New Year, New Health Insurance Fee


A whole bunch of ObamaCare changes kick-in in this year. One of them is a little-known new fee the government is charging health insurers to fund research. The research will be carried out by the
Patient-Centered Outcomes Research Institute (PCORI), an independent non-profit entity created by Congress in the Affordable Care Act of 2010 (ACA). So far, so good. But under provisions of ObamaCare, insurance companies are supposed to foot the bill, meaning you can pretty much expect the cost will be passed along to you, the consumer.

You may not see the charge immediately, but it’s coming. Health insurers are required to donate $1, multiplied by the number of people covered under every health insurance plan, including self-insured plans, for policy or plan years ending after September 30, 2012. That fee will increase to $2 per plan participant by 2013, and will be indexed afterward for inflation until the fee is phased out in 2019. Over the next six months, the IRS will provide guidelines for insurers to help them comply with the new requirement.

What kind of bang will the health insurance companies, and you, get for the bucks? Well, the federal government says it wants to know which medical procedures, tests, treatments and drugs are most effective. Some people are concerned that the findings of the research will be used to direct health care decisions by determining what’s covered and what isn’t. They may or may not be comforted to learn that provisions of ObamaCare state that the government can’t direct PCORI’s research and places limits on how Health and Human Services can use the research to tinker with Medicare and Medicaid

According to an Associated Press story released December 28, 2011 PCORI’s director, Dr. Joe Selby, claims he’s taking the Patient-Centered part of his organization’s name to heart. As far as Selby is
concerned, doctors and patients will continue to make the decisions. However, the same AP story says the insurance industry fully intends to get its money’s worth by using the research to “fine-tune work-place health plans.” Let us hope it comes in the form of better, more cost-effective health care for all of us. 

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