Posts Tagged ‘uninsured Americans’

Health Insurer OKs Reform No Matter What the Supreme Court Does

Monday, June 18th, 2012

Even if the Supreme Court declares the Patient Protection and Affordable Care Act (ACA) unconstitutional, UnitedHealth, the nation’s largest health insurer will still cover certain types of preventive care. The extensions will apply primarily to its customers who have individual policies or small-group health insurance through their employer, a minority of its 35 million total members.  The ACA, whose goal is to provide coverage for millions of uninsured people, started unfolding in 2010 after health insurers fought to block its passage.  Challenges to the law from states and other groups opposed to it wound their way to the Supreme Court.  Bob Laszewski, a consultant and former insurance executive, UnitedHealth’s move a “very smart business decision.”  The provisions are relatively inexpensive and are already factored into the coverage price.  If insurers cut these benefits, customers probably will expect a corresponding premium drop, he noted.  “It would probably be more trouble to roll these things back than go ahead with them,” Laszewski said.  “It just makes common sense to leave these things in there and not take these benefits away since they’re already priced in.”  Laszewski expects other insurers and large employers to take a similar approach.

The provisions UnitedHealth will maintain include providing coverage for dependents up to age 26 under their parents’ plan.  The company will still offer certain preventive healthcare services without requiring a co-payment.  These include yearly check-ups, screening for high-blood pressure and diabetes, and immunizations.  Additionally, UnitedHealth will continue to forgo lifetime dollar coverage limits on policies.  “The protections we are voluntarily extending are good for people’s health, promote broader access to quality care and contribute to helping control rising healthcare costs,” UnitedHealth Chief Executive Officer Stephen Hemsley said.  “These provisions make sense for the people we serve and it is important to ensure they know these provisions will continue.”

The ACA is the largest overhaul of the $2.6 trillion American healthcare system in nearly a half century.  It is designed to ultimately expand coverage to more than 30 million uninsured Americans, by setting up insurance exchanges and opening Medicaid for low-income Americans.

According to estimates, the ACA let approximately 6.6 million young adults remain on their parents’ health insurance plans last year, according to a report from The Commonwealth Fund. If the law is declared unconstitutional, Republican lawmakers may reinstate the extension of young adults dependent coverage.  Other provisions that UnitedHealth plans to maintain include providing easily understandable ways for members to appeal coverage claim decisions; and eliminating rescissions, which are considered to be retroactive policy cancellations, except in the case of fraud.  DeAnn Friedholm, director for health reform at the Consumers Union, called UnitedHealth’s actions “a positive step” and said she hopes other companies follow suit should the law be struck down.

Ronald Pollack, executive director of the consumer advocacy group Families USA and a supporter of the law, applauded UnitedHealth’s move.  “It would make a huge difference for a great number of people who would otherwise be left out in the cold in terms of getting coverage,” he said. “And hopefully, given UnitedHealthcare’s market share, this would have tremendous influence on other companies.”  Even if other large insurers follow suit, Pollack said, it would hardly make up for the loss of other provisions in the law that are set to take effect in 2014 — including subsidies to help low-income Americans buy insurance and bans against discriminating against adults with preexisting conditions.

Writing for CBS News, Stephanie Condon says that UnitedHealth’s decision “Could also alter the political fallout from the high court’s decision.  Should the Supreme Court reject President Barack Obama’s law, he could point to UnitedHealthcare’s announcement to validate his policy agenda.”

The Associated Press’ Ricardo Alonso-Zaldivar points out that dismantling the ACA could be messy.  “It sounds like a silver lining.  Even if the Supreme Court overturns President Barack Obama’s healthcare law, employers can keep offering popular coverage for the young adult children of their workers.  But here’s the catch: The parents’ taxes would go up.  That’s only one of the messy potential ripple effects when the Supreme Court delivers its verdict on the Affordable Care Act this month.  The law affects most major components of the U.S. healthcare system in its effort to extend coverage to millions of uninsured people.  Because the legislation is so complicated, an orderly unwinding would prove difficult if it were overturned entirely or in part.  Better Medicare prescription benefits, currently saving hundreds of dollars for older people with high drug costs, would be suspended.  Partially overturning the law could leave hospitals, insurers and other service providers on the hook for tax increases and spending cuts without the law’s promise of paying more to offset losses.”

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.”

Healthcare Law Repeal DOA in Senate; Likely Headed to the Supreme Court

Monday, February 14th, 2011

The Republican House of Representatives’ attempt to repeal the Patient Protection and Affordable Care Act was DOA — as expected — in the Democratic-controlled Senate.  Voting along strict party lines, all 50 Democratic Senators who were present and one Independent gave the repeal a thumbs down.  All 47 Republican Senators voted in favor of repeal.  Two Senators – one a Democrat and the other an Independent – were not present to vote.

Senator Barbara Mikulski (D-MD) delivered a scornful speech during the heated debate, saying the Republicans are offering “one more hollow, symbolic pander-to-the-masses amendment.  If you want to rewrite the bill, keep your promise, Republican Party, that if you want to repeal, then let’s go replace.  I want to hear their ideas for replacement.  I challenge them right here, right now, today on this amendment.”  Not surprisingly, Republican Senate leaders disagree with Senator Mikulski’s stance. “We think it is just the beginning,” Senate Republican Minority Leader Mitch McConnell (KR-KY) said Wednesday after the Senate voted to reject an amendment he offered to repeal the law.  “This issue is still ahead of us and we will be going back at it in a variety of ways,” McConnell noted.  “We’ll be looking at it in every different way to revisit it.”

The Republicans can claim a small victory as the Senate voted to repeal the 1099 requirement that was a highly unpopular inclusion in the healthcare reform law. Many perceived this as a tax on healthcare consumers and small businesses because it required anyone performing a transaction equaling $600 or more to file a 1099 form with the IRS.  The cost of the requirement had the potential to add up to 40 percent for some small businesses, which could have resulted in closures or layoffs.  The amendment passed the Senate by an 81 – 19 vote and has President Barack Obama’s support. Opponents of the amendment, such as Senator Carl Levin (D-MI), said that Congress, not the White House, should wield the budget-cutting ax.

The Senate’s actions come on the heels of a decision by Florida Federal District Court Judge Roger Vinson that it is unconstitutional for Congress to pass a healthcare law that requires Americans to obtain insurance coverage.  Judge Vinson’s decision created a 2 – 2 tie in lower courts. According to Judge Vinson’s decision, “The act, like a defectively designed watch, needs to be redesigned and reconstructed by the watchmaker.”

Judge Vinson’s decision increases the likelihood that the Affordable Care Act will end up in front of a Republican-dominated Supreme Court. “A year ago, it was a long shot,” said Randy Barnett, a law professor at Georgetown University.  “Now, it’s seen as a 5 to 4 case.  And nobody’s sure which way the 5 – 4 will come down.”  The stakes are enormous for the defining achievement of the Obama presidency.  The decision also has the potential to define the limits of federal power for generations.  “This case could define federalism for the next 100 years,” said Jonathan Turley, a George Washington University constitutional law professor.  “This is a very difficult case for the Supreme Court as an institution.  You have a slight majority of the states opposing it.  You have a national law that’s affecting hundreds of billions of dollars and services.  This is the type of case the justices do not relish.”

Additionally, Virginia Attorney General Ken Cuccinelli has asked the Supreme Court to fast track his state’s challenge to the healthcare law, saying he thinks the legal dispute has become so important that the nation’s highest court should take it up immediately. “We want to eliminate the uncertainty in both our governmental budgets and in the private sector,” he said.  “We want to eliminate at least the uncertainty associated with health care.” The Obama administration opposed the move, saying the case should follow the regular process.  This would put off until 2012 a Supreme Court ruling on the law that aims to provide more than 30 million uninsured Americans with medical coverage and cracks down on unpopular insurance industry practices.

Medicaid Expansion Could Insure 20 Million Americans

Thursday, May 27th, 2010

Medicaid expansion could provide healthcare coverage to 20 million lower-income Americans.  As healthcare reform is ushered in over the next few years, Medicaid will play a leading role in bringing coverage to as many as 20 million Americans who don’t have the resources to buy insurance on their own.  “Medicaid is finally living up to its role of serving as the healthcare safety net for poor and lower-income individuals and families,” said Jennifer Tolbert, principal policy analyst with the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.

Healthy adults under the age of 65 will qualify for Medicaid starting in 2014 if they earn $14,404 in current dollars for a single person or $29,326 for a family of four.  That adds up to 133 percent of the federal poverty level.  Most asset requirements will be abolished, so people who lose their jobs can get health coverage even if they own a home or have money saved for retirement.  Bringing as many as 20 million people into the Medicaid system is a herculean task, even though four years have been set aside to make the changes necessary to make enrollment easier.  Many Americans don’t even know that they will be eligible, and it is the states’ responsibility to inform them.

“We’re pretty busy, I can tell you that,” said Ann Kohler, director of health services with the American Public Human Services Association, which administers the National Association of State Medicaid Directors.  “Many of my members opposed the bill and still do, frankly.  But it is the law, and we’re working hard to get it implemented.”  The most frequently cited obstacles include the fact that many doctors refuse to accept Medicaid payments because it doesn’t reimburse as much as private plans or Medicare.  Additionally, filing claims involves significant paperwork and lengthy payment delays.

The federal government is sweetening the pot for physicians by increasing Medicaid payments for primary care to Medicare levels in 2013 and 2014.  That may not be enough, though.  Physicians prefer to avoid Medicaid patients because they tend to be sicker than insured patients, miss appointments and do not cooperate with treatment plans.

Lack of Healthcare Insurance = More Deaths

Wednesday, March 10th, 2010

Failure to pass healthcare reform legislation could result in 275,000 premature deaths over the next decade.  The real cost of failure to pass healthcare reform legislation could mean that 275,000 Americans nationwide will die unnecessarily over the next 10 years – simply because they lack insurance.  According to a new study by Families USA, “This is only the tip of the iceberg, and the most severe consequence, which is death,” said Kathleen Stoll, director of health policy at Families USA.

The states with the largest populations were found to be the ones where the majority of projected premature deaths would occur.  The top states are California (34,600 early deaths); Texas (31,700); Florida (25,400); and New York (13,900).  Families USA estimates that 68 adults under the age of 65 die every day because they lack healthcare insurance coverage.  Unless a significant change occurs, that figure will climb to 84 by 2019.

Research exploring the connection between a lack of health insurance and an increased risk of death has found that the uninsured are more likely to avoid screenings and preventive care.  As a result, their medical problems tend to be diagnosed later when they are advanced and difficult to treat.  “The bottom line is that if you don’t get a disease picked up early and you don’t get necessary treatment, you’re more likely to die,” said Stan Dorn, a senior fellow at the Urban Institute and author of an earlier study of premature deaths.

Healthcare experts warn that the Families USA’s study’s premature death estimate errs on the side of caution, although the report calculated that a lack of insurance increases mortality rates by 25 percent.  More recent research found that people who do not have healthcare research are 40 percent more likely to die early.

Healthcare Industry Offers Cost Savings

Thursday, July 16th, 2009

Healthcare providers will slash up to $1.7 trillion in costs over the next 10 years by enhancing the care of chronic diseases, reorganizing administrative procedures and eliminating unnecessary treatments.medical_bill

This is a sneak peak at how healthcare systems, physicians, pharmaceutical companies, insurers, medical device manufacturers and other stakeholders plan to respond to President Barack Obama’s request that the industry find ways to control patient costs.  Among the American Medical Association’s (AMA) suggestions are cutting overused – and often unnecessary — procedures, such as Caesarean sections.  The savings are crucial to funding the Obama administration’s proposed health system overhaul.

A new White House study states that reforming healthcare will increase the nation’s GDP by two percent in 2020 and eight percent in 2030, cut unemployment and save families an average of $2,600 a year by 2020.  Without healthcare reform, the number of uninsured Americans will rise to 72 million by 2040, compared with 46 million today.

Christina Romer, chair of the president’s Council of Economic Advisers, said “The one thing that’s happened relative to the 1990s is the nightmare scenario is getting closer.”  Other recommendations include reducing medical errors, using common insurance forms, improving physician performance standards, readmitting fewer patients to hospitals, improving drug development efficiency and expanding in-home care for patients with long-term illnesses.