Because of healthcare reform, all medical insurance plans offered by Anthem Blue Cross will change on December 1, 2010. Anthem is implementing these changes to existing policies one month earlier than previously stated.
The added benefits to each plan will depend on whether or not the member's medical insurance plan is grandfathered or not.
Non-grandfathered members will receive the full list of mandated healthcare reform benefits:
- No lifetime limits or annual dollar limits
- No pre-existing condition exclusions or waiting periods for kids under the age of 19.
- Expanded dependent coverage to include medical insurance coverage for dependents up to the age of 26 on a member's plan.
- New rescission limitations
- New protections for the patient
Grandfathered members will receive a portion of the mandated healthcare reform benefits:
- No lifetime limits
- Expanded dependent coverage to include coverage for dependents up to the age of 26 on a member's plan.
- New rescission limitations
- New protections for the patient
There are a few exceptions when members of grandfathered medical insurance plans will receive the full set of mandated healthcare reform benefits, such as those members that are enrolled in HIPAA plans. However, if those members change their plans or benefits, then they won't keep their grandfathered status, and any changes in the future due to healthcare reform will have a significant impact on their plan.
Due to the global economic recession, Americans have cut back their usage of routine healthcare much more than people living in nations with a universal medical care system.
The National Bureau of Economic Research, who conducted the study, says that people living in the U.S. have cut back on their healthcare much more than residents of Canada, Britain, Germany and France because of the higher out of pocket costs Americans face.
In each of the five countries, residents had unemployment and lost wealth and income due to declining stock prices. This caused residents in each country to have less routine care. However, Americans used far less routine care compared to other nations because approximately 15% of Americans do not have medical insurance, and the other countries have near universal medical coverage.
According to the report, 26.5% of Americans that responded to the survey said that they reduced their usage of routine healthcare since the global economic crisis began in 2007. However, for other nations the percentage was much lower. In Canada it was 5.3%, in France it was 12%, in Germany it was 10.3% and in Britain it was 7.6%.
People who live in nations with universal coverage have to pay some health care costs out of their own pockets. The percentage of people that reported reducing routine healthcare was lower in Canada and Britain, where the copays are lower, compared to Germany and France, where they have larger copays.
Generally speaking, the report indicated that the people that were most likely to reduce their usage of routine care were those who lost a big proportion of their wealth during the economic crisis, those with low income, and the young.
The new health care reform law forbids insurers from charging any copays or deductibles for preventative services that are recommended, such as immunizations, colonoscopies and mammograms.
This report has been consistent with the American Hospital Association's findings, which states that 70% of their hospitals reported fewer patient visits and procedures classified as "elective", as patients are forgoing and delaying care because of the recession.
According to the Census Bureau, 2009 saw the largest number of Americans without insurance...over 50 million. That translates to 1 in 6 Americans that do not have medical insurance.
Private medical insurance companies lost about 6.5 million of their customers, and government funded medical insurance plans rose to 6.6 million, with Medicaid alone leaping to 5.2 million people. This is the highest amount of people ever recorded by the Census Bureau that are covered by a public plan. In fact, 30.6% of Americans are covered by public plans, which is a record high, while 63.9% are covered by a private insurer, which is a record low.
The real decrease was among employer sponsored medical plans, and the major increase was among those covered by Medicaid.
Under the Affordable Care Act, all U.S. citizens will have to carry medical insurance in 2014 or they will be fined. Individual state health plan exchanges will be set up to aid consumers in purchasing individual coverage, in the hopes that it will make the process easier for Americans.
America's Health Insurance Plans has stated that medical costs are hurting the economy and not making it any easier for families and small companies to keep their medical insurance. That has been accentuated by a suffering economy, and as Americans have trouble managing their finances, young and healthy people tend to drop their medical insurance, making the remaining group, or risk pool, unhealthy and older.
Statistics have shown that the amount of children without insurance has stayed about the same...which is about 1 in 10 children, but that number is skewed for poverty stricken children. It was also shown that Americans with higher household incomes are more likely to have medical insurance coverage. However, households that earned at least $75,000 per year also didn't have medical insurance about 9.1% of the time. This statistic has made medical insurance companies fearful that some healthy people may decide to avoid purchasing medical insurance under the new healthcare reform laws, which would leave people that are healthy out of the pool. Right now, America's Health Insurance Plans feels that the penalties that people will face who don't purchase medical insurance in 2014 simply won't be enough of an incentive for them to buy medical insurance.
Please read this letter from a doctor in California to her patients. She spells out the problems with Obamacare very clearly. And since she wrote this, McDonald's has decided to eliminate the health care plan that they already have for their thousands of employees because of the rising cost and are dumping them into the government plan. The flaws in in law are just beginning to show themselves.
Please just click this link Dr Silver's Letter Regarding Obamacare to read the letter, consider it, and share it if you want to. We all want something to be done about the soaring cost of health care and medical insurance. That is a good place to start.
Please forward this blog post and letter to your friends and family.
Last week, 49 grants were given out to states, including Washington, D.C. to help them setup new medical insurance exchanges. Each state has received approximately $1 million in grants. Only Alaska and Minnesota turned down the grants...both of which are suing to overturn the mandate, along with other states.
The state based medical insurance exchanges will be the central online based marketplace for Americans who don't get their medical insurance through their jobs.
By the year 2019, approximately 24 million consumers will be shopping online for coverage on these exchanges, selecting among medical plans that offer a variety of medical benefits that comply with the government's basic standards. Beginning in 2014, most citizens in U.S. will also have to purchase insurance, as will be required by law, either on their own or through their employers.
Just two states had medical insurance exchanges before the healthcare reform bill was signed into law last March...Utah and Massachusetts.
As states begin working on creating their medical insurance exchanges, most will probably need updated internet systems, new boards to oversee the regulations, and new customer assistance personnel.
Pennsylvania's former insurance commissioner, Joel Ario, oversees the federal healthcare reform endeavor. He has said that the Obama administration is also encouraging each state's lawmakers to pass the legislation that is needed in order to setup the medical insurance exchanges in 2011.
Minnesota's governor, who is anticipated to run for the next presidency, ordered his state's officials to not seek Federal "discretionary" healthcare funds. Similarly, Alaska did not apply for the funds because they're against the medical insurance mandate law. They do not wish to establish a tool to implement a law that they believe is not constitutional.
The new law states that the federal government must setup and operate a medical insurance exchange in 2014 for any states that have not chosen to do so on their own.
The Pre-Existing Condition Medical Insurance Plans, a key element of Obamacare, is not living up to what was expected. Nationwide enrollment in the plan has been weak, and sickly Americans who could benefit most from these plans can't afford the monthly premiums.
For example, in California, their Pre-Existing Condition Insurance Plan has enough funds to insure approximately 20,000 Californians. However, since this summer, less than 450 people have actually applied. In Texas, only about 200 have been enrolled. In Wisconsin, they've only received less than 300 enrollment applications, leaving room for almost 7700 more.
That's not what was planned when healthcare reform laws were passed in March of this year. As recently as April, government economists had projected that 375,000 Americans would get medical insurance coverage this year through that healthcare reform provision
What's happening with the Pre-Existing Condition Insurance Plan could be vital, because it could possibly be a sign of problems to come with major changes within the healthcare reform law that are still a couple of years away.
To qualify for the plan, you must have not been insured for at least the past 6 months, you must be an American citizen or legal resident, and you must been declined from getting medical insurance because of a pre-existing medical condition.
The Pre-Existing Insurance Plan program will only be in existence until the year 2014, when healthcare reform laws require all medical insurance companies to accept applicants whether or not they have a pre-existing condition.