State Trends in Premiums and Deductibles, 2003–2009: How Building on the Affordable Care Act Will Help Stem the Tide of Rising Costs and Eroding Benefits- A Commonwealth Fund Brief

Rapidly rising health insurance costs have strained U.S. families and employers in recent years. The  Commonwealth Fund issue brief below examines data for all states on changes in private employer premiums and deductibles for 2003 and 2009.

The analysis finds that premiums for businesses and their employees increased 41 percent across states from 2003 to 2009, while per-person deductibles jumped 77 percent in large as well as small firms. If these trends continue at the rate prior to enactment of the Affordable Care Act, the average premium for family coverage will rise 79 percent by 2020, to more than $23,000.

The authors describe how health reform offers the potential to reduce insurance cost growth while improving value and protection. If reforms succeed in slowing premium growth by 1 percentage point annually in all states, by 2020 employers and families together will save $2,323 annually for family coverage, compared with projected trends.

Realizing Health Reform’s Potential

Power Point Premium Increrases by State

New Law Protects Consumers From Discriminatory RX Copayments

Senator Kenneth P. LaValle announced that legislation which prevents health insurance plans from creating new “specialty tiers” to dramatically increase the copayments that consumers pay has been signed into law.  The law becomes effective October 31, 2010 and will protect people suffering from chronic or life threatening illnesses from discriminatory copayments.

According to Senator LaValle, several states across the country have begun adding to their prescription copayment structure to include additional tiers, or “specialty tiers,” for the most expensive medications.  These “specialty tiers” assign a percentage of the cost of a medication as a copayment instead of the traditional set dollar amounts used for “generic,” brand-name preferred,” and “brand name non-preferred” drugs.    In states where this has happened, the copayments have typically been 20% to 35% of the cost of the medication.

“The creation of ‘specialty tiers’ for prescription copayments could have a debilitating financial impact on people who take medications on a daily basis, particularly those who are suffering from serious illnesses,” said Senator LaValle.  “I am pleased to have supported this new law to protect people in need of prescription medications from suffering the possibility of financial ruin on top of coping with their illness.”

Governor Patterson’s Budget Proposal Threatens NYS Hospitals

The Governor’s proposal would significantly increase the tax burden on hospitals, nursing homes, and home care providers at a time when they are already struggling to remain afloat. It would also cut an additional 20% from the indigent care pool, further weakening the already fragile health care safety net for New York’s most vulnerable populations. 

New York City’s Health and Hospitals Corporation—a public provider of an extraordinary volume of uncompensated care to low income, uninsured populations—stands to lose hundreds of millions of dollars under the Governor’s plan, and, as a result, forecasts a deficit of $1 billion for its upcoming fiscal year.

To get specific information on how your local hospital will be impacted by these proposed changes go to .  Please spread the word and share with your family, friends, neighbors, and colleagues.  If you share this message with just ten people, together we can convince state legislators to reject Governor Paterson’s proposed health care provider taxes and cuts.

Thank you for taking the time to protect your community and support New York’s hospitals, nursing homes, and home health care providers.

NY & NJ Consumer Health Insurance “Hot Topics”

Please review the “Hot Topics” that the New York and New Jersey Departments of Insurance have released.

New York

NYS Age 29 Dependent Coverage Extension

COBRA and Premium Assistance-Information Index

Unemployment Health Insurance Options

New Jersey

Health Insurance Scams

Limits on Benefits under NJ Health Benefit Plans

COBRA and NJ Continuation

Taking Control of the Healthcare Experience

I’m often surprised by the number of C-suite executives I meet who buy only “best in class” services and products, yet accept far less than this standard from the organizations that are responsible to manage their family’s healthcare experience.  While it often seems that we have little real control over the quality of our family’s healthcare experience, several new organizations are helping their members to receive far greater control than most would have imagined possible. 

PinnacleCare is one of a new breed of “private patient advocacy” service providers that empower their members to take back control of the entire healthcare experience.  PinnacleCare members receive efficient access to the finest healthcare experiences, expert guidance through the complex healthcare system and the assurance of leading the healthiest lives possible, whether at home or while traveling or living abroad. 

I’ve had the opportunity to meet with representatives of this fine organization, and urge all C-Suite executives to learn how this firm can help you and your family.  Click this link to access a video about PinnacleCare’s services, or this link to be directed to the section on their website that details the many membership options available.

Please feel welcome to contact me for a personal introduction to this firm and or additional information on Pinnacles services.

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