Health Care

Report | Georgia PIRG Education Fund | Health Care

Should I Stay or Should I Go?

Tips for consumers deciding whether to keep their individual health insurance plan or switch to a new plan for 2014

Resource | Health Care

SO YOU NEED HEALTH INSURANCE. NOW WHAT?

Having the facts can make all the difference when it comes to health insurance. To make the most of new choices, protections and financial help, you need good information. This guide can help you find quality coverage that won’t break the bank.

Issue | Health Care

Health Insurance Tips

Here's that Rx refill you didn't order

By

Health care analysts are wary of automatic-refill programs at major pharmacies, as unnecessary refills are billed to insurance companies and Medicare without customer approval.

Report | Georgia PIRG Education Fund | Health Care

Making the Grade

When it comes to health care, there are few magic-bullet solutions for the many problems consumers face in the marketplace: insurers don’t compete for their business, leading to higher prices and lower quality. Important information about coverage is buried in the fine print, making it ha rd to know what’s really covered or which plan is right. And costs are continuing their unsustainable rise.  

Yet there are policy solutions that can make a difference and give consumers a better deal on health care. One of the most important of these is the creation of new state-based health insurance marketplaces, called exchanges. These exchanges, authorized by 2010’s health reform law, offer the states the chance to address the win problems of cost and quality, and help consumers get a fair shake when buying insurance. 

Exchanges give individuals and small businesses the same advantages that large businesses generally enjoy when it comes to buying health insurance. Large businesses have strong negotiating power, allowing them to get a lower rate for coverage as insurers compete for their business. They also benefit from economies of scale that lower administrative costs, and have sophisticated human resources departments and brokers at their disposal, making it easier for employees to understand their options and decide which plan is right for them. 

In much the same way, exchanges give individuals and small businesses the ability to band together and gain the same benefits of size, negotiating power, and information. By providing better options and better information, and negotiating on behalf of its enrollees, the exchange can level the playing field for consumers. 

States thus have an important opportunity to improve their health care marketplaces through the creation of an exchange. And the health reform law gives the states substantial leeway to define critical aspects of the exchange, including who is eligible to buy coverage through it, how aggressively it will set standards and negotiate with insurers, and who will run it. A weak exchange could wind up taking its cues from the insurance industry, not consumers, and do little to shift the fundamental problems in most states’ health care markets. A strong exchange, though, can be just the tool states need to revolutionize their health care systems and improve quality while lowering costs.

As of this writing, several states have already taken this opportunity and established their exchanges. But not all exchanges are created equal, and many states have yet to commit to establishing one. This report assesses the progress that the states have made, and for the states that have begun to set up their exchange, evaluates them on the myriad policies and criteria that will determine whether it is ultimately successful in improving health care for consumers.

Report | Georgia PIRG Education Fund | Health Care

Building a Better Health Care Marketplace

Consumers across the state know that the health insurance marketplace is broken.  Insurers don’t compete for their business, instead offering take-it-or-leave-it deals.  Important information about coverage is buried in the fine print, making it hard to know what’s really covered.  Instead of working to lower costs and improve quality, too many insurers focus on covering healthy enrollees and dumping the sick.  And costs are continuing their unsustainable rise.  Nationally, the great majority of individual-market policyholders—77% —saw a premium increase from early 2009 to early 2010, with an average rate hike of 20%.  Small businesses, too, pay 18% more for insurance than their larger competitors and have seen repeated double digit premium increases.

The creation of a new health insurance exchange offers our state the chance to build a better marketplace for health care.  The exchange can help individuals and small businesses by increasing competition and improving choices in the state’s insurance market.  By providing better options and better information, and negotiating on behalf of its enrollees, the exchange can level the playing field for consumers.

Success is not assured, however, as states confronting the task of setting up their exchange must grapple with important policy questions.  This report is a blueprint for creating a strong, pro-consumer exchange that lives up to its promise of a better marketplace.

Report | Georgia PIRG Education Fund | Health Care

The Cost of Repeal

On March 23, 2010, after a long debate, President Barack Obama signed into law comprehensive federal health care reform legislation, known as the Affordable Care Act or ACA, but the enactment of the law did not end the debate. This year, Georgia’s elected officials will face their own choices about what to do about our health care system. They must ask whether repeal would make our health care work better or worse for the taxpayers, consumers, and businesses of the state. The close examination of the consequence of repeal provided in this report demonstrates that repeal fails that test. 

News Release | Georgia PIRG Education Fund | Health Care

New Rules to Deliver Options for Young Adults in Georgia

A provision of the new federal health care law that goes into effect today will allow 43,500 young adults in Georgia to remain on their parent’s health insurance plan until age 26

Report | Georgia PIRG Education Fund | Health Care

The Young Person's Guide to Health Insurance

For people in their late teens and twenties, getting health insurance can be a lot like a lottery . . .

If you’re lucky, your parents have a good plan that covers you while you are in school or your employer picks up the tab. If you’re not, your options shrink to two: a plan offering good coverage that you can’t afford, or a plan you can afford that covers little to nothing.

Starting this year, under the new health care law, young people will gain access to new, previously unavailable health insurance options. To make the most of those new choices, you need to learn the facts. This guide is designed to help you do that.

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