Heather Darling, a Lawyer from Morris County
Ridgewood NJ, Obamacare has been an epic fail for many who had insurance. The Affordable Care Act has been anything but affordable for those of us paying in part or in full for our own Healthcare. For many, basic health care previously covered by insurance is now approaching prohibitive cost levels. Although insurance was previously expensive, after payment for insurance was rendered the cost of medical care itself was substantially covered by the insurance company.
Shortly after Obamacare was introduced, many did see a significant reduction in their premiums. However, there was an equal and sometimes greater increase in their out-of-pocket costs after the care was rendered. Over a short period of time, premiums increased to pre-Obamacare levels and the out-of-pocket costs continue to climb. These facts alone indicate that the program was overreaching and a failure.
Additionally, here in New Jersey, those such as small business owners or independent contractors responsible for their own insurance coverage are limited to a minimal number of insurance companies and an even smaller number of those companies are actually accepted by a majority of medical care providers. The net result is that many who were previously insured are now unable to afford insurance and those who were previously uninsured currently remain either uninsured or covered by government programs paid for by the very people who can no longer afford insurance of their own.
the staff of the Ridewood blog
Fort Worth Tx, On Friday night a federal judge in Texas ruled the Affordable Care Act unconstitutional , likely setting up a final decision on the law’s fate at the Supreme Court.
The law, known as Obamacare, was effectively nullified by the ruling. Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas, in Fort Worth, heard arguments in the case in early September, but did not issue his ruling until Friday evening.
He did not, however, grant the plaintiffs’ request for an injunction, meaning the law’s provisions remain in effect until an appeal reaches the Supreme Court, or the ruling is reversed by an Appeals Court. That means that the current open enrollment period regulated by Obamacare continuing through its Saturday deadline.
At issue in the case was the individual mandate, the provision in Obamacare that requires everyone to have health insurance or face a penalty in the form of a tax. The Supreme Court upheld that part of the law in 2012, ruling it fell in line with Congress’ power to levy taxes.
Congress, eliminated the tax penalty last December as part of President Trump’s major tax overhaul which, means the mandate is no longer a tax and therefore is unconstitutional.
June 10 ,2018
the staff of the Ridgewood blog
Washington DC, The U.S. Department of Justice said on Thursday that the part of Obamacare requiring individuals to have health insurance aka the individual mandate is unconstitutional. This should be interesting to New Jersey voters with the recent signing by Governor Phil Murphy of a rule requiring the enforcement of the individual mandates and thereby fining individuals without insurance .
In a brief filed in a federal court in Texas, the department said a tax law signed last year by President Donald Trump that eliminated penalties for not having health insurance rendered the so-called individual mandate under Obamacare unconstitutional.
The Justice Department said that also nullifies two other major provisions of Obamacare linked to the individual mandate, including one barring insurance companies from denying coverage to people with pre-existing conditions.
Attorney General Jeff Sessions, in a letter to House of Representatives Speaker Paul Ryan, said he had determined the individual mandate will be unconstitutional when the tax law becomes effective in 2019.
the staff of the Ridgewood blog
Ridgewood NJ, in an amazingly honest article about Obamacare , CNN Money (http://money.cnn.com/2016/11/04/news/economy/obamacare-affordable/index.html ) called it , “a tale of two health insurance programs. “For the 85% of enrollees with lower incomes, federal subsidies make the premiums somewhat more affordable. Those even closer to the poverty line can get additional subsidies that reduce the deductibles, which can run into the thousands of dollars. For many middle class Americans a single person earning more than $47,520, not very much in Bergen County or a family of four with an income of $97,200 still not a lot of money for a family of four , still not very much in Bergen County the pricey premiums and deductibles mean health care coverage remains out of reach.
Which always bring us back to the argument that defenders of Obamacare, either don’t pay for it , or they don’t have it .
For the 10.5 million enrollees on the Obamamcare exchanges, the health insurance cost burden falls on the consumer. That is leaving an untold number of Americans opting to remain uninsured, rather than shell out thousands a year for premiums and deductibles. In 2015, 46% of uninsured adults said that they tried to get coverage but did not because it was too expensive, a Kaiser study found.
Over 150 million people have insurance through work, paying only about $440 a month for a family plan, while employers cover the rest, or about $1,075 per month.
For a 30 year old enrollee for Obmacare your $311 a month Bronze Plan premium comes with a $6092 deductible , ouch. This represents little sense to the average 30 year old and still amounts to nothing more than a “tax’ , on working people.
the staff of the Ridgewood
Washington DC, President Donald J. Trump is taking action to improve access, increase choices, and lower costs for healthcare. The President thru executive action on Thursday , the president said , “The time has come to give Americans the freedom to purchase health insurance across state lines, which will create a truly competitive national marketplace that will bring costs way down and provide far better care.”
EXPANDING ACCESS TO MORE AFFORDABLE OPTIONS: President Donald J. Trump is taking action to increase the healthcare choices for millions of Americans, potentially allowing some employers to join together across State lines to offer coverage.
• President Trump signed an Executive Order to reform the United States healthcare system to take the first steps to expand choices and alternatives to Obamacare plans and increase competition to bring down costs for consumers.
• The order directs the Secretary of Labor to consider expanding access to Association Health Plans (AHPs), which could potentially allow American employers to form groups across State lines.
o A broader interpretation of the Employee Retirement Income Security Act (ERISA) could potentially allow employers in the same line of business anywhere in the country to join together to offer healthcare coverage to their employees.
It could potentially allow employers to form AHPs through existing organizations, or create new ones for the express purpose of offering group insurance.
o By potentially making it easier for employers to band together, workers could have access to a broader range of insurance options at lower rates in the large group market.
o Employers participating in an AHP cannot exclude any employee from joining the plan and cannot develop premiums based on health conditions.
• The order directs the Departments of the Treasury, Labor, and Health and Human Services to consider expanding coverage through low cost short-term limited duration insurance (STLDI).
o STLDI is not subject to costly Obamacare mandates and rules. One study found that on average STLDI costs one-third the price of the cheapest Obamacare plans.
o Despite its low cost, STLDI typically features broad provider networks and high coverage limits.
o The main groups who benefit from STLDI are people between jobs, people in counties with only a single insurer offering exchange plans, people with limited coverage networks, and people who missed the open enrollment period but still want insurance.
• The order directs the Departments of the Treasury, Labor, and Health and Human Services to consider changes to Health Reimbursement Arrangements (HRAs) so employers can make better use of them for their employees.
o HRAs are employer-funded accounts that reimburse employees for healthcare expenses, including deductibles and copayments.
o The IRS does not count funds contributed to an HRA as taxable income.
o Expanded HRAs could potentially give American workers greater flexibility and control over how to finance their healthcare needs.
OBAMACARE IS FAILING: The status quo is not delivering quality healthcare options for the American people, who are facing higher premiums and fewer options.
• The percentage of workers at small firms receiving coverage through their employer has declined from nearly half in 2010 to about one-third in 2017.
• In 2018, more than 1,500 counties (nearly 50 percent of all counties) are projected to have only one option on their individual insurance exchanges, according to the Centers for Medicare and Medicaid Services.
o This means 2.6 million Americans, or nearly 30 percent of exchange participants, will be left without a choice of insurers.
• From 2013 to 2017, average premiums for individual health insurance plans have doubled, increasing by $2,928 according to the Department of Health and Human Services.
o During this period, every State using www.healthcare.gov saw individual insurance premiums increase.
• Americans are departing the Obamacare exchanges and millions are choosing to pay the law’s penalty instead.
o 500,000 fewer Americans enrolled in an Obamacare plan in 2017 compared to the prior year.
o Current exchange enrollment is 60% below what the Congressional Budget Office expected when the law took effect.
o 6.7 million Americans chose to pay the Obamacare penalty in 2015 rather than purchase insurance on the exchanges. 37% of penalized households made less than $25,000, and 79% of penalized households made less than $50,000.
Any reasonable person could have predicted this when analyzing the Affordable Care Act as written. Premiums rise, payments to physicians go down, and those who want to fix this law believe that increased subsidies to insurance companies will help. It is truly time to scrap ObamaCare and start over. Minimizing the federal role would be a great place to start , Alieta Eck, MD For Real Health Care Reform
Government control of healthcare is reducing access
by Dr. Deane Waldman and Jennifer Minjarez | Aug 29, 2017, 12:01 AM
The Affordable Care Act has made health insurance even more unaffordable than before Obamacare was enacted. Many insurers have lost hundreds of millions of dollars selling Obamacare insurance and have exited the market. The remaining insurance sellers are charging prices many cannot afford and are planning to raise rates an average of 19 percent.
To make the situation worse, payment schedules to doctors continue to go down, making care even less accessible.
Alieta Eck, MD
Meet Kelly Kelly. She is a 36 year old mother of two who was found to have gallstones two years ago. She was on Medicaid. She had frequent abdominal pain that sent her to the ER many times. The solution for gallstones is removal of the gallbladder, but she could not find a surgeon who takes Medicaid. When she was diagnosed, she went to her primary Medicaid doctor and was told that having the gallbladder removed would increase her chances of getting diabetes. Another told her to eat hummus and couscous and take probiotics.
One ER physician told her that with her Medicaid “insurance” she would need to be dying to get an operation– which meant having the gallbladder be on the verge of bursting. Apparently, only a fever, high white cell count and elevated liver enzymes qualified for an admission and emergency surgery. Persistent gallbladder pain only qualifies for 5 days of pain meds.
She called the offices of many surgeons and was always rebuffed– “We don’t take Medicaid.”
Half the patients we see at the Zarephath Health Center are on Medicaid and cannot find a doctor. Most notably, patients who need psychiatrists, pain control specialists and those who need surgery on a non-emergent basis are out of luck. This is especially irksome since the taxpayers of NJ are paying $15 billion on Medicaid per year, up because most newly insured patients under the Affordable Care Act are on Medicaid.
We at the Zarephath Health Center work to find solutions. We called a local surgeon and offered to have the Zarephath Health Center pay a fair fee. The surgery is being scheduled for next week and we will follow up.
This demonstrates why we need NJ S239– the Volunteer Medical Professional Health Care Act. Tell Senator Vitale to bring it up before the NJ Senate Health Committee.
By Anjalee Khemlani, August 11, 2017 at 8:05 AM
Weeks after the collapse of the attempt to repeal and replace the Affordable Care Act, uncertainty around federal action is affecting premium rates and continues to unsettle the health insurance industry.
“The continued uncertainty is making it very difficult for carriers,” said New Jersey Association of Health Plans president Ward Sanders.
In two recent reports, from the Kaiser Family Foundation and the Stop the Health Insurance Tax Coalition lobbying firm, premiums are estimated to increase by hundreds of dollars for New Jerseyans.
According to Stop the HIT, with the reintroduction of the premium fee:
Individuals will see an increase of at least $178.
Small group plans will increase by $209 for individuals and $556 for families.
Large groups will see an increase of $207 for individuals and $615 for family.
Seniors and disabled individuals in Medicare Advantage will see their premiums increase $516 per couple (or $248 for every individual).
State Medicaid programs will incur an additional cost of $268 for each of their insured Medicaid enrollees in 2018.
“From what we’ve seen from other state filings (as highlighted in the KFF report), the cost sharing reduction payments, if they are not going to be there, it is going to have a significant impact on insurance premiums,” Sanders said.
Whether or not the individual mandate and federal subsidies are kept intact, plus the reintroduction of the premium fee on insurers — which alone will increase premiums by close to 3 percent — are forcing significant increases for 2018 plans.
If subsidies are cut off for marketplace enrollees and the individual mandate is removed, insurers are likely to see fewer (mostly healthy) enrollees and therefore need to increase premiums.
Jeanne Pinder , CONTRIBUTOR
Psst: You might pay less for health care if you put away your insurance card.
Like most of us, you probably think your insurance policy gives you access to better prices. But that’s not always true.
How do you find out? It takes a little bit of work. But when you’re done, you’ll know more about health care and insurance – whether you’re an individual looking for a simple blood test or a sore-throat visit, or whether you’re an employer trying to beat back health costs.
And with the confusion in Washington over the future of health care in this country, we will all need to take ownership of issues we previously left to the insurer and the doctor.
Here’s an example: A person in California was asked to pay $1,850 for an MRI. Because he has a high deductible, he asked the office manager and she said if he agreed not to report the transaction to his insurance company, he could have the MRI for $580.
file photo Phil Murphy
the staff of the Ridgewood blog
Ridgewood NJ, Assemblywomen Holly Schepisi blasts Gubernatorial candidate Phil Murphy and Democrat led ACA hysteria yesterday on Facebook ,
“I’ve taken some very targeted hits over the past month with claims that I am responsible for women dying and/or I hate women. These comments have been reprehensible and are flat out false as well as bizarre considering I am female and my own grandma died of ovarian cancer. For the record I support access for women to all health care, including family planning services. Several years before I ever ran for office a $7.5 million budgetary cut was made to “family planning services.” During this same period of time the ACA was enacted and several hundred thousand more people in New Jersey became eligible for health insurance coverage and Medicaid services. Certain medical providers, including Planned Parenthood saw significant increases in reimbursements during this time. Indeed Planned Parenthood has been funded to the tune of $1.5 BILLION per year and has felt financially secure enough to increase their executive salaries by 20 percent over the past two years (for an average executive salary of over $350-$400,000 per year) while giving out over $35 million in campaign contributions. But we shouldn’t let facts get in the way of hysteria.
Murphy’s Comments on Women Dying Are False, NJ Health Officials Say
By Christian Hetrick • 08/10/17 7:52pm
New Jersey health officials fired back at Phil Murphy on Thursday after the Democratic gubernatorial nominee said “women are dying” because of Gov. Chris Christie’s cuts to Planned Parenthood.