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This Week in Health Care Reform

After months of public debate and private negotiations, health care reform discussions stalled following Tuesday’s Senate vote in Massachusetts. The Democratic Senate lost its 60th vote supermajority when Republican Scott Brown was elected to the United States Senate in the Massachusetts special election.

Health Care Reform Negotiations Post-Massachusetts Special Election

Massachusetts Election of Senate Republican Recasts Debate: Following the election of Republican Scott Brown to the Massachusetts Senate seat Tuesday night, Democratic leaders have been scrambling to revive what could now be a dying bill. The loss of the Democrat’s 60th vote in the Senate opens up the legislation to a Republican filibuster – something the Democrats have managed to avoid thus far in the debate.

House and Senate Democrats met this week to discuss how to move forward with the reform legislation in light of this election and promised Wednesday that they would push ahead. There are a number of options that Democrats are considering, but at this point they have not charted their course.

On Wednesday, Speaker of the House Nancy Pelosi (D-CA) attempted to rally House Democrats around a strategy to push the Senate bill through the House and onto President Barack Obama’s desk so as to avoid the need to again secure 60 Senate votes. However, the Speaker indicated on Thursday morning that she did not believe she has the needed 218 House votes necessary to move forward. This option would have allowed lawmakersto then propose additional modifications to the approved legislation through a process called “reconciliation,” which only requires 51 votes in the Senate.

Other remaining options:

1.
House and Senate Democrats could also quickly complete the merging of the two bills and vote on the combined package before Mr. Brown is sworn in.
2.
Democratic leaders could attempt to re-engage Sen. Olympia Snowe (R-ME), the only Republican who voted for the Senate Finance Committee’s bill passed in October. Democrats would need to allow her to amend the bill so that she could support its passage and give Democrats the needed 60th vote; or,
3. House and Senate Democrats could essentially start over in their respective chambers and propose scaled-back versions of the bill under “reconciliation” procedures or regular order. Reconciliation procedures would greatly limit the scope of the legislation to issues only related to raising or spending federal funds; therefore, many provisions, such as creating new insurance exchanges and an individual mandate, might be excluded.

President Obama seemed to indicate that he favors having House and Senate lawmakers start over again and produce a scaled-back bill. In addition, more moderate Senate Democrats – hesitant to push through such a huge partisan bill in light of the Massachusetts election – urged leaders to slow down.
Sen. Jim Webb (D-VA) has called on Senate leaders to suspend voting on health care reform until Mr. Brown is sworn into office. President Obama and Senate Majority Leader Harry Reid (D-NV) have iterated this same message. Further, Sen. Joe Lieberman (D-CT) called for a bipartisan effort as the best way to achieve health care reform legislation.

Health Care Reform Negotiations Prior to Massachusetts Special Election

Senators Urge Guarantee of Government Savings: In a letter sent last Thursday to Sen. Reid, five Democratic Senators asked for the inclusion of a “fail-safe mechanism” in the final bill. This mechanism would give Congress “the tools to keep costs under control should the current savings estimates fail to materialize.”

Both the Senate and House versions of the bill rely heavily on reductions in government spending, particularly around Medicare, to help pay for reform. Republicans and some nonpartisan analysts believe the government will not follow through on these spending reductions, which will lead to soaring costs.

President Obama Pushes for Less Protection for Biologic Drugs: Last Thursday President Obama pushed for a change in the health care reform legislation that would reduce the number of years that biologic drugs were patent protected from generic competition, previously set at 12 years. White House officials and Rep. Henry Waxman (D-CA) were negotiating for 10 years protection or less.

Members of the news media speculated that the move to reduce biologic drug protections could be a leverage point for President Obama to pressure the drug industry to increase contributions to pay for health care reform. In fact, the Wall Street Journal reported that Congressional Democrats had already asked drug companies to contribute an additional billion or more, over and above the billion which the industry agreed to early on in the reform negotiations.

President Obama Strikes Deal with Unions: Last week Democratic negotiators struck a deal with union officials and conceded to union demands to scale back a tax on high-end insurance plans. The deal would exempt union workers from having to pay the tax until 2018, five years after the tax would apply to other workers. While the deal would help gain union support for the bill, it would also reduce the amount of tax revenue generated by about 40 percent, to billion. As such, Democratic leaders would need to find other sources of revenue to make up the difference.

Public Opinion

Exit Poll Indicates Health Care Reform as Hot Button Issue: As the ballot polls closed on Tuesday night’s Massachusetts Senate election, an exit poll conducted by Frabrizio, McLaughlin & Associates indicated that 52 percent of voters said that they oppose the federal health care reform measure and 42 percent said they cast their ballot to help stop President Obama from passing this legislation. In addition, 48 percent said that health care was the single issue driving their vote.

Polls Show Discontent: The latest Wall Street Journal/NBC News poll indicated that almost half of Americans believe the health care reform bill in Congress is a bad idea (46 percent). This figure is up dramatically from April when only 26 percent believed the plan was a bad idea. Further, just 33 percent say the plan is a good idea. Nearly half of those surveyed (48 percent) believe that passing the current legislation would be a “step backward.”

In addition, a new Quinnipiac University poll showed that public support for health care reform continues to decline. Thirty-four percent mostly approve, while 54 percent mostly disapprove. At the end of December, 53 percent of Americans mostly approved, while 36 mostly disapproved.

Looking Ahead

Currently, the path to health care reform is unclear. Democrats seek a way to secure the necessary votes to pass the legislation, and some now question the value of pushing such a large bill. President Obama had hoped to see a final bill prior to his State of the Union address, which has been scheduled for January 27; however, it appears this goal is likely out of reach.

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But the Democrats’ effort to sell the law to the public may be undermined by what even some ardent supporters consider its biggest shortfall. The overhaul left virtually untouched one big element of our health-care dilemma: the price problem. Simply put, Americans pay much more for each bit of care — tests, procedures, hospital stays, drugs, devices — than people in other rich nations.

Health-care providers in the United States have tremendous power to set prices. There is no government “single payer” on the other side of the table, and consolidation by hospitals and doctors has left insurers and employers in weak negotiating positions.

“We spend fewer per capita days in the hospital compared with other advanced countries, we see the doctor less frequently, and we swallow fewer pills,” said Jon Kingsdale, who oversaw the implementation of Massachusetts’s 2006 health-care law. “We just pay a lot more for each of those units than other countries.”

The 2010 law does little to address this. Its many cost-control provisions are geared toward reducing the amount of care we consume, not the price we pay. The law encourages doctors and hospitals to join “accountable care organizations” that have financial incentives to limit unnecessary care; it beefs up “comparative effectiveness research” to weed out inefficient treatments; and it will eventually tax the most expensive insurance plans to restrain consumers’ superfluous use of health care.

Such measures could reduce redundant tests, emergency room visits and hospital readmissions, which would help control the costs of Medicare, where the government sets rates. But they are less likely to lower prices outside Medicare and stem the growth of private insurance rates.

The main reason for this is politics. Remember how drawn-out the health-care battle was? It started in the spring of 2009 and was waged for a full year. The bill’s proponents in the White House and in Congress had some inkling of how tough the fight with the insurance companies would be. Taking on hospitals, doctors, and drug and device manufacturers as well — the people you’d face in a showdown over prices — might have been fatal.

So there was no price fight. The law will go on to face a likely post-midterm Republican onslaught — and dismantling it may be easier if Americans think it does little to restrain costs. It is one of those fine political ironies: The law derided as socialism may have had an easier time winning favor from a skeptical public if it was, well, a little more socialist.

It’s pretty far from socialist as it stands. The administration decided not to seek lower drug rates for Medicare, and it didn’t press for a “public option,” a government-run insurance plan that people under 65 could buy into. While supporters of the public option sold it as a way to compete with insurers, the real target was hospitals and doctors. A public option would have created a nationwide purchaser of health care that could have exerted leverage on providers to cut prices. This would have lowered the law’s costs by reducing the subsidies needed to make insurance affordable.

To avoid the wrath of hospitals and doctors, proponents of the bill rarely emphasized this cost-control argument. Nonetheless, when conservative “Blue Dog” Democrats weakened the public option in committee, they cited opposition from providers. And when the bill’s supporters floated a close alternative to the public option — letting people over 55 buy into Medicare — the reaction from Sen. Olympia Snowe, the moderate Maine Republican, said it all: “I am talking to a lot of my providers . . . and I know they are mighty unhappy.” Snowe exposed where the lobbying strength lay: No senator ever spoke of listening to “my insurers.”

“The public hates the insurance industry and trusts doctors and hospitals,” said Richard Kirsch, head of the liberal coalition Health Care for America Now. “But what killed the public option was the hospitals, not the insurance industry.”

Politicians wanted to avoid a confrontation over providers’ prices. So a different policy argument took hold: The real reason everything cost so much was the overuse of health care, not the actual prices of treatment.
This argument came primarily from Dartmouth College researchers who had amassed data showing wide disparities in Medicare spending among different regions. Hospitals in the lower-spending areas, mostly in the Upper Midwest and the Northwest, seized on the study to argue that the key to controlling costs was to reward providers like them. The case was popularized by Atul Gawande’s widely read New Yorker article in June 2009 focusing on McAllen, Tex., one of the highest spenders in the Dartmouth rankings. If health-care delivery in places such as McAllen could be brought in line with lower-spending places such as the Mayo Clinic’s home town, Rochester, Minn. — through the formation of integrated networks of salaried doctors — costs could be reined in.

The theory caught fire at the White House. It gave President Obama and his then-budget guru Peter Orszag a way to talk about costs without taking on doctors and hospitals; instead, the White House could simply differentiate between providers that offer “value” and those that don’t.

But the Dartmouth rankings, and the concept they supported, did a “disservice” to the debate, said Robert Berenson of the Urban Institute. For one thing, he and others say, the figures overstate regional differences in Medicare spending, which shrink when socioeconomic factors are taken into account. Second, rates of Medicare spending are not necessarily representative of health-care spending for people under 65. Some of the places that do well in the Dartmouth rankings charge high prices for non-Medicare patients — and were, not surprisingly, among those pushing hardest against a public option.

More broadly, the skeptics argue that merely providing care in smaller quantities will not sufficiently lower costs. They note that Americans already have shorter hospital stays and fewer doctors’ visits than people in other advanced countries. What sets us apart is our high prices for these health-care “units” — a finding trumpeted in a landmark 2003 paper by Princeton’s Uwe Reinhardt and others titled “It’s the Prices, Stupid.” The price problem is only getting worse, researchers and antitrust investigators have found, because of consolidation among providers, and it could be exacerbated by goading them to form even bigger networks.

But the notion that we pay more, despite using health care less, never caught on during the long march to reform. The main culprits driving our health-care costs were deemed to be inefficient doctors in a few corners of the country and demanding consumers — say, people seeking unnecessary surgery or patients with unhealthy habits and chronic conditions.

The camp that believes volume is the main problem disputes the idea that bigger networks of hospitals and doctors would make the price problem worse. “The more we’re able to encourage integrated systems of care, the better,” the new Medicare director, Donald Berwick, a Dartmouth data champion, told me before his nomination by Obama.

Berwick and his allies say they never meant for overuse of care to become the sole focus. Elliott Fisher, the lead Dartmouth researcher, said he did not intend for his data to be “interpreted as letting off the hook” those providers that kept overuse in check but charged high prices. “We clearly need to do both” prices and volume, he said.

But we didn’t do both in the health-care law, which raises the question of what will happen once the overhaul proves inadequate to the price problem. Perhaps the public option will be reconsidered, as many liberals hope. Perhaps there will be a new push for lower drug prices. Or maybe there will be a return to the rate-setting that prevailed decades ago, when hospitals, insurers and state officials worked together to agree on prices. Maryland is the only state that still does this, and data suggests that it has kept its cost growth lower than average. Massachusetts is considering a similar approach.

Would such measures have a chance? Perhaps. For one thing, as skeptical as insurers are of government intervention, they are glad to discuss reform that aggressively goes after providers. “We have a major cost problem, and we have to get on with the job of attacking it — with every stakeholder who is responsible for that,” said Karen Ignagni, the insurance industry’s chief lobbyist.

And the public? The Brookings Institution’s Henry Aaron predicts that there may be support for tougher action on high prices once the principle of universal health coverage is established, since taxpayers will be on the hook for more of the cost of insurance. “If we attacked costs right at the front end, [the legislation] would have died,” he said. “Now, we’ll have a mechanism that will force us to address it. There are only so many fronts you can fight a war on at the same time.”

That’s assuming, of course, that the law survives long enough to enjoy any embellishment.

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Mr. President:

I know that you are a very busy man so I will try to keep my questions about health care reform and the recently passed legislation as short and simple as possible.

- I could ask you why you think this is a good piece of legislation even though I truly believe that it will be a failure and will come very close to bankrupting the country. The basis for my conclusion has nothing to do with political partisanship (in fact, I have never voted for a Republican for national office in my life.) From my perspective, “Obama Care” never effectively addressed the root causes of our escalating health care costs: Americans eat too much of the wrong kinds of food, they exercise far too little, they are overweight, they smoke too much, and they are getting older. This legislation does not address these causes, it just raises taxes and moves money around within the bureaucracy. I could ask you about this but I will not.

- I could ask you why you have not stepped forward and denounced those in your party that have likened Americans like myself, i.e. those that have legitimate and honest concerns about this health care reform bill, to the racists who fought against the civil rights movement from the 1960s. I thought that we lived in a free country where citizens could freely address their elected representatives without being slurred in the most debasing way possible, just for having a different opinion. Your lack of fortitude to oppose those Democrats who frequently use the term “racist” to malign myself and those Americans expressing their honest opposition, cheapens the bravery and contributions of those from long ago that fought actual racism. I could ask you about this but I will not.

- I could ask you why you felt it necessary to pass this legislation by the back door called reconciliation. This is a major, major issue in the country that will affect every American for decades to come. Sneaking it in the back door, without using the traditional, time honored method of passing laws in his country, belittles the approach and makes it look like it was forced through without the full weight of the democratic process behind it. I could ask you about this but I will not.

Here is what I will ask you about. But first, some background facts:

- Let me reiterate that both my wife and myself have never voted for a Republican for national office in our lives.

- We both spent several decades of our lives working hard for AT&T, retiring several years ago, secure in our thinking that AT&T’s promise of health care benefits and coverage for our long years of service was a good bet.

- We both try to eat well, we exercise at our local YMCA on an almost daily basis, neither of us smoke, and we rarely drink. In other words, we take personal responsibility for our health and our health care.
One reason for our personal responsibility behavior is that we are on a high deductible insurance plan with AT&T. We are each responsible for the first ,200 of our annual health care costs before we get any insurance coverage at all. However, for this personal responsibility, we also pay nothing in annual premiums.

- During the debate leading up to the passage of health care reform, you reiterated more than once that those of us that currently had health care coverage would be able to keep it. However, in a recent article in Fortune magazine, the CEO of AT&T, Randall Stephenson, was interviewed (several pages of the article are attached). Towards the end of the interview, he was explicitly asked whether AT&T would consider dropping health care insurance coverage for its employees and retirees. His response made it clear that this was a very viable option for two reasons. First, from a business profitability perspective, under the new health care reform law, “you’re better off paying the government a fine and dropping health care coverage for your employees”, improving AT&Ts bottom line. Second, he talks about “economic gravity” which appears to be code words for “if others in his industry do it, AT&T will have no choice but to do it also.”

Thus, a few quick questions for you:

1) Were you just naive when you made the comments that we could all keep our current health care insurance, not realizing the simple fact that companies are in business to make money and if this bill makes it easier for them to make more money by not insuring their workforce, that is what they will do? Or were you being disingenuous, knowing that this would happen and deliberately misinforming the country to help get your health care reform bill passed? Naive or disingenuous, in either case you will be making millions of American voters unhappy in November and in 2012 when we are forced out of our current health care coverage and will blame you for either ignorance or arrogance in this situation.

2) I am 57 years old and my wife is 56 years old and if Mr. Stephenson does decide to terminate AT&T’s health care coverage for employees and retirees, where do you suggest that my wife and I get coverage? What insurance company is going to want to pick us up, and millions of other older Americans who lost their coverage, at our ages even though we are both healthy and taking personal responsibility for our continued good health?

3) If we are forced out onto the market for health care insurance coverage, our new coverage is likely going to be much more expensive. Our annual health care costs will go from a maximum of ,200 each to a minimum of several thousand dollars each. Is this how you planned to reduce health care costs for middle class America? Is so, then you need to explain the math to me. Maximum of ,200 to a minimum of several thousand dollars, does not make sense out here in the real world. How does this reduce the escalating health care costs for the 90% of Americans that already had health care insurance prior to the passage of this bill?

Thus, I am not going to ask you about why you and the rest of Congress did not address the root causes of high health care costs in your legislating process. I am not going to ask why you have sat back and been silent while those Americans with legitimate and honest dissent against this bill have been likened to racists by members of your party. I thought you represented all Americans, not just those that agreed with your policies. I will not ask you about why you did not have the courage and guts to pass this legislation the right way, through the front door like every other piece of legislation, but instead snuck it through the back door of reconciliation.

However, I will ask you or your staff to contact me and explain where and how I can get health care coverage at my age if AT&T and the rest of corporate America decides it is a better economic choice to pay a government fine than to cover their employees and retirees with health insurance. I will ask you to explain whether you were naive or disingenuous when explaining that we would be able to keep our current health insurance coverage. And finally, please explain how paying no more than ,200 a year under my current coverage (with many years paying nothing for coverage during healthy years) is a better deal then finding new coverage at my age and paying several thousand dollars a year for the privilege.

Although I have written to the White House many times, I have never received any answer to my questions on a wide variety of topics even though you promised to have the most open and responsive administration of all time. That has not happened yet. However, in this case I do require, in fact I demand specific answers to my three questions above. For your political sake I hope to receive those answers before early November and certainly before 2012.

Thank you for your time,

Walter “Bruno” Korschek

[Follow up note: a month after sending this to the White House, no answers to the questions have been received or even a simple confirmation that this letter was received has been forthcoming from the Obama adminstration.]

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The Pensions Policy Institute (PPI) has issued a report which supports the Pension Commission’s recent demand for reform in the structure of the basic state pension. In fact the report goes further than simply backing the report, it calls for reforms to be implemented more rapidly than the Commission has recommended.

Essentially, the reforms that are proposed are for simplifications to be made to the current variations in available state pensions for those who are eligible. Means testing, currently used in determining eligibility and the extent of the pension available, would be dropped in favour of an across the board pension rate. Additionally, tax breaks for those who try to save for a personal pension would be put in place to encourage saving.

These reforms would serve to make pension availability, and budgeting for retirement, much clearer to understand and buy into, thereby preventing nasty surprises for the individual late in life, or the government as a generation becomes dependant on a state pension. A recent survey by the Financial Services Authority (FSA) concluded that very little provision is being made for the future by those aged 18-40 and that a very large number of UK citizens could well become dependant on state pensions.

Personal finance has become a boom sector amongst that same generation, with online access to personal finance databases such as Moneynet (http://www.moneynet.co.uk ) and Motley Fool (http://www.fool.co.uk ) providing a wealth of options for UK consumers. However despite the fact that many of those options include savings and pension schemes, it appears that they are rarely taken up, with consumers opting for credit card deals, mortgages, insurance, and personal loans instead.

Pension experts have showed their backing for the proposed Pension Commission reforms with their overwhelming response in the PPI report, and it is to be hoped that the simplifying of the state pension will bring the importance of the issue to the attention of the age range identified by the FSA.

Disclaimer

All information contained in this article is for general information purpose only and should not be construed as advice under the financial Services act 1986. You are strongly advised to take appropriate professional and legal advice before entering into any binding contracts.

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Home Page > Finance > Health Savings Accounts Are Still Popular After Health Care Reform

Health Savings Accounts Are Still Popular After Health Care Reform

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Health Savings Accounts Are Still Popular After Health Care Reform

By: Wiley Long

About the Author

By Wiley Long – President, HSA for America http://www.health–savings–accounts.com – Professional advisors offering personal assistance on health insurance plans that qualify for a Health Savings Account.

(ArticlesBase SC #3145494)

Article Source: http://www.articlesbase.com/ – Health Savings Accounts Are Still Popular After Health Care Reform

With the passage of The Patient Protection and Affordable Care Act and The Health Care and Education Reconciliation Act of 2010, the U.S. has achieved the most sweeping change in medical accessibility since Medicare.

Coming in 2014, anyone who is not covered through Medicaid, Medicare or another government-sponsored program will be required to carry at least minimum health insurance.

This is expected to increase the already rapidly growing market for high-deductible health insurance plans that can be combined with a Health Savings Account (HSA).

Penalties For Inadequate Health Insurance

Minimum coverage will include eligible employer-sponsored plans, plans in the individual market, grandfathered group health plans and other forms of coverage accepted by the secretary of Health and Human Services along with the Treasury secretary.

There are a few exceptions to this requirement. Anyone who is incarcerated, not legally present in the U.S. or who qualifies for a religious exemption won’t be required to maintain minimum health insurance.

Beyond those exemptions, inadequate insurance could leave you facing a penalty equal to the greater of either a flat amount or a percentage of your income. Under the Reconciliation Act, the flat-amount penalty will be $95, and the income percentage penalty will be one percent of income beginning in 2014.

Fortunately the same act specifies that liens and seizures are will not be authorized to enforce the new law. In addition, people who fail to comply will not be subjected to criminal penalties.

Why Health Savings Accounts Are Already Seeing Higher Demand Health Savings Accounts have been reported to be growing exponentially in the past few years as the cost of health insurance rose even faster. High-deductible health insurance plans are particularly popular because such plans typically offer lower premiums in exchange for the cost-sharing aspect of high deductibles.

This attractive combination of lower-premium plans and savings accounts that earn tax-free interest while allowing tax deductions for health care expenses has sparked record investments. The demand is expected to continue growing as more people search for health care insurance in the coming years.

How Legislation Will Change Health Savings Accounts

While HSA Plans remain top contenders among low-cost premium choices, the recent legislation has had less favorable impacts on such plans. Under the Patient Protection Act, over-the-counter drugs will no longer be reimbursable through an HSA.

The same will be true for similar accounts, including Archer medical savings accounts, health flexible spending accounts and health reimbursement arrangements.

That change does not affect medications prescribed by a doctor or insulin, though. All of these will still meet the definition of “qualified medical expenses.” This particular change will be effective for expenses incurred as of 2011.

HSA Distributions Not Used For Qualified Expenses Face Increased Tax

Also starting in 2011, the tax on distributions from an HSA or Archer MSA that are not used for qualified medical expenses will be increased to 20 percent of the disbursed amount.

Before the new legislation, that tax was just 10 percent of the disbursed amount for an HSA and only 15 percent for an Archer MSA.

Increased taxation will make it more important to follow guidelines regarding which purchases will be treated as qualified medical expenses in the future.

Medical Expense Deduction Threshold Will Be Higher

Beginning in 2013, the threshold to claim an itemized deduction for unreimbursed medical expenses is going to increase from 7.5 percent to 10 percent of adjusted gross income.

However, from 2013 through 2016, the increased threshold will not apply if either the taxpayer or the taxpayer’s spouse will be 65 before the end of the year.

Health Savings Accounts Continue to Offer Premium Plans

Despite the reduction in qualified expenses and increased penalties, the opportunity for tax deductions and higher account earnings with tax-free interest will keep HSA Plans growing in popularity. Combine those benefits with the lower premiums of qualified high-deductible health insurance plans and HSA Plans may well be the number one choice in coming years.

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Wiley Long -
About the Author:

By Wiley Long – President, HSA for America http://www.health–savings–accounts.com – Professional advisors offering personal assistance on health insurance plans that qualify for a Health Savings Account.

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Home Page > Law > Health Insurance Reform Economics

Health Insurance Reform Economics

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Posted: Oct 27, 2010 |Comments: 0

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Health Insurance Reform Economics

By: Pahy Tragy

About the Author

New York health insurer

(ArticlesBase SC #3557286)

Article Source: http://www.articlesbase.com/ – Health Insurance Reform Economics

I don’t know where to start to talk about The Patient Protection and Affordable Care Act. There’s too much to say with regards to the inconsistencies and dubious content in all its pages. It seems like it’s focus is on the people’s money and not on our welfare.

Trillions of dollars had been allocated to the Health Care reform to support the problems with cost. It is meant to provide a better health care system for the citizens but its effects seem to promote the opposite. Every citizen will now be mandated to get an adequate health plan.

The government mandated the type of health insurance policy that will be available to all citizens and the price tag that we the people are mandated to pay annually. The government is really not too concerned as to how each individual will pay for their health insurance policy. They are only looking at how much more money the government can confiscate from we the people.

The medical health care community will fall into disarray because of the additional individuals that will be on the health insurance rolls. This is beginning to occur currently and this will develop into very long waiting lists and the need for permission from the Internal Revenue Service for required surgeries.

The cost of all surgeries will be calculated by the age of the individual and in some cases, needed surgeries, medical health care treatments, and therapies will be denied because it is now costing the government more than they care to spend. We are beginning to see this happen already and we the people are only in the early stages of the implementation of the new health insurance reform bill.

Many doctors have decided not to take new Medicare patients. Then how can senior citizens get the medical care they deserve?

As many more people are going to be added to the system, rates are also expected to go up. At the very least, you can hope for the rates to remain the same.
In recent weeks, many medical health care physicians in various states have also begun announcing they will no longer accept new applications for Medicaid patients. However, please continue to pay your average monthly cost for health insurance because the government needs and wants your money so the authorities can continue living in the lifestyle, they are accustomed.

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(ArticlesBase SC #3557286)

Pahy Tragy -
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New York health insurer

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Source:  http://www.articlesbase.com/law-articles/health-insurance-reform-economics-3557286.html

Article Tags:
health care, health care reform, health insurance, health insurance reform, law

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The White House last week continued to rail against rising health insurance premiums to help build popular support for his health care reform package. But the effort to focus the blame for rising costs on insurers was questioned, in particular, by state insurance experts and economists quoted in a New York Times story last week. Insurance commissioners said that trying to hold down premiums before costs were under control would be very risky. This approach could mean solvency issues in some cases, they told the Times. To help educate Americans about the true drivers of rising health care costs, America’s Health Insurance Plans, the industry trade association, last week launched a new national ad campaign. The ad demonstrates that health insurance company costs represent a small slice of the overall health care cost pie.

Federal

With a cadre of staff operatives searching for the right health insurance reform provisions among those previously discarded from the House, Senate and the President’s proposals, Democratic leadership has been relentlessly pursuing every possible pathway to pass a final bill. The expected process would have: 1) the House pass the Senate-adopted reform bill (which most House members hate), 2) the House passing a bill to “fix” all the things it hates using a reconciliation legislative vehicle, followed by 3) the Senate passing the very same reconciliation bill — requiring only 51 votes in the Senate. The House Budget and Rules Committees are expected to start the review, hearing and mark-up process of the reconciliation bill this week. The Senate commitment to using reconciliation was made official in a scathing letter from Leader Harry Reid to the Minority Leader. Along the way the two Chambers will need to see the latest CBO “scores” on the bill before voting, and 216 House Democrats will have to resolve policy disagreements over abortion, federal health insurance rate review and authority, and other substantive issues. Additionally, the House will have to trust that the Senate can pass the reconciliation measure without changing one comma. Partisanship has blossomed into open hostility over health reform. Whether Congress can overcome these policy, process and political mine fields remains as murky as ever, but Democrats have chosen to try and will push for resolution by the Easter recess.

The Senate has passed Jobs Bill II and shipped it off to the House, where passage is not certain. Within the bill are two health-related items of note. First, the COBRA eligibility and subsidy program will be extended to the end of 2010. (These provisions are set to expire at the end of March.) Second, the bill contains a suspension until September 30, 2010 of the cut to physician Medicare reimbursements for the current calendar year. (This provision is also set to expire at the end of March.) Aetna urged Congress to apply the “doc fix” to next year’s reimbursement as well, since insurers’ Medicare rates are based on what doctors are paid, but in the end Congress failed to make this change. Aetna and the industry will continue to find ways both to establish a more lasting, if not permanent, doc fix and to devise a legislative solution to the disconnect between doctor reimbursement and Medicare Advantage rates for 2011 and beyond.

States

ARIZONA: Budget issues remain front and center as the governor and Republican leadership proposed a plan they hope will close the $700 million deficit this year and reduce the anticipated $2.6 billion deficit in 2011. Righting the state’s fiscal ship has become a very partisan exercise, with the Republicans supporting reductions in Medicaid and KidsCare, and the elimination of full-day kindergarten. As the special session on the budget is running concurrently with the regular session, no other bill hearings were held. The oral chemotherapy parity bill may be dead for this year as proponents did not meet the deadline for submitting amendatory language.

CALIFORNIA: The Assembly Accountability and Administrative Review Committee chaired by Assemblyman Hector De La Torre held a hearing last week to examine how the Department of Managed Health Care (DMHC) and the Department of Insurance (CDI) has handled issues surrounding the rescission of policies in the individual market. According to a report prepared for the committee by Bryan Liang, director of the Institute of Health Law Studies at the California Western School of Law, fewer than 300 of 6,000 former policyholders are participating in health insurers’ agreements to settle such cases. Republican committee members were highly critical of this witness, while De La Torre was critical of the Departments. The DMHC reported that since their settlements were completed there have only been nine rescissions over the past two years, proof that the DMHC and the health plans have revamped their processes for rescission and have worked to address the problem.

COLORADO: A bill mandating maternity and contraceptive coverage in individual policies continues to receive significant attention in the Senate. The most recent amendment proposes requiring maternity coverage in at least three of the plans marketed by an insurer. It would also allow a current member of a plan without maternity coverage to switch to a plan with maternity coverage from the same carrier during the first trimester. The other major bill would require that second level appeals be performed by physicians who are actively involved in clinical practice. This measure is counterintuitive in the current economy, since it would result in outsourcing appeals and drive up costs for plan sponsors and their employees.

CONNECTICUT: A proposal that would require health insurance plans to cover oral chemotherapy in the same way that intravenous chemotherapy is covered made it through the legislature’s Insurance and Real Estate Committee last week. Currently, many health plans treat the two kinds of cancer treatments differently. Chemotherapy treatments that come in pill form are often categorized as prescription drug benefits that can require patients to pay a larger share of the cost. Cancer patients, doctors and patient advocates spoke in favor of the bill, while insurers and the Connecticut Business and Industry Association opposed it, arguing that it would put a mandate on health plans that could raise costs and make it more difficult for employers to afford insurance.

GEORGIA: A bill restricting the use of rescissions in individual health insurance policies passed a Senate committee last week. Aetna continues to work with its trade organizations to educate legislators about the adverse effect of this type of legislation. Discussions also continue regarding legislation affecting the use of rental networks.

KANSAS: Roughly half way through the legislative session, several health care bills are still moving through the process. On the regulatory front, the Insurance Department has proposed a regulation that would mandate coverage of routine patient care costs while the insured is enrolled in a cancer clinical trial – a mandate that was rejected by the legislature in 2008. A hearing will be held on April 20, and Aetna will have an opportunity to present testimony on this issue. Bills still alive include mandates for autism and orally administered chemotherapy, legislation prohibiting dental contracts that require the dentist to follow a fee schedule for non-covered services, and a ban on “most favored nation” clauses by some insurers. Another bill would allow small employers to create individual HRAs to fund premium payments on individual policies, require administering insurers to offer employees the option of receiving health insurance coverage through a high-deductible health plan with an HSA, and requiring insurers who offer small group health plans to offer high-deductible health plans with HSAs, while authorizing tax deductions for health insurance premiums for individual insurance policies. Separate legislation would amend the definition of “eligible employee” to include part-time workers (currently less than 30 hours per week). Pending legislation concerning hospital charges would prohibit charging private-pay patients more than 25 percent of what the hospital’s highest volume private payer would pay for the same goods or services. Legislation that died includes a telemedicine mandate and creation of a health care insurance database for employers.

KENTUCKY: Health issues that are being hotly debated by the legislature right now include an autism mandate, a dental bill that would not allow insurers to hold dentists, optometrists or ophthalmologists to a fee schedule for non-covered services, and a bill setting a reimbursement floor for chiropractic services. The chiropractic services proposal would allow chiropractors to bill, and would require insurers to reimburse, an evaluation and management (E&M) CPT code on each and every visit. In addition to billing for follow-up services for manipulations and other therapies, the chiropractor would be allowed to submit, and the insurer required to pay, for another E&M code on each and every visit. The legislation would also add a new mandated benefit to the Kentucky statutes. Currently, reimbursement for chiropractor visits is required only if the chiropractor performs a service already covered by the health benefit plan. Under the proposal, any service within the scope of practice of a chiropractor that is billed would become a mandated benefit. Finally, the bill would require health benefit plans to provide reimbursement without the chiropractor having to provide any documentation that the services were medically necessary. Each of these bills has, or is expected to, pass at least one chamber.

SOUTH DAKOTA: Several important legislative deadlines are approaching, resulting in a flurry of activity. Bills or resolutions not passed by the second chamber by March 9 died. But the Governor has already signed a bill that amends the premium rate-setting procedure for the high-risk pool so that rates for a given classification are 150 percent of the average actively marketed premium. The pool will have to offer three or more plan designs, remove coverage requirements for the plans (such as disease management) and remove set cost-sharing values. The bill was signed by the Governor on March 1 and will become effective on July 1, 2010. The Governor has also signed a bill prohibiting rating based on injuries caused by domestic violence and legislation requiring refunds of premiums for partial months, in the case of mid-month cancellations. Both chambers have passed legislation prohibiting contract language requiring dentists to accept a fee schedule for non-covered services, and the bill awaits the Governor’s signature. Finally, the legislature passed a resolution opposing the federal health care reform proposals passed in the U.S. Senate and House.

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