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Senate To Unveil Healthcare Bill Thursday, June 22nd

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US Senate Republicans plan to release their draft healthcare bill tomorrow and expect to vote on the bill next week once it has been scored by the CBO (Congressional Budget Office).  
While final details are being worked out, President Trump has asked the Senate to pass a more generous bill than the House bill (AHCA) which Trump referred to as "mean".  
Given the opposition of all Senate Democrats to repealing Obamacare, Republican leaders will need the support of at least 50 of the chamber's 52 Republicans to ensure passage.Vice President Mike Pence predicted that new healthcare legislation would be enacted this summer.
Read the full article from Reuters

I will be very curious to read the draft bill once released.
Dave www.davefluker.com



Healthy California Meets Schoolhouse Rock?

Well, if nothing else, it is a catchy tune ;-) 



The Middleman from Healthy California on Vimeo.



Dave
www.davefluker.com


Interactive Benchmark Exchange Premium Rates 2017

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NASHP (National Academy for State Health Policy) and KFF (Kaiser Family Foundation) have provided a 2017 interactive premium map for exchange plans in 2017.  

This map is for Benchmark plans in each county for a 40-year-old individual.  The Benchmark is the second lowest cost silver plan.  Subsidy eligibility is based on the benchmark plan.

For California, cheapest premiums are in Los Angeles, Orange, Riverside and San Bernardino counties.  San Diego and Central Valley are also on the lower end.  Central Coast, Sierra and northern counties are higher with highest being northern Central Coast including Monterey, Santa Cruz and San Benito counties.  

Several counties in western Arizona have the highest benchmark premiums at over $700 per month!  

http://www.nashp.org/health-insurance-marketplace-second-lowest-cost-silver-plan-by-county-2017/


Dave
www.davefluker.com



California Single Payer Reality - LA Times

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The LA Times didn't mince words in their June 5th evaluation of California's Single Payer Healthy California Act (SB 562).

All that passed was authorization to keep yakking about it in dreamland.  Or you can look at it this way: A fantasy-driven single-payer healthcare concept was given the equivalent of a grade-school social promotion.
There is serious doubt that SB 562 will make it out of the Assembly... 

“This is the Senate kicking the can down the road to the Assembly and asking the Assembly to fill in all of the blanks,” Hueso said. “I don’t see this bill coming back from the Assembly. I think this bill will die in the Assembly.”
Anyway, even if the Legislature did manage to pass a bill, Gov. Jerry Brown probably would veto it. He’s very skeptical about the financing.
I guess we will have to wait and see how things unfold in the California Assembly.   In the meantime don't forget that the 2018 Open Enrollment Period has been shortened from 90 days to 45 days.  


Read LA Time…

Healthy California Act Passes State Senate, Moves To Assembly

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SB 562, the Healthy California Act for single payer healthcare passed the California State Senate by a vote of 23-14.  

Next stop for the bill is the California State Assembly where it is expected to meet a more difficult path.  If the Assembly ammends the bill, it would have to go back to the Senate for approval before being sent to the Governor for signature or veto.

Voting for this bill was as follows...

Ayes: Allen, Atkins, Beall, Bradford, De León, Dodd, Galgiani, Hernandez, Hertzberg, Hill, Jackson, Lara, Leyva, McGuire, Mendoza, Mitchell, Monning, Newman, Portantino, Skinner, Stern, Wieckowski, Wiener

Noes: Anderson, Bates, Berryhill, Cannella, Fuller, Gaines, Glazer, Moorlach, Morrell, Nguyen, Nielsen, Stone, Vidak, Wilk

No Votes Recorded: Hueso, Pan, Roth

http://www.healthycaliforniaact.org/california-senate-says-yes-guaranteed-healthcare/


Dave
www.davefluker.com





Interactive TrumpCare Premium Increase Map

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The Century Foundation has released an interactive premium map based on CBO projections if the AHCA (TrumpCare) were to become law.


On May 24, the Congressional Budget Office (CBO) estimated the House-passed American Health Care Act (AHCA) would cause premiums in the individual market to rise by 20 percent next year.This rate hike may happen even if Congress fails to pass the AHCA. On his first day in office, President Trump signed an executive order to scale back Affordable Care Act (ACA) policies which could have a similar double-digit impact as the ACHA next year. 
The Century Foundation Interactive Map and Article


Dave
www.davefluker.com




Blue Shield Tops Covered CA Enrollments

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California Healthline reports that Blue Shield of California has the highest share of enrollees in Covered California Health Benefits Exchange (Covered CA).

The data, from Covered California, show that Blue Shield had 389,480 enrollees in the exchange as of December 2016, about 31 percent of the market. Anthem was next with 310,690 members, for a 25 percent share. Kaiser Permanente was third with 297,030 exchange enrollees, or 24 percent. Health Net and Molina Healthcare were fourth and fifth, respectively.
I believe this, in part, may be due to Blue Shield offering the only state-wide PPO plan on the individual exchange market.  Anthem offers a PPO as well but it is limited to certain areas of the Central Valley and Central Coast. 

A new analysis, also released this month, shows that Covered California continues to have among the healthiest exchange enrollees in the nation — a designation Covered California officials hopes will tame premium increases.
Rates for 2018 plans have been filed…

Healthy California Act SB 562 Cost Estimate: $400 Billion

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The cost estimate came in for the 'Californians for a Healthy California Act' (SB 562) as announced yesterday by the Sacramento Bee.  

"The price tag is in: It would cost $400 billion to remake California’s health insurance marketplace and create a publicly funded universal heath care system, according to a state financial analysis released Monday."

"California would have to find an additional $200 billion per year, including in new tax revenues, to create a so-called “single-payer” system, the analysis by the Senate Appropriations Committee found. The estimate assumes the state would retain the existing $200 billion in local, state and federal funding it currently receives to offset the total $400 billion price tag."

I have considered that a chunk of the shortfall could be recovered from employer plans. The article says that $100-$150 billion could be available to offset.  

Remember, the Healthy California Act, if made law, would eliminate all private health i…

Cost Share Reduction Subsidy To Continue 90 More Days

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The Trump Administration will continue to fund cost share reduction subsidies for another 90 days.  

At issue is a court decision which determined the subsidy to be illegal.  The appeal was originally filed under the Obama Administration and continues under the Trump Administration (for now).

"A federal appeals court on Monday granted the Trump administration a 90-day delay on its decision to appeal a case brought by House Republicans against ObamaCare subsidies paid to insurers."

This is going to create a bit of uncertainty in the markets as insurers prepare for 2018.

"Insurers need to decide by June whether they will continue to operate in the ObamaCare exchanges, and companies will have finalized their 2018 premium requests before the end of the three-month window."

Read the full article at TheHill


Dave
www.davefluker.com




Tourist Owes Mexican Hospital $40K - Claims They Won't Let Her Leave

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Fox News reports that a retired Idaho Teacher, who got sick while on vacation in Mexico, now owes $40,000 to the Mexican Hospital.  Her son claims they won't release her until she pays the balance owed. About $8,000 has been paid so far.

The article does not state whether the 67-year-old is covered by Medicare or a retiree health plan.  Either way, it seems that her domestic health insurance isn't going to do much on her behalf (they are using a GoFundMe to try and raise the balance).  Certainly not until she returns home and files claim forms.  

Stories like this are a good reminder of the importance of global health insurance coverage when traveling abroad.  Insurance companies like GeoBlue provide benefits in over 180 countries and handle any claims in the host country.    

Fox News Article



Dave www.davefluker.com


UPDATE
May 17, 2017.  Follow up article says she was allowed to leave last Friday and is now home in Idaho.  
Vickki Moormann Home

Jimmy Kimmel Chats With Senator Bill Cassidy (R-LA) On AHCA (TrumpCare)

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An interesting conversation between television host Jimmy Kimmel and Louisiana Senator Bill Cassidy (co-author of the Cassidy-Collins Senate Bill).  

I think it's obvious that the Senate does not share the "love" for the House Bill that was recently passed.








Dave www.davefluker.com


House Passes American Health Care Act (TrumpCare)

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Today the US House of Representatives passed the AHCA (American Health Care Act) by a narrow margin of 217 votes.  All yes votes were GOP and all Democrats voted against--as well as a small number of GOP Representatives.  

Now the TrumpCare makes its way to the US Senate where it is likely in for contentious debate and some likely changes.  The Senate has indicated that they are working on their own bill.

While something needs to be done with regard to the ACA (ObamaCare), there is great debate whether this is the best or most appropriate solution.  Some States or portions of States are facing a situation where no health insurer will be available in 2018 from which to purchase health coverage.  

Even Covered CA hinted in an agent e-mail earlier this week that California could see rates increase up to 48% for 2018.  

Here's a quick overview of what the AHCA (TrumpCare) would do...

*Eliminate Obamacare taxes on the wealthy, insurers and others, and get rid of the individual mandate impos…

Molina Healthcare Ousts CEO and CFO

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Molina Healthcare has fired CEO Dr. J. Mario Molina as well as his brother who served as the CFO.  

Molina Healthcare is a traditional Medicaid provider and offers services for Medi-Cal and Covered CA health plans in southern California (as well as other states).

"This comes out of nowhere. Molina, a major player on the Affordable Care Act's individual marketplaces, had a rough 2016 due to the ACA plans. But the company was still profitable overall. Molina has been one of the most outspoken health insurance CEOs and was particularly critical of Republican efforts to repeal and replace the ACA."

Full Article from Axios.com



Dave
www.davefluker.com



Tokio Marine HCC To Suspend Short Term Health Sales

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Tokio Marine HCC has announced that the company will no longer offer short term health insurance plans as of 6/1/17.  

"We have made this decision based on the 90 day policy duration limitation to the STM insurance marketplace that was effective April 1, 2017.  This has caused many producers in the web broker community to focus their efforts on other supplemental health insurance products like limited medical plans.  As a result of marketplace conditions, we are no longer able to profitably maintain this business. "

This leaves IHC and Petersen International Underwriters for Californians seeking short term coverage.

Dave
www.davefluker.com



Covered CA Benchmark And Premium Tax Credit Subsidy Limit

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When it comes to clients under age 30, it is often the case that the generic income chart shows income level that should receive the premium tax credit subsidy.  In many cases they do not receive subsidy--even with income in the 300-400% range.  This creates some confusion and an understanding of the "benchmark" used in this calculation.

The benchmark plan is the second lowest cost Silver plan in any rating area.  Subsidy eligibility is strictly based upon the premium cost of the benchmark plan.

This is from a recent case...

Single Age 27, Los Angeles, MAGI (modified adjusted gross income) $34,000.  This is generally found on line 37 form 1040.

According to the income chart (see below), that income should qualify for the premium tax credit subsidy.  In this case however, due to the low premium of the benchmark plan in the LA rating area, no subsidy is allowed.

Premium tax credit subsidy is designed to reduce the total annual premium for health insurance to not more than 9.69% of …

Support For ObamaCare Repeal and Replace Dwindling

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An ABC News poll now shows only 37 percent of those polled support a repeal and replace strategy for ObamaCare.  As the current poll shows, more Americans would prefer fixing the existing ACA than to tear it down and start over.  61% favor an effort to keep and improve ObamaCare.  79% favor trying to make it work versus 13% for trying to make it fail.

Just 37 percent of Americans in the national survey say Obamacare should be repealed and replaced; 61 percent say it should be kept and fixed instead. Even more broadly, the public by 79-13 percent says Trump should seek to make the current law work as well as possible, not to make it fail as soon as possible, a strategy he’s suggested.These lopsidedly pro-Obamacare views are far different from the results of an ABC/Post poll in mid-January asking if Americans supported or opposed repealing Obamacare, 46-47 percent. That question did not offer “keeping and improving” it as an alternative -- and it was asked before the contours of the firs…

Cost Share Reduction (CSR) Subsidy Has Uncertain Future Under Trump

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One of the features of ObamaCare is the Cost Share Reduction Subsidy.  This is separate from the Premium Tax Credit Subsidy and applies in California to those with incomes between 138% and 250% of the Federal Poverty Level (100%-250% in states that did not expand Medicaid).

The CSR is used to reduce expenses under Silver Tier health plans for those who qualify. 

138%-150% are eligible for Silver 94
150-200% are eligible for Silver 87
200%-250% are eligible for Silver 73 

As an example of the CSR at work, here are the primary care office visit co-pays for four Silver plans...

Silver 70 (standard no CSR)    $45
Silver 73 with CSR                   $40
Silver 87 with CSR                   $15
Silver 94 with CSR                   $ 3

The cost share reduction is an important benefit for those with lower incomes.  Whether it will continue to be funded is uncertain at the moment.

President Trump may try to use the funding of CSR as a bargaining chip to get Democratic support for TrumpCare reform.  From…

Final Regulations Issued for Individual Market Stabilization

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April 13, 2017 Department of Health and Human Services (HHS) issued final regulations to help "stabilize" the individual & family health insurance market.  These will take effect June 19th, 2017.  

Shortened Open Enrollment Period
2018 Open Enrollment Period will be shortened from 3 months to 6 weeks.  OEP will run from November 1st through December 15th 2017.  That's it!

Greater Control Over Special Enrollment Periods
The rules expand verification of eligibility for special enrollment periods in Marketplaces, limit the ability of Marketplace enrollees to change plan metal levels during the coverage year, and adjust requirements for special enrollments due to marriage.

Promote Continuous Coverage
Issuers will be allowed to collect premiums for unpaid coverage within the past year before re-enrolling individuals for the next year to promote continuous coverage.

Increase Consumer Choice
To help provide enrollees with more coverage options, beginning with 2018 plans, issuers wi…

Trump: Health Reform Still Top Priority

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President Donald Trump says that tax reform will be better dealt with (as well as infrastructure) when billions are freed up from the healthcare system and ObamaCare.  





Dave
www.davefluker.com



ObamaCare Disintegration Begins in Iowa, Tennessee

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Things aren't looking good for ObamaCare in Iowa and Tennessee.  

Wellmark Blue Cross Blue Shield has announced that they will offer no health plans for 2018 in Iowa.  On that news, Aetna announced they would also leave the Iowa market in 2018.  The remaining two health insurers for Iowans in 2018 may be regional carriers - Medica Insurance Company and Gundersen Health Plans.  And Medica is not a solid bet right now...


A third Iowa insurer, Medica, told CNBC is has not yet decided whether to continue selling plans there next year. Medica is the only company to offer individual plans in all of the state's counties. The fourth insurer, Gundersen Health Plan, said that its current plan is to participate in the Obamacare marketplace in Iowa.
If Medica pulls out for 2018 that will leave only Gundersen which does not sell plan in all Iowa counties.  

Iowa Obamacare market gets second big hit as insurer Aetna says it will drop out in 2018


Related, Humana has announced they will exit the K…

Healthy California Act Would Eliminate Medicare, Medi-Cal and ObamaCare in California

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Californians, especially California's Senior 65+ population currently receiving Medicare benefits, may want to take note of provisions in the newly released Healthy California Bill (SB 562).

Section 1 of the Act (formerly Section 2) clearly spells out the following impacts (italics are mine)...

(6) It is the intent of the Legislature to enact legislation that wouldestablish a comprehensive universal single-payer health care coverage program and a health care cost control system for the benefit of all residents of the state.(b) (1) It is further the intent of the Legislature to establish the Healthy California (HC) program to provide universal health coverage for every Californian based on his or her ability to pay and funded by broad-based revenue.(2) It is the intent of the Legislature for the state to work to obtain waivers and other approvals relating to Medi-Cal, the state’s Children’s Health Insurance Program, Medicare, the PPACA, and any other federal programs so that any fede…

Why the republican health bill failed - Right Angle

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Bill Whittle, Scott Ott and Steve Green discuss the failure of the American Health Care Act (AHCA) 








Dave www.davefluker.com


California Short Term Health Insurance Reminder

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Just a quick reminder that 4/1 will be the last day to purchase renewable 6-month short term health insurance.  HCC e-blast says plans can be purchased until 12:00 PM EST 4/1/17.  

4/1 plans go dark temporarily pending CA state approvals for new products.  The new short term products are limited to 3 months maximum and are NOT RENEWABLE.  

If you are thinking of picking up a short term health plan for interim coverage, you will want to act now to secure coverage before the rules change.  

Short Term Health Insurance California




Dave
www.davefluker.com
www.gilroyhealthinsurance.com
www.facebook.com/gilroyhealthinsurance/





Mo Brooks Introduces One Line Bill to Repeal Obamacare

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Mo Brooks (R-AL) has entered a one sentence bill for repeal of the ACA (ObamaCare). Seen as more of a symbolic gesture (the bill did not go to vote in the House), he gets right to the point in a succinct fashion...


“Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted.”
Full article from The Libertarian Republic


Dave
www.davefluker.com
www.gilroyhealthinsurance.com
www.facebook.com/gilroyhealthinsurance/







Stefan Molyneux - How To Save Health Care: A Memo to Donald Trump

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I know it's a bit long, but Stefan hits on so many truths about insurance, health insurance and the comparative between Single Payer (he's Canadian, by the way) and free market reform.

Much to digest but important and provocative points in this podcast.  Well worth a watch in my opinion.





Dave www.davefluker.com www.gilroyhealthinsurance.com www.facebook.com/gilroyhealthinsurance




None and Done?! House GOP Withdraws AHCA (TrumpCare) Bill

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On Thursday, Republican House Leaders delayed a floor vote on the AHCA (American Health Care Act) also referred to as TrumpCare.

President Trump instructed House GOP to vote Friday (today) and if the bill did not pass, he would be done with reforming health care at this time and move on to tax and budget.

This afternoon, House GOP leaders were unable to secure sufficient votes for the bill and chose to withdraw it prior to vote.  

Republican leaders pulled the ObamaCare replacement bill Friday as they failed to pick up enough votes to get the bill passed.


 Appearances indicate that President Trump and the House GOP will let ObamaCare either sink or swim on its own for the foreseeable future.  They are of the belief that it will implode on its own.  

Fox News Live Blog


Dave
www.davefluker.com
www.gilroyhealthinsurance.com
www.facebook.com/gilroyhealthinsurance/

GOP Postpones Health Care Vote (AHCA/TrumpCare)

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Republic Leadership has postponed the House vote on the American Health Care Act (AHCA).  House Floor vote was scheduled for today.  


Republican leaders canceled a vote in the House on the plan to replace ObamaCare Thursday, after leadership's attempts to lobby enough votes apparently failed -- a major setback for House Speaker Paul Ryan and President Trump.
Looks like this may take longer than expected, if it can pass at all.  Stay tuned for updates and news on the AHCA/TrumpCare

Fox News Full Article


Dave
www.davefluker.com
www.gilroyhealthinsurance.com
www.facebook.com/gilroyhealthinsurance/





Short Term Health 3-Month Rule Goes Into Effect in California

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Received a notification from my short term health carrier, Tokio Marine HCC, that the new CMS/HHS rule allowing only 3 months short term coverage will go into effect April 1st.

Due to this change (was hoping HHS would void it), carriers re-filed their short term plans with the State of California. Currently, those re-filed short term plans are pending regulatory approval.  As such, it is likely that approvals will not be granted prior to April 1 and the product will be off of the market until such approval is received.  

If you want to get a short term health plan up to 6 months, you will need to purchase it prior to April 1st with effective start date of 3/31 or earlier.  

You can shop and enroll online on this link




Dave www.davefluker.com www.gilroyhealthinsurance.com www.facebook.com/gilroyhealthinsurance