Supremely Historic Week
The United States Supreme Court spent an unprecedented six hours over three days last week hearing oral arguments in the constitutional challenge to the Patient Protection and Affordable Care Act (PPACA) that has been mounted by 26 states and the National Federation of Independent Business (NFIB). While conventional wisdom says that oral arguments rarely influence decisions at the Supreme Court level, conventional wisdom also said that the justices would almost certainly uphold the health reform law and that the oral arguments would be pro forma and non dramatic. What went on in the courtroom last week turned conventional wisdom on its head. While there are certainly no guarantees as to what the justices will do, and we probably won’t know what their decision is before mid-June at the earliest, it would seem that at least part of PPACA may be in serious danger.
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WASHINGTON — The survival of President Barack Obama’s health care overhaul rests with a Supreme Court seemingly split over ideology and, more particularly, in the hands of two Republican-appointed justices. Chief Justice John Roberts and Justice Anthony Kennedy put tough questions to administration lawyers defending the health care law during three days of arguments that suggested they have strong reservations about the individual insurance requirement at the heart of the overhaul and, indeed, whether the rest of the massive law can survive if that linchpin fails. But Roberts and Kennedy also asked enough pointed questions of the law’s challengers to give the overhaul’s supporters some hope. In any event, justices’ questions at arguments do not always foretell their positions. The court’s decision, due in June, will affect the way virtually every American receives and pays for health care and surely will reverberate in this year’s campaigns for president and Congress. The political effects could be even larger if the court votes 5-4 with all its Republican-appointed justices prevailing over all the Democratic appointees to strike down the entire law, or several important parts of it. Not since 2000, when the court resolved the Bush v. Gore dispute over Florida election returns that sealed George W. Bush’s election as president, has a Supreme Court case drawn so much attention. The court wrapped up public arguments Wednesday on the overhaul, which aims to extend health insurance to most of the 50 million Americans now without it. The first and biggest issue the justices must decide is whether the centerpiece of the law, the requirement that nearly all Americans carry insurance or pay a penalty, is constitutional. Wednesday’s morning session was unusual in that it assumed, for purposes of argument, a negative answer to that central question. What should happen to other provisions, the justices and lawyers debated, if the court strikes down the requirement? If the justices are following their normal practice, they had not even met to take a preliminary vote in the case before all argument concluded. Questions at the court this week showed a strong ideological division between the liberal justices who seem inclined to uphold the law in its entirety and the conservative justices whose skepticism about Congress’ power to force people to buy insurance suggests deep trouble for the insurance requirement, and possibly the entire law. The divide on the court reflects a similar split in public opinion about the law, which Congress approved two years ago when Democrats controlled both the House and Senate. Liberal and conservative justices alike appeared to accept the administration’s argument that at least two important insurance changes are so closely tied to the must-have-coverage requirement that they could not survive without it: provisions requiring insurers to extend coverage to people with existing medical problems and limiting how much those companies can charge in premiums based on a person’s age or health. Less clear was whether the court would conclude that the entire law, with its hundreds of unrelated provisions, would have to be cast aside. The justices also spent part of the day considering a challenge by 26 states to expansion of the federal-state Medicaid program for low-income Americans _ an important feature which alone was expected to extend coverage to 15 million people and which no lower court has rejected. The conservative justices appeared open to the states’ argument that the expansion is unconstitutionally coercive. Audio of Wednesday morning’s argument can be found at: http://apne.ws/GX1p23; the afternoon argument at: http://apne.ws/GXdZOP. Solicitor General Donald Verrilli Jr. took a few seconds at the end of the Medicaid argument to make a final plea for the court to uphold the entire law, which he said would “secure the blessings of liberty” for millions of Americans by providing them with affordable health care. Verrilli told the court that Congress had made a policy decision to fight the high cost of medical care through the new law. “I would urge the court to respect that judgment,” he said. Paul Clement, the lawyer for the states challenging the law, answered that it would be a strange definition of liberty to make people who may not want it buy health care insurance. And he called Congress’ threat to cut all Medicaid funding from states that refuse to expand the program “a direct threat to our federalism.” Did you know that the majority of retirees are not overly confident they have saved enough for a comfortable retirement? In addition, nearly four in 10 retirees have not estimated how many years their assets and investments might last in retirement, according to LIMRA’s study “Will Retirement Assets Last a Lifetime.” Enter annuities. Now before you stop reading because the word turns you off, know that you are not alone. According to the study “Reclaiming the Future” by Allianz Life, 54% of those surveyed did not like the word “annuity.” But when asked to choose between high returns and guarantees, 69% of those surveyed said they would prefer a product that was “guaranteed not to lose value,” which describes an annuity. In retirement planning, lifetime income annuities provide safety, security and a guarantee that you (the annuitant) will not outlive their income. Annuities have a long history of helping people. I bet you didn’t know that they’ve been around since the Roman Empire? Here are a few highlights of the history of annuities as compiled by Tom Hegna in his book Pay Checks and Play Checks.
Are you part of the nearly half of Americans ages 45 to 70 who have no financial plan in place to protect against outliving their assets and the rising cost of health care should they live longer than they expected? Safety, security and an income you cannot outlive: An annuity is the ideal investment for longevity and retirement planning. Boomers Blank on Medicare Details By Bill Kenealy February 29, 2012 The study, by the Bankers Life and Casualty Company’s Center for a Secure Retirement, found that 56 percent of respondents admitted to knowing little or almost nothing about the Medicare program, while 13 percent falsely believe Medicare is free. Indeed, 72 percent of Boomers did not know that most Americans on Medicare pay a monthly premium, co-pays and deductibles. Not surprisingly, 62 percent of Boomers, even those within a few years of turning 65, do not understand what their health insurance benefit will be for doctor visits and hospitalization once they are on Medicare, while 27 percent could not venture a guess on how much they think they will pay for healthcare once on Medicare versus what they pay today. Chris Campbell, VP of strategic marketing and business development for Bankers Life and Casualty Company, urged Boomers to take a more proactive approach to understanding the role of Medicare in their retirement planning. “Minimize financial surprises by understanding your retiree health insurance benefits well in advance,” Campbell said in a statement. “Estimate what your financial responsibility is under Medicare, including premiums, co-pays, deductibles and uncovered expenses, in particular, long-term care. Earmark a portion of your savings or income for retirement and consider speaking to a professional advisor who is well-versed in Medicare for guidance.” Bill Kenealy writes for Insurance Networking News.
Sales is one of the hardest professions out there. We are expected to consistently produce results despite little formal training, constant rejection and frequent disappointment. We work so hard to get an opportunity to pitch our unique solutions, endlessly providing information to the elusive prospect, only to find out they’ve gone with a competitor who came in at a lower price. Are your products/services overpriced? Are your competition’s offerings under-priced? Why does the prospect perceive your product as a mere commodity—easily replaceable by any number of competitive products? Has the prospect become a smarter and better negotiator, or do they simply hear the same needs-focused pitch from you and everyone else, that ultimately demotes your superior solution to commodity status? Check out this video http://youtu.be/9Ya-aZdQ4Yo CMS will be preliminarily increasing Medicare Advantage reimbursements by 1.6% for 2012.This is fantastic news since the Health Care Reform Law called for lower reimbursements. Popular wisdom says that President Obama didn’t want to implement that cut until after the 2012 election.How does this affect agents? When the companies make less money, they leave the market entirely, or pull out of less profitable counties (rural areas should be rejoicing) and reduce benefits. No one was willing to say that agent commissions were on the table, but it stands to reason that when reimbursements to the companies get cut, it all rolls down hill. So this is great news for your clients and you! Thanks, Sylvia CMS has recently released information regarding the 2012 Medicare Part D & Medicare Advantage plans. This information also includes preliminary figures on the benefit amounts and cost sharing for 2012 Part D plans. There was also a news release in the Courier-Journal that CMS will be preliminarily increasing Medicare Advantage reimbursements by 1.6% for 2012. This is excellent news, as the expectation had been that the reimbursements would either remain flat or decrease for next year. There was also a news release in the 2012. This is excellent news, as the expectation had been that the reimbursements would either remain flat or decrease for next year. Now that the Republicans are a majority in the House, the health care reform bill that threatens to make us extinct stands to change. This election should be a game-changer! Most Americans believe some reform is necessary, but few are happy with the way the law was put together and fed to us–especially the small business person who sells insurance and has been told he is “unnecessary.” During AEP, there is no better time for the government to see just how invaluable we are in their convoluted process that confounds consumers and agents alike! Medicare without agents would be a great disservice to Medicare beneficiaries and this election promises to protect our role in the process. Sylvia If you are a seasoned Medicare Advantage agent and you have not had a problem with doctors dropping out of a network and the client blaming you–then count your blessings! And prepare for the inevitable because a complaint may be just around the corner. It is false advertising when you present a PPO or HMO directory listing to a client without the caveat “This is subject to change at anytime, but you will be locked into your plan for the rest of the year.” Provider contracts expire at different times so the client who purchases a network plan because his providers are all in the network on November 15th, is rightfully upset on February 1st when he finds out his doctor’s contract is expiring and he will no longer be in-network if he continues to see his doctor. I’ve had too many calls where the relationship is destroyed with the client, because the client blames this on the agent. Clients can call CMS and allege agent abuse, get a SEP to move into another plan. All the agent gets is a black eye and a complaint on his record. So how do you protect yourself ? 1. Explain the situation to the client so they don’t blame you if a provider drops out of the network mid year. 2. Prior to your appointment, have the client call the provider (ask for billing department, not the front desk clerks) and find out the date the contract expires. 3. Alternately, you could do this yourself and keep a database, but it is often time consuming to the get billing clerk on the line to get this information. With PFFS virtually gone, networks are the future of Medicare Advantage. Directories are not worth the paper they are printed on, so be forewarned. I hope this saves you some frustration down the line! Sylvia
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