Does ObamaCare Doom HSA/HDHPs?

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Are HSAs Doomed Under ObamaCare? GRACE-MARIE TURNER
ObamaCare has claimed the first of what surely will be many victims in the insurance industry. A Richmond, Va., insurance company called nHealth has closed its doors due to the "new demands imposed by national health care reforms," according to a letter from a co-founder.
...
NHealth specialized in insurance plans that coupled incentives for wellness and coordinated care with health savings accounts (HSAs). ... CEO Paul Kitchen said ObamaCare creates so many uncertainties that investors believed the company's offerings could not comply with the bureaucratic requirements of the new law.
Unfortunately, several of ObamaCare's provisions could doom all HSAs. Patients would suffer because they would have fewer insurance choices and would be forced to pay for much more extensive and expensive health insurance.
...
When McKinsey & Co., a consulting firm, analyzed the early impact of HSA-compatible health plans, its researchers found that people with consumer-driven plans were more value-conscious.
They were 50% more likely to ask about costs and three times more likely to have chosen a less-extensive, less-expensive treatment option, like calling a nurse hotline instead of visiting a hospital emergency room. There was no evidence they were skimping on care, and in fact, HSA holders were more likely to get preventive care than those with traditional insurance.
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The health law requires that all insurance policies provide a minimum actuarial value of at least 60% for the benefits covered. If HHS allows contributions by individuals and employers to health savings accounts to "count" as part of the actuarial value, then HSAs and other account-based plans would likely meet the test. But if contributions are not included, the plans likely would not qualify, removing an important tool to hold health costs down.
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Washington should make sure that HSAs remain an option. These plans expand patient choice and encourage just the sort of responsible medical spending that can drive down health costs. NHealth's closing is a warning sign that ObamaCare must be stopped before it forces more innovative companies to shut their doors and deprives 10 million people of an affordable health insurance option.
Insurance News - Are HSAs Doomed Under ObamaCare?
I love my HSA/HDHP. Obama promised I could keep it. November's election seems the only path to a solution = vote in new Congress to repeal ObamaCare.
 
Remember, carriers who sell plans OUTSIDE of the exchanges (like HDHP/HSA) also will be required to sell plans INSIDE the exchanges.

This nhealth has no plan that could conform to the inside exchange requirement, therefore they bailed. It was either that or create conforming non-HSA plans to market.

Other carriers who CAN sell both in and out of the exchange will likely continue offering HSA outside if they are not allowed inside.
 
You can keep your HSA/HDHP until January 1, 2014 if the Patient's Protection and Affordable Care Act is not modified. If you had it prior to March 23 you will be able to keep it even longer. If you got it after March 23 you will not have that option after 1/1/20114.

Even if Obama's mandate is held unconstitutional and thrown out the other parts of Obamacare will still stand. Unless the congress and president elected in 2012 redo the bill entirely, the HSA/HDHP will disappear in a little over 3 years.:mad:
 
Even if Obama's mandate is held unconstitutional and thrown out the other parts of Obamacare will still stand. Unless the congress and president elected in 2012 redo the bill entirely, the HSA/HDHP will disappear in a little over 3 years.:mad:

This is pretty much all incorrect.

First, if the individual mandate is struck down by the courts, the entire law goes down the tubes because there is no severability clause in the legislation. (See my other post somewhere around here relating to the Florida AG's Reply Brief to the Administration's Motion to Dismiss.)

That would actually create more havoc because 1) it will take years to get a final decision from the S. Ct., and 2) in the meantime, a ton of new "mandates" will be imposed and a ton of new regulations will be implemented.

Idiots.
:yes:

With respect to 2014+ plans, the "Bronze" plan actually was designed around the HSA chassis. This was a political "compromise" made by Obama. Thus, the HSA itself is effectively written into the legislation.

That being said, there is no guarantee that 10,000 family deductible plans will be perceived as "thrifty" when the annual premium is $12,000 or more.
:nah:

What I am not clear about is just how comprehensive "non-exchange" plans can be. It is entirely possible that there could be 2 separate and distinct health plan systems: 1 for sickos (Obamacare) and 1 for healthy people (non-exchange). One will pay 3% commission with sky high premiums nobody can afford - even with subsidies; the other will pay 20-30% commission with very affordable plan premiums and tons of options.

Hmmm, I wonder which one has the best chance to succeed?

caveat: I'm playing loose with some of the numbers. But hey, give me a break. The Regs haven't even been written yet for crying out loud.
 
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What I am not clear about is just how comprehensive "non-exchange" plans can be. It is entirely possible that there could be 2 separate and distinct health plan systems: 1 for sickos (Obamacare) and 1 for healthy people (non-exchange). One will pay 3% commission with sky high premiums nobody can afford - even with subsidies; the other will pay 20-30% commission with very affordable plan premiums and tons of options.
Plans purchased through the exchange are not going to pay any commissions, so not sure where you got the "3%" from.
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Individual Plans are going to have to pay 80% of the collected premiums back to actual medical claims, so not sure how you think you will be getting " 20 to 30% commissions"..

Plans bought through the exchange will pay 0% commissions, and plans bought outside the exchange will probably pay the "3%" you wrote about....(maybe 5%)
 
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What I am not clear about is just how comprehensive "non-exchange" plans can be.

Non exchange plans can be as comprehensive (or not) as the carrier wants them to be.
The question that clients will be asking is whether or not it is classified as a "qualified health plan".

If it is not qualified it will be subject to the fine, which will obviously increase the cost of it.
(i realize that the fines will be hard to enforce, but many people are law abiding and will pay them, or not want to be subject to them, even if they are uncollectable)



It is entirely possible that there could be 2 separate and distinct health plan systems: 1 for sickos (Obamacare) and 1 for healthy people (non-exchange).
One will pay 3% commission with sky high premiums nobody can afford - even with subsidies; the other will pay 20-30% commission with very affordable plan premiums and tons of options.

The only hope of affordable premiums outside of the exchange will be with non-qualified health plans that are subject to the fine.

All Qualified health plans (in or out of the exchange) will have their rates regulated.

Qualified Health Plans outside of the exchange have to charge the exact same rates as the carriers plans inside the exchange.

But if its outside of the exchange, there is no subsidy available.

So basically, the only affordable health plans (or the only ones with a chance of being affordable) will be subject to the penalty.


And you can forget about 30% comp rates on any health plan. I would guess that 10% will be the highest comp level out there after a few years. Most will go to paying a per head fee (as they are already doing).

The only hope for an agent is in the group arena, but it will require a lot more volume than it has previously.
 
There is also the high probability that employer plans will lose grandfathering when they change carriers.
 
Plans purchased through the exchange are not going to pay any commissions, so not sure where you got the "3%" from.

Individual Plans are going to have to pay 80% of the collected premiums back to actual medical claims, so not sure how you think you will be getting " 20 to 30% commissions"..

Plans bought through the exchange will pay 0% commissions, and plans bought outside the exchange will probably pay the "3%" you wrote about....(maybe 5%)

Source? Of course not, you don't have a source. It is possible that exchange plans will pay zero compensation, but that is not yet a foregone conclusion. My point was that the compensation will be minimal, at best.

Plans sold outside the exchange will pay HUGE commissions. I have no idea what makes you guys think otherwise? These will be traditionally underwritten plans, and companies will steer agents toward those plans by commissioned incentives.

There will be a wide range of non-exchange plans from the bare bones to the full boat. My question has been and remains: how full can the full boat plan be and not be required to be marketed under the exchange?

If companies can in fact copy exchange plans and sell those outside the exchange, subject to underwriting, at ridiculous discounts - those plans will be very popular.

My home office people don't know the answers to these questions so with all due respect, I have no reason to believe that anyone on this board has any keen insights.

:twitchy:
 

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