Hawaiian Unemployed People Can’t Afford Health Insurance

Health insurance has a become a big issue as more and more people are laid off due to the financial crisis, their options being either seeking new individual health insurance or using the COBRA plan, which was created especially for laid-off workers.

The problem with COBRA is that it is largely unaffordable, taking up more than three-quarters of a worker's government unemployment compensation. Currently, the unemployment rate is 7.2%, which is the highest the US has seen in 16 years. This means that millions and millions of people are jobless, thus looking for health insurance. A laid off worker with health problems is very unlikely to find individual health insurance, as companies are afraid to cover them.

The situation in Hawaii is even worse, even though the COBRA plan is the cheapest in Hawaii, most of the unemployed people can’t afford paying for health insurance. This is very hard, as one is constantly thinking and wondering what is to do if he gets seriously sick.

The large majority of Americans get their health insurance from their work place, those who are jobless are thus in a big predicament. About 46 million people have no health insurance and the rest are covered by government insurance. Surveys show about 18 to 26 percent of people eligible for COBRA use the program in any given year, meaning that a low percentage of the people without a job live without a health insurance.

The health care system needs to be reformed, one way or another, and this should be the number one priority.

Health Insurance If You Lose Your Job

(CBS) When people lose their jobs, they also lose their health insurance. Finding alternative insurance can be intimidating, and expensive. But in this column, Early Show financial adviser Ray Martin goes through some of the available options.

For starters, he says, do NOT go without insurance, assuming it's going to be prohibitively expensive. The No. 1 reason individuals file for bankruptcy is medical bills that can't be paid thanks to a lack of insurance. But, he stresses, you do have some choices.


According to recent statistics, about 46 million Americans are going without health insurance coverage. With the souring economy and rising unemployment, the number of folks losing job-related health insurance benefits is set to rise significantly. And with more folks looking for jobs, finding a job will take longer, which means more displaced workers can go without health insurance for longer periods of time.

Unfortunately, there is no universal health insurance plan for folks who need temporary health insurance coverage due to loss of coverage when they are between jobs or no longer qualify as a dependent under a spouses or parents plan. However, many insurance companies are developing more individual and "gap" plans in an effort to make some options more affordable to individuals, due to a growing market demand. Sorting through the available options and finding affordable short-term health insurance can be challenging, but it's not impossible.

Here's what to look for:

COBRA Continuation of Coverage

Under a Federal law called COBRA (Consolidated Omnibus Budget Reconciliation Act), displaced workers are provided the right to continue coverage under their employers' group plans after they change or lose jobs. Continuation of coverage can also apply to children who no longer qualify as covered dependents because they are no longer full-time students. This option is available to employees of companies with group health plans that cover 20 or more workers. Some employers with other health plans (such as self-insured plans) may not be required to provide COBRA continuation coverage. The cost of health coverage under COBRA for displaced workers is usually more expensive than health coverage for active employees, since, usually, the employer pays a part of the premium for active employees, while displaced workers are required to pay the entire premium themselves. Since it is the full cost for the coverage, it can be expensive: On average, the monthly premium for an individual policy in 2008 was $392, and for a family plan, about $1,056 a month, according to a recent Kaiser/HRET survey. But typically, that is still less expensive than individual health coverage with the same features and benefits.

Coverage under COBRA can be continued for up to 18 months, and up to 36 months when loss of coverage is due to divorce, disability, etc. When electing COBRA coverage, you must be sure to do so within 60 days of your “qualifying event” (such as loss of your job, divorce, etc.); after that time, the insurance company can decline your eligibility. Once you select COBRA, your coverage is effective with no gaps, so your eligible medical claims during that period of time should all be covered. Because this is the same coverage that the worker had before losing his or her job, the same benefits and features are available, and there are typically no restrictions for preexisting conditions. You can also discontinue participating at any time after permanent coverage is found.

But continuation of health insurance under COBRA is not always available for workers of companies that go out of business: When a company shuts its doors and also terminates its health insurance plan, usually there is no COBRA coverage available. If, however, there is another plan offered by the company, you may be covered under that plan.

Short-Term Medical Insurance

Short-term medical insurance can provide coverage for a limited period of time, and may be a good solution for those between jobs or waiting for other health insurance to start. This form of coverage is offered by a select group of insurance companies and features coverage from one-to-12 months. This can be a good option for those between jobs, when COBRA is not available and you do not have significant pre-existing conditions. For example, the Celtic Insurance Company offers a short-term medical plan for a 45 year-old male that can cost as little as $74 a month. Of course, the cost of this coverage will depend on your age, other health related factors, and the deductible you select (some products feature a selection of deductibles from $250 to $2,500). After the deductible is paid, covered individuals typically pay 20 percent of covered expenses up to an out-of-pocket limit, and then all covered expenses are covered 100 percent up to $2 million. Another provider that offers short-term medical insurance is Golden Rule (a UnitedHealthOne Company). Also, check out www.ehealthcobra.com, a Web site developed by eHealthInsurance that offers quotes and side-by-side comparisons of several short-term and high-deductible medical plans for individuals and families.

Catastrophic Health Insurance

As the name implies, these policies are primarily designed to cover major emergency medical expenses. The cost is relatively low, because insured people must first satisfy a high deductible, ranging from $500 up to $15,000, depending on the plan purchased. These policies are not intended to pay for routine doctor office visits or trips to the emergency room for the flu, nor for preventative care, maternity care or mental health care. However, most catastrophic plans cover hospital stays, X-rays, and surgical expenses. Think of this as affordable medical coverage for the worst that can happen, which primarily provides coverage so your other assets do not get wiped out from the high cost of a true medical emergency. Folks who get this coverage will need to be prepared to pay a deductible if they incur a serious illness or accident. If you have a pre-existing condition such as heart disease, cancer or diabetes, you are generally not eligible for this type of coverage. There are several Web sites that will compare catastrophic plans in your area and provide quotes for you, including gohealthinsurance.com and medhealthinsurance.com.

Association Coverage

Many trade, professional or other associations offer health insurance to their members. If you belong to any groups or associations, call their membership services to find out if they offer this coverage. There can occasionally be a small, additional administrative fee such as two percent of the annual premium that the Association may charge you, but this is still a good way to obtain a group rate for coverage.

Non-Group Coverage

Many health insurance companies offer individual health insurance coverage. This can be very expensive and may not available in your state. Often, application requirements will apply, and preexisting conditions will be excluded from covered health and medical conditions. Some states mandate a “high-risk pool” that guarantees by law that they accept those who apply, under certain conditions. Check with your state's insurance department for more information.

Local Clinics

Some uninsured adults turn to local clinics for low-cost or free medical care for things such as routine visits or check-ups. But this is not a viable alternative for a major illness or accident, as hospitalization is not provided. If you decide to forgo health insurance, it does not mean that you can't still seek care from your family physician or local doctors; you will just need to pay as you go. And don't be afraid to negotiate those fees. This is a much more affordable way to seek care then going to an emergency room, where the cost can be more than 10 times higher.

Medicaid

This is a joint federal-state health insurance program for individuals who meet near poverty-level income and asset qualifications. States usually provide Medicaid for individuals who receive federally-funded cash assistance payments, such as SSI. The set poverty-levels can vary by state so, for more information about Medicaid, contact your state's Medicaid agency, social service or welfare office.

Hartford Financial, Lincoln National Receive Thrift Charters

WASHINGTON -(Dow Jones)- Hartford Financial Services Group (HIG) and Lincoln National Corp. (LNC) were granted thrift charters Friday, clearing a hurdle for their insurance affiliates to receive capital infusions under the Troubled Asset Relief Program.

Hartford Financial has a number of life-insurance affiliates, while Lincoln National is the parent of Lincoln National Life Insurance Co.

The Office of Thrift Supervision announced the approval of the thrift charters for Hartford and Lincoln on its Web site.

The life-insurance industry has been lobbying to receive federal rescue aid under TARP, as insurers' investment portfolios have been badly battered by the financial turmoil.

The Treasury told the industry that only companies with a federal regulator are eligible for the program. Some insurers, such as MetLife (MET), have long held thrift charters. The industry, however, is almost exclusively regulated at the state level.

Paterson Would Insure Dependents Up to Age 29

ALBANY — Gov. David A. Paterson will propose that private employers be required to offer health insurance to workers’ dependents who are ages 19 to 29, part of what the administration hopes will be a step toward universal health care coverage in New York.
Mr. Paterson plans to call for the legislation during his State of the State address on Wednesday afternoon.

“This year, we will take another important step as we move toward increasing access to coverage for all New Yorkers,” Mr. Paterson said in a written statement on Tuesday.

Currently, employers are not required to offer health insurance to dependents who are older than 18 or, if they are in college, 22.

The proposal would amount to a wide expansion of coverage to some 800,000 people 19 to 29 years old who are uninsured. And it ties into a continuing initiative by Mr. Paterson, who is asking the State Legislature to approve deep cuts in spending this year, to enhance the kinds of social safety nets that are overwhelmed during an economic downturn.

According to the governor’s office, 31 percent of New York’s uninsured are ages 19 to 29. Many of them lose coverage once they graduate from college and remain uninsured until they are able to find a job that offers health insurance. But as the job market worsens, the state anticipates that the issue will become more pressing, with more and more young people unemployed and uninsured.

If the Legislature approves the proposal, the state expects that about 10 percent, or 80,000 people, will take advantage of it.

Paterson administration officials said that the plan would not cost the state or businesses anything. The only cost would be to families that chose to pay for the expanded coverage.

Kenneth Adams, president of the Business Council of New York State, a group that represents businesses across New York and was briefed on the plan by the governor’s advisers, called the proposal “compelling” and said that it would be especially critical given the economic climate.

“Out of the gate, a program that gets 80,000 New Yorkers health insurance is a good thing,” Mr. Adams said. “Considering where the economy is right now, and that by definition this is a tough period for this age group to obtain insurance, it is a very important issue.”

Mr. Paterson’s legislation would round out proposals to expand access to health care that he laid out in his budget for the 2009-10 fiscal year, which begins on April 1.

One proposal would simplify the application process for public health insurance programs by eliminating the requirement for face-to-face interviews, among other things. Another proposal would expand eligibility for the state’s Family Health Plus insurance program, which covers people who exceed the limits for Medicaid eligibility.

Ten healthcare suggestions for the Texas Legislature

The 2009 legislative session is unlikely to lift the state out of its rock-bottom national ranking in healthcare.

Texas has the highest rate of uninsured residents and spends the least per resident on healthcare — $2,141 compared with the national average of $3,508. The state is not impoverished, ranking 21st in per-capita income, and consistently has a lower unemployment rate than the nation.

Healthcare spending is simply not a priority.

But legislators can improve accessibility and affordability by exerting leadership.

Here are 10 suggestions.

Aggressively enroll eligible children in the Medicaid and Children’s Health Insurance Program (CHIP).

According to the Austin-based Center for Public Policy Priorities (CPPP), about half of uninsured children are eligible for these programs.

Extend children’s Medicaid eligibility from six to 12 months.

The 2007 Legislature extended CHIP enrollment to annual eligibility. Medicaid children deserve the same. When California extended Medicaid eligibility re-enrollment to 12 months in 2001, it saved an estimated $17 million when 3,000 fewer children were hospitalized for asthma, pneumonia and gastroenteritis, says a recent study in Medical Care.

Allow Texans to buy their way into the CHIP program.

According to CPPP, there are families who request pay cuts to enable their children to qualify for the program. Parents making up to $63,000 (more than current eligibility, 200 percent of the federal poverty level, or $42,400 for a family of four) should be able to sign up their children and pay a premium for coverage.

Make insurance companies accountable for their rates.

Texas premiums for family coverage increased 40 percent between 2001 and 2005 while income was up only 3.5 percent. But according to the Journal of Insurance Regulation, Texas is only one of 10 states that do not actively review health insurance rates. The Texas Department of Insurance is up for a sunset review, and lawmakers should use the opportunity to strengthen the department’s oversight.

Assist in forming risk pools to protect individuals and small businesses from unaffordable rates.

Other states have implemented reforms for reinsurance — or insurance for insurance companies — to lower rates, made high-risk pools more affordable for those with chronic conditions, and formed health insurance exchanges to assist in creating a larger risk pool and foster competition among insurance companies.

Improve the Texas Advance Directives Act.

A 2007 compromise bill that would have improved the 1999 version for disputes over end-of-life care failed primarily because the session ran out of time. The measure built more time and a swift legal appeal into the process and dictated better communication between the care providers and patient families. It deserved passage.

Keep the funds for trauma care where they belong.

Money designated for hospital trauma centers from the Driver Responsibility Program fines continues to be diverted for other uses. Trauma centers are only getting about half of the fines’ proceeds.

Implement a statewide smoking ban.

Cigarette smoking and obesity are the two most preventable causes of chronic disease and death. Smoking restrictions and excise taxes are the most effective means of decreasing smoking rates. The House passed an exception-laden ban in 2007 that deserved its legislative death.

Build on protections against "balance billing."

This hoary practice bills patients treated by physicians outside their insurer’s network for the portion the insurance company won’t pay. This is especially outrageous in emergency situations where the patient is in no condition to make informed choices. California and Illinois have taken measures to protect residents, and Texas should do the same. Lawmakers in 2007 passed requirements for disclosure of non-network practitioners, but they need to go further.

Increase healthcare access by increasing providers and broadening scope of practice.

The the state demographer reports Texas will need at least 40,000 new doctors by 2025 because of physician retirements and population growth. The Task Force on Access to Health Care in Texas recommends increasing the number of medical school graduates by 25 percent and dentists by 20 percent over the next decade. Physician assistants and nurse practitioners are increasingly important in rural areas, and staff most retail health clinics. Onerous physician oversight requirements handcuff too many opportunities to give basic care.