Healthcare Digest 5/18: Should You Switch to Obamacare Come October?

Come October, whether or not to stick with your company’s insurance — should you be so lucky to have a job that provides insurance in October; it’s still not easy out there, guys — or take advantage of Obamacare could be a choice you’ll need to make. And, according to Kathleen Kingsbury, writing for Reuters, it’s a choice that many people should give a good long thinking to.

“Just because you can slip in under the grandfather exemption doesn’t mean you should. You may find it advantageous to move into one of the new plans.”

Her rationale:

1) “The Obamacare plans are largely designed to protect consumers – limiting what workers have to pay out of pocket and what insurers can refuse to cover. All new individual policies will have to cover more services, including medication, maternity and mental healthcare.”

2) However, regarding your current, or “grandfathered,” plan: “Grandfathered plans don’t have to provide full, co-payment-free coverage of preventive services, such as flu shots, mammograms and cholesterol screenings. They don’t have to cover a government-designated “essential benefits package” of procedures and treatments. Out-of-network emergency care may still require prior authorization, unlike with new plans.”

3) Additionally, “Despite the enchancements, plenty of people will look at the new benefits under PPACA and think, ‘Thanks, but no thanks.’ Their current policy, grandfathered in, may satisfy their needs and include their doctors in its networks – at a manageable price.”

4) “Technically, a plan can stay grandfathered indefinitely, but few, if any, will. Most grandfathered plans have gone away already.”

Monday’s Headlines

Department of Defense Could be Out of Healthcare Money Soon: “The Department of Defense’s Health Program could be out of money as soon as August, resulting in possible disruptions to payments for Tricare Providers.” [Alabama.com]

Slipping the Tyranny of the Mandatory Flu Shot: “Wisconsin employers, including hospitals, nursing homes and other health care agencies, could no longer require workers to get flu shots under a bill pending in the Legislature.” [FDL.com]

You Guys Got Any Good Ideas About Healthcare Reform?: “This is a big question, and could easily form the subject of several books. But since I don’t have the time to do this, I am only going to highlight a couple points and keep the discussion brief, and welcome input from others.” [FitnessGoop.com]

Voters Will Save Healthcare Reform!: “Obamacare backers stymied by conservative legislatures in red states may have a new approach: letting the voters break logjams with state ballot initiatives in 2014.” [Politico.com]

Healthcare Costs Too Damn Much: “Capping prices of drugs is not enough; the government has to deliver on affordable healthcare, says Biocon founder Kiran Mazumdar Shaw.” [MoneyControl.com]

An Easier Way to ICD-10?: “University of Illinois at Chicago researchers have developed a website that walks healthcare providers through the challenging transition from the current International Classification of Diseases — ICD-9 — to the new ICD-10.” [ClaimsJournal.com]

The Healthcare Paradox: “We have a real paradox in American healthcare. On the one hand we have exceptionally well educated and well trained providers who are committed to our care…But, on the other hand, we have a dysfunctional health care delivery system.” [MedCityNews.com]

Can We Trust This Healthcare Spending Slow-Down?: “We all know that Stein’s Law will someday apply to health care spending, which has risen from 5 percent of the economy (gross domestic product) in 1960 to almost 18 percent now. What we don’t know is how and when its share of the economy will stabilize. Will this result from spending controls imposed by Washington; or from delivery-system ‘reforms’ that spontaneously cut ‘waste’; or from rationing, which limits spending by denying people treatment; or by some combination of these? As for when, could it be now?” [Telegram.com]

How Do You Screen for Bad Debt?: “Medical centers in western North Dakota’s booming oil patch will get some help in diagnosing which patients seeking nonemergency services are bad debt risks.” [San Francisco Chronicle]