Archive for November, 2011

Healthcare Confidence, Behavior & Reform

Friday, November 11th, 2011

 

 

It has been more than a year – 18 months and 11 days to be exact – since the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA) of 2010 were passed. And still, after all this time, recent surveys show Americans are not extremely well versed on the new laws nor satisfied with current healthcare issues. It seems nothing has changed.

 

Amendments to the Acts and future application deadlines can all be attributed to the lack of knowledge regarding health care reform. Moreover, there are numerous concerns which polls are now returning regard confidence, behaviors and reform in the eyes of the American public.

 

Confidence

 

The Employee Benefit Research Institute (EBRI) has been conducting annual health confidence surveys (HCS) on healthcare since 1998. Highlights of this year’s survey provide:

 

1)     Dissatisfaction with the American health care system remains widespread. 56% of respondents rated the system as poor or fair. The percentage of Americans which rated the system as poor, doubled between1998 and 2004.

 

2)     60% of Americans are very satisfied with their own current health insurance coverage; 29% are somewhat satisfied.

 

3)     57% are very confident that their employment-based health coverage will continue to be offered by their or their spouse’s, employer or union. Confidence in this belief was 68% in 2000.

 

4)     Just 18% of people are extremely satisfied with the cost of their health insurance.

 

5)     Only 12% are extremely confident they are able to afford health care without financial hardship.

 

 

Behaviors

 

What human behaviors are impacting healthcare? Last September, the Thomas Reuters-NPR Health Poll released their query of 3,000 Americans on the subject of human behavior and healthcare.

 

Smoking was, of course, the top named impacting behavior, however, by less than a 1% difference, obesity was ranked second. Stress, by less than a 4% difference, was rated third. Taking the fourth and fifth top cited answers were alcohol use at 11.2% and workplace safety at 7.5%.

 

On the subject of cost, 84.8% of those polled believe that people who exercise, eat healthy and don’t smoke should receive a discount on their health insurance premiums. 30% say overweight people should have to pay more for health insurance. 11.3% went as far to say it is acceptable to deny employment based upon obesity.

 

Reform

 

The EBRI survey reports that confidence regarding today’s health care system has neither fallen nor increased as a result of the passage of health reform.

 

62% of Americans are also not familiar with a “key aspect of the law”. The unfamiliarity refers to legislation requiring that each state must set up a health care “exchange” by 2014, where health benefits can be shopped at competitive rates. This mandate is part of the Act’s objective to broaden health insurance coverage. The proposed goal is purposed to create an alternative coverage solution for the remaining minority of the American population without employment-based benefits.

 

Changes to the Act since its March 2010 inception have altered the original passage, which further complicates American awareness. As of today, it is unknown whether any of the current court challenges filed by States, business and other parties regarding the constitutionality of certain mandates within the law will further modify how health care reform unfolds.

 

The EBRI survey also found that health care is not the issue that the majority of Americans consider to be most pressing in America today:

 

32% of those polled say the economy is the most critical issue at hand.

 

14% say the federal budget deficit is.

 

14% cite unemployment as most important.

 

12% believe healthcare is.

 

11% think education is top priority.

 

Thanks for reading,

Kurt Rusch  CLU, ChFC

 

 

 

New Medicaid Laws May Impact Families

Tuesday, November 1st, 2011

 

We just received confirmation from our Elder Care Attorney that the Illinois Medicaid Laws will change January 1, 2012.  Current and future planning needs are now at crucial issue.

 

Why should you care?

 

The current state laws are much more favorable to applicants and their families; the new laws will make it more difficult to receive Medicaid benefits.

 

This is extremely important news for all senior parents and adult children – those with current need and those who have yet to reach that advent.

 

Legislated changes such as these can severely impact assumed expectations. Assisted and higher level care can drain an average middle income estate very quickly; for those without long term care coverage, pre-planning for Medicaid in the event it may be needed should be of paramount consideration.

 

There are many changes to the Medicaid system which will take place in the coming year. These highlights examine the issues of timely application (all assets do not have to be spent down prior to filing a Medicaid application) and asset protection.

 

Applications Filed Prior to January 1, 2012 Will Fall Under Current Medicaid Laws

 

Under the current laws if a nursing home or supportive living resident applies for Medicaid benefits the applicant is required to provide three years for all financial records to verify their assets. This includes all bank, investment, pension and retirement account statements, life insurance policies, and tax returns.

 

Medicaid is particularly concerned with whether the applicant has given anything away during the three year “look back” period, such as a gift to help pay for a grandchild’s college tuition or to a son or daughter in need. The current laws allow any ineligibility created from the gifts to begin tolling immediately when the gift is given. This offers the Medicaid applicant an important advantage in avoiding any penalties which may result from the gift.

 

NOTE: For those who are planning to enter nursing home or supportive living facilities before January 1st,  it is essential to determine if Medicaid application should be filed before the implementation of the changes in Illinois law.

 

Applications Filed After January 1, 2012 Fall Under New Medicaid Laws

 

Applicants will be required to provide five years for all financial records to verify assets. More importantly, gifts will not begin to toll until the applicant is already spent down. This is a significant change between the old and new laws.

 

Under the new law, applicants will likely have to try to recoup any significant gifts that were made within five years of filing a Medicaid application. In the event that the applicant cannot recoup the funds that were given away, then they will have an opportunity to plead for a hardship waiver and hope that the waiver is granted in order to obtain Medicaid benefits. The criterion in which a hardship waiver will be granted is somewhat unclear at this time, but it is anticipated it will be a very difficult process.

 

The current laws allow the spouse (community spouse) of a Medicaid applicant to protect all the assets that the community spouse has held solely in their own name (for three years or more) prior to filing for Medicaid. Current laws also allow applicants and their spouse to divide their joint accounts in half, so that the community spouse can keep half of the joint accounts.

 

Under the new laws, joint accounts will not be permitted to be divided between spouses. The community spouse will be allowed to retain a specified amount of account funds (currently $109,560). This amount is also subject to change from year to year.

 

For many families, it may be extremely advantageous to file a Medicaid application prior to the law change from an asset protection planning standpoint. After January 1st, asset protection will become more difficult to navigate under the new rules.

 

Please consider these options now and do not hesitate to contact me if you are unsure of the timing regarding your family situation at hand.

 

Kurt Rusch CLU, ChFC

 

Many thanks to John Belconis, JD, for his help in sharing this information with us.