Big news for same-sex couples in North Carolina. North Carolina’s largest health insurance company, Blue Cross and Blue Shield of NC has decided to reverse a systematic decision that took affect in mid-January. The decision lead to the cancellation of 20 policies for customers who were same-sex couples. After much embarassment, the company’s CEO issued a public apology. Along with the apology Blue Cross’ CEO also admitted that the company should have given more thought and consideration before making the decision to cancel policies. Blue Cross actually provides coverage to same-sex couples for their own employees and most consider the company to be “gay friendly.”
Despite consulting NC state officals regarding the cancellation of the health insurance policies; Blue Cross was still in violation of the Affordable Care Act. The cancellation of the insurance policies is considered illegal under guidelines issued by the U.S. Department of Health and Human Services. According to HHS insurance companies can’t deny coverage to same-sex couples under the Affordable Care Act. Based on the the new laws in the Affordable Care Act there are several nondiscrimination provisions in place for any insurance company that offers coverage through the federal insurance marketplace. Some of the provisions cover things specific things such as nondiscrimination of consumers based on gender identy or sexual orientation. Blue Cross to offer gay N.C. couples family policies – News-Record.com: Local News. Blue Cross stated that their rationale for cancelling the policies was due to advice from the NC Department of Insurance, which defined marriege as a couple of the opposite sex. However the NC Department of Insurance stated that the agency had approved an amendment to it’s policies last year that would have resolved this issue and added that all Blue Cross had to do was file an amendment instead of cancelling the policies.
According to Blue Cross any policies that were cancelled will be restored retroactively. Any new same- sex couples who want to purchase health insurance will be able to buy family coverage which will be effective as of March 1, 2014. However for many couples this news comes a little late. Many couples have already purchased seperate policies due to the fact that they were not allowed to purchase family coverage with Blue Cross. Which leaves them wondering how their situation can be “fixed” at this point.
Blue Cross has also decided it will offer coverage to unmarried couples and small businesses for the first time. It seems like Blue Cross has learned a hard lesson.However it also seems like they are taking the necessary steps to resolve the mess they have made. Hopefully other insurance companies will learn from the mistake that Blue Cross made and won’t follow down the same path. It is difficult enough to find affordable healthcare coverage and navigate all the various options. There’s no need to add additional obstacles to the process. http://www.newsobserver.com/2014/01/29/3574446/blue-cross-reverses-course-and.html
With so much talk about the new changes that would come into effect January 1, 2014 when the Affordable Care Act (or Obamacare as some call it) officially became an enforceable law in America. Some haven’t really given much thought to any of it at all. While others are tired of hearing about it all together. There has also been much talk around the state of NC, especially since we were one of about 25 states that opted to decline federal funding to expand Medicaid. Many in the healthcare industry have mixed feelings. However still quite a few wonder what things would be like if our state had made some different decisions. It is estimated that if NC had participated in the Medicaid expansion around 500,000 individuals & families would have become eligible to enroll in Medicaid. This would have also helped to reduce the number of uninsured North Carolinians as well, which is estimated to be around 1.5 million. It also would have helped to create some competition among the private insurance companies that decided to participate in the federal insurance exchange marketplace. (There was only one company that decided to participate.) http://www.ncjustice.org/sites/default/files/Medicaid-Expansion-OnePager-NCJusticeCenter_0.pdf
In October 2013 at a speaking engagement in Washington D.C., North Carolina Gov. Pat McCrory cited a couple of concerns such as adding an additional 500,000 people to the state’s Medicaid program & also concern over whether or not the federal government would actually pay its portion of the cost of the program after the first 3 years as factors in why he ultimately chose to decline the federal funds for the Medicaid Expansion. http://www.charlotteobserver.com/2013/10/23/4410230/gov-mccrory saysnorthcarolina.html#.UuR4_WQo7BIThe Governor also admitted that due to another new piece of federal legislation that had recently become law, NC may not have a choice but to reconsider the Medicaid Expansion. The new federal law allows hospitals to make “presumptive eligibility” decisions for those uninsured patients they feel may qualify for Medicaid under the current NC Medicaid eligibility requirements. Based on the “presumptive” decisions made by hospital personnel the state can be billed for services received by the patient until a final decision is made, which can take up to 60 days. In the event that the hospital has made the wrong decision about a patient and their ability to qualify for Medicaid the state still has to pay for any services the patient received prior to a final decision made about their Medicaid eligibility, regardless of the fact that ultimately they did not qualify for services.
Although many might believe that not excepting federal funding for expanding Medicaid in NC was a good decision. When you think about the amount of money that hospitals across the state end up attempting to collect every year from those that are uninsured, it makes one wonder if some of the expenses can’t be avoided or decreased. It is estimated that within the first 8 years of expanding Medicaid an estimated $65 million could have been saved by providing coverage to those who would typically be uninsured. The North Carolina Hospital Association is even encouraging our Governor to reconsider his position on the Medicaid Expansion. The Hospital Association feels that this is an opportunity for hospitals to be compensated for services they provide (which they would normally be providing for free.) They also point out that expanding Medicaid would also be an opportunity to provide primary care to those who utilize emergency rooms across the state for non-emergent care regularly thus providing access to primary care for everyone & hopefully helping to close the gap in the access to care.
At the end of December 2013 our state ranked 6 out of all the states with individuals or families using the federal exchange marketplace to enroll in some type of healthcare coverage. According to the data in a New York Times article, there were a little more than 274,000 people enrolled in our state. Out of that number only a little more than 31,000 of them were found to qualify for Medicaid or CHIP (a type of medical insurance assistance program for children from the government.) http://www.nytimes.com/interactive/2014/01/13/us/state-healthcare-enrollment.html?_r=0 It seems like the residents of this state want affordable health insurance, improved access to care, and they don’t mind paying for it either.
When you consider the fact that the state has to budget for Medicaid expenses annually any way and one of the purposes of declining federal funding was to save NC money, you begin to wonder if that is still possible with some the new developments since the Governor made his decision. If the state will now be responsible for unknown amounts of hospital expenses regardless of whether or not an individual actually qualifies for Medicaid; you wonder will this plan lead to savings for the state? Or will this cost the state more in the long run? Will Gov. McCrory end up trying to get others in his party to reconsider accepting federal funding for the state to expand Medicaid? (Many believe this would be very difficult and therefore is very unlikely.) Whatever happens NC is sure to continue experiencing some growing pains with all of the changes that are sure to come as far as healthcare is concerned.
Welcome to our new blog, Temp Chicks! We are a couple of ladies in North Carolina who manage & operate a temporary staffing agency for medical professional & allied healthcare professionals. Between the two of us we have over 50 years of combined experience in the healthcare industry. At our staffing agency we cater exclusively to licensed & certified medical processionals. Our staff are placed in various types of medical facilities & medical settings throughout the state. Due to the fact that we only cater specifically to those in the medical arena, it allows us to focus more on getting to know our staff and our clients- which helps ensure better client & staff satisfaction at the end of the day.
Having worked in the healthcare industry for so many years, we both saw the growing shortage of nurses in our state and others. We also recognized & agreed that agencies don’t function well when they are not properly staffed. These two factors were our motivation for starting 1st Choice. We saw the real value that staffing agencies can bring to the healthcare industry. Regardless of whether it is just a short-term assignment to fill in for someone who is out for several weeks for things like a temporary disability or maternity leave; or whether an agency needs to find qualified staff and they just don’t have the time to do the recruiting themselves- 1st Choice can help with all types of staffing solutions.
Temp Chicks blog will discuss various medical topics and things that are going on in the medical industry in our state & around the world. We also plan to discuss some medical awareness observances throughout each month.
Have a great weekend!