Insurelane Insurance Blog

If you’re looking for the lowest health insurance rates in the Midwest, you’ll find them in Wisconsin and Michigan.

America’s Health Insurance Plans’ Center for Policy and Research recently released the average premiums for private plans in the Midwestern states, reported the Detroit Free Press. They found that Wisconsin’s rates were the lowest at $1,254 in annual premiums for an individual.

Michigan came in second at $1,878 for individuals. For a family in Michigan, the yearly premiums totaled $4,118.

Both states were considerably lower than the national average premiums — $2,613 annually for individuals and $5,799 per year for a family plan.

“Lower health premiums in the state reflect Michigan’s strong union history that bargained for workplace benefits. [Michigan is] a national leader regarding the provision of generous and affordable health insurance,” said Dr. A. Mark Fendrick, director of the Center for Value Based Insurance Design at the University of Michigan.

The data also showed that 94% of large businesses and 50% of small businesses in Michigan provide health insurance for their workers. And 10% of the state’s population has no insurance, lower than the national average of 16%.

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In Texas, there are an estimated 1.5 million children that have no health insurance. But the state’s Health and Human Services found that over 850,000 of those uninsured children are eligible for Medicaid or the State Children’s Health Insurance Program (SCHIP).

Now Texas is increasing their efforts to enroll more children in the state health insurance programs. One effort in Houston has been using the communities’ churches as a way to get the word out about SCHIP and Medicaid. State officials are considering using the church model around the whole state.

“Texas is a very large state, and it’s very difficult to get that information out,” said outreach campaign manager, Geoff Wool. “We’re really looking at every opportunity that’s available to let families know about these programs.”

The state has also contracted $3.5 million with 28 organizations to help increase awareness of the programs and get children enrolled. And parents are getting calls if their applications were missing necessary information, rather than requests by mail.

Texas’ U.S. Senator John Cornyn visited Austin recently to get the word out, and hear about solutions to get more children enrolled, reported the Austin-American Statesman.

“The positive outreach efforts are encouraging, but there are still hundreds of thousands of low-income children across the state who are going without essential health care services,” said Senator Cornyn.

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Fluoride in public water systems has long been touted as a great health initiative — helping prevent cavities and tooth decay, and improving the dental health of citizens by the millions. But only around half of the residents living in Pennsylvania have fluoridated tap water, reported the Harrisburg-Patriot News.

The Pennsylvania House Health and Human Services Committee recently approved a bill that requires all public systems to fluoridate water if they have 500 or more customers. The measure will now go to the Appropriations Committee for approval.

Most scientists and lawmakers agree that putting fluoride in tap water has big health benefits. And the Pennsylvania Dental Association is leading the push for fluoridating all public water.

“The state supports fluoridation as a preventive measure. It has been proven and it’s supported by research from the CDC, the American Dental Association and other independent researchers,” said Pennsylvania public health dentist, Dr. Howard Tolchinsky.

But not everyone supports fluoridating. One dentist from New Jersey claims that there isn’t enough evidence that say communities with fluoridated water have healthier teeth than those with no fluoride.

“If everybody wanted shinier floors, would you put floor wax in the water supply?” challenged the New Jersey dentist, wary of fluoride’s alleged health benefits.

There is, though, widespread acceptance that fluoride does help communities’ dental health.

“The cost to repair those teeth is far greater than [fluoridated water]. I’m not a doctor or a scientist, but I wouldn’t promote it if it wasn’t considered a positive public health strategy,” said executive director of the Carlisle Area Health and Wellness Foundation, Bets Clever.

It costs anywhere from 50 cents to $3 per person to fluoridate tap water depending on the size of the public system, wrote the Harrisburg-Patriot.

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Next June, California will exhaust its federal funding for the State Children’s Health Insurance Program (SCHIP). But state healthcare officials have to decide in the next two weeks if they will stop SCHIP enrollment and notify around 56,600 families that their children will lose coverage.

Even though the funding will stop next summer, the state will have to cut children off of coverage by December 31, reported the San Francisco Chronicle.

California's Healthy Families is one of the largest SCHIP programs in the country — with approximately 835,000 children enrolled. Medi-Cal, also funded by SCHIP, covers an additional 250,000 children and 8,000 pregnant women.

Officials say that these programs need $1.2 billion for fiscal year 2008 to continue enrollment at the current pace. But the continued SCHIP stalemate between the U.S. Congress and the White House has left the SCHIP programs about $265 million short.

If funding from U.S. Congress doesn’t meet the state’s needs, then California’s SCHIP programs might be forced to drop almost 600,000 children off coverage.

State officials are still trying to figure out what action to take in the coming funding shortfalls. One option to ensure the program stays alive is to drop children off coverage. Another option is to continue with regular operations and keep enrolling children, hoping the funding comes along. But if it doesn’t or falls flat, then every child will lose coverage on June when the SCHIP programs shut down.

“These are horrible options. We never thought we were going to be in this place,” said Lesley Cummings, manager of Healthy Families.

California’s Managed Risk Medical Insurance Board will meet on December 5 to decide what to do.

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Massachusetts is ready to start their new auto insurance system in hopes of bringing more big name auto insurance companies into the state, and driving rates down. In the first step, private insurance companies will be allowed to set their own rates for any policy with a renewal date past April 1, 2008. The state has been setting auto insurance prices since 1977.

As result, insurance companies will reduce rates by 10 percent or more, affecting 1.2 million Massachusetts’ drivers, reported the Newburyport News.

Insurance companies will also offer additional rate reductions for good driving behavior and good grades for students. The best drivers will receive the highest savings. Residents can also save more by driving less than 10,000 miles a year and using public transportation.

Another key part of the system will cap rate increases. Rates for drivers with unfavorable driving records won’t go up any more than 10 percent.

But the insurance industry is going to have to make sure consumers are prepared for the system overhaul.

“This is going to be a learning process for everyone,” said Don Beaulieu from Beaulieu Insurance. He pointed out that the industry will have to do their part in explaining the new system’s processes.

“The insurance companies are going to have to lay out a plan to make their businesses look more competitive,” added Beaulieu.

So far, state officials think the new auto insurance system will be a success.

“I’m seeing it not only in the rates but in the flurry of activity to provide additional [auto insurance] products. And companies are trying to make sure they try to retain customers,” said Massachusetts Insurance Commissioner Nonnie Burnes.

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By December 31, 2007, all Massachusetts residents are required to have health insurance coverage. If they can afford it, they have to buy a plan for themselves — if they cannot afford a plan on their own, the state will provide help.

Any resident who earns less than 300 percent of the federal poverty level can get state-subsidized coverage from the program, Commonwealth Care. The premiums are paid in full by the state for lowest earning residents.

This year health officials estimated around 136,000 would enroll in Commonwealth Care by June 30, 2008, reported the Boston Globe. But the enrollment in Commonwealth Care has been higher than anyone expected. Already, approximately 133,000 have signed up — and now the total enrollment by June 2008 could reach over 178,000.

That means the state may spend $147 million more than the $472 million budget for Commonwealth Care this fiscal year.

“It’s a good problem to have — people are getting insured and hopefully getting care. But any shortfall is a big deal,” said state Senator and co-chairman of the Health Care Financing Committee Richard T. Moore.

To solve the budget shortfall, lawmakers are considering shifting money in from funds originally intended to help hospitals pay for care for the uninsured. Some funds from the Health Care Safety Net Trust Fund can be transferred, along with money going to the Boston Medical Center and Cambridge Health Alliance.

State Legislature could also approve additional funding, if necessary.

The budget shortfall has yet to happen, but lawmakers and healthcare officials are considering their options anyway.

“It’s too early to make any departure from the health reform plan. We will follow the trends and adjust, if needed,” said Leslie Kirwan, chairperson of the Commonwealth Health Insurance Connector.

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A study conducted by the Insurance Research Council in 2006 found that approximately 17% of Michigan’s drivers are on the road without insurance. But the state requires that all drivers have no-fault auto insurance — giving them coverage for personal injury, property damage, and legal defense costs if sued.

Some state lawmakers say there are too many uninsured drivers, and it’s putting many at risk. State Representatives Bert Johnson and Mike Nofs have introduced a bill that would allow police to identify drivers who have no insurance, reported the County Press.

The system of auto insurance verification would be paperless and check coverage status instantly.

One co-sponsor of the bill, State Representative Rick Jones, argued that it’s hard for police to verify if drivers have active insurance. They only look at the driver’s proof-of-insurance card. But drivers could show officers an expired insurance card.

“It is a big problem, because it’s fairly easy to get away with. Some people are simply irresponsible,” said Rep. Jones.

Police officers could call the insurance company to make sure the driver’s policy is in effect, but it takes too much time, said Michigan State Police Sergeant Matt Bolger.

Critics of the bill contend that verification systems haven’t been proven to be effective. Executive director of the Insurance Institute of Michigan, Peter Kuhnmuench, pointed out that no other state has such a system.

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Democrats in the U.S. House of Representatives have been negotiating with House Republicans to pass legislation expanding the State Children’s Health Insurance Program (SCHIP).

But eight Democratic U.S. senators said they would not support a compromise bill if it took away coverage for parents currently on SCHIP, reported the New York Times.

“Our states have taken the lead to provide healthcare to this specific population, and we do not want to inhibit their ability to continue providing this important coverage,” wrote the senators in a letter to House Speaker Nancy Pelosi and House Majority Leader Steny H. Hoyer.

Those who signed the letter include Senators Amy Klobuchar, Frank R. Lautenberg, Robert Menendez, Jeff Bingaman, Jack Reed, Sheldon Whitehouse, Russ Feingold, and Herb Kohl.

They warn other Democrats in the House from compromising too much, and they’ve created a potential hurdle for SCHIP legislation to be passed with a veto-proof margin. President Bush has already vetoed one version of the SCHIP bill, and it was sustained in the House.

The White House has made it clear they want to provide SCHIP coverage for only children. They argue that covering parents was not the mission of the program when it was created in 1997.

But many believe covering parents increases the chances they will get their children insured.

“Parent coverage is an important part of keeping families healthy, and I don’t believe we should roll back the gains we’ve made in this area,” said Senator Bingaman.

“When you cover parents, you get more children enrolled,” said Heather Howard, policy counsel to New Jersey Governor Jon Corzine.

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Maryland Governor Martin O’Malley introduced a bill to the state Senate floor that would expand state sponsored health plans to help cover uninsured residents. The Senate passed the measure in a vote of 30 to 17 last week, reported the Baltimore Sun.

Under the new bill, more adults will be eligible for Medicaid. Families earning up to 116 percent of the federal poverty level — $ 22,446 for a family of four and $11,101 for individuals — will qualify for Medicaid. The Sun wrote the expansion can put as many as 70,000 additional adults on Medicaid.

The bill will also provide $1,000 a year for small businesses who do not provide insurance and $1,000 for each employee to help them pay for coverage. To receive these subsidies, small businesses will be required to offer wellness programs.

In total, the healthcare expansion will cost the state $850 million, and they’ll get an extra $600 million from the federal government. But state legislators are worried they would stretch the state’s budget too thin. Next fiscal year, Maryland is facing a $1.7 billion deficit.

The General Assembly has considered raising taxes, cutting spending, and legalizing slot machines to offset the deficit.

“As hard as it is to vote for a tax because I know its effects, I can’t think of a more worthy expansion. [Healthcare expansion is] a moral obligation.” said state Senator and chairman of the Senate Finance Committee, Thomas M. Middleton.

The bill will now go to the state House of Delegates for approval.

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Last week, Illinois Governor Rod Blagojevich declared a healthcare emergency and expanded state-sponsored health insurance to any family earning up to 400 percent of the federal poverty level.

Under the expansion, state lawmakers said the Illinois FamilyCare program would cost state taxpayers an estimated $300 million every year, reported the Daily Herald.

Governor Blagojevich also changed the rules of one state healthcare program which allowed parents to stay covered if they lose their insurance from the State Children’s Health Insurance Program (SCHIP).

The moves were widely rejected by state lawmakers from both sides of the aisle, because they implemented the expansion and rules without approval from state Congress. They also pointed out that the state did not have the funds to pay for the expansion.

“No matter how you feel about healthcare, this isn’t a proper way for an initiative that’s this important, to kind of slide it through this way,” said Republican state Senator Randy Hultgren.

But Blagojevich’s proposals were subject to approval by a 12 member rules-making committee, which rejected the healthcare changes in a vote of 9 to 2.

“I don’t think the 12 members of this panel ought to be the body that decides, for the whole state of Illinois, whether or not a plan like this takes place,” said state Representative and Democrat Lou Lang. “This [should] be done through the legislature.”

Even though the committee rejected the proposed changes, Blagojevich’s administration is still working on other healthcare expansions, wrote the Chicago Tribune. The governor is still concerned that the state’s estimated 20,000 parents may lose their SCHIP coverage because of the standstill in Washington.

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Wisconsin’s rate of uninsured children is one of the lowest in America, but Governor Jim Doyle still wants to reduce the amount of children without insurance. He recently laid out the details of BadgerCare Plus, a program to help insure the estimated 71,000 children without coverage.

Families earning up to 300 percent of the federal poverty level will be eligible for BadgerCare Plus plans for their children. Depending on income, families will be able to buy insurance for their children at premiums ranging from $10 to $68.53 a month, reported to the Milwaukee Journal Sentinel.

Children in families earning less than $38,202 will be eligible for coverage with other state programs.

“We have a moral obligation to provide every child in Wisconsin with affordable, quality health care,” said Governor Doyle. “With BadgerCare Plus, we will reach out to every family across this state to ensure their children get the care they need at a price they can afford.”

The BadgerCare Plus program will begin February 1, 2008.

Along with the program, state health care officials will try to cut costs and get children covered faster. While BadgerCare applications are being completed, children can receive temporary insurance cards. Families will also be able to apply for coverage in community health centers and hospitals.

The state will also save $12 million in administrative costs by allowing families to report only drastic changes in income.

Wisconsin’s Medicaid Director, Jason Helgerson, said that it would take at least two years to make all of these changes. He also conceded that it would be difficult to get every eligible child covered. But he was optimistic of the program.

“We have a golden opportunity to make sure every child in Wisconsin has access to healthcare,” said Helgerson.

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Massachusetts residents must have health insurance by December 31, 2007 or they will be penalized $219 on their personal tax returns, reported the Cape Cod Times.

With the deadline approaching, state officials warn residents that they only have three days to find coverage. If they don’t by a plan by this Thursday, there’s no guarantee that their insurance coverage will start by December 31.

“If you purchase it by {this Thursday] November 15, your coverage starts December 1. After that date, it’s most likely your coverage won’t start until January 1,” said Richard Powers. Powers is the spokesperson for the Commonwealth Connector, the agency offering the state-subsidized Commonwealth Care plan.

Any residents who earn less than 300 percent of the federal poverty level — $28,710 for individuals and $61,956 for a family of four — are eligible for the Commonwealth Care plan.

There are almost 218,000 newly insured Massachusetts residents thanks to the law and the many available insurance programs such as Commonwealth. But the state’s Division of Health Care Finance and Policy estimates that at least 178,000 people still need insurance.

“It took three years to pass health care reform. It’s going to take several years to implement it as well,” said Powers.

“There are many more people today who have the security of a good health plan who didn’t one year ago. It’s certainly progress but still a long way to go,” he added.

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Assembly Speaker Fabian Núñez and Governor Arnold Schwarzenegger are coming closer to an agreement in how to bring universal health care and system reform to the state, reported the San Diego Union-Tribune.

Núñez, a Democrat, recently introduced a plan that would increase state tobacco taxes $1.13 per pack and require most residents obtain health coverage. State Democrats had previously been against a health insurance mandate as Schwarzenegger proposed, because they thought it would force many middle and low-income residents to buy expensive coverage.

But Núñez’s new plan would exempt families whose insurance costs would be more than 6.5 percent of their annual income.

The tobacco tax increase would need to be approved by public vote, but Núñez says it is a popular idea among residents.

“[The tobacco tax increase] passes the litmus test with voters,” said Núñez.

Governor Schwarzenegger opposes the tax increase, but may be willing to compromise. Schwarzenegger proposed to lease the state lottery to a private firm to pay for his health care plan — an idea rejected by the Democrats.

The governor and the Democrats do agree on some things — both plans from Núñez and Schwarzenegger include an increased hospital tax and requiring businesses who do not provide health insurance to pay a certain amount of their payrolls to help pay for their employees’ coverage.

Schwarzenegger said Núñez’s plan was a “positive movement.”

It’s a sign that lawmakers on both sides of the aisle are willing to negotiate to bring health care reform to the state’s system by the years end.

“We look forward to seeing details of the proposal but understand there are still issues to be resolved,” said the governor’s press secretary, Aaron McLear.

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This week, Nov 5 through Nov 11, is Long Term Care Awareness Week...

Long term care (LTC) is defined by Medicare.gov as “a variety of services that includes medical and non-medical care to people who have a chronic illness or disability.” LTC also includes nursing home care. People over 65 years old have a 40 percent chance of going into a nursing home, and 10 percent of those who do will stay for five years or longer.

But many baby boomers soon headed toward retirement have some misconceptions about insurance coverage for long term care. A survey conducted by America’s Health Insurance Plans (AHIP) found that one in four Baby Boomers think they have insurance coverage for long term care, when they actually do not.

LTC can be very expensive, costing as much as $6,266 for a month’s stay in a nursing home or $19 an hour for an in-home aide, according to AARP.

The survey’s results also found that 54 percent of Baby Boomers believe Medicare will cover all LTC expenses. But Medicare will only cover a limited amount of long term care, and only after most assets are completely spent, said a press release on PRNewswire.

Another 44 percent believe that other insurance will cover LTC — but most plans don’t provide extra coverage for extensive long term care.

“Baby Boomers believe they have more coverage than they actually do, giving them a false feeling of financial preparedness to handle long-term care costs,” said Senior Vice President of StrategyOne, Robert Moran.

“This should be a wake-up call to Baby Boomers. They aren’t factoring expenses for long-term care into their retirement planning and are missing an opportunity to protect themselves,” said AHIP President, Karen Ignagni.

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