Question: I have been offered a job that only offers HRA insurance and I don't understand it fully, so I am hesitant to accept the job. What should I do?

Answer:: One of my group clients is in the game business. Most of the employees there are young people - under 30 for the most part. The company was providing a defined contribution per month for each employee to pay for group health insurance coverage but found that many of the employees did not value the benefit. We quickly found that the "young invincibles" were healthy and they felt the insurance was too expensive. They believed that they'd never meet the deductibles required before they could get medical expenses paid for. Moreover it wasn't even medical services that they needed. Rather it was treatment for that nagging toothache that the health plan didn't even cover.

So the employer initiated an HRA plan that reimburses medical, dental and vision expenses as well as health insurance premiums. The employees love it and the employer is actually spending less than before.

Question: I read in the newspaper that the Preexisting Conditions Health Insurance Plan was a bust. What happened?

Answer: It's not a failure by any means, however enrollment is less than expected so far.

Several months ago, the special insurance pools became one of the earliest facets of the new health-care law to take effect. They are intended as a temporary coping mechanism for people with preexisting medical conditions that traditional insurance companies do not want to cover. The program is temporary, because, starting in 2014, the law will forbid insurers to reject customers based on whether they are healthy or sick.

One must be a resident of California, have a pre-existing condition as shown by a
Rejection letter from a health insurance company in the last 12 months, or coverage offered with premiums higher than those of the state risk pool, be a U.S. Citizen, U.S. National or lawfully present foreign national, and have been uninsured for 6 month prior to application for the plan.

A fundamental problem is that insurance for people with existing medical problems remains too expensive for many. Monthly premiums range from $350 to $600 for a middle-aged individual in California.

Another hurdle is the requirement that an applicant must have been uninsured for 6 months prior to applying for the special risk pools. The thinking behind this requirement is to prevent a wholesale migration of insureds from existing state major risk pools to the new pools where rates and coverage are better. HHS needs to take a look at removing that requirement.

Question: Obama claims health reform will lower health insurance rates. The Republicans say they'll go up. Who's right?