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Thursday, January 28, 2010

Health Insurance Reform in State of the Union in U.S

Everyone's weighing in on the State of the Union address in which President Obama chose his words very carefully when discussing health care.

Obama called it "Health Insurance Reform"-- not health care reform. And he was candid about the political drama that has unfolded since he championed overhauling the nation's health care system: "And by now it should be fairly obvious that I didn't take on health care because it was good politics," he said.

One of the bills could include a measure to repeal the antitrust exemption for insurance companies, a provision included in the House health care bill but left out of the Senate version. State from paying increased Medicaid expenses, and a 40 percent excise tax on Insurance Companies that provide the most expensive health insurance coverage.

The White House has negotiated with labor leaders to modify the tax plan for expensive health policies by exempting many health plans covering union workers until 2017.

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Friday, January 22, 2010

Amid rising rates, workers' compensation reform urged Insurers seek 23 percent premium hike

Workers' compensation insurance rates are expected to increase by about 4 percent this year on average. California law requires employers to have Workers' Compensation Insurance.

All California employers must provide Workers' Compensation Insurance benefits to their employees under California Labor Code Section 3700. There are five basic types of Workers' Compensation Insurance benefits - medical care, temporary disability benefits, permanent disability benefits, vocational rehabilitation services, and death benefits.

Workers' Compensation coverage is offered under Part One of a Workers' Compensation Insurance policy. In Part one, the insurance company agrees to promptly pay all benefits and compensation due to an injured worker. Employers Liability insurance can provide important coverage in addition to Workers' Compensation Insurance. Employers Liability is offered under Part Two of a Workers' Compensation and Employers Liability Insurance policy. Employers Liability Part Two protects the employer against instances where an employee's injury or disease is not considered work related.

In California, almost all employers, whether large or small, are required to have coverage for their employees with Workers' Compensation Insurance. An employee does not have to be full-time, or employed by only one employer for any number of months or days. In addition, there is no need for a written employment contract and employees can include legal and illegal aliens, minors and prisoners. Under certain circumstances; i.e., a home owner, you may be required to have workers' compensation if you hire someone to perform gardening, maintenance, house cleaning, etc.

The RAND/Navigant study recommended 29 changes in the workers' compensation insurance program, including:
-- Requiring the state Department of Insurance to appoint and pay the actuaries who certify that insurers have set aside adequate reserves for expected claims.
-- Directing the Workers' Compensation Insurance Rating Bureau of California to publicly release the quarterly reports that compare the rates insurers charge with their expected claims costs.
-- Increasing the capital workers' compensation that insurers must hold to protect against adverse events.

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Monday, January 11, 2010

Children's Healthcare Program in California lay on the line

The health of an entire generation of children is prone to risk in California.

The advocacy group Children Now reported that California ranks an appalling 36th in the nation in the percentage of children with health insurance. More than 1 million of the state's 9 million children are uninsured. And Gov. Arnold Schwarzenegger's finance director has already said to "expect the worst" in the upcoming budget year regarding the prospects for the state's Healthy Families program, which funds health care for poor kids.

"The worst" would mean devastating cuts to the program in the 2010-11 budget proposals. In 2009, that calamity was avoided at the last minute only because the federal government and the state's First 5 program came to the rescue with an additional $196 million in funding. The state shouldn't expect that temporary fix to be available in 2010.

The Children Now report shows cutting children's health care is a poor fiscal move, too. The average cost of treating a child for a preventable hospitalization is $7,000. In California, the cost of providing health coverage for a child is roughly $1,200. It doesn't take a math wizard to figure out that this investment in children's health is in the best interests of all Californians.

California falls further behind in the competition to have the healthiest, best educated work force in the nation, whenever it decides to underfund (or not fund at all) programs to bring the state closer to universal coverage for children

Unlike other programs,California's Healthy Families program provides an easy target for the Legislature. It is because its funding is not secured by the state constitution. Finding a steady, feasible funding stream for children's health care should be one of the top priorities for the governor,the Legislature and Californians in 2010.

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Sunday, December 27, 2009

Health Bill Benefits for the Impatient

Some immediate benefits from the health care legislation advancing on Capitol Hill will ease the minds of parents who may have hit up against limitations of their existing health insurance. In many cases, the requirements, including the extended coverage for adult children, would apply only to new insurance plans, though insurers could apply the changes to existing policies.

Many major provisions in the health care legislation would not take effect for several years. New federal subsidies to help moderate-income Americans afford coverage would not begin until 2013 under the House bill, and 2014 under the Senate bill. A new requirement that nearly all Americans obtain insurance would take effect at the same time that the subsidies become available.

On the flip side, many of the new taxes and fees that will help pay for the legislation would take effect much sooner. For this reason, some Republicans have criticized the bill as akin to legislation on a layaway plan: pay now for benefits later.

Short-term Insurance expansion of state high risk pools To help people who cannot obtain insurance because of pre-existing conditions, both the Senate and House bills would provide $5 billion to increase the availability of coverage through state high-risk insurance pools. This provision would take effect 90 days after enactment of the legislation, but many details remain to be worked out.

Consumer assistance provisions Both the House and Senate bills would begin to impose new requirements aimed at making it easier for consumers to interact with insurers, including a requirement that health plans adopt uniform descriptions of plan benefits and appeals procedures and that they begin using identical forms.


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Friday, December 18, 2009

The Facts about Health Insurance Reform

As Congress continues to inch toward passing comprehensive health insurance reform, there are many misconceptions about the plans details. To be informed citizens, though, we need to know the facts. So, what are the facts that you should know?

First, our health insurance system is broken. Currently, 36 million Americans, including 8 million children, lack health insurance. Not only does this limit health care access to those who are uninsured, but it also results in more than $60 billion annually in uncompensated care costs that are passed on to insured consumers in the form of higher prices and premiums.

Second, health care costs are spiraling out of control. These costs not only threaten family budgets but the federal budget as well. In the next decade government expenditures for Medicare and Medicaid will nearly double, crowding out spending on other important government programs.

Finally, there is widespread dissatisfaction at unethical insurance company practices. There have been too many cases where insurance companies have denied claims and dropped coverage when their customers got sick.

As a result of these problems, congressional leaders have proposed reforms to fix this broken system. This would reduce the number of uninsured by 31 million, would require insurance companies to cover everyone regardless of health or preexisting conditions, would rein in spiraling health care costs by introducing more competition and efficiencies, and would reduce the national debt by $130 billion during the next 10 years.

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Tuesday, December 15, 2009

Health Insurance Lacking Among Youthful Adults in California

When it comes to health insurance in California, the 19th birthday is a milestone. Young adults are usually dropped from their parents' insurance unless they go to college full time.

Researchers from the Commonwealth Fund have reported that the amount of uninsured young adults climbed to 13.7 million in 2006, an increase of 400,000 from the previous year.

They also found that 39 percent of high school graduates who don't attend college and 34 percent of college graduates go without health insurance during the year after graduation.

Young adults normally work low-paying jobs where employers are less likely to offer them health coverage.

Researchers said health insurance in California is especially important for young adults because they have a high rate of pregnancy, serious injuries, and HIV diagnoses.

To help combat this need of insurance coverage, 22 states have passed legislation that extends family private insurance coverage for young adults into their 20s.

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Thursday, December 10, 2009

Aetna will force thousands off clients of their insurance plans to increase profits

Health insurance giant Aetna is planning to force up to 650,000 clients to drop their coverage next year as it seeks to raise additional revenue to meet profit expectations.

"The pricing we put in place for 2009 turned out to not really be what we needed to achieve the results and margins that we had historically been delivering," said chairman and CEO Ron Williams. "We view 2010 as a repositioning year, a year that does not fully reflect the earnings potential of our business. Our pricing actions should have a noticeable effect beginning in the first quarter of 2010, with additional financial impact realized during the remaining three quarters of the year."

Aetna actually made a profit in 2009 but not at levels that it anticipated.

Folks, we have tried insurance through the private Marketplace.Its not working out. The public option falls far short of the action we should be taking on health care, which is a government-run, single-payer system. But given that we are not, Congress had better at least pass a plan that creates some new competition for our out-of-control insurance companies.

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