Confused about the federal budget struggle? So are doctors, hospital administrators and other medical professionals who serve the 100 million Americans covered by Medicare and Medicaid.

Rarely has the government sent so many conflicting signals in so short a time about the bottom line for the health care industry.

Cuts are coming, says Washington, and some could be really big. Yet more government spending is also being promised as President Barack Obama's health care overhaul advances and millions of uninsured people move closer to getting government-subsidized coverage.

"Imagine a person being told they are going to get a raise, but their taxes are also going to go up and they are going to be paying more for gas," said Thornton Kirby, president of the South Carolina Hospital Association. "They don't know if they are going to be taking home more or less. That's the uncertainty when there are so many variables in play."

Real money is at stake for big hospitals and small medical practices alike. Government at all levels pays nearly half the nation's health care tab, with federal funds accounting for most of that.

It's widely assumed that a budget deal will mean cuts for Medicare service providers. But which ones? How much? And will Medicaid and subsidies to help people get coverage under the health care law also be cut?

As House Speaker John Boehner famously said: "God only knows." The Ohio Republican was referring to the overall chances of getting a budget deal, but the same can be said of how health care — one-sixth of the economy — will fare.

"There is no political consensus to do anything significant," said Dan Mendelson, president of Avalere Health, a market analysis firm. "There is a collective walking away from things that matter. All the stuff on the lists of options becomes impossible, because there is no give-and-take."

As if things weren't complicated enough, doctors keep facing their own recurring fiscal cliff, separate from the bigger budget battle but embroiled in it nonetheless.

Come Jan. 1, doctors and certain other medical professionals face a 26.5 percent cut in their Medicare payments, the consequence of a 1990s deficit-reduction law gone awry. Lawmakers failed to repeal or replace that law even after it became obvious that it wasn't working. Instead, Congress usually passes a "doc fix" each year to waive the cuts.

This year, the fix got hung up in larger budget politics. Although a reprieve is expected sooner or later, doctors don't like being told to sit in the congressional waiting room.

"It seems like there is a presumption that physicians and patients can basically tolerate this kind of uncertainty while the Congress goes through whatever political machinations they are going through," said Dr. Jeremy Lazarus, president of the American Medical Association. "Our concern is that physician uncertainty and anxiety about being able to pay the bills will have an impact on taking care of patients."

A recent government survey indicates that Medicare beneficiaries are having more problems when trying to find a new primary care doctor, and Lazarus said that will only get worse.

Read More: Source

Miami
Miami, Fla. is another U.S. city that was unable to escape high auto insurance premium rates. The Runzheimer International study performed in 2011 marked the average car insurance premium in Miami at a hefty $3,388. Due to the city's no-fault auto insurance rule and an influx of fraudulent claims, Miami has experienced a significant premium hike in recent years.

Newark, N.J.
Last but certainly not least, Newark, N.J. has one of the highest car insurance premium averages in the U.S. The city features an average auto insurance premium of $2,867. Newark's residents certainly have quite a hefty expense in order to keep their vehicles insured. Similar to Miami and Detroit, New Jersey has a no-fault insurance rule, and costs have risen as a result.

The Bottom Line
Car insurance premiums vary substantially depending upon where you live. States with no-fault laws and higher populations are prone to have higher average auto insurance premiums due to the higher amount of accidents and collisions that occur. The numbers presented are based off studies, and it is possible to find less expensive auto insurance. Many factors apply when determining what your auto insurance rate is, including driver safety, your zip code and your age. Shop carefully when buying car insurance, and make sure you are getting the best rate possible.

Original story - 5 Most Expensive Cities In The U.S. For Car Insurance

Copyright (c) 2012 Investopedia US. All rights reserved. Investopedia.com is a division of ValueClick, Inc.

First comes the storm, then — all too often — the higher insurance premiums.

When Hurricane Sandy makes landfall this weekend it could cause as much as $1 billion in damage along the eastern seaboard, by some estimates. The result could be widespread damage to homes, including fallen trees, torn-off roofs and broken windows. And even homeowners spared the worst of the storm might not get off entirely scot free: Insurance agents say premiums may rise and coverage could be slashed for homes in affected areas, whether or not they file claims. “Even if you haven’t been hit, [that] doesn’t mean some of your neighbors haven’t been adversely impacted by the storm — and that could impact you,” says Michael Barry, a spokesman for the Insurance Information Institute, which represents home insurers.

Homeowner insurance premiums have been on the rise for years. They average $1,004 this year, up 5% from a year ago and up 22% since 2007, according to the Insurance Information Institute. This is the first year the national average cracked the $1,000 mark. Meanwhile, insurers in some states have already raised premiums by as much as 12% this year .

Insurers cite several reasons for the spike, including losses from claims filed in previous years and low returns on their investments.

But critics say insurers have more leeway to avoid hiking insurance premiums for the time being. The first half of this year saw a drop in catastrophic losses, which totaled $13.8 billion, compared to $24.4 billion during the same period a year ago, according to the Insurance Information Institute. The industry’s overall net income after taxes skyrocketed during this period to $16.4 billion, compared to $4.8 billion a year prior.

Still, the risk of rising premiums or scaled back coverage isn’t off the table, especially as severe weather events rise in frequency in the northeast. In the last 14 months, the region has been hit by Hurricane Irene, a severe October 2011 snowstorm, and now there’s pending Hurricane Sandy. “They’re looking at changing weather patterns and saying this is changing the way we need to look at risk,” says Scott Simmonds, an independent insurance consultant in Saco, Maine.

To avoid changes to clients’ policies, some independent insurance agents say they will recommend they don’t file claims from this storm. Spencer Houldin, president of Ericson Insurance, an independent insurance agency based in Washington Depot, Conn., says he plans to tell clients who’ve filed two claims within the past three years to refrain from filing another one related to a natural disaster—if they can afford to cover the costs for the repairs themselves. Otherwise, he says, there’s a good chance their insurance company won’t agree to provide coverage when their policy is up for renewal. (Even if they don’t file, insurers could look to raise premiums anyway, says Barry.)

The type of coverage homeowners receive could also change. Some experts say if severe weather events persist in the Northeast, insurance coverage could begin to mirror policies in the Gulf Coast. In the Gulf Coast many basic homeowner insurance policies have limited wind damage coverage — or exclude it entirely. “As more of these events happen, the chances increase that policy structures will change,” says Simmonds.

For its part, the insurance industry says that’s an unlikely scenario for much of the Northeast for the time being. Barry says roughly 98% of homeowner insurance policies in New York are provided by private insurers. In some Gulf Coast states, by contrast, many homeowners are now covered only by state-run property insurers of the last resort.

So what can homeowners do? If the loss sustained by Hurricane Sandy is too large to realistically cover on their own or if it’s the first damage in years, experts say they should file a claim with their insurer. Keep in mind that insurers can’t raise premiums or drop coverage until a policy is up for renewal. And even then in many states they’ll need approval from the state’s insurance department before they can do this.

If premiums rise, homeowners can avoid that hit by increasing their deductible. But that means they’ll have to pay more out of pocket when they file a claim in the future.

Read More: Source