Obamacare’s Y2K: Coverage for pre-existing conditions

Starting in 2014, one of the signature features of the Affordable Care Act (ACA) will be implemented: No adult with a pre-existing condition can be denied health insurance.

But it seems from recent news reports that both the administration and the nation’s health insurance carriers are getting a little nervous about exactly how much that will cost and whether sufficient funds will be available.

In theory, the individual mandate ensures that enough healthy young people buy insurance to keep premiums affordable and provide enough money to cover the care of the already sick. But no one knows with any certainty … Continue reading

The demise of competition

I read with concern yesterday that one of the victims of the recent fiscal cliff deal was the program funding the creation of new non-profit health insurance carriers. Consumer Operated and Oriented Plans, CO-OPs for short, were meant to provide some much-needed competition to the private carriers on the health insurance exchanges and keep premiums more affordable.

At least, that was the theory.

But now Congress has sliced the program’s budget from $6 billion to $2.4 billion. And the money is in the form of loans, not grants. Besides the many other challenges facing these start-ups,¬†they have a very … Continue reading

Beware that bonus!

Two days ago I wrote a post about the proposed health insurance exchanges and the federal premium subsidies.

Beginning in 2014, if you buy health insurance from a state-run exchange, your estimated 2014 income will determine if you qualify for a subsidy.

You will need to supply that information to the insurance exchange when you sign up for health insurance. If you qualify for a subsidy, the exchange will then apply to the federal government for the extra funds to cover your premiums.

When you prepare your 2014 tax return (in 2015), you will discover how accurately you guestimated.

The … Continue reading

Sticker shock

My family does not have an employer-provided health plan, and we live in a state that will set up a state-run health insurance exchange, so I wanted to learn more about the exchanges and proposed subsidies.

Several recent articles have warned of “sticker shock.” Beginning in 2014, state exchanges must offer plans that cover all “essential health benefits” as defined by the government. In other words, there will be no more “catastrophic” plans with low monthly premiums and high deductibles. (Except perhaps for young adults under 30, but information on this point remains unclear.)

To make such comprehensive … Continue reading

Nightmare

Last night I dreamt that my husband was diagnosed with metastatic melanoma.

He was lying on an exam table for some reason when the nurse spied a large, red spot on his head (he’s not bald, but in my dream he was!) and said “Oh my, that doesn’t look too good.” The doctor then looked and said “It’s a melanoma. I’ll take it off.”

Immediately the doctor excised the melanoma as well as some cervical (neck) lymph nodes, which were also cancerous. The melanoma had spread.

As I watched the operation, I thought Oh, please let this be a dream. Continue reading

A picture worth a thousand words

Last week, the publication of three short health care reports caught my eye. Separately, each is a “bad-news-as-usual” snapshot of health concerns; spliced together, however, they create a bigger, grimmer picture of the health and financial future of our country.

First, the Centers for Disease Control and Prevention (CDC) reported that between 1995 and 2010, the incidence of adults diagnosed with diabetes has almost doubled.

Part of the rate increase is explained by improved diagnosis and diabetics living longer, but the report’s authors concluded that the “major driver” is that “the increase in diabetes prevalence coincides with the increase in … Continue reading

Will the Affordable Care Act really be affordable?

Last night, Barack Obama was re-elected president of the United States.

So, the Affordable Care Act (ACA or Obamacare, as it’s commonly known), having survived its precipitous birth and a few close-calls with death, is poised to enter a prolonged and awkward adolescence.

I haven’t spent a lot of time educating myself about Obamacare because of the possibility that it would be overturned after the election. Now, however, I want to know more, but it’s not easy to get clear answers because so much has yet to be decided and defined.

Kaiser Health News has prepared a brief summary, After Continue reading