Insuring Resources Commentary:
I will now refrain from calling this a health care reform bill. This is health insurance reform and therefore is an ugly stepsister of true reform. This reform does not provide the incentives we need for quality and efficiency. Therefore, I do not believe it will rein in health care costs. Opportunity Lost.
The insurance reforms listed below are essential, there is no question about that. But the opportunity to make health care and health insurance affordable has been botched. The efficiency and quality incentives apply only to Medicare, which covers about 15% of Americans.
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This list was posted by CBS News
Cost: $940 billion over ten years.
Deficit:
Would reduce the deficit by $143 billion over the first ten years. That is an updated CBO estimate. Their first preliminary estimate said it would reduce the deficit by $130 billion over ten years. Would reduce the deficit by $1.2 billion dollars in the second ten years.
Coverage:
Would expand coverage to 32 million Americans who are currently uninsured.
Health Insurance Exchanges:
The uninsured and self-employed would be able to purchase insurance through state-based exchanges with subsidies available to individuals and families with income between the 133 percent and 400 percent of poverty level.
Separate exchanges would be created for small businesses to purchase coverage -- effective 2014.
Funding available to states to establish exchanges within one year of enactment and until January 1, 2015.
Subsidies:
Individuals and families who make between 100 percent - 400 percent of the Federal Poverty Level (FPL) and want to purchase their own health insurance on an exchange are eligible for subsidies. They cannot be eligible for Medicare, Medicaid and cannot be covered by an employer. Eligible buyers receive premium credits and there is a cap for how much they have to contribute to their premiums on a sliding scale.
Federal Poverty Level for family of four is $22,050
Paying for the Plan:
Medicare Payroll tax on investment income -- Starting in 2012, the Medicare Payroll Tax will be expanded to include unearned income. That will be a 3.8 percent tax on investment income for families making more than $250,000 per year ($200,000 for individuals).
Excise Tax -- Beginning in 2018, insurance companies will pay a 40 percent excise tax on so-called "Cadillac" high-end insurance plans worth over $27,500 for families ($10,200 for individuals). Dental and vision plans are exempt and will not be counted in the total cost of a family's plan.
Tanning Tax -- 10 percent excise tax on indoor tanning services.
Medicare:
Closes the Medicare prescription drug "donut hole" by 2020. Seniors who hit the donut hole by 2010 will receive a $250 rebate.
Beginning in 2011, seniors in the gap will receive a 50 percent discount on brand name drugs. The bill also includes $500 billion in Medicare cuts over the next decade.
Medicaid:
Expands Medicaid to include 133 percent of federal poverty level which is $29,327 for a family of four.
Requires states to expand Medicaid to include childless adults starting in 2014.
Federal Government pays 100 percent of costs for covering newly eligible individuals through 2016.
Illegal immigrants are not eligible for Medicaid.
Insurance Reforms:
Six months after enactment, insurance companies could no longer deny children coverage based on a preexisting condition.
Starting in 2014, insurance companies cannot deny coverage to anyone with preexisting conditions.
Insurance companies must allow children to stay on their parent's insurance plans through age 26.
Abortion:
The bill segregates private insurance premium funds from taxpayer funds. Individuals would have to pay for abortion coverage by making two separate payments, private funds would have to be kept in a separate account from federal and taxpayer funds.
No health care plan would be required to offer abortion coverage. States could pass legislation choosing to opt out of offering abortion coverage through the exchange.
**Separately, anti-abortion Democrats worked out language with the White House on an executive order that would state that no federal funds can be used to pay for abortions except in the case of rape, incest or health of the mother. (Read more here)
Individual Mandate:
In 2014, everyone must purchase health insurance or face a $695 annual fine. There are some exceptions for low-income people.
Employer Mandate:
Technically, there is no employer mandate. Employers with more than 50 employees must provide health insurance or pay a fine of $2000 per worker each year if any worker receives federal subsidies to purchase health insurance. Fines applied to entire number of employees minus some allowances.
Immigration:
Illegal immigrants will not be allowed to buy health insurance in the exchanges -- even if they pay completely with their own money.
Showing posts with label uninsured. Show all posts
Showing posts with label uninsured. Show all posts
Monday, March 22, 2010
Thursday, November 5, 2009
They call this "Reform"
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.****
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.****
Monday, September 21, 2009
5 Facts on the Uninsured
Source- Kaiser News
I think most would agree that this is sobering information on the impact of being uninsured. What this information does not factor is in the resulting impact of non-covered pre-existing conditions once an individual obtains health insurance.
In addition medical related expenses played a key role in more than 700,000 home foreclosures in the U.S. in 2008. In a recent study by the Univ. of Pennsylvania the authors found that compared to a sample of residents in the general public, those in foreclosure were more likely to be uninsured (22 percent compared to 8 percent). Nearly 60 percent reported that they had skipped or delayed meals because they couldn’t afford food, and people undergoing foreclosure were also more likely to have forgone filling a prescription because of the expense during the preceding year (48 percent vs. 15 percent).
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1) Most of the 46 million uninsured are in working families and do not have access to employer-sponsored insurance. Eight in ten of the 46 million uninsured in the U.S. come from working families. Most uninsured workers are self-employed or work for small firms where health benefits are much less likely to be offered.
2)About two-thirds of the uninsured have low incomes, meaning their family income is less than 200% of the poverty level (about $44,050 a year for a family of four or $21,982 a year for a single person in 2008). Moderate income families, those from 200-399% of poverty, comprise 23% of the uninsured (Figure 2). The average annual cost of employer-sponsored family coverage has doubled since 2000. Because the cost of family coverage in 2009 was $13,375, many families can only afford coverage if they receive sizable employer contributions.
3) In 2008, an increase in Medicaid coverage helped to offset declines in private insurance. Medicaid’s role in covering children was particularly important. While about 700,000 children lost employer-sponsored coverage in 2008, more than twice as many (1.7 million) gained Medicaid coverage—decreasing the number of uninsured children by 800,000 in a single year. Some states have expanded Medicaid coverage beyond federal minimums and made more of their low-income population eligible. The number of adults in Medicaid has increased as incomes declined due to the recession. Meanwhile, other states have left most low-income individuals ineligible for public coverage.
4) The uninsured suffer from negative health consequences due to their lack of access to necessary medical care. About one-quarter (24%) of uninsured adults go without needed care each year due to cost. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions, including traumatic injuries, heart attacks, and chronic diseases—and many suffer serious consequences. The uninsured receive less preventive care and recommended screenings than the insured. Adults who have been uninsured for more than one year are three to four times more likely to have not received recommended breast cancer screenings or to have had their blood pressure checked.
5) The uninsured pay for more than one-third (35%) of their care out-of-pocket. They are typically billed for any care they receive, often paying higher charges than the insured. Medical bills can put great strain on the uninsured and threaten their physical and financial well-being. The uninsured are nearly three times as likely (14% versus 5%) as those with health insurance coverage to be unable to pay for basic necessities due to medical bills (Figure 5). Additionally, 20% of the uninsured report having used up all or most of their savings because of medical bills. The average uninsured household also has no net assets.
I think most would agree that this is sobering information on the impact of being uninsured. What this information does not factor is in the resulting impact of non-covered pre-existing conditions once an individual obtains health insurance.
In addition medical related expenses played a key role in more than 700,000 home foreclosures in the U.S. in 2008. In a recent study by the Univ. of Pennsylvania the authors found that compared to a sample of residents in the general public, those in foreclosure were more likely to be uninsured (22 percent compared to 8 percent). Nearly 60 percent reported that they had skipped or delayed meals because they couldn’t afford food, and people undergoing foreclosure were also more likely to have forgone filling a prescription because of the expense during the preceding year (48 percent vs. 15 percent).
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1) Most of the 46 million uninsured are in working families and do not have access to employer-sponsored insurance. Eight in ten of the 46 million uninsured in the U.S. come from working families. Most uninsured workers are self-employed or work for small firms where health benefits are much less likely to be offered.
2)About two-thirds of the uninsured have low incomes, meaning their family income is less than 200% of the poverty level (about $44,050 a year for a family of four or $21,982 a year for a single person in 2008). Moderate income families, those from 200-399% of poverty, comprise 23% of the uninsured (Figure 2). The average annual cost of employer-sponsored family coverage has doubled since 2000. Because the cost of family coverage in 2009 was $13,375, many families can only afford coverage if they receive sizable employer contributions.
3) In 2008, an increase in Medicaid coverage helped to offset declines in private insurance. Medicaid’s role in covering children was particularly important. While about 700,000 children lost employer-sponsored coverage in 2008, more than twice as many (1.7 million) gained Medicaid coverage—decreasing the number of uninsured children by 800,000 in a single year. Some states have expanded Medicaid coverage beyond federal minimums and made more of their low-income population eligible. The number of adults in Medicaid has increased as incomes declined due to the recession. Meanwhile, other states have left most low-income individuals ineligible for public coverage.
4) The uninsured suffer from negative health consequences due to their lack of access to necessary medical care. About one-quarter (24%) of uninsured adults go without needed care each year due to cost. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions, including traumatic injuries, heart attacks, and chronic diseases—and many suffer serious consequences. The uninsured receive less preventive care and recommended screenings than the insured. Adults who have been uninsured for more than one year are three to four times more likely to have not received recommended breast cancer screenings or to have had their blood pressure checked.
5) The uninsured pay for more than one-third (35%) of their care out-of-pocket. They are typically billed for any care they receive, often paying higher charges than the insured. Medical bills can put great strain on the uninsured and threaten their physical and financial well-being. The uninsured are nearly three times as likely (14% versus 5%) as those with health insurance coverage to be unable to pay for basic necessities due to medical bills (Figure 5). Additionally, 20% of the uninsured report having used up all or most of their savings because of medical bills. The average uninsured household also has no net assets.
Thursday, August 6, 2009
Dental benefits
Dental Coverage Included in Health Care Reform?
At this point it is doubtful that dental coverage will be included in any health care reform legislation passed by Congress this year. According to CNN’s medical correspondent, Dr. Sanjay Gupta, for every one person without health insurance in the U.S., there are roughly two without dental insurance. That means 80-90 million Americans or more go without dental coverage.
For more on dental coverage issues and health care reform please see this brief video.
http://portal.tds.net/video/?vendid=18&vid=268733&sc_cid=wvtabb4
At this point it is doubtful that dental coverage will be included in any health care reform legislation passed by Congress this year. According to CNN’s medical correspondent, Dr. Sanjay Gupta, for every one person without health insurance in the U.S., there are roughly two without dental insurance. That means 80-90 million Americans or more go without dental coverage.
For more on dental coverage issues and health care reform please see this brief video.
http://portal.tds.net/video/?vendid=18&vid=268733&sc_cid=wvtabb4
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