Bradenton Florida Health Insurance

Bradenton Florida Health Insurance News

Do you think Universal Health Care is a good investment for the young children of Bradenton, Florida? It seems to be the hot debate for all of the Presidential candidates this year, 2008. With nearly 9 million children uninsured in Florida, it seems time to come up with a solution. Will a Democratic President bring a Universal Health Care program that will flourish in our modern times? Will the system stay broken if a Republican is re elected?


Will investing in affordable health care coverage for our nation's low-income children saves taxpayer dollars in the long run? Is it the right thing do to.... Nothing is more important than the health of our children. Yet many of the estimated 47 million Americans who go without health insurance every day are children. These kids will either forego health care, which could lead to costly chronic conditions, or land in the emergency room at taxpayer expense.
In 1997, Congress approved by an overwhelming and bipartisan margin the creation of the children's health insurance program to extend health care to 6 million kids across the country. The results have been a resounding success. Since its creation, the program has reduced the number of uninsured kids in America by one-third. Nearly all of those children live in families with income levels not much higher than the federal poverty level, or about $41,000 for a family of four.
Currently 6.6 million low-income kids nationally are enrolled in the health care program. Under the program, money is sent to the states to administer the benefit. The federal match makes up approximately 70 cents of every dollar the State of Florida spends on "KidCare" to provide health insurance to some of Florida's low-income children.
Without this state and federal partnership, the children of Florida would depend on our emergency rooms and other high-cost medical coverage, which in many cases is unpaid and further burdens all taxpayers. Also, with the program providing coverage, many serious illnesses can be prevented and lives can be saved. That's why the Children's Health program is such a worthwhile investment. It gives kids from low-income families access to the care and medicine they need to live healthy lives.
"KidCare" is currently providing coverage for approximately 226,000 children in Florida who are at or below the 200 percent federal poverty level. Unfortunately, this is less than half the children who are eligible for the program. Efforts are ongoing in the Florida Legislature to streamline the process, make it more efficient, and remove barriers to enrollment so that we can provide coverage for the most children possible. But we need continued federal support to increase enrollment and provide a safety net for our children.
Recently, Congress voted to expand the program to provide coverage for up to 10 million kids nationwide. The bill was approved with bipartisan support in the House and Senate. It would reauthorize the program for five years and provide states with sufficient funding to cover an additional 4 million kids. Florida would receive $51 million more in 2008 to cover low-income children, according to the House Energy and Commerce Committee.
Like most legislation that emerges from Congress, this bill is not perfect. But it represents significant progress as we search for ways to reduce the ranks of the uninsured and protect our children.
In addition to covering more kids, this bill shores up dental and mental health benefits. This is particularly important given that tooth decay is the most common chronic disease of childhood, while 1 in 10 kids suffer from serious mental health problems.
The bill is endorsed by a wide range of groups, including the American Medical Association, AARP and the YMCA.
Millions of kids across the country have been given a healthy start in life thanks to this important program. We can't turn our backs on them now. Our kids are worth it.
Congressman Vern Buchanan, R-Sarasota, helped pass House legislation to renew and expand the Children's Health Insurance Program. State Rep. Bill Galvano, R-Bradenton, is chairman of the Healthy Families Committee in the Florida House and the sponsor of the KidCare reform legislation of the 2007 regular session.

Will Florida Children Suffer?

U.S. Senate passes legistlation for childrens health care................

Democratic Debate On Health Care Reform

John Edwards, Hillary Clinton......

Senator Pat Roberts Against Bush Veto On Health Care

Tampa Florida Health Care

The Senate has passed the bill to increase funding for state SCHIP programs. Over 10 million more children will now have health coverage. Will Bush Veto this bill? Senator Pat Roberts think a Veto of this bill will do no good. What do you think?

New York Times) Senate Passes Children’s Health Plan: The Senate gave final approval on Thursday to a health insurance bill for 10 million children, clearing the measure for President Bush, who said he would veto it. The 67-29 vote followed a series of speeches by Republican senators supporting the bill and urging Mr. Bush to reconsider his veto threat. Senator Pat Roberts of Kansas, one of 18 Republicans who voted for the bill, said the White House had shown “little if any willingness to come to the negotiating table.”
(Reuters) Congress sends kids health care to Bush: But Bush's threat to veto the children's health care bill has angered some of his own Republicans. Sen. Pat Roberts of Kansas said Bush should "rethink" his veto threat and sign the bill. "This bill and this debate has turned into a political showdown," Roberts said during the Senate debate. "Unfortunately, low-income children will be the ones who will ultimately pay the price."
(LA Times) Allies push Bush to pass children's insurance: On the Senate floor, some of the sharpest challenges to Bush's position came from Republicans. The bill's GOP supporters said the administration was misinformed -- and even misleading the public -- when it argued that the bill's provisions for extending aid upward to families far from the poverty line would put the nation on a slippery slope toward socialized medicine. "The administration is threatening to veto this bill because of 'excessive spending' and their belief that this bill is a step toward federalization of healthcare," said Sen.Pat Roberts (R-Kan.), a supporter of the plan. "I am not for excessive spending and strongly oppose the federalization of healthcare. And if the administration's concerns with this bill were accurate, I would support a veto. But, bluntly put, they are not."

Florida Health Insurance * Republicans View On Health Insurance

Florida has millions of individuals going without health insurance, due to the high cost.. Democracts feel their must be a Universal Health Care Plan, while Republicans think Health Care is just perfect the way it is. What can we as Americans do to fix the broken Health Care system? How many jobs does the Health Care Industry bring to our economy?

Jacksonville, Florida

September 27, 2007 -- Florida Health Insurance Web, in its continuing series, examines the 2008 presidential race and its impact on the State of Florida and how the election may effect Florida Health Insurance benefits and available rates. Morgan Moran in a phone interview said the "sadly the Republican candidates offer little to help Florida's uninsured." Insurance consultant Moran said, If you're one of the tens of million Americans without coverage, or if you don't like the coverage you have, "next November you will have a chance to pick the person who will deliver the best health care plan." So far, "the Democrats seem to be winning the health insurance debate.



We don't need universal health care mandated by federal edict or funded through ever-higher taxes.
Last night Democratic Senator Hillary Clinton spoke about her health care plan which, according to Moran, "gives the choice of health insurance plans to pick from and, Clinton said her insurance coverage plans will be affordable." Clinton also said, if you like the health insurance plan you currently have, you can keep it, or switch to a less expensive plan.

On the other side of the isle, Republicans are pointing to terror and border security rather than addressing Americas health care crisis.

Republican Senator John McCain's website John McCain under 'the issues', fails to mention healthcare, Moran said, instead of giving America a health plan; "McCain is focusing on 'fighting Islamic Extremists, Government Spending, Border Security, and Iraq." To be fair, McCain is not the only Republican ignoring healthcare. Former Mayor Rudy Giuliani has posted nothing about health insurance in his bid for the White House. His Join Rudy web site says, the issues for the upcoming election are: Fiscal Discipline, Cutting Taxes, Winning the War on Terror, Iraq, Public Safety, Judges, Education, The Right to Bear Arms and Marriage.

Governor Mitt Romney, on his 'True Strength for America's Future' website Mitt Romney has his list of campaign issues as: Defeating the Jihadists, Competing with Asia, Taxes, Immigration, Energy, Education and yes, finally, Healthcare. In USA Today, July 5, 2005 Romney said, "We can't have 40 million people saying, 'I don't have insurance', and if I get sick, I want someone else to pay." Individuals have responsibility for their own health care. Romney went on to say "The health of our nation can be improved by extending health insurance to all Americans, not through a government program or new taxes, but through market reforms."

Arkansas Governor Mike Huckabee's campaign said, "The health care system in this country is irrevocably broken, in part because it is only a 'health care' system, not a 'health' system." Huckabee said, "We don't need universal health care mandated by federal edict or funded through ever-higher taxes." We can make health care more affordable by reforming medical liability; adopting electronic record keeping; making health insurance more portable from one job to another; expanding health savings accounts to everyone, not just those with high deductibles; and making health insurance tax deductible for individuals and families as it now is for businesses, the Gov said.

Senator Sam Brownback on his web site said the "healthcare system will thrive with increased consumer choice, consumer control and real competition." Brownback went on to say "I will continue to work at the forefront to create a consumer-centered, not government-centered, healthcare model that offer both affordable coverage choices and put the consumer in the driver's seat."

Congressmen Tom Tancredo stand on health care focuses on the uninsured. Tancredo said, "The two major problems are the high cost of care and the number of uninsured." Tort reform and immigration enforcement would save the system billions and drive down costs. As for the uninsured: as many as 25% of them are illegal aliens and should be deported or encouraged to leave. For citizens and legal residents who are employed by businesses which cannot afford coverage, "Tancredo favors association health plans which band small businesses together to access lower cost insurance." For those out of work, state governments should be the primary source of relief, although I would not rule out federal incentives or limited subsidies to make sure families who have fallen on hard times are not without coverage.

About Florida Health Insurance Web
Florida Health Insurance Web is a Florida health insurance consulting service. Find out about health insurance from the experts in a free online or phone consultation. You can get insurance quotes, search rates online by city, read current insurance news and events. Florida Health Insurance Consultants, best rates and free quotes, please contact Morgan Moran @ Florida health insurance web.

Health Insurance Costs Are High

Are you thinking about starting a new career? If so be sure that you know that health benefits are included. Have you ever thought of starting your own company? Think again, the average costs for family healthcare in the United States is $12,000 per year. Can you afford that? Are your health insurance costs to high?

For Americans not eligible for Medicare, the prospect of getting health insurance can be daunting. It requires navigating a hodgepodge of federal and state laws. Ignoring health insurance can be catastrophic if you wind up in the hospital without coverage.

So what are the options for the self-employed?

"The key is to plan ahead," says David Guilmette, managing director of Towers Perrin's Health and Welfare practice.

The health of you and your dependents, where you live, who you know and what you can afford to pay are among the factors you need to consider when weighing your options, he says.

"Nine times out of 10, if you can get access to employer-sponsored group coverage, take the employer-sponsored policy," says Karen Politz, a research professor at the Georgetown University Health Policy Institute. "Dollar-for-dollar, you get a lot more protection."

Under federal law, you can't be denied coverage on medical grounds in an employer-sponsored health plan. By contrast, in the majority of states, insurers offering individual policies can permanently exclude pre-existing conditions, such as high cholesterol, or deny you coverage for chronic illnesses, such as diabetes. The states where you can't be denied coverage are New York, New Jersey, Massachusetts, Maine and Vermont.

Employer-sponsored group policies are also likely to provide certain benefits, such as maternity care, that individual plans typically don't. A normal pregnancy and delivery can cost $8,000 to $12,000.

If your spouse has access to health-care benefits through his or her employer, getting coverage under that plan is the most cost-effective strategy, according to Ms. Politz.

According to a recent survey by the Kaiser Family Foundation and the Health Research and Educational Trust, an employee's average monthly contribution in an employer-sponsored health plan for family coverage is about $273 and $58 for an individual.

In addition, a growing number of employers are extending health-care benefits to domestic partners. About 47% of the 60% of employers who offer health benefits to employees offer them to opposite-sex domestic partners; 37% to same-sex domestic partners.

Be mindful of deadlines. If you quit your job, your spouse generally has 30 days to notify his or her employer that you want to enroll. Also, employers may limit when domestic partners can sign up, and there can be tax implications, so it's important to check, experts say.

If the first option isn't available, and you currently receive health-care benefits through your employer, you can extend that coverage after you quit. Under the federal Consolidated Omnibus Budget Reconciliation Act, or Cobra, you can purchase coverage for as long as 18 months after you leave or lose your job, providing that you weren't fired for misconduct. For the law to apply, the company must have 20 or more employees.

According to Tom Billet, a senior consultant with Watson Wyatt Worldwide, the main advantage of Cobra is that you will continue to receive the same health benefits as you did under your employer's plan. If you're receiving treatment and it was covered under the plan, this is important. If you join another group plan, temporary exclusions for pre-existing conditions can be imposed.

However, Cobra is much more expensive than job-based coverage because you have to pay the entire premium. Based on figures in the Kaiser Family Foundation study, that would equate to $1,009 a month for family coverage and $373 a month for an individual. You also pay a 2% administration fee.

"Most people have no idea how much health insurance costs," says Vince Ashton, executive director of HealthPass, a nonprofit agency created by the New York Business Group on Health, the City of New York and the health-insurance industry to improve access to coverage for businesses with two to 50 employees.

Typically, your employer has 30 days to notify you of your Cobra rights, and you have a further 60 days to make your decision. Premiums vary greatly from employer to employer, so find how much your plan costs.

About 40% of employers don't offer benefits. If you don't have access to an employer-sponsored plan, you may be able to get coverage through professional associations, trade or affinity groups. However, such coverage isn't as common as it used to be, and associations can deny coverage on health grounds.

Organizations in which health insurance is an incidental benefit rather than its reason for being, and which have strict entry requirements such as requiring a certified public accountant designation, tend to offer the better plans, according to Michael Crifasi, a certified financial planner with CEI Financial Planning, Inc, in Atlanta, who is also an independent insurance agent. It's important to find a well-established plan with a history of reasonable annual renewal rate increases, he adds.

Experts also advise calling your state insurance department to find out if the insurer that underwrites the association's plan is licensed in the state where you live and if your state insurance regulator is authorized to intervene if you have any problems with coverage.

In about a dozen states, a self-employed person can buy health insurance in the small group market. For instance, in Connecticut and Delaware, you are considered a small business even if you are a sole proprietor with no employees. While you can't be denied coverage, many states apply rating bands based on health or adjusted for your age. The exception is Vermont, which requires insurers to charge everyone the same premiums. Most states do set limits on how much insurers can charge. Hawaii doesn't impose any restrictions, so premiums there can be very high. Be aware that some states, like Florida and New Hampshire, have limited annual enrollment windows. See http://www.statehealthfacts.org for information about your state.

If you are healthy, purchasing an individual policy, such as a high-deductible health plan, and opening a tax-free health savings account, or HSA, could be the best option. A Humana PPO policy in Florida with a $5,200 deductible will cost a healthy 54-year-old woman $168 a month. In 2007, she could put as much as $2,850 in a HSA.

"Savings not needed to pay for the deductible and other out-of-pocket medical expenses can accumulate in HSAs for years," especially if you are young and open an account, says Carolyn McClanahan, founder of Life Planning Partners, a financial-planning company in Jacksonville, Fla.

Start your research a year before you plan to leave your job and enlist the help of an independent insurance agent. See your state insurance department's Web site for listings.

RELATED ARTICLES AND BLOGS

Affordable Florida Health Insurance
Florida Health Insurance Web

Congress Vs. Bush on Child Health Care

Orlando, Florida Health Insurance
Congress Tackles Child Health Care
By Carl Hulse

The war in Iraq will take a backseat to domestic issues in Congress this week.
While the Senate wraps up its Pentagon policy debate, much of the focus will be on a children’s health insurance bill that has split Congressional Democrats and the Bush administration. The House intends to approve an expansion of the program as early as Tuesday, with the Senate hoping to vote by the end of the week as well.
President Bush has threatened to veto the legislation, which he and some conservatives in the House and Senate contend is a step toward national health insurance. They also say the program, known as the State Children’s Health Insurance Program, was meant to provide care for the working poor while the program pushed by Democrats would extend too far into the middle class.
Michael Leavitt, the secretary of Health and Human Services, stuck to that line Sunday on CNN’s “Late Edition.”
“We need to focus it on low-income children and not use this as an opportunity to move millions of more people on to government-run health insurance,” said Mr. Leavitt. “Everyone needs health insurance. But we’ve got to get down to the business of looking at the big picture, where everyone has insurance, not just children.”

But Democrats like their position on this issue. They believe that the public supports making health insurance more affordable and that many families with middle-class incomes are struggling to provide coverage and care for their children. Some Republicans in both the House and Senate are expected to support the plan.
In addition, Democrats intend to emphasize the Bush administration’s pending request for an additional $50 billion for the war in Iraq while resisting $35 billion more for children’s health over the next five years, with the money generated by a boost in tobacco taxes.
“For this president who helped rack up three trillion dollars in new debt, it is not about the spending, it is about priorities and the president has made his clear,” Representative Rahm Emanuel of Illinois, chairman of the House Democratic Caucus, said Sunday in a statement.
With the health care fight looming, Congress is putting off a wider clash with the president over spending. The federal fiscal year ends Sunday and Congress has yet to send any of a dozen spending bills to the White House. Congress is expected to pass a measure that would keep agency spending at current levels to avoid any shutdown of government services. Congress is also expected to approve an increase in the federal debt limit to prevent a default.

Jacksonville, Florida health insurance * Letters from our readers

Jacksonville, Florida health insurance examination continues

Letters from readers......

Every candidate of this years presidential election seems to be offering a program for Universal Health Care. Why does that seem to be the main topic of this years campaign?

The latest report from the Census Bureau said that 16 percent of Americans do not have health care coverage, which means that 84 percent do.

But, the report also stated that the 45 percent of "Americans" who do not have coverage are "noncitizens," i.e., not Americans.

So, actually, about 91 percent of Americans have health care coverage. Of the remaining 9 percent, the report stated that most are young people who choose not to have coverage. Where's the crisis?

Our politicians should be focusing on a plan that will cover the small number of uninsured Americans who want coverage but can't afford it. They should not try to create a new government-run program that we will all be forced to participate in at tremendous expense.

SCOTT SANBORN

Orange Park, Florida health insurance

HEALTH INSURANCE

Program can cover children

If the federal State Children's Health Insurance Program is allowed to end, 250,000 children in Florida are at risk of losing health insurance on Sept. 30.

With bipartisan support, a House-Senate compromise has been reached that will extend the program for the next five years, and expand coverage to 3.3 million more children than are currently insured.

However, the president has stated he will veto any legislation that calls for expanded coverage for America's children.

Since 1997, SCHIP has successfully provided health insurance to millions of U.S. children. Today, nearly 7 million American children are insured through the program.

Even with passage of the Senate-House compromise, 4 million American children will remain uninsured.

With respect to Florida's SCHIP program, we have the worst record in the country for insuring our children; 550,000 of our children are uninsured.

Legislative and administrative barriers to eligibility and enrollment have resulted in a 50 percent decrease in the number of our children receiving health insurance.

We have sent hundreds of millions of our dollars back to Washington - money that has been used to insure children in other states.

If the Bush administration's plan is enacted, it will have a compounding impact on our children, as federal funding would be capped at the amount we are currently spending.

Please contact your federal legislators immediately to let them know if you support expanding health insurance coverage to 3 million to 6 million more of our children or the Bush administration's plan to cap current coverage.

Also, please contact our state delegation, the Senate president and House speaker to let them know if you are satisfied with the current status of Florida's uninsured children. The president's plan will decrease these numbers even further.

JEFF GOLDHAGEN,

pediatrician,

Jacksonville

JEA

Don't approve bonuses

I have said many times that JEA needs to look at costs before raising rates.

JEA is spending over $6 million on advertising to inform us about how to conserve energy. Due to the cost, the majority of JEA customers conserve energy and water already.

Now we are being told that JEA is prepared to give out bonuses in the amount of $8 million to JEA employees for doing their job. Some of these bonuses will be paid to the same executives who cannot seem to contain costs.

An executive for JEA stated that the bonuses are one-half of the $16 million that JEA saved. Well, simple math tells you that $16 million plus $8 million is $24 million in savings.

In addition, JEA wants to add a 3 percent franchise fee to help the city. How much of that $8 million would go toward helping the city?

The bottom line is, the JEA board should not consider paying any bonuses when rate increases and fees are being added to JEA customers' utility bills. I hope the JEA board has the sense to not approve the bonus payouts and save the $8 million.

ANDY RUSNAK

Jacksonville

TRUANCY

All students need ID

Why is my child, who attends a public school, required to carry a photo ID but home-schooled students do not?

I am a security professional. It just seems to make all jobs harder, because if children or teenagers are in a business during school hours, they claim they are home-schooled and it is hard to disprove.

I am not picking on the home-school program. I am trying to protect it from truant students who attempt to abuse it.

I think photo identification from the School Board, with emergency contact information, would greatly eliminate wasted time by truant officers and businesses trying to stop truancy by having to verify a student's status.

If the School Board wants to help curb truancy, then please help those trying to stop truancy by allowing them to easily identify home-schooled students. Stop those truant students who try to abuse the program.

SHEILA DOYLE

Jacksonville

Florida Health Care * Bush Will Vetoe

Miami, Florida


President Bush calls the democrats "irresponsible" in trying to improve health care for the many children of this country that go uninsured. He promises to veteo this new legistlation in an attempt to use his power....(Read More)

Clintons Health Insurance Proposal

Will insurance rates soon be affordable? Check out this article and let me know what you think on Hillary Clintons new health plan proposal. Is it far fetched? We want to know.

Clinton's Florida Health Insurance Proposal

Florida Health Insurance * Regulators Look To Reform

Jacksonville, Florida

The Health Insurance Advisory Board of Florida has considered a list of legistlative recommendations that adress many aspects of health care reform.

The board, which is chaired by Florida Insurance Commissioner Kevin McCarty, will consider the list during a public hearing Sept. 17 at noon at the Senate Office Building in Tallahassee.


Also during the hearing, the board will hear a presentation on expenditures of low-income pool dollars and other sources of funding for the care of uninsured persons, and will review a draft of a report on Florida's commercial health insurance market.

The Agency for Healthcare Administration will present an update on its efforts to improve the transparency of health care systems. The Heritage Foundation, a think tank that promotes conservative public policies, will make a presentation on its proposals for health care reform.

Floida Health Insurance * Hillary Clinton Promotes Health-Care

Miami, Florida

Florida Health Insurance Web reports Democratic contenders continue their appeals to everyday voters, as Senator Hillary Rodham Clinton of New York promotes her health-care ideas on the morning chat shows and through a Webcast tonight. And this seems like econ week for Senator Barack Obama of Illinois, who plans to outline a set of tax cuts for the middle class during a speech here in Washington this afternoon.
According to a release from his campaign, the proposal would provide $80 billion to $85 billion in tax cuts to workers, older people and homeowners. The full plan is posted on his Web site. At Nasdaq in New York yesterday, he criticized Wall Street executives for not doing enough to protect middle-class interests.
Meanwhile, Senator Clinton will not only hold a Webcast tonight to take questions about her health care plan, she is also is putting up a new television ad in Iowa and New Hampshire. It’s warm and fuzzy: she holds babies and talks about fighting for children’s insurance programs.

Patrick Healy and Robin Toner of The New York Times examine her health insurance proposal in detail, against the backdrop of her previous efforts to push a far broader plan during her husband’s administration. They include some new survey results:

A CBS News poll released Monday night suggests that Mrs. Clinton has already turned the health care issue from a liability to an asset, at least among Democratic primary voters: 61 percent said they had confidence in her ability to make the right decisions on health care, compared with 42 percent who felt that way about Mr. Obama, and 39 percent about Mr. Edwards. The survey also found that few voters held her responsible for the failure to pass universal health insurance during her husband’s presidency.

While mentioning estimates that her plan could cost $110 billion a year, The Wall Street Journal looks at how Mrs. Clinton is trying to turn old enemies in the business world into allies by offering tax breaks as part of the proposal.
On the other hand, The Los Angeles Times takes stock of the ways her proposal underscores how she has become the main target for Republican candidates. Rudolph Giuliani and Mitt Romney both weighed in with criticism of her plan yesterday. Interestingly, The Boston Globe finds similarities between her plan and a Romney-backed state law to insure Massachusetts residents.

Health insurance in Florida is on Romney's agenda today for another “Ask Mitt Anything” town hall meeting, this one in Orange Park. Fred Thompson also campaigns in Florida today.

And Mr. Giuliani heads to London for meetings and fundraisers. As The Washington Post notes, several of the candidates or their spouses are wooing expatriot American voters overseas.

Florida Health Insurance Blog

Find more information on Florida health insurance here....Florida Health Insurance Web news Blog. Post comments on current situation with the crisis we know as HEALTH INSURANCE!

Florida Health Insurance Debate

Senate Debate Over Health Insurance
July -- Jacksonville, Florida Health Insurance

Republican's Fight Bill
The health insurance debate continues in Washington. The House Democrats are trying to pass a measure that will raise taxes on tobacco - and some minor cuts to Medicare insurers to pay for the proposed $50 billion expansion of a children's health insurance program.

The new health insurance proposal could eliminate or lower the reimbursement rate for doctors who treat Medicare patients. The 10 percent cut is scheduled to take effect Jan. 1 would give doctors a 0.5 percent increase in their reimbursement rates each of the next two years when they treat Medicare patients.

Democrats point to tobacco as another way to pay for the expansion of the State Children's Health Insurance Program. Health Insurance Consultant, Morgan Moran of Florida Health Insurance Web said, leaders want to pay for the plan with a 45 cent increase (excise tax) on every pack of cigarettes sold. They would also lower payments to many insurance plans participating in the Medicare Advantage program over the next four years.

the new insurance bill takes on the new Medicare drug benefit. Moran said, "When this bill hits the Senate, "they will consider the tax cigarettes" which could raise 60 billion over the next five years.

President Bush speaking at a press conference said "he would veto the insurance bill." The President has made his feeling clear about health insurance saying American's have health insurance, if they're sick, and need a doctor, they can go to the emergency room." Some members of Congress, like Pete Stark from California said, "historians will deal with that".

Insurance specialist Moran said, "more than 6 million people, including about 600,000 adults", get health insurance coverage ( www.FloridaHealthInsuranceWeb.com ) each year through SCHIP. The federal government pays for about 70 percent of the SCHIP program and the states like Florida pay the rest.

The health insurance bill is quite long and deals with much more than SCHIP. It would eliminate cost-sharing for preventive services in Medicare, such as cancer screenings. In addition, it reduces the co-payment on mental health outpatient services from 50 percent to 20 percent.

The insurance bill would also freeze reimbursement rates for some Medicare providers next year, such as: home health agencies, nursing homes and long-term care hospital. Moran said, "the new insurance bill takes on the new Medicare drug benefit." Currently, Medicare recipients must have less than $11,700 in assets to qualify for extra help in paying for their medicine. The new House bill would increase that payment threshold to around $17,000.

Moran estimates, "the overall cost of the bill at about $90 billion over five years." On Fox News, Republican leaders have made it clear that "they believe the proposed expansion of SCHIP is too large."

The ranking Republican on the House Ways and Means Committee, Jim McCrery who is against the measure released a statement saying "The health insurance bill will continue to increase taxpayer-funded coverage for adults and middle-class children and move the United States toward a system of completely government-controlled health care". Democrats said the bill would allow 5 million uninsured children to become insured and deny that the proposal would expand eligibility for the program.


Florida Health Insurance Stats
Here are a few facts: Health Insurance Premiums Rose 11.2% in two years - Premiums Increased at Five Times The Rate of Growth in Workers’ Earnings and Inflation -- About Five Million Fewer Workers Covered By Their Own Employer’s Health Insurance Since 2001. In Washington, DC – Employer-sponsored health insurance premiums increased an average of 11.2% in 2004 -- less than last year’s 13.9% increase, but still the fourth consecutive year of double-digit growth, according to the 2004 Annual Employer Health Benefits Survey released by the Kaiser Family Foundation and Health Research and Educational Trust (HRET). Premiums for employer-sponsored health insurance rose at about five times the rate of inflation (2.3%) and workers’ earnings (2.2%).

In 2004, premiums reached an average of $9,950 annually for family coverage ($829 per month) and $3,695 ($308 per month) for single coverage, according to the new survey. Family premiums for PPOs, which cover most workers, rose to $10,217 annually ($851 per month) in 2004, up significantly from $9,317 annually ($776 per month) in 2003. Since 2000, premiums for family coverage have risen 59%.

The survey also found that the percentage of all workers receiving health coverage from their employer in 2004 is 61%, about the same as in 2003 (62%) but down significantly from the recent peak of 65% in 2001. As a consequence, there are at least 5 million fewer jobs providing health insurance in 2004 than 2001. A likely contributing factor is a decline in the percentage of small employers (three to 199 workers) offering health insurance over this period. In 2004, 63% of all small firms offer health benefits to their workers, down from 68% in 2001.

“The cost of family health insurance is rapidly approaching the gross earnings of a full-time minimum wage worker,” said Drew Altman, President and CEO of the Kaiser Family Foundation. “If these trends continue, workers and employers will find it increasingly difficult to pay for family health coverage and every year the share of Americans who have employer-sponsored health coverage will fall.”

“Since 2000, the cost of health insurance has risen 59 percent, while workers wages have increased only 12 percent. Since 2001, employee contributions increased 57 percent for single coverage and 49 percent for family coverage, while workers wages have increased only 12 percent. This is why fewer small employers are offering coverage, and why fewer workers are taking-up coverage,” said Jon Gabel, vice president for Health Systems Studies at the Health Research and Educational Trust.

The survey was conducted between January and May of 2004 and included 3,017 randomly selected public and private firms with three or more employees (1,925 of which responded to the full survey and 1,092 of which responded to an additional question about offering coverage). This is the sixth year the joint survey was conducted by Kaiser and HRET, and the 17th year this survey has been conducted overall. Findings appear in the September/October issue of the journal Health Affairs.

Survey highlights include:


Worker contributions. This year, workers on average contribute $558 of the $3,695 annual premium cost of single coverage and $2,661 of the $9,950 cost of premiums for family coverage. Average employee contributions for single coverage are statistically unchanged from 2003, while average employee contributions for family coverage grew by 10% – a similar rate to the average overall premium increase. The percentage of premiums paid by workers is statistically unchanged over the last several years, at 16% for single coverage and 28% for family coverage.
Cost-sharing. Cost sharing rose modestly in 2004 compared to the larger increases observed in recent years. Most covered workers are in health plans that require a deductible be met before most plan benefits are provided. In PPO plans, which cover more than half of all workers with health benefits, the average deductible for single coverage is $287 for services from preferred providers and $558 for services from non-preferred providers, about the same as in 2003. In addition, half of covered workers must either pay a separate deductible (average $224) or pay additional co-insurance (averaging 16% of the costs) when they are admitted to the hospital. The proportion of covered workers facing a $20 copayment for an office visit increased to 27% in 2004 from 19% in 2003.
Consumer-driven plans. While about 10% of all firms offer a high-deductible plan to covered workers this year, only about 3.5% of those firms offer a personal or savings account option along with a high-deductible plan. These accounts permit employers (and sometimes employees) to make pre-tax contributions, which can be used by employees to pay for routine medical care. The survey finds that employers, particularly larger firms, are interested in high-deductible plans (a plan with a deductible of at least $1,000 for single coverage). About 6% of all firms (accounting for 13% of covered workers) say that they are “very likely” to offer such a plan within two years, and another 21% of all firms (accounting for 26% of covered workers) say that they are “somewhat likely” to do so.
Type of insurance. In 2004, PPOs continue to be the most common form of health coverage, with more than half (55%) of all employees with health coverage enrolling in a PPO. HMOs, which cost significantly less than PPOs, cover about 25% of covered workers. Conventional, or indemnity, benefit plans have all but disappeared, covering just 5% of covered workers. These enrollment shares are statistically unchanged from 2003.
“You have to look over the past several years to really understand why Americans are so worried about health care costs. Just for premium contributions alone, families are paying $1,000 more this year for their health coverage than they paid in 2000,” Dr. Altman said. “More than any other factor, these out-of-pocket cost increases are what's driving voter concern about health.”

Facing continued premium increases, many employers say they looked to make cost-saving changes in the past year. Among firms offering coverage, 56% report that they shopped for a new plan in the past year. Of those firms, 31% (17% overall) report changing insurance carriers in the past year and 34% (19% overall) report changing the type of health plan offered.

When asked about future plans, about half (52%) of large firms (200 or more workers) say they are “very likely” to increase employee contributions in the next year. In contrast, just 15% of small firms (3 to 199 workers) say that they are “very likely” to increase employee contributions next year.

Across all firms offering coverage, relatively low percentages say that they are “very likely” in the next year to raise deductibles (9%), raise office visit cost-sharing (5%), raise prescription drug copayments (5%), introduce tiered networks for physicians or hospitals (2%), or restrict eligibility for benefits (1%). In addition, 3% of firms say they are “very likely” to drop health coverage entirely in the near future.

Tampa Florida Health Insurance * Giuliani Breezes Through State

Tampa Florida Health Insurance


Giuliani Breezes Through State
Skip directly to the full story.
By WILLIAM MARCH The Tampa Tribune

Published: Sep 18, 2007


TAMPA - Republican presidential candidate Rudy Giuliani devoted a quick, one-day tour of Florida on Monday mainly to bashing the health care reform plan released the same day by potential Democratic opponent Hillary Clinton, calling it "socialized medicine."

With his schedule altered by transportation problems, Giuliani breezed quickly through a planned appearance at a cafe frequented by Tampa Bay Young Republicans in Tampa's South Howard Avenue district. After just five minutes of meeting and greeting, he headed downtown for a $2,300-a-person fundraiser organized by his prominent Tampa supporter, Al Austin.

He did a public appearance and a fundraiser in Fort Lauderdale, and stopped in Miami, before coming to Tampa.

Clinton proposed a health care plan that would require individuals to buy health insurance, and require businesses to offer it to employees or contribute to a fund to offer it.

The plan is similar in some ways to one instituted by one of Giuliani's Republican opponents, Mitt Romney, while he was Massachusetts' governor.

Giuliani told reporters in Tampa that Hillary's plan is "government-mandated medicine, government-regulated medicine. Mandated health care ends up being socialized medicine, deteriorated medicine."

Giuliani, who has had prostate cancer, contended that the chances of survival for a patient with his illness in the United States were twice those of a similar patient in Britain, which has a national health care program.

Giuliani has proposed a plan including tax deductions to help people buy insurance. Under his plan, people wouldn't have to pay taxes on up to $15,000 of income that they spend for health insurance and health care costs.

"My approach is to encourage people to buy their own health insurance … give people incentives to buy health insurance, not demand that they do it," he told reporters in Fort Lauderdale.

Asked in Tampa whether he considers the Massachusetts plan "socialized medicine," Giuliani, who was being hustled into his car by aides, didn't answer.

Florida Health Insurance News Flash * Universal Health * Hillary Clinton's Plan

The debate on universal health care is heating up. What do you think about Hillary Clinton's plan for Universal Health Care? Do you currently have a health insurance policy? Please give us your opinion!!!


Clinton Calls for Universal Health Care
By BETH FOUHY – 12 hours ago

DES MOINES, Iowa (AP) — Democrat Hillary Rodham Clinton called for universal health care on Monday, plunging back into the bruising political battle she famously waged and lost as first lady on an issue that looms large in the 2008 presidential race.

"This is not government-run," the party's front-runner said of her plan to extend coverage to an estimated 47 million Americans who now go without.

Her declaration was a clear message to Republicans, the insurance industry, businesses and millions of voters who nervously recall what sank her effort at health care reform 13 years ago in her husband's first term — fear of a big-government takeover.

In unveiling her plan, she called for a requirement for businesses to obtain insurance for employees, and said the wealthy should pay higher taxes to help defray the cost for those less able to pay for it. She put the government's cost at $110 billion a year.

Mindful of the lessons of her failed attempt, Clinton said that under her new plan anyone who is content with their health coverage can keep what they have. She insisted no new government bureaucracy would be created even as it seeks to cover tens of millions uninsured.

"I know my Republican opponents will try to equate health care for all Americans with government-run health care," Clinton said. "Don't let them fool us again. This is not government-run."

The New York senator said her plan would require every American to purchase insurance, either through their jobs or through a program modeled on Medicare or the federal employee health plan. Businesses would be required to offer insurance or contribute to a pool that would expand coverage. Individuals and small businesses would be offered tax credits to make insurance more affordable.

"I believe everyone — every man, woman and child — should have quality, affordable health care in America," Clinton told an audience at a medical center in Iowa, the early voting state that launches the nomination process.

As the front-runner, Clinton drew swift criticism from Democratic and Republican rivals, including party foes Bill Richardson and John Edwards who argued she was merely following their lead in offering a similar plan.

Clinton framed her quest as a moral imperative in which individuals, businesses, the insurance industry and the federal government each had a role to play. She said her plan would be bipartisan and would only be successful through negotiation — a sharp departure from her earlier effort.

Then, the Clinton health care task force met in secret and tried to drive legislation through Congress. Now, Clinton, a senator for seven years, spoke of compromise although she vowed to accomplish her goal in her first term if elected.

"She's running against essentially not just the other candidates but her own plan. She's trying to convince you that this is a new Clinton plan," said Robert Blendon, a professor of public health at Harvard Medical School.

To pay for her plan, Clinton said the tax cuts for Americans making $250,000 or more that were enacted under President Bush would be allowed to expire. She also projected she would identify $56 billion in savings through computerized record keeping, reducing the price of prescription drugs and cutting Medicare overpayments to hospitals and HMOs.

Despite the focus on letting people who are happy with their insurance keep what they have, her plan would raise taxes on some coverage for the wealthy.

The current exclusion from taxes of employer-provided health premiums would be limited for those who make more than $250,000 and have "very generous" plans. For such people, a portion of the premiums paid by the employer could become taxable income for the employee.

Joking that her proposals "won't make me the insurance industry's woman of the year," Clinton said companies would no longer be able to deny coverage for pre-existing conditions or genetic predisposition to certain illnesses.

The centerpiece of Clinton's latest effort is the so-called "individual mandate," requiring everyone to have health insurance just as most states require drivers to purchase auto insurance. Such a mandate has detractors at both ends of the political spectrum, and questions abound over how it would be enforced.

"Perhaps more than anybody else I know just how hard this fight will be," said the New York senator.

Clinton adviser Laurie Rubiner said the mandate could be enforced in a number of ways, such as denying certain tax deduction to those who refused to buy insurance. But she stressed that a specific mechanism would be worked out once the plan was passed.

Rival John Edwards has also offered a plan that includes an individual mandate, while the proposal outlined by Barack Obama does not. Obama has insisted individuals can't be forced to buy insurance until its costs are substantially reduced.

Obama released a statement Monday saying Clinton's plan is similar to one he proposed in the spring. He took a swipe at the Clinton administration's closed-door sessions on health care in the 1990s, saying "the real key to passing any health care reform is the ability to bring people together in an open, transparent process that builds a broad consensus for change."

For his part, Edwards said that on his first day in office he will submit legislation that would pull health insurance for the president, members of Congress and all political appointees unless they pass universal health care within six months.

Republican Mitt Romney, in New York City for a fundraising stop, criticized Clinton's proposal, saying, "'Hillary care' continues to be bad medicine ... in her plan, we have Washington-managed health care. Fundamentally, she takes her inspiration from European bureaucracies."

The plan that Romney helped institute while governor of Massachusetts requires the same individual insurance mandate as Clinton's and uses state subsidies to help reduce the cost of private coverage. Since then, Romney has said he would leave it up to the states to decide whether they supported such a mandate.

Campaigning in Florida, Republican Rudy Giuliani said Clinton's plans was a "pretty clear march to socialized medicine."

"Government command and control only increases costs and decreases quality," the former New York mayor said. "My approach is to encourage people to buy their own health insurance ... give people incentives to buy health insurance, not demand that they do it."


Associated Press writers Ashley M. Heher in Chicago, Curt Anderson in Fort Lauderdale, Fla., and Nedra Pickler in Washington contributed to this report.

Florida Health Insurance For Your Family

Florida Health Insurance For Your Family, Is it Affordable?

Florida family health insurance policies are hard to come by today if you are not so healthy. Costs of medical services are on the rise and Family Health Insurance plans increase on average of 15% per year. It is very interesting to know that many American pay their large medical bill with the help of Family Health Insurance only. As the cost of Family Health Insurance premium is also rises dramatically it is very important for every one to understand the different Family Health Insurance plan offered by many Insurance companies.

According to a survey conducted by Kaiser Family Foundation, the yearly premium for Family Health Insurance is around $ 10,880 in the year 2006. This figure cause trouble and concern in many political parties since the rising in the Family Health Insurance premiums has direct effect to numbers of individuals covered. In the year 2001 69 % of employed Americans are covered under Family Health Insurance, where as in the year 2006 only 60 % of Americans are covered under Family Health Insurance.

Different types of Family Health Insurance

There are basically four types of Family Health Insurance plans available they are:

Reimbursement plans or Indemnity plan
HMO or Health Maintenance Organization
PPO or Preferred Provider organizations
POS or Point of Service
Some plans allow you to select Doctors or Hospitals etc. Whereas other plan has already selected the Doctors or Hospitals and you have to take their services if you want your medical bill to be paid by your Insurance Company. Purchasing Family Health Insurance in group or individually you must consider this important difference.

What Family Health Insurance plan covers?

The Family Health Insurance plan covers according to the different plans like hospital expanse plan usually covers all hospital related expenses like hospital room charges, incidental services etc. Doctor expense plan usually covers expanses like visiting Doctor’s office or Doctor visiting you in Hospital etc. Apart from the standard coverage there are other expanses that are covered by only some plans like expanses for prescription drugs, maternity care, eye care etc.

Select whatever plan of Family Health Insurance that suits you best considering the pros and cons of each plan very carefully.

Florida Health Insurance News Flash * Clinton Unveils Universal Health Care Proposal

Florida Health Insurance News Flash

Clinton unveils universal health care proposal
Democratic candidate's 'American Health Choices Plan' has a price tag of about $110 billion per year.
September 17 2007: 11:54 AM EDT


DES MOINES, Iowa (AP) -- Democratic presidential candidate Hillary Rodham Clinton is unveiling a sweeping health care proposal Monday that would require everyone to carry health insurance and offer federal subsidies to help reduce the cost of coverage.

Fulfilling a pledge to bring health care to all, Clinton's "American Health Choices Plan" has a price tag of about $110 billion per year. It represents her first major effort to achieve universal health coverage since 1994, when the plan she authored during her husband's first term collapsed.

"It is long past time that Americans and the richest of all countries realize that health care is a right and not a privilege," Clinton said at a labor forum in Chicago. "And that goes especially for people who work hard every single day."

The former first lady says she has learned from the 1990s experience, which almost derailed Bill Clinton's presidency and helped put Republicans in control of Congress for years to come. Aides say she has jettisoned the complexity and uncertainty of the last effort in favor of a plan that stresses simplicity, cost control and consumer choice.

The centerpiece of Clinton's plan is the so-called "individual mandate," requiring everyone to have health insurance - just as most states require drivers to purchase auto insurance. Rival John Edwards has also offered a plan that includes an individual mandate, while the proposal outlined by Barack Obama does not.

Clinton, the Democratic front-runner, has already laid out proposals to improve health care quality and reduce costs. She was to release her universal health care plan in Iowa, the first voting state.

The social networking election
With 47 million Americans currently uninsured, the Democratic presidential contenders have been united in advocating universal coverage. They have parted ways on certain specifics, including the individual mandate, which has detractors from both ends of the political spectrum.

Republican skeptics say it would be too invasive and would restrict personal freedom and choice. Liberal Democrats have expressed concern that such a mandate would be too financially burdensome for lower-income individuals and families - a concern shared by Obama, who has said individuals cannot be forced to purchase insurance until the cost of coverage is substantially reduced.

Aides said Clinton believes that an individual mandate is the only way to achieve health care for all. A key component of her plan would be a federal tax subsidy to help individuals pay for coverage.

Clinton's plan builds on the existing employer-based system of coverage. People who receive insurance through the workplace could continue to do so; businesses, in turn, would be required to offer insurance to employees, or contribute to a government-run pool that would help pay for those not covered. Clinton would also offer a tax subsidy to small businesses to help them afford the cost of providing coverage to their workers.

For individuals and families who are not covered by employers or whose employer-based coverage is inadequate, Clinton would offer expanded versions of two existing government programs: Medicare, and the health insurance plan currently offered to federal employees. Consumers could choose between either government-run program, but aides stress that no new federal bureaucracy would be created under the Clinton plan.

Aides said Clinton will propose several specific measures to pay for her plan, including an end to some of the Bush-era tax cuts for people making more than $250,000 per year. Edwards has vowed to completely repeal the tax cuts for high earners to pay for the cost of his plan, estimated at $90 billion-$120 billion per year, while Obama would pay for his plan in part by letting the tax cuts expire in 2010.

In response, Obama said Clinton's plan is similar to one he proposed in the spring, "though my universal health care plan would go further in reducing the punishing cost of health care than any other proposal that's been offered in this campaign."

He took another swipe at the Clinton administration's closed-door sessions on health care in the 1990s, saying "the real key to passing any health care reform is the ability to bring people together in an open, transparent process that builds a broad consensus for change."

Republican Mitt Romney, in New York City for a fundraising stop, criticized Clinton's proposal, saying, "'Hillary care' continues to be bad medicine ... in her plan, we have Washington-managed health care. Fundamentally, she takes her inspiration from European bureaucracies."

Who will win the entrepreneurial vote?
The plan that Romney helped institute while governor of Massachusetts requires the same individual insurance mandate as Clinton's and uses state subsidies to help reduce the cost of private coverage. Since then, Romney has said he would leave it up to the states to decide whether they supported such a mandate.

Clinton is also expected to stress several cost-saving measures to help pay for universal coverage. She's already recommended several such proposals, such as computerized medical record-keeping and a reduction in federal overpayments to hospitals and health maintenance organizations. She would also promote wellness and disease prevention as a way to reduce costs.

Clinton is sure to court danger from the health insurance industry by proposing several industry reforms. Among other things, she would require insurance companies to provide coverage to all consumers regardless of pre-existing conditions.

The insurance industry helped kill Clinton's earlier attempt at health care reform through a multibillion-dollar media and lobbying campaign that included television ads featuring a middle-class couple named Harry and Louise fretting over having to get their insurance through a new "billion-dollar bureaucracy."

Limited Health Policies Vex Some Buyers * Mega Life And Health Insurance Company

Limited health policies vex some buyers

Enlarge By Robert Alan Benson for USA TODAY

Christopher Closson, right, with Kristen, from left, Lindsay and Jonathon, was left owing $200,000 for his late wife's medical bills under a Mega Life policy that he says was deceptively advertised.



RESOURCES

National Association of Insurance Commissioners online complaint tracking tool



Actions taken by the Massachusetts Division of Insurance



Delaware market conduct exam of MegaLife



Massachusetts lawsuit against MegaLife





By Julie Appleby, USA TODAY
Sales agents peddling health insurance through Mega Life or Mid-West National told customers the coverage was affordable and good.
What they often didn't say, according to Massachusetts' top prosecutor, was that the companies' standard policies didn't cover doctors' office visits. Or prescription drugs. Or chemotherapy. Or some lab tests and X-rays.

The insurers, whose parent company is HealthMarkets, waged a "campaign of deception and unfair practices," alleges a lawsuit filed Aug. 22 by Massachusetts Attorney General Martha Coakley.

For years, similar allegations have dogged the company, which sells policies with strict limits on what they pay toward medical care. Since 2002, the company has been fined by seven states and faced lawsuits from dozens of policyholders. It is now the focus of a probe by insurance regulators in 36 states, led by Alaska and Washington.

The results of the probe are likely to be released this fall. The findings could have far-reaching effects on HealthMarkets, which insures 650,000 people in 44 states. And it could set an example for other insurers competing for a growing market: The 17-million-plus people who buy their own insurance because they are students, self-employed or aren't offered coverage at work.

FIND MORE STORIES IN: Massachusetts | Insurance Commissioners | Consumer complaints
No one connected with the probe will disclose its findings or expected recommendations, but a settlement HealthMarkets made last year with Massachusetts insurance regulators could offer clues to a possible result.

The insurer, without admitting any wrongdoing, now is writing to 22,000 Massachusetts policyholders, offering to reassess medical treatment claims it had denied dating to January 2002. Some consumers may get their money back.

The multistate probe's findings "will tell us a whole lot about … the new approach (HealthMarkets) says it's taking," says Mila Kofman of the Georgetown University Health Policy Institute. "Other insurers want to know what state regulators perceive as problems and look at whether they are engaged" in similar practices.

HealthMarkets Chief Executive Officer William Gedwed says, "We vigorously deny and disagree with the allegations" in the Massachusetts attorney general's lawsuit. Gedwed — and some regulators — say it's a better company today.

"From at least 2003 on, we've put a tremendous amount of effort into ensuring we do things the way regulators want," he says.

Since he took over in 2003, Gedwed says, the company has announced initiatives to improve customer service. Starting in 2005, HealthMarkets began making follow-up phone calls to new customers to make sure they understood their policies. And last year executives created a regulatory advisory panel that includes former state insurance investigators and former Health and Human Services secretary Tommy Thompson.

Consumer complaints against the company's insurance subsidiaries have fallen since 2005. But they're still at least twice the national median for insurers, according to a ratio of complaints to premiums calculated by the National Association of Insurance Commissioners, which in 2005 called for the ongoing probe.

State regulators have investigated other health insurers that sell similar types of policies with limited coverage; often the issue has been whether the policies' limits were clearly explained to customers. But no other health insurer has had the kind of multistate scrutiny HealthMarkets faces.

Leslie Krier, a Washington state investigator overseeing the probe, says it has examined a range of company practices "brought to our attention as … problematic in many jurisdictions."

Investigation a 'tremendous benefit'

Despite the ongoing scrutiny, HealthMarkets' three insurance subsidiaries — Mega Life, Mid-West National and Chesapeake Life — make up a business attractive enough that the company was purchased last year for $1.6 billion by the Blackstone Group (BX) and two other private-equity firms.

Gedwed says the multistate investigation has been a "tremendous benefit" because HealthMarkets has been able to work closely with state regulators. The company was given a draft copy of the probe's findings on July 31.

"A lot of the things they will recommend to us have already been implemented," Gedwed says. "We have a strong commitment to consumers and regulators as we go forward."

Many of HealthMarkets' policies are what are known as limited- or scheduled-benefit plans, a fast-growing but controversial type of coverage that sets tight limits on what an insurer will pay toward benefits such as hospital care.

Limited-benefit plans are better than no insurance, some health care analysts say, and their generally lower premiums appeal to those on tight budgets. Others question whether coverage that can leave policyholders with large bills can truly be called insurance.

Many HealthMarkets' policies cap payments for hospital care to a few hundred dollars a day, far short of the thousands of dollars it may cost a patient for daily hospital care.

Limits are set on other services, such as surgery or outpatient care. Its policies often have multiple "per sickness" deductibles, rather than one annual deductible.

Unlike more traditional insurance, HealthMarkets' policies usually have no upper limit on how much policyholders could pay each year toward such things as hospital bills or chemotherapy.

"In a typical insurance policy, what you have to pay is generally capped," says Antony Stuart, a Los Angeles attorney who has represented about a dozen policyholders suing HealthMarkets. "These (policies) are upside down, where what the company has to pay is capped and what you have to pay is not."

One of Stuart's clients is Christopher Closson, whose lawsuit alleges he bought a health insurance policy in 2003 from Mega Life that Closson thought covered a broad range of medical costs.

It was only after his wife, Kathy, was diagnosed with colon cancer that they learned the policy's payment caps of $800 a night for hospital care and $1,250 a day for chemotherapy were far below what such care costs, Closson's lawsuit says. By the time Kathy died at age 40 in 2005, the couple owed more than $200,000 to hospitals and doctors, according to the lawsuit filed in California state court.

Closson's lawsuit alleges his sales agent assured him the most they would pay out of pocket for medical care under the policy would be $10,000 to $15,000 a year. "The bottom line, the way they sold me the policy (was by saying), 'You have nothing to worry about with this policy. … Everything will be covered,' " Closson says.

Gedwed will not comment on the Closson case, which is pending.

In court papers, HealthMarkets has sought to have the case dismissed, saying Closson has no legal standing because Closson's wife bought the policy, not him.

Sales practices questioned

Private lawsuits such as Closson's and the Massachusetts attorney general's complaint have targeted HealthMarkets' sales practices.

One practice cited by regulators is one requiring most policyholders to join one of three associations — the National Association for the Self-Employed, the Alliance for Affordable Services or Americans for Financial Security — that have ties to HealthMarkets.

The Massachusetts attorney general's lawsuit says the requirement is unfair because consumers should not be required to pay to join the associations to get insurance. The associations cost $100 to join plus $40 a month to maintain membership, according to the attorney general's office.

Insurance regulators in Massachusetts investigated the firm after receiving complaints that sales agents had told consumers that insurance sold by the firm was "just as good as anything else sold in the state," says Kevin Patrick Beagan, deputy commissioner for the Massachusetts Division of Insurance.

But HealthMarkets sharply limits coverage for hospital care, cancer treatment and physical therapy, "things not normally excluded," from most plans, Beagan says.

The company also has been challenged for charging high premiums relative to the benefits it pays.

The company spent an average of 47% of its total premium revenue on medical care from 2003 to 2006 in Massachusetts, the attorney general's lawsuit says. Other insurers spent an average of more than 75% of revenue on medical benefits, the complaint says.

HealthMarkets "has misrepresented … that they charge premiums that will be reasonable in relation to the benefits provided, when (it) pays benefits in Massachusetts that are less than half of premiums received," the lawsuit alleges.

HealthMarkets says its average annual premium in individual plans in 2006 were $2,577, about half the cost of a typical individual plan offered by employers.

However, employer plans generally have far lower deductibles, an annual out-of-pocket cap on costs and other benefits that many HealthMarkets policies don't have.

In a May report, Delaware regulators alleged that some additional benefits that can be added to standard policies sold by the company from 2002 to 2004 were barely worth the premiums paid for them and that consumers were not given enough information about their true cost.

Delaware regulators also alleged the company enrolled policyholders as individuals even when they qualified for more generous group policies under state law, and directed its customer service representatives to discourage policyholders from making written complaints.

Delaware's insurance commissioner will decide this month whether to uphold recommendations made by investigators. HealthMarkets can challenge the findings at a public hearing.

Among HealthMarkets' critics is Kansas Insurance Commissioner Sandy Praeger. "We have a lot of problems," she says. "I don't think the people selling them are upfront about the policies' limits."

She says she spoke with HealthMarkets recently, "And they've implemented a new procedure of contacting people to make sure they understand. We'll see if that diminishes the complaints."

Not all regulators are as critical. Kim Holland, Oklahoma's Insurance Department commissioner, says HealthMarkets and Mega Life have made substantial improvements in areas such as agent training.

"They are working very hard to improve their relationship with insurance regulators," she says. "I have no problems with Mega."

Massachusetts' Insurance Division investigators also say the company has made changes. "We know Mega has … taken steps to address what's been pointed out within all of our examination reports," says Beagan, whose division continues to monitor the insurer.

Gedwed says the company's improvements include revising its training manuals and boosting its tracking of complaints in all states. "We go out of our way to communicate with (customers) and tell them what the loopholes (in the coverage) are," he says.

Explaining policies better

Gedwed says that since 2005, when HealthMarkets began calling new customers to see whether they understood the limits of their policies, the company has reached 160,000 policyholders in calls that are tape-recorded and average 16 minutes in length. He says 98% of those contacted have kept their policies after such calls.

"Unfortunately, what doesn't get printed (in media reports) are all the positive aspects of our coverage," Gedwed says.

"We have a family in Connecticut whose son had a stroke, and they will praise our product and say their son is alive today because of that coverage. We have a 15-year-old boy in Arizona who is battling leukemia, and we've paid over a million (dollars) in coverage for him."

When contacted by USA TODAY, both families lauded their insurance and praised their agents, who they said made calls to HealthMarkets and took other steps to ensure their bills were paid. "Everyone came together for the good of my son," says Gary Mendez, father of the stroke patient.

But both also had substantial bills that were not covered by their insurance policies. Penny Wilson, mother of the teen with leukemia, owes $22,000 in hospital bills. She says that's better than the $1 million she might have owed without insurance.

Mendez says because his son was 19 and a full-time student, the state's Medicaid program picked up about $150,000 in costs not covered by the insurance. He says he would have been pleased with HealthMarkets' coverage even if Medicaid had not stepped in.

Although Wilson and Mendez were chosen by the company as examples of happy customers, they also represent a shortcoming of HealthMarkets' coverage.

"The idea behind being privately insured is that your insurance company will pick up the bills when you're sick, not for government programs to pick up the bills after you've paid premiums to the insurer," says Georgetown's Kofman. "By the time a consumer realizes they don't have a major medical policy, it's too late."

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Comments: (290)Showing: Newest first Oldest first


catahoulagirl wrote: 2d 16h ago
This comment was made...and the guy has NO IDEA what he is talking about...

"Insurance companies like to insure young people of which their studies show the benefits are used less than the more elderly. As a person ages the price becomes unfordable and it becomes better to qualify as destitute if you want to live. It's all about profit."


First off, the young people are the ones who KEEP THE INSURNACE PREMIUMS ON INDIVIDUAL AND GROUP POLICIES IN LINE. Unfortunately, more and more younger, healthier individuals are choosing NOT to carry health insurance, only opting to finally insure themselves WHEN THEY NEED IT. So, the younger, healthier generation are not buying healthcare insurance, then when they get sick, then they try looking for a policy. THIS IS WHAT MAKES INSURANCE PREMIUMS HIGH PEOPLE!!!!! We need more people to have insurance, and not just be willing to pay WHEN THEY NEED IT. It does not work like that, because the insurance companies are then insurance ONLY the sick, so naturally the premiums are going to be higher. We must ALL do our part to help keep premiums down, to maintain health insurance coverage on ourselves, EVEN IF WE "DONT NEED IT". If we were to practice this, it would keep premiums down! (and we will ALL benefit from this move)

Think about it.


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acarroll wrote: 2d 21h ago
This guy puts Mark Antony to shame ("so are they all, all honorable men...")

"Gedwed says the multistate investigation has been a "tremendous benefit" because HealthMarkets has been able to work closely with state regulators."

"...we've put a tremendous amount of effort into ensuring we do things the way regulators want," he says."

It's no great credit to the company's reputation that previous denials may be reviewed and some people may "get their money back." What about the people who died or were permanently injured because they couldn't afford to get the medical care they needed, all while having "insurance"? What about the lives of their families and caregivers? What about the people who had to declare medical bankruptcy and ruin their future prospects? How can such a callous outcome not be called out for what it is?

Part of the problem that is buried in this article is the way the financial services industry (of which insurance companies are part) is structured, which is antithetical to the mission of a company that is not selling widgets but human services and human trust. The obvious aim of the company was to raise its stock prices enough to make it attractive to potential buyers, and it was immaterial how it reached that goal. Private equity firms don't look at the processes or whether the goal was attained ethically or not, just the bottom line. It is not important to the buyout "experts" whether the company met its business responsibilities--the purpose of insurance is to pay out when there is an adverse event, after all--but if the dollar goals were reached by dishonest sales and administrative tactics, that is immaterial to evaluating the "quality" of the company--and caveat emptor. The multiple lawsuits and state actions against the company apparently didn't bother the three private equity firms when they did their analysis and decided that it was a good risk--and that is the point that is hardest to swallow.

There ought to be a legal and regulatory category for and separation between for-profit companies that sell consumer commodities and companies that sell human services and human trust, just like there is (or used to be) between religion and government. Standards should be different for evaluating their business practices and their risk status and their market success, and ethical standards should definitely be required to be added to the calculation by the financial services industry, rather than rewarding them for their bad behavior.



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wfrobinette wrote: 3d ago
jazzeewun wrote: 12h 27m ago
I am writing to all the naysayers that are complaining how much extra taxes they would be paying for national healthcare programs. ARE YOU KIDDING ME? The cost would just transfer from from the money deducted from your paychecks already for the current healthcare programs you are already enrolled in.
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HUH? I only pay 30% of my premium. The company pays the rest. Unless the plan calls for increased tax burden on the employer to offset the rest of the premium(Similar to FICA) I'll lose another 6% to 7% of my income to tax. 10% of my income to pay for universal health care is unacceptable. That would be nearlty 30% to 38% of my income going to taxes. I call BS.


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jacksmith wrote: 3d 12h ago
Well said jazzeewun. I hope people like you will spread the word to all your family, and friends. You all stand to gain a lot. But you must all come together now! You must make the whole country buzz about this.

And pressure their politician's to pass HR 676 now! Even the little children should be pestering their parentS about seeing to it that they are protected with Universal National Health Care For Life. So they can go out and play, and be in sports with out worry.

You must bring the gates of Hell, and Heaven down on your politician's heads Now! YOU HAVE THE POWER!!!! You can do it!! You Can Do Ti!! YOU CAN DO IT!!! ... Now is the time! Do this for Your-self, and all America. It's the Right THING, AND THE SMART THING to do...



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jazzeewun wrote: 3d 13h ago
I am writing to all the naysayers that are complaining how much extra taxes they would be paying for national healthcare programs. ARE YOU KIDDING ME? The cost would just transfer from from the money deducted from your paychecks already for the current healthcare programs you are already enrolled in. Everyone likes to think that their lives will always good (if they are good right now) but for the unforseen tragedies, injuries, inflation or other catastrophic loss of income, I would love for medical care not to be one of my worries. You can always recognize the guy that thinks he's supporting everyone--he's usually the one with the biggest mouth. But when his life gets turned upside down or unravels he quietly tries to fit in unnoticed. What's wonderful today can always be gone tomorrow. Ask some of them Enron folks and some of those others that saw their retirements go up in smoke. Are you really that untouchable?


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jacksmith wrote: 3d 13h ago
I have the best health care coverage money can buy in this country. Which, as I said before is very poor coverage. Because the medical care in America is so bad. Because it has been corrupted by greed, and the profit motive.

You really cant trust your medical care in America at the present time.

"Whether you have the finest full coverage health insurance. Or no insurance at all. Whether you are the President of The United States, senator, or congressman. Or a premature infant in some inner city icu struggling for your life. Your medical care has been severely compromised by greed, and the profit motive. And in medicine, compromised care means injury, disability, and DEATH."

Love.... With a clinched fist.


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newengland wrote: 3d 14h ago
Great comments MY HSAguy!!! Agreed...Health Insurance is for what you can't afford to pay!!! I have had a policy with Mega Life for over 20 years...I have the highest deductible and no other benefits..it was my choice!! It is for every one.?.no..but the agent explained everything..I also was left an outline of coverage which told me what I took...my question to those complaining about the company...did you every read the outline or policy?...one of the pages in the policy has an outline of all the benefits..if you took a limited plan and did not know it ,you would have immediately, if you took the time to read it...that is your responsibility..I also think that if these programs have limited coverage then complain to your Commissioner of Insurance in YOUR State ...that are the ones that allow these policies in..maybe they should be sued and not the insurance company..the state allows them to sell these limited policies then they are the ones that should be held liable...the insurance company had to disclose all the benefits and exclusions and how the plan worked...if the states are so upset about Mega's policies then don't approve them...so why do they.....well...every consumer is different...what you want may not be what I want...for some consumers they are not concerned with a Catastrophic illnes..they are concerned with a ten, -twenty thousand dollar bill..and those limited policies fit their needs...ultimately it all comes down to YOU and the responsibility you have in reading and questioning what you have...always easy to point fingers at someone else to justify your own failures...Are their bad agents...well yes I am sure...there are bad CEO's--Ken Lay for ie...Bush tells us things all the time that are not true...I believe 1/2 what I hear...when the agent sold me my plan I read the outline with him so I knew then if it were true or not..and I questioned him on what I read.. I can buy a limited house and car insurance policy too...if I do, is it fair to be complaining about it when I have a problem..?.and if I don't know it is limited ,doesn't that become my responsibility..Maybe those that didn't read their policy should be sued.by the insurance company..on the 1st page of your policy you have a 10 day free look...review it etc...and since you didn't read it you did not uphold your end of the contract...It works 2 ways..MY biggest recommendation though is to question your commissioner of insurance...if they didn't allow these limited plans in then the problem would stop immediately. or would it?? is that fair to the consumer who cares more about the cost...not the coverage...ummmmmmmmmmm


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GotOutOfMI wrote: 3d 15h ago
Insurance companies like to insure young people of which their studies show the benefits are used less than the more elderly. As a person ages the price becomes unfordable and it becomes better to qualify as destitute if you want to live. It's all about profit.


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jacksmith wrote: 3d 16h ago
You see. These people against universal National Health Care For All arent really concerned about what it would cost. They know we can easily afford it. And it would cost much less than what we pay now.

They arent worried about socialism. Or government taking over controls of our lives. They know that will never happen. Having guaranteed health care will just make America stronger, and more free. Because people will be healthier.

Americans can take more chances. And change jobs without worry over loss of health care. Or being bankrupted, and financially destroyed if they get sick. Or have an accident.

Parents can let children go out to play. And let them participate in sports. Without fear of financial destruction if the child gets injured or hurt. No more children will die from a tooth ache that turns into an abscess and destroys their brain before the parents can get help for the child.

Sounds beautiful doesn't it. And you can have it. But you have to act now. Get on your politician's. And run against them if you have too. sickocure.org

These people opposed to universal national health care for all. Are the people who have raped you. Your family's. And your loved ones with, and through medical care for years. Doctors. Pharmaceutical company's, insurance company's, hospitals, and politician's.

Forget about these bums. Take what is yours. And make your politicians give you what you want. Or be thrown out of office by the seat of their pants.

For those of you whining about possibly having to pay your fair share for your fellow Americans health care. I have no problem with giving you an option to opt out of the benefit of guaranteed National Health For All.

They could give you a tax deduction. But if you or any member of your family gets in an accident. Or gets sick and has to be cared for through any part of the National Health Care system. You and your insurance company will be billed the full cost of care. And if you fail to pay. Reported to a credit agency. And forced into bankruptcy if you don't pay.

You nor your children should receive any of the protections of National Health Care For All until you pay your full bill. Although we would allow you minimal emergency room care. Before we dump you on skid row. :-) :-) :-)

Best of luck

Love.... With a clinched fist.


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MyHSAguy wrote: 3d 17h ago
Why is it that we look at health insurance so much different than any other type of insurance we purchase? Does our auto insurance cover oil changes and windshield wiper blades? Does our homeowners insurance cover our washer/dryer or furnace? Why is it we expect health insurance to cover every minor expense? The problem with our current health insurance system lies in how the services are delivered. What else in our free-enterprise society today is delivered in a "copay" system? Imagine buying a car and paying a $200 copay with someone else paying the rest. Would any of us be driving the same car we are today? Of course not! No wonder health care now consumes over 16% of our total GDP which is 60% more than Americans spend on housing!

With skyrocketing health insurance premiums companies such as Mega Life and Health can easily sell these limited policies to people because they get insurance that includes copays for doctor's office visits and some prescription drug coverage at a much lower premium than comprehensive major medical plans.

There needs to be a change in vocabulary in order for people to understand how to purchase health insurance. Most comprehensive major medical health insurance plans have 3 moving parts consisting of deductible, coinsurance, and copays. These 3 combine to represent some sort of out-of-pocket maximum that is difficult to understand. Most plans do not even count copays towards this maximum. Those plans should be described as "unlimited" out-of-pocket. Other than the new HSA qualified major medical insurance plans, which are required by IRS guidelines to have maximum out-of-pocket limitations, it can be very difficult to understand how much is covered.

This is why you should consider an HSA qualified comprehensive major medical PPO insurance plan. Once you own a qualified insurance plan you are then allowed to open a triple tax-advantaged (pre-tax deposits, tax-deferred interest earned, and tax-free withdrawals for eligible medical expenses) HSA account. You then pay your smaller bills out of your HSA at the in-network PPO discount while retaining insurance in case of a larger expense. Whatever is left in your HSA account YOU KEEP! The insurance deductible is offset by your HSA so that your total out-of-pocket maximum is usually much lower than it is with traditional plans.

I have read many of Julie Appleby's writings and she has mentioned HSAs on many occasions. Although most health insurance brokers are hesitant to recommend HSA designs experts are still predicting 10 million HSAs will be in use by 2008. HSAs provide a vested interest in saving health care dollars for possible future expenses, or if we never spend it, keep it to help supplement retirement income (think IRA).

I just wish the people victimised in this article had been given this information.

Scott Borden
OFM Benefits Consulting, LLC

Florida indiviudal health insurance group FREEHEALTH reports

A Florida indiviudal health insurance consumer group, FREEHEALTH, in its August insurance health insurance review for Florida said, 'Sen. Hillary Clinton plans to improve the quality of health care', by expanding health insurance to all Americans while at the same time, one Republican, former Massachusetts Governor Mitt Romney, 'tried to beat Clinton to the punch by releasing his health care plan while in Florida.' Both plans have merits.

(PRWEB) August 28, 2007 -- During a speech in New Hampshire, Presidential Candidate Hillary Clinton defended her vision of Universal Health Care. "She has a plan for the 45 million Americans who currently don't have health insurance, said Lex Poppins, spokesman for the insurance group, "In order to forge a consensus on universal health care, we need to assure people that they will get the quality they expect at a cost they can afford."

Health insurance consultant, Morgan Moran of (www.floridahealthinsuranceweb.com) Florida Health Insurance Web, said, "Health insurance seems to be the hot topic with both Democratic and Republican Candidates. Hopefully, the end result will be that everyone in Florida will have some sort of health insurance." Throughout the August report, there are similarities between the candidates.

departs significantly from the universal health care measure that he helped forge as governor of Massachusetts
Read the FREEHEALTH report available at:
(http://www.floridahealthinsuranceweb.com/FREEHEALTH_REPORT_AUGUST.htm) - (Both Clinton and Romney were getting a lot of attention because of their stands on health care.)

In 1994, when Hillary Clinton headed a White House task force on the health insurance issue, a Democratic-controlled Congress rejected her health care proposal. Ignoring those defeats in from 1994, Clinton has frequently talked about health care at every stop along the campaign trail.

Mitt Romney, the architect of Massachusetts' universal health coverage plan, is unveiling his proposal for overhauling the nation's health care system, calling for a state-by-state approach that he says will "help millions of uninsured in this country gain access to affordable medical coverage."

Health insurance expert Moran said, The proposal, which Mr. Romney detailed before the Florida Medical Association, "departs significantly from the universal health care measure that he helped forge as governor of Massachusetts", reflecting the conservative audience he must now appeal to in order to win the Republican presidential nomination.

The Romney health insurance plan, which went into effect this year is still being watched closely to see how it will fare. This health insurance plan was Mr. Romney's stellar legislative accomplishment as governor but the insurance plan has elements that trouble many Republican conservatives, most notably a mandate that everyone who can afford it must buy health insurance or face penalties.

Mr. Romney often promotes his health care bill in Massachusetts on the campaign trail, holding it up as a private-market-based solution to the problem of the uninsured, as opposed to "socialized medicine," or "Hillary-care," as he often says. But "he almost never mentions the requirement that individuals buy coverage", the Florida health insurance consultant said,

There is no individual mandate in Mr. Romney's plan for the rest of the country. Instead, it concentrates on a "federalist" approach, premised on the belief that it is impossible to create a uniform system for the entire country. Along these lines, the federal government would offer incentives to states to take their own necessary steps to bring down the cost of health insurance. According to a spokesman for the Romney campaign, Mr. Romney will highlight how the nearly 45 million uninsured in the country will get coverage if he is elected.

In his health insurance plan, Romney proposes taking federal money to cover the cost of medical care for the uninsured. He also wants to "allow people who buy their own health insurance to be able to deduct premiums", deductibles and co-payments from their income.

According to Florida Health Insurance Web, "the goal would be for people to be able to opt out of employer plans if they do not like them and go out on the individual market to buy health insurance on their own." Read more about the Clinton and Romney health insurance plan, and other tips on lower health insurance rates at: www.FloridaHealthInsuranceWeb.com/Clinton_Romney_Health_Insurance.html