The Best Damn Health Insurance Blog. Ever.

Sean Sheffer Generic Drugs Reduce Health Insurance Costs for Families


In a study conducted by the RAND Corporation, the financial burden and impact of prescription drug costs on families have decreased thanks to the boom of the generic drug market.

The study highlights how the number of Americans who live a family that spent at least 10 percent of its income out-of-pocket on prescription drugs decreased from 2003 to 2008.

The Breakdown

The study looked at people who were under the age of 65, uninsured Americans and people with public or private health insurance. They separated families who spent more then 10 percent of their income for prescription drugs out-of-pocket ...

Sean Sheffer Final Regulations Released for Consumer Health Insurance Summaries


One of the initiatives of the federal health reform law was to implement new requirements for summaries of health insurance plans. This would enable consumers to make more informed coverage choices and have more clarity into the many health plans available to them.

"For too many Americans today, choosing a health plan means reading through a human resources book usually the size of a small phone book, and important information about eligibility and benefits is often buried in the fine print," said Marilyn Tavenner, the acting head of the Centers for Medicare and Medicaid Services, the agency within the Department ...

Sean Sheffer The End of Health Insurance Companies


Former Advisers to the Obama Administration Predict: “The End of Health Insurance Companies”

It’s hard to imagine a world without health insurance, but that’s just what Ezekiel Emanuel and Jeffrey Liebman – former advisers to the Obama administration – have predicted in their most recent issue of The New York Times.

It’s a bold claim, “By 2020, the American health insurance industry will be extinct,” but Liebman and Emanuel have reason. They breakdown their reasoning as follows:

Current health insurance providers don’t act like insurance providers

Insurance companies are supposed to be the body that assumes most of ...

Sean Sheffer What are the "Essential Benefits" New Health Plans Must Include?


One of the many changes that the Affordable Care Act brings is determining a group of “essential benefits” that health insurance plans must provide. The Act requires that the Secretary of Labor conduct a survey of employer-sponsored coverage to determine benefits that should be covered by employers.

In a report from the Secretary of Labor to the Department of Health and Human Services, here are the twelve essential benefits and their respective descriptions:

  • Emergency Room Visits - This benefit includes visits to a hospital emergency facility or emergency room due to accidental injury or a sudden and serious medical condition.  Emergency ...

Sean Sheffer What is the Effect of the Mandatory Essential Benefits on Premiums?


The Department of Health and Human Services released a report on what the essential benefits health plans must include by 2014. A summary of the report can be read here.

To summarize the effects that this mandatory package will have on your premiums, consider this quote:

“HHS cannot both make the plans extremely generous, and also make them affordable so that they cover millions more Americans. Those goals contradict one another.”

- Jonathan Gruber, an MIT economist who helped design health care reform in Massachusetts, and a strong supporter of the original Obama bill.

Shawn Tully, editor at large with Fortune ...

Sean Sheffer Are You Aware of the Premium Tax in the Affordable Care Act?


There are many factors that attribute to rising healthcare costs, but you’ve probably never heard of this one.

 As reported by America’s Health Insurance Plans, the Affordable Care Act imposes a new sales tax on health insurance. Beginning 2014, the tax will start at $8 billion and rise to $14.3 billion in 2018. It is calculated that by 2019, the tax will impose $73 billion on individual, small businesses and seniors in the form of a sales tax on health insurance. After 2018, the new tax will increase annually based on premium growth.

How does this premium ...

Sean Sheffer Video: Designing a Health Insurance Exchange


In this video, we explore the importance and significance of health insurance exchanges.

See a great video describing the role of Health Insurance Exchanges here.

Here is the description:

“Milliman consultants and industry experts discuss the benefits and challenges of state healthcare exchanges, the dynamic between public and private plans, the importance of tailoring health exchanges to the needs of individual states, and how Milliman’s expertise can help states design a health exchange suitable for their healthcare market. Milliman consultants and industry experts discuss the importance of tailoring health exchanges to the needs of individual states.”

The video gives ...

Sean Sheffer How Will Healthcare Reform Influence Medical Costs this Year?


There are factors that will both inflate medical cost, and factors to decrease medical costs, and so in the mix, how will Healthcare reform affect the medical costs of this year?

According to data from the PwC Health Research Institute here’s a brief message to sum it up: “Health reform [is] expected to have minimal impact on medical cost trend[s] in 2012.”

Why is that? Well most of the major provisions under the Patient Protection and Affordable Care Act are in 2014. To name a few: the expansion of Medicaid, health insurance exchanges, health insurance subsidies for small ...

Sean Sheffer Health Insurance Providers Market Share Graph


Ever wonder how much market share your healthcare provider actually has in your state?

Check out this great InfoGraphic that represents the market shares of various healthcare providers in each state.

Here’s the description of the graphic:

“Opponents of the public option claim that by being forced to compete against the government, health care companies will be at an unfair advantage. But right now, health care companies hardly have to compete at all. In most states, one health care provider controls the vast share of the market, which allows them to raise premiums far faster than the wages of ...

Sean Sheffer Medical Breakthroughs that Will Help You Save on Healthcare Costs


A lot is expected to take this year in the healthcare industry to improve patient outcomes and health. Improvements in technology and legislative policies will give you better access to healthcare and have better outcomes.

According to an article by Healthline, here are highlights from the breakthroughs that you can expect this year that will save you on your health care costs.

Improved Diabetes Treatment

With the epidemic of Obesity across the nation Diabetes has dramatically increased. Many Americans suffer from this disease, in which the body cannot store sugar in the form of fat because the cells have become ...