Thousands of consumers get insurance cancellation notices due to health law changes

Published: Wednesday, October 23, 2013 @ 8:05 AM
Updated: Wednesday, October 23, 2013 @ 8:05 AM

Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.

The main reason insurers offer is that the policies fall short of what the Affordable Care Act requires starting Jan. 1. Most are ending policies sold after the law passed in March 2010.  At least a few are cancelling plans sold to people with pre-existing medical conditions.

By all accounts, the new policies will offer consumers better coverage, in some cases, for comparable cost -- especially after the inclusion of federal subsidies for those who qualify. The law requires policies sold in the individual market to cover 10 “essential” benefits, such as prescription drugs, mental health treatment and maternity care. In addition, insurers cannot reject people with medical problems or charge them higher prices. The policies must also cap consumers’ annual expenses at levels lower than many plans sold before the new rules.

But the cancellation notices, which began arriving in August, have shocked many consumers in light of President Barack Obama’s promise that people could keep their plans if they liked them. 

“I don’t feel like I need to change, but I have to,” said Jeff Learned, a television editor in Los Angeles, who must find a new plan for his teenage daughter, who has a health condition that has required multiple surgeries.

An estimated 14 million people purchase their own coverage because they don’t get it through their jobs. Calls to insurers in several states showed that many have sent notices.

Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state. Kaiser Permanente in California has sent notices to 160,000 people – about half of its individual business in the state.  Insurer Highmark in Pittsburgh is dropping about 20 percent of its individual market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent.

Some Policies Targeted

Both Independence and Highmark are cancelling so-called “guaranteed issue” policies, which had been sold to customers who had pre-existing medical conditions when they signed up. Policyholders with regular policies because they did not have health problems will be given an option to extend their coverage through next year.

Consumer advocates say such cancellations raise concerns that companies may be targeting their most costly enrollees.

They may be “doing this as an opportunity to push their populations into the exchange and purge their systems” of policyholders they no longer want, said Jerry Flanagan, an attorney with the advocacy group Consumer Watchdog in California.

Insurers deny that, saying they are encouraging existing customers to re-enroll in their new plans.

“We continue to cover people with all types of health conditions,” said Highmark spokeswoman Kristin Ash.

She said some policyholders who may have faced limited coverage for their medical conditions will get new plans with “richer benefits” and the policies “in most cases, will be at a lower rate.”

Paula Sunshine, vice president of marketing with Independence, said the insurer hopes the cancelled policyholders will “choose Blue when they decide on a new plan.”

Higher Costs?

Some receiving cancellations say it looks like their costs will go up, despite studies projecting that about half of all enrollees will get income-based subsidies.

Kris Malean, 56, lives outside Seattle, and has a health policy that costs $390 a month with a $2,500 deductible and a $10,000 in potential out-of-pocket costs for such things as doctor visits, drug costs or hospital care.

As a replacement, Regence BlueShield is offering her a plan for $79 more a month with a deductible twice as large as what she pays now, but which limits her potential out-of-pocket costs to $6,250 a year, including the deductible.

“My impression was …there would be a lot more choice, driving some of the rates down,” said Malean, who does not believe she is eligible for a subsidy.

Regence spokeswoman Rachelle Cunningham said the new plans offer consumers broader benefits, which “in many cases translate into higher costs.”

“The arithmetic is inescapable,” said Patrick Johnston, chief executive officer of the California Association of Health Plans. Costs must be spread, so while some consumers will see their premiums drop, others will pay more -- “no matter what people in Washington say.”

Health insurance experts say new prices will vary and much depends on where a person lives, their age and the type of policy they decide to buy.  Some, including young people and those with skimpy or high-deductible plans, may see an increase. Others, including those with health problems or who buy coverage with higher deductibles than they have now, may see lower premiums.

Blue Shield of California sent roughly 119,000 cancellation notices out in mid-September, about 60 percent of its individual business.  About two-thirds of those policyholders will see rate increases in their new policies, said spokesman Steve Shivinsky.

Like other insurers, the Blue Shield letters let customers know they have to make a decision by Dec. 31 or they will automatically be enrolled in a recommended plan.

“There is going to be a certain amount of churn in the marketplace as people have to make their decisions,” Shivinsky said.

Jay Hancock contributed.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.

Video shows couple driving on interstate with passed out man on trunk

Published: Wednesday, May 24, 2017 @ 8:42 PM
Updated: Wednesday, May 24, 2017 @ 8:43 PM

It's a story almost too strange to be true.

A drunk man passes out and goes for a ride on the trunk of a stranger's car down a busy Memphis interstate, and neither the drunk man nor the driver knew it.

>> Read more trending news 

It's amazing this man didn't fall off the car and get run over.

He is lucky, to say the least. The man crawled up on the back of the car with a trunk that's only about 14 inches wide.

He was apparntly curled up and passed out. Thankfully, an Memphis Police Department officer spotted him, but not before he went on a ride that he doesn't remember. On the other hand, it’s a trip the driver will never forget.

"There's no way to describe it. It's unbelievable," said Carl Webb.

Webb and his wife were leaving Barbecue Fest on Thursday night in downtown Memphis.

They had backed their car into a parking space at Carolina and Riverside.

"We came down the aisle, walked right to the car, opened it up on both sides then we got in the car."

It was dark out and Webb’s sunshade was stuck up, so he couldn't see what was on his trunk.

“The officer came up and he said, ‘Mister, are you aware there's a body on your trunk?, and that did not register. He goes, ‘Mister, I'm not messing with you. There's a body on your trunk.’ So I got out. We walked around and sure enough, there he was, still hanging on, still unconscious, just lying there.”

Webb had driven 14 miles with the uninvited and unaware passenger sleeping on his 14-inch-wide trunk.

"I have no explanation other than that little lip right there saved his life."

The officer had to wake the man up. Webb said the man was so drunk, he started to stumble into traffic and the officer grabbed him.

Webb said he's just thankful for the officer's good police work.

“Good job man, good job. It was just outstanding,” Webb said.

Webb also has a message for the man who ended up on his trunk.

"I hope he takes a good look at where he put himself and the hazard that he had open up to himself. It would've been death."

The man was put in the cruiser, but there's no word on his identity or if he was charged with anything.

Thousands of dollars raised for heroic homeless men rushed to aid children during Manchester bombing

Published: Wednesday, May 24, 2017 @ 8:05 PM

Armed police officers patrol a police cordon near the Manchester Arena in Manchester, Wednesday, May 24, 2017. Britons will find armed troops at vital locations Wednesday after the official threat level was raised to its highest point following a suicide bombing that killed 22, as new details emerged about the bomber. (AP Photo/Kirsty Wigglesworth)
Kirsty Wigglesworth/AP

Two homeless men are being called a heroes after running to help victims when a bomb went off at the Manchester Arena in England as concert goers left an Ariana Grande concert.

According the Press Association, Chris Parker, 33, regularly begs for money in the area as concert goers leave the venue. The New York Times reported that Stephen Jones, 35, was in the area since he found a space to sleep. 

>> Read more trending news

Parker said he was pushed off his feet when the bomb went off, but got up and ran to victims to help them.

"My gut instinct was to run back and try and help,” Parker said, according to the Press Association.

Parker recalled tending to a young girl who lost her legs, as well as a 60-year-old woman who was badly burned and had serious head and leg injuries.

“She passed away in my arms. She was in her 60s and said she had been with her family,” Parker said. “I haven’t stopped crying. The most shocking part of it is that it was a kids’ concert.”

RELATED: Ariana Grande’s mom rushed to help fans after deadly explosion at concert 

In an interview with ITV, Jones said he did what anyone else would have done.

“Just because I’m homeless doesn’t mean I haven’t got a heart and am human still,” Jones said. “They needed the help. I’d like to think someone would come and help me if I needed the help. It’s just instinct to go and help.”

“If I didn’t help, I wouldn’t be able to live with myself for walking away and leaving kids like that. ”

GoFundMe page was set up for Parker to raise money for him. Since it was posted one day ago, the page has raised more than £40,000, which is more than $50,000.

CBS News reported that West Ham United Football Club co-chairman David Sullivan has offered to pay for six months of housing for Jones, plus pay for food and new clothes. Another person offered to get him a job with his company.

One man, Graeme Seddon, created a JustGiving fundraising page for Jones and has raised more than  £40,000, after setting a £300 goal.

Kelcie Willis with the Cox Media Group National Content Desk contributed to this story.

Police dog wins legal battle after burglary suspect sues over bite

Published: Wednesday, May 24, 2017 @ 7:03 PM

Draco, a now retired member of the Gwinnett County Police Department in Gwinnett County, Georgia has won a legal battle after a judge ruled against a burglary suspect, who was suing the K-9 officer after  the suspect was bitten. 
Gwinnett County Police Department

Dog bites man. Man sues dog. Dog wins.

The dog was Draco, a prized member of the Gwinnett County Police Department’s K-9 unit. But on July 6, 2013, Draco bit the arm of burglary suspect Randall Kevin Jones, who later claimed the dog clamped down for what “seemed like a lifetime.”

>> Read more trending news

Jones was taken to Gwinnett Medical Center and given stitches for the dog bite before being jailed and charged with burglary and obstruction. Two years later, he filed a highly unusual lawsuit, in that he not only sued the officers involved but also “Officer K-9 Draco of the Gwinnett County Police Department in his individual capacity.”

The lawsuit, alleging excessive use of force, said Draco “viciously mauled” Jones, “tearing his flesh and permanently injuring and disfiguring him, while … officers stood by and failed to intervene.”

When a federal judge rejected Gwinnett’s initial attempt to dismiss the lawsuit, the county appealed. On Friday, the 11th U.S. Circuit Court of Appeals in Atlanta threw out the case against Draco.

>> Related: Dog saves family with 9 children from house fire

“We hold that a dog may not be sued individually for negligence since a dog is not a ‘person,’” Judge Robin Rosenbaum wrote for a unanimous three-judge panel. Georgia law, she noted, does not allow such claims to be litigated against dogs.

The mere notion of allowing a lawsuit against a dog raises abundant practical issues, Rosenbaum added. How would you formally serve the lawsuit on a dog? What about the dog’s retention of legal representation? How can a dog be expected to pay damages?

>> Related: Why is there a dog on the roof in a Texas neighborhood?

Draco, a Belgian Malinois, retired from the K-9 unit in mid-2014 after seven years on the force, helping officers track down suspects and find stashes of illegal drugs.

Read more here.

23 million would lose insurance under new health care bill, CBO says

Published: Wednesday, May 24, 2017 @ 5:29 PM

23 million would lose insurance under new health care bill, CBO says

The House Republican plan to replace Obamacare would reduce deficits by $119 billion over the next decade, but increase the number of Americans without health insurance by 23 million over the same period, according to a report released Wednesday by the nonpartisan Congressional Budget Office.

The report, done with the Joint Committee on Taxation, also found that in states that receive a waiver from market regulations, the price for those who become ill or who have preexisting conditions could skyrocket to the point that they would ultimately be priced out of the market.

RELATED: Democrats reach out to GOP senators to come up with deal

In short: Those that are healthy will still be able to buy health insurance with lower premiums, but those that are not will not. The report also found that while premiums would be about the same or lower for young people with lower income, premiums for older people with lower income would be “much larger than under current law” on average.

And the report cautioned that the narrower scope of benefits covered in many plans might cause “substantial” increases in out-of-pocket health care costs for everything from mental health care to maternity leave care to pediatric dental care.

The score was released 20 days after the House narrowly passed a bill that aimed to make sweeping changes to the 2010 health care law known as Obamacare. Since then, the Trump Administration has moved forward on a budget proposal that assumed the passage of the House bill.

Rep. Pat Tiberi, R-Genoa Township, said the bill was “just the start,” and is needed to help stop skyrocketing costs caused by Obamacare.

“House Republicans and the Administration will continue to focus on additional steps we can take to restore the free market, increase choices and lower costs so that Americans can afford the plans they want and need,” he said.

By contrast, Rep. Tim Ryan, D-Niles, said the GOP bill “takes away health care from 23 million Americans, reduces the deficit even less than the first version and gets there by throwing people with pre-existing conditions under the bus.

“This legislation is offensively bad, and will destroy the health care system Americans have come to rely on,” he said.

The House bill faces an uncertain future in the Senate. Senate Majority Leader Mitch McConnell told Reuters Wednesday that he does not yet now how the Senate gets to 50 votes on the bill.

Sen. Rob Portman, R-Ohio, earlier this month indicated that he doesn’t support the House bill as it stands “because I continue to have concerns that this bill does not do enough to protect Ohio’s Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse.” Emily Benavides, a Portman spokeswoman, said Portman had not shifted on that position since then. "We will review the new analysis as we work on a different approach here in the Senate," she said.

RELATED: Dayton congressman among those who voted no on health care bill

Sen. Sherrod Brown, D-Ohio, called the House GOP bill “a bad deal.”

“The House bill will drive up costs, kick Ohioans off their insurance, and leave folks who have asthma or cancer unable to even purchase a plan,” he said. “Instead of moving forward with this bill, we need to work together to reduce costs and improve care for those we serve.”

Failing to repeal and replace Obamacare would be a political embarrassment for Republicans who made that promise a centerpiece of last year’s campaign. An earlier attempt to pass a bill to repeal and replace the 2010 law officially known as the Affordable Care Act failed to muster enough votes, and House leadership chose to pull the bill rather than see it fail on the floor.

The bill passed in May came after an earlier effort failed to muster the votes for passage. That GOP plan would’ve boosted the number of uninsured to 24 million by 2026 but would have cut the deficit by $150 billion, according to a CBO report on that plan.

The report released Wednesday found “average premiums for insurance purchased individually — that is, non-group insurance — would be lower, in part because the insurance, on average, would pay for a smaller proportion of health care costs. In addition … some people would use the tax credits authorized by the act to purchase policies that would not cover major medical risks and that are not counted as insurance in this cost estimate.”

The largest savings resulted from cutbacks in Medicaid.

The 2010 Affordable Care Act — also known as Obamacare — extended health-care coverage by offering middle-class people federally subsidized insurance policies in the individual market, and by expanding eligibility for low-income people to be covered by Medicaid, a joint federal and state program which provides health care for the poor.

The nonpartisan Congressional Budget Office is tasked with determining the impact of bills. The current head of the office was selected by Republican lawmakers.