West Virginians Warned – Health Plan Enrollment Closing Soon, But Be Wary of Short-Term Plans

West Virginians for Affordable Health Care is reminding all West Virginians that the deadline to enroll in your 2019 health insurance plan is fast approaching!

Open enrollment for 2019 plans is now underway, and ends December 15.

Go to healthcare.gov to enroll in a comprehensive health care coverage plan.

However, you should be aware that short term plans that offer little coverage, discriminate based on your medical history, and have life time limits are being sold. These plans may be cheaper, but do not meet the Affordable Care Act requirements for a comprehensive plan, and can leave you without the coverage that you and your family needs.

Here are seven problems consumers could face under a short-term plan:

  1. Short-term plans leave consumers without adequate coverage to meet their health needs because they may not cover essential health benefits.
  2. Preexisting condition exclusions and denials are the norm for short-term policies.
  3. The insurer could retroactively cancel (rescind) a short-term policy if you get sick with a previously undisclosed health condition; even if you didn’t know you had the condition.
  4. Short-term plans can price older people and less healthy people out of the market because they are allowed to charge much higher rates for them.
  5. Short-term insurers can make high profits at enrollees’ expense while offering very little protection in return.
  6. Short-term insurance sales can undermine the market for comprehensive coverage.
  7. Short-term plans puts consumers at risk of incurring medical debt because they don’t necessarily cover critical services that can be very expensive.

Here’s more information from FamiliesUSA on the pitfalls of short term plans.

Understand your plan before you buy. Talk to a local navigator to ensure that you are getting the plan that is best for you and your family.

West Virginians for Affordable Health Care can help you find a local navigator with their Assister List, here.

Between the Cracks of the Public Health System Is Where You’ll Find Dr. Angie Settle

Last year, the nonprofit health advocacy organization known as West Virginia Health Right provided free health services to more than 23,000 low-income people in the southern part of the state.

The organization was founded in 1982 by a small group of doctors and nurses in Charleston who believed that every person is entitled to quality healthcare, even if they don’t have private insurance.

As its CEO, Dr. Angie Settle has a close and personal understanding of the urgent plight of many West Virginians that are slipping through the cracks of America’s public healthcare system.

Having started with West Virginia Health Right as a Family Nurse Practitioner 20 years ago, Dr. Settle has dedicated her entire career to serving the uninsured and underinsured of West Virginia.

Like many born and raised West Virginians, she is stunned by the swift and devastating impact of drug addiction in local communities.

“The use of heroin is a startling, but common, reality that I would have never imagined just 10 years ago,” Dr. Settle says. “We must continue to battle this war that is being waged, to take back the health and wellbeing of our families and end the economic instability it has compounded.”

You can join inspired and ambitious healthcare leaders like Dr. Angie Settle as a member of the West Virginia Rural Health Association.

Memberships start at just $10. Learn more at wvrha.org/become-a-member/

And although it doesn’t receive the same public attention that the opioid crisis does, Dr. Settle and West Virginia Health Right have also started to focus on what they are seeing as an urgent health need – dental services for low-income West Virginians.

“It is my goal during my lifetime to see a move toward preventative care for impoverished individuals, and not just treatment after the fact with multiple extractions,” she says. “This leads to a sad reality of the need for dentures in the very young. We can and must do better in West Virginia. We must offer preventative care, cleanings and restorative dental services for all West Virginians.”

Dr. Settle, a newly elected WVRHA board member, believes the organization plays a critical role for anyone interested in working toward creative and impactful solutions to the state’s pressing health issues.

“Being with like-minded individuals, focused on bettering the physical and mental wellbeing of our state’s citizens, is so important to all of our endeavors,” she says. “It will take a combined effort, like that of the WVRHA, to truly propel us all forward on the road to a healthier West Virginia. We must strive to rank as one of the best state’s in the nation and no longer settle for last place.”

Learn more about joining the West Virginia Rural Health Association at wvrha.org/become-a-member/

CVS Health Corp Agreed To Buy Health Insurer Aetna Inc For $69 Billion

Pharmacy giant CVS Health has agreed to buy Aetna in a $69 billion blockbuster acquisition that could rein in health-care costs and transform its 9,700 pharmacy storefronts into community medical hubs for primary care and basic procedures, the companies announced Sunday afternoon.

The pharmacy chain agreed to buy Aetna for about $207 per share, broken down into $145 in cash and the rest in stock. The deal — the biggest health-care merger announced in more than a year — is expected to close in the second half of 2018, subject to approval by shareholders and regulators.

If approved, the megamerger would create a giant consumer health-care company with a familiar presence in thousands of communities. Aetna chief executive Mark T. Bertolini described the vision in an interview as “creating a new front door for health care in America.”

Act Now – Congress Considering Devastating Cuts to Rural Hospitals

By Jessica Seigel
National Rural Health Association

Today, on National Rural Health Day, the National Rural Health Association is in disbelief.

Today, the urban-centric House Ways and Means Committee is advancing legislation that will result in the closure of even more rural hospitals, further decimating access to health care and further escalating economic decline in rural communities across the country.

Instead of advancing policies to improve the plight of rural America (where health disparity and mortality gaps between urban and rural populations escalate, and unemployment rates continue at levels of the Great Recession), the Ways and Means Committee calls for payment reductions to rural safety net hospitals known as Critical Access Hospitals.

Maybe the Ways and Means Committee doesn’t understand the depth of health workforce shortages, chronic poverty and chronic disease in rural America.

And, perhaps the most hypocritical factor, is that the Committee plans to use this devastating payment cut to Critical Access Hospitals to partially pay for other important rural health programs that Congress has irresponsibly let expire.

Maybe the Ways and Means Committee is unaware that one in three rural hospitals are in financial risk of closure, and 41 percent of rural hospitals operate at a negative financial margin.

Maybe the Ways and Means Committee doesn’t realize that when a rural hospital closes, 20 percent of the rural economy vanishes and other health providers in the community, who are almost always hospital based, leave the rural area.

We urge you to Call Your Member of Congress and oppose cuts to Critical Access Hospitals.

Maybe the Ways and Means Committee doesn’t understand the depth of health workforce shortages, chronic poverty and chronic disease in rural America.

If they did, perhaps the Committee would advance a robust health and economic development plan for rural America, instead of a plan to decimate rural health care delivery.

We urge you to Call Your Member of Congress and oppose cuts to Critical Access Hospitals.

Find contact information for your Congressional representative at www.govtrack.us/congress/members

New York Times: Which Country Has The Best Healthcare System?

Photo by Ray Kim/FlickrCC

By Aaron E. Carroll and Austin Frakt/New York Times

To better understand one of the most heated U.S. policy debates, we created a tournament to judge which of these nations has the best health system: Canada, Britain, Singapore, Germany, Switzerland, France, Australia and the U.S.

“Medicare for all,” or “single-payer,” is becoming a rallying cry for Democrats.

The commonality is universal coverage, but wealthy nations have taken varying approaches to it.

This is often accompanied by calls to match the health care coverage of “the rest of the world.” But this overlooks a crucial fact: The “rest of the world” is not all alike.

The commonality is universal coverage, but wealthy nations have taken varying approaches to it, some relying heavily on the government (as with single-payer); some relying more on private insurers; others in between.

Experts don’t agree on which is best; a lot depends on perspective. But we thought it would be fun to stage a small tournament.

We selected eight countries, representing a range of health care systems, and established a bracket by randomly assigning seeds…

Read the full story at nytimes.com

WV Public Broadcasting: Could These 5 Controversial Ideas Fix Our Health Insurance Markets?

Photo by Paradise.Found/FlickrCC

By Julie Rovner/Kaiser Health News

With Republican efforts to “repeal and replace” the Affordable Care Act stalled, tentative bipartisan initiatives are in the works to stabilize the fragile individual insurance market that serves roughly 17 million Americans…

…Policymakers generally agree on what immediate efforts to stabilize the market might include. At the top of most lists is prompt federal payment of the subsidies to insurers known as “cost reduction payments.”

Here are five proposals that are more controversial — but are starting to generate buzz in policy circles.

These are the payments that reimburse insurers for the discounts on copayments and deductibles they are required by law to give to their low-income customers.

Insurers also want the federal government to continue enforcing the requirement that most Americans either have insurance or pay a tax penalty.

The government also needs to work hard to get uninsured people to sign up for coverage during the upcoming open enrollment period, from Nov. 1 to Dec. 15, insurers insist.

Those federal efforts are essential, the firms say, to keeping enough healthy customers in the mix to defray the costs of beneficiaries who have high medical needs.

Those are among the most commonly proposed fixes for the insurance market. Here are five proposals that are more controversial — but are starting to generate buzz in policy circles.

1. Allow people into Medicare starting at age 55.

Getting slightly younger people into Medicare, the federal program for the disabled and Americans 65 and older, is a longtime goal of Democrats. It dates at least to President Bill Clinton’s administration and was nearly included in the Affordable Care Act in 2010…

Read the full story at wvpublic.org