Health Insurance Info

Income guidelines for health insurance subsidies [email protected], consumerreports.org

Income guidelines for health insurance subsidies The great majority of people—about 85 percent—who have bought insurance through their state Health Insurance Marketplace have received financial aid to help pay for it. Millions more found ou…

What A Republican Senate Means For Obamacare—and What It Doesn’t By Sam Baker, nationaljournal.com

Republicans won a Senate majority in part by pledging to repeal Obamacare. Now they have to figure out what to do instead.

Mitch McConnell, soon to be the Senate majority leader, has to strike a somewhat delicate balance on the 2010 health care…

I've been worried about something like this for weeks and now my worst fears have been realized. Antisemitism is at a fever pitch; the like of which I have not seen before in my lifetime. To put that into perspective, keep in mind that I lived in Richmond, VA during the early 70's and in St. Louis, MO during the late 70's. I did not grow up surrounded by Jews, like a lot of my friends from the New York City area did. 

For a barometer of Jew hatred, we need look no further than Ramapo, NY. As I have been writing about for weeks, the festering bigotry there has boiled over and it is only a matter of time before it escalates into a violent and perhaps deadly break point. While the behavior of the Hasidic community in Ramapo has been deplorable and without a doubt a chilul Hashem (a desecration of G-ds name and the Jewish people), the reaction of the community at large has been shockingly hateful and ignorant. 

The comments I've seen on Facebook, Twitter and other various news sources, while not original, have been some of the most vile and despicable that I have ever read. According to these "intellectuals" the Holocaust was a hoax, not a single Jew died during WWII, all the money in the world is controlled by the Rothschild family, Jews worship Satan, and my personal favorite, a revival of the age old myth that Jews use the blood of gentile children to make matzo. 

An interesting article written by my close friend, Tony Melé. I worked on Tony's campaign when he ran for Town Supervisor of Ramapo, NY. It was my first foray into the sleazy underworld of politics and an eye opening, no make that eye gouging, experience. Tony’s honesty, loyalty, experience and intellect made him an easy guy to support and like. I truly believe that had he won that election he would have cleaned up the mess and I would still be living in Ramapo. Tony’s perspective is a unique one, as Friedman worked with us on the campaign, only to jump ship and flock to the Town Supervisor like a bee to honey. As with any politician, Friedman’s motive for suddenly declaring the goings on at Ramapo Town Hall “criminal” are called into question and Tony asks some of the hard questions that have gotten lost in the sea of vitriolic attacks and conspiracy theories.

Tony is President of AMI GLOBAL SECURITY, LLC, International Security Consultant Registered Defense Trade Broker, U.S. Department of State, and Bureau of Military-Political Affairs. He is a graduate of the Defense Intelligence University and holds a M.A. Diplomacy, International Conflict Management from Norwich University, as well as a B.S. International Relations /Counterterrorism

Growing up in the era of Watergate, AbScam, Iran Contra, and Wedtech dirty politics and political scandal made for an interesting read while I perused current events on my way to the sports section. I never expected that one day I too would find myself in the thick of a dirty game of political football, both as spectator and as an unwilling participant, nor was I prepared for the consequences both physically and emotionally. 

There is no definitive criteria that separates major from minor scandal. Scandals as a whole tend to be defined by their details, not their technical details or their intended or unintended consequences, but rather their gory details. The scandals that include the most sex, violence and greed are usually the scandals that get the most notoriety. From my time as an “insider” I can assure you that the scandal at Ramapo Town Hall (coincidently the town where I was born) will sate public desire for all of the above and just about every other taboo transgression (with the exception of small farm animals…..maybe).

While I have lived happily, peacefully and anonymously in South Florida for 6+ years, I still find myself drawn to the contentious “Battle of Ramapo” and not because of the sordid details. While I was once firmly planted on one side of the fence, I now find myself torn between supporting what's right and separating myself from what's wrong.  Without going into all of the gory details, it comes down to this in a nutshell:

The current Supervisor and his administration has, for many years, allegedly (and I use that term so loosely it’s slipping through my fingers) used the town as a personal ATM machine.

Every 4 years, by virtue of an Orthodox Jewish (primarily Hasidic) 100% bloc of votes he easily wins re-election. Challenger after challenger has come and gone, with nary a dent made in the Supervisors stronghold on the town and the result is always 4 more years of essentially the “Wild West” in a little hole in the wall town about 30 miles north of New York City.

Building and fire codes are eschewed, and the construction of homes, schools and synagogues are haphazardly strewn about like a 5 year old on a sugar high playing with Legos. To call the aesthetics less than appealing is an understatement, it’s an eyesore that smells almost as bad as it looks because the sanitation services cannot keep up with the huge growth in population.

While the crumbling town infrastructure is ignored, fines from the EPA and other regulatory agencies are amassed at an alarming rate. Not to mention the disturbing environmental impact on a town that was once an ideal place to raise a family in the suburbs of New York City and now is little more than a ghetto on steroids. 

All the while the town coffers are emptied with scarcely a nod and there is accountability to no one of any particular authority. Which I guess is where Mr. Friedman comes in.

The East Ramapo Central School District is controlled by a majority of Orthodox Jews, who in all fairness, as property owners and tax payers have a right to be there. The problem is that because they resent paying taxes for something they have no use for, they have ran the school district into the ground, rendering it an educational hazard, rather than an educational asset. You would probably not send your dog to school in East Ramapo because he would get a better education at Pet Smart. Oh and if you want your kid to have any sort of elective? Forget about it. The school district budget has been slashed to barely pay for chalkboard erasers and toilet paper.

All the while, and with the town operating on a downward spiral, the supervisor decided that the town must build a ballpark for an independent minor league baseball team called the….wait for it….wait for it…..ROCKLAND BOULDERS! Which is a lot like building a theatre for your 10 year olds class play because the same 30 people that show up are the same 30 people who show up to watch a baseball game played by guys who couldn’t even make it in Class A ball. I should know, I actually get to watch Class A baseball down here. No! Not the Marlins….lol. The Jupiter Hammerheads and the Palm Beach Cardinals, REAL minor league teams, with real players. The details of this monstrosity are murky to me but this much is pretty clear, while the dollar amounts may not be comparable, the shadiness of the Miami Marlins – Miami Dade County deal, pales in comparison to this and the effect on the taxpayers is felt more deeply.

The result of all of these issues has been an unbelievable divide between the Orthodox Jewish community and the community at large. As with any great divide, comes hatred and vitriol, which in this case has escalated into the most disgraceful display of anti-Semitism that I have ever seen up close. The comments that I’ve read from people who I used to stand with have literally caused me to lose sleep and even my lunch on an occasion or two. I’m loathe to stand with people who believe that the Holocaust was a hoax, or that Jews were responsible for 9-11. At the same time, I believe that the actions of a few has made for terrible and disgraceful Chillul haShem (desecration of the Name meaning desecration of the name of God, is a term used in Judaism for any act or behavior that casts shame or brings disrepute to belief in God, any aspect of the Torah's teachings, Jewish law, or the Jewish community) and for that I am truly saddened and ashamed.

For me there's not much of a dilemma here and while I will always side with what’s right, I will never side with hate. I pray for the day when my hometown finds its way out of deceit, thievery and corruption and that those responsible get what they deserve. I also pray that my hometown finds its way out of the bigotry, lies and hate and that those responsible get what they deserve. Maybe the people in Ramapo truly deserve each other and maybe this is exactly what they deserve. Either way “to the victor go the spoils” and that’s just the way life goes I suppose.Anyway it's 1:42 AM and I need to get up early to enjoy another sunny, 80 degree, hate free, South Florida day. :) 

  http://rocklandvoice.com/featured/ramapo-councilman-friedman-blows-whistle-on-town-supervisor/

The issue: Some people are unhappy with the size of deductibles of plans on the new health insurance exchanges.

Our view: Health care is expensive, and there's no way we can meet the Obamacare goal of expanded coverage without higher deductibles and costs.

From the beginning, any effort to reform health insurance, including the Affordable Care Act, has been a tug-of-war of sorts between helping everyone get needed care while figuring out a way to pay for it. 

President Barack Obama sold his plan on the unrealistic premise that we could cover nearly everyone under private plans that included 10 "essential benefits" that all add to the cost, protect people from losing coverage if they change jobs or have a "pre-existing condition," and save money in the process.

It kind of falls under the category that if something sounds too good to be true, it probably is.

Obamacare proponents hope the program can pay for itself by requiring everyone to buy health insurance. That certainly should help, but those with lower incomes won't pay the full freight.

A New York Times story a few weeks back reported that some people signing up on the exchanges aren't happy with the cost they're seeing. The story told of a couple in El Paso, Texas, both age 35, who found one of the cheapest plans on the federal exchange had a monthly premium of less than $300 (not half bad), but an annual deductible of more than $12,000 (not so good).

That's a lot of money, but a healthy person at age 35 hopefully won't have to spend nearly that much.

But all you have to do is crunch a few numbers to realize the Obamacare coverage expansions are going to add to already expensive health insurance costs.

The average annual cost of a family health insurance plan is about $15,745, according to statisticbrain.com, and that's pre-Obamacare. That means many healthy people are paying into a system to help not-so-healthy people. That's just how the insurance system works. And while most working couples in good health would be severely squeezed if they had to cover a $12,000 deductible, at least they wouldn't be financially ruined for life by a catastrophic illness or accident.

That's been the problem in this country for some time. Everybody wants good health insurance but wants somebody else to pay for it. High-deductible plans may not seem like a very good deal, but that's probably the only way Obamacare can work. There's no other reasonable way to meet its provisions and expect "government" to pay for it.

High-deductible plans may also help make people smarter consumers of health care and hopefully force providers to be more up front with the costs of their services and procedures. It shouldn't be harder to get cost information up front about health care than auto repairs. But let's also not kid ourselves. Health care has gotten more expensive because it's gotten more comprehensive and specialized.

 In 1980, Americans spent 9.2 percent of our Gross Domestic Product on health care. Today it's about 18 percent. Knee replacements are much better than a cane or a walker, but also much more expensive, and as Baby Boomers age, the demand for such procedures will increase, and we'll all have to pay.

The Department of Health and Human Services (HHS) announced new steps last week designed to boost access to coverage and minimize disruption as we approach January 1, 2014. The steps lean heavily on insurers to make last-minute changes in administering requests for coverage under the ACA. For example, HHS said insurers will be required to accept payment through Dec. 31, 2013 for January 1 coverage, and insurers are being asked to give consumers additional time to pay their first month’s premiums. HHS also is encouraging insurers to treat out-of-network providers as in-network for acute episodes and refill prescriptions covered under previous plans during January. The new recommendations chiefly will impact insurers on the federal marketplace serving 36 states; the 14 states that run their own exchanges can make their own decisions regarding the recommendation, which could result in uneven application of the changes. America’s Health Insurance Plans (AHIP) noted in a prepared statement “that so many 11th-hour changes in guidance and rules could worsen administrative challenges.”

In general, insurance carriers support the administration’s attempts to support consumer enrollment during this critical transition period. They already comply with some of the recommendations. They have already adapted their service workflow to support the new 12/23 enrollment date and are giving consumers some additional time to make their initial payment for a 1/1 plan. However, carriers are concerned that some of the proposed recommendations may in fact create significant confusion for consumers.

The administration also announced that it is extending by one month the transitional insurance program known as the Pre-existing Condition Insurance Plan (PCIP), which was set to expire on January 1. The program provides coverage for high-risk individuals with conditions such as cancer, stroke and heart disease. These individuals are expected to transition to new marketplace coverage.

Federal

The House approved the “Bipartisan Budget Act of 2013” last week by a vote of 332-94.  This bill was adopted with bipartisan support from 169 Republicans and 163 Democrats.  The bill also includes a limited package of Medicare/Medicaid provisions, namely a three-month patch to the Medicare physician payment formula (providing a 0.5 update from January 1 through March 31, 2014) and a one-year extension for Medicare Special Needs Plans (SNPs). The patch averts a 20.1 percent cut in Medicare doctor payments, mostly paid for by adjusting hospital payments.  This bill, which the White House supports, will be considered on the Senate floor this week.

The House Ways and Means Committee and the Senate Finance Committee also considered and passed two different Medicare Sustainable Growth Rate (SGR) repeal-and-replace bills. SGR is the method currently used by the Centers for Medicare and Medicaid Services (CMS) to control spending on Medicare physician services. The next step is to merge those plans with the version that was approved by the House Energy and Commerce last summer and get a final version passed before the most recent patch runs out. Lawmakers are expected to tackle the issue when they return in January.

States

CALIFORNIA: Covered California™ issued a press release last week touting a broad mix of physicians and hospitals available through the exchange health insurance plans when coverage starts in 2014. Updated numbers released by the exchange show that consumers will be able to choose from more than 80 percent of the state’s practicing physicians through the new marketplace, as well as a significant majority of California’s hospitals. More than 58,000 physicians and more than 360 hospitals are available through Covered California plans. Exchange officials said the data underscore the importance of consumers making informed choices as they select health insurance plans through Covered California.

MAINE: A committee tasked by the legislature with overseeing the implementation of the ACA in Maine has developed a set of recommendations that includes exploring the possibility of setting up a state-based health insurance exchange in 2016 if problems with the federal exchange continue.  The Maine Health Exchange Advisory Committee also recommended unanimously applying for federal funds to help individuals and small businesses sign up for health care coverage.  Steering more people toward health insurance coverage one way or another was at the core of recommendations released by the committee. But the recommendations sidestep an outright call for the expansion of Medicaid in the state. Instead of advocating for the Medicaid expansion, the committee adopted language that calls for measures that will help close the coverage gap.  The consensus report also recommended pursuing changes in state and federal law to create more transparency around pending changes to composite ratings by health insurers.

MASSACHUSETTS: The Division of Insurance has proposed amendments to the state’s Medicare supplement insurance regulations to standardize and simplify the terms, benefits, organization and format of Medicare supplemental policies.  A public hearing on these proposed amendments is scheduled for December 27. Written comments are due December 30.

Special One Hour Show

Thursday December 19, 2013 

6:00-6:30 PM - Special guest financial analyst Brad Crawford who will give us his outlook for 2014. 

6:30-7:00 PM- Hot Stove Baseball Round Table with special guests.