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PPACA

IRS 2013 HSA Contribution Limits

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The IRS announced that the 2013 HSA contribution limit for an individual would increase by $150, from $3,100 to $3,250. The family contribution limit is increasing from $6,250 to $6,450 (+$200).

The maximum annual out-of-pocket increased as well. The individual out of pocket maximum is going from $6,050 to $6,250. The family out of pocket maximum is increasing from $12,100 to $12,500.

The minimum deductible on an HSA qualified plan also increases from $1,200 to $1,250 for individuals and increases from $2,400 to $2,500 for families.

What are the 2012 HSA Contribution Limits?

According to the Patient Protection and Affordable Care Act, OTC drugs may be reimbursed only if there is a prescription.

Non-medical withdrawals from an HSA are taxable income and subject to a tax penalty, which increased from 10% in 2010 to 20% in 2011 and remains the same for 2013.

Exception to the IRS tax penalty for non-medical withdrawals:
The tax penalty does not apply if the withdrawal is made after you:
1) Attain age 65;
2) Become totally and permanently disabled; or
3) Die.

More details and research about HSAs and HSA qualified plans.

A Good Trend In Medicare Spending

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[…] She specifically addresses Medicare costs, but it stands to reason that the same cost-saving strategies and paradigm shifts will also help to lower healthcare costs that are being reimbursed by private health insurance carriers. Not only do private carriers tend to follow Medicare’s lead, but the focus on value over volume from a provider perspective will benefit everyone, as it’s unlikely to be applied only to Medicare patients.

Seeking Certainty

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[…] And finally, if the Supreme Court is going to hand down a ruling like the one we got from the Appeals Court last week, we need to know that as soon as possible too. If the individual mandate does indeed end up being tossed out, the health care reform law will need an awful lot of compromises and revisions in order to make it tenable. Perhaps I’m being overly pessimistic, but given the level of compromise we’ve seen from the political system over the last decade or so, I have a hard time seeing how the PPACA could go on with one of its major provisions deleted. […]

More On Health Insurance Exchanges

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[…] We need exchanges that are easy to navigate, accessible for people who are not fluent in English, and that provide seamless access to the subsidies that the PPACA provides to help people afford health insurance. I’ve already pointed out that we’re going to have to walk a fine line in terms of keeping things fair for both insureds and insurers, in order to attract as many enrollees and high quality insurers as possible to the exchanges. […]

The Challenge Of Creating Unbiased Health Insurance Exchanges

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[…] In order to attract high-quality health insurance carriers to the exchanges, we have to make sure that the exchanges represent a business environment that is appealing to carriers. We also have to make their appealing and fair to consumers, in order to attract enough people into the exchanges. To work well, the exchanges will need to have a delicate balance between the interests of consumers, providers, and health insurer carriers, with no one group more heavily favored than another.

Health Care Reform In The 2011 Colorado Legislative Session

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The Colorado legislative session that wrapped up this month was a busy one for Colorado-specific health care reform. Despite a few bumps in the road, SB200 passed, which means that Colorado is now on its way to creating a health insurance exchange that will address the particular needs of individuals and small businesses in the state. Although this bill was controversial simply because the whole idea of exchanges is too closely tied with the PPACA […]

Handling Income And Job Fluctuations Under The PPACA

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[…] There’s no simple answer to all of this. We’re trying to create a somewhat universal health insurance system based on a conglomeration of government-run health insurance, private coverage from hundreds of carriers, eligibility for coverage that is tied to employment and state of residence, and also based on income levels… of course it’s going to get complicated. Hopefully the suggestions raised by this report will help to guide regulations that will ensure health insurance coverage that is as gap-free as possible for most Americans.

MLRs – One Size Does Not Fit All

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[…] A state with two functional insurance carriers offering individual policies is obviously going to have a very different marketplace than a state with ten major carriers competing for business. It will be interesting to see how things play out in the states that are granted temporary MLR waivers by CMS. Three years from now, will their insurance markets be able to provide adequate coverage and also comply with the 80/85% MLR guidelines? Or will the waivers morph into something that allows the impacted states to set their own guidelines? Time will tell.

HHS To Stop Accepting Early Retiree Reinsurance Applications After May 5, 2011

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[…] Although the program has proven quite popular – as of last month, HHS had approved approximately 5850 applications – one of the concerns from the beginning was that the $5 billion allocated to the ERRP might not be sufficient to last until 2014. HHS said from the start that they would only accept applications as long as they had enough available funding. They have now announced that they will not accept any new applications after May 5, 2011. […]

Spending Caps Will Help Individual Families But Won’t Reduce Overall Costs

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[…] But although the spending caps will be beneficial to families that have large medical expenses, they do nothing to actually address the rising cost of health care, and the over-utilization that is also driving costs. This has been a recurring theme with a lot of the provisions created by health care reform: we’re finding ways to spread the costs in a more equitable fashion, but we’re not really addressing the fact that the total cost burden of health care in this country isn’t sustainable on its current trajectory, no matter how much we spread it out across the population.

Colorado Bill Would Allow State To Opt Out Of Federal Healthcare Laws

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The Healthcare Opportunity and Patient Empowerment (HOPE) Act (HB 1273) was introduced in the Colorado House of Representatives this week, with primary House sponsorship from Reps Nikkel and Stephens (the House majority leader), and primary Senate sponsorship from Senator Kopp. The idea behind HB1273 is to allow Colorado to legally opt out of the PPACA – not just the individual mandate portion, but the entire law. […]

SB 168 Introduced With Goal Of Creating Colorado Health Care Cooperative

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In a continuation of the string of healthcare-related legislation we’ve seen recently, Colorado Senate Bill 168 was introduced earlier this week. SB 168 would create a nonprofit healthcare cooperative to act as the benefits administrator and payer for health care services in Colorado. Similar to several other healthcare bills we’ve seen over the years, this one would implement change in a multi-step process: first by creating a proposed Colorado Health Care Authority, which would design the cooperative and take it to the legislature and then voters for approval. […]

Repealing The Mandate – Some Simple Math

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[…] As I’ve mentioned before, health care costs are what drive health insurance premiums. And until we figure out how to reduce the amount we spend on health care, health insurance premiums will continue to rise. But they will rise even faster if we require health insurance carriers to accept all applicants without imposing some sort of system that eliminates the possibility for people to wait until they are sick to purchase coverage.

Consumer Protections And The PPACA

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I doubt that regulators will simply throw out the existing rules and allow ACOs to operate without consumer protections to place to guard against fraud and abuse. Instead, I see them coming up with new regulations that take into account the changing landscape of health care delivery, including ACOs. But either way, the creation of new consumer protections while suspending others does make for an interesting discussion. […]

Is Colorado Representative’s Information Based On Email FWD?

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Last week, the House of Representatives voted to repeal the PPACA. One of the Representatives voting for repeal was Scott Tipton, a Republican from Colorado’s 3rd congressional district. Obviously each Representative had to vote according to his or her own conscience and the general consensus from constituents, but one would also hope that prior to voting, each Representative would clearly understand the facts surrounding the various issues within the law. […]

Colorado Senator Introducing Legislation To Study Health Care

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Colorado Senator Irene Aguilar, a Democrat from Denver, will be introducing legislation next month to address the fact that there are still 700,000 people in Colorado without health insurance. Although Colorado has made strides recently in areas like the expansion of Medicaid, we didn’t even come close to fulfilling former Governor Bill Ritter’s hopes for health insurance for all Colorado citizens by the end of 2010. […]

Health Care Costs Are The Driving Factor Behind Premium Hikes

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I’ve long supported the idea that our health care system was in need of reform that would make care more affordable and accessible to everyone, regardless of their health or financial situation. But I’m starting to feel a bit frustrated by what feels like an over-emphasis on regulation of health insurance carriers and not enough focus on ways to actually control the cost of health care (including over-utilization). If people are thinking of this process as health insurance reform rather than health care reform, it’s doomed to failure. […]

Is A Symbolic Repeal Vote Worth The Time?

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[…] Political analysts generally agree that a repeal vote in the House is likely to pass, but much less likely to clear the Senate. If it did, it would be virtually impossible to override a presidential veto. So the vote next week is basically symbolic – which can also be looked at as a waste of congressional time and resources. A more productive solution might be to start looking for ways to significantly reduce the actual cost of health care. […]

Possible Alternatives To The Individual Mandate

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[…] While many other aspects of reform are generally popular (like the provision to allow young adults to remain on their parents’ health insurance until age 26, and the requirement that all policies be guaranteed issue starting in 2014), the individual mandate has raised a lot of hackles, with people feeling that the government is infringing on their rights by telling them that they have to buy a product (and in most cases, that product will come from a private company). […]

The Value Of Preventive Care

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[…] I found this article by Dr. Lucy Hornstein to be particularly interesting. Dr. Hornstein takes the view that preventive care does not save money in the long run, and wonders if the provision in the PPACA to provide preventive care to everyone – with no copays or deductibles – is a wise idea. The discussion is made even more interesting with a comment from Maggie Mahar (who was referenced in the article) noting that some preventive care is more worthwhile than others. […]

Most Employers Have Not Enrolled In Early Retiree Reinsurance Program

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[…] a Robert Wood Johnson Foundation report indicates that the majority of employers who offer retiree health insurance benefits have not yet signed up for the program, scheduled to last until the end of 2013. The RWJF study notes that in addition to the many small employers who offer retiree health insurance benefits, there are also about 24,000 large employers who do so. Obviously, most employers have not enrolled in the early retiree reinsurance program yet, and it’s unclear whether they plan to do so or not. […]

430 People Already Enrolled In GettingUsCovered

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[…] Even when policies are free or very low cost (such as Medicaid or Child Health Plan Plus), a significant number of eligible individuals continue to go without coverage, for a myriad of reasons. So it stands to reason that plenty of uninsured people who are eligible for GettingUsCovered won’t apply. Some likely aren’t aware of the availability, and many others simply can’t afford to pay the premiums. But apparently Colorado is enrolling people at a fairly fast pace – as of November 1, there were 20 states that had fewer than 50 people enrolled in their newly-created high risk pools.

Funding Health Care Reform

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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. […]

Guaranteed Issue Policies For Children Happened Too Quickly

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[…] Regardless of the practicalities involved, there’s no doubt that the headlines about insurers ceasing to issue child-only policies is generating some ill will and bad PR for insurance carriers. Either lawmakers knew that would happen, or else they put very little thought into considering the details of how insurers would go about making children’s coverage guaranteed issue a mere six months after the bill was signed into law, and just added the provision as a feel-good part of the bill.