This Week in Health Reform
Federal Legislative Overview
House and Senate
Republican Scott Brown’s victory over Massachusetts Attorney General Martha Coakley (D) in the Jan. 19 special election to fill the seat of the late Senator Edward Kennedy (D) is proving to be a game-changer for the health care reform debate. It is now unclear what Democrats can do to pass President Obama’s most important legislative agenda item. Even though the Democrats held a majority in the House and Senate this year, they failed to coalesce around a strategy to pass this legislation.
Initially after Brown’s win, there were two options under discussion for moving the current legislation forward.
Have the House take up the Senate-passed bill and use the “reconciliation” bill process to “fix” several of the provisions the House finds unacceptable (e.g., the “Cadillac” tax). If the House passes the Senate bill, it will go directly to the President for his signature, with no further action needed in the Senate. A “reconciliation” bill, which would need only 51 votes in the Senate, could be passed either in tandem with the Senate bill or follow soon after.
.
Scale back the health care reform bill. A scaled-back bill could include health insurance reforms and exchanges, as well as several other provisions, and could possibly attract bipartisan support. While many Democrats are likely to view this approach as a major lost opportunity, leadership may determine this is the most viable approach.
However, Speaker of the House Nancy Pelosi (D-CA) publicly stated on Jan. 21 that the House does not have the 218 votes needed to pass the Senate version of the health care reform bill. This takes the first option off the table.
While numerous private discussions are reportedly being held on the matter, it seems that the Democrats’ only option for keeping the current legislation alive is to reach across the aisle to their Republican counterparts, most notably, moderate Senator Olympia Snow (R-ME). That would mean a more conservative bill, which could anger rank and file Democrats, who are supportive of the legislation.
Although no plans have emerged for how to move forward, it now looks like Democrats will have to modify their plans. On the night of Scott Brown’s win in Massachusetts, Representative Anthony Weiner (D-NY) – one of the biggest proponents for a single-payer health care system – said, “The only way to go forward is to take a step back. If there isn't any recognition that we got the message and we are trying to recalibrate and do things differently, we are not only going to risk looking ignorant but arrogant. I don't think it would be the worst thing to take a step back and say we are going to pivot to do a jobs thing,” and include elements of health care reform in it, he said.
Representative David Camp (R-MI), Ranking Member on the House Ways and Means Committee, declared Democrats’ health care overhaul legislation “dead.” He said that instead of full-scale change, Congress should take a “first step toward comprehensive reform” of the nation’s health care system.
Issue Overview: Nebraska Medicaid Deal
While key elements of the health care reform legislation remain in flux, the Congressional Budget Office (CBO) released its cost estimate of the expansion of the State of Nebraska’s Medicaid Deal. The expansion was negotiated by Senator Ben Nelson (D-NE), who then voted for the Senate’s Patient Protection and Affordable Care Act, HR 3590.
The letter responds to a request from Representative Paul Ryan (R-WI), Ranking Member, House Committee on the Budget, asking if the cost estimate of the Senate health reform bill would change if all states received the same level of federal assistance for Medicaid as Nebraska receives under the bill.
The CBO stated on Jan. 21 that the net spending for the Senate legislation would increase by $35 billion over ten years if all states received the same level of assistance as Nebraska.
Under the Senate’s provisions, non-elderly individuals with incomes below 133 percent of the federal poverty level would be eligible for Medicaid beginning in 2014. The federal government would pay the cost of covering newly eligible enrollees through 2016; and federal spending would be about 90 percent by 2019. The Senate legislation states that it would pay all Medicaid expansion costs to Nebraska beginning in 2014.
Read the complete CBO report at:
http://www.cbo.gov/ftpdocs/109xx/doc10992/hr3590_RyanLtr.pdf.
The Health Insurance Shoppe is Chicago's first storefront marketplace for individual, family and group health insurance coverage. You can walk in and shop for a comprehensive plan that fits your lifestyle, needs and budget.
Wednesday, January 27, 2010
Thursday, January 21, 2010
Whats the fuss, cont....
I also wanted to mention that my cable bill is $130/month, which includes my internet.
Whats the fuss about health insurance premiums for the young?
I am 29 years old and a plan of health insurance with a $1,200 deductible with 100% coverage after will cost me $146/month with Blue Cross and Blue Shield of Illinois.
$146/month would provide me with a $1,200 deductible for the calendar year. Once I were to meet the deductible than Blue Cross will begin to pay 100% of further charges in the year. The cost is only to go lower if I am to raise the deductible.
$146/month....
I currently pay Verizon Wireless $146/month for my cell phone service, and am not making a fuss. The money I pay verizon allows me to talk on the phone, text and email to my friends and contacts. Some pay more, depending on service contracts.
If I present someone an insurance plan for $146/month with a deductible above $500, it seems to become the end of the world for that individual. However, the $146/month will protect their life, if there is an accident or illness. What's the deal?
I recently had bought a new car that cost me $18k. I have been in only one car accident 5 years ago, and the cost that I was paying then was around $90/month for a $1,000 deductible. The total repair of the accident was $1,100. I have never received a speeding ticket, and I am currently paying $160/month for car insurance policy with a $1,000 deductible. $160/month... I am not making a fuss. I wish it could be lower, but in order to drive the car I need to have car insurance and $160/month was the best price I could get. I am sure there are many who pay more. Are they making a fuss???
I just wanted to point out that we currently pay premiums to insure automobiles that do nothing but depriciate in value, as well as paying premiums to cell phone carriers. But when it comes to paying a premium for health insurance, there become a big fuss. Why? Is your life not more important than your car or your Blackberry?
Why all the fuss?????
$146/month would provide me with a $1,200 deductible for the calendar year. Once I were to meet the deductible than Blue Cross will begin to pay 100% of further charges in the year. The cost is only to go lower if I am to raise the deductible.
$146/month....
I currently pay Verizon Wireless $146/month for my cell phone service, and am not making a fuss. The money I pay verizon allows me to talk on the phone, text and email to my friends and contacts. Some pay more, depending on service contracts.
If I present someone an insurance plan for $146/month with a deductible above $500, it seems to become the end of the world for that individual. However, the $146/month will protect their life, if there is an accident or illness. What's the deal?
I recently had bought a new car that cost me $18k. I have been in only one car accident 5 years ago, and the cost that I was paying then was around $90/month for a $1,000 deductible. The total repair of the accident was $1,100. I have never received a speeding ticket, and I am currently paying $160/month for car insurance policy with a $1,000 deductible. $160/month... I am not making a fuss. I wish it could be lower, but in order to drive the car I need to have car insurance and $160/month was the best price I could get. I am sure there are many who pay more. Are they making a fuss???
I just wanted to point out that we currently pay premiums to insure automobiles that do nothing but depriciate in value, as well as paying premiums to cell phone carriers. But when it comes to paying a premium for health insurance, there become a big fuss. Why? Is your life not more important than your car or your Blackberry?
Why all the fuss?????
Wednesday, January 20, 2010
This week in reform
Federal Legislative Overview
House and Senate
Republican Scott Brown’s victory over Massachusetts Attorney General Martha Coakley (D) in the Jan. 19 special election to fill the seat of the late Senator Edward Kennedy (D) might prove to be a game-changer for the health care reform debate. The loss of the 60th Democratic vote now robs Senate Democrats of a filibuster-proof majority. Last week, Democrats were rushing to wrap up a House/Senate agreement on the bill, likely due to reports that Coakley’s lead had diminished.
Congressional leaders are still aiming to have the controversial points in the health care reform bill settled as soon as possible, so they can send the compromised bill to the Congressional Budget Office (CBO) for scoring. The CBO will then need twelve days to analyze the legislation.
In addition to Senate Majority Leader Harry Reid (D-NV) and Speaker of the House, Nancy Pelosi (D-CA), lawmakers participating in the White House meetings include: House Majority Leader Steny Hoyer (D-MD), House Majority Whip James Clyburn (D-SC), House Energy and Commerce Committee Chairman Henry Waxman (D-CA), House Ways and Means Committee Chairman Charlie Rangel (D-NY), House Education and Labor Committee Chairman George Miller (D-CA), Assistant Senate Majority Leader Richard Durbin (D-IL), Senate Finance Committee Chairman Max Baucus (D-MT), Senate HELP Committee Chairman Tom Harkin (D-IA), and Senate Banking Committee Chairman Christopher Dodd (D-CT).
A main point of contention between the two houses of Congress pertained to the 40 percent excise tax on high-cost health insurance plans passed by the Senate. Since many labor union members would be affected by the tax on high-cost health insurance plans, the House of Representatives was not supportive of this provision in the Senate bill. Union leaders have also been included in key negotiations on this provision, and on Jan. 14, signaled that they are ready to support the merged legislation with the compromised provision.
The main revenue source for the Senate’s health care reform bill (H.R. 3590) would be from an excise tax – beginning in 2013 – on employer-provided, high-cost health insurance plans costing more than $8,500 for individuals and $23,000 for a family. The reported compromise on the legislation now makes the tax kick-in on policies costing $8,900 for individuals and $24,000 for families. The tax threshold would still rise at inflation plus 1 percentage point, as is currently written in the Senate bill. Additionally, dental and vision benefits would be removed from the calculation of threshold costs, and plans offered by state and local governments, as well as plans covered by collective bargaining agreements, would be exempted from the excise tax until 2018. This would allow current agreements to expire and negotiation of new contracts.
In an effort to make up the lack of revenue from the modification of the excise tax provision, leadership will have to come up with new funding to finance the merged bill. Some reports have mentioned that the pharmaceutical industry has agreed to provide more money than the $80 billion they have already negotiated with the White House. Medical device companies could also face additional fees. Portions of the main revenue source in the House bill – a Medicare payroll tax on wealthy U.S. residents – could be added as well.
On Jan. 14, Richard Trumpka, president of the AFL-CIO, said, “Union leaders approached negotiations with the White House and congressional leaders with one overriding goal in mind – getting a bill signed into law.” Gerald McEntee, president of the American Federation of State, County and Municipal Employees (AFSCME), said, “We do like the way it’s shaping up, but it’s still not finished. We’ve got to see a final product.”
House and Senate
Republican Scott Brown’s victory over Massachusetts Attorney General Martha Coakley (D) in the Jan. 19 special election to fill the seat of the late Senator Edward Kennedy (D) might prove to be a game-changer for the health care reform debate. The loss of the 60th Democratic vote now robs Senate Democrats of a filibuster-proof majority. Last week, Democrats were rushing to wrap up a House/Senate agreement on the bill, likely due to reports that Coakley’s lead had diminished.
Congressional leaders are still aiming to have the controversial points in the health care reform bill settled as soon as possible, so they can send the compromised bill to the Congressional Budget Office (CBO) for scoring. The CBO will then need twelve days to analyze the legislation.
In addition to Senate Majority Leader Harry Reid (D-NV) and Speaker of the House, Nancy Pelosi (D-CA), lawmakers participating in the White House meetings include: House Majority Leader Steny Hoyer (D-MD), House Majority Whip James Clyburn (D-SC), House Energy and Commerce Committee Chairman Henry Waxman (D-CA), House Ways and Means Committee Chairman Charlie Rangel (D-NY), House Education and Labor Committee Chairman George Miller (D-CA), Assistant Senate Majority Leader Richard Durbin (D-IL), Senate Finance Committee Chairman Max Baucus (D-MT), Senate HELP Committee Chairman Tom Harkin (D-IA), and Senate Banking Committee Chairman Christopher Dodd (D-CT).
A main point of contention between the two houses of Congress pertained to the 40 percent excise tax on high-cost health insurance plans passed by the Senate. Since many labor union members would be affected by the tax on high-cost health insurance plans, the House of Representatives was not supportive of this provision in the Senate bill. Union leaders have also been included in key negotiations on this provision, and on Jan. 14, signaled that they are ready to support the merged legislation with the compromised provision.
The main revenue source for the Senate’s health care reform bill (H.R. 3590) would be from an excise tax – beginning in 2013 – on employer-provided, high-cost health insurance plans costing more than $8,500 for individuals and $23,000 for a family. The reported compromise on the legislation now makes the tax kick-in on policies costing $8,900 for individuals and $24,000 for families. The tax threshold would still rise at inflation plus 1 percentage point, as is currently written in the Senate bill. Additionally, dental and vision benefits would be removed from the calculation of threshold costs, and plans offered by state and local governments, as well as plans covered by collective bargaining agreements, would be exempted from the excise tax until 2018. This would allow current agreements to expire and negotiation of new contracts.
In an effort to make up the lack of revenue from the modification of the excise tax provision, leadership will have to come up with new funding to finance the merged bill. Some reports have mentioned that the pharmaceutical industry has agreed to provide more money than the $80 billion they have already negotiated with the White House. Medical device companies could also face additional fees. Portions of the main revenue source in the House bill – a Medicare payroll tax on wealthy U.S. residents – could be added as well.
On Jan. 14, Richard Trumpka, president of the AFL-CIO, said, “Union leaders approached negotiations with the White House and congressional leaders with one overriding goal in mind – getting a bill signed into law.” Gerald McEntee, president of the American Federation of State, County and Municipal Employees (AFSCME), said, “We do like the way it’s shaping up, but it’s still not finished. We’ve got to see a final product.”
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