A little-known option for Americans in search of health insurance on the newly launched insurance exchanges has been gaining publicity lately, perhaps despite the administration’s best efforts to keep it under wraps: and that is the ‘catastrophic’ health plan option.
Originally meant to be coverage for the under-30 crowd, it could actually be a viable stop-gap option for some of those people whose affordable plans are being terminated. The problem right now seems to be, however, finding the plan and signing up for it.
“Presumably, people would be able to get that as soon as the [enrollment system] is working,” said Tim Jost, a professor at Washington and Lee University and expert on the Affordable Care Act. “That’s probably why they’re not pushing it real hard right now.”
This plan can also help people whose health insurance bill suddenly exploded. Not only can those under 30 get the catastrophic plan, but also older people who are exempt from the individual mandate due to their limited incomes. The problem is the Department of Health and Human Services has not finished building the system for applying for and certifying those exemptions. It could take several more weeks until they are.
Subsidies cannot be used to reduce the cost of the catastrophic option, but those eligible for subsidies can choose the so-called ‘bronze plan,’ the cheapest plan eligible for subsidies.
“The difference between catastrophic and bronze is very minimal,” said Yevgeniy Feyman, a fellow at the Manhattan Institute. “You might be paying $5 or $10 less for the catastrophic plan than the bronze. … The bronze plans are, in some way, becoming the new catastrophic plans.”
The catastrophic plan has been almost invisible in the public discussion of the Affordable Care Act. During the recent congressional testimony of the HHS Secretary Kathleen Sebelius and the head of Centers for Medicare & Medicaid Services Marilyn Tenner mentioned the catastrophic plan only as an option for young people. The reality is however it is an option for others as well.
Manhattan US District Court Judge Paul A. Crotty is fighting against a tactic proposed by an organization called Medical Justice, whose result would be to limit the ability of consumers to place critical, on-line reviews for services they’ve received but were unhappy with.
Medical Justice advises medical professionals to force their patients to sign over their copyright interests on any online reviews they may write. Therefore, if the patient criticizes the health care professional on an online review site, the doctor will have the ability to threaten a lawsuit for copyright infringement.
Judge Crotty’s decision to disallow this practice stems from a dispute between Robert Lee, a disgruntled former patient of dentist Stacy Makhnevich.
Lee claimed that Makhnevich charged him over $4,000 for a filling a cavity, and then refused to give Lee the records that he needed to file an insurance claim. Unhappy with that service, Lee described his experience with Makhnevich on Yelp and DoctorBases. In response to the critical posts Makhnevich claimed that she and her dental practice owned the copyright to Lee’s reviews.
The dentist demanded that the Web sites remove Lee’s posts and also demanded from Lee $100 per day that the posts remained up.
Public Citizen, and advocacy group for consumers, represented Lee in a suit against Makhnevich. Judge Crotty ruled last year that the copyright agreement Makhnevich had with Lee was invalid for a long list of reasons, one of those being that such an agreement is unethical. Furthermore, Cotty argued, even if somehow Makhnevich did own Lee’s reviews, Lee would still retain a “fair use” right to post them on websites like Yelp.
According to the original Obama healthcare coverage proposal, women’s health issues, including full coverage for birth control, is included. However, over the past 15 months since the new health law went into effect, who has to pay for the coverage of contraceptive care has come under fire from religious institutions who believe they should not have to be forced to pay for a service that they believe in immoral.
In August 2011 the Obama administration proposal required insurance providers to fully cover birth control for women, following the recommendations of the National Academy of Sciences. In January 2012 the Roman Catholic Church asked for an exemption, saying that as providers of insurance to their employees they felt that they should not have to pay for services they believe are immoral, such as birth control. At first the Obama administration rejected the Church’s sensitivities, but after an uproar from Church leaders and Republicans the administration came up with a compromise proposal in February, 2012. The compromise however still left many questions open, including how insurance coverage would be provided by self-insured religious institutions.
The new proposal states that those religious institutions that are against the use of birth control will not be forced to pay for it. Instead insurance companies will pay, using the money they will save due to fewer births.
Deputy Director of the federal office in charge of health insurance, Chiquita Brooks-LaSure explained,
“Under the proposed rule, insurance companies — not churches or other religious organizations — will cover contraceptive services. No nonprofit religious institution will be forced to pay for or provide contraceptive coverage and churches and houses of worship are specifically exempt.”
She added, “Nonprofit religious organizations like universities, hospitals or charities with religious objections won’t have to arrange, contract or pay for coverage of these services for their employees or students.”
The latest compromise proposal which President Obama announced on Friday would expand the number of institutions that could be included in the exemption. Not only churches and other religious organizations would be exempt, but also some hospitals, universities and social service organizations which are merely affiliated with religious institutions will be included in the exemption.
The Secretary of Health and Human Services, Kathleen Sebelius said the compromise would “respect religious concerns” while still providing free contraceptive coverage.
The Washington based Becket Fund for Religious Liberty, a group representing employers in eight lawsuits against the Obama healthcare proposal is not happy with the compromise.
“Today’s proposed rule does nothing to protect the religious freedom of millions of Americans,” said Kyle Duncan, general counsel of the Fund.