No lying Leftists, Trump is NOT trying to “end coverage for preexisting conditions”

No lying Leftists, Trump is not trying to “end coverage for preexisting conditions“. His D.O.J. however has chosen not to defend Obamacare against the latest legal challenge to it led by Texas and 19 other states. That case argues (legitimately) that since the SCOTUS found the “Individual Mandate” constitutional in 2012 by defining it as a “tax” and later Republicans passed tax reform which included repeal of the Individual Mandate. The Individual Mandate can no longer be constitutional because there will be no more penalties assessed for not buying health insurance as of January 1, 2019. The D.O.J. is also arguing that two other Obamacare provisions should be struck down — one requiring insurers to cover those with preexisting conditions AT THE SAME PRICE AS THOSE WITHOUT PREEXISTING CONDITIONS.

I put that last part in caps because the lying Leftist propagandists at Politico, WAPO and every other Left wing rag have left that important part OUT. The truth is, if this legal challenge prevails (and that’s a BIG if) those who have preexisting conditions would simply pay more than those without preexisting conditions and coverage for preexisting conditions would still exist as it did for decades before Obamacare. For responsible reporting on this issue read the following article from the Washington Examiner.

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Cheaper non-Obamacare Short Term health plans lasting 365 days returning.

By May 1st of 2018 United Healthcare, Aetna, Cigna, Humana, Blue Cross and other carriers will once again be able to legally offer non-ACA (Obamacare) Short Term health insurance plans that will cover you for an entire year. This is thanks only to President Trump who reversed Barack Obama’s previous order restricting these much less expensive health insurance plans to 90 days of maximum policy ownership.

This is very good news for millions of healthy Americans who do not qualify for federal health subsidies and as such cannot afford to pay for individual health insurance that now costs more than their mortgage payment. THANK YOU President Trump!

Please note: Non ACA-qualified Short Term health insurance plans are not required to cover preexisting conditions or certain ACA (Obamacare) mandate “Essential Health Benefits” that are covered with ACA-qualified plans. These benefits are:

1.) Maternity and newborn care.
2.) Mental health and substance use disorder services.
3.) Certain Preventive care benefits such as routine mammograms and cancer screenings are covered with Consecutive Short Term health insurance plans.
4.) Pediatric services (including both oral care and vision care).



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Group health insurance for one person ensures access to Chicago Teaching hospitals for small businesses owners.

In November of 2015, Chicagoland residents were shocked to learn that Northwestern Memorial hospital, University of Chicago medical center, Rush University medical center and the Ann & Robert H. Lurie Children’s hospital would no longer accept patients who have ACA (Obamacare) qualified individual health insurance plans.

This action led to a significant increase in the purchase of small group health insurance policies which still provide national PPO networks and still ensure access to the aforementioned teaching hospitals in Chicago.

For small corporations who could afford to insure themselves and 70% of their eligible full time employees (the minimum participation requirement), purchasing small group health insurance was a costly fix to the new narrow networks in the individual health insurance marketplace.

The ability to purchase group health insurance for you and your full-time employees is well known. What is not well known is the fact that you can purchase a small group health insurance policy without insuring your employees during a small window each year. This year that window begins on November 1st and ends on December 15th. The same time period that 2018 ACA Open Enrollment for individual plans begins and ends.

During this little known ‘relaxed underwriting’ period, an owner of a small corporation (less than 50 full-time employees) can purchase small group health insurance while employees ‘waive’ coverage without producing an eligible waiver. Normally, 70% of all full-time employees must participate in a group health insurance plan unless they have an eligible waiver such as an offer of group health insurance from a spouse’s employer or Medicare and Medicaid coverage. If you do decide to offer coverage to your full-time W2 employees during this Special Enrollment period, you do not have to pay any portion of your employee’s premium. Normally, you must pay 25% of your employee’s premium.

If you are a small business owner who is seeking to purchase small group health insurance and cannot afford to insure your employees or, your employees simply do not want to participate in a group health insurance plan. Now is the time to learn more about “relaxed underwriting”. The cost for group health insurance is now commensurate with individual health insurance but the PPO network is much larger and far more inclusive than any of the narrow networks now available in the individual marketplace. Want to learn more? Click on “contact” at


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Consistent Short Term health insurance returns as ACA Open Enrollment begins

On October 12, 2017 President Donald Trump signed this Executive Order designed to restore consumer choice in the Short Term health insurance marketplace. Short Term health insurance is the only kind of non-ACA (Obamacare) qualified health insurance available in the individual marketplace. While both ACA-qualified health insurance and non-ACA qualified Short Term health insurance policies are considered major medical health insurance, or comprehensive health insurance and both cover major health events in your life, there are important differences between the two. ACA-qualified health plans are guaranteed issue, meaning you cannot be denied coverage based on preexisting conditions. ACA-qualified health insurance plans are also required to cover certain “Essential Health Benefits” that are not covered with non-ACA qualified Short Term health insurance plans. “Essential Health Benefits” that are not covered with Short Term health insurance policies are as follows:

1.) Maternity and newborn care
2.) Mental health and substance use disorder services
3.) ACA mandated Preventive care benefits, routine mammograms and cancer screens ARE COVERED with Consecutive Short Term health insurance policies.
4.) Pediatric Services (including both oral care and vision care).

On March 31, 2017 a preexisting Obama era regulation limited Short Term health insurance coverage to 91 days of policy ownership. This regulation exposed millions of Americans to new and unique risk factors. Prior to March 31, 2017, consumers could purchase Short Term health insurance policies that would last for the entire year without interruption. So, there was no risk of your policy ending in the middle of the year outside of the annual ACA open enrollment period. Those who developed new medical conditions during the first 91 days of Short Term policy ownership, faced the new risk of not being able to qualify for another Short Term policy when their first Short Term policy ended at the end of 91 days. Consumers placed into this difficult position would then be left uninsured and uninsurable in the individual marketplace until the next annual ACA open enrollment period began again when they could once again obtain coverage for preexisting conditions. President Trump’s executive order plans to rectify that situation as soon as the 60 day comment period expires. So, we should be able to once again purchase Short Term health insurance that provides consistent coverage for 365 days as early as January or February of 2018.

Until then, the health insurance industry has responded by creating “Consecutive” Short Term health insurance coverage that will be available for purchase as of 12/01/2017. With these new Short Term health insurance policies from National General Accident and Health you are guaranteed to be issued up to four Consecutive Short Term health insurance policies, each lasting 90 days. You answer health questions only for the first policy which lasts 91 days, then on day 92, National General guarantee issues you a second policy, 90 days later they gaurantee issue you a third policy and finally a fourth policy 90 days later all without evidence of further underwriting and without any new preexisting condition clause. So, you can now remain consistently insured for up to 360 days without answering any new health questions and without the fear of conditions developed during the first, second, third or fourth policies being excluded.

Click here to download the brochure for National General’s Consecutive Short Term health insurance. National General Consecutive Short Term health insurance policies use the Aetna Open Choice PPO network. This network includes access to Northwestern Memorial hospital, University of Chicago Medical Center, Rush University Medical Center and the Ann & Robert H. Lurie Children’s hospital as well as many other hospitals and medical providers nationwide. Search Aetna’s Open Choice PPO network here. For quotes and to apply online for Consecutive Short Term health insurance policies from National General click their logo. Please note: You can only purchase Consecutive Short Term plans AFTER 12/01/2017.


Please note: Because U.S. Senate Republicans failed to repeal or even repair the PPACA (Obamacare) the fine for not having ACA-compliant health insurance is still law and still being enforced by the IRS. This being the case, you will be fined 2.5% of your AGI – Adjusted Gross Income – by the IRS for purchasing non-ACA compliant Short Term health insurance. 

National General Holding Corporation
 is a publicly traded company with $2.5 billion in annual revenue. Their new “Consecutive Guaranteed Issue” Short Term health insurance plans are underwritten by Time Insurance Company (est. in 1892), National Health Insurance Company (incorporated in 1965), Integon National Insurance Company (incorporated in 1987) and Integon Indemnity Corporation (incorporated in 1946). These four companies, together, are authorized to provide health insurance in all 50 states and the District of Columbia.

Short Term health insurance for less than 91 days

If you need short term coverage for less than 91 days you can purchase coverage from United Healthcare which includes their Choice PPO network. To get quotes and apply click the link below.

2018 ACA (Obamacare) Open Enrollment begins on 11/1/2017 and ends on 12/15/2017

The 2018 PPACA (Obamacare) Open Enrollment period begins on November 1, 2017 and ends on December 15, 2017.  During this 45 day window, individuals and families can purchase guaranteed issue individual health insurance (with no preexisting condition exclusions). Coverage will not begin until January 1, 2018. Depending on your projected 2018 MAGI – Modified Adjusted Gross Income – you may qualify for one or more federal health insurance subsidies to lower your premium, deductible, coinsurance and copays. To learn the income levels necessary to qualify for health insurance subsidies scroll down this page. If you do not qualify for subsidies please click “Shop for unsubsidized plans OFF the exchange” below to purchase health insurance directly from the carrier of your choice Questions? Call (630) 674-1551. Out of state? Call toll free (866) 724-7123.

Buying on the exchange? If you do qualify for subsidies please click “Shop for subsidized plans ON the exchange” below. You will be able to pick a plan, get your subsidies and finish the entire process much faster than using alone. HealthSherpa speeds up the process.

unsubsidizedshopping                   subsidizedshopping

Determining your elibility for subsidies

Depending on what you expect your 2018 total household MAGI – Modified Adjusted Gross Income = (after deductions but before taxes) to be, you may qualify for a significant APTC – Advance Premium Tax Credit (federal subsidy) under the new health care law to lower your premiums. You may also qualify for a Cost Sharing subsidy to lower your deductible. If you believe your 2018 total household MAGI will be lower than:

$48,240 for an individual
$64,960 for a couple
$81,680 for a family of three
$98,400 for a family of four
$115,120 for a family of five
$131,840 for a family of six

you will be better off financially by shopping for a plan on the exchange (via in order to receive an Advance Premium Tax Credit and/or a Cost Sharing reduction to reduce the premium and deductibles of either the Bronze, Silver, Gold or Platinum Qualified Health Plans.

Buying on the exchange? If you qualify for a subsidy please click the link below. You will be able to pick a plan, get your subsidy and finish the entire process much faster than working solely with


Shopping from another state? Call us toll free at (866) 724 7123 or scroll down to get quotes from carriers in your state. 

Please note: If your income is lower than the 2018 Federal Poverty Level Information – 2018 FPL in your state, which is less than 138% of the FPL – Federal Poverty Level in states that expanded Medicaid and less than 100% of the FPL in states that did not.  You will be offered Medicaid will not be able to qualify for subsidized health insurance. You can purchase health insurance even if you qualify for Medicaid but you must do so without a subsidy. Click the chart below to determine the current Federal Poverty Level and percentages above it. 2018 Federal Poverty Levels will not be released until late January of 2018 so, the 2017 FPL chart must be used to determine 2018 subsidy eligibility.


Please also note: If you qualify for a federal health insurance subsidy and your state has expanded CHIP – Children’s Health Insurance Plan – under Medicaid you may not be able to insure your children on your policy. will instead send them to Medicaid. You may wish at that juncture to purchase private health insurance at full price for your children instead.

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2018 Individual health plan rates include higher prices for Illinois consumers thanks to Bruce Rauner’s “side hustle”.

Back on August 1, 2017 the Chicago Tribune provided a preview of 2018 annual premium increase requests made by Blue Cross Blue Shield of Illinois for their 2018 individual health insurance plans. Then on October 12, 2017 the U.S. Health and Human Services Department issued a statement reconfirming that former president Barack Obama authorized CSR – “Cost Sharing Reduction” subsidies (which artificially reduce deductibles and co pays for those under 250% of FPL) illegally, unilaterally and unconstitutionally. As such, those subsidies were ended after a thorough review by HHS, the U.S. Treasury, the Office of Management and Budget, and an opinion from the U.S. Attorney General.

Since the Surrender party in the U.S. Senate failed again to repeal and replace the PPACA a.k.a. Obamacare (after promising to do so for 7 years), Obamacare remains the law of the land. Because Obamacare is still the law, health insurers are still obligated to artificially reduce deductibles and co pays for those under 250% of Federal Poverty Level. So, someone still has to pay for these CSR “subsidies”. “Someone” is the 17 million Americans who purchase health insurance in the individual marketplace.

The hope was that time would be allotted for congress to legally appropriate the $7 billion needed to continue CSR subsidies so that additional premium increases would not be levied on self employed consumers seeking individual health insurance coverage.  In fact, Patty Murray and Lamar Alexander are working on such a piece of legislation now.

Instead of waiting for congress to legally appropriate money to continue CSR subsidies, “Social Justice Warrior” Bruce Rauner (who recently became the first U.S. governor to initiate publicly funded abortions for all state employees and for all Medicaid recipients) wasted no time in taking swift action to “protect Obamacare” by directing health insurers offering individual health plans to attach a surcharge—on average 15 percent—to Silver health plan premiums. Silver health plans are the most popular health insurance plans available under Obamacare because they are the only health plans that consumers who (qualify) can receive federal subsidies for. So, what are the end results of Governor Rauner’s “side hustle” to protect Obamacare? Below are the new 2018 approved health insurance premium increases released today via after they were “fundamentally transformed” by “Social Justice Warrior” Bruce Rauner.

BEFORE Bruce’s “side hustle”: 

38.2% for BlueCare Direct HMO Silver plans
14.5% for Blue Precision HMO Silver plans
9.3% for Blue FocusCare HMO plans

5.4% for Blue Choice Preferred Silver PPO plans.


AFTER Bruce’s “side hustle”: 

35% Blue Care Direct HMO Silver plans
28% Blue Precision HMO Silver plan
11% Blue FocusCare HMO Silver plan
13% Blue Choice Preferred PPO Silver plan

Since the Blue Choice Preferred Silver PPO plan includes access to the last individual PPO network that Chicagoland consumers have left to purchase (since we only have three carriers left in Chicagoland that offer individual plans). And, the Blue Precision HMO Silver plan is the most popular individual HMO plan. This means that Illinois consumers who do not qualify for subsidies and have already received on average a 99% increase (and in many cases more than a 200% increase in their individual health insurance plan premiums since 2014) will now pay double the annual premium increases for the two most popular individual health plan options. Namely, the Blue Choice Preferred Silver PPO plan and Blue Precision Silver HMO plan.  Obamacare remains anything but “affordable” and our elected “Republicans” are providing no assistance whatsoever.

Source data:

Click here > BCBSIL2017IndividualPlanRates < to see quotes for a 50 year old male in Will county, Illinois run with today’s effective date.

Click here > Healthcare.govBCBSIL2018IndividualPlanRates < to see quotes for a 50 year old male in Will county, Illinois run with a January 1, 2018 effective date.




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Blue Cross Blue Shield of Illinois proposed 2018 premium increases

Blue Cross Blue Shield of Illinois proposed (not APPROVED) 2018 premium increases for Individual policies are as follows:

38.2% for BlueCare Direct HMO plans
14.5% for Blue Precision HMO plans
9.3% for Blue FocusCare HMO plans
5.4% for Blue Choice Preferred PPO plans.

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New Ted Cruz-like amendment to the Senate Better Care Reconciliation Act literally changes EVERYTHING.

The new amendment to the Senate “Better Care Reconciliation Act” which was derived from the mind of Senator Ted Cruz literally changes EVERYTHING. Conservatives have been clamoring for an escape from the Obamacare regulations which have driven health insurance premiums through the roof  in the last few years.  For the first time, their requests have been clearly and unequivocally answered. The new “Cruz-like” amendment creates two separate health insurance marketplaces. They are the “On-exchange” and “Off-exchange” marketplaces. Below are the differences between these two market places and they are huge differences. These difference should significantly deter the initial worries about churning (moving between both markets) that concerned myself and other health care policy experts. And, they should bring former naysayers like Senator Rand Paul back into the ‘aye’ vote column as well as any other Conservative hold-outs like Senator Mike Lee.

How individual health insurance will work in the ON-exchange marketplace 

ON-exchange plans will contain all of the same PPACA (Obamacare) regulations and consumer protections that have existed since the full implementation of Obamacare on January 1, 2014. This includes all of the Obamacare “Essential Health Benefits” and so long as consumers keep consistent creditable coverage in place (with no lapse of more than 63 days in coverage) preexisting conditions will be covered seamlessly when moving from policy to policy during the annual OEP – Open Enrollment Period – and for those eligible for SEP – Special Enrollment Period – rights (loss of employer sponsored coverage, divorce, marriage, birth of a child, adoption etc.) during the rest of the year.

Here’s where everything changes

Only ON-exchange plans will qualify as creditable coverage. This means that if you purchase OFF-exchange plans, those plans will not count as creditable coverage. So, you would have to wait 6 months before preexisting conditions would be covered if you decided to jump into the ON-exchange marketplace in order to receive a richer benefit plan. This difference should significantly reduce the risk of churning between OFF-exchange plans (when you’re healthy) and ON-exchange plans (when you’re not). So, system-gaming should be significantly thwarted by this intelligent plan design and it should help stabilize pricing in both markets.

Other differences for OFF-exchange plans

OFF-exchange plans will not have to include the Obamacare EHBs – Essential Health Benefits – or other Obamacare provisions like unlimited lifetime maximums, coverage for drug rehab, maternity, sexual reassignment surgery and other mandated benefits. This means that premiums for these OFF-exchange plans will most likely be much lower and they had better be because OFF-exchange plans will not be eligible for ANY federal subsidies a.k.a. APTCs – Advance Premium Tax Credits. In other words, regardless of your income, you will pay the actual premium for health insurance without any assistance from other taxpayers. And, these plans will be medically underwritten which means that you can be denied coverage for these OFF-exchange plans or charged more based on a preexisting condition.

Protections that will still exist for OFF-exchange plans

In order to alleviate the predictable pearl clutching from the naysayers, it must also be understood that in order for a health insurer to be able to offer OFF-exchange plans in a state that allows them, that insurer must also offer ON-exchange plans. Also, in order for a state to be allowed to offer OFF-exchange plans, they must also first have a working state risk mitigation program in place and funded (utilizing the nearly $200 billion included in the Senate Better Care Act for such purposes). This will ensure that those who do not qualify for an OFF-exchange plan due to a preexisting condition have access to a state run high risk pool plan that the state makes available.  This also does not mean that state regulators won’t also require OFF-exchange plans to provide a certain amount of “Essential Health Benefits” that they require to be included. For example, coverage for Cancer and a whole host of other medically necessary benefits.

The point is, it will be up to state regulators to determine this new set of “Essential Heath Benefits” for OFF-exchange plans and not a one-size fits all set of benefits designed by the Federal government and the Special Interest groups who helped them craft them. It’s also important to note that OFF-exchange health plans also do not have to redistribute their profits to other insurers that did not do as well. This too should lead to consistently lower premiums in the OFF-exchange marketplace.
Full repeal is not possible with 52 votes but this is the next best thing
Considering the fact that “full repeal” is NOT possible without 60 votes and that we’re working under the constraints of the Budget Reconciliation process under the Byrd Rule, I’d say Senator Cruz did a very good job providing an off-ramp for Conservatives who were looking for actual relief from Obamacare. Kudos to Senator Cruz and to Conservatives who are still holding out for “full repeal”, it’s time now to support the “Better Care Act”. This is no longer about politics, 44% of counties in our nation will have NO health insurer or only ONE health insurer next year. The time for posturing is OVER.
KUDOS to Seth Chandler at Forbes for doing the heavy lifting on this new amendment.


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