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Premium Increases May Give HMOs a Boost


Despite the fact that many offer low premiums, require minimal paperwork and have low co-payments, many federal workers -- and most retirees -- continue to shy away from health maintenance organizations.

The debate on managed care has refocused the limelight (not always kindly, or accurately) on HMOs.

But fear of HMOs could change next year as policyholders, worried about the average 9.3 percent increase in premiums, take another look at premiums charged by some HMOs.

About 30 percent of enrollees in the federal employees health benefits program are in a managed-care HMO. In the federal health program, HMOs have traditionally offered the best dental coverage (with some paying for up to half the cost of many procedures). They are also rated highly for maternity benefits, well-baby care and preventive maintenance.

But most HMOs restrict the choice of doctors and facilities (more than fee-for-service plans) and their coverage is local. HMOs will cover emergencies out of the area, but otherwise require policy-holders to adhere to local HMO rules, visit selected local doctors and hospitals and practice managed care.

The average 9.3 percent federal health premium increase in January has unnerved many feds -- and especially retirees. But that’s an average. Some plans will go up, some down.

Federal workers and retirees have a wider choice of health plans than most private-sector workers. That gives them more leeway when premiums go up. They can simply switch to a less costly (if premiums are the issue) plan.

Under the federal program, nobody can be denied coverage because of age or existing medical conditions. Retirees (unlike many private-sector health plans) and their survivors pay the same premiums, and get the same coverage, as younger, healthier workers in the same plans. The government pays an “average” of 72 percent of the premium. In some instances, workers and retirees can cover grandchildren. Former spouses can also get coverage under the federal health program -- via court order -- but they must pay the full premium. Even so, paying the group rate full premium is often less than the cost than if they sought nongroup coverage for the same kind of plan.

Housing Funds Announced at AIDS Conference for Women (Los Angeles)


With an unprecedented gathering of women infected by the AIDS virus under way in Los Angeles, city and federal officials said Monday that millions of additional dollars will be spent in minority communities fighting AIDS.

Ferd Eggan, director of AIDS programs for Los Angeles, said the municipal Housing Authority has just sent to the City Council a proposal to spend $8.3 million in federal housing subsidies made available this summer by the Clinton administration. After the City Council approves the allocation, the money will be disbursed, Eggan said.

“The money has now been allocated, mainly in the form of rental subsidies,” Eggan said during a break in the four-day 1999 National Conference on Women and HIV/AIDS being held at the Los Angeles Convention Center.

The convention attracted more than 1,000 women infected with the AIDS virus, the largest such gathering ever, convention sponsors said. Since 1992, the number of women living with AIDS has jumped from 13.8 percent of all AIDS cases to 24 percent. The convention ends Tuesday.

Eggan’s agency was stung by criticism in a recent Los Angeles Times story reporting that the city was sitting on $17 million while minority communities are being hit hard by an AIDS epidemic that has created, among other problems, a shortage of housing for HIV-positive patients.

Wanda K. Jones, deputy assistant secretary for health in the Clinton administration, said federal officials expect a large infusion of money for AIDS programs directed at Latino and black women. She said the administration earlier this year allocated $150 million to correct what it agrees are racial and ethnic disparities in the way money is divided up for health care and medical research dollars.

Jones, who addressed the convention Monday, said “the need is so great we’d like to see more money” earmarked to correct the disparities. She said she thought programs for women suffering from the AIDS virus were in need of increased support, but that they were having difficulty overcoming a perception that HIV is a men’s disease.

“There is still a notion that it is a men’s problem -- a gay men’s epidemic,” Jones said. “It’s very clear, especially when we look at the HIV data, that in many communities, particularly among young people, the cases are almost evenly distributed between men and women.”

Among those attending was Brenda Calderon, a 28-year-old immigrant from Guatemala. She got pregnant, went to a doctor for a routine test and discovered she was carrying the AIDS virus.

Calderon, who works now with the group Women Alive counseling other women, was standing in a group of fellow HIV sufferers who told similar stories. A social worker from New York state said she also learned she was HIV positive during testing related to a pregnancy.

Cathy Elliott-Lopez said she got tested when she became suspicious about symptoms she saw in her boyfriend, including a chronic cough, sores, skin rashes, night sweats and fevers.

“They say women are presenting a new face in the AIDS epidemic,” said Elliott-Lopez. “We aren’t a new face. We’ve been here all along. They just haven’t seen us.”

The women in the group with Calderon and Elliott-Lopez shared this in common: None of their boyfriends or husbands warned them they were infected.

Calderon said she left her husband.

“He is with someone else now and he infected her,” said Calderon, the mother of a 2{-year-old daughter, Alexandra.