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Entries Tagged as 'Healthcare'

Panel close to deciding which costs health insurers can define as beneficial to patients

October 7th, 2010 · Democrats, Government Control, Healthcare, Obama's Scheme, Selling Out the US, Tax Dollars, Taxes

By N.C. Aizenman Washington Post Staff Writer
Wednesday, October 6, 2010; 8:15 PM

At first blush, the mandate in the new health-care law sounds simple: Starting next year, health insurers must use at least 80 to 85 percent of the premium dollars they collect to pay medical bills or otherwise improve their customers’ health.

But deciding which expenses insurers can include has been proving a monumental and controversial task for the National Association of Insurance Commissioners, an independent body made up of state insurance commissioners that the law tasked with advising the federal government on the issue.

Write the “medical loss ratio” rules too expansively, consumer advocates warn, and insurers will subvert the spirit of the law by passing off overhead and administrative expenses as activities that benefit patient health. Write the rules too narrowly, insurers counter, and plans may be squeezed out of business or forced to cut back initiatives that are genuinely helpful to patients.

For months, NAIC officials have been holding hours-long conference calls, poring over hundreds of public comments and revising draft upon draft of their suggested guidelines.

Now the NAIC has entered the homestretch. As soon as Oct. 14, the last committee charged with signing off on its proposed regulations could hold its final vote, likely enabling the NAIC as a whole to approve its completed recommendations to the Department of Health and Human Services at its meeting in Orlando this month.

HHS officials aren’t obliged to adopt the commissioners’ advice, but HHS Secretary Kathleen Sebelius has indicated that, for the most part, she will follow it closely.

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Health insurance costs are up, but it could be worse like McDonalds.

October 5th, 2010 · Deception, Federal Spending, Healthcare

By Joe Davidson Washington Post Staff Writer
Monday, October 4, 2010; 7:09 PM

The good news is that the price federal employees and retirees will pay for their health insurance next year won’t go up as much as premiums did this year.

The bad news is that the 7.2 percent increase for 2011 is much greater than inflation or any pay increase or cost of living adjustment they might get.

The other news is that employee organizations say premiums in the Federal Employee Health Benefits Program could be lower if the Office of Personnel Management would stop refusing a subsidy.

“FEHBP premiums could have been lowered if it were not for the Administration’s decision to decline a payment available to other public and private employers who provide drug coverage as generous as Medicare’s,” National Active and Retired Federal Employees Association President Margaret L. Baptiste said in a news release Friday. “Once again, this year, the Administration left $1 billion on the table – a subsidy available to and accessed by private employers in the marketplace, which could be used to lower worker and annuitant premium costs.”

The subsidy was created in 2003 to encourage employers – including Uncle Sam – to keep their retiree prescription drug coverage even though a new Medicare prescription program had been created.

Sounds good at first blush, but federal organizations should be careful what they ask for.

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Healthamburglar: McDonald’s meets ObamaCare. 29,500 employees lose coverage due to reform.

October 3rd, 2010 · Deception, Democrats, Economy, Federal Spending, Government Control, Healthcare, Obama's Scheme, Selling Out the US, Tax Dollars, Taxes, Terrorism from Within

 Among President Obama’s core health-care promises was that Americans can keep their current coverage if they like it. Among the reasons that a new ObamaCare squall blows in every other day is that this claim simply is not true, as people are discovering.

The latest fracas was incited by Janet Adamy’s scoop in the Journal this week that McDonald’s Corp. may be forced to cancel its current coverage for 29,500 employees as a result of ObamaCare. McDonald’s told Health and Human Services regulators that new mandates will make its plans “economically prohibitive” and cause “a huge disruption” unless it gets a waiver.

At a Christian Science Monitor breakfast Thursday, HHS Secretary Kathleen Sebelius claimed that the Journal story was “flat-out wrong,” adding that “I’m sorry that they were not more accurate in their reporting.” If only for the sake of her own credibility, at some point Ms. Sebelius is going to have to try to persuade people who actually know something about the industries she regulates.

In a statement, McDonald’s did say that it was “completely false” to suggest that “we plan to drop health care coverage for our employees,” and “regardless of how the regulations evolve over the next several months, McDonald’s is committed to providing competitive pay and benefits.” No doubt that’s true: McDonald’s will still need to attract workers—not to mention that corporations of its size and brand recognition are very sensitive to political intimidation.

But McDonald’s didn’t deny that the new rules will wipe out its existing plans. And that’s precisely the point. The entire philosophical and policy architecture of ObamaCare is explicitly designed to standardize health benefits and how those benefits should be paid for. Those choices and tradeoffs will be made for everyone by Ms. Sebelius’s regulators.

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ObamaCare’s Hotel California: The state moves to impose price controls you can never leave.

September 28th, 2010 · Deception, Democrats, Economy, Federal Spending, Government Control, Healthcare, Immigration, Non-Transparency, Selling Out the US, States, Tax Dollars, Unemployment

California, the novelist Wallace Stegner famously wrote, is like the rest of America, only more so—meaning that wherever the country is headed, the Golden State is probably there already. So the state’s ObamaCare advance planning deserves closer scrutiny, given that it mirrors the regulatory and ideological model that the White House favors for everyone else.

In a matter of days, California will set a precedent for the future of the U.S. individual and small-business insurance markets via ObamaCare’s “exchanges,” where people will purchase coverage at heavily subsidized rates. The exchanges don’t start up until 2014, but the states were given wide bureaucratic latitude in how they’re run, and Sacramento is using this flexibility to convert them into a pretext for imposing de facto price controls on the insurance industry.

Jerry Seib and Gerard Baker discuss the renewed furor over health care, including the war of worlds between House Minority Leader John Boehner and House Speaker Nancy Pelosi.

That may be what Democrats had in mind when they passed the bill, but it’s particularly unfortunate because in principle exchanges could be a useful reform. States could sponsor transparent, neutral clearinghouses that compare costs and benefits among plans, encouraging insurers to compete to offer the products that consumers find most valuable. An exchange could operate much like travel websites such as Expedia.com, and a good one along those lines started in Utah last year.

California looked further east for inspiration—to Massachusetts, which has the only other exchange in the country. Known as the connector, it’s the centerpiece of the ObamaCare beta test that Mitt Romney passed in 2006 and is now the power center of the state’s public utility-style insurance regulation. In the daisy chain of “expertise” that is the health policy world, California’s regulations were shaped by Jon Kingsdale, a devout White House ally who used to run the Massachusetts connector and is now a consultant.

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New Medicare chief speaks out on health care

September 14th, 2010 · Deception, Democrats, Ethics, Government Control, Healthcare, Non-Transparency, Obama's Scheme, Selling Out the US

By Ricardo Alonso-Zaldivar – Tuesday, September 14, 2010

The nation’s health-care system cannot be transformed by rationing medical care, President Obama‘s new Medicare chief said Monday in his first major speech.

Donald Berwick’s appointment this summer without Senate confirmation was contentious because some Republicans accused him of being willing to deny care to save on costs. Since then, the administration has kept Berwick out of the spotlight, turning the otherwise well-known medical innovation expert into something of a mystery man in Washington.

Berwick broke his silence Monday, telling an audience of health insurance industry representatives that pushing back against unsustainable costs cannot and should not involve “withholding from us, or our neighbors, any care that helps” or “harming a hair on any patient’s head.”

He also said he does not think federal bureaucrats have all the answers when it comes to remaking the system. “A massive top-down national project is not the way to do this,” he told a conference held by America’s Health Insurance Plans, the industry lobbying group.

Berwick, 64, who was a pediatrician and Harvard professor, has long advocated “patient-centered care,” or the coordination of services to provide better quality and avoid duplication and waste.

Republicans have seized on previous comments he has made, such as this one from an interview last year: “The decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open. And right now, we are doing it blindly.” They say that raises questions about what Berwick really thinks of rationing.

His supporters counter that rationing already takes place, through actions of insurance companies, and that all he wants is to bring the medical decision-making process into the open.

Berwick told the insurers that he has three objectives: better care for individuals; better care for groups of people, such as diabetics or the poor; and reducing per-capita costs by eliminating waste and duplication.

He left without taking questions from reporters.

- Associated Press

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Health insurance tax credit likely to affect small part of small-business workforce

September 2nd, 2010 · Democrats, Economy, Federal Spending, Healthcare, Money Lost, Non-Transparency, Obama Exposed, Obama's Scheme, Selling Out the US, Small Business, Tax Dollars, Taxes

By N.C. Aizenman Washington Post Staff Writer
Thursday, September 2, 2010; 12:09 AM

About 16.6 million workers are employed by small businesses that are eligible for health insurance tax credits under the new health-care law, according to estimates that were to be released by a nonpartisan research foundation Thursday.

However, the report by the Commonwealth Fund estimated that only 3.4 million of those workers are at firms that would take advantage of the tax credit. For the most part, those are firms that already offer their employees health insurance.

Those firms that do not offer coverage are unlikely to consider the tax breaks enough of a financial incentive to start doing so, according to the report’s authors.

Still, the authors stressed the potential stimulus benefits of the tax credits, which apply beginning this taxable year and will increase in value in 2014 from as much as 35 percent of an employer’s premium contribution to as much as 50 percent. (The lower the wages and number of workers at a small business, the greater the size of the tax credit it is eligible for.)

The Congressional Budget Office has estimated that by 2016, the last year for which the tax credits will be available, they will have reduced health insurance premiums for small business by 8 to 11 percent.

At that point, small businesses and their employees will be able to buy comprehensive insurance on state-based exchanges, which will be established in 2014 and are expected to offer more affordable rates than available in the current market.

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How a Republican Congress could begin the process of repealing this unpopular law.

August 25th, 2010 · Change of Power, Healthcare, Obama Exposed, Obama's Scheme, Republicans

Putting the Brakes on ObamaCare

By Grace-Marie Turner

If Republicans take control of one or both houses of Congress this fall, many will have been elected with a promise to “repeal and replace” ObamaCare. But what are their options, really? There likely will be an initial showdown, but President Obama will surely veto any challenge to the law, and it would be hard to imagine mustering the votes to overturn it.

Information is the key weapon. Republicans can use congressional hearings to explain what ObamaCare is doing to the economy and the health sector. Their strongest cases would be built around jobs, the cost of health care, and the rising deficit.

If evidence shows that looming mandates on employers are crippling job-creation, they should be repealed. If health costs are rising, as they inevitably will be, Congress needs to hold hearings to investigate the causes and explain why the offending taxes and regulations must be repealed.

Here are six key strategies that a Republican Congress could employ to put on the brakes:

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Missouri vote cited as proof that public dislikes health-care overhaul

August 9th, 2010 · Accountability, Change of Power, Dissention, Government, Healthcare, Non-Transparency, Obama Exposed, Politics, States

By Alec MacGillis Washington Post Staff Writer
Thursday, August 5, 2010

A day after Missouri voters rejected a key component of the nation’s new health-care overhaul, Republicans seized on the result as conclusive evidence that Americans don’t like the law.

Primary voters in Missouri were the first to vote directly on the law, in a ballot referendum that prohibits the federal government from requiring people to have health insurance. The measure passed 71 percent to 29 percent.

Supporters of the overhaul played down the vote, noting that it has no practical impact and that Tuesday’s electorate was largely Republican. But they conceded that a lack of public support could make it hard to put the law into practice.

Lawmakers in several other states, such as Virginia, have already passed laws rejecting the “individual mandate,” a central feature of the health-care overhaul. The state laws, including Missouri’s, are largely symbolic because they are trumped by federal law.

More consequential are the legal challenges that have been brought by Republican state attorneys general, including a lawsuit by Virginia’s Ken Cuccinelli II. A federal judge ruled Monday that Virginia’s suit can go forward, rejecting arguments from the Obama administration that the state had no standing to sue.

Regardless, Republicans said Wednesday that the vote in Missouri marks a turning point in the health-care debate.

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ObamaCare and the Constitution: A federal court denies the motion to dismiss the challenge.

August 4th, 2010 · Accountability, Deception, Democrats, Economy, Ethics, Government Control, Healthcare, Obama's Scheme, Selling Out the US

A federal court denies the government’s motion to dismiss the challenge.

By Betsy Mccaughey

Last November, a reporter asked House Speaker Nancy Pelosi if it was constitutional for Congress to require Americans to buy health insurance. Ms. Pelosi responded, “Are you serious?”

On Monday, U.S. District Judge Henry Hudson got serious. He denied Health and Human Services Secretary Kathleen Sebelius’s motion to dismiss a lawsuit brought by the state of Virginia challenging the new health law. His ruling stated that it is far from certain Congress has the authority to compel Americans to buy insurance and penalize those who don’t.

Judge Hudson’s ruling paved the way for a trial to begin on October 18, with possible appeals all the way to the Supreme Court, a lengthy process. Some states will likely delay creating insurance exchanges and slow down other costly preparations for ObamaCare until its constitutionality is determined by this case.

If mandatory insurance is declared unconstitutional, the entire health law could collapse like a house of cards. Most complex legislation states that if one part of the law is struck down, other parts remain enforceable. But authors of ObamaCare chose to omit that clause, suggesting that the health overhaul won’t work without mandatory insurance.

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Health-care law may pose compliance issues for IRS, taxpayers

July 11th, 2010 · Accountability, Democrats, Ethics, Federal Spending, Government, Government Control, Healthcare, Non-Transparency, Obama's Scheme, Selling Out the US, Tax Dollars, Taxes, Terrorism from Within, Treasury

By David S. Hilzenrath – Friday, July 9, 2010

The new federal health-care law may pose compliance challenges for taxpayers and the Internal Revenue Service, an IRS ombudsman said.

The agency, which will be responsible for administering major aspects of health insurance finance, is neither structured nor funded to effectively oversee social programs, the National Taxpayer Advocate Service said Wednesday in a news release.

In addition, a tax reporting requirement in the health-care law “may impose significant burdens on businesses, charities and government agencies,” the advocate service said.

Those burdens “may turn out to be disproportionate as compared with any resulting improvement in tax compliance,” the head of the service, Nina E. Olson, said in the release. The advocate service is an independent organization in the IRS that helps taxpayers solve problems with the agency and recommends reforms.

Although the IRS’s main mission is to collect taxes, it has been given a key role administering health insurance premium subsidies, tax credits for small businesses, assessments on employers and the mandate that beginning in 2014, everyone must obtain insurance.

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