Insurers Will Propose Changes to Obamacare

Insurers Will Propose Changes to Obamacare
LM Otero/AP
By RICARDO ALONSO-ZALDIVAR

WASHINGTON -- Insurers want to change President Barack Obama's health care law to provide financial assistance for people buying bare-bones coverage. That would entice the healthy and the young, the industry says, holding down premiums.

So-called catastrophic plans are currently not eligible for the law's subsidies, and only 2 percent of the 8 million consumers who signed up this year picked one. Subsidies bring down the cost of monthly premiums.

The proposed change is part of a package of recommendations that America's Health Insurance Plans, the main industry trade group, plans to release Wednesday. Others address how to smooth transitions for consumers who switch insurance companies, as well as making it easier for patients to find out which hospitals and doctors are in particular plans and whether their medications are covered.

"What is crucial for public policy leaders is to balance access and affordability," said Karen Ignagni, head of the trade group. "Unless people feel that coverage is affordable, they won't participate in the system."

Adults ages 18-34, the health care law's most coveted demographic, are under-represented among those enrolled for subsidized private insurance this year. Insurers are currently filing their proposed premiums for 2015, and increases of 10 percent or more are anticipated. Nonetheless, the new state insurance exchanges are poised to grow, with more carriers entering the market to compete for business.

Given the polarized politics of health care in Washington it's unclear how the industry's latest proposal might advance. It might get a chance if Republicans in Congress abandon their crusade to repeal Obama's law and start focusing on making changes to individual components.

The proposal could also encounter opposition from consumer groups, which take a dim view of catastrophic plans. Some consumer organizations have instead called for reducing out-of-pocket costs borne by consumers who buy a midlevel silver plan, the pick of 65 percent of those signed up this year.

Catastrophic plans offer low monthly premiums but require consumers to foot a hefty share of their annual medical costs. They are designed to protect healthier people from financial ruin due to an accident or an unexpected diagnosis of serious illness. Catastrophic plans are only available to people under 30 in the new insurance exchanges.

The industry proposal would create a new catastrophic plan open to people of any age and eligible for tax credits provided by the law. It would have an annual limit on out-of-pocket costs and preventive care would be covered at no charge to the patient.

Other elements of the insurers' plan can be voluntarily adopted by the companies or codified by government regulation.

They include a 30-day transition period for certain patients who switch insurance companies or whose doctors no longer participate in the plan. During the transition, patients would be able to remain under the care of their current physician while paying lower in-network rates. Similar transition policies would apply to medically necessary prescriptions.

The health insurance industry has a complicated relationship with the health care law.

Insurers spent tens of millions of dollars to defeat the legislation as it was being debated in Congress and still seek to roll back taxes and Medicare cuts that affect the plans.

But the industry has also become one of the administration's main allies in carrying out the law, enduring the cascade of rollout problems last fall and working behind the scenes to make sure consumers whose old plans got canceled were able to maintain coverage. That's earned insurers public expressions of gratitude from top health care officials in the administration.


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teaparty2implode

Flashback: Republicans Block VA Benefits

Republicans in February blocked important legislation from Sen. Bernie Sanders to improve veterans' access to health care among other things. Only two Republicans, Sens. Dean Heller and Jerry Moran, voted for the veterans benefits bill, which was endorsed by every major veterans organization. Read more about the bill: http://www.sanders.senate.gov/veterans/

The TPGOP is on a mission to block all legislation that Obama and the Democrats try to put forth to congress. Yes, even funding for the VA.

June 12 2014 at 7:38 AM Report abuse +1 rate up rate down Reply
1 reply to teaparty2implode's comment
dopey.obamite

What were the other things?

June 12 2014 at 9:19 AM Report abuse -1 rate up rate down Reply
jrb359

And the winners in Obamacare are the insurers,and the obama administration! The Middle Class will again get hit the hardest because Democrats see us as cash cows.

June 12 2014 at 6:02 AM Report abuse -1 rate up rate down Reply
stevendy1

I see the insurance companies recommendations for improving the policies and ways to keep costs down,BUT, after all these years, I have yet to see any republican " improvements" to help the people...WHY NOT? too busy trying to vote it down???

June 12 2014 at 1:50 AM Report abuse rate up rate down Reply
analyst0042

To the same extent that the Democrats asked for Republican input in writing this bill the Republicans should offer the same amount of help to the Democrats in saving this rotten piece of legislation. You say the Dems passed and wrote this bill on their own well then the Repubs should match that assistance to save that bill.

June 11 2014 at 11:24 PM Report abuse rate up rate down Reply
mrck922

Getting rid of this abysmal program would be a good first move….

June 11 2014 at 9:22 PM Report abuse +3 rate up rate down Reply
johnny18350

I bet insurers would like that. not only do they enjoy having us delivered on a silver platter, but they want even more. I bet you that even if they get this they wont lower anything. So far they are charging more than ever and paying out less than ever. Nothing like being forced to buy insurance only to have to pay most of the bills yourself anyway.

June 11 2014 at 7:51 PM Report abuse +3 rate up rate down Reply
2 replies to johnny18350's comment
pfuzell

I am SOOOO glad to see that I'm not the only person who figured out early on that the law was a golden goose for the insurance industry. It disgusted me to see it being marketed as good for providing access to health care for more people. It certainly is NOT affordable. The premiums and deductibles before one actually benefits are outrageous, the same figures we were paying for my insurance many years ago that I dropped for the same reason. I've always seen most insurances as thinly disguised gambling. You are betting the triggering event will happen to get you a payout before you wager too much money. The insurance companies are wagering that you will never have a triggering event so they don't have to pay out. They get to keep all your premium money (bets) and pay it out in dividends to their shareholders. The House always wins people!

June 12 2014 at 12:04 AM Report abuse +4 rate up rate down Reply
dopey.obamite

You think knowing that families earning up to $94k/year will get taxpayer sunsidies has anything to do with it?

June 12 2014 at 9:22 AM Report abuse rate up rate down Reply
am0714

This is how this is supposed to work, input from both sides. If fox is allowed to continue to broadcast outright lies about the ACA, Americans will never understand what is for their own good. I just spoke with a friend of mine, an avid fox student, who tried to explain to me how he is losing his SS because he refuses to sign up for 'Obamacare'. It's NOT funny that he thinks that way, he has just been fed that information on a daily basis for a very long time. Let's stop the attacks and get together and this thing will work just fine. !

June 11 2014 at 7:47 PM Report abuse +4 rate up rate down Reply
socalflash

Maybe Insurers are pushing catastrophic plans because overall risk to them is lower due to the weak coverage, and if they are subsidized insurers will sell more of the lesser, but more profitable, plans. Bad for customers = good for insurers. Insurers would never recommend any changes that they did not profit from. imo

June 11 2014 at 7:37 PM Report abuse +4 rate up rate down Reply
mac2jr

The VA is the largest single payer medical system in the U.S.A., and possibly the world, and as such will have those that cheat the system, do not follow the rules, etc., and this 'Rule Breaking' can only be stopped at the LOCAL Levels...

Now, I and my relative and friends have been to Public, Private, and VA Medical facilities and by far the best service, the best care, was provided at the VA (New York, Pennsylvania, Maryland, Arizona)..

The VA doctors are knowledgeable, and are willing to spend the time with you to determine the 'true' causes of your ailments, which is totally UNLIKE the Private and Public medical communities that are 'Rush, rush, rush, time is money' oriented.

If Insurers really wanted to HELP, and to cut cost, each would require that the NON-VA hospitals and Doctors follow the methods of the VA personnel, which by the way also (in Philadelphia and other places) train many of the private would-be doctors and nurses.

June 11 2014 at 5:49 PM Report abuse +4 rate up rate down Reply
mac2jr

MyHealtheVet... heard of it?

This is an on-line medical site for Veterans so that he or she can enter his medical information and schedule appointments, and chat with his or her VA appointed doctors. In-hospital, the doctors at one VA facility can with the patient's permission look at the patient's records from any other VA medical facility. This is far better than most Public and Private hospitals that do NOT have interchangeable medical software and systems, thus leaving a person to 'chance' if he or she must go to a hospital which he or she has not previously attended.

June 11 2014 at 5:42 PM Report abuse +1 rate up rate down Reply