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Monthly Archives: September 2013

Start Your Exchange Shopping Early, But Don’t Rush To Buy

In recent months, all eyes have been focused on today, the day health insurance marketplaces open for business. While the date is a milestone in the implementation of the health law, other dates are likely more critical for consumers planning to shop for health insurance on their state marketplace.

Start Window Shopping Early

Experts say they expect few consumers to enroll in a plan right away in October—and that may be wise. They advise that it’s a good idea to start looking at the options early and to give yourself plenty of time for the application process. “Expect glitches” has become the catchphrase for officials who are working on implementation of the marketplaces, as well as politicians of every stripe, including President Barack Obama.

More From This Series Insuring Your Health

That’s not all. Health insurance is a complicated product. Understanding how the plans work and picking one that suits someone’s needs will take time, perhaps several visits to the marketplace website or conversations with those trained to help with enrollment.

“I think it’s going to be a pretty thoughtful process for most people to make a decision,” says Mila Kofman, executive director of the DC Health Benefit Exchange Authority.

The open enrollment period for 2014 marketplace coverage runs through March. The uninsured and people who don’t get insurance through work and purchase their own policies on the individual market will make up the bulk of the 7 million people expected to buy coverage on the marketplaces, also called exchanges.

Dec. 15 Looms Large

The health law’s mandate that most people have coverage goes into effect Jan. 1. But consumers can’t wait until New Year’s Eve to meet that deadline.

In general, consumers who want insurance to begin on the first day of any month have to enroll by the 15th day of the previous month. So someone who wants coverage to start on Jan. 1 should buy a plan by Dec. 15. If someone signed up from Dec. 16 to 31, coverage would begin Feb. 1 at the earliest.

Experts say they expect a rush of activity around Dec. 15 before the Jan. 1 coverage requirements kick in and again in mid-March before the open enrollment period ends.

Second Thoughts Are OK

If people sign up for a plan but then decide during the annual enrollment period that they want to switch, they can do so as long as their policy hasn’t yet become effective, according to the Department of Health and Human Services.

If someone signs up in November for a plan that starts Jan. 1, for example, she could switch to another plan until Dec. 31. If she waited until after Dec. 15 to make a change, however, the new coverage wouldn’t begin until Feb. 1 and she would be without coverage in January.

Once a consumer’s plan actually becomes effective, in general no changes may be made until the following open enrollment period. Next year that will be between Oct. 15 and Dec. 7. There are exceptions if someone experiences a significant change in life circumstances, such as a birth, divorce, job loss or permanent relocation.

Three-Month Reprieve

Although the law requires most people to have insurance starting in January, people are allowed to be uninsured for a three-month period once a year without penalty. The latest date that someone could generally buy a plan and avoid facing a penalty for being uninsured next year would be March 15 for coverage that starts on April 1, three months after the coverage requirement kicks in, says Carrie McLean, director of customer care for ehealthinsurance.com, an online vendor that has received approval from the federal government to sell exchange plans on its site.

What Information You’ll Need To Gather

When consumers call or visit their state exchange website or stop by in person to get assistance with enrollment (contact information for all options are available through healthcare.gov or state insurance departments), they’ll need to have certain personal information available, including Social Security numbers and health insurance policy numbers for any health plans that cover household members. 

Federal officials estimate that most people who enroll in an exchange plan will be eligible for subsidies to help cover the cost of premiums. These subsidies, which will come in the form of tax credits, will be available to people with incomes up to 400 percent of the federal poverty level ($45,960 for an individual or $94,200 for a family of four in 2013). To help determine eligibility for subsidies or health insurance programs for people with lower incomes, such as Medicaid and CHIP, consumers will need income information such as pay stubs available for everyone who is seeking coverage.

Subsidies will be based on an estimate of income for the coming year. If a consumer expects a bonus or raise, it’s important to factor that in, say experts. Otherwise, consumers may receive a bigger premium tax credit than they’re entitled to and have to repay it in their񎧞 taxes when the IRS reconciles their actual income with the amount they projected.

“If you anticipate an increase in income over the course of the year, people can choose not to take the full tax credit up front,” says Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation (KHN is an editorially independent program of the foundation.) “They may be better off paying a little more up front [themselves] toward the premium, so they’re at lower risk of having to repay at the end of the year.”

Please send comments or ideas for future topics for the Insuring Your Health column to questions@kaiserhealthnews.org.

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Ontarians more likely to survive 1 year after hospitalization: study

More people in Ontario are living longer after hospitalization than in 1994, with a 22% decrease in the risk of death after 1 year from admission, found an article in CMAJ (Canadian Medical Association Journal). Hospitals deliver a substantial proportion of health care, from treating acute illness to performing surgery, offering specialist medicine and care for people from birth to death. They are large consumers of health care costs world-wide, and it is important to understand how they are performing as part of the health care system…

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Retired people less likely to take medications for hypertension and diabetes

Men and women with hypertension and men with diabetes were 1.3 times to 2.4 times less likely to take their prescription medications after retirement, according to a study in CMAJ (Canadian Medical Association Journal). Poor adherence to prescription medication is common and can affect the ability to manage hypertension and diabetes, two illnesses linked with heart disease and death…

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Canada should screen baby boomers for hepatitis C

Canada should begin screening baby boomers for hepatitis C (HCV), a curable disease that is usually asymptomatic until liver damage is severe, argue several liver specialists in an analysis in CMAJ (Canadian Medical Association Journal). “Unlike most chronic viral infections, HCV infection is curable,” write Drs. Hemant Shah, Jenny Heathcote and Jordon Feld from the Toronto Centre for Liver Disease, University Health Network, Toronto, Ont. “Successful treatment leads to viral eradication, halting the progression of liver disease and decreasing all-cause mortality…

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Shape and color of wine glass influences amount consumed

Whether you see the glass as half full or half empty, chances are, you will pour more wine into a glass that is wide or matches the wine color, resulting in unintentional overconsumption. This is according to a study published in the journal Substance Use and Misuse. For the study, researchers from Iowa State and Cornell University had 73 students who drank at least one glass of wine a week participate in an experiment involving different pouring scenarios…

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Insertable ring could prevent HIV in women

Scientists from Northwestern University have developed a new intravaginal ring that they say could help prevent women from being infected with HIV. The device is easily inserted and remains in place for 28 days, delivering a measured amount of the anti-retroviral tenofovir directly to the site of transmission. HIV affects an estimated 34 million people around the world. In 2011, 2.5 million people were newly diagnosed, and in sub-Saharan Africa, women make up 60% of people living with HIV/AIDS…

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Psychotropic use in preschool-age children 'stabilizing'

The use of psychotropic prescription medications to treat mental health disorders in very young children is stabilizing, according to a study published in the journal Pediatrics. Psychotropic medications that are commonly prescribed to treat ADHD, mood disorders and other mental health problems include both typical and atypical antipsychotics, antidepressants, antianxiety agents, stimulants and mood stabilizers. Few of these medications have been approved for use at preschool age by the US Food and Drug Administration (FDA)…

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Target Meeting's 3rd World Drug Discovery online conference, October 15-17, 2013: join for free��

A Free Virtual Drug Discovery Conference at Targetmeeting.com featuring 55+ live oral presentations from academic and industry experts around the world. The 13 sessions (55+ oral presentations), which will be spread over three days will discuss Biotechnology & biopharmaceuticals, General pharmaceutical research, Herbal drug, Drug delivery & targeting, Gene/cell therapy, Clinical trials, and many more. Attendees can earn the free Certificates of Attendance. Computer and internet connection are required. Do not need any special equipment or software…

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DigiPharm 2013 conference, October 8-10, London

Healthcare organisations that once focused on developing products or delivering services – often independently – must now come together to deliver improved health solutions and patient outcomes. Life sciences companies are chief among the health organisations expected to deliver this change. One of the key catalysts and tools to this change is the evolution of digital communication and engagement with patients and prescribers…

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Battle Over Health Law Brings Gov't To Brink Of Shutdown

A stopgap bill to fund the government when the fiscal year ends Oct. 1 continues to be caught up in Republican efforts to defund, delay or derail the health law. Federal agencies have contingency plans in place.

The New York Times: Senate Action On Health Law Moves To Brink Of Shutdown
The Senate is expected to reject decisively a House bill that would delay the full effect of President Obama’s health care law as a condition for keeping the government running past Monday, as Senator Harry Reid, the Democratic majority leader, expressed confidence that he had public opinion on his side. Angering Republicans who lead the House, Mr. Reid kept the Senate shuttered on Sunday, in a calculated move to stall action on the House measure until Monday afternoon, just hours before the government’s spending authority runs out at midnight (Peters and Weisman, 9/29).

The Wall Street Journal: Government Heads Toward Shutdown
The nation braced for a partial shutdown of the federal government, as time for Congress to pass a budget before a Monday midnight deadline grew perilously short and lawmakers gave no signs Sunday they were moving toward a resolution. … House Speaker John Boehner (R., Ohio) urged Senate leaders to pass legislation that the Republican-controlled House had approved early Sunday morning, which would fund the government through mid-December. But that prospect was remote, as the House legislation included a one-year delay of the new federal health law that Democrats have vowed to reject, as well as a repeal of the new law’s tax on medical devices (Hook and Peterson, 9/29).

The Associated Press: Who’ll Blink? Dems, GOP In Shutdown Stare Down
With the government teetering on the brink of partial shutdown, congressional Republicans vowed Sunday to keep using an otherwise routine federal funding bill to try to attack the president’s health care law. … Since the last government shutdown 17 years ago, temporary funding bills known as continuing resolutions have been noncontroversial, with neither party willing to chance a shutdown to achieve legislative goals it couldn’t otherwise win. But with health insurance exchanges set to open on Tuesday, tea-party Republicans are willing to take the risk in their drive to kill the health care law (Taylor, 9/29).

Politico: Obamacare Medical Device Tax Assumes Big Role In Spending Battle
Along with a one-year delay in the president’s health law, House Republicans have included provisions repealing the 2.3 percent tax on medical devices in their bill to fund federal agencies into the next fiscal year. And some have suggested the move to wipe out that tax might — at some point— become a path to compromise with the Senate. But Senate Democratic leaders have so far opposed the device tax as part of a short-term spending bill (Faler and Norman, 9/29).

The New York Times: Federal Agencies Lay Out Contingency Plans For Possible Shutdown
As Congress continued to spar on Saturday over a stopgap spending measure to keep the government running, federal agencies made contingency plans for a potential shutdown. … Although more than half of the Department of Health and Human Services would be furloughed, Medicare and Medicaid beneficiaries would continue to receive services. Retirees would continue to get checks from the Social Security Administration. The rollout of President Obama’s health care law, with the first insurance marketplaces to go online starting on Tuesday, would continue because most of the money for that program was provided by the Affordable Care Act and other laws (Schmidt, Shanker and Siddons, 9/28).

CQ HealthBeat: More Than Half Of HHS Employees Would Be Furloughed In Shutdown
If the federal government shuts down next week, the Department of Health and Human Services’ contingency plan calls for furloughing more than half of its 78,198 employees. Services such as the Centers for Disease Control and Prevention’s flu program and the majority of the Food and Drug Administration’s food safety activities would be suspended, according to a plan the agency posted on its website late Friday (Bunis, 9/27).

In other congressional action –

Reuters: U.S. House Passes Bill To Regulate Drug Compounding
The U.S. House of Representatives on Saturday passed legislation that would give the Food and Drug Administration more authority to regulate companies that compound sterile drugs and ship them across state lines. The bill, called the Drug Quality and Security Act, now goes to the Senate for a vote. House and Senate committees agreed on the legislation on Wednesday (9/28).

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