Study offers early look at new health law’s premiums

 

This Oct. 11, 2012 file photo shows a basket of medical supplies await storage in Brookhaven, Miss. The No. 1 question about President Barack Obama’s health care law is whether consumers will be able to afford the coverage. Now the answer is coming in: The biggest study yet of premiums posted publicly by states finds that the sticker price will average about $270 a month if you’re a 21-year-old buying a mid-range policy. That’s before government tax credits that will act like a discount for most people, bringing down the cost based on their income.ROGELIO V. SOLIS, FILE — AP Photo

This Oct. 11, 2012 file photo shows a basket of medical supplies await storage in Brookhaven, Miss. The No. 1 question about President Barack Obama’s health care law is whether consumers will be able to afford the coverage. Now the answer is coming in: The biggest study yet of premiums posted publicly by states finds that the sticker price will average about $270 a month if you’re a 21-year-old buying a mid-range policy. That’s before government tax credits that will act like a discount for most people, bringing down the cost based on their income.
ROGELIO V. SOLIS, FILE — AP Photo

WASHINGTON — The No. 1 question about President Barack Obama’s health care law is whether consumers will be able to afford the coverage. Now the answer is coming in.

 

Published: September 4, 2013

By RICARDO ALONSO-ZALDIVAR — Associated Press

 

The biggest study yet of premiums posted by states finds that the sticker price for a 21-year-old buying a mid-range policy will average about $270 a month. That’s before government tax credits that act like a discount for most people, bringing down the cost based on their income.

List-price premiums for a 40-year-old buying a mid-range plan will average close to $330, the study by Avalere Health found. For a 60-year-old, they were nearly double that at $615 a month.

Starting Oct. 1, people who don’t have health care coverage on their job can go to new online insurance markets in their states to shop for a private plan and find out if they qualify for a tax credit. Come Jan. 1, virtually all Americans will be required to have coverage, or face fines. At the same time, insurance companies will no longer be able to turn away people in poor health.

The study points to the emergence of a competitive market, said lead author Caroline Pearson, a vice president of the private data analysis firm. But it’s a market with big price differences among age groups, states and even within states. A copy was provided to The Associated Press.

The bottom line is mixed: Many consumers will like their new options, particularly if they qualify for a tax credit. But others may have to stretch to afford coverage.

“We are seeing competitive offerings in every market if you buy toward the low end of what’s available,” said Pearson, a vice president of Avalere.

However, for uninsured people who are paying nothing today “this is still a big cost that they’re expected to fit into their budgets,” Pearson added.

The Obama administration didn’t challenge the study, but Health and Human Services spokeswoman Joanne Peters said consumers will have options that are cheaper than the averages presented. “We’re consistently seeing that premiums will be lower than expected,” she added. “For the many people that qualify for a tax credit, the cost will be even lower.”

With insurance marketplaces just weeks away from opening, the Avalere study crunched the numbers on premiums filed by insurers in 11 states and Washington, DC.

Eight of them are planning to run their own insurance markets, while the federal government will run the operation in the remaining four. There were no significant differences in premiums between states running their own markets and federal ones.

The states analyzed were California, Connecticut, Indiana, Maryland, New York, Ohio, Rhode Island, South Dakota, Vermont, Virginia and Washington. No data on premiums were publicly available for Texas and Florida — together they are home to more than 10 million of the nation’s nearly 50 million uninsured people — and keys to the law’s success.

However, Pearson said she’s confident the premiums in the study will be “quite representative” of other states, because clear pricing patterns emerged. Official data for most other states isn’t expected until close to the Oct. 1 deadline for the new markets.

The study looked at premiums for non-smoking 21-year-olds, 40-year-olds and 60-year-olds in each of the 11 states and the District of Columbia.

It compared four levels of plans available under Obama’s law: bronze, silver, gold and platinum. Bronze plans will cover 60 percent of expected medical costs; silver plans will cover 70 percent; gold will cover 80 percent, and platinum 90 percent.

All plans cover the same benefits, but bronze features the lowest premiums, paired with higher deductibles and copays. Platinum plans would have the lowest out-of-pocket costs and the highest premiums.

Mid-range silver plans are considered the benchmark, because the tax credits will be keyed to the cost of the second-lowest-cost silver plan in a local area.

The average premium for a silver plan ranged from a low of $203 a month for a 21-year-old in Maryland to a high of $764 for a 60-year-old in Connecticut.

The silver plan premiums for 40-year-olds were roughly $75 a month higher than for 21-year-olds across the states. But the price jumped for 60-year-olds. The health law allows insurers to charge older adults up to three times more than younger ones. That’s less of a spread than in most states now, but it could still be a shock.

“It’s striking that the curve increases quite dramatically above age 40,” said Pearson. “As you get older and approach Medicare age, your expected health costs start to rise pretty quickly.”

But older consumers could also be the biggest beneficiaries of the tax credits, because they work by limiting what you pay for health insurance to a given percentage of your income.

For example, an individual making $23,000 would pay no more than 6.3 percent of their annual income — $1,450 — for a benchmark silver plan.

That help tapers off for those with solid middle-class incomes, above $30,000 for an individual and $60,000 for a family of four.

The study also found some striking price differences within certain states, generally larger ones. In New York, with 16 insurers participating, the difference between the cheapest and priciest silver premium was $418.

Cherokee Nation To Fund $100 Million Overhaul of Tribal Health Care System

Source: Indian Country Today Media Network

Cherokee Nation Principal Chief Bill John Baker announces a copy00 million investment in the tribe's health care system. (Cherokee Nation)

Cherokee Nation Principal Chief Bill John Baker announces a copy00 million investment in the tribe’s health care system. (Cherokee Nation)

The Cherokee Nation runs the country’s largest tribally operated health care system. And now it is investing copy00 million from its business holdings to improve it.

“This is exactly what our businesses were designed to do,” said Cherokee Nation Principal Chief Bill John Baker in a press release. “Our financial success belongs to the Cherokee people. For the first time ever, we are taking a substantial amount of money directly from our businesses and putting it where it counts the most—health care for our citizens. Using our businesses to invest in and improve our health care system is the right thing to do, and it will literally save Cherokee lives.”

The tribe plans to replace or renovate four health centers and build a new hospital over the next two to three years. Cherokee Nation Businesses’ construction division will manage the entire project, hiring dozens of Cherokee subcontractors certified by the Tribal Employment Rights Office (TERO), which will help boost the local economy.

A major component of the health system expansion is a new 100-bed hospital, which replaces the current W.W. Hastings Hospital in Tahlequah, Oklahoma. Built as an Indian Health Services facility in 1984, the hospital was constructed to serve 65,000 outpatient visits each year. Today, the facility is serving more than 400,000 patient visits per year. The new $53.1 million hospital allows the current hospital to become an outpatient center.

The expansion projects also include a new 28,000-square-foot health center near Ochelata and a 42,000-square-foot health center in Jay. The Redbird Smith Health Center in Sallisaw will see a 30,000-square-foot expansion and 11,000 square feet of renovations. In Stillwell, 28,000 square feet will be added to the Wilma P. Mankiller Health Center.

The CNB board of directors unanimously approved the investment. Under current Cherokee law, an annual dividend totaling 35 percent of CNB’s profits is deposited in the Cherokee Nation’s general fund. The Cherokee Nation general fund supports a variety of services, including housing, education, social services, health care and more. Last year, that dividend payment totaled $57 million.

“The needs of the Cherokee people are so diverse that the dividend payment helps us get closer to where we need to be on health care, but very slowly,” Baker said. “This infusion of copy00 million, solely to health care infrastructure, helps us impact the health outcomes of Cherokees so much quicker. Our businesses have become so successful in recent years that it just makes sense and, quite frankly, is the right thing to do.”

“This is a great opportunity to show the Cherokee people why our casinos are here,” said Shawn Slaton, CEO of CNB. “Our goal is to create jobs, grow businesses and provide funding to the Cherokee Nation for services to the Cherokee people. We are proud to be in a position where we can make such a huge contribution to the health and well-being of Cherokee citizens.”

Aside from annual dividends, this is the first major investment the tribe’s businesses have made directly to tribal infrastructure. CNB will pay for the construction of the facilities and lease them back to the tribe for operation. One of CNB’s subsidiaries, Cherokee Nation Construction Resources, will serve as the prime contractor and construction manager of the project.

“By managing this project in-house, our construction division grows in its capabilities and gains an important past performance résumé, which they can use to win contracts from the federal government and private developers,” Slaton said. “This is a real win-win for CNB and the Cherokee Nation.”

Cherokee Nation Construction Resources, a division of CNB’s environmental and construction portfolio, is managing the construction of the health system expansion. The company is using this as an opportunity to perform work for the tribe and earn past performance credit, which is a valuable credential in both government and commercial contracting.

“When we do a project, we always know that the revenue it is generating helps the Cherokee people, but normally that’s through providing jobs and via the dividend payment,” said Cheryl Cohenour, executive general manager of Cherokee Nation Construction Resources. “But this project is so much more meaningful to us. For the first time, our work will directly affect citizens in ways the 35 percent dividend or job creation cannot.  There is so much pride in knowing that as a Cherokee Nation, tribally owned business, we have something tangible to show our businesses’ commitment to making change for the Cherokee people. These new, updated health facilities are going to be a source of pride for our company, as well as the entire Cherokee Nation.”

The Cherokee Nation’s health system supports 1.2 million patient visits annually. It consists of eight health centers throughout the Cherokee Nation and W.W. Hastings Hospital in Tahlequah. Most Cherokee Nation health centers offer medical, dental, lab, radiology, public health, WIC, nutrition, contract health, pharmacy, behavioral health, optometry, community health service and mammography, or a combination of those services.

The Cherokee Nation also has future plans to make renovations at the Three Rivers Health Center in Muskogee and build a new Jack Brown Center in Tahlequah. The Jack Brown Center serves Cherokee citizens who may be struggling with an alcohol or drug dependency.

“I promised to make the health of our people a main priority,” said Baker. “This is a major step in the right direction.”

 

Read more at http://indiancountrytodaymedianetwork.com/2013/03/29/cherokee-nation-fund-100-million-overhaul-tribal-health-care-system-148430