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Why Some Americans Are Risking It and Skipping Health Insurance

Prices and deductibles are rising. Networks are shrinking. And even some well-off Americans are questioning what they’re paying for. In tiny Marion, North Carolina, the Buchanans decided that $1,800 a month was too much to pay for health insurance, and are going without it for the first time in their lives. In Harahan, one bend of the Mississippi River up from New Orleans, the Owenses looked at their doubling insurance premiums and decided no, as well. “We’re not poor people but we can’t afford...

In the Face of Great Health Care Uncertainty, AAFD Health Benefits Gives Business Owners Alternative Options

The American Association of Franchisees and Dealers has announced major upgrades to its AAFD Health Benefits programs. The past few years have seen great upheaval in the health care insurance market, with mixed messages coming from Washington and insurers raising rates and dropping out of insurance markets altogether. In light of these ongoing changes, many franchise owners are struggling to afford insurance for themselves and to offer health benefits to their employees. To help alleviate these challenges, the American Association of Franchisees and Dealers (AAFD) has announced that it is upgrading its AAFD Health Benefits Program and will now offer its members several alternative health options, including AAFD Limited Medical Benefit Plans and AAFD Short Term Medical Plans. The AAFD continues to offer AAFD Health Savings Accounts, our FREE WellCard Health Discount Card, and our health insurance marketplace through eHealth.com.

22 Million Americans Could Lose Their Health Insurance Coverage

Following its scoring of the proposed Senate plan, the Congressional Budget Office projected that 22 million people would lose their health care coverage. The plan’s Medicaid funding cuts would terminate the Obamacare Medicaid expansion by 2023, expelling many expansion enrollees from the program. Low-income early retirees who may have qualified for Medicaid under the program expansion will lose this coverage option. Click here to see state-by state percentage of people who could lose their health insurance or medicaid with Obamacare Repeal and Replace.

You can lead a horse to water, but...

I don't profess to be a health care thought leader; nor do I profess to have an advanced degree in health-related studies. But since the health care universe has been a major part of my professional life for the past 35 years, I feel as though I have acquired some insights into the workings of the business of health. It is with this knowledge that I read with interest and, sometimes, great amusement, the proposals for replacement of the PPACA, colloquially known as Obamacare.

The foundation of health insurance is built upon one, simple core principle:
There must be a large enough pool of younger, healthier individuals in a plan to offset the claims that will be incurred by older, sicker individuals.

Silver Exchange Premiums Rise 34% on Average in 2018

New analysis from Avalere finds that the 2018 exchange market will see silver premiums rise by an average of 34%. According to Avalere’s analysis of filings from Healthcare.gov states, exchange premiums for the most popular type of exchange plan (silver) will be 34% higher, on average, compared to last year.

Uninsured rate up to 12.3% amid Obamacare turmoil

"The number of U.S. adults without health insurance is up nearly 3.5 million this year, as rising premiums and political turmoil over 'Obamacare' undermine coverage gains that drove the nation's uninsured rate to a historic low.

That finding is based on the latest installment of a major survey, released Friday. The Gallup-Sharecare Well-Being Index asks a random sample of 500 people each day whether they have health insurance.

The survey found that the uninsured rate among adults was 12.3% during the period from July 1-Sept. 30, an increase of 1.4 percentage points since the end of last year. The increase in the number of uninsured is more striking because it comes at a time of economic growth and low unemployment.

The annual sign-up season for subsidized private insurance plans under the Affordable Care Act starts Nov. 1, but it may not make much of a difference."

"Uncertainty Over Health Care Law's Future Hobbles Entrepreneurs"

"Stinson Dean, an entrepreneur from Independence, Mo., is used to taking risks. He buys Canadian softwood framing lumber to sell to lumberyards in the U.S. and says coping with the ups and downs of the market is an inevitable part of doing business. But when he started the company about a year and a half ago, he laid down a firm rule.

'One of the things I wasn't willing to risk was the health of my family,' Dean Dean is the proud father of three young children — two girls and a boy. Playing with them in the front yard before dinner, he and his wife, Stephanie, talk about the possibility of another.

Like many Americans, Stinson Dean has nervously watched this year's national health care debate. He says the Affordable Care Act made it possible for him to start his business. Now, uncertainty about the ACA's future is affecting his business's ability to grow."

Trump cutting off subsidy payments poses tough decisions for insurers

"President Donald Trump's decision Thursday to end federal cost-sharing reduction payments to insurers puts the spotlight on Republican and Democratic senators who are trying to craft a bill to fund those payments and stabilize the individual insurance market.

But it's not at all clear Sen. Lamar Alexander, the Republican chairman of the Senate Health, Education, Labor and Pensions Committee, and Sen. Patty Murray, the senior Democrat on the panel, will be able to reach a deal or that they will be able to get it through the full Senate, let alone the more conservative House. That's because many Republicans still yearn to repeal and replace the Affordable Care Act and balk at doing anything to shore it up.

The federal payments to insurers for cost-sharing reductions make coverage more affordable for low-income people by reducing deductibles and copayments."

"Steep Premiums Challenge People Who Buy Health Insurance Without Subsidies"

"Paul Melquist of St. Paul, Minn., has a message for the people who wrote the Affordable Care Act: 'Quit wrecking my health care.'

Teri Goodrich of Raleigh, N.C., agrees. 'We're getting slammed. We didn't budget for this,' she says.

Millions of people have gained health insurance because of the federal health law. Millions more have seen their existing coverage improved.

But one slice of the population, which includes Melquist and Goodrich, is unquestionably worse off. They are healthy people who buy their own coverage but earn too much to qualify for help paying their premiums. And the premium hikes that are being announced as enrollment looms for next year — in some states, increases topping 50 percent — will make their situations more miserable."

Study: Premiums for popular ACA plan up by 34 percent

"WASHINGTON >> Premiums for the most popular 'Obamacare' plans are going up an average of 34 percent, according to a study that confirms dire predictions about the impact of political turmoil on consumers.

Window-shopping on HealthCare.gov went live Wednesday, so across the country consumers going online can see the consequences themselves ahead of the Nov. 1 start of sign-up season for 2018.

The consulting firm Avalere Health crunched newly released government data and found that the Trump administration’s actions are contributing to the price hikes by adding instability to the underlying problems of the health law’s marketplaces."

Medical Insurance Reform: The Problems Ahead

"Throughout the healthcare reform debate we have never questioned the fact that change is needed. The cost of medical insurance has gotten completely out of hand. I think most people would agree, that while the reform bill currently in place may offer great medical benefits to many uninsured Americans, it also ensures that healthcare costs are going to continue to escalate. Compare the average cost of family medical insurance by state (the government has issued a report on this), to see that Massachusetts has the highest family healthcare cost in the nation. Since the current healthcare reform bill was largely modeled on the state run system in Massachusetts, it seems fair to predict that costs will continue to rise. The government report shows the average family medical insurance cost ranges from a low of $9,365 in Idaho to a high of $14,138 in Massachusetts."

Looking past health care reform to a stronger benefits program

"Is it in or out? For the past eight years — through two administrations, numerous proposals, countless hours of debates and hundreds of votes — health care reform legislation has been a near-constant source of concern and confusion for many of America’s employers, their benefits brokers and insurance providers. And with good reason: Major medical insurance is the bedrock of a solid employee benefits program and a major employer expense. Unfortunately, on-again, off-again changes to health care reform legislation are needlessly distracting employers from looking at the full scope of their employee benefits plan."

"The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments"

"Controversy has emerged recently over federal payments to insurers under the Affordable Care Act (ACA) related to cost-sharing reductions for low-income enrollees in the ACA’s marketplaces. The ACA requires insurers to offer plans with reduced patient cost-sharing (e.g., deductibles and copays) to marketplace enrollees with incomes 100-250% of the poverty level. The reduced cost-sharing is only available in silver-level plans, and the premiums are the same as standard silver plans. To compensate for the added cost to insurers of the reduced cost-sharing, the federal governments makes payments directly to insurance companies. The Congressional Budget Office (CBO) estimates the cost of these payments at $7 billion in fiscal year 2017, rising to $10 billion in 2018 and $16 billion by 2027."

Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion

"As the 115th U.S. Congress deliberates the future of the Affordable Care Act, an interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2017 ACA marketplace health plan and the political party of each district’s representative as of October 2017.

The analysis also includes maps charting the total number of people enrolled under the ACA Medicaid expansion in 2016 in states that implemented the ACA Medicaid expansion, along with the political parties of their governors and U.S. senators. As of October 2017, among states that adopted the Medicaid expansion, 17 have Republican governors, 13 have Democratic governors, and one has an Independent governor. In Washington, D.C., which also expanded Medicaid, the mayor is a Democrat."

Healthcare leaders downbeat on compromise ACA bill

"PARADISE VALLEY, Ariz.—Healthcare leaders gathered here for Modern Healthcare's second annual Leadership Symposium have grown pessimistic about the prospect for passing legislation that would stabilize the insurance exchanges for next year's open enrollment season—now just two weeks away.

President Donald Trump's sudden reversal on support for the compromise legislation crafted by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) cast a pall over a meeting where the nearly 100 top officials are discussing leadership challenges during a time of 'disruption, complexity and uncertainty.'

'The president had six different perspectives on Murray-Alexander within the course of 48 hours,' said Dr. Bruce Siegel, CEO of America's Essential Hospitals. 'I don't see how this Congress passes something that fixes the ACA and goes back to its constituents and funders.'"

"Employee Benefit Plans – Highest Cancellation Rate In Two Decades!"

"Small businesses desperately looking for ways to reduce operating costs are canceling their employer group health plans at a rate not seen in more than twenty years, creating a spike in individual and family health insurance enrollments. As the nation is engaged in overall health care reform, a focus on making sure small businesses are able to receive affordable health coverage is being called a top priority at a joint press conference with the National Federation of Independent Business and (NFIB) and America’s Health Insurance Plans (AHIP). On the accessibility of affordable medical insurance coverage, Dan Danner, the CEO and president of the NFIB, stated his thoughts on the importance of this matter: 'We must work together to pursue creative, private market solutions to what has become an unsustainable problem for small businesses – increasing small group health insurance costs.' He continued by adding, 'It is imperative that insurance market reform – specifically in the individual health and small group health insurance markets – leads to greater access to larger pools, increased portability and competitive choices.'"

"ACA enrollment schedule may lock millions into unwanted health plans"

"Millions of Americans with insurance through the Affordable Care Act could find themselves locked into health plans they do not want for the coming year because of the Trump administration’s schedule for the enrollment season that starts in less than two weeks.

The complication arises when people who already have health plans under the law are automatically re-enrolled in the same plan. In the past, a few million consumers each year have been auto-enrolled and then were sent government notices encouraging them to check whether they could find better or more affordable coverage.

This time, according to a federal document obtained by The Washington Post, the automatic enrollment will take place after it is too late to make any changes. Auto-enrollment will occur immediately after the last day of the ACA sign-up season, which the Trump administration has shortened, leaving the vast majority of such consumers stranded without any way to switch to a plan they might prefer."