Jump to content

With Affordable Care Act, Canceled Policies for New York Professionals


fargo
 Share

Recommended Posts

December 13, 2013

With Affordable Care Act, Canceled Policies for New York Professionals

By ANEMONA HARTOCOLLIS

 

Many in New York’s professional and cultural elite have long supported President Obama’s health care plan. But now, to their surprise, thousands of writers, opera singers, music teachers, photographers, doctors, lawyers and others are learning that their health insurance plans are being canceled and they may have to pay more to get comparable coverage, if they can find it.

 

They are part of an unusual, informal health insurance system that has developed in New York, in which independent practitioners were able to get lower insurance rates through group plans, typically set up by their professional associations or chambers of commerce. That allowed them to avoid the sky-high rates in New York’s individual insurance market, historically among the most expensive in the country.

 

But under the Affordable Care Act, they will be treated as individuals, responsible for their own insurance policies. For many of them, that is likely to mean they will no longer have access to a wide network of doctors and a range of plans tailored to their needs. And many of them are finding that if they want to keep their premiums from rising, they will have to accept higher deductible and co-pay costs or inferior coverage.

 

“I couldn’t sleep because of it,” said Barbara Meinwald, a solo practitioner lawyer in Manhattan.

 

Ms. Meinwald, 61, has been paying $10,000 a year for her insurance through the New York City Bar. A broker told her that a new temporary plan with fewer doctors would cost $5,000 more, after factoring in the cost of her medications.

 

Ms. Meinwald also looked on the state’s health insurance exchange. But she said she found that those plans did not have a good choice of doctors, and that it was hard to even find out who the doctors were, and which hospitals were covered. “It’s like you’re blindfolded and you’re told that you have to buy something,” she said.

 

The people affected include not just writers, artists, doctors and the like, but also independent tradespeople, like home builders or carpenters, who work on their own.

 

Some have received notices already; others, whose plans have not yet expired, will soon receive letters in the mail. It is unclear exactly how many New Yorkers are affected; according to state health officials, as many as 400,000 independent practitioners get health insurance through job-related group plans, but that number also includes people who receive coverage through their spouses’ employers.

 

The predicament is similar to that of millions of Americans who discovered this fall that their existing policies were being canceled because of the Affordable Care Act. The crescendo of outrage led to Mr. Obama’s offer to restore their policies, though some states that have their own exchanges, like California and New York, have said they will not do so.

 

But while those policies, by and large, had been canceled because they did not meet the law’s requirements for minimum coverage, many of the New York policies being canceled meet and often exceed the standards, brokers say. The rationale for disqualifying those policies, said Larry Levitt, a health policy expert at the Kaiser Family Foundation, was to prevent associations from selling insurance to healthy members who are needed to keep the new health exchanges financially viable.

 

Siphoning those people, Mr. Levitt said, would leave the pool of health exchange customers “smaller and disproportionately sicker,” and would drive up rates.

 

Alicia Hartinger, a spokeswoman for the Centers for Medicare and Medicaid Services, said independent practitioners “will generally have an equal level of protection in the individual market as they would have if they were buying in the small-group market.” She said the president’s offer to restore canceled polices temporarily applied to association coverage, if states and insurers agreed. New York has no plans to do so.

 

Donna Frescatore, executive director of New York State of Health, the state insurance exchange, said that on a positive note, about half of those affected would qualify for subsidized insurance under the new health exchange because they had incomes under 400 percent of the poverty level, about $46,000 for an individual.

 

But many professionals make too much money to qualify for the subsidies, and even if they are able to find comparably priced insurance, the new policies do not have the coverage they are accustomed to.

 

David Rubin, vice president of Teiget, the Entertainment Industry Group Insurance Trust, which had served as a broker for about 1,000 members of creative guilds, said a big complaint was that in New York City and much of the state, the new individual plans both on and off the exchange did not allow patients to go to doctors out of network. “All these people had these customized plans which are better than most of the things out there, and most of them are saving only a small amount of money,” Mr. Rubin said.

 

Roy Lyons, managing director of Marsh U.S. Consumer, an insurance brokerage, said he had heard complaints from physicians, lawyers, pharmacists and optometrists. “At first they think it’s the bar association making the decision or the insurance company doing it,” Mr. Lyons said. “We have to explain that this is the Affordable Care Act; that’s what was put into law. Once they understand, they’re less emotional, but they’re not happy with it.”

 

Among those affected are members of the Authors Guild; the Advertising Photographers of America; the Suzuki Association of the Americas, a music teachers organization; the Society of Children’s Book Writers and Illustrators; the New York City Bar Association; and the New York County Medical Society. (One group, the Freelancers Union, negotiated a one-year exemption with the state.)

 

“One of the reasons to join a society is to get health insurance,” said Dr. Paul N. Orloff, president of the New York County Medical Society. Even doctors pay a lot for coverage, he said, because the days of trading medical care with colleagues are long gone. “In the old days, professional courtesy was the norm,” Dr. Orloff said.

 

The medical society has not yet formally notified its solo practitioners, because their insurance plans do not expire until April. But those letters will be going out soon, officials said.

 

It is not lost on many of the professionals that they are exactly the sort of people — liberal, concerned with social justice — who supported the Obama health plan in the first place. Ms. Meinwald, the lawyer, said she was a lifelong Democrat who still supported better health care for all, but had she known what was in store for her, she would have voted for Mitt Romney.

 

It is an uncomfortable position for many members of the creative classes to be in.

 

“We are the Obama people,” said Camille Sweeney, a New York writer and member of the Authors Guild. Her insurance is being canceled, and she is dismayed that neither her pediatrician nor her general practitioner appears to be on the exchange plans. What to do has become a hot topic on Facebook and at dinner parties frequented by her fellow writers and artists.

 

“I’m for it,” she said. “But what is the reality of it?”

 

http://www.nytimes.com/2013/12/14/nyregion/with-affordable-care-act-canceled-policies-for-new-york-professionals.html?_r=1&&pagewanted=print

Link to comment
Share on other sites

Fargo, in part you quote, “But under the Affordable Care Act, they will be treated as individuals, responsible for their own insurance policies. For many of them, that is likely to mean they will no longer have access to a wide network of doctors and a range of plans tailored to their needs. And many of them are finding that if they want to keep their premiums from rising, they will have to accept higher deductible and co-pay costs or inferior coverage”.

 

I do not believe that the affordable care act prevents independent insurance entities from offering group rates to groups other than employers. Thus I doubt your source’s creditability or your source is not revealing germane factors that were considered; (i.e. it’s BS).

 

What precise reason did the insurance company provide to explain their inability to continue offering the group rate policies?

 

Respectfully, Supposn

Link to comment
Share on other sites

If you'd like to doubt the NY Times, feel free.

 

There are two ways to prevent what you say. Either you outright ban it by law or you make it so expensive that no company provides it as an option.

 

Look past the end of your nose. People are hurting because of ACA Obamacare. That is an indisputable fact.

Link to comment
Share on other sites

Government Takeover: White House Forces Obamacare Insurers To Cover Unpaid Patients At A Loss

Of all of the last-minute delays, website bungles, and Presidential whims that have marred the roll-out of Obamacare’s subsidized insurance exchanges, what happened on Thursday, December 12 will stand as one of the most lawless acts yet committed by this administration. The White House—having canceled Americans’ old health plans, and having botched the system for enrolling people in new ones—knows that millions of Americans will enter the new year without health coverage. So instead of actually fixing the problem, the administration is retroactively attempting to force insurers to hand out free health care—at a loss—to those whom the White House has rendered uninsured. If Obamacare wasn’t a government takeover of the health insurance industry, then what is it now?

http://www.forbes.com/sites/theapothecary/2013/12/14/government-takeover-white-house-forces-obamacare-insurers-to-cover-unpaid-patients-at-a-loss/?partner=yahootix

Link to comment
Share on other sites

Don't bother asking for actual facts. He is just obediently cut and pasting propaganda.

You obviously do not read or listen to TV. The Federal Register July 2010 has in it a set of tables stating the percentage of the people in different categories going to lose their policies because of the rules Sibelius created. The had minimum, middle and max ranges. There is the individual of up to 67%, small business of up to 65%, and big business of up to 45%. These are the expected number of policies that WILL be dropped because of the rules HHS has created. The White House staff knew this and the political part of the staff argued to keep on saying the lie because people would get upset and put pressure on Democrats in congress if they knew the truth. So Obama just kept on lying.

Link to comment
Share on other sites

Fargo, Romneycare will (similar to Social Security and Medicare) be a major net political asset for the Democratic Party.

It will deny Republicans access to the oval office and the majority of both Congressional houses for no less than a quarter century. Hurbert Hover was a fine honorable man but the term Hooversvilles’ and the great depression denied Republicans access to the oval office between 1939 through1953. People already have forgotten the term Romneycare, Due to federal medical insurance, Democrats will remain in the White House for no less than a quarter of a century.

 

Excerpted from the NY Times article “With Affordable Care Act, Canceled Policies for New York Professionals” by Anemona Hartocollis, published December 13, 2013

 

“But while those policies, by and large, had been canceled because they did not meet the law’s requirements for minimum coverage, many of the New York policies being canceled meet and often exceed the standards, brokers say. The rationale for disqualifying those policies, said Larry Levitt, a health policy expert at the Kaiser Family Foundation, was to prevent associations from selling insurance to healthy members who are needed to keep the new health exchanges financially viable”.

 

I have every confidence that the Affordable Care Act’s determination of what qualifies as minimum medical coverage is if not explicitly and specifically described in the draft of the act itself, it has been by written description so described by those given the task to make such determinations. I consider the accusation attributed to Larry Levitt as increditable.

 

I’m disappointed in the newspaper that promised “all the news that’s fit to print”. If the NY Time’s couldn’t find space within this article to briefly describe what disqualified the specific insurance policies in question, it could have at very least made reference to that information and where it could be read.

 

Respectfully, Supposn

Link to comment
Share on other sites

You obviously do not read or listen to TV. ...

 

Endosopy, l, you obviously read right wing headlines and listen with undiscriminating ears to less than logical rightwing commentators.

A secondary purpose of ACA was to reduce if not eliminating the numbers or proportions of inferior medical insurance policies sold to individuals.

You’re upset because the ACA does not respect or accept inferior medical insurance policies. Are you also upset that the SEC prosecutes “boiler operations” and the FDA prosecutes producers and distributors of impure or ineffective drugs?

 

The increased proportion and numbers of persons that will now upgrade to quality medical insurance, the reduction or elimination of the accelerating increases for quality medical insurance, the proportions of our population that were not and now will be medically insured was the justification of the Affordable Care Act. That justification will prove to be well founded.

 

Respectfully, Supposn

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...