Our Healthcare Is Frightening

A free public service for a better community

Oct 31, 2023

Happy Halloween, Advocates

I would like to encourage you to send comments and suggestions. If there is a special topic you’d like to see please let me know. Please use the comment button below. It is now.

National News Identifies Insurance Delay Scams for Profits

Here is an NBC story on how private insurers deny claims to make more money. Something we have been harping about for a year. I’m glad to see others discuss it widely. Enjoy. Thanks to everyone who sent me the link this morning.

Reproductive Rights News - Kansas

A Kansas judge on Monday put a new state law on medication abortions on hold and blocked older restrictions that for years have spelled out what providers must tell patients and forced patients to wait 24 hours to end their pregnancies.

The ruling was another big victory for abortion rights advocates in Kansas, where a statewide vote in August 2022 decisively confirmed protections for abortion access under the state constitution. District Judge K. Christopher Jayaram’s order suspends some restrictions that have been in effect for years. The waiting period had been in place since 1997. The judge’s orders will remain in effect through the trial, expected in June of 2024. The suit was brought by abortion providers. The full AP report is here.

Action

Let’s remind our representatives in Washington that women are treated as 2nd class citizens by almost half the country and they need to fix that by passing the Women’s Health Protection Act to restore the right to an abortion nationwide. You can cal/email your Congressperson and Senators and remind them. Their contact info is in the Resources section below.

Or you can use RESISTBOT to send this email to them. Just text SIGN PYIIVR to 50409 on your cell phone.

“I am your constituent and I want you to know that it is very important for me that you cosponsor and actively support the Women’s Health Protection Act that will restore the right to an abortion nationwide. Almost half the country treats women as 2nd class citizens. Are you ok with that? I promise you, I will remember your stand on this issue.”

Pharmacists Fed Up

Pharmacists protesting deteriorating working conditions inside the nation’s largest retail chains launched their third and largest walkout of the season on Monday with a three-day movement they've dubbed "Pharmageddon." Organizers estimated the effort has drawn as many as 4,500 pharmacists and pharmacy technicians from multiple chains, including CVS, Rite Aid and Walgreens. It also drew support from the American Pharmacists Association, the industry’s largest professional organization, which said in a statement it stands with every participant of the movement. (Link to USA Today Report)

It Costs How Much?

What a doctor visit or medical procedure costs varies dramatically by county in the US. Medicare set rates administratively, but when private insurance is involved they usually negotiate rates with providers or provider networks. Those negotiated rates are what we are discussing.

A recent report in the Journal of the American Medical Association using Humana data found generally higher rates for office visits and medical procedures in the Upper Midwest and Southeast, and the lowest costs in the Central U.S. and Florida.

More than half the US population gets health insurance from private insurance plans and such variations can have an effect on premium costs as well.

The researchers looked at Humana's negotiated rates for seven procedures, including colonoscopies, patient office visits and high-severity emergency department visits, as of October 2022.

The rate Humana paid providers for office visits ranged from $69 to $114 across the country, according to the study. Higher-priced counties often bordered lower-priced ones, the researchers found.

Overall, the prices commercial health insurers pay to hospitals and physicians have been rising quickly, according to a non partisan Congressional Budget Office report last year. This underlying cost growth has inflated consumers' health insurance costs.

Here is a graphic of the Humana Data so you can see how costs are in your neighborhood.

Affordable Care Act - Start Shopping

November 1st is the beginning of enrollment for those who purchase health insurance on their own via the Affordable Care marketplace. Last year about 16.3 million did so. Millions who were dis-enrolled from Medicaid, so-called unwinding when the COVID-19 pandemic was declared over, will also be shopping for plans.

Networks will be changing so it is a good idea to log in early to find plans that cover your providers with the coverage you’ll need. Consumers this year will be asked to certify that they voluntarily agreed to brokers’ assistance and that their income and other information provided by brokers is accurate. Another good reason not to leave this to the last minute.

Prices are also changing. While some premiums may decline, most experts anticipate 2% - 10% increases in premiums. Experts say that’s a good reason to start early. Here is the federal site, healthcare.gov, for the 32 states that use it. Or use this link for the 18 states and the District of Columbia that use their own.

Changing insurers might mean a lower premium. Online calculators, including one at healthcare.gov, can provide subsidy estimates.

In addition to the premium subsidies, most ACA enrollees qualify for reduced deductibles, copayments, and other types of cost sharing if their income is no more than 2.5 times the federal poverty level, or about $75,000 for a family of four or $36,450 for a single-person household.

Cost-sharing reductions are available only in silver-level (mid range) plans and are more generous for those on the lower end of the income scale. New this year: To help more people qualify, the federal marketplace will automatically switch eligible people to a silver plan for next year if they are currently enrolled in a bronze (low level) plan, as long as the enrollee has not made an adjustment in coverage themselves. Also new is that you can stay on your parent’s plan for the whole year that you turn 26 instead of only until your 26th birthday.

The entire report published by NPR is here. Of course, if we had Universal Healthcare we wouldn’t have to do any of this. I’m just saying.

RESOURCES

Healthcare Advocacy (Us)

Website

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Find My Elected Officials

Contact the White House https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

By phone: (202) 224-3121
By email: democracy.io

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Organizations to Contact

National Nurses United Medicare4All

Physicians for a National Health Program

One Payer States

Healthcare Now

Reproductive Health

NARAL - Pro Choice America

Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion

Planned Parenthood

Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.

United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.

Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.