Insurance categories, everything traditional obamacare, to advantage advantage medicare shortterm Health Insurance plans, we have a wide ariety of information, what we do, alongside of that, we provide unbiassed market trends, regarding those different areas. Host how long have you been around . Since 2012, as i remember. Host it is a free site, how do make monsne guest we do advertising on the to allow us tod, monetize things. One reason the company was created, there was the open data initiative, which freed up enormous amount of information we rding health plans and thought would be a great idea to provide consumers with unbiassed information, n rather than worrying about the investments of one pundit versus another. Host open enrollment fast approaching for those who buy hrough the Affordable Care act marketplaces. When is that, how long is it pen this year and what should consumers be looking for . Guest open enroll cemetery through rom november 1 december 15th. One reason they are doing that, they are trying to keep people until the last minute and then enrolling, they ant people to start paying for premiums as early as possible and not having adverse selection within the risk pools. To things like consumers have to consider, there is great deal of regarding right now what rates and deductibles are plans, be for 2018 along with that, there is also great deal of concern around the of competition in various counties across the United States. Things prior Government Research has shown is that if you have three or more Company Options within a particular region, you end to have lower benchmark premiums, likewise, if you only have one or two, you have a you have less downward pressure on premiums. Thealso have to worry about networks of healthcare providers. Ne thing i try to emphasize to consumers at the end of the day, is only as good as doctors and hospitals that accept it. Plan, it ve affordable doesnt include the best question, you have to god forbid you develop a medical greater that requires expertise. Host we talk with kev coleman, special lines if you are insured Affordable Care act. Phone number, 2027488000. Others, 2027488001. Get your questions, your concerns, especially ahead of this open enrollment period. What are the biggest changes going to bee likely seeing as they look at their options this year . You well, depends where live. One thing about the Affordable Care act is that there is a great deal of difference in number of carriers and which carriers are available epending where you live in the United States. You also tend to see different etcetera. Remiums, just as all politics are local, so is all Health Insurance. Important for is consumers to do, make sure they do appropriate research before enrolling, make sure you are taking a look at premiums, but costs forut of pocket medications that you take for he type of healthcare you regularly use . And sometimes the out of pocket what you would pay in premiums. For instance, about two weeks released a study on drug out of pocket costs. Course, Prescription Medications were always a concern within american 10 of healthcare dollars are spent on drugs and we found things within silver plan, the most popular of the Exchange Plan in the dable care act is that out of pocket cost for specialty about 16 . Going up host why . Um, variety of reasons. Seen an increase in utilization of Specialty Drugs for several years now. Consist also drug have rather interesting instance, tics, for orphan drugs mean you are serving less than 200,000 within the nation. Now what happens, it takes you billion and nearly dollars to develop that drug and your rica, you know, patent laws give you about 20 years of patent protection, that filing the patent f. It takes 12 years to develop and ou file patent at the beginning, you might have eight years of patent protection for a single patent. Amount of time, Smaller Group of people to spread out those costs and also a profit. With that said, there are also within the American Health care market which have good job at bringing Competitive Pressures on drug pricing. Being the issues that is investigated right now around pharmacy benefits managers, firms that negotiate the cost of drugs between the Health Insurance companies and pharmaceuticals who are providing the drugs. There isnt a great deal of with the companies and there is questions now about effectiveness. Host the report available at healthpocket. Com, kev coleman month, in early ther the fourth year of the Affordable Care act coverage, specially out of pocket costs remain a problem for consumers, Specialty Drug out of pocket problem. Main a check it out there. Give us a call, well talk about enrollment g open period. Special line for those who will be buying or get tHeir Insurance through the Affordable Care act marketplaces. 2027488000. Franklin, new n jersey. Glen, go ahead. Caller you there . Yes, sir, go ahead. Guest hi, glen. Caller all right. Had singlepayer plan like bernie says, wouldnt that of a guy like you out business . Ouldnt you be working for a mechanical company . Guest well, i dont think so. The hank you for suggestion. I think one of the things with to be payer, it has investigated at this point, the could to which this introduce deficiencies within the health care market. For me as orrisome Health Care Analyst is the degree to which the government actually efficiently administer health care. Ill give you an example. I have been in the past medicarel architect of Exchange Many years ago. Had to do requirements, work with engineers to have that built. Complicated process. Hen i take a look at money spent on healthcare. Gov, that website, 700 million and 2 billion that, is literally frightening to me given the fact the data the operational logic, the interface designs are not particularly complicated world of software design. So those are some things that give me hesitation when i hear about if we just had single payer, that would reduce so those are some things that o costs. There is great deal of mythology health care and i find, i do research as i go data, having myths slain before me. Immediate future, health care legislation, want to get your thoughts on the new repeal, n obamacare Affordable Care act repeal as rt facing tight deadline Washington Post headline puts it this morning. Of have to move by the end the month, when procedural rules to passhat allow senate the legislation by a simple in the senate. Have you had a chance to review that legislation . It . Are your thoughts on guest thats a good question. I happen to pick up a newspaper his morning before i came into the interview host the idea guest just a little bit about t, im not particularly well versed on the subject. As i understood, they are taking going to block grants states to allow states better es to try and design and innovate things rchlt my perspective, i dont really have invest oment one Political Party or another winning. Can be is what steps taken that would help consumers ay less in premiums and out of pocket costs for health care. I think whether we talk to democrats, or theres still a list of things that could be reformed in health care. If the legislation could fit litate that, great cant, then why are we discussing it . Havent had a chance to give the level of i lysis policy deserves, so cant comment upon it in greater detail. Editorial board of the New York Times looks at the bill. M cassidy after spending much of this year trying to kill Affordable Care act, republican lawmakers try a worse plan, if you want to read the Editorial Board on op ed section of the paper. Good morning. Morning, gentlemen. I really do appreciate this im 35 year because urvivor of the aids virus and the drug pricing im glad you it because in the hiv community, that is where a large of abuse is happening because most cocktails cost or more per month, no matter what your combination is. Me, thats one of those consider,at we have to but to the meat of my question is, the ability or the control. Y for cost we have a spend it all so we for more type of entality within these type of government programs. Of that and rid while were talking about that, block granting really this entire system . Because kansas, with just over a shouldnt get the exact same amount of money arizona, with six Million People needs to get. Where we see waste, fraud and abuse nstates like kansas oklahoma, who have onefifth people, but the exact same amount of money. Think you bring up some excellent points. With respect to allocation of in block grants, i dont have the at that tima on this latest legislation in terms of allocate it. Whether it is going to be even or have a just even state by state allocation of funds. Going back to your discussion of hiv drugs, id like to take the to talk about the increase infects of Specialty Drug costs are. We did take a look at the top drugs in the United States right now, which humira, ember are havarney, axone, hich treat a variety of conditions, ranging from ms, to to mmatory conditions hepatitis c. When we run the numbers we find monthly increase in cost that from 200 a month to over which is really huge burden on americans, especially when you consider polls showed about 57 of mericans have saved less than 1000. I think we need to take a look are some things we know we can do that can help bring the price of Specialty Drugs, whether they be for hiv, ms, etcetera. Some of those deal with nature of competition, when you have drug in a drug class treating a particular condition, obviously less downward cost pressure. To do this or lessen this, how can we increase competition more quickly . Re there ways for Industry Leaders to work with government regulators to be able to approval the drug process without compromising consumer safety . A look at s taking when is price gouging happening . You know, what are people paying for the same drugs in other ountries and how can pharmaceutical companies justify big price differences in the United States. Those are the immediate things look at to help this situation and help many populations. Ost on the Graham Cassidy legislation, we should have more information next week when the Budget Office is expected to preliminary assessment, but explaining a little bit more about what that bill does from story shington post under the new bill, starting in 2021, the federal government would lump together all money it spends on subsidies distributed hrough the marketplaces and expanded Medicaid Program covering poor, childless adults 133 of the to federal poverty level, this approach would result in less states that expand medicaid under the aca, and more that didnt. Tes it would redistribute money to thatopted to expand medicaid. More information from earlier. Jewel sewait nothing gathersburg, maryland. Good morning. Morning. Good thank you for taking my call. I have a couple comments. All, i am uninsured because i cannot afford the even subsidized, nor pocket afford the out of expense if i could afford the premiums. In favor of single p it r, im not afraid of because even if i required 10 tax increase, its still going be far less than my out of pocket would be to pay for the i would be d then fully covered. I am in favor of the government states have and budgets that are balanced and profits and ing cov covering healthcare. Consist handle the situation better than the federal government. Me add to , let comments. First the aspect of insurance affordability affordability. One area that i think politicians in various pundits failed is eform have taking a look at some of the structural issues that high Health Insurance premiums. At the end of the day, most, not but most Health Insurance premiums are determined by type used, how often it is used. We have not looked at ways to be able to actually lower the cost of Health Care Delivery. Thats one of the best nearterm things we can do to improve Health Insurance cost within the United States. Buckets two big driving healthcare cost. Are Health Issues diabetes, cardiovascular disease, obesity, smoking, etcetera. Unfortunately, these things take decades before they express Health Care Cost and sxhelth wellness efforts to may not be oblems, judged success or failure for a decade. That leaves us with the actual of Health Care Delivery. Have quite expensive to lots of little gimmicks, lots of hospitals, each one fully one outfitted with medical equipment. Ne thing we have not done well in america, taking a look at how etter leveraged Health Care Delivery, like telemedicine and how do we break down walls and out of e if someone is state and certified doctor services, that there is, you know, cross statability to be able to access cost care. It will not address all healthcare scenarios, but one wed be able to start bending the cost curve in a meaningful way in my opinion. Host we have a special line for those getting insurance through the Affordable Care act marketplace. 2027488000. Allrwise, 2027488001, for others. 10 minutes left with kev coleman f healthpocket and healthpocket. Com. Head of research and data with healthpocket, joining us this morning. Cindy, highridge, missouri, youre up next, go ahead. Caller hi. Y. St hi, cind thank you for having me. Information that has been my experience with the cost of the diabetes pply of the drugs, insulin pens, longterm and short term. And unfortunately, we had Power Outages more than one, back during the month and the irst one that we had involved the fact the insulin went bad because of the outage. Therefore, i was trying to get found out theen i cost of trying to get the medications before they were an emergency supply by my private insurer, the cost to me, spur of the moment, when had a power outage and lost pen sulin was 1500 per roughly and it ended up being uch a high cost we were going what are we going to do because hat is a lot of money for two pens and doesnt include other supplies. Thinking, we have private insurance, what does the have do that doesnt and do not have the insurance capability we have and we were basically forced to ait until the following morning, no insulin, and go all the actual l when private insurer opens up their door for phone calls and say, we emergency. Pharmacy would not even dispense one pen, even though they were to issue one pen to hold to get that law the this was some of the frustration. Drugs, nd has specialty as well, and some of his drugs, one of them just dropped. Specialty drug and it was close to 100 and it dropped reasonable copay and the difference in generic. I say, spread it around the world, were giving drugs out to other countries, research around the world and then look at the profit margin of all the companies. There is research, cost and everything, but everyone should be paying for it. Sharing your or story. Kev coleman. Guest she brought up many points. Nt going back to an earlier issue about why it is important to ower cost of Health Care Delivery that, is enormously important to uninsured. Not care with robbery to medication, shes that g about making sure internationally there is, you know, a better effort to be able o distribute cost and things im assuming shes talking about research and development, and i enormously s important and would agree with her. Baldwin, maryland. Bernie, on the line for those through Heir Insurance the Affordable Care act. Good morning. Caller good morning. Want to talk about the brought up by your guest earlier of medicare for privateem as opposed to insurance. You know, the efficiency of administrative cost the , the aca limited administrative cost of private insurance at 20 , which means prior to the a. C. A. , it was 30 . R, could have been united is the c. E. O. Of health care received in one year totally n bonus, ridiculous. The other thing, on drugs, we for the same drugs, in other pay 20, 30, 40 or 100 percent more of private drug cost. T is more efficient to have system. E for all guest you seem to agree with me on some point necessary terms of one thing the government should take a look at, the list prices countries g in other versus america and significant variance forcing companies to ustify that or face fines over price gouging. With respect to the uhc c. E. O. , specifics of he their situation, i know that uhc enormous company not to justify exorbitant c. E. O. Pay, sdwrouft give it a little nuance. His insurance ts through the Affordable Care act. Want to get your thoughts on the sustainability of the a. C. A. , critics, including critics in administration used the term death spiral. What is your analysis . Is t i think there significant differences regionally. You cant talk about the a. C. A. Rather what are we seeing individual carriers nd different parts of the country. The Biggest Issue for the Affordable Care act is nature of the risk pool. Underestimated how many less the hy people would be in risk pools and how that would affect the typology of medical costs are higher than they would have anticipated within that realm. Currently they dont have the mechanisms within the to slation to be able significantly lower the costs of hese claims and thats one of the areas that hopefully there may be some bipartisan discussions. Hard to talk about in washington, d. C. Right now, but actually having and rats, independents republicans talking together about well, we have this issue, find a , we tend to small portion of the population rives the greatest portion of healthcare costs. What type of interventions might could preserve quality of care while lowering costs at the same time . For one or two more calls. Anne in powder springs, georgia, go ahead. Caller hi, how are you this morning . Host doing well. Appreciate you taking our calls. R. Coleman, what im curious about is im a General Motors get my insurance designed by General Motors and o we have a selection that we have to make dividing us up Medicare Advantage network ortional care Health Maintenance organization, have. Hree options we and when i look down through this, i dont know what to is kind of like, okay, i look at traditional which is what , ive been sticking with tis what i can seeo and i know my doctors and i dont have to change doctors because i have i have to goalists to. Down at when i look monthly it says, the contribution is zero for single and zero for a family. Contribution is 17 a month. And then the deductible is 245 a and 400 for the ppo me under traditional care network. That out of e than pocket. I dont know exactly what that out like 6 or this year out of pocket, i dont know what the deductible applies to and how it works, but i dont get it. Pocket i have this year out of max of 800. I dont understand what that me. Ns for host go ahead, kev coleman. Guest you brought up the series hopefully my sufficient to address as many as possible. I will say i got a bit of a smile on my face listening to you, your discussion reminded me healthcare. Nto i was at a Technology Startup founded by the former head of sloan school of management at mit, and Medicare Part d was got the t and he instructions for it, he said im professor at mit, one of the top institutions in the world, i dont understand the stuff. A lot of issue with what the caller brought up. Deductible is amount that you pay out of pocket of cost her forms sharing begin like copayment or coinsurance fees. Pay full list price for medical service or Prescription Drug up 285, 400, depends on your plan. There are ing plans, several things you need to consider. Obviously youre comparing premiums, you should lso be taking a look at what drugs you are on, what type of medical services you use and options ifferent plan and see what are the cost sharing obligations for those. What are a look at annual capos your out of pocket costs. Medicare in the advantage plan that i like as traditional medicare, they have capos covered medical drugs. S and prescription that can save enormous amount of money. With respect to network coverage, you should always take at whether or not your current doctors and specialists are in network and then also to see whether or not the best hospital necessary your area are part of network. An earlier point, as goodnsurance is only as hospitals and doctors that accept it. Make sure you have health plan has network that includes hospitals or has out of network there is cost sharing from the health plan when you go out of network. Anne hung on the line to hear your answer 6789 good luck. Healthpocket, h head of research and data there. Healthpocket. Com, appreciate your time. Back again. Guest thank you very much. Host up next on washington journal, we end today with open phones. Want to hear from you about Public Policy issues that you want to discuss. Line for democrats, republicans, independents are on the screen. Start call nothing now. Well be right back. It is that time of year to nnounce 2018 student cam video documentary competition, help us spread the word to middle school and High School Students and teachers. Years theme is constitution and you. Asking students to choose provision of u. S. Constitution and create a video why it is important. Our competition is open to middle school and High School Students, grades 612. Students work alone or in a group up to three and produce 5 documentary on provision selected. Nclude cspan programming and explore opposing opinion. 100,000 awarded in cash prizes, of 5000 go to the student or team with best overall entry. Deadline is january 18th, 2018. Mark your calendars and help us the word to student filmmakers. Studentcam. Org, for more information. Washington journal continues. To end is open phones our program today. Any Public Policy issue you want to discuss. Open. Hone lines are democrats, 2027488000. Republicans, 2027488001. Independents, 2027488002. Y, the end of the program