Posts Tagged ‘reform’

This Week in Health Care Reform Easy To Insure ME

May 31st, 2011

Millions of Americans went to the polls on Tuesday, feeling anxious about the economy and health care reform, and yielding election results that gave Republicans control of the House of Representatives and weakened the Democratic majority in the Senate. Republicans picked up at least 60 House seats and at least six Senate seats in the election, removing Democrat Nancy Pelosi from her powerful position as speaker of the House and putting Republicans in charge of House leadership and committees.

The Republican sweep extended from coast to coast and removed more than 30 Democratic incumbents from the House of Representatives, including Armed Services Committee Chairman Ike Skelton, Budget Committee Chairman John Spratt and Transportation Committee Chairman James Oberstar.

Exit polling shows more than eight in 10 voters feel the economy is the No. 1 issue facing the nation, and three times as many people believe it is getting worse rather than better. Health care reform followed as the second-most important issue for voters during this election cycle. Nearly three in four voters expressed dissatisfaction with Congress and six in 10 say they believe the country is headed in the wrong direction.

With the midterm elections close to complete, we encourage you and others to see how health care reform affected congressional races by visiting the updated Health Action Network.

Health Care Reform
How the Election Results Affect the Future of Health Care Reform: With the new Republican majority in the House, a stronger showing in the Senate and greater numbers of GOP governors, the health care debate is expected to focus on implementation of the law, as well as efforts to repeal it. While full repeal will face a presidential veto, lawmakers will most likely pursue incremental changes, “tinkering and tweaking” the law to keep the debate top of mind for voters leading up to the 2012 elections.

According to political strategists, Republicans could also use the oversight authority of Congress to slow down or block regulations, essentially stalling the law’s progress. Congressional hearings are likely to focus on the impact of the immediate reforms on costs and coverage, the outlook for reforms that take effect in 2014 and stronger direct oversight of federal regulators. Additionally, the annual appropriations process is likely to serve as a battleground for health care reform issues, with a focus on funding for federal agencies involved in the implementation process.

Two More States Vote to Reject Health Insurance Mandate: At the polls this week, voters in Oklahoma and Arizona resoundingly supported ballot initiatives to opt out of the federal health care reform law. Missouri voters approved a similar measure, Proposition C, with 71% support on a primary ballot in August. A similar proposal on Tuesday’s ballot in Colorado would have prohibited the state from forcing residents to buy public or private health insurance. However, the measure was rejected by a narrow margin.

Public Opinion
Exit Polls Show Half of Americans Still Want Repeal: According to the Pew Research Center, voters were divided over whether to repeal health care reform (48%) or maintain or even expand it (47%) in exit polls on Tuesday. However, the major priorities for 2011 include reducing the deficit, creating jobs and boosting the economy.

Looking Ahead
President Barack Obama has invited the Republican and Democratic leaders of Congress to the White House on November 18 to discuss the new political landscape and ways to work together in the future. The meeting with Rep. John Boehner, Senate Minority Leader. Mitch McConnell, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid is expected to take place during the first week of Congress’ “lame-duck session,” which begins on November 15.

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Health Insurance Reform Easytoinsureme February 5 2010

May 31st, 2011

FEBRUARY 5, 2010

This Week in Health Care Reform EasyToInsureME FEBRUARY 5 2010   

Despite proclaiming to focus on other issues, such as the economy and jobs, President Barack Obama injected new energy into the health care reform debate this week.

On Monday, President Obama held a Q&A session via YouTube in which he responded to questions submitted during his State of the Union address. He commented that “it is my greatest hope” to have health care reform legislation “not just a year from now, but soon.” He also responded to criticisms regarding the lack of transparency around the reform negotiations.

On Tuesday, at a town-hall-style meeting in New Hampshire, President Obama rejected the notion that health care reform was dead, saying “we’ve got to punch it through.” Further, on Wednesday, he met with Senate Democrats reiterating his commitment to reform and encouraging lawmakers to press forward. He also suggested that Republicans play at least some role in negotiating a final bill.

Health Care Reform Negotiations

Democrats Look for Path Forward: Recent statements made by Rep. Charles Rangel (D-NY) are the first concrete signs that Democrats have started working to revive comprehensive health care reform legislation. Rep. Rangel indicated to the media that lawmakers have begun writing a compromise bill based on the legislation passed by the Senate last December. The bill will incorporate changes agreed upon last month by White House negotiators and members of the House and Senate.

Senate Majority Leader Harry Reid (D-NV) did not commit to a timeline for reform, but hopes that Democrats can agree to a path forward by next week. So far, he has been unable to identify compromise language that will win the needed 51 Senate votes.

At the same time, Speaker of the House Nancy Pelosi (D-CA) indicated that the House would vote on a small piece of the overall health care reform package next week. The proposed bill would overturn the insurance industry’s exemption from federal antitrust laws. The Senate version of health care reform did not include this measure because Sen. Reid could not secure the 60 votes needed to include it; however, Sen. Reid indicated the Senate would reconsider the measure.

Additional Activities

President Obama’s Budget Assumes Health Care Reform: On Monday, White House officials released a proposed .8 trillion 2011 budget including several measures aimed at improving health care:

·        Hiring more fraud detectives to root out waste in Medicare and Medicaid

·        Providing .5 billion to help state Medicaid programs swelling with enrollment due to unemployment

·        Eliminating Congressional earmarks for building hospitals and other facilities, including million for Alaska and million for Mississippi

·        Initiating or increasing funds for the following research projects:

o       quality improvements for seniors with chronic conditions

o       effective medical treatments for the costliest conditions

o       expeditious ways to adopt electronic medical records

o       medical fields such as genetic medicine that may provide breakthrough treatments.

Further, the budget assumes that some form of health care reform legislation will pass Congress. It includes a “reserve fund for health care reform” totaling 4 billion as a “down payment” for the legislation and also assumes that the reform effort will generate 0 billion in savings over 10 years.

States Begin Initiatives to Expand Coverage: With the fate of national health care reform in question, state legislators are pushing their own bills to expand coverage. Last Thursday, California’s State Senate passed a measure to create a government-run health care system, ignoring a veto threat from Gov. Arnold Schwarzenegger. The measure is now with the State Assembly. Missouri legislators have introduced a similar bill to create a government-run plan whereas lawmakers in other states, including Virginia and New Jersey, are working to tweak existing state programs to expand coverage. Tight budgets in all of those states may hinder these efforts.

Virginia Senate Says No to Individual Mandates: On Monday, Virginia’s Democratic-controlled State Senate passed measures that would make it illegal to enforce an individual health care mandate. This decision comes in direct conflict with the House and the Senate health care reform bills, both of which require all individuals to purchase health insurance.

Public Opinion

Majority of Americans Doubt Passage of Health Care Reform, but Growing Optimism: A survey released by the Pew Research Center on Wednesday shows growing optimism around the passage of health care reform. While the poll indicates that the majority of Americans (60 percent) do not believe health care reform legislation will pass this year, the figure is down from the 67 percent who said – just after a special Senate election was held last month in Massachusetts – that such legislation would not pass.

Poll Indicates Damage Done On Health Care Reform: A poll released Tuesday by Public Policy Polling shows that Republicans currently have the advantage over Democrats in the ballot races for Congress, regardless of the final outcome of health care reform. In general, the poll shows that 43 percent of voters surveyed would vote for a Republican, whereas 40 percent would vote for a Democrat. When asked about the implications of the health care overhaul.

* If health care reform passes, 45 percent would likely vote Republican and 40 percent would likely vote Democrat.
* If health care reform does not pass, 43 percent would likely vote Republican and 38 percent would likely vote Democrat.

The poll also shows that 36 percent of respondents support the President’s health care reform effort, while 51 percent oppose it.

Looking Ahead

Currently there is no timeline for the development of a comprehensive health care reform package. However, Speaker Pelosi is moving forward with smaller pieces of the bill, starting next week with the repeal of the antitrust exemption for insurance companies.

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Proposed Rate Hikes to Health Care Reform

May 29th, 2011

Health insurers across the country are planning to raise premiums for some of their customers in the coming weeks, the Wall Street Journal reports, and they are in part blaming President Obama’s health care reform package for the rate hikes.

On the surface, at least, the news boosts Republicans’ arguments against the Democrats’ reforms ahead of this year’s midterm elections. But the White House and other supporters of the reform package say they are skeptical of the health insurance companies’ rationale.

Aetna Inc., some BlueCross BlueShield plans and other smaller carriers have asked regulators to approve premium increases of between one percent and nine percent to pay for the bill’s early benefits, the Journal reports. The rate increases would largely apply to individual plans (9 percent of Americans have individual plans) and those offered for small businesses (about 20 percent of Americans get coverage from small employers).

The early benefits cited by insurers for the rate increase include allowing children up to 26 years old to stay on their parents’ health care plans, eliminating co-payments for preventive care and prohibiting insurers from denying coverage to children with pre-existing conditions. These benefits apply to all plans, not just individual and small business policies.

The insurers are also reportedly asking for further rate increases they are not tying to the health care overhaul that they say are needed to cover rising medical costs. Some customers could see their premiums increase by more than 20 percent.

Nancy-Ann DeParle, the director of the White House Office of Health Reform, told the Journal that insurers were using the new health reforms as an excuse to raise rates.

“I would have real deep concerns that the kinds of rate increases that you’re quoting… are justified,” she said. “We believe consumers will see through this.”

Health Care for America Now, a coalition group in support of the health care overhaul, slammed the insurance industry and pointed to insurers’ history as evidence that its latest claims were misleading. For instance, WellPoint’s Anthem subsidiary had to reduce its proposed rate hike in California earlier this year after it tried to justify increases as high as 39 percent with erroneous numbers.

“The health insurance industry is doing the same thing it has always done, raising premiums to achieve excessive profits and outrageous salaries for their CEOs,” HCAN executive director Ethan Rome said in a statement.

The complaints haven’t stopped Republicans from jumping on the opportunity to criticize the Democrats’ policies. Senate Republicans are highlighting the Journal’s report while pointing to past comments from Mr. Obama and other Democrats, who promised that premiums would not increase as a result of the reforms.

In Kentucky, Republican Senate candidate Rand Paul slammed health care reforms in his first general election ad.

The health care overhaul has proven to be a harder sell to the American people than Democrats anticipated, prompting at least a handful of Democrats up for re-election to campaign on their vote against the reforms. Moderate Democrat Stephanie Herseth Sandlin (S.D.), for instance, says in an ad that she voted against the bill because “it wasn’t right for South Dakota.”

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Health Insurance Reform Latest News

May 26th, 2011

Recently barred fast track resolution by the U.S. Supreme Court, opponents of the Affordable Care Act (ACA) have resumed their legal quest to derail the law through the traditional Circuit Court route. Twenty-six states last week filed a motion in the 11th Circuit Court of Appeals in Atlanta urging the court to strike down the health care overhaul law. The motion asks the court to uphold a Florida federal judge’s ruling that the law’s core requirement, that everyone purchase health coverage, is unconstitutional. The filing comes about a month after the Obama administration formally appealed the Florida ruling. Once the 11th and 4th Circuits rule on ACA appeals, the U.S. Supreme Court is finally expected to take on the issue and become the final arbiter — but probably not until late 2012.

Federal

Last week the Republican-controlled House approved two bills  that would repeal funding for construction of school-based health centers and assist the states in establishing school-based health centers, as otherwise authorized by ACA.  Both items are part of a package of bills that are coming to the House floor to either repeal or revise ACA provisions that provide funding for various parts of the health care reform law. Neither will make it though the Democratic Senate, nor get past the President’s veto pen. This effort is all about setting up various lines in the sand from which to bargain with respect to the bigger battle over the budget and the national debt.  Whether either side will back down remains unclear. But it is clear that Republicans and Democrats are preparing for a major fight just around the corner.

On the Senate side, the top Republican on the Senate Finance Committee, Senator Orrin Hatch (R-UT), introduced legislation designed to further erode a provision of ACA.  The Senator’s legislation proposes repeal of the Medicaid/CHIP Maintenance of Effort (MOE) provision in ACA, which would give the states financial relief from the funding requirements demanded by ACA.  While the House companion bill (Congressman Phil Gingrey, R-GA) may have better luck than the Hatch bill in the Senate, this effort may have more life than other anti-ACA proposals because the states are in dire financial straits and both Republican and Democratic governors are clamoring for relief from Washington.

States

CALIFORNIA: The 2011 version of a hospital transparency bill was unanimously voted out of the Senate Health Committee last week. The legislation would prohibit hospitals from including provisions, commonly referred to as “gag-clauses,” in contracts with health insurers. These provisions prevent disclosure of hospital cost and quality information to health plan members. Individual hospital systems, the UC System and the California Hospital Association continue to oppose the bill, while insurers, payers and labor unions support the measure.  Also, the Senate Health Committee last week announced its new policy of making almost all benefit mandate proposals two-year bills. The Chair believes that the legislature should wait until the federal government defines essential health benefits under the ACA.  The only exception to this committee policy will be the maternity mandate bill, which the Chair believes is certain to be part of the essential benefits package.  There have been a dozen benefit mandates bills introduced this year.

COLORADO:  The Colorado General Assembly passed an insurance exchange bill after the Senate concurred to amendments added by the House. Passage of the bipartisan-sponsored bill is the culmination of nearly nine months of work that drew the support of the governor, business and the health insurance industry. Key bill provisions include:

Establishes an exchange as a nonprofit, unincorporated public entity
Designed to foster a competitive market, the exchange shall not solicit bids or engage in the active purchase of insurance
No duplication of Division of Insurance regulatory authority, including rate review
All carriers licensed in Colorado may be eligible to participate
Governed by a nine-member board of directors appointed by the governor and legislative leadership; plus three non-voting ex officio members
Majority of voting board members shall not be directly affiliated with the insurance industry
A legislative implementation review committee will review grant applications, financial and operational plans and have the ability to propose up to five bills per session
No separate state appropriation was made to fund the implementation

The bill does not address substantive issues such as the merging of the individual and small group markets or the size of eligible small employers.

CONNECTICUT: Governor Dannel Malloy last week signed a biennium budget bill, without a proposed increase in the premium tax. To avoid paying million in retaliatory taxes to other states, insurers supported temporarily lowering the amount of premium tax credits that can be used, from 70 percent to 30 percent for two years.  The budget includes the tax credit measure, which will sunset in 2013 .

Legislators are now focusing on other issues, including rate review. If enacted, the current rate review bill would: require a lengthy notice and public hearing timeline for all proposed rate increases; authorize the Healthcare Advocate and the Attorney General to be parties to any hearing; and broadly define “excessive” to include consideration of commissions, transfer of funds to a holding or parent company, the rate of return on assets or profitability, and a “reasonable” profit margin. The bill would also require that plans send written notice to insureds or subscribers of both the proposed rate and, later, the new rate. This bill would be effective July 1, 2011. The estimated cost of holding hearings for all proposed rate increases of 10 percent or more is million, for a department that has an annual budget of million. The bill was voted out of the Appropriations Committee nonetheless. If the bill were to be voted on today, it likely would pass. However, Insurance Commissioner Thomas B. Leonardi raised concerns about the potential cost and workload. The current law allows for the insurance commissioner to hold a rate hearing at his discretion. Leonardi said rates that aren’t justified by actuarial science will be rejected. Senate Insurance Chair Joe Crisco called the bill a “work in progress” and said he and other legislators will be working with Leonardi.

KANSAS: Kansas has joined the growing list of states asking the federal Department of Health and Human Services (HHS) for a waiver of ACA’s minimum loss ratio (MLR) requirements. If granted, the waiver would allow Kansas carriers until 2014 to fully comply with the 80 percent requirement under federal law. In a letter to HHS Secretary Kathleen Sebelius, Insurance Commissioner Sandy Praeger proposed a rule modification for the individual market to allow for a gradual implementation of the 80 percent requirement. The waiver would offer companies appropriate time to adjust their business practices and maximize opportunities for new companies to enter the Kansas market. The current MLR requirement for major medical coverage in the state’s individual market is 55 percent.  Commissioner Praeger’s letter proposes adjustments to the MLR standard at 70 percent in 2011, 73 percent in 2012, 76 percent in 2013 and 80 percent in 2014. To date, Maine is the only state to have received approval from HHS for a waiver. Guam and nine other states — Florida, Georgia, Iowa, Kansas, Kentucky, Louisiana, North Dakota, Nevada, and New Hampshire — have submitted waiver applications that are pending.

MAINE: The House last week voted 76-72 to approve an ambitious health care reform bill introduced by the Republican majority. The bill would overhaul Maine’s health insurance system and create a new one designed to foster more competition. If enacted, the bill would repeal Maine’s standard benefit package and geographic access rules (Rule 750 and Rule 850) and expand the rating bands to open up the individual and small-group insurance market to greater competition. The changes in rating for individual health plans and small group plans would be phased in over four years, with a maximum rate differential of 1.5:1 to 5:1, based on age, for individual and small group health plans. The bill also would authorize the renewal of short-term health insurance policies for a period not to exceed 24 months, instead of the current 12-month limit. By 2014, the bill would allow Maine residents to purchase insurance across state lines in four New England states: Connecticut, Massachusetts, New Hampshire or Rhode Island. In addition, it would establish an individual market reinsurance pool to be funded through a covered lives assessment capped at per month, per person. The bill is likely to pass the Senate as well, where Republicans hold a 20-14 majority.

In other legislative action, the Health and Human Services Committee heard testimony on a bill to repeal Maine’s 2003 Pharmacy Benefit Management (PBM) law. The law requiring PBMs to disclose contractual agreements with drug makers has been detrimental to the growth of competition. Medco testified that the law has led the company to turn down business in Maine. Express Scripts and Caremark, which is owned by drugstore chain CVS, also testified in support of repeal, portraying the law as the “most extreme in the country.” Michael Cianchette, an attorney for the LePage administration agreed, saying that Maine should conform to the national norm. Community pharmacies, which face competition from PBMs’ mail-order operations, oppose the repealer.

NEW JERSEY: Both chambers of the legislature are fully engaged in budget hearings as the legislative and executive branches work toward passing a balanced budget by the June 30 deadline. Proposed changes to Medicaid have been a hot button issue, as the state attempts to address a .3 billion deficit in the program.  The Department of Human Services testified that it has already started moving 200,000 Medicaid participants to managed care plans and will be working the Department of Health and Senior Services to take similar action with the long-term care population.

On the legislative front, Senate President Stephen Sweeney announced last week that he will be amending his bill to reform health benefits for public sector employees. The current legislation calls for a moratorium on governmental entities joining the State Health Benefits Plan (SHBP).  Due to alleged conflict of interest claims, the Senate President has decided to remove this provision, which will continue to allow local governments the option of providing health benefits through either a commercial plan or the SHBP. Reform of public employees’ benefits is major part of Governor Chris Christie’s initiative to save more than 0 million in the coming fiscal year.

NEW YORK: The New York City Human Resources Administration (HRA) wants the state to be aware that a statewide exchange solution may not work well for them. The HRA released a brief discussing the creation of a Navigator program, which gives grants to qualified organizations to provide health insurance education and enrollment assistance services. HRA’s brief focuses on such a program in the city and looks at the most effective ways to implement the required services.

OKLAHOMA:  The health care compact measure pressed by state Sen. Clark Jolley cleared the House last week and now returns to the state Senate for final consideration. The bill lays out the basis for Oklahoma’s participation in an agreement with other states in an attempt to restore authority and responsibility for health care regulation to member states. The compact would allow Oklahoma to create health care policies by joining an interstate compact that supporters believe supersedes prior federal law. The compact, which has been introduced in 14 states, was signed recently into law in Georgia. The concept is also advancing in Missouri, where a compact proposal cleared the state Senate and is headed to Governor Jay Nixon. Compact proposals are also alive in Montana, Colorado and Texas.

TEXAS:  Republicans pushed the next two-year budget through the Texas Senate last week by using a procedural maneuver to bypass Senate tradition requiring a two-thirds agreement to consider any legislation. Senators voted 19-12, along party lines, to approve the plan. The move clears a path for negotiations to begin with the House on the 6.5 billion spending plan. The plan would make about billion in cuts, which is less severe than those in the bare-bones House version. Public schools and Medicaid providers, including nursing homes, would take the brunt of the cuts. In the face of criticism on both sides of the aisle, Senator Steve Ogden, the bill author, offered an amendment that stripped about billion in rainy-day fund money from the budget. The move helped garner support from conservative Republican senators but cost the support of key Democrats.

Ogden’s GOP-condoned compromise replaces about billion in rainy-day money by underfunding Medicaid, pushing those payments to the end of the budget period. Absent increased revenue from an improving economy, the budget would then force across-the-board cuts to state agencies other than basic public school operations. Ogden’s plan underfunds public schools by about billion. It cuts reimbursement rates to Medicaid providers by 6 percent, compared to more than 10 percent proposed in the House. Senate leaders are bracing for tough negotiations with the conservative House. The state is facing a revenue shortfall of at least billion. The legislature has until May 30 to reach a deal and avoid a special session to resolve the issue.

VERMONT: The House last week voted to approve a single-payer measure, which now advances to the governor’s desk for signing. Governor Peter Shumlin is expected to sign it. The bill passed in the House by a vote of 94-49 and was passed earlier in the Senate by a 21-9 vote. In addition to establishing a single-payer system, the bill would establish new rate review requirements and a Vermont Health Benefit Exchange that would be operational by 2014, in accordance with the ACA. A single-payer system would begin in 2017, when the ACA begins to allow states to request waivers to opt out of many of its requirements, or earlier with federal approval.

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Health Care Reform: an Opportunity for Insurance Industry Participation in Sierra Leone’s Medical Care System

May 22nd, 2011

The socialized system of healthcare delivery and financing, a relic of the British colonial era, still practiced in Sierra Leone has glaringly failed and any efforts at resuscitating it without implementation of major structural and systemic reform will only serve to prolong the inevitable.

Throughout the world, total state control and management of industries, services, markets and the means of production are gradually becoming a relic of the past. This model as practiced in the Sierra Leone healthcare system has empirically been proven to have served only to stifle innovation, growth, productivity and quality output with a resultant decline in overall living and healthcare standards of the citizenry. The current state of the hospitals and health centers glaringly highlights the systemic problems endemic in the entire government owned, managed, financed and operated health care system.

The continued operation of such a decadent and dilapidated delivery and financing system, lacking in even the basics of a modern healthcare infrastructure continues relegating Sierra Leone to the very bottom of the human development index.

The transformation thus of the medical healthcare delivery and financing system into a private insurance or a national insurance based system offers opportunities not only for insurers to develop market-based medical insurance plans and policies but also serves to effectuate the Ministry of Health & Sanitation’s desired policy goals, as espoused in the 2002 National Health Policy Paper.

Both policy and regulatory officials, healthcare providers, the insurance industry and other stakeholders must be engaged to effectuate implementation of fundamental systemic reforms if the country is to avert an even greater catastrophe.

Privatization:

 

Under the proposed privatization plan, the Ministry of Health & Sanitation will be transformed from ownership and management of hospitals, clinics, and employer of last resort for all physicians, nurses and ancillary healthcare providers into a health agency with only policy and regulatory functions.

The goal will be for the health agency to serve as a policy and regulatory watch dog mandated with ensuring that adequate and quality medical care is provided at the various private hospitals, clinics and pharmacies that will inevitably be established with the break-up of the current government owned facilities.

With the break-up and subsequent purchase or leases of these hospitals, clinics, health centers and other facilities, investors and entrepreneurs in an effort to realize maximum returns on investments, will economically be compelled to upgrade quality and standard of care, introduce state of the art equipment and technologies and engender a type of market forces competition which will inure only to the betterment of health consumers in the country.

A much needed infusion of capital into the health care industry by such a privatization plan will clearly spur additional economic activities in ancillary industries, as the dynamic forces of privatization and market mechanism forces of demand and supply will ensure competition for the healthcare pie.


Divestiture of Government Ownership:


The dismantling of the current mammoth and highly inefficient government owned healthcare delivery and financing entity must from a public policy perspective be designed and restructured to ensure governmental ownership and management divestiture from hospitals and other health care facilities.

Under such a scenario the government’s current enormous but woefully mismanaged capital outlay for health services will be substantially decreased as inefficiencies of corruption, salaries of providers, infrastructure maintenance, costs of medications and diagnostic equipments and other overhead operating costs will no longer be recurrent expenditures from the nation’s depleting coffers.

A system based entirely on a private market-based national health insurance plan with private enterprise and market competition at its core appears the most logical reform policy route to ensure a future sound, efficient and profitable health care infrastructure.

 Health Insurance Plans:

The cog which the proposed new system must revolve around is a nationwide network of affordable health insurance plans creatively designed to ensure a greater pool participation of a majority of the population. In such a system health insurance companies and provider organizations will be established to market various health plans, with minimum services and premiums based on market conditions. The responsibility for monitoring compliance by the various plans would fall under the ambit of both the Ministry of Health and Sanitation and the Sierra Leone Insurance Commission.


Multi-Payer System:


A major plank in this proposed health care delivery and financing privatization hinges on the enactment of health insurance legislation providing for employers to provide health care for their employees and dependants as part of a standard benefits package with concomitant tax incentives and governmental subsidies to ensure compliance. With such legislation the virtual free socialized medical care system, the costs of which have been borne exclusively by the government will now be based on a multi-payer system in which government, employees and employers will all participate.

With the system as currently structured however, only the government has a financial interest and stake and when other programs conflict with the financing of health care, politicians have only been too willing to sacrifice the health of their citizens on he alter of their greed and personal aggrandizement.

It is envisaged that health insurance providers will introduce concepts and plans, such as Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO), through alliances of health providers and insurance companies and marketed to employers, labor unions, governmental ministries and corporations on an annual premium basis.

The competition engendered by such health organizations for the medical insurance pie will subsequently result in competitive rates, coverage, deductibles, co-payments and premiums to make health care costs affordable for all.


The Unemployed:


As unemployment and underemployment are perennial problems in the Sierra Leonean economy, the provision of health care benefits to this category of the population must remain the responsibility of government. Medical services provided to this category of citizens in a private enterprise environment must be reimbursed by the government on a negotiated and pre-determined fee schedule or an insurance mechanism established in which government negotiates with providers and carriers for the provision of services.

As an example a fund established by levying taxes on the private health care providers, envisaged to emerge with such privatization, could be instituted and utilized to pay for these indigent services.

Further, since the hospitals, medical clinics and other medical facilities will be operated as businesses, either for profit or as non-profit organizations, the market forces of demand and supply will certainly ensure that patient quality care, improvements in diagnostic technologies, competent personnel and a general responsiveness to the demands of the clients will drive the new marketplace. The lethargic and inefficient atmosphere witnessed at most government hospitals today with customer service virtually non existent would be a philosophy of the past.

The economic viability of healthcare businesses will depend largely on the clientele they can attract and maintain utilizing the above yardstick. Providers of lousy health care plans and services will inevitably loose business to competitors as every year participants will have an opportunity to change health insurance plans.

Since a large population of Sierra Leone resides in rural areas, the proposed privatization plan will ensure the expansion of health care facilities into areas currently inadequately serviced. This plan will ensure that clinics and doctors put up shop in every part of the country in order to tap into the healthcare services available in these rural areas.


Challenges to Insurance Companies:


Designing an insurance system and plan to cater to the needs of the rural population who often are self employed in farming and mining activities posses a challenge to insurers in Sierra Leone, who in the past have been largely passive and unimaginative in policy design to meet the challenges and risks confronting the nation’s socio-economic landscape.

Proactive and creative underwriting of risks must be undertaking by underwriters, actuaries and marketing specialists to design, tailor and price health insurance coverage to meet the diverse needs of the insuring public. For example, the creation of pools by occupational categories could be one method by which insured’s, engaged in similar trades could be encouraged to form co-operatives for purposes of obtaining health insurance coverage at affordable rates for themselves and dependants. Premium payments through the pooling together of the co-operatives commodities can be an alternative payment method for the medical services. Health insurance companies could possibly establish subsidiary or ancillary companies solely for the handling of payments made by cash crops.

The current system under which nearly all doctors and related health care providers are employed by the government while at the same time owning private practices would be changed with a concomitant government savings on salaries, productivity and other fringe benefits. As privatization takes over in the hospitals, physicians, nurses and other providers will no longer be on the government’s payroll but will rather be independent contractors with their own practices.

Conclusion:

Whilst a micro version of the proposed reform has mushroomed in an ad hoc manner over the years with some large companies and corporations contracting with individual physicians and clinics for the provision of health care to their employees and dependants, the kind of systemic and structural overhaul needed to forestall a total collapse of the system and extend similar services to all could only be realized by a comprehensive approach along lines of reforms proposed in this policy paper.

 




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Health Care Reform 2, Opponents 1

May 19th, 2011

Three recent court decisions have given two, at least preliminary, victories to the supporters of federal health care reform law. In another court decision the supporters of health care reform suffered a preliminary loss.

In a case called Baldwin v. Sebelius, the US Supreme Court refused to hear a challenge to the constitutionality of the federal health care reform law. Opponents of the law tried to persuade the Supreme Court to hear the case before it had been ruled on by lower federal appeals courts. The Supreme Court refused to do this.

The request for immediate Supreme Court review was submitted by Steve Baldwin, a former California state legislator, and the Pacific Legal Institute. This case is currently pending in the 9th US Court of Appeals.

The health care reform law mandates that everyone in the nation get health insurance or pay a penalty. However, that mandate does not become effective until 2014. Baldwin asserts that this requirement can be challenged in court now, even though it will not be enforced for over 3 years. He also asserts that Congress does not have the power, under the US Constitution, to enact this mandate. And finally, Baldwin urged that the health care reform law be suspended pending court review of these issues.

Baldwin initially brought his complaint to the US District Court in San Diego, California. But, on August 27, District Court judge Dana Sabraw issued a decision dismissing Baldwin’s complaint and refusing to issue an injunction putting the reform law on hold.

Baldwin then appealed Judge Sabraw’s decision to the 9th US Circuit of Appeal. However, even before Judge Sabra issued her decision in the case, Baldwin appealed directly to the US Supreme Court. He said the Supreme Court should intervene because different US District courts had issued different rulings on whether lawsuits against the reform bill are premature or can go forward. But the Supreme Court refused to take up the case.

(Note: these conflicts between federal District Courts, and even between federal Appeals Courts, happen all the time. It is usually when appeals courts issue conflicting decisions that the US Supreme Court hears a case.)

In another case, that illustrates Baldwin’s point about conflicting decisions (Virginia ex rel Cuccinelli v. Sebelius), US District Court judge Henry Hudson refused to dismiss a challenge to the reform law. This case dwelled, in part, on the constitutional authority of Congress to regulate interstate Commerce.

The courts have long agreed that Congress does have this authority. However, the state of Virginia, claimed that, when a person decides to do nothing about getting health insurance, he or she is choosing not to engage in interstate commerce. The state contended that Congress, in passing the health care reform law, was seeking to regulate people’s decision to do nothing and they do not have the power to do that, even under their right to regulate interstate commerce.

The federal government urged the court to dismiss the case. But, Judge Henry Hudson concluded that the arguments over health care reform: “all seem to distill to the single question of whether or not Congress has the power to regulate—and tax—a citizen’s decision not to participate in interstate commerce.” The judge said, “Neither the U.S. Supreme Court nor any circuit court of appeals has squarely addressed this issue. No reported case from any federal appellate court has extended the Commerce Clause or Tax Clause to include the regulation of a person’s decision not to purchase a product, notwithstanding its effect on interstate commerce. Given the presence of some authority arguably supporting the theory underlying each side’s position, this Court cannot conclude at this stage that the complaint fails to state a cause of action.”, Judge Hudson allowed the trial to continue”.

But, the decision in another case (Thomas Law Center v. Sibelius) went the other way. In this case, Judge George Steeh, of the US District Court for the eastern district of Michigan, refused to issue an injunction stopping the enforcement of the health care reform law.

The judge noted that Congress had determined that not requiring everyone to buy health insurance would result in only sick people buying insurance. With no premiums from healthy people to cover insurance industry costs to cover sick people, all of that industry’s resources would be drained and the industry would disappear. Congress enacted the mandate with the goal of preventing the destruction of that industry. The judge said it is legal for Congress to try to meet this goal and the insurance mandate is a “a reasonable means of effectuating Congress’s goal”.

Judge Steeh added, “Plaintiffs’ claim that the minimum coverage provision of the Health Care Reform Act is unconstitutional under the Commerce Clause has failed on the merits. Defendants have also succeeded in overcoming plaintiffs’ challenge to the penalty provision of the Individual Mandate”. So the Judge dismissed the challenge to the health care reform law.

All this confusion will eventually have to be resolved by the US Supreme Court.

You may see copies of all three court decisions, by clicking on the following link, or cutting and pasting the following link into your browser. Then scroll down to, and click on, the links at the bottom of the web based copy of this article. Here is the link to start you in this process. http://www.calcomui.org/nwsflsh111110.html

Boyce Hinman

California Communities United Institute

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Florida health insurance block health-care reform

May 19th, 2011

On his first day as Florida’s new House speaker, Rep. Dean Cannon took a clear shot at President Barack Obama’s new health-care reform law. Easy To Insure ME has the answers

“Should it really be the role of government to require people to purchase a health insurance product they don’t want, raise taxes to give that same product to others who can’t afford it, and commandeer our state government and its resources to carry it out?” Cannon, a Winter Park Republican, told House members after being sworn in two weeks ago.

“Or, should we work to limit government and empower the private sector?”

On numerous fronts, Florida policymakers have already answered that question.

While the fight against President Obama’s health-care reform may be centered in the Beltway, Republican resistance to the sweeping new mandates is also taking shape in Tallahassee. Among the battlefronts:

• Florida led the charge with 19 other states last March by challenging the law in federal court, claiming the mandates that uninsured people buy coverage violated states’ rights. A judge in Pensacola is expected to rule shortly after a Dec. 16 hearing on whether the suit can move forward. More states are expected to join after a new crop of state attorneys general are sworn into office in January.

•Last spring, GOP legislators hastily drafted a constitutional amendment spelling out that Florida businesses and residents couldn’t be forced to buy insurance, but a Tallahassee judge threw it off the November ballot for “misleading” language. Lawmakers have re-filed an altered version and hope to place it before voters in 2012.

•And perhaps most significantly, legislative leaders are poised to block spending and rules necessary to implement the law. Already, state regulators has refused to impose minimum spending mandates that might generate refunds for consumers – but which health insurers say will hurt their profits. And Gov.-elect Rick Scott has also made clear he doesn’t want the state doing anything to help the law along.

The Patient Protection and Affordable Care Act passed last spring anticipated that the states would lead the way on many of its more than 100 changes to the nation’s health care system. With 3.8 million uninsured residents, Florida is one of the states that would be most affected by the law.

The most controversial reforms – including the requirement that individuals buy coverage or pay a penalty — don’t start until 2014, and phase-ins continue until 2018. But the bill requires states to start working now to improve their data-collecting and enforcement mechanisms.

It was hoped states would create their own insurance exchanges, to match individuals with insurance plans; establish “high-risk” pools to insure people now shunned by providers; and police new restrictions on insurance company profits.

But Gov. Charlie Crist opted last spring not to immediately tap into federal grant money to create a Florida high-risk pool to cover people with pre-existing medical conditions, deferring to the federal government. And now Cannon, R-Winter Park, and Senate President Mike Haridopolos, R-Merritt Island, may seek to block any cooperation by the state.

Florida has been awarded million in grants to provide 0 rebates to seniors who fall into the “donut hole” in the Medicare prescription drug program; to help prepare the Office of Insurance Regulation to evaluate out-of-state insurers seeking to sell health coverage in the state; and to plan for creating a health-care marketplace, or “exchange,” and other changes.

But even before he was officially named speaker, Cannon warned Crist that no state agency should take any steps to comply with the law “without clear and comprehensive guidance from the Legislature.” The Oct. 19 letter demanded an itemized accounting of all state agency activities regarding the federal law.

Specifically, the letter singled out the Office of Insurance Regulation for work it has begun – and which legislative budget-writers approved – to study how Florida’s health-care laws should be amended to conform to the federal reform, and to boost the state’s ability to handle new rate-filing data.

“Not only are Florida insurance officials helping the federal government to write rules on these matters, but [OIR] is jumpstarting these new regulatory functions by developing data systems necessary for enforcement,” Cannon complained.

He added: “We intend to develop a clear and statutorily-defined framework for Florida agencies’ activities in regard to the federal health law. Pending such legislative action, state agencies should examine each anticipated action or function in light of their specific statutory authority.”

Laura Goodhue, executive director of Jupiter-based health-care advocacy group Florida CHAIN, said the criticism appeared designed to bully agencies into slowing their efforts to follow the federal law.

“I know transparency is important in implementing laws, but creating a chilling effect is certainly not helpful,” said Goodhue, who attended meetings with OIR over the last year as part of an advisory health insurance board.

 

In response, most all of Florida’s state agencies produced itemized lists of what they had done — down to how many staff hours Department of Management Services staff spent examining new rules requiring lactation rooms and milk storage for breast-feeding mothers in the workplace.

Cannon spokeswoman Katherine Betta said last week that Cannon’s staff was still reviewing the responses and hadn’t decided “what the next step will be.”

OIR communications director Jack McDermott defended his agency’s work, adding there was no intent to be “an advocate for the implementation of federal healthcare.”

“Virtually all of this information — whether it is actual review of large group rates, or expanding data systems to collect additional data – would require additional statutory authority or administrative rules,” McDermott e-mailed in response to questions.

And recently, OIR decided to slow one of the new law’s reforms – by not imposing new profit limits on health insurers beginning Jan. 1.

A new federal “medical loss ratio” requirement would force insurers to spend 80-to-85 percent of the premiums they collect on medical care, with the remainder set aside for overhead including executive salaries and profit. Nearly half the country’s insured population are covered by providers that spend more than that on overhead and profit.

Florida’s “medical loss ratio” is 65-to-70 percent, and OIR will ask the federal government for a three-year waiver from the tougher standard, said McDermott.

At a recent hearing, most of Florida’s main health insurers complained that the new standard would hurt their bottom lines and restrict the Florida insurance market. Insurance Commissioner Kevin McCarty agreed, saying he feared making the change next year would “destabilize” the market and hurt competition.

The move could have a pocketbook implication for Floridians.

The law requires insurers to provide rebates to customers if they exceed the overhead limits in 2011. The feds estimate the rebates could average 4 for individuals in 2012. But if OIR wins the three-year delay, Florida consumers won’t be eligible for those checks in 2012.

“To me, the delay obviously would be helpful to the insurance companies and HMOs, and not to the patients,” said Senate Minority Leader Nan Rich, D- Weston. “That’s less money for care for patients.”

Legislative conservatives like Rep. Scott Plakon, R-Longwood – who’s re-filed the constitutional amendment that says Floridians could not be compelled “directly or indirectly… to participate in any health-care system” – say they are determined to fight every way they can.

Plakon’s House Joint Resolution 1 has already picked up a prime sponsor in the Senate: its new leader, Haridopolos.

“We have to follow the law. But in the process, we need to put Floridians first,” Plakon said. “So if there is any room there, we would default to the position of putting Floridians first instead of this kind of massive federal takeover.”

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This Week in Health Care Reform EasyToInsureME health insurance

May 15th, 2011

JANUARY 22, 2010

This Week in Health Care Reform

After months of public debate and private negotiations, health care reform discussions stalled following Tuesday’s Senate vote in Massachusetts. The Democratic Senate lost its 60th vote supermajority when Republican Scott Brown was elected to the United States Senate in the Massachusetts special election.

Health Care Reform Negotiations Post-Massachusetts Special Election

Massachusetts Election of Senate Republican Recasts Debate: Following the election of Republican Scott Brown to the Massachusetts Senate seat Tuesday night, Democratic leaders have been scrambling to revive what could now be a dying bill. The loss of the Democrat’s 60th vote in the Senate opens up the legislation to a Republican filibuster – something the Democrats have managed to avoid thus far in the debate.

House and Senate Democrats met this week to discuss how to move forward with the reform legislation in light of this election and promised Wednesday that they would push ahead. There are a number of options that Democrats are considering, but at this point they have not charted their course.

On Wednesday, Speaker of the House Nancy Pelosi (D-CA) attempted to rally House Democrats around a strategy to push the Senate bill through the House and onto President Barack Obama’s desk so as to avoid the need to again secure 60 Senate votes. However, the Speaker indicated on Thursday morning that she did not believe she has the needed 218 House votes necessary to move forward. This option would have allowed lawmakersto then propose additional modifications to the approved legislation through a process called “reconciliation,” which only requires 51 votes in the Senate.

Other remaining options:

1.
House and Senate Democrats could also quickly complete the merging of the two bills and vote on the combined package before Mr. Brown is sworn in.
2.
Democratic leaders could attempt to re-engage Sen. Olympia Snowe (R-ME), the only Republican who voted for the Senate Finance Committee’s bill passed in October. Democrats would need to allow her to amend the bill so that she could support its passage and give Democrats the needed 60th vote; or,
3. House and Senate Democrats could essentially start over in their respective chambers and propose scaled-back versions of the bill under “reconciliation” procedures or regular order. Reconciliation procedures would greatly limit the scope of the legislation to issues only related to raising or spending federal funds; therefore, many provisions, such as creating new insurance exchanges and an individual mandate, might be excluded.

President Obama seemed to indicate that he favors having House and Senate lawmakers start over again and produce a scaled-back bill. In addition, more moderate Senate Democrats – hesitant to push through such a huge partisan bill in light of the Massachusetts election – urged leaders to slow down.
Sen. Jim Webb (D-VA) has called on Senate leaders to suspend voting on health care reform until Mr. Brown is sworn into office. President Obama and Senate Majority Leader Harry Reid (D-NV) have iterated this same message. Further, Sen. Joe Lieberman (D-CT) called for a bipartisan effort as the best way to achieve health care reform legislation.

Health Care Reform Negotiations Prior to Massachusetts Special Election

Senators Urge Guarantee of Government Savings: In a letter sent last Thursday to Sen. Reid, five Democratic Senators asked for the inclusion of a “fail-safe mechanism” in the final bill. This mechanism would give Congress “the tools to keep costs under control should the current savings estimates fail to materialize.”

Both the Senate and House versions of the bill rely heavily on reductions in government spending, particularly around Medicare, to help pay for reform. Republicans and some nonpartisan analysts believe the government will not follow through on these spending reductions, which will lead to soaring costs.

President Obama Pushes for Less Protection for Biologic Drugs: Last Thursday President Obama pushed for a change in the health care reform legislation that would reduce the number of years that biologic drugs were patent protected from generic competition, previously set at 12 years. White House officials and Rep. Henry Waxman (D-CA) were negotiating for 10 years protection or less.

Members of the news media speculated that the move to reduce biologic drug protections could be a leverage point for President Obama to pressure the drug industry to increase contributions to pay for health care reform. In fact, the Wall Street Journal reported that Congressional Democrats had already asked drug companies to contribute an additional billion or more, over and above the billion which the industry agreed to early on in the reform negotiations.

President Obama Strikes Deal with Unions: Last week Democratic negotiators struck a deal with union officials and conceded to union demands to scale back a tax on high-end insurance plans. The deal would exempt union workers from having to pay the tax until 2018, five years after the tax would apply to other workers. While the deal would help gain union support for the bill, it would also reduce the amount of tax revenue generated by about 40 percent, to billion. As such, Democratic leaders would need to find other sources of revenue to make up the difference.

Public Opinion

Exit Poll Indicates Health Care Reform as Hot Button Issue: As the ballot polls closed on Tuesday night’s Massachusetts Senate election, an exit poll conducted by Frabrizio, McLaughlin & Associates indicated that 52 percent of voters said that they oppose the federal health care reform measure and 42 percent said they cast their ballot to help stop President Obama from passing this legislation. In addition, 48 percent said that health care was the single issue driving their vote.

Polls Show Discontent: The latest Wall Street Journal/NBC News poll indicated that almost half of Americans believe the health care reform bill in Congress is a bad idea (46 percent). This figure is up dramatically from April when only 26 percent believed the plan was a bad idea. Further, just 33 percent say the plan is a good idea. Nearly half of those surveyed (48 percent) believe that passing the current legislation would be a “step backward.”

In addition, a new Quinnipiac University poll showed that public support for health care reform continues to decline. Thirty-four percent mostly approve, while 54 percent mostly disapprove. At the end of December, 53 percent of Americans mostly approved, while 36 mostly disapproved.

Looking Ahead

Currently, the path to health care reform is unclear. Democrats seek a way to secure the necessary votes to pass the legislation, and some now question the value of pushing such a large bill. President Obama had hoped to see a final bill prior to his State of the Union address, which has been scheduled for January 27; however, it appears this goal is likely out of reach.

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Health Care Reform Was Passed!! I Can Get Coverage Now…. Or So I thought

May 12th, 2011

So the days of hearing ‘we cannot cover you due to x medical condition” are soon coming to a close. However, don’t be so fast to leave your company-offered and probably too expensive group plans yet! The health care reform that was passed doesn’t do as much as you may think it does.

 

As a health insurance agent myself, I cannot tell you how many people I talk with on a daily basis who believe that they will immediately be eligible for medically-underwritten (individual health insurance) plans. I also cannot tell you how many of those people believe there is more to the bill than there actually is. The short and sweet of it is: hold your horses! Nothing went into effect immediately. In fact, unless you are a child under the age of 19, you will still be declined for medical conditions until the year 2014! Beginning September 23, 2010, those under 19 will no longer be denied due to medical conditions and that is it. The rest of us will have to wait nearly 4 years to feel the impact of the health care bill. Well, except for our taxes inevitable going up to support it; that should be coming rather quickly. In any case, so many people heard ‘health care reform” and “no more denials” and jumped the gun wanting policies issued right away and folks, that’s just not the way it is going to work.

 

In talking with a hundred or so people a day, one point is often overlooked by them. Insurance companies charge a monthly premium based on things like height, weight, age, whether or not medicines are being taken, and overall health, denying those whose medical background is too risky. There is a reason for this; insurance companies don’t want to go bankrupt by paying the claims of the chronically ill. Now being that health care reform has been passed, let me ask you a rather logical question: if insurance companies come 2014 are no longer allowed to deny people due to medical conditions meaning, they are forced to take on those who unfortunately have things such as cancer, AIDS, emphysema, COPD, diabetes, etc then where is the money going to come from to help pay these inevitable and rather huge claims? The answer is: YOU! Every one of you. Not only the sick, but the healthy. In 2014, one of two things is GOING to happen. Either everyone’s rates are going to jump astronomically or…. private insurance companies will go bankrupt. This simple fact seems to have gotten lost somewhere in translation between the excitement of finally being able to get coverage and sitting down and thinking about what it really means to all of us. For the man who just had a heart attack and cannot get medical coverage right now because of it, sure- he may feel a lot better knowing that there is something out there that will eventually help him; but at what cost? If the insurance company you choose in 2014 is willing to accept you, but at 00 per month, was the reform really as great as many make it seem to be? Probably not. Most people cannot afford the rates as they are now let alone once everyone is considered acceptable. I’ll let you in on a little insider information, which, really, should be common knowledge by now- health care reform did nothing to put a cap on what the insurance companies can charge. So, whether you can’t have medical coverage because of health conditions or because you can’t afford it, in the end, what is the common fact? You STILL don’t have medical coverage.

 

Health insurance companies are taking a preemptive strike as well. Many of the carriers in each state have pulled out of the child-only market beginning October 1, 2010. Meaning, they will no longer be issuing policies to those under 19 and in some cases under 26. Why? Because as I stated earlier, beginning September 23, 2010, those who do continue to cover kids only will have to accept sick kids. Once again, there was nothing in this bill that required insurance companies to stay in the child-only market. In fact, there will be very few options for parents to look at come what is now 7 days away.

 

What good does this health care reform really do? Well, that is up to personal opinion. There are some who believe the intention of this bill is to bankrupt insurance companies, which would transition the country into a state of having social health care. In other words, the USA would become a socialist nation and we would get there in a back handed way- instead of telling people ‘hey, we are moving towards socialism and we are going to start with your healthcare”, just pass a bill that looks good on the surface, yet has a hidden agenda in the background. Again, these are just the opinions of some, and probably does not represent the opinions of the masses. However, it does make you think- if this bill were truly intended to help Americans gain access to healthcare within the private sector and hold insurance companies accountable, then why was there no clause in the bill preventing them from leaving the market where kids are concerned?  Why was there no clause placing a cap on what insurance companies can charge?

 

‘So, I’ll just go without health insurance if I can’t afford it once the bill takes full effect”. Not so fast! If you can’t afford to pay for health insurance, then how will you be able to pay your fine for not having it? What fine, you ask? Yet another fact that got lost in translation is that if you do not have health insurance come a certain point in 2014, and you are not eligible for a federal program of some sort such as Medicaid, then you will be fined yearly. If you do not pay the fine, it first increases, and if still not paid, you are looking at imprisonment. In the United States as it is right now, the only times you see health insurance and jail time going hand-in-hand is when someone commits insurance fraud or when the company does something unethical and we see the CEO go to the clink. Come 2014, we will see health insurance and jail time sharing a relationship for those who do not purchase it! Which, as many of you know, but for those who don’t, that is against the constitution. However, that is another topic for another time.

 

The bottom line is, while many are both for and against health care reform, there are a lot of facts that people don’t seem to be aware of. So, to recap, unless you are under 19, you will see no changes in your acceptability regarding medical coverage until 2014. Come 4 years from now, your health insurance rates will skyrocket, placing coverage out of reach for many. A few years after that and maybe even sooner, you will most likely see many insurance companies leaving the market as they will not be able to keep up with the claims, and finally, if you do not purchase health insurance, you will face fines and possibly jail time.

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the new Congress might repeal health care reform

May 12th, 2011

Many conservatives running for Congress, including many who won, say they want to revisit health care reform – repeal or tweak or defund or something. Easy To Insure ME has the answers

Americans do remain split on the legislation overall – CNN said exit polls showed half want it repealed and the other half want it expanded or maintained.

Though, advocates point out that many of the individual elements remain popular, such as keeping kids up to 26 on their parent’s health insurance, closing the Medicare prescription benefit “donut hole,” banning insurers from bumping those who get sick out of coverage and not covering kids with pre-existing conditions.

It seems the part many have a problem with is the mandatory coverage for everyone, mainly because of the costs. Though, the advocates say putting so many more people in the system spreads the risk and makes the other provisions possible.

Those advocates, including Health Care for America Now, said they believe the election hinged more on the economy than health care. The group points to a CNN poll that found only 19 percent of voters named health care as their top concern, second, and well behind, the 61 percent who said it was the economy that was most important.

The group also pointed to Politico’s assessment that 22 of the 34 Democrats who voted against the health care legislation still lost, as well as three of five senators. Certainly, few even mentioned the legislation on the campaign trail, and many of those who did were running away from it.

For sure, not all lawmakers are anti-health care reform. Senate Majority Leader Harry Reid, who won reelection to his post, says he doesn’t want the legislation dismantled. And Maryland officials, led by Gov. Martin O’Malley and Lt. Gov. Anthony Brown, have embraced health care reform.

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