Florida Health Insurance Topic:
"an end to coverage denials based on pre-existing conditions..."

JACKSONVILLE, FL -- If Congress passes health reform law similar to Massachussetts' universal health care system, currently uninsured families could become insured, and those below a certain income level would be able to get assistance for premium payments, said John Carlos, regulatory administrator at the Department of Revenue and Taxation last week.

The Affordable Health Choices Act grants health insurance credits to low- and moderate-income families, while requiring all individuals to obtain health insurance coverage, according to a summary released by the House Committees on Ways and Means, Energy and Commerce, and Education and Labor. The bill also penalizes non-insured individuals, the summary said.

The measures are similar to those in Massachusetts health reform law, passed three years ago, which required that all residents to become insured, and included subsidized insurance programs and fines for the uninsured in its health care plan.

The health care reform bill mandates employers to either provide insurance coverage to their workers or contribute funds on their behalf, in an amount based on 2 to 8 percent of their payroll. Businesses with payrolls that do not exceed $250,000 will be exempt from the requirement, according to the legislative summary.

Carlos said businesses on Guam, particularly those with 20 or more employees, are already providing assistance to their employees in terms of health insurance premium payments.

Citing Massachussetts state law, Carlos said that with an increase in the number of people insured on Guam, insurance companies may earn more compared to the number of claims paid. Consequently, Carlos said, insurance premiums may become stable, and premiums may not increase as much every year.

Frank Campillo, health plan administrator for Calvo's Select Care, disagreed. "It could be argued that more people insured will translate into lower premiums," Campillo said. "However, there are other parts of this bill that negate those possible savings, including the fact that a public plan will compete with private enterprise."

Carlos said the cost of health insurance is rising yearly on Guam.

"At some time in the future, if this trend continues, the premiums would become not affordable for both Government of Guam or for the employees of the government," Carlos said.

In a Wednesday news conference, President Obama called attention to the 47 million Americans who are uninsured, the rising costs of premiums and out-of-pocket costs for those who are insured, and Americans' fears of the loss of health care coverage, should they change or lose their jobs.

In both the House of Representatives and the Senate, versions of the bill are being heavily debated. Senate leaders recently stated they could not meet President Obama's August deadline for health care reform before their monthlong recess.

On July 16, the American Medical Association endorsed the House version of the bill, citing these provisions: coverage to all Americans through health insurance market reforms, an end to coverage denials based on pre-existing conditions, and individual responsibility for health insurance, including premium assistance for those who need it.

Vincent Tyquiengco, 22, of Baza Gardens hopes the legislation will pass. He's been searching for a job that includes health insurance, because he is no longer covered under his family's health insurance plan.

"It's scary, because if something happens, I might not have the money," Tyquiengco said. "Not a lot of people have the money to pay for health insurance, or have jobs that come with health insurance."

He said some of his friends are in a similar situation. "They said if something happens to them, they just can't afford it," Tyquiengco said."We're trying our best not to get hurt or sick." Because they are uninsured, he and his friends hold back from going to the doctor if they can help it, Tyquiengco said. "Only if it's serious, we go," he said. Jacqueline Dayrit of Yigo supports health insurance reform, including the bill's provision to prevent coverage denials based on pre-existing conditions.

Dayrit said she knows people who have switched jobs after developing a medical condition, such as cancer, and who have then found out that treatments for their pre-existing condition are excluded from their new health care coverage. "We have health insurance to take care of us," Dayrit said, "not to give us stress."

The bill is facing considerable opposition from legislators in Congress who say the plan is too expensive.

Opponents of the bill cite the bill assessment by Congressional Budget Office Director Douglas Elmendorf, who has said the current legislation significantly expands federal responsibility for health care costs, according to the Associated Press. "Changes ... made to health care have all resulted in higher costs," Campillo said, citing health care-related laws such as ERISA, COBRA, OBRA, HIPAA and most recently, the American Recovery and Reinvestment Act, more commonly known as the economic stimulus act.

"Consequently, I am doubtful that a new bill that completely changes the entire health care system will be able to contain costs, which is the main objective of this administration's bill," Campillo said.

He is concerned in particular with the public health insurance plan included in the House bill. "We know that private plans on Guam and throughout the nation pay higher amounts for health services than Medicare to medical providers and the hospitals," Campillo said.

If the bill becomes law, then health insurance companies will be competing with a public plan, and the medical loss ratios (the portion of a plan's premiums that pay for medical services) may be even higher for private plans, Campillo said. He added, "My opinion is that if the bill is passed in its current form, it will increase costs again to the nation and to individual citizens. We will watch the development of the bill and see what the U.S. Senate will do with their version."

The Senate committee on Health, Education, Labor and Pensions passed its version of the bill on July 15, and the bill is now before the Senate Finance committee. The committee's version, which requires that all individuals become insured, provides health insurance subsidies for Americans with low to moderate incomes. Small business tax credits also will be available to companies with fewer than 50 employees, who pay 60 percent or more of their employees' health insurance premiums.

At the same time, the committee's bill penalizes companies with 25 workers or more who do not provide health insurance for their employees. If the bill becomes law, annual penalties will be $750 per uninsured full time worker and $375 per uninsured part-time worker, though companies are exempted from paying penalties on its first 25 worker. Businesses with 25 workers or fewer would not pay a penalty.

Health Insurance *** Top Health Insurance News

Get a Health Quote |  Florida Health Insurance |  Florida Life Insurance

Health Insurance