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your employees and instead can only insure yourself and or your family without insuring employees normal 70 minimum participation requirements are waived if you are a small business owner who is seeking to purchase small group health insurance and cannot afford to insure your employees or your employees simply do not want to participate in a group health insurance plan now is the time to learn more about relaxed underwriting period the cost for group health insurance is now commensurate with individual health insurance but the ppo network is much larger and far more inclusive than any of the narrow networks now available in the individual marketplace want to learn more click on contact at healthinsurancementors com 2 comments filed under uncategorized march 27 2019 3 38 am my testimony delivered at our state capitol today regarding short term health insurance plans my purpose here today is to ask for your help to protect an unrepresented minority specifically those who have been priced out of the aca marketplace and do not qualify for federal health insurance subsidies to lower their health insurance premiums according to cms centers for medicare medicaid services numbers released yesterday during last year s aca open enrollment period 360 168 individual applications were processed in illinois via our state federal partnership health insurance exchange 282 491 of those applications were eligible for a federal health insurance subsidy to help lower their premiums that means 77 677 applications did not receive financial assistance and were forced to pay the full price for health insurance in addition to those who applied via our exchange and were denied a federal subsidy there were an additional 127 459 applicants who applied off our exchange directly with insurance companies because they already knew they were not eligible for financial assistance that equates to 205 136 applicants who were forced to pay the full premium for individual health insurance a premium that has more than doubled since 2014 the most important aspect of the aca we can all agree on is that the law was intended to provide some form of health insurance coverage to everyone whether they could afford it or not that s why subsidies were written into the law unfortunately for the 205 000 consumers who do not qualify for federal health insurance subsidies in illinois that is no longer the case for them aca qualified coverage has become anything but affordable the full price for a family of four for the cheapest bronze ppo plan with blue cross blue shield of illinois with a 15 800 out of pocket expense in chicago is now 1 835 per month which equates to 22 000 annually this is why so many who do not qualify for health insurance subsidies have been priced out of the aca marketplace and are now seeking other options that are not safe now but can be made much safer by this legislative body those non safe products are known as non aca qualified short term policies they are not safe now because this legislative body restricted the amount of time one can own these policies from 12 months to 6 months of maximum policy ownership and i am asking you to restore the amount of time one can own a non aca qualified policy back to 12 months so that they are once again safe to purchase it s not that applicant s who don t qualify for federal health insurance subsidies don t want aca coverage they d be crazy not to want it it is the most comprehensive health insurance coverage ever sold in the united states and there is no underwriting everyone gets coverage regardless of preexisting conditions that is a very good thing however the recent actions taken by this legislative body are not only placing those priced out of the aca marketplace at great peril but you are threatening the structural integrity of our health insurance exchange and the aca overall it may sound strange that i m asking you to fortify non aca policies in order to protect the aca but there is sound reasoning and supporting data behind this request first and foremost is the fact that consumers who purchase short term policies in illinois are now placed at great risk if at the end of the 6 month policy period they are then laying in a hospital bed with a life threatening condition when their coverage ends even if that individual could qualify for another 6 month short term policy that life threatening condition would be considered preexisting which means it would not be covered under their next 6 month short term policy this would leave them uninsured entirely until the next annual aca open enrollment period begins again in november in which case their coverage cannot begin until the 1st of the following year this is why it is essential to have 12 month short term policies available in illinois so that consumers stay consistently insured between aca open enrollment periods this way when the short term policy ends at the end of 12 months it ends safely the following year during the aca open enrollment period if a family member develops a new medical condition they can obtain coverage for that new condition via the aca exchanges secondly let s identify the fiscal implications companies who provide health insurance both aca qualified and non aca qualified short term health insurance are required to contribute hundreds of billions of dollars in order to help stabilize the aca health insurance marketplace and ensure those who are eligible for subsidies continue to receive them section 1910 of the affordable care act outlines the health insurance tax which has resulted in 58 billion dollars being collected from health insurance companies since 2014 14 3 billion of that was collected last year alone that money is then used to stabilize the health insurance marketplace by ensuring that those who do qualify for federal health insurance subsidies continue to receive them the health insurance tax is an essential risk mitigation system build into the aca and without it premiums would be much higher and subsidies would be much smaller and available to fewer people the pertinent section of section 1910 of the aca was outlined in the final rules posted in the federal register on november 29 2013 in those final rules the following paragraph outlines which type of health insurers are subject to this tax and i quote section 9010 a imposes an annual fee beginning in 2014 on each covered entity engaged in the business of providing health insurance section 9010 c provides that a covered entity is any entity that provides health insurance for any united states health risk during each year the important point to note here is that the tax is levied only on health insurance plans by restricting short term policies to 6 months this legislative body has unknowingly left these consumers with no other option but to enroll in similarly low priced christian sharing plans which do not end abruptly but are also not insurance and as such are not required to contribute anything under the aforementioned health insurance tax by shifting those dollars that would normally be spent on short term health insurance to sharing plans which are not insurance you are undermining the structural integrity of the aca and so is every other state legislative body that has restricted this type of health insurance to 6 months or less as aca qualified policies continue to increase in price this trend is going to continue unless you take action to stop it lastly let me address the often repeated fallacy that short term health insurance policies are junk policies or that they are skinny plans whilst it is true that short term health insurance plans do not cover preexisting conditions those that are offered by companies like united healthcare do provide coverage for the vast majority of illnesses and injuries such as cancer stroke heart attack organ transplants mental nervous disorders newborn care diabetes autism durable medical equipment home health care inpatient and outpatient diagnostic testing as well as nuclear medicine mri and ct including a routine colonoscopy they also provide coverage for inpatient and outpatient surgery anesthesia as well as outpatient prescription drugs they even provide first dollar coverage with no deductible required for outpatient doctor visits urgent care visits and state mandated routine preventive care such as mammograms cancer screenings and contraceptives that does not sound like a junk plan to me neither does it sound like a skinny plan these policies also provide 2 000 000 in coverage annually for each insured member so no they do not provide all the protections that aca qualified policies do but they do provide very good coverage and for half the price this makes them very attractive to those who do not qualify for health insurance subsidies equally important to know is that both united healthcare and national general which are the two largest short term health insurance policy providers in illinois provide a national ppo network with their policies which includes in network access to northwestern memorial hospital university of chicago medical center rush university medical center and the lurie children s hospital none of those hospitals accept any individual aca qualified health insurance policy not even those offered by blue cross blue shield of illinois no matter how much you pay for an aca qualified individual policy in illinois you cannot take your sick child to the premier children s hospital in the midwest which is lurie children s hospital with non aca qualified short term policies you can walk right in the door at all four of those hospitals and hospitals around the nation in closing because so many are now abandoning the aca exchanges and can no longer safely purchase short term health insurance due to the aforementioned 6 month restriction and instead are now shifting those dollars to christian sharing plans which are not insurance and as such do not contribute anything under the aforementioned health insurance tax and because those who participate in christian sharing plans have no policy no contract and no regulatory recourse when sharing plans stop paying claims as they have done repeatedly i am asking for this regulatory body to restore non aca qualified short term health insurance plans to 12 months in order to ensure that those who have been priced out of the aca marketplace remain safely insured with actual health insurance without risk of running out of coverage in the middle of the year which can lead to disastrous consequences i thank you for your valuable time today i will take questions if time allows leave a comment filed under uncategorized november 6 2018 2 45 pm the truth about republicans and preexisting conditions contrary to popular belief both democrats and republicans have had a long history of ensuring that americans have access to coverage for preexisting conditions in fact a bipartisan piece of federal legislation requiring coverage for preexisting conditions existed long before the implementation of the aca affordable care act known colloquially as obamacare public law 104 191 also known as hipaa health insurance portability accountability act of 1996 outlined in sections 2741 2742 and 2744 the role that both health insurers and state regulators must play in ensuring coverage for those with preexisting conditions that law was supported by both democrats and republicans for more than a decade before obamacare not long after hipaa was signed into law states began developing one or more state run risk mitigation mechanisms to ensure that those in the individual health insurance marketplace were ensured access to coverage for preexisting conditions 35 states decided to develop high risk health insurance pools in illinois our high risk health insurance pool was called ichip illinois comprehensive health insurance plan the existence of ichip ensured that illinois residents who purchase their own individual health insurance were guaranteed coverage for preexisting conditions long before obamacare in order to qualify for ichip coverage one would have to have been denied coverage from a health insurer in the individual marketplace due to a preexisting condition or have exhausted cobra continuation coverage from a former employer if that individual applicant had kept consistent health insurance coverage without a lapse of more than 63 days they were guaranteed immediate coverage from blue cross blue shield of illinois via ichip if they had a lapse in coverage of more than 63 days they would have to wait up to 6 months before preexisting conditions would be covered these regulations provided a strong impetus for consumers to keep consistent health insurance coverage in place this prevented applicants from gaming the system by waiting until they were sick to purchase health insurance coverage 10 other states chose to implement an individual market guaranteed issue mandate under this state run risk mitigation system residents of those states were guaranteed coverage for preexisting conditions from a variety of health insurers operating in that state for example in the state of ohio there were multiple health insurance carriers that had to guarantee issue 4 of their block of business to people with preexisting conditions during an annual open enrollment period during this annual open enrollment period each health insurance carrier had to report to the ohio department of insurance as to whether or not they met their 4 guarantee issue quota once one health insurer met their 4 quota all future applicants with preexisting conditions were then referred to one of the other health insurers operating in ohio who had not met their 4 quota and those remaining applicants would then be guaranteed coverage from that carrier under this innovative and intelligent state run risk mitigation system all health insurers in the state shared the risk and everyone had access to coverage for preexisting conditions again long before obamacare see page 10 of the ohio guide to health insurance to learn more more about consumer protections under hipaa law download protecting your health insurance coverage from cms centers for medicare and medicaid services there is nothing new under the sun you probably noticed something familiar about how ohio s annual open enrollment period you should because that is how risk in the individual health insurance marketplace is managed today under the aca we now have a national aca open enrollment period which begins on november 1st and ends on december 15th of each calendar year during this 45 day window all americans can purchase individual health insurance regardless of their health history and preexisting conditions are not excluded from coverage why though is this annual open enrollment window only 45 days long why can t we just buy health insurance whenever we want why do we have to wait until november each year the reason you cannot do so is because if you were allowed to buy heal...
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