Tampa Florida Health Insurance
Giuliani Breezes Through State
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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.
Tuesday, September 18, 2007
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.
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 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.
Monday, September 17, 2007
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."
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."
Monday, September 10, 2007
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."
Posted 5d 12h ago
Updated 5d 10h ago E-mail | Save | Print | Reprints & Permissions |
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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
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."
Posted 5d 12h ago
Updated 5d 10h ago E-mail | Save | Print | Reprints & Permissions |
To report corrections and clarifications, contact Reader Editor Brent Jones. For publication consideration in the newspaper, send comments to letters@usatoday.com. Include name, phone number, city and state for verification.
Conversation guidelines: USA TODAY welcomes your thoughts, stories and information related to this article. Please stay on topic and be respectful of others. Keep the conversation appropriate for interested readers across the map.
You must be logged in to leave a comment. Log in | Register
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
Sunday, September 9, 2007
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
(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
Thursday, September 6, 2007
SCHIP Program in Trouble?
Children's health program in limbo
SCHIP to expire Sept. 30; Congress can't reach agreement
Getting assistance
To enroll in Florida's KidCare program, visit floridakidcare.org. Participants must be under age 19, uninsured and meet requirements. The program is open to U.S. citizens and qualified non-citizens who are neither in a public institution nor a dependent of a state employee eligible for health insurance.
What is SCHIP?
The State Children Health Insurance Program debuted under the Clinton administration in 1997. The bill's 10-year authorization expires Sept. 30.
Via Florida's KidCare program, SCHIP funds 71 cents out of every dollar Florida spends on children's health insurance. The state covers the remaining 29 cents using tobacco settlement trust funds, general revenues and premium payments.
According to a University of Rochester study, most SCHIP enrollees in Florida and New York:
Are black or Hispanic.
Are 12 to 16 years old.
Live in poverty.
And had no health insurance the previous year.
Lukas Richmond started wheezing again this week.
The boisterous Titusville 8-year-old missed 52 days of school last year because of severe asthma and allergies -- he fell ill with pneumonia four times. Wednesday, his mother, Leigh Richmond, took Lukas back to the Children's Medical Services clinic in Rockledge for another round of respiratory testing.
The result? More expensive drugs for Lukas, though "he's on enough medicine to make a person's head spin," Richmond said.
Like 5,805 other Brevard County children, Lukas relies on Florida KidCare for medical coverage, an initiative funded by the federal State Children's Health Insurance Program
"It's been a lifesaver for Lucas," Leigh said.
But Richmond and others worry the end may be near: SCHIP expires Sept. 30, and Congress has not determined the program's fate.
SCHIP provides health coverage for 225,593 Florida youngsters from low-income households who do not qualify for Medicaid. A study has shown most of the recipients are black or Hispanic, live in poverty and went without any health insurance before signing up for the program.
Supporters fear if Congress doesn't agree to continue the funding, tens of thousands of poor children in Florida alone and millions more across the country will go without regular medical care or flood already busy emergency rooms, driving up health care costs for everyone. Critics argue the tax-funded program has stretched beyond its original aim and is vulnerable to abuse.
Last month, an $86 billion reauthorization bill providing coverage for 5 million children passed the House by a 225-204 vote, a measure President Bush threatened to veto. The Senate proposed and passed a more modest, $35 billion version that would cover 1 million fewer children nationwide.
Both of Brevard County's representatives -- Tom Feeney,
R-Oviedo, and Dave Weldon,
R-Indialantic -- voted against the House bill.
Feeney said he supports extending SCHIP, but Democrats wanted to expand its breadth into a version of "Hillarycare" and "secret socialized medicine" that could provide tax-funded health care for illegal aliens.
"I did not support some of the changes that turned this into an international socialized medicine program," Feeney said. "When you mix sugar with rotten garbage, you don't improve the garbage. And you ruin the sugar."
Weldon's press secretary, Kurt Heath, said Weldon supports SCHIP.
"The problem with the House bill is it goes way, way, way, way, way beyond that. You have what is essentially a tripling of that program," Heath said.
Feeney said conference-
committee politicking to beat the Sept. 30 deadline will begin soon on the Senate version, which passed by a 68-31 margin.
Sen. Bill Nelson, D-Orlando, voted "yes" and Sen. Mel Martinez, R-Orlando, voted "no." Messages seeking comment were left for both senators.
Last week, about 50 people attended a pro-SCHIP "Cover All Children" rally at Our Lady of Lourdes Catholic Church in Melbourne. The event was organized by Congregations for Community Action, a coalition of eight south Brevard churches.
"They said no child would be left behind. There are a lot of kids getting left behind," said Sandra Pelham, who chairs the Melbourne-Palm Bay Powell subdivision neighborhood watch program. Meanwhile, the Rockledge CMS facility serves 453 special-needs KidCare patients, Regional Program Administrator Rob Bridger said, including children with attention-deficit disorder, diabetes and cleft palates.
"Loss of funding will mean less primary care visits, less preventative care visits," said Lukas Richmond's pediatric pulmonologist, Dr. Floyd Livingston. "It'll probably create more emergency room visits and drive up health care costs."
SCHIP to expire Sept. 30; Congress can't reach agreement
Getting assistance
To enroll in Florida's KidCare program, visit floridakidcare.org. Participants must be under age 19, uninsured and meet requirements. The program is open to U.S. citizens and qualified non-citizens who are neither in a public institution nor a dependent of a state employee eligible for health insurance.
What is SCHIP?
The State Children Health Insurance Program debuted under the Clinton administration in 1997. The bill's 10-year authorization expires Sept. 30.
Via Florida's KidCare program, SCHIP funds 71 cents out of every dollar Florida spends on children's health insurance. The state covers the remaining 29 cents using tobacco settlement trust funds, general revenues and premium payments.
According to a University of Rochester study, most SCHIP enrollees in Florida and New York:
Are black or Hispanic.
Are 12 to 16 years old.
Live in poverty.
And had no health insurance the previous year.
Lukas Richmond started wheezing again this week.
The boisterous Titusville 8-year-old missed 52 days of school last year because of severe asthma and allergies -- he fell ill with pneumonia four times. Wednesday, his mother, Leigh Richmond, took Lukas back to the Children's Medical Services clinic in Rockledge for another round of respiratory testing.
The result? More expensive drugs for Lukas, though "he's on enough medicine to make a person's head spin," Richmond said.
Like 5,805 other Brevard County children, Lukas relies on Florida KidCare for medical coverage, an initiative funded by the federal State Children's Health Insurance Program
"It's been a lifesaver for Lucas," Leigh said.
But Richmond and others worry the end may be near: SCHIP expires Sept. 30, and Congress has not determined the program's fate.
SCHIP provides health coverage for 225,593 Florida youngsters from low-income households who do not qualify for Medicaid. A study has shown most of the recipients are black or Hispanic, live in poverty and went without any health insurance before signing up for the program.
Supporters fear if Congress doesn't agree to continue the funding, tens of thousands of poor children in Florida alone and millions more across the country will go without regular medical care or flood already busy emergency rooms, driving up health care costs for everyone. Critics argue the tax-funded program has stretched beyond its original aim and is vulnerable to abuse.
Last month, an $86 billion reauthorization bill providing coverage for 5 million children passed the House by a 225-204 vote, a measure President Bush threatened to veto. The Senate proposed and passed a more modest, $35 billion version that would cover 1 million fewer children nationwide.
Both of Brevard County's representatives -- Tom Feeney,
R-Oviedo, and Dave Weldon,
R-Indialantic -- voted against the House bill.
Feeney said he supports extending SCHIP, but Democrats wanted to expand its breadth into a version of "Hillarycare" and "secret socialized medicine" that could provide tax-funded health care for illegal aliens.
"I did not support some of the changes that turned this into an international socialized medicine program," Feeney said. "When you mix sugar with rotten garbage, you don't improve the garbage. And you ruin the sugar."
Weldon's press secretary, Kurt Heath, said Weldon supports SCHIP.
"The problem with the House bill is it goes way, way, way, way, way beyond that. You have what is essentially a tripling of that program," Heath said.
Feeney said conference-
committee politicking to beat the Sept. 30 deadline will begin soon on the Senate version, which passed by a 68-31 margin.
Sen. Bill Nelson, D-Orlando, voted "yes" and Sen. Mel Martinez, R-Orlando, voted "no." Messages seeking comment were left for both senators.
Last week, about 50 people attended a pro-SCHIP "Cover All Children" rally at Our Lady of Lourdes Catholic Church in Melbourne. The event was organized by Congregations for Community Action, a coalition of eight south Brevard churches.
"They said no child would be left behind. There are a lot of kids getting left behind," said Sandra Pelham, who chairs the Melbourne-Palm Bay Powell subdivision neighborhood watch program. Meanwhile, the Rockledge CMS facility serves 453 special-needs KidCare patients, Regional Program Administrator Rob Bridger said, including children with attention-deficit disorder, diabetes and cleft palates.
"Loss of funding will mean less primary care visits, less preventative care visits," said Lukas Richmond's pediatric pulmonologist, Dr. Floyd Livingston. "It'll probably create more emergency room visits and drive up health care costs."
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