New Jersey passes 9 health insurance laws

Early this month New Jersey elected to resume the operation of its own health insurance exchange by taking back this role previously handled by the federal government. The state named contractors who will handle programming and customer service for the new state exchange.

Immediately following that announcement the legislature passed a group of related bills signed into law on January 16

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, 2020. The intent is to stabilize health insurance in New Jersey in the event that federal health insurance law is repealed or scaled back.This article summarizes the new laws.

No maximum benefits – prohibits insurance companies from imposing annual or lifetime spending limits on these. S562

Must include 10 essential health benefits: outpatient care (like visiting a doctor), emergency room services, hospitalization, maternity and newborn care, mental health and substance-addiction disorders, prescription drugs, rehabilitation services and devices, lab work, preventive care and chronic disease management, and pediatric services of all kinds. S562

Applicants with preexisting conditions must be offered covered at no extra charge. S626

Prohibits limited benefit or so-called mini-med insurance as “basic and essential” health benefits plans under individual health benefits plans and other statutes concerning basic health plans in all state markets.

Requires coverage for certain preventive services, like cancer screenings A5507 and expands access to birth control. A5508

The Department of Banking and Insurance may review rate increases of more than 10% for individual and small-business health-benefits plan under S3809

Requires an 85% loss-ratio requirement to large-group health insurance plans S3812 A5504

A child may remain on a parent’s health insurance until age 26. A5501

An adequate open enrollment period will be ensured under the Individual Health Coverage Program 5503

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Six states require health insurance in 2020

Six states now require residents to have health insurance coverage in 2020 or they may pay an increased state tax penalty. California, Massachusetts, New Jersey, Rhode Island, Vermont and Washington DC have laws similar to the Affordable Care Act health insurance requirement that expired last year. Other states are expected to follow this trend if the federal government does not set a national standard. (At Freedom Benefits we have long advocated that this should be a state-controlled and not federal legal issue).

Most types of insurance including Medicare, Medicaid and employer-sponsored coverage satisfy the coverage requirement. Many exceptions to the penalty are built into the law for people with lower income

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, where insurance is too expensive, or who otherwise cannot be covered by insurance.

If you live in one of these states and aren’t covered in 2020, the possible penalty is calculated when you file your 2020 tax return in 2021. The penalty is $695 for an adult and half that much for dependent children. Some people with higher incomes have to pay 2.5% of their income. Health insurance generally costs 5% to 10% of income so some people still prefer the less expensive option of paying the penalty.

Freedom Benefits works with individuals to find affordable coverage or find a way to avoid the penalty

, including filing the tax return with the proper notations to avoid the extra tax.

Wide range of state responses to new health insurance options

Freedom Benefits completes its state-by-state analysis of non-ACA low cost health plan options. Summary results are now online.

Beginning with the executive order he signed on the first day he took office

, president Trump and his administration have taken many actions to dramatically affected the health insurance and care options available to individual consumers.  The White House web site recently removed some of the press releases and links to many of the politically sensitive actions but nevertheless they remain a part of the legal and market structure. Endorsements of inexpensive alternative health plans rated by health and age of the applicant and short term health insurance remain promoted on Whitehouse.gov web site. Behind the scenes, health insurance companies rushed to create a wide range of new product offerings and get them approved for sale to the public. These plans offer choice but do not include the protections intended by the 2010 Affordable Care Act. That means that consumers may need more information and education about the range of new health plans on the market today. But that’s not the whole story.

Regulation of health plans rests primarily with state government, not federal government. Every state reacted differently to the federal government’s changes intended to loosen legal requirements and make health insurance options available to consumers. This means that it was important for firms like Freedom Benefits, that follows these legal changes for their impact on consumers, to expand our coverage  on current legal events in each state.

Each state has the ability to regulate or restrict health insurance plans issued within its boundaries. States do not have the authority to regulate or restrict health insurance issued in another state or nation that cover individuals who live in or visit their state. As a result, the medical insurance travel industry was born. People who do not qualify for coverage where the live can visit another state and purchase a short term medical insurance policy

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, for example, that covers them everywhere within the U.S., including their home state where the coverage cannot be purchased. It’s created an odd market scenario!

Freedom Benefits investigated the status of health insurance laws of each of the 50 states and the District of Columbia. The summarized results are included as a news item on “Status of alternative non-ACA health plans” available by clicking on the state page icons on the right sidebar of this page. We do not endorse any product or strategy but support every individual’s right to have access to information and the widest possible range of health insurance and treatment options.

 

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Health care turmoil triggers more consumer use at Freedom Benefits

The past week was a crazy period for U.S. health insurance. Consumers are understandably confused. The turmoil resulted in a higher level of user activity for Freedom Benefits, a web-based service that directs online consumers to various health insurance exchanges.

Within a period of just one week – Monday April 25 to Monday April 1 – we saw the executive branch of the federal government make a surprise announcement that it will not support the popular features of the Affordable Care Act in federal court, then the Trump administration’s new alternate small business health plan was defeated in federal court, then the President denounced Obamacare and promoted his party’s health plan that does not exist, then the White House announced that it will not make any more health care push until after the 2020 election. Whew!

The commotion triggered a higher than usual amount of consumer web traffic, calls and emails to the OnlineNavigator service supported by Freedom Benefits. Our focus is to direct consumers and small businesses on the options as they exist under the law now, and deliberately staying away from the confusing news headlines that cause speculation about what options may or may not exist in the future.

Freedom Benefits’ simple strategy of focusing on facts, not opinion, is apparently paying off in this tumultuous and otherwise divisive environment. The number of enrollments in currently available health plan options effective April 1 appears to be at the highest level since the implementation of the Affordable Care Act that began in 2010.

Freedom Benefits was founded by Philadelphia accountant Tony Novak to provide health insurance support to regional construction workers. It grew to a national service by 1999 when Novak joined the Board of the National Association of the Remodeling Industry. Novak believed that by being insurance-licensed and up-to-date on health insurance legal and market issues in all 50 states and DC, consumers would use an online adviser that eventually became the trademarked OnlineNavigator service. Novak was then asked to testify before Congress on Republican Party ideas to modernize healthcare for small businesses under the Bush administration. Most of Freedom Benefits’ business assets were sold to a public company prior to passage of the Affordable Care Act (ACA). After enactment of the ACA, Yahoo Finance and the Better Business Bureau were critical of our fee-based business model  and so Freedom Benefits has been mostly dormant since then. Freedom Benefits is not an insurance company, producer, exchange or agency. It has no direct revenue and web site operating expenses are paid by another related business. It is still not clear that a business model that does not collect leads or make sales can be successful. Freedom Benefits’ sole function has been to make referrals – both paid and unpaid – based on specific consumer circumstances. Occasionally that advice is combined with basic related personal or business financial planning.

The recent surge in consumer activity triggered discussions about reviving the Freedom Benefits brand and updating the services offered. Last week a Philadelphia area employee benefits and health insurance business wrote that they now perceive Freedom Benefits as a competitor. That strategic business planning is ongoing and no decisions are finalized.

 

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Anti-vaxers listed as worst health risks

For the first time ever, the World Health Organization listed “vaccine hesitancy” on its 2019 list of 10 worst global health risks. That list was published in January. Since then

, we have epidemic outbreaks in New York and New Jersey, with Pennsylvania not far behind. The problem is getting worse.

In my early adulthood I supported Rotary International’s efforts to get vaccinations distributed to third world countries. I never imagined that there would be a problem with these old diseases right here at home where vaccines are available and covered by health insurance plans.

Social media outlets that allowed anti-vax propaganda are now being shut down. Crowdfunding platforms like Go Fund Me now disallow these campaigns. Research into the motivations of anti-vax social media posters is underway. Meanwhile

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, companies like Facebook realize they may be held legally accountable for the deadly impact of false information spread on their platform.

New research on anti-vax propaganda exploring the motivations of those who post propagande was published two days ago. Most anti-vax propaganda appears to be attributable to ‘social media ignorance mindset’; a situation with which we are all too familiar. However, even with this limited data, we cannot dismiss the possibility that not all propagandists are driven by ignorance or exercise of free speech rights. There might be more sinister motivations.

Some, maybe most, scientists believe that the planet is overpopulated with humans Past the point of  sustainability. If so, some mechanism of depopulation is in our future. It seems logical to conclude that bad actors taking advantage of health propaganda would have an open path toward this end.

Child vaccinations are covered by health plans for good reason. Unfortunately, parental ignorance or the requirement to do the right thing is not covered. Freedom Benefits has long supported the rights of individuals to make their own health decisions including the right to make bad decisions. However, our support does not extend to the right to transfer the pain, cost or suffering of your poor decision to another person.

Pharmacy industry’s powerful political base with seniors

Much of the media attention critical of the pharmacy industry focuses on the lobbying actions directly with lawmakers and administrative officials. But there is another potentially more powerful force available to the industry.

Seniors are overwhelmingly satisfied with their prescription drug plans. The pharmacy industry has taken action to make it clear that senior voters would be likely to vote out of office an elected official who damages those prescription drug benefits.

The latest demonstration of this power base is the focus of a polling report by the Pharmaceutical Care Management Association released on Mar 18

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, 2019. The leading point of the press release accompanying the poll result said “Senior registered voters enrolled in Medicare Part D will be less likely to support the reelection of their members of Congress and presidential candidates if those elected officials back proposals eliminating prescription drug negotiations and price concessions that would result in Part D premium increases

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, according to a new poll from North Star Opinion Research”. Point taken.

The pharmacy industry wants us all to know: the political power of the status quo cannot be ignored.

American Health Shield alternatives

A representative from the former administrator of American Health Shield Dental Insurance and American Health Shield Short Term Medical Insurance wrote to me by email today with a reminder that these products are no longer available but that their company information is still associated with previously published materials that explain and market the products. In an effort to prevent consumer confusion

, I removed the outdated pages.

But what does that mean to consumers who look for the products? There are alternatives in most states. It makes sense to do a search for available products listed where you live through the online insurance exchanges and request a call if you want to discuss the options with an agent. We can help connect you with a licensed agent in your area.

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Change of tune: Trump administration seeks to reaffirm Obamacare

In a surprise move Friday, December 21, lawyers for the Trump administration filed a brief asking clomid kaufen apotheke

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, serif; font-size: 18px; font-style: normal; font-variant-caps: normal; font-weight: normal; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-tap-highlight-color: rgba(26, 26, 26, 0.301961); -webkit-text-size-adjust: 100%; -webkit-text-stroke-width: 0px; text-decoration: none; display: inline !important; float: none;”>U.S. District Judge Reed O’Connor, federal judge in Texas who declared Obamacare unconstitutional, to downplay the impact of the case. The Trump administration wants to reassure the public his decision was not effective immediately and he did not intend “substantial disruption to the healthcare markets” after the presidents’s misleading public comment made about the December 14 court ruling. The president wrote “As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster!”. Late the White House Communications Office issued a corrective statement “the law remains in place” and was not, in reality, “struck down”.

U.S. Justice Department originally backed the court case to declare Obamacare unconstitutional but now realizes that they have no other plan to fund healthcare. The Trump officials want to assure the public that Obamacare is still the ‘law of the land’ despite the president’s statements that “Obamacare Is dead” that are meant for political purposes and are not meant to confuse people or to lie to the public about the availability of legally available health coverage under Obamacare. At least one public official believes that Trump can be held legally liable for his lies that could cost people to forfeit government-provided health insurance.

The issue is expected to be resolved in the when the Democrat-led Congress regains power and resumes a “healthcare for all” agenda. Neither the Judge’s ruling nor the U.S. Justice Department have any effect on the private commercial health plans listed at Freedom Benefits that are exempt from most Obamacare laws.

Low cost health insurance expands

President Trump signing
President Trump authorized new health plan options

The market for lower cost affordable health insurance is expected to grow with at least to more companies making public securities market offerings for expansion. Bright Health and Oscar Health both completed successful public offerings this year.  These health plans offer lower beenfits at a lower cost in states that allow these alternatives. President Trump pushed for approval of these plans that were previously prohibited by Obamacare. Not all plans are available in all states.

Freedom Benefits has served as a leading adviser in this field since 1995. We support freedom of choice for well-informed consumers and we will continue to monitor, review and recommend these alternative health plans as they develop. Personal support is available online or by telephone.

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Uninsured: what does it mean to health care access?

The number and percentage of uninsured children rose in 2017 after a decade of improvement.  One in five uninsured children live in Texas, according to recent research. The number of uninsured people in the US overall is rising but the percentage of uninsured remained at 8.8% overall.

What does this actually mean as a matter of public health policy? Are those without health insurance actually being denied access to healthcare? Or is the quality or quantity of care affected? There is much written on this topic but the answers are not easy to discern. Maryland health officer Russell Roy writes: “Uninsured people receive less medical care and less timely care

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, they have worse health outcomes, and lack of insurance is a fiscal burden for them and their families”.

At Freedom Benefits our anecdotal observation is that once a person has access to the healthcare system they have a much better chance of receiving high quality ongoing care

, with or without ongoing insurance. Some people, even with health insurance, never gain access to the healthcare system. This appears to be because some people do not have the cash for office visits or required co-copayments. For this reason we focus on coverage that provides easy and affordable up-front access to the healthcare system. Benefits in the affordable health insurance plans are limited but at least the patient is ‘in the door’ of the healthcare system. Once inside the healthcare system, professionals tend to have more resources to provide for continued patient care.

Having health insurance is important but it is more important to have easy access to the healthcare system regardless of insurance.