On March 23, Republican Congressman Joe Pitts, Chairman of the Health Subcommittee of the House Energy and Commerce Committee, held a public hearing in Harrisburg to mark the one-year anniversary of PPACA. In testimony before the Committee, Governor Tom Corbett, who as Attorney General joined Pennsylvania in the multi-state suit against the law, reiterated his belief that the law’s Pennsylvania health insurance individual mandate is unconstitutional. He further noted he has joined 27 other governors in petitioning the Obama Administration to call for expedited Supreme Court review of suits challenging the law. Acting Insurance Commissioner Michael Consedine and Acting Department of Public Welfare Secretary Gary Alexander discussed the regulatory and financial burdens imposed by the law. Specifically, Commissioner Consedine claimed the law’s initial reforms have already resulted in premium increases of up to 9 percent. Secretary Alexander said the law’s scheduled expansion of Medicaid will result in 891,000 additional state enrollees by 2019.
Posts Tagged ‘individual health insurance mandate’
When the nation’s governors came calling at the White House last week, President Obama greeted his guests with the offer of new flexibility toward implementation of the Patient Protection and Affordable Care Act (PPACA). The President said he is willing to give states an earlier opportunity to opt out of certain key requirements of the law, but only if the states can find their own way to cover as many people without added costs. If Congress agrees to the new approach, states could gain exemptions by 2014 rather than 2017. But a number of governors expressed skepticism that the proposal offers them any real benefits, given the difficulty states would have meeting the President’s caveats. Some prefer to continue to pursue outright repeal. Still, the change in timing means exemptions could be earned in the same year that some of the most controversial provisions of the law go into effect. And, with the governors’ immediate focus on rising Medicaid costs, the proposal reportedly would let states send HHS officials a combined request to alter Medicaid and their approach to health care reform.
Federal
Last week a Florida federal judge clarified (at the request of the Obama Administration) his earlier decision back in January 2011 in which he ruled that the PPACA’s individual health insurance mandate is unconstitutional. He also wrote that the
mandate could not be severed from the rest of PPACA and, therefore, the whole law had to be set aside as unconstitutional. In last week’s rather colorful ruling, the judge
chided the government for sitting on its hands for weeks before asking for the clarification. He re-emphasized that the mandate and the whole law are unconstitutional and chastised
the government both for failing to appreciate, as a matter of law, that the prior Declaratory Judgment was the “functional equivalent” of an injunction (meaning that the government
could not proceed with implementation) and for having the temerity to suggest otherwise. The judge did not stop there, which would have halted all implementation of the PPACA had he
done so. He instead decided that the government’s motion to clarify was also a motion to “stay” the imposition of the original ruling, and he granted the stay. But he
conditioned it with the requirement that the government file an appeal within seven days seeking an expedited “fast-track” appellate review, either in the Court of Appeals (11th
Circuit) or the U.S. Supreme Court. This filing requirement is the major takeaway from last week’s ruling because it accelerates the timeline for the litigation, to the applause of
the state and others who oppose the law. The Administration and the proponents of the law are less happy, since stringing out the ultimate decision would make it more difficult, if
not impossible, to dismantle.
With House approval (314 to 112) last week, Congress is well on the way to repealing the 1099 provision of the PPACA, which imposes a costly and burdensome reporting requirement on employers. Earlier this year, the Senate also voted to repeal the 1099 provision; however, the two chambers are worlds apart with respect to paying for the repeal. While the House version pays for the repeal by revising the rules for repayment of excess premium subsidies down the road, the Senate version doesn’t directly pay for it and only gives OMB the authority to go find the money. A House-Senate Conference (or an unofficial compromise) will be needed to resolve this impasse.
The anticipated government shut-down on March 4 was put off last week when both chambers passed (and the President signed) a two-week extension of a continuing resolution to keep the
government officially funded until March 18. This particular resolution actually cuts federal spending for the current fiscal year by $4 billion, which means that the House
Republican savings target of $60 billion for FY 2011 is now down to $56 billion. Congress could very well bump along with such short-term resolutions throughout the spring. But at
some point, the Republicans in the House and the Democrats in the Senate will have to permanently fund FY 2011 and get on with the FY 2012 budget, which is supposed to be in the works
right now.
Multiple health-care-related hearings were held on Capitol Hill last week. In testimony before the House Energy and Commerce Committee, Mississippi Gov. Haley Barbour voiced support
for funding Medicaid with block grants, under which the federal government would give states a set dollar amount for Medicaid rather than paying a percentage of costs. Under this
system, states would have “total flexibility” to manage their Medicaid programs, according to Barbour. The panel’s Democrats were quick to dismiss the idea of block grants,
saying the change would harm vulnerable beneficiaries. Karen Ignagni, the President and CEO of America’s Health
Insurance Plans, testified before the House Ways and Means Committee Subcommittee on Oversight Health Plan
Programs to Combat Fraud, Waste, and Abuse. Her testimony addressed two issues: how health plans’ fraud detection units are using cutting-edge techniques to identify practices leading
to substandard care – including overuse, underuse, or misuse of medical treatment; and suggestions for improving fraud detection and prevention in both public and private
programs. Part of her testimony also focused on the medical loss ratio (MLR) regulation, which she said will hurt the insurance industry’s efforts to detect and prevent fraud.
The Government Accounting Office (GAO) last week released a study that shows “nearly 10 percent all Medicare payments are fraudulent or otherwise improper, and the government isn’t doing enough to stop them.” The Medicare “fraud margin” is 9 percent, nearly triple the profit margin for the health plan industry (3.58 percent). The GAO also provided correspondence to the Hill on Medicare Private Sector Initiatives to Bundle Hospital and Physician Payments for an Episode of Care. As one of the five largest national payers, Aetna insuranceae was interviewed and provided relevant materials. The GAO found that ongoing private sector bundling initiatives that achieve savings are an important consideration, in light of Medicare’s financial challenges. Bundled payments are feasible for Medicare, but there are several obstacles to overcome — such as manual claim processing systems, resistance to limiting provider choice and the lack of standard definitiions.
States
With the California health insurance deadline for the introduction of legislation during the 2011 session looming, and now passed. several health care-related measures were reintroduced, such as a single payer/universal care bill, prior approval and rate regulation, and mandatory autism coverage. In addition, a host of bills are in play that take another step toward implementing federal reform but appear to be inconsistent with PPACA. As in past years, legislators have proposed a host of new mandated benefits – 15 in total. They include several new ones, including the proposed elimination of step therapy for pain medications, fertility preservation services and forensic medical evaluations. The state’s mandate commission is reviewing the cost and public benefit of each of these proposed mandates and will issue a report that should be publicly available by the end of March.
Democratic Senator Irene Aguilar, the sponsor of a Colorado health insurance single-payer bill, engaged in a verbal confrontation last week with a representative of the Colorado Association of Industry and Commerce regarding the potential impact of her bill on employment in the state. Subsequent to a rally on the steps of the Capitol, the bill was voted out of committee, 4 to 3, along party lines. The bill has little hope in the Republican-controlled House and may not reach the Senate floor without some Republican support.
As in the past two years, the Connecticut Health Insurance Committee approved Speaker Chris Donovan’s bill called An Act Establishing the Connecticut Healthcare Partnership. This bill would open the expensive state employee health plan to small businesses, nonprofits and other groups. The goal is to attract a number of new employee groups to the state employee plan – nearly all of whom already have health insurance. In addition, the new state-run health plan would compete directly against the private marketplace. Given the high benefit levels, state employee plans are among the most expensive in the state. As such, this bill would not offer small businesses any real cost relief, achieve intended cost savings or increase the number of people with insurance. It could lead to substantial cost increases for taxpayers. The 11-9 committee vote was mostly along party lines, with most Democrats supporting the measure (except Sen. Joan Hartley and Rep. Linda Schofield), and all Republicans opposing it. This bill passed in 2008 and again in 2009, but was vetoed both times by former Governor M. Jodi Rell.
The Governor and Commissioner of Georgia Health Insurance are considering issuing an executive order that would create an Exchange Review Board. The Board would then consider and possibly develop legislation to implement a state insurance exchange in 2012. A bill is expected to be filed creating this advisory committee and is supported by the Governor’s office. The Governor may then follow with an executive order. Also, Aetna insurance expects an MLR waiver request to be filed by the DOI sometime this month.
The Department of Louisiana Health Insurance has indicated it will file an MLR waiver request this week despite indications from the Governor’s office that he does not approve of the request.
The Senate Appropriations Subcommittee on Oklahoma Health Insurance and Human Services passed a bill last week that would create a website to permit Oklahomans to see approximate pricing information for medical procedures and pharmaceutical products. The bill requires the Insurance Department, in collaboration with the State Department of Health, to establish and maintain an online health care information system that permits consumers to see pricing information from different types of providers and pharmaceuticals. The bill states that the purpose of the website is to serve as a resource for insurers, employers, providers, purchasers of health care and state agencies to continuously review health care utilization, expenditures and performance. It would also enhance the ability of consumers and employers to make informed, cost-effective health care choices. The bill would require that the presentation of data in the system allow for comparisons in the context of geography, demographics, general economic factors and institutional size.
Also of interest is a bill passed by the Senate Rules Committee last week that would allow Oklahoma to opt out of federal health care reform requirements. The bill asserts state control in the regulation of health care, would create a compact between certain states and would set forth formulas for figuring the right to federal funds for each member state. The bill also would create the Interstate Advisory Health Care Commission and establish membership requirements and duties of the commission. Primarily the commission would assist the legislatures of member states in the regulation of health care. It states the formation of this compact is contingent upon approval from the U.S. Congress. Democrats in Oklahoma’s Senate opposed the bill, some saying that it would force Oklahoma to rely on other states for regulating Oklahomans. Both bills will continue through the legislative process, which is scheduled to end in late May.
Rep. John Zerwas’ bill authorizing the creation of a state Texas health insurance exchange encountered mostly smooth sailing last week when it was heard by the House Insurance Committee. Going by the name of the Connector in the bill, the primary purpose of the exchange is to prepare Texas for changes in health insurance markets set to roll out in three years as part of federal health system reform. One important change in the new bill language presented at the hearing was the absence of an individual mandate to buy an insurance product. Groups expressing support for the bill included the Texas Association of Business and the Texas Hospital Association, among others. The bill was left pending by the Committee and will likely see more changes before it is brought to a vote. The Texas legislature continues in its regular session until June 1, 2011.
If you’re keeping score, three federal judges have now ruled in favor of the constitutionality of the Patient Protection and Affordable Care Act (PPACA) while two have ruled against it. The latest to weigh in was a federal judge in the District of Columbia who last week upheld the constitutionality of the health reform law. The decision reinforces the divided opinion the lower courts have toward the law, which is expected to wind up before the U.S. Supreme Court for a final decision sometime in the next year or two. Predicting an outcome, many analysts agree, will not be easy.
Federal
Group customers offering Medicare Advantage and prescription drug coverage got some good news from the Centers for Medicare & Medicaid Services last week. Last November, CMS
announced that group customers would no longer be allowed to offer a Medicare Advantage-only plan alongside a stand-alone prescription drug plan and that as of January 2012 the
customer would have to offer an integrated Medicare Advantage-Prescription Drug Plan (MA-PDP). This set off a scramble to get ready for 2012, which would have been a very difficult,
if not impossible, timeframe. Aetna health insurance began working with employers and trade
groups to reverse or delay the CMS rule. Last week, CMS issued a favorable ruling to suspend indefinitely its November 2010 decision and not require an MA-PDP as the employer’s only
option.
There were two important court developments last week related to health care reform and the constitutionality of the PPACA’s individual health insurance mandate, with more to come in the next week or two. First, a federal judge in Florida two weeks ago invalidated the mandate, striking down the whole statute with a declaratory judgment but stopping short of issuing an injunction directing the conduct of the parties. At the same time he said the declaratory judgment was the “functional equivalent” of an injunction. The plaintiffs (many of the states) have publicly stated that the law no longer applies to them while the defendant (the federal government) has stated that nothing changes until appellate review is complete. Last week, the Florida judge ordered legal briefs on this issue and is expected to rule shortly on the impact of his prior ruling on the parties involved. Second, early last week, as expected, the U.S. District Court for the District of Columbia upheld the constitutionality of the PPACA’s individual mandate, making it the third court to so rule. But the score is 3-2, and this is a best of seven series that won’t be settled before at least one Circuit Court decision and an essential Supreme Court opinion are rendered. Both could be well down the jurisprudential road.
States
A California health insurance bill that would bring state tax law into
conformity with new federal tax rules governing the health coverage of adult children passed the
Assembly Revenue and Taxation Committee by a unanimous vote last week. This conformity is important to employers, plans, and families because it exempts employee contributions toward
covering certain adult children from state personal income taxes. It would also reduce a potential administrative burden for employers. Aetna insurance worked with its trade associations and joined a diverse group of interested parties, including labor, to help achieve a
bipartisan outcome. The bill is expected to be fast-tracked and may be heard in Assembly Appropriations in the coming weeks.
In Colorado health insurance the newly released 2010 Annual Health Insurance Report of the Commissioner of Insurance contains a wealth of information — much of it collected from the insurance industry for 2009 — about the cost of health insurance and the factors that drive individual and group premiums in the state. The report notes that an estimated 15.7 percent of Coloradans had no health insurance in 2010, which is a slight improvement over 2009. More than 61 percent of Coloradans were covered by either commercial health insurance or a self-insured employer plan, compared to 54 percent in other states nationwide. Roughly 84 percent of premiums collected in 2009 by carriers went directly to the cost of providing health care services; 13.87 percent of premiums was used for administrative expenses and producer commissions. Not all coverage is regulated by the state — just over 40 percent of Coloradans had coverage regulated by the division of Insurance.
The Colorado Trust, a private grant making foundation, has issued a brief called The Economic Impact of Health Reform in Colorado that projects, as a result of national health care reform, insurance premiums will be nearly $2,000 less per year for individuals and nearly $4,000 less for family coverage by 2019. The projections are in part due to slower health care cost growth. Indeed, costs are expected to grow 5.5 percent to 17 percent less in Colorado by 2019 than without reform. Even after accounting for the costs of financing health care reform, this research projects that the state’s economic output will be nearly 1 percent more in 2019 than without reform, and 19,000 new jobs would be added as a result of coverage expansion.
The Connecticut Health Insurance Exchange Planning Committee held its first meeting under the new Administration of Governor Malloy last week. Jeannette DeJesus, Department of Public Health Deputy Commissioner and the Governor’s Special Advisor on Health Care Reform led the meeting and stated that Senator Crisco’s insurance exchange legislation is the Administration’s proposal, based largely on the NAIC model act. Speaker Chris Donovan also has introduced an exchange bill in the House. Both proposals call for the establishment of a quasi public governing structure but differ on some timelines and board representation. DeJesus said the Administration would work with the House and solicit input form residents and stakeholders around the state to resolve the differences. Passage of a consensus bill is critical to the state’s ability to access Level II federal funding by June 30th. If legislation is not passed, DeJesus said that Connecticut will fall behind in its planning process. The state recently was awarded a $35.6 million federal grant aimed at helping New England states develop a state-of-the-art, online gateway to health insurance options. While Connecticut and other New England states are directly participating, the project is centered at the University of Massachusetts Medical Center in Worcester and the Massachusetts Executive Office of Health and Human Services, supported by the non-profit New England States Consortium Systems Organization. The first meeting of that group will be in March.
Illinois health insurance advocate Governor Pat Quinn signed into law an Aetna-sponsored piece of legislation relating to insurer payments to certain non-participating providers. The bill applies to individual or group accident and health insurance carriers. Effective on June 1, 2011, when an enrollee utilizes a network hospital or ambulatory surgery center and an in-network provider is unavailable for radiology, anesthesiology, pathology, neonatology or emergency department services, the carrier is to ensure that the enrollee shall not incur greater out-of-pocket costs than for participating providers. The enrollee cannot be balance billed by the provider past the insurers’ in-network rate for these non-participating provider services. In addition, the insurer may pay the billed amount or attempt to negotiate the reimbursement with the out-of-network provider. In the event that the insurer and physician cannot agree on a reimbursement amount, either party can initiate binding arbitration within 30 days of receipt of an explanation of medical benefit. The bill is a major victory for consumers.
Kansas health insurance as a result of budget shortfalls, greater political attention is being paid to the significant cost of state Medicaid programs, and Gov. Sam Brownback has said he wants to get rid of the fee-for-service model. The governor has made redesigning Medicaid a priority in his proposed budget, Dispensing with the fee-for-service model would mean using marketplace tools, such as pharmacy benefit managers, to negotiate lower dispensing rates at pharmacies and communicate with physicians about generics. The Kansas Medicaid program could save $62 million in the next decade by using pharmacy benefit managers and other market-based tools, according to a recent study by The Lewin Group. Missouri could save $282 million. Bryan O’Neal, the assistant director of pharmacy at The Kansas Hospital, recently testified that the real opportunity for savings is getting clinical data and cost of medications in front of doctors at the time of prescribing. He recommended using electronic prescription systems, which allow doctors to see patients’ current medications and drug allergies as well as cost and clinical data. More than 500 pharmacies and 2,400 clinicians in Kansas use e-prescribing systems. But some have said legislation working its way through the Kansas and Missouri Senates could undermine the states’ e-prescribing systems by limiting information and discouraging physicians from using them. The bills would establish a separate set of standards for Medicaid and prohibit the use of “intervening parties” or pharmacy benefit managers. The Kansas bill came under fire during a Feb. 10 committee hearing. The lone proponent of the bill at the hearing was a pharmacy representative.
Michigan health insurance In his first budget, Governor Rick Snyder has proposed that the state’s current HMO-use tax on Medicaid plans be replaced by a 1 percent assessment on paid health claims to raise approximately $400 million. The paid claims would be an obligation on insured and self-insured entities. Details regarding this budget proposal, including operational issues and effective date, are unclear at this time. But the Michigan budget is predicated on the implementation of this provision. If it fails, then the remaining options will be reductions in Medicaid, largely in provider rates and health plan premiums.
A Missouri health insurance bill that would create a health insurance exchange has been introduced by Representative Chris Molendorp, a Republican and chair of the House Insurance Committee. Despite input from a wide range of stakeholders, the complex bill is not likely to sail through the legislative process quickly or easily. It would 1) establish a health benefit exchange to facilitate the purchase and sale of qualified health plans and qualified dental plans in the individual market, and 2) provide for the establishment of a small business health options program to assist qualified small employers in facilitating the enrollment of their employees in qualified health and dental plans. The bill would still allow for sales of plans outside the exchange. The exchange would be funded by assessments or user fees charged to health carriers and health benefit plans. The bill would establish the exchange as a quasi-governmental agency within the Department of Insurance, Financial Institutions and Professional Registration (DIFP) and under the direction of a 13-member board of trustees. The governor would appoint five members of the board, including a member from a licensed health insurance carrier. The exchange would also require each health carrier seeking certification as a qualified health plan to submit a justification for any premium increase before implementing that increase. Premium rates and contract language would have to be approved by the director of DIFP. The bill would exempt individuals from the federal PPACA mandate if there is no affordable qualified health plan available through the exchange or the individual’s employer. We expect the bill will be heard in Committee this week, after which drafting and negotiations will continue.
Two North Carolina health insurance exchange bills were filed last week. The bill that will likely move closely mirrors the National Association of Insurance Commissioner model legislation and is expected to be passed as a placeholder for legislation to come in 2012.
The Tennessee health insurance Department of Commerce and Insurance announced its legislative package last week, and it included a rate review bill. The bill is broadly written and gives the Commissioner authority to deny any rebates when the solvency of the company is in question.
The Department of Texas Health Insurance announced last week that it is in the process of reviewing and preparing for implementation of the PPACA MLR and rate review rules. They have invited stakeholders to participate in an informal work session on March 2 to obtain input on these topics. Additionally, since insurance carriers are not required to file rates for small group coverage in Texas, Department staff members are seeking input regarding the best and most efficient method of obtaining premium rate information for the small group market.
An expected four million people in the U.S can be fined for failing to buy individual health insurance by the year 2016. This is when when the health care overhaul law will be in full force. According, to the CBO forecast on Thursday.
United States citizens must buy health insurance and abide by the individual health insurance mandate set forth in the landmark legislation passed by Congress last month. If citizens do not comply they will face fines. People without coverage can be fined up to two and a half percent of their personal income.
The Congressional Budegt Office also forecasted that the government will collect close to $4 billion annually from these penalties between the years 2017 and 2019.
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.
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.
Republicans in Georgia are continuing fight against health insurance reform passed by the Democratic Congress.
State Insurance Commissioner John Oxendine announced on Monday that the state will not participate in a $5 billion temporary high risk Georgia health insurance pool established under the new law.
Oxendine is concerned that the financial burden of this program will fall into the lap of tax paying residents. Georgia is also among the 19 states that have questioned the constitutionality of the new law and is currently in battle with the federal government through the U.S. court system. They have filed a lawsuit claiming the federal government doesn’t have the right to require individual, family, and businesses to buy health insurance.
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.
Days after the president Barack Obama signed his massive $2.5-trillion health insurance reform bill into law, we are just beginning to uncover the payoffs, exceptions and special interest deals that are hidden in the 2,700 pages of legislation.
The spirit thus far has been plagued with broken promises and corruption. The health insurance bill exempts top Congressional leaders from reform. This is completely counter to the promises of Democrats and Obama that the people would receive the same health insurance care as those in the U.S. government.
One of Obama’s main talking points is that his plan prevents health insurance carriers from denying coverage to people with pre-existing conditions. Now the new law does not protect children from this outcome of being denied.
This is only the beginning, the attack on our liberties continues. The “fixer” bill to the takeover of health care by the goverment bill (H.R. 3590) just passed through Congress the other day and has been sent to the President. This is turning out to be the most devastating year for freedom that the people have had in a long time. In any other year, this bill would have been shot down and alone would qualify as the worst bill of the year beacuse of all its faults.
It raises taxes when they’re already scheduled to increases this year. Takes over the student loan industry with a replacement of private employees with government bureaucrats. It increases the no health insurance fine from $750 to $2,000 per employee for employers who do not provide coverage to all of their employees. None of this will make our health care system more secure or affordable for anyone.
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