Posts Tagged ‘health care reform’

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Arizona Health Insurance Legislative Update

Friday, May 21st, 2010

The Arizona Legislature convened its regular session in January. With the state facing a deficit of more than $4 billion in fiscal years 2010 and 2011, the budget overshadowed all other issues again this year. Lawmakers faced difficult decisions, including the elimination of critical state programs, in their effort to balance the budget. State agencies have been cut drastically.
Among the most severe budget cuts were the elimination of KidsCare and the reduction of over 300,000 AHCCCS enrollees. Although lawmakers initially approved these budget reductions, they are likely to restore these cuts as a result of the new federal health care reform law. Because the law prohibits states from changing eligibility for CHIP and Medicaid, Arizona risks losing billions of dollars in federal matching funds if KidsCare and AHCCCS enrollment reductions are not reinstated.

In an effort to increase revenues and lessen additional cuts to key programs, legislators referred a temporary one-cent sales tax to the ballot. If approved, the measure will generate approximately $1 billion that will fund education, health care and public safety. A special election on the temporary tax is scheduled for May 18.

On another topic, the Legislature passed a bill giving the Governor authority to sue the federal government over the recently passed health care reform law. Stating that the federal government is overstepping its constitutional authority by mandating that individuals have insurance, Arizona is joining a suit with 18 other states against the implementation of the law.

While the budget dominated the session, below is a description of some other bills of interest.

Health Insurance-related Bills

  • HB 2296 (law enforcement officer; spouse; insurance payment) – Allows the surviving spouse of a law enforcement officer killed in the line of duty to receive payments for health insurance premiums from the officer’s former employer for one year after the officer’s death. Status: Passed House, awaiting final vote in the Senate.
  • HB 2308 (insurance information; transfer of business) – Adds “transfer of business” to the definition of insurance transaction in the statutes governing insurance information and privacy protection. Status: Signed by Governor.
  • HB 2579 (insurance; continuing education; continuation) – Continues education requirements for insurance agents indefinitely. Status: Signed by Governor.

Health Care-related Bills

  • SB 1189 (admissibility of expert opinion testimony) – Changes the standard used in civil and criminal trials relating to admissibility of expert testimony from the Frye standard to the Daubert standard. Establishes criteria for expert testimony to be admissible in court. Legal experts expect this change will be particularly helpful in defending medical malpractice suits. Status: Passed Senate and House; awaiting Senate action on House amendments.

Other Legislation

  • SB 1070 (safe neighborhoods; immigration; law enforcement) – Makes changes to laws relating to the enforcement of immigration laws, failure to carry an alien registration document, day laborers and harboring or transporting illegal aliens. Amends the employer sanctions provisions of law in the following ways:
  • Provides employers with the affirmative defense for entrapment;
  • Requires employers to keep a record of the employment verification from E-verify for the duration of an employee’s employment, or three years, whichever is longer. Status: Awaiting action by the Governor.
  • HB 2250 (Arizona’s job recovery act) – Provides income and property tax reductions and incentives. Creates a new supplemental Arizona Job Training Program, the Arizona Opportunity Fund and the Arizona Quality Jobs Program. Restructures Enterprise Zones into a statewide Arizona Enterprise Development Program. Status: Passed the House; awaiting debate in the Senate.

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Posted in AHCCS, arizona health care cost containment system, arizona health insurance, CHIP, health care reform, health insurance, kids care | No Comments »

CBO Adds Billions of Dollars for Discretionary Spending Cost Estimate

Thursday, May 20th, 2010

On May 11, the Congressional Budget Office (CBO) released a report with additional information about the potential effects of the new health insurance reform law, the Patient Protection and Affordable Care Act (PPACA), on discretionary spending that the CBO initially provided on March 13, prior to the legislation being passed.

The updated analysis adds a minimum of $115 billion over 10 years – more than twice the initial estimate released before President Barack Obama signed the bill into law. This new estimate brings the cost of the new law to well over $1 trillion.

CBO Director Douglas Elmendorf stated that while the CBO does not have a comprehensive estimate of all the potential discretionary costs, they provided information on the major components broken down into three general categories:

  • Costs incurred by federal agencies to implement the new policies
  • Explicit authorizations for grant and program spending for one or more years
  • Explicit authorizations for grant and program spending for which no specific funding levels are specified

Minority Leader John Boehner (R-OH) immediately released a statement admonishing the Administration, saying that the new estimate “provides ample cause for alarm,” and nearly wipes out “the purported deficit reduction in the law.”

A Senate Finance Committee Democratic aide said, “The bulk of discretionary spending referenced in the report is for programs – like the Indian Health Service, the National Health Service Corps and Federally Qualified Health Centers – that were not created under health care reform and would have been funded through the appropriations process, like they have for decades, with or without health care reform.”

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Posted in health care overhaul, health care reform, health insurance reform | No Comments »

Health Insurance Reform State High Risk Pools

Friday, May 7th, 2010

In the new health insurance reform law the states are permitted to create their own high risk pools, expand existing pools, or allow the federal government to create and administer the pools for them.

The following states will operate their own pools:
Alaska, Arkansas, California, Colorado, Connecticut, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, Montana, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Vermont, Washington, West Virginia, Wisconsin, and District of Columbia.

The following states will allow the federal government to create and manage the pools:
Alabama, Delaware, Georgia, Hawaii, Idaho, Indiana, Louisiana, Minnesota, Mississippi, Nebraska, Nevada, North Dakota, South Carolina, Tennessee, Texas, Virginia, and Wyoming.

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Posted in alabama health insurance, arizona health insurance, arkansas health insurance, california health insurance, colorado health insurance, connecticut health insurance, delaware health insurance, florida health insurance, georgia health insurance, health care overhaul, health care reform, health insurance reform, high risk pool, illinois health insurance, indiana health insurance, iowa health insurance, kansas health insurance, kentucky health insurance, louisiana health insurance, maryland health insurance, michigan health insurance, mississippi health insurance, missouri health insurance, nebraska health insurance, nevada health insurance, new mexico health insurance, north carolina health insurance, ohio health insurance, oklahoma health insurance, pennsylvania health insurance, south carolina health insurance, tennessee health insurance, texas health insurance, virginia health insurance, wisconsin health insurance | No Comments »

Nevada Health Insurance No High Risk Pool

Tuesday, May 4th, 2010

In Nevada health insurance, an April 29 letter to HHS Secretary Kathleen Sebelius, Governor Jim Gibbons estimated that the $61 million his state would receive to implement a high-risk pool under the federal health care reform law would be grossly inadequate; serving roughly 2,900 of the 100,000 people who may be eligible. In opting out, the governor stated that he does not believe there are sufficient financial or human resources available to operate the pool.

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Posted in health care reform, nevada health insurance | No Comments »

Nebraska Health Insurance No High Risk Pool

Tuesday, May 4th, 2010

In Nebraska health insurance, an April 27 letter, Governor Dave Heineman informed Secretary of Health and Human Services Kathleen Sebelius that Nebraska has elected not to participate in the temporary federal high-risk pool created under the Patient Protection and Affordable Care Act of 2009. In his letter, Governor Heineman cited Department of Insurance Director Ann Frohman who said that “the proposed level of federal support and premiums will be inadequate to meet all expected obligations of this program. Even with enrollment caps, we are very concerned that funding will not be sufficient to assure a solvent runoff of all claims when the program expires in three years.”  While he acknowledged that the federal government would proceed with a new high-risk pool in Nebraska health insurance regardless of the state’s decision, Governor Heineman noted that the existing state high-risk pool and the proposed federal pool are sufficiently different to require running separately. He questioned the value of adding a new layer of bureaucracy at the state level to administer this program. Secretary Sebelius gave Governors an April 30 deadline for indicating whether they intend to operate the pool or allow HHS to do so.

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Posted in health care reform, nebraska health insurance | No Comments »

Aetna Health Insurance Extends Dependent Coverage

Wednesday, April 28th, 2010

We know many families are worried about their dependents losing health insurance coverage when they graduate from high school or college or otherwise age out of coverage. Health care reform will address this issue nationwide later this year, when new regulations will go into effect. However, some plan sponsors may want to make changes earlier, to help these dependents remain insured without a gap in coverage.

In keeping with the spirit of health care reform, Aetna health insurance and Easy To Insure ME will work with clients to extend coverage to their medical plans’ current dependents ahead of schedule. This means current dependents under the age of 26 would not have to leave their plans when they would otherwise age out or are no longer full-time students (including those who would have lost eligibility effective May 31, 2010). Note that this would not include reinstatement of dependents who previously aged out of their plan. It also does not affect dental, vision, standalone pharmacy or other benefits.

For individual and small group medical plans (as defined in state law), Aetna health insurance will continue coverage effective June 1, 2010 for dependents under age 26 currently covered on a parent’s medical plan. Aetna health insurance will not change the plan’s premium until renewal.

For fully insured larger groups, and for all self-funded medical plans, Aetna health insurance will offer the option of expanding medical coverage for dependents under the age of 26 currently covered on a parent’s medical plan, effective on or after June 1, 2010. This would include dependents who would have aged out on May 31, 2010. Aetna will provide pricing for this plan design change, as appropriate, for plans that choose this option.

Regardless of whether a plan makes this change ahead of schedule, health care reform is bringing changes to all plans soon. On the next renewal date on or after September 23, 2010, all health insurance plans must cover all dependents up to age 26 (and older for insured plans in states that mandate coverage above age 26). This may include dependents who are not currently enrolled in the plan, in accordance with regulations. We will be able to tell you more when the federal government issues regulations telling insurers and employers how this must be administered.

Aetna is pleased to offer our plan members the ability to keep their dependents insured. This is one step toward the goal of health care coverage for all Americans.

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Posted in aetna health insurance, children, health care reform, student health insurance | No Comments »

Blue Cross Blue Shield Texas Health Insurance Dependents

Wednesday, April 21st, 2010

Blue Cross Blue Shield Texas health insurance (BCBSTX) will be accelerating its implementation of the “Dependent Age 26″ reform provision for premium business. You may have heard that concerns about this spring’s college graduates spurred the government to ask some insurers to comply before the Sept. 23, 2010, effective date (i.e., for plan years beginning on or after six months post-enactment of the federal law). Days after passage, BCBSTX decided to implement and was in the process of determining the needed system changes. We expect to have this new benefit in place by the end of April.

Young adults will be able to continue to stay on their parents’ health plans (premium group or individual) up until age 26, regardless of their student, marital or employment status. It is important to note that any dependents who have dropped off their parents’ coverage earlier will not be eligible to come back onto those policies until their open-enrollment period.

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Posted in blue cross blue shield texas, children, health care reform, student health insurance, texas health insurance | No Comments »

Health Insurance Reform Update April

Wednesday, April 21st, 2010

The Senate reconvened on April 12, following its two-week recess.  That day, by a vote of 60 to 34, the Senate approved a cloture motion paving the way for Senate floor action on H.R. 4851, the “Continuing Extension Act.”  This bill, which the House approved on March 17, includes a temporary extension – through April 30 – of the Medicare physician payment fix and the eligibility period for premium assistance for COBRA and state continuation coverage.

The Senate passed the legislation by a vote of 59-38, on April 15. Three Republicans supported the bill, Sen. George Voinovich (OH) and Maine Senators Olympia Snowe and Susan Collins and three Democrats did not vote – Evan Bayh (Indiana health insurance), Bill Nelson (Florida health insurance) and Mark Warner (Virginia health insurance).  An amendment to the legislation offered by Senator Max Baucus (D – MT), which was passed by a voice vote, would extend most of the benefits for another month – until the end of May – so as to avoid a repeat battle over this legislation two weeks from now.  President Obama signed the bill into law Thursday night, April 15th.

Under previous law, these legislative provisions expired on March 31, so this bill offers the retroactive benefits to those people laid off between April 1, and when the bill becomes law. It would guarantee that people who enroll for the subsidy by the end of April will get the entire 15 months of federally subsidized health premiums.

It should be noted that Congressional leaders are also focused on passing a longer-term benefit extensions bill, H.R. 4213.  The longer-term options being considered include a Senate bill that would extend the subsidy through the end of the year. A House bill also offers a longer extension, but the two bills would have to be reconciled, prior to becoming law.

Consideration of the annual budget resolution will be another high priority during the next several weeks, beginning with markups in the Senate and House Budget Committees.  One of the key issues the committees will consider is whether to adopt language allowing the budget reconciliation process to be used to advance any major legislative priorities later this year.

The next stretch of the 2010 legislative session will run for seven weeks before Congress recesses again around Memorial Day.

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Posted in cobra, florida health insurance, health care reform, health insurance reform, indiana health insurance, virginia health insurance | No Comments »

Truth of Health Insurance Reform by the New York Times

Monday, April 19th, 2010

In Sunday’s edition of the NY Times, buried in the Regional section, comes an analysis of the current health insurance reforms in the state of New York that were implemented over fifteen years ago.  Similar to Obama Care, the state of New York required all health insurance carriers to issue guaranteed acceptance policies to people with pre existing conditions as a means of making the health industry fair and imposes community pricing rather than risk based insurance premiums.  So how did this work for New Yorkers?  About the same way Obama Care critics predict.

According to the New York Times Sunday Edition
“New York’s insurance system has been a working laboratory for the core provision of the new federal health care law — insurance even for those who are already sick and facing huge medical bills — and an expensive lesson in unplanned consequences. Premiums for individual and small group policies have risen so high that state officials and patients’ advocates say that New York’s extensive insurance safety net for people like Ms. Welles is falling apart.

The problem stems in part from the state’s high medical costs and in part from its stringent requirements for insurance companies in the individual and small group market. In 1993, motivated by stories of suffering AIDS patients, the state became one of the first to require insurers to extend individual or small group coverage to anyone with pre-existing illnesses.
New York also became one of the few states that require insurers within each region of the state to charge the same rates for the same benefits, regardless of whether people are old or young, male or female, smokers or nonsmokers, high risk or low risk.

Healthy people, in effect, began to subsidize people who needed more health care. The healthier customers soon discovered that the high premiums were not worth it and dropped out of the plans. The pool of insured people shrank to the point where many of them had high health care needs. Without healthier people to spread the risk, their premiums skyrocketed, a phenomenon known in the trade as the “adverse selection death spiral.”

That death spiral has nearly wiped out the individual health insurance market in the state.  New York has the highest annual premiums for individual policies in the country, at over $6600 for an individual and double for families.

Obama Care supporters argue that the federal individual health insurance mandate will solve this problem. However, the mandate in Massachusetts hasn’t kept costs in line. The New York Times is also skeptical.

“The new federal health care law tries to avoid the death spiral by requiring everyone to have insurance and penalizing those who do not, as well as offering subsidies to low-income customers. But analysts say that provision could prove meaningless if the government does not vigorously enforce the penalties, as insurance companies fear, or if too many people decide it is cheaper to pay the penalty and opt out.

Under the federal law, those who refuse coverage will have to pay an annual penalty of $695 per person, up to $2,085 per family, or 2.5 percent of their household income, whichever is greater. The penalty will be phased in from 2014 to 2016.”

The math is very simple. If an individual has to pay $6600 per year for a policy they feel they don’t really need or pay $2500 on a salary of $100,000, which one will healthy young earners take? Of course this is based on the assumption that the government will actually enforce the mandate, which Democrats insisted the Obama Care bill couldn’t do.

Arguments to this will be that most young  people earn much less and will get federal subsidies, but that still depends on them deciding whether to pay anything for a policy that clearly doesn’t suit them.  The argument has neglected the fact that the actual costs will absolutely skyrocket and that taxpayers will be on the hook for the subsidies, which will have to increase to match the premium hikes to remain effective.  Instead of having premiums based on a rational risk assessment, we have the young and healthy subsidizing premiums for the older and the much less healthy in comparison, who then subsidize the younger and healthier through federal handouts. A crazy way to run health care in the U.S.

The individual health insurance mandate is nothing more than a way to get young people to create a proxy welfare state by forcing them into a extorting health insurance model.  It does nothing to reduce actual costs at all, and in fact makes cost increases both more frequently and more rapidly.

Easy To Insure ME .com would also like to note that this story was buried in the regional section and not the front page.  This reflects on the arrogance of the whole Obama administration and their gag orders on speaking out about health insurance reform.

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Posted in health care overhaul, health care reform, health insurance reform, individual health insurance, individual health insurance mandate, obama care, pre existing condition | No Comments »

This Week In Health Care Reform

Friday, April 16th, 2010

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.

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Posted in alabama health insurance, arizona health insurance, cobra, colorado health insurance, florida health insurance, georgia health insurance, health care overhaul, health care reform, indiana health insurance, individual health insurance mandate, louisiana health insurance, michigan health insurance, mississippi health insurance, nebraska health insurance, nevada health insurance, obama care, pennsylvania health insurance, south carolina health insurance, texas health insurance, unemployment | No Comments »

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