The federal penalty for smaller businesses of between 50 to 100 employees choosing not to carry health insurance for its employees could be less than the cost of health insurance, it attractive for smaller businesses to drop employee coverage, said Mathieu.
Mathieu also said all the good stuff (in federal health care reform) is up front - the bad and the ugly stuff is coming later.
You kind of have to guess at what the costs will be, he said, adding the changes will result in younger customers subsidizing older customers premiums. As insurance companies, we would like to be able to assess the risk.
Mathieu said the next presidential election or the Supreme Court will eventually decide the future te of health care reform and associated insurance costs.
Mathieu discussed upcoming changes in health insurance coverage due to the federal overhaul of the health care system. He also said the coming changes would drastically affect health care coverage, including the associated costs.
STEUBENVILLE - E. David Mathieu Jr., vice president of marketing for the the Health Plan insurance provider, was guest speaker for the city Rotary Clubs Frihealth insurance Health care insurance focus for Rotaryday luncheon meeting at the city YWCA.
The insurance carrier will pass that (increased cost) along to (consumers), he said, adding smaller businesses also could be fined for any employee entering a health exchange rather than staying withhealth insurance a group plan.
Massachusetts has the highest (health insurance) premiums in the U.S., said Mathieu, adding there also is a physician shortage in the state due to its health care reforms.
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It keeps everyone responsible, said Mathieu.
The reality is they should have named it health care insurance reform (bill), said Mathieu, adding the five largest health insurance companies made profits of $11.7 billion in 2010. Thats an average of about 3.2 percent (annual profit).
The medical loss ratio portion of federal health care reform also prevents health insurance companies from gouging consumers, he added.
I look forward to some interesting times, he said.
The coming reforms include limiting insurance companies to refuse adults for pre-existing conditions or consider risk ctors, such as minimum employer and employee contributions to health care premiums, gender ratings and group sizes. Age, geographic and smoking ctors still will be allowed to be considered by insurance companies, but Mathieu said the changes wont allow insurance companies to properly assess their risks and charge customers accordingly.
The federal reform would have helped reduce health care costs if it stopped there, said Mathieu, but other aspects of the reform, set to kick in Jan. 1, 2014, will result in higher costs for the industry, which will in turn be passed onto to those purchasing health insurance.
Mathieu said the good stuff that goes into effect in 2012 includes formation of a high-risk pool somewhat subsidized by government funds. He added there will no longer be lifetime limits placed by insurance companies on individuals with chronic health problems. Also, children would no longer be excluded from health insurance coverage because of pre-existing conditions. Federal health care reform also enables children to be covered under their parents health insurance up to age 26 (Ohio extends that to 28), as well as requiring qualified health plans to provide first dollar coverage for certain preventive services and immunization, said Mathieu.
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Mathieu also said hidden fees, taxes and penalties in the federal law will result in higher costs for health care insurance.
