The presumptive leader in the 2010 race for governor of the Sunshine State has launched a controversial public campaign to persuade Attorneys Generals in other states to join him in “launching a full review of the constitutionality of the individual mandate and potential legal options for States to pursue on behalf of their citizens should this mandate become law,” Florida Attorney General Bill McCollum writes in a letter to his AG peers.

The Senate recently approved a draft of the healthcare reform bill that provides for a mandatory tax of $700 to $4,000 against individuals who do not obtain health insurance coverage, either individually or through their employers, before 2013. The provision was added when lobbyists for the nation’s top health insurance companies successfully negotiated it in exchange for dropping an additional proposal that bans insurance companies from declining to provide coverage for people with pre-existing health conditions.

McCollum maintains that the tax would violate the provision of individual freedoms contained in both the United States Constitution and that of the State of Florida.

“I have grave concerns about the constitutionality of this mandate,” said McCullom. “Such a ‘living tax’ is worrisome because it would be levied on a person who does nothing, a person who simply wishes not to be forced to buy health insurance coverage…The mandate is especially troubling to Floridians who are guaranteed through the Florida Constitution to have ‘the right to be let alone and free from governmental intrusion into [their] private life.’”

In another public statement to the media, McCullom explained his stance against the proposed tax and threatens legal action if it becomes law.

“I am committed to pursuing any legal action necessary to defend (the rights)…of the more than 18 million individuals who call Florida home,” writes McCollum.

Earlier this year, McCollum announced his intent to seek the Republican nomination for Governor of Florida in 2010. He intends to replace Governor Charlie Crist, a fellow Florida Republican, after serving one term as Attorney General. McCollum is considered the frontrunner in the race for the nomination because Crist also served as AG for Florida before he took over the state’s highest office.

Democratic Senator Dan Gelber of Miami, who is running to replace McCullom as Attorney General, quickly criticized McCullom in a statement shortly after McCllom announced his intent to review the constitutionality of the healthcare tax.

“General McCollum’s decision to use his office to investigate ways to block health insurance reform is exactly why we need new leadership in the Attorney General’s office,” said Gelber. “There are four million Floridians without health care including 800,000 children. Only one state has a higher percentage of uninsured. I wish McCollum was as concerned about solving Florida’s health care crisis as he was about stopping the solving of the health care crisis.”

The reform bill passed in the House has the potential to change what all health insurance plans cover. An amendment proposed by Bart Stupak, which passed in the House of Representatives, prevents federal funding from being used to buy any health insurance plan that offers coverage of elective abortions. In exchange for the votes of pro-life Democrats essential to pass the legislation, the healthcare reform bill was modified. The previous language only prevented government money from being used directly to pay for an abortion.

Obviously, the public option will not include abortion coverage. However, the ban extends to private health insurers participating in the government’s insurance exchange. Low- and medium-income individuals and families will receive subsidies in order to buy a health insurance plan. A compromise proposed by Speaker Nancy Pelosi, which would serve to distinguish private dollars from federal money and allow insurers to cover abortion services with solely the latter, was rejected. Many people with employer-provided or individual health insurance have abortion coverage provided in their policies. In order to enter the potentially lucrative exchange market, insurers might eliminate that coverage entirely.

Those who pay for their entire health insurance policy out-of-pocket will still be allowed to buy plans that provide abortion coverage, although the availability and affordability of these plans will most likely decrease. Pro-choice advocates, such as Planned Parenthood, are crying foul.

Interestingly, the amendment received 240 votes–higher than the actual bill’s margin of victory. Assuming that many pro-choice Democrats voted against it, this result means that a significant portion of Republicans voted for the amendment. Whether they wanted to salvage something they wanted out of a bill that was almost certain to pass or sabotage the bill by creating a schism between Democrats, they decided to amend a bill while rejecting the bill itself.

(Image: mahalie under CC 2.0)

Continuing the use of technology that fueled his successful presidential campaign, President Barack Obama is now using Facebook and other social media sites to push the Democratic healthcare reform bill. By reaching the younger demographics most supportive of the public option where they congregate, Obama hopes to motivate them to call their representatives and express their support of reform. Generations X and Y live on the Internet, and are also the portion of the population most likely to be uninsured. Some of them might think that they’re healthy now and therefore invincible, but others realize the importance of having a health insurance plan at any age.

The House of Representatives will most likely be voting on healthcare reform this weekend, and representatives will no doubt be hearing from their constituents about it. Opponents of the Democrats’ reform are fired up, and the Obama administration’s goal is to light that fire under supporters who believe it’s the best way to provide affordable health insurance to the nation. They must hope that Obama’s millions of Facebook friends and Twitter followers keep up with their news feeds and become inspired to get involved in helping him enact part of the change he promised them. Their presence was sorely lacking for Democrats earlier this week, when Republicans won governor’s races in two states in off-year elections–largely fueled by anger over reform, and fears of people scared of losing their existing health insurance plans. We’ll see if Obama’s final push pays off.

The H1N1 may spread worse because people say they can’t afford to to stay home if they get sick.

Public health experts are raising concerns that workers who deal with the public, like waiters and child care employees, are jeopardizing others by reporting to work sick because they do not get paid for days they miss for illness.

Tens of millions of people, or about 40 percent of all private-sector workers, do not receive paid sick days, and as a result many of them cannot afford to stay home when they are ill. Even some companies that provide paid sick days have policies that make it difficult to call in sick, like giving demerits each time someone misses a day.

Public health experts say policies like these encourage many people with H1N1, commonly called swine flu, to report to work despite official warnings from the government and most companies that they should stay home.

Some people who are really caught on a weekly income might say they are desperate for money and that they are going into work even though they are sick.

Many of these financially squeezed workers might also send their flu-stricken children to school, infecting others. Many will not see a doctor because they do hot have health insurance. Although there are affordable health insurance plans.

Well before President Obama declared H1N1 a national emergency, the federal Centers for Disease Control and Prevention was emphasizing that businesses should adopt “flexible leave policies” to allow workers with the flu to stay home. In one advisory, the C.D.C. encouraged employers “to develop nonpunitive leave policies.”

Despite such recommendations, some employees say they have no choice but to go to work sick.

Lenneice A. Drew is an experienced journalist currently focused on healthcare reform. She is working to help others achieve better lives by finding affordable health insurance alternatives and reporting stories related to the health care industry. She lives in Miami, Florida.

Although it seems like the Democrats’ healthcare reform bills have been zooming through Congress, Senate Majority Leader Harry Reid predicts that there will soon be roadblocks.  To the chagrin of the Obama administration, Reid believes that a final bill won’t pass before the ball drops on Times Square and 2009 draws to a close. The White House wanted a bill passed prior to Ryan Seacrest’s countdown to the new year. Why is that so important? Well, 2010 is an election year; the entire Congress will be up for re-election. Judging from the few elections held yesterday, things don’t look good for the Democrats. Their prospects will be even worse if the fight to reform the health insurance industry continues to drag on, instead of  allowing the public’s memory to fade.

Unlike the House of Representatives, which is already close to voting on its bill, the Senate may not begin debate until December. There is some speculation that Reid is waiting for the final cost analysis from the Congressional Budget Office. He commented publicly that he doesn’t want to rush such an important bill. However, he is still striving to pass Obama’s top domestic priority by years’ end. They may be worried that waiting too long will make more likely that this administration’s attempt at providing more affordable health insurance will follow the failing path of Clinton’s.

This new development is just another example of why you shouldn’t wait for the public option if you can afford a health insurance plan now.

With all the controversy over the public option proposed by Democrats in their healthcare reform bills, the number of Americans who will actually be covered by the public option is surprisingly low. Speaker of the House Nancy Pelosi estimates that just six million (2%)  of the population under 65 years of age will choose the government run health insurance program. One out of five individuals who are buying insurance on their own or in a small group (and will participate in the insurance exchanges central to the House’s bill. would take the public option. The most important issue that has been lost in the debate is providing affordable health insurance to the nation, whatever form it takes.

The public plan might not be the panacea to increased health care costs its supporters claim it will be. The people most likely to be attracted to it will be those with pre-existing conditions private insurers are less likely to cover. Therefore, average health insurance quotes would be cheaper with a private plan, steering the healthier segment of the population away from the public option. Less stringent regulations that allow the less healthy to use more medical services and see more specialists would also drive up costs. (Private insurance companies sometimes limit their offerings based on profitability.)

All in all, the public option doesn’t seem to be as far-reaching as first expected, at least for now. Most Americans will continue to have health coverage through their employers. Senior citizens already have Medicare. What about the masses of low-income uninsured individuals and families? It turns out that most of them will be covered through Medicaid, another government program that will be expanded.

(Image: Speaker Pelosi under CC 2.0)

Last year, a representative from Texas was the true Republican maverick in the presidential race. Ron Paul may not have won the nomination, but he is still bringing his unique libertarian perspective to Congress’ table. His proposals for healthcare reform are no different. He recognizes that the current health insurance situation is untenable, but is against governmental involvement. Recently, he presented several intriguing bills to the House of Representatives.

1. The Comprehensive Health Care Reform Act of 2009 would give Americans a 100% tax credit on their health care costs (e.g. prescriptions, hospital stays, doctor visits). Health Savings Accounts (HSAs) with high-deductible health insurance plans would also be tax-free. Low-wage employees who don’t file tax returns can have the credit refunded against their payroll taxes, so the bill would help those who need it most afford healthcare. Currently, only medical expenses that reach over 7.5% of an individual’s income can be deducted.
2. Dr. Paul’s Coercion Is Not Health Care Act of 2009 would forbid the government from enacting a health insurance mandate. There has been some speculation as to the legality of such a mandate. Congressional Democrats, along with the Obama administration, believe that it has to be part of healthcare reform legislation. Their view is that universal coverage must include the young and healthy in order for the insurance pool to afford covering those with pre-existing conditions. This interference in the free market is anathema to Paul. Incidentally, if there is no public option, such a mandate might not be necessary.
3. Finally, his Freedom From Unnecessary Litigation Act of 2009 would save money through indirect tort reform. This act would establish so-called “negative outcomes insurance”, which would pay off if a patient’s medical treatment goes wrong; it would also offer a tax credit to make the purchase more affordable. The goal is to decrease some of the unnecessary (and costly) testing done in order to avoid malpractice liability, as well as lessen the need for hospitals and physicians to carry billions of dollars in insurance.

As Paul is himself a doctor, his views on the healthcare industry are worth listening to. His opinions tend to be shortchanged in the House because he doesn’t walk in lockstep with either party’s platform, giving his bills little chance of passing.  However, many Americans–who fear socialized medicine, yet acknowledge that we need more affordable health insurance as soon as possible–could find something to applaud in his plans.

New Rules for Old Healthcare: Many of us are ‘Going it Alone’

After nine months of back-and-forth public debate, big corporate bail-outs and strained political ties amongst members of Congress, the shock of the new economy and all its moving pieces has officially worn off. But healthcare reform still dominates our national agenda at a time when few of us can afford to be without. Whether or not the so-called “Public Option” becomes part of any finalized healthcare bill signed into law, the average American will have some vital decisions to make about when, where and how they seek coverage. The old rules of group coverage no longer apply in the new economy.

No Safety in Numbers

Just as fast as the U.S. housing meltdown completely redefined what it means to live within our means, so too are the days when finding a good job guaranteed you’d find affordable health coverage where you work. Companies of all sizes are cutting back benefits now that they’ve cut back their workforces. As a result, the old-school “pool” insurance model is proving less and less sustainable. The good news is while debate still rages on Capitol Hill, health insurance providers are restructuring their product portfolios to make coverage more affordable for millions of individuals — no matter if they’re employed or not.

“Next to salary, health insurance is the largest expense any company has,” says Larry Johnson, a human resources officer with Nashville, Tenn.-based Hospital Corporation of America (HCA), the nation’s largest for-profit hospital company. “The reality is that individuals can go online and out in the open market now and get low cost, low deductible coverage on their own.  Lots of times it’s cheaper than what we can provide our own employees.”

Inside Out

In the same way telephone companies broke themselves up into smaller, regional providers in the 1980s (to address government concerns that telecommunications had become a monopoly of a few big providers), health insurance companies are breaking themselves up from the inside out. It was clear several years ago, says one industry health insurance executive, many healthcare companies saw the governmental reform train coming down the tracks.

“Changing an entire product set, expanding a marketing strategy and creating a new pricing model for an industry that’s been pretty much self-regulated up until now doesn’t happen overnight,” says Miami-based independent health insurance agent Jerry Sommers. “Public option or not, this has been in the corporate pipeline for years before it ever got into the media or Congress. It’s only going to get more confusing before it gets better. I’m quoting a lot of policies for people who are scared of what we might end up with when the government gets done.”

Sometimes having the wrong health insurance is even worse than being uninsured. An recent article in Chester County’s Daily Local News made that clear. After becoming unemployed, many people are left in dire straits once their employer’s COBRA coverage expires. With little money, most are only able to buy inferior health insurance plans. At that point, millions of individuals and families become underinsured. Imagine if your insurer refused to cover even one emergency room visit! No wonder some people decide to go uninsured instead; they’d still have to pay for their medical care, but at least wouldn’t still be paying premiums.

Unfortunately, some people doesn’t find out what their health insurance plan does and doesn’t cover until it’s too late.  Avoid the underinsurance trap by reviewing your plan and talking with an insurance agent. The best solution is to find a plan that suits your needs and provides the most value. It’s important to save money on insurance, but don’t forget your health. If you are currently underinsured, you can get an affordable health insurance quote for a better plan.

(Image: Commonwealth Fund)

So far, Republicans in Congress have mainly expressed opposition to the healthcare reform plans proposed by the Democrats. They haven’t offered many solutions of their own, but that’s about to change.  John Boehner, the most powerful member of the minority party in the House of Representatives, has promised that the GOP will present an alternative bill that doesn’t entail major government involvement or adding to the national debt. Obviously, there will be no public option in this version.

Boehner acknowledges that the current system isn’t ideal. How does he plan to give more Americans access to health insurance? These are several things Republican healthcare reform bill would do:

• Severely decreasing the number of medical malpractice lawsuits. This would lower health care costs through a reduction in the unnecessary tests given by overly cautious doctors. Malpractice insurance can also cost doctors millions of dollars per year. As a bonus, it doesn’t hurt that trial lawyers tend to support and contribute to Democratic politicians; this measure wouldn’t affect many GOP supporters.
• Creating a pool that allows small businesses and individuals to buy affordable health insurance in large groups. That proposal is similar to part of the Democrats’ healthcare plan. It’s pretty noncontroversial.
• Repealing the regulations that prevent people from going across state lines to buy health insurance plans. Some states, such as New York, regulate the industry more than others. These regulations include prohibitions on denying insurance to people with pre-existing conditions, for example. While these measures allow more people to be insured, they also result in higher health insurance premiums. Boehner believes that creating a nationwide free market will be more effective in lowering healthcare costs than a public option.

A Republican plan wouldn’t include a health insurance mandate, and would avoid tax increases. It sounds nice, but would it actually be successful? Even party leaders admit that their proposals wouldn’t come close to covering most of America’s uninsured.