Health Insurance Reform Washington Update

Thursday, August 12th, 2010

Summary of what has been happening in Washington as of Aug. 6, 2010.

Senators Introduce New Legislation to Increase Transparency and Competition in Insurance Industry
Senators Mark Pryor (D-AR), Jay Rockefeller (D-WV) and Barbara Boxer (D-CA) introduced “The Insurance Competition and Transparency Act” (S. 3685) in the Senate Committee on Commerce, Science and Transportation on Aug 2. The legislation would authorize the Federal Trade Commission (FTC) to use its authority under the Federal Trade Commission Act to “investigate and disclose information about practices employed by insurance companies that may reduce competition in the marketplace.”

The bill goes a step further and explicitly states that since many insurance companies have non-profit status, it would eliminate the exemption under the Act for non-profit insurers. S. 3685 is based on an amendment that was filed by Senators Pryor, Rockefeller and Boxer during the Senate’s health reform debate in December 2009.

Senate Passes Child Nutrition Bill
Led by the Senate Agriculture Committee Chairwoman Blanche Lincoln (D-AR) and Ranking Member Saxby Chambliss (R-GA), the Senate passed the “Healthy, Hunger-Free Kids Act of 2010” (S. 3307) by unanimous consent on Aug. 5. The legislation authorizes a $4.5 billion increase over 10 years for school lunches and other nutrition programs. It also gives the Agriculture Department authority to set nutrition standards for foods sold in vending machines and in a la carte lines in schools.

Of the $4.5 billion, the legislation provides $1.2 billion to increase the number of children receiving food, in an effort to meet President Barack Obama’s pledge to end childhood hunger by 2015. The remaining $3.2 billion would be used to improve the quality of school meals. The cost of the legislation is entirely offset. Review the Congressional Budget Office’s budgetary impact report.

Chairman Tom Harkin (D-IA) of the Senate Health, Education, Labor and Pensions Committee commended Agriculture Committee Chairwoman Lincoln for her work on the bill, noting that it passed both the Agriculture Committee and the full Senate without a single dissenting vote.

The House of Representatives still needs to pass its version of the bill, “The Improving Nutrition for America’s Children Act” (H.R. 5504), in order for President Obama to sign the bill before Sept. 30, when many of the programs are set to expire. The House Education and Labor Committee approved the measure on July 15.

The American Academy of Pediatrics also commended the Senate for its action on the legislation and pushed the House to follow the Senate’s lead. “The AAP urges the House to follow the Senate’s swift action on this bill and pass strong child nutrition legislation when Congress reconvenes in September. All children deserve a healthy future, which starts with access to healthy, nutritious meals every day.”  See the American Academy of Pediatrics’ entire statement.

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Revive the Public Health Insurance Option

Thursday, July 29th, 2010

Progressive Democrats Attempt to Revive the Public Health Insurance Option

A group of 129 progressive House of Representatives Democrats, seeking to revive the public option, introduced legislation on July 22 to establish a public health insurance plan that would compete with private health insurers. It is highly unlikely that the House will vote on the legislation this year. Republicans and some moderate Democrats remain strongly opposed to the public option, and Democratic leaders have little interest in reigniting the divisive health care reform debate before the November elections.

Supporters of the Public Option Act (H.R. 5808) claim that the legislation would sharply reduce the federal deficit. The non-partisan Congressional Budget Office (CBO) estimates that the bill would reduce the federal deficit by approximately $68 billion from 2014 to 2020.

The public plan would be administered by the Secretary of Health and Human Services and would be offered through the new health insurance exchange beginning in 2014.  The bill would require the public plan to charge premiums that fully cover its costs for benefit payments and administrative expenses. The plan’s provider payment rates would be based on Medicare reimbursement rates. The legislation has been referred to the House Energy and Commerce Committee.

President Obama Signs Unemployment Insurance Extension Bill into Law

President Barack Obama signed H.R. 4213, the Unemployment Compensation Extension Act of 2010, into law on Thursday, July 22, ending months of partisan squabbling over the measure. Moments after the late Senator Robert Byrd’s (D-WV) replacement, Carte P. Goodwin, was sworn into office, the Senate quickly voted to invoke cloture on the legislation, sending it back to the House, which then passed the measure by a vote of 272-152.

The legislation did not include an extension of the COBRA health insurance subsidies and other safety-net programs that had also expired earlier this year. The legislation will provide unemployment insurance for those who have already exhausted their normal six months of benefits through Nov. 30, 2010; it is retroactive to June 2, 2010. The Congressional Budget Office estimates this extension will add $33.9 billion to the federal deficit over 10 years.

House Republicans Criticize New Rules for $27 Billion Electronic Health Records Program

House Ways and Means Health Subcommittee Republicans alleged during a July 20 hearing that eligibility criteria for the new $27 billion federal electronic health records (EHR) program are too lenient. The EHR program will provide additional Medicare and Medicaid payments, beginning in 2011, to health professionals and hospitals that adopt certified EHRs. The additional payments, which were enacted in 2009 as part of the American Recovery and Reinvestment Act, will likely encourage many physicians and hospitals to purchase and implement EHR systems.

In order to be eligible for additional Medicare and Medicaid payments, hospitals and health care professionals must adopt and make “meaningful use” of certified EHR technology. Dr. David Blumenthal, the National Coordinator for Health Information Technology (IT), testified that the eligibility criteria were designed to accommodate diverse providers, while appropriately encouraging the adoption of EHRs. The Obama Administration had originally proposed more strict eligibility requirements that were denounced by the health care industry as unrealistic.

The new qualification standards are the first in a series of rules, and they apply only to additional payments before 2013. Dr. Blumenthal stated that HHS will place higher demands on providers in the future.

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Health Insurance Reform Schedule

Wednesday, July 21st, 2010

2010
New programs:

  • Temporary retiree reinsurance program.
  • National risk pool, small business tax credit.
  • $250 rebate for Medicare members who reach the “doughnut hole”.

Health Insurance Reforms:

  • No lifetime benefit limits based on dollar amounts.
  • Allowed restricted yearly limits on the dollar value of certain benefits.
  • No coverage rescissions/cancellations (except for fraud or internal misrepresentation).
  • No cost-sharing obligations for preventive services.
  • Must have dependent coverage up to age 26.
  • New internal and external appeal process.
  • No pre-existing condition exclusions for dependent children (under 19 years of age).
  • New health plan disclosure and transparency requirements.

2011
Insurance Reforms:

  • New uniform coverage documents and standard definitions are developed.
  • Must have minimum medical loss ratios.

Medicare Reforms:

  • Start of Medicare Advantage cost-sharing limits.
  • Medicare beneficiaries who reach the doughnut hole to get a 50% discount on brand name drugs.
  • Primary care doctors and general surgeons practicing in underserved areas, such as inner city and rural communities to get a 10% bonus.
  • Medicare Advantage plans begin having payments frozen.

Other:

  • Yearly fee for brand-name drug manufacturers.
  • Start of voluntary long-term care insurance program giving a cash benefit to help those with disabilities stay in their homes or pay nursing home cost: benefit starts 5 years after paying coverage fee.
  • Increased funding for community health centers to provide care for many low-income and uninsured people.

2012

  • Hospitals, doctors and payers encouraged to join forces in “accountable care organizations”.
  • Hospitals with high rates of preventable readmissions facing reduced Medicare payments.

2013

  • Individuals making $200,000 a year or couples making $250,000 would have a higher Medicare payroll tax of 2.35% on earned income – up from the current 1.45%. A new 3.8% tax on unearned income, such as dividends and interest, also added.
  • Contributions to flexible spending accounts (FSAs) limited to $2,500 a year – indexed for inflation. And the threshold for deducting medical expenses on taxes goes from 7.5% to 10% income.
  • Medical device manufacturers have a 2.9% sales tax on medical devices; with exemptions for some, like eyeglasses, contact lens, and hearing aids.
  • No more deduction for expenses allocable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D-eligible retirees.

2014
Coverage Mandates & Subsidies:

  • New Individual and employer coverage responsibilities.
  • New Individual affordability tax credit and expanded small business tax credits.

Health Insurance Exchange & Insurance Reforms:

  • State individual and small group health insurance exchanges operational.
  • Guaranteed issue, guaranteed renewability, modified community rating and minimum benefit standards (“essential benefits” plan) effective.
  • No more lifetime and yearly dollar limits for essential benefits.
  • New taxes on health insurers.

2018

  • New tax (“Cadillac tax”) on employer-sponsored health plans that offer policies with generous coverage levels.

2020

  • Doughnut hole coverage gap in Medicare prescription benefits is fully phased out. Seniors continue to pay the standard 25% of their drug costs until they reach the threshold for Medicare catastrophic coverage.
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Health Insurance Updates July

Friday, July 16th, 2010

Florida health insurance: Attorney General Bill McCollum and Secretary Tom Arnold of the Florida Agency for Health Care Administration have submitted a formal request for a waiver from the federal government that, if granted, would launch a Florida pilot program for enhanced Medicaid fraud enforcement.

Illinois health insurance: Last week Governor Pat Quinn signed the package of budget proposals passed by lawmakers in May, leaving Illinois with one of the largest budget deficits in the country.

Michigan health insurance: Priority Health and the Physicians Health Plan of Mid-Michigan, both non-profit insurers and subsidiaries of large hospital systems, have applied to sell coverage to new Patient Protection and Affordable Choices Act (PPACA) high-risk pool enrollees.

Missouri health insurance: Lt. Gov. Peter Kinder has filed a legal challenge against the recently enacted federal health care reform law.

Pennsylvania health insurance: The Insurance Department is planning to file an application with HHS for a $1 million grant to buttress its rate review efforts.

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Health Insurance Reform News July 2010

Friday, July 9th, 2010

Health insurance reform will inevitably add to the already unsustainable federal deficit. In addition, it will prove impossible for the government to create and establish a more efficient system than the one now in place.

These are some of the arguments of more than a dozen states that have filed lawsuits. The lawsuits challenge the constitutionality of the reform. Their arguments also include that the government should not force citizens to buy health insurance.

It will be several years before the reforms take effect, and opponents are trying to ensure that they never will.

But significant improvements have already been made and insurers are also moving into compliance ahead of schedule. New rules forbid insurance companies from denying coverage to children, young adults can now stay on their guardians’ policies until age 26, and setting a lifetime limit on benefits will be banned soon.

Let’s not forget the true objective and that is to reduce costs. The Obama administration  must demonstrate that reforms will eventually bring down costs. This is the true test.

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Republican Attempt To Repeal Individual Mandate

Wednesday, June 23rd, 2010

The United States House of Representatives voted 187 to 230 to defeat a Republican proposal to repeal the individual health insurance mandate in the new health reform law, the PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 (PPACA). Twenty-one Democrats joined 166 House Republicans in voting against the requirement that most Americans purchase health care coverage beginning in 2014.

Representative Dave Camp (R-MI) – the senior ranking Republican on the powerful House Ways and Means Committee – offered the proposal as a procedural motion to an unrelated bill. Despite the proposal’s failure, some Republican members believe they scored political points by forcing a vote on the new health reform law. However, House Ways and Means Committee Chairman Sander Levin (D-MI) stated that the vote displayed increased support among House Democrats for the health reform law, because only 21 Democrats voted in support of the Republican proposal, whereas 34 Democrats voted against the health care reform bill in March.

SENATE PASSES DOC FIX LEGISLATION
The Senate passed legislation on June 18 that would avert a 21.3 percent reduction in Medicare physician payment rates that became effective June 1. Senate Majority Leader Harry Reid (D-NV) and Minority Leader Mitch McConnell (R-KY) took to the floor and passed a six-month delay in reimbursement cuts by unanimous consent, after extracting it from a larger tax and benefits package, H.R. 4213, the American Jobs and Closing Tax Loopholes Act of 2010. The $6.5 billion bill was offset with spending reductions that appeased both Republicans and Democrats.

The House, which is not scheduled to return until the evening of June 22, still must pass the “doc fix” legislation. Earlier this week, a procedural vote to end debate on the legislation failed 52 to 45 (60 votes were necessary for passage). Eleven Democrats broke with their party leaders to vote no. Many Republicans and moderate Democrats believed that the more than $50 billion net cost of the bill should be offset by spending cuts and/or federal revenue increases. The fate of the full tax-extenders legislation, H.R. 4213, remains up in the air.

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The Best Health Insurance Quotes & Plans On The Market

Monday, June 14th, 2010

Real user experiences documented from client and non-client satisfaction testimonials place Easy To Insure ME at the top of the list for client satisfaction and customer service.

Searching for health insurance is no easy job and most clients need to take care of their own job first. The easiest way is to find a convenient source for information regarding health insurance quotes for individual plans. On the internet, there seems to be many sources for individual health insurance quotes. However, very few websites will actually give the visitor real and accurate instant online health insurance quotes.

To make things easier for visitors, the sites that do offer individual health insurance online are the best resources for finding coverage. All tools are available to search every plan in the country instantly and research every benefit available to the applicant. Applying online is very quick and allows applications to be submitted starting the health insurance application process.

Processing, also known as underwriting, can be as quick as 24 hours or longer than a month. This depends on which health insurance quotes website was used and which carrier an application is submitted to. The best individual health insurance quotes website with the best plans on the market is Easy To Insure ME .com The difference is in the customer service. Nobody does what Easy To Insure ME does for their clients.

Owner Chad Levin states “Having the best customer service in the world is a hard measure to live up to. As long as you call when you are going to call and do what you are going to do, you are doing well. But if you can do more and provide knowledge and guidance that is where the service comes along.

In recommending plans I just think to myself about what I would want for my family. Personally, I like copay plans with a $2500 deductible. They are very affordable individual health insurance plans with copays for doctors, emergency room, prescription, and preventative care. That is what is important to me.”

Free services are available on all health insurance quote websites. Sites that have many different plans and carriers are called brokers. Brokers are paid by the health insurance carriers and not by clients that apply for individual health insurance through the website.

All carriers, brokers, and agents have the same exact prices and premiums. Prices and premiums are regulated by the government and cannot be changed unless voted on in congress. The difference is in the customer service and recommendations provided to help visitors decide what plan has the best benefits and lowest premiums.

Customer service and recommendations are very important in this process. In reality four hundred plans can be stripped down to four if working with a knowledgeable advisor.

Visitors at Easy To Insure ME say

Marie
Everything that was discussed, and all of policy/certificate information that I have read is OK. Thanks for double and triple checking. I remember you mentioning that you broker for 401s. Does it have to be a 401, or do you also deal with investments, etc. When I sell my present house I hope to get enough to have a nest egg and will need to put into something safe and with as high an earning yield as possible. Not a rush thing, just something for you (& me) to think about. Thanks again Chad, I could NOT have done it WITHOUT YOU!

Theo
I never fill out forms online because I am a computer programmer and I know I will get all kinds of spam. Your site enticed me to start searching for health insurance and to fill out the form and I didn’t receive any spam. Your site is designed perfectly for navigation and is very easy to use. When you called me earlier and emailed me back at 9 pm I realized I was dealing with a real person and not an online bot that sends out auto responses. I am very impressed. Also, the plan you got me is almost to good to be true.

Mrs. Stephenson
Thank you so much for following up with me every week letting me know the application status until my son’s application was approved.

Billy R.
You are a great salesman. You do what you say your going to do.

Mrs. Mercer
This is a great service you are providing and you are a very nice man. Keep up the good work.

Susan
Thank you so much Chad for continuing to work with us to get me insured.
This United Health One plan looks good. I’ll take it!
I know I haven’t been a very easy candidate to work with so I want you to know that I do appreciate your determination and effort in helping me.

Lauren
Your follow up routine is great. Thank you very much for following up on me.

Brian
The proposals you send are great they are so easy to read and understand. Great job and thank you so much for your help and guidance.

Mark
That was great customer service. You called me back before I even got to leave a voicemail.

Julia
Chad, Thanks for all your help in selecting my medical and dental benefits. It really was a timesaver for me.

David
Thanks again for all your help, U R THE MAN.

Donna
I read through many of the plans and had a difficult time deciding what one to take. You were helpful with the health insurance and helped me figure out the best plan with a low monthly rate and a moderate deductible.

Steve
That just seems amazing, compared to what we had before. With her generic meds at $15 copay, compared to about $47 that applied to a $600 annual deductible, that’s additional out of pocket savings of about $30 a month right off the bat. This is over $2,000 annual decrease in premiums.

Frank
I appreciate you being available for general questions. It really helps. I will definitely be recommending you to others.

Joanne
I’m sorry I cannot accept the policy but you are great thank you for everything you have done for us.

Stephanie
Thanks for all of your help. Your service is excellent.

*(Full name not complete for privacy regulations) http://www.easytoinsureme.com/

The mission of Easy To Insure ME is to help Americans find affordable health insurance in the easiest way possible. Licensed advisors do this by shopping all carriers available to the client and picking out four plans that will provide the best benefits at the lowest cost to the consumer. Then an easy to read side by side recommendation of these plans is sent through email to make the process as simplified as possible.

Easy To Insure ME is not a lead generation website. Real licensed professionals are here to help clients make knowledgeable and affordable health insurance decisions. “Nobody does what we do for our clients.”

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This Week in Health Care Reform

Friday, June 11th, 2010

Primary elections were held in 11 states this week as lawmakers returned to Washington, D.C., to face a growing list of unfinished legislative business including a jobs bill and environmental issues stemming from the Gulf crisis. Meanwhile, President Barack Obama launched a public relations campaign to combat skepticism around his new health insurance reform legislation and to promote the early implementation of certain provisions of the law.

Health Care Reform
Health Care Reform Debate Alive and Well: Democrats continue to sell their plan for health care reform to Americans in the face of mixed public opinion, simultaneously battling Republicans pushing for its repeal.

Congressional lawmakers address concerns about the new health care reform legislation, particularly among senior citizens , who make up a disproportionate share of voters in midterm elections. Democrats and the administration are eager to publicize certain provisions of the bill, like retaining young adults on their parents’ plans until age 26, as a way to gain support and to turn voters away from Republicans who called for its repeal.

On Tuesday, President Obama held a nationally televised town hall meeting at a senior center in Maryland to highlight the distribution of $250 rebate checks for senior citizens who hit the so-called “doughnut hole ” in Medicare’s prescription drug coverage. The first round of checks was mailed yesterday and serves as the law’s first monetary benefit.

State Battle Against Health Care Reform Law Continues: On Monday, Virginia Attorney General Ken Cuccinelli disputed the administration’s claim that the state lacks standing to challenge the new federal health care reform law. The lawsuit filed by Cuccinelli in the Eastern District Court cites a Virginia law that exempts state residents from being required to have health care coverage. Sebelius argued that states cannot simply pass a statute that would nullify a federal law. A hearing to determine next steps is set for July 1.

Public Opinion
Americans Want Repeal of Health Care Reform: A recently released Rasmussen report suggests that Americans are strongly in favor of repealing President Obama’s health care reform law. Fifty-eight percent of those polled favor repeal, while 62 percent believe the new legislation will increase the budget deficit. In addition, 57 percent predict health care costs will increase, while 51 percent feel the quality of care will decrease as a result of the new health care reform law.

Looking Ahead
Democrat lawmakers are expecting to pass the jobs bill next week but will need Republican support in order to get the 60 votes needed for passage. One provision of the bill, a 21 percent cut in Medicare payments to doctors, is being delayed as the bill moves through Congress and would ultimately be blocked if the legislation passes.

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Texas Health Insurance House Ways & Means Committee

Thursday, June 3rd, 2010

Texas health insurance House Ways & Means Committee held a hearing last week to examine another potential new revenue source as it looks ahead to a rough budget session next year. The hearing was one of several in which the tax committee examined exemptions from the state sales and property taxes. The insurance industry testified that the premium tax is a predictable source of revenue and that a direct swap of the premium tax for a franchise tax would actually be detrimental to the state’s bottom line. The Ways & Means Committee will continue to meet until the legislature goes back into session in January 2011.

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Oklahoma Health Insurance Plugging a $6.8 billion Hole

Thursday, June 3rd, 2010

Oklahoma health insurance seeking to plug a $6.8 billion hole in the state’s budget, the House forwarded one of several “revenue enhancement” bills to the Senate, which promptly adopted the bill and sent it to Governor Brad Henry. The bill would impose a 1 percent fee on all health insurance claims paid. It would apply to third party administrators, HMOs, self-insured plans, excess carriers, stop loss carriers, multiple employer welfare arrangements, professional employer organizations, and the state employee program. The revenue would be used to fund the Oklahoma Health Care Authority, which administers the state’s Medicaid program. Questions persist as to whether the measure will withstand a likely court challenge on the grounds that the Oklahoma constitution states that no tax increases may be passed during the last five days of the session. Also, if a tax increase is not approved by three-fourths of both legislative chambers – it was not – then the increase must be put to a statewide vote. If signed, the bill will go into effect on July 1.

Additionally, a conference committee released compromise language on the topic of the state’s employee health plan. The bill would change the existing Board to become the “Oklahoma Health and Wellness Board” with a HealthChoice Health Insurance Division within it. The new 11-member board is required to contract with a web-based, doctor-patient mutual accountability incentive program for 2011 and establish a wellness program for all participants in the plan including financial incentives for participation in the wellness program and healthy living practices. The board would be required to contract with only one HMO. This bill now requires the Governor’s signature to take effect.

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