Who Should Pony up for Health Insurance Reform?

Who Should Pony up for Health Insurance Reform? in Politics and Legislation

Here’s Senate Majority Leader Harry Reid suggestion: Plastic Surgeons and the People Who Love Them!

The connection? No idea!

The Senate health bill would impose a 5 percent tax on elective cosmetic procedures to help defray the cost of health care reform. Proponents claim it would raise an estimated $5 billion over 10 years toward the $849 billion pricetag of current legislation.

But how did the fans and practitioners of plastic surgery come to bear the burden of bankrolling health insurance reform? The only thing we could figure out is that it presumes that people getting plastic surgery are wealthy and can afford to shell out a little more. Whatever the case, we can’t help but see this is as rather creative taxing.

Granted, the market for cosmetic surgeries is sailing through the bad economy. The American Society of Plastic Surgeons reported that 12 million cosmetic procedures were performed in 2008, up 3 percent from 2007.

On the other hand, the measure could be less lucrative than proponents hope. In 2004, the state of New Jersey passed a 6 percent tax on plastic surgery that was expected to raise $24 million a year. But, in 2005, it only brought in about $7.5 million.

Of course, the so-called “Botox” provision isn’t the only inventive one in the Senate bill, but it’s certainly the most joke-ready. On second thought, maybe this is simply Washington’s way of finally getting back at the old “Hollywood for ugly people” barb.

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Trauma Patients Less Likely to Survive Without Health Insurance?

Trauma Patients Less Likely to Survive Without Health Insurance? in Individual Health Insurance

In a recent study from the Archives of Surgery, they found patients in trauma centers were twice as likely to die if they didn’t have health insurance.

An extremely interesting study considering emergency rooms are required by law to treat all patients regardless of ability to pay for services.

So what could possibly be the explanation for the difference in survival rates in trauma centers?

According to the Los Angeles Times, researchers believe that the disparity could be due to the fact that the uninsured are more likely to receive fewer specialized services such as MRIs and are less likely to receive rehabilitation care.

Researchers also guessed that patients without health insurance plans may have more additional conditions that factor into their recovery. They even suggested that doctors and nurses are less likely to interact with the uninsured.

Pretty tough findings. This study is telling us that uninsured patients are simply treated more poorly then those who have coverage?

The study’s authors did say the difference could be coincidental. But still, it’s not the sunniest of studies.

All the more reason not to go without health insurance.

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Abortion Amendment a Flashpoint in Health Insurance Debate. Again.

Abortion Amendment a Flashpoint in Health Insurance Debate. Again. in Politics and Legislation

Concessions on abortion coverage were vital in the House’s passage of their health insurance bill last Saturday. But those concessions are not sitting well with a lot of Democrats, including two of the main contenders for Ted Kennedy’s seat. Both frontrunners Attorney General Martha Coakley and Representative Michael E. Capuano have come out against the bill in response to the Stupak-Pitts Amendment, which prohibits federal plans from covering abortions.

“To pretend that now the House has passed this bill is real progress — it’s at the expense of women’s access to reproductive rights,” Coakley told Boston radio station WTKK-FM.

The president isn’t sold on the abortion provisions in the House bill, either. “There needs to be some more work before we get to the point where we’re not changing the status quo (on abortion),” President Obama told ABC News on Monday.

While the president is unequivocal about not allowing federal funds to subsidize abortion (this has been barred by the Hyde Amendment since 1976), he promises to balance this against “not restricting women’s insurance choices.”

This issue gets grey very quickly because reform can affect abortion in a myriad of ways — all that honors the Hyde Amendment — but pan out differently in practice. Unfortunately, this is generating a lot of bombast and misleading statements from both sides. It’s probably creating much more controversy than it should, but certainly understandable since abortion is such an emotionally wrought issue.

Even the White House acknowledges the sensitivity of the issue. They were quick to point out that this is a health care bill, not an abortion bill.

For a good, sober breakdown of the Stupak-Pitts Amendment’s nitty-gritty details, we recommend Politifact’s discussion of the matter.

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Health Insurance Reform in the Senate: The Real Battle

Health Insurance Reform in the Senate: The Real Battle in Politics and Legislation

As momentous as the passage of the House health insurance bill was this weekend, it was actually the easy part. The next step, passage in the Senate, will prove far more treacherous. How much more treacherous? Let’s review.

• In the House, Democrats enjoy a 258 to 177 majority. In the Senate, the Republicans are also a minority but possess considerably more power.
  
  
• That means that House Speaker Nancy Pelosi could afford losing 40 votes from her own party and still pass the bill. But Senate Majority Leader Harry Reid can’t afford to lose a single vote from his caucus members. And that’s just to bring the bill to the floor; he also needs it to thwart a Republican filibuster. 
  
  
• What’s more, Ms. Pelosi wields more control over proceedings in the House than Mr. Reid does in the Senate. She has a Rules Committee that determines debate parameters — including which amendments are offered. The best Mr. Reid can do is prepare himself for a near-certain ambush of amendments from Republicans. And possibly Democrats.
  
  
• This also means that where the floor debate in the House only took one day, it could (and probably will) take several weeks in the Senate.

And at this point, there isn’t even a bill to try to bring to the floor. Why? To There are two bills that have to be merged into one; a slew of factions to be appeased among the Democrats before even addressing Republican opposition; a plausible threat from Senator Tom Coburn to read all two-thousand pages of the bill aloud.

Phew, that’s a lot.

From where we’re standing, Mr. Reid’s task makes the bill’s passage in the House look as easy as falling off a log.

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AARP Endorsement a Coup for House Health Insurance Bill

AARP Endorsement a Coup for House Health Insurance Bill in Politics and Legislation

With the AARP’s official endorsement yesterday, the House health bill is moving more confidently toward its floor vote, just one day away. Several aspects of this moment gave us pause. The AARP has never endorsed this kind of comprehensive health care overhaul, and the House bill is the most sweeping overhaul of health care policy in four decades.

"We started this debate more than two years ago with the twin goals of making coverage affordable to our younger members and protecting Medicare for seniors,” said AARP CEO Barry Rand to the Associated Press. "We've read the Affordable Health Care for America Act and we can say with confidence that it meets those goals with improved benefits for people in Medicare and needed health insurance market reforms to help ensure every American can purchase affordable health coverage.”

House Speaker Nancy Pelosi and Majority Leader Steny Hoyer are no doubt breathing a little easier. The AARP’s support (or lack thereof) has proved powerful in the past, helping to pass the 2003 Prescription Drug Benefit Act and stop the privatization of Social Security under former President George W. Bush.

But some major issues still remain. In particular, the coverage of illegal immigrants and restrictions on federal funds for abortion could both be explosive debates. The NY Times does a nice job of parsing out the different factions and deals being brokered around the latter, which are many and could still unravel the legislation. Here’s to hoping compromise prevails. 

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Can I Find Affordable Health Insurance in the City?

Can I Find Affordable Health Insurance in the City? in Individual Health Insurance

We recently collaborated with the Chicago Sun-Times for an article that showed health insurance rates actually vary by Zip code. Using our instant health insurance quoting technology, we saw that residents living in the city of Chicago pay a bit more than those in the suburban areas.

But after reading the article, you might wonder: Does this mean it’s impossible for city-dwellers to find affordable health insurance?

Well, thankfully, no. It’s possible to find a plan that fits just about any budget — even if you reside within the city limits.

Okay then. How, you ask?

First, it always pays to compare plans from a few different companies. As the article reported, we know that rates can vary by carrier, so if you’re looking to trim as much off your monthly bill as possible, shop around a bit.

Another major factor that determines your premiums, besides your health history, is your deducible. The key here is to find the perfect premium/deductible combination, so you can minimize your premiums and your out-of-pocket costs at the same time.

Typically, if you hover around the $1,000 to $2,500 deductible range, you can get the best value for your health care dollar. Most plans give you the option to choose a deductible from a menu of options. Just make sure whichever deductible you choose you realistically afford just in case you experienced a medical emergency.

Also, it’s vital to assess which benefits you need. For example, if you rarely visit the doctor, you can find a plan that limits the number of routine visits, which in effect lowers your premiums. And if you’re not picky on which doctors or hospitals you visit, health insurance plans with smaller provider networks have more affordable price tags.

Oh yeah, one more thing — quit smoking.

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How Employer-Mandated Health Insurance Stacks Up

How Employer-Mandated Health Insurance Stacks Up in Group Health Insurance

All the bills currently in play — the house bill and the two in the Senate — contain employer mandates, but differ to what degree. This has provoked a few layers of questions.

The Senate Finance Committee’s bill penalizes employers who don’t offer their workers any kind of coverage, but stops short of making any requirements whereas the bills from the House and the Senate Health Committee flat-out require employers offer their employees coverage. As a matter of fact, they go one step further: They require employers to contribute a significant share of the cost (except for small businesses) or pay a fine. 

That’s a big difference. And it’s hard to tell which way Majority Leader Harry Reid will lean in his reconciliation of the two Senate bills alone. 

Now, it’s true that for about 60 percent of Americans at big firms, the point is moot since they get their health insurance through their jobs, where they are covered at about 75 percent. But it isn’t for those who work at smaller companies where coverage and employer contribution aren’t as considerable. 

It’s also important to note that anywhere from 2.3 to 2.6 million businesses are expected to opt to pay the penalty rather than offer group health insurance should that version of the mandate go into law.

It will be interesting to see which provision ends up in the final bill, and even more interesting to see how it pans out.

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Report: Kids Without Health Insurance 1.6 Times More Likely to Die

Report: Kids Without Health Insurance 1.6 Times More Likely to Die in Individual Health Insurance

A new report from the Johns Hopkins Children's Center in Baltimore estimates that the deaths of 17,000 children in the United States over 17 years were due to lack of health insurance.

The study analyzed 23-million hospital records from 37 states. After adjusting for different variables, the study concluded that uninsured kids were 1.6 times more likely to die than children who had insurance.

While health reform is urgent from almost any angle, this really underscores the point. David C. Chang, a co-author of the study, said that health insurance had more of a dramatic impact on children’s outcomes than any medical treatment he could think of.

It’s heartening to see that both health bills in the House and Senate include subsidies for moderate-income families as well as provisions to extend the eligibility period for young adults under their parents’ plan. The Senate bill would require insurers to allow kids to stay on it until age 26. Under the House bill, they would be covered until 27.

Hopefully, even in the swirl of political games, we don’t forget about actually taking good care of people — especially children.

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House Debuts Their Bill for Health Insurance Reform

House Debuts Their Bill for Health Insurance Reform in Politics and Legislation

Speaker of the House Nancy Pelosi presented the Affordable Health Care for America Act today, the House’s health reform bill.  At 1,990 pages and $894 billion, the measure would extend coverage to 36-million people and reduce future federal deficits by $30 billion over the next 10 years.

That last fact is a big win for President Obama and the Democrats who are face daily scrutiny from their Republican counterparts on adding to the deficit.

It would broadly expand Medicare and provide subsidies to moderate-income Americans to purchase insurance. And, as promised, it includes a public health insurance plan.

The bill has strong similarities with the one emerging from the Senate, but important distinctions as well. The Senate version would fund reform in part with a “Cadillac” tax on higher-priced policies (to the vocal dismay of labor unions). But the House bill would instead tax incomes of over $500, 000, something Speaker Pelosi calls the “millionaire’s tax.” Pelosi’s version also prompts almost twice the Medicare cuts on the prescription-drug industry as the Senate’s $80 billion cuts.

Other points of note are that, as expected, the House bill bars health insurance companies from denying coverage based on health history and requires employers to offer coverage to their workers.

On a sidenote, we enjoyed the NYTimes’ reporting on some of the symbolic theatre that accompanied the bill’s unveiling. Apparently, Representative John Dingell brought out the gavel he used in 1965, while presiding over the House the year it passed Medicare. “I had the privilege of sitting in the chair when we offered Medicare, originally offered by my old dad,” Mr. Dingell said, brandishing the old mallet at the rally.

“I used this here gavel to preside over the House, and I’m going to lend it to whoever gets to preside over this legislation, because a good piece of wood doesn’t wear out with one great event,” he declared.

Mr. Dingell’s father, John Dingell Sr. began pushing for national health insurance in 1943.

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Health Insurance Goes on the Grocery Shopping List

Health Insurance Goes on the Grocery Shopping List in Individual Health Insurance

Health insurance companies are coming up with all sorts of interesting ways to reach out to consumers who need coverage.

Today, we read that BlueCross BlueShield of Florida recently teamed up with grocery retail stores Winn-Dixie and Save-Rite to offer in-store shoppers health insurance and discount cards at the cash register.

Based on the article, it looks like a popular choice in the grocery store are inexpensive bare-bones health insurance plans. These bare-bones plans, available thanks to Governor Charlie Crist, are so affordable because they aren’t required to provide many of the state’s mandated benefits.

Winn-Dixie and Save-Rite will also have health care discount cards on sale. For participating providers, the cards offer discounts for basic health care services and prescription drugs.

Consumer alert! Discount cards are not the same as health insurance! You can get $50 off or so for a routine doctor’s visit, but you get little or no relief you need major care.

It’s quite the novel approach to selling affordable health insurance, though we’re not sold on how good it is for  consumer. We’ve actually seen many people need the assistance of an agent before they buy.

If we hear more on how this is doing, we’ll let you know.

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The Public Health Insurance Option and the Public Misconception of Reform

The Public Health Insurance Option and the Public Misconception of Reform in Politics and Legislation

The big news, to a health insurance blog anyway, was the health reform bill in the U.S. Senate will include a public health insurance option, reported CNN.

A senior aide to Senate Majority Leader Harry Reid told CNN that the public option would be included in the bill and have a clause allowing individual states to opt-out of the plan if they chose.

The opt-out clause, something we blogged about last week, is a political answer to for the progressive Democratic base that’s becoming increasingly agitated at the bill’s current form.

Risky move, Senator. Holding on to votes like conservative Democrats like Senator Ben Nelson and Senator Blanche Lincoln could make or break health reform. And we surely can’t forget about Senator Olympia Snowe, who is the only Republican to show interest in what the Democrats are pushing.

So say we do get reform. Say it passes in December and the Democrats, especially President Obama, get a $800 billion Christmas present. Does that mean we the people get ours too? Actually, no, we don’t.

Most of the bill’s provisions, as it currently stands, don’t go into effect until 2013. That’s four years of wondering if the bill to change the health care and health insurance system will work.

Now, on one hand it makes sense. The health system in the United States is such a complicated mess there’s no way we can implement major changes within a few months or even a year. Giving us four years of prepping will likely do a lot of good to help ensure what does work, will work very well.

But for Americans who need relief now, this bill is going to be a big disappointment. And there’s a very good chance public opinion of the bill will take a dive soon after its potential passage.

According to a recent poll from Kaiser Family Foundation, half of America believes that health care and health insurance changes will start to happen in the next year.

A staggering 49 percent think within the next year, people will get financial help in buying health insurance plans. What’s more, 51 percent believe health insurance companies will accept all applications with pre-existing conditions.

So no relief for four years and the push for a public option that could doom health reform entirely?

Talk about a political time bomb.

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The HHS on How Health Insurance Reform can Help Women with Breast Cancer

The HHS on How Health Insurance Reform can Help Women with Breast Cancer in Politics and Legislation

We don’t really have to tell you that cancer and health insurance don’t really get along all too well.

These days, Americans with serious pre-existing health conditions, such as breast cancer, definitely have trouble finding coverage.

In light of Breast Cancer Awareness Month this October, Secretary Kathleen Sebelius and the Department of Health and Human Services released a report highlighting the benefits that health reform will have for women with breast cancer.

The report touts different aspects of the current health reform bill, including out-of-pocket cost limits, access to health insurance exchanges for comparison shopping and the eventual elimination of pre-existing condition exclusions.

In addition to the health insurance side of things, the HHS says health reform will also help improve care quality for breast cancer patients.

We thought it was a pretty good (and timely) way to promote the health reform bill’s passage through Congress.

Even though it’s not really a scientific report, you can see the full text of it here: http://www.healthreform.gov/reports/breastcancer/index.html.

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Senate Shoots Down Bill to Intercept Medicare Pay Cuts

Senate Shoots Down Bill to Intercept Medicare Pay Cuts in Politics and Legislation

Unsurprisingly, the bill to block pay cuts to Medicare doctors was defeated in the Senate yesterday. This is the bill that would have intercepted the sustainable growth rate (SGR) formula that is more or less intended to curb doctors’ rates from climbing too fast.

Both the American Medical Association and the AARP said they were “deeply disappointed,” reports the Wall Street Journal’s health blog.

But, if history is any indication, the proposed 21% cuts won’t go through anyway. Congress usually passes a short-term fix to stop that year’s scheduled cuts. Then does it again the next year and the one after that, but always stops short of scrapping the system altogether.

The way Senate Majority Leader Harry Reid put it: “Right now, we’re going to a one-year fix.”

Here’s the thing: Blocking the cut would add $247 billion in federal spending over the next decade. And while there is talk that the Republicans will offer amendments to offset the cost, nothing has yet materialized.

However, the issue is far from over. More wrangling is going to ensue around this, especially with the recently introduced House bill that would completely axe the SGR formula. 

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The Opt-Out Clause: CPR for the Public Health Insurance Option?

The Opt-Out Clause: CPR for the Public Health Insurance Option? in Politics and Legislation

The public health insurance plan is back.

Back on the court.

Back on tour.

Back on the make with new hair, new shoes and — sing it, Patti — a new attitude.

What makes it so politically viable this time? A little opt-out clause that may very well be the magic bullet the Obama administration has been seeking.

The newest vision for the public option proposes establishing a national health care plan that states can opt out of. That means that Republicans and conservative Democrats could more easily sign off on the overall legislation knowing that they can defer the actual decision to local governments.

And, clearly, it would get on board progressive Democrats who insist on a government-sponsored plan. That it has a good chance of garnering bipartisanship that runs more than one-deep? Even better.  

Now, it’s true something similar has already been proposed (the Carter plan), wherein states could choose to opt in for a national plan.

But it’s been estimated that an opt-in would only produce a government plan in 10-20 states whereas the hurdle of having to affirmatively vote a public plan out on a referendum could conceivably bring that number up to 47, reports the Huffington Post.

This idea is still young, yet to be officially introduced, but out of everything that’s bubbling up in the current phase of amendments and bill-melding, this is one we’re keeping an eye on. 

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Is Massachusetts a Good Model for the National Health Insurance Bill?

Is Massachusetts a Good Model for the National Health Insurance Bill? in Individual Health Insurance

Well, it depends on what you define as model-like.

If you look at the percentage of insured residents, then yes, Massachusetts is a phenomenal model. A whopping 96 percent of the population of Massachusetts has health insurance as a result of the new law, reported the Chicago Tribune.

The Massachusetts health insurance law also makes reform look good for those afraid their current coverage might go down the tubes. According to the Tribune article, “many middle-class people who had insurance before the overhaul see little change.” And, “the employer-based insurance system remains intact.”

Low-income Massachusetts residents who normally could not afford health insurance are also rejoicing at reform and the subsidies to help pay for coverage.

On the other hand, health reform in Massachusetts certainly has its problems. The first, and arguably the biggest, problem is still-skyrocketing health care costs.

A state commission report said the high price of health care “threatens the viability” of the reform effort, wrote the article.

And as we already know, as health care costs go up, so do health insurance premiums. That’s exactly what’s happening in Massachusetts, with some policyholders facing 10 percent increases in their premiums.

The other issue, not mentioned in the Tribune article, is a significant doctor shortage. There just aren’t enough primary care physicians, particularly in rural areas, to see all these new patients.

As wait times to see a doctor get longer, the idea of “rationed care” becomes more of a reality.

Like just about everything in this world, health reform in Massachusetts has its ups and downs. So is the Bay State a good model? We’re still not sure.

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