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Monthly Archives: November 2014

Top Democrat Says Party ‘Blew Opportunity’ With Health Care Focus

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Obama Order On Immigrants Could Extend Medicare Benefits

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Turning 21? Here’s How To Avoid A Big Hike In Health Insurance Premiums

For young people, turning 21 is generally a reason to celebrate reaching adulthood. If they’re insured through the federal health insurance marketplace that operates in about three dozen states, however, their birthday could mean a whopping಺ percent jump in their health insurance premium in񎧟, according to an analysis by researchers at the Center on Budget and Policy Priorities.

The reason: They’re no longer considered children under the age-rating rules insurers use to set premiums.

broken piggy bank 21Many 21-year-olds who qualify for premium subsidies will be able to sidestep the rate increase if they re-evaluate their coverage options on the federal marketplace before Feb. 15, when the annual open enrollment period ends. If they don’t, they’ll generally be automatically renewed into the same plan and with the same premium tax credit they had in 2014.

“If they don’t come back to the marketplace, they’re going to get a premium tax credit that’s based on their age rating as a child, and that premium difference is going to hit them,” says Judith Solomon, a vice president for health policy at the budget center.

Families with federal marketplace plans whose now 21-year-old children are covered as dependents will face a premium jump as well.

Under the health law, insurers can no longer base premiums on people’s health or pre-existing medical conditions. They’re permitted to apply just four premium rating factors in their calculations: age, where someone lives, how many people are going to be covered and whether someone uses tobacco. The law also prohibits premiums for older adults from being more than three times higher than those for younger adults.

More from this series

Because of age rating, premiums for most adults will rise slightly every year as they get older. But with children, it’s different. Insurers apply the same age-rating factor to all children when computing their premiums. When children turn 21, however, the insurer begins to compute their premiums based on an adult age-rating factor, which results in that 58 percent premium increase.

Young people who go back to the marketplace to shop for a 2015 plan can generally avoid any age-related premium increases. They likely qualify for premium tax credits that are available to people with incomes between 100 and 400 percent of the federal poverty level ($11,670 to $46,680 for an individual). If they return to the marketplace, their premium tax credit will be adjusted to cover the higher age-related premium for their 2015 coverage.

“We’ve been encouraging everyone to update their profiles on healthcare.gov so they can ensure that they have a tax credit that reflects what they should be getting,” says Jen Mishory, executive director at Young Invincibles, an advocacy group for young people.

Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.

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First Edition — November 26, 2014

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Administration Warns Employers: Don’t Dump Sick Workers From Plans

As employers try to minimize expenses under the health law, the Obama administration has warned them against paying high-cost workers to leave the company medical plan and buy coverage elsewhere.

Such a move would unlawfully discriminate against employees based on their health status, three federal agencies said in a bulletin issued this month.

exchange choice employersBrokers and consultants have been offering to save large employers money by shifting workers with expensive conditions such as hepatitis or hemophilia into insurance marketplace exchanges established by the health law, Kaiser Health News reported in May.

The Affordable Care Act requires exchange plans to accept all applicants at pre-established prices, regardless of existing illness.

Because most large employers are self-insured, moving even one high-cost worker out of the company plan could save a company hundreds of thousands of dollars a year. That’s far more than the $10,000 or so it might give an employee to pay for an exchange plan’s premiums.

“Rather than eliminating coverage for all employees, some employers … have considered paying high-cost claimants relatively large amounts if they will waive coverage under the employer’s plan,” Lockton Companies, a large brokerage, said in a recent memo to clients.

The trend concerns consumer advocates because it threatens to erode employer-based coverage and drive up costs and premiums in the marketplace plans, which would absorb the expense of the sick employees.  The burden would fall on consumers buying the plans and taxpayers subsidizing them.

This KHN story can be republished for free (details).

Administration officials approached independent lawyers about the practice in May, saying, “We don’t like this, but how can we address this?” said Christopher Condeluci, principal at CC Law & Policy, a legal firm. This month’s guidance, he said, “is the first time that they’ve come out explaining how and why the administration believes it violates the law.”

The Affordable Care Act itself doesn’t block companies from paying sick workers to find coverage elsewhere, lawyers said. But other laws do, including the Health Insurance Portability and Accountability Act and the Public Health Service Act, according to three federal agencies.

Specifically, paying a sick worker to leave the company plan violates those statutes’ restrictions on discriminating against employees based on medical status, the departments said in their bulletin.

“If you were to cherry-pick your high-cost individuals and offer them money to send them over to the exchange … this would be a violation of HIPAA,” according to the regulators, said Amy Gordon, a benefits lawyer with McDermott Will & Emery.

The agencies publishing the guidance were the departments of Labor, Treasury and Health and Human Services.

Starting next year, the health law requires large employers to provide medical insurance to most workers or face fines.

How many companies have offered to pay workers with chronic conditions to find coverage elsewhere is unclear.

“I know there are some brokers out there that were pushing this, but it was a limited number that I had heard about,” Condeluci said. Even so, he added, the attitude of the administration was: “We don’t want it to become widespread. Let’s nip it in the bud now.”

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Viewpoints: As More People Covered, Fewer Doctors?; ‘Shameful’ GOP Lawsuit

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State Highlights: Mich. Delays Dual-Eligible Program; Negotiations Stuck Between Big Ga. Hospital, Insurer

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Health Reporter Sets Up Crowdsourcing Site For Medical Care

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Peace Corps Inspector General Says Delayed Care Contributed To Volunteer’s Death

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Congress Weighs Efforts To Cut Generic Drug Costs

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