If you're a baby boomer, especially a boomer on a tight budget, full implementation of the federal health care reform law can’t come soon enough.
In 2009, about 8.6 million Americans age 50 to 64 were uninsured. Three out of four said they couldn’t afford health care, or had problems paying for things such as prescription drugs and medical equipment. The federal health care reform law promises to bring those numbers down considerably.
A new study from The Commonwealth Fund found that those 8.6 million uninsured boomers will benefit from the law, along with 9.7 million boomers who have what the organization calls inadequate health insurance. The Commonwealth Fund is a nonprofit foundation that researches health care issues.
Among the 18.3 million boomers who stand to benefit are 7 million who either will be able to afford subsidized private insurance or can be covered by Medicaid. The Medicaid program will be expanded to include all legal residents with income up to 133 percent of the federal poverty level ($14,404 for a single adult or $29,327 for a family of four).
According to the study, high unemployment has contributed to the health insurance gap among boomers. Texas (22.5 percent), Florida (20.6 percent) and New Mexico (20.1 percent) lead the nation for the highest percentages of baby boomers who are uninsured, the study indicates.
The 50-64 age group is susceptible to chronic health problems, making it difficult to obtain affordable insurance in today’s marketplace. In fact, of the 8.6 million uninsured baby boomers, about 25 percent hadn’t had a colonoscopy in the past five years and another 10 percent hadn't had a cholesterol screening, the study shows.
Insurance fraud on the rise: Suspicious property and casualty insurance claims jumped 12 percent in the third quarter of 2010 compared with the same period in 2009, according to the National Insurance Crime Bureau.
Among the most popular reasons for referral of questionable casualty insurance claims to the crime bureau were excessive medical treatment (33 percent), staged auto accidents (31 percent) and inflated billing (29 percent). Questionable hail damage claims (84 percent increase) led the way in the property insurance category, according to the crime bureau.
Mini-meds in plain English: The U.S. Department of Health and Human Services has issued new guidelines for insurers that offer limited-benefit health insurance plans, or “mini-meds.”
Most notably, the Department of Health and Human Services said insurers must notify consumers in plain language if the annual benefits of their mini-med plans are lower than what's required by law. The federal health care reform law will prohibit annual dollar limits beginning in 2014.
The plain-language measure stems from a Capitol Hill hearing Dec. 1 where U.S. senators grilled a McDonald’s Corp. executive about the fast-food chain's limited-benefit health insurance plans. Those plans serve about 30,000 hourly employees.
Annual benefits for most mini-med plans range from $2,000 to $25,000. A little more than 1 million consumers have these plans.
Proponents praise these plans for providing affordable health insurance to low-income workers who normally wouldn't have access to even the most basic health benefits. Opponents say these policies give consumers a false sense of security, because many of them don’t realize that major medical procedures and extended hospital stays aren't covered.
“Now, we’re taking an unprecedented step to ensure consumers are informed when they purchase policies that offer limited coverage,” Health and Human Services Secretary Kathleen Sebelius says.