A report from Consumer Watchdog Campaign showed that healthcare premiums are increasing for more than 300,000 California residents.

The rise took place on March 1, and will affect those under Blue Shield healthcare plans, according to the report. The company's increasing rates have prompted many consumers to sign a petition to prevent any healthcare provider from making a rate hike without first justifying the increase.

"This initiative gives voters the chance to rein in health insurance prices, and Blue Shield just gave 320,000 policyholders a reason to sign the ballot petition," said Carmen Balber, campaign manager for the non-profit Consumer Watchdog Campaign.

There are 35 states in the U.S. where this type of justification is law, the report added. However, California's regulators are unable to take these measures.

Consumers who are experiencing insurance rate hikes may want to look elsewhere for their healthcare plan. There are many affordable health insurance rates available online, and comparing health insurance quotes may help a person find what they want for a good price.

A recent report from the Bankers Life and Casualty Company's Center for a Secure Retirement showed that more than 55 percent of average income Baby Boomers do not know about how Medicare works.

The report, "Retirement Healthcare for Middle-Income Americans," showed that 13 percent of this group felt that Medicare was free, which is incorrect. More than 70 percent noted that they didn't know that Medicare requires a monthly premium, as well as deductibles and co-pays. Also, close to two-thirds of those polled didn't understand how they would benefit from their Medicare plan when visiting the doctor or staying in a hospital.

"Minimize financial surprises by understanding your retiree health insurance benefits well in advance," said Chris Campbell, vice president of strategic marketing and business development for Bankers Life and Casualty Company. "Estimate what your financial responsibility is under Medicare, including premiums, co-pays, deductibles and uncovered expenses, in particular, long-term care."

Those who don't think Medicare is for them may want to look at other health insurance options. Comparing affordable health insurance rates may help make finding the right plan easier.

The Safety Net Hospital Alliance of Florida warned consumers that legislation in the Senate and House of Representatives could hurt the state's chances of taking care of ill children.

There are 14 hospitals in the Sunshine state specifically used for children, but Medicaid cuts could hurt these venues from helping many of the state's youth, according to the report.

Approximately two-thirds of children in Florida are covered by Medicare, and more than 60 percent hospital days are provided by these children's hospitals in the state. The Senate would cut nearly two-thirds of funding, while the House's proposal would cut 56 percent of funding.

"We are deeply concerned that Senate and House leaders may mistakenly believe children's hospital programs are not harmed by proposed Medicaid cuts, when in fact pediatric programs at children's hospitals across the state are facing devastating cuts," said Lindy Kennedy, a senior vice president at the Safety Net Hospital Alliance of Florida.

Consumers who want to make sure their family is covered may want to compare health insurance quotes, as there are many affordable health insurance rates available.

The American College of Emergency Physicians noted that thousands of residents of Washington state could be denied emergency room care due to their Medicaid plans.

The report examined Oregon patients who, if they were living in Washington, would be locked out from receiving such care. In addition, nearly $100 million in Medicaid funds are used in Washington - less than 2 percent of which is used for emergency-related healthcare.

The information also suggests that 35 percent of cases have nothing to do with emergencies, which is far off from the national average of just under 10 percent.

"The Washington State Medicaid plan is flawed because it assumes that physicians know the final diagnosis when a patient walks in the door," said Dr. Robert Lowe, professor in the department of medical informatics and clinical epidemiology at Oregon Health and Science University. "But many patients come in with minor symptoms that turn out to be serious medical conditions."

Consumers who are on a publicly-funded health insurance plan, but not happy with it, may want to consider using a private option. There are many options available that are affordable, and comparing affordable health insurance rates may help a person find what they need.

Today, HHS released a new “guidance bulletin” stating what they intend to propose in upcoming regulations defining how actuarial value will be determined. I’ve copied the relevant section (from page 9) on HSAs below. The AV bulletin can also be found here: AV bulletin

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Treatment of Health Savings Accounts and Health Reimbursement Arrangements in Calculating Actuarial Value

Section 1302(d)(2)(B) of the Affordable Care Act directs the Secretary to issue regulations under which employer contributions to a health savings account (within the meaning of section 223 of the Internal Revenue Code of 1986) may be taken into account in determining the level of coverage for a plan of the employer. Calculation of the AV of high-deductible health plans (HDHP) linked to a health savings account (HSA) or a health plan linked to a health reimbursement arrangement (HRA) poses a special challenge. Simply calculating the AV of the HDHP based on the insurance product could understate the value of coverage and some HDHPs could fall below the level of a bronze plan based on the HDHP alone. Yet accounting for the total coverage provided by the combination of the HDHP and the full value of the HSA or HRA could overstate the AV because, empirically, only a portion of these accounts are used toward health in a given year. The AV calculation should, therefore, reflect an appropriate adjustment to these contributions. We intend to propose that for purposes of calculating the AV of an employer health benefit plan, the annual employer contribution to the employee’s HSA associated with a qualifying HDHP and the amount made available for the first time in a given year under a HRA that is linked to an employer health benefit plan shall be considered part of the benefit design of the health plan. In calculating the AV of the combined HDHP and HSA or combined employer health benefit plan and HRA, the calculation would assume that the employer contribution to the HSA or HRA is used by the employee to pay for cost-sharing. Accordingly, these amounts would be credited to the numerator of the AV calculation. This means that the AV calculator would include any current year HSA contributions and amounts first made available under an HRA as an input into the calculator that can be used to determine the AV of an employer health benefit plan. For example, if a HDHP with a $3,000 deductible has an AV of 55 percent and the employer provides an HSA contribution of $1,000, that contribution would be applied towards the numerator of the AV calculation. However, because generally only a portion of an HSA is used in a year for health services, HSA contributions would be adjusted so that the employer receives the same credit for HSA contributions in the numerator of the AV calculation as it would receive for the same amount of first-dollar insurance coverage. The same rule would apply for amounts first made available under an HRA. In the individual market, we intend to propose that HSA contributions paid directly by the individual would not count towards AV.
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As I read this, it is not yet possible to tell whether employee contributions made via payroll deduction (which are treated as “employer contributions” for tax purposes) would be treated as “employer contributions” for purposes of calculating AV. HHS clearly states in the last sentence that they do not intend to include individual HSA contributions in the AV of HDHPs purchased in the individual market. They are currently silent on whether an insurance carrier could build HSA contributions into their premiums (and the AV of the HDHP) and “pass them along” to the HSA account, as the federal government does for federal employees.

CMS says it welcomes public input on this bulletin. Comments on AV should be sent to ActuarialValue@cms.hhs.gov and cost-sharing reductions to CostSharingReductions@cms.hhs.gov .

I urge all of you to read this section carefully and submit comments/questions to HHS. What is interesting is that that are willing to consider including some HSA contributions in the numerator of the Actuarial Value, but not include these same contributions in the numerator of the medical loss ratio.

Roy Ramthun, "Mr. HSA"
HSA Consulting Services, LLC