Insuring Resources Commentary
Details on the Republican's "Health care reform" bill. I put that in quotes because calling this reform is a slam on the english language.
The assessment from the Cngressional Budget Office conculdes that the proposal would barely dent the ranks of the uninsured.
The measure would cover 3 million additional people at a cost of $60billion through 2019, according to an analysis by the nonpartisan Congressional Budget Office. The Democrats' bill, by comparison, would cover far more -- 36million additional Americans -- at a much higher cost -- $1.055 trillion through 2019, the CBO has said, while adding nothing to the deficit.
The bill leaves out a number of the key features of the Democrats' 1,990-page legislation, such as new requirements for employers to insure their employees and for nearly all Americans to purchase insurance. It also doesn't block insurers from denying coverage to people with pre-existing health conditions, as Democrats would do.
Instead, Cong. Boehner, the bills author, said the Republicans would encourage creation of insurance pools for high-risk individuals and take other steps to ease their access to coverage. By the way, on average those pools charge premiums equal to 130% in the individual market. Gee thanks, Cong. Boehner that'll help!
Many of the most respected health care voices in the GOP have historically treated the idea of eliminating pre-existing condition exclusions as an obvious plank in any reform effort. Apparently there's a little dissension on this issue. Here aere three examples:
Rep. Paul Ryan (R-Wisc.), who is widely regarded as one of the sharpest health care policy wonks in Republican circles, told MSNBC back in May that consumers needed to have "access to affordable coverage, regardless of [their] pre-existing condition." Representative Dave Camp (R-Mich), meanwhile, has insisted that Republicans "must address" the issue of pre-existing conditions. Rep. Joe Barton (R-Tex.) has called for the creation of a "straightforward national plan that covers pre-existing conditions."
Instead, the Republican plan increases incentives for people to use health savings accounts, caps non-economic jury awards in medical malpractice cases at $250,000, provides various incentives to states with the aim of driving down premium costs and allows health insurance to be sold across state lines.
By enhancing HSAs the GOP is putting more health care costs on the backs of its citizens. Since the bill is still in hiding and not viewable by the public its hard to assess the details.
**** This material was compiled from several sources including CNN, the AP, the Huffington Post and others.****
Showing posts with label pre-x. Show all posts
Showing posts with label pre-x. Show all posts
Thursday, November 5, 2009
Friday, October 30, 2009
The House Health Care Reform Bill
We now have health care reform bill sfrom both the House and the Senate. They will be debated over the next few weeks and then come to a final vote in each House. Then a conference committee will negotiate a final bill to be voted on by each House of congress. Its projected that the final bill could be signed by President Obama in time for Christmas.
Coverage Highlights-**Provides coverage for 96% of legally residing Americans.
** Subidizes coverage for the poorest Americans
** Caps annual out-of-pocket costs
** Eliminates Pre-x condition exclusions
Fiscal and Cost Issues
** Cuts federal deficit by $30 mill over ten years according to the CBO
** Individuals with annual incomes over $500,000, as well as families earning more than $1 million, would face a 5.4 percent income tax surcharge.
** Cuts Medicare expenditures by 1.3% annually
** The House bill imposes a fine of up to 2.5 percent of an individual's income. Both versions include a hardship exemption for poorer Americans.
** Requires larger companies to provide employee insurance for everyone or pay a penalty of up to 8 percent of total revenue.
CNN, conforming with the rest of our wonderful media, ignores the question of whether true cost controls and waste reduction strategies exist within this bill.
I'll get a copy of the bill and research those questions.
--------------------------------- ----------------------------
From CNN, October 31, 2009
The battle over health care reform reached another milestone Thursday as top House Democrats unveiled sweeping legislation that includes a highly controversial public health insurance option.
The nearly 2,000-page bill -- a combination of three versions passed by House committees -- would cost $894 billion over 10 years to extend insurance coverage to 36 million uncovered Americans, according to House Speaker Nancy Pelosi.
However, the bill's total cost, including Medicare changes, is expected to be higher and could push the price tag over $1 trillion, according to an initial CNN analysis.
The bill guarantees that 96 percent of Americans have coverage, Pelosi stated. The claim is based on an analysis by the non-partisan Congressional Budget Office.
Among other things, the bill would subsidize insurance for poorer Americans and create health insurance exchanges to make it easier for small groups and individuals to purchase coverage. It would also cap annual out-of-pocket expenses and prevent insurance companies from denying coverage for pre-existing conditions.
Pelosi's office said the bill would cut the federal deficit by roughly $30 billion over the next decade. The measure is financed through a combination of a tax surcharge on wealthy Americans and spending constraints in Medicare and Medicaid.
Specifically, individuals with annual incomes over $500,000, as well as families earning more than $1 million, would face a 5.4 percent income tax surcharge. Medicare expenditures would be cut by 1.3 percent annually.
"Today, we are ... laying the foundation for a brighter future for generations to come," Pelosi said on Capitol Hill.
"For Americans struggling with the cost of health care, this is an urgently needed bill," said House Majority Leader Steny Hoyer, D-Maryland. "This is an idea whose time has come."
President Obama praised House Democrats for forging "a strong consensus that represents a historic step forward."
Republicans tore into the bill, characterizing it as a series of tax increases and new regulations that would destroy jobs while doing little to stop spiraling health care costs.
"This really is a government takeover of health care in America," said Rep. Mike Pence, R-Indiana. "It appears for all of the world like a massive government-run insurance plan paid for with a freight train of mandates and taxes and bureaucracy."
Critics argue that the Democrats' $894 billion price tag excludes the cost associated with closing the Medicare "donut hole" prescription drug coverage gap.
The donut hole refers to some drug costs left uncovered by Medicare before catastrophic coverage kicks in. Pelosi highlighted plans to close the gap while discussing the bill Thursday.
Under the public option in the House plan, health care providers would be allowed to negotiate reimbursement rates with the federal government, according to Democratic leadership aides.
Pelosi and other liberal Democrats had argued for a more "robust" public option that ties reimbursement rates for providers and hospitals to Medicare rates plus a 5 percent increase. Several Democrats representing rural areas, however, complained that doctors and hospitals in their districts would be shortchanged under such a formula.
The Democratic leadership "pushed as hard as they could" for the robust option but couldn't win majority support for it, said liberal New York Rep. Jerrold Nadler. "There is no point crying over spilt milk."
The House bill differs from legislation now being considered by the Senate in a number of critical ways. Senate Majority Leader Harry Reid, D-Nevada, also favors a public option but would allow individual states to opt out of the plan. Reid would allow for the creation of nonprofit health care cooperatives; the House bill does not include such a measure.
A bill recently passed by the Senate Finance Committee does not include a tax surcharge on the wealthy but would instead impose a new tax on high-end health care policies, dubbed "Cadillac plans" by critics. A large number of House Democrats are adamantly opposed to taxing such policies, arguing that such a move would hurt union members who traded higher salaries for more generous benefits.
Individuals under the $829 billion Senate Finance Committee plan would be required to purchase health insurance coverage or face a fine of up to $750. The House bill imposes a more stringent fine of up to 2.5 percent of an individual's income. Both versions include a hardship exemption for poorer Americans.
The Senate Finance Committee bill would require large companies to contribute to the health care costs of lower income workers if those workers receive a government subsidy for insurance. The House legislation would require larger companies to provide employee insurance for everyone or pay a penalty of up to 8 percent of total revenue.
Democratic leaders in both chambers agree on establishing nonprofit health care cooperatives and stripping insurance companies of an antitrust exemption that has been in place since the end of World War II.
Moderate House Democrats, whose votes are needed to pass the bill, appeared to be cautiously optimistic. They didn't, however, offer any definitive judgments.
"I'm not leaning one way or the other right now, but I just have to get into the bill and read it for myself," said Rep. Baron Hill, D-Indiana. "I'm hoping to be able to vote for it."
The House Democratic leadership posted the bill online Thursday and agreed to give members at least 72 hours to read it before a vote. Under that timetable, the full House could begin debating the bill next week.
Any bill passed by the House of Representatives will eventually have to be merged with legislation passed by the Senate. Both chambers would then have to pass a revised measure before sending it to Obama to be signed into law.
One thorny issue remaining to be resolved among House Democrats is the final abortion language in the bill. Rep. Bart Stupak, D-Michigan, has been pushing leaders to add stronger language prohibiting the use of federal money to pay for abortions under new health care reforms.
Stupak has vowed that if he isn't allowed a vote on the issue, a group of 40 anti-abortion Democrats will work to block the bill from getting to the House floor.
Leadership aides admit that they need to find compromise wording on abortion but say they are confident the issue will be resolved by the time the bill gets to the floor.
Coverage Highlights-**Provides coverage for 96% of legally residing Americans.
** Subidizes coverage for the poorest Americans
** Caps annual out-of-pocket costs
** Eliminates Pre-x condition exclusions
Fiscal and Cost Issues
** Cuts federal deficit by $30 mill over ten years according to the CBO
** Individuals with annual incomes over $500,000, as well as families earning more than $1 million, would face a 5.4 percent income tax surcharge.
** Cuts Medicare expenditures by 1.3% annually
** The House bill imposes a fine of up to 2.5 percent of an individual's income. Both versions include a hardship exemption for poorer Americans.
** Requires larger companies to provide employee insurance for everyone or pay a penalty of up to 8 percent of total revenue.
CNN, conforming with the rest of our wonderful media, ignores the question of whether true cost controls and waste reduction strategies exist within this bill.
I'll get a copy of the bill and research those questions.
--------------------------------- ----------------------------
From CNN, October 31, 2009
The battle over health care reform reached another milestone Thursday as top House Democrats unveiled sweeping legislation that includes a highly controversial public health insurance option.
The nearly 2,000-page bill -- a combination of three versions passed by House committees -- would cost $894 billion over 10 years to extend insurance coverage to 36 million uncovered Americans, according to House Speaker Nancy Pelosi.
However, the bill's total cost, including Medicare changes, is expected to be higher and could push the price tag over $1 trillion, according to an initial CNN analysis.
The bill guarantees that 96 percent of Americans have coverage, Pelosi stated. The claim is based on an analysis by the non-partisan Congressional Budget Office.
Among other things, the bill would subsidize insurance for poorer Americans and create health insurance exchanges to make it easier for small groups and individuals to purchase coverage. It would also cap annual out-of-pocket expenses and prevent insurance companies from denying coverage for pre-existing conditions.
Pelosi's office said the bill would cut the federal deficit by roughly $30 billion over the next decade. The measure is financed through a combination of a tax surcharge on wealthy Americans and spending constraints in Medicare and Medicaid.
Specifically, individuals with annual incomes over $500,000, as well as families earning more than $1 million, would face a 5.4 percent income tax surcharge. Medicare expenditures would be cut by 1.3 percent annually.
"Today, we are ... laying the foundation for a brighter future for generations to come," Pelosi said on Capitol Hill.
"For Americans struggling with the cost of health care, this is an urgently needed bill," said House Majority Leader Steny Hoyer, D-Maryland. "This is an idea whose time has come."
President Obama praised House Democrats for forging "a strong consensus that represents a historic step forward."
Republicans tore into the bill, characterizing it as a series of tax increases and new regulations that would destroy jobs while doing little to stop spiraling health care costs.
"This really is a government takeover of health care in America," said Rep. Mike Pence, R-Indiana. "It appears for all of the world like a massive government-run insurance plan paid for with a freight train of mandates and taxes and bureaucracy."
Critics argue that the Democrats' $894 billion price tag excludes the cost associated with closing the Medicare "donut hole" prescription drug coverage gap.
The donut hole refers to some drug costs left uncovered by Medicare before catastrophic coverage kicks in. Pelosi highlighted plans to close the gap while discussing the bill Thursday.
Under the public option in the House plan, health care providers would be allowed to negotiate reimbursement rates with the federal government, according to Democratic leadership aides.
Pelosi and other liberal Democrats had argued for a more "robust" public option that ties reimbursement rates for providers and hospitals to Medicare rates plus a 5 percent increase. Several Democrats representing rural areas, however, complained that doctors and hospitals in their districts would be shortchanged under such a formula.
The Democratic leadership "pushed as hard as they could" for the robust option but couldn't win majority support for it, said liberal New York Rep. Jerrold Nadler. "There is no point crying over spilt milk."
The House bill differs from legislation now being considered by the Senate in a number of critical ways. Senate Majority Leader Harry Reid, D-Nevada, also favors a public option but would allow individual states to opt out of the plan. Reid would allow for the creation of nonprofit health care cooperatives; the House bill does not include such a measure.
A bill recently passed by the Senate Finance Committee does not include a tax surcharge on the wealthy but would instead impose a new tax on high-end health care policies, dubbed "Cadillac plans" by critics. A large number of House Democrats are adamantly opposed to taxing such policies, arguing that such a move would hurt union members who traded higher salaries for more generous benefits.
Individuals under the $829 billion Senate Finance Committee plan would be required to purchase health insurance coverage or face a fine of up to $750. The House bill imposes a more stringent fine of up to 2.5 percent of an individual's income. Both versions include a hardship exemption for poorer Americans.
The Senate Finance Committee bill would require large companies to contribute to the health care costs of lower income workers if those workers receive a government subsidy for insurance. The House legislation would require larger companies to provide employee insurance for everyone or pay a penalty of up to 8 percent of total revenue.
Democratic leaders in both chambers agree on establishing nonprofit health care cooperatives and stripping insurance companies of an antitrust exemption that has been in place since the end of World War II.
Moderate House Democrats, whose votes are needed to pass the bill, appeared to be cautiously optimistic. They didn't, however, offer any definitive judgments.
"I'm not leaning one way or the other right now, but I just have to get into the bill and read it for myself," said Rep. Baron Hill, D-Indiana. "I'm hoping to be able to vote for it."
The House Democratic leadership posted the bill online Thursday and agreed to give members at least 72 hours to read it before a vote. Under that timetable, the full House could begin debating the bill next week.
Any bill passed by the House of Representatives will eventually have to be merged with legislation passed by the Senate. Both chambers would then have to pass a revised measure before sending it to Obama to be signed into law.
One thorny issue remaining to be resolved among House Democrats is the final abortion language in the bill. Rep. Bart Stupak, D-Michigan, has been pushing leaders to add stronger language prohibiting the use of federal money to pay for abortions under new health care reforms.
Stupak has vowed that if he isn't allowed a vote on the issue, a group of 40 anti-abortion Democrats will work to block the bill from getting to the House floor.
Leadership aides admit that they need to find compromise wording on abortion but say they are confident the issue will be resolved by the time the bill gets to the floor.
Wednesday, September 16, 2009
Baucus health plan released
Analysis of the key issues-
Pre-existing conditions are eliminated. Okay, that's a no-brainer.
Businesses are not mandated to provide coverage but instead must defray the cost of its employees share. This seems to be a potential administrative nightmare for small businesses. I'll need to look into this very closely. Shouldn't reform make it easier on businesses? What is the encourage ment for them to join the co-ops?
Public Option is nixed- Instead Baucus proposes nonprofit consumer-owned cooperatives. This is a non-issue if they pay the contracted doctors a salary instead of on a fee-for-service basis and put LEAN processes in place. But, why do I have a nagging feeling that they'll get this wrong and set up EVERYTHING on a fee reimbursement basis? Fee reimbursement would only cause health care costs to skyrocket at an even faster pace than we've seen before?
Penalty for non-purchase of health insurance- The devil is in the details on this as I have to research how this will interplay with the non-profit coops. What are the eligibility standards for getting into the co-op insurance, for instance?
Republicans- Every indication appears that few Republicans will support the Baucus plan yet it offers numerous concessions and seriously waters down true reform. The fact that there is no business mandate but instread allows defraying of employee costs just seems ridiculous on its face and thus requires me to do a lot of digging.
As always, stay tuned-in and please provide your feedback to your legislators. I really believe the next three months will be the most important in congress since the mid-60's when we saw the Civil Rights Act and the Great Society legislation.
------- ------- -------- --------
Soure: Politico.com
Senate Finance Committee chairman Max Baucus (D-Mont.) proposed an $856 billion plan Wednesday to overhaul the health care system, releasing a bill after months of bipartisan negotiations without any immediate Republican support.
The bill forces insurance companies to change the way they do business, such as prohibiting them from dropping or denying coverage based on preexisting conditions. To force competition with private insurers, Baucus chose creating nonprofit consumer-owned cooperatives over the public insurance option, which most Democrats prefer.
“This is a unique moment in history where we can finally reach an objective so many of us have sought for so long,” Baucus said in a statement. “We worked to build a balanced, common-sense package that ensures quality, affordable coverage and doesn’t add a dime to the deficit.”
The long-awaited bill sets off a battle over what could be the shape of a health reform deal that wins at least one or two Republicans votes in the Senate. By trying to add measures to appeal to some Democrats and some Republicans, Baucus has managed to upset all sides. But what he came up with could be viewed as the kind of balanced approach that threads the needle to achieve a final compromise.
None of the three Republicans involved in the bipartisan negotiations have signed onto the bill, saying there are outstanding issues that need to be resolved. But they said they would continue talking with Baucus and the other two Democrats in the so-called Gang of Six.
The lack of Republican support — at the outset, at least — suggests Democrats will need to make more concessions if they hope to produce a bipartisan bill. Otherwise, the Senate leadership may have to use a last-ditch procedural maneuver known as reconciliation to move the bill through the chamber with 51 votes.
The absence of Republicans could also damage President Barack Obama's efforts to convince Americans that his reform plan has broad support.
The Finance Committee markup is expected to begin Tuesday. Baucus will meet Thursday with the full committee, and amendments will be due Friday at 5 p.m.
The Baucus plan is a more conservative approach than those produced by three committees in the House and by the Senate's Health, Education, Labor and Pensions Committee, but it tracks closely with the concepts that Obama promoted in his speech to Congress last week. The bill is deficit neutral and fully paid for, and less costly than bills approved by other committees.
Baucus chose an alternative to the public insurance option – nongovernmental consumer cooperatives – to provide competition with private insurers.
The bill requires individuals to buy insurance, or else face penalties as high as $3,800 for a family. It would not mandate businesses to provide coverage for their employees – as the House bills do – but it would require them to defray the cost of any government subsidies for which their employees would qualify.
To pay for the overhaul, the legislation calls for imposing a 35 percent excise tax on high-end insurance plans, assessing fees on industry players, including device manufacturers, insurers and clinical laboratories, and making a series of tax code changes.
The bill expands Medicaid coverage to include adults whose incomes are 133 percent above the poverty line, and requires states to pick up more of the tab for the federal-state cost-sharing program. Government subsidies would be available to families between 100 percent and 300 percent of the poverty line to purchase insurance plans through a new marketplace known as an exchange.
For families with incomes 300 percent and 400 percent of poverty, their annual premiums would be capped at 13 percent of their income. It’s a level that Sen. Ron Wyden (D-Ore.) says is too high, but it would be less than the current average cost of a family insurance plan, which is $13,375, according to the Kaiser Family Foundation.
Sen. Olympia Snowe (R-Maine), the likeliest Republican to support the bill, said she is waiting for cost estimates from the Congressional Budget Office, which she has not yet seen.
Sen. Chuck Grassley (R-Iowa) released a statement Tuesday that was silent on his ultimate decision, but the tone of his message does not bode well for Baucus’s hopes of bringing him on board.
He ticked off a long list of concerns, saying the bill “does not meet the shared goals for affordable, accessible health coverage,” and it does not resolve outstanding issues dealing with abortion and illegal immigration. He suggested the bill does not include his alternative proposal to the individual mandate, nor does it include stronger medical liability reform measures he had pushed.
“We’ve been clear from the start that we’re willing to stay at the table,” Grassley said. “There’s no reason not to keep working until we get it right. In the end, legislation that impacts every American should have strong bipartisan support.”
Pre-existing conditions are eliminated. Okay, that's a no-brainer.
Businesses are not mandated to provide coverage but instead must defray the cost of its employees share. This seems to be a potential administrative nightmare for small businesses. I'll need to look into this very closely. Shouldn't reform make it easier on businesses? What is the encourage ment for them to join the co-ops?
Public Option is nixed- Instead Baucus proposes nonprofit consumer-owned cooperatives. This is a non-issue if they pay the contracted doctors a salary instead of on a fee-for-service basis and put LEAN processes in place. But, why do I have a nagging feeling that they'll get this wrong and set up EVERYTHING on a fee reimbursement basis? Fee reimbursement would only cause health care costs to skyrocket at an even faster pace than we've seen before?
Penalty for non-purchase of health insurance- The devil is in the details on this as I have to research how this will interplay with the non-profit coops. What are the eligibility standards for getting into the co-op insurance, for instance?
Republicans- Every indication appears that few Republicans will support the Baucus plan yet it offers numerous concessions and seriously waters down true reform. The fact that there is no business mandate but instread allows defraying of employee costs just seems ridiculous on its face and thus requires me to do a lot of digging.
As always, stay tuned-in and please provide your feedback to your legislators. I really believe the next three months will be the most important in congress since the mid-60's when we saw the Civil Rights Act and the Great Society legislation.
------- ------- -------- --------
Soure: Politico.com
Senate Finance Committee chairman Max Baucus (D-Mont.) proposed an $856 billion plan Wednesday to overhaul the health care system, releasing a bill after months of bipartisan negotiations without any immediate Republican support.
The bill forces insurance companies to change the way they do business, such as prohibiting them from dropping or denying coverage based on preexisting conditions. To force competition with private insurers, Baucus chose creating nonprofit consumer-owned cooperatives over the public insurance option, which most Democrats prefer.
“This is a unique moment in history where we can finally reach an objective so many of us have sought for so long,” Baucus said in a statement. “We worked to build a balanced, common-sense package that ensures quality, affordable coverage and doesn’t add a dime to the deficit.”
The long-awaited bill sets off a battle over what could be the shape of a health reform deal that wins at least one or two Republicans votes in the Senate. By trying to add measures to appeal to some Democrats and some Republicans, Baucus has managed to upset all sides. But what he came up with could be viewed as the kind of balanced approach that threads the needle to achieve a final compromise.
None of the three Republicans involved in the bipartisan negotiations have signed onto the bill, saying there are outstanding issues that need to be resolved. But they said they would continue talking with Baucus and the other two Democrats in the so-called Gang of Six.
The lack of Republican support — at the outset, at least — suggests Democrats will need to make more concessions if they hope to produce a bipartisan bill. Otherwise, the Senate leadership may have to use a last-ditch procedural maneuver known as reconciliation to move the bill through the chamber with 51 votes.
The absence of Republicans could also damage President Barack Obama's efforts to convince Americans that his reform plan has broad support.
The Finance Committee markup is expected to begin Tuesday. Baucus will meet Thursday with the full committee, and amendments will be due Friday at 5 p.m.
The Baucus plan is a more conservative approach than those produced by three committees in the House and by the Senate's Health, Education, Labor and Pensions Committee, but it tracks closely with the concepts that Obama promoted in his speech to Congress last week. The bill is deficit neutral and fully paid for, and less costly than bills approved by other committees.
Baucus chose an alternative to the public insurance option – nongovernmental consumer cooperatives – to provide competition with private insurers.
The bill requires individuals to buy insurance, or else face penalties as high as $3,800 for a family. It would not mandate businesses to provide coverage for their employees – as the House bills do – but it would require them to defray the cost of any government subsidies for which their employees would qualify.
To pay for the overhaul, the legislation calls for imposing a 35 percent excise tax on high-end insurance plans, assessing fees on industry players, including device manufacturers, insurers and clinical laboratories, and making a series of tax code changes.
The bill expands Medicaid coverage to include adults whose incomes are 133 percent above the poverty line, and requires states to pick up more of the tab for the federal-state cost-sharing program. Government subsidies would be available to families between 100 percent and 300 percent of the poverty line to purchase insurance plans through a new marketplace known as an exchange.
For families with incomes 300 percent and 400 percent of poverty, their annual premiums would be capped at 13 percent of their income. It’s a level that Sen. Ron Wyden (D-Ore.) says is too high, but it would be less than the current average cost of a family insurance plan, which is $13,375, according to the Kaiser Family Foundation.
Sen. Olympia Snowe (R-Maine), the likeliest Republican to support the bill, said she is waiting for cost estimates from the Congressional Budget Office, which she has not yet seen.
Sen. Chuck Grassley (R-Iowa) released a statement Tuesday that was silent on his ultimate decision, but the tone of his message does not bode well for Baucus’s hopes of bringing him on board.
He ticked off a long list of concerns, saying the bill “does not meet the shared goals for affordable, accessible health coverage,” and it does not resolve outstanding issues dealing with abortion and illegal immigration. He suggested the bill does not include his alternative proposal to the individual mandate, nor does it include stronger medical liability reform measures he had pushed.
“We’ve been clear from the start that we’re willing to stay at the table,” Grassley said. “There’s no reason not to keep working until we get it right. In the end, legislation that impacts every American should have strong bipartisan support.”
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