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AMA Statement on Supreme Court Affordable Care Act Ruling

AMA Statement on Supreme Court Affordable Care Act Ruling

By Lori Morgan

The American Medical Association has long supported health insurance coverage for all, and they believe that this decisionPDF FIle means millions of Americans can look forward to the coverage they need to get healthy and stay healthy.

Jeremy A. Lazarus, MD – President, American Medical Association statement:

“The AMA remains committed to working on behalf of America’s physicians and patients to ensure the law continues to be implemented in ways that support and incentivize better health outcomes and improve the nation’s health care system.

“This decision protects important improvements, such as ending coverage denials due to pre-existing conditions and lifetime caps on insurance, and allowing the 2.5 million young adults up to age 26 who gained coverage under the law to stay on their parents’ health insurance policies. The expanded health care coverage upheld by the Supreme Court will allow patients to see their doctors earlier rather than waiting for treatment until they are sicker and care is more expensive. The decision upholds funding for important research on the effectiveness of drugs and treatments and protects expanded coverage for prevention and wellness care, which has already benefited about 54 million Americans. 

“The health reform law upheld by the Supreme Court simplifies administrative burdens, including streamlining insurance claims, so physicians and their staff can spend more time with patients and less time on paperwork. It protects those in the Medicare ‘donut hole,’ including the 5.1 million Medicare patients who saved significantly on prescription drugs in 2010 and 2011. These important changes have been made while maintaining our American system with both private and public insurers.”

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AMA Statement on Supreme Court Affordable Care Act Ruling

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Healthcare law: What’s at stake for you

Obama healthcare opponents from the Tea Party Patriots group rally on the sidewalk during the third and final day of legal arguments over the Patient Protection and Affordable Care Act at the Supreme Court in Washington, March 28, 2012. Two years after President Barack Obama signed into law the healthcare overhaul, the Supreme Court is taking up a historic test of whether it is valid under the country's Constitution. REUTERS-Jonathan Ernst

By Mark Miller

Ordinary Americans have a lot at stake this week as the Supreme Court holds hearings on the constitutionality of the Affordable Care Act (ACA).

It is not clear what the outcome will be, and it is not clear where Americans stand on it. While two-thirds of Americans oppose the individual insurancemandate that is at the heart of the Obama Administration’s healthcare reform law, according to a Kaiser Family Foundation survey, the polls also reveal more nuanced attitudes.

Americans are evenly divided on the overall law, with 47 percent supporting it, according to Pew Research. And a New York Times/CBS News poll finds that many of the law’s key provisions are backed by large majorities: the law’s popular features include the requirement that insurance companies cover people with pre-existing conditions (85 percent), letting children stay on parents’ policies until age 26 (68 percent) and cutting the cost of prescription drugs for seniors (77 percent).

Here’s a breakdown of what is at stake if the Supreme Court strikes down the law:

BENEFITS ALREADY IN PLACE: Although key benefits of the ACA won’t be implemented until 2014, significant changes are already in place. For example, 2.5 million young adults age 19 to 25 are now covered on their parents’ policies. For Medicare, the first steps to close the gap in prescription drug coverage — the notorious “donut hole” — saved $2.1 billion for nearly 3.6 million seniors last year, according to the U.S. Department of Health and Human Services.

STATE EXCHANGES: State insurance exchanges, which are being set up now and will fully launch in 2014, will open up access to insurance for anyone who can’t access group healthcare coverage through the workplace — a crucial, growing problem in an economy characterized by volatility and stubbornly high levels of structural unemployment.

Obama healthcare legislation supporter Margot Smith (L) of California tries to block out legislation opponent Janis Haddon (R) of Georgia as groups rally on the sidewalk during the third and final day of legal arguments over the Patient Protection and Affordable Care Act at the Supreme Court in Washington, March 28, 2012. Two years after President Barack Obama signed into law the healthcare overhaul, the Supreme Court is taking up a historic test of whether it is valid under the country's Constitution. REUTERS-Jonathan Ernst

For example, nine million Americans age 50 to 64 were uninsured as of 2010 — up from 5.3 million in 2002, according to The Commonwealth Fund. Too young for Medicare, their only option now is the individual insurance market, where premium prices are high, coverage is partial and many can’t buy policies at all due to pre-existing conditions. Nine million individuals were turned down for coverage in the individual market over the past three years due to pre-existing conditions, Commonwealth says.

Starting in 2014, the law will ban charging higher premiums or denying coverage based on health or age, and insurance companies will no longer be permitted to disqualify applicants based on pre-existing conditions. And applicants will be eligible for federal subsidies on the cost of coverage if they make less than 400 percent of the federally defined poverty level — currently $92,000 for a family of four. For this group, the subsidy uses a sliding scale to hold costs as a share of income between 2 percent and 9.5 percent.

The Congressional Budget Office (CBO) projects that 23 million Americans will gain coverage through the state exchanges by 2019. “That’s a very sweeping change for people who need to retire early, are unemployed, or have a job that doesn’t offer health care benefits,” says Sara Collins, vice president for affordable insurance at The Commonwealth Fund.

The process will start with an application for insurance submitted to your state exchange; depending on your income, you’ll be eligible to buy a policy in the exchange — or receive coverage under Medicaid.

MEDICAID EXPANSION: Medicaid primarily serves parents with very low incomes, and few states cover adults who do not have children. The ACA provides federal funding for a dramatic expansion of Medicaid. The new program will serve all households that are living around the federal poverty level — about $30,000 in annual income for a family of four. Fifty-seven percent of adults in that income range were uninsured for at least part of 2011, and 41 percent were uninsured for one year or longer.

So that’s what’s at stake if the healthcare reform law is struck down by the Supreme Court. All told, 31 million Americans who otherwise would have health insurance won’t be covered at the end of this decade, and we’ll be back to the drawing board on healthcare reform. Here’s hoping it doesn’t happen.

Healthcare law: What’s at stake for you

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The Health Care Law Turns Two

By REGINA M. BENJAMIN, M.D., M.B.A.

This week, we are celebrating the two-year anniversary of the Affordable Care Act. Since the health care law took effect, people all across the country have been directly benefiting from the law. And many aspects of this law aim to reduce health disparities.

The health care law uses common sense rules to ensure that you and your family’s insurance coverage will be there for you when you need it. It also ensures that you have the freedom to choose your physician and to take charge of your own health care.

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The Affordable Care Act gives you the peace of mind that, soon, you will not be denied coverage due to a pre-existing condition, and that you will not be dropped from your insurance if you get sick. This means that people with chronic diseases and pre-existing conditions will no longer be at the mercy of insurance companies.

Starting in 2014, insurance companies will no longer be able to deny coverage due to a pre-existing condition or gender. This is a key aspect of the law, and especially important for women. In the past, insurance companies have denied coverage to women because they were victims of domestic violence or had a C-section. They have also charged women up to 1.5 times higher premiums than men for the same coverage. Soon, they will no longer be able to do either.

I am particularly excited about the prevention benefits of the law. Most insurance plans are now required to cover recommended preventive services without a co-pay or deductible such as:

Blood pressure, diabetes, and cholesterol tests;

Cancer screenings, such as mammograms and colonoscopies;

Counseling for quitting smoking, losing weight, and reducing alcohol use;

Routine vaccinations, such as the flu shot; and

Well-child visits.

As a family doctor, too often have I seen patients put off preventive care even if they have insurance — simply because they could not afford the co-pay.

Finally, starting in 2014, over 30 million uninsured Americans will gain health insurance — a historic step in prevention and in the elimination of health disparities to ensure America’s future as a healthy and fit nation.

You can read more on the Affordable Care Act benefits to African Americans, at Healthcare.gov

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Home Insurance Goes Through the Roof

By AnnaMaria Andriotis

Faced with falling home prices and climbing maintenance costs, struggling homeowners may soon face another setback: higher insurance premiums.

After rising steadily for the past few years, homeowner insurance premiums are expected to jump another 5% this year to $1,004, according to the Insurance Information Institute. That’s the biggest yearly increase since the market downturn and will mark the first time the national average premium is above $1,000.

Premiums will rise even higher in some states. In Georgia, GuideOne Insurance will raise rates by 12% on average starting this month. Farmers Insurance is increasing rates in Texas by 10% on average. Last month, Allstate started raising rates by 15% in Pennsylvania. And Florida insurer Citizens Property Insurance Corp. and North Carolina Farm Bureau are raising rates on some condo and homeowners by 21% and 6%, respectively.

Also See: 3 Ways Home Insurers Charge More, Cover Less

The higher premiums come at a challenging time for American homeowners, as millions are behind on their mortgage payments and many owe more on their home than it’s worth. Insurers say the higher premiums are partly to cover their rising costs: Insured catastrophe losses in the U.S. totaled $35.9 billion in 2011, compared to a 2000 to 2010 average of $23.8 billion, according to the III. The companies are also paying more in premiums to so-called reinsurers, which provide insurers coverage for widespread catastrophic events, says Steven Weisbart, senior vice president and chief economist at the III.

Meanwhile, insurers’ returns on their investments — roughly 70% of their assets are in bonds – have been low, he says, and they’re looking for other ways to make up that lost revenue. “The only other place insurance companies can get money from is premiums,” he says.

Typically, when policyholders are informed of premium increases they shop around for better prices, but experts say that’s become harder to do. As insurers exit some markets altogether, homeowners are left with fewer companies to choose from. For instance, starting in May, State Farm will not renew roughly 11,000 homeowner policies in five coastal counties in Texas. The company says it’s trying to lessen its exposure to future losses.

To lower premiums, some homeowners increase their deductible, which means they’ll have to pay more out of pocket if disaster strikes before their insurance kicks in. But this strategy might not be as helpful this time around, since some insurers are dropping other types of coverage that were previously part of basic homeowner insurance policies. When coupled with a high deductible, a homeowner’s expenses could soar.

Allstate, for instance, recently introduced a new homeowner’s policy in Kansas and Oklahoma that doesn’t pay out the full cost of replacing all roofs that incur windstorm or hail damage. Kevin Smith, a company spokesman, says Allstate will determine which roofs qualify based in part on their age and condition. If Allstate declines to pay the full cost, it will pay the current value of that roof and the homeowner will be on the hook for the difference. The company says the homeowner’s other option is to purchase so-called replacement cost coverage for roof losses in addition to their basic policy.

Even if homeowners find a lower premium, it might not stay low for long. Experts say many insurers filed requests with states to raise rates this year. (When states approve higher rates, that leads to higher premiums for policyholders.) For instance, last month, Pennsylvania received requests from Erie Insurance and Travelers to increase premiums by roughly 9% by June and July, respectively, according to the state’s insurance department. (The companies didn’t respond to requests for comment.) In Georgia, most of the major companies filed requests to raise rates from 18% to 22%, says Steve Manders, director of insurance product review at the state’s department of insurance. The states say they don’t usually approve requests for increases by the exact amount insurers ask for.

Home Insurance Goes Through the Roof

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