JANUARY 29, 2010
This Week in Health Care Reform
Following the election of Republican Scott Brown to the Massachusetts State Senate last week and the resulting loss of Senate Democrats' supermajority, lawmakers continue to pave the way for health care reform - with limited progress. In addition, polls indicate that the public would rather lawmakers focus more on the economy than on health care.
State of the Union Address
President Obama Gives State of the Union Address: On Wednesday evening, President Barack Obama delivered his first State of the Union address before a joint session of Congress. Having hoped to have a health care reform bill on his desk prior to his address, the President instead used his speech to encourage Congress to push forward on health care reform. Yet, he did not give specific guidance as to how to proceed with the legislation. Instead, he made it clear that his primary focus would be on jobs and the economy.
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Health Care Reform Negotiations
Democrats Still Seek Way Forward: While vowing not to give up, Democratic Senate leaders indicated Tuesday that they no longer felt pressure to move quickly on health care reform; and, in the wake of the Massachusetts election and in reaction to public opinion, they shifted focus to jobs and the economy. Senate Majority Leader Harry Reid (D-NV) commented that there is "no rush" on health care and said that he and Speaker of the House Nancy Pelosi (D-CA) were working to map out a way to complete health care reform in the coming months. On Wednesday, Sen. Pelosi floated a two-pronged strategy to pass incremental changes now and pursue comprehensive reform later.
Some lawmakers have considered breaking up the legislation into smaller pieces that have bipartisan support. However, this option will prove challenging given the complexities and interdependencies of the measures. For example, lawmakers would like to include a measure that requires all insurance companies to insure those with pre-existing conditions; however, premiums will most likely increase unless there is an individual mandate.
Earlier this week, Democrats appeared to be coalescing around a different strategy through which Senate lawmakers would make changes to their bill to appease members of the House. The Senate would then pass the revised bill via reconciliation, which only requires 51 votes. Following that, the House would approve the revised bill, giving it to President Obama for his review. However, movement on this strategy stalled Tuesday when two centrist Senators, Sens. Evan Bayh (D-IN) and Blanche Lincoln (D-AK), indicated that they would oppose using reconciliation to bypass Republican support. Others, including Sen. Joe Lieberman (I-CT) and Sen. Dianne Feinstein (D-CA), have suggested a "time out" on health care reform until there is a clear path forward.
In the GOP response to President Obama's State of the Union address, Virginia Governor Robert McDonnell said that Republicans share the Democrats' desire for health care reform, but do not agree with their proposed solutions. Republicans suggest that Democrats scrap the current proposals and start over with more Republican input on issues such as medical malpractice reform and selling insurance policies across state lines.
Republicans Call for Transparency: On Wednesday, the House Energy and Commerce Committee marked up a resolution presented by Rep. Michael Burgess (R-TX) which requested that the administration divulge documentation regarding the health care reform deals made with trade associations and a labor union. Committee Chairman Henry Waxman (D-CA) said that while details remained to be worked out, he would support a narrowed version of the Republican request for White House records.
President Obama to Speak with House Republicans: President Obama will meet with House Republicans on Friday in response to an invitation to speak at their annual retreat in Baltimore that begins Thursday and ends Saturday. The meeting comes just after the President's State of the Union address, and members of the news media speculate that the meeting may spur more bipartisanship or potentially lead to even more tension between the two parties.
Interest Groups Call for Reform: With health care reform's fate in jeopardy, interest groups have voiced their support, encouraging Democrats to push forward with legislation. The AARP, American Cancer Society Cancer Action Network, Consumers Union, Families USA and Service employees International Union sent a joint letter last Thursday urging Congress not to abandon comprehensive health care reform. Further, the United States Conference of Catholic Bishops also sent a letter to Congress urging a push for reform.
Public Opinion
Polls Show Concern with Health Care Reform; More Focus on Jobs and Economy: Several polls were released this week that highlight the public's disenchantment with health care reform and anxiety around the struggling economy.
A new CNN/Opinion Research poll released Tuesday shows that only three in ten Americans say they want Congress to pass legislation similar to the bills currently being discussed in Congress. Forty-eight percent of Americans would like lawmakers to start again on a new bill, and 21 percent believe Congress should not work on bills that would change the current health care system. Further, a Wall Street Journal/NBC poll released Wednesday found that 51 percent of Americans believe President Obama has paid "too little attention" to the economy and that 44 percent feel he has paid "too much attention" to his proposed health care overall.
In addition, a new USA Today/Gallup poll released late last week finds that most Americans call for a more bipartisan effort in health reform. A 55 percent majority of Americans say that President Obama and Congressional Democrats should suspend movement on health care reform and consider alternatives that would increase Republican support.
A poll released last weekend by the Washington Post , Henry J. Kaiser Family Foundation and Harvard University's School of Public Health indicated that dissatisfaction with the direction of the country, including the Democrats' health care reform proposals, drove the outcome of the Massachusetts election. The post-election survey of Massachusetts state voters showed that overall 43 percent say they support the health care reform proposals advanced by President Obama and Congressional Democrats, while 48 percent oppose them.
A new poll released Monday from the Robert Wood Johnson Foundation found that fears regarding the health care reform package increased significantly in December as members of the Senate finalized their bill. Thirty-three percent of respondents said they believed their access to care would worsen if the legislation passed, up from 25 percent in November. Forty-two percent said the country's finances would suffer under reform, compared with 34.6 percent in November.
Looking Ahead
Next week, the President will present his Budget to Congress (which includes health programs), after which Congressional hearings will commence. We expect health reform to be discussed in these sessions. While there remains no clear path forward for health care reform, Congressional leaders will continue to work to find a solution.
Chad Levin EasyToInsureME.com | Work: 866-492-3905 Fax: 215-364-3990 easytoinsureme@yahoo.com  |  |
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Showing posts with label individual. Show all posts
Showing posts with label individual. Show all posts
Sunday, January 31, 2010
Friday, January 8, 2010
This Week in Health Insurance Quotes Reform : EasyToInsureME
JANUARY 8, 2010
This Week in Health Care Reform
While still technically in recess, members of Congress trickled back to Washington, D.C. this week to get a jump start on reconciling the health care reform bills passed by the House and Senate last year.
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Health insurance
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On Tuesday, Democratic leaders began conversations around a final package, pledging to overcome differences and aiming to have a bill passed by the President Barack Obama's State of the Union Address, anticipated in early February. Members of the news media, however, have highlighted the difficult negotiations ahead, given some major differences in the proposed packages and the time pressure being imposed by President Obama.
We continue to encourage you and others to engage members of Congress during this debate by visiting the Health Action Network.
Health Reform Negotiations
Senate Passes Reform Bill: At 7:05 a.m. on Christmas Eve, Senate Majority Leader Harry Reid (D-NV), along with 59 other Senate members, voted to pass reform legislation that, according to the Congressional Budget Office (CBO), would expand health coverage to approximately 31 million people at a cost of $871 billion over 10 years. The bill passed on party lines (60-39), without a single Republican vote in favor. Republicans believe the bill would impose many regulatory and financial burdens on taxpayers and businesses while increasing government debt.
Reconciliation Poses Difficult Road Ahead: Before lawmakers can present a final health care reform bill to President Obama, the approved Senate bill needs to be merged with the House version passed in November 2009, which extends coverage to 36 million Americans at a cost of about $1 trillion. However, the bills have some major differences that will need to be addressed as lawmakers shape the final package, including:
* Insurance market reform and exchanges - Both bills would bar insurers from denying coverage to those with pre-existing conditions and from dropping coverage for those who get sick. Both would also create insurance exchanges through which small businesses and individuals could shop for insurance. The Senate bill would create state-based exchanges, however, whereas the House bill would create a national exchange with an option for states to run state-based programs if they meet certain requirements.
* The government-run plan - A government-run plan was a central component to the House bill. The Senate bill would instead direct the U.S. Office of Personnel Management to contract with private insurance companies to offer policies on the exchanges. Despite much commotion over the need to include the public option, House leaders conceded Tuesday that they may be willing to agree to a bill without a public option if other parts of the bill fulfill the same goals, with the hope of expanding available subsidies.
* Reform financing - Members of the House would pay for the reform effort - which carries a price tag of about $1 trillion - through a 5.4 percent surtax on individuals making more than $500,000 a year and couples making more than $1 million and by imposing a 2.5 percent excise tax on medical devices. Members of the Senate, on the other hand, plan to pay for their $871 billion plan through several measures:
- a 40 percent excise tax on high-cost health insurance plans;
- an increase in payroll taxes for Medicare on individuals making more than $200,000 a year and couples making more than $250,000 per year;
- fees on insurers, medical device manufacturers and drug companies;
- and, a 10 percent tax on indoor tanning salons.
On Wednesday, President Obama expressed his preference for the insurance tax contained in the Senate bill, but the excise tax is strongly opposed by labor unions.
* Coverage Mandates - Both bills require that individuals obtain health insurance and impose a penalty on those who do not. The House bill also includes an employer mandate for companies with payrolls above $750,000. The Senate bill does not include this mandate but would require companies with more than 50 employees to pay a fine if employees obtain federally subsidized coverage on the insurance exchange.
* Medicaid expansion - Both bills expand Medicaid. The Senate bill makes Medicaid available to those with incomes up to 133 percent of the poverty level, whereas the House allows for coverage for those with incomes up to 150 percent of the poverty level.
* Abortion - While both bills bar the use of federal funds for abortions, the House bill includes stricter language requiring anyone seeking abortion coverage to buy separate insurance riders. The Senate bill would let the states choose whether or not to include plans with abortion coverage in the insurance exchange and would require those with abortion coverage to write a separate check for this insurance.
President Obama Pushes Swift Action: In a meeting at the White House Tuesday, President Obama encouraged House Speaker Nancy Pelosi (D-CA) and House Majority Leader Steny Hoyer (D-MD), as well as Senate Majority Leader Harry Reid and Sen. Dick Durbin (D-IL), who participated via phone, to bypass the traditional conference committee used to negotiate reconciliation, in the interest of time. The move, which creates a three-way negotiating construct involving top Democrats in the House and Senate and the White House, will exclude Republican lawmakers from the debate and reduce their ability to delay the voting.
Further, President Obama indicated that he would be taking a hands-on approach to the final stages of the negotiations. The President held another meeting with leading Democrats on Wednesday to help iron out differences between the House and Senate bills. Democrats also held a noon meeting and conference call on Thursday to discuss how reconciliation will proceed and some of the priorities for the final bill.
Additional Activities
C-SPAN Calls for Transparency: Noting that President Obama mentioned several times during his campaign that health care negotiations would be transparent and broadcasted on C-SPAN, Brian Lamb, C-SPAN CEO, sent a letter to House and Senate leaders on December 30 asking for negotiations to be opened up for public viewing. Republicans pointed out that the most critical discussions on health reform have taken place behind closed doors so far. Top House Democrats deflected the C-SPAN request, saying the process has been highly transparent through more than 100 public hearings held by the House. They pledged to make the final stages transparent in part via the Internet.
Opponents Question Constitutionality: On Wednesday, December 30, Republican attorneys general in 13 states - including Colorado, Florida, Idaho, Michigan and Virginia - sent a letter to Sens. Nancy Pelosi and Harry Reid stating that Congressional leaders must remove the amendment exempting Nebraska from having to pay for the state's Medicaid expansion. The prosecutors are calling the deal unconstitutional and threatened legal action. Members of the news media report that South Carolina Attorney General Henry McMaster and Oklahoma top prosecutor Drew Edmondson are asking attorneys general across the country to call on Sens. Pelosi and Reid to remove the provision.
In addition, a contingency of legal scholars as well as many Republican lawmakers are calling the measures passed by both the House and the Senate unconstitutional , primarily due to the inclusion of an individual mandate. "In the history of this country, the federal government has never required every American to enter into a contract with a private company," said Randy Barnett, a professor of constitutional law at Georgetown University Law Center.
Looking Ahead
Formal sessions in Congress are scheduled to begin January 19, 2010. Sen. Pelosi, however, plans to continue to work with key committee chairs and other Democratic leaders prior to the official sessions..
This Week in Health Care Reform
While still technically in recess, members of Congress trickled back to Washington, D.C. this week to get a jump start on reconciling the health care reform bills passed by the House and Senate last year.
Quoting & Saving just got easier...Easy To Insure ME Health Insurance Quotes... Quote all carriers in seconds
Health insurance
Health insurance quotes
On Tuesday, Democratic leaders began conversations around a final package, pledging to overcome differences and aiming to have a bill passed by the President Barack Obama's State of the Union Address, anticipated in early February. Members of the news media, however, have highlighted the difficult negotiations ahead, given some major differences in the proposed packages and the time pressure being imposed by President Obama.
We continue to encourage you and others to engage members of Congress during this debate by visiting the Health Action Network.
Health Reform Negotiations
Senate Passes Reform Bill: At 7:05 a.m. on Christmas Eve, Senate Majority Leader Harry Reid (D-NV), along with 59 other Senate members, voted to pass reform legislation that, according to the Congressional Budget Office (CBO), would expand health coverage to approximately 31 million people at a cost of $871 billion over 10 years. The bill passed on party lines (60-39), without a single Republican vote in favor. Republicans believe the bill would impose many regulatory and financial burdens on taxpayers and businesses while increasing government debt.
Reconciliation Poses Difficult Road Ahead: Before lawmakers can present a final health care reform bill to President Obama, the approved Senate bill needs to be merged with the House version passed in November 2009, which extends coverage to 36 million Americans at a cost of about $1 trillion. However, the bills have some major differences that will need to be addressed as lawmakers shape the final package, including:
* Insurance market reform and exchanges - Both bills would bar insurers from denying coverage to those with pre-existing conditions and from dropping coverage for those who get sick. Both would also create insurance exchanges through which small businesses and individuals could shop for insurance. The Senate bill would create state-based exchanges, however, whereas the House bill would create a national exchange with an option for states to run state-based programs if they meet certain requirements.
* The government-run plan - A government-run plan was a central component to the House bill. The Senate bill would instead direct the U.S. Office of Personnel Management to contract with private insurance companies to offer policies on the exchanges. Despite much commotion over the need to include the public option, House leaders conceded Tuesday that they may be willing to agree to a bill without a public option if other parts of the bill fulfill the same goals, with the hope of expanding available subsidies.
* Reform financing - Members of the House would pay for the reform effort - which carries a price tag of about $1 trillion - through a 5.4 percent surtax on individuals making more than $500,000 a year and couples making more than $1 million and by imposing a 2.5 percent excise tax on medical devices. Members of the Senate, on the other hand, plan to pay for their $871 billion plan through several measures:
- a 40 percent excise tax on high-cost health insurance plans;
- an increase in payroll taxes for Medicare on individuals making more than $200,000 a year and couples making more than $250,000 per year;
- fees on insurers, medical device manufacturers and drug companies;
- and, a 10 percent tax on indoor tanning salons.
On Wednesday, President Obama expressed his preference for the insurance tax contained in the Senate bill, but the excise tax is strongly opposed by labor unions.
* Coverage Mandates - Both bills require that individuals obtain health insurance and impose a penalty on those who do not. The House bill also includes an employer mandate for companies with payrolls above $750,000. The Senate bill does not include this mandate but would require companies with more than 50 employees to pay a fine if employees obtain federally subsidized coverage on the insurance exchange.
* Medicaid expansion - Both bills expand Medicaid. The Senate bill makes Medicaid available to those with incomes up to 133 percent of the poverty level, whereas the House allows for coverage for those with incomes up to 150 percent of the poverty level.
* Abortion - While both bills bar the use of federal funds for abortions, the House bill includes stricter language requiring anyone seeking abortion coverage to buy separate insurance riders. The Senate bill would let the states choose whether or not to include plans with abortion coverage in the insurance exchange and would require those with abortion coverage to write a separate check for this insurance.
President Obama Pushes Swift Action: In a meeting at the White House Tuesday, President Obama encouraged House Speaker Nancy Pelosi (D-CA) and House Majority Leader Steny Hoyer (D-MD), as well as Senate Majority Leader Harry Reid and Sen. Dick Durbin (D-IL), who participated via phone, to bypass the traditional conference committee used to negotiate reconciliation, in the interest of time. The move, which creates a three-way negotiating construct involving top Democrats in the House and Senate and the White House, will exclude Republican lawmakers from the debate and reduce their ability to delay the voting.
Further, President Obama indicated that he would be taking a hands-on approach to the final stages of the negotiations. The President held another meeting with leading Democrats on Wednesday to help iron out differences between the House and Senate bills. Democrats also held a noon meeting and conference call on Thursday to discuss how reconciliation will proceed and some of the priorities for the final bill.
Additional Activities
C-SPAN Calls for Transparency: Noting that President Obama mentioned several times during his campaign that health care negotiations would be transparent and broadcasted on C-SPAN, Brian Lamb, C-SPAN CEO, sent a letter to House and Senate leaders on December 30 asking for negotiations to be opened up for public viewing. Republicans pointed out that the most critical discussions on health reform have taken place behind closed doors so far. Top House Democrats deflected the C-SPAN request, saying the process has been highly transparent through more than 100 public hearings held by the House. They pledged to make the final stages transparent in part via the Internet.
Opponents Question Constitutionality: On Wednesday, December 30, Republican attorneys general in 13 states - including Colorado, Florida, Idaho, Michigan and Virginia - sent a letter to Sens. Nancy Pelosi and Harry Reid stating that Congressional leaders must remove the amendment exempting Nebraska from having to pay for the state's Medicaid expansion. The prosecutors are calling the deal unconstitutional and threatened legal action. Members of the news media report that South Carolina Attorney General Henry McMaster and Oklahoma top prosecutor Drew Edmondson are asking attorneys general across the country to call on Sens. Pelosi and Reid to remove the provision.
In addition, a contingency of legal scholars as well as many Republican lawmakers are calling the measures passed by both the House and the Senate unconstitutional , primarily due to the inclusion of an individual mandate. "In the history of this country, the federal government has never required every American to enter into a contract with a private company," said Randy Barnett, a professor of constitutional law at Georgetown University Law Center.
Looking Ahead
Formal sessions in Congress are scheduled to begin January 19, 2010. Sen. Pelosi, however, plans to continue to work with key committee chairs and other Democratic leaders prior to the official sessions..
Friday, December 18, 2009
Individual Health Insurance Reform EasyToInsureME
December 17, 2009
It appears that the U.S. Senate will vote to close debate on its version of federal health care reform as early as this weekend. Whether or not you have contacted your senators previously, now is the time for you to consider contacting both of your senators and encourage them to continue debate and to improve the legislation.
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Health insurance quote
It is difficult to overstate the negative implications of Senate Majority Leader Harry Reid's (D-NV) proposal. According to the Congressional Budget Office, this legislation - if enacted - will have a significant, negative impact on the cost and nature of coverage for our customers. The administration's chief actuary for Medicare and Medicaid Services has determined that if the Senate health care bill became law, it would increase national health care spending more than if we did nothing. Our own analysis concurs with these assessments and further indicates that Sen. Reid's proposal will likely lead to higher premiums for many of our customers without reducing the growth in underlying health care costs.
A new Washington Post-ABC News poll indicates that 53% of Americans understand that their personal costs will increase under this proposal and only 37% believe that their personal health care will improve under this legislation. The Senate needs to set aside this version of health care reform and construct a proposal that has broad and deep public support.
Throughout the health care reform debate, our company has sought to partner with our elected leaders in both parties to pursue responsible, sustainable reform that lowers costs and increases access. The current legislation does not meet these goals and Congress needs to hear from individuals who are concerned about the consequences of well-intended but flawed reforms.
While we continue to support health care reform, we cannot support reform that fails to address the cost and quality issues in our health care delivery system and undermines the bipartisan consensus for responsible and sustainable reform.
The holiday season is a busy time for all. Now is the time to get involved today.
The Senate needs to hear from you and time is short.
It appears that the U.S. Senate will vote to close debate on its version of federal health care reform as early as this weekend. Whether or not you have contacted your senators previously, now is the time for you to consider contacting both of your senators and encourage them to continue debate and to improve the legislation.
Quoting & Saving just got easier...Easy To Insure ME Health Insurance Quotes... Quote all carriers in seconds
Individual health insurance
Health insurance quote
It is difficult to overstate the negative implications of Senate Majority Leader Harry Reid's (D-NV) proposal. According to the Congressional Budget Office, this legislation - if enacted - will have a significant, negative impact on the cost and nature of coverage for our customers. The administration's chief actuary for Medicare and Medicaid Services has determined that if the Senate health care bill became law, it would increase national health care spending more than if we did nothing. Our own analysis concurs with these assessments and further indicates that Sen. Reid's proposal will likely lead to higher premiums for many of our customers without reducing the growth in underlying health care costs.
A new Washington Post-ABC News poll indicates that 53% of Americans understand that their personal costs will increase under this proposal and only 37% believe that their personal health care will improve under this legislation. The Senate needs to set aside this version of health care reform and construct a proposal that has broad and deep public support.
Throughout the health care reform debate, our company has sought to partner with our elected leaders in both parties to pursue responsible, sustainable reform that lowers costs and increases access. The current legislation does not meet these goals and Congress needs to hear from individuals who are concerned about the consequences of well-intended but flawed reforms.
While we continue to support health care reform, we cannot support reform that fails to address the cost and quality issues in our health care delivery system and undermines the bipartisan consensus for responsible and sustainable reform.
The holiday season is a busy time for all. Now is the time to get involved today.
The Senate needs to hear from you and time is short.
Thursday, November 19, 2009
Individual Health Insurance Reform EasyToInsureME
Week of November 16, 2009
The Business Roundtable released a report late last week that found key components of existing health care reform legislation could slow the growth of health care costs and offer real savings for companies and their employees. The results were immediately welcomed by the White House. Yet, the report goes on to warn that certain provisions within the legislation could actually accelerate costs. "The report also shows that reform done wrong won't work and could make a bad situation much worse," said Antonio M. Perez, Chair of Business Roundtable's Consumer Health and Retirement Initiative. Aetna, a supporter of bipartisan health care reform, has expressed similar concerns. Specifically, the report notes changes that threaten to increase health care spending include failure to implement a strong individual mandate, increases in the cost of health care to individuals from changes to consumer spending accounts, and increased cost shifting to the private sector from reduced reimbursements to providers and the public plan option.
Quoting & Saving just got easier...EasyToInsureME Health Insurance Quotes... Quote all carriers in seconds
Health insurance
Health insurance quotes
Federal
The Democratic leadership continues to play an "inch-by-inch" game on health care reform. In the House, Speaker Pelosi is fully aware of the fact that the very bill she managed through the House would very likely not pass a second time because of the abortion issue. But she succeeded in inching the bill forward, which was the plan all along. In the Senate, Majority Leader Harry Reid continues weaving policy substance with political reality in order to create a mosaic that can inch forward to the next milestone, which is getting the 60 votes needed to allow the Senate to proceed to debate. He has yet to release the final "merged" bill; Senator Reid is going one-on-one with the Senate to sort out the combination of provisions that will allow him to get past the next hurdle. The abortion issue is the latest stumbling block, as at least one Senator is saying "no" to proceeding without this very provision. To jump start the process, Senator Reid is using the first of myriad procedural tactics to get the bill to the Senate floor. But if Republicans stand their ground, Senator Reid probably can't get to that next step (the "motion to proceed") until Friday. That would leave only enough time to make a few introductory speeches and go home for Thanksgiving.
On Thursday, the House is expected to proceed to debate and possibly pass a permanent "fix" to the perennial problem of what to do about scheduled cuts to physician reimbursement in Medicare. The House leadership wants to spend $210 billion (with no good funding source) to eliminate the upcoming 21 percent cut in 2010, along with all future cuts. The Speaker needs to make the gesture, given the AMA's support for her health care reform bill. It is unclear whether this measure will pass in the House; however, it is clear that such a measure will have a more difficult time in the Senate. For one, the Finance Committee reform bill already contains a one-year "fix" costing $10.9 billion, which is the best Chairman Max Baucus thinks is currently possible. The Senate already tried two weeks ago to pass a permanent fix, and Senator Reid was soundly rebuffed in the effort.
States
ILLINOIS: A leader in the Senate has prefiled a bill to amend Illinois' HIPAA law with a proposal that group and individual health insurance carriers be prohibited from imposing any pre-existing condition exclusions. Current limitations imposed by state law would be deleted. While the issue is being discussed on the federal level, this issue has had a lot of traction with both House and Senate Insurance Committee members for the past six months. As amended, the current proposal may not meet current federal HIPAA requirements. The bill will not be considered until January 2010.
MICHIGAN: The Office of Financial and Insurance Regulation (OFIR) has scheduled a hearing on November 23 to review Blue Care Network's proposal to buy Physicians Health Plan. In late September, Blue Care Network, a Michigan nonprofit HMO, filed a statement with OFIR regarding its intention to acquire control or merge with Physicians Health Plan of Mid-Michigan-Family Care and PHPMM Insurance Company. OFIR has 90 days to review the statement. Various parties have requested that OFIR conduct public hearings before making a decision on the sale, due to concerns raised regarding the size of the Blue Cross Blue Shield of Michigan.
NEW JERSEY: The governor has directed state departments and agencies to collectively cut $400 million from the state budget due to state revenue collection falling well short of budget projections. Furthermore, the Governor requested that the legislature not pass any spending bills during the upcoming "lame duck" session. This nearly half-a-billion dollar shortfall, coupled with a projected $8 billion budget deficit for next fiscal year, puts the state in dire fiscal straits. With options limited for making up the lost revenue, businesses operating in the state will be closely monitoring this developing situation.
NEW YORK: The legislature has passed a bill that prohibits all subrogation (collateral source or third party) recoveries by an insurer for medical expenses. The former collateral source rule eliminated the potential windfall of double recoveries by plaintiffs who receive medical benefits and win recoveries from defendant payments. The old rule of law allowed insurance companies to offset potential premium increases to consumers by authorizing them to recover medical costs from payments made to an injured plaintiff from a jury award or settlement. With that option no longer available, insurance premiums in New York will be further stressed. In addition, Governor Paterson and the hospital sector are proposing that the current Patient Services Assessment (PSA) of 9.63 percent be increased by 0.25 percent to generate an additional $54 million as part of the Governor's second Deficit Reduction plan (DRP) for 2009. The hospitals are advocating for this insurance tax increase to offset some of the governor’s proposed Medicaid cuts on hospitals. The $800 in insurance taxes adopted this year already includes an increase in the PSA, and the new proposal would make the latest increase retroactive to November 1, clearly not included in premium increases for 2010. The legislature is set to return to the Capitol for two more special session days to address the DRP.
OKLAHOMA: Two Republican State Senators are sounding the alarm bell regarding both U.S. House and Senate versions of health care reform, charging that either would devastate at least one new health care facility in Oklahoma City and cost Oklahoma County and surrounding environs more than 500 jobs. State Sen. Jim Reynolds and Sen. Harry Coates say both bills would financially devastate many top-quality health care facilities, including Oklahoma Heart Hospital’s $98 million South Campus, which is set to open soon. The bills would financially undermine the facility by denying the facility federal reimbursement for services such as Medicare and Medicaid. A joint venture of Mercy Hospital, Midwest City Regional and a group of local physicians, the facility will serve much of southeast Oklahoma County along with hundreds of active-duty military and veterans. Both Sen. Coates and Sen. Reynolds say they will ask Gov. Brad Henry to intercede quickly to remove the onerous provisions.
UTAH: The Department of Insurance is circulating a draft bill to amend the state's uniform electronic standards law to require insurers to provide coverage eligibility and detailed coordination of benefits information to physicians. Aetna will be submitting comments, including the fact that an insurer is not the repository of each member's applicable insurance coverage information and that a July 1, 2010, effective date does not allow sufficient time for implementation.
The Business Roundtable released a report late last week that found key components of existing health care reform legislation could slow the growth of health care costs and offer real savings for companies and their employees. The results were immediately welcomed by the White House. Yet, the report goes on to warn that certain provisions within the legislation could actually accelerate costs. "The report also shows that reform done wrong won't work and could make a bad situation much worse," said Antonio M. Perez, Chair of Business Roundtable's Consumer Health and Retirement Initiative. Aetna, a supporter of bipartisan health care reform, has expressed similar concerns. Specifically, the report notes changes that threaten to increase health care spending include failure to implement a strong individual mandate, increases in the cost of health care to individuals from changes to consumer spending accounts, and increased cost shifting to the private sector from reduced reimbursements to providers and the public plan option.
Quoting & Saving just got easier...EasyToInsureME Health Insurance Quotes... Quote all carriers in seconds
Health insurance
Health insurance quotes
Federal
The Democratic leadership continues to play an "inch-by-inch" game on health care reform. In the House, Speaker Pelosi is fully aware of the fact that the very bill she managed through the House would very likely not pass a second time because of the abortion issue. But she succeeded in inching the bill forward, which was the plan all along. In the Senate, Majority Leader Harry Reid continues weaving policy substance with political reality in order to create a mosaic that can inch forward to the next milestone, which is getting the 60 votes needed to allow the Senate to proceed to debate. He has yet to release the final "merged" bill; Senator Reid is going one-on-one with the Senate to sort out the combination of provisions that will allow him to get past the next hurdle. The abortion issue is the latest stumbling block, as at least one Senator is saying "no" to proceeding without this very provision. To jump start the process, Senator Reid is using the first of myriad procedural tactics to get the bill to the Senate floor. But if Republicans stand their ground, Senator Reid probably can't get to that next step (the "motion to proceed") until Friday. That would leave only enough time to make a few introductory speeches and go home for Thanksgiving.
On Thursday, the House is expected to proceed to debate and possibly pass a permanent "fix" to the perennial problem of what to do about scheduled cuts to physician reimbursement in Medicare. The House leadership wants to spend $210 billion (with no good funding source) to eliminate the upcoming 21 percent cut in 2010, along with all future cuts. The Speaker needs to make the gesture, given the AMA's support for her health care reform bill. It is unclear whether this measure will pass in the House; however, it is clear that such a measure will have a more difficult time in the Senate. For one, the Finance Committee reform bill already contains a one-year "fix" costing $10.9 billion, which is the best Chairman Max Baucus thinks is currently possible. The Senate already tried two weeks ago to pass a permanent fix, and Senator Reid was soundly rebuffed in the effort.
States
ILLINOIS: A leader in the Senate has prefiled a bill to amend Illinois' HIPAA law with a proposal that group and individual health insurance carriers be prohibited from imposing any pre-existing condition exclusions. Current limitations imposed by state law would be deleted. While the issue is being discussed on the federal level, this issue has had a lot of traction with both House and Senate Insurance Committee members for the past six months. As amended, the current proposal may not meet current federal HIPAA requirements. The bill will not be considered until January 2010.
MICHIGAN: The Office of Financial and Insurance Regulation (OFIR) has scheduled a hearing on November 23 to review Blue Care Network's proposal to buy Physicians Health Plan. In late September, Blue Care Network, a Michigan nonprofit HMO, filed a statement with OFIR regarding its intention to acquire control or merge with Physicians Health Plan of Mid-Michigan-Family Care and PHPMM Insurance Company. OFIR has 90 days to review the statement. Various parties have requested that OFIR conduct public hearings before making a decision on the sale, due to concerns raised regarding the size of the Blue Cross Blue Shield of Michigan.
NEW JERSEY: The governor has directed state departments and agencies to collectively cut $400 million from the state budget due to state revenue collection falling well short of budget projections. Furthermore, the Governor requested that the legislature not pass any spending bills during the upcoming "lame duck" session. This nearly half-a-billion dollar shortfall, coupled with a projected $8 billion budget deficit for next fiscal year, puts the state in dire fiscal straits. With options limited for making up the lost revenue, businesses operating in the state will be closely monitoring this developing situation.
NEW YORK: The legislature has passed a bill that prohibits all subrogation (collateral source or third party) recoveries by an insurer for medical expenses. The former collateral source rule eliminated the potential windfall of double recoveries by plaintiffs who receive medical benefits and win recoveries from defendant payments. The old rule of law allowed insurance companies to offset potential premium increases to consumers by authorizing them to recover medical costs from payments made to an injured plaintiff from a jury award or settlement. With that option no longer available, insurance premiums in New York will be further stressed. In addition, Governor Paterson and the hospital sector are proposing that the current Patient Services Assessment (PSA) of 9.63 percent be increased by 0.25 percent to generate an additional $54 million as part of the Governor's second Deficit Reduction plan (DRP) for 2009. The hospitals are advocating for this insurance tax increase to offset some of the governor’s proposed Medicaid cuts on hospitals. The $800 in insurance taxes adopted this year already includes an increase in the PSA, and the new proposal would make the latest increase retroactive to November 1, clearly not included in premium increases for 2010. The legislature is set to return to the Capitol for two more special session days to address the DRP.
OKLAHOMA: Two Republican State Senators are sounding the alarm bell regarding both U.S. House and Senate versions of health care reform, charging that either would devastate at least one new health care facility in Oklahoma City and cost Oklahoma County and surrounding environs more than 500 jobs. State Sen. Jim Reynolds and Sen. Harry Coates say both bills would financially devastate many top-quality health care facilities, including Oklahoma Heart Hospital’s $98 million South Campus, which is set to open soon. The bills would financially undermine the facility by denying the facility federal reimbursement for services such as Medicare and Medicaid. A joint venture of Mercy Hospital, Midwest City Regional and a group of local physicians, the facility will serve much of southeast Oklahoma County along with hundreds of active-duty military and veterans. Both Sen. Coates and Sen. Reynolds say they will ask Gov. Brad Henry to intercede quickly to remove the onerous provisions.
UTAH: The Department of Insurance is circulating a draft bill to amend the state's uniform electronic standards law to require insurers to provide coverage eligibility and detailed coordination of benefits information to physicians. Aetna will be submitting comments, including the fact that an insurer is not the repository of each member's applicable insurance coverage information and that a July 1, 2010, effective date does not allow sufficient time for implementation.
Monday, November 16, 2009
EasyToInsureME Health Insurance Quotes Reform Weekly
This Week in Health Reform: November 13, 2009
This week's debate focused on last Saturday's approval of health care reform legislation by the House of Representatives. Some members of the media have raised concerns over the costs associated with the Democrat version of health care reform, highlighting the challenges Democrats might face politically as health care reform legislation evolves in Congress.
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House and Senate Negotiations
House Passes Health Care Reform Legislation: Late last Saturday, the House narrowly passed its health care reform package with a 220-215 vote, which included opposition from 39 Democrats. One Republican, Rep. Joseph Cao (R-LA), voted in favor of the bill. President Barack Obama visited Capitol Hill on Saturday morning to encourage House Democrats to pass the legislation.
The $1.1 trillion legislation passed by the House would extend coverage to an estimated 36 million Americans, vastly expand Medicaid, establish a government-run option, and create individual and employer mandates. It would also bar insurers from denying coverage based on pre-existing conditions or from dropping coverage for those who become sick. To pay for the expansion, the House passed measures including a $400 billion cut in Medicare spending over the next 10 years and new taxes on the wealthy. While the Congressional Budget Office (CBO) estimates that the bill will reduce the federal deficit by about $104 billion over a decade, the bill's longer term impact remains unclear, and some Democrats are still raising concerns over its costs.
In order to secure enough votes for passage, House Speaker Nancy Pelosi (D-CA) agreed to hold a vote on an amendment that would specifically bar the public plan from covering abortion and prohibit those who receive insurance subsidies from using the subsidy to purchase private plan options that cover abortion. The amendment was approved 240 to 194, with 64 Democrats in favor. Abortion rights supporters, however, vowed to oppose the final legislation if it remains in the amendment, highlighting the difficult road ahead.
AARP and AMA Back House Bill: The House reform legislation received a boost last Thursday, winning the support of two highly influential lobbies - AARP and the American Medical Association (AMA). The announcements came at a critical time as the House Speaker was working to shore up the last votes needed to pass the reform legislation.
Small Businesses Voice Concern: Groups and coalitions representing small businesses showed their opposition to the health care reform late last week, sending letters to lawmakers urging them to vote against the House health care reform bill. In a statement Saturday, Susan Eckerly, Senior Vice President of the National Federation of Independent Business, said, "With unemployment at a 26-year high, the punitive employer mandates and atrocious new taxes will force small business owners to eliminate jobs and freeze expansion plans at a time when our nation's economy needs small business to thrive."
Obstacles Remain for Senate: While Senate Majority Leader Harry Reid (D-NV) waits for the CBO to review the Senate's health care proposal, many hurdles remain before securing the 60 votes needed for it to pass. These obstacles include the incorporation of a public option, issues associated with federal funding for abortion, and how to pay for the health care overhaul. Recent reports indicate that Sen. Reid is favoring an increase in payroll tax on the wealthy to help pay for reform. In addition, U.S. drug makers, medical-device manufacturers and insurers are gearing up for another opportunity to reduce proposed industry fees in the Senate version of reform legislation.
With continuing pressure from White House officials to pass health care reform legislation by the end of the year, Sen. Reid has indicated that he will bring the reform package to the Senate floor for debate as early as Monday. However, Senators have indicated that, more realistically, voting will take place before Christmas, with the final passage in mid-January. In an effort to spur on Senate Democrats, Former President Bill Clinton - whose health care reform efforts failed 15 years ago - told the senators over lunch last Tuesday that "passing health care reform is not only a moral issue but also an economic imperative."
Public Opinion
American Support Slips for Passing a Health Care Reform Bill: A new Gallup Poll released last Monday shows that Americans have moved in a more negative direction on whether or not a new bill should be passed into law. Thirty-eight percent of Americans now say they would advise their member of Congress to vote against a new health care bill this year, while 29 percent would advise their member to vote for it. In addition, 41 percent say a new health care bill would make the U.S. health care system better in the long run, while 40 percent say it would make things worse.
Other Activities
Republicans Mobilize to Increase Opposition: In an effort to drum up opposition to the Democratic health care reform bills, Senate Republican Conference Chairman Lamar Alexander (R-TN) indicated that Republicans are "quietly" planning approximately 50 in-person and telephone town hall gatherings over the next three weeks.
Looking Ahead
CBO estimates of the cost of the Senate health care reform package are expected late this week or early next week, which will clear the way for Senate Majority Leader Harry Reid to bring the legislation to the Senate floor for debate as early as Monday.
This week's debate focused on last Saturday's approval of health care reform legislation by the House of Representatives. Some members of the media have raised concerns over the costs associated with the Democrat version of health care reform, highlighting the challenges Democrats might face politically as health care reform legislation evolves in Congress.
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House and Senate Negotiations
House Passes Health Care Reform Legislation: Late last Saturday, the House narrowly passed its health care reform package with a 220-215 vote, which included opposition from 39 Democrats. One Republican, Rep. Joseph Cao (R-LA), voted in favor of the bill. President Barack Obama visited Capitol Hill on Saturday morning to encourage House Democrats to pass the legislation.
The $1.1 trillion legislation passed by the House would extend coverage to an estimated 36 million Americans, vastly expand Medicaid, establish a government-run option, and create individual and employer mandates. It would also bar insurers from denying coverage based on pre-existing conditions or from dropping coverage for those who become sick. To pay for the expansion, the House passed measures including a $400 billion cut in Medicare spending over the next 10 years and new taxes on the wealthy. While the Congressional Budget Office (CBO) estimates that the bill will reduce the federal deficit by about $104 billion over a decade, the bill's longer term impact remains unclear, and some Democrats are still raising concerns over its costs.
In order to secure enough votes for passage, House Speaker Nancy Pelosi (D-CA) agreed to hold a vote on an amendment that would specifically bar the public plan from covering abortion and prohibit those who receive insurance subsidies from using the subsidy to purchase private plan options that cover abortion. The amendment was approved 240 to 194, with 64 Democrats in favor. Abortion rights supporters, however, vowed to oppose the final legislation if it remains in the amendment, highlighting the difficult road ahead.
AARP and AMA Back House Bill: The House reform legislation received a boost last Thursday, winning the support of two highly influential lobbies - AARP and the American Medical Association (AMA). The announcements came at a critical time as the House Speaker was working to shore up the last votes needed to pass the reform legislation.
Small Businesses Voice Concern: Groups and coalitions representing small businesses showed their opposition to the health care reform late last week, sending letters to lawmakers urging them to vote against the House health care reform bill. In a statement Saturday, Susan Eckerly, Senior Vice President of the National Federation of Independent Business, said, "With unemployment at a 26-year high, the punitive employer mandates and atrocious new taxes will force small business owners to eliminate jobs and freeze expansion plans at a time when our nation's economy needs small business to thrive."
Obstacles Remain for Senate: While Senate Majority Leader Harry Reid (D-NV) waits for the CBO to review the Senate's health care proposal, many hurdles remain before securing the 60 votes needed for it to pass. These obstacles include the incorporation of a public option, issues associated with federal funding for abortion, and how to pay for the health care overhaul. Recent reports indicate that Sen. Reid is favoring an increase in payroll tax on the wealthy to help pay for reform. In addition, U.S. drug makers, medical-device manufacturers and insurers are gearing up for another opportunity to reduce proposed industry fees in the Senate version of reform legislation.
With continuing pressure from White House officials to pass health care reform legislation by the end of the year, Sen. Reid has indicated that he will bring the reform package to the Senate floor for debate as early as Monday. However, Senators have indicated that, more realistically, voting will take place before Christmas, with the final passage in mid-January. In an effort to spur on Senate Democrats, Former President Bill Clinton - whose health care reform efforts failed 15 years ago - told the senators over lunch last Tuesday that "passing health care reform is not only a moral issue but also an economic imperative."
Public Opinion
American Support Slips for Passing a Health Care Reform Bill: A new Gallup Poll released last Monday shows that Americans have moved in a more negative direction on whether or not a new bill should be passed into law. Thirty-eight percent of Americans now say they would advise their member of Congress to vote against a new health care bill this year, while 29 percent would advise their member to vote for it. In addition, 41 percent say a new health care bill would make the U.S. health care system better in the long run, while 40 percent say it would make things worse.
Other Activities
Republicans Mobilize to Increase Opposition: In an effort to drum up opposition to the Democratic health care reform bills, Senate Republican Conference Chairman Lamar Alexander (R-TN) indicated that Republicans are "quietly" planning approximately 50 in-person and telephone town hall gatherings over the next three weeks.
Looking Ahead
CBO estimates of the cost of the Senate health care reform package are expected late this week or early next week, which will clear the way for Senate Majority Leader Harry Reid to bring the legislation to the Senate floor for debate as early as Monday.
Thursday, November 12, 2009
EasyToInsureME Individual Health Insurance Reform Weekly
Week of November 9, 2009
Given that the Senate is expected to require much more time than the House to vote on a health care bill (see below), it is likely there is not enough legislative time left in 2009 to wrap up a bill for Christmas delivery to the White House. Senate Majority Leader Harry Reid fueled concerns about the schedule last week when he refused to commit publicly to passing an overhaul bill this year. This makes a "conference" between the House and Senate MORE likely in January 2010 THAN IN 2009, and that could require some time since the current House and Senate versions are vastly different on several key provisions. If the Conference pathway proves too contentious, House Speaker Nancy Pelosi and Reid could play legislative "ping-pong," whereby each Chamber makes a modest change and ships if off to the other, back and forth, until they both approve the same language.
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Federal
Late Saturday night the House of Representatives approved its version of health care reform by the slim margin of 220 to 215 (218 was the minimum needed). The core of the approved House bill remained unchanged from the version the Speaker introduced a few weeks ago and includes: an employer mandate to provide and pay for coverage; a fairly strong individual coverage requirement; a public plan option set up by government that would pay "negotiated" rates to providers; and insurance reforms, including guaranteed issue and modified community rating. It does not include the "Cadillac" plan tax or the insurer tax provisions currently in the Senate bill. The House bill would be paid for in part with cuts to Medicare Advantage and a surcharge on the "wealthy."
On the Senate side, Majority Leader Reid is waiting for the revenue score from CBO on several different Senate Bill scenarios, given that several Senators have publicly stated opposition to going forward without a hard and fast number on both cost and impact on bending the spending curve. He also needs this time to win over the 60 votes needed to even proceed with consideration of the bill, let alone the 60 needed to cut off debate once the debate begins; he may not have either right now. The earliest the Senate could start debate would be the week of November 16, but a date in December seems more likely. Approval of the House bill will surely put increased pressure on the Senate to move forward but to do so cautiously, given the slim voting margin in the House, as the issue moves closer to the finish line.
Bills to extend and expand COBRA have been introduced in both the House and Senate and could well be part of the final push on health care reform. Both versions extend the Special COBRA subsidy program from end of 2009 to June 30, 2010 and maintain the government's 65 percent subsidy. The Senate version increases this subsidy to 75 percent, and the House extends basic COBRA eligibility from 18 to 24 months. Given the unemployment numbers, it seems likely that, whether as part of health reform or on its own, a COBRA extension (including the subsidy) will be enacted in 2009.
States
ARIZONA: Governor Jan Brewer and legislative leaders have reached a tentative agreement to reconvene to address the projected 2010 budget shortfall, which ballooned from $1 billion in early September to $2 billion by the end of October. Although the governor favors a temporary tax increase to boost revenue, she is unlikely to float that idea this time around to help limit the length of the session. Governor Brewer is expected to announce her candidacy for re-election. Although the former lieutenant governor is now the incumbent and has never lost an election, she is viewed as vulnerable by some Republicans because of budget concerns and her continued focus on obtaining additional revenue through taxation.
CALIFORNIA: California’s state budget deficit could reach $7 billion for the current fiscal year in part because of recent court decisions blocking state funding cuts. For example, a federal judge recently blocked the state's plans to cut $80 million from its budget for In-Home Supportive Services, and Insurance Commissioner Steve Poizner has filed a suit to block the sale of part of the State Compensation Insurance Fund, which was projected to generate $1 billion. Some analysts project that the state’s budget deficit will range from $10 billion to $20 billion in the upcoming fiscal year. In other developments, Lt. Governor John Garamendi won a special election to fill the Congressional seat vacated by U.S. Representative Ellen Tauscher (D). Garamendi was elected lieutenant governor in 2006 after 16 years in the legislature and two terms as insurance commissioner.
COLORADO: Senator Betty Boyd, President Pro Tem and Chair of the Health and Human Services Committee, met with insurer representatives to highlight the issues likely to get attention in the upcoming session. A proposal to prohibit the use of gender in rating individual policies has a high likelihood of passing, she said. Senator Boyd also advised that efforts will be made to ensure that the Cover Colorado program remains solvent, as it has potential to be used as the state’s public plan option. Speculation has it that Colorado could become one of the first states to act on federal health care reform if it is enacted. Finally, she expressed a strong interest in authorizing the DOI to establish standardized policy forms.
DELAWARE: Department of Health and Social Services Secretary Rita M. Landgraf has issued an update to existing statutes adding virtual colonoscopy as an approved colorectal screening modality. Delaware law requires coverage for colorectal screening modalities and empowers the Secretary to add modalities as recommended by the Delaware Cancer Consortium. Accordingly, all contracts for health insurance issued, delivered or renewed after December 1, 2009 must include coverage for virtual colonoscopy for colorectal cancer screening.
DISTRICT OF COLUMBIA: Newly passed legislation requires individual and group health plans to provide coverage for orally administered chemotherapy medication in a manner no more restrictive than intravenously administered treatment or injected cancer medications. In other business, the Council of the District of Columbia confirmed Acting Commissioner Gennet Purcell as Commissioner for the District of Columbia Department of Insurance, Securities and Banking (DISB). Commissioner Purcell, who served as DISB’s Deputy Commissioner since 2008, is an attorney and member of both the State of Maryland Bar and the Commonwealth of Virginia Bar. As deputy, her primary responsibilities included oversight of the agency’s core functional areas, including the divisions of Insurance, Securities, Banking, Fraud Enforcement and Investigation, and Risk Finance.
GEORGIA: A meeting was held last week between health insurance representatives and the Chairman of the Senate Insurance Committee to discuss legislation for 2010 that would restrict rental networks. The Medical Association of Georgia also was represented. Aetna has committed to work with all interested parties on the legislation.
ILLINOIS: A fall veto session concluded at the end of October, and three health insurance bills of import passed both chambers. The first bill creates external review requirements for all commercial insurance products, rather than just HMOs, effective July 1, 2010. The bill also establishes committees to create a uniform small-employer group health status questionnaire and an individual health statement for use on January 1, 2011. The legislation also requires insurers to semi-annually prepare and provide the Department of Insurance a statement on aggregate administrative expenses and other information. It is a good compromise versus what was originally proposed. In addition, both chambers passed an orthotics and prosthetics mandate on health carriers and HMOs for policies amended, delivered, issued, or renewed six months after the effective date of the amendatory act. The third bill changed the requirements to obtain a producer license. The Illinois General Assembly is not expected to reconvene until January 2010.
MISSOURI: The Secretary of the State recently approved a ballot initiative proposal for the November 2010 ballot that would essentially eliminate network-based health care delivery in Missouri. The move follows unsuccessful efforts to enact an any-willing-provider bill in past legislative sessions.The petition effort behind the ballot initiative appears to have been spearheaded by a local surgical practice that has been excluded from the medical staffs of local hospitals. Any willing provider is only one portion of the proposal. It would apply to health carriers and health benefit plans, including Medicare and Medicaid, and facilities. It would, for example, prohibit carriers from: Imposing on a beneficiary any co-payment, fee, or condition that is not equally imposed on all other beneficiaries in the same benefit category, co-payment level, or class; prohibiting or limiting a provider from the opportunity to participate in the network if that provider is willing to accept the carrier’s operating terms and conditions, fee schedule, covered expenses, utilization and quality standards. The State Auditor is preparing an assessment of the fiscal impact of the proposed measure as well as a brief summary of the fiscal impact for the petition. Legal challenges to the ballot initiative are permitted. A group of stakeholders, including Aetna, are discussing strategy.
NEW JERSEY: Health insurance issues were front and center in a bitter battle for the governor's office, which ended last week when Republican candidate Chris Christie defeated Democratic Governor Jon Corzine. The governor-elect has publicly supported greater flexibility for carriers to make health coverage more affordable via mandate-free plan designs and interstate sales of health policies. The Democrats remain in firm control of the legislature, which will make the governor-elect's agenda an uphill battle. Also, the Department of Banking and Insurance (DOBI) adopted a regulation standardizing the information and format on health identification cards. Additionally, DOBI initiated a meeting with the state's major health plans seeking guidance as to how the state might proceed in limiting plans,’ and members,’ exposure to exorbitant out-of-network provider charges. This is one in a series of meetings aimed at developing consensus on an appropriate fee schedule or other mechanism for non-par provider charges. Lastly, the NJ Department of Health & Senior Services (DHSS) has launched a six-month Hospital Newborn Pilot Program. Nine hospitals throughout the state are participating in a pilot to ensure no newborn leaves the hospital without health insurance. The participating hospitals are expected to submit data to the DHSS.
NEW YORK: Governor David Paterson is calling for a special session to address the current state budget deficit. The Governor’s two-year, $5.2 billion Deficit Reduction Package would have a current-year impact of $3.2 billion in 2009-10 and a recurring impact of $2 billion in 2010-11. The components include across-the-board spending reductions and a tax penalty forgiveness program. The Governor indicated that his agenda will include a bill that would completely prohibit all subrogation (collateral source) recoveries on any insured or self-insured plans. The existing collateral source rule eliminates the potential windfall of double recoveries to plaintiffs who receive benefits and make recoveries from both their insurance coverage and defendant payments, while still ensuring that uncompensated losses are fully compensated. This subrogation legislation passed the Senate earlier this year, but it has not passed the Assembly. In other business, State Sen. Eric Schneiderman, chairman of the Codes Committee, and Sen. Neil Breslin, chairman of the Insurance Committee, introduced a bill known as "Ian's Law," which is named after a patient with muscular dystrophy. The proposed legislation would prohibit non-renewal of group policies and would require heath plans to get state Department of Insurance approval before discontinuing a class of insurance. The bill also would require plans to continue covering a totally disabled policyholder for 18 months, even if the plan gets state permission to cancel an entire class of policies.
Given that the Senate is expected to require much more time than the House to vote on a health care bill (see below), it is likely there is not enough legislative time left in 2009 to wrap up a bill for Christmas delivery to the White House. Senate Majority Leader Harry Reid fueled concerns about the schedule last week when he refused to commit publicly to passing an overhaul bill this year. This makes a "conference" between the House and Senate MORE likely in January 2010 THAN IN 2009, and that could require some time since the current House and Senate versions are vastly different on several key provisions. If the Conference pathway proves too contentious, House Speaker Nancy Pelosi and Reid could play legislative "ping-pong," whereby each Chamber makes a modest change and ships if off to the other, back and forth, until they both approve the same language.
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Federal
Late Saturday night the House of Representatives approved its version of health care reform by the slim margin of 220 to 215 (218 was the minimum needed). The core of the approved House bill remained unchanged from the version the Speaker introduced a few weeks ago and includes: an employer mandate to provide and pay for coverage; a fairly strong individual coverage requirement; a public plan option set up by government that would pay "negotiated" rates to providers; and insurance reforms, including guaranteed issue and modified community rating. It does not include the "Cadillac" plan tax or the insurer tax provisions currently in the Senate bill. The House bill would be paid for in part with cuts to Medicare Advantage and a surcharge on the "wealthy."
On the Senate side, Majority Leader Reid is waiting for the revenue score from CBO on several different Senate Bill scenarios, given that several Senators have publicly stated opposition to going forward without a hard and fast number on both cost and impact on bending the spending curve. He also needs this time to win over the 60 votes needed to even proceed with consideration of the bill, let alone the 60 needed to cut off debate once the debate begins; he may not have either right now. The earliest the Senate could start debate would be the week of November 16, but a date in December seems more likely. Approval of the House bill will surely put increased pressure on the Senate to move forward but to do so cautiously, given the slim voting margin in the House, as the issue moves closer to the finish line.
Bills to extend and expand COBRA have been introduced in both the House and Senate and could well be part of the final push on health care reform. Both versions extend the Special COBRA subsidy program from end of 2009 to June 30, 2010 and maintain the government's 65 percent subsidy. The Senate version increases this subsidy to 75 percent, and the House extends basic COBRA eligibility from 18 to 24 months. Given the unemployment numbers, it seems likely that, whether as part of health reform or on its own, a COBRA extension (including the subsidy) will be enacted in 2009.
States
ARIZONA: Governor Jan Brewer and legislative leaders have reached a tentative agreement to reconvene to address the projected 2010 budget shortfall, which ballooned from $1 billion in early September to $2 billion by the end of October. Although the governor favors a temporary tax increase to boost revenue, she is unlikely to float that idea this time around to help limit the length of the session. Governor Brewer is expected to announce her candidacy for re-election. Although the former lieutenant governor is now the incumbent and has never lost an election, she is viewed as vulnerable by some Republicans because of budget concerns and her continued focus on obtaining additional revenue through taxation.
CALIFORNIA: California’s state budget deficit could reach $7 billion for the current fiscal year in part because of recent court decisions blocking state funding cuts. For example, a federal judge recently blocked the state's plans to cut $80 million from its budget for In-Home Supportive Services, and Insurance Commissioner Steve Poizner has filed a suit to block the sale of part of the State Compensation Insurance Fund, which was projected to generate $1 billion. Some analysts project that the state’s budget deficit will range from $10 billion to $20 billion in the upcoming fiscal year. In other developments, Lt. Governor John Garamendi won a special election to fill the Congressional seat vacated by U.S. Representative Ellen Tauscher (D). Garamendi was elected lieutenant governor in 2006 after 16 years in the legislature and two terms as insurance commissioner.
COLORADO: Senator Betty Boyd, President Pro Tem and Chair of the Health and Human Services Committee, met with insurer representatives to highlight the issues likely to get attention in the upcoming session. A proposal to prohibit the use of gender in rating individual policies has a high likelihood of passing, she said. Senator Boyd also advised that efforts will be made to ensure that the Cover Colorado program remains solvent, as it has potential to be used as the state’s public plan option. Speculation has it that Colorado could become one of the first states to act on federal health care reform if it is enacted. Finally, she expressed a strong interest in authorizing the DOI to establish standardized policy forms.
DELAWARE: Department of Health and Social Services Secretary Rita M. Landgraf has issued an update to existing statutes adding virtual colonoscopy as an approved colorectal screening modality. Delaware law requires coverage for colorectal screening modalities and empowers the Secretary to add modalities as recommended by the Delaware Cancer Consortium. Accordingly, all contracts for health insurance issued, delivered or renewed after December 1, 2009 must include coverage for virtual colonoscopy for colorectal cancer screening.
DISTRICT OF COLUMBIA: Newly passed legislation requires individual and group health plans to provide coverage for orally administered chemotherapy medication in a manner no more restrictive than intravenously administered treatment or injected cancer medications. In other business, the Council of the District of Columbia confirmed Acting Commissioner Gennet Purcell as Commissioner for the District of Columbia Department of Insurance, Securities and Banking (DISB). Commissioner Purcell, who served as DISB’s Deputy Commissioner since 2008, is an attorney and member of both the State of Maryland Bar and the Commonwealth of Virginia Bar. As deputy, her primary responsibilities included oversight of the agency’s core functional areas, including the divisions of Insurance, Securities, Banking, Fraud Enforcement and Investigation, and Risk Finance.
GEORGIA: A meeting was held last week between health insurance representatives and the Chairman of the Senate Insurance Committee to discuss legislation for 2010 that would restrict rental networks. The Medical Association of Georgia also was represented. Aetna has committed to work with all interested parties on the legislation.
ILLINOIS: A fall veto session concluded at the end of October, and three health insurance bills of import passed both chambers. The first bill creates external review requirements for all commercial insurance products, rather than just HMOs, effective July 1, 2010. The bill also establishes committees to create a uniform small-employer group health status questionnaire and an individual health statement for use on January 1, 2011. The legislation also requires insurers to semi-annually prepare and provide the Department of Insurance a statement on aggregate administrative expenses and other information. It is a good compromise versus what was originally proposed. In addition, both chambers passed an orthotics and prosthetics mandate on health carriers and HMOs for policies amended, delivered, issued, or renewed six months after the effective date of the amendatory act. The third bill changed the requirements to obtain a producer license. The Illinois General Assembly is not expected to reconvene until January 2010.
MISSOURI: The Secretary of the State recently approved a ballot initiative proposal for the November 2010 ballot that would essentially eliminate network-based health care delivery in Missouri. The move follows unsuccessful efforts to enact an any-willing-provider bill in past legislative sessions.The petition effort behind the ballot initiative appears to have been spearheaded by a local surgical practice that has been excluded from the medical staffs of local hospitals. Any willing provider is only one portion of the proposal. It would apply to health carriers and health benefit plans, including Medicare and Medicaid, and facilities. It would, for example, prohibit carriers from: Imposing on a beneficiary any co-payment, fee, or condition that is not equally imposed on all other beneficiaries in the same benefit category, co-payment level, or class; prohibiting or limiting a provider from the opportunity to participate in the network if that provider is willing to accept the carrier’s operating terms and conditions, fee schedule, covered expenses, utilization and quality standards. The State Auditor is preparing an assessment of the fiscal impact of the proposed measure as well as a brief summary of the fiscal impact for the petition. Legal challenges to the ballot initiative are permitted. A group of stakeholders, including Aetna, are discussing strategy.
NEW JERSEY: Health insurance issues were front and center in a bitter battle for the governor's office, which ended last week when Republican candidate Chris Christie defeated Democratic Governor Jon Corzine. The governor-elect has publicly supported greater flexibility for carriers to make health coverage more affordable via mandate-free plan designs and interstate sales of health policies. The Democrats remain in firm control of the legislature, which will make the governor-elect's agenda an uphill battle. Also, the Department of Banking and Insurance (DOBI) adopted a regulation standardizing the information and format on health identification cards. Additionally, DOBI initiated a meeting with the state's major health plans seeking guidance as to how the state might proceed in limiting plans,’ and members,’ exposure to exorbitant out-of-network provider charges. This is one in a series of meetings aimed at developing consensus on an appropriate fee schedule or other mechanism for non-par provider charges. Lastly, the NJ Department of Health & Senior Services (DHSS) has launched a six-month Hospital Newborn Pilot Program. Nine hospitals throughout the state are participating in a pilot to ensure no newborn leaves the hospital without health insurance. The participating hospitals are expected to submit data to the DHSS.
NEW YORK: Governor David Paterson is calling for a special session to address the current state budget deficit. The Governor’s two-year, $5.2 billion Deficit Reduction Package would have a current-year impact of $3.2 billion in 2009-10 and a recurring impact of $2 billion in 2010-11. The components include across-the-board spending reductions and a tax penalty forgiveness program. The Governor indicated that his agenda will include a bill that would completely prohibit all subrogation (collateral source) recoveries on any insured or self-insured plans. The existing collateral source rule eliminates the potential windfall of double recoveries to plaintiffs who receive benefits and make recoveries from both their insurance coverage and defendant payments, while still ensuring that uncompensated losses are fully compensated. This subrogation legislation passed the Senate earlier this year, but it has not passed the Assembly. In other business, State Sen. Eric Schneiderman, chairman of the Codes Committee, and Sen. Neil Breslin, chairman of the Insurance Committee, introduced a bill known as "Ian's Law," which is named after a patient with muscular dystrophy. The proposed legislation would prohibit non-renewal of group policies and would require heath plans to get state Department of Insurance approval before discontinuing a class of insurance. The bill also would require plans to continue covering a totally disabled policyholder for 18 months, even if the plan gets state permission to cancel an entire class of policies.
Friday, November 6, 2009
EasyToInsureME Health Insurance Quotes Reform Weekly
This Week in Health Reform: November 6, 2009
As we near the end of a busy week in Congress, WellPoint sent a letter to Congressional Members highlighting the detrimental impact of current legislation on our health care system. The letter focuses on the potential impact of the Affordable Health Care for America Act (HR 3962) currently being debated in the House of Representatives.
WellPoint also provided Congress with a point-by-point response to the White House Blog's criticism of its actuarial analyses released late last week.
And, earlier this week, The Wall Street Journal published alead editorial highly critical of House Speaker Nancy Pelosi (D-CA) and the House bill. In addition, House Republicans proposed their own health care reform legislation.
Quoting & Saving just got easier...EasyToInsureME Health Insurance Quotes... Quote all carriers in seconds
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URGENT ACTION IS NEEDED
On Saturday, November 7, the House of Representatives is scheduled to vote on health care reform legislation that would force individuals to purchase coverage through the government health care exchange. Section 202(c) of HR 3962 prohibits individual coverage from being sold outside of the government health care exchange.
Forcing individuals to purchase coverage through the exchange reflects a sharp departure from the current system, and we believe Americans should have the choice of not buying coverage through the government exchange if they choose not to do so.
We encourage you to take action and contact your Congressional Member today.
House and Senate Negotiations
House Republicans Offer Health Care Reform Plan: On Tuesday, House Republican Leader John Boehner (R-OH) described key aspects of the newly proposed health care reform bill that focus more on controlling health care costs than on expanding coverage. The proposed bill will:
* cap medical malpractice damages;
* increase incentives for people to open health savings accounts;
* allow insurance companies to sell insurance across state lines;
* allow trade associations and guild members to band together to purchase group insurance , and
* create state-based, high-risk insurance pools for individuals who have difficulty obtaining health care coverage.
The bill does not bar insurance providers from denying coverage based on pre-existing conditions, nor does it create individual or employer mandates. It also does not raise taxes. The media suggest that Republicans may galvanize around their newly introduced bill. However, the media also speculate that the proposed legislation may make Republicans more vulnerable to criticism. Late Wednesday, the Congressional Budget Office (CBO) indicated that the bill would only cover 3 million additional people at a cost of $60 billion through 2019.
Biofuel Tax Credit Restrictions Added to House Health Care Reform Legislation: A measure introduced by Rep. Chris Van Hollen (D-MD), a member of the House Democrat leadership, would save the federal government $24 billion in biofuel tax credits over 10 years.
The measure would restrict the paper industry from claiming tax incentives for use of a fuel known as "black liquor." The tax credit savings could be used to offset costs of the health care bill, Van Hollen said.
Abortion and Immigration Issues May Imperil House Legislation: As House Speaker Nancy Pelosi works to shore up 218 votes for the House health care reform legislation introduced last week, two key contentious issues remain at the center of debate - funding for abortions and coverage for illegal immigrants . This week, anti-abortion Democrats circulated legislation to strengthen prohibitions in the bill against federal funding of abortion. It is also still up for debate as to whether or not illegal immigrants would be allowed to shop for insurance within the new exchange.
Senate Leader Signals Delay: Senate Majority Leader Harry Reid (D-NV) signaled Tuesday that Congress may fail to meet the end-of-year deadline for health care reform imposed by President Barack Obama. Senators are currently waiting for CBO cost estimates on their health care reform proposal, which may not come until late next week. Given this timeline and the upcoming Thanksgiving holiday, a bill may not reach the Senate floor until December.
Public Option Developments
CBO Indicates House Bill Would Attract Less Healthy: According to the CBO, the House health care reform legislation would attract less healthy enrollees in its version of the public option and would subsequently result in higher health care costs. In addition, the CBO predicted that of the 30 million Americans likely to purchase insurance through the insurance exchanges, one fifth would purchase insurance from the public option.
Looking Ahead
President Obama indicated that he will visit Capitol Hill late this week to address House Democrats and encourage a final push towards health care reform legislation. While House leaders plan to hold a rare Saturday vote on their proposed measure, Senate leaders still await a CBO cost estimate.
As we near the end of a busy week in Congress, WellPoint sent a letter to Congressional Members highlighting the detrimental impact of current legislation on our health care system. The letter focuses on the potential impact of the Affordable Health Care for America Act (HR 3962) currently being debated in the House of Representatives.
WellPoint also provided Congress with a point-by-point response to the White House Blog's criticism of its actuarial analyses released late last week.
And, earlier this week, The Wall Street Journal published alead editorial highly critical of House Speaker Nancy Pelosi (D-CA) and the House bill. In addition, House Republicans proposed their own health care reform legislation.
Quoting & Saving just got easier...EasyToInsureME Health Insurance Quotes... Quote all carriers in seconds
Health insurance
Health insurance quote
URGENT ACTION IS NEEDED
On Saturday, November 7, the House of Representatives is scheduled to vote on health care reform legislation that would force individuals to purchase coverage through the government health care exchange. Section 202(c) of HR 3962 prohibits individual coverage from being sold outside of the government health care exchange.
Forcing individuals to purchase coverage through the exchange reflects a sharp departure from the current system, and we believe Americans should have the choice of not buying coverage through the government exchange if they choose not to do so.
We encourage you to take action and contact your Congressional Member today.
House and Senate Negotiations
House Republicans Offer Health Care Reform Plan: On Tuesday, House Republican Leader John Boehner (R-OH) described key aspects of the newly proposed health care reform bill that focus more on controlling health care costs than on expanding coverage. The proposed bill will:
* cap medical malpractice damages;
* increase incentives for people to open health savings accounts;
* allow insurance companies to sell insurance across state lines;
* allow trade associations and guild members to band together to purchase group insurance , and
* create state-based, high-risk insurance pools for individuals who have difficulty obtaining health care coverage.
The bill does not bar insurance providers from denying coverage based on pre-existing conditions, nor does it create individual or employer mandates. It also does not raise taxes. The media suggest that Republicans may galvanize around their newly introduced bill. However, the media also speculate that the proposed legislation may make Republicans more vulnerable to criticism. Late Wednesday, the Congressional Budget Office (CBO) indicated that the bill would only cover 3 million additional people at a cost of $60 billion through 2019.
Biofuel Tax Credit Restrictions Added to House Health Care Reform Legislation: A measure introduced by Rep. Chris Van Hollen (D-MD), a member of the House Democrat leadership, would save the federal government $24 billion in biofuel tax credits over 10 years.
The measure would restrict the paper industry from claiming tax incentives for use of a fuel known as "black liquor." The tax credit savings could be used to offset costs of the health care bill, Van Hollen said.
Abortion and Immigration Issues May Imperil House Legislation: As House Speaker Nancy Pelosi works to shore up 218 votes for the House health care reform legislation introduced last week, two key contentious issues remain at the center of debate - funding for abortions and coverage for illegal immigrants . This week, anti-abortion Democrats circulated legislation to strengthen prohibitions in the bill against federal funding of abortion. It is also still up for debate as to whether or not illegal immigrants would be allowed to shop for insurance within the new exchange.
Senate Leader Signals Delay: Senate Majority Leader Harry Reid (D-NV) signaled Tuesday that Congress may fail to meet the end-of-year deadline for health care reform imposed by President Barack Obama. Senators are currently waiting for CBO cost estimates on their health care reform proposal, which may not come until late next week. Given this timeline and the upcoming Thanksgiving holiday, a bill may not reach the Senate floor until December.
Public Option Developments
CBO Indicates House Bill Would Attract Less Healthy: According to the CBO, the House health care reform legislation would attract less healthy enrollees in its version of the public option and would subsequently result in higher health care costs. In addition, the CBO predicted that of the 30 million Americans likely to purchase insurance through the insurance exchanges, one fifth would purchase insurance from the public option.
Looking Ahead
President Obama indicated that he will visit Capitol Hill late this week to address House Democrats and encourage a final push towards health care reform legislation. While House leaders plan to hold a rare Saturday vote on their proposed measure, Senate leaders still await a CBO cost estimate.
Thursday, November 5, 2009
EasyToInsureME Individual Health Insurance Reform Weekly
Week of November 2, 2009
That the bill going to the floor of the House contains a government plan option is no surprise. But Senate leadership's decision to pursue a government plan option in defiance of the Senate Finance Committee's preference is something of a surprise (see below), given it was perhaps the most bitterly argued reform issue of the summer's town hall meetings. The path ahead in the Senate will not be an easy one, as Connecticut Senator Joseph Lieberman's opposition makes clear. Lieberman is a former Democrat who still caucuses with Senate Democrats and had been counted among a potential 60 filibuster-proof majority. As the issue heats up, expect more debate and media attention on the real ramifications of this controversial provision.
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Federal
Several discrete events occurred this past week that have bearing on the health care reform (HCR) debate. First, Majority Leader Harry Reid boldly moved where he was not expected to go: He announced that a relatively strong form of the public plan, the "opt-out" version, would be in the bill he brings to the Senate floor. Most observers thought Reid would pick a "lighter" form of public plan. However, he clearly wants to keep the Democratic left on board while he works to secure votes on the right, rather than the other way around. Second, within 24 hours, Senator Joseph Lieberman (I-CT) broke ranks publicly and stated flat-out that he would filibuster against Reid's bill because of the government plan option. The Senate is expected to take a week longer to merge its two Committee bills and secure a score from the Congressional Budget Office, which is likely fine with Reid who probably does not have the 60 votes needed to bring the bill to the floor or end a filibuster. The Senate Floor debate is likely to begin around Veteran's Day. On the House side, Speaker Nancy Pelosi has unveiled the merged House bill (1990 pages, $894 billion in costs and rising), setting the stage for an expected vote -- with no real debate and no amendments allowed -- on the House floor late this week. The Speaker likely would not let the bill come to the floor unless she knows she has the votes or she believes can get them.
On related fronts, in order to get the HCR bill below the $1 trillion mark, the Speaker purged it of a $200+ billion item by deleting the Medicare physician reimbursement fix provision and introducing this as a freestanding bill, which has no "pay fors," i.e., it would add to the federal deficit. The Senate has already rejected this freestanding bill approach, which means Congress still has no solution for the impending slashing of 21 percent in doctor Medicare fees in 2010. Separately, Congressman McDermott (D-WA) has introduced a bill to neutralize ERISA's preemption protection by allowing state law causes of action for claims disputes to be processed under state liability law. Aetna would oppose either measure should it gain traction.
States
COLORADO: Governor Bill Ritter has unveiled another plan to shore up the state’s ever-widening budget shortfall by using federal stimulus dollars as a short-term stop gap. Although $1 billion has been trimmed from the budget since last year, a deficit of $271 million remains. Additional revenue through tax increases is being discussed, but health insurers have not been a part of the discussion.
FLORIDA: The Senate Health Committee and Senator Gaetz have asked the health insurance industry to sign a voluntary compact regarding coverage for cancer clinical trials. The compact would be similar to those signed in Georgia and New Jersey, to which Aetna was a signatory. A preliminary meeting was held last week at which concerns were raised. Aetna will continue to be engaged in these discussions.
KANSAS: Four state lawmakers announced last week that they are co-sponsoring a "Health Care Freedom Amendment" in the form of a Senate concurrent resolution that would add a new article to the Kansas Constitution to "preserve the right and freedom of Kansans to provide for their health care." Essentially the resolution is the first step toward trying to opt out of any potential federal health care legislation. The co-sponsors expressed opposition to a federal health care plan, stating that Washington is ill suited to manage health care. If passed, the resolution will be on the ballot in the fall of 2010. The legislators expressed confidence that they have the votes to pass the measure, but they conceded that many members had yet to be contacted.
MICHIGAN: As the state's budget crisis continues, legislators and engaged groups at the capitol are actively looking for ways to find revenue. Legislators and the Michigan Hospital Association have raised the issue of a 1.8 percent tax on all insurance claims paid, including disability and workers' compensation. There have also been discussions about taking the life, health, and property & casualty guarantee fund(s) reserves, but no concrete proposal has been floated to date. In addition, Public Employee Health Care Reform Committee hearings continue regarding the consolidation of purchasing benefits for public employees in Michigan. To date, over 30 organizations have asked to make public comments. The Speaker said that the proposal is still evolving but that he expects it to expand to include vision, dental and disability/workers' compensation benefits. Approximately $900 million in savings have been projected from administrative savings, economies of scale, "better benefits" and lower costs.
MISSOURI: The Missouri Speaker of the House, Ron Richards, has appointed an Interim Committee on autism spectrum disorders. The Committee will evaluate the impact autism spectrum disorders are having on families in the state. The committee's goal is to identify a solution that considers medical, educational and insurance changes to improve the lives of families dealing with autism. Aetna was very involved with last session's debate over an autism mandate and will continue to have a voice in this interim committee's work. The next Missouri legislative session begins in January 2010.
OHIO: Two bills concerning physician/insurer relationships are moving in the Ohio legislature. A bill that passed out of the House on October 21 specifies that a material amendment to a health care contract does not become part of the contract unless agreed upon by both parties. A different bill passed the House Health Committee on October 14, and its companion bill had sponsor testimony on October 27 in the Senate Insurance, Commerce & Labor Committee. The bill would place various requirements on health insurers that operate a system for physician designations to assign a grade or rating for certain physicians. This bill includes what must be considered in the evaluations, disclosure requirements, appeal rights and legal remedies against an insurer if a provider is adversely affected by a violation of the requirements. It is sponsored by the Ohio State Medical Association. Aetna opposes both measures and continues to discuss what may be agreeable language for physician designation programs.
WISCONSIN: The Office of the Insurance Commissioner (OCI) is working on several regulations and bulletins regarding recently passed laws. The OCI has issued a revised bulletin summarizing the provisions of the 2009-2011 state budget that impact insurance, including: establishing a uniform application for individual major medical policies; expanding independent review rights to adverse findings regarding coverage denial determinations, including preexisting condition exclusion denials and rescissions; requiring an insurer to provide coverage for an unmarried child dependent who is not eligible for other group coverage and is under age 27 or a full-time student regardless of age; and requiring coverage for autism spectrum disorders and contraceptives. Related to implementation of the budget bill, OCI published an emergency rule on September 30, 2009 related to the coverage of treatment for autism spectrum disorders that is effective on Nov. 1, 2009.On issues unrelated to the budget bill, OCI has issued two regulations. First, OCI issued emergency rules providing for eligibility for continuation of coverage under the American Recovery and Reinvestment Act of 2009 (ARRA) for individuals whose group coverage is terminated. Second, the OCI recently issued a proposed rule intended to expand the eligibility requirements for guarantee issue of Medicare supplemental policies and bring Wisconsin rules more closely in line with the NAIC Medicare Supplement Model Regulation. The proposed regulations establish two new categories of eligible individuals for Medigap guaranteed issue; modify current regulations pertaining to Wisconsin's "Plan M and N" look-alike plans to more closely follow corresponding NAIC model regulations; and reintroduce a high-deductible Medigap option.
That the bill going to the floor of the House contains a government plan option is no surprise. But Senate leadership's decision to pursue a government plan option in defiance of the Senate Finance Committee's preference is something of a surprise (see below), given it was perhaps the most bitterly argued reform issue of the summer's town hall meetings. The path ahead in the Senate will not be an easy one, as Connecticut Senator Joseph Lieberman's opposition makes clear. Lieberman is a former Democrat who still caucuses with Senate Democrats and had been counted among a potential 60 filibuster-proof majority. As the issue heats up, expect more debate and media attention on the real ramifications of this controversial provision.
Quoting & Saving just got easier...EasyToInsureME Health Insurance Quotes... Quote all carriers in seconds
Health insurance
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Federal
Several discrete events occurred this past week that have bearing on the health care reform (HCR) debate. First, Majority Leader Harry Reid boldly moved where he was not expected to go: He announced that a relatively strong form of the public plan, the "opt-out" version, would be in the bill he brings to the Senate floor. Most observers thought Reid would pick a "lighter" form of public plan. However, he clearly wants to keep the Democratic left on board while he works to secure votes on the right, rather than the other way around. Second, within 24 hours, Senator Joseph Lieberman (I-CT) broke ranks publicly and stated flat-out that he would filibuster against Reid's bill because of the government plan option. The Senate is expected to take a week longer to merge its two Committee bills and secure a score from the Congressional Budget Office, which is likely fine with Reid who probably does not have the 60 votes needed to bring the bill to the floor or end a filibuster. The Senate Floor debate is likely to begin around Veteran's Day. On the House side, Speaker Nancy Pelosi has unveiled the merged House bill (1990 pages, $894 billion in costs and rising), setting the stage for an expected vote -- with no real debate and no amendments allowed -- on the House floor late this week. The Speaker likely would not let the bill come to the floor unless she knows she has the votes or she believes can get them.
On related fronts, in order to get the HCR bill below the $1 trillion mark, the Speaker purged it of a $200+ billion item by deleting the Medicare physician reimbursement fix provision and introducing this as a freestanding bill, which has no "pay fors," i.e., it would add to the federal deficit. The Senate has already rejected this freestanding bill approach, which means Congress still has no solution for the impending slashing of 21 percent in doctor Medicare fees in 2010. Separately, Congressman McDermott (D-WA) has introduced a bill to neutralize ERISA's preemption protection by allowing state law causes of action for claims disputes to be processed under state liability law. Aetna would oppose either measure should it gain traction.
States
COLORADO: Governor Bill Ritter has unveiled another plan to shore up the state’s ever-widening budget shortfall by using federal stimulus dollars as a short-term stop gap. Although $1 billion has been trimmed from the budget since last year, a deficit of $271 million remains. Additional revenue through tax increases is being discussed, but health insurers have not been a part of the discussion.
FLORIDA: The Senate Health Committee and Senator Gaetz have asked the health insurance industry to sign a voluntary compact regarding coverage for cancer clinical trials. The compact would be similar to those signed in Georgia and New Jersey, to which Aetna was a signatory. A preliminary meeting was held last week at which concerns were raised. Aetna will continue to be engaged in these discussions.
KANSAS: Four state lawmakers announced last week that they are co-sponsoring a "Health Care Freedom Amendment" in the form of a Senate concurrent resolution that would add a new article to the Kansas Constitution to "preserve the right and freedom of Kansans to provide for their health care." Essentially the resolution is the first step toward trying to opt out of any potential federal health care legislation. The co-sponsors expressed opposition to a federal health care plan, stating that Washington is ill suited to manage health care. If passed, the resolution will be on the ballot in the fall of 2010. The legislators expressed confidence that they have the votes to pass the measure, but they conceded that many members had yet to be contacted.
MICHIGAN: As the state's budget crisis continues, legislators and engaged groups at the capitol are actively looking for ways to find revenue. Legislators and the Michigan Hospital Association have raised the issue of a 1.8 percent tax on all insurance claims paid, including disability and workers' compensation. There have also been discussions about taking the life, health, and property & casualty guarantee fund(s) reserves, but no concrete proposal has been floated to date. In addition, Public Employee Health Care Reform Committee hearings continue regarding the consolidation of purchasing benefits for public employees in Michigan. To date, over 30 organizations have asked to make public comments. The Speaker said that the proposal is still evolving but that he expects it to expand to include vision, dental and disability/workers' compensation benefits. Approximately $900 million in savings have been projected from administrative savings, economies of scale, "better benefits" and lower costs.
MISSOURI: The Missouri Speaker of the House, Ron Richards, has appointed an Interim Committee on autism spectrum disorders. The Committee will evaluate the impact autism spectrum disorders are having on families in the state. The committee's goal is to identify a solution that considers medical, educational and insurance changes to improve the lives of families dealing with autism. Aetna was very involved with last session's debate over an autism mandate and will continue to have a voice in this interim committee's work. The next Missouri legislative session begins in January 2010.
OHIO: Two bills concerning physician/insurer relationships are moving in the Ohio legislature. A bill that passed out of the House on October 21 specifies that a material amendment to a health care contract does not become part of the contract unless agreed upon by both parties. A different bill passed the House Health Committee on October 14, and its companion bill had sponsor testimony on October 27 in the Senate Insurance, Commerce & Labor Committee. The bill would place various requirements on health insurers that operate a system for physician designations to assign a grade or rating for certain physicians. This bill includes what must be considered in the evaluations, disclosure requirements, appeal rights and legal remedies against an insurer if a provider is adversely affected by a violation of the requirements. It is sponsored by the Ohio State Medical Association. Aetna opposes both measures and continues to discuss what may be agreeable language for physician designation programs.
WISCONSIN: The Office of the Insurance Commissioner (OCI) is working on several regulations and bulletins regarding recently passed laws. The OCI has issued a revised bulletin summarizing the provisions of the 2009-2011 state budget that impact insurance, including: establishing a uniform application for individual major medical policies; expanding independent review rights to adverse findings regarding coverage denial determinations, including preexisting condition exclusion denials and rescissions; requiring an insurer to provide coverage for an unmarried child dependent who is not eligible for other group coverage and is under age 27 or a full-time student regardless of age; and requiring coverage for autism spectrum disorders and contraceptives. Related to implementation of the budget bill, OCI published an emergency rule on September 30, 2009 related to the coverage of treatment for autism spectrum disorders that is effective on Nov. 1, 2009.On issues unrelated to the budget bill, OCI has issued two regulations. First, OCI issued emergency rules providing for eligibility for continuation of coverage under the American Recovery and Reinvestment Act of 2009 (ARRA) for individuals whose group coverage is terminated. Second, the OCI recently issued a proposed rule intended to expand the eligibility requirements for guarantee issue of Medicare supplemental policies and bring Wisconsin rules more closely in line with the NAIC Medicare Supplement Model Regulation. The proposed regulations establish two new categories of eligible individuals for Medigap guaranteed issue; modify current regulations pertaining to Wisconsin's "Plan M and N" look-alike plans to more closely follow corresponding NAIC model regulations; and reintroduce a high-deductible Medigap option.
Sunday, November 1, 2009
EasyToInsureME Health Insurance Quotes Reform Weekly
Oct. 30, 2009
This Week in Health Care Reform
This week, lawmakers fine-tuned their reform proposals and, once again, the public option became the central issue of the health care reform debate.
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Senate and House Negotiations
Senate Majority Leader Announces Senate Bill that Includes Public Option: On Monday, Senate Majority Leader Harry Reid (D-NV) announced that the health care reform package from the Senate is expected to include a public option with an opt-out provision should a state choose to not participate in the government plan. While liberal Democrats cheered the inclusion of the government-run plan, some moderates - including Sens. Joe Lieberman (I-CT), Blanche Lincoln (D-AR), Evan Bayh (D-IN) and Mary Landrieu (D-LA) - all voiced concerns.
Sen. Lieberman said that he would vote to block the passage of the Senate health care reform bill in Sen. Reid's proposed form. In addition, Sen. Olympia Snowe (R-ME), the only Republican to vote in favor of any health care reform legislation to date, stated that she is "deeply disappointed" with the inclusion of the public option.
This backlash comes as a blow to Sen. Reid and calls into question whether he has the 60 votes needed for final passage of the bill without an anticipated Republican filibuster. Sen. Reid has delivered a variety of proposals to the Congressional Budget Office (CBO) for cost estimates as he works to finalize the legislation.
Pelosi Unveils House Health Reform Bill: On Thursday, following weeks of negotiations to merge three bills passed by House committees last summer, House Speaker Nancy Pelosi (D-CA) unveiled the House's 1,990-page health care reform legislation.
The merged legislation includes a version of the public option, favored by moderate Democrats, that uses reimbursement rates negotiated with private insurers rather than the option favored by liberal Democrats that pegs rates to Medicare. The bill also includes:
*
Mandates for individuals and employers to purchase coverage (with some exemptions)
*
Subsidies to help lower-income individuals purchase insurance
*
An expansion of Medicaid eligibility to include individuals and families with incomes of up to 150% of the federal poverty level
*
Taxes on the wealthy of 5.4% for individuals who earn more than $500,000 and for couples who earn more than $1 million
*
Significant insurance market reforms
*
Fees collected from the medical device industry totaling $20 billion
The House bill does not include the "Cadillac Tax," a controversial tax on high-end insurance plans. And, House Democrats indicated that party leaders have yet to resolve long-standing disagreements regarding coverage for abortion and illegal immigrants.
This bill is estimated to cost just under $900 billion over the next 10 years. However, the legislation does not address Medicare physician payments and instead moves this portion of the proposal to a separate bill, which is anticipated to increase the U.S. budget deficit by more than $200 billion over 10 years.
Senate and House Propose Lower Medical Device Industry Fees: In the bill originally passed by the Senate Finance Committee, fees collected from the medical device industry would have totaled $40 billion over 10 years. Lawmakers from both the Senate and the House are proposing lower fees. In the emerging Senate legislation, Sen. Reid is expected to adjust the fees to between $15 and $20 billion over 10 years. By comparison, the House version includes a tax that would be imposed at the point of sale, thereby spreading its impact across manufacturers, wholesalers and distributors, and would yield $20 billion between 2013 and 2019.
Additional Activities
U.S. Business Group Opposes Public Option: On Wednesday, The Business Roundtable, comprised of chief executives at Verizon Communications, JPMorgan, General Electric, Wal-Mart and other companies, said the federal government is inefficient and would underpay providers while driving up costs for employers and their workers.
Public Opinion
American Opinion on Public Option Remains Steady: The October Kaiser Family Foundation poll found that 55% of Americans believe that it is now more important than ever to take on health care reform, while 41% say the country cannot afford it, results that are unchanged from the previous month. Other findings include:
*
Americans' support for taxing the wealthy to pay for reform decreased slightly in October, while support for taxing insurance companies increased.
*
Americans still worry about the potential impact of the reforms on measures such as wait times, cost and choice of providers.
*
Most Americans believe that health care reform will deliver changes immediately. About half of Americans believe that if Democrats pass health care reform legislation, help for the uninsured and consumer protections in the insurance market will begin within a year. In actuality, however, most of the reform provisions will take years to kick in.
Looking Ahead
Sen. Reid awaits CBO financial estimates to finalize the Senate bill before bringing it to the Senate floor. The House bill will be submitted to the full House for debate as early as next week.
This Week in Health Care Reform
This week, lawmakers fine-tuned their reform proposals and, once again, the public option became the central issue of the health care reform debate.
Quoting & Saving just got easier...EasyToInsureME Health Insurance
Health insurance
Health insurance quote
Senate and House Negotiations
Senate Majority Leader Announces Senate Bill that Includes Public Option: On Monday, Senate Majority Leader Harry Reid (D-NV) announced that the health care reform package from the Senate is expected to include a public option with an opt-out provision should a state choose to not participate in the government plan. While liberal Democrats cheered the inclusion of the government-run plan, some moderates - including Sens. Joe Lieberman (I-CT), Blanche Lincoln (D-AR), Evan Bayh (D-IN) and Mary Landrieu (D-LA) - all voiced concerns.
Sen. Lieberman said that he would vote to block the passage of the Senate health care reform bill in Sen. Reid's proposed form. In addition, Sen. Olympia Snowe (R-ME), the only Republican to vote in favor of any health care reform legislation to date, stated that she is "deeply disappointed" with the inclusion of the public option.
This backlash comes as a blow to Sen. Reid and calls into question whether he has the 60 votes needed for final passage of the bill without an anticipated Republican filibuster. Sen. Reid has delivered a variety of proposals to the Congressional Budget Office (CBO) for cost estimates as he works to finalize the legislation.
Pelosi Unveils House Health Reform Bill: On Thursday, following weeks of negotiations to merge three bills passed by House committees last summer, House Speaker Nancy Pelosi (D-CA) unveiled the House's 1,990-page health care reform legislation.
The merged legislation includes a version of the public option, favored by moderate Democrats, that uses reimbursement rates negotiated with private insurers rather than the option favored by liberal Democrats that pegs rates to Medicare. The bill also includes:
*
Mandates for individuals and employers to purchase coverage (with some exemptions)
*
Subsidies to help lower-income individuals purchase insurance
*
An expansion of Medicaid eligibility to include individuals and families with incomes of up to 150% of the federal poverty level
*
Taxes on the wealthy of 5.4% for individuals who earn more than $500,000 and for couples who earn more than $1 million
*
Significant insurance market reforms
*
Fees collected from the medical device industry totaling $20 billion
The House bill does not include the "Cadillac Tax," a controversial tax on high-end insurance plans. And, House Democrats indicated that party leaders have yet to resolve long-standing disagreements regarding coverage for abortion and illegal immigrants.
This bill is estimated to cost just under $900 billion over the next 10 years. However, the legislation does not address Medicare physician payments and instead moves this portion of the proposal to a separate bill, which is anticipated to increase the U.S. budget deficit by more than $200 billion over 10 years.
Senate and House Propose Lower Medical Device Industry Fees: In the bill originally passed by the Senate Finance Committee, fees collected from the medical device industry would have totaled $40 billion over 10 years. Lawmakers from both the Senate and the House are proposing lower fees. In the emerging Senate legislation, Sen. Reid is expected to adjust the fees to between $15 and $20 billion over 10 years. By comparison, the House version includes a tax that would be imposed at the point of sale, thereby spreading its impact across manufacturers, wholesalers and distributors, and would yield $20 billion between 2013 and 2019.
Additional Activities
U.S. Business Group Opposes Public Option: On Wednesday, The Business Roundtable, comprised of chief executives at Verizon Communications, JPMorgan, General Electric, Wal-Mart and other companies, said the federal government is inefficient and would underpay providers while driving up costs for employers and their workers.
Public Opinion
American Opinion on Public Option Remains Steady: The October Kaiser Family Foundation poll found that 55% of Americans believe that it is now more important than ever to take on health care reform, while 41% say the country cannot afford it, results that are unchanged from the previous month. Other findings include:
*
Americans' support for taxing the wealthy to pay for reform decreased slightly in October, while support for taxing insurance companies increased.
*
Americans still worry about the potential impact of the reforms on measures such as wait times, cost and choice of providers.
*
Most Americans believe that health care reform will deliver changes immediately. About half of Americans believe that if Democrats pass health care reform legislation, help for the uninsured and consumer protections in the insurance market will begin within a year. In actuality, however, most of the reform provisions will take years to kick in.
Looking Ahead
Sen. Reid awaits CBO financial estimates to finalize the Senate bill before bringing it to the Senate floor. The House bill will be submitted to the full House for debate as early as next week.
Friday, October 30, 2009
EasyToInsureME Individual Health Insurance Reform Weekly
Week of October 26, 2009
While Aetna and the rest of the insurance industry continue to focus on important health care reform issues, some members of Congress and The White House appear unwilling to stop or even slow the political attacks against insurers. Even as yet another analysis released last week showed real concerns persist that current proposals will worsen, rather than alleviate, rising health care costs, the House Judiciary Committee used its powers last week to try to punish the industry for speaking out (see below). Actually, the industry remains committed to seeing meaningful health care reform passed this year, a view made clear in a Washington Post op-ed authored by the President of America's Health Insurance Plans. The reactions on the Hill continue to largely side-step the specific cost concerns raised in the past two weeks. But Aetna remains hopeful that the dialogue may yet return to substantive issues before bills are brought to the floor of the House and Senate in the next several weeks.
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Individual health insurance
Health insurance quotes
To ease the burden of a scheduled 21-percent pay cut for Medicare doctors in 2010, Senate Democrats tried to pass a stand-alone bill that would have wiped out both next year's cut and all future cuts. Eliminating the cut for one year would cost $10.9 billion -- such a provision is in the Finance Committee version of health care reform and would be fully funded. To totally wipe out the fee cuts for all years would cost $245 billion. Without a "pay for" such a bill would add close to a quarter-trillion dollars to the deficit. This is precisely the bill Majority Leader Harry Reid brought forth. Senator Reid needed 60 votes; he got 47 as all Republicans and 13 Democrats voted against cutting off debate. Senate Democrats had hoped to gain physician support for health care reform by providing relief from the cuts. But the results should serve as a "wake-up" call to the Democratic leadership that health reform will not be a walk in the park. The strong vote could also embolden moderate Democrats to band together and make "hard votes" on health care reform as well.
In the House, legislative activity for the week came down to passage in the Judiciary Committee of a bill that Democratic sponsors describe as repeal of the health insurer antitrust immunity known as the McCarran-Ferguson Act. The bill more accurately can be described as codifying various court interpretations of the Act, all of which the industry lives with day in and day out. The bill specifically says health insurers (and MedMal insurers) can't hide behind McCarran-Ferguson to price-fix, bid-rig or engage in market allocations with competitors. Insurers can't do that now. Thus, the bill is much more of a vehicle for some in Congress to further demonize a well thought-out piece of legislation with positive policy underpinnings. Whether this item gets added to a health care reform bill or progresses on its own remains to be seen.
The timing for floor debate on health care reform will likely ebb and flow for several weeks, but the current thinking is that this process may take all of 2009 and possibly into 2010 to complete. The House merging process is all but done along with the CBO review of the House bill. The House bill could be released this week, go to the Rules Committee on Thursday/Friday and on to the House floor the first week of November. This schedule requires that everything fall into place and that the Speaker be willing to begin floor debate before the Senate, which seems to be the case. On the Senate side, merging the HELP and Finance Committee bills seems to be picking up speed, particularly with reports of an emerging public plan compromise. But the process will not be finished until later this week, which would bring the bill to the floor the week of November 2 at the earliest. There is a real chance that too many variables will get in the way and neither Chamber will get to the floor until December, which, if true, would translate into a January Conference.
States
COLORADO: The Colorado Health Care Task Force has voted several bills out of committee, including: a prohibition on the use of gender in developing rates for individual policies; a maternity coverage requirement in individual policies; and a requirement that the Department of Insurance develop standardized formats for such things as policy forms and explanations of benefits. Aetna will provide comments.
GEORGIA: Commissioner Oxendine signed the regulation allowing health insurers to utilize health status at renewal when underwriting small groups (2-50). Aetna has worked with the Georgia Association of Health Plans for some time to help enact this regulation. The Commissioner has also scheduled a meeting with health plan representatives to discuss his 2010 legislative agenda, which will include a bill similar to one defeated this year that would have regulated rates for individual policies.
ILLINOIS: The legislature last week completed the first week of a two-week veto session and took on two insurance-related issues. One bill would create external review requirements for all commercial insurance products, rather than just HMOs, effective July 1, 2010. The bill also would establish committees to create a uniform small-employer, group-health status questionnaire and an individual health statement for use beginning January 1, 2011. Lastly, the bill would require insurers to semi-annually prepare and provide the Department of Insurance a statement on aggregate administrative expenses and other information. Surprisingly, Chairman of the Executive Committee Mary Flowers stated that she was not going to allow the bill to be called for a vote until she had an opportunity to question the sponsor. Thus, no vote was taken, even though there was no opposition. It appears the bill will be moved for a vote this week in a different committee. Also, negotiations have begun on an insurance mandate bill for prosthetics and orthotics. The General Assembly has indicated that when they adjourn late this week, they will not return again until January.
PENNSYLVANIA: Governor Ed Rendell signed spending, revenue and fiscal code bills earlier this month, ending the 101-day budget standoff. But negotiations continue over the unresolved issue of expanding legalized gambling to include table games. Of primary interest, one bill signed into law embraces an extension of the 5.9 percent gross receipts tax on Medicaid MCOs as an alternative to the Administration’s proposed 2 percent health insurance tax as the basis for federal matching Medicaid funds. The final bill also dropped the proposed “trigger provision,” which would have authorized the Department of Public Welfare to abrogate its Medicaid MCO contracts if the Centers for Medicare & Medicaid Services were to disapprove the GRT approach for fund matching.
UTAH: The Health Reform Task Force has drafted two proposals to recommend to the 2010 legislature. The first, under the guise of administrative simplification, would establish procedures to be followed for coordination of benefits for dependents subsequent to a divorce, superseding the provisions in the applicable insurance contract. The second proposal would require the DOI to develop standards for the use and electronic exchange of uniform claim forms, billing and claim codes, eligibility and coverage information and coordination of benefits.
While Aetna and the rest of the insurance industry continue to focus on important health care reform issues, some members of Congress and The White House appear unwilling to stop or even slow the political attacks against insurers. Even as yet another analysis released last week showed real concerns persist that current proposals will worsen, rather than alleviate, rising health care costs, the House Judiciary Committee used its powers last week to try to punish the industry for speaking out (see below). Actually, the industry remains committed to seeing meaningful health care reform passed this year, a view made clear in a Washington Post op-ed authored by the President of America's Health Insurance Plans. The reactions on the Hill continue to largely side-step the specific cost concerns raised in the past two weeks. But Aetna remains hopeful that the dialogue may yet return to substantive issues before bills are brought to the floor of the House and Senate in the next several weeks.
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To ease the burden of a scheduled 21-percent pay cut for Medicare doctors in 2010, Senate Democrats tried to pass a stand-alone bill that would have wiped out both next year's cut and all future cuts. Eliminating the cut for one year would cost $10.9 billion -- such a provision is in the Finance Committee version of health care reform and would be fully funded. To totally wipe out the fee cuts for all years would cost $245 billion. Without a "pay for" such a bill would add close to a quarter-trillion dollars to the deficit. This is precisely the bill Majority Leader Harry Reid brought forth. Senator Reid needed 60 votes; he got 47 as all Republicans and 13 Democrats voted against cutting off debate. Senate Democrats had hoped to gain physician support for health care reform by providing relief from the cuts. But the results should serve as a "wake-up" call to the Democratic leadership that health reform will not be a walk in the park. The strong vote could also embolden moderate Democrats to band together and make "hard votes" on health care reform as well.
In the House, legislative activity for the week came down to passage in the Judiciary Committee of a bill that Democratic sponsors describe as repeal of the health insurer antitrust immunity known as the McCarran-Ferguson Act. The bill more accurately can be described as codifying various court interpretations of the Act, all of which the industry lives with day in and day out. The bill specifically says health insurers (and MedMal insurers) can't hide behind McCarran-Ferguson to price-fix, bid-rig or engage in market allocations with competitors. Insurers can't do that now. Thus, the bill is much more of a vehicle for some in Congress to further demonize a well thought-out piece of legislation with positive policy underpinnings. Whether this item gets added to a health care reform bill or progresses on its own remains to be seen.
The timing for floor debate on health care reform will likely ebb and flow for several weeks, but the current thinking is that this process may take all of 2009 and possibly into 2010 to complete. The House merging process is all but done along with the CBO review of the House bill. The House bill could be released this week, go to the Rules Committee on Thursday/Friday and on to the House floor the first week of November. This schedule requires that everything fall into place and that the Speaker be willing to begin floor debate before the Senate, which seems to be the case. On the Senate side, merging the HELP and Finance Committee bills seems to be picking up speed, particularly with reports of an emerging public plan compromise. But the process will not be finished until later this week, which would bring the bill to the floor the week of November 2 at the earliest. There is a real chance that too many variables will get in the way and neither Chamber will get to the floor until December, which, if true, would translate into a January Conference.
States
COLORADO: The Colorado Health Care Task Force has voted several bills out of committee, including: a prohibition on the use of gender in developing rates for individual policies; a maternity coverage requirement in individual policies; and a requirement that the Department of Insurance develop standardized formats for such things as policy forms and explanations of benefits. Aetna will provide comments.
GEORGIA: Commissioner Oxendine signed the regulation allowing health insurers to utilize health status at renewal when underwriting small groups (2-50). Aetna has worked with the Georgia Association of Health Plans for some time to help enact this regulation. The Commissioner has also scheduled a meeting with health plan representatives to discuss his 2010 legislative agenda, which will include a bill similar to one defeated this year that would have regulated rates for individual policies.
ILLINOIS: The legislature last week completed the first week of a two-week veto session and took on two insurance-related issues. One bill would create external review requirements for all commercial insurance products, rather than just HMOs, effective July 1, 2010. The bill also would establish committees to create a uniform small-employer, group-health status questionnaire and an individual health statement for use beginning January 1, 2011. Lastly, the bill would require insurers to semi-annually prepare and provide the Department of Insurance a statement on aggregate administrative expenses and other information. Surprisingly, Chairman of the Executive Committee Mary Flowers stated that she was not going to allow the bill to be called for a vote until she had an opportunity to question the sponsor. Thus, no vote was taken, even though there was no opposition. It appears the bill will be moved for a vote this week in a different committee. Also, negotiations have begun on an insurance mandate bill for prosthetics and orthotics. The General Assembly has indicated that when they adjourn late this week, they will not return again until January.
PENNSYLVANIA: Governor Ed Rendell signed spending, revenue and fiscal code bills earlier this month, ending the 101-day budget standoff. But negotiations continue over the unresolved issue of expanding legalized gambling to include table games. Of primary interest, one bill signed into law embraces an extension of the 5.9 percent gross receipts tax on Medicaid MCOs as an alternative to the Administration’s proposed 2 percent health insurance tax as the basis for federal matching Medicaid funds. The final bill also dropped the proposed “trigger provision,” which would have authorized the Department of Public Welfare to abrogate its Medicaid MCO contracts if the Centers for Medicare & Medicaid Services were to disapprove the GRT approach for fund matching.
UTAH: The Health Reform Task Force has drafted two proposals to recommend to the 2010 legislature. The first, under the guise of administrative simplification, would establish procedures to be followed for coordination of benefits for dependents subsequent to a divorce, superseding the provisions in the applicable insurance contract. The second proposal would require the DOI to develop standards for the use and electronic exchange of uniform claim forms, billing and claim codes, eligibility and coverage information and coordination of benefits.
Thursday, October 22, 2009
Health Insurance Reform EasyToInsureME
October 21, 2009
The Week in Health Care Reform
Federal Legislative Overview
Senate
On Tuesday, October 13 the Senate Finance Committee approved Chairman Max Baucus’ amended “America’s Healthy Future Act” by a vote of 14-9. Olympia Snowe (R-ME) was the only Republican who joined all 13 Democrats in supporting the bill. After the vote Snowe stated, “Is this bill all that I want? Far from it. Is it all that it could be? No. But when history calls, history calls. And I happen to think the consequences of inaction dictate the urgency of Congress to take every opportunity to demonstrate its capacity to solve the monumental issues of our time.” She went on to say, “My vote today is my vote today, it doesn’t forecast what my vote will be tomorrow,” quelling any predictions for what her vote will be on the Senate floor.
The legislation has now moved to Majority Leader Harry Reid’s (D-NV) office, who will work hand-in-hand with key Democratic leadership in the Senate, as well as the White House, to craft a single bill. This process will likely take weeks and we do not expect it to reach the Senate floor until November.
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House
Speaker Nancy Pelosi (D-CA) continued to say this week that the merged bill in the House of Representatives will have a “robust” public plan – meaning that provider reimbursement rates will be tied to Medicare. This is the opposite of the agreement made in Henry Waxman’s (D-CA) Energy & Commerce Committee with Blue Dog Democrats, in which payment rates would be negotiated.
Interestingly enough, Rep. Mike Ross (D-AR), the leader of the Blue Dogs’ Health Care Task Force, who was vehemently against a public health insurance option during reform debates in July, came out this week saying that he supported the idea of opening Medicare to those under 65 without insurance. He later backpedalled and said, "I do not endorse this idea, as it was just one of many ideas we, as legislators, have brought up and discussed in the numerous, ongoing negotiations and discussions we have had on healthcare reform over the past several months." Ross has changed his mind numerous times during this debate. After he negotiated the deal in the Energy & Commerce Committee in July he faced significant opposition from conservative constituents during the August recess. He then returned from recess stating that he couldn’t support a public option. Ross’ statements show how difficult the push and pull will be in the upcoming weeks over key provisions in the health care reform bills.
The Week in Health Care Reform
Federal Legislative Overview
Senate
On Tuesday, October 13 the Senate Finance Committee approved Chairman Max Baucus’ amended “America’s Healthy Future Act” by a vote of 14-9. Olympia Snowe (R-ME) was the only Republican who joined all 13 Democrats in supporting the bill. After the vote Snowe stated, “Is this bill all that I want? Far from it. Is it all that it could be? No. But when history calls, history calls. And I happen to think the consequences of inaction dictate the urgency of Congress to take every opportunity to demonstrate its capacity to solve the monumental issues of our time.” She went on to say, “My vote today is my vote today, it doesn’t forecast what my vote will be tomorrow,” quelling any predictions for what her vote will be on the Senate floor.
The legislation has now moved to Majority Leader Harry Reid’s (D-NV) office, who will work hand-in-hand with key Democratic leadership in the Senate, as well as the White House, to craft a single bill. This process will likely take weeks and we do not expect it to reach the Senate floor until November.
Quoting & Saving just got easier...EasyToInsureME Health Insurance
Individual health insurance
Health insurance quotes
House
Speaker Nancy Pelosi (D-CA) continued to say this week that the merged bill in the House of Representatives will have a “robust” public plan – meaning that provider reimbursement rates will be tied to Medicare. This is the opposite of the agreement made in Henry Waxman’s (D-CA) Energy & Commerce Committee with Blue Dog Democrats, in which payment rates would be negotiated.
Interestingly enough, Rep. Mike Ross (D-AR), the leader of the Blue Dogs’ Health Care Task Force, who was vehemently against a public health insurance option during reform debates in July, came out this week saying that he supported the idea of opening Medicare to those under 65 without insurance. He later backpedalled and said, "I do not endorse this idea, as it was just one of many ideas we, as legislators, have brought up and discussed in the numerous, ongoing negotiations and discussions we have had on healthcare reform over the past several months." Ross has changed his mind numerous times during this debate. After he negotiated the deal in the Energy & Commerce Committee in July he faced significant opposition from conservative constituents during the August recess. He then returned from recess stating that he couldn’t support a public option. Ross’ statements show how difficult the push and pull will be in the upcoming weeks over key provisions in the health care reform bills.
Individual Health Insurance Reform Weekly EasyToInsureME
Week of October 19, 2009
Inside-the-Beltway politics were in full swing last week as the insurance industry came under heavy fire from some members of Congress and the media for releasing a PricewaterhouseCoopers report prior to the Senate Finance Committee's scheduled vote on its health care reform proposal. The report found that the Committee's reform package would drive up the cost of private insurance coverage for individuals, families and businesses. As a result, the industry was openly accused of trying to scuttle health care reform, even though America's Health Insurance Plans (AHIP) stated clearly in a press release and a letter to key Senate leaders that the industry was simply fulfilling its responsibility to bring to light serious flaws in the bill. The industry still intends to work toward bipartisan reform. By the time the furor died down, no one had seriously refuted the substance of the report. In fact, just a day later a new report from Oliver Wyman arrived at very similar conclusions. Regardless of these reports, Aetna has consistently warned that meaningful health care reform must address rising costs and that insurance market reforms must be linked with a strong individual coverage requirement to work effectively. Aetna will continue to deliver this message and help others understand how the market works.
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Federal
While there was some drama, the actual outcome of the Senate Finance Committee's vote to approve its health care reform bill was never really in doubt. By a vote of 14 to 9, the Committee approved the bill with all Democrats and one Republican, Olympia Snowe of Maine, saying yes. The drama was two-fold: a) would Snowe agree or hold her powder dry until the floor debate to improve her ability to bargain for changes; and b) would Ron Wyden (D-OR) and/or Jay Rockefeller (D-WV) vote no or hold their vote to protest the absence of the public plan. Neither possibility materialized, but the "drama" could merely have shifted from the Committee to the Senate floor. The Finance Committee approval of health reform set in motion the next step in the process, as the Senate Democratic leadership began the process of melding the Finance and HELP Committee bills. Majority Leader Harry Reid is working with Finance Chairman Max Baucus, HELP Vice-Chairman Christopher Dodd and Chairman Harkin to hammer out a single bill, and three issues appear the most contentious: the Finance Committee's weak individual mandate vs. HELP's stronger one; a HELP public plan vs. the co-op approach from Finance; and the HELP employer mandate vs. no mandate from Finance.There are hundreds of subordinate issues as well, all of which translates into a contentious merging process that will likely delay debate on the floor to late October/early November.
Senate Democrats, led by Senator Stabenow (D-MI), will likely vote this week on a stand-alone bill to eliminate a scheduled 21 percent cut in physician Medicare reimbursement on a permanent basis. The one-year cost of this doctor "fix" in the current Senate Finance Committee bill is $10.9 billion; the permanent fix (buried in the House reform bill) would cost upwards of $250 billion. The idea behind this maneuver is to pull out a costly item from the health reform bill, which is supposed to be deficit-neutral, in order to free up more money to spend on other items or to reduce the total cost of health reform, e.g., the House Democrats want to get their bill under $1 trillion. While most agree that the payment level for physicians should be much more aligned to quality and performance, the debate will likely turn on whether Democrats can shift to the deficit another $250 billion in money for doctors without stirring up the American public.
States
COLORADO: The Colorado Division of Insurance adopted amendments revising the state's early intervention services (EIS) benefit mandate in accordance with newly adopted legislation. Individual and group policies or contracts that include dependent coverage are required to cover EIS delivered by qualified providers to eligible children through age 3. The new law modifies this mandate by requiring, among other things, an increase in the reimbursement rate for EIS by carriers, if the base rate for state-funded EIS increases by more than the cost-of-living adjustment. The amended rule was effective October 1. The DOI also adopted amendments establishing standards for the sale of limited benefit plans by HMOs. This legislation allows HMOs to offer access to basic health care services through limited benefit plans to employer groups that have not offered health coverage to their employees for the previous 12 months and to individuals who have been uninsured for the previous 12 months. HMOs are prohibited from offering limited health benefit plans in Colorado counties with a population of more than 25,000 people.
ILLINOIS: The Department of Insurance (DOI) has taken the position that carriers cannot require, in their contracts, that claims for proceeds on a life insurance policy be made “in writing.” The insurance industry has requested that the DOI reconsider its position. The DOI maintains that the only required documents for a life insurance claim are the insured’s death certificate and a copy of the claim check. The insurance industry believes that this interpretation of the law runs contrary to generally accepted claim procedures that were put in place to confirm that coverage was in force, that a covered loss occurred, and that there are no exclusions or limitations that affect the claim payment. Illinois statute directs a life insurer to settle a death claim within two months of the receipt of due proof of the insured’s death and places no limit on what an insurer may reasonably require during the statutory period to assure proper verification of the insured’s death, as well as verification that claim proceeds are being correctly paid to the proper claimant.
KENTUCKY: Last week the Department of Insurance held a public meeting at which it briefly discussed its proposed 2010 legislative package, approved by the Governor's office, for the upcoming session. The proposals include updating state laws to incorporate federal changes with respect to mental health parity, Michelle's law, HIPAA clarifications; updates to the limits under the life and health guaranty model; and uniformity changes to the producer licensing law. Also discussed was the possible elimination of the requirement that insurers offer a standard benefit plan under the Kentucky Access law.
MASSACHUSETTS: The Commonwealth Health Insurance Connector Authority is proposing amendments to the Minimum Credible Coverage (MCC) regulations, with a public hearing on the matter scheduled for Nov. 17. The MCC regulations set the standard for minimum benefits Massachusetts residents must carry in order to be considered insured and avoid penalties. The proposed regulation changes were approved by the Connector Board and filed with the Secretary of State. They would: make prescription drugs one of the categories of services/benefits that are considered “core services” under minimum creditable coverage, thus prohibiting the imposition of dollar caps on its prescription drug benefit; require a health benefit plan covering dependents to provide coverage to all “broad range of medical benefits” as provided to subscribers in order to ensure that maternity benefits are extended to pregnant dependents; and allow employer groups to pair a high-deductible health plan with a Health Reimbursement Arrangement (HRA), as an alternative to a Health Savings Account (HSA). There likely will be some push back on the additions to the MCC standard. However, some version of the amendments is expected to pass. If enacted, the prescription and dependent benefits amendments would be effective in 2011; the HDHP/HRA amendment would take effect on 1/1/2010.
NEW JERSEY: The state has launched a database designed to track autism cases and direct affected families to health care and other services. The New Jersey Autism Registry requires psychiatrists, psychologists, neurologists and medical professionals to register children diagnosed with autism and birth defects such as Down's Syndrome, cleft palate, and heart or muscular defects. The registry is confidential and will be used to enable officials to better assist New Jersey's families with autism and other special needs. Access to the database is restricted to medical professionals.
NEW YORK: Governor David Paterson last week proposed a new two-year, $5 billion deficit-reduction package (DRP) that will fill the $3 billion (and growing) gap in the 2009-2010 spending plan and have a recurring impact of $2 billion in 2010-11. The new proposal does not include new taxes or assessments, a reflection of the extraordinarily high taxes already imposed on health plans in the main '09-'10 budget. The Governor's new DRP focuses on across-the-board Medicaid cuts, a $14.7 million cut in the managed long-term care program, a $14 million reduction in the Child Health Plus program, and a $7 million reduction in section 332 assessment sub-allocation, which includes both the Healthy New York and Timothy's Law programs. The budget announcement was sharply criticized by the hospital industry and hospital workers' union SEIU/1199. Assembly Democrats have already scheduled two hearings on the Governor's proposed DRP for Wednesday, October 21st, in Albany and Friday, October 23rd in Syracuse.
OREGON: The state Insurance Department has issued a second bulletin regarding legislation that established a premium assessment on health insurers. The primary purpose of the new bulletin is to provide information about the approved manner of calculating premium increases to offset the cost of the new assessment. The bulletin states that the law limits the amount carriers are allowed to increase premiums, as a result of the assessment, to one percent. The amount derived from dividing premiums by .99 is greater than one percent and is therefore illegal. Any insurers that calculated the increase in the .99 manner and have already collected premiums are required to issue refunds.
TEXAS: The Department of Insurance held a stakeholder meeting last week to discuss implementation of the new "Healthy Texas" program, legislation that passed in May. The program is modeled after Healthy New York and will offer state re-insurance for up to 80 percent of the claims corridor of $5,000-$75,000 for an insurance product, which can be sold only to small groups that have been uninsured for at least a year and have at least 30 percent of their employees' salaries at a maximum of 300 percent of the federal poverty level. The employer must agree to pay at least 50 percent of the premiums, and at least 60 percent of the employees must enroll. The legislature provided $17.5 million dollars annually to fund the program for the next 2 years. TDI and the Texas HHSC have been awarded almost $5 million a year for the next five years in HRSA grant money to assist with costs of actuarial contracts, marketing contracts and additional staff to help fully implement the program. They have posted informal rules to implement the program and plan to adopt a formal rule by the end of 2009. They would like to see members enrolled in qualifying plans by June 1, 2010, at the latest. Aetna has been involved with the drafting of legislation for this program from the beginning and will continue to be involved throughout the rulemaking process.
WASHINGTON: The state Office of the Insurance Commissioner has released its legislative agenda for 2010. The OIC proposals include; 1) new and extended grace periods for individuals to take up conversion coverage -- 31 days after a person has received notice of termination of coverage; 2) a revised definition of emergency services and the elimination of a requirement that the covered health care services are provided in a hospital emergency department; and 3) a health care reform proposal that would cover catastrophic medical costs over $10,000 per year and limited preventive care for all state residents. The catastrophic health plan was also proposed in 2009 but failed to gather much attention in the legislature.
Inside-the-Beltway politics were in full swing last week as the insurance industry came under heavy fire from some members of Congress and the media for releasing a PricewaterhouseCoopers report prior to the Senate Finance Committee's scheduled vote on its health care reform proposal. The report found that the Committee's reform package would drive up the cost of private insurance coverage for individuals, families and businesses. As a result, the industry was openly accused of trying to scuttle health care reform, even though America's Health Insurance Plans (AHIP) stated clearly in a press release and a letter to key Senate leaders that the industry was simply fulfilling its responsibility to bring to light serious flaws in the bill. The industry still intends to work toward bipartisan reform. By the time the furor died down, no one had seriously refuted the substance of the report. In fact, just a day later a new report from Oliver Wyman arrived at very similar conclusions. Regardless of these reports, Aetna has consistently warned that meaningful health care reform must address rising costs and that insurance market reforms must be linked with a strong individual coverage requirement to work effectively. Aetna will continue to deliver this message and help others understand how the market works.
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Federal
While there was some drama, the actual outcome of the Senate Finance Committee's vote to approve its health care reform bill was never really in doubt. By a vote of 14 to 9, the Committee approved the bill with all Democrats and one Republican, Olympia Snowe of Maine, saying yes. The drama was two-fold: a) would Snowe agree or hold her powder dry until the floor debate to improve her ability to bargain for changes; and b) would Ron Wyden (D-OR) and/or Jay Rockefeller (D-WV) vote no or hold their vote to protest the absence of the public plan. Neither possibility materialized, but the "drama" could merely have shifted from the Committee to the Senate floor. The Finance Committee approval of health reform set in motion the next step in the process, as the Senate Democratic leadership began the process of melding the Finance and HELP Committee bills. Majority Leader Harry Reid is working with Finance Chairman Max Baucus, HELP Vice-Chairman Christopher Dodd and Chairman Harkin to hammer out a single bill, and three issues appear the most contentious: the Finance Committee's weak individual mandate vs. HELP's stronger one; a HELP public plan vs. the co-op approach from Finance; and the HELP employer mandate vs. no mandate from Finance.There are hundreds of subordinate issues as well, all of which translates into a contentious merging process that will likely delay debate on the floor to late October/early November.
Senate Democrats, led by Senator Stabenow (D-MI), will likely vote this week on a stand-alone bill to eliminate a scheduled 21 percent cut in physician Medicare reimbursement on a permanent basis. The one-year cost of this doctor "fix" in the current Senate Finance Committee bill is $10.9 billion; the permanent fix (buried in the House reform bill) would cost upwards of $250 billion. The idea behind this maneuver is to pull out a costly item from the health reform bill, which is supposed to be deficit-neutral, in order to free up more money to spend on other items or to reduce the total cost of health reform, e.g., the House Democrats want to get their bill under $1 trillion. While most agree that the payment level for physicians should be much more aligned to quality and performance, the debate will likely turn on whether Democrats can shift to the deficit another $250 billion in money for doctors without stirring up the American public.
States
COLORADO: The Colorado Division of Insurance adopted amendments revising the state's early intervention services (EIS) benefit mandate in accordance with newly adopted legislation. Individual and group policies or contracts that include dependent coverage are required to cover EIS delivered by qualified providers to eligible children through age 3. The new law modifies this mandate by requiring, among other things, an increase in the reimbursement rate for EIS by carriers, if the base rate for state-funded EIS increases by more than the cost-of-living adjustment. The amended rule was effective October 1. The DOI also adopted amendments establishing standards for the sale of limited benefit plans by HMOs. This legislation allows HMOs to offer access to basic health care services through limited benefit plans to employer groups that have not offered health coverage to their employees for the previous 12 months and to individuals who have been uninsured for the previous 12 months. HMOs are prohibited from offering limited health benefit plans in Colorado counties with a population of more than 25,000 people.
ILLINOIS: The Department of Insurance (DOI) has taken the position that carriers cannot require, in their contracts, that claims for proceeds on a life insurance policy be made “in writing.” The insurance industry has requested that the DOI reconsider its position. The DOI maintains that the only required documents for a life insurance claim are the insured’s death certificate and a copy of the claim check. The insurance industry believes that this interpretation of the law runs contrary to generally accepted claim procedures that were put in place to confirm that coverage was in force, that a covered loss occurred, and that there are no exclusions or limitations that affect the claim payment. Illinois statute directs a life insurer to settle a death claim within two months of the receipt of due proof of the insured’s death and places no limit on what an insurer may reasonably require during the statutory period to assure proper verification of the insured’s death, as well as verification that claim proceeds are being correctly paid to the proper claimant.
KENTUCKY: Last week the Department of Insurance held a public meeting at which it briefly discussed its proposed 2010 legislative package, approved by the Governor's office, for the upcoming session. The proposals include updating state laws to incorporate federal changes with respect to mental health parity, Michelle's law, HIPAA clarifications; updates to the limits under the life and health guaranty model; and uniformity changes to the producer licensing law. Also discussed was the possible elimination of the requirement that insurers offer a standard benefit plan under the Kentucky Access law.
MASSACHUSETTS: The Commonwealth Health Insurance Connector Authority is proposing amendments to the Minimum Credible Coverage (MCC) regulations, with a public hearing on the matter scheduled for Nov. 17. The MCC regulations set the standard for minimum benefits Massachusetts residents must carry in order to be considered insured and avoid penalties. The proposed regulation changes were approved by the Connector Board and filed with the Secretary of State. They would: make prescription drugs one of the categories of services/benefits that are considered “core services” under minimum creditable coverage, thus prohibiting the imposition of dollar caps on its prescription drug benefit; require a health benefit plan covering dependents to provide coverage to all “broad range of medical benefits” as provided to subscribers in order to ensure that maternity benefits are extended to pregnant dependents; and allow employer groups to pair a high-deductible health plan with a Health Reimbursement Arrangement (HRA), as an alternative to a Health Savings Account (HSA). There likely will be some push back on the additions to the MCC standard. However, some version of the amendments is expected to pass. If enacted, the prescription and dependent benefits amendments would be effective in 2011; the HDHP/HRA amendment would take effect on 1/1/2010.
NEW JERSEY: The state has launched a database designed to track autism cases and direct affected families to health care and other services. The New Jersey Autism Registry requires psychiatrists, psychologists, neurologists and medical professionals to register children diagnosed with autism and birth defects such as Down's Syndrome, cleft palate, and heart or muscular defects. The registry is confidential and will be used to enable officials to better assist New Jersey's families with autism and other special needs. Access to the database is restricted to medical professionals.
NEW YORK: Governor David Paterson last week proposed a new two-year, $5 billion deficit-reduction package (DRP) that will fill the $3 billion (and growing) gap in the 2009-2010 spending plan and have a recurring impact of $2 billion in 2010-11. The new proposal does not include new taxes or assessments, a reflection of the extraordinarily high taxes already imposed on health plans in the main '09-'10 budget. The Governor's new DRP focuses on across-the-board Medicaid cuts, a $14.7 million cut in the managed long-term care program, a $14 million reduction in the Child Health Plus program, and a $7 million reduction in section 332 assessment sub-allocation, which includes both the Healthy New York and Timothy's Law programs. The budget announcement was sharply criticized by the hospital industry and hospital workers' union SEIU/1199. Assembly Democrats have already scheduled two hearings on the Governor's proposed DRP for Wednesday, October 21st, in Albany and Friday, October 23rd in Syracuse.
OREGON: The state Insurance Department has issued a second bulletin regarding legislation that established a premium assessment on health insurers. The primary purpose of the new bulletin is to provide information about the approved manner of calculating premium increases to offset the cost of the new assessment. The bulletin states that the law limits the amount carriers are allowed to increase premiums, as a result of the assessment, to one percent. The amount derived from dividing premiums by .99 is greater than one percent and is therefore illegal. Any insurers that calculated the increase in the .99 manner and have already collected premiums are required to issue refunds.
TEXAS: The Department of Insurance held a stakeholder meeting last week to discuss implementation of the new "Healthy Texas" program, legislation that passed in May. The program is modeled after Healthy New York and will offer state re-insurance for up to 80 percent of the claims corridor of $5,000-$75,000 for an insurance product, which can be sold only to small groups that have been uninsured for at least a year and have at least 30 percent of their employees' salaries at a maximum of 300 percent of the federal poverty level. The employer must agree to pay at least 50 percent of the premiums, and at least 60 percent of the employees must enroll. The legislature provided $17.5 million dollars annually to fund the program for the next 2 years. TDI and the Texas HHSC have been awarded almost $5 million a year for the next five years in HRSA grant money to assist with costs of actuarial contracts, marketing contracts and additional staff to help fully implement the program. They have posted informal rules to implement the program and plan to adopt a formal rule by the end of 2009. They would like to see members enrolled in qualifying plans by June 1, 2010, at the latest. Aetna has been involved with the drafting of legislation for this program from the beginning and will continue to be involved throughout the rulemaking process.
WASHINGTON: The state Office of the Insurance Commissioner has released its legislative agenda for 2010. The OIC proposals include; 1) new and extended grace periods for individuals to take up conversion coverage -- 31 days after a person has received notice of termination of coverage; 2) a revised definition of emergency services and the elimination of a requirement that the covered health care services are provided in a hospital emergency department; and 3) a health care reform proposal that would cover catastrophic medical costs over $10,000 per year and limited preventive care for all state residents. The catastrophic health plan was also proposed in 2009 but failed to gather much attention in the legislature.
Friday, October 16, 2009
Health Insurance Quotes Reform Weekly EasyToInsureME
Oct. 16, 2009
This Week in Health Care Reform
This week, Senate Finance Committee members voted on the committee's health care reform bill, and the conversation shifted to how to reconcile the bill with pending legislation from the House.
EasyToInsureME.com offers clients the easiest way to buy individual health insurance. Free services include instant online health insurance quotes, custom proposals for each client, free phone consultation, and 10-minute application by phone. Nobody does what we do for our clients!
Senate Negotiations
Senate Finance Committee Passes Bill: On Tuesday, after months of negotiations, the Senate Finance Committee passed its $829 billion health care reform package with a 14-9 vote. One Republican, Sen. Olympia Snowe (R-ME) voted with Democrats on the committee. The proposal would expand coverage to 29 million uninsured Americans while reducing deficits by $81 billion over 10 years. The bill includes insurance market reforms, an individual mandate to purchase coverage that appears reduced when compared with prior versions, an expansion of Medicaid, a cut in future Medicare spending, new fees and taxes on employers, and billions in new fees on health insurance and other sectors of the health care industry. The bill also includes seed funding for state cooperative plans and subsidies for other state coverage programs.
Shortly after the vote, labor unions and large business organizations requested changes to the Finance Committee bill primarily because it omitted a public option . The swift feedback from interest groups underscores the difficult road ahead for Senate Majority Leader Harry Reid (D-NV), who will work to merge the Finance Committee bill with the Senate Health, Education, Labor and Pensions (HELP) bill passed last summer. Unions and lawmakers such as Sens. Chuck Schumer (D-NY) and Jay Rockefeller (D-WV) have criticized the legislation for not including a public option . At the same time, insurance companies, medical device makers and others in the health care industry are voicing strong concerns about the increased premium costs of the proposed legislation.
House Activities
Legislators Look to Reconcile Health Care Measures: House leaders indicated that negotiators have trimmed costs for its proposed health care reform bill to President Barack Obama's goal of $900 billion, down from $1.2 trillion. Aides said the final bill will include slightly lower subsidies for copayments and deductibles for people who buy coverage through the new insurance exchanges that be would established for those who can't access affordable employer coverage. A provision preventing doctors who see Medicare patients from having their fees cut was excluded, while a surcharge tax on incomes of individuals ($500,000 or more) and families ($1 million or more) was included. House members will consider including more low income families in Medicaid instead of the insurance exchange market, and adopting tax increases featured in the Senate Finance Committee bill, including a profit tax on health insurers. They have, however, rejected the tax on "Cadillac" plans.
Additional Activities
Insurance Industry Study Indicates Higher Costs: On Sunday, the insurance industry trade association, America's Health Insurance Plans, released a study indicating that the proposed Finance Committee legislation would raise the price of a typical policy. The study, completed by PricewaterhouseCoopers, projected that family premiums could be $4,000 higher and individual premiums could be $1,500 higher in 2019. The report details that a weak individual mandate, measures preventing insurers from barring people with pre-existing conditions, taxes on high-cost health care plans and new taxes on some health care industry sectors will rapidly raise costs.
On Wednesday, another study conducted by Oliver Wyman Inc. and sponsored by the Blue Cross Blue Shield Association indicated that the proposed legislation would raise premiums 50% for individual and 19% for small group policies. Premium increases would likely be a result of a weak individual insurance mandate over the next five years.
Looking Ahead
Following the Senate Finance Committee vote, health care reform legislation negotiations will continue behind closed doors. Sen. Reid will merge the Senate Finance and the HELP Committee bills. He has indicated that the full Senate will begin debating the merged legislation the week of October 26.
House leaders are expected to vote the first week of November.
This Week in Health Care Reform
This week, Senate Finance Committee members voted on the committee's health care reform bill, and the conversation shifted to how to reconcile the bill with pending legislation from the House.
EasyToInsureME.com offers clients the easiest way to buy individual health insurance. Free services include instant online health insurance quotes, custom proposals for each client, free phone consultation, and 10-minute application by phone. Nobody does what we do for our clients!
Senate Negotiations
Senate Finance Committee Passes Bill: On Tuesday, after months of negotiations, the Senate Finance Committee passed its $829 billion health care reform package with a 14-9 vote. One Republican, Sen. Olympia Snowe (R-ME) voted with Democrats on the committee. The proposal would expand coverage to 29 million uninsured Americans while reducing deficits by $81 billion over 10 years. The bill includes insurance market reforms, an individual mandate to purchase coverage that appears reduced when compared with prior versions, an expansion of Medicaid, a cut in future Medicare spending, new fees and taxes on employers, and billions in new fees on health insurance and other sectors of the health care industry. The bill also includes seed funding for state cooperative plans and subsidies for other state coverage programs.
Shortly after the vote, labor unions and large business organizations requested changes to the Finance Committee bill primarily because it omitted a public option . The swift feedback from interest groups underscores the difficult road ahead for Senate Majority Leader Harry Reid (D-NV), who will work to merge the Finance Committee bill with the Senate Health, Education, Labor and Pensions (HELP) bill passed last summer. Unions and lawmakers such as Sens. Chuck Schumer (D-NY) and Jay Rockefeller (D-WV) have criticized the legislation for not including a public option . At the same time, insurance companies, medical device makers and others in the health care industry are voicing strong concerns about the increased premium costs of the proposed legislation.
House Activities
Legislators Look to Reconcile Health Care Measures: House leaders indicated that negotiators have trimmed costs for its proposed health care reform bill to President Barack Obama's goal of $900 billion, down from $1.2 trillion. Aides said the final bill will include slightly lower subsidies for copayments and deductibles for people who buy coverage through the new insurance exchanges that be would established for those who can't access affordable employer coverage. A provision preventing doctors who see Medicare patients from having their fees cut was excluded, while a surcharge tax on incomes of individuals ($500,000 or more) and families ($1 million or more) was included. House members will consider including more low income families in Medicaid instead of the insurance exchange market, and adopting tax increases featured in the Senate Finance Committee bill, including a profit tax on health insurers. They have, however, rejected the tax on "Cadillac" plans.
Additional Activities
Insurance Industry Study Indicates Higher Costs: On Sunday, the insurance industry trade association, America's Health Insurance Plans, released a study indicating that the proposed Finance Committee legislation would raise the price of a typical policy. The study, completed by PricewaterhouseCoopers, projected that family premiums could be $4,000 higher and individual premiums could be $1,500 higher in 2019. The report details that a weak individual mandate, measures preventing insurers from barring people with pre-existing conditions, taxes on high-cost health care plans and new taxes on some health care industry sectors will rapidly raise costs.
On Wednesday, another study conducted by Oliver Wyman Inc. and sponsored by the Blue Cross Blue Shield Association indicated that the proposed legislation would raise premiums 50% for individual and 19% for small group policies. Premium increases would likely be a result of a weak individual insurance mandate over the next five years.
Looking Ahead
Following the Senate Finance Committee vote, health care reform legislation negotiations will continue behind closed doors. Sen. Reid will merge the Senate Finance and the HELP Committee bills. He has indicated that the full Senate will begin debating the merged legislation the week of October 26.
House leaders are expected to vote the first week of November.
Thursday, October 15, 2009
Health Insurance Reform EasyToInsureME
October 14, 2009
The Week in Health Reform
Federal Legislative Overview
Quoting & Saving just got easier...EasyToInsureME Health Insurance
Individual health insurance
Health insurance quotes
Senate
The long-awaited cost estimate of the Senate Finance Committee’s health care reform proposal, “America’s Healthy Future Act,” was released this week by the Congressional Budget Office (CBO).
The CBO concluded that the proposal would cost $829 billion over 10 years – an increase from the previous $738 billion estimate of the revised Chairman’s Mark – and would cover 94 percent of Americans. A more detailed overview of the CBO cost estimate is discussed in the next section of this article.
The Senate Finance Committee waited to vote on its health care reform proposal until the CBO completed its work. On Tuesday October 13, the Finance Committee voted 14 to 9 to approve the legislation. Senator Olympia Snowe (R-ME) was the only Republican who voted in support of the measure. This now paves the way for Democratic leadership to begin merging the Senate Finance legislation with the Senate HELP bill (S 1679). Senators Max Baucus (D-MT), Christopher Dodd (D-CT) and Majority Leader Harry Reid (D-NV) will lead those efforts, working alongside the White House. The blended legislation could potentially be on the Senate floor the week of October 19.
House
House Speaker Pelosi and other Democratic leaders in the House of Representatives continue to meld its three pieces of health care reform legislation into one bill, while aiming to cut its total cost by another $200 billion. Although Pelosi has publicly stated that she will not consider a “trigger option” for the public plan, nor health care cooperatives, she has seemingly become a bit more open to the idea of the creation of a public plan that would be allowed to negotiate provider reimbursement rates, an idea that has more commonly belonged to conservative Democrats in this debate.
This past week, more than 150 House Democrats wrote a letter to Pelosi (D-CA) urging her “to reject proposals to enact an excise tax on high-cost insurance plans that could be potentially passed on to middle-class families.” This letter was in reference to the Senate Finance Committee’s health care reform proposal that includes a 40 percent excise tax on insurers that exceed certain cost thresholds, also known as a tax on “Cadillac plans”. Beginning in 2013, the threshold for individual plans will be $8,000 and $21,000 for family coverage. It is clear that more than half of House Democrats recognize that insurers will be forced to pass on these proposed new taxes to consumers – undermining the shared goal of ensuring affordable health coverage for all Americans.
Overview: CBO Score of Senate Finance Committee Proposal
As briefly mentioned above, the CBO has issue its preliminary analysis of the Senate Finance Committee’s “America’s Healthy Future Act.” CBO estimates that under this legislation, the percentage of legal nonelderly residents covered by health insurance would increase from 83 percent today to about 94 percent by 2019. CBO further estimates that:
* The bill’s coverage provisions would cost $829 billion over ten years. This includes $345 billion in increased spending in Medicaid and CHIP, $461 billion for premium subsidies provided through the exchange and related spending, and $23 billion for small employer tax credits.
* These costs would be offset by increased tax revenues and spending reductions in other areas, resulting in a net reduction in the federal budget deficit that is estimated to be approximately $81 billion over ten years. The bill’s offsets include: $201 billion from the high-cost health plan tax; $117 billion from changes to Medicare Advantage payments; $106 billion from changes to Medicare hospital payments; $23 billion from penalty payments by employers; and $4 billion from penalty payments by individuals.
The Week in Health Reform
Federal Legislative Overview
Quoting & Saving just got easier...EasyToInsureME Health Insurance
Individual health insurance
Health insurance quotes
Senate
The long-awaited cost estimate of the Senate Finance Committee’s health care reform proposal, “America’s Healthy Future Act,” was released this week by the Congressional Budget Office (CBO).
The CBO concluded that the proposal would cost $829 billion over 10 years – an increase from the previous $738 billion estimate of the revised Chairman’s Mark – and would cover 94 percent of Americans. A more detailed overview of the CBO cost estimate is discussed in the next section of this article.
The Senate Finance Committee waited to vote on its health care reform proposal until the CBO completed its work. On Tuesday October 13, the Finance Committee voted 14 to 9 to approve the legislation. Senator Olympia Snowe (R-ME) was the only Republican who voted in support of the measure. This now paves the way for Democratic leadership to begin merging the Senate Finance legislation with the Senate HELP bill (S 1679). Senators Max Baucus (D-MT), Christopher Dodd (D-CT) and Majority Leader Harry Reid (D-NV) will lead those efforts, working alongside the White House. The blended legislation could potentially be on the Senate floor the week of October 19.
House
House Speaker Pelosi and other Democratic leaders in the House of Representatives continue to meld its three pieces of health care reform legislation into one bill, while aiming to cut its total cost by another $200 billion. Although Pelosi has publicly stated that she will not consider a “trigger option” for the public plan, nor health care cooperatives, she has seemingly become a bit more open to the idea of the creation of a public plan that would be allowed to negotiate provider reimbursement rates, an idea that has more commonly belonged to conservative Democrats in this debate.
This past week, more than 150 House Democrats wrote a letter to Pelosi (D-CA) urging her “to reject proposals to enact an excise tax on high-cost insurance plans that could be potentially passed on to middle-class families.” This letter was in reference to the Senate Finance Committee’s health care reform proposal that includes a 40 percent excise tax on insurers that exceed certain cost thresholds, also known as a tax on “Cadillac plans”. Beginning in 2013, the threshold for individual plans will be $8,000 and $21,000 for family coverage. It is clear that more than half of House Democrats recognize that insurers will be forced to pass on these proposed new taxes to consumers – undermining the shared goal of ensuring affordable health coverage for all Americans.
Overview: CBO Score of Senate Finance Committee Proposal
As briefly mentioned above, the CBO has issue its preliminary analysis of the Senate Finance Committee’s “America’s Healthy Future Act.” CBO estimates that under this legislation, the percentage of legal nonelderly residents covered by health insurance would increase from 83 percent today to about 94 percent by 2019. CBO further estimates that:
* The bill’s coverage provisions would cost $829 billion over ten years. This includes $345 billion in increased spending in Medicaid and CHIP, $461 billion for premium subsidies provided through the exchange and related spending, and $23 billion for small employer tax credits.
* These costs would be offset by increased tax revenues and spending reductions in other areas, resulting in a net reduction in the federal budget deficit that is estimated to be approximately $81 billion over ten years. The bill’s offsets include: $201 billion from the high-cost health plan tax; $117 billion from changes to Medicare Advantage payments; $106 billion from changes to Medicare hospital payments; $23 billion from penalty payments by employers; and $4 billion from penalty payments by individuals.
Friday, October 9, 2009
Health Insurance Quote Reform Weekly EasyToInsureME
Oct. 9, 2009
This Week in Health Care Reform
This week, legislators from the Senate Finance Committee waited for the Congressional Budget Office (CBO) to provide a cost estimate for the revised health care reform bill before bringing the legislation to a committee vote, now expected to take place next week.
EasyToInsureME.com offers clients the easiest way to buy individual health insurance. Free services include instant online health insurance quotes,custom proposals for each client, free phone consultation, and 10-minute application by phone. Nobody does what we do for our clients!
Senate Negotiations
CBO Provides Revised Cost Estimate: On Wednesday, the CBO estimated that the revised Senate Finance Committee bill would cost $829 billion over the next 10 years, reducing the budget deficit by $81 billion over the same time period. The CBO also projected that the health reform legislation would expand health care coverage to 94% of Americans by 2019 . This estimate provides a significant political boost to the Finance Committee bill, as it is the only proposed health care reform legislation that meets President Barack Obama's guidelines, which include having a price tag of $900 billion or less over 10 years, vastly expanding coverage and not adding to the budget deficit. However, the CBO's estimate did not include the impact of the legislation on premiums.
Senate Finance Committee Finalizes Bill: Last Friday, the Senate Finance Committee wrapped up days of negotiations and finalized its bill to overhaul the U.S. health care system. In the last days of committee negotiations, lawmakers voted to:
*
Reduce penalties on those who do not obtain insurance;
*
Modify the proposed tax on high-cost insurance policies;
*
Prevent health insurance companies from taking tax deductions for compensation in excess of $500,000; and
*
Create a government plan to offer a state option operated by private insurers.
The committee originally planned to vote on the bill this week. However, the vote was delayed to give the CBO time to assess the cost of the revised package and to give the committee time to review the legislation before the vote.
Sen. Max Baucus (D-MT) has indicated he has the necessary votes to bring his bill across the committee finish line. Yet, it is still unclear whether or not he will achieve bipartisan support of the bill. In addition, at least two Democrats , Sens. Ron Wyden (D-OR) and John D. Rockefeller IV (D-WV) have refused to support the bill in its current form.
Joint Committee on Taxation Reports Increase in Industry Fees: On Tuesday, the Joint Committee on Taxation indicated that the revised bill coming out of the Senate Finance Committee would raise $121 billion from fees on drug companies, health insurers and medical device manufacturers, up from the original $92 billion previously reported. The increase in tax revenue stems from restrictions prohibiting companies from deducting the proposed industry fees from their corporate taxes. The new estimate has fueled increased Republican opposition to the reform legislation.
Senators Call for 72-Hour Window for Public Review: On Tuesday, a group of six moderate Democratic senators and one independent senator sent a letter to Senate Majority Leader Harry Reid (D-NV). The letter called for a 72-hour period for public review of the upcoming combined Senate health care reform legislation, along with the complete budget score from the CBO, prior to a full Senate vote.
House Activities
House Democrats Reject Taxing "Cadillac" Plans: On Wednesday, 154 House Democrats signed a letter addressed to Speaker of the House Nancy Pelosi (D-CA) denouncing a plan to pay for health care reform by taxing high-end health insurance plans, known as "Cadillac" plans. The letter urged the Speaker to reject proposals with a tax on Cadillac plans because it could potentially place a heavy burden on the middle class. This letter is in contrast with legislation moving through the Senate Finance Committee that includes a tax on insurers who offer these high-end plans. Speaker Pelosi has indicated she is considering adding a tax on health insurance to the House bill.
Public Opinion
Poll Shows Increased Public Support: The latest Associated Press-GfK poll has found that public support for President Obama's health care reform initiative has increased, split evenly between those who support reform (40%) and those who do not (40%). In September, 34% of the public supported Congressional proposals and 49% opposed them.
Additional Activities
President Obama Pitches Health Care Reform to Doctors: President Obama addressed approximately 150 doctors from across all 50 states on the White House lawn to win their support for health care reform. Many doctors oppose reform efforts, particularly due to potential cuts in Medicare and lack of protection from "abusive" malpractice lawsuits.
Looking Ahead
Following the Senate Finance Committee vote expected next week, Sen. Reid will work to merge the Senate Finance Committee bill with the other proposed legislation from the Senate Health, Education, Labor and Pensions Committee. He expects that the debate before the full Senate will begin after Columbus Day (October 12). House Speaker Pelosi expects to have merged the three proposed bills coming out of the House and to begin full House voting by mid-October.
This Week in Health Care Reform
This week, legislators from the Senate Finance Committee waited for the Congressional Budget Office (CBO) to provide a cost estimate for the revised health care reform bill before bringing the legislation to a committee vote, now expected to take place next week.
EasyToInsureME.com offers clients the easiest way to buy individual health insurance. Free services include instant online health insurance quotes,custom proposals for each client, free phone consultation, and 10-minute application by phone. Nobody does what we do for our clients!
Senate Negotiations
CBO Provides Revised Cost Estimate: On Wednesday, the CBO estimated that the revised Senate Finance Committee bill would cost $829 billion over the next 10 years, reducing the budget deficit by $81 billion over the same time period. The CBO also projected that the health reform legislation would expand health care coverage to 94% of Americans by 2019 . This estimate provides a significant political boost to the Finance Committee bill, as it is the only proposed health care reform legislation that meets President Barack Obama's guidelines, which include having a price tag of $900 billion or less over 10 years, vastly expanding coverage and not adding to the budget deficit. However, the CBO's estimate did not include the impact of the legislation on premiums.
Senate Finance Committee Finalizes Bill: Last Friday, the Senate Finance Committee wrapped up days of negotiations and finalized its bill to overhaul the U.S. health care system. In the last days of committee negotiations, lawmakers voted to:
*
Reduce penalties on those who do not obtain insurance;
*
Modify the proposed tax on high-cost insurance policies;
*
Prevent health insurance companies from taking tax deductions for compensation in excess of $500,000; and
*
Create a government plan to offer a state option operated by private insurers.
The committee originally planned to vote on the bill this week. However, the vote was delayed to give the CBO time to assess the cost of the revised package and to give the committee time to review the legislation before the vote.
Sen. Max Baucus (D-MT) has indicated he has the necessary votes to bring his bill across the committee finish line. Yet, it is still unclear whether or not he will achieve bipartisan support of the bill. In addition, at least two Democrats , Sens. Ron Wyden (D-OR) and John D. Rockefeller IV (D-WV) have refused to support the bill in its current form.
Joint Committee on Taxation Reports Increase in Industry Fees: On Tuesday, the Joint Committee on Taxation indicated that the revised bill coming out of the Senate Finance Committee would raise $121 billion from fees on drug companies, health insurers and medical device manufacturers, up from the original $92 billion previously reported. The increase in tax revenue stems from restrictions prohibiting companies from deducting the proposed industry fees from their corporate taxes. The new estimate has fueled increased Republican opposition to the reform legislation.
Senators Call for 72-Hour Window for Public Review: On Tuesday, a group of six moderate Democratic senators and one independent senator sent a letter to Senate Majority Leader Harry Reid (D-NV). The letter called for a 72-hour period for public review of the upcoming combined Senate health care reform legislation, along with the complete budget score from the CBO, prior to a full Senate vote.
House Activities
House Democrats Reject Taxing "Cadillac" Plans: On Wednesday, 154 House Democrats signed a letter addressed to Speaker of the House Nancy Pelosi (D-CA) denouncing a plan to pay for health care reform by taxing high-end health insurance plans, known as "Cadillac" plans. The letter urged the Speaker to reject proposals with a tax on Cadillac plans because it could potentially place a heavy burden on the middle class. This letter is in contrast with legislation moving through the Senate Finance Committee that includes a tax on insurers who offer these high-end plans. Speaker Pelosi has indicated she is considering adding a tax on health insurance to the House bill.
Public Opinion
Poll Shows Increased Public Support: The latest Associated Press-GfK poll has found that public support for President Obama's health care reform initiative has increased, split evenly between those who support reform (40%) and those who do not (40%). In September, 34% of the public supported Congressional proposals and 49% opposed them.
Additional Activities
President Obama Pitches Health Care Reform to Doctors: President Obama addressed approximately 150 doctors from across all 50 states on the White House lawn to win their support for health care reform. Many doctors oppose reform efforts, particularly due to potential cuts in Medicare and lack of protection from "abusive" malpractice lawsuits.
Looking Ahead
Following the Senate Finance Committee vote expected next week, Sen. Reid will work to merge the Senate Finance Committee bill with the other proposed legislation from the Senate Health, Education, Labor and Pensions Committee. He expects that the debate before the full Senate will begin after Columbus Day (October 12). House Speaker Pelosi expects to have merged the three proposed bills coming out of the House and to begin full House voting by mid-October.
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