Posts Tagged ‘healthcare insurance’

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Employer-Susidized Healthcare Insurance at a New Low

Wednesday, November 23rd, 2011

Fewer than half of  America employers - just 44.5 percent in the 3rd quarter, a decline of more than five percent in three years, — contribute to their employees’ healthcare coverage, according to a Gallup and Healthways Inc., poll.  The firms, which surveyed more than 90,000 adults, blamed the decline on high unemployment, under-employment and an increased number of employers who do not offer health insurance to their workers.

Employer-sponsored health insurance is one of the pillars of the $2.6 trillion U.S. healthcare industry.  Unfortunately, companies have scaled back benefits and raised employee charges to cope with fast-rising healthcare costs and anemic economic growth.  The latest figure was 5.3 percent below the 2008 high of 49.8 percent, when the companies began tracking trends in employer-sponsored health insurance.  “The health insurance system in the United States is experiencing numerous changes.  Governments and businesses have and will continue to cut back and/or reform their health coverage offerings,” according to the pollsters.

There was also an increase in the ranks of those covered by government plans from Medicaid, Medicare and military programs, which was up 2.2 percentage points since 2008 at 25.1 percent but off a 2010 high of 25.7 percent.

According to the Kaiser Family Foundation, there were 41 million uninsured American adults and 24 million adults under retirement age receiving the Medicaid program for low-income people and other public insurance plans last year.  Medicare covers an estimated 48 million beneficiaries.  The survey found higher levels of health insurance coverage among young people aged 18 to 26, which the pollsters attributed to a provision of the ACA that allows parents to cover grown children under their insurance plans.  Other portions of the law, including tax credits for small businesses, did not appear help those aged 25 to 64, whose uninsured ranks increased.

One large employer cutting back on healthcare coverage is Wal-Mart, the nation’s largest private employer.  Citing rising costs, the retailer told its employees that all future part-time employees who work less than 24 hours a week will no longer be eligible for any of the company’s health insurance plans.  Additionally, new employees who average 24 hours to 33 hours a week will no longer be able to include a husband or wife as part of their healthcare plan, although children can still be covered.  This is a massive shift from a few years ago when Wal-Mart expanded coverage after being criticized because so many of its 1.4 million workers could not afford or did not qualify for coverage — sending many of them to Medicaid.

“Over the last few years, we’ve all seen our healthcare rates increase and it’s probably not a surprise that this year will be no different,” said Greg Rossiter, a Wal-Mart spokesman.  “We made the difficult decision to raise rates that will affect our associates’ medical costs.  The decisions made were not easy, but they strike a balance between managing costs and providing quality care and coverage.”

There’s also some good news on the employer-subsidized healthcare front. Nearly 75 percent of medium-to-large employers plan will continue to offer their workers health insurance once the major provisions of the ACA take effect, according to a survey by consulting firm Towers Watson.  According to the survey of 368 mid-to- large-sized companies, 71 percent plan to continue to offer healthcare benefits to their employees through 2014, the year that everyone will be required to have health insurance and state-based health insurance exchanges will kick off.  Approximately one-third of the companies are not certain if they will continue offering insurance, or, if they stopped providing insurance, whether they would compensate employees by offering pay raises.

“With so much still unknown regarding both the short- and long-term impact of healthcare reform, most employers will not make wholesale changes to employer-sponsored health plans in 2012,” said Ron Fontanetta, senior healthcare consulting leader at Towers Watson.

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Most Unemployed Americans Have No Healthcare Insurance

Tuesday, September 27th, 2011

Nearly 75 percent of unemployed Americans can’t afford needed healthcare or have their prescriptions filled; another 50 percent struggle with medical bills or medical debt.  As many as 60 percent of working Americans depend on employer-based health insurance;  when 15 million working-age adults lost their jobs between 2008 and 2010, an estimated nine million also lost their health insurance, according to the Commonwealth Fund report.

The report also concludes that when the most important provisions of the Patient Protection and Affordable Care Act (ACA) are fully in effect in 2014, unemployed people will have more health insurance choices.  Unfortunately, the current lack of options has led to a health and financial crisis for many Americans who lost their health insurance benefits along with their jobs.  The report’s researchers analyzed data from the 2010 Commonwealth Fund Biennial Health Insurance Survey.

“It’s clear from this report that losing a job and health insurance simultaneously is a serious threat to a family’s health and financial stability,” Commonwealth Fund President Karen Davis said.  She noted that “the Affordable Care Act will assure that families already struggling with the devastation of unemployment will still be able to get the health care they need and will be protected if they become seriously ill.”

The survey of 3,033 adults was conducted by Princeton Survey Research Associates International between July, 2010, and November, 2010.  The results indicate that many individuals who lost health coverage are carrying medical debt or skipping needed healthcare or neglect to fill prescriptions because of cost.  In 2010, two of five (40 percent) adults aged 19 to 64 — or 73 million people — reported difficulty paying medical bills, being contacted by a collection agency about unpaid bills, having to change their way of life to pay bills.  This is up from 34 percent, or 58 million people, in 2005.  Increasingly, cost is becoming a barrier to getting needed care. 

Approximately 70 percent of adults who earned less than 200 percent of the federal poverty level and lost their jobs and health benefits became uninsured, compared with about 42 percent of those at or above 200 percent of the poverty level.  Just eight percent of lower-income workers continued their coverage through COBRA after losing their jobs, compared with about 21 percent of those with higher incomes who chose COBRA. 

“Clearly, COBRA subsidies made a big difference for millions of unemployed people who had no other option for affordable health insurance coverage,” Michelle Doty, vice president at the Commonwealth Fund said.  “As the economy continues to struggle to recover, extending those subsidies would assure that workers, particularly those with lower incomes, could maintain their health insurance.”

The report  — which advocates for universal coverage — the Commonwealth Fund said that 60 percent of those left uninsured during the recession were unable to find a replacement plan they could afford and 35 percent were refused coverage by insurers.  “Once you are unemployed and uninsured, it’s nearly impossible to afford COBRA or buy an individual policy,” said Commonwealth Fund Vice President Sara Collins.

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Walgreens: One-Stop Shopping for Healthcare Insurance

Monday, August 15th, 2011

The nation’s largest drugstore chain is planning to begin selling health insurance this fall.  Walgreens, which operates 7,742 drugstores in all 50 states, the District of Columbia and Puerto Rico, will sell health insurance products with different price ranges and coverage levels nationally through a private health insurance exchange.

According to Walgreens officials, “As always, we’re looking at a number of options in light of healthcare reform as we continue to seek ways to help our customers better navigate today’s healthcare system.”  Health reform mandates the creation of federal and state-funded public health insurance exchanges by 2014 that will offer subsidized insurance for people who lack insurance. Multiple companies, many not typically associated with health insurance, are also expected to jump into the embryonic but lucrative market for health insurance exchanges — estimated to be worth billions of dollars — prior to 2014.  These include retailers, financial services providers and a major payroll processer that are actively planning to create their own private health insurance exchanges.  Walgreens neither confirmed nor denied the report,  but it’s expected that the insurance plans will be available online, in-store or via call centers and will be branded by national insurers in some instances.  Walgreens currently offers flu shots and vaccinations at its “take care clinics” so this new move is seen as a bid to become a one-stop shop for healthcare needs.

The investment banking firm TripleTree,  which focuses on the healthcare and technology market, estimates that between 2014 and 2019, as many as 36 million Americans will buy their health insurance from exchanges.  “For retailers, (creating a private insurance exchange) is a way to generate more revenue from a new business,” Chris Hoffman, TripleTree’s chief marketing officer, said.  “Those companies that get their exchanges up and running before 2014 could also succeed in stealing customers away from the public exchanges.”.

Hoffman pointed out one crucial distinction between public and private health insurance exchanges.  Consumers who qualify for government subsidies can participate only in public exchanges, and not private exchanges.  Still, Hoffman said that private exchanges will attempt to stay competitive with public exchanges by offering other incentives to join, such as loyalty programs that tie in discounts and bundling other types of insurance like life insurance along with their health insurance products.

By entering into a partnership with some of the nation’s biggest health insurers, selling health insurance is a natural evolution in Walgreens’ process of becoming a one-stop shopping destination for all healthcare needs.  Some forms of insurance will be branded by national insurers and others will be “private label” insurance products sold through Walgreens’ exchange.

Writing on the bizmology website, Alexandra Biesada says that “I wouldn’t be surprised if it’s true.  Walgreen has rushed to fill gaps in our nation’s fractured healthcare system, opening hundreds of in-store Take Care Clinics, worksite healthcare centers and by offering a slew of healthcare services, including immunizations and counseling for chronic conditions, such as diabetes.  It also provides products and services to pharmacy patients and prescription drug and medical plans through its Walgreens Health Services unit.  Already a leader in healthcare services, offering health insurance is a logical next step for Walgreen.  With the ranks of the uninsured and underinsured swelling, consumers are being steered to health insurance exchanges under the Patient Protection and Affordable Care Act (aka the healthcare reform bill) passed into law in March 2010.  In addition to the creation of federal and state-sponsored health insurance exchanges, the private sector, including retailers such as Walgreen, is expected to enter the market.  While only consumers enrolled in government-sponsored exchanges are eligible for subsidies, privately-sponsored exchanges could still be competitive by offering subscribers other incentives to join their network.  Some retailers, Sam’s Club comes to mind, already offer select customer groups services, including group health insurance.  So the idea of buying coverage from a retailer, rather than through an employer or broker, isn’t unprecedented.  Walgreen has moved quickly to capitalize on the transformation of our healthcare system and is looking for growth opportunities beyond its vast network of retail stores.”

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HHS Issues Guidance for State Healthcare Exchanges

Wednesday, July 27th, 2011

The Department of Health and Human Services (HHS) has proposed a structure for health insurance exchanges that gives states significant flexibility in how and when they set up open marketplaces designed to boost competition.  HHS announced a sliding deadline for states to create the exchanges, allowing them to receive conditional approval if they are in advanced preparation by 2013.

Additionally, states that are not ready by the final 2014 deadline can delay opening the exchanges until 2015 or later.  States that are still deciding whether to establish health insurance exchanges have sought clarity on how these insurance marketplaces will function.  The federal government previously had provided few details on this key part of the Patient Protection and Affordable Care Act (ACA).

The rationale for the exchanges is to create convenient access to an open marketplace of insurance plans that lets uninsured people and small businesses join together to negotiate affordable rates.  States had faced a January 1, 2013, deadline to decide if they would participate in the program.  Those opting to participate are expected to create governance and information technology structures virtually from scratch to have the exchanges in full operation by 2014.

“If we don’t have significant progress made by the end of the year, the IT experts tell us it’s going to be really hard to meet the deadline,” Kansas Insurance Commissioner Sandy Praeger said.  She is working to establish an exchange despite a lack of legislation in her state to move forward with it, not to mention a conservative governor who strongly opposes the health law.  “The health insurance market is often broken, especially for small businesses,” said HHS Secretary Kathleen Sebelius.  Sebelius said the exchanges would share three key features: They will serve as one-stop shops for comprehensive insurance needs; create competition between insurers based on price and quality; and provide basic coverage to all Americans.  “This is how members of Congress get their health insurance today,” she said.  “And once these reforms are fully in place, buying insurance will become much more like buying a home appliance or an airline ticket.”

Meanwhile, HHS announced three new initiatives to help states improve the quality and cut the cost of care for “dual eligible” – the approximately nine million Americans who qualify for both Medicare and Medicaid.  The programs include a demonstration program to try out two new financial models to better coordinate care for people who are eligible for both government programs; a demonstration program to help states upgrade the quality of care for people in nursing homes that focuses on cutting hospitalizations; and setting up a technical resource center to help states improve care for high-need high-cost beneficiaries.  “By improving care to the most vulnerable of our citizens, we can improve the quality of their lives and prevent wasteful spending,” Sebelius said.  “Governors and their staff have been looking for tools to help them accomplish these important goals.  I am pleased that we can continue our strong partnership with the states to do this.”

These moves couldn’t come at a better time.  It is estimated that the growth in the uninsured adult population continued in 2010 — particularly among the number of long-term uninsured and poorer uninsured.  Americans of all ages who were uninsured during the last year reached 60.3 million in 2010, an increase of nearly two million when compared with 2009, according to a report by the National Center for Health Statistics, a division of the Centers for Disease Control and Prevention.

Private health coverage continued to decline while public coverage increased, especially for children.  Among non-elderly adults, 61.1 percent had private coverage in 2010, a 1.7 percent decline.  The rate of privately insured children fell 1.9 percent to 53.8 percent.  While greater numbers of adults became uninsured, fewer children on the whole lost coverage.  That’s largely because the percentage of kids with public coverage — Medicaid and the Children’s Health Insurance Program (CHIP) — increased to 39.8 percent, up nearly two percent.  “Medicaid and CHIP have been a real success story,” said Tom Buchmueller, PhD, a University of Michigan health economist.  State expansion of children’s health programs began increasing the percentage of publicly covered children beginning in 2008.

Sebelius was joined by Washington State Governor Christine Gregoire,  who said the 135,000 dual eligible residents of her state cost $1 billion annually in healthcare costs.  Though they represent only 12 percent of the Medicaid caseload, they total more than one-third of the spending, she said.  “If we could just reduce the cost of two percent a year by investing in community-based solutions rather than nursing homes, which is what our patients want anyway, by helping them avoid psychiatric hospitalizations, we believe we could save at least $10 million a year just with that small segment – that high-risk segment of our dual eligible population.  This is our costliest population, with the greatest need, yet we’re not able to focus on what’s right for them,” Gregoire said.  “The opportunities you’ve provided us will make this possible now.”

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Man Robs Bank of $1 to Gain Access to Needed Healthcare

Thursday, July 7th, 2011

Few news stories have provided more compelling testimony about how the nation’s healthcare system fails millions of people is the report that a North Carolina man robbed a local bank of just $1 so that he could have multiple healthcare problems treated in jail.  Richard James Verone,  a 59-year-old unemployed man with multiple health issues, robbed a local bank so he could go to prison and receive treatment for his conditions — he said it was the only way he could get healthcare.

Verone has an undiagnosed growth in his chest, two ruptured back discs, and a foot problem.  His medical condition made working difficult after his 17-year career as a Coca-Cola delivery driver ended.  He tried living off savings and part time jobs, but that proved inadequate.  He applied for Social Security but only received food stamps with no resolution to his medical problems.  When robbing the bank, Verone gave the teller a note explaining that he only wanted $1.  He did not want to frighten anyone and was not doing it for the money.  After the teller handed him a dollar, Verone said “I’ll be sitting right over here on the chair waiting for the police.”  When the police arrived, Verone was sitting on a sofa inside the bank.  “I’m sort of a logical person and that was my logic,” Verone said.  “If it is called manipulation, out of necessity because I need medical care, then I guess I am manipulating the courts to get medical care.”

Verone faces charges for larceny from a person, which is unlikely to keep him behind bars for more than one year.  He is being held in Gaston County Jail, where he has already been seen by several nurses, on a $2,000 bond.  If his sentence is too short, Verone said he plans to rob again.

“The pain was beyond the tolerance that I could accept,” Verone said.  “I kind of hit a brick wall with everything.”  Verone said he “exercised all the alternatives” before the bank heist.  As the day approached, Verone paid his last month’s rent, donated his furniture and moved into a hotel.  Before going to the bank, he mailed a letter to the Gaston Gazette outlining his plans.  According to the letter, “When you receive this, a bank robbery will have been committed by me.  This robbery is being committed by me for one dollar,” he wrote, wanting to make clear that the motive for his crime was strictly medical and not monetary.  “I am of sound mind but not so much sound body.”

Writing in the San Francisco Chronicle, John Thorpe says that “After depleting his life savings and realizing he had, literally, nowhere else to turn, Verone committed the crime, hoping he could get the medical care that he so desperately needs.  This is what America has come to?  Otherwise honest folks, with nowhere to turn in life, have to resort to fake-robbing a bank with the hopes they’ll be arrested so they can receive medical care?  There is absolutely no reason for an allegedly civilized country, particularly one as wealthy as America, to pass the buck on providing healthcare for everyone.  Yes, everyone: the employed and the unemployed; the sick and the healthy; old and young.  Before you scream ‘oh no, socialism!!!’ stop and consider what you mean by that.  How do socialist systems pay for healthcare?  Taxes are collected from businesses and citizens, and a portion of those taxes go to cover the healthcare costs of everyone in the plan – in other words, everyone in the country.

“How do health insurance systems pay for healthcare?” Thorpe asks.  “Premiums are collected from businesses and employees, and a portion of those premiums go to cover the healthcare costs of everyone in the plan.  The difference between the two?  Socialized care costs less (because it has a much larger pool of people to draw from), covers everyone at all times, and prevents people from purposefully committing crimes to get treated.  Insurance systems ARE socialized systems, except they don’t cover everyone and allow a corporation – an entity that neither receives nor provides the medical treatment – to skim a profit off the top.  In what sort of twisted mind is that the rational way to provide medical care?  It’s not like the marketplace can rationally set prices for healthcare.  A dying man has no ability to check prices and compare services before deciding which hospital he’ll take his heart attack to.”

Robert Oak of the Economic Populist,  agrees with Thorpe.  “He (Verone) got his healthcare and how many others are committing felonies so they can get food, shelter and medical attention to save their lives?  If we cannot get universal single payer, perhaps all of America should behave as Verone did, so finally, we could all get some healthcare.  What’s wrong with this picture?”

Suzy Khimm of Mother Jones, points out that the cost of caring for Verone for the year that he is likely to be incarcerated does not come cheaply.  “The story is telling not just because it shows the sad desperation of uninsured Americans who have trouble finding healthcare — but also how costly it is to leave such problems unattended.  James Verone may have only robbed the bank of one dollar, but the cost of jailing him for just one year in North Carolina is over $23,000, not to mention the legal fees his case will rack up as well.  Similarly, if he wasn’t in prison, and his health problems worsened, he could end up in an emergency room, where the state would again have to help foot the bill if he couldn’t pay.  Insuring him would likely be the cheapest option — which is one reason why Democrats have made universal coverage a priority under federal health reform.”

Verone concludes “I didn’t have any fears.  If you don’t have your health you don’t have anything.”

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Healthcare Costs Have Doubled in Just Nine Years

Wednesday, June 1st, 2011

"Where does it hurt?"

American families have seen their healthcare costs rise by more than 50 percent over the last nine years, a trend that shows no sign of reversing, according to a report from the actuarial consulting firm Milliman, Inc.

Healthcare show few signs of dropping, according to a report released Wednesday by the actuarial consulting firm.  When you add in employers’ contributions, this year’s total healthcare cost for a family of four more than doubled to $19,393 from the $9,235 reported in 2002.  The 2011 figure represents a seven percent increase compared with 2010.  The primary reason for the rising costs are primarily due to price increases in categories like pharmacy, inpatient or outpatient hospital care and doctors’ office visits.  Lorraine Mayne, one of the report’s authors, said these charge increases are a bigger factor than changes in how Americans use healthcare.  Even the passage of the Patient Protection and Affordable Care Act, which started phasing in during 2010 and aims to eventually cover millions of uninsured people, had virtually no impact on healthcare costs in 2011, Mayne said.  She doesn’t believe that new law will have any “direct, immediate impact” on the trend.

In an important finding, the study found that employers are making workers shoulder an even bigger share of total health care expenses.   The employee portion of costs paid for a family of four covered by employer-sponsored health insurance will rise to approximately $8,008 this year from $3,634 in 2002.  That is an additional $84 a week from household budgets for healthcare.  Of the $1,319 yearly increase, workers’ out-of-pocket costs rose 9.2 percent in 2011.  That outpaced the 6.6 percent increase in 2010.  Payroll deductions for insurance coverage climbed 9.3 percent this year, an increase over the previous year.  Adding insult to injury, employers’ share of their workers’ healthcare costs fell six percent in 2010, compared with eight percent the previous year.  Of the $19,393 annual cost, employees’ share is moving closer to 50 percent, according to Mayne.  “Employees are paying $8,000 of the $19,000.  That’s a decent amount much larger than other areas of consumer spending.  What we’ve observed in the past few years is employers have increasingly been offering health plans with higher deductibles and co-insurance, co-payment limits,” she said.

The rise in outpatient care is making the difference. For three consecutive years, outpatient care has led all other categories in cost increases – as high as 90 percent.  “Unit costs are increasing both because the same services have increased in price and also because new, more expensive services continue to emerge,” the report says.  Hospital costs represent the second reason for last year’s increase (for the most part because acute care is so expensive), followed by physician care, drug costs, and other types of care, such as durable medical equipment and home healthcare.  People can rein in some costs by moving to a different part of the country, according to Milliman.

Healthcare was costliest in Miami,  where spending averaged $23,362.  New York came in second at $22,785 and Chicago third at $21,996  The three lowest-cost cities were Phoenix, which averaged $17,336; Atlanta, which averaged $18,292; and Seattle, which averaged $18,536.  “These cost differences result from variation in local practice patterns and from differing costs for health care goods and services,” said Chris Girod, a Milliman principal and consulting actuary.

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The Affordable Care Act: A Tale of Two Studies

Monday, May 23rd, 2011

A study of medical bills under the Patient Protection and Affordable Care Act (ACA) determined that most households will be able to afford premiums and related expenses after paying bills for food, child care, transportation and other necessities, according to the Commonwealth Fund. The mission of The Commonwealth Fund is to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.

Approximately 8.5 to nine percent of American families living closest to the poverty line could not afford basic necessities and typical medical bills proposed by the health reform law.  The ACA requires individuals to purchase insurance by 2014, although with occasional exceptions.  The ACA restricts household out-of-pocket costs and subsidizes plans available through insurance exchanges to people with low-incomes.  Fewer households in high cost-of-living states could afford healthcare expenses, according to the Commonwealth Fund study.  The report included projections of spending on necessities, premiums and out-of-pocket costs for households between the federal poverty line and 500 percent of the threshold.  Those insured by safety net or state run insurance exchanges were not factored into the study.

Even with implementation of the ACA, some families across all income levels would continue to struggle to afford coverage because of steep out-of-pocket costs.  According to the report, 17 percent of families of four earning up to $44,700; approximately 25 percent of families earning between $44,700 and $67,050, would struggle with healthcare costs.  The data examines costs in 2014, the first year the ACA will be fully implemented and the start of state-based health insurance exchanges.  The law provides federal subsidies for the lowest-income people to buy insurance.  Americans with incomes between 133 and 399 percent of the poverty level are eligible for income-based tax credits.  Some low-income people will be eligible for subsidies to make up for out-of-pocket costs.  Americans who make less than 133 percent of the poverty level are eligible for Medicaid.

“The Affordable Care Act is very good news for millions of Americans who are struggling to afford health care, going without health insurance, or skipping the care they need because they can’t afford it,” said Commonwealth Fund President Karen Davis. “The new law makes health insurance and health care affordable for nearly all families, and introduces delivery system reforms that have the potential to greatly improve quality and efficiency.  If implemented well, new entities like accountable care organizations may bring even greater savings and affordability than this report predicts.”

Although the Commonwealth report is positive about the likelihood that more families will be able to afford health insurance, Craig Pollack, M.D., M.H.S., assistant professor of medicine at Johns Hopkins, and Katrina Armstrong, M.D., from the University of Pennsylvania, are not as upbeat about the ACA.  The physicians warn that as a result of certain provisions in the ACA, wealthy hospitals and physician practices might “cherry-pick” similar institutions and create Accountable Care Organizations (ACOs).  In this way, they can avoid poor and minority-heavy patient populations who will be treated elsewhere to cut costs.  ACOs encourage patients to seek care within their own network, which highlights the disparities between networks.

According to Pollack, hospitals and physician practices that treat too many minorities may be unable to join ACOs and will fall further behind in the cost and quality of care that is likely to occur in such networks.  “There is ample evidence of racial and ethnic disparities in healthcare,” Pollack said.  “Hospitals and private practices that care for greater numbers of minorities tend to have larger populations of Medicaid and uninsured patients.  These patients have less access to specialists, and their hospitals and practices tend to have fewer institutional resources than their counterparts.”

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Affordable Care Act Under Siege As It Celebrates Its 1st Birthday

Wednesday, March 30th, 2011

As the Patient Protection and Affordable Care Act (ACA) celebrates its first birthday, the future of the law is still unclear, but its effects have been enormous.  The debate over the law likely created the “tea party” movement.  Last November, Republicans took control of the House of Representatives and strengthened their numbers in the Senate.  Potential contenders for the 2012 Republican presidential nomination need only say one word, “Obamacare,” to get a negative reaction from a crowd.  President Obama at times himself has struggled to ensure that his first term isn’t defined solely by this legislation.

Public opinion over the ACA remains divided, despite the efforts of Democrats to showcase how it will provide healthcare insurance to millions of uninsured Americans.  Additionally, most Americans remain confused about what the healthcare overhaul actually accomplishes.  Republicans considering a 2012 presidential race for the most part stand united in their opposition to the legislation.  Former Minnesota Governor Tim Pawlenty is using his opposition to the law to gain a national following.  “If courts do not do so first, as president, I would support the immediate repeal of Obamacare and replace it with market-based healthcare reforms,” Pawlenty said.  Former Massachusetts Governor Mitt Romney is in a different position because he supported a similar law during his tenure.

Representative Steve King (R-IA), the Iowa Congressman who is in the vanguard to repeal the ACA, says that “America will never become the nation it can be if were saddled with Obamacare“, “I have a deep conviction that this is unconstitutional, that this is unsustainable, and I have a duty.  And that doesn’t mean I sit back and wait for the Supreme Court to save America from itself.  It’s my job to step up and lead.”

Taking a difference stance, Carmela Coyle, president and chief executive of the Maryland Hospital Association, said her group strongly supports the reform law and will work to assure that the effort translates into better and cost-effective care.  “We support healthcare reform because hospitals see every day what happens when patients don’t have the healthcare coverage they need and can’t get their care at the right time and in the right setting.  Expanding coverage was necessary, and it was right.  We must ensure that the health coverage now guaranteed to many Marylanders is meaningful coverage.”

What’s the future of the Affordable Care Act? House Republicans, who say the law gives the federal government too much control and doesn’t cut costs, passed a repeal bill after they became the majority in January.  Full repeal is unlikely unless Republicans successfully take control of the Senate and the presidency in the 2012 presidential elections.  The current Democratic-led Senate will not vote to repeal and President Obama would certainly veto a repeal bill.  Democrats argue the law’s reforms will slow the growth of healthcare costs while improving care and reducing the ranks of the uninsured.  Republican efforts to withhold funds to block the law’s implementation will be DOA in the Senate.  That leaves Republicans the option of picking apart the law regulation by regulation, a strategy that could prove more successful.

In the meantime, implementation is underway.  “As we look forward with implementation of the health reform law, the states really become the focus now,” said Jennifer Tolbert, a principal policy analyst at the Kaiser Family Foundation.  “When thinking about the coverage expansions in particular because it is going to be up to the states to implement the expansion of the Medicaid program for lower-income individuals and to create the new health-insurance exchanges that will provide access to private insurance for moderate and middle income individuals.”

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Healthcare Spending Slowed in 2009

Tuesday, January 25th, 2011

Americans’ healthcare spending grew by just four percent in 2009 (the last year for which statistics are available), the smallest annual increase in 50 years. This suggests that Americans did not seek healthcare because of lost jobs and a lack of healthcare insurance due to the recession.  At the same time, healthcare insurance premiums increased at a faster pace than in 2008.  Additionally ,the number of Americans with coverage fell by 6.3 million.  Out-of-pocket spending on healthcare showed a slight increase.  Medicaid spending rose sharply by nine percent, compared with less than five percent in 2008.  This is a result of more people qualifying for Medicaid, again because of the recession.

The statistics, released by the Department of Health and Human Services (HHS), are a sign that the recession left a deep imprint on healthcare in America – far worse than other recent recessions.  “Job losses caused many people to lose employer-sponsored health insurance and, in some cases, to forgo health-care services they could not afford,” according to economists and statisticians at HHS’s Centers for Medicare and Medicaid Services.  The report, which has been compiled by the government annually since 1960, is the most recent snapshot of spending across the healthcare system.

Healthcare spending in the United States totaled $2.5 trillion in 2009, adding up to an average of $8,068 per person.  The four percent rise recorded in 2009 compares with more than six percent in 2007, eight percent in 2005 and double-digit increases in 1990 and 1980.  Even with the slowdown in spending, healthcare spending still comprised 17.6 percent of the GDP in 2009.

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Affordable Care Act Passes Its First Court Test

Thursday, October 28th, 2010

Healthcare reform survives its initial court case. Can the government make people buy insurance?  The Affordable Care Act (ACA) has survived its first court test, an attempt in Michigan to overturn the mandatory insurance provision that requires Americans to buy minimum coverage. The ruling by U.S. District Judge George Steeh was in response to a lawsuit filed by the Thomas More Law Center, which had requested an injunction against the ACA on the grounds that it exceeds Congress’ authority and is an unconstitutional tax.

In his 20-page decision, Steeh ruled that Congress has the power to pass the law under the Commerce Clause of the United States Constitution.  According to the decision, “The minimum coverage provision, which addresses economic decisions regarding healthcare services that everyone eventually, and inevitably, will need, is a reasonable means of effectuating Congress’ goal.”

Steeh noted that “Without the minimum coverage provision, there would be an incentive for some individuals to wait to purchase health insurance until they needed care, knowing that insurance would be available at all times.  As a result, the most costly individuals would be in the insurance system and the least costly would be outside it.  In turn, this would aggravate current problems with cost-shifting and lead to even higher premiums.”

The Thomas More Law Center plans to appeal Judge Steeh’s ruling.

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