Healthcare News Updates for January 2019

Our Take on Healthcare News

1. Judge Warren in Texas declared the ACA unconstitutional. Attorney generals in more than 20 states have appealed the judge’s decision. It may take up to a year before the appeal reaches the Supreme Court where four liberal judges and Chief Justice Roberts previously upheld the ACA. House Speaker Pelosi announced a vote to authorize lawyers from the House of Representatives to join and support the repeal of the Judge’s decision.

Our Take
The ACA is alive and well. Sign-ups for 2019 ACA plans in the 39 states that provide Internet access to purchase ACA-approved policies via were only 5% less than in 2018. If you missed the December 15, deadline to obtain ACA insurance, refer to our January 2019 forum that explains qualifications for late signups.

2. Hospitals and other healthcare facilities must publish online (the Internet) their list prices for medical procedures and services. Prices must be updated yearly.

Our Take
Warning – Don’t be dissuaded from seeking medical care because list prices may not take into account the high portion paid by your insurance. List prices are much, much higher than the “approved” amount negotiated between the insurance company(s), the doctor(s) and facility(s). Also, some not-for-profit hospitals calculate their charges according to a patient’s income.
Suggest: When in doubt, call the facility’s business office, explain what insurance you have and request their “estimate” both verbally and in writing. Also, ask if the doctors and aftercare services (e.g. rehab) are “in-network” with your insurance. If some are out-of-network, your out-of-pocket responsibility may be substantial.

February’s healthcare forum will focus on “insider” (doctor) strategies for reducing your out-of-pocket medical expenses. We’ll keep you updated about “our take” on interesting “breaking news”.

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