A couple weeks ago I walked the streets of Lincoln, Nebraska, talking to men and women about whether they thought Washington was listening to their economic concerns. Jeff Melichar manages his family’s Phillips 66 gas station on the city’s main street, and one of his big financial problems happens to be health insurance. The more we talked, the more I realized what a jam he could be in down the road because of a loophole in the health reform law, which has received almost no press coverage or public discussion: If you have health insurance from your employer, you may have to keep it whether or not it’s adequate or affordable. Buying less expensive or better coverage from one of the state “exchanges” or shopping services will be off limits. So despite all that talk about consumer choice, for many like the Melichars, there may be no choice.
Melichar’s wife is eligible for health insurance from the optical company where she works. But the family waited until this fall to enroll when the firm offered coverage they finally could afford. Their premium is Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
There’s just so much hidden and buried in the Affordable Care Act (ACA) that it’s like trying the find all the goodies in an Easter egg hunt. ACEP News pointed out one hidden goodie, nicely illustrated in this article from Kaiser Health News:
Under the new health law, insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: Patients who need emergency treatment will have their costs covered at the same rate, regardless of whether they are treated at “in-network” or “out-of-network” hospitals.
The law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the “prudent layperson” rule. For example, if a person goes to the ER with chest pain, but ends up being diagnosed with indigestion, the claim has to be covered because going to the hospital under those circumstances made sense.
The provisions go into effect for every health plan issued after Sept. 23 – six months after the law was enacted — that offers emergency coverage.
This is potentially quite significant. As with so many things, the devil is in the details, and the implementation is not yet actualized. Read more »
*This blog post was originally published at Movin' Meat*