Posts Tagged - ‘healthcare reform’

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Mini-Med Health Care Policies Under Senate Investigation

Wednesday, December 1st, 2010

Mini-medical plans are controversial. On the one hand, they provide some coverage for emergency care, and in many cases are better than nothing. On the other hand, they often come with extremely low annual benefit payout limits that make them nearly useless if a person needs major medical treatment.

Mini-meds are typically offered by low-wage companies, and administered by major health insurance plan providers like Cigna and Aetna. A Senate committee is currently investigating the issue; the probe has been expanded from McDonald’s to other employers. The issue is that although policyholders are usually saddled with high medical bills, the plans are sometimes promoted as full-fledged comprehensive health care.

Although the healthcare reform law bans annual and lifetime limits, dozens of mini-med providers have been granted exceptions from that provision. Mini-meds are also subject to a lower medical loss ratio, which determines the percentage of premiums that must be spent on medical care.

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Are Health Insurance Brokers An Endangered Species?

Tuesday, November 30th, 2010

Image: H. Michael Karshis under CC 3.0

In many states, regulators fear that health insurance brokers are falling by the wayside. The healthcare reform law passed this year requires that a certain percentage of premiums be spent on providing medical care, as opposed to being spent on administrative costs.

Some consider brokers as middlemen, standing in the way of affordable health insurance by creating yet another level of bureaucracy. However, they can help people navigate the confusing variety of plans available and shop around–although that purpose may become irrelevant once states get their own health insurance exchanges up and running.

In addition, many brokers may end up out of work if they cannot adapt to the changes in the market and regulatory environment.

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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

Image: DonkeyHotey under CC 3.0

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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Congress’ Health Insurance Coverage Takes Time to Kick In

Wednesday, November 17th, 2010

Image: SourceWatch

Elected officials tend to enjoy generous health insurance benefits, fully paid for by the government. Members of Congress are no different. However, in one way they aren’t different from you and me: their employer-sponsored health coverage doesn’t kick in immediately.

Newly hired (or elected) representatives and senators must wait 28 days before they can take advantage of the federal health insurance plan. Rep.-elect Andy Harris of Maryland is currently protesting this waiting period, and expressed his problem during freshman orientation earlier this week. It may raise the eyebrows of some that Harris is a Republican who largely ran (and won) on his opposition to healthcare reform and the Obama administration’s increased involvement. He has vowed that he will seek to repeal the law as a member of the House of Representatives.

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Another State to Join Healthcare Reform Lawsuit?

Tuesday, November 16th, 2010

Image: davis.jaque under CC 3.0

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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Obama Didn’t Realize Affordable Health Insurance Reform Would Be So Hard

Monday, November 8th, 2010

Image: Beverly & Pack under CC 3.0

After his party’s drubbing in the midterm elections, President Obama is Monday-morning quarterbacking. In an exclusive interview with 60 Minutes, he admitted that he didn’t expect the passage and implementation of affordable health insurance reform to have such a high political cost.

Many would consider this view naive, given that presidents have struggled with the complex system for decades. Also, there are many interest groups heavily involved, with a major stake in the issue.

According to Obama, he assumed that his incorporation of proposals previously advanced by Republicans such as Mitt Romney would help bring about some compromise with the GOP. As it turns out, the final product ended up pleasing few: progressive Democrats wanted more, while conservatives wanted far less.

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