Connect with us

Retirement Planning

Obama: GOP’s Stance On Preexisting Conditions Off-Base, Especially During Pandemic

Published

3 years ago

on

Endorsing his former vice president, Joe Biden, to win the White House, former President Barack Obama sought to contrast the 2020 platforms of Democrats and Republicans on a critical plank: their stance on the Affordable Care Act. It’s a difference, he argued, that has assumed newfound urgency.

“The Republicans occupying the White House and running the Senate … have shown themselves willing to cut millions off their health insurance and eliminate preexisting condition protections for millions more, even in the middle of this public health crisis,” Obama said.

Obama was referring to a couple of GOP policies, the former president’s senior adviser Eric Schultz told KHN. The first: a pending Supreme Court case, Texas v. Azar, in which the Trump administration has argued the 2010 health law should be struck down. Schultz also highlighted the White House’s refusal to provide a special open enrollment period for the ACA health exchanges in the midst of the coronavirus pandemic.

We’ve previously checked claims about President Donald Trump’s stance on the law’s preexisting condition protections — arguably its most popular component ― and his position on the Texas v. Azar lawsuit.

But COVID-19 adds new relevance, because of both the virus’s devastating health implications and bludgeoning impact on the American economy. Indeed, the Trump administration’s handling of the virus crisis is shaping up to be a defining issue in the run-up to November. Meanwhile, Biden made the health care law a signature component of his presidential platform and has been a vocal critic of the administration’s pandemic response.

With that in mind, we decided to take another look.

The Republican Agenda

Obama is correct: The Republican Party has opposed the ACA for years. In 2016, then-candidate Trump campaigned on its repeal. Since then, the White House and congressional Republicans have pursued an agenda that would dismantle the law’s preexisting condition protections. Republicans haven’t united behind an alternative plan, either.

First: the lawsuit. Texas v. Azar stems from the 2017 Tax Cuts and Jobs Act. That measure took the teeth out of the health law’s individual mandate, which required that all Americans have health insurance or pay a penalty. The tax law, pushed by Republicans and signed by Trump, set that penalty to $0.

A collection of Republican states’ attorneys general now argue that, without the penalty, the rest of the health law doesn’t work and should be struck down.

Killing the ACA would eliminate the stipulation that insurance plans cannot charge people more if they have a preexisting condition, get rid of the subsidies it provides for people to buy insurance on the exchanges and gut the Medicaid expansion that, in six years, directly extended coverage to more than 13 million people. The Supreme Court has agreed to hear the case, although it won’t rule until after the November election.

The Trump administration, while technically in the position that would defend the law in court, has declined to support it — a move legal experts say is almost unprecedented.  In fact, the administration has even sided with the states arguing that it should be struck down. Neither the White House nor Senate Republicans have put forth a replacement bill that would maintain the ACA’s protections in the event the high court rules against the law.

We asked the White House if the administration had changed its stance in the wake of the pandemic. Trump’s staff redirected us to the Department of Justice, the federal government’s legal arm. The DOJ did not respond to emailed requests for comment. As recently as the end of March, though, Trump told reporters he still wanted the law “terminated.”

Senate Democrats have pushed the administration to change its position on the lawsuit. But Republicans, who hold the Senate majority, have been silent, a position that hasn’t changed even since COVID-19 effectively shut down large swaths of the country.

In some ways, the Republican stance isn’t important, argued Thomas Miller, a resident fellow at the American Enterprise Institute, a public policy think tank. It’s hard to imagine the Supreme Court voting to get rid of the health law, especially in the midst of COVID-19, he said.

Still, that doesn’t change the facts of what Trump is arguing.

And the lawsuit is also only one part of the equation. Another, is healthcare.gov.

Americans who have lost their jobs ― and, often, the insurance that came with it — are eligible to buy insurance on the federal exchange, since job loss is a“qualifying life event” that gets you special access. Those who otherwise lack coverage would normally have to wait until the regular open enrollment period, which takes place at the end of the year. But the threat of COVID-19 has changed the risk for many of these potential shoppers.

In response, 11 states have independently reopened their state-run health exchanges for a special sign-up period. But the administration has declined to take such steps for the national marketplace.

“If you have been uninsured and picked up your newspaper, or turned on your news and realized your health was in much greater risk than you had anticipated, and would like to rush and get health insurance in case you end up on a ventilator ― you’re out of luck,” said Linda Blumberg, a health policy fellow at the Urban Institute, a nonprofit research organization.

Even before coronavirus, the institute estimated that 32 million Americans were uninsured. About 20 million of them could benefit from a special enrollment period, Blumberg said. Without insurance, coronavirus treatment poses not just a health risk, but also a financial one.

The Trump administration has said it will pay hospitals directly, out of a pool of $100 billion, to cover the cost of treating uninsured people with COVD-19. After treating patients, hospitals would get paid at the Medicare rate.

But the administration’s policy extends only to covering COVID-19 treatment. Uninsured people with underlying chronic conditions don’t have a way to pay for health care, noted Robert Berenson, another Urban Institute fellow. If left untreated, those chronic ailments make COVID-19 far more dangerous than it would be for someone able to get preventive treatment earlier on.

Coronavirus And The ACA

President Trump’s stance raises another question, experts noted. Without the ACA, what kind of impact would COVID-19 have?

Even with the heath law intact, many Americans won’t be able to find affordable health insurance. That particularly applies to people who can’t afford the premiums on the individual marketplace, don’t qualify for federal subsidies or live in one of the 14 states that didn’t opt into the ACA’s Medicaid expansion provision.

And the ACA is nowhere near sufficient on its own, Miller noted. Having insurance is part of the picture, but it doesn’t guarantee access to testing or that a hospital will be able to treat you. “On the margins, it does help a little bit to have insurance coverage, but the problem is so much larger than that,” Miller argued.

Still, without the health law, the virus’s impact would be “catastrophic,” said Jonathan Oberlander, a health policy professor at the University of North Carolina-Chapel Hill.

Striking the individual marketplace and Medicaid expansion would leave almost another 20 million people uninsured — “at risk,” said Larry Levitt, a vice president at the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

Without the ACA, COVID-19 could be considered a preexisting condition. Insurance companies could charge more to cover people who have previously contracted the virus (assuming, of course, those people can get tested and recorded as having had COVID-19). Plus, emerging evidence suggests severe cases of COVID-19 may leave lingering health consequences, that even after recovery would require ongoing medical care, Levitt said.

“The ACA’s consumer protections ensure that persons with COVID-19 can obtain insurance without fear of being turned away or charged exorbitant premiums because of their preexisting condition,” Oberlander said.

The health law also imposed strict regulations over what insurance must cover. Without those regulations, plans could ― and likely would — revert to skimpier coverage, Blumberg said.

That, she said, means plans that perhaps don’t cover ventilators or branded medicines, or that cap how many days of hospital care they’ll cover, or that require people to pay much more out-of-pocket.

“Insurers, given the legal ability to do it, would limit their legal liability and protect themselves from high claims,” she said. “They did it before and will do it again.”

Our Ruling

Obama accused the Trump administration and Senate Republicans of being “willing to cut millions off their health insurance and eliminate preexisting condition protections for millions more, even in the middle of this public health crisis.”

Evidence indicates that this is an apt characterization. None have put forth a plan that would maintain coverage or consumer protections ― policies that benefit millions of Americans — if the Supreme Court rules against the ACA. And as Obama asserts, striking down the law without an equivalent replacement could be devastating, especially during the COVID-19 pandemic. We rate this claim True.

—————–

By: Shefali Luthra, Kaiser Health News
Title: Obama: GOP’s Stance On Preexisting Conditions Off-Base, Especially During Pandemic
Sourced From: khn.org/news/obama-gops-stance-on-preexisting-conditions-off-base-especially-during-pandemic/
Published Date: Fri, 17 Apr 2020 09:00:05 +0000

Always check our latest articles at…
https://getinvestmentadvise.com/category/retirement-planning

Related Topics:
Continue Reading
Advertisement Attention Stock Investors

Retirement Planning

At Least 1.7M Americans Use Health Sharing Arrangements, Despite Lack of Protections

Published

3 months ago

on

July 6, 2023

By

 

A new report has provided the first national count of Americans who rely on health care sharing plans — arrangements through which people agree to pay one another’s medical bills — and the number is higher than previously realized.

The report from the Colorado Division of Insurance found that more than 1.7 million Americans rely on sharing plans and that many of the plans require members to ask for charity care before submitting their bills.

The total membership numbers are likely even higher. The state agency collected data from 16 sharing plans across the U.S. but identified five other plans that did not report their data.

“These plans cover more people than we had previously known,” said JoAnn Volk, co-director of the Center on Health Insurance Reforms at Georgetown University.

Under the arrangements, members, who usually share some religious beliefs, agree to send money each month to cover other members’ health care bills. At least 11 of the sharing plans that reported data operated in or advertised plans in all 50 states in 2021.

Sharing plans do not guarantee payment for health services and are not held to the same standards and consumer protections as health insurance plans. Sharing plans are not required to cover preexisting conditions or provide the minimum health benefits mandated by the Affordable Care Act. And unlike health insurance, sharing plans can place annual or lifetime caps on payments. A single catastrophic health event can easily exceed a sharing plan’s limits.

In Colorado, at least 67,000 people were members of sharing plans in 2021, representing about 1 in 4 Coloradans purchasing health care coverage on their own. That rate concerns Kate Harris, a chief deputy commissioner of the Colorado Division of Insurance, which she said regularly receives complaints from sharing plan enrollees.

“What we hear from consumers is that when they purchase one of these, they do think there is some guarantee of coverage, for the most part, despite the disclaimers on many of the organizations’ websites,” Harris said.

The Colorado report found that health sharing arrangements often require their members to seek charity care or assistance from providers, governments, or consumer support organizations before submitting sharing requests. Those costs are then shifted to other public or private health plans.

Katy Talento, executive director of the Alliance of Health Care Sharing Ministries, which represents five of the largest and longest-operating sharing plans in the country, said sharing ministries encourage members to act like the uninsured people they are. Such requirements to seek charity care reflect a desire to be good stewards of their members’ money, Talento said.

“Think about it like a soup kitchen,” she said.

Fourteen sharing plans reported that Colorado members submitted a cumulative $362 million in health bills in 2021, and nearly $132 million of those requests were approved. The remainder, sharing plan executives told the division, reflected duplicative bills, ineligible charges, negotiated discounts, and the members’ agreed-upon portion of medical bills.

“It’s not like every claim line on a health care sharing request is going to be eligible for sharing,” Talento said. “They have to submit the whole bill. They can’t just pull out a piece of it.”

But consumer complaints to the Division of Insurance and to consumer assistance programs, such as the Colorado Consumer Health Initiative, show that members do not always realize what sharing plans will cover.

“We have seen firsthand the risks that people face when they sign up for these arrangements without recognizing the magnitude of the risk that they’re assuming for their health care costs,” said Isabel Cruz, the initiative’s policy director.

Talento disputed the notion that members don’t know the parameters of their sharing plans.

“That’s just suggesting that our members are dumb,” she said. “Is it likely that somehow our people are going to be willy-nilly jumping blindly into something?”

Theresa Brilli, a small-business owner in Longmont, Colorado, said she and her partner signed up for a direct primary care plan in 2017 that covered primary care visits for $179 a month. Direct primary care plans are payment arrangements between patients and providers for receiving health services without billing insurance. The plan had an arrangement with Liberty HealthShare, a Canton, Ohio-based sharing plan with more than 131,000 members nationwide, to cover additional services like preventive screenings, emergency room care, and hospitalizations for $349 a month with a $1,000 deductible. The rates increased to $499 a month, with a $1,750 deductible, in 2020, Brilli said.

But Brilli said getting payments was a major hassle.

“It took about four to eight months to get reimbursed,” she said. “It was a fight, every bill.”

When she heard about enhanced subsidies for ACA marketplace plans in 2022, she decided the hassle was no longer worth it and switched to a Kaiser Permanente plan for $397 a month.

“I will never go back to Liberty Health or a health care sharing plan,” she said. “I didn’t agree with the whole ministry thing. They made you sign off saying you believed in God, which was like, ‘Whoa, I guess that’s what I have to do to get my health insurance.’”

Laura Murray, 49, of Aurora, Colorado, said she signed up for a Liberty HealthShare plan in 2017 as a more affordable alternative to her husband’s employer-based plan.

“We kind of felt we were cutting out the middleman in a way, and it was a helping-out-your-neighbor sort of deal,” she said.

But when she became pregnant unexpectedly, she had trouble getting her health bills paid. Initially, Liberty paid only a portion of the tab, and her bills got sent to a collection agency. It was only through multiple calls that she learned she needed to send the bills to a third party that would negotiate with the providers.

“It took years to get it cleared up,” she said.

Timothy Bryan, Liberty’s vice president of marketing and communication, disputed many of the details of Brilli’s account and attributed some of the delay in payment to her “failure to submit the required supporting documentation.” Murray’s payments, he said, were delayed more than 10 months because she had failed to provide the required pre-notification.

Mike Quinlan, 42, of Denver, turned to a health sharing ministry in 2014 after the birth of his first child cost him more than $17,000 out-of-pocket, on top of nearly $24,000 in premiums that year, under an employer-sponsored health plan. He said the births of his three youngest children were covered in full by Samaritan Ministries International, a Peoria, Illinois-based sharing plan with 359,000 members, to which he contributes $600 a month. When he incurs large health expenses, he receives a slew of $600 checks from other members, he said.

Every year, Quinlan attests that he is a Christian and identifies the church he attends.

“This is a group of like-minded people who have said voluntarily we’re going to trust each other to cover each other’s health costs,” he said.

The rules differ from plan to plan. Some sharing plans require members to pledge to abide by Christian principles, and some exclude payment for out-of-wedlock births or health issues that arise from drug use. Many sharing plans exclude coverage of contraception, mental health services, and abortion, often with no exceptions for rape or safety of the mother.

Regulators in Colorado and other states have also expressed concerns that health sharing arrangements are paying brokers much higher commissions for signing up members than health plans do. That could create financial incentives to push sharing plans over health insurance without adequately educating consumers about the differences.

In 2019, Covered California, the Golden State’s ACA marketplace, instituted a requirement that its certified agents who sell both sharing plans and health insurance provide consumers with a list of disclosures about sharing plans and show them the subsidies they could receive for buying traditional health insurance coverage.

“It’s really important that consumers understand what these arrangements are, and what they are not,” said Jessica Altman, executive director of Covered California.

Harris said the Colorado Division of Insurance is investigating multiple health sharing arrangements based on consumer complaints but declined to name them.

Colorado officials are also concerned that health sharing arrangements might appeal primarily to people who don’t expect to use many health services. That could increase the proportion of sicker and more expensive patients among enrollees in traditional health insurance plans, driving up premiums.

Harris said many consumers can get a health plan for less than the cost of a sharing plan, particularly with increased federal and state subsidies put in place in recent years. State officials are also working to inform consumers of the financial risks associated with health sharing arrangements, some of which have gone bankrupt in recent years.

“It might look cheaper on its face, month to month,” Harris said. “But if they do really actually need their costs covered, there’s a real risk that they may not be.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

USE OUR CONTENT

This story can be republished for free (details).

—————–

By: Markian Hawryluk
Title: At Least 1.7M Americans Use Health Sharing Arrangements, Despite Lack of Protections
Sourced From: kffhealthnews.org/news/article/health-sharing-arrangements-ministries-protections-risks/
Published Date: Wed, 14 Jun 2023 09:00:00 +0000

 

 

 

Always check our latest articles at…
https://getinvestmentadvise.com/category/retirement-planning

Continue Reading

Retirement Planning

Give Yourself the Perfect Retirement Gift

Published

3 months ago

on

July 5, 2023

By

Give Yourself the Perfect Retirement Gift

From day one, everyone looks forward to retirement, that day where they can finally let go of the stresses of the daily grind and spend their leisurely days traveling, reading and basically having fun. As compared to previous generations, we have longer life spans so we all expect our golden years to be fulfilling and rewarding.

Instead of waiting for people to help you plan your retirement, you should do it yourself. Although retirement planning is probably one of the most draining activities where one spends loads of time perusing over financial and brokerage statements, benefits brochures and insurance policies. One does this in terms of the benefits of long term planning: if one retires earlier, he/she will think and anticipate less on government-funded plans which only gives a pittance of a pension and focus more on the beauty of life.

Why Retirement Planning is Necessary

Obviously, retirement planning isn’t all about numerous hours of stress by chugging down numbers and analyzing mutual funds: it’s about fixing and deciding how you will live the final years of your life. If one can balance financially and plan fully on a retirement plan, rest assured that your future is secure.

But remember that retirement planning isn’t a singular activity. It is something that stretches forth to decades, spanning your 30s, 40s and 50s. In every decade, one must rethink their strategies since you are inching closer and closer to retirement, thus one must forgo risky investments and go to bonds and reliable mutual funds as the years pass by.

Build the Right Retirement Plan

A retirement plan must be suited to your risk tolerance and apparent need for cash when retirement comes. If you prefer a general 401(k) that has a good balance of everything, you may go for equal amounts of low-risk bonds and riskier stocks or you may also opt for an assortment of mutual funds that both have high-risk and low-risk funds.

Generally, risk tolerance is congruent to one’s age. If you are on your 20s or early 30s, you may opt for a more stock-saturated mutual fund in the hope of getting a good return because of the added risk stocks give. If ever the worst comes and you face some declines in the stock market, you still have a good 20 to 30 years to compensate for the losses.

On the other hand, if one is teetering on the 40s or 50s, it is necessary that one must go low-risk in his/her investments. One’s mutual funds must now be concentrated more on low-risk government bonds, which virtually assure no losses and minimum gain, if there will be no huge political crisis, of course.

If one follows this general age/risk rule, then one has better chance that one has an ample amount of cash to spend on the pleasures of life when retirement age finally comes.

Conclusion

One has always dreamt of traveling the world, playing golf all day and enjoying the best life can give. But one cannot do all that while working away in the office. Therefore one must give importance to the rising necessity of building a retirement plan.

It is probably as stressful as work itself, but if you can carry all that heap of information and mix it into the delicacy that is a finely tailored retirement plan, then rest assured that your dream of tasting and relishing the best of life is definitely reachable by 65.

Continue Reading

Retirement Planning

Ends-of-the-World Every Year Since 1970

Published

3 years ago

on

August 14, 2020

By

There always has been and always will be a reason not to invest or not to stay invested. This is all the mainstream media reports to us. Below you will find a list of some of the worst global events each year since 1970. I have some commentary to follow.

1970: War: US troops invade Cambodia.
1971: Civil Unrest: Anti-war militants march on Washington.
1972: Political: Start of Watergate Scandal.
1973: Economic: OPEC raises oil prices in response to US involvement abroad.
1974: Political: Nixon resigns as President of the United States.
1975: Political: Multiple assassination attempts on President Ford.
1976: World: Ebola virus.
1977: Political: Government shutdowns.
1978: Market: U.S. Dollar plunges to record low against many European currencies.
1979: World: Iranian militants seize the U.S. embassy in Teheran and hold hostages.
1980: Economic: Inflation spiked to a high of 14.76%.
1981: Political: President Reagan assassination attempt.
1982: Economic: Recession continues in the U.S. with nationwide unemployment of 10.8%.
1983: Economic: Unemployment in the U.S. reaches 12 million.
1984: Economic: 70 U.S. banks fail during the year.
1985: World: Multiple airplane hijackings around the world.
1986: World: Chernobyl Nuclear Power Station explodes.
1987: Market: DOW drops by 22.6% on October 22.
1988: Environment: Awareness of global warming and the greenhouse effect grows.
1989: Environment: Exxon Valdez dumps 11 million gallons of crude oil into Prince William Sound.
1990: World: Persian Gulf War starts.
1991: World: Mass shooting in Killeen, TX.
1992: Human Rights: Los Angeles riots following the death of Rodney King.
1993: Terrorism: World Trade Center bombing.
1994: World: Mass genocide in Rwanda.
1995: Terrorism: Oklahoma City bombing.
1996: Terrorism: Olympic Park bombing.
1997: World: Bird flu.
1998: World: Multiple U.S. embassy bombings.
1999: World: Columbine shooting.
2000: Economic: Start of the Dotcom Market Crash.
2001: Terrorism: Terrorist Attacks in NYC, DC & PA.
2002: Economic: Nasdaq bottomed after a 76.81% drop.
2003: World: The U.S. invades Iraq.
2004: World: The U.S. launches an attack on Falluja.
2005: World: Hurricane Katrina
2006: World: Bird flu.
2007: Economic: Start of the Great Recession.
2008: Economic: Great Recession continues.
2009: Economic: S&P bottomed after a 56.8% drop.
2010: Market: Flash crash.
2011: Market: Occupy Wall Street and S&P downgrades U.S. Debt.
2012: Political: Fiscal cliff.
2013: Political: Taper tantrum.
2014: World: Ebola virus.
2015: World: Multiple mass shootings.
2016: Political: Divided U.S. Presidential election.
2017: World: North Korea testing nuclear weapons.
2018: Economic: U.S. & China trade war.
2019: Economic: Student loan debt reaches an all-time high of $1.4 trillion.
2020: World: COVID-19.

While many of these events were undoubtedly terrible (and there are certainly others not named here that were worse), most of these were broadcast as end-of-the-world events for the stock market. Despite that attention, it is worth noting that these were, for the most part, one-time events. In other words, most faded into the newspapers of history. We moved on.

Obviously, some caused monumental shifts in the way the world works. Just think about how much air travel continues to be impacted by the events of 9/11. But, outside of the resulting inconveniences (if we want to call safety protocols inconveniences) associated with air travel, flying is safer than ever before.

Take a look at just about any of the events and you will find there are many that people will hardly remember. My point here isn’t that these events are to be ignored or that they were easy to stomach at the time, but that they have become a distant memory.

I want to also make the point that we should expect these types of negative events. As investors, we know these types of crises, economic catastrophes, and global phenomena are going to happen.

But in almost all cases, here is what we can say in the next breath – this too shall pass.

Will there be legal, humanitarian, economic, or some other aid required as a result of these events? Almost certainly the answer is yes, but that doesn’t mean it they won’t eventually fade into history.

Lastly, what’s worth noting is how the market has performed over these last 50 years despite the continual advertisements of the world crashing down around us. On January 2, 1970, the Dow Jones stood at 809 and the S&P at 90 -> those are not typos. These same indexes have grown (not including dividends) to 26,387 and 3,232 respectively. Amazing, no?

Perhaps what gets overlooked more than anything else is what separates the above one-time negative events from the positive stories that go largely ignored over our lifetimes. And that is a story worth telling. See the companion post below:

Unheralded Positive Events Every Year Since 1970

Stay the Course,
Ashby

Retirement Field Guide Mission:

“To help 10 million people make better retirement decisions.”

If you would like to join us in achieving our mission, I hope you will consider sharing our site if you have found it helpful in your own retirement planning.

This post is not advice. Please see additional disclaimers.

The post Ends-of-the-World Every Year Since 1970 appeared first on Retirement Field Guide.

—————–

By: Ashby Daniels, CFP®
Title: Ends-of-the-World Every Year Since 1970
Sourced From: retirementfieldguide.com/ends-of-the-world-every-year-since-1970/?utm_source=rss&utm_medium=rss&utm_campaign=ends-of-the-world-every-year-since-1970
Published Date: Tue, 04 Aug 2020 13:26:19 +0000

Did you miss our previous article…
https://getinvestmentadvise.com/retirement-planning/wildfire-prone-property-insurance-bill-in-california-due-for-hearing/

Continue Reading

Trending