October 2010

Funding Health Care Reform

by Louise October 29, 2010

For months now, one of the main arguments against the PPACA is that it doesn’t address health care costs or provide a means to pay for the reforms that it includes. Opponents of the reform law have used the money argument to drum up support for their cause, and – along with opposition to the individual mandate requiring everyone to have health insurance starting in 2014 – it remains one of the first things that people will mention when asked why they oppose the PPACA. [...]

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High Risk Pool Eligibility

by Louise October 27, 2010

[...] There is another significant difference between Cover Colorado and GettingUsCovered, in terms of eligibility. Both plans allow eligibility for applicants who have one of several specific medical conditions, and both plans accept applicants who have either been declined by a private insurance company or offered coverage with a pre-existing condition exclusion. But while Cover Colorado also allows people to enroll if they have been offered a private policy with a rate that is higher than a comparable Cover Colorado plan, GettingUsCovered does not allow this option. [...]

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Some Mini-Med Policies Are Better Than Others

by Louise October 26, 2010

This week’s Grand Rounds included an article by David Williams about mini-med plans that I thought was worth sharing. David explains that although he’s not a fan of mini-med policies, sometimes they are indeed better than nothing. Mini-med policies come in all shapes and sizes, and David’s article describes policies with $25,000 or $50,000 benefit maximums… a far cry from the $2,000 maximum policies that I wrote about earlier this month. [...]

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IMG Europe Wins Award

by Jay October 26, 2010

IMG Europe just won Best International PMI Provider at the Health Insurance Awards 2010. IMG Europe is a subsidiary of International Medical Group Inc. – one of the most popular travel insurance benefits providers [...]

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Mega And Mid-West Being Investigated Again

by Louise October 22, 2010

A west coast legal firm has launched an investigation into the market conduct of Mega Life and Health Insurance Company and Mid-West National Life Insurance Company. Their parent company, HealthMarkets, Inc., is also being investigated, along with the two shareholders (Blackstone Group, L.P. and Goldman Sachs Group, Inc.) who purchased HealthMarkets in 2006 for $850 million. [...]

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The Wisdom Of Evidence Based Medicine

by Louise October 21, 2010

David mentioned that “…ideologues would call this rationing.” I couldn’t agree more, and I think that research like this is the best defense against those who criticize any sort of evidence-based medicine that results in less treatment – but better or equally good outcomes. The word rationing has a bit of a negative connotation in our culture. It conjures up images of people standing in line for hours to get a loaf of bread, or only being allowed to buy five gallons of gasoline at the pump. It makes us think of hardship and having to do without things that we need. I believe that people who are opposed to scientific, evidence-based medicine are capitalizing on the public’s general dislike of the concept of rationing [...]

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NAIC Considering Transitional Period For New MLR Requirements

by Louise October 20, 2010

The National Association of Insurance Commissioners is meeting this week to figure out the specifics of how the new medical loss ratio (MLR) rules should be implemented, and they’ll be voting on the issue tomorrow. Basically, health reform law calls for health insurance carriers to be spending 80 – 85% of premium dollars on medical care as of January 1, 2011. But the insurance industry would prefer to see the increased MLRs phased in gradually. They say that they can meet the new MLR requirements over the next few years, but that trying to do so all at once by the first of the year will only serve to drive some carriers out of business entirely. [...]

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Baseless Fear Mongering Hurts The Healthcare Reform Debate

by Louise October 19, 2010

[...] There’s nothing wrong with being opposed to all or part of the health care reform law. However, it’s not factual to call the PPACA “socialism”. It’s does a disservice to voters to say that the reform law contains “death panels”. It’s not factual to say that patients will have to go to a bureaucrat before seeing his or her doctor. Spreading this sort of misinformation is truly harmful to the debate. Rather than discussing the actual facts of the law and searching for sensible solutions and compromises, fear-mongering sound bites with no basis in reality only serve to get people riled up.

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Maternity Coverage In The Individual Health Insurance Market

by Louise October 15, 2010

The House Committee on Energy and Commerce released a memorandum this week detailing the practices of the four largest private health insurance carriers (Aetna, Humana, UnitedHealth Group and Wellpoint) regarding maternity coverage on individual policies. For anyone who is familiar with the individual health insurance market, the details of the memo will come as no surprise. But since the majority of Americans are covered by group health insurance plans that cover maternity just like any other claim, the details of how maternity coverage works in the individual market may be eye-opening for a lot of people. [...]

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