Posts Tagged ‘health insurance’
Jul 22nd, 2010 | by
Dear President Obama,
Thank you…thank you for the release of the Patient’s Bill of Rights. This public proclamation that describes how patients will be protected by the rising costs and complexities of the health care system is exactly what this country needs. It is fundamentally consistent with the philosophies of our nation. The Patient’s Bill of Rights builds a foundation that allows opportunities to exist, opportunities open to all, and most notably our country’s underserved population.
Underserved people continue to suffer in our country. And one of the most profound challenges to this demographic is having the forum to voice opinion. Underserved communities struggle to be heard…struggle to tell their stories…struggle to instill empathy in those most able to be helpful.
The Patient’s Bill of Rights gives the underserved a voice. It protects them from elements that have been traditionally uncontrollable. It protects our children, it protects those with pre-existing conditions, and it protects women. But most importantly, it protects the integrity of our country and the goodwill we extend to our citizenship.
So thank you, Mr. President, for embracing our country’s underserved, and moving hope to what is tangible. And we’re happy to answer your request and spread the word about the new Patient Bill of Rights.
The Patient’s Bill of Rights
“Starting in September, some of the worst abuses will be banned forever. No more discriminating against children with pre-existing conditions. No more retroactively dropping somebody’s policy when they get sick if they made an unintentional mistake on an application. No more lifetime limits or restrictive annual limits on coverage. Those days are over.” – PRESIDENT BARACK OBAMA
President Obama announced a Patient’s Bill of Rights made possible under health reform—a basic set of consumer protections.
The Patient’s Bill of Rights:
- Prevents insurance companies from canceling your policy if you get sick. Right now, insurance companies can retroactively cancel your policy when you become sick if you or your employer made an unintentional mistake on your paperwork.
- Stops insurance companies from denying coverage to children with pre-existing conditions. Beginning in September, discrimination against children with pre-existing conditions will be banned—a protection that will be extended to all Americans in 2014.
- Prohibits setting lifetime limits on insurance policies issued or renewed after Sept. 23, 2010. No longer will insurance companies be able to take away coverage at the very moment when patients need it most. More than 100 million Americans have health coverage that imposes lifetime limits on care.
- Phases out annual dollar limits on coverage over the next three years. Even more aggressive than lifetime limits are annual dollar limits on what an insurance company will pay for your health care. For the people with medical costs that hit these limits, the consequences can be devastating.
- Allows you to designate any available participating primary care doctor as your provider. You’ll be able to keep the primary care doctor or pediatrician you choose, and see an OB-GYN without referral.
- Removes insurance company barriers to receiving emergency care and prevents them from charging you more because you’re out of network. You’ll be able to get emergency care at a hospital outside of your plan’s network without facing higher co-pays or deductibles or having to fight to get approval first.
Mar 23rd, 2010 | by
On behalf of the 15 million Americans who will be eligible for Medicaid as a result of health care reform…we thank you.
On behalf of the children that need health care to support every possible opportunity for a successful and productive life…we thank you.
On behalf of Americans who must choose between buying food and getting health care…we thank you.
On behalf of the senior citizens who are wondering how to maintain their health on a modest budget…we thank you.
Despite the contentious year-long debate, Congress has done what’s right for the American people. Making health care a right – not a privilege – is a fundamental element that has been sorely missing from the ideals of our nation…until now!
Was this the best possible outcome? Probably not.
Does the new legislation fix every problem that ails the current health care system? No, not really.
But it is definitely a start. We elected our leadership to do what is best for the American people given the challenges our country is currently facing. Right now, what is best has arrived in the form of a new and improved health care system that will turn away no one; that will take care of our children; and most importantly, that is in reach to all Americans.
- Expansion of Medicaid to everyone (under age 65) below 133% of the Federal Poverty Level by 2014– removing categorical eligibility which currently forces many individuals in poverty to go uninsured.
- Creation of state-based health exchanges through which individuals can purchase coverage, with premium and cost-sharing credits available to individuals and families with incomes between 133 percent and 400 percent of the poverty level, or $14,404 to $43,320 for individuals and $29,326 to $88,200 for a family of four.
- An individual mandate for all to ensure all Americans participate in the insurance risk pool resulting in lower cost coverage options for all. Requires insurers to cover those with pre-existing conditions, removes lifetime limits, prohibits rescission of coverage and mandates prevention services be covered at 100 percent.
- Equalization of treatment of managed care and fee-for-service under the Medicaid drug rebate program.
- Closure of the Medicare prescription drug “doughnut hole” by 2020.
- Reauthorization of the Medicare Advantage Special Needs Plan program.
- Improved coordination for Medicare and Medicaid dual-eligibles.
Each of these provisions propels our country into a new era in health care for which we should embrace and build upon. There are many that vow to fight the passing of this bill, and that’s to be expected. But we should applaud all of our policymakers for remembering why and how this nation was created…to be a land of opportunity, of freedom, and of equality. Thank you, Congress, for doing what’s right for all people.
Article Tagscongress • cost of health care • drug rebate program • Federal Poverty Leve • fee-for-service • health care costs • health care exchange • health care reform • health insurance • individual mandate • managed care • Medicaid • Medicare • Medicare Advantage • michigan medicaid eligibility • ohio medicaid eligibility • poverty level • state based health exchanges
Feb 24th, 2010 | by
So there are some Democrats threatening to use reconciliation to get a health care plan passed (CNN article). Well, first things first. Let’s get through the President’s summit and see how it goes. Who knows what surprises may be in store? They may actually be “welcomed” surprises for a change.
This entire debate has been one surprise after another. As a result of this summit, we may actually see a few members of the minority party decide that the President’s plan (albeit not perfect) is currently the best option we have given the times. What do the Dems have to lose? Reconciliation should be used as a last resort and quite frankly, that is exactly what they seem to be doing. All we ask is – just do something – and do it soon – and don’t make it a band-aid approach.
So much debate and finger pointing and arguing and going back to the table threatens to completely dilute any meaningful reform. Despite the fact that the majority of Americans have said that reform is what they want and what America needs. Meanwhile, another $25-billion in Medicaid relief has been included in the President’s budget proposal to states that are seeing current enrollment numbers rise due to our economic environment.
The President’s plan has some really good aspects that will change the course of the health care system today and we finally have the momentum to actually make the health of our nation better. Why stop now?
Why stop when it includes a meaningful expansion of Medicaid so that our most vulnerable citizens can get the monetary relief and care they need to stay healthy? Why impede the development of an insurance exchange to make it easier for Americans to purchase health care? Why prevent important insurance reforms from taking place? Why dilute a requirement that says all of us have to buy coverage to ensure the health care system will be there when we need it and not bankrupt the nation in the process? And why in the world would we want to encumber a real focus on managing high-cost chronically ill populations?
All of these things that make a lot of sense are included in the President’s plan, and can be passed with or without reconciliation.
It will be interesting to see what plays out with the President’s health care summit. Perhaps some consensus can be met that may not address everything, but will at least garner enough votes to put something meaningful in place that we can build upon over the next decade.
A couple question to our readers – Do you think imposing reconciliation is the right way to go? Do you think the President’s health care summit will prove productive?
Dec 23rd, 2009 | by
We know. We don’t want to “make the perfect enemy of the bad” and all.
But really, this new thing about the insurance company tax exemption? We need to take another look. As of now, non-profit insurance companies that operate in the private marketplace (primarily the Blue Cross/Blue Shield companies) and spend at least 92% of premiums directly on medical costs would be exempted from the new tax on insurers in the Senate bill. (Wall Street Journal’s explanation of this “bright spot” ).
This needs to be extended to companies serving the public through Medicaid, Medicare and CHIP. Otherwise, millions of state tax dollars currently being used to provide health care to children, seniors and others will instead be sent straight back to Washington, leaving the states to find some way to make up the difference.
We don’t think anyone meant the new tax on insurers to actually be a tax on states, but that’s how it works out in the current iteration of the bill. It doesn’t make sense to us.
By the way, Associated Press offers a pretty comprehensive list of all the compromises in the Senate bill as it stands, here.
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 TagsChildren'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
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 TagsACAP • 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
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.
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.
Article TagsCharles Schumer • CHIP • co-op plan • exchange • health care reform • health insurance • Jay Rockefeller • managed care • Maria Cantwell • Max Baucus • Medicaid • Medicare • michigan medicaid • michigan medicaid eligibility • michigan medicaid program • non-profit • Ohio medicaid • ohio medicaid eligibility • Ohio medicaid program • Olympia Snowe • public plan • senator • Steny Hoyer
Oct 2nd, 2009 | by
“Funny or Die”, the comedic website developed by Will Ferrell, Adam McKay and Chris Hench posted a hilarious video about the health insurance industry called “Protect Insurance Companies PSA”. Obviously satiric, the clip showcases many Hollywood personalities supporting the need for health care reform to protect Americans from the interests of greedy health insurance executives. The clip ends with a call to action to support the public option, and email your Congressman.
The only unfortunate thing about this video is that it lumps all insurance companies together. But there are some insurance companies – ours for instance – that actually support reform efforts that offer the uninsured an array of affordable health care options from which to choose. Look, the truth is we are embarking on a new era in health care. The entire health care industry – providers, hospitals and insurance companies alike – will be completely revolutionized once reform is introduced. And the legacy insurance companies who have profited unscrupulously will find it hard to adjust because they’ve operated the same way for years.
The insurance companies of the future – those that are non-profit, customer-focused first, and genuinely engaged in finding ways to decrease spending while increasing quality – are the companies ready to thrive in this new era. Do we stand to benefit? Of-course we certainly hope so. But I’d rather have a system that rewards transparency, honesty, inclusion, wellness and empathy than one that rewards profitability and size.
Public option, co-op, exchange, expanded Medicaid and/or individual mandates …whatever shape reform ends up taking, there are a handful of progressive companies ready to embrace this new world. Will Ferrell and team are funny indeed! I just hope they know there are some insurance companies out there that support his team’s ideals and don’t make us all pay for the sins of others!