With the 2020s underway, let’s take a look back at seven key milestones and issues that marked the evolution of healthcare over the past 25 years.
Just months into 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. The Affordable Care Act, often referred to as the ACA or Obamacare, changed the nation’s health insurance landscape and brought about numerous provisions to help make health insurance more affordable and accessible to as many Americans as possible.
Some key provisions include:
Ten years later, uninsured rates have declined. In 2010, nearly 16% of Americans were uninsured. But in 2016, the uninsured rate hovered just above 8% - its lowest point in the decade. Although, it started to increase again slightly in 2017.
Short-term health insurance is temporary insurance that provides coverage in certain medical situations like an unexpected accident or illness. However, it doesn't include the same essential health benefits that ACA plans do, making it a more affordable insurance option for many.
Short-term health plans remained a relevant health insurance option throughout the decade with sales increasing sharply after the ACA took full effect in 2014. These plans became an attractive option for people who were exempt from the individual mandate or opted to pay a penalty for not having an ACA-compliant health plan.
Obama limits short-term policies
Concerned that short-term health insurance was impacting ACA enrollment, the Obama administration created regulations that limited their availability. In 2016, short-term policies were capped at three months.
Trump expands short-term policies
In 2018, the Trump administration lifted Obama-era limits. Policies can now last up to 12 months and can be renewed for up to 36 months, depending on state laws. Arizona, for example, has adopted the Trump administration’s regulation. Some states, such as Oregon, still limit short-term plans to less than 90 days.
High-deductible health plans, called HDHPs, were introduced in the early 2000s and were considered "mainstream plans" by 2012. People obtained these plans usually through their employer group-based coverage (if offered), the healthcare exchange, or from private insurers.
Here are some interesting facts:
But while consumers can appreciate the lower monthly premium of a high-deductible insurance plan, they also tend to delay or skip medical care because of the high out-of-pocket costs associated with HDHPs.
The popularity of HDHP may be slowing - at least in the group market. The percentage of employers offering a high-deductible health plan as the only option is projected to decrease in 2020, with more employers beginning to offer additional coverage options.
If it seems like your healthcare costs increased throughout the past decade, it probably did. In 2018, the average American household spent $5,000 on healthcare, with nearly 70% of the $5,000 going towards health insurance.
The more staggering fact: medical bills are reported to be the number one cause of bankruptcies nationwide. And today, medical costs are considered America’s "real healthcare crisis". And while politicians continue to debate issues including health insurance reform and prescription drug pricing, they have not agreed upon a clear solution.
Until things change, consumers must continue to find ways to save on their own, from finding flexible and affordable health insurance options and taking advantage of preventive care, to comparing provider rates before seeking services and getting alternative healthcare through options like telemedicine.
Another wave of opioid-related deaths hit around 2013 and this time, synthetic opioids like fentanyl were behind the surge. The crisis continued to escalate from there, with prescription drugs playing a significant role.
Here are some of the most shocking reports:
So what’s being done about it? In early 2019, the Trump administration launched a $353 million initiative to cut opioid overdoses by 40% over the next three years.
The federal government is also working to hold drug companies accountable. For example, top executives at Insys Therapeutics were found guilty of racketeering conspiracy—a charge typically assigned to drug dealers and mob bosses.
In 2018, the CDC reported that drug overdose deaths decreased for the first time since 1990.
The 2020 pandemic was not only the biggest health event in the U.S. in the past decade, but a major burden on an already fragile healthcare system. From shortages of hospital beds and staff to healthcare facilities having to ration medical supplies to keep up with COVID-19 cases, we’ve seen how our healthcare infrastructure is in need of improvements to better prepare for crises.
Not only that, researchers at the Massachusetts Institute of Technology assert that the pandemic revealed some deeper issues in our healthcare system, such as disproportionate access to care among marginalized groups and the country’s dependence on healthcare services from underpaid workers.
Medicare Advantage plans, which are an alternative to Original Medicare, have seen a steady increase in enrollment each year over the past decade. As of 2022, there are 28.4 million Medicare Advantage enrollees which account for 48% of the Medicare-eligible population. People enrolled in MA plans back in 2012 represented about a quarter of all beneficiaries, so enrollment rates have just about doubled.
Another interesting fact as reported by Kaiser Family Foundation is that “the average Medicare beneficiary in 2022 has access to 39 Medicare Advantage plans, the largest number of options available in more than a decade.”
Here’s a breakdown of MA plan enrollment:
Discussions about healthcare reform and our healthcare landscape did not stop when the ACA was passed. Conversations about legal challenges continue to this day. There has been proposed legislation to repeal and replace the ACA under the Trump administration.
New tax legislation passed in December 2017, which changed one key aspect of the ACA. Previously, you could be penalized for not having health insurance, but Congress and President Trump eliminated the mandate rule for all coverage beginning Jan. 1, 2019.
The 5th Circuit also ruled in Texas vs. United States that the individual mandate is unconstitutional, at which time, a A Texas Judge was deciding what, if any, of the ACA still stands. But in 2021, the Supreme Court ruled that states don’t have any grounds to challenge the constitutionality of the ACA mandate.
With the Presidential election in 2020, Democrats were focused on building upon the ACA with tactics like a “Medicare for all” national health insurance system. However, this agenda never took effect with the Democratic party winning the election.
Now twelve years after the passing of the ACA, the Biden-Harris administration has promised to continue upholding the ACA and making affordable health insurance accessible. With ongoing talks of a universal health insurance option for Americans and how to navigate health-related issues post pandemic, there’s no doubt that healthcare legislation will continue to make headlines over the next decade.
From Obamacare to the opioid epidemic to the Covid-19 pandemic, healthcare-related issues have made major headlines. And it’s inevitable that they’ll only continue to evolve and impact our lives for years to come.
We’ll continue to follow the trends and changes as well as their impacts on our nation.
More than 6.65 million Americans filed for unemployment benefits over the last week alone – a bleak result of the Coronavirus pandemic. But those impacted aren’t just losing their jobs: They’re often losing their health insurance benefits too. And now is the time, especially, when health insurance may be extra crucial to you as you work to maintain good health or need coverage if you do get sick. Before weighing your options, take these steps: Know your budget and what you can afford each month. Make a list of your current health conditions and medications. List any doctors any healthcare providers you want to keep. Determine if you need dental or vision coverage. If you’ve lost your job and job-based insurance coverage, here are six options for you: 1. Join your spouse’s plan You may be able to obtain coverage through your spouse’s job-based health insurance plan, as long as your spouse or partner is already covered, which can be a cost-effective option. Ask your spouse to talk to his or her HR or benefits team to see if this is an option and what the associated healthcare costs may be for you. 2. COBRA You’ll likely receive a COBRA enrollment notice that includes information to continue your health insurance through your employer. Pros: You can keep your current health plan and continue to use your doctors and pharmacists under a policy you’re already familiar with. Your copays and deductibles will remain the same. Your spouses and children are eligible. Cons: You will likely face a higher premium because your employer will not subsidize the cost, and you’ll be charged a 2% administrative fee for continuing the plan. You can stay on COBRA for a limited time – typically up to 18 months. Some employers don’t offer this option, so be proactive and ask about it if you’re interested. 3. ACA (Obamacare) Plans Though the 2020 open enrollment period has ended, losing your job may qualify you for a special enrolment period exception. You can see if you can get coverage for an ACA plan through the Health Insurance Marketplace. Pros: Offers comprehensive major medical coverage for the 10 essential health benefits. You can’t be denied for pre-existing conditions. Tax credits are available if you meet the qualifications. Cons: You may not qualify to enroll in a plan at this time.* Can be costly if you don’t qualify for a subsidy. Plans can have narrow networks, so it’s wise to check if your doctors and providers are in-network. *Note: U.S. officials are also considering a special enrollment period to help uninsured Americans during the COVID-19 crisis. 4. Short-Term Health Insurance This type of temporary health insurance is designed to be a cost-effective and flexible insurance option if you’ve lost your job and have a gap in health insurance coverage. Pros: Flexible plan duration: Your coverage period can range from 30 to 364 days, with policy renewal of up to three years, depending on your state’s rules. Cancel anytime: You can choose how long you want to be covered (anywhere from 30 to 364 days). Plus, you can cancel your plan anytime. Enroll anytime: You can apply for and enroll in a temporary health insurance plan any time of year. And you can get coverage as soon as the day after you apply. Cons: There’s no coverage for pre-existing conditions. There are limits on prescription drug coverage: Most short-term health plans do not cover prescription drugs, but a few do offer add-on benefits and include prescription drug coverage after a deductible is met. There are limits on the number of covered doctor visits. Does not cover all of the 10 essential health benefits. You can be denied coverage. 5. Medicaid Medicaid is based on your income, family size and asset level. Though each state can set its own requirements, the limit is typically 133% of the Federal Poverty Level. If you do qualify for Medicaid, you’ll receive low-cost health insurance through your state which may cover you for: Inpatient care (hospital-type visits) Outpatient care (doctor’s office visits) Home health care Nursing care Dental, vision and hearing (in many cases) Again, benefits vary by state. And Medicaid should not be confused with Medicare (here’s how to know the differences between the two). 6. Telemedicine (not health insurance – but a way to get care) Though telemedicine isn’t a form of insurance, it’s a helpful service that people are turning to during a time of social distancing and stay-at-home orders. With telemedicine, you pay a monthly membership fee and, when you use the service, you may also pay a charge for the ‘televisit.’ Telemedicine connects you with virtual doctors who can diagnose and treat your non-emergency medical conditions, including: Allergies Asthma Behavioral and mental health services Common cold Fever Flu Men’s health issues Nausea and vomiting Pink eye Sore throat Skin conditions Sinus infections Women’s health issues Telemedicine doctors can also prescribe medications for certain conditions and submit the order to your pharmacy of choice. You can get a telemedicine quote with no obligation to you. We will continue to provide educational resources to you throughout the Coronavirus pandemic: Follow us on Facebook for news about COVID-19, telemedicine, health insurance and more. Visit our feed to get frequent updates on COVID-19 news.
Did you know that 66% of people who file for bankruptcy cite medical issues as a key contributor to their financial downfall? It's no wonder why rising healthcare costs continue to be a hot topic of conversation. So finding creative ways to save on healthcare costs should be top of mind for you. Whether you have Medicare, coverage through your employer, or insurance through the marketplaces, here are 9 ways to save on medical costs. 1. Incorporate Healthy Habits Finding ways to improve your general health and wellness can lower your out-of-pocket health care costs. After all, fewer trips to the doctor means fewer copays and less money spent on healthcare. Here are 4 simple actions you can take to live a healthier lifestyle. Less sugar, more water. Drink plenty of water and eat foods high in water: Think cucumbers, watermelon and celery. Sit less, more movement. Stand up throughout the day, stretch, take the stairs, and park further away: These are just a few ways to move more. Get rest. When thinking of healthy habits, sleep often falls low on the list. But chronic sleep deprivation can increase heart disease, diabetes, stroke, obesity, and many other illnesses. Wash your hands. The coronavirus pandemic serves as a major reminder to wash our hands frequently and correctly. Wash your palms, fingernails, and the backs of your hands thoroughly for at least 20 seconds. 2. Reduce Stress Stress often increases with age, leading to a host of health problems. Finding ways to lower your stress can go a long way. There are many simple ways to reduce stress in your daily life. Try things like working out or moving daily, spending more time with friends and family, and reducing your caffeine intake. And don't forget to laugh more. 3. Save Money on Medications The cost of prescription drugs can really take a lot out of your wallet. So if you're used to getting brand-name medications, consider asking your doctor for a generic alternative. It could save you money in the long run. For seniors especially, the cost of medications continues to rise at an alarming rate. One of the simplest ways for seniors to save is to find and compare Prescription Drug Plans (Medicare Part D). Start by comparing quotes, or talking to an insurance agent who is willing to research the medications you take. The right agent will have knowledge of all the pharmacies close to your home and plans available in your area. He or she can also help you identify ways to save on your prescriptions. 4. Use a Health Savings Account (HSA) You may have access to a Health Savings Account (HSA) through your employer (or previous employer). Using an HSA can save you money because your contributions are pre-tax dollars and can accrue interest. And unlike a Flexible Savings Account (FSA), the HSA is owned by you, so it can carry over into your retirement. And there is no deadline on when you can spend the funds. 5. Know The Difference Between Emergency Care and Urgent Care Some people don't know the difference between emergency care and urgent care. But knowing which option to use in a given situation can save you money: Emergency room visits can cost far more than urgent care center visits. Your initial reaction might be to go to the ER when you need medical treatment but can't see your primary care doctor. But in many cases, an urgent care facility will serve you just as well at a lower cost. Start by keeping a list of nearby ERs and urgent care centers handy. An urgent care visit is good for a minor illness or injury, but if your condition is life-threatening, always go to the ER. You might also consider going the telemedicine route, which entails talking to a doctor online, rather than going to an in-person appointment. Telemedicine usage also gained momentumduring the coronavirus pandemic. Overall, turning to telehealth may not only reduce your healthcare costs - it could save you time and keep you out of the waiting room. 6. Ask If All Tests Are Necessary You may think that doctor-ordered tests are standard protocol, but those tests could get expensive fast. Be sure to ask your doctor if all diagnostic tests are necessary for your health. Don't be afraid to ask your doctor if all diagnostic tests are necessary for your health. Here are some questions to get the conversation started. Why is the test being done? What steps does the test involve? How long will it take to get the results? What will the test cost? 7. Request Outpatient Services When Possible Did you know that some inpatient procedures can be performed on an outpatient basis? Often, doctors choose to have a procedure performed on an inpatient basis, simply for the convenience of the patient and the medical staff. Many procedures do require a medically supervised period of recovery, but not all of them. There's nothing wrong with asking your doctor if a procedure can be performed in an outpatient clinic rather than at the hospital. If so, the savings can be significant. 8. Choose Your Doctors Wisely Just because a physician or facility accepts your health insurance or Medicare plan doesn't mean that your costs will be controlled. If you're on Medicare, consider these two steps: First, check if the provider accepts assignment. This means that the provider has agreed to accept the Medicare-approved amount as full payment for services. If your provider doesn't accept assignment, then your out-of-pocket costs may be higher. Second, choose the right doctor for you. The ideal provider has specialized experience with those age 65 and over, which can save you repeated visits to the doctor. One way to shop around for doctors and specialists is through the physician compare feature on Medicare.gov. You can use this tool to compare providers in your area, or you may opt to discuss the topic with a licensed insurance agent. In general, researching and shopping around for the right healthcare provider could save you money over time. 9. Use Your Medicare Benefits It may sound contradictory, but going to the doctor can ultimately lower your healthcare costs. Most insurance plans, including Medicare Advantage, come with certain wellness benefits. Getting regular physicals and patient-specific tests can uncover minor health problems before they become major ones. Let's say a man gets a routine PSA blood test done, which reveals the possibility of low-grade prostate cancer. Early intervention makes the treatment cost far less early on, resulting in fewer trips to the doctor and fewer copays. In other words: lower cost. You Can Save On Healthcare Costs Bottom line: Don't be afraid to do your research, ask the right questions, and incorporate healthy habits to decrease healthcare costs. You can also find more tips to avoid medical debt in this article.
The Affordable Care Act (ACA) was originally implemented to protect people from the skyrocketing costs of health care. But the bankruptcy rate across America remains high - despite how the ACA has contributed to fewer bankruptcies across the country. Roughly 700,000 people declare bankruptcy each year, with 66.67% of this amount coming from costly hospital bills. Take Susan, a young mother, as an example: Susan had to have a Cesarean section when giving birth to her second child. During the procedure, she and the baby suffered an amniotic fluid embolism, which caused her to need multiple plasma and platelet transfusions and a full hysterectomy. While both mother and child survived, the family finances did not. Under the unforeseen circumstances, Susan had to stay longer than expected. And the final hospital bill caused Susan and her husband to file bankruptcy. Their experience is all too common. People enter the hospital for "routine" procedures and sometimes leave under crushing debt. And while hospitals give lifesaving care to patients, you may find many items on your bill that'll drive up the total cost. In most cases, the final statements are so extensive that patients don’t even question their accuracy. So how can people protect themselves against high — often inflated — hospital costs? How hospital charges add up quickly Hospitals are a business. Patients are charged for everything including incidental expenses. As examples, the average rate hospitals charge is $15 for a single Tylenol pill. Hospitals can also charge $10 per plastic medication cup, so the cost of each dose of Tylenol is even higher. And every time the hospital staff cleans a patient with an alcohol swab, the cost of the swab is $23. And those tiny alcohol swabs can add up fast. Other ways patients may see higher costs on their hospital bills: Mistakes in billing. A medical billing company discovered that 80% of hospital bills they reviewed had errors. As with any other service, mistakes happen. But it seems that billing errors at hospitals are commonplace. Network nuances. The hospital you chose might be in-network, but some of the providers and associated procedures like radiology techs, lab services, and specialists such as anesthesiologists may not be. If these are used during your stay, you may have to pay for these services out of pocket. Unnecessary tests. Doctors often ask for tests which are not deemed necessary by the insurance company. How a hospital indemnity plan can offset certain costs Many people are finding that hospital indemnity plans can offset certain costs associated with their hospital stays that major medical health insurance does not cover. The truth is few insurance policies cover 100% of hospital costs. Most contain some form of patient share as a coinsurance percentage or a copay amount. And there are deductibles and items which fall outside of the in-network coverage. In other words, having a single health insurance policy is sometimes not enough to protect you from the high costs of a hospital stay. What is a hospital indemnity plan? A hospital indemnity plan is a form of insurance developed that helps you cover additional costs not included in a major medical plan. Unlike major medical, which pays the provider, hospital indemnity plans will pay the person covered. The way it works is an insurance company can pay cash directly to you (or you can have the hospital submit a claim), so you can use it toward out-of-pocket expenses your health insurance might not cover. This allows you to use the funds as you see fit, whether it's for deductibles, travel, or lost income while you're in the hospital. Simply put: The owner of a hospital indemnity policy is in control of the funds — not the provider. But it’s important to know this type of plan is a supplement to - not a replacement for - major medical plans. There are many other terms often used for hospital indemnity plans, which include: Supplemental hospitalization Hospital insurance Hospital cash plans Healthcare indemnity Medical indemnity Health benefit indemnity Fixed indemnity health insurance Indemnity medical plan Health benefit indemnity insurance How does an indemnity plan work? When you buy a hospital indemnity plan, your insurance company will pay you a fixed amount to pay for your medical bills or use the money to supplement income, child care, or any expenses you faced while hurt or sick. If you’re admitted to the hospital for a covered service or condition, you'll notify your insurance company. Your insurer will then pay you a set amount based on a predetermined rate listed in your policy. You'll still want to review your hospital bill to make sure you're not being overcharged - even with a hospital indemnity plan. Doing this will put more money in your pocket for other costs related to the hospital stay. Is a hospital indemnity plan right for you? A hospital indemnity plan can work for most people. Hospital expenses average nearly $4,000 a day, with a typical hospital stay costing more than $15,000 total. So let’s say you have a $6,500 deductible on your health insurance plan and are responsible for 30% coinsurance. This means you would owe a total of $8,200 out of pocket for a $15,000 hospital bill. And this doesn’t even account for lost time at work for you, or travel, food, and parking expenses for your family if they come to visit. And the reality is: Not many Americans can afford that expense. So hospital indemnity plans can go a long way toward protecting your finances. 6 tips to reduce costly hospital bills Although a hospital indemnity plan can help you cover many of the direct and indirect costs of a hospital stay, most people would still prefer to avoid needless charges. To help, here are some tips to reduce costly hospital bills. Watch for billing errors. Ask your provider for the medical billing codes of the procedures you receive so you can make a note of them. Then, request an itemized bill and compare the billing costs after you've been treated. You'll bill probably isn't correct if you see a procedure performed on Thursday, but you checked out on Wednesday. Don't be afraid to challenge any charge that might be an error. Request only in-network providers. Be sure to let hospital staff know that you only want in-network providers. Most will honor this, if they can. Some states even have laws requiring them to honor your request. Watch for unnecessary tests. Ask if each test is necessary and covered. If it’s not necessary, you can let the doctor know you don’t want the test. Your doctor may have a good reason for requesting the test, but it's up to you to make an informed choice. Shop around. Call hospitals in your area and ask for their rates if you have a planned procedure. Choose the right facility. Consider an urgent care or clinic before going to the hospital. If it's an emergency situation, your best bet is to always call 911. But if not, choosing the right facility might lower your out-of-pocket costs. Don’t stay any longer than necessary. Extending your hospital stay even one day longer can add hundreds or even thousands to your bill. While it's at the doctor's discretion, it's OK to ask if another night is needed. The bottom line is that billing mistakes happen: Don't be afraid to question charges on your hospital bill. Be sure to request an itemized billing statement so you can review all charges. And if you're calling the hospital or a customer service line, be sure to get reference numbers and names of the people you speak with. That way, the call can be tracked and the issue can be potentially corrected. More on hospital indemnity plans A good hospital indemnity plan can provide you with protection from the high - often hidden - costs of hospitalization. And there are many hospital indemnity plans on the market today, so knowing which is right for you can be difficult. Our licensed insurance agents are here to talk through your needs and help you find the best hospital indemnity plan to ensure you understand how each will work for you. Save time and money by finding and comparing hospital indemnity plans in your area. You can also click here to get more tips on how to reduce healthcare costs