Monday, 9 September 2013
Webinar Tuesday from 12:30 to 1:30 p.m. Eastern Time will look at rates and plan offerings in state health-insurance exchanges
The second in a series of webinars for journalists covering the Patient Protection and Affordable Care Act will be held Tuesday from 12:30 to 1:30 p.m. ET. This one will look at insurance rates and plan offerings in the new state-based marketplaces known as health benefits exchanges.
The co-directors of the Kaiser Family Foundation's program for the study of health reform and private insurance, Senior Vice President Larry Levitt and Vice President Gary Claxton, will give a brief presentation on the early reports of rates, how and why they vary, and what consumers would pay after taking tax credits into account. They will also answer journalists' questions about the new insurance market rules taking effect in 2014, and how to interpret insurance rates.
Journalists who want to register for the webinar can RSVP by clicking here. Shortly after registering, each participant will receive a confirmation email that contains information about how to join the webinar. If you are unable to attend the second webinar, but would like to receive all future updates on the series, please email your name and media affiliation to acawebinars@kff.org.
During the webinar series, participants are welcome to continue the conversation on Twitter with the hashtag #ACA101KFF. Archived video from the first webinar, "What Do Consumers Need to Know About Health Reform's Changes," is available on the foundation website. For more information, contact Victoria Chao at 650-854-9400 or the email address above.
The co-directors of the Kaiser Family Foundation's program for the study of health reform and private insurance, Senior Vice President Larry Levitt and Vice President Gary Claxton, will give a brief presentation on the early reports of rates, how and why they vary, and what consumers would pay after taking tax credits into account. They will also answer journalists' questions about the new insurance market rules taking effect in 2014, and how to interpret insurance rates.
Journalists who want to register for the webinar can RSVP by clicking here. Shortly after registering, each participant will receive a confirmation email that contains information about how to join the webinar. If you are unable to attend the second webinar, but would like to receive all future updates on the series, please email your name and media affiliation to acawebinars@kff.org.
During the webinar series, participants are welcome to continue the conversation on Twitter with the hashtag #ACA101KFF. Archived video from the first webinar, "What Do Consumers Need to Know About Health Reform's Changes," is available on the foundation website. For more information, contact Victoria Chao at 650-854-9400 or the email address above.
State health-insurance exchange plans to make smokers pay 40 percent more for coverage; varied interests, observers object
By Molly Burchett
Kentucky Health News
Supporters of the Patient Protection and Affordable Care Act have touted its goal to provide health insurance to all Americans without discrimination, such as prohibiting insurers from denying coverage due to pre-existing conditions. But it allows them to charge smokers more for it, and the officials running Kentucky's health-insurance exchange plan to do just that.
When Kynect, the state's online insurance exchange, opens Oct. 1, smokers can expect to pay up to a 40 percent surcharge, not far from the 50 percent limit in the law. That has brought objections from a wide range of observers, including tobacco companies and anti-cancer activists, saying it may be well-intended but is unfair and may backfire.
"Ranked No. 1 in adult smoking and cancer deaths, Kentucky should be doing all it can to bring tobacco users under the care of medical professionals. Yet some Kentucky smokers — perhaps many — will still be unable to afford health insurance, even after historic reforms take effect next year," says a recent Lexington Herald-Leader editorial. In 2011, the last year for which figures are available, 29 percent of adult Kentuckians smoked, and that does not include those who use smokeless tobacco.
UPDATE, Sept. 11: The state Department of Insurance says the 40 percent is a ceiling, and some companies are charging less, but 40 percent is the most common tobacco surcharge on health insurance policies sold in Kentucky. "There are health care costs associated with tobacco use," spokeswoman Ronda Sloan said. "With no tobacco use surcharge, insurers would have raised rates for everyone to offset those costs. . . . Plans will provide benefits for tobacco use cessation."
Seven states (California, Connecticut, Massachusetts, New Jersey, New York, Rhode Island and Vermont) and the District of Columbia will not charge smokers higher premiums. Connecticut voted against a smoking surcharge for individual policies, saying higher individual rates would disproportionately penalize poor people who tend to smoke.
Surchage critics in Kentucky agree. "This penalty is being applied to the working poor and medically indigent," writes Dr. Kevin Kavanagh, chairman of Health Watch USA, in a Herald-Leader op-ed. "Tobacco use is inversely related to education and income. In Kentucky, 48 percent of adults without a high school diploma smoke. These are the working poor."
Since most smokers tend to have lower incomes, the surcharge could discourage them from signing up for coverage at all because they can't afford it, restricting health care access for those that need it most, critics say. Although people with incomes up to four times the federal poverty level will get premium subsidies on the exchanges, the tobacco surcharge will be added to the final rate, reports Sarah Kliff of The Washington Post.
"The smoker's premium alone will account for 24 percent to 29 percent of his salary not counting deductibles and co-pays," Kavanagh writes. "This policy clearly blocks insurability for the low-income worker." Cigarette makers say the policy amounts to discrimination against smokers, reports Kliff.
The surcharge makes sense from a strictly actuarial perspective, and is supported by the insurance industry because smokers have much higher health costs, reports WebMD Health News. Kentucky's health costs attributable to smoking add up to about $1.5 billion a year, and smoking-caused productivity losses total $2.3 billion a year, says the Centers for Disease Control and Prevention.
However, punitive measures like higher premiums have not been proven to reduce smoking, say health organizations opposing the surcharge, such as the American Cancer Society and American Lung Associaton. In addition to being ineffective, higher premiums for smokers could make health insurance coverage unaffordable, leaving tobacco users without coverage for smoking-cessation programs, or any other type of coverage that Obamacare has sought to provide.
"From the longer-term perspective on how to improve people's health and contain medical costs, the tobacco penalty is a policy disaster," says the Sept. 8 Herald-Leader editorial. The Cancer Society says states would see greater public health and economic benefits from increased tobacco taxes, implementation of strong smoke-free laws and the funding prevention efforts, rather than penalizing smokers.
In closing, Kavanagh poses an important question: "Wouldn't it be better to provide these individuals access to the health care system where tobacco withdrawal could be encouraged and assisted and preventative care for other ailments can be provided?" (Read more)
Kentucky Health News
Supporters of the Patient Protection and Affordable Care Act have touted its goal to provide health insurance to all Americans without discrimination, such as prohibiting insurers from denying coverage due to pre-existing conditions. But it allows them to charge smokers more for it, and the officials running Kentucky's health-insurance exchange plan to do just that.
When Kynect, the state's online insurance exchange, opens Oct. 1, smokers can expect to pay up to a 40 percent surcharge, not far from the 50 percent limit in the law. That has brought objections from a wide range of observers, including tobacco companies and anti-cancer activists, saying it may be well-intended but is unfair and may backfire.
"Ranked No. 1 in adult smoking and cancer deaths, Kentucky should be doing all it can to bring tobacco users under the care of medical professionals. Yet some Kentucky smokers — perhaps many — will still be unable to afford health insurance, even after historic reforms take effect next year," says a recent Lexington Herald-Leader editorial. In 2011, the last year for which figures are available, 29 percent of adult Kentuckians smoked, and that does not include those who use smokeless tobacco.
UPDATE, Sept. 11: The state Department of Insurance says the 40 percent is a ceiling, and some companies are charging less, but 40 percent is the most common tobacco surcharge on health insurance policies sold in Kentucky. "There are health care costs associated with tobacco use," spokeswoman Ronda Sloan said. "With no tobacco use surcharge, insurers would have raised rates for everyone to offset those costs. . . . Plans will provide benefits for tobacco use cessation."
Seven states (California, Connecticut, Massachusetts, New Jersey, New York, Rhode Island and Vermont) and the District of Columbia will not charge smokers higher premiums. Connecticut voted against a smoking surcharge for individual policies, saying higher individual rates would disproportionately penalize poor people who tend to smoke.
Surchage critics in Kentucky agree. "This penalty is being applied to the working poor and medically indigent," writes Dr. Kevin Kavanagh, chairman of Health Watch USA, in a Herald-Leader op-ed. "Tobacco use is inversely related to education and income. In Kentucky, 48 percent of adults without a high school diploma smoke. These are the working poor."
Since most smokers tend to have lower incomes, the surcharge could discourage them from signing up for coverage at all because they can't afford it, restricting health care access for those that need it most, critics say. Although people with incomes up to four times the federal poverty level will get premium subsidies on the exchanges, the tobacco surcharge will be added to the final rate, reports Sarah Kliff of The Washington Post.
"The smoker's premium alone will account for 24 percent to 29 percent of his salary not counting deductibles and co-pays," Kavanagh writes. "This policy clearly blocks insurability for the low-income worker." Cigarette makers say the policy amounts to discrimination against smokers, reports Kliff.
The surcharge makes sense from a strictly actuarial perspective, and is supported by the insurance industry because smokers have much higher health costs, reports WebMD Health News. Kentucky's health costs attributable to smoking add up to about $1.5 billion a year, and smoking-caused productivity losses total $2.3 billion a year, says the Centers for Disease Control and Prevention.
However, punitive measures like higher premiums have not been proven to reduce smoking, say health organizations opposing the surcharge, such as the American Cancer Society and American Lung Associaton. In addition to being ineffective, higher premiums for smokers could make health insurance coverage unaffordable, leaving tobacco users without coverage for smoking-cessation programs, or any other type of coverage that Obamacare has sought to provide.
"From the longer-term perspective on how to improve people's health and contain medical costs, the tobacco penalty is a policy disaster," says the Sept. 8 Herald-Leader editorial. The Cancer Society says states would see greater public health and economic benefits from increased tobacco taxes, implementation of strong smoke-free laws and the funding prevention efforts, rather than penalizing smokers.
In closing, Kavanagh poses an important question: "Wouldn't it be better to provide these individuals access to the health care system where tobacco withdrawal could be encouraged and assisted and preventative care for other ailments can be provided?" (Read more)
Teen use of e-cigarettes doubles in past year but may equal nicotine patches in helping smokers to quit or cut back
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| E-cigarettes use battery-operated products that turn nicotine and other chemicals into vapor to be inhaled by the user. |
The report is the first of its kind to shine a potentially positive light on the public-health debate about e-cigarettes, which are not yet regulated by the Food and Drug Administration and have generated concern from U.S. health officials and public health experts; the Centers for Disease Control says they are addictive and could be dangerous.
However, Chris Bullen of the University of Auckland in New Zealand and colleagues recruited 657 participants who wanted to quit smoking for a study, finding that e-cigarettes were just as effective as nicotine patches in doing this, reports Maggie Fox of NBC News.
“While our results don’t show any clear-cut differences between e-cigarettes and patches in terms of quit success after six months, it certainly seems that e-cigarettes were more effective in helping smokers who didn’t quit to cut down,” Bullen said.
The study, which was published in the British medical journal The Lancet, found that 57 percent of volunteers given real e-cigarettes were smoking half as many cigarettes a day as before, compared to 41 percent of those who got patches.
The study's findings also show that participants were more enthusiastic about using e-cigarettes as a means of quitting, compared to patches, suggesting that the product may have greater consumer acceptability, Dr. Cheryl Healton, president and CEO of the anti-tobacco Legacy Foundation, told NBC News.
E-cigarettes are already becoming more popular among young consumers. The CDC and FDA released a report on Thursday showing that the number of high school students who have tried them in the past year has doubled - to an estimated 1.78 million or 10 percent of middle and high school students. This trend raises concerns among public health professionals.
CDC researchers worry that e-cigarettes might be a gateway to conventional tobacco products, but it's not known whether e-cigarettes may lead young people to try cigarettes or other tobacco products, which are known to cause disease and lead to premature death, says the FDA. It's also unknown whether e-cigarettes are safe or how much nicotine or other potentially harmful chemicals are being inhaled during their use, says the FDA website.
Nicotine itself may also be harmful, said Dr. Tim McAfee, director of the CDC Office on Smoking and Health. “We are particularly concerned about adolescents being exposed to nicotine in any form because it has the potential to impact their brain development.”
Another unknown is whether e-cigarette use has potential benefits, says the FDA, but this new study suggests two: helping smokers to quit or lessen smoking. The study's authors do agree with public health advocates, saying that additional research is needed to study long-term e-cigarette use and "to clearly establish their overall benefits and harms at both individual and population levels."
Sunday, 8 September 2013
Webinars to be held Thursday, Sept. 12, for small businesses to help them plan for implementation of the Affordable Care Act
What will the Patient Protection and Affordable Care Act mean for Kentucky's small businesses? A webinar Thursday, Sept. 12 is designed to address such questions about the federal health-care reform law, often called Obamacare.
The webinar will be presented twice, at 11:30 a.m. and 3:30 p.m. ET. Its topics will include tax credits available to businesses and tax-exempt non-profits, an update on the Kentucky health-insurance exchange, the concept of shared responsibility, efforts to contain costs, planning for implementation of the law, a checklist for getting ready, and tools and resources available for small businesses.
The webinar will conclude with a question-and-answer period with the presenter, Mary Huttlinger, outreach manager for Small Business Majority, a national organization focused on public-policy concerns of small businesses. The webinar is sponsored by Kentucky Voices for Health. To register for the 11:30 ET webinar, click here. For the 3:30 session, click here.
The webinar will be presented twice, at 11:30 a.m. and 3:30 p.m. ET. Its topics will include tax credits available to businesses and tax-exempt non-profits, an update on the Kentucky health-insurance exchange, the concept of shared responsibility, efforts to contain costs, planning for implementation of the law, a checklist for getting ready, and tools and resources available for small businesses.
The webinar will conclude with a question-and-answer period with the presenter, Mary Huttlinger, outreach manager for Small Business Majority, a national organization focused on public-policy concerns of small businesses. The webinar is sponsored by Kentucky Voices for Health. To register for the 11:30 ET webinar, click here. For the 3:30 session, click here.
Saturday, 7 September 2013
Are health insurers trying to trick individual policyholders into renewing before they can shop on new insurance exchange?
UPDATE, Sept. 25: The state has fined Humana $10 per letter, or $65,430, for sending the letters, Chris Kenning of The Courier-Journal reports.
State officials say Humana Inc. is misleading individual policyholders by telling them they can keep their current policy for a year at current rates or get a costlier policy that complies with federal health reform and asking them to choose by Sept. 20. That's 10 days before they will be able to "shop for less-expensive insurance that complies with the health care law, often called Obamacare, and possibly qualify for government subsidies to help pay for it," writes Laura Ungar of The Courier-Journal. "State officials are also reviewing a letter by Anthem Blue Cross Blue Shield asking people to "call now' to lock in 'today’s affordable rates'."
Ray Brundige of Louisville told Ungar that it’s unfair to rush customers into decisions before the exchange announces its coverage, premiums and subsidies. “They are not giving people the ability to make an informed choice, because the information is not yet out there,” said Brundige, 63. “They’re doing themselves and the community a disservice.” Democratic U.S. Rep. John Yarmuth of Louisville told her the letters “appeared to pre-empt people’s use of the exchange,” which opens Oct. 1.
The letters say, “Please choose one of these two options no later than 30 days from the date of this letter.” Kevin Gibson of Humana told Ungar that someone could still shop on the exchange and cancel their earlier coverage. He said Brundige's current $279-a-month policy would cost $619 because he now has "limited coverage, which will no longer be allowed on the individual insurance market under the health care law," Ungar reports.
"Anthem spokesman Tony Felts said urging people to renew their current policies before the health care law takes effect in earnest Jan. 1 is allowed under insurance regulations. He said the option to keep current rates will be available into mid-November, after the exchange is underway."
State Insurance Commissioner Sharon Clark said the Humana letter is "misleading intentionally" and has objected to the company. Kate Marx of Humana told Ungar, "We feel the need to clarify that although we've asked for a 30-day selection, we will continue to make ourselves available to assist members with plan selections until the end of the year." Policies sold on the exchange will take effect Jan. 1 but any policy can be canceled before April 1, said D.J. Wasson of the Department of Insurance.
Ungar writes, "Wasson said Anthem’s letter improperly conveys a sense of great urgency" because it says, “We can only offer current plans and rates for a limited time.” The letter, sent to all individual policyholders in Kentucky, does mentions that the exchange will offer subsidies.
"Department officials reiterated that insurers should be straightforward and truthful with customers, and not take advantage of uncertainty surrounding the health care law," Ungar writes. "And they said consumers should get educated about the law."
Insurance is complicated, on your best day,” Clark told Ungar. “It is just such a new environment.” (Read more)
State officials say Humana Inc. is misleading individual policyholders by telling them they can keep their current policy for a year at current rates or get a costlier policy that complies with federal health reform and asking them to choose by Sept. 20. That's 10 days before they will be able to "shop for less-expensive insurance that complies with the health care law, often called Obamacare, and possibly qualify for government subsidies to help pay for it," writes Laura Ungar of The Courier-Journal. "State officials are also reviewing a letter by Anthem Blue Cross Blue Shield asking people to "call now' to lock in 'today’s affordable rates'."
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| Humana's letter (Courier-Journal photo) |
The letters say, “Please choose one of these two options no later than 30 days from the date of this letter.” Kevin Gibson of Humana told Ungar that someone could still shop on the exchange and cancel their earlier coverage. He said Brundige's current $279-a-month policy would cost $619 because he now has "limited coverage, which will no longer be allowed on the individual insurance market under the health care law," Ungar reports.
"Anthem spokesman Tony Felts said urging people to renew their current policies before the health care law takes effect in earnest Jan. 1 is allowed under insurance regulations. He said the option to keep current rates will be available into mid-November, after the exchange is underway."
State Insurance Commissioner Sharon Clark said the Humana letter is "misleading intentionally" and has objected to the company. Kate Marx of Humana told Ungar, "We feel the need to clarify that although we've asked for a 30-day selection, we will continue to make ourselves available to assist members with plan selections until the end of the year." Policies sold on the exchange will take effect Jan. 1 but any policy can be canceled before April 1, said D.J. Wasson of the Department of Insurance.
Ungar writes, "Wasson said Anthem’s letter improperly conveys a sense of great urgency" because it says, “We can only offer current plans and rates for a limited time.” The letter, sent to all individual policyholders in Kentucky, does mentions that the exchange will offer subsidies.
"Department officials reiterated that insurers should be straightforward and truthful with customers, and not take advantage of uncertainty surrounding the health care law," Ungar writes. "And they said consumers should get educated about the law."
Insurance is complicated, on your best day,” Clark told Ungar. “It is just such a new environment.” (Read more)
Friday, 6 September 2013
Kentucky has nation's first statewide, comprehensive plan for diabetes prevention; 10 percent of us have the disease
Kentucky leads the way in the fight against diabetes and towards improving health for future generations of Kentuckians by becoming the first state to legislatively require a statewide, comprehensive action plan for addressing this disease epidemic.
Over 500,000 Kentuckians, 10 percent of the state’s population, are living with diabetes, costing the state about $4.8 billion a year in direct and indirect medical costs, write R. Stewart Perry and Larry Smith, co-chairs of the American Diabetes Association's national board of directors, in an op-ed piece in The Courier-Journal. While it hasn't been widely reported, state policymakers recently tackled the issue.
In 2011, the General Assembly passed a law (KRS 211.752), sponsored by Sen. Tom Buford, R-Nicholasville, and Rep. Ruth Ann Palumbo, D-Lexington, directing the Cabinet for Health and Family Services to report every two years on the impact of diabetes on the commonwealth. The report must include the scope of the disease, its costs and what state government is doing about it.
The law requires the Department for Medicaid Services, the Department for Public Health, the Office of Health Policy and the Personnel Cabinet to “collaborate to identify goals and benchmarks while also developing individual entity plans to reduce the incidence of diabetes in Kentucky, improve diabetes care, and control complications associated with diabetes,” Perry and Smith note.
Such reporting will encourage the development of prevention strategies that are more effective and efficient, representing an unprecedented, coordinated effort against diabetes, they write. Many other states are using Kentucky’s plan as a model for legislation. "We call on every Kentuckian to enlist in the effort to step up the fight against diabetes," they urge.
In 2011, the General Assembly passed a law (KRS 211.752), sponsored by Sen. Tom Buford, R-Nicholasville, and Rep. Ruth Ann Palumbo, D-Lexington, directing the Cabinet for Health and Family Services to report every two years on the impact of diabetes on the commonwealth. The report must include the scope of the disease, its costs and what state government is doing about it.
The law requires the Department for Medicaid Services, the Department for Public Health, the Office of Health Policy and the Personnel Cabinet to “collaborate to identify goals and benchmarks while also developing individual entity plans to reduce the incidence of diabetes in Kentucky, improve diabetes care, and control complications associated with diabetes,” Perry and Smith note.
Such reporting will encourage the development of prevention strategies that are more effective and efficient, representing an unprecedented, coordinated effort against diabetes, they write. Many other states are using Kentucky’s plan as a model for legislation. "We call on every Kentuckian to enlist in the effort to step up the fight against diabetes," they urge.
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