Category Archive - Reform & Regulation

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Florida Rep. Tries Anti-Health Insurance Mandate Amendment Again

Wednesday, November 24th, 2010

Image: turtlemom4bacon under CC 3.0

Last year, State Representative Scott Plakon (R-Florida) attempted to put a measure that would amend the state’s constitution to forbid mandating the purchase of health insurance on the ballot. That time, a judge rejected it due to what was considered overly political and misleading language.

Undaunted, Plakon is trying again. House Joint Resolution 1 would challenge the Obama administration’s healthcare reform legislation, which will eventually fine certain individuals and employers for failing to purchase affordable health insurance. It would give Florida more legal standing in its lawsuit against the federal government’s provision.

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Health Insurance Reform: Healthcare Mergers Coming Up?

Monday, November 22nd, 2010

Image: Frits Ahlefeldt-Laurvig under CC 3.0

The healthcare reform law may end up having an unfortunate side effect: although one of its stated goals is to help make affordable health insurance more widely available by spurring competition, several health care providers are considering merging.

According to many groups of doctors, hospitals, and clinics, the alliances and joint ventures are necessary in order to maintain their profit margins and take advantage of the potential savings of the law while avoiding the additional costs. However, consumers may suffer as a result.

The industry’s lobbying groups also want the Federal Trade Commission and the inspector general of the Department of Health and Human Services to give them exceptions from antitrust and Medicare fraud laws. This could potentially be dangerous. On the positive side, it can force medical service providers to coordinate care, leading to better health outcomes for patients.

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Health Insurance Companies Spent $86 Million on Anti-Healthcare Reform Lobbying

Thursday, November 18th, 2010

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Some people may worry that this is what at least a portion of their health insurance premiums has been paying for: according to Bloomberg’s examination of major insurers’ tax records, they spent a total of $86 million on the U.S. Chamber of Commerce’s campaign to defeat the Obama administration’s healthcare reform legislation in 2009.

These expenses–public rallies and events, media advertisements, and sponsored polling meant to sway opinion–would probably not qualify as falling under the medical loss ratio guidelines, which say that a certain percentage of customer premiums should be spent on providing care through their health insurance plans, as opposed to administrative and other expenses. Cigna and United HealthCare were among the biggest givers. In addition, the Chamber of Commerce is only one of the myriad interest groups opposing the law.

Was it a worthwhile investment? The bill passed early this year, so maybe not. However, they appear to have successfully swayed the views of a significant portion of the American public. The Republicans now taking over Congress will do their best to weaken the law, if not repeal it entirely.

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Another State to Join Healthcare Reform Lawsuit?

Tuesday, November 16th, 2010

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Although the very first challenge to the Obama adminstration’s affordable health insurance reform law was rejected by the Supreme Court, that isn’t stopping states from continuing to oppose it. Over 20 attorney generals launched a lawsuit over the individual mandate provision earlier this year; it is predicted that arguments will be heard sometime in 2011.

Now, Kansas is mulling over the possibility of becoming yet another plaintiff in the large Florida-led case. The Republicans recently elected to state office, Governor-elect Sam Brownback and Attorney General-elect Derek Schmidt, have vowed to mount legal challenges. However, it will most likely take awhile for them to gear up for it.

Ironically, former Kansas Governor Kathleen Sebelius, who retired in order to become the Secretary of Health and Human Services, is in charge of promoting and implementing the healthcare reform legislation.

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First Legal Challenge of Healthcare Reform Fails

Tuesday, November 9th, 2010

Image: Collection of the Supreme Court of the United States

A rare bright spot for the Obama administration this past week: a legal review of the healthcare reform law was rejected by the U.S. Supreme Court.

Granted, it wasn’t necessarily a referendum on the merits (or lack thereof) of the changes to the health insurance plan market in America. Instead, the challenge–filed by a conservative legal group in California–was denied because similar legal challenges are already winding their way through the lower courts. Moreover, the individual mandate provision at the centerpiece of the lawsuit is not scheduled to take effect until 2014.

Interestingly, both Justices Elena Kagan (a former Department of Justice lawyer for the current administration, although she didn’t participate in healthcare reform-related litigation) and Clarence Thomas (whose wife, Virginia, is a high-profile activist seeking repeal of the law) did not exclude themselves from the decision.

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First Step for GOP: Repealing Health Insurance Reform?

Monday, November 8th, 2010

Image: Gage Skidmore under CC 3.0

After a mostly triumphant Tuesday, Republicans are gearing up to take on several legislative centerpieces of the Obama administration. Most significantly, they are looking to say sayonara to healthcare reform by repealing what they refer to as “Obamacare”.

On CBS’ Face the Nation, current Senate Minority Leader (the Democrats retained control of the Senate) Mitch McConnell stated that the GOP was given a wide mandate by independent voters to repeal healthcare reform. According to them, they owe it to the American people to do better and come up with another way of making health insurance plans more accessible.

For their part, Dems are skeptical that the law can actually be reversed so easily. Those looking for it to happen as soon as the new congresspersons are sworn in in January will be disappointed. For one thing, Obama is sure to veto any such legislation that reaches his desk.

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IRS’ Affordable Health Insurance Reform Implementation in Danger

Wednesday, October 27th, 2010

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Understandably, most people aren’t huge fans of the IRS. For the most part, Americans communicate with them when they’re taking money out of their pockets during tax season. However, a provision of the new healthcare reform law has the Internal Revenue Service actually attempting to give money back!

The law is meant to make affordable health insurance more widely available through tax credits to small businesses that provide coverage to their employees. Doing so will require more manpower and resources for implementation and enforcement of the program. Some Republican candidates are considering defunding the IRS and other agencies involved to stifle healthcare reform, since it is predicted to take $5 to $10 billion for each agency to fully implement it.

Congress has the power to do so, and does not require President Obama to sign off on a repeal he would be guaranteed to veto. Ironically, one of the most business-friendly provisions may suffer as a result.

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State Health Insurance Commissioners To Rule on Medical Loss Ratios

Thursday, October 21st, 2010

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All eyes are on Orlando today, but not because of anything Mickey Mouse has done. Rather, it is a meeting of several states’ insurance commissioners. Their topic: coming up with the rules that insurers will have to abide by post-healthcare reform.

Specifically, they are responsible for calculating minimum medical loss ratios. MLRs are also known as the percentage of premiums spent on providing health care, as opposed to profits and administrative expenses. Proponents of the limits believe that they will result in more affordable health insurance for consumers. However, some are worried that the new rules will make some niches and entire markets–such as small groups–less appealing, and that people will become uninsured as a result.

The group’s recommendations will become effective next year. Although the already-determined limits are 85% for large group plans and 80% for small groups and individuals, the commissioners will consider tax exemptions and a longer phasing-in period. Most significantly, they will help determine what counts as a medical expense. Insurers obviously want a wider definition of qualified medical costs.

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Virginia Judge To Rule on Health Insurance Mandate on New Year’s Day

Tuesday, October 19th, 2010

Image: USA Today

Those hoping for a quick resolution to the lawsuits seeking to overturn a portion of the Obama administration’s healthcare reform law are out of luck. At least one of the suits–the one filed by Virginia–will take longer to resolve. According to U.S. District Court Judge Henry E. Hudson, he will rule on whether the affordable health insurance mandate provision is constitutional on January 1st.

If Hudson determines that the state’s Attorney General Ken Cuccinelli II has a case for the federal government overstepping its boundaries, the challenge will be one step closer to the Supreme Court. Since Virginia has its own specific law forbidding anyone from mandating that its residents purchase health insurance, it filed a lawsuit separate from the class action joined by over 20 states.

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McDonalds, Other Businesses Exempt from Healthcare Reform Law

Monday, October 18th, 2010

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There has been much concern surrounding healthcare reform’s impact on businesses. Many are worried that employers will drop their health insurance plans altogether, rather than complying with new requirements that increase the standard of care.

However, 30 companies and unions–McDonalds is the most popular–have received an exemption from that provision. The waiver must be renewed by Secretary of Health and Human Services Kathleen Sebelius each year until 2014. HHS made the judgment that rather than risking companies discontinuing seasonal and temporary workers’ health coverage entirely, it makes more sense to allow them to retain the inferior mini-med plans with extremely low annual limits of coverage. This will be the case for several years, until the health insurance exchanges are fully operational to give such employees more options.

Other firms are protesting this move, because small businesses will suffer while the big names with lobbying influence can get around the unfavorable provision.

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