In fact, they could be eligible for coverage in a high-risk insurance pool that would accept anyone regardless of health condition.

In theory, it sounds very good. Yet, there are a few things to point out. A number of experts say that the high-risks pools currently in use in 35 states are being undermined by high costs and insufficient coverage.

Current plans suggest that the pool could be in place in 2010 and could remain operations for three years, or until the regular health insurance exchanges are in place. At that point, a high-risk pool would no longer be necessary since using the exchanges would be mandatory for all customers.

Still, many details have not been finalized. The state high-risk pools are typically managed by state-created non-profit organizations, which are funded via assessments on insurance companies or state funds. These non-profit groups would contract with heath insurance companies to maintain the day-to-day functions of the pool program.

At present, there are about 200,000 people enrolled in the high-risk pools, yet critics believe that there would be more people using them if they provided comprehensive coverage at more affordable prices.

Most states have established premiums at 150% of a standard individual plan statewide. In some areas, the policies cost more. The majority of these policies come with lifetime caps on benefits. Many are under $1 million. Others also include annual caps.

The question of whether a national high-risk pool could be conceivably adapted to the national level is prompting new debate. This concept would provide coverage in those states that do not have high-risk pools currently. Yet, the challenges inherent in establishing such a national pool cannot be understated.

Pre-Existing Conditions And Coverage is a post from: Peppercoin Insurance

The reason for the investigation is centered on a customer mailer concerning health care legislation.

Criticism from Republican Congressmen has increased ever since the Centers for Medicare and Medicaid Services started their examination into Humana due to Senator Baucus’ charges that the mailer misled seniors about the proposed amendments to Medicare.

Opponents suggest that the administration was penalizing the insurer because it criticized the health-care plan. It also served as a warning to other insurance companies that might have been thinking about voicing their own concerns. Some Republicans are comparing the probe to a gag order meant to silence criticisms against Obama’s ideas about health care reform.

The Department of Health and Human Services targeted Humana initially, but it also sent out a broad directive to all Medicare Advantage participants. This was essentially a mandate to discontinue all such mailings and remove any such material from participating web sites.

Some characterize it as a move to silence opposition to the president’s Medicare cuts. Minority members of the House Ways and Means Committee drafted a letter to Chairman Charles Rangel requesting a special hearing to investigate allegations that the CMS’s decision to eliminate the flow of facts between private insurance plans and enrollees were politically motivated.

According to the mailer, programs like Medicare need to be made more efficient, but the proposed funding cuts would cause millions of enrolled seniors and disabled citizens to loose important benefits that come with the Medicare Advantage health plans. The mailer also suggested that senior citizens sign up with Humana to receive updates on the status of legislation and contact legislators for more information. Fears that the spending cuts would cause benefits reductions may be legitimized.

At the same time, Democrats maintained their position that Humana had made false claims. They also said that Republicans were demonstrating their bias towards the insurance companies.

Republican Congressmen Call For Hearing On Insurance Company is a post from: Peppercoin Insurance

Spearheaded by Senator Max Baucus of Montana, the proposal is the fruit of more than a year’s work. The fee on insurers was suggested by a number of liberal Democrats back in July. By adding it to the current bill, Baucus potentially has a way to cover some of the outlined costs.

Yet, at the same time, such an addition could turn away many of the Republican legislators Baucus has been courting for support. Baucus, and others, are attempting to create a bipartisan consensus among 6 of the 23 senators on the Finance Committee.

Baucus’ proposal lacks the government run plan or public option that many Democrats are anxious to see as a part of any new legislation. As such, there are questions about whether Baucus’ plan will be flexible enough to accommodate the president’s proposals.

Currently, there are doubts about whether Baucus’ proposal will actually make it to the final table in its current form or garner enough support from Republican members on the committee.

The new fee on insurance companies would be one of several means of funding the implementation of the plans. Starting in 2010, the fee would raise $6 billion annually. It would be allocated among the various insurers based on their market shares.

“The health insurance industry should pay its fair share of the cost because it stands to gain over 40 million new consumers under health care reform legislation,” said Senator Schumer, one of the architects of the proposed fee.

Both insurance companies and various Republicans in Congress have voiced their opposition to the fees, going as far as saying that the costs would be passed on families and employers who purchase insurance plans. In essence, the fee would lead to higher coverage costs.

New Fee Proposed On Health Insurance Companies is a post from: Peppercoin Insurance

House Majority Leader Steny Hoyer, a Democrat from Maryland, stated to reporters that having a Medicare-like plan for middle-class Americans and their families was not necessarily a non-negotiable aspect of any proposed legislation. The comments actually came just after a key Democratic moderate announced he was not supporting any bill that offers a new government plan.

For progressives in the party, this has become a sore issue since many liberal Democrats have said in no-uncertain terms that they will not vote ‘yes’ for legislation if it fails to have a robust public option that would serve as a competitor with private insurers.

With even weaker support coming from the Senate, any hopes for reaching a bipartisan agreement are stretched thin. The goal for groups like the Finance Committee is to forge a genuine consensus on any compromise bill.

The question is whether or not the public option is “vitally important” or if it is something that can be put aside for the sake of a legitimate policy of health care reform.

Congressmen like Hoyer had this to say, “I think there is a lot in the bill that is very good in addition to the public option.”

He went on to add, “If the public option were not in there I could still support a bill, because I think there is a lot in there that is good.”

Prior to his Wednesday congressional address, President Obama told a Labor Day audience of union members that now was the moment when insurance companies should share accountability for those problems that are plaguing the system.

The president was confident that the presence of a public health insurance option would be an important tool to reduce the excesses of private industry. Still, there are indications that new legislation could be signed without the public option.

Government Insurance Plan May Be Doomed is a post from: Peppercoin Insurance

In fact, even the U.S. postal service, retail stores, and hotels get better marks for customer satisfaction than health insurance providers.

It is a fact that has been exploited by politicians on Capitol Hill and in the White House in order to paint health insurers as the bad guys.

It is understandable that when you have an industry that performs poorly and ultimately restricts choices the focus of comprehensive health reform would start by offering customers more options. It is the best to make a dynamic plan that fits every citizen.

Yet, there are questions as to whether the latest plans offered by legislators can make this happen—or if lawmakers consider this as part of their stated agendas.

There is a tide of skepticism rushing through the citizenry, half-prompted by media hype and half proven by the ill-conceived efforts of the past. Both parties have reason to share the blame in how this issue has been addressed and what motives are driving efforts towards finding reasonable solutions. Questions about outside interests and preserving the status quo abound.

It may also be that the quest for a health care plan that affords people more options is being obscured by the party politics and the tendency for the industry itself to hide the total costs of the system.

What is clear is that a majority of Americans do stand to benefit from having more health care options. Even now, there are proposals being fielded around Congress that would open the way for a lot of progress. Yet, it remains to be seen whether a solution will be found that will appease everyone.

More Choices May Make For Better Health Care Plan is a post from: Peppercoin Insurance