More Good News!

  

 The current Special Open Enrollment Period will come to an end on August 15^th.   Many of you have taken advantage of the changes in the Tax Credit Subsidy.  Several of my clients have saved over $1,000 per month!  We have one more change coming next week. 

First, let’s review the Tax Credit Subsidy.  This may be one of the most important changes of the new law.  The Patient Protection and Affordable Care Act (Obamacare) included provisions to help Americans pay for their health insurance, the way most of us access and pay for health care.  The 2010 law created Tax Credit Subsidies which were tied to the Federal Poverty Level.  If you, or you and your family, earned less than 400% of the FPL, you could get help.  This was never updated till now.  The new subsidies are going to increase for most of you who have policies on the Exchange.  And the 400% cut-off is going to be eliminated for at least 2021 and 2022.  Instead, the law will extend benefits to all Americans purchasing their own coverage on the Exchange with a goal to limit the cost of insurance to no more than 8.5% of their income.   These changes will impact over 3 million Americans this year. 

One of the provisions of the American Rescue Plan Act of 2021 is a special subsidy for anyone who has received unemployment compensation during 2021.  Even if you only received one week of unemployment, you may be eligible for a significant reduction in your monthly premium.  The system will be ready as of July 1^st and your new, LOWER premium will start as of August 1^st for the rest of the year.  

     Action:

·         If you are currently on the Exchange, you should review your current subsidy.  You may qualify for a higher subsidy which would lower your premium or allow you to switch to a more comprehensive policy.

·         If you are not currently on the Exchange but you or a family member received unemployment in 2021, you need to see if you, or you and your family, now qualify for a subsidy.  There’s no guarantee that you will, but it doesn’t hurt to try.

 Delivering good news isn’t normally part of my job description.  This has been a lot of fun.  A large number of you are fully vaccinated and agents are enjoying the return of in-person appointments.  Whether you meet in your agent’s office or by phone, it is time to save some money. 

We are all in this together. 

Dave 

Picture – More Good News – David L Cunix

They Don't Have A Leg To Stand On

 

“What right does Texas have to take away my insurance?”  I can’t tell you how many times my clients have asked me that question.  The Texas Lawsuit has weighed heavily on many of my clients, especially those with preexisting conditions.  The idea of eliminating the Patient Protection and Affordable Care Act (Obamacare) and all of its protections with nothing, scared the daylights out of many of us.  Who would sell health insurance to someone with cancer?  Where would a pregnant woman, or even a family that wanted to have children, get covered?  The answer, of course, was to have faith that the system would not fail them.  Whether help would come from the State of Ohio, our elected representatives in Washington, or the Supreme Court, someone would step up and protect them.  Someone will do the right thing for them.  Have faith.  Be patient.  Don’t worry. 

To be clear, I may have had faith, but I was more than a little worried. 

Today, in a 7 – 2 ruling, the Supreme Court saved my clients and Obamacare for the third time.  As always, the best analysis of the decision was written by Amy Howe at ScotusBlog.  I strongly urge you to read her three page post. 

On June 17^th the Supreme Court ruled what many of us had suspected, neither the groups of states led by Texas nor the individuals challenging the mandate have a legal right to sue.  They didn’t have standing.  My attorney readers will enjoy both the way the decision was reached as well as that the majority included Chief Justice Roberts, Justices Amy Coney Barrett, Brett Kavanaugh, Clarence Thomas as well as the two remaining liberals.  The majority opinion was written by Justice Stephen Breyer.  An opinion that bridges the court’s extremes is guaranteed to surprise or confound the pundits.

There will be more challenges.  Since there are no problems in Texas, the Governor and Attorney General feel compelled to spend their time fighting to destroy our health care system.  And we can only hope that like this time, the Supreme Court will again tell them that they don’t have a leg to stand on. 

Dave 

www.cunixinsurance.com 

Picture – You Say Hello. I Say GOODBYE – Original batik by Batik by Amit

The Impact Of External Pressure

 

Richard Stengel, the former Editor of Time Magazine and Under Secretary of State during the Obama administration, said something on TV the other day that stopped the other guests in their tracks.  “The same fire that melts the butter, hardens the egg”.  Mr. Stengel didn’t create this idiom, nor did he claim authorship.  A quick Google search will reveal that lots of Americans found the comment insightful, and more importantly, got them to think. 

I, of course, thought about the health care legislation of the last dozen years.  From 2011 through 2016 our Republican members of the US House of Representatives and Senate voted over 50 times to repeal the Patient Protection and Affordable Care Act even though there wasn’t a viable replacement.  Why?  Perhaps a few didn’t really have any idea the damage repeal would have done.  Most didn’t really care.  Their votes were inconsequential.  The law wasn’t going to be repealed, but their base remained riled up and the fundraising dollars flowed in.  My local Congressman, Dave Joyce, was just one of the guys.  We live in Ohio, a state where all districts are safe.  Mr. Joyce rode the wave, the fire melted the butter. 

Everything changed in November 2016.  With the election of Donald Trump as President and the Republicans controlling both the US House and Senate, the PPACA could finally be repealed.  The alternative was the abominable American Health Care Act (House of Representatives) and the Senate bill, the Better Care Reconciliation Act of 2017 which was analyzed in this blog at the time.  We all remember that the House passed its bill and the beer celebration held by the White House.  And we remember that Senators Lisa Murkowski (R-AK), John McCain (R-AZ), and Susan Collins (R-ME) saved the day and voted with the Democrats to defend our system.  Few recall that twenty Republicans in the House also voted against the bill.  One of them was Dave Joyce.  The same fire that had melted the butter hardened the egg. 

We are now back to the Democrats holding the keys to power.  And though President Biden may want to make Obamacare better and improve access to health care, he can’t do it by himself.  It will take Congressmen and Senators from both sides of the aisle to work together.  The previous paragraph isn’t an endorsement of Mr. Joyce, simply an acknowledgement of the Congressman rising to the moment.  And we will need a lot of those moments as our elected representatives feel the heat from their respective bases.  The denizens of the extremes are never quiet.  Our elected officials will have to overcome the pressure to move our country forward.  The fire must harden the egg. 

DAVE 

www.cunixinsurance.com

 Picture – Ready for Action – David L Cunix  

Getting To Work

 

Here is a problem.  You live in Mayfield Heights and your job is in Strongsville, about 30 miles away.  Worse, you hate your old car, it is unreliable, gets terrible gas mileage, and needs expensive repairs.  Do you

1.   Get a job closer to home?
2.   Move?
3.  Get a better car?
4.   Put your car up on blocks, give away the tires, and hope that a new way to get to work will magically appear? 

I have a lot of faith in my readers.  I’m absolutely positive that almost all of you will choose some combination of options 1, 2, or 3.  

Our health insurance system, an organized way for most of us to access and pay for health care, had a lot of problems twelve years ago.  Some people thought that it was OK.  Some thought that it wasn’t great, but major action wasn’t needed.  But, a lot of Americans demanded significant improvements.  A year’s worth of haggling, negotiations, and foot-dragging resulted in the Patient Protection and Affordable Care Act.  President Barack Obama’s new book, A Promised Land, details the negotiations with Republicans such as Senators Chuck Grassley and Olympia Snowe.  There were concessions made and amendments accepted, but in the end the legislation passed along party lines.  The law was hardly perfect.   

It has been eleven years since the law’s passage.  The law was fully implemented January 1, 2014.  Some of my clients were adversely impacted by the law, principally with higher pricing.  Many more benefited from the elimination of medical underwriting, comprehensive benefits, and the Tax Credit Subsidies.  Again, the law is hardly perfect and I certainly would have structured it differently, but the transition to life under Obamacare was infinitely smoother than the naysayers had predicted.  There was, and still is, plenty of room for improvement. 

How do you improve the PPACA?  What would you do to make it better? For eleven years some people have had only one answer.  Like the guy who disables his car to improve the way he gets to work, their answer was to repeal Obamacare without any viable replacement.   Chest pounding, meaningless votes, and even a beer celebration with President Trump didn’t pay for a single doctor’s visit or hospital stay.  The last four years featured the defunding of the Cost Share Reduction and untold stress for the millions of Americans with preexisting conditions. 

The new administration has taken a much different approach.  President Biden is trying to make the system work.  We are in the middle of a Special Enrollment that has opened the process to purchase individual (non-group) coverage until August 15^th.  Over one million Americans have signed up since March 15^th. The Tax Credit Subsidy has been updated to cover more people.  And all of this is once again being publicized so that Americans will have a chance to improve their coverage.  Perfect?  Not yet.  But this is a step in the right direction. 

Your representatives in Washington may be Republicans or Democrats.  Here is a quick experiment.  If you ever see them in person again, ask them what, specifically they would do to improve Obamacare (Both sides call it that.  It is not a pejorative.)  Ask to see their plan.  It has been eleven years.  If they can’t answer the question by now, then your Congressman or Senator is no better than the guy at the beginning of this post who put his car up on blocks.  

Dave 

www.cunixinsurance.com

 Picture – The Hard Way – David L Cunix

 

 

 

We May Not Be Able To Prevent This

What image comes to your mind when you hear the word “Texas”?  Do you see cowboys and old Westerns?  Do you see Ted Cruz boarding a plane to Mexico while over half of his constituents were sitting in the dark without heat or water?  Perhaps you see a stadium full of COVID deniers watching their baseball team lose their home opener.  When I think of Texas I think of millions of uninsured Americans and a State government that not only doesn’t care about its citizens, but for some unexplained reason, feels compelled to drag the rest of the country down to their citizen’s level of health care insecurity.

This blog has extensively covered the Texas Lawsuit, the effort by the Attorney General of Texas, a number of other Republican Attorneys of State, and the previous administration to declare the Patient Protection and Affordable Care Act (Obamacare) unconstitutional.  That case was argued before the US Supreme Court last November.  We should have a decision soon.  But one attempt to disrupt the country’s health insurance is not enough.

Preventive Care

Chances are that your health insurance coverage includes Preventive Care.  Preventive Care is defined by HealthCare.gov as “Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.”  The goal is to keep Americans healthy, to prevent certain illnesses or to catch those medical conditions at an early stage which might improve the odds of a positive outcome.  The benefit was designed to be provided at no charge to the patient.  And the list of covered services is extensive.  As this article from Kaiser Health News notes, “These changes have made it more affordable for Americans to get a wide range of services, such as cancer screenings, contraception, HIV prevention drugs, vaccines, tobacco cessation treatment, alcohol abuse counseling and domestic violence counseling.”

The same article quotes Tim Jost, a retired Washington & Lee University Law Professor.

“It’s billions and billions of dollars of services that Americans get every year, not just from ACA health plans but also from employer plans. If this benefit ends, it would mean a lot of people would forgo preventive services and end up with much worse medical problems.”

It works!  Free access to preventive care is allowing some Americans to get annual physicals, vaccines, and have a chance to get/stay healthy.  That would appear to run counter to the Texas model.  The lead plaintiff, Dr. John Kelley, is a Fort Worth, Texas orthodontist.  He and a small group of others have sued to eliminate the Preventive Care benefit from the PPACA.  Their suit appears to have been motivated, in large part, by the inclusion of contraception and HIV prevention drugs within the definition of Preventive Care.  Birth Control has had a significant impact on the PPACA.  It is not a coincidence that this case landed in the court of Judge Reed O’Connor, the judge who has previously ruled that the entire Patient Protection and Affordable Care Act should be dismantled.  Though Judge O’Connor’s decisions have been mocked by legal scholars on the Right and the Left, he is a federal judge, appointed for life, and capable of doing untold harm.

The PPACA was signed into law 11 years ago.  Since then it has withstood over 50 votes in Congress, most designed not to overturn the law but to empty the pockets of potential campaign supporters. (Yes, the initial bill in January 2011 really was “H.R.2 - 112th Congress (2011-2012): Repealing the Job-Killing Health Care Law Act”.  This was not serious legislation.)  The law has also been upheld by the Supreme Court. Twice!  The new strategy is to pick away at the law by filing lawsuits in “friendly” courts.  And no court is as friendly as Reed O’Connor’s when it comes to limiting your access to coverage.

It would appear that Texas seeks to infect our insurance, the way most Americans access and pay for health care.  We might not be able to prevent that.

DAVE

www.cunixinsurance.com

Picture – The Texas Option – David L Cunix

The News Is Good

 

We are getting a better understanding of the American Rescue Plan Act of 2021 and how it will impact your health insurance if you are under age 65 and buying your own policy.  Much of the focus on the recently passed law has been on the stimulus checks and child tax credit.  Today’s post is from an update I sent my clients.  This blog has a national following according to Google Analytics.  Most of you reading this are outside of my service area.  It is not an advertisement.  The information is relevant whether you live Portland, Maine or Portland, Oregon.  I encourage you to talk with your local agent to review your specific options. 

Tax Credit Subsidy – This may be one of the most important changes.  The Patient Protection and Affordable Care Act (Obamacare) included provisions to help Americans pay for their health insurance, the way most of us access and pay for health care.  The 2010 law created Tax Credit Subsidies which were tied to the Federal Poverty Level.  If you, or you and your family, earned less than 400% of the FPL, you could get help.  This was never updated till now.  The new subsidies are going to increase for most of you who have policies on the Exchange.  And the 400% cut-off is going to be eliminated for at least 2021 and 2022.  Instead, the law will extend benefits to all Americans purchasing their own coverage on the Exchange with a goal to limit the cost of insurance to no more than 8.5% of their income.   These changes will impact over 3 million Americans this year.

     Action:

·         If you are currently on the Exchange, you should review you current subsidy.  You may qualify for a higher subsidy which would lower your premium or allow you to switch to a more comprehensive policy.

·         If you are currently on the Exchange and don’t do anything, you will probably get a larger refund when you file your taxes next year.

·         If you are not currently on the Exchange, you and your agent should take a look to see if you would save money.  I can’t guarantee that you will, but it doesn’t hurt to try.

·         THE SYSTEM WILL NOT HAVE THE NEW CALCULATIONS INSTALLED UNTIL EARLY APRIL.  You will be much happier if you wait till at least the middle of April to meet with your agent. I am going to schedule my clients for the end of April and the first two weeks of May.

 COBRA – Some people will qualify for a 100% premium subsidy for COBRA coverage for as much as March 1, 2020 to September 1, 2021.  There are some details to be resolved, but the key is that the employee must have been involuntarily terminated or had his/her hours reduced to zero.  Please contact your former employer’s COBRA administrator if you think that you might qualify. 

Grandmothered Policies – We hold our breath each year waiting for the federal and state governments to approve an extension of Transitional Relief, the right to retain the policies sold and put in place between April 2010 and December 2013.  The Biden administration pushed this through in February and Ohio quickly followed.  This is good news for some of my individual and small group clients.  

Rx Discount Cards – Many of you have asked how to deal with the ridiculous cost of prescription drugs.  This is especially relevant for those of you with high deductible policies that don’t have an Rx copay.  Clever Rx is new option.  The link will let you to sign up for a free discount card.  There is a great app that will allow you to price your medications based on both the dosage and the drug store.  Yes, the drug store matters.  This may help.  There are other Rx plans, too.  Find the one that works with drugstores in your area. 

The American Rescue Plan Act of 2021 is major legislation.  Today’s post is just to make sure that you are aware of a few of the ways it will impact your health insurance options.  Please contact me if you have any questions. 

It is great to be able to deliver good news.  My second shot is scheduled for March 31^st!  New vaccine locations are being announced every day.  Be smart.  Be careful.  

Dave 

www.cunixinsurance.com      

Picture – We Celebrate Good News – David L Cunix

Leadership 2021

Congress has its fair share of villains.  You know their names because once elected they view being on television as important as breathing.  They may not actually do anything you or I might associate with legislating.  Their names are seldom connected to legislation that ever becomes law.  At best, they often seem to delight in their ability to prevent action.  You will see them on the Sunday morning shows bragging about the presidential appointees they have tried to block or the meaningless amendments they have offered in an attempt to clutter the process.  Other Congressmen are merely placeholders.  They carefully embrace anonymity.  Their weekly constituent emails extol the virtues of mom and apple pie and hope like heck that they are never called upon to exhibit leadership or to take a stand on a controversial issue.  For them, reelection is the only goal.

I would rather focus on the heroes.  And yes, Congress does have heroes, individuals who view their election as an opportunity to devise legislation that could help their constituents.  I introduced my readers to Representative Lauren Underwood (D-IL) this past July.  She drafted H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2019 as a freshman Congresswoman.   Her legislation was designed to expand Medicaid services a full year postpartum.  The logic was clear.  “The majority of pregnancy-related deaths happen after the day of delivery, and nearly one quarter of deaths happen more than six weeks postpartum.”  It took a nurse to bring this to Congress’s attention.  And now, the American Rescue Plan Act of 2021 includes her legislation!

The current COVID relief package includes several other provisions to help Americans acquire health insurance, the way most of us access and pay for health care.

Tax Credit Subsidy

The Patient Protection and Affordable Care Act (Obamacare) was designed to help people purchase their health insurance.  The initial plan was to provide a tax subsidy starting with individuals earning 150% of the federal poverty rate that decreased in value until it ended with an income equivalent to 400%.  This has never been updated until now.  For the next two years the subsidy at the lower income levels has been increased and, and this is really important, it doesn’t cut off at 400%.  Many of my clients have had difficulty paying for insurance because they make just a little too much to qualify for a subsidy.  This is going to allow them to purchase a regular policy instead of short term major medical.

COBRA

The COBRA regulation allows a former employee to retain the health insurance coverage he/she had from the previous employer.  The former employee must pay the full premium plus a fee of up to 2%.  The American Rescue Plan Act of 2021 will help laid off employees by paying the premiums through September.  This will allow some people to retain their coverage who might not have otherwise.

There are other provisions in the new law related to Medicaid and subsidy relief.  Much of the focus of the new COVID relief package will be on the stimulus checks coming to American families by the end of this month and the enhanced unemployment checks.  Others will focus on the fact that no Republicans voted for the bill, even after some of their amendments were included.  My focus is on health insurance and our elected representatives who are trying to make things better.  That’s leadership.

DAVE

www.cunixinsurance.com

Picture – Visiting The People’s House – David L Cunix