Archive
One Playground Accident Away from Bankruptcy
Author : Toni Bigby
Dec 14th, 2009 | by
It’s true…the cost of health care for most families in our country has put them in a seriously helpless situation. It’s sad to think that one playground accident could bankrupt a family of four. A fall from the monkey bars, a broken leg from a football game, an ill-timed sprint in front of the swings. It’s enough to keep many parents up at night.
However, Senator Robert Casey’s (D-PA) recent amendment to the Patient Protection and Affordable Care Act (H.R. 3590) should be applauded because of its focus on protecting and improving the successful Children’s Health Insurance Program (CHIP). Our country’s children have a lot at stake in health reform. More than eight million children remain uninsured, and more are losing employer-sponsored coverage daily. Each day a child is uninsured is a lost opportunity to strengthen America’s future. Casey’s amendment goes a long way toward protecting and improving coverage for millions of children in low-income working families across the nation by:
- Providing full funding for CHIP through 2019;
- Maintaining current CHIP eligibility through 2013, and setting a floor for income eligibility for children in all states at 250 percent of poverty ($55,125 for a family of four) beginning in 2014;
- Streamlining enrollment procedures making it easier for children to get coverage and keep it;
- Ensuring that coverage for children remains affordable;
- Guaranteeing all children in CHIP the comprehensive care they need from head to toe; and
- Requiring an HHS report in 2016 that will compare coverage for children in CHIP with coverage for children in the new Health Insurance Exchange and if coverage (including benefits, cost-sharing, premiums, and other features) is comparable or better, children can be transitioned from CHIP into the Exchange in 2019.
Our nation has made great strides over the last decade in securing health coverage for low-income children of working families. We must now seize this historic opportunity to build on the success of prior efforts and the bipartisan CHIP program, and ensure that children will be better off, not worse off, as a result of health reform. This amendment will do just that.
Along with 610 organizations/individuals across the nation, we offer our strong support for the CHIP Amendment (#2790). We stand ready to work with the Senate to achieve our common goal of reforming our nation’s health care system and ensuring that all children, indeed everyone in America, have access to the health coverage they need and deserve.
Insurer Fee – Reasonable Idea… Unintended Consequences
Author : Chris Whistler
Dec 10th, 2009 | by
Whenever a new concept is proposed, those at the deliberation table automatically ask “what would happen if?” before they decide to act. With health care reform for example, the driving questions are more like: “Are the changes going to result in more Americans getting coverage? Are the proposed changes budget neutral?” Given the broad scope of the proposed health care legislation, it’s easy to see how details can get overlooked. And when time is ticking, unintended consequences have a higher chance at prevailing.
One concern that should be brought to light is the $6.7B annual fee proposed on insurers. While conceptually this might make sense given the number of Americans who will be required to obtain coverage and the new revenue that insurers stand to gain, a portion of this fee would not be limited exclusively to commercial health insurance companies. Health plans that contract with federal and state governments to serve Medicaid, Medicare, and beneficiaries of the Children’s Health Insurance Plan (also known as CHIP) would also get taxed too.
Well, the challenge is that a significant portion of this fee will fall on state budgets because of the way states are required to reimburse health plans that serve its most vulnerable residents. The new fee will unintentionally require states and the federal government to ultimately come up with additional public dollars to pay for this added fee.
Also, this fee would unfortunately raise the overall costs of these government programs and place additional strains on programs that are already in extreme financial distress. For example, Ohio’s Medicaid program would have to potentially come up with an estimated $65 million annually. Subsequently, the burden of this fee will be paid for by taxpayer-funded government programs and beneficiaries that use these health plans.
Easy solution to the problem? Just exempt health plans administering government entitlement programs from the application of this fee. Problem solved; Unintentional consequence diverted.
Article Tags
Children's Health Care • Children’s Health Insurance Plans • CHIP • health care plan • health care reform • health insurance • health insurance plan • insurer fee • Medicaid • medicaid ohio eligibility • medicaid program • Ohio medicaid • Ohio medicaid program • ohio medicaid providers • SCHIP • taxes
The “Public Option” is NOT Revolutionary… Actually, It’s Been Working Great For Years
Author : Bobby Jones
Nov 6th, 2009 | by
You’ve probably noticed that the health care reform debate has shifted from health care reform to health “insurance” reform. Despite its efforts to work collaboratively, the insurance industry is the simple target to blame for the health care mess we so urgently need to fix. (There is no single villain, of course. It’s the entire system that’s broken.)
However, that may explain the “co-op” approach passed as part of the Senate Finance Committee bill. But, as 30 Senators pointed out in a letter to Senate President Harry Reid, co-ops (as currently written in America’s Healthy Future Act) are pretty much a non-solution:
The Senate Finance Committee included a cooperative approach to insurance market competition. While promoting more co-ops may be a worthy goal, it is not realistic to expect local co-ops to spring up in every corner of this country. There are many areas of the country where the population is simply too small to sustain a local co-op plan. We are also concerned that the administrative costs associated with financing the start-up of multiple co-op plans would far outstrip the seed money required to establish a public health insurance program.
There’s another point made further down in that letter that really is something to think about:
The major differences between the public option and for-profit plans are that the public plan would report to taxpayers, not to shareholders, and the public plan would be available continuously in all parts of the country.
Guess what? We’re already here. Established and ready to serve. A health plan that is accountable to taxpayers. CareSource, the nation’s second largest, not-for-profit Medicaid health plan and a number of other organizations like us around the country have been helping Americans get the care they need at the right place, at the right time and at a lower cost.
My point here is that even though the health care system is broken, there are still a lot of working parts, including a number of proven, experienced and effective non-profit insurance companies in place that can help get a “public option” off the ground. The best part – we can do it fast and transparently.
And while 47 million Americans now have no health care at all, speed and honesty is a big part of what we all need.
Article Tags
ACAP • American's Healthy Future Act • America’s Healthy Future Act • Co-op health plan • health care reform • health insurance • health insurance reform • Medicaid • michigan medicaid • non-profit • Ohio medicaid • Public Option • public plan • Senate Finance Committee • Senator Harry Reid • taxpayers • uninsured
Can We Wait Until 2014?
Author : Chris Whistler
Oct 14th, 2009 | by
The US Senate Finance Committee just approved a health care plan that includes a provision that would significantly expand Medicaid. This is great on so many levels. However, it has one flaw. That being, the full expansion wouldn’t actually start until 2014. Is it just me, or does that seem to contradict the whole idea of protecting the most vulnerable first?
Yes, it’s true that we’ve been trying to fix the health care system since at least 1948. So from one point of view, spending another few years trying to get it right doesn’t seem out of line. But imagine if all you hear around you is that health care reform is going to make a difference in the lives of the 47 million uninsured Americans right now, but then you find out that you have to wait longer than everybody else. Then, to make matters worse, your income is among the lowest in America and is the primary reason you are uninsured in the first place.
The unfortunate truth about this health care plan is that once again, those who are most in need are expected to wait longer than the rest of us. This includes hard working people with low incomes who just don’t happen to have dependent children – the current ticket for most people to qualify for Medicaid. And parents who are doing all they can to make ends meet for their children who are blocked from Medicaid coverage because their very limited income is deemed too high for them to qualify. The list goes on.
Where’s the justice in waiting to expand Medicaid until 2014? Or, maybe more pragmatically, where is the preventive care and coordination that is going to enable the right care at the right time in the right setting – you know, rather than causing the first stop to be in an emergency room after waiting until the cancer spreads, the diabetes worsens, or the heart attack occurs.
Doesn’t it make sense to have health care coverage for those that need it most first?
Ask your health care reform questions here
Article Tags
2014 • cancer • care source • diabetes • health care plan • health care reform • health care system • heart disease • Medicaid • michigan medicaid • michigan medicaid program • Ohio medicaid • Ohio medicaid program • poverty • Preventive Care • Senate Finance Committee • underserved
Dissecting the Senate Finance Committee Proposal
Author : Toni Bigby
Oct 9th, 2009 | by
Senate Finance Committee Completes Mark-up; Expected to Vote Out of Committee on Oct. 13
The Senate Finance Committee completed debate on proposed health care legislation at 2:18 am last Friday. The Finance Committee was the last congressional panel to consider a health care reform bill and plans to vote this week after the bill’s final language has been made public and the Congressional Budget Office has provided final cost figures. Democrats hold a 13-10 committee majority which clears the way for the full Senate to begin debating the measure on October 13, 2009.
The panel considered many amendments over a two-week period and voted to reduce or waive fines for people who fail to buy coverage and give states money to help insure low-income Americans.
The legislation, estimated to cost $900 billion over 10 years, mandates that Americans get insurance and provides subsidies to those who need them, creates nonprofit cooperatives to offer an alternative to private insurance companies, and prohibits insurers from denying coverage to people with pre-existing medical conditions.
Instead of approving a public option amendment, the finance panel voted 12-11 for a compromise plan offered by Sen. Maria Cantwell, D-Wash., that would give federal funds to states to negotiate with private managed care plans to buy coverage for people who would not qualify for the Medicaid program. This compromise option would be eligible to people with income between 133-200% FPL. For individuals, that means income between $14,403 annually and $21,660. For families of four, the eligibility would be $29,326 to $44,100.
Individual mandate – Lowering the Penalty & Allowing Exemptions Dismays Insurers
An amendment proposed by Senators Charles Schumer (D-NY) and Olympia Snowe (R-ME) was also approved that reduce the penalty for those who fail to comply with an individual insurance mandate to $750 per adult, from $1,900 per family as originally proposed. It also waives the penalties in 2013 and phases them in through 2017. In addition, people who would have to pay more than eight percent of their income to buy insurance would be exempt from the penalties, down from 10 percent.
This amendment is of significant concern to commercial insurers as it could allow 2 million Americans to remain uninsured without contributing to the insurance pool.
Insurers are outraged by the risk involved as they would be required to guarantee coverage for all Americans should the health reform measure pass. A strong individual mandate made this option feasible.
Other notable items:
- By a vote of 13 to 9, the committee approved an amendment by Senator Jay Rockefeller (D-WV) that would keep low-income children in the Children’s Health Insurance Program (CHIP), instead of covering them through the Exchanges. This was a key interest for CareSource as we hope to continue to provide coverage to children who qualify through CHIP in Ohio and Michigan.
- Physician groups were upset to find out that the hospital industry is exempt from a crucial cost-cutting measure related to Medicare payments included in Senate Finance Chairman’s mark. Hospitals were held exempt because they were able to negotiate a $155 billion cost-cutting agreement with Baucus and the White House.
What’s Next?
The bill that emerges from Baucus’s panel must be merged with one that passed the Senate Health, Education, Labor and Pensions (HELP) Committee for debate and vote by the full Senate and eventually reconciled with a House measure.
Across the Capitol, Democratic leaders in the House met privately with moderate members, with liberals, and then with first-termers as they struggled to achieve a consensus on legislation to bring to the floor. Majority Leader Steny Hoyer announced it would probably be at least two more weeks before House legislation was ready.
