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The White House has been under fire recently because of its new law that requires all employers to cover birth control in their health care plans. However, Jay Carney, the White House press secretary said there’s not going to be a debate on the controversial issue as it’s a final decision. The criticism over the mandate has been led by Catholic leaders and Republicans.

Carney made the announcement on Feb. 2 during a media conference call and said that no health care providers will be made to prescribe contraception to patients and no policyholders will be forced to use or buy any methods of birth control. He said the law just means that it has to be made available to people via their employer-sponsored health insurance plans.

Carney said the government considered the issue very carefully before coming to its decision on it about two weeks ago. The new rule means that just about all health plans will have to cover female preventive services without any deductibles or co-payments. This includes various types of contraception that have been approved by the FDA.

Many Catholic schools, charities, and hospitals aren’t too happy with the rule though because they’re opposed to birth control. They were hoping the government would exempt them from it, but Carney said they won’t be. Some religious employers, such as places of worship, will be able to receive an exemption though, but those who haven’t will have to comply with the rule by August of 2013.

According to an article by the Wall Street Journal, Kathleen Sebelius of the Health and Human Services said the rule offers a good balance respecting the religious freedom of people and improving access to important birth control services. But John Boehner, the House Speaker, said the government should reconsider its decision as it undermines religious liberty.

The government said medications that cause abortion won’t be covered and that a recent study showed a high percentage of Catholic women used contraceptives for birth control rather than natural family planning. However, Senate and House Republicans have introduced new bills which would force the government to scrap the contraceptive rule for insurance plans.

Even though many Americans have health insurance plans, a lot of them don’t take advantage of them if they’re unemployed because they still find the costs, such as deductibles and co-payments are too high. According to an article in HealthDay News, those without jobs are less likely to use prescription drugs or seek medical care than those who have jobs, even though they’re insured.

A study by the U.S. Center for Disease Control and Prevention said that having a private insurance plan didn’t mean a person was receiving good health care. It reported that unemployed people with insurance had worse mental and physical health than those who were employed. It found that many jobless people weren’t using the insurance to the fullest due to the costs they still had to pay.

The Center said having insurance is better than not having it, but people who had coverage and a job were better off. The study used data from a U.S. National Health Interview Survey that was conducted in 2009 and 2010 and it focused on people aged between 18 and 64. The report stated that 48 per cent of jobless adults were insured and 81 per cent of adults who had jobs had coverage with more unemployed people having public insurance compared to the employed.

Dr. Steffie Woolhandler, who is a co-founder at the Physicians for a National Health Program, said she doesn’t believe the new health insurance reform will actually improve the situation. She said there was almost a 20 per cent drop in primary care during the recent recession because people who lost their jobs, but still had insurance, couldn’t afford to take advantage of their health care because of the high costs attached to plans in America.

She said there will be about 23 million people still without a health plan after the reforms are all implemented and that’s a good start, but it’s not going to be much help to some people if they can’t afford to get the medical attention they need. In fact, she said the health reform could make it worse for some people because some of the new policies offered will come with even costlier deductible and co-payments.

According to the numbers, health insurance companies have been reaping record profits ever since President Obama’s health care reform act was announced. This comes after private insurers complained the new legislation would drive them out of business. However, it’s hard to see how companies would suffer if more people are purchasing their products.

A recent Bloomberg Government report said more private insurers are now involved in the managing of public health insurance programs and the five biggest publicly-traded companies made more money in the first three quarters of 2011 than any other three-quarter period in the past 10 years. According to the report, the average company’s operating margin rose to 8.65 per cent last year compared to 6.9 per cent during the 18 months before Obama’s reform legislation was passed.

Even though insurers argued it would be costly for them to follow the new laws, such as insuring children who have pre-existing conditions, profits are rising. According to an article by the National Journal, a lot of the profits are the result of investing in public programs such as Medicaid and Medicare.

The insurers are offering customers of these programs managed-care plans and it was reported that more than 40 per cent of their revenue now comes from this. Combined, the top four insurers saw their Medicaid revenue double in 2011 to $4.11 billion from 2 billion. But in the 18 months since the health law was passed the growth on their commercial revenue was just three per cent.

The recent moves by some of America’s top private insurers leads one to believe that they feel the new health care laws will be implemented fully in the near future even though they are being challenged in the courts. The insurers feel more and more Americans will be leaning toward purchasing managed-care health programs. Some insurance analysts say private companies are making a lot of money by moving in on the public health programs, but this outsourcing isn’t going to save the tax payers money.

For instance the Congressional Budget Office figures show that Medicare Advantage plans cost the tax payers 10 per cent more than the traditional Medicare plan.

Beginning this year, the American government will be adding on a fee to peoples’ health insurance plans that will be used to fund research to discover which medical procedures, tests, treatments, and drugs are the most effective. The research is a part of President Obama's new health care legislation and will try to determine if new prescription medications are any better than less expensive older generic types.

However, according to an article by SFGate.com, many people are suspicious of the new research fee since they view it as a tax and could become an issue in this election year. The research will be performed by a new governmental agency which was formed by Congress called The Patient-Centered Outcomes Research Institute.

The government has already started funding the institute and starting in 2012 there will be a $1 insurance fee per person that will go towards the research. However, the Treasury Department said that the fee might not be collected until 2013, but insurance companies would still owe the government the money that is to be collected in 2012. During the second year of the program, the fee will double to $2 per insured person. After that, the rate will be adjusted according to the rate of inflation.

Kathryn Nix, who is an insurance analyst with Heritage Foundation wonders if the results of the research will be used to make insurance coverage determinations. However, Dr. Joe Selby, who is the institute’s director, said his organization won’t make the decisions since that will be the job of doctors and patients. Selby said the institute isn’t a policy-making organization and its job is to simply carry out research and make the findings of it available.

Some representatives of the insurance industry feel that policyholders could be encouraged to visit doctors and hospitals which provide the most effective methods of treatment and those who go elsewhere may have to pay higher co-payments, such as people do now when they pay extra charges for buying non-preferred drugs. The article states that several major insurance companies are doing their own research, but the government-funded studies are seen as more credible.

At the moment, drug companies just have to prove that their new medications are more effective than sugar pills to gain governmental marketing approval. They don’t have to show that the medication is better than a competing brand.

Many American states have handed the government Medicaid program to private insurance companies over the past decade or so as a way to improve health care and reduce costs. It’s estimated that about 30 million Medicaid patients, which represents about half of the total, are looked after by private managed-care plans. However, according to an article by USA Today, Connecticut has decided to run the show itself.

Starting Jan. 1, 2012, Connecticut is going to take Medicaid plans back from private insurers and will take over financial responsibility. This is because state officials said the private companies weren’t providing better care and lower costs. In America, about 27 million Medicaid participants are looked after by managed-care plans and they represent $150 billion of the total Medicaid spending of $400 billion.

While Connecticut is taking Medicaid plans out of the hands of private insurers, many other states such as California, Texas, and Florida, are requesting that more residents join managed-care plans. Officials in numerous states are keeping their eyes on Connecticut to see how everything pans out. According to a Connecticut health care consultant, there are a lot of people against profit-making health care companies and this move is welcomed by them.

Ironically, Connecticut is known as the insurance capital of the world and about 2.1 per cent of the state’s population work in the insurance industry. Oklahoma was the first state to get rid of its private, for-profit Medicaid plans back in 2005 and it’s been reported that officials there are happy with the results. Oklahoma reported that Medicaid members there were happy with the cost and quality of their health care and the cost has risen just 1.2 per cent annually over the past five years.

In 2011, Connecticut’s Medicaid managed-care operations were worth over $800 million to several private companies. Critics of the managed-care Medicaid plans are hoping more states will follow Connecticut's lead and seek out alternatives. An advocacy group representing the poor, known as The New Haven Legal Assistance Association, said managed-care Medicaid sees too much money and too many resources going toward profits and administration.

The group said a report in 2009 showed that Connecticut overpaid insurers by close to $50 million per year, which represented six per cent of total expenses. Other states said the plans weren’t spending enough money on health services and some of the doctors that belonged to networks wouldn’t accept patients who were on Medicaid.

The article said many doctors in Connecticut are also happy with the state’s decision as they had to follow a different set of rules for the different plans. In addition, they also said there were delays in payments and they had difficulty referring some patients to specialists.

The Supreme Court recently announced that it has set aside a week in March to listen to arguments over the constitutionality of the new health insurance legislation as it wants to settle the issue before the presidential elections in 2012. The court said it will listen to arguments concerning the Patient Protection and Affordable Care Act from March 26 to 28.

According to an article by the Associated Press, the court time means there should be a final decision on the controversial health care law by Independence Day as President Obama campaigns for re-election. The new legislation has been strongly opposed by all of the president’s potential GOP opponents. The Republicans claimed that the new law was unconstitutional before the president signed it in March 2010.

In March, the justices will listen to over five hours of debates on the new health care law. The last time the Supreme Court set aside that much time for an issue was in 2003. The arguments will start on Mon. March 26 and decide whether or not court action is actually premature since nobody has paid a fine for not participating in the health care overhaul.

American law typically doesn’t allow any court challenges concerning things such as taxes until they have been paid. An appeals court in Richmond, Va., made a ruling earlier in 2011 which said the fines for not buying insurance wouldn’t be paid before the federal income tax returns need to be sent in by April 2015, meaning it’s too early for the court to rule.

The next day of arguments will deal with whether Congress has the authority to require Americans to buy health insurance in 2014 or be fined. The White House said it’s well within its power to enforce the law while opponents of it say Congress is overstepping its authority with the mandate. So far, just one of four appellate courts have ruled that the mandate is unconstitutional.

The last day of Supreme Court time will deal with arguments regarding whether the remainder of the health care law can be put into effect if the health insurance mandate is ruled to be unconstitutional. In addition, discussions will be held over whether the new law has gone too far by coercing individual states to join in on the legislation by threatening to cut off federal money. Opponents to the law say it should all be scrapped if the individual insurance mandate is ruled unconstitutional, while the government says most of the legislation should still be allowed to function.

With the current year quickly coming to an end it’s a good time to check out your health insurance plans to make sure you use them to your advantage. This is because many individual and employer-sponsored health care policies reset themselves on January 1 and annual deductibles and certain benefits will be set back to square one.

Some policies cover yearly physicals with no or little out-of-pocket expense and vision or dental coverage often allows for annual or biennial benefits such as eye glasses and contact lenses. You could be eligible for these benefits before the year ends and if you are, it’s a good idea to use them up instead of losing them.

In addition, a lot of health care plans reset the deductible at the start of a new year. If you've paid your yearly deductible already you may want to send claims before year end as they’ll result in lower out-of-pocket expenses to you. If you figure you’ll have a lot of expenses next year you may want to send in your claims early in the year to pay your deductible as quickly as possible.

If you’ve paid a lot toward the deductible during the final three months of a year some insurance companies may allow you to use these fourth-quarter payments to roll over and be counted toward next year’s deductible. However, be aware that the money in the majority of employer-sponsored FSAs (Flexible Spending Accounts) won’t roll over from one year to the next. If you have any money left in an FSA you should use it up before the new year arrives.

You need to be aware of any rate changes in the coming year as well. If insurers are changing your rates or benefits they should notify you well in advance. Keep your eye out for any correspondence from your insurance company and make sure you open any mail or e-mail from them before throwing it out.

Some insurance companies also offer discounts and deals on national or local health club memberships. It’s a good idea to check and see if you’re eligible for any discounts. This will enable you to kick off the new year in a healthy manner as well as save you some money.

President Obama announced on Dec. 16 that the individual states will have a major say on health-care benefits under the new health insurance law. He said each state will be able to set the minimum essential benefits that insurance companies will be required to provide its customers. Instead of the government defining what benefits must be offered across the nation the responsibility will lie with each state.

This means that the necessary benefits will likely vary quite a bit from state to state, similar to the differences in current Children's Health Insurance and Medicaid programs. Many consumer groups criticized the announcement as they feel Americans could end up with substandard health insurance coverage. But on the other side of the fence, insurers and employers are afraid that the opposite could be true if a state requires expensive, comprehensive benefits to be provided.

According to an article by the Seattle Times, the government didn’t get into any specific details when announcing the plan, but some of the fundamental benefits that have to be included are emergency services, inpatient, outpatient, childhood and maternity care along with prescription drugs and preventive screenings and labs. Substance-abuse and mental-health treatments also need to be covered along with rehabilitation for cognitive and physical disorders and vision and dental care for children. All of these benefits need to be included on new small-business and personal health plans that are bought starting in 2014.

The Health and Human Services said the states will be able to come up with coverage benefit options which meet the unique needs of their state. This may lead to some states offering coverage for things such as in vitro fertilization and chiropractic therapy while other states choose not to. However, there are 10 specific coverage areas that have been mandated. This means many Americans will receive minimum coverage they may not be receiving at the moment for things such as prescription-drugs and maternity care.

It’s estimated that millions of Americans will benefit from some of the added coverage since many consumers don’t have maternity care and prescription drug benefits with their current policies.

The early retiree health insurance fund that was set up by President Obama is almost out of money already, even though it was designed to last up until at least 2014. The government set up a fund of $5 billion, known as the Early Retiree Reinsurance Program, which helped to pay for health insurance costs for over five million Americans who retired early.

According to an article by reason.com, there is a notice in the Federal Register that says the fund won’t be taking any more expense claims after Dec. 31, 2011, simply because there isn’t enough money left in it. The money was used to reimburse employers who had subsidized health coverage for people who retired between the ages of 55 to 64 and weren’t yet eligible for Medicare.

The program is a part of the 2010 health legislation and $4.5 billion of the $5 billion had already been paid out by Dec. 9. The money has gone so quickly due to heavy enrollment in the program. In fact, the program ceased back in April because of the heavy demand on it, which means it ended about 2.5 years earlier than it was scheduled to.

The program gave out generous subsidies to unions, corporations, schools, educational facilities, and religious organizations, etc. that funded health coverage for their early retirees. Employers were able to utilize the savings to cut down on their own health care costs or to supply relief to their employees and families or to combine both options. The number of employers that took advantage of the program came as a bit of a surprise to the government though.

The UAW (United Auto Workers) had received just over $200 million by April 2011 while telecom businesses Verizon received $91 and AT&T received $140 million. It was reported that over half of the money that was spent in the first year of the program went directly to government-operated retirement plans in several states including New Jersey, California, and Kentucky. However, the lack of funds now means new claims must be entered by the end of this month.

With the new health exchange programs coming into play, it’s possible that some employers will stop providing group health plans for their workers. This would see them heading to these new health insurance marketplaces to receive subsidized health coverage. The employers would face fines for discontinuing health insurance, but the fines would be cheaper than continuing to pay for their workers’ health benefits.

According to an article by the Washington Post, if this scenario was to take place, it would cost employees who are in a group plan now to move over to a subsidized program. For the employer, if they stopped offering health insurance to their employees it’s estimated that their health care costs would drop by more than 40 per cent.

If you’re wondering why this wouldn’t mean the costs would drop totally by 100 per cent, you have to remember that the employers would still have costs because they would be fined financially for dropping the health coverage. They could conceivably stop offering health insurance, pay the fines and save quite a bit of money while doing so.

However, things don’t look so rosy for those workers who would suddenly find themselves without health coverage. At the moment, employers are paying a sizable chunk of employees’ insurance costs. In fact, they’re paying a lot more of it than the federal government will be with the new subsidized method.

It’s estimated that the average worker who goes to a health exchange for coverage would see their current rates increase between 79 and 125 per cent. It’s hard to predict exactly because the amount of subsidies received by the government will depend on a person’s income. People who earn more money will be eligible for smaller subsidies while those who make less will receive more in subsidies.

The possibilities are something to think about. Perhaps the way to stop this from happening is to increase the fines to employers if they stop offering health insurance. That way there would be nothing to gain by doing so.

Thousands of children in Arizona may be able to get their health insurance back if a Nov. 28 proposal by state hospital executives and Governor Jan Brewer is approved by the federal Centers for Medicaid and Medicare Services. If it is, then close to 20,000 youngsters will be able to enroll is a subsidized health coverage program known as KidsCare, which is aimed at low-income families.

In January of 2010 Arizona froze program enrollment due to cost-cutting procedures. There were about 46,000 children in the program when it was frozen and now there are just over 14,000, but there are over 120,000 more on its waiting list. The new proposal was constructed by Phoenix Children's Hospital, the University of Arizona Health Network, and Maricopa Integrated Health System.

These organizations will put together $226 million over the next two years to receive a total of $229 million in additional federal funds. The money will help the state and the hospitals as it will supply more insurance for children who aren’t covered while federal money will help offset the price of providing health care for which the hospitals aren’t compensated. The state of Arizona won’t be required to donate any money.

Under the proposal, the majority of federal money given to the hospitals would then offset the price of uncompensated care with the KidsCare program receiving about $44 million. Some of the federal money would go towards improvements to the three hospital systems, such as expanding the electronic health-record system and trauma services as well as adding services and beds to the Phoenix Children's emergency and pediatric trauma center departments.

According to an article by azcentral.com, if the government approves the proposal, then families which have been waiting on the list the longest would be allowed to reapply and the program will take on a total of 19,283 more patients for at least two years. The KidsCare program is designed for families that aren’t eligible for Medicaid because they earn too much. Once accepted and depending on the family’s income, members of KidsCare pay between $10 and $70 each month for coverage. It covers dental and vision care, doctors' visits, surgery, prescriptions, and emergency-room visits.

The program was introduced by Arizona in 1998 and belongs to the Children's Health Insurance Program. The state ended the program because of its budget deficit, but restored it when it realized close to $7 billion could be lost each year in federal Medicaid dollars. Enrollment was then frozen to save money, but the number of children with coverage dropped dramatically and the freeze has been challenged in court.

The federal government turned down the state of Indiana’s request for it to waive new insurance rules on Nov. 28. The rule in question states that insurance companies must spend a minimum of 80 per cent of their revenue from premiums on medical care instead of on things such as administrative costs, salaries, and marketing etc. If the insurers don’t follow the rules then customers are entitled to rebates.

However, the government refused to let the rule slide and this means residents who purchase health insurance on their own instead of through employers will indeed be entitled to rebates starting in 2012 if the rules are broken. The U.S. Department of Health and Human Services made the announcement.

State officials claimed that insurance companies were leaving Indiana due to the new law, but the federal agency replied that there’s no evidence of that happening. The government said there’s no reason to adjust the new rule and it’s in the customers’ best interest that it remains the way it is. According to estimates by the state, Indiana residents would have been eligible for about $24 million worth of rebates last year if the law was in place then.

Stephen W. Robertson, the Commissioner of Insurance for Indiana, wrote in the waiver application that was sent to the government that five insurance companies notified him that they would be withdrawing from the health insurance market in Indiana if the law wasn’t waived.

But the federal government said one of the insurers didn’t even sell individual insurance plans in the state, another didn’t have any active business there and two of them were complying with the rule when they decided to pull out. The fifth company was said to be in financial trouble in several states where it does business. The government concluded that residents wouldn’t lose coverage if these companies left the market.

According to an article by pal-item.com, Indiana’s biggest health insurance provider is WellPoint/Anthem as they cover close to 60 per cent of residents who purchase their own plans. It was reported that they spent 77 per cent premiums on medical care in 2010 and it plans on meeting the 80 per cent requirement. The minimum on premiums sold to large groups is 85 per cent.

So far, the federal government has turned down four state requests waive the law, but has approved the modified versions of six other state requests. In addition, it’s still looking over requests from seven other states.

California’s health care providers could find their insurance plans regulated in the future if a state consumer group gets its way. The group that kick started the state into regulating the cost of auto insurance coverage now wants the same type of regulations brought in for health insurance plans.

A Santa Monica organization known as Consumer Watchdog proposed the idea about health care regulations to the state attorney general's office on Nov. 9th. They want the local health maintenance organizations, preferred-provider organizations, and insurance companies to ask for approval before hiking their rates. This means they would have to get the consent of the California Department of Insurance first.

It’s believed that once the group’s petition receives clearance for circulation it would require approximately 505,000 signatures of registered voters for the proposal to show up on the California state-wide ballot next November 2012. There’s no doubt that the state’s health insurance companies and other types of health care providers will fight against the proposal tooth and nail.

Back in 1988 the state’s voters voted for Proposition 103, a proposal that made California’s homeowners' and auto insurance some of the most regulated in America. Consumer Watchdog said it wants the insurance providers to get approval of rate increases as well as be more transparent in their dealings.

In addition, under the proposal, if any health providers supply false information when seeking approval for higher rates for small-group and individual policies they could be charged with perjury. However, it’s hard to predict how far this proposal will go since similar bills in the California Legislature haven’t been passed in the last five years.

According to an article by the Los Angeles Times, Dave Jones, the State Insurance Commissioner, is all for regulating rates when it comes to health insurance and he’s looking over the ballot initiative he received from Consumer Watchdog. On the other side of the fence, members of the health insurance industry said the proposal has some serious flaws in it and it will be opposed by health plans, employers, hospitals, medical groups and doctors.

According to the latest figures released by eHealth, the average cost for individual health insurance in America in 2011 was $2,196 for an average of $183 a month. Family plans cost $4,968 at $414 per month. These numbers come from a report called the Cost and Benefits of Individual and Family Health Insurance Plans, which was released at the start of November. In addition, the average deductible for an individual plan was $2,935 and for a family plan it reached $3,879.

The annual report deals with average deductibles, benefit standards, and premiums for individually- bought health coverage and it was based on the study of more than 384,000 family and individual health plans that were bought via eHealthInsurance.com. All 50 states are represented in the report as well as the District of Columbia.

The study found that the price of an individual plan increased by an average of 9.6 per cent between February 2010 and February 2011 and a family plan went up on average 5.6 per cent. The deductible for an individual policy increased 11.5 per cent for individuals and for families it went up 9.9 per cent. Half of the individual policyholders were paying $149 a month or less for their premiums while half of the families were paying $353 each month or less for coverage.

The average lifetime limit for these plans was found to be $4.2 million, but this applies to plans that come with specified limits. However, lifetime limits will eventually he phased out by the Patient Protection and Affordable Care Act. The cost of premiums naturally varied from state to state with individual plans ranging from a low in Iowa of $119 up to a high in New York of $382. Family plans ranged from Iowa’s low of $261 to New York’s high of $932.

According to an article by marketwatch.com, the report also found that just about all families and individuals chose plans that included emergency room and x-ray coverage. Most of them, 88 per cent, also selected health plans which included coverage for chiropractic care and prescription drugs.

There’s a new federal requirement in America that states all health insurance companies must spend at least 80 per cent of the money they receive from premiums on actual medical care. However, the insurance regulator for the state of Wisconsin is asking the government to exempt local insurers from this rule.

The Office of the Commissioner of Insurance is asking the government to allow the new rule to be implemented in three separate phases instead of all at once. Ted Nickel, who is the commissioner of insurance, would like to see just 71 per cent of premiums spent on medical care this year then 74 per cent in 2012 and 77 per cent in 2013.

Nickel said that if insurance companies are forced to spend 80 per cent of premiums from individuals and small employers on medical care then some of them might stop selling health policies and the citizens of Wisconsin will suffer from lack of insurers. According to Nickel, six of the two dozen insurance firms that sell policies in the individual market might suffer from the federal rule since the law would require them to pay their customers rebates if they don’t hit 80 per cent.

It didn’t come as a surprise when Rep. Jon Richards of Milwaukee criticized Gov. Scott Walker's administration and Nickel for worrying about big insurance companies instead of their customers. Richards said the interest of the consumers should come before insurance companies especially when the government is trying to slash the cost of health care.

However, most of the insurance firms in Wisconsin said they wouldn’t have a problem meeting the 80 per cent threshold, but these were mainly non-profit clinics or health care systems. Nickel insisted that there are a lot of obstacles to hurdle though for insurers to spend 80 cents of each dollar on medical care. He added that six insurance companies spent less than that last year.

According to an article by the Milwaukee Wisconsin Journal Sentinel these firms spent just 65 to 72.9 per cent of each dollar on medical care and they make up about a third of the market in Wisconsin when it comes to individual health insurance.

A survey carried out by the Kaiser Family Foundation found that Wisconsin possesses the country’s most competitive market when it comes to health insurance that’s purchased by families and individuals. They feel there would be lots of insurers to purchase plans from even of these six companies dropped out of the market.

Robert Kraig, who is the Citizen Action of Wisconsin’s executive director, said that state regulators are suggesting that the insurance companies should be allowed to keep the money that should be sent out to customers as a rebate if they don’t spend the required 80 per cent.