Health, Healthcare Reform, Patient Assistance

Understanding Health Insurance

NeedyMeds

by Richard Sagall, M.D.

Insurance is really a simple concept. But few people, and even fewer politicians, seem to understand how insurance works and why so many of the promises we hear are impossible.

Here are the basic concepts of insurance:

Number 1 – You Never Win with Insurance – You always lose with insurance. Think about what happens when you have health insurance.

Outcome 1 – You get sick, perhaps really sick, and you suffer while ill. You may experience long-term or even permanent disability from your illness. Or, in the worst case, you die. Your health insurance helps with the cost, but in any case, you suffer.

Outcome 2 – You spend a lot of money on premiums getting nothing in return. It’s true that you remain physically healthy, but, due to the high cost of health insurance, you may not be so financially healthy. So, you also suffer, just in a different way.

Number 2 – What You Really Get from Insurance – Or perhaps more accurately, what you should be getting from health insurance. What you are paying for with health insurance is a sense of comfort that you won’t

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Affordable Care Act, Healthcare Reform

Better Care Reconciliation Act

Evan O'Connor

We have been tracking the new healthcare bill being proposed by the U.S. House of Representatives, the American Health Care Act (AHCA). After passing the House last month, the bill was sent to the United States Senate where it was redrafted into the Better Care Reconciliation Act (BCRA), which they are planning on holding the vote for after the July 4th recess. The Congressional Budget Office (CBO) has released their analysis report on the BCRA’s impact on the Federal deficit and American’s premiums and insurance status.

Previous CBO scores for Affordable Care Act (ACA) repeal/replace bills have shown millions of Americans would lose health insurance while premiums rise for several years before falling, primarily for the healthiest and youngest Americans while older people and those with pre-existing conditions could see much higher healthcare costs. The analysis of the most recent bill concurs that 49 million Americans under 65 years old would be without

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Affordable Care Act, Healthcare Reform

Amended AHCA Passes House Vote, Fails CBO Score

Evan O'Connor

In a previous blog post, we explored the proposed Affordable Care Act (ACA; aka Obamacare) repeal/new healthcare law called the American Health Care Act (AHCA). Congress decided the bill would not be voted on shortly thereafter due to lack of support, but it has since been modified and passed by the U.S. House of Representatives. The passing of the House bill was celebrated by the Trump administration before the Congressional Budget Office (CBO) could analyze how the bill would affect the federal deficit and the healthcare costs for Americans. Last week the CBO released their report on the amended AHCA.

According to supporters of the bill, the AHCA’s aim is to lower premiums and the deficit. The CBO report finds that the deficit will decrease by $119 billion by 2026 (as opposed to the $337 billion decrease from the previous version of the AHCA rejected in March) but would increase the number of uninsured people by 23 million in the same time period. It also found that insurance premiums would rise an average of 25% by 2019

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Affordable Care Act, Health, Healthcare Reform

American Health Care Act

Evan O'Connor

After several years of attempts and Donald Trump running on platform of repealing the health care law, the U.S. Republican party has released their proposed replacement for the Affordable Care Act (ACA; aka Obamacare). The American Health Care Act (AHCA) was developed by Republicans in the House of Representatives, Senate, and the White House. The law will be debated in committees in the House and Senate before being voted on by all of Congress and then sent for the president’s signature if passed. In that time many changes could be made to the law. For now, we will outline what is being proposed to stay the same from the ACA to what may change with the AHCA.

The GOP-proposed healthcare law keeps ACA provisions such as people under 26-years-old remaining on their parents’ insurance, banning insurance companies from discriminating against patients with pre-existing conditions as well as banning caps on lifetime spending. One of the more significant changes removes

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Health, Patient Assistance

Out-of-Pocket Costs on the Rise

Evan O'Connor

NeedyMeds’ mission has always been to help patients find help covering the costs of health care expenses. A previous guest post from Consumer Reports outlined the problem patients may face when confronted with expensive prescriptions, sometimes having to choose between needed medicine and groceries for their family.  Two recent studies show that the problem may be growing as out-of-pocket costs for health care are continuing to rise.

According to a study from TransUnion Healthcare, the consumer’s share of healthcare costs rose by 13% from 2014 to 2015. The report also shows that while costs rose, patients had fewer resources to pay for the increase expenses, as the amount of revolving credit had declined.  Out-of-pocket costs include deductibles, copayments, and coinsurance.

The University of Michigan conducted a second study that calculated the average out-of-pocket expenses for an inpatient hospital stay for a patient with private insurance was more than $1000, increasing 37% from 2009 to 2013. 

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