Health Reform - Myth and Spin Meet Reality

Myth - Free Health Insurancebest: "Policy holders may experience increases in
Early on the Monday morning after the health reformmonthly premiums on their share of the costs when
bill passed, we received several calls from people whothey seek medical care due to the richer benefits
wanted to sign up for the new free health care. Freeprovided by these reforms."
health insurance is a myth. The health reform bill doesSpin - Health Insurance Costs Will Come Down Over
not provide for free health insurance. It does expandTime
Medicaid eligibility to 133% of the Federal Poverty LevelOn January 1, 2011, insurance companies will have to
starting in 2014 which will result in more people beingoperate at an 80% or 85% loss ratio depending on
able to qualify for the state Medicaid programs.type of insurance. This means that 80 cents or 85
Additional subsidies and tax credits will also becents out of every premium dollar has to be spent on
available to those who qualify."medical care". What expenses are to be included in
Spin - You Can Keep Your Current Planhave not been determined yet. Many insurance
You can keep your current plan until September 23,companies already meet this requirement or are close
2010 (group plans until the first renewal after that date).so it probably will not lower costs as much as thought.
Your plan will then have to incorporate several newRegardless, in 2014 additional benefits have to be
federally mandated benefits. This modified plan canincluded in all health plans driving costs up even further.
then be kept past 2014 only if there are no otherNew taxes in 2014 on insurance companies and some
changes in benefits. For example, you would not bemedical providers will be passed on to you in higher
able to change your deductible to cut costs. It ispremiums. Your own income taxes may go up due to
unclear as to what happens if new state mandateda loss in the amount of medical deductions you can
benefits are added to your plan or the insurancetake.
company makes any plan changes.Part Spin Part Fact - Small Businesses Will Save
Spin - Health Insurance Will Be More AffordableMoney
The benefits and provisions mentioned above have toSmall businesses will see an across-the-board
be added to your policy on September 23, 2010. Theypremium increase on or shortly after September 23,
include:2010 just like everyone else. Small businesses of 25 or
• No lifetime limits on benefits (currently many plansfewer employees who meet certain salary
have a $1 million or $2 million limit).requirements will get up to a 35% tax credit when
• Dependent coverage to age 26 even if marriedthey file taxes due April 15, 2011. Unfortunately, many
(OOPS, a child of a married dependent would not besmall businesses may not be able to keep their group
covered at birth. The parent would have to apply for ainsurance or stay in business to take advantage of it.
new policy).We have already had at least six small businesses
• No denial of coverage for children under 19drop their group health insurance this year just to keep
(already provided for on in some states and on smalltheir doors open.
group plans of 2-50 employees. Some state high riskPart Spin Part Fact - Medicare Beneficiaries Will Be
pools also provide for this).Better Off
• Certain preventive care benefits (yet undefined)Medicare Advantage plans will not get a cost-of-living
must be covered with no copays or cost sharing.increase this year. On October 1, 2011 you will see
All these added benefits will increase costs andpremiums on these plans go up, benefits go down, or
everyone will see a premium increase in September orsome combination of both.
on group renewal. It could be anywhere from 5-20If you spend enough on prescriptions to enter the
percent or more. It will vary by state, company anddonut hole, which could cost you up to $3,800, you are
plan design depending on what is already covered. Aneligible for up to a $250 refund for this year. About half
April 13, 2010 Oregon Insurance Division bulletin says itof 2011's larger donut hole would be covered.