The Affordable Care Act ensures new required preventative health services for women, and as of August 1, 2012, about 47 million women will have access to additional preventative services without paying more at their doctor’s office for policies renewing on or after this date (Ubezpieczenie). Under health care reform, many private health insurance plans also must cover regular well-baby and well-child visits without cost sharing. The new law places a focus on preventative care for all members of the family. With women often being the primary decision maker when it comes to health, emphasis on preventative care for them specifically makes sense. Women are more likely to need preventative care services, but are less likely able to pay according to HealthCare.gov. The Commonwealth Fund completed a study in 2009 that showed over half of women delayed or avoided health care because of the cost. Hopefully these new requirements under the Affordable Care Act can change these statistics. Some of the new required preventative care services include well visits for women, HPV testing, gestational diabetes screening, sexually transmitted infection counseling, contraception counseling, breastfeeding support, breastfeeding supplies and domestic violence screening. These important tests are made a priority under health care reform which goes to show how important it is to the administration. The rules which govern coverage of preventative services allow health plans to use reasonable medical management to define the nature of included services. Plans will aim to keep flexible options to control consumer costs and encourage the efficient workings of the health care system. These requirements give Americans access to many of the services that are already available to the women in Congress and they are closely *****ociated with the list of preventative services recommended by the National Business Group on Health. Many private employers and health insurers already offer these services, but now there will be more mainstream access to preventative care.

There are many aspects of the Affordable Care Act that are up for debate, but many Americans will be pleased to hear that a refund check could be coming their way (Ubezpieczenia Olsztyn). By August 1, 2012, health insurance companies will be refunding about $1.1 billion in premiums to approximately 12.8 million customers. In the Affordable Care Act, the 80/20 Rule mandates that health insurance companies spend at least 80% of collected premiums on health services and about 20% on administrative costs and advertising. So if a company only spends 78% on health services they must send rebated checks to customers for the other 2%. The whole point to the 80/20 Rule is that customers ultimately get value for their health care premium dollars. There is not currently a system in place to determine if you are eligible for a refund check and while the checks will average about $151 per household there is a great amount of variability. Some households may get more, while some households get nothing. The size of the check will depend heavily on how your specific health insurer handled collected premiums and could vary from state to state. Insurance companies have a few options on how to get the refunds to their customers. They can send an actual check in the mail, or they may refund credit cards that were used to pay premiums. They may also discount future premium costs. There is also the possibility that insurers will charge their customers more upfront, knowing they may have to send refund checks later according to the article on KATV.com. This means you may never fully notice the refund that is owed to you, but at the same time, keep your eye on your mailbox over the coming weeks. Adam Powell, a healthcare economist, is quick to point out that a refund check from an insurer does not automatically imply that the company is overcharging their customers. There are many other factors in play determining if a health insurance refund check is available. Customers shouldn’t *****ume their insurer is taking more money than they need. It’s challenging for companies to determine an exact 80/20 placement of premiums beforehand. Much of the math will have to be completed at the end of the year once revenue and profits are determined. This aspect of the Affordable Care Act is one example of why the health insurance industry struggles with the new health law. Many question how insurance companies are expected to grow with these types of restrictions placed on them. The debate places emphasis on how health insurance companies are regulated and how insurers could ultimately suffer from President Obama’s health care law. It is possible that insurance companies start buying competitors and consolidating the market in an effort to save money and make the 80/20 Rule less damaging. This could start as early as 2013 as the Affordable Care Act’s full implementation happens in 2014.

President Obama and his administration are stepping up their fight against health care fraud in an effort to save Americans billions of dollars (Ubezpieczenie Olsztyn). They announced last week that they are sharing new data and investigative know-how on a scale we have not seen before to shut off as many questionable payments as possible. Health care fraud costs our country too much money and initiatives should be taken to decrease the impact. Health and Human Services Secretary Kathleen Sebelius made a statement at the White House event with many insurance executives in regards to the health care fraud issue. She said a new public-private partnership will give government programs and insurers the power to take the high ground against fraudulent claims in an effort to stop the scam artists in their tracks. Many perpetrators take advantage of the weaknesses in the health care system and through a unified front the activity and be brought to light. According to Mark S. Smith and Ricardo Alonso-Zaldivar’s article on HuffingtonPost.com, health care fraud is an major problem affecting many big programs including Medicare and Medicaid. Private insurance companies also feel the wrath of fraudulent activity and everyone agrees that solving the problem must be a focus. The partnership between private and public programs still has many details to be ironed out, but there should soon be a budget *****igned as well as a goal to start seeing results in as little as six months. This partnership is unique in the sense that it brings together two forces that often see themselves working against each other. By coming together they can be a team working against a group of people who attack the weak areas caused by the â€sfeudâ€�. This is a huge and necessary step towards cleaning up the weaknesses in America’s health care system. Many insurance companies are frustrated with President Obama’s health care reform and the President continues to hone in on the abuses he believes many insurers are permitting. They don’t always see eye to eye on Medicare and Medcaid and they definitely work against each other at times. Despite their differences, these two entities are coming together to stop fraud quickly and ultimately save the industry, the government and Americans a lot of money.

Here is some more information on this monumental report released this summer (Ubezpieczenia Olsztyn). The mortality declines from expanding Medicaid were greatest among adults ages 35-64 including minorities and residents in poorer counties. The Medicaid expansions had other positive effects such as decreased rates on uninsured residents, lower rates of delayed care due to costs, and an increase in people reporting their health status as â€sexcellentâ€� and â€svery goodâ€�. There has always been a lot of controversy over Medicaid and how necessary it is for our country, but an interesting study has recently come out with some facts that may sway this debate. According to Lewis Krauskopf’s article on MSNBC.com, state expansions of Medicaid reduced adult mortality rates by over 6% when compared to states that did not broaded eligibility for their plans. The study was released Wednesday from the New England Journal of Medicine and it may create some fierce discussions after the U.S. Supreme Court’s ruling to uphold President Obama’s health care law. The ruling also left it up to states to decide whether or not to participate in the new Medicaid plan which has broader eligibility. It would end up extending health insurance to as many as 16 million more Americans starting in 2014. The study was headed up by Benjamin Sommers, *****istant professor in health policy and economics at the Harvard School of Public Health. They looked at three states that substantially broadened Medicaid eligibility for adults since the year 2000. The states were New York, Maine and Arizona. They then compared the findings to other states that did not implement expansions, including Pennsylvania, New Hampshire, Nevada and New Mexico. Adults from 20-64 years of age were examined for five years before and after the expansion using the data from the U.S. Centers for Disease Control and Prevention. Medicaid expansions were linked with a reduction in mortality from all causes in the states who implemented the plan. This may change the landscape of Medicaid throughout America, even in states that oppose the expansion plan.

Since August 1st, 2012, the Affordable Care Act and the Office of Women’s Health has required that most private health insurance plans cover preventative care for women, which could in the long run, drop prices even further for women (Ubezpieczenie Olsztyn). Some of the preventative services that must be covered are well-visits, screening for gestational diabetes, screening for breast cancer, screening for colorectal cancer, screening for cervical cancer, counseling for STD education, and domestic violence screening and counseling. If women’s health improves due to these screenings, then the cost of health insurance should be more manageable for both genders, but it will take consistent care to see this happen over time. Women’s health insurance has always struggled to find balance between affordability and quality coverage. Over 90% of individual health insurance plans charge women higher premiums than men for equal coverage according to Michelle Andrews’ article on NPR.org. This practice is known as gender rating and has been considered acceptable for years, but this is to change with the implementation of health care reform, set to start in 2014. A recent report from the National Women’s Law Center calculated that women spend over $1 billion more a year on their health insurance premiums when compared to men. This shocking statistic lends the question of whether or not this is fair. Health insurance companies argue that women’s health care costs are typically higher, due in part to maternity health related costs. Gender rating will be banned starting in 2014 under health care reform and many women are happy to hear this. Surprisingly, about 65% of people are unaware of this provision in the Affordable Care Act based on a poll conducted by the Kaiser Family Foundation’s April health tracking poll. There needs to be more education available to Americans to truly understand how health care reform will affect their lives. Health care reform will still allow health insurance rates to be based on four main factors. These factors are family vs individual enrollment options, age of applicant, location of applicant and whether or not the applicant smokes. The new formula could dramatically change the way health insurance rates are charged and some people may see rates decrease, including women. What will this mean for men? Some men may end up paying more to balance out the change. The poll shows about 60% of people favor the new provision, feeling that it levels the playing field for paying premiums.