2017 Renewal of Individual and Family Medical Plans

Insurance companies are mailing renewal information for individual and family policies, both benefit and premium changes. Some of the benefit changes are positive, some are not but most of these changes are dictated by The Affordable Care Act (ACA) commonly referred to as Obamacare. In most cases the premium increases are very substantial. I do not have complete rates for all the insurance companies as of yet.

Changes for 2017 cannot be made until November 1st for an effective date of January 1, 2017.

The individual health insurance market is shrinking. I will be setting phone appointments to begin on November to review plans. I strongly encourage that you to contact me. If you want to set a phone appointment with me, please respond to this e mail now and I will send you dates and times as options beginning in November.

Before your phone appointment, I will need to know the exact spelling of the names of doctors you want to continue to see, including their zip code. I will also need the exact spelling of any medications you need and the dosage.

If you believe you may be eligible for a subsidy through Covered California, I need to know your Estimated Modified Adjusted Gross Income for 2017. If you do not report a 2017 amount, I cannot complete a Covered California application as it will not be accepted into their system. I would encourage you to have a discussion with your tax professional. I need this information at the time of a phone appointment.

Some Grandfathered plans will be discontinued in 2017, we need to discuss replacement of those plans.

IRS Form 1095

The Affordable Care Act requires that everyone been enrolled in a qualified health plan or a penalty will be assessed at your tax filing. The method used to verify your enrollment is with a 1095 tax form. The form is to be mailed to all enrollees in a qualified health plan and submitted with your tax filing for IRS confirmation.

If you are receiving a subsidy through Covered California, the subsidized premium will be included on the 1095. The IRS will verify that the income reported on your Covered California application matches your actual income. If your income is less than what is listed on the application, you will receive an additional credit. If the income is more, you will be required to pay back a calculated amount.

Most insurance companies have sent out the 1095 to enrollees. If you have not received yours, it should arrive soon. Please review the form for its accuracy in terms of premium paid and subsidy allowed.

The above pertains to the 2015 tax year.

The companies that offered policies through my agency in 2015 were:
Anthem Blue Cross

Blue Shield of California

Cigna

Assurant Health

Aetna

United Health Care

Health Net

Kaiser

 

Covered California Subsidies for 2016

Covered California has sent letters to Exchange customers who are receiving subsidies. The letter was sent on August 14th and advises clients who receive subsidies that they must give their consent for Covered CA to verify income and family size to determine their subsidy for their health plan in 2016. Members must provide their consent by either;

1. Calling Covered CA at 1-800-300-1506 options 1, 2, 0 for a live body

OR
2. Logging into your CoveredCA.com account and following the instructions in the letter.
If members do not provide the necessary information to Covered CA by the 9/30/15 deadline, subsidy will end on 12/31/15.

The companies that I represent that participate in Covered California are Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser.

Medicare Plans to Pay Doctors for Counseling on End of Life

This article is taken from the Los Angeles Times, dated July 9, 2015

Proposal to plan for life’s end

BY NOAM N. LEVEY

WASHINGTON — Six years after end-of-life planning nearly derailed development of the Affordable Care Act amid charges of “death panels,” the Obama administration has revived a proposal to reimburse physicians for talking with Medicare patients about how they want to be cared for as they near death.

The proposal, contained in Medicare regulations unveiled Wednesday, comes amid growing public discussion about medical care that better reflects patients’ wishes as they age.

The American Medical Assn. has recommended the Medicare billing change.

The Department of Health and Human Services’ proposal would not require patients to sign any order or even to talk with their physicians about end-of-life care. Rather, it would allow medical providers to bill Medicare for “advance care planning” if a patient wants to have the discussion. noam.levey@latimes.com 

My Clients Evaluate My Agency- Thank You!

Names of my clients have been removed for privacy.

Health insurance concerns can be difficult to navigate at times. Whenever I call Dennis he has always created time to patiently explain all aspects of my insurance plan. He collects all the information and addresses the pros and cons to answer my specific questions which I truly appreciate! He is wonderful to work with and I highly recommend him!

I have had the pleasure of working with The Dennis L. David Insurance Agency since 1997. Mr. David is consistently prompt, professional and thorough. He always provides me with the most up-to-date information available in the industry. No matter how tough the challenge, he works through it until he finds a reasonable solution to fit my insurance needs. Over the years, I have referred him to friends and family. He has provided them with the same level of care and attention. I truly appreciate and highly recommend the services of The Dennis L. David insurance agency.

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The Dennis David Insurance Agency came highly recommended through a good friend of mine several years ago. He and his wife have relied on Dennis David for years for their insurance needs. Dennis has a gift for simplifying what could potentially be a complex process for his clients. His follow-up is timely, clear and concise. Dennis David’s Agency provides outstanding service with an integrity and excellence I know I can count on!

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I have been a client for over 20 years and there has not been a time when I asked a question that Dennis has not been helpful. Dennis makes you feel that you are his most important client. He is very knowledgeable about the insurance industries.

Thank you for being so patient and explaining everything to me so thoroughly! I was so overwhelmed and you made it all so clear!

Dennis took so much time with me and my family to find the right Insurance plan for us. We have switched plans many times for various reasons and he was always so knowledgeable, patient, creative and helpful. He listened and understood our unique needs and came up with many choices for us and went through the pros and cons of each option. He knows the business so well and really has such a gentle way of dealing with people that it made it so easy to reach out and ask questions. I have recommended him to many of my friends and feel confident that anyone who works with him will be extremely satisfied.

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I have been with Dennis for years. His service is second to none. I always get well informed and detailed information on how to make the best decisions for insurance that is cost effective for the coverage I need. He is available when I have questions and gives updates about changes in insurance programs. Nice to have an agent that keeps me current. I highly recommend Dennis.

Dennis David has helped me enroll employees in health insurance plans, has walked me through Affordable Care, and just recently held my (electronic) hand as I waded through the medicare system and enrolled in supplementary insurance. He is thoughtful, he makes sure I understand what I’m doing, he keeps me updated on changes. I absolutely trust him and I would — and have — recommend him to my friends.

Dennis advised us of our options and carefully explained the pros and cons of the different choices. We have excellent personal health insurance coverage and have been able to maintain the same policy for years. We were so pleased that we asked him to find insurance for my company. He looks at different options and price compares for us every year. We made the right decision in choosing Dennis!

Dennis is amazing! He is very knowledgeable and always up to date on the healthcare industry. He’s helped me in so many ways. I always check with him, first, before I make any decision on health insurance!

I have known Dennis for over 30 years, we met while colleagues in an Insurance Firm, and have remained steadfast friends ever since. Dennis’s work ethics have never changed, honest, truthful, responsible and accountable. He takes care of his clients, understanding their needs, always offering guidance with such kindness, which in today’s marketplace, is not easy to find. When my time came for a Long Term Health Policy, Dennis gave me options, explaining the differences in coverages and costs. A financial planner recently took a look at my policy and was so impressed with its detail, thank you Dennis. When time came for retirement and entering the Medicare world, Dennis was so very thorough in every aspect of all the Plans. I felt very taken care of and secure, thank you Dennis The insurance world is very lucky to have Dennis David with his expertise and caring ways, he will not disappoint.

Dennis David has been my insurance agent for many years. He is very helpful and knows his stuff. He is always well prepared when it comes time for me to make insurance decisions and he offers me different choices, so I can make informed decisions. I highly recommend Denis David for all insurance needs.

I found my experience with Mr. David to be an example of true expertise. He was patient and really listened to my concerns and got right to the heart of what I needed for my family. His efficient communication really assisted me in trusting the whole insurance process and made it simple not complicated. All of my questions were answered swiftly and I knew that I was in good hands, thank you again!

I have used Dennis David’s services for over 20 years and been extraordinarily satisfied with EVERYTHING! Not once has he disappointed me or not been able to help me with questions or issues. I have recommended him to all of my friends, most of them self-employed over this time period and they are all still with him. Dennis is not only proficient in his profession but he is really kind and compassionate. There is nothing at all that I have been reticent to tell him.

Dennis is very attentive and knowledgable. We have done business with him for many years and he always gets back to us in a timely and efficient manner. I am very happy we found someone we can trust and work with!

 

I had the great good fortune of working with Mr. David, just this past year. During the most confusing and high pressure time the Affordable Care Act proposed. He not only was he exceedingly professional, knowledgeable he made the process smooth and very comprehensible for a novice like me. With his guidance I feel confident that I choose the best health care plan for my budget and my needs. I have used it twice now with no surprises. I would highly recommend Mr. David’s services to anyone; businesses and individuals a like, he is very approachable, quick to respond and has many avenues of access one of which is his website.

I have bought insurance from Dennis – Health, Life and Liability – over 20 years. Insurance can be complex and Dennis is always able to explain what is important and he is able to help me make the right decision. I value his advice and look forward to continuing to do business with the Dennis David Agency

We are using Dennis for closee to 20 years. We admire his knowledge, and his devvotion to his customers. Dnnis is always there when you need him, is esponsee time is fantastic. His proffeesionlism is a 10.

Dennis is the most professional and knowledgable insurance broker I have ever known. He makes it a point to stay informed with the latest changes in the industry that effects me. He is exceptional in staying in good contact with me. His very high ethical standards are apparent at all times.

I have been very happy dealing with insurance companies because I have Dennis David to help me. I have had an awesome experience with Dennis L. David insurance company. Every time there is an issue or a billing error, they instantly attend to it and take care of it for me. I would recommend this company to everybody.

I have worked with Dennis for many years and as an Insurance Broker his knowledge and service is second to none! He provides his clients with competitive products to meet all of their insurance needs. For Dennis, helping clients is his priority!

I have worked with Dennis David for over 15 years. He always takes care of me and my needs. Now he also takes care of members of my family. Dennis has been especially wonderful during the changes in our healthcare system. I mean, who can figure it out? I am grateful to have him to explain it all. I am well taken care of.

I have worked with a number of insurance agents through the years, but without a doubt, this agency has been by far the best. Dennis David, in particular, is exceptional in his knowledge and expertise, and when he doesn’t know the answer, he researches it and in a timely manner reconnects with you. There is a true conscientiousness and concern for the client. As for me, with the dramatic and sweeping changes that occurred in health insurance, I felt very unclear as to what direction I should take. He was able to significantly help me sort through the morass of choices, and help land an insurance plan that was the best fit for me. I very much appreciated his guidance and I learned later that his suggestions were offered irrespective of the commission he could potentially receive. I highly recommend this agency.

Health insurance concerns can be difficult to navigate at times. Whenever I call Dennis he has always created time to patiently explain all aspects of my insurance plan. He collects all the information and addresses the pros and cons to answer my specific questions which I truly appreciate! He is wonderful to work with and I highly recommend him!

I have known Dennis David for many years and he is the most professional and honest insurance agent. I highly recommend his services for all of your insurance needs.

“Dennis has worked with my family for years. He’s consistent and reliable along with being very nice and easy to work with! Insurance can be complicated and costly, it’s of so much value have someone like Dennis on your side during the process. I would recommend him time and time again! I’m grateful to have him on my team. I always feel like my needs are met and that I’ve accomplished what I wanted after our phone meetings. He’s also great on email which is a plus for me!”

– Lucy F.
“Dennis is very knowledgeable, friendly and helpful when it comes to sorting through the confusing world of insurance. I highly recommendation Dennis.”
Hi Dennis, I wanted to let you know that of May 1, 2016  I need to cancel our insurance with Anthem Blue Cross. I would like to thank you again for all your help at a time we had no idea what we were going to do. You walked us through every option and helped us make the best choice and decision for our family. I don’t know what we would have done with out you. Thank you again for always being there to help with our many questions.
Thank you so much Dennis for your dedication in helping us.

Insurance premiums spark new front in Obamacare war

In this the second year of implementation of the Affordable Care Act, premiums have not stabilized but it is probably an unreasonable expectation of the giant upheaval in a the health insurance system. The coming years will be the litmus test, hopefully the trend of large rate increases will turn around.

Below is an article from the Washington Examiner, date July 6, 2015.

Republicans target big increases as evidence that healthcare law isn’t working

Insurance premiums have quickly become a new front in the Obamacare fight, with opponents pouncing on big increases and supporters and experts countering the increases won’t be so bad.

The fight started last month when insurers were required to disclose estimated 2016 rates of 10 percent or more for Obamacare customers. Some figures grabbed headlines, especially with certain insurers calling for 50 to 70 percent increases.

The premium spikes vary by state and insurer. For instance, some plans in Florida are actually proposing reduced premiums, but 13 plans want rate increases of 10 percent or more, including Time Insurance Co.’s 63 percent hike.

Republicans say the higher rates are evidence that the law is hurting Americans and not lowering healthcare costs.

“The whole point of Obamacare was to make health care more affordable. But premiums aren’t going down; they’re going up — way up,” said Rep. Paul Ryan, R-Wis., chairman of the House Ways and Means Committee, in a recent hearing.

“The model we’re on in the Affordable Care Act is not sustainable,” said Rep. Mike Kelly, R-Pa., at the same hearing.

This is the first time since Obamacare’s passage that insurers can look at a full year’s worth of claims data and calculate premiums, Rep. Pete Roskam, R-Ill., said at the hearing. He added that the premium spikes are not growing pains.

“The law created a number of temporary programs to pay out billions in taxpayer funds during the first few years to lower costs seen by individuals and to protect big insurance companies against financial losses,” he said. “But those programs are beginning to phase out, and as the government is slowly taking off the training wheels, Obamacare is looking pretty wobbly.”

Supporters counter that any increases aren’t finalized and will have a modest impact overall.

“We have just the bad news,” said Kathy Hempstead, who directs coverage issues for the Robert Wood Johnson Foundation.

One analysis found that Obamacare customers as a whole may only see a modest increase.

The research firm Avalere looked at proposed rate filings in seven states and the District of Columbia. The average premiums for silver plans, the second cheapest option and a popular choice for Obamacare enrollees, will increase nearly 6 percent, Avalere said.

Avalere also noted that the low-cost silver plan options are likely to be smaller than the silver plan as a whole. Premiums for the lowest- and second-lowest silver plans in the seven states and D.C. will increase on average 4.5 percent and 1 percent.

A separate analysis from the nonpartisan Kaiser Family Foundation found that in 11 major cities the cost of a regular silver plan would be on average 4.4 percent higher in 2016 than this year.

Premiums must be finalized by October. That way customers facing a high premium can choose a different plan during the next open enrollment this fall.

Another reason why the rates could change is states need to conduct reviews themselves.

Obamacare requires states to report on any premium increase trends and recommend whether certain plans should be excluded from the exchanges, according to the National Conference on State Legislatures.

In 2011, the federal government started to work with states to strengthen or alter their rate review programs. If a state doesn’t have the resources to conduct the required review, the Department of Health and Human Services will do it, the National Conference on State Legislatures said.

“The carriers really have to be able to explain their rates, and that is part of the point of the whole medical loss-ratio regulations,” Hempstead said.

The medical loss ratio is another new regulation installed under Obamacare. It requires insurers to devote 85 percent of the cost of a premium on medical care and the other 15 percent on administrative costs.

The ratio ensures that insurers don’t devote too much of their costs to overhead.

Amid the rhetoric over the premium increases are certain trends that could affect the insurance market as a whole.

Many Blue Cross Blue Shield insurers kept premiums in marketplaces comparatively low with small increases from year to year, but that varies considerably across the country, according to a study of trends for market place plans done by the foundation and the left-leaning think tank Urban Institute.

The report looked at the cheapest silver plans in 30 states. Some insurance companies were reluctant to enter the Obamacare marketplaces in 2014 and when they did the plans were more expensive.

However, the report projects insurers will lower premiums to keep prices low to attract enough customers buying insurance through the Obamacare marketplaces.

But for opponents of Obamacare, the proposed increases represent a long-standing criticism about the law’s ability to battle healthcare costs, which was levied even before the exchanges opened in 2014.

Cigna Completes Acquisition of Sterling Life

An announcement from Cigna dated July 1, 2015  follows.

Cigna recently completed its acquisition of Sterling Life Insurance Company (“Sterling”). Based in Bellingham, WA, Sterling primarily offers Medicare Supplement policies to individuals. We will integrate Sterling within Cigna’s U.S. Individual segment and currently plan to migrate business processing to our Austin, TX, facility, which services our existing individual Medicare Supplement business. We are working directly with Sterling’s management on the transition, which we expect to take about 12 to 18 months.

Roberts again shows independent streak

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This article from the Los Angeles Times dated June 26, 2015 is a follow up to the Supreme Court decision to uphold the Affordable Care Act.

WASHINGTON — Since becoming chief justice 10 years ago, John G. Roberts Jr. has been determined to show that the court he leads is made up of impartial jurists, not politicians in robes.   In the phrase he used at his confirmation hearings, each justice is “like an umpire” at a baseball game — not favoring one team over the other.   On Thursday, Roberts showed again his willingness to brush aside partisan politics and forge a middle ground on some of nation’s most divisive issues, writing a 6-3 decision that upheld the broad reach of President Obama’s healthcare law.   It was the second time in three years that Roberts had led the Supreme Court to uphold the Affordable Care Act, also known as Obama-care. The decision surprised and disappointed some of the conservatives who had once hailed his appointment.   “We might as well call the law … RobertsCare,” said Ilya Shapiro, a lawyer at the Cato Institute, a libertarian think tank in Washington.   When Roberts spoke of being an umpire, “a lot of people on the left sneered,” said Neal Katyal, who served as acting U.S. solicitor general in Obama’s first term. “Today’s decision shows he really meant what he said. It’s a profound statement about the difference between law and politics.”   Roberts cringes at the regular references to the “conservative bloc” or the “liberal wing” of the court. Last year, he was pleased when the justices were able to agree unanimously in a much higher percentage of their cases.   Thursday’s decision sent a particularly loud message about a nonpartisan court because the chief justice gave a generous reading to a liberal law passed by a Democratic-controlled Congress.   But the decision is not a sign that Roberts has become a liberal or shifted strongly to the left, as some allege.   On the same day, Roberts joined three conservatives in dissent when the majority held that the Fair Housing Act forbids practices that have a “discriminatory effect” on racial minorities even if there is no intentional discrimination. In 2013, he voted with conservatives to strike down part of the Voting Rights Act.   His decisions on easing campaign finance rules, including Citizens United, which gave corporations and unions the ability to make unlimited contributions to political causes, firmly established Roberts’ record as a conservative.   But on most issues, the chief justice has shown himself to be most comfortable in the moderate middle and unwilling to push the law too far to the right or too quickly.   In April, he joined with the court’s four liberal justices to uphold a Florida law that prohibited elected judges from personally soliciting campaign contributions. Roberts supports the 1st Amendment right to spend freely on campaigns, but judges are not politicians, he said.   In other alliances with liberals, he helped forge a 6-3 majority to rule that a police officer may not detain a car stopped for a traffic violation so a drug-sniffing dog may be brought to the scene. He also joined a 5-4 opinion by Justice Ruth Bader Ginsburg that freed a Florida fisherman from federal obstruction-of-justice charges for having tossed overboard several undersized red grouper.   Further evidence on how Roberts sees his role could come as early as Friday in the court’s decision on gay marriage. It’s widely expected that a majority of justices will declare the right of gays and lesbians to marry nationwide, but given Roberts’ growing independent streak, combined with the impact that case will undoubtedly have on his legacy, some are wondering whether the chief justice will find a way to side with liberals in what would be a landmark decision.   Roberts’ reasoning in the healthcare case showed several of his characteristic traits — a desire for moderation as well as a concern over the real-world impact of the court’s decisions, particularly on business.   Had the justices ruled for the conservative activists who sued the administration, more than 6.4 million people could have lost their health coverage. That in turn could “well push a state’s individual insurance market into a death spiral,” Roberts said.   It would be “implausible,” he said, to think the Congress that passed the healthcare law intended to limit its tax subsidies to the 13 states that established an exchange, or marketplace, of their own.   He rejected the claim brought by conservative activists who pointed to one part of the law that said subsidies were limited to insurance policies bought on an exchange “established by the state.” This hyper-technical reading of one phrase did not make sense and was contradicted by other parts of the law, he said.   “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he wrote.   Duke Law professor Neil Siegel called the majority opinion “a masterpiece of legal craft, good sense and fidelity to the law at a time when political polarization threatens to spill over into the judiciary.”   But the three conservative dissenters accused the majority of “interpretive jiggery-pokery” and “somersaults of statutory interpretation” to fix a political, not legal, problem.   “This court’s two decisions on the [healthcare] act will surely be remembered through the years,” wrote Justice Antonin Scalia, joined by Justices Clarence Thomas and Samuel A. Alito Jr. “And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”   In most cases, Roberts is still more likely to vote with the court’s conservatives. University of Chicago Law professor David Strauss said the final word about the Roberts court wouldn’t come until it weighs in on broad major issues like abortion and race.   “But the chief justice has made it clear that he meant what he said in his confirmation hearings: The big decisions should be made by the people who won an election, whether the court agrees with them or not, as long the justices don’t have to distort the law to do that,” Strauss said. david.savage@latimes.com

Getty Images   CHIEF JUSTICE reenforced his statement that each justice is “like an umpire.”

WIN MCNAMEE Associated Press   JOHN G. ROBERTS JR. says he dislikes the references to the “conservative bloc” or the “liberal wing” of the U.S. Supreme Court, which he’s led for a decade.

Supreme Court Upholds the Affordable Care Act

The article below from the Los Angeles Times, dated June 26, 2015 explains the decision
OBAMACARE APPEARS CEMENTED INTO LAW
Supreme Court rejects serious threat to health reform
BY NOAM N. LEVEY

WASHINGTON — The Affordable Care Act, upheld in a decisive 6-3 Supreme Court ruling Thursday, is now virtually assured of surviving as a permanent feature of the American healthcare system.   Republicans’ chances of repealing the law, which provides health coverage to more than 20 million Americans, all but evaporated after the strongly worded decision written by Chief Justice John G. Roberts Jr.   It was the second time in three years that the high court had turned aside a legal threat to the law, one of President Obama’s signature achievements.   With no serious Republican alternatives and a historic expansion in medical coverage well underway, Obamacare is about as firmly ensconced as a new law can be in a politically divided country.   The ruling came in a lawsuit that had threatened to strip insurance subsidies from more than 6 million Americans in at least 34 states.   The law’s wording was at times “inartful,” the majority said, but Congress clearly intended for the aid for low- and moderate-income Americans to be available everywhere. The justices rejected claims from the challengers that a handful of words in the statute made subsidies available only in a few states.   “We must read the words in their context,” the chief justice wrote.   In the decision, Roberts also explicitly blessed the law’s sweeping system for guaranteeing coverage, noting that the model, pioneered in Massachusetts, had accomplished what other attempts to extend insurance protections to Americans had not.   “The Affordable Care Act adopts a version of the … reforms that made the Massachusetts system a success,” he wrote.   Congressional Republicans, meanwhile, still have no plan to replace the law enacted more than five years ago.   Speaking to reporters after the court’s decision, House Speaker John A. Boehner (R-Ohio) repeatedly refused to commit to any new strategy to repeal or revise the health law.   And across the country, as millions of previously uninsured Americans have gained coverage, a growing number of Republican governors are signaling their interest in moving on.   Still, political battles over the law won’t end anytime soon.   In the presidential campaign, Republican hopefuls need to appeal to conservative voters — many of whom deeply dislike the law and the president who championed it. That guarantees that cries for repeal will remain prominent, particularly during next year’s primaries.   “This is not the end of the fight,” former Florida Gov. Jeb Bush said Thursday. “We need to repeal and replace Obamacare.”   Nearly all of the other major candidates for the nomination echoed Bush’s statement.   But away from the campaign trail, implementation of the law and its coverage expansion will continue.   “We appreciate that the deep uncertainty of this issue has been resolved,” Michigan Gov. Rick Snyder, a Republican, said Thursday after the court issued its decision. “The health and well-being of the people of Michigan is always a top priority.”   In his state, more than 200,000 low- and moderate-income residents stood to lose insurance assistance if the court backed the challengers, who argued that no subsidies should be available in any state that did not establish its own insurance marketplace through the law.   Michigan is one of the 34 states that instead deferred to the federal HealthCare  .gov   marketplace.   Like many other Republican governors, Snyder has been more focused on expanding access to healthcare than continuing the battle over the law.   Michigan is working to secure approval from the Obama administration for further changes to the state’s Medicaid program, which was expanded under the law to guarantee coverage to the poorest residents .   Michigan is one of 29 states that have accepted federal aid in the law to broaden Medicaid coverage   — a number that has steadily grown over the last several years to include even very conservative states such as Indiana.   In the last two years, some 11 million people have newly enrolled in Medicaid, mostly in states that expanded their programs.   An additional 10 million Americans, many of them previously uninsured, now get health coverage through marketplaces created by the law.   That has fueled a historic coverage expansion. In the first quarter of this year, 11.9% of adults in the U.S. lacked insurance, down from 18% in the third quarter of 2013, before the current expansion began, according to Gallup.   And more red states, including Utah, Tennessee and Wyoming, have been exploring ways to expand Medicaid coverage.   In Washington, by contrast, GOP congressional leaders kept up their criticism of the law.   “Republicans are ready to reduce the cost of healthcare so more people can afford it, put patients back in charge, and restore freedom and choice to the healthcare market,” said Senate Health Committee Chairman Lamar Alexander (R-Tenn.).   But it is unlikely there will be significant new legislation, at least until after next year’s presidential election.   To date, Alexander and most other congressional Republicans have offered little more than general outlines rather than real legislation that would fulfill such promises.   Several GOP blueprints even incorporate key protections from the current law, including guaranteeing coverage and providing government assistance to help consumers purchase insurance.   On the other side of the debate, supporters of the health law redoubled their calls on Republicans to stop fighting.   “It’s time for people on both sides of the aisle to accept that the law is working and take important steps to fully implement it,” said Sue Berkowitz, head of South Carolina Appleseed Legal Justice Center, a nonprofit that has been working to expand coverage in that state despite Republican officials’ resistance to Medicaid expansion.   The president joined the chorus, speaking from the White House Rose Garden on Thursday afternoon.   “The Affordable Care Act is here to stay,” he said. noam.levey@latimes.com   Twitter: @NoamLevey

JIM LO SCALZO European Pressphoto Agency   SUPPORTERS of the Affordable Care Act cheer outside the Supreme Court after justices ruled 6 to 3 that the healthcare law’s tax credits can go to residents of any state.

CHIP SOMODEVILLA Getty Images   HOUSE SPEAKER John A. Boehner (R-Ohio), at a news conference after the decision, wouldn’t commit to any new strategy to repeal or revise the law.

ALEX WONG Getty Images   “THE AFFORDABLE Care Act is here to stay,” said President Obama, with Vice President Biden at the White House Rose Garden after the ruling was announced.

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Insurance Companies no longer reinstate individual and family plans for non payment of premium.

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