Five things to know about the Senate’s healthcare bill

Posted by Emily Kubis on Thu, Jun 22, 2017 @ 14:06

Cuts Medicaid and subsidies, expands state flexibility

The U.S. Senate released a first draft of the Better Care Reconciliation Act, their plan to replace the Affordable Care Act.

The bill shares the bones of its predecessor, the House of Representatives’ American Health Care Act. It cuts taxes for the wealthy and rolls back Obamacare regulations, while keeping some of the ACA’s individual market structures.

Of course, this bill hasn’t passed yet. This bill could continue to be negotiated, but Senators are planning a vote next week before the July 4th recess.

But if the bill does pass, here’s what it would do:

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Tags: Affordable Care Act, obamacare, aca, Individual health insurance, Donald Trump, individual digest, repeal, American Health Care Act, AHCA, Better Care Reconciliation Act, BCRA

Oscar Healthcare to sell individual plans in Nashville

Posted by Emily Kubis on Wed, Jun 21, 2017 @ 12:06

Two insurers planning to sell 2018 ACA plans in the city

Individual health insurance consumers in Nashville will have a new Affordable Care Act option in 2018, as New York-based insurer Oscar Healthcare announced plans to enter the market.

This will be welcome news for many consumers, who were down to one exchange option after BlueCross BlueShield of Tennessee pulled out of the city last year, and Humana announced this spring plans to exit the individual market entirely.

So far, Cigna and Oscar Healthcare are the only two insurers who have filed with the state to sell individual health plans in Nashville. They will file for their requested rates by July 1.

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Tags: Affordable Care Act, obamacare, aca, Individual health insurance, nashville, individual digest, repeal, American Health Care Act, Oscar Healthcare

The American Health Care Act’s winners and losers in Tennessee

Posted by Alex Tolbert on Mon, Jun 19, 2017 @ 12:06

Some consumers would benefit, others would be worse off

Health policy is complicated — for every decision, there are equal and opposite reactions. If the American Health Care Act (AHCA) becomes law, there will be both “winners” and “losers” in Tennessee. In other words, some consumers will benefit, and others will be worse off. 

This makes it tricky for policymakers to strike a balance. The Affordable Care Act certainly didn’t figure this out perfectly, and the Republican Obamacare repeal bill probably won’t, either. 
The AHCA, which passed the U.S. House of Representatives last month, still has to make it through the Senate. But based on the first pass at repealing Obamacare, we can make some predictions on the AHCA’s “winners and losers.”

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Tags: Affordable Care Act, healthcare, aca, health reform, The Tennessean, individual market, individual digest, American Health Care Act, AHCA

Will insurers drop maternity coverage if the AHCA passes?

Posted by Emily Kubis on Fri, Jun 16, 2017 @ 08:06

Maternity, substance abuse and mental health treatment least covered before health reform

A key piece of the American Health Care Act, the GOP plan to repeal and replace Obamacare, would allow states to waive the regulation that requires insurers to cover ten “essential health benefits.”

The Affordable Care Act required all individual plans to cover ten “EHBs.” These are services like hospitalizations, prescriptions, maternity and pediatric care, among others.

In order to reduce premium prices, the AHCA would allow individual states to decide whether to keep this regulation or waive it. In other words, plans in states that waive the EHBs would be “skinnier,” or cover less, than plans in states that uphold the EHBs.

But what does this mean for consumers? Would insurers stop covering these ten services if the state does not require them to?

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Tags: Affordable Care Act, obamacare, aca, Individual health insurance, maternity, Donald Trump, individual digest, repeal, American Health Care Act, AHCA, maternity coverage

Two ways health insurance auto-enrollment might work

Posted by Alex Tolbert on Wed, Jun 14, 2017 @ 09:06

Devil in the details

A new health policy idea with increasing bipartisan support in the U.S. Senate is auto-enrolling consumers in catastrophic health plans.

Repealing Obamacare’s individual mandate, the government would automatically sign consumers up for emergency-only coverage. Surprisingly, this is one healthcare idea that seems to cross party lines, but most of the conversations stop when the details start.

How would it work? What would it cost? How would the government know who needed catastrophic coverage?

It would be a big change from our current system, certainly, but that doesn’t mean it’s impossible. Here are two ideas for how the policy might work—a registry model, and a universal coverage model. But first, let’s explain what auto-enrollment means.

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Tags: health insurance, Individual health insurance, healthcare costs, Huffington Post, auto-enrollment, insurance

Millennials push employers to evolve benefits

Posted by Alex Tolbert on Mon, Jun 12, 2017 @ 09:06

Check out this column in the Nashville Business Journal

Last year, Millennials surpassed Baby Boomers as the largest generation in the workforce. There are 53 Millennial workers in the U.S., and their benefits needs and expectations are different than their parents’.

At Bernard Health, we’re particularly affected by this trend—not only do we have a benefits brokerage advising employers in Nashville and elsewhere, but the vast majority of our nearly 100 team members are proud members of the Millennial generation.

One example of how we’re affected relates to participation on our group health plan. At Bernard, almost 40 percent of our team waives our group health plan, as they are still covered under their parents’. We’ve found that it doesn’t matter how good your health plan is—if you’re hiring college graduates, many of them aren’t going to take your benefits, even if they’re better than their parents’ option.

We’re not the only ones facing this dynamic. Nashville is a key city for Millennial job growth, and with more companies like Warby Parker, Lyft and newcomer Houzz setting up shop in Middle Tennessee, the search for young talent will only become more competitive, here and in peer cities like Denver, Charlotte and Portland. 

As this dynamic takes root, robust benefits packages will remain key differentiators among hot startups and Millennial-attracting businesses. But these younger employees are shaping a new benefits landscape, and if employers want to attract the best and brightest, benefits packages need to keep up.

Click here to read the full article in the Nashville Business Journal.

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Tags: health insurance, employer health benefits, healthcare costs, millennials, Nashville Business Journal, employer digest

Why the Senate’s all-male healthcare group is a big problem for Americans

Posted by Alex Tolbert on Fri, Jun 09, 2017 @ 10:06

Women make 80 percent of healthcare decisions

The entirely male panel tasked with drafting the Senate’s version of the American Health Care Act is problematic for U.S. consumers, because it isn’t representative of the group of Americans who really drive healthcare consumerism.

An established point of understanding in the healthcare industry is that women are the nation’s healthcare decision-makers. According to the Department of Labor, women make 80 percent of all healthcare decisions in the U.S., and are significantly more likely to be caregivers when a loved one falls ill. 

Excluding women from the health reform panel is ill-conceived. These are the constituents with the most direct contact with our nation’s dysfunctional, fragmented healthcare system, and they should be represented.

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Tags: Affordable Care Act, health insurance, obamacare, aca, healthcare costs, essential health benefits, Huffington Post, American Health Care Act, AHCA

What are "Centers of Excellence" networks?

Posted by Emily Kubis on Wed, Jun 07, 2017 @ 11:06

The next level of reference based pricing for employers

Walmart has made healthcare headlines over the last few years with their innovative “Centers of Excellence” program for employees. 

For employees needing certain surgeries—most recently, spinal surgery was added to the list—Walmart will pay for the entirety of the procedure, as well as travel, lodging and an expense allowance for the patient and a caregiver.

To take advantage of this benefit, eligible employee must receive the procedure at one of the company’s “Centers of Excellence” facilities around the country.

 GE and Lowe’s also offers a similar Centers of Excellence program—but why, and how do they work?

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Tags: employers, solutions for employers, health insurance small employers, employer digest, reference based pricing

Predicting which Texas insurance carrier might enter Tennessee

Posted by Alex Tolbert on Tue, Jun 06, 2017 @ 07:06

New insurer could change state dynamic

Tennessee’s individual insurance market has hit a rough patch over the last few years, as BlueCross BlueShield left the Nashville market and UnitedHealthcare and Humana pulled out of the Affordable Care Act exchanges altogether. But reports that a new carrier might enter the state could change this dynamic.

The Tennessean recently reported that Tennessee’s insurance commissioner, Julie Mix McPeak, said that a Texas health insurer was considering entering a metro Tennessee market in 2018. This news could give health insurance consumers in Nashville, Memphis or Chattanooga more choices than initially expected. 

McPeak declined to specify which carrier was considering Tennessee. Examining the carriers currently operating in Texas, we can make a few predictions.

First, there are several carriers we can rule out pretty easily. 

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Tags: Affordable Care Act, healthcare, aca, health reform, The Tennessean, individual market, individual digest, Centene Healthcare, Ambetter

Three tips for a sustainable benefits plan

Posted by Emily Kubis on Thu, Jun 01, 2017 @ 09:06

A strategic plan design can lower costs

Health insurance costs continue to rise for employers and employees alike. Premiums for family coverage have increased 20 percent since 2011 and 58 percent since 2006, according to the Kaiser Family Foundation.

With costs exceeding the rate of inflation, employers are looking for ways to bend the cost curve. Here are three approaches organizations of all sizes should consider.

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Tags: HSA, High Deductible Health Plan, Defined Contribution, employers, solutions for employers, health insurance small employers, HSA-based plan, employer digest, limit plan liability, HSA-eligible plans

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