Feds: Repeal, States: Replace

Avik Roy wrote an excellent piece in Forbes taking on the issue of guaranteed issue head on:

Thanks To Democrats, Pre-Existing Conditions Outweigh The Uninsured In The GOP Obamacare Deal

Should we continue letting the “ludicrously dishonest” (well stated Avik Roy) presumptions of the ACA shape the future of our healthcare delivery system?

I think not.

Prior to the ACA, 6 states (Maine, Massachusetts, New Jersey, New York, Vermont and Washington) required guaranteed issue individual plans. In 2010 these states had some of the highest individual insurance rates in the country:

There were another 35 states that offered guaranteed issue high risk pools:  

High-Risk Pools For Uninsurable Individuals

That means 41 states already had access to guaranteed issue individual health insurance plans prior to the ACA. 

Here’s another point… around my part of the country (KS / MO) the guaranteed issue plans available prior to the ACA were less expensive than the non-subsidized 2017 individual plans! 

ACA proponents are quick to point out that there are more people insured now than prior to the ACA. What they fail to mention is that most of those gains are from new Medicaid enrollments (15 million) vs. state or federal Marketplaces (11 million):

Key Facts about the Uninsured Population

Since I don’t just want to be the one pointing out problems without offering a solution, here are my recommendations for an ACA replacement plan:

• Repeal the ACA… All of it
• Individual mandates and employer mandates would be gone (no more 1095-C forms… would anyone be disappointed?)
• All individual health insurance premiums should be tax deductible just like employer group plans are tax deductible
• Employers should be able to contribute to individual health insurance premiums or group health insurance premiums pre-tax so employees can choose to keep their individual plans if they prefer
• States should decide if they want dependents covered through age 26
• States should decide if they want to require all individual plans to be guaranteed issue
• States that don’t require guaranteed issue should be required to have a high risk pool

Since government programs are the nearest thing to eternal life we’ll ever see on earth (Reagan / Byrnes), I am assuming subsidies are here to stay.

• These high risk pools would be partially subsidized by states and the federal government to help make them affordable
• Low income people would receive reduced tax credits / subsidies to purchase whichever health plans they want (no minimum essential coverage / minimum value requirements)

Keep in mind, the subsidies could be reduced (if not eliminated) for a lot of people when the cost of insurance goes back down to pre-ACA rates.

• States should decide if they want Medicaid expansion (and be willing to pay for it themselves)
• Include tort reform legislation limiting frivolous lawsuits and capping malpractice settlements
• Include Price Transparency legislation letting patients know up front what tests and procedures will cost

And since health insurance does not equal health care, there needs to be fundamental changes to physician access:

• Direct Primary Care’s (DPC) monthly membership fees should be allowed as an eligible HSA / FSA / HRA expense (are you surprised I made it this far before mentioning HSA?)
• States should be given block grants to explore more effective health care delivery systems (i.e. HSA & DPC) for Medicaid, Medicare, and VA

Allowing healthy Americans to purchase underwritten health insurance plans at substantially lower rates has been called discrimination by some. That is true. Insurance companies discriminate.

What would happen to auto insurance rates if everyone paid the same regardless of driving records or previous accidents? Most would pay substantially higher, some would pay less.

What would happen to life insurance rates if everyone paid the same regardless of weight / tobacco use / health issues? Most would pay more, some would pay less.

Providing access to high risk individual insurance plans for the few that need it while allowing healthy individuals to purchase lower cost underwritten plans would make individual health insurance affordable again.

 

ObamaCare is HERE!

ObamaCare is here…
The healthcare landscape has changed.

Dave Ramsey’s ELP

As Dave Ramsey’s Endorsed Local Provider (ELP), our goal is to make you aware of these changes.

We have tools available to help answer your questions:

• Do I qualify for a subsidy?
• What would my penalty be if I don’t have health insurance?
• Should I buy a plan now or wait for 2014?
• Should I keep my current plan?

You have more options available now than you will have next year.

MyObamaCareCalculator.com

For an individual / family PRE-OBAMACARE QUOTE, click on your state:

Alabama                             Montana
Alaska                                 Nebraska
Arizona                               Nevada
Arkansas                            New Hampshire
California                            New Jersey
Colorado                            New Mexico
Connecticut                        New York
Delaware                            North Carolina
Florida                                North Dakota
Georgia                              Ohio
Hawaii                                Oklahoma
Idaho                                  Oregon
Illinois                                  Pennsylvania
Indiana                                Rhode Island
Iowa                                   South Carolina
Kansas                                South Dakota
Kentucky                            Tennessee
Louisiana                            Texas
Maine                                 Utah
Maryland                            Vermont
Massachusetts                   Virginia
Michigan                             Washington
Minnesota                          West Virginia
Mississippi                          Wisconsin
Missouri                             Wyoming

Obama-Car

While talking about healthcare reform with my wife, our teenage son started asking questions. We tried to answer him in a way he could understand, but we just weren’t getting through. Health insurance is a foreign language to him. However he is dreaming about which car he will soon purchase. So we introduced ObamaCare to him by way of the Affordable Car Act… a.k.a. Obama-Car:

Obama says his reforms will include additional mandated essential health benefits AND reduce health insurance costs by $2500 per family. That’s simply impossible. That would be like requiring all 2014 cars to be either hybrid or fully electric (more energy efficient), include run-flat tires with electronic low-pressure warnings (better fuel economy), HID headlights (better night vision), GPS (less fuel wasted getting lost), and satellite radio (because it sounds good) at a lower price.

Yes, these OPTIONS are nice if you have the money to pay for them, but they should remain OPTIONS, not REQUIREMENTS.

Instead of a Chevy Cruze starting at $17,000 the new Obama-Car compliant version (such as the Chevy Volt) would be priced around $34,000.

Obama claims these new cars will only be paid in full by the “millionaires and billionaires” because anyone making less than 400% of the poverty level will have some (or all) of their car subsidized by the government.

Now let’s talk about used cars…

Let’s say you like your existing car.  As long as you owned it before March 23, 2010, you would be allowed to keep it. You cannot make any changes to it or it would no longer be “grandfathered” and you would be forced into buying a new Obama-Car next year or pay a penalty.

If it doesn’t get good enough gas mileage or include all the new Obama-Car required Overpriced Bureaucratically Authorized Mandated Add-ons (OBAMA), then you would also be penalized.

Our son is glad Obama-Car doesn’t exist. He can save his own money to purchase any car he chooses… as long as Dad (not Obama) approves of it!

Dislaimer:  This article was never meant to suggest Obama-Car legislation is needed or should ever become law.

Prepare For ObamaCare

Dear Nancy Pelosi,

After 3+ years and 20,000+ pages of additional clarifications…
WE STILL DON’T UNDERSTAND WHAT’S IN IT!

Senate Minority Leader Mitch McConnell (R-KY) points up at ObamaCare

Peter Newman and Scott Borden Talking about ObamaCare & HSAs on Moneyline

In case you missed the Saturday March 16th edition of Moneyline, here you go!

Don’t forget to maximize your 2012 tax deduction by funding your HSA by April 15th.

2012 Maximum HSA Contributions:
$3100 single
$6250 family
$1000 55+ catch-up contributions

What was Obama texting during Dr. Benjamin Carson’s HSA explanation?

Here is proof that Obama has heard the truth about the right way to reform healthcare:

Dr. Carson’s low income / Medicaid proposal:
“Instead of sending it [big pot of government money] to some bureaucracy, let’s put it in their HSAs. Now they have some control over their own healthcare. And what are they going to do? They are going to learn very quickly how to be responsible.”

The real question is what was so important that Obama needed to be texting during Dr. Carson’s excellent HSA explanation?

Here are a few of my initial guesses:
– This just ruined breakfast. What’s for lunch?
– Need a distraction NOW… How about a round of golf with Tiger?
– I hope this guy doesn’t run for president
– Who scheduled this guy?
– FIRE HIM!

So what are some of your guesses?
(the best ones will be posted here)

TAX TIME! Maximize Your Tax Deductions for 2012

Here are a couple little known tips that could significantly reduce your taxes for 2012:

1. If you are a small business owner with less than 25 full-time employees and you are paying health insurance premiums for your employees, you could be eligible for a TAX CREDIT of up to 35% of the employer portion of premiums paid in 2012.

2. If you were covered by an HSA qualified High Deductible Health Plan (HDHP) on or before December 1st, 2012 then you have until you file your taxes (or April 15th 2013) to contribute to your HSA and get a 2012 tax deduction.

2012 Contribution limits:
Single – $3100
Family – $6250
Catch up contribution (age 55 or older) $1000 per person*

2013 Contribution limits:
Single – $3250
Family – $6450
Catch up contribution (age 55 or older) $1000 per person*

*If both are 55+ then both have to open HSA accounts for both to participate in catch up contribution

These limits are also stated on the U.S. Department of Treasury website.

These maximum contributions will not be pro-rated if your HSA qualified health insurance plan (HDHP) was either in force all 12 months of 2012 OR if it was in force by December 1st of 2012 AND remains in force all 2013.

Your tax deduction is based on how much you DEPOSIT into your HSA, not how much you spend.

You do not have to itemize to get the tax deduction.

You do NOT have to pay your eligible expenses out of your HSA.

HSA Eligible Medical Expenses

You are required to keep receipts of your eligible expenses in case the IRS audits you. You can choose to reimburse yourself at a later date up to the medical receipts you have accumulated without being subject to 20% penalty or taxable income.

The triple-tax advantages (tax deductible deposits, tax free interest earned, and tax free withdraws for eligible medical expenses) only available with HSAs make them an important tax planning tool that is unmatched when used properly.

Other statistics show that nearly half of the 14 million Americans covered by the required HDHP insurance plans have not established their HSA account, and therefore are not participating in the tax savings they offer. Although OFM Benefits is one of the nation’s premier HSA focused insurance agencies, there are probably some of you that have procrastinated setting up your account.

As many Americans are facing huge health insurance premium increases and revenue decreases, HSA qualified plans are becoming even more popular. The average household pays nearly $16,000 per year for health insurance premiums! We feel HSA qualified plans offer the best value in healthcare today.

If you are self employed or a business owner and would like to receive the premium savings and tax deductions only available with HSAs, please visit www.missionHSA.com

N. Scott Borden
Dave Ramsey’s Endorsed Local Provider (ELP)
Health Insurance Director
OFM Benefits Consulting, LLC
6400 Glenwood, Suite 307
Overland Park, KS 66202
913-980-4694 mobile
913-432-2061 fax
http://www.missionHSA.com

More Employers Steer Towards Consumer-Driven Health Plans

Renewing your health insurance used to be easy. Now it seems to take all year. Your employees seem to be healthy, but your renewal rates disagree. You contact your old consulting firm. Utilization is too high…again. Emergency room visits are too frequent…again. Generic prescription substitution is too low…again. You are told to increase co-pays and raise deductibles to create the necessary “steerage” to help hold down your health care costs. The result? Double-digit premium increases…again. You are reminded of the definition of insanity: doing the same thing over and over again expecting different results.

What other options are there?

By now you’ve heard of “consumer-driven” health care plans. At this time there are two versions showing promise, Health Reimbursement Arrangements (HRA) and Health Savings Accounts (HSA). They are designed to lower health insurance costs by engaging employees to take a vested interest in their own health care expenses.

There are significant differences between how these plans work. The employer is the owner of the HRA. The more successful HRA plans are designed to allow a portion of the unspent accounts to roll over from year to year as an incentive to the employee not to spend them. There are no requirements for which type of insurance you use with an HRA. The money that is not spent stays with the employer if an employee leaves.

The employee is the owner of their HSA. Both the employer and the employee can fund this account. HSA funds can be used to help offset all medically related expenses including a tremendous number of things that do not count towards the insurance deductible such as dental, vision, and even some over-the-counter medications. In order to establish an HSA the employee must be covered exclusively by a High Deductible Health Plan (HDHP). The federal government has placed specific guidelines for deductibles and out-of-pocket maximums for these plans to be qualified. Since these plans have a higher deductible than most co-pay plans there is usually a significant premium savings. The concept is to place the premium savings in the tax deductible HSA account and use these dollars to pay your smaller expenses at the insurance company’s negotiated PPO discount while maintaining the insurance plan for major expenses. There are now many examples of the premium savings being large enough to cover most or all of the HDHP deductible!

The HSA accounts can be opened through local banks and credit unions. As long as your HSA qualified health insurance plan is effective by December 1st 2012 you have until April 15th of the following year to deposit up to $3,100 individual or $6,250 family into an HSA account for 2012 and $3,250 individual or $6,450 family for 2013. If you are 55 or over then you can deposit an additional $1000. Account balances roll over year to year. HSAs are the only products that offer triple tax advantages; tax-deductible deposits, tax-free interest earned, and tax-free withdrawals as long as they are spent on qualified medical expenses. Since the employees own their HSA account there is a significant difference in how this money is spent. Imagine your employees all having a vested interest in not spending their health care dollars. This is why self-funded plans tend to benefit most.

The city of Iola, KS is a perfect example. They switched all of their employees to an HSA plan in 2004. Their utilization has decreased substantially which has allowed the city to deposit half of the employee’s individual deductible into their HSA account each year. Employees have embraced the new plan and are seeing their HSA not as an entitlement to be spent but as a retirement account that should be saved whenever possible. The city now has their health insurance costs in check.

The new generation of consultants will need to be focused on educating businesses and their employees offering workshops and educational tools to help employees understand how these plans work.

Otherwise you can keep your current consultant and accept your insurance premium increase… again!

(Originally printed in the Kansas City Star July 17, 2007)

TAX TIME! Maximize your Tax Deductions for 2011

Click HERE for latest update

Since this blog is dedicated to offering the most up-to-date Health Savings Account information, we want to make sure you maximize your HSA for 2011. Remember, if you were covered by an HSA qualified High Deductible Health Plan (HDHP) on or before December 1st, 2011 then you have until you file your taxes (or April 17th 2012) to finish up your 2011 contributions and get a 2011 tax deduction.

2011 Contribution limits:
Single – $3050
Family – $6150
Catch up contribution (age 55 or older) $1000 per person*

2012 Contribution limits:
Single – $3100
Family – $6250
Catch up contribution (age 55 or older) $1000 per person*

*If both are 55+ then both have to open HSA accounts for both to participate in catch up contribution

These limits are also stated on the U.S. Department of Treasury website.

These maximum contributions will not be pro-rated if your HSA qualified health insurance plan (HDHP) was either in force all 12 months of 2011 OR if it was in force by December 1st of 2011 AND remains in force all 2012.

Your tax deduction is based on how much you DEPOSIT into your HSA, not how much you spend.

You do not have to itemize to get the tax deduction.

You do NOT have to pay your eligible expenses out of your HSA.

HSA Eligible Medical Expenses

You are required to keep receipts of your eligible expenses in case the IRS audits you. You can choose to reimburse yourself at a later date up to the medical receipts you have accumulated without being subject to 20% penalty or taxable income.

The triple-tax advantages (tax deductible deposits, tax free interest earned, and tax free withdraws for eligible medical expenses) only available with HSAs make them an important tax planning tool that is unmatched when used properly.

Other statistics show that nearly half of the 11 million Americans covered by the required HDHP insurance plans have not established their HSA account, and therefore are not participating in the tax savings they offer. Although OFM Benefits is one of the nation’s premier HSA focused insurance agencies, there are probably some of you that have procrastinated setting up your account.

OFM is proud to recommend HSA Bank because of their great combination of low fees, competitive interest rates, and a large number of investment options.  With over 400,000 HSA accounts and over $1 billion in HSA deposits, HSA Bank has established themselves as one of the nations leading HSA administrators.  They also recently eliminated all setup fees.

As many Americans are facing huge health insurance premium increases and revenue decreases, HSA qualified plans are becoming even more popular. The average household pays over $15,000 per year for health insurance premiums! We feel HSA qualified plans offer the best value in healthcare today.

If you are self employed or a business owner and would like to receive the premium savings and tax deductions only available with HSAs, please visit www.missionHSA.com

http://www.missionHSA.com

Scott Borden
Host of “Insurance Talk with Scott & Mike” Saturday mornings 7-8 on KCMO Talk Radio 710
  OFM Benefits Consulting, LLC
6400 Glenwood, Suite 307
Overland Park, KS 66202
913-432-2732
913-432-2061 fax

Set up your HSA today!

So you finally switched to an HSA qualified High Deductible Health Plan (HDHP).  You love the lower health insurance premiums these plans offer.  However, life happened and you didn’t get around to setting up your Health Savings Account (HSA).  Now you are sitting there with a medical bill you need to pay, and you remember the triple tax advantaged HSA account that allows you to pay for HSA qualified eligible medical expenses with tax deductible money.

Unfortunately the HSA account needed to be established BEFORE the expense was incurred to be an HSA eligible expense.

For all you procrastinators out there, here’s my advice… take 5 minutes and set up your HSA with HSA Bank.  They have no setup fees and offer very competitive interest rates along with thousands of investment options.

HSA Bank Home Office

HSA Bank was one of the very first financial institutions that recognized the importance of Consumer Driven Health Plans.  They opened their first Medical Savings Account in 1997.  They currently have nearly 400,000 HSA accounts holding over $1 billion in HSA deposits.

Nobody knows for sure how many people are eligible to set up an HSA and have yet to do so.  It only takes a few minutes and it could save you a lot of money on your next tax return.

We had the privilege of interviewing several HSA Bank executives recently on Insurance Talk.

September 3, 2011 Dean Mason, CEO

September 10, 2011 Phil Hartsig, Regional Vice President

September 17, 2011 Itamar Romanini, Senior Vice President of Business Development

December

How to SAVE MONEY on Health Insurance – Dave Ramsey

Dave Ramsey’s ELP

As the health insurance Endorsed Local Provider (ELP) for Dave Ramsey here in the Kansas City area I am very pleased to find out just how supportive Dave Ramsey has always been towards Health Savings Accounts (HSAs).

How to SAVE MONEY on Health Insurance   

Although HSA qualified plans do work very well for healthy people, HSA qualified plans are the type of plans I want and choose for my family knowing that a catastrophic medical condition could happen at any time.

A typical expensive low deductible copay plan exposes high utilizers not only to the deductible, but also coinsurance (the 80/20 part) and unending copays.  This in some cases can add up to thousands more than the initial deductible.

Most HSA qualified High Deductible Health Plans (HDHPs) have one deductible for all inpatient, outpatient, office visits, testing, prescription drugs, surgery expenses, emergency room visits and physician services, and then pay all remaining in-network medical expenses at 100% for the rest of that calendar year.  So yes, you do have a larger deductible to begin with. But these plans are the only ones that truly have a maximum out-of-pocket.  By the time you calculate the annual premium savings these plans offer and subtract that from the annual deductible, these are the best plans you could own for both healthy and unhealthy situations.

So how much money could you be saving each month?  If you are self employed or want to find quotes for you or your family, click here.  If you are a business owner or a group administrator and are tired of paying too much for health insurance every month, CALL US!  (913) 432-2732 or visit www.missionHSA.com.