A new study released by the Kaiser Health Foundation found that millions of people who pay for their own insurance are facing big increases in premium costs. The study says that most people in the US get health insurance through an employer, but there are 14 million under the age of 65 who purchase it through the individual market. And three out of four of those people have recently been told their rates were on the rise.

The study found that the average recent rate increase was 20 percent. Most are paying the increase, but some are switching plans or changing to a different company. “With people in the individual market being hit with average increases of 20%, the survey shows that the steep increases we have been reading about over the last several months are not just extreme cases,” Kaiser Family Foundation President and CEO Drew Altman said in a news release.

The survey found that the average annual premium for someone paying for their own insurance is $3,606 while those with employer-sponsored coverage have annual premiums that are $4,824 on average. Typically older people say they’re paying higher premiums than younger people.  The survey questioned 1,038 people between the ages of 18-64 who pay for their own health insurance coverage.

New laws in New York make it harder for insurance companies to raise premiums. The governor signed into law the Governor’s Program Bill No. 278 which gives the New York State Insurance Department authority to review and approve insurance premiums before they are issued. It passed with overwhelming support in a 111-17 vote.  Before this new law the insurance industry was pretty much self-regulated, according to a report by dotmed.com. “Deregulation of health insurance premiums is a failed experiment leading to unjustified premium increases and more people losing their health insurance coverage,” Governor Paterson said in prepared remarks.

Now, if insurance companies want to raise rates, they have to apply for approval first. “Before, health insurance companies could raise premiums as much as they wanted, and all we could do is check long afterward if, in fact, they were overcharging,” David Neustadt, spokesman for the New York State Insurance Department, told DOTmed News. “The current rates are increasing at a much faster rate than before [the file and use law].” This way governing bodies can make sure any increases are justified, and not just created by insurance companies so they can increase bottom lines.

The law will impact any rate increases set to take effect on or after October 1, 2011. “I applaud New York on its bold move to hold insurance companies accountable and prevent the kind of unreasonable rate increases that have made health insurance unaffordable for many American families,” said U.S. Health and Human Services Secretary Kathleen Sebelius in a statement, according to dotmed.com. “This is the kind of action that, together with the Affordable Care Act, is shifting power back to consumers.”

People who get laid off on or after June 1 can no longer turn to the government for help to cover 65% of their premium costs for COBRA health coverage. COBRA lets workers stay on their former employer’s group health plan for a period of three months. This assistance that once came from the government expired on June 1, and it does not appear that lawmakers will continue it according to the Wall Street Journal.

A new jobs bill once held an extension of the COBRA payment plan, but it was removed. The bill is now in the Senate. Those who lost their jobs between September 2008 and May 31, 2010 could still apply for insurance assistance for up to 15 months. Their former employer would be responsible for paying health insurance costs plus a two percent administrative fee. Under subsidies provided by the economic stimulus package, premiums run $387 on average. Without the assistance, family premiums jump to over $1100 a month. For those who lose their jobs after June 1, the government will no longer pick up that $720 difference.

Families USA found that those laid off after June 1 would have to spend 84% of their monthly unemployment insurance checks on COBRA premiums in order to keep their families covered. Unemployment checks are about $1,313 on average. However in 11 states unemployment income actually would not be enough to cover insurance costs. ”It’s ironic that in a little over two months after health reform passed and is designed to achieve significant coverage improvement, in the short term we will go backwards,” said Ron Pollack, executive director of Families USA, in a Wall Street Journal report.

Another option would be finding individual coverage which could be cheaper, as long as there are no preexisting conditions. “Cobra coverage is so expensive, but the alternatives are either going without coverage or having to go to the individual market,” Park said to the Wall Street Journal. “As long as there’s not a gap of 63 days or more in coverage, you’re guaranteed access to the individual market so insurers can’t deny you. But it may not provide the same comprehensive benefits.”

Even if you already have health insurance, the cost of prescriptions can still be extreme. According to a 2009 poll by the Kaiser Family Foundation, six out of ten people have skilled or delayed healthcare because of the cost. Three in ten people have not filled a prescription because of the cost and one in five have cut pills in half or skipped doses because of the cost.  There are lots of programs available through non-profits and even drug companies that help people cut costs of medicines. Whether you have insurance or not, try checking out these assistance programs.

HealthWell Foundation: The HealthWell Foundation is a 501(c)(3) non-profit created in 2003 in order to help those who have insurance, but can’t afford copayments, coinsurance, and premiums.

Xubex: Xubex offers affordable quality care through a Patient Assistance Program, Free Medication Program and other resources. Xubex offers assistance for generic medications which are historically not included in assistance programs.

Rx Outreach: Through Rx Outreach, qualified patients can buy more than 150 medications for $20 for a 180-day supply. You must meet certain income requirements and apply to receive the discounted medications.

Pfizer Connection to Care: Various drug companies, including Pfizer, offer free medications to those who qualify. Pfizer’s Connection to Care program offers free medicines through your doctor’s office for those who meet household income guidelines.

NeedyMeds: To do more of your own research on available assistance programs head to NeedyMeds.com. Simply search for your medication and you’ll find a list of available programs that offer free or reduced prices. There is also a list of state-sponsored programs that offer help to residents.

A new initiative could help four to six million uninsured restaurant employees get coverage. According to the Chicago Tribune, the National Restaurant Association along with UnitedHealth Group Inc teamed up to make health insurance coverage easier for restaurant workers to get. The move comes three years before the US government will require everyone to have health insurance and will help roughly ten percent of the uninsured workforce.

An array of insurance plans geared toward the restaurant industry will be unveiled by officials. Plans will be released first in Pennsylvania and Colorado, then expanded to California, Florida, Illinois, Texas and other states within the upcoming year. Eventually the plan will encompass the whole year. “Because of the narrow profit margins of the restaurant business, it has been an ongoing real challenge for our industry to find affordable [insurance] products they could offer to employees,” said Dawn Sweeney, chief executive of the influential restaurant group, which represents about 380,000 employers nationwide, according to the Chicago Tribune.

Officials from UnitedHealthcare say they’ve been working on the program for two years. “We hope that by working together, we can make inroads in covering the people who don’t have insurance,” said Austin Pitman, chief growth officer for UnitedHealthcare, according to the Nation’s Restaurant News. He says the program will also offer a 24-hour health care hotline and wellness programs. The NRA’s chairman of the board, Mike Gibbons believes that health care reform will put a huge burden on the restaurant industry, but this plan may alleviate some of that. “The cost of health care reform could be potentially devastating,” he said. “The alliance will give lower cost health care alternatives.”

The restaurant industry employs nearly 13 million people around the country, but has one of the lowest levels of health care coverage. Sweeney says that’s why identifying health care was identified as a top concern of the association. So what’s included in the plan? According to reports restaurant owners and employees will have a web portal dedicated to them to shop for UnitedHealth insurance products. Restaurant owners could use the site to find plans for their employees, and the site would also offer individual plans for workers whose workplace doesn’t offer the benefit of health insurance. A variety of employer-sponsored plans would be available including plans that offer coverage for preventative care, routine medical visits, catastrophic events and more.

This week the White House unveiled new details about a plan that will allow young adults to stay covered under their parents’ health insurance policies until they’re 26-years-old. The new policy forces companies offering employer-sponsored  health plans to offer coverage for their employees’ children up to the age of 26. The rules don’t require the young adult to live with his or her parents, attend college or even be a dependent. The twenty-somethings can also be married or unmarried.

Health and Human Services Secretary, Kathleen Sebelius estimates that 1.2 million people currently without health insurance coverage will have it because of this new rule. According to a report in the New York Times, the health department estimates that it will cost $3,380 in 2011 to cover each new insurance customer and $3500 in 2012. In 2013 it will cost about $3690 for this coverage. This equates to about a one percent increase in family premiums, according to government officials.

These new rules will begin to take effect September 23, but there are some exceptions. Companies are allowed to exclude adult children of their employees until 2014 if the children already have access to their own insurance through their employee. Some companies are offering this additional coverage now, and they aren’t waiting until the upcoming deadlines. Under the new rules, employers must give young adults a 30-day enrollment window for signing up under their parents’ coverage.

Some people feel the rules or too lenient. “Regulatory agencies may have stretched their authority in writing these rules. Adult children can live 2,000 miles away from their parents, be married and not have spoken to Mom and Dad in a year, and they could still be added to the parents’ employer-sponsored health plan just like any other child,” said James P. Gelfand, director of health policy at the United States Chamber of Commerce, to the New York Times. However, according to the Chicago Tribune, other companies are getting a jump on the new rules. Trustmark, an insurance provider to more than two million people across the US, started offering the coverage My 1. “This early implementation will ensure graduating college students maintain health insurance coverage without falling into the ranks of the uninsured,” said John Anderson, the company’s senior vice president . “This ultimately closes the possible gap in coverage that would have occurred until this fall.”

It didn’t take long. Scam artists are already using the new health care overhaul to cheat and confuse Americans. Secretary of Health and Human Services Kathleen Sebelius warned of the scam artists this week. “Unfortunately, scam artists and criminals may be using the passage of these historic reforms as an opportunity to confuse and defraud the public,” Ms. Sebelius said in a letter to state insurance commissioners and attorneys general, according to the New York Times.

The scams to watch out for include people establishing toll-free phone numbers and door-to-door salesmen looking for buyers of fake insurance policies. The scammers are spreading lies about requirements in the new health bill, confusing Americans even more. Similar scams were seen during the H1N1 epidemic. Sebelius said that any rip-offs should be investigated and prosecuted. She believes senior citizens could be a big target for the crime.

It’s important to note that the insurance changes created under the new bill do not go into effect until 2014, unlike the crooks are saying. So if you are approached by someone selling an insurance product who makes claims about the new health care bill, make sure you do your research before becoming a victim.

Should the government be allowed to force Americans to buy health insurance? More than a dozen states are saying no. Attorneys General from 13 states filed suit in a northern Florida federal court saying that mandating individuals to buy health insurance should not be permitted. Virginia filed a separate complaint as Virginia law states, “No resident of this Commonwealth … shall be required to obtain or maintain a policy of individual insurance coverage.” This statute gives Attorney General Ken Cuccinelli the ability to challenge the federal law since it immediately conflicts with state law. The 13 other states are claiming that if the federal government is allowed to force the  purchase of health insurance, then they would be allowed to mandate the purchase of an unlimited number of other products or services. Those involved in the suit are:

1. Florida
2. South Carolina
3. Nebraska
4. Texas
5. Michigan
6. Utah
7. Pennsylvania
8. Alabama
9. South Dakota
10. Louisiana
11. Idaho
12. Washington
13. Colorado

But whether or not the states have a case is also up for debate. Roger Pilon, Vice President for Legal Affairs at the Cato Institute told the Arena Digest he believes they do. “Do the 13 state attorneys general have a case against the health care bill? Absolutely. It will be an uphill battle, because modern “constitutional law” is so far removed from the Constitution, but a win is not impossible. There are three main arguments. First, under the Constitution, properly interpreted, Congress has no power to enact such a plan. Second, the plan conscripts state governments into carrying out and paying for federal mandates. Third, the individual mandate amounts to an unlawful capitation or direct tax.” But Theda Skocpol, a professor at Harvard University disagrees. “This is all just pot-banging for political purposes. Even the most ridiculous judges won’t buy this. The key indicator is no case law cited in the filings,” says Skocpol.

The health care debate is heating up and even though there are lots of angles to argue– no one can deny that insurance is expensive. According to the Commonwealth Fund it’s going to keep increasing. In the past decade the average annual family premium plan doubled in cost, jumping from $6,958 to $13,436. And some say it could double again in the next ten years, reaching a whopping $24,000 by 2020.

Soaring premiums have forced some healthier Americans to forgo insurance coverage altogether. Delaware’s Daily Times says that’s the case for resident Dequilla Hurt who canceled her insurance and won’t have any coverage until her probationary period ends at her new job. They interviewed Hurt for a recent report on the state’s rising health care costs. “I have this window of time where I have no health insurance. If something happens to me, if I go to the emergency room now, the total cost will be on me. Will I be able to afford the cost of an emergency room visit? That worries me,” said Hurt.

A Gallup poll found that the salary you bring in greatly impacts the likelihood of having insurance. Of young adults making more than $48,000 a year, 86 percent have insurance. But of those who bring in half that annually, less than $24,000, only 58 percent spring for a health plan.

Some are pointing to the insurance industry’s lack of competition as the reason why costs are increasing at such a fast rate. In just over a dozen years the industry has experienced more than 400 mergers and the number of choices for consumers has dropped by 20 percent which means fewer options for employers looking for the best deal. The Government Accountability Office says that the five largest providers of small group insurance control 75 percent or more of the market share in 34 states. In fact, one out of every nine Americans has insurance with WellPoint, which is the parent company of Blue Cross Blue Shield and Anthem.

Some say that while insurance companies can carry part of the blame for rising premiums, there are other sectors of the health care industry that are driving up costs for Americans. The Journal Sentinel in Wisconsin talked to a Harvard professor who believes part of the problem lies with consumers themselves. “The primary reason that health care costs and health insurance premiums are rising so rapidly is the amount of health care that we consume,” said Katherine Baicker, a professor of health economics at the Harvard School of Public Health. “Now, that is not to say there are no problems with the insurance industry.”

A panel of CEOs reported to the White House at the request of Health and Human Services Secretary Kathleen Sebelius. Sebelius wanted to know why insurance premiums were increasing so rapidly in recent months. Attending the meeting were CEOs of United Health Group, Inc, WellPoint Inc, Aetna Inc, Health Care Service Corp, CIGNA HealthCare Inc, as well as representatives from the National Association of Insurance Commissioners. President Obama also visited the meeting and read a letter from a 50-year old cancer survivor from Ohio who had experienced a 25% hike in insurance premiums since 2009.

According to reports, Sebelius wanted to hear from the executives as to why there was a recent jump in premium rates in several states. “I asked them to explain why these crushing burdens are being placed on middle-class families and what we can do to lower costs,” Sebelius said in a report on Insurance Networking News. “I also asked the CEOs to post the actuarial justification for these stunning rate increases online in an easy-to-understand manner, so that consumers can see why premiums are skyrocketing to the point that some people in the individual market can no longer afford coverage. I hope they will act quickly and make this information available to all of us. If insurance companies are going to raise rates, the least they can do is tell us why.”

The report says that Aetna CEO Ron Williams defended the increases, saying they were reflective of costs that insurance companies were paying to drug makers, hospitals and other health-care companies that were forcing increases to the cost of medical care. “The rate is really reflective of our other parts of the health-care delivery system,” said  Williams in a Wall Street Journal report. They said that trying to lower premiums without addressing those costs was destined to fail.

NAIC’s President says the hikes are another example of why all states need to be allowed to regulate their own insurance premiums. “State regulators are best positioned to perform rate review and many of us do so with great success,” said Jane L. Cline, NAIC President and West Virginia Insurance Commissioner. “Some, however, have not been given the authority by their state legislatures to review and deny unjustified increases. We believe that a federal backstop could help encourage these legislatures to provide that authority.”

Sebelius asked the CEOs to post information online that explains their breakdown of revenue including how much goes towards administrative costs, how much is spent on marketing and what goes towards actual care. She said making that information easy to access by consumers would increase transparency about what is happening in the health care industry and why rates are increasing.