Will more be insured? Will we have the health professionals to meet their needs?
Last month’s column looked at how health insurance eligibility changed under ACA and explored the “coverage gap” in states choosing not to expand Medicaid. This week we’ll explore other implications of this revolutionary change in how health insurance is secured and paid for.
On balance, will the share uninsured go down?
Cutting the ranks of the uninsured is a key objective of ACA. Not all of the 8 million who signed up for new plans were previously uninsured: According to early surveys, two thirds to three quarters of these enrollees were changing plans. No surprise here. ACA offers subsidies that are significant for many, making the Marketplace plans very attractive for those who qualify. Others who didn’t qualify for subsidies still found the Marketplace plans a good deal. Competition spurred by the Marketplace drove down prices for nonemployer plans in some states, including New York.
Yet some will choose to pay the penalty for being uninsured instead of the premiums. Insurers are now required to cover a fixed set of preventative services at no extra cost to the consumer. The law also limits what consumers can be charged for care within a single year. Initially, ACA required that a 2014 policy must cover all costs above $6,350 for singles or $12,700 for families. That’s the “out-of-pocket maximum,” now delayed until 2015. (These deductibles are subsidized for individuals and families below 250% of the poverty line.) This shifts the financial burden of major illness from the insured to the insurer. Both changes make for better insurance—but they cost insurers more and premiums will rise. Read more »
The decade of continuous combat in Iraq and Afghanistan has created a demand for veterans’ services that the US has not experienced since Vietnam. The sheer numbers of veterans (almost 2 million troops deployed since 2001) would be hard enough for the Veterans Administration (VA) to address. But the heavy reliance on National Guard and Reservists has changed the veteran population, subsequent needs and community impact substantially. Read more »
How’d you like to be a county executive, legislator or member of a board of supervisors and have to decide the future of a financially-troubled county-owned nursing home? Often one of the area’s major institutions and employers, it provides an important community service, even though typically costing the county taxpayers significant amounts of money. No matter what you decide, you’re likely to be criticized from one or more directions. That is the unpleasant reality currently being faced by public officials in counties throughout all regions of New York State.
As recently as 2005, more than 40 counties outside New York City owned and operated public nursing homes containing some 9,900 beds. Now those numbers are closer to 35 counties and 8,100 beds, and those totals are likely to dwindle further over the next few years. Why the sharp declines in such a short period of time? Rising costs and declining revenues combine to force county taxpayers to plug steadily-rising deficits. Read more »
In this column, we address the challenge of expanding health insurance coverage. First, we explore why our employer-based system leaves gaps in coverage, even for people with jobs. Second, we discuss the challenge of relying on the individual insurance market, which has to fill these gaps.
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New York swept the annual property tax competitions sponsored by the Census Bureau. Scored by the Tax Foundation, New York counties dominated the competition in the “property tax as a share of median home value” event, capturing all of the top ten places. Camden, New Jersey was pushed off the top ten after a spirited showing from New York’s Chemung County. Newcomer to the Top Ten, Chemung ranked #16 in 2007.
In the “property tax per dwelling” event, New York’s perennial champions, Nassau and Westchester counties, took the top two spots with Rockland and Putnam counties also placing. The remainder of the Top Ten was dominated by New Jersey, always a contender in the nation’s tax competition.
What a contest to win! Is there hope of ever losing this competition? What must we do to cut the cost of state and local government? Does it matter?
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I’m in the third month of my high deductible health plan (HDHP) experience. And we’ve had some big bills to pay—I’m thinking that we may actually reach that family deductible early in the year. No surprises, though. I’ll let you know how it turns out. (If you’d like to read my earlier series on this subject, find the link to our blog site at www.cgr.org.)
A good friend sent me a column penned by someone who feels differently. The title tells it all: “I regret enrolling in an HSA.” Author Kelley Butler is having a major case of buyer’s remorse.
Kelley Butler is the editor of Employee Benefit News and her article can be found at http://ebn.benefitnews.com/news/regret-enrolling-hsa-2670271-1.html.
Kelley liked everything about her old health plan—except the price: “I knew we couldn’t afford the premiums we’d have to pay to keep our beloved PPO.” So she signed up for the high deductible health plan with a health savings account (HSA) and “hoped for the best.”
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