A new report issued by the Institute for Women’s Policy Research found that access to paid sick days could save $1 billion each year in medical costs. Right now more than 44 million American workers don’t receive paid sick days and even more than that are not allowed to use time off to take care of sick children or family members. “Taking time off work to see a primary care doctor is common sense, but over 40 million Americans cannot do so without losing pay or their job,” said Kevin Miller, Senior Research Associate with IWPR, and an author of the report. “Americans are paying over $1 billion each year in preventable emergency department costs because hard-working people without paid sick days are unable to get the preventative and early treatment they and their children need.”

Around $47 billion are spent on emergency department services each year in the US. If some of that funding was shifted to preventing illnesses in the first place through less expensive doctor’s visits, access to paid sick days would save $1.1 billion each year. About $500 million in these preventable costs are covered by taxpayers with allocated funds going to veterans and low income families. “As high and rising health care expenditures continuing to be a top concern for policymakers and businesses alike, paid sick days is a cost saving solution that should receive serious attention,”  said Claudia Williams, Research Analyst with IWPR and an author of the report.

If an employee has paid sick days they are more likely to go to a doctor during regular business hours. They’re also less likely to put off needed care. Some states are considering legislation that would make sure workers have the ability to earn paid sick time. Some industries are less likely to have paid six days. For instance, two-fifths of private sector employees, including three in four food service workers, three in five personal health care workers and three in four child care workers, do not currently have access to paid sick days.

Wondering what the top trends in workplace benefits will be for 2012? Colonial Life and Accident Insurance Company released their top five predictions for the coming year in terms of workplace insurance:

1. Products: Critical illness insurance will continue to get attention

Major medical issues like cancer, heart attacks and strokes usually exceed many employees’ major medical coverage. Critical illness insurance can provide vital out-of-pocket protection in these cases. “One way to think of critical illness insurance is as ‘living life insurance,’” says Randy Finn, assistant vice president of supplemental health products at Colonial Life, where critical illness sales increased 24 percent from 2009 to 2010. “If you get a serious illness such as cancer and die, life insurance helps with that. But what if you survive? You’re likely to have years of financially crippling bills to pay.”

2. Sales: Voluntary insurance sales will improve significantly

Experts believe sales will increase as more workplaces feel the need to offer a variety of choices to employees. “There’s a big need for better education of workers about the need to protect their most valuable assets with life and disability coverage,” points out Jeff Koll, Colonial Life’s assistant vice president of life and disability products.

3. Services: Wellness programs will become more common as a cost-reduction strategy for employers

Employers have more motivation to keep their employees healthy as health care costs continue to rise. “Good communication about wellness programs is essential for them to be effective,” says Steve Bygott, Colonial Life’s assistant vice president of marketing analysis and programs. “Without a focused effort to ensure employees understand the program and its value to them, participation tends to be low.”

4. Technology: Employees will receive access to more online insurance tools

Employers are putting more decisions into their employees’ hands which means easily accessible tools are going to become even more important.

5. Economy: Government sector employers will need more money-saving options

Government employers are feeling the financial pinch and will need more affordable insurance solutions. “The good news is there’s a huge opportunity for government employers to control costs by changing their benefits plan design,” says Pat McCullough, Colonial Life’s public sector practice leader. “Government employers have been slower than other industry segments to shift away from the more comprehensive, paternalistic benefits models of the past, but there are solutions to help them offer strong packages and still save money.”

A man who risked his life to save others during the Joplin tornado has been facing a continual storm. Mark Lindquist, 51, was seriously hurt while trying to protect group home residents from the destruction. He placed mattresses on top of three middle-aged men with Down syndrome and climbed on top to further protect them. The three men died. Lindquist was injured and in a coma for three months.

Lindquist’s job didn’t provide medical insurance so according to the Washington Post he tried to qualify for workers’ compensation since he was injured on the job. But in June the claim was denied, leaving Lindquist with $2.5 million in bills, according to his sister. Lindquist Baldwin said last week.

Fortunately some good news finally arrived when the Accident Fund Insurance Company of America announced it had changed its mind. “Upon further review of the case, and receiving additional information on the facts involved in this situation, Accident Fund believes the appropriate decision is to honor Mr. Mark Lindquist’s claim for worker’s compensation benefits,” Mike Britt, president of the Lansing, Mich.-based insurance company, told the Washington Post. “We are committed to working with Mr. Lindquist to ensure he receives all the benefits to which he is entitled and helping him to recover from his injuries.” Lindquist told the newspaper that this may mean he won’t have to sell his home like he had previously thought.

According to analysis, the average cost of healthcare service covered by insurance and Medicare programs increased by nearly 6 percent over the last 12 months. It’s the fourth consecutive increase noted by the S&P Healthcare Composite Index. The survey also monitors healthcare costs not covered by insurance and found that those prices increased by nearly eight percent over the last year. Medicare claim costs hit a new low, raising at an annual rate of just over two percent.

Indexes monitoring hospital and professional services saw only small increases. “As the summer of 2011 ended, we continued to observe the recent trend of a deceleration in the annual growth rates of Medicare costs and a sustained acceleration in the annual rates of commercial healthcare costs,” David M. Blitzer, Chairman of the Index Committee at S&P Indices said in a news release. “The Composite Index posted an annual rate of +5.73%, the Commercial Index +7.89% and the Medicare Index +2.16%. With this month’s data, the Medicare index is almost one-fourth of its peak annual rate of +8.02% recorded in November 2009.  This is a very sharp deceleration.”

The S&P Healthcare Economic Indices determine annual growth rates by calculating a percentage change over a 12-month period, examining increases and decreases each month. “If you further separate commercial plans’ costs into their hospital and professional services components, you can see that the August 2011 commercial hospital index is above the rate it posted at the beginning of the year – specifically +9.05% in August versus +8.68% in January,” explains Blitzer. “In contrast, the commercial professional services index has decreased to +6.68% from its +7.25% January growth rate. The increasing growth rate for hospitals is primarily due to rising rates of employment and wages. Professional services wages have also seen increasing rates during 2011; however, employment trends have declined over the same period.”

It’s currently benefits open enrollment season for millions of American employees. This is the season they’ll be faced with some big decisions about their 2012 health care coverage. Health care costs are expected to increase by seven percent in 2012 to $10,475 per employee, according to Aon Hewitt, a global consulting firm. Employees are projected to contribute roughly $2,300 to that expense in 2012. That’s an 11 percent increase compared to 2011. Aon Hewitt’s analysis shows that beyond that cost, employees will spend an average of $2,275 on out-of-pocket expenses while seeking care next year.

The Consumer Health Mindset survey, Aon Hewitt‘s recent survey of 3,000 health consumers, shows more than half of consumers participated in health risk assessments and/or screenings such as blood pressure and cholesterol screendings in the past year. Many employers are offering opportunities for employees to address health risks and conditions that will help them with things like managing their diabetes or quitting smoking. Choosing to take part in these assessments and screenings is a crucial part of the open enrollment process. “The most important advice we can provide to an employee is to be an active participant in the open enrollment process,” suggests Craig Rosenberg of Aon Hewitt. “Health care needs and benefit costs can vary from year to year, and when you combine that with the changing health care landscape, it’s critical for employees to educate themselves on their available coverage and reevaluate their choices.”

These are important steps in preventative health care, which is something that employees need to consider, according to experts. “When it comes to choosing and using their employers’ health care plans and programs, workers want their employers to do four things, according to our Consumer Health Mindset survey: make it easy to do, make it personal so I know how to get the best value, make it move me in the right direction, and make it meaningful, so I feel supported as I try to improve my health,” said Joann Hall Swenson, health engagement best practice leader with Aon Hewitt. “Employers who craft their health engagement strategies around these four insights will have a chance at reaching and engaging their employees, which in turn will lead to improved health and productivity, and reduced cost.”

The November issue of Consumer Reports provides rankings of 830 private, Medicare, and Medicaid health insurance plans, an analysis that reveals wide variations in quality for some of the country’s largest insurers. This is a great time for the information to be released since many companies offer open enrollment in the fall.

The rankings are conducted by the nonprofit National Committee for Quality Assurance. “All the health plans in these rankings are exemplary,” said NCQA President Margaret E. O’Kane in a news release. “First, they measure their quality in painstaking ways that help them improve and that make comparing plans possible. Then they take the extra step of revealing their results for the world to see—a true public service.” This is the second year for the rankings, but the first time that Preferred Provider Organizations, also known as PPOs, are being included. PPOs are generally less restrictive than Health Maintenance Organizations. About one-third of the US population is enrolled in a PPO plan.

The rankings include insurance plans in all 50 states and involve an estimated 127 million Americans. “American consumers who assume that ‘bigger is better’ and that doctor choice equates with quality might be surprised when they see how insurance plans stack up in the rankings.  We were struck by the strong performance among HMOs in general, and by some of the smaller, community-based plans,” says Nancy Metcalf, senior program editor, Consumer Reports in a news release. Among the plans receiving the highest scores include 15% of HMOs, 6% of PPOs, 33% of plans not owned by one of the six biggest health insurers and 4% of plans owned by the six biggest health insurers.

A new survey from Children’s Mercy Hospitals and Clinics in Kansas City found that three out of four parents think that insurance should cover obesity treatment. With more and more children falling into the obese category, the study wanted to investigate how obesity ranks among parents’ concerns. They found that about half of parents feel overweight children should undergo medical care while 81% feel the same about diabetes symptoms, 80% about asthma and 74% about a learning disability.

The study also asked parents if they would seek medical attention for a condition that would limit their child’s life expectancy and 94% said yes. The survey also found that 93% of parents would get their children medical attention if they had an issue that would impact their future health care costs. “Despite the attention on the obesity epidemic, the disconnect found among parents regarding the long-term outcomes associated with childhood obesity is concerning,” said Sarah Hampl, MD  medical director, Weight Management Services at Children’s Mercy. “Obese children have both immediate and future health problems, including hypertension, heart disease and diabetes. The survey illustrates that parents need help connecting the dots between having an overweight child and what their future health consequences may be.”

Eight out of ten parents surveyed say they have the greatest potential to prevent obesity, but roughly six in ten think schools need to pitch in. The majority of parents are in favor of schools changing physical education requirements and restricting unhealthy foods during fundraising activities. “It is evident that parents recognize that there is an issue and that they can have an impact on combating obesity,” said John Lantos, MD, the hospital’s Director of Pediatric Bioethics. “They need to set a healthy example and work with both physicians and schools to encourage a healthy lifestyle that includes physical activity, healthy habits and nutritious food.”

Employers aren’t expecting to make too many changes to health care plans in 2012 according to a new survey by Towers Watson. However, employer health care costs will still increase by about 5.9%. Most employers agree they’ll have to do something to control costs. The study also shows that nearly half of employers have a lot of thinking to do when it comes to health care strategy and many aren’t sure how they’ll respond to state-based insurance Exchanges in 2014.

Roughly half of those surveyed say they’re expecting health care reform to move forward as planned, but their unsure about other areas. “With so much still unknown regarding both the short- and long-term impact of health care reform, most employers will not make wholesale changes to employer-sponsored health plans in 2012,” said Ron Fontanetta, senior health care consulting leader at Towers Watson in a news release. “However, a small group of employers is driving more fundamental change in 2012 by using account-based platform designs, aggressively positioning incentives and rethinking subsidization levels.”

The survey found that 71 percent of companies plan to continue health care benefits through 2014 for active employees. However, 29 percent aren’t sure if they’ll continue to offer benefits or instead provide salary increases to offset costs. The study found that over the next few years employers are considering increasing their offering of account-based health plans. Around half also plan to use value-based benefit designs or increase use of preferred networks.

The dentist may not be a top priority for you, but skipping this routine maintenance can actually end up costing you far more than you save by not going. Skipping dental visits in an effort to cut costs actually creates much more expensive side effects. Unfortunately millions of Americans are forgoing routine dental care because they don’t have insurance or can’t afford it. However, the Institute of Medicine found that 33 million Americans live in areas that don’t provide sufficient dental services. The Institute of Medicine also reports that nearly five million children skilled dental checkups because their parents can’t afford it.

Many dentists say they see patients regularly who haven’t had their teeth checked in years in an effort to save money. However, skipping the dentist means minor issues can turn into serious medical problems which cost far more to treat than to prevent. “You do not save anything by ignoring your teeth,” Thomas P. Connelly, a cosmetic dentist practicing in New York City recently wrote. “In fact, it will end up costing you a lot — either in high dental bills, or lost teeth (which, trust me, you don’t want to happen).”

Eliminating regular dental care from your routine can lead to aching teeth and sensitive gums. Routine checkups can also help reduce the risk of diabetes, respiratory disease, cardiovascular disease and more. Even without insurance a cleaning can cost less than $100, which makes it a good investment against future procedures.

Residents in Kansas can now sign up for child-only health insurance. The legislation, signed into law in early June allows children  under the age of 19 to be included in insurance plans provided there is no similar, child-only coverage available at the county level. Many Kansas insurance providers stopped selling insurance to those under the age of 19 and this new law fills a void.

Any minor unable to purchase or obtain individual health insurance can now be included in the state’s high risk pool which is handled by the Kansas Health Insurance Association, or KHIA. “Now, those families that need a child-only policy can seek coverage through the KHIA plan if they meet the new eligibility requirements,” Sandy Praeger, Commissioner of Insurance, said in a news release. “It provides a starting point for a Kansas-based solution to a coverage problem. We appreciate the understanding of Gov. Brownback and the Kansas Legislature in supporting this change.”

In New York, parents with children under the age of 19 who need health insurance can not be denied health coverage due to pre-existing conditions thanks to a new law signed in late April. If a parent applies for insurance and is approved, then the child will also be approved.

If a parent is not applying for coverage, the application is known as a “child-only plan.” SB-11-128 mandates that child-only plans will be sold only during two open enrollment periods during the year — the month of August for this year. Starting in 2012, it will be the month of January and July. If a parent is not signing up, then the best time to sign up for “child-only” policies in New York is during August which is the open enrollment period. The situation is similar to Kansas and other states looking for a temporary solution until health care reform takes full effect. “The new law provides a temporary solution until 2014, when all health plans are required by law to provide coverage without consideration of health status,” Praeger said.

Most bank robberies steal because they’re after the code hard cash. But for James Verone, the motivation was healthcare. According to WHP-tv, Verone, 59, took $1 from a bank because he wanted to go to prison as a way to access healthcare. Verone is from Gason County, North Carolina and thought that prison would be a welcomed change because it meant a solid roof and medical care.

Verone told authorities he has a growth on his chest and two ruptured disks. The medical issues need attention, but he’s out of work and has no insurance. WHP-tv says Verone walked into a Gastonia, North Carolina bank with a note saying, “This is a bank robbery. Please only give me one dollar.” Then he calmly waited to be arrested.

According to WCNC-tv in Charlotte, Verone is hoping to stay behind bars for three years. The TV station reported, “He is hoping for a three-year sentence. He would then be able to collect Social Security when he got out and said he would head for the beach. ‘I’ve already looked at a condominium. I’ve spoken to a realtor on Myrtle Beach,’ Verone said.” Authorities say they’ll charge him with larceny– not bank robbery. Which could foil Verone’s prison plan.

A radiologist, a neurologist and two other people are accused in a $17 million workers’ compensation insurance over-billing scheme, according to Insurance Journal. The Orange County, California District Attorney’s Office and the California Department of Insurance released details of the case this week.

According to officials Dr. Sim Carlisle Hoffman of Newport Beach, a radiologist and owner of several medical practices, is charged with 592 felony counts of insurance fraud for one of his businesses, and 291 felony counts of insurance fraud for another. That means if he’s convicted he could face a sentence ranging from two years to more than 892 years in state prison. He’s currently been released on bail. Insurance Journal reports that Beverly Jane Mitchell, who served as the administrator in charge of insurance billing at  Hoffman’s businesses, faces the same charges and sentence.

Another doctor, neurologist Thomas Michael Heric, worked with Hoffman and faces 296 counts of insurance fraud. He could face any where from two years to more than 315 years in state prison. Finally a fourth man, Louis Umberto Santillan, worked for Hoffman in his billing collections area and faces 141 felony counts of insurance fraud. All four will be arraigned on June 22.

Authorities say Hoffman billed certain tests as many as 20 times per patient, but he never completed the test. Insurance billings that should have cost about $2,000 were inflated to $10,000. Hoffman is accused of fraudulently billing seven different insurance companies for millions of dollars in fake claims.

The city of Des Moines is taking on a unique plan to save taxpayers about a million bucks and keep their city employees insured. The Des Moines Register reports that City Council members approved a plan to move to a self-insurance system. The city is looking for ways to reduce expenses significantly since property values have dropped and commercial property tax rates are dropping by 40 percent.

They’re not the only ones moving to a self-insured program. Nearby Ankeny and West Des Moines are using similar models. “I hope we stay self-insured,” City Councilwoman Christine Hensley said according to The Des Moines Register. “I think the time is right for us to go forward with that. I think there have been some changes made.” This isn’t the first time the city has used a plan like this. The system was in place  until 2003 when the city started buying private insurance from Wellmark.

Leaders expect to start seeing significant savings in 2013 because of this move. “Conservatively speaking, we anticipate it being more than $1 million,” one leader said. Alternatively, council members said they would have been paying millions more– rather than saving a million dollars. The new plan starts July 1.

No matter what goal you’re working towards– taking a trip to Europe, buying a home, helping your kids through college– you likely need money to make it happen. But a new survey from nonprofit LIFE Foundation found that only one in six working Americans consider their paychecks their most valuable assets. The organization says many people fail to consider what their back up plan is in the event that they become sick or injured and can no longer work.

If you become disabled, your finances will most likely be impacted. According to LIFE Foundation, a 25-year-old who earns $50,000 a year could lose $3.8 million in future earnings if they become permanently disabled. Despite that information, fewer than one in three workers carry long-term disability coverage according to the US Department of Labor. “Most people don’t realize that they have a three in 10 chance of suffering a disabling illness or injury that could keep them out of work for three months or more,” Marvin H. Feldman, CLU, ChFC, RFC, president and CEO of the LIFE Foundation said in a statement. “Disability insurance makes sure that financial hardship doesn’t follow the physical and emotional toll that comes along with disability. It’s insurance for your income. When you think about it, your most valuable asset isn’t your home, car or jewelry. It’s what allows you to pay for all these things – it is your paycheck.”

Wondering how to get disability insurance? For many it’s available through employers. Your employer may offer short and long term group policy coverage at little or no cost. You can also check with professional associations which can offer insurance options to members.

Uninsured families typically don’t have the means to pay their hospital bills. The average  uninsured family can only afford to pay about 12 percent of hospital stays according to a report by the US Department of Health and Human Services. Hospital visits by uninsured patients who can’t pay their bills in full account for 95 percent of all the hospital bills accumulated by the uninsured, according to Insurance Journal. That amount of care equals about $73 billion a year, much of which creates higher costs for Americans who do have insurance.

Each year, close to two million uninsured Americans end up in the hospital with more than half facing bills over $10,000. According to this recent study, the vast majority of the country’s 50 million uninsured people don’t have any savings. The report found that half of families with income at 400 percent of the federal poverty level (which is $89,400 for a family of four) have financial assets totally less than $4,100.

The report found that living without health insurance is actually a financially riskier move than going without car or homeowner’s insurance. People are 50 percent more likely to have a car accident than to be hospitalized in a given year, but the average bill for a trip to the hospital is two and a half times greater than the cost of the average car accident. “Health insurance is critical in helping protect families from unexpected hospital costs,” Sherry Glied, HHS assistant secretary for planning and evaluation, told Insurance Journal. “This report shows that even higher-income uninsured families are struggling to meet the high costs of health care. No family should bear the burden of being one illness or accident away from bankruptcy.”

In the past as soon as college graduates grabbed their degrees they had to worry about finding a job with benefits. Typically insurance plans stopped coverage once school was done for good. But new changes in health care reform mean that adult children can stay under their parents’ plans until they are 26.

The LA Times talked to 22-year-old Boston University graduate Rochelle O’Sullivan who says she’s relieved she can keep her mom’s coverage. O’Sullivan broker her hip during a fall and needs good health coverage while she heals. “I’m worried about getting a job, getting experience,”  the mass communications major told the newspaper. “And if that means taking a job without insurance, I’d do that.”

The new law even covers adult children who don’t live at home and who may be married. But if the twenty-something-year-olds do find a job with benefits, they can’t opt to stay on their parents’ plan. For some recent grads that means they’ll give up mom and dad’s good coverage for entry level benefits that may not be as good.

According to a news release, WellPoint, the country’s largest public health insurer says they’ve seen the addition of 280,000 new members who fall under this new dependent provision. Aetna added roughly 100,000 young adults, Kaiser Permanente about 90,000 and Highmark says they saw an additional 72,000 young people added on. US Health and Human Services estimates that up to 1.2 million young adults will likely sign up during 2011.

A new study shows that insurance reform may not impact the increase in emergency room visits. More than 80 percent of emergency physicians say they’re increasing their emergency departments. Ninety-seven percent of emergency physicians also report helping Medicaid patients daily because they could not find a doctor to accept their health insurance.

Officials worry that new health care reform legislation may provide insurance coverage that reimburses doctors at Medicaid rates which will make this problem worse. “This poll confirms what we are witnessing in Massachusetts — that visits to emergency rooms are going to increase across the country, despite health care reform, and that health insurance coverage does not guarantee access to medical care,” said Dr. Sandra Schneider, president of the American College of Emergency Physicians in a news release.   “Emergency medicine provides lifesaving and critical care to millions of patients each year and yet only represents 2 percent of the nation’s health care expenditures.  Emergency physicians command the resources of a hospital to provide the best care for patients, but we must be prepared for increasing numbers of patients, not fewer, especially given our growing elderly population.”

The poll included responses from 1,768 emergency physicians. Seventy-nine percent of those responding say they’re using resources more efficiently, but nearly half worry that lawsuits will force them to cut costs in their departments. “Emergency departments need more resources, not fewer, and medical liability reform would help reduce overall costs by reducing the need for defensive medicine,” said Dr. Schneider. Roughly two-thirds of ER visits occur when doctor’s offices are closed and patients need urgent care. In 2008, ER visits reached nearly 124 million, an all-time high according to the Centers for Disease Control and Prevention.

A new report from the National Insurance Crime Bureau, NICB, shows a big jump in questionable claims in New York. With 145 questionable claims, the city of Buffalo came in second behind New York City which had 4,016 questionable claims. New York City held57% of the statewide total of questionable claims. In all, 7,026 questionable claims were filed across the state of New York in 2010. That’s up from 6,378 in 2008.

So how does an insurance claim become “questionable?” Authorities say there are seven reasons, but most are because they were “faked/exaggerated injury”. Other reasons include “excessive treatment” and “staged/caused accident.” According to reports, most of the questionable claims come from automobile insurance policies. In fact 83% of questionable claims in 201 involved auto insurance.

Allstate responded to the report. Krista Conte, New York spokesperson for Allstate said, “We commend the NICB on their efforts to fight fraud and raise awareness about this issue, which is extremely important to all New Yorkers. Not only is no-fault fraud, or auto accident fraud, costing New York consumers and insurers hundreds of millions of dollars, it puts drivers at risk. Those who would commit this type of crime are taking advantage of the broken no-fault system and are organized, calculating and part of a big business. They are gaming the auto insurance system and the victims are honest, hard working New Yorkers.”

A massive assessment of high-deductible health plans shows that while they cut health spending they also prompt patients to reduce preventative health care. The study, completed by RAND Corporation, looked at more than 800,000 families across the US and found that when people shift to a high deductible insurance plan of at least $1,000 per person, their health spending declined by 14% on average.

Spending was also lower in high deductible households where health savings accounts were sponsored by employers. Some of the cut backs families experienced were reduced immunizations, cancer screenings and routine tests for diabetes. “We discovered that costs go down dramatically during the first year people are enrolled in high-deductible health plans, as long as the deductible is at least $1,000 per person,” said Amelia M. Haviland , a study co-author and a statistician at RAND, a nonprofit research organization in a news release. “But we also found concerning reductions in use of preventative care. This suggests people are cutting both necessary and unnecessary care.”

High-deductible plans have been gaining interest because they are more affordable than other plans. By 2009, 20% of Americans with employer-sponsored plans had high-deductible coverage. A 2010 study found that more than half of large employers offered at least one high deductible plan to their employees. Officials believe that health care reform will push even more people into high-deductible plans.

So what’s the real cost savings of having a high deductible plan? The study shows that the deductibles had to be at least $1000 in order for the savings to be significant. With high-deductible plans spending was lower both on inpatient care, outpatient care, and prescription drugs.  Rates of mammography, cervical cancer screening, colorectal cancer screening and blood tests were among preventative care that dropped with high deductible plans. “We saw that patients reduced preventive care, and if this persists, it is likely to have health consequences in the future,” Haviland said in a news release. “These cutbacks could cause a spike in health care costs down the road if people end up sicker and need more-intensive treatment.”

A new study released from the Kaiser Family Foundation investigated what the impact would be if the age of eligibility for Meidcare was increased from 65 to 67 in 2014. The study found that the move would indeed save the federal government a lot of money– $7.6 billion in fact, but it also found that there are downsides to the change. Increasing the age would pass on an added $5.6 billion in out-of-pocket expenses for about five million 65 and 66-year-olds as well as $4.5 billion to employer retiree health care costs.

The study also says that changing Medicare’s requirements would mean a 3% increase in premiums for those who remain on Medicare and for those who receive coverage through the new health care reform insurance exchanges. About three in four 65 and 66-year-olds would pay an average of $2,400 more for health care in 2014 than if the current system remained in tact. One-fourth would see a drop in out-of-pocket expenses. “Raising Medicare’s age of eligibility would obviously reduce Medicare spending, but would also shift costs onto seniors and employers, and increase costs elsewhere on the federal ledger,” said Kaiser Family Foundation Vice President Tricia Neuman in a news release. Neuman leads the new Kaiser Project on Medicare’s Future.  ”This analysis drives home the tough policy choices that lie ahead when Washington gets serious about reducing the federal deficit.”

This study is the first to investigate the impact health reform will make on seniors’ expenses. Without reform, the organization says other studies have shown that raising Medicare’s age requirement would increase the number of uninsured people. By increasing the age for Medicare to 67 in 2014, that would mean $31.1 billion in Medicare savings because people who are 65 or 66 would not be included.

Fidelity Investments announced that they are seeing significant growth in their Health Savings Account business. They’ve added 14 new HSA clients which marks a 52% increase over the previous year. In a news release the company explained how customers using Fidelity HSA are taking advantage of tax benefits of having this medical account.

On average, participants contributed $2,620 in 2010 which included both personal additions and employee contributions. “The continuing rise of health care costs combined with health care reform really drove the adoption of HSA-qualified health plans  by employers last year and thus the growth of HSAs,” said William Applegate, vice president, HSA products, Fidelity Investments in a company news release.  “As for participants, it is clear that many are using the health-savings product to help manage not only their current medical expenses but also plan for future expenses, with nearly all participants carrying some balance over to the following year.”

Currently Fidelity has 74,000 HSA participant accounts. One in five of those participants contributed more than $5,000 to their account in 2010. About half added around $2,500 in 2010. By law, in 2011 the maximum an individual can contribute is $3,050 and for families that number is $6,150. HSA’s allow consumers to make pre-tax contributions, realize tax-free growth and make withdrawals for qualified medical expenses.

Health care records for millions of Americans is missing according to a report by ABC News. The missing data also includes Social Security numbers for about two million of Health Net Inc.’s past and current customers. The company announced this week that it’s missing several hard drives from its data center which is located in the Sacramento area.

The California Department of Managed Health Care issued a news release saying that nine server drives are unaccounted for and that it’s investigating the missing information. The department believes about 1.9 million people could be impacted. Of those, more than 622,000 have insurance products regulated by the state Department of Managed Health Care, more than 223,000 are currently enrolled in California Department of Insurance products and another portion are Medicare clients.  “Obviously something went wrong, but we don’t know,” department spokeswoman Denise Schmidt said according to ABC News.

Health Net has about six million customers and this is not their first experience with data loss, according to reports. Back in January the company paid about $55,000 in a settlement over the loss of similar information of 1.5 million people. The incident happened in Vermont and customers were not told about the potential security breech for six months. ABC says IBM handles the company’s information technology.

Healthcare reform may not limit medical bankruptcy, according to a new study and a report by the LA Times. While more people will have coverage, many will still have poor coverage and end up struggling with medical debt. The article refers to a study published in the American Journal of Medicine.  “These data suggest that reducing medical bankruptcy rates in the United States will require substantially improved — not just expanded — insurance,” the report says.

Researchers investigated those who have filed for bankruptcy in Massachusetts during 2009 and compared that to national data compiled earlier. What they discovered as that medical bills contributed to more than half of all bankruptcies. Medical bankruptcies increased by a third and total bankruptcies went up by 51% between 2007 and 2009.

The study shows that insurance in Massachusetts has continued to become more expensive. “It’s really too much money for the average family — especially if the breadwinner is the one who gets sick,” the report says. Uncovered services could make expenses even greater, the study reported. “We need to reduce limits on deductibles and out-of-pocket costs,” an author study said according to the LA Times.

Many major US companies are expanding their insurance coverage to include paying for sex change operations, according to Daily Mail. Companies like Coca Cola, Yahoo!, American Express and AT&T are among those changing their employees’ insurance coverage. Stephanie Battaglino, an employee for New York Life, underwent a transition but her insurance didn’t cover it. She borrowed money from her retirement accounts to fund the surgery, according to Daily Mail. Now she’s working with her company to change the insurance plan.

She says at first the company feared it would face large payouts if they allowed the $75,000 in coverage, but Battaglino explained that only a few would need the benefit. ‘The big misconception is we are going to go broke and all these transgender people are going to come out of the woodwork asking for gender reassignment surgery,’ Battaglino told the Daily Mail.

Those in favor of the change say it’s not just cosmetic surgery. Those with Gender Identity Disorder are at high risk for suicide and those who are treated will in turn be better employees. ‘Wells Fargo elected to offer this benefit to be competitive as an employer and also to support our comprehensive corporate commitment to diversity,’ company spokesman Mary Eshet told the Daily Mail.

New federal rules state that children with chronic health conditions can’t be denied coverage. Now officials are trying to get the word out to parents and enroll thousands of children who couldn’t get health coverage before this new rule. Statistics from the White House show that around 72,000 uninsured children in California alone will now have access to insurance because of these rules.

And in California, the rule was taken even further according to the Sacramento Bee. Insurance companies can’t charge premiums that are more than double those applied to healthy children. But here’s the catch– parents must sign up during open enrollment which ends March 1. “It is important for all parents to purchase coverage for their children to help keep this new requirement from impacting premiums,” Pat Johnson, president of California Association of Health Plans told the Sacramento Bee in an email. “If only people with high health care needs buy insurance, it can drive up the prices for everyone.”

California parents are urged to take advantage of this otherwise they’ll risk having to wait until their child’s next birthday. “There is real urgency. The time is now to sign up children for the coverage,” Kelly Hardy, the health policy director for Children Now, told the Sacramento Bee. The rules potentially impact more than 575,000 kids in California who have pre-existing conditions that may have lead to a denial of insurance coverage in the past. Most are insured through the parents’ employers, but for parents who buy insurance on the individual market this will be a huge advantage.

UCLA researchers say that 1.5 million California children don’t have health insurance, but a whopping two-thirds of them would likely be eligible for public health insurance through programs like Medi-Cal or Healthy Families. “One of the most important changes that federal health care reform has brought about is allowing for children with pre-existing conditions to obtain health coverage,” Insurance Commissioner David Jones told reporters during a news conference according to the Sacramento Bee. “This initial open-enrollment window is critical, and parents should take full advantage of it by signing their children up for coverage.”

Health care reform has been deemed unconstitutional by a federal judge in Florida. The judge ruled that the government can’t force people to buy health insurance. The lawsuit was brought forward by 26 states pushing to overturn the 2010 law pushed by the Obama administration that would have required people to purchase insurance by 2014. Most people are not surprised by the ruling since the judge is a republican and was appointed by President Reagan in the 80s.

Judge Roger Vinson announced his decision on Monday, saying that the law should be overturned as long as higher courts follow his opinion. “The act, like a defectively designed watch, needs to be redesigned and reconstructed by the watchmaker,’’ Vinson wrote. Vinson also said that the law would remain in effect until all appeals were wrapped up which could take as long as two years.

Other lawmakers are responding to the news including House Speaker John Boehner of Ohio who said in a statement, “The House has passed legislation to do just that, and I hope Senate Democratic leaders will bring up the measure for an up-or-down vote.” According to the Boston Globe, the Tea Party movement is speaking out about the move. “We’ll be happy to see this law go and we look forward to the Supreme Court siding with the Constitution,’’ Tea Party spokeswoman Shelby Blakely said according to the Boston Globe.

ABC News may have helped the wife of a Vietnam War vet avoid getting her insurance coverage axed over a two-cent error. ABC News says when the cancer patient made a payment to Ceridian, the company that distributes the couple’s COBRA insurance, they made a two-cent mistake. The check was made out for $328.67, when it should have been $328.69. That mistake prompted the insurance company to cancel coverage.

When the company found that the couple had not made their full payment they issued this statement, “We did not receive a full and timely payment and [the insured] was provided several notices of the shortage and a grace period reminder notice on the last invoice, along with extended grace dates as provided for under COBRA regulations,” the company said according to reports. “Since the payment was not full, it fit into the definition in the regulations of an ‘insufficient payment.’ … Ceridian understands nothing is more important than one’s health. … Unfortunately, we simply do not have the capacity to be able to personally call continuants and remind them of the status of their Cobra benefits.”

Once ABC News got involved, however, the insurance company had a chance to rethink their decision. “We’ve reviewed the situation thoroughly,” a rep for the company told the news agency. “And we’re pleased to say… [the policyholder's] insurance coverage was reinstated.” However, Ceridian did not feel that it needed to apologize for the error.

Health care is coming from an unusual place: Sam’s Club. Starting this month Sam’s Club members can now pick up preventative health care along with their bulk boxes of diapers and gallon jugs of shampoo. “The Prevention Plan” is offered by US Preventive Medicine and costs $99, according to CNN Money. Right now Sam’s Club members can purchase the product through the website and by May the company says they’ll offer it in every store.

The company’s CEO is adamant about the fact that the product is not insurance, and it doesn’t include access to doctors, but Christopher Fey does say that it may help keep people out of the doctor’s office. “Think of it as what a financial planner does,” Fey told CNN Money. “He takes all the information you provide, assesses the risk and gives you a plan on how to improve your financial health. The prevention plan does a similar thing, but for your [personal] health.”

With their $99, buyers will get a year-long subscription to a web-based program that monitors at-home blood screening tests and also tracks cholesterol, blood sugar and hemoglobin levels. Customers will also have access to an around the clock nurse line, two health coaching sessions and a series of health-related recommendations based on the person’s age, gender and risks. “The aim of the prevention plan is to keep individuals healthy, identify illness early rather than wait for symptoms to develop and assist in chronic care management such as for diabetes or heart disease,” Fey told CNN Money. “We are boosting our staff in anticipation of the Sam’s Club offering.”

Some worry that people will see this $99 product as a replacement to insurance, but Kathleen Stoll, director of health policy with Families USA says that’s not a good idea. “This plan is not a replacement for health insurance,” Stoll told CNN Money. “Think of this way. If you were training for a marathon, you may buy a heart monitor and monitor yourself while you train. But you still need to see a professional to give you a full cardiovascular checkup. I worry about people thinking of this prevention plan as a substitute for an annual checkup at a doctor’s office.”

Pennsylvania’s subsidized health insurance will come to an end next month, according to The Pennsylvania Inquirer. The insurance for low-income people currently assists more than 40,000 people and has another 400,000 on a waiting list for service. “AdultBasic is not sustainable,” Kevin Harley, a spokesman for the governor’s transition team told the newspaper. The program began eight years ago under Gov. Tom Ridge.

Both the exiting governor and the new one say the program is not doing well and would run out of money by the end of February. Currently it’s funded by tobacco-settlement money and donations from the state’s four Blue Cross plans. “There is no apparent source of funds,”David F. Simon, chief legal counsel of Jefferson Health System, told The Inquirer.

For people on the plan, they will have some help switching to Blue Cross. The company says it will not restrict people for preexisting conditions, something it would normally do. But the cost will be several times higher than what they are currently paying under the adultBasic plan. “Special care is horrible insurance,” Gene Bishop, an internal medicine doctor at Pennsylvania Hospital, told reporters. “When I was in practice and I first saw someone with that insurance, I thought they were mistaken. Who would sell someone insurance that you can only go four times a year?”

Californians are bracing for a big shake up– an earthquake of sorts in health insurance. Blue Shield of California is headed for another rate hike, which will hit March 1, 2011 according to reports. At that time 193,000 policyholders will experience increases of about 30%. This will be the third rate jump in six months, increasing costs by about 59%. “For families, there are few things as painful as a 59 percent health insurance rate increase,” Doug Heller, from the Santa Monica-based advocacy group, Consumer Watchdog told the International Business Times.

California’s Insurance Commissioner Dave Jones is asking for Blue Shield to hold off on the bump, even though he doesn’t have the authority to stop it. “Many Californians will no doubt be surprised to learn that the Insurance Commissioner does not have the legal authority to reject excessive health insurance premium increases,” Jones, a former state lawmaker, told the International Business Times. “I have fought hard to give the Insurance Commissioner this authority for the last six years. I have authored strong legislation to give the Insurance Commissioner the authority to reject excessive premium increases, only to see it defeated in the Legislature by conservative legislators.”

According to reports, Blue Shield issued this statement concerning their March 1 increase: “Our individual market medical costs are rising rapidly due to higher provider prices, increased utilization, and the fact that healthier people are dropping coverage during a bad economy,” the statement read. “Blue Shield of California expects to lose tens of millions of dollars on its individual healthcare business in both 2010 and 2011.”

A Pennsylvania woman is believed to have faked a cancer diagnosis in order to receive thousands in insurance money. The Pennsylvania state attorney general’s office charged the woman on Monday with altering hospital paperwork and filing fraudulent insurance claims. Authorities say 50-year-old Deborah Brown of Canonsburg told her insurance company she got treatments that she never got for an illness she never had in order to pocket nearly $100,000 in insurance money.

Officials say Brown submitted the fake documents to AFLAC, a policy she opened in 2003. Between August of 2006 and May of 2008, Brown turned in altered documents to the insurance company in order to receive money for cancer treatments for both she and her husband, according to the Pittsburgh Tribune-Review. Officials say Brown’s husband did have surgery for prostate cancer in 2006, but didn’t receive any care after that.

According to news reports, Brown was diagnosed with lipoma, a non-cancerous fatty tissue, but she altered official hospital paperwork to make it appear that she had been given a diagnosis of liposarcoma which is a form of cancer. She was released on a $25,000 bond and her hearing is scheduled for February 3.

Hulk Hogan is fighting– but not in a ring. This time he’s in a battle with his ex-wife and his insurance company. Hogan, also known as Terry Bollea is suing his ex-wife Linda over insurance issues. Back in 2007, Hogan’s son Nick was in a car crash that seriously injured a passenger, John Graziano, according to reports. The insurance company, Wells Fargo Southeast, paid out its maximum coverage of $250,000, leaving Hogan and his family with the rest of the financial burden.

The Hogan family also faced legal battles over negligence. “The resulting personal injury damage to Graziano was ultimately far greater than Hogan’s policy limits of only $250,000 per injured person, and with no excess/umbrella insurance coverage, Hogan’s net worth was clearly exposed and unprotected,” the lawsuit, filed April 22, 2010 stated, according to reports.

According to reports Terry says Linda served as his business manager and was responsible for maintaining his insurance policy. That’s why he’s now suing her. Hogan’s lawyer Wil Florin was quoted in the St. Petersburg Times saying that while he “does not relish litigation with his ex-wife, her refusal to accept legal responsibility for her errors and omissions necessitates this action.” Hogan has recently remarried.

This week the battle in health care reform is centering in on Florida. Earlier this week the focus was in Virginia where a federal judge ruled that mandating health insurance was unconstitutional. Florida Attorney General Bill McCollum released a statement saying that the state will move forward with arguments in a Pensacola courtroom.

According to ABC News, the 20 states that are involved in the Florida lawsuit maintain that health care reform will put additional burden on their stretched budgets. However, research from the Kaiser Family Foundation shows that the federal government would pay for more than 95% of the added costs and states would only be responsible for $21.2 billion.

US District Judge Roger Vinson is expected to rule on the expansion of Medicaid, according to The News Service Florida. “The implementation of this law could add more than 1.9 million Floridians to the Medicaid program, a tremendous financial burden on our state at a time when our budget has no room for extra expenses,” McCollum said, according to reports. “As our lawsuit heads to oral argument this Thursday, I am hopeful we will obtain a favorable decision that will strike down the individual mandate and also halt the hundreds of millions of taxpayer dollars required to be spent by states to implement the Affordable Care Act.”

Most experts believe the issue will eventually be ruled on by the US Supreme Court. US District Judge Henry E. Hudson struck down the push to force people to have insurance. “The unchecked expansion of congressional power to the limits suggested by the Minimum Essential Coverage Provision would invite unbridled exercise of federal police powers,” Hudson wrote, according to The News Service Florida. “At its core, this dispute is not simply about regulating the business of insurance – or crafting a scheme of universal health insurance coverage – it’s about an individual’s right to choose to participate.”  The states involved in the suit are Florida, South Carolina, Nebraska, Texas, Utah, Louisiana, Alabama, Michigan, Colorado, Pennsylvania, Washington, Idaho, South Dakota, Indiana, North Dakota, Mississippi, Arizona, Nevada, Georgia and Alaska, according to The Washington Post.

Hundreds of thousands of people will likely be receiving notices that their insurance health plans don’t meet standards set by the new health care law. According to Kaiser Health News at least 1.5 million people will be getting the word either from their employer or insurer. According to officials, the notices must go out within 60 days.

The Obama administration said the notices must be sent to people with limited-benefit plans which are plans that cap coverage at as little as $2,000 a year. It’s possible to get a waiver which lots of employers including McDonald’s and Waffle House have already done. “This is clear notice that you have a policy that does not comply with the Affordable Care Act,” Steve Larsen, deputy director for oversight in HHS’ Office of Consumer information and Insurance Oversight, told MSNBC.

If you receive a notice it will likely direct you to HealthCare.gov to receive more information about coverage options. “The Affordable Care Act is giving consumers more control over their health care by providing them with information about their health insurance options”, said Secretary Kathleen Sebelius, according to The Gov Monitor. “Now, we’re taking an unprecedented step to ensure consumers are informed when they purchase policies that offer limited coverage”.

Limited-benefit insurance plans are also known as mini-med plans and they will be eliminated by 2014 thanks to The Affordable Care Act. Right now though, mini-med plans are the only affordable options available to some Americans, but Sen. Jay Rockefeller, D-W.Va., says the plans give people a false sense of protection. “It gives people a false sense of security — it lets them think they have health insurance when they really don’t. By the time they realize they don’t have real health insurance, it’s too late,” he told MSNBC.

For those who can’t afford other policies, they may be granted a temporary waiver that will be good for one year. For plans starting from September 23, 2010 and September 22, 2011, limits to annual coverage of essential health benefits including hospital, physician and pharmacy can not be less than $750,000.

eHealthInsurance is offering up tips for making the most of your insurance dollars before the year ends. “Many health insurance consumers aren’t aware that their health insurance benefits and deductibles may reset on New Year’s Day,” said eHealthInsurance Vice President of Customer Care, Gary Matalucci in a news release. ”We recommend that people with individually-purchased or employer-sponsored health insurance re-familiarize themselves with their benefits in December of each year to make the most of their coverage before the next benefit cycle begins.”

Look for Calendar-Year Benefits: Some health plans pay for annual physicals and exams. You may also be eligible for a teeth cleaning or vision check-up.

Take Advantage of Discounts: Some insurance companies offer discounts for gyms. If you’re planning to buy a membership check for this money-saving perk.

Use Your Deductible: If you’ve already met your deductible for 2010, you may want to take advantage of last-minute claims for the year that would be completely covered.

Keep Tabs of FSA and HSA Funds: Most Flexible Spending Accounts sponsored by employers don’t allow the money to roll over to the  next year. Ask your human resource department what your terms are. Also, starting in 2011 FSA and HSA funds can no longer be used to pay for most over-the-counter medicines so you may want to stock up before the year ends.

Check Your Mail: Health insurance companies will commonly send out notices at the end of the year if they plan to make changes to your account. Make sure that when these changes are issued that you’re still using a health care plan that works for you.

A bachelorette party turned tragic for bride-to-be Rachelle Friedman of North Carolina. The 25-year-old was planning to get married on June 27 to her fiance Chris Chapman. But the bachelorette party in Virginia Beach a month before the wedding changed that.

Friedman’s best friend jokingly pushed her into a swimming pool and Friedman hit her head on the bottom of the pool. “It was playful, but it went wrong,” Friedman told ABC News recently.  “It was a freak accident.”She told reporters she couldn’t move and her body went stiff. Turns out Friedman suffered a C6 spinal cord injury which means she can feel almost nothing below her neck and she may never walk again.

The former dance and aerobics instructor is not giving up hope that she’ll be able to marry her fiance one day. The reason she’s put off the wedding for now is because they say as a married couple their combined income would be too high to qualify for Medicaid, which Friedman says she needs to pay for constant care and rehabilitation.

Just like summer, spring, fall and winter, Medicare open enrollment season is a sure thing. The annual review process runs from November 15-December 31 every year. Seniors interested in the insurance program can visit Medicare.gov for information and assistance. But according to HelathNews.com those who want to find out if they’re eligible should just head to that site. You’ll also be able to research the plans that would be the best fit for you.

Interested in joining Medicare? You have four options to choose from:

• Medicare Part A

This is is hospital insurance. The premium cost is based on the number of quarters you were employed. If you or your spouse worked more than 40 quarters of Medicare-covered employment you will probably not have to pay a monthly premium for this coverage.

• Medicare Part B

This is medical insurance that typically costs around $100 a month if your income is less than $85,000 or $170,000 for a couple. Expect about a 4% increase in costs in 2011 compared to 2010.

• Medicare Part C

This is the Medicare Advantage Plan, similar to an HMO or PPO. It covers both Part A and Part B services and is offered by private insurance companies. These premiums aren’t government-regulated.

• Medicare Part D

This is Medicare Prescription Drug Coverage that is provided by private insurance companies. This can help people reduce their drug costs and is typically added on to Medicare Part A or Part B coverage.

Even if you’re already enrolled in Medicare, you may want to revisit the plans and make sure you’re in the one that is a good fit for you. Just as with any kind of insurance– auto, home, life or health– revisiting your plan can be a good way to cut costs. “This year there are substantial savings available to beneficiaries in Medicare Part D, so it’s important they learn as much as possible about their options to realize these benefits,” said Richard Ashworth, Walgreens vice president of pharmacy operations, in a news release. “Our pharmacists are among the most trusted and accessible sources for help with making an informed plan choice. They can’t make the decision for you, but they can certainly be a resource to help you understand your options. This is another way our pharmacists are helping people stay well in all the communities we serve.” Cheryl Matheis, senior vice president for health strategy at AARP, told HealthNews.com, “It always pays to do the search again, if your plan’s cost is going up, then you really do need to make sure you have the best deal.”Another way to cut costs is to shop around to other pharmacies. You may be able to find your prescriptions available at a lower price elsewhere. Not all drugs cost the same at each location.

MetLife announced that it will stop selling individual long-term care insurance. It will also cease to include new enrollments into group and multi-life plans. This news was announced in a company-issued news release. The company says this move won’t impact current policyholders as long as they remit payment for their premiums on time.

According to the Wall Street Journal, extremely low interest rates are creating problems for insurance companies because it lowers their profitability. And since it looks like rates could remain low, life insurers are changing products they offer. They’re not able to provide the features they once could, and this includes long-term care insurance as well as retirement-income products. “MetLife remains committed to our current LTCI policyholders and certificateholders and will continue to ensure that they receive quality service, particularly when needed most — at time of claim,” Jodi Anatole, vice president, Long-Term Care Products, for MetLife said in a news release. “While this is a difficult decision, the financial challenges facing the LTCI industry in the current environment are well known.”

Those with long-term care insurance policies will likely face more premium rate increases. This type of insurance helps cover costs of in-home care or nursing home fees. The reason for the increases is due to the fact that many policyholders are living longer which means the claims they generate cost more.

Looking to cut costs on insurance? More Americans are turning to high deductible insurance plans as a way to reduce costs. According to the Los Angeles Times, doctors worry that this means many people will skip routine exams that won’t be covered by these policies. Those routine doctor visits can often help catch serious ailments sooner. According to statistics, the number of employees with deductibles of at least $1,000 has tripled over the last four years to roughly 20 million people.

Those with high deductibles often skip preventive procedures including:

• Colonoscopies
• Blood Tests
• Skin Checks
• Annual Exams
• Physicals

According to the LA Times, UCLA’s Center for Health Policy Research recently found that one out of six Californians with high deductible plans held off seeing doctors because of the cost. “They are more likely to end up in emergency rooms or hospitals because they are delaying more appropriate preventive care,” Dylan Roby, a researcher with the UCLA center, told the LA Times.

Research shows that smaller companies, those with 200 employees or less, have increasingly moved to high-deductible plans for employees. The number has tripled to 11.7 million, according to the Kaiser Family Foundation and the Health Research & Educational Trust. “The way employers have been dealing with cost is by moving to less comprehensive, flimsier coverage with higher deductibles because it costs them less,” Kaiser foundation President Drew Altman told the LA Times. “That’s why workers have never been more upset about their own healthcare costs. The share they pay out of their pockets has been going up mostly because more people are in high-deductible plans.”

Fall can be a tough time for American workers. In addition to gearing up for the holidays, many are also gearing up for higher premiums that will come next year. Typically in the fall is when employers give their workers insurance options for the following year. And as the Washington Post reports, many workers may be faced with less-than-ideal options. According to experts, studies show that rates will be increasing and companies will be putting more of the financial burden for premiums, deductibles and co-pays on their employees.

A study from the Kaiser Family Foundation and the Health Research & Educational Trust found that the share of costs put on employees rose from 27 percent to 30 percent. That equaled a 13.7 percent jump in the amount paid by workers. Another study that will provide more insight into these trends will be released in 2011, but most officials believe it will just reemphasize what’s already known. A study by Mercer found that employers are seeing health care costs increase by about 10 percent, but with cost saving methods will be able to drop that added burden to 6 percent. One way they’re doing that is by having their employees pay more of the cost. Another method is by encouraging employees to lose weight and get healthier. A Mercer official says lowering employee premiums or providing rewards for taking health assessment surveys are becoming more common.

A federal judge in Florida announced that a lawsuit could proceed that claims that requiring Americans to buy health insurance is unconstitutional. Twenty states are involved in the lawsuit. US District Judge Roger Vinson rejected an effort by the Obama administration to have the case thrown out, according to the Los Angeles Times. Vinson’s decision was similar to one made by a federal judge in Virginia. “To say that something is ‘novel’ or ‘unprecedented’ does not necessarily mean that it is ‘unconstitutional’ or ‘improper.’ There may be a first time thing for anything,” Vinson wrote in his 65-page ruling, according to the LA Times. Continuing he wrote, “the plaintiffs have at least stated a plausible claim that the line has been crossed.” Florida is leading the challenge to the new healthcare law and 19 states have joined including:

• Alabama
• Alaska
• Arizona
• Colorado
• Georgia
• Indiana
• Idaho
• Louisiana
• Michigan
• Mississippi
• Nebraska
• Nevada
• North Dakota
• Pennsylvania
• South Carolina
• South Dakota
• Texas
• Utah
• Washington

Louisiana is the only state not led by a Republican attorney general or governor. “This ruling is a victory for the states, small businesses and the American people,” Florida Attorney General Bill McCollum said in a statement Thursday according to the LA Times. “It is the first step to having the individual mandate declared unconstitutional and upholding state sovereignty in our federal system.”

According to the American Medical News, spokeswoman Tracy Schmaler said the Dept. of Justice will continue to defend the new law and is confident their arguments will come out on top. “This case is in the early stages of litigation, and the department will continue to vigorously defend this law in ongoing litigation,” she said according to AMN. In Michigan, US District Judge George C. Steeh dismissed a third challenge arguing that the insurance requirement was unconstitutional. The next step comes December 16 when both sides will present their cases in a courtroom during a summary judgment hearing.

Government programs are helping kids get insurance, and not just those in households below the poverty line. The New York Times interviewed Dean McCrea, a 55-year-old widow who lost his job when his employer went out of business. McCrea could no longer afford insurance for him and his 16-year-old son, but recently he was able to get help through a program called Healthy Kids. It’s a state-run health insurance program for middle class families. McCrea was able to get his son insurance for just $38 a month. “A lot of people in my circle, solid middle-class families, are struggling,” McCrea told The New York Times. “The peace of mind that this program has supplied me is not measurable.”

According to the Census Bureau, the number of insured children under the age of 19 was just under 91 percent which is a record high. “To a surprising extent, the government has really stepped up to provide affordable coverage options for middle-class kids, along with their lower-income counterparts,” Jocelyn Guyer, co-executive director of the Center for Children and Families at Georgetown University, told the New York Times. “It’s a success story.”

That means that close to ten percent of children, or seven million, don’t have insurance. But experts say more than  half could qualify for government insurance through programs like Medicaid and CHIP (the Children’s Health Insurance Program). “Our biggest obstacle has been to convince families that don’t qualify for food stamps or other subsidies that they qualify for our program,” Cathy Kaufmann, administrator of the Healthy Kids program in Oregon, told The New York Times. Children in families of four with incomes of up to $44,100 qualify for certain government insurance programs. And if you live in a state like New York where the cost of living is higher, families of four can earn over $88,000 and still qualify.

Eligibility varies greatly depending on which state you live. But in a dozen states, even if you earn too much you still may be able to buy in to to more affordable CHIP policies. Finding out if you qualify is easy. Just visit InsureKidsNow.gov to find out about what’s available in your state. You can also visit the government’s new health insurance website Healthcare.gov to search for child-only policies. Plug in your child’s information and you’ll immediately have access to various policies at different price points so you can make an educated decision about keeping your child insured.

McDonald’s Corp. says the health care overhaul may force many of its franchises to close. According to a report by the Kansas City Star, The Department of Health and Human Services is having some serious discussions with the fast food giant over impending changes in health insurance. New regulations force health plans to spend at least 80 percent of premium dollars on medical costs, which is what McDonald’s has an issue with. According to reports, the company worries that forcing these ratios will force franchises out of business. McDonald’s says it may have to change its current insurance plan.

Government officials say they’re working closely with business like McDonald’s to work through issues with the insurance ratios. “Medical-loss ratios are important because they demonstrate to the employer or family that premium dollars are being used on health care,” Illinois Department of Insurance Director Michael McRaith told the Kansas City Star. McRaith and other insuranc commissioners are developing guidelines on medical-loss ratios for the Obama administration. The government plans to issue guidance about the ratios by the end of the year so that companies have a better idea as to what is considered a medical expense and what isn’t.

New data released by the Census Bureau shows that there has been a record increase in the number of people without health insurance. Nearly one in six US residents, or about 50 million people, were uninsured in 2009, according to the report. Previously the number of uninsured Americans was at 46.3 million and authorities say the reasons for the jump include job loss, companies axing health care benefits, and families cutting costs.

Another reason could be that it costs more. Statistics show that workers pay 47% more to keep their families insured than they did in 2005. “Eventually, more people will be covered if everything goes the way it should starting in 2014,” Helen Darling, president of the National Business Group on Health, which represents large employers, told USA Today. “But that’s four years away, and there’s going to be a lot of financial pain and economic burden before 2014.” In 2014, the newly passed health care bill will take effect and some say this report will increase support of that move.  “If ever one needed an affirmation about how essential the Affordable Care Act is, this is that affirmation,” Ron Pollack, executive director of the health consumers group Families USA, told USA Today. “The clear message for people now is that help will be on the way.”

Healthcare reform may have won the votes it needed in Congress, but it has yet to win the support of public opinion. The latest poll conducted by USA Today/Gallup found that 56% of people disapprove of the new law. “The White House and its allies won the legislative debate. They lost the debate in the court of public opinion,” Robert Moffit, director of the Center for Health Policy Studies at the conservative Heritage Foundation, told USA Today.

This increase in uninsured Americans isn’t a complete surprise since layoffs have soared. Some of the findings of the report include:

* Those in low-income households are three times more likely to be uninsured than those with an income over $75,000.

* Among race groups, Asian households had the highest median income in 2009.

* In 2009, households in the West and Northeast had the highest median household incomes.

* The Northeast had the lowest uninsured rate in 2009.

Estimates show that as many as 10,000 people nationwide may have been duped by Association of Independent Managers (AIM). Nancy Stowe is one of them, according to WBTV. She was looking for affordable healthcare coverage online and contacted the North Carolina Department of Insurance for a reference before completing a purchase. “They had nothing that made me think this wouldn’t be a good purchase,” Stowe told WBTV. So she went ahead and purchased coverage from AIM, but now she’s out thousands of dollars in unpaid medical bills. “I am going to testify in this cease and desist order being put up against this company by the state of North Carolina,” Stowe told WBTV.

Stowe thought she was getting a good deal– paying hundreds less for coverage for her and her husband. She checked out AIM’s website and membership materials and moved forward with her purchase. Her premium was more than $400 a month, but then Stowe’d doctor told her all of her medical bills were being denied by her insurance company. “It was so frustrating because I owed thousands of dollars, plus all of those monthly premiums my boss had reimbursed me for,” Stowe told WBTV.

WBTV offered some tips to help others from going through what Stowe went through. Their tips include:

• Always remember that if it sounds too good to be true, it probably is.
• Deal only with licensed agents and companies.
• If you have any doubt, call your state’s Department of Insurance, Consumer Services Division.
• If the agent you are dealing with starts becoming vague or hard to reach, consider canceling.
• Do NOT sign any blank application or claims forms.
• NEVER pay premiums in cash.
• Keep all your records and proof of payments.
• You can always call your insurance company (the company who has the policy) to confirm your policy exists and is what you think it is.

Some scams to look out for when it comes to insurance include:

• Companies that try to look and act like licensed insurance companies when they’re not. They offer low rates regardless of your health history, but then claims are either paid slowly or not paid at all. These companies typically operate under different names.
• Web sites that look like companies you are familiar with, but that are actually stealing your information.
• Pyramid schemes where insurance companies offer incentives for paying a membership fee or recruiting more members.

A new government report issued by the Centers for Medicare and Medicaid Services (CMS) says they’re not so sure that healthcare reform will slow healthcare spending. In fact, the experts are predicting that spending will increase at an average rate of 6.3 percent which is .2 percent more than spending would have grown if Obama’s plan had not become law.

According to ABC News, nearly one in five US dollars spent in 2019 will go towards healthcare costs. While the report predicts added expenditures, it also points to the fact that more people will be covered under the plan. They predict that roughly 93 percent of Americans will have health insurance in 2019, an additional 32.5 million people compared to current data.

The experts behind the report see the main expenditures of implementing the new health care program to be $38 billion spend on establishing new health insurance exchanges and a $31 billion increase in the cost of Medicaid. While they predict higher spending over the next decade, the researchers did not delve into predictions after 2019.

Even though the healthcare bill hasn’t begun yet, some changes have already started which are increasing expenditures. The creation of a temporary high-risk insurance pool and providing coverage to dependents under the age of 26 are two moves adding $10 billion to national health spending through 2013, according to ABC News. “While the impacts are relatively moderate on net spending, the underlying effects on coverage and financing are more pronounced,” Andrea Sikso, an economist with CMS’ Office of the Actuary and lead author of the study told ABC News reporters Wednesday. “When you peel back the onion, and you look past the surface, you start to see much more pronounced impacts,” John Poisal, deputy director of the National Health Statistics Group at CMS’ Office of the Actuary, and one of the authors of the study, told ABC News.

Employers are still the main source for insurance coverage for most Americans, according to The Columbus Dispatch. Nearly 70 percent of employers offer health coverage which is an increase of about 10 percent compared to last year. That sounds like good news, but even though about 157 million people receive insurance through their jobs, that doesn’t mean they’re not paying for it.

A new survey released from the Kaiser Family Foundation found that Americans will pay about $4,000 to cover their families with health insurance through work. That’s a 14 percent increase, $482 more, compared to 2009 numbers. The main reason workers are being forced to pay more is because a slow economy is forcing companies to push more of the burden on their employees. The price of family policies increased by three percent to $13,770 according to Bloomberg.com. “Businesses have been shifting more of the costs of health insurance to workers through premiums, deductibles and other cost-sharing,” Drew Altman, Kaiser Family Foundation Chief Executive Officer, said in a statement according to Bloomberg.com. “From a consumer perspective, the cost of health insurance just keeps going up faster than wages.”

Wages have increased by about 18 percent while inflation rose 12 percent since 2005. During that same time employees have experienced a 47 increase in their insurance contributions, while premium costs have increased 27 percent. And even though workers are paying more and more each year, they’re actually receiving less coverage. In 2010 more than one out of four employees had deductibles of at least $1,000. “What insurance is in this country is gradually changing. It’s becoming less comprehensive. It looks less and less like the comprehensive coverage their parents got,” Altman told Bloomberg.com. “From the perspective of working people, they’re getting less for more.”

Experts believe large employers are pushing the trend of having employees handle more of the health care cost burden. “We’re seeing that the continued economic downturn is leading to more burden for employees,” Kaiser Foundation Vice President Gary Claxton told Bloomberg.com. He believes that the health care overhaul will help lower insurance costs. “We don’t know how quickly that might happen. At least in the early years, I’m not sure health reform is going to mean that workers are going to face lower contribution amounts,” he said.

Some experts say that insurance agents, brokers and small insurance companies may become victims of the massive health care overhaul set to kick in in 2014. The health care reform bill will impact nearly every corner of the health care industry which makes up one-sixth of the US economy. According to a report by Time Magazine, agents and brokers are concerned they’ll soon be viewed as redundant under the new legislation.

At a recent meeting of the National Association of Insurance Commissioners, 25 commissioners passed a resolutions stating that health care reform should “recognize and protect the indispensable role that licensed insurance professionals play in serving consumers.” At issue is how insurance companies should now calculate their medical and administrative expenses. Most experts believe health care reform will put an end to agent and broker commissions which make up anywhere from 5-20 percent of premiums. Health care reform may also make their roles as sales people and marketers unnecessary as new state insurance exchanges will be posted online by 2014. This will be a place where people and small groups can go to purchase insurance directly.

One role that brokers and agents are confident they’ll still be able to fulfill is that of a navigator through the health insurance maze. “More of the upfront stuff will be done online, but it won’t replace the service,” Janet Trautwein, CEO of the National Association of Health Underwriters, which represents agents and brokers, told Time Magazine.

A proposed  health insurance rate hike in New Mexico prompted death threats against top staff at Blue Cross Blue Shield, according to TV station KOB. Extra security was hired to protect high ranking Blue Cross Blue Shield officials at a hearing held this week in Santa Fe. There were also four additional officers provided by the Public Regulation Commission, according to reports.

The hearing was held in response to Blue Cross Blue Shield’s request to regulators to approve a 21.3 percent rate increase on 12 of their insurance plans. The proposed hike would impact thousands of residents in New Mexico, according to KOB. State officials listened to information provided by the Attorney General’s office and Blue Cross Blue Shield about whether or not the hike was justified and necessary.

Towards the end of the hearing the public was allowed to provide their thoughts on the proposed increase. Many argued that it wasn’t necessary when Blue Cross Blue Shield has a reported reserve fund of about $7 billion, according to KOB. But Blue Cross Blue Shield argued that the $7 billion was for emergencies like pandemics and said that higher expenses warranted a rate hike. Company officials say they actually needed a 36 percent increase to break even, but settled on 21.3 percent increase. Officials aren’t expecting any decisions to be made for about a month.

Forty-five states are getting $1 million dollar grants to keep an eye on insurance premium increases. The Obama administration said the money is only the beginning in a $250 million, five-year program to help states limit rate increases. Premiums have at times jumped as much as 30 percent in one year, and many people are paying double what they were paying a decade ago, according to the Washington Post.

Secretary of Health and Human Services Kathleen Sebelius said some states are already regulating premiums well, others can do a better job. “Some states have full and rigorous rate review and [the right of] prior approval, so before a company raises a rate it goes through intense actuarial analysis. . . . In others the company doesn’t even have to file [with state authorities],” she told the Washington Post.

The states that already regulate premiums closely will be using the grant money differently than states who don’t. For example, Maryland already has a system in place for regulating insurance premiums. Officials there say they’ll use the $1 million to hire consultants to investigate what additional data needs to be requested from insurers. Some states say they plan to start requiring insurance companies to get pre-approval before any rate increases are implemented. Delaware Insurance Commissioner Karen Weldin Stewart thanked the Obama administration for the money. “This important grant will help my department and I not only protect Delawareans from redundant rate increases, but will also allow me to pave a critical path toward modernizing our approaches in reaching the goal of affordable, accessible and first rate care for all,” Stewart told the Dover Post .

Starting in 2014 states will have the ability to punish insurance providers that raise rates unreasonably. They’ll be able to exclude those companies from subsidized state-run insurance programs. Five states opted out of the first round of grant money. They are Alaska, Georgia, Iowa, Minnesota and Wyoming.

While insurance companies argue that rate increases are a direct response to rising medical costs, Sebelius believes there needs to be better oversight of the industry. “Just having transparency . . . in itself is going to change the dynamics of what is happening in terms of the massive rate increases in this country,” Sebelius told the Washington Post.