State Healthcare Coverage May Aid in Creating a National Plan

A feeling of excitement was felt on Capitol Hill in one of the first hearings, conducted after the inauguration of President Barack Obama. On Thursday January 22, 2009, the Senate’s Health, Education, Labor, and Pensions committee held a hearing to examine measures states are enacting to keep their citizens healthy.

According to Senator Edward M. Kennedy of Massachusetts, the chairman of the committee, 38% of deaths related to chronic illness among Americans arise from alcohol use, smoking, physical inactivity and poor diet. In addition, 75% of health care costs associated with chronic disease are preventable. State Senator of Iowa, Jack Hatch, stressed the importance of preventative healthcare measures. He mentioned that Iowa should lead prevention and wellness initiatives by enabling doctors to use efficient practices and administer proper protocols necessary to treat chronic illnesses. Health care costs are continuing to rise making it necessary for people to receive proper health education, so they can make better lifestyle choices to improve health and contain costs. The state of Iowa has enacted preventative healthcare measures as a means of reform. Some include: 1. By 2011, the state is expected to provide healthcare coverage for all eligible children 2. Iowa has strengthened its public health and prevention programs by launching the healthy communities initiative, enabling small businesses to receive a qualified wellness tax credit.

Mr. Emmet spoke about our country’s failure to treat mental illness. He revealed mental illness is a major cause of disability, yet many insurance services do not provide coverage for mental health visits.

Dr. Dobson stressed the need for community healthcare services. He revealed quality of healthcare can be enhanced and the cost of healthcare can be reduced by providing people with primary care, creating local networks to gather resources and providing state funding for healthcare related programs. State healthcare systems need to be sustained in order to enable one to have access to care and be treated efficiently.

Dr. Bigby spoke about the importance of prevention. She mentioned the 2006 Massachusetts health care reform bill designed to provide the citizens of the commonwealth with universal coverage. 97.4% of Massachusetts residents contain healthcare coverage, 99% of kids contain coverage and 90% of residents have regular healthcare providers and thus receive preventative care. In addition, Dr. Bigby spoke about “Mass in Motion,” a program designed to promote healthy eating and exercise through grants to cities and towns in hopes of making wellness a priority. She also addressed the need to remedy the racial and ethic disparity prevalent in who receives healthcare coverage.

The experts at this hearing were in agreement that access to and quality of healthcare needs to be augmented. In order for people to live healthier lives, they say diet and exercise programs, as well as preventative and routine healthcare services need to be provided to the people of our nation.

Laid Off: How to Stay Insured

The holiday season is upon us. With Thanksgiving around the corner and the winter holidays just weeks away, many American workers are receiving an unexpected (and unwanted) gift from their employers: pink slips. According to the Wall Street Journal, 1.2 million workers have been laid off this year. Lay-offs are occurring across the board and impacting a wide range of industries. Tinseltown legends Harvey and Bob Weinstein laid off 11% of their employees at Weinstein Co. on Friday, while publishing powerhouse Conde Nast has begun cutting their staffs by 5%, a move that bloggers have begun referring to as "Empty Nast syndrome." The unstable economy is causing stress for many workers, who wonder if their jobs may be the next to go. "I put all this time and effort into my education," says New York based graphic designer Ashley Jones. "Now I'm hoping it wasn't all in vain." But as major magazines fold daily, Jones says "I'm feeling uncertain about my future and I just hope I can support myself."

Every Thanksgiving, at tables across America, families lift their glasses and wish for good health for themselves and their loved ones. But how do you take care of your health if losing your job also means losing your health insurance? For the newly-unemployed, the animal of the season may no longer be the turkey: it may be time to embrace the COBRA. COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, a law that provides continued group healthcare coverage for uninsured former employees. COBRA allows you to keep the insurance plan you used at your former place of employment for an additional cost, though this cost is usually less than the cost of opening an individual insurance policy. On the other hand, there are affordable individual insurance policies as well as government programs for those who qualify. Explore your options and make sure you and your loved ones remain insured during this holiday season.

• "Newly Out of a Job? Here's how to replace the health benefits" by Anna Wilde Mathews at the Wall Street Journal: Mathews offers information and tips on using COBRA coverage, finding an individual insurance plan, and qualifying for government coverage.
  
• The Healthier and WISER series: The "Healthier and Wiser" series addressed some of the main health care coverage issues women encounter at different stages of their lives. It offers a variety of resources and information on how to stay insured.
  
• FAQs About COBRA: This FAQ from the U.S. Department of Labor offers extensive information on COBRA coverage.

Healthier and Wiser: After Retirement

Healthier and Wiser

Many people who have health insurance obtain it through an employer. However, there may be times in your life when you are without coverage, facing coverage choices or grappling with retirement health issues. The "Healthier and Wiser" series will address some of the main health care coverage issues women encounter at different stages of their lives. It will point you in the direction of where to go to find more information. It is not intended as legal advice. You can check out the "Healthier and Wiser" series on Wednesdays.

This Week: After Retirement

If you are enrolled in Medicare and cannot afford to pay the out-of-pocket costs Medicare does not cover, is there any other assistance for you?

• There are state programs for individuals with incomes below or near federal poverty limits. For those at or below the poverty level, with limited resources, the Qualified Medicare Beneficiary Program (QMB) will pay your premiums, deductibles and co-payments under Medicare. The Specified Low-Income Medicare Beneficiary Program (SLMB) and the Qualified Individual Program (QI) pay Medicare Part B premiums for those with incomes between 120% and 135% of the federal poverty level. Call your state Medicaid office and ask if you are eligible. The programs can save you hundreds, or even thousands, of dollars each year.

• You might benefit from a Medigap insurance policy - a private insurance policy that pays out-of-pocket medical costs not covered by Medicare. Contact Medicare for more information on Medigap insurance policies sold in your state or call your state insurance commissioner. Every state offers free insurance counseling to seniors through a program called the SHIP program. Call Medicare at 1-800-Medicare for the nearest SHIP site.

• The National Council on the Aging has an interactive website program, called Benefits Check-Up, that will point you toward an array of state and private programs that can help you with medical costs. Find it on the web at www.benefitscheckup.org.

Healthier and Wiser: You and Your Family

Healthier and Wiser

Many people who have health insurance obtain it through an employer. However, there may be times in your life when you are without coverage, facing coverage choices or grappling with retirement health issues. The "Healthier and Wiser" series will address some of the main health care coverage issues women encounter at different stages of their lives. It will point you in the direction of where to go to find more information. It is not intended as legal advice. You can check out the "Healthier and Wiser" series on Wednesdays.

This Week: You and Your Family

1. What are your rights to health care coverage through your husband’s job if you and your husband separate or divorce? If your husband dies? What are your children’s or step-children’s rights in these cases?

• In general, a divorce or the death of the spouse with the plan qualifies you under COBRA to remain covered under the plan for up to 36 months, but your own circumstances could lengthen or shorten this period. Children covered under the plan may be able to retain coverage even longer in the event of a divorce. If you are getting a divorce or need to enforce child support, you should also ask your attorney about filing a qualified medical support order (QMSO). A QMSO can be used to require employer-sponsored group health plans to extend health care coverage to the children of a parent/employee who is divorced, separated, or never married when ordered to do so by state authorities.

2. Can you or your family qualify for health care coverage through the military if one of you served and was honorably discharged even though s/he did not serve a full 20-year career?

• Depending on your family’s income, you and your family may be eligible for health care coverage through the military, even if the one who served did not serve a full career. You should contact your local Veteran’s Affairs office if you think you might qualify; their phone number and address is in your telephone directory in the federal government section, or go to US Department of Veterans Affairs website to find the office nearest you.

Healthier and Wiser: On the Job

Healthier and Wiser

Many people who have health insurance obtain it through an employer. However, there may be times in your life when you are without coverage, facing coverage choices or grappling with retirement health issues. The "Healthier and Wiser" series will address some of the main health care coverage issues women encounter at different stages of their lives. It will point you in the direction of where to go to find more information. It is not intended as legal advice. You can check out the "Healthier and Wiser" series on Wednesdays.

This Week: On the Job

If both you and your husband are offered health care coverage through your employers, should you each enroll in your own plan, both enroll in one plan, or both enroll in both plans?

• What you should do depends on what each of your plans says. Ask for the Summary Plan Descriptions for each plan (the documents should have this title) and read about family coverage and coordination of benefits.
  

• Your plans may require that each of you be enrolled in your own employer’s plan as your primary plan. In that case, you could still enroll in your spouse’s plan, but your spouse’s plan would only cover expenses your own plan does not. You may also have a choice of choosing one plan and enrolling in family coverage. Many times, it is more cost effective for an entire family to be enrolled in one plan, and face only one deductible and set of premiums.

Healthier and Wiser: Week 1

Healthier and Wiser

Many people who have health insurance obtain it through an employer. However, there may be times in your life when you are without coverage, facing coverage choices or grappling with retirement health issues. The "Healthier and Wiser" series will address some of the main health care coverage issues women encounter at different stages of their lives. It will point you in the direction of where to go to find more information. It is not intended as legal advice. You can check out the "Healthier and Wiser" series on Wednesdays and Fridays.

This Week: Women Without Coverage

If you, your husband, or both, are working, but your employers do not offer health care coverage, are there affordable coverage options for you?

• You may be able to get group coverage—and more favorable rates—if you are a member of an organization that offers group health care coverage. This could be a fraternal organization or a professional society, for example.

• High-deductible plans often offer more affordable monthly premiums and take care of major medical expenses such as hospitalizations, but not routine care. However, you would have to cover expenses that arise before you meet the deductible out of your own pocket.

• If you can’t enroll in a group plan and have a chronic condition that prevents you from buying an individual plan, you can check with your state’s insurance department to see if you might qualify for plans available for people in your circumstances.

• If you have a high deductible health insurance plan, you might also consider opening a Health Savings Account (HSA). The HSA is a special tax-advantaged savings account that is used for health care needs. You can deposit before taxes money into HSA accounts and use the tax-free money to pay medical expenses and insurance premiums. This option may be right for you if you have the money to set aside in an HSA, if you can use additional tax deductions, and if you have trouble finding traditional health care coverage that you can afford. (A word of caution: for many people, the tax savings of an HSA will be lower than the out-of-pocket costs of a higher deductible health insurance plan. Talk to a bank or credit union that sponsors HSA plans for more details.)