Massive Rate Increases in Texas Health Insurance Looming

Just this week Sen. Rockefeller and Rep. Courtney (D-CT) are attempting to destroy any control Texans have on their Texas health insurance cost. Of course some folks may say we have already lost control of our health insurance in Texas cost and you know what, Peeler Insurance might just agree with you, but these two dingbats are going to destroy any cost containment features we presently enjoy.

Two bills introduced last week by these two liberal yahoos form the north east will eliminate insurance companies ability to do medical underwriting and mandate guaranteed issue on any and all health insurance policies. OK, sure, on the surface this sounds like a great idea. No more underwriting means come one come all. Never another rejection letter or exclusion for health conditions will make a few of my clients happy, heck, I have uninsurable health conditions, I should like this proposal. Do I? Absolutely not!

With the bills the liberal Obama clones are pushing I will never be forced to call a client and inform them of a denial, rate up or exclusion riders, that will be sweet, but something very important is missing from the equation. Selective enrolment. What is that you may ask. Well, its my word, I made it up. Basically it means that there are no requirements that all Texas residents are required to be covered. I feel that it will have only sick people applying for coverage.

Now here is how this will play out. Texas presently has more uninsured residents than any other state. We just have people in this state that just flat don’t want coverage. The southern mentality of some residents is that heck, I’m healthy, I don’t need health insurance in Texas. Guess what, those people are not going to get Texas health insurance with the adoption of this new law. The only Texans that will apply and purchase health insurance in Texas will be those with major health conditions like cancer, heart attacks and AIDS just to name a few. These people, who by the way have always had an option of purchasing Texas health insurance without pre existing condition limitations through  the Texas Health Risk Pool but didn’t do it because of cost, will flood the health insurance in Texas rolls and drive cost up faster than stock car at Texas Motor Speedway.

I predict that the first year all will be well, but come that second year all hell will break loose. Consumers that have been covered will now experience either one of two things, rate increases at a clip of 50% or policies being reintroduced with limited benefits, or both.

Now, how could this idea work? I just don’t know, but one way is to require all Americans to be covered. By increasing the number of Americans on the insurance rolls then the risk is spread out more evenly. I do have a better idea and I have spoke about it before. Leave the present system in place, don’t rock that apple cart. Focus your attention on the Texas Health Risk Pool. Make the risk pool a national pool. Now, premiums inside the risk pool will be higher than traditional insurance just because consumers with health conditions will posses those policies. One idea to offset the sure to be higher prices is to require a subsidy from each and every health insurance company based on the market share that you have. Example would be if Aetna controlled 7% of the health insurance market they would be required to pay 7% or any subsidy. Now, since Obama will most assuredly be throwing tax dollars at the perceived health insurance problem he can chunk some money to pay half of the subsidy.

OK, now what have you done with my proposal? I feel you have stabilized the problem. All Americans now have the right to be covered with health insurance. But here is a little secret. I bet the number of uninsured Texans doesn’t change much. Some Texans just will not purchase health insurance in Texas. Period. And keep in mind, we don’t like to be told we must do anything in this state. Right now health insurance in Texas has never had more competitive companies offering more than adequate benefits. This is the time to get your Texas health insurance quote and see what I mean.

Texas Health Insurers Ask, Where is your Certificate of Creditable Coverage

The magic letter arrives in the mail from your old Texas health insurance provider, you look at it, have no clue what is is and the next thing you do is fire it off in the trash… STOP! Go get that confusing little piece of paper, you need it more than your driver license. This letter is called a  certificate of creditable coverage, says so in big bold print at the top, so keep it close.

The big question asked by Texas health insurance consumers is why do I need this thing. Well, it’s simple. When you elect to go in a different direction with your Texas health insurance plan this letter acts as somewhat of a “get out of jail” card. A certificate of creditable coverage provides proof that you were covered for Texas health insurance and for how long and and will also provide evidence of how long you have been without coverage.

Now, why do I call this a “get out of jail” card? Well, most major medical Texas health inurance plans opperating in the individual arena honor this certificate when applying pre existing condition limitations. If you have been covered without a gap of 63 days between coverage then, unless the health condition is excluded by name, the condition will often times be covered from day one. Keep in mind though that Texas law does allow excluding a health condition by name so if your health condition is a costly condition you may find an exclusionary rider attached to the policy at time of approval.

Presently there are two Texas health insurance plans for individuals that do not apply exclusion riders, Aetna and Cigna, so with these two Texas health plans if accepted for coverage there are never exclusion riders. All that is needed is to provide your certificate of creditable coverage and the condition will be covered, provided of course the policy pays for  such treatment.

All that is need is to fax of mail the certificate to the Texas health insurance company upon receipt of this all important document from the old insurance company. After that, your set, that allergy claim or blood pressure treatment should be covered unless it was excluded.

Generally it takes a week or so to get your certificate of creditable coverage for your old Texas health insurance company, so be patient. Also of note, be smart, the most important thing is to be completely honest on the application by disclosing whatever health conditions you may have. Also, because so many of the Texas health insurance plans on the market allow exclusions by name is is critical to work with an experienced Texas health insurance  broker that knows the ins and outs of each company. If you have not lapsed coverage for a period greater than 63 days, be 100% truthfully on the application and deal with experienced Texas health insurance brokers, then your health condition could be covered from day one. So now that you are prepared with the facts it’s time to get you new Texas health insurance quote!

State of the Union..Naw, State of Texas Health Insurance

If President Obama can deliver his State of the Union… So can I. However, as a veteran Texas health insurance broker mine will be the State of Texas Health Insurance. And the state of our industry is “confusing”.

I will start out by saying there has never in my 16 plus years in the individual health insurance in Texas market been a time where there are more quality options and companies available to the Texas health insurance consumer. We have all the major health insurance companies slugging it out with each other. I cant think of but one or two of the national companies that have not entered Texas to take a stab at market share. Also, the benefit configurations these Texas health plans offer are again, better than I have seen in years. You want doctor co-pay plans, got ‘em, you want adequate preventive care, got them too. Looking for plans that cover lab and xray outpatient, those exist also. High deductible HSA qualified in your vocabulary, tons of those options sitting out there. So the state of Texas health insurance plans is super strong. Now is definitely the time to get your Texas health insurance quotes!

Now, lets discuss the state of underwriting. Well, sad to say that’s one of the areas of concern. Underwriting operates just like the credit market. Texas health insurance companies are reluctant to offer coverage if you are saddled with health conditions and if you consume several prescription medications. The way Texas health insurance companies are operating reminds me of the late 90’s. It seems to be getting harder and harder to squeeze Texans with health conditions through that underwriting needle. I do think it will loosen up once the economy straightens out, so look for relaxed underwriting toward the end of the first quarter of 2010. Healthy people still get issued with no problems and we are getting some health conditions approved , there are just more “hoops” Texans are being forced to jump through to accomplish approval of their health insurance in Texas policy.

Lastly, the state of premiums. Come on guys, stop raising prices. Texans can only endure so much and we are reaching the point of no return with some companies. I know the putrid stock market has blistered your bottom line, but you cant survive if there are no Texas health insurance clients on the books. Why not we instill a rate freeze for 12 months? Normal second quarter rate increase have been brutal. Several Texas health insurance companies raise rates for their yearly new business on the first day of the second quarter. Now, kudos to Cigna health insurance of Texas for having one of the lowest price plans on the market, in some cases Cigna is 20% cheaper than the other Texas health insurance companies. Also ataboy’s all around to Blue Cross and Blue Shield of Texas for having a very minor rate reduction on some age bands for second quarter of 2009, and only a 3 or 4% increase on existing business with some plans. So the state of pricing for Texas health insurance is ‘fluid”. Get your Texas health insurance quote to see if Blue Cross of Texas or Cigna is cheaper than your current plan, I bet is is.

Like I said before the State of Texas health insurance appears to be confusing however find a veteran broker located here in Texas and allow him to assist you in navigating the crazy state of Texas health insurance.

Drug Companies Choking the Life out of Texas Health Insurance

On a regular basis I get the same set of questions from Texas health insurance consumers. The question? Why does health insurance in Texas cost so much, and, why won’t the insurance company approve me for coverage. Oh, the questions I’m being asked may not be the exact ones I just mentioned but most times it’s some variation of those two. And my answer most times is the same. Runaway drug prescription cost and an industry that has Congress in their hip pocket.

Just last week I had a Texas health insurance client that was upset because she was denied coverage due to the health of her child. After doing some research I found the child was taking a drug called Abilify. According to her this drug was used to treat Attention Deficit Disorder. OK, that’s fine but the problem was the drug cost. Abilify cost somewhere around $450 a month.Yes, I said 450 bucks a month! Her entire family premium was about the same monthly as the drug cost so of course the Texas health insurance company said no thanks. Can you blame them? Even before the first claim was filed the Texas health insurance company was loosing money on this family. We need to keep in mind health insurance companies are in the business to turn a profit, so obviously they won’t take someone that is a loss from the beginning.

There are hundreds of stories like the one mentioned above I could discuss but the bottom line is this, Texas health insurance companies will not approve consumers with high drug expenses. Some insurance companies will offer exclusions for the health condition being treated but no matter what, if your drug cost get anywhere close to half the premium amount, forget it. You are not getting issued for that health condition.

So, whats the problem? My view is this problem lies squarely at the shoes of pharmaceutical companies and the U.S. Congress.

Have you ever noticed the amount of campaign contributions that drug companies make to elected public officials? If not you should take a peek at that little meal ticket. Kind of hard to regulate an industry that feeds your family. And please Congress, don’t give me the song and dance that you make unbiased decisions regardless of the contributions. I was involved in politics for years, I took campaign donations for my election, I know how the game is played so that unbiased speech won’t work with me. Also, ever noticed the influence the big huge pharmaceutical lobbyist have? The dollars spent wooing our congressional leader is stunning.

OK, the next thing to do to control this runaway drug policy will not make my fellow pro business republicans happy. Eliminate drug prescription advertisement. This policy would stop drug companies from wetting the appetite of the Texas health insurance consumer with the latest and greatest new expensive drug. Texans watch these advertisements on television and then march into their doctor and tell them they have the health condition they saw in the add and want that drug . Why not leave the medical advice to the doctors.

Any Texan that looks into the cost of drugs in other countries like Canada and Mexico will be shocked at the gouging the consumer of affordable health insurance in Texas receives. Why is it that my in-laws in Sweden can purchase drugs at such reduced rates?

All we seem to hear about now is health care reform, why not reform and regulate the way drug companies do business? Eliminate drug companies from applying high pressure tactics on our elected officials. I promise you that this will go a long way to improving Texas health insurance cost.

Keep in mind that there are still affordable health insurance options in Texas available for individuals and families but don’t bring a laundry list of drugs with you.