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Wonder Why Our Healthcare Costs Are So High?

Bob Laszewski is an insurance health industry expert we regularly track to stay up to speed on the national healthcare picture. His typically even-handed analysis has been consistently the most accurate of any of the opinion leaders we follow.  Here’s how Laszewski summed up the primary reason for our country’s runaway healthcare costs during a recent interview broadcast on the national news program Full Measure in a segment entitled Zombiecare: 

The healthcare establishment has been getting unlimited dollars from government, from employers, from consumers. They built this incredible infrastructure now that’s very expensive. And the only way we’re going to make healthcare more affordable is to deal with all this infrastructure we’ve got and get it to an efficient place.

 When asked how we address this infrastructure problem, here’s the pragmatic Laszewski take:

“We’re going to have to do it over many years. In the private sector and the public sector, we’re going to have to put them on a diet. It really is the prices we charge. We’re going to have to, in real terms, ratchet those back so that hospitals and doctors understand there’s going to be less money in the years to come.”

During the interview Laszewski addressed several things related to the current status of health insurance and the Affordable Care Act. Among the items he addressed:

The Individual Mandate and Paying the Penalty

“The law technically says that you have to have health insurance. If you don’t have health insurance, you will pay a fine. But the Trump administration has told the Internal Revenue Service, who is in charge of collecting the fines, that when people file their tax returns, if they refuse to say whether they have health insurance or not, the IRS should not pursue them. You technically have to pay it. Your accountant’s probably going to tell you, you technically have to pay it, but it’s not being enforced.”

ObamaCare as Zombie Care(because a Zombie is the walking dead)

“Obamacare is still there, it’s still walking around. It’s still selling health insurance plans to people. But it has no chance in its present form of ever offering affordable and attractive health insurance. And more and more people are just exiting it and going uncovered because they can’t afford it.”

Our takeaway from all this? Be smart.  Stay incredibly vigilant.  Take full advantage of every tool we have at our disposal to do the best we can to help our clients control costs and navigate the turbulent healthcare waters.

There’s still no clear big picture path anywhere in sight.

To watch the entire interview or to read the full transcript, go here.

This and That on FMLA: Non-Traditional Families and the FMLA

Employers with over 50 employees must pay attention to FMLA. With some employers, we are finding that concerns about abuse are growing.

While FMLA is designed to help employees that are in a tough spot, the prepared employer can head off abuses by having good processes in place and have access to the right information. In some cases, we have found the employees abusing FMLA are actually the experts!

Here is some FMLA info you may find useful – FMLA Rights for Nontraditional Families.

If you need assistance on FMLA resources, we can help.

UnitedHealthcare News Release Indicates Small Group Transitional Relief Plans (pre-ACA) Are Likely To Be Extended Beyond 2017

While we wait to see what happens with the New Trump Administration’s plans to repeal and replace………….

In a recent field communication pertaining to Small Group renewals, UnitedHealthcare (UHC) announced that they were making provisions for small employers with non-ACA compliant plans to have the option to keep those plans in place beyond 2017. This “Keep Your Plan” option from UHC is contingent upon the Transitional Relief provision being extended again as expected.  Our guess is that some of other carriers in the Small Group market will follow suit.

The Transitional Relief provision was first enacted when the ACA went into full effect in 2014. Often referred to as the “Keep Your Plan” provision, this provision was extended twice after it first went into effect.  Under the last extension all plans not compliant with ACA were set to expire 12/31/2017.

In January, the new Trump Administration issued a memo “to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the [ACA] that would impose a…cost…or regulatory burden on individuals, families, [or]…purchasers of health insurance.” UHC’s move indicates they expect the new Administration to issue another “Keep Your Plan” extension and that the expiration date will be postponed for at least another year (through 2018) and perhaps indefinitely.

UHC indicated that the Transitional Relief notice applies to: Arizona, Arkansas, Alabama, Florida, Georgia, Illinois, Iowa, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, and Wisconsin.

We’ll be following closely and will keep our clients, especially those who currently have Transitional Relief Plans, posted.

For more info click on the links below:

Trump Administration Aims to Reduce Regulatory Burden

Previous Extension of Transition Policy for Non-ACA Compliant Health Plans Issued 2_29_16

DO ELECTION RESULTS SIGNAL END OF OBAMACARE?

Highly respected industry expert Bob Laszewski provides an ongoing review of health care policy activity and the health insurance marketplace. We have followed his takes on healthcare reform for some time and have always found them to insightful, balanced, realistic and mostly on target.  And, you can count on straight talk, no bull.  We were very interested in his reaction to last night’s election results.

Here’s some of what Laszewski had to say about Obamacare immediately on the heels of last night’s presidential election:

There is no doubt that Obamacare is dead……..

…….There are two routes they will consider:

  1. Immediate repeal and replace that can rebuild insurance reform under the Senate 51-vote budget rule. Following this route will mean that the pre-existing condition reforms, for example, would have to remain in any new law because they are not budget related and would have to stay. The individual mandate (the Supreme Court declared it a tax) could be done away with as well as all of the exchange subsidies and the Medicaid expansion because they are spending related. Just what this path would look like in detail will depend upon what Senate budget rules ultimately determine to be budget items and whether that would be enough to build a health law consistent with a Republican vision.
  2. Effectively repealing by using the Senate 51-vote budget rules to gut the financing of the law on a future date certain. That would be followed by the Republicans saying to the country and the Democrats that Obamacare would continue as is until that future date––Obamacare would continue to cover everyone in the exchanges and under Medicaid. But if Democrats didn’t cooperate in legislating a new health insurance law, they will argue, it will be on the head of the Democrats that people lost their coverage on the day funding ends. This course could have the effect of forcing the Congress to agree on a new bipartisan path for health insurance reform––or result in one incredible implosion of coverage if the Democrats didn’t cooperate.

Either way, Obamacare is over.”

No words minced, for sure.

You can read Bob’s entire article Obamacare: Dead Law Walking!  here.

http://healthpolicyandmarket.blogspot.com

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