PSA

Time for a quick Public Service Announcement from Health Insurance Issues With Dave:

By now almost all of us accept that the Coronavirus threat is real.  The two ways we can protect ourselves and others is to wash our hands properly for a full 20 seconds and to stay home as much as possible.  It turns out that lots of people are asymptomatic and capable of infecting others for days before they start coughing and/or running a fever.  It is important that even though you need to maximize social (physical) distancing, you shouldn’t let this force you to minimize social interaction.  My friend John in New Orleans, a veteran of Hurricane Katrina, has expressed to me his concerns about the mental health implications of both the virus and the necessary lockdown.  Stay connected.  Your friends, your family, and even your co-workers miss you.

The insurance companies have a variety of resources for all Americans, not just their clients.  Aetna has an excellent information post about coping with the obvious and reasonable fears that we are all experiencing with the Coronavirus pandemic.  This link is worth a couple of moments of your time.

Oscar has created a personal risk assessment survey that is available to both their clients and the general public.  This survey is no replacement for a test, but you will find it useful.  This is a reminder that the more information you have the better chance you have to protect yourself.

The federal government reports, per Dr. Fauci and Dr. Birx, that if we do everything correctly between 100,000 and 200,000 Americans will succumb to COVID 19.   Mr. Trump considers 100,000 dead Americans a victory.  Let’s be clear, there is nothing special about being 1 out of 100,000.  Stay Safe.  Stay Healthy.

DAVE

www.cunixinsurance.com

Picture – A Quiet Place in Tennessee – David L Cunix

The Connections

         The Lakota universe can be described as Mitakuye Oyasin.

         That means that everything is connected,

         Interrelated, and dependent in order to exist.

                     The universe includes all things that grow,

                     things that fly-everything you see in the world

                     or the place that you walk on.

         These are all included in what

         The Lakota see as the universe.

         All of this is related.

                     Robert Two Crow, Community Curator, 1999

For every action there is an equal and opposite reaction.

         Newton’s Third Law

                    

Your car has a group of idiot lights that alert you when the vehicle needs service.  If the tires need air, a light comes on.  When the car needs gas, a different light comes on.  Time for an oil change?  There is a light for that, too.  Until now there hasn’t been an idiot light to warn the American public that our health care system is under attack.  Until now.  On Monday the U.S. Supreme Court agreed to hear Texas v. U.S., the lawsuit that could dismantle the Patient Protection and Affordable Care Act (Obamacare).  The red light is on.

The 974 pages of the PPACA touch every aspect of how Americans access and pay for health care.  It is far from perfect.  It did not even do everything it set out to accomplish.  But millions of Americans have benefited from:

·   Coverage for preexisting conditions

·   Policies that are guaranteed issue

·   Maternity treated the same as any other condition

·   Children covered till age 26 on a parent’s policy

·   Medicaid expanded to cover the working poor

·   No maximum benefit

Successive Republican Congresses and the current administration have promised something better.  There have been over 60 votes to repeal the law.  The Supreme Court has upheld the law twice.  Donald Trump promised that he would cover everybody with a plan that would cost less and provide better coverage.  After he was elected he said, “Nobody knew health care could be so complicated”.  No sir.  Everybody knew but you.

Eliminate the law and you eliminate our protections.  Amend the law, improve the law and we retain the benefits Americans need and have come to expect.

This is all connected.  The Individual Mandate was designed to enlarge the pool of insureds.  We can’t build a health care system based on the sick and responsible.  The 23 year old woman might get pregnant.  The 63 year old man might develop prostate cancer.  And any of us could fall victim to the Coronavirus or countless other risks.  An efficient health care system must collect enough money to be prepared for the illnesses and accidents that inevitably strike all humans.

Few of us could ever pay all of the costs associated with our health care.  So whether or not we wish to admit it, we are connected.  The Texas lawsuit doesn’t end the connection, just our current method of addressing the costs.

There aren’t any viable alternatives on the table.  Russell Voight, Trump’s Acting Office of Management and Budget Director, was asked last month during his Congressional testimony about the president’s health care plan.  “The president is working on his own plan that we’re not yet ready to reveal.”  This plan is as non-existent as his pre-election plan.  Your preexisting conditions are real.  His plans are not.

The Supreme Court will hear oral arguments this summer, but it is unlikely that a ruling will be issued prior to Election Day.  The red is flashing.  The invalidation of Obamacare, ruling that the Patient Protection and Affordable Care Act is unconstitutional, would cause immediate irreparable chaos.

For every action, there is an equal and opposite reaction.

DAVE

www.cunixinsurance.com

Picture – The Lakota Universe – David L Cunix.  This is part of the exhibit at the National Museum of the American Indian, Washington DC.

Clean Hands

A friend of mine, an attorney, had a couple of quick questions about Medicare.  He will be turning 65 soon and needed to confirm that he didn’t have to sign up for Medicare Part B since he plans to stay on his wife’s group health policy.  I verified that his wife works for a company with over 20 employees.  So yes, he doesn’t need Medicare Part B.  But, I asked, is the group plan a High Deductible Health Savings Account (HSA) Qualified Policy and do you contribute to the HSA?  He confirmed that Yes and Yes.  In that’s case, he must renounce Medicare Part A, too.  You can not contribute to a Health Savings Account if you have Medicare.  In fact, there is a six month look-back.  He didn’t know.  And if an attorney could have accidentally screwed this up, what are the chances that your average office worker or machinist couldn’t make the same mistake?

Capitol Conference, the annual opportunity for members of the National Association of Health Underwriters to hear from members of the administration and meet with our elected officials, was the last week of February.  Fourteen of us from Northeast Ohio were part of the audience of over 700 that heard from Seema Verma the Administrator of the Center of Medicare and Medicaid Services (CMS).  House members Lauren Underwood (D-IL), Joe Courtney (D-CT), Greg Walden (R-OR), Kurt Schrader (D-OR), Adrian Smith (R-NE) as well as Senator Todd Young (R-IN) shared their views on pending legislation.  The speeches were interesting, the graphs (!) colorful, but the most important part of our annual trip to Washington are our scheduled appointments with our Congressman and Senators.

For many of us, our favorite appointment each year is with Abby Duggan, Senator Sherrod Brown’s legislative aide.  We appreciate that she is well prepared and that Senator Brown has shown a real interest in some of our issues.  Ms. Duggan has acknowledged that we come with “Clean Hands”.  Our issues – Surprise Billing, Employer Reporting, and the big Medicare concerns dealing with the Observation Trap, COBRA as Medicare compliant, and HSA's – have nothing to do with our incomes.  We are here to solve problems, to represent our clients.

Senator Brown is the sponsor of S. 753 which would allow observation stays to be counted toward the three day mandatory inpatient stay for Medicare coverage of a skilled nursing facility.  This happens to be one of our priorities.

We talked about the Medicare COBRA and HSA issues in Senator Brown’s office three days before my friend asked his questions.  H.R. 2564 and H.R. 3796 address these problems.  Our members discussed these bills with every Congressman and legislative aide we met.

Our #1 issue was Surprise Billing / Balance Billing.  As Congressman Walden noted, 1 in 5 emergency room visits and 1 in 6 hospital admissions produce a Surprise Bill.  We’ve discussed and defined Surprise Billing in previous posts.  Our goal is to take the unsuspecting client out of the equation and to focus on reimbursement being tied to the median in-network amount determined by reasonable, contracted amounts paid by private health plans to similar providers in a geographic area.  Obviously, we don’t want our clients forced into arbitration.

Our friends and clients count on us for good advice and to be alert to their needs.  Our periodic trips to Washington and our state capitols allow us to work with our elected officials to make health insurance, the way most Americans access and pay for health care, better.  We carry with us two messages wherever we go.  All health care is local.  And, we are all on the same team.

DAVE

www.cunixinsurance.com

Pictures – Looking For Something To Read At The Library Of Congress – David L Cunix

And – A Plane Washington – David L Cunix