The General Assembly in Colorado health insurance recently adjourned a 2010 session that was focused heavily on health care issues. Outgoing Governor Bill Ritter succeeded in his goal of leaving a health care reform legacy with the passage of unisex rating in the individual market, a plain language requirement for insurance forms and contracts, an all-payer database and the creation of a task force to develop standard coding and edits for claims. Although the oral chemotherapy mandate passed, the industry was successful in helping to defeat a bill that would have prohibited carriers from setting rates for non-covered services and one making the wrongful denial of a claim an unfair claim practice. Aetna took a lead role in reaching a compromise on a bill that would have prohibited subrogation.
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As lawmakers returned to Washington this week, Republicans affirmed their commitment to repealing the health care reform legislation, while Democrats continued to campaign on the health care reform law’s merits. Meanwhile, President Obama stepped up his efforts to energize his core supporters by capitalizing on health care reform.
Health Care Reform
New Health Care Reform Law Means Tax Increase for Middle Class: According to a report recently received by congressional staffers, the new health care reform law will result in higher taxes for approximately 14.7 million middle class Americans. Taxpayers can currently deduct medical expenses in excess of 7.5 percent of their adjusted gross income (AGI). Starting in 2013, most taxpayers will only be able to deduct expenses greater than 10 percent of AGI. By limiting the medical expense deduction – a provision widely used by taxpayers who either have a serious illness or are older – the new law is expected to save billions of dollars. However, according to the Joint Committee on Taxation, those taxpayers earning less than $200,000 a year will pay roughly $3.9 billion more in taxes in 2019 alone because of the new limits for this deduction.
Members of Congress Baffled by Health Care Reform Provisions: According to the Congressional Research Service, the new health care reform law may have serious unintended consequences for members of Congress and their employees. Due to ambiguous and confusing language, members of Congress and their staff members may lose access to the Federal Employees Health Benefits Program, effective immediately. Rep. Jason Chaffetz (R-UT) said lawmakers were in the same boat as many Americans, trying to figure out what the new law meant for them. Congressman Chaffetz asked, “If members of Congress cannot explain how it’s going to work for them and their staff, how will they explain it to the rest of America?”
Additional Activities
Massachusetts Court Rejects Bid to Increase Premiums: Last month, insurance executives in Massachusetts attempted to increase their companies’ premiums by as much as 32 percent,
citing the expected rise in medical costs associated with insuring individuals and small group customers in Massachusetts. Insurance Commissioner Joseph Murphy rejected the proposals,
citing the increases as “excessive.” As a result, representatives from six of the insurance companies sued, claiming the state does not have the authority to cap premiums. On Monday,
a Superior Court Judge in Suffolk County ruled against the insurance providers on procedural grounds for not exhausting all administrative remedies within the Department of Insurance
before seeking legal intervention.
Unemployment Benefits Extended Again: On Monday, Senate Democrats advanced a measure temporarily extending the unemployment benefits that expired during the recent two-week congressional recess. Democrats achieved cloture (the only formal procedure that Senate rules provide for breaking a filibuster) with 4 key Republican votes in the Senate. The $9.2 billion bill would extend long-term unemployment benefits along with COBRA health care subsidies for unemployed Americans. It would also extend an annual increase in payments to doctors who treat Medicare patients. The unemployment benefits and health care subsidies will continue until May 5, while the other changes will expire on April 30.
The Senate’s action late Monday set the stage for a final vote on the legislation. On Thursday evening, the bill passed 59-38 , and the measure was sent back to the House, which was expected to vote and send it to President Obama for his signature.
Another State Joins Lawsuit Against Health Care Reform Bill: This week, Georgia Governor Sonny Perdue appointed a special assistant attorney general to lead the state’s challenge against the health care reform law. Georgia joins 18 other states in alleging that the new law infringes on Americans’ Constitutional rights by mandating that individuals purchase health care coverage or pay a penalty. Frank Jones, the state’s pro bono special assistant attorney general, will represent the State of Georgia and join the multiparty lawsuit filed on March 23 in a federal court in Florida. Other states in the suit include Alabama, Arizona, Colorado, Florida, Idaho, Indiana, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington.
Insurance Commissioner Won’t Comply with Law: Also in Georgia, Insurance Commissioner John Oxendine refused a request from the U.S. Department of Health and Human Services to create a pool for high risk insurance plans. His decision to opt out of creating a high risk pool will not affect the cost of insurance for any patients. However, the federal government, instead of the state, will oversee the distribution of certain federal health care funds in Georgia health insurance to ensure that high risk patients receive subsidized premiums on health insurance.
Chairman Waxman Cancels Hearing: House Energy and Commerce Committee Chairman Henry Waxman (D-CA) issued a statement on Wednesday cancelling a hearing called to listen to concerns from major corporations about how they will be impacted by the health care reform bill. Over the past few weeks, several company executives contacted Chairman Waxman and expressed their feelings that the new law may ease their costs if it is implemented properly. Companies like AT&T, Verizon and Caterpillar made news last month when they informed investors they would need to take billions of dollars in write-downs because of changes in how health care subsidies will be taxed.
Public Opinion
Polls this week show that the number of Americans favoring repeal of the health care reform law continues to rise following the law’s enactment. At the same time, President Obama’s
job approval ratings have slipped since passage of health care reform.
More Americans Strongly Favor Repeal: In a recent Rasmussen report, 58 percent of Americans – up 4 points from last week – support repealing the new health care reform law. Further, 52 percent of likely voters continue to feel the legislation is bad for the country.
Similar results were found in a new study conducted by Indiana University. Researchers at the Center for Health Policy and Professionalism Research found that 58 percent of Americans are in favor of repealing the health care legislation.
Obama’s Approval Ratings Slip: In a recent AP/Gfk poll, 52 percent of Americans said they disapprove of the way President Obama is handling health care reform, up 6 points since last month. At the same time, 50 percent disapprove of his performance overall, which is up from 46 percent just a month ago.
Looking Ahead
As lawmakers shift their attention to debating financial reform and climate change legislation, President Obama continues to travel the country to discuss with Americans the details
of the new health care reform legislation.
President Obama finalized his health care reform package this week, signing into law the package of fixes approved by the House late last week. While some of the new provisions won’t take effect until 2014, some will be phased in beginning this year.
Health Care Reform
President Obama Signs Final Health Care Bill into Law: On Tuesday, President Obama signed into law the package of changes to the newly enacted Patient Protection and Affordable
Care Act. Approved over unanimous Republican opposition in both chambers of Congress, this reconciliation bill increases the overall cost of the health care reform legislation by $65
billion, bringing the new total to $940 billion over the next 10 years.
What Does This Health Care Reform Legislation Mean: The biggest changes to the nation’s health insurance system will not take effect until 2014. Some of the changes include: the creation of insurance marketplaces called “exchanges” where people can shop for insurance; rules requiring insurers to accept all applicants, including those with pre-existing conditions; and an expansion of state Medicaid programs. Some additional provisions will become effective immediately while others will kick in later this year.
These are some of the features of the new health care overhaul bill passed through the reconciliation process and slated to begin to take effect in 2010:
- For new sales and subscribers who change policies after March 23, 2010, insurance companies will be required to make additional changes beginning in approximately 6 months, such as removing any member cost sharing for “preventive” benefits (as defined by the legislation). The renewal product requirements beginning for plan years 6 months after enactment include:
- Coverage for dependents up to age 26;
- Removal of limits on lifetime maximum benefits;
- Temporary federal high-risk pools; and
- Tax credits for small group employers.
Health Care Reform Impacts on Premiums: There are concerns that the new taxes on health insurance will likely increase premiums. Members of the news media report that under the health care overhaul , young adults who buy their own individual health insurance will carry a heavier burden of the medical costs of older Americans. This is expected to raise insurance premiums for young people when the plan takes full effect in 2014.
Additional Activities
Several Companies Push to Repeal Provision of Health Care Law: The American Benefits Council, an association representing hundreds of large corporations, urged President Obama and
Congressional Democrats to repeal a provision in the health care bill that reduces the tax deductions allowed to companies that provide drug coverage for their retired employees. As a
result of this impending provision, companies like AT&T, Caterpillar, Prudential, Deere Co. and 3M have all announced substantial charges against their first-quarter earnings in
order to comply with federal accounting rules.
Insurers Will Comply With Law Regarding Children’s Coverage: This past week, despite vague language in the new health care law regarding coverage of children with pre-existing conditions, insurance companies assured HHS Secretary Kathleen Sebelius that they await clarification and will comply with the law, effective later this year.
Indiana health insurance Joins States’ Lawsuit Against Health Care Bill: In response to the new health care reform legislation, the Attorneys General of several states across the country filed lawsuits arguing against the constitutionality of requiring Americans to purchase health insurance. This week, the state of Indiana joined 13 others in a lawsuit filed last week in a Florida federal court. The 14 states – Indiana, Florida, Alabama, Colorado, Idaho, Louisiana, Michigan, Nebraska, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington – will become joint plaintiffs in the suit and split the costs of the legal challenge.
Doctors Group Files Lawsuit to Repeal Health Care Legislation: The Association of American Physicians and Surgeons filed a lawsuit in the U.S. District Court for the District of Columbia against HHS Secretary Kathleen Sebelius and Social Security Administration Commissioner Michael Astrue. Attorneys for the group argue that the insurance mandate is unconstitutional. They also argued against the constitutionality of other provisions saying, “If the bill goes unchallenged, then it spells the end of freedom in medicine as we know it.”
Public Opinion
More Americans Disapprove of President’s Handling of Health Care: In a recent CNN poll, 54 percent of Americans said they disapprove of the way President Obama is handling health care
reform, while 45 percent approve. In addition, 56 percent of respondents feel the Democrats’ health care legislation creates too much government involvement in the nation’s health
care system.
Americans Unhappy over Health Care Reform Passage: In a recent USA Today/Gallup poll, 50 percent of Americans said the recent passage of health care reform legislation is a bad thing. Further, 55 percent say health care costs in the U.S. will rise as a result of the bill.
Two Polls Offer Different Results: In a newly released Rasmussen report, 54 percent of Americans favor repealing the recently enacted health care legislation. Further, 49 percent believe the new law will reduce the quality of care, while 60 percent think it will increase the federal budget deficit. In contrast, supporters of reform are touting the recent CNN poll that shows 50 percent of Americans are either fine with the new legislation or would favor seeing more government involvement in health care. In this poll, only 47 percent of Americans favor repealing the bill.
Looking Ahead
Late this week , President Obama traveled to the swing states of Maine and North Carolina to discuss
details of the new health care reform law and its effects on unemployment and small business. At the same time, Republicans continue to debate how best to leverage growing discontent
over the bill and its implications in the months leading up to the November elections. In the meantime, it’s within federal agencies such as HHS that much of the detail, timing and
how-to questions will be worked out going forward.
On March 23, thirteen states (Alabama, Colorado, Florida, Idaho, Louisiana, Michigan, Nebraska, Pennsylvania, South Carolina, South Dakota, Texas, Utah, and Washington) filed one lawsuit in the U.S. Court system for the Northern District of Florida challenging the Patient Protection and Affordable Care Act. This came minutes after President Barack Obama signed the comprehensive health insurance reform legislation into law. The attorneys general’s argument is centered on two elements:
1) the Act’s individual health insurance mandate is an unconstitutional expansion of Congress’ ability to regulate interstate commerce;
2) the penalties for being non compliant within the individual health insurance mandate violates the taxation powers provided to Congress under the Constitution.
In addition, U.S. states are challenging provisions of the new law that will create dramatic Medicaid spending increases for the financial burden of the states.
Governor Jan Brewer also announced her support for a legal challenge to the federal reform law in an initiative to amend the constitution to prohibit mandatory coverage requirements. The attorney general will not contest the federal law. He also suggested to Brewer that she use any additional funds to reinstate the Arizona health insurance KidsCare program, which was cut due to the budget deficit and eliminated coverage for over 35,000 children.
Senator Tom George and Representative Marc Corriveau have introduced four bills that would completely change the individual Michigan health insurance market. The bills amend Blue Cross Blue Shield from being the insurer of last resort. Therefore, it would require all plans to be guarantee issue and will include a reinsurance pool to reimburse carriers for eligible claims.
Health and Human Services granted $100 million in federal funds to Maine, Oregon, Pennsylvania, North Carolina, Florida, Massachusetts, Colorado, Utah, South Carolina, and Maryland. This will be completed over a five year period and will improve health care quality for children enrolled in CHIP. The Children’s Health Insurance Program Reauthorization Act of 2009, (CHIPRA) allowed this grant to occur.
Lawmakers have passed a bill in the House that requires Colorado health insurance carriers to include prenatal care and birth control coverage. All individual health insurance plans offered to women must provide these benefits. These new laws will lead to healthy pregnancies.
The Colorado health insurance bill is to provide a minimum of one policy that covers maternity care. It will make it mandatory that Colorado health insurance policies cover maternity coverage and contraception.
The bills is recommended by Beth McCann of Denver. This proposed bill will not include abortion coverage.
Colorado health insurance : The Colorado Division of Insurance issued its long anticipated report regarding the effects of the state’s balance billing law, which is subject to automatic repeal on July 1, 2010, absent legislative intervention. The statute prohibits consumers from being balance billed while requiring insurers to reimburse out-of-network physicians their billed rates as the “allowed charge.” Commissioner Morrison is recommending against allowing the law to sunset, citing reduced complaints and the fact that many carriers have found ways to negotiate billed charges to a reasonable amount
Colorado health insurance : Although bills are still being introduced, three legislative issues have already been abandoned for this year: the Colorado Medical Society’s practice of medicine definition that includes “medical necessity” decisions, a diabetes mandate, and provider fee transparency. One bill of particular interest that has emerged would impose a one-year moratorium on new benefits mandates, to allow the Colorado health insurance market to stabilize and to provide time to consider implementation issues should federal health care reform be enacted. The bill would also prohibit the applicable legislative committee from voting on a mandate until it receives an analysis from the mandated Colorado health insurance benefits commission.
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