Poll Shows Older Americans Want Medicare Covered Long Term Care

WASHINGTON -- A growing number of Americans age 40 and older think Medicare should cover the costs of long-term care for older adults, according to a poll conducted by the Associated Press-NORC Center for Public Affairs Research.

That option is unlikely to gain much traction as President Donald Trump's administration and Republicans in Congress look to cut the federal budget and repeal President Barack Obama's 2010 health care law. Most older Americans mistakenly believe they can rely on Medicare already for such care, the poll shows, while few have done much planning for their own long-term care.

Things to know from the AP-NORC poll of older adults:

MOST WANT MEDICARE TO PAY

More than half of older Americans - 56 percent - think the federal government should devote a great deal or a lot of effort to helping people with the costs of long-term care, and another 30 percent think it should make a moderate effort to do so.

According to the poll, 56 percent of Americans age 40 and over think Medicare should have a major role in paying for ongoing living assistance, up from 39 percent who said so in 2013. Majorities of both Democrats and Republicans now think Medicare should bear a large part of the burden.

The poll has other signs of growing support for government involvement in providing long-term care. Seventy percent of older Americans say they favor a government-administered long-term care insurance program, up from 53 percent who said so a year ago. Most also favor tax policies to encourage long-term care planning, including tax breaks to encourage saving for long-term care and the ability to use nontaxable accounts like 401(k)s and IRAs to pay for long-term care insurance premiums. Most also favor tax breaks for people who provide care to family members and employers who give paid family leave to workers.

But just 25 percent would favor requiring individuals to purchase long-term care insurance, perhaps echoing opposition to the individual mandate to buy insurance that has long been the least popular part of the 2010 health care law.

The poll suggests many Americans have misconceptions about current government aid to pay for living assistance. Fifty-seven percent plan to rely on Medicare quite a bit or completely for their own ongoing living assistance if and when they need it, even though Medicare does not cover most nursing care or home health aides. Just 25 percent plan to rely on Medicaid. Medicaid is much more likely to pay for long-term care, but is only available to lower income and disabled individuals and families.

FEELING UNPREPARED

Two-thirds of Americans age 40 and up say they've done little or no planning for their own long-term care needs. In fact, the survey shows that if anything, older Americans feel less prepared for the costs of care than they have in recent years. Just 15 percent say they're very or extremely confident that they'll have the financial resources they need to pay for any ongoing living assistance, down from 27 percent who said so in 2013.

Just a third have set aside money to pay for nursing care or home health aides, less than half have talked to their families about their preferences for receiving long-term care and most have not created a living will or advance treatment directive.

They're not just feeling personally unprepared. Two-thirds of older Americans think the country as a whole is not ready for the rapid growth of the older adult population over the coming decades.

RELYING ON FAMILY

Most of those with experience either providing or receiving care say that it was provided in the home, usually by a friend or family member rather than a paid health aide. And among those who think a friend or family member will need living assistance in the next five years, most anticipate being at least partially responsible for providing that care. But just as most have done little preparation for their own care needs, just 12 percent feel very well prepared to provide long-term care, while another 56 percent feel somewhat prepared.

Two-thirds of older Americans say they are confident in being able to rely on their own families for support as they age. But those with lower incomes are less likely than those with higher incomes to have quite a bit of confidence in help from family members, 59 percent to 74 percent.

Just 20 percent of older Americans think family members should have a large responsibility to help their older relatives pay for long-term care.

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The survey was conducted March 2-29 by The Associated Press-NORC Center for Public Affairs Research, with funding from the SCAN Foundation.

It involved interviews in English and Spanish with 1,341 people aged 40 and older nationwide who are members of NORC's probability-based AmeriSpeak panel, which is designed to be representative of the U.S. population. Results from the full survey have a margin of sampling error of plus or minus 2.2 percentage points.

© 2017 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.

Insurers Continue To Hike Prices, Abandon ACA Markets

People shopping for insurance through the Affordable Care Act in yet more regions could be facing higher prices and fewer choices next year as insurance companies lay out their early plans for 2018.

Blue Cross and Blue Shield of North Carolina is asking regulators for a 23 percent price hike next year because it doesn't expect crucial payments from the federal government to continue. That announcement comes a day after Blue Cross and Blue Shield of Kansas City said it will leave the individual market next year, a decision that affects about 67,000 people in a 32-county area in Kansas and Missouri.

The Kansas City company's decision also will leave shoppers in 25 counties with no options for this kind of coverage next year unless another insurer steps in, according to data compiled by The Associated Press and the consulting firm Avalere.

Other insurers around the country, such as Aetna and Humana, have already said they will not offer this coverage next year, though some, including Centene, say they will.

Blue Cross and Blue Shield of North Carolina said Thursday that it expects no help from federal cost-sharing reduction payments next year. With that help, it said prices would rise about 9 percent instead of 23 percent on average for this kind of coverage. The plan covers about 500,000 people who buy insurance through the Affordable Care Act and it is the lone option in nearly all of the state's counties.

It said about two thirds of its customers get cost-sharing help.

The government has been giving insurers money to help customers with modest incomes cover out-of-pocket expenses like co-payments and deductibles. But the future of those payments, which are separate from the income-based tax credits that help customers buy coverage on the exchanges, is in political limbo.

Republicans had sued the Obama Administration to stop the subsidies, and that case is now tied up in court. President Donald Trump's administration has sent mixed signals over how it will pursue the case or whether the payments will continue. Insurers want to know that the payments, which total about $7 billion, will continue through 2018 so they can decide whether to offer coverage and what to charge for it.

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AP data journalist Meghan Hoyer contributed to this report from Washington, D.C.

GOP Bill: 23M More Uninsured = Evaluates Trumpcare

WASHINGTON — The health care bill that Republicans recently pushed through the House would leave 23 million more Americans without insurance and confront many others who have costly medical conditions with coverage that could prove unaffordable, Congress' official budget analysts said Wednesday.

Premiums on average would fall compared to President Barack Obama's health care overhaul — a chief goal of many Republicans — but that would be partly because policies would typically provide less coverage, said the report by the nonpartisan Congressional Budget Office.

In some areas of the country, people with pre-existing medical conditions and others who were seriously ill "would ultimately be unable to purchase" robust coverage at premiums comparable to today's prices, "if they could purchase at all," the report said.

Related:

Trump budget would boost Colorado Springs defense programs

Democrats jumped on the report as further evidence that the GOP effort to repeal Obama's 2010 law — a staple of Donald Trump's presidential campaign and those of numerous GOP congressional candidates for years — would be destructive. It comes three weeks after the House passed the legislation with only Republican votes, and as Senate Republicans try crafting their own version, which they say will be different.

"The report makes clear that Trumpcare would be a cancer on the American health care system," said Senate Minority Leader Chuck Schumer, D-N.Y., using the nickname Democrats have tried pinning on the bill. Schumer said the legislation would end up "causing costs to skyrocket, making coverage unaffordable for those with preexisting conditions and many seniors, and kicking millions off of their health insurance."

Trump's Health and Human Services secretary, Tom Price, dismissed the new analysis.

"The CBO was wrong when they analyzed Obamacare's effect on cost and coverage," he said of the agency's report on Obama's law, "and they are wrong again."

That was sharply different from Republican House Speaker Paul Ryan's take.

"This CBO report again confirms that the American Health Care Act achieves our mission: lowering premiums and lowering the deficit. It is another positive step toward keeping our promise to repeal and replace Obamacare."

The report said the House bill — named the American Health Care Act — would reduce federal deficits by $119 billion over the next decade.

Trump and Republicans celebrated House passage of the bill earlier this month in a Rose Garden ceremony, even as GOP senators signaled their opposition and signaled that the bill had little chance of becoming law.

The budget office raised concerns about a key legislative compromise that allowed the bill to narrowly pass the House on May 4, by a vote of 217-213.

To win needed votes after several embarrassing setbacks, Republican conservatives and moderates struck a deal that would let states get federal waivers to permit insurers to charge higher premiums to some people in poor health, and to ignore the standard set of benefits required by Obama's statute.

CBO said states adopting those waivers run the risk of destabilizing coverage for people with medical problems. The agency estimated that about one-sixth of the U.S. population — more than 50 million people — live in states that would make substantial changes under the waivers.

"Over time, it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance because their premiums would continue to increase rapidly," the report said.

The new estimates will serve as a starting point for GOP senators starting to write their own version of the legislation as they consider changing the House's Medicaid cuts, tax credits and other policies.

Amanda Senior Care Information You Will Love to Know About!

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OUR STORY

America is graying rapidly and baby boomers are creating an insatiable demand for quality senior care.

Ken Jenson, Amada business owner, knew he wanted to play a role in providing that care. Ken has extensive business experience running his own companies, but he reached a point where he wanted to affect people’s lives in a more hands-on way. His respect for seniors led him to join the Board of Directors of the Colorado Springs Senior Resource Council. That is when he recognized the huge need for quality care at every level and the importance of seniors understanding their options.

We also have an office in and serve the Pueblo, CO area.

Shopping For High-Quality, Low-Cost Healthcare

Shopping for high-quality, low-cost healthcare is the smart thing to do.

Shopping is central to the American way of life. We clip coupons, take advantage of special promotions and brave Black Friday sales – all to save a couple of dollars. For some reason, this sense of saving doesn’t translate to shopping for medical procedures. Instead, we opt to go on referral alone without doing the price comparisons we do in most other areas as consumers. 

Medical tests and procedures are one area where we can become better consumers and save money. While insurance companies negotiate on behalf of members for many tests, medical procedures, and mental health services, you will likely pay some of that cost, so take the time to find the best price and understand how much of that cost you will be responsible for paying. Your Health Insurance company can tell you which facilities or physicians are in your network and provide the needed care at a lower cost. If you live in Colorado please call me or go to my website for further information.  

www.peakinsurancebroker.com

Colorado Event Change To Purchase Affordable Care Act Health Insurance

The answer is maybe. Did someone you know recently change jobs, move to a new area, get married or have a baby? Perhaps you’ve just experienced one of these life-changing events yourself? These are just some of the circumstances that trigger a Special Enrollment Period that provides an opportunity to shop for health insurance—even though Open Enrollment has ended. Typically, people only have 60 days from the event to enroll, so it’s important to check out all the options as soon as possible. Help me spread the word to friends, family, and neighbors. Please go to www.peakinsurancebroker.com and email me or call regarding questions! Thank you.

Behavioral Health Law Excludes Jail Cells As Mental Health Response

Jail cells are no longer a substitute for the help needed by people in behavioral and mental health crises in Colorado.

Thursday Gov. John Hickenlooper signed legislation on 72-hour mental health holds, a significant issue for Colorado's far-flung rural areas where proper help can be hours away. When there's not a hospital nearby to take a person in crisis, a jail cell often is the landing spot, even if the person hasn't committed a crime.

Colorado Politics' Peter Marcus first told you about the dilemma and legislative efforts in January.

"Until now, people in Colorado could spend up to 72 hours in jail simply because they had a behavioral health issue and needed help," Nancy VanDeMark, director of the state's Office of Behavioral Health, said in a statement.

"Through the hard work of many people, we're now able to expand and enhance the availability of crisis response services statewide. Coloradans in crisis will be connected with the right behavioral health services in an appropriate setting."

Related:

Transportation in Colorado called a glass half full, but lawmakers contributed only a sip

Senate Bill 207 abolishes the practice of locking up people simply because of mental health distress. Instead, the new law creates a needs study, regional contractors, training for first-responders, community partnerships, mobile units, and, by Jan. 1, a 24-hour walk-in center on the Western Slope.

The Department of Human Services, which runs the state's response program, will get about $7.1 million from marijuana taxes next year and $7.4 million the next year to extend and bolster services across the state.

About $5.2 million a year will go toward law enforcement and mental health professionals working together on ways and means.

The bill had strong, diverse leadership. Republican John Cooke, the retired Weld County sheriff, and liberal attorney Daniel Kagan sponsored the bill in the Senate. In the House it was led by Deomocrat Joe Salazar, a civil rights lawyer and Democratic attorney general candidate, with former Top Gun pilot Lang Sias.

The legislation passed the Senate 27-6 and the House 51-14.

Lawmakers and DHS have been focused more intently on behavioral health response since the Aurora theater shooting in 2012, when clues were missed that might have led to a better intervention with gunman James Holmes, who killed 12 people and injured at least 70.

The next legislative session lawmakers passed Senate Bill 266 to appropriate about $29 million to create many of the services being extended to rural areas this year.

The bill four years ago charged the Department of Human Services with creating a 24-hour hotline staffed by mental health professionals.

Since it launched in October 2014, the hotline has heard from 293,663 people, or about 1 in 20 Coloradans, according to DHS's count.

The line can be reached at 1-844-493-TALK (8255), by texting TALK to 38255.

Raising awareness about increasing mental health care needs

May is Mental Health Awareness Month across our country. Believe it or not, one in four Americans experiences a diagnose mental illness each year. That’s someone in your office, your neighborhood, and, perhaps, your family. While we have come a long way to ensure that those 25 percent have accessible care, much still stands to be gained … and much could easily be lost if we do not continue to stand up for ourselves, our neighbors and our friends and family members.

Right now, our national lawmakers are deliberating on legislation and considering amendments that could alter the health care landscape. Regardless of the outcome of the American Health Care Act Bill, or future iterations, access to affordable mental health care should never be taken off the table.

I am also concerned about the stigma that continues to be associated with persons who report a mental illness and seek treatment. It unnecessarily prevents those who suffer from seeking help. According to the National Alliance on Mental Illness, 60 percent of adults in America with a mental illness did not receive services the year prior. Fifty percent of our youths did not reach out. And the Colorado Health Foundation reported that 442,000 persons in 2015 did not receive mental health care. These stats are unacceptable. We can do better. Please notice I wrote “we.”

That’s not to say we haven’t made progress, some of which I will highlight below. But let’s be candid: Our hometown has faced some challenging times in the past year. There have been alarming trends in youth suicides as well as increases in opioid, heroin and alcohol use across several ZIP codes and demographics. As a community, we have to be available with open arms and adequate resources.

To better serve increasing behavioral health needs in northern Colorado Springs, a new Walk-in Crisis Center will open this summer at the Penrose-St. Francis Medical Center Campus, at Woodmen Road and Powers Boulevard. Complementing the community’s first Walk-in Crisis Center, at 115 S. Parkside Drive, this new facility will provide 24/7 crisis mental health services. Suicidal ideation, anxiety, depression, bullying and just tough times are some of the reasons to use the center, which offers care at no cost.

A visit to the Walk-in Crisis Center typically lasts one to two hours in a comfortable living room environment. An outpatient care component will provide individual and family counseling across the lifespan, child and adult ages, and provide continued care to prevent crises.

The Walk-in Crisis Centers are part of the greater Colorado Crisis Services initiative that was established by the governor of Colorado. It also includes a Crisis Response Team (CRT). These two three-person teams, consisting of a Colorado Springs Police Department officer, Colorado Springs Fire Department medical provider and a licensed clinician respond to 911 calls.

Before the CRT, the data showed us that 50 percent of 911 calls in Colorado Springs were categorized as nonurgent situations and mostly mental health-related.

As a result, police officers saw extended time on location, repetitive calls from the same individuals, and were unprepared for some of the challenges that were presented by mental health sufferers. From December 2014 to January 2017, the CRT responded to 3,557 calls. Half of these calls were treated in place. A quarter were transported to the Walk-in Crisis Center. Less than 15 percent ended up in the emergency room.

The numbers are remarkable. The teamwork is truly inspiring. Without the tireless dedication of our police and fire departments, alongside clinicians, our emergency rooms and first responders would not be free to treat those who are truly in need of their services.

I would like to encourage readers to learn more about improvements in health care locally and available resources by joining us in watching the Sky Sox play the Iowa Cubs for “Home Runs for Mental Health” night, Friday, June 9. This is a unique opportunity for people to help raise our collective awareness of mental health challenges and opportunities while enjoying an evening at the ballpark. Community mental health providers (AspenPointe, Peak View BehavioralHealth and Cedar Springs) will have representatives on-site to answer questions and provide information on available services.

Again, one in four Americans will experience a mental illness this year. Take note of how many people you encounter today. A quarter of those might not show it, but they are suffering. A simple gesture, a smile, a “How are you doing?” can go a long way in making them feel better. Others, however, will likely need professional care. If you or someone you know is that person, please call 1-844-493-8255, Text “TALK” to 38255 or visit our Walk-in Center. Together, we can help one another live a full and prosperous life.

Health insurers, state officials: Trump undermining Obamacare

BY NOAM N. LEVEY
Tribune Washington Bureau
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WASHINGTON • Health insurers across the country are making plans to dramatically raise Obamacare premiums or exit marketplaces amid growing exasperation with the Trump administration’s erratic management, inconsistent guidance and seeming lack of understanding of basic health care issues.

At the same time, state insurance regulators — both Democrat and Republican — have increasingly concluded they cannot count on the Trump administration to help them ensure that consumers will have access to a health plan next year.

The growing frustration with the Trump administration’s management — reflected in letters to state regulators and in interviews with more than two dozen senior industry and government officials — undercuts a key White House claim that Obamacare insurance marketplaces are collapsing on their own.

Instead, according to many officials, it is the Trump administration that is driving much of the current instability by refusing to commit to steps to keep markets running, such as funding aid for low-income consumers or enforcing penalties for people who go without insurance.

“All this uncertainty is not helpful,” warned Blue Shield of California CEO Paul Markovich, who said health plans are being forced to make plans to raise premiums to account for the turmoil, jeopardizing Americans’ coverage.

Markovich was one of the few senior insurance officials who agreed to speak on the record, as many fear retribution from the White House or its allies.

But privately, many executives, including chief executives of major health plans, offered withering criticism of the Trump administration’s lack of leadership.

“It’s hard to know who’s home,” said one CEO. “We don’t know who is making decisions.”

Another chief executive said: “There seems to be no coordination or coherent planning. It’s a mess.”

A third official observed: “There is a sense that there are no hands on the wheel and they are just letting the bus careen down the road.”

Trump and GOP congressional leaders insist the marketplaces are collapsing because of flaws in the original law. They cite premium hikes in some states, and decisions by several insurers to stop selling Obamacare plans, including major national companies such as Humana and United-Health Group. That has left some areas of the country with just one health plan option next year.

“Obamacare has failed,” said Alleigh Marre, a spokeswoman for the U.S. Department of Health and Human Services. “For this reason, Republicans are reforming health care so it delivers access to quality, affordable coverage to the American people.”

Several Republican state insurance commissioners also blamed weaknesses in the law for the current instability. “There has been uncertainty with the Affordable Care Act since it started,” said Maryland Insurance Commissioner Al Redmer Jr. Maryland’s largest insurer, CareFirst, is seeking to raise rates by more than 50 percent next year.

But most health plans and state regulators interviewed for this story said the Trump administration has significantly exacerbated turmoil in the marketplaces, contributing to rising premiums and the threat of marketplaces exits.

“There is no consistency to the messages,” said Ceci Connolly, CEO of the Alliance of Community Health Plans, whose members include leading health systems such as Kaiser Permanente and Geisinger Health Plan. “We are very confused.”

The Trump administration has sent mixed signals about whether it will enforce penalties on people who don’t buy health insurance. The penalty, though unpopular, is seen as critical to inducing younger, healthier people to get coverage.

Trump and his deputies have also repeatedly threatened to withhold federal aid that helps millions of low-income Americans afford their deductibles and co-pays.

The aid, which reimburses insurers for lowering out-ofpocket costs, was paid by the Obama administration, but is now the subject of a lawsuit by congressional Republicans, who argue Congress must approve the payments.

The Trump administration hasn’t taken an official position in the lawsuit. But in recent months, the president publicly mused about stopping the payments to force Democrats to negotiate a repeal of the current law. It remains unclear whether the administration will continue the payments, known as cost-sharing reductions, or CSRs.

Anthem New 90 Day Maximum Term For Short Term Plans

New 90-day maximum term for short-term plans

May 15, 2017

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In late 2016, the Department of the Treasury, Department of Labor, and Department of Health and Human Services announced new rules for interim or short-term medical plans. Starting April 1, 2017, these plans will have a 90-day maximum term.

When the 90-day term is up, members can reapply, but their deductibles and other benefits will start over again. Certain other rules may also apply, depending on the state, as outlined here.

This change in benefit term does not apply to members on short-term plans with effective dates before April 1, 2017.

Our short-term medical plans are offered though The IHC Group, a trusted partner who’s been selling these plans for more than 20 years. A short-term plan may be a good option for an Individual client who:

• missed the open enrollment period
• is a new hire with a waiting period
• is waiting on an Affordable Care Act plan to take effect

This article applies to:

• Colorado
• Individual (under 65)

A Congressman Said Making A Man Get Maternity Insurance Was Crazy A Women Reply Went Viral

Between rounds of jeering that interrupted his every sentence, Rep. Rod Blum (R-Iowa) took a little more than two minutes to explain what else he'd like to change about the Obama-era health-care law now that he has voted for the GOP's partial repeal of the Affordable Care Act.

“Get rid of some of these crazy regulations that Obamacare puts in,” Blum suggested at an Iowa town hall meeting Monday, “such as a 62-year-old male having to have pregnancy insurance.” The crowd yelled all the louder.

The gathering in a Dubuque high school gym went on for more than an hour like that: angry questions, political explanations, boos from the bleachers.

Barbara Rank, a retired special education teacher, did not get up from her seat like many of her neighbors did. “I did not have a question to ask,” she told The Washington Post. But the next day, on her morning walk past a boulevard of government-maintained flowers, Rank realized she had a response to Blum. She wrote it down in 96 words and sent it to her local newspaper — and since then, more than 100,000 people have offered a fair critique.

From the May 12 Telegraph Herald. (Courtesy of Barbara Rank via The Washington Post) 

Rank, 63, has an AOL email account but no Facebook account. She learned what Reddit was only on Friday, she said, when her daughter informed her that someone had posted a snapshot of her letter under the headline, “This is democracy manifest,” and that tens of thousands of people were voting it onto the website's front page.

“It makes me laugh,” Rank said. “It's such a silly little piece.”

Tell that to the Daily Kos, where a writer thanks her “for calling out ignorant so-called public servants like Rod Blum of Iowa.”

Or to thousands of like-minded commenters on Reddit and Twitter.

Around Of Premium Hikes Brewing: Blame Trump or Obama?

WASHINGTON (AP) — Another year of big premium increases and dwindling choice is looking like a distinct possibility for many consumers who buy their own health insurance — but why, and who's to blame?

President Donald Trump has seized on early market rumbles as validation of his claim that "Obamacare" is a disaster, collapsing of its own weight. Democrats, meanwhile, accuse Trump of "sabotage" on a program he's dissed and wants to dismantle.

It's more complicated, say some independent experts. Trump inherited some problems and risks making things worse.

Many insurers in the subsidized markets created by the Affordable Care Act are still struggling to overcome financial losses. The cost of care for their new customers turned out higher than expected, a fundamental factor driving premiums higher and nudging some insurers to the exits next year.

But the Trump administration has also sent mixed signals that insurers find unsettling.

On the positive side, a market stabilization regulation gave the industry changes it wanted. And Wednesday, officials announced an enrollment option intended to make it easier for insurers and brokers to sign customers up.

However, insurers' top priority has become a political football. Trump keeps hinting he might stop paying billions of dollars in subsidies to reduce deductibles and copayments.

Insurers are also worried that under Trump the IRS will ease up enforcing the health law's unpopular requirement that most individuals have coverage, seen as driving healthy people into the market. Finally the GOP legislation in Congress would cut private insurance and Medicaid subsidies indirectly flowing to the companies.

The impact will vary by state and insurer, but "I think it is the case that the uncertainty we are dealing with is adding to the premium increases this year," said Cori Uccello of the American Academy of Actuaries, which represents experts who make long-range cost estimates for health care and pension programs.

Oregon is the latest state to unveil insurers' premium requests for 2018: 7 out of 8 carriers are seeking double-digit increases. Nationally, about 20 million people buy their own health insurance policies. Roughly half receive subsidies through the ACA marketplaces, and are cushioned, but the rest will face the brunt of increases. In the latter group are many early retirees, self-employed professionals and small business owners — a traditional Republican constituency.

In Virginia, seven insurers are seeking average premium increases that range from just under 10 percent to more than 50 percent. Kurt Giesa, a partner with the Oliver Wyman consultancy, said such a wide spread signals to him that some insurers may be pricing for political uncertainty.

"Insurers are operating under a lot of uncertainty right now, and really, the uncertainty isn't being cleared up," he said. "The administration isn't clearing up the uncertainty." Virginia state officials declined to comment.

Standard & Poor's analyst Deep Banerjee had earlier forecast relatively modest increases. Now he's not so sure. "There is a cloud of uncertainty that is hanging over 2018," he said.

In Maryland, where five insurers are seeking increases that average from 18 percent to nearly 59 percent, Insurance Commissioner Al Redmer, Jr., says he's told the companies he's not inclined to make allowances for political uncertainty.

"Trump hasn't been in office for three or four years, and for anybody to try to point to him as the problem, that's either falsifying history or delusional," said Redmer, a Republican. The fundamental factors are sicker customers and higher operating costs, he added. "Congress needs to put aside partisan differences and fix the ACA."

Pennsylvania Insurance Commissioner Teresa Miller said she's not expecting price shock in her state, but she's convinced the Trump administration isn't helping. "They would rather destabilize the markets and see them fail," said Miller, appointed by a Democratic governor.

If that is Trump's strategy, it could well fail. In a recent poll by the nonpartisan Kaiser Family Foundation, 75 percent said his administration should do what it can to make the health care law work. Three out of five said Trump and the Republican Congress are responsible for any future problems.

In Tennessee, the CEO of a major insurer says political uncertainty has the potential to raise premiums.

"Given the potential negative effects of federal legislative and/or regulatory changes, we believe it will be necessary to price-in those downside risks," JD Hickey of BlueCross BlueShield of Tennessee wrote to Insurance Commissioner Julie Mix McPeak earlier this month.

Translation: Part of the company's premium request may reflect the impact of uncertainty.

In a statement, the Trump administration said the problems lie with the ACA, not its own stewardship. "It requires impressive mental gymnastics to make the case that Obamacare is working," said spokeswoman Alleigh Marre.

But former President Barack Obama's Medicare administrator said Trump is deliberately trying to make things worse.

"This is purposeful so that the president can create a crisis and use that to force the Congress to pass his law," said Andy Slavitt. "He's holding the match."

Progress Reducing Uninsured Rate Comes To A Halt

WASHINGTON (AP) — Five years of progress reducing the number of Americans without health insurance has come to a halt, according to a government report out Tuesday. More than a factoid, it shows the stakes in the Republican drive to roll back the Affordable Care Act.

The report from the Centers for Disease Control and Prevention estimates that 28.6 million people were uninsured in 2016, unchanged from 2015. It was the first year since passage of the health care overhaul in 2010 that the number of uninsured did not budge.

The uninsured rate for 2016 was 9 percent, an insignificant difference from 9.1 percent the previous year. When former President Barack Obama signed the ACA in 2010, the uninsured rate had been 16 percent.

Tuesday's report suggests that the ACA was running low on gas in Obama's final year as president. Premiums for private insurance were about to jump, and 19 states continued to refuse the law's Medicaid expansion.

Now, the number of uninsured could start climbing again under policies being considered by President Donald Trump and congressional Republicans.

The politically unpopular GOP bill passed narrowly by the House would limit Medicaid financing and curtail subsidies for many consumers buying their own private policies. Republicans also would repeal the requirement that most Americans carry health insurance or risk fines, a much-disliked nudge to get healthy people covered.

The legislation would lead to an estimated increase of 24 million uninsured people within 10 years, according to congressional analysts. Under "Obamacare," there are 20 million fewer uninsured since 2010.

"It's disappointing that it's stalled out," said health economist Gail Wilensky, a Republican. "The real question is, will we be able to keep the gains that we have made?" Critical of the ACA and co-author of an alternative plan by GOP policy experts, Wilensky nonetheless supports the goal of expanding coverage. She's concerned about the impact of the House bill on Medicaid, the federal-state program for low-income and disabled people.

The new numbers come from CDC's National Health Interview Survey, which is considered an authoritative source, and publishes findings earlier than the Census Bureau. Estimates for 2016 were based on data for nearly 97,500 people.

"It looks like we are kind of sticking a landing and holding on to the gains," said Katherine Hempstead, who directs research on health insurance at the nonpartisan Robert Wood Johnson Foundation. "To increase coverage, you would have to see more states take up the Medicaid expansion, and some reforms to increase take-up in the individual (private) market."

Could the number of uninsured start rising again? Absolutely, say both Wilensky and Hempstead.

"This release is really timely because it just helps everybody focus on what's at stake," said Hempstead.

The report found a significant increase in the percentage of people under age 65 covered last year through government-sponsored insurance markets like HealthCare.gov. About 11.6 million (4.3 percent) had marketplace insurance in the last three months of 2016, compared with 9.1 million (3.4 percent) in the same period the previous year.

States that expanded Medicaid were more effective at reducing the number of uninsured. Of the 16 states with adult uninsured rates significantly lower than the nation as a whole, 15 expanded Medicaid. In that group, only Wisconsin had not extended coverage for low-income people.

Conversely, of the nine states that had significantly higher uninsured rates, only New Mexico expanded Medicaid.

The CDC numbers do not reflect any changes directly attributable to Trump, who took office this year on Jan. 20.

During the campaign and since, the president has made some big promises about health insurance, talking of coverage for everybody and much more affordable premiums and deductibles. But Trump has also embraced a GOP bill that would make more people uninsured, even if it delivers on his campaign pledge to repeal "Obamacare." And he's threatened to stop paying subsidies that reduce out-of-pocket costs such as deductibles for people with modest incomes.

Hillary Clinton, whom Trump defeated, had promised to increase government assistance for private insurance costs, and also work to convince holdout states to expand their Medicaid programs.

"This is really pre-election activity" reflected in the CDC survey, said Wilensky. "It's news because people need to know we seem to have reached a plateau." What that will look like a year from now is unclear, she added.

Senate Likely To Slow Repeal Of Obamacare, May Write New Bill

BY THE WASHINGTON POST

Passage of the House's health-care bill gives the Obamacare repeal effort new life after months of wrangling, but key Republican senators are already pushing it aside to write their own bill with no clear timetable to act.

The narrowly passed House measure can't get anywhere near the 51 votes needed as is, even though Republican senators insist they're united on delivering on their seven-year vow to repeal and replace the Affordable Care Act. Instead, they want to write their own bill.

Lamar Alexander of Tennessee, who chairs the Senate health committee, Rob Portman of Ohio, and Roy Blunt of Missouri, a member of GOP leadership, described the plan even as the House was celebrating passing its repeal after weeks of back-and-forth.

"We'll write our own bill," Alexander said in an interview, although he said senators would consider pieces of the House bill. "Where they've solved problems we agree with, that makes it a lot easier for us."

The decision will delay the prospect of any repeal bill reaching President Donald Trump's desk. Before the failure of the House bill in March, Senate Majority Leader Mitch McConnell had talked of taking it up and passing it in a week.

A senior White House official said the administration is ready for a slower, more deliberative debate in the Senate, where the main sticking point is expected to be how to address Obamacare's expansion of Medicaid.

AHIP Issues Statement as the American Health Care Act Heads To The Senate

WASHINGTON, D.C. – Marilyn Tavenner, president and CEO of America’s Health Insurance Plans (AHIP), offered the following statements upon the passage of the American Health Care Act (AHCA) by the House of Representatives:

“AHIP believes that every American deserves coverage and care that is affordable and accessible, including those with pre-existing conditions. The American Health Care Act needs important improvements to better protect low- and moderate-income families who rely on Medicaid or buy their own coverage. We stand ready to work with members of the Senate and all policymakers, offering our recommendations for how this bill can be improved to ensure the private market delivers affordable coverage for all Americans.

“Immediate challenges exist in the individual market today, and the bill includes key provisions to stabilize the market in 2018 and 2019. We need certainty now about funding for cost-sharing reductions that lower copayments for patients so they can better afford to get care from their doctor. The tax credit should be enhanced to reduce premiums and better meet the needs of people with low and modest incomes, are older, or live in areas with high health care costs.

“We want to work with the Senate to ensure the continued strength of the Medicaid program, which delivers real value to more than 70 million Americans.  States need adequate resources to administer an efficient, effective program that helps beneficiaries improve their health. If changes are made to criteria for who is covered by Medicaid, we need to give people more time to adjust – and more time for the individual market to stabilize.

“More than 80 million Americans rely on the Medicaid and individual market, and they deserve affordable coverage and access to quality care. AHIP believes that by working together, we can create good private market solutions that improve the health and financial stability of all people.”

About AHIP

America’s Health Insurance Plans (AHIP) is the national association whose members provide coverage for health care and related services to millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access and well-being for consumers. Visit www.ahip.org  Learn more about health insurance and how it works at myhealthplan.guide

New 8 Billion For Those With Preexisting Conditions Appears to Boost AHCA Critics Say Amount Is To Low

On May 3, 2017, the House of Representatives may have broken the gridlock that has prevented its passage of Republican changes to the Affordable Care Act. Representative Fred Upton (R MI) and six other moderate Republicans offered what they viewed as a corrective amendment (summary) to the MacArthur-Meadows amendment to the American Health Care Act (AHCA). MacArthur-Meadows, offered to secure the votes of conservative Republican members of the House Freedom Caucus, authorized states to obtain waivers to permit their insurers to charge higher rates based on health status to individuals with preexisting conditions for a period of about a year if those individuals let their insurance coverage lapse for a period of at least 63 days.

The House appears set to vote on the AHCA on May 4, without waiting for a new score from the Congressional Budget Office.

The Upton amendment would create a fund of $8 billion for the years 2018 to 2023. The money would go to states that permit insurers to charge higher health-underwritten premiums to such individuals; the funds would be used to provide “assistance to reduce premiums or other out-of-pocket costs of individuals who are subject to an increase in the monthly premium rate for health insurance coverage as a result of such waiver.” The funds would be apportioned to the states taking into account other stabilization fund grants.

The amendment has been described as funding state high-risk pools. A state could certainly use its share of the $8 billion to fund risk pools as one approach to making coverage affordable to persons subject to high premiums because of their health status. But the money could also be used to directly subsidize the premiums or cost-sharing that high-cost consumers might have to pay for commercial insurance.

Others have commented that $8 billion falls well short of the amount needed to adequately ensure coverage to high-risk consumers and have additionally noted the problems that have plagued high-risk pools in the past. There is also the question of a strategy that allows insurers to up-rate people who do not maintain continuous coverage, purportedly to discourage breaks in coverage, but then seeks to cover the cost of the penalty when the consumer seeks insurance again after the coverage break.

In any event, the Upton amendment is likely to be added to the AHCA as it currently exists on May 4 and may bring in enough votes to secure passage in the House of the bill. The fate of the AHCA in the Senate, however, is a whole another matter, as the Senate operates on different procedural rules that may well block a number of parts of the AHCA and with a much smaller, and quite diverse, Republican majority.

Trump, GOP Lawmakers Planning Obamacare Repeal

Vice President-elect Mike Pence visited with House GOP lawmakers on Wednesday morning to discuss President-elect Donald Trump’s first moves in the Oval Office, including a plan to repeal ObamaCare by Feb. 20.

The date was put forth by incoming House Budget Committee Chairman Diane Black (R-Tenn.). Pence announced during a press conference Wednesday morning that the Trump Administration’s first order of business will be to follow through on the important campaign promise of repealing and replacing the Affordable Care Act, also known as ObamaCare.

Through both executive action and legislation, Trump and GOP lawmakers aim to dismantle the healthcare law and replace it with a free-market based system. Pence offered scant details of what a replacement system would look like, however he ensured that any GOP sponsored fix would be less problematic for Americans than ObamaCare itself.

Pence noted that he and Trump are in “the promise-keeping business” on repealing the law, jabbing at President Barack Obama for the many empty promises surrounding his crowning achievement. Obama and Democratic lawmakers often shared the falsehood that Americans could keep their current doctors, healthcare plans and providers once ObamaCare went into effect, which turned out to be untrue.

Pence added that the American people spoke in November when they elected Trump, who made healthcare a focal point of his campaign. Pence said the election results show Americans want a “better future for healthcare in this country,” and alluded to a Department of Health and Human Services report that shows health care premiums for those enrolled in ObamaCare are expected to increase on average by 25 percent in the coming year.