and for profit and greed. Their batallion of lobbyists paid off the best Congress money can buy. But with the passage of this health reform initiative, which requires that everyone participate -- and allows for policies to be shopped around, even with "pre-existing conditions" -- patients/consumers have more choices, and aren't stuck with policies that cost too much while offering too little--let alone increase so egregiously each year.
The only thing more ideal than that is the Public Option, which would be the equivalent of Medicare for every citizen, not just those over sixty-five. Just imagine: you're in your twenties, and you can finally go to a doctor, without it costing you the equivalent of a month of rent! Ask the citizens of Canada, the United Kingdom, and any other First World country who has it: it works. It's the most important service provided by their hard-earned taxes. It's fair for everyone.
Will Americans one day join their ranks? I hope so. I hope to see it in my lifetime, but I'm not so optimistic.
Not until all the lobbyists get out of the way.
Or until the citizens of the U.S. make it clear to their elected officials that they deserve the same heathcare plans provided to Congress and its families.
Yep, that's right: our elected officials gets it for free or for a pittance--and for life no less.
If they have it, you should, too.
Contact your U.S. senators, and tell the to support ALL platforms within the Affordable Care Act, because they will mandate patient healthcare reform.
Contact your Congressperson, to also support the Affordable Care Act because it lowers your healthcare costs, as opposed to protecting the health insurers' profits. In fact, challenge him/her to write a bill that provides you the same coverage as what they are getting for themselves.
Most importantly, contact your state's governor, and tell him future votes to him and his party are predicated on his expanding Medicaid in your state, which allows the Federal program to work for those most needy, and gives funds to your state to cover them.
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Health Plan Cost for New Yorkers Set to Fall 50%
By RONI CARYN RABIN and REED ABELSON / New York Times
Published: July 16, 2013
Individuals buying health insurance on their own will see their premiums tumble next year in New York State as changes under thefederal health care law take effect, Gov. Andrew M. Cuomo announced on Wednesday.
State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower.
Supporters of the new health care law, the Affordable Care Act, credited the drop in rates to the online purchasing exchanges the law created, which they say are spurring competition among insurers that are anticipating an influx of new customers. The law requires that an exchange be started in every state.
“Health insurance has suddenly become affordable in New York,” said Elisabeth Benjamin, vice president for health initiatives with the Community Service Society of New York. “It’s not bargain-basement prices, but we’re going from Bergdorf’s to Filene’s here.”
“The extraordinary decline in New York’s insurance rates for individual consumers demonstrates the profound promise of the Affordable Care Act,” she added.
Administration officials, long confronted by Republicans and other critics of President Obama’s signature law, were quick to add New York to the list of states that appear to be successfully carrying out the law and setting up exchanges.
“We’re seeing in New York what we’ve seen in other states like California and Oregon — that competition and transparency in the marketplaces are leading to affordable and new choices for families,” said Joanne Peters, a spokeswoman for the Department of Health and Human Services.
The new premium rates do not affect a majority of New Yorkers, who receive insurance through their employers, only those who must purchase it on their own. Because the cost of individual coverage has soared, only 17,000 New Yorkers currently buy insurance on their own. About 2.6 million are uninsured in New York State.
State officials estimate as many as 615,000 individuals will buy health insurance on their own in the first few years the health law is in effect. In addition to lower premiums, about three-quarters of those people will be eligible for the subsidies available to lower-income individuals.
“New York’s health benefits exchange will offer the type of real competition that helps drive down health insurance costs for consumers and businesses,” said Mr. Cuomo.
The plans to be offered on the exchanges all meet certain basic requirements, as laid out in the law, but are in four categories from most generous to least: platinum, gold, silver and bronze. An individual with annual income of $17,000 will pay about $55 a month for a silver plan, state regulators said. A person with a $20,000 income will pay about $85 a month for a silver plan, while someone earning $25,000 will pay about $145 a month for a silver plan.
The least expensive plans, some offered by newcomers to the market, may not offer wide access to hospitals and doctors, experts said.
While the rates will fall over all, apples-to-apples comparisons are impossible from this year to next because all of the plans are essentially new insurance products.
The rates for small businesses, which are considerably lower than for individuals, will not fall as precipitously. But small businesses will be eligible for tax credits, and the exchanges will make it easier for them to select a plan. Roughly 15,000 plans are available today to small businesses, and choosing among them is particularly challenging.
“Where New York previously had a dizzying array of thousands upon thousands of plans, small businesses will now be able to truly comparison-shop for the best prices,” said Benjamin M. Lawsky, the state’s top financial regulator.
Officials at the state Department of Financial Services say they have approved 17 insurers to sell individual coverage through the New York exchange, including eight that are just entering the state’s commercial market. Many of these are insurers specializing inMedicaid plans that cater to low-income individuals.
North Shore-LIJ Health System, the large hospital system on Long Island, intends to offer a health plan for individuals as well as businesses for the first time. Some of the state’s best-known insurers, UnitedHealth Group and WellPoint, are also expected to participate. Insurers may decline to participate after they receive approval for their rates, but this is unlikely.
For years, New York has represented much that can go wrong with insurance markets. The state required insurers to cover everyone regardless of pre-existing conditions, but did not require everyone to purchase insurance — a feature of the new health care law — and did not offer generous subsidies so people could afford coverage.
With no ability to persuade the young and the healthy to buy policies, the state’s premiums have long been among the highest in the nation. “If there was any state that the A.C.A. could bring rates down, it was New York,” said Timothy Jost, a law professor at Washington and Lee University who closely follows the federal law.
Mr. Jost and other policy experts say the new health exchanges appear to be creating sufficient competition, particularly in states that have embraced the exchanges and are trying to create a marketplace that allows consumers to shop easily.
“That’s a very different dynamic for these companies, and it’s prodding them to be more aggressive and competitive in their pricing,” said Sabrina Corlette, a professor at Georgetown University’s Center on Health Insurance Reform.
But some consumers may still find the prices and plans disappointing. Jerry Ball, 46, who owns a recycling business in Queens, said the cost of covering his family increased so rapidly in the last few years that he had to scale back their coverage. Still, he pays nearly $18,000 a year for a high-deductible policy for a family of three.
He said he would be reluctant to part ways with his insurer, Oxford, and was disappointed that even the least expensive Oxford plan being offered next year would cost about as much as he pays now.
With another plan, he said: “Will I be able to maintain my doctors? I’m concerned that some of the better doctors aren’t going to take health insurance.”
He acknowledged that the new law would allow him for the first time to easily switch plans, but it is still hard for him to believe it guarantees coverage for pre-existing conditions. “I have to be careful. I can’t be denied coverage, right?” he asked.
(c) 2013 New York Times
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JULY 17, 2013OBAMACARE IN NEW YORK: SOME GOOD NEWS
POSTED BY JOHN CASSIDY / New Yorker
Politically, these are rocky days for Obamacare. A couple of weeks ago, the Administration announced that it wassuspending for a year the employer mandate that will oblige businesses with fifty or more employees to offer health coverage or pay a fine. Instead of going into effect next January, as was originally planned, the mandate will apply beginning January 1, 2015. In seemingly trying to bury the news by putting it out just before the July 4th holiday, the Administration only made things worse. In Congress, gleeful Republicans seized upon their opponents’ discomfort, calling for theindividual mandate to be postponed as well.
The Administration rejected that idea, and plans are going ahead to get the insurance exchanges at the heart of the health-care reform up and running within six months. It’s a monumental task, in part because many G.O.P.-led states have refused to coöperate, but progress is being made. Following recent announcements in other states, including California and Oregon, confirming that a wide range of insurers have applied to sell individual and family plans through the exchanges, officials in New York are presenting some details of how the new insurance market will work here.
According to a front-page story in the Times on Wednesday, one important piece of news is that the cost of individual plans, which from Staten Island to Buffalo have long been astronomical, will come down substantially on the new exchange. In Manhattan, for example, people who have been paying well over a thousand dollars a month for individual coverage will be presented with a choice of plans that start at less than five hundred dollars a month. Those who make a modest income will be eligible for generous federal subsidies that will bring the cost down much further—perhaps as low as a hundred or two hundred dollars a month.
New Yorkers purchasing family plans will also get a break. For example, Empire Blue Cross currently charges Manhattanites $4,755 a month for a standard family plan. (Yes, that’s close to sixty thousand dollars a year.) On the new exchange, the monthly rate for a comparable plan will be $1,573, a difference of $3,182. Over twelve months, that adds up to more than thirty-eight thousand dollars. Elsewhere in the state, where current rates are a bit (just a bit) cheaper, the savings will be less, but they will still be considerable. And these numbers don’t even account for the new federal subsidies, which reflect a political decision to extend private health-care coverage to millions of Americans who couldn’t otherwise afford it. (I’ve long thought that the subsidies are so large that they may eventually encounter political opposition, but that’s not the issue here.)
How is this possible? The savings outlined in the previous paragraph reflect a chronic failure in the private health-care industry which Obamacare will help to correct. As such, they provide a timely reminder of why radical reform was necessary in the first place.
The first task of any health-care system is to provide readily available coverage for the sick, especially those with chronic conditions, such as heart disease or cancer. As it operates at the moment, the U.S. system doesn’t meet this standard. In many states, particularly in the South, health insurers refuse to sell individual coverage to people with serious illnesses on the perfectly logical grounds that they are likely to need a lot of costly care and attention.
In New York and other progressive states, the authorities require insurers to offer coverage to people with preëxisting conditions, but that has simply forced up the prices of individual plans to extortionate levels. As the cost of premiums rose, many young and healthy folks who didn’t have group plans chose to go without any coverage, at least until they got ill. That further biased the risk pool for individual plans toward sick people, and the insurers responded by raising the price of coverage even further, making it even more difficult to obtain for those who needed it most.
Economists refer to this problem as “adverse selection,” and the individual mandate was designed to address it. By obliging even healthy people to take out insurance, the government can change the nature of the risk pool, which should allow insurers to charge lower premiums. In New York, at least, the initial signs are encouraging. Today, the cost of individual insurance plans is so high that fewer than twenty thousand people buy them. Under the new system, state officials project, the number of people enrolled in individual plans will expand to more than six hundred thousand. In a state with a population of nearly twenty million, that isn’t an enormous number, but it is a significant one.
It’s too early to say how Obamacare will shake out. New York is just one state. In other, less regulated, places, where insurers are currently able to offer cheap plans that provide very limited coverage, the cost of individual plans may well go up—but so will their quality.
And expanding individual coverage is just part of a bigger picture. Without making the employer mandate work effectively, containing the cost of small-business plans and persuading more G.O.P.-run states to expand Medicaid, the whole thing won’t hang together.
Even if Obamacare does get up and running nationwide, there will still be questions about its cost, and about whether it wouldn’t have been cheaper and more effective to cut out the private insurers and adopt the public option.
But don’t let anyone tell you that the current health-care system is working well, or anything close to it. In Manhattan, where the median household income is about sixty-seven thousand dollars, it costs some families upward of fifty thousand dollars a year to purchase health coverage. That’s nuts, and it’s about to change for the better.
