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This post of mine first appeared at Kaiser Health News last week.What if a Republican governor and a Republican legislature had the ability to implement their version of health insurance reform and the federal government would have to pay for it? It's a great idea. And I'm thrilled to say that a bi-partisan bill has already been introduced in the Senate by Ron Wyden, D-Ore., and Scott Brown,

When will the Congress and the White House finally make the hard decisions in order come to grips with the federal deficit problem?When will we finally deal with real health care reform and get the entitlements, and with them the private health care cost issue, under control?My focus on trying to answer those questions has always centered on what's going on in the health insurance market: When

This whole medical loss ratio (MLR) provision in the new health care law is a fool’s errand. When it comes to controlling health care costs it is about as productive as taking your shoes off at the airport is valuable at improving air travel security.Without a doubt, the new health care law does far too little toward making health care costs affordable. And, marginal health insurance carriers

This is post of mine that appeared last week at Kaiser Health News.Just after the election, I saw an exchange between CNN’s Anderson Cooper and the head of the Tea Party House Republican caucus, Michele Bachmann. Cooper tried to pin Bachmann down on just exactly what “specific spending cuts” she would make to get federal spending under control. When he suggested that Medicare was going to need

While many surveys shows the country divided on the benefits, or failings, of health reform, the Consumer Perceptions of Health Reform Survey from Deloitte Center for Health Solutions found that 38% of U.S. adults said they are “not at all” knowledgeable about the Patient Protection and Affordable Care Act (ACA). Despite this lack of knowledge, most of the Deloitte respondents felt that the ACA will have a positive impact on the country. For example, 59% believe the ACA will increase access to affordable health insurance for the uninsured, 49% believe it will encourage consumers to live healthier lives, 45% said it will reduce overall health care costs, and 45% said it will reduce the cost of prescription drugs. And a segment this morning on National Public Radio's Morning Edition reported on a study that found that the number of small firms with 10 or fewer workers buying health insurance rose by 14%, bouyed by the ACA-provided tax credit for these firms to buy health insurance. ...

Recent results of the National Health Interview Survey reported by the Centers for Disease Control and Prevention (CDC) help to debunk major health care myths about health care coverage. These myths hold that only the poor, and young, healthy people are uninsured and that the young, healthy folks choose to not have health insurance. Hear this: “Uninsurance of young and middle-class adults increased by 4 million people from 2008 to the first quarter of 2010,” reported Thomas Frieden, the CDC director, on November 10 in the CDC’s most recent Vital Signs monthly report. The Vital Signs report collected data from more than 90,000 interviews done through the National Health Interview Survey conducted in January through March 2010, just before the passage of the Patient Protection and Affordable Care Act. According to Mr. Frieden, “Half of those who are uninsured are non-poor and there’s a serious impact on access to needed health care. Specifically, among adults age 18 to 64, the proport...

Wait ‘til next year!! This is a chant that we Chicago Cubs fans are often heard to say, sometimes as soon as May or June of each year. However, people with health insurance may be soon be saying the same thing, too. You see, under the new health reform law, starting in 2011, health insurers must meet certain minimum “medical loss ratios,” which essentially require insurers to spend at least 80 percent (for individual and small group plans) or 85 percent (for large group plans) of the premiums they collect on actual medical care. If they don’t meet these rules, insurers have to send rebates to their customers. This rule applies to insurers offering both group and individual coverage and takes effect starting in 2011. Now, you might be saying, “but my insurance premiums go up every year, how could this be?” Well, it’s like this. In tough economic times, such as these, more than a few people tend to put off elective surgeries and otherwise skimp on their healthcare expenses. What this amo...

The Co-Chairs of the President’s Deficit Reduction Commission are out with their preliminary recommendations.They’ve done a great job—they’ve offended about everyone!But we have a nearly impossible but unsustainable challenge in front of us if we are ever going to crawl out of this deep hole.It is not so much what is on their list as what this list tells us about just how fundamental the changes

The $64,000 question of health reform is this: What will employers do in response to health reform changes? Will they continue to offer health benefits to their employees or will they drop health insurance as an employee benefit altogether? Thanks to a new survey by benefits consultant,  Mercer , we have a better idea of what will likely happen once the state-run health insurance exchanges become operational in 2014 when employers can opt out by paying a penalty. Not likely to abandon plan sponsor role. When Mercer asked employers how likely they will be to get out of the business of providing health coverage to their employees, for most employers, the answer is “not likely.”   Survey responses varied by employer size, with larger employers most committed to their health plan sponsor role. In fact, Mercer says, only 3 percent of the largest employers (10,000+ employees) say that they’re likely to terminate their health plans and let employees seek coverage through insurance e...

@font-face { font-family: "Cambria"; }p.MsoNormal, li.MsoNormal, div.MsoNormal { margin: 0in 0in 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; }div.Section1 { page: Section1; } The election has given us a Republican House and a still Democratic controlled Senate. But, instead of Democrats having the 60 Senators they had when health care was passed in December, they will have a

Now that the mid-term elections are over, many people are wondering what’ll happen with recently-enacted health reform legislation. The Republicans have been talking about trying to “repeal and replace” or attempting to defund the law. However, starting in 2011, they control the House but not the U.S. Senate or the presidency. After the election, Prresident Obama has suggested that he would be open to tweaking the legislation. He cites the 1099 provision in the law as something that “ appears to be too burdensome for small businesses” and is an example of something that should be looked at. L ikely new House Speaker, Rep. John Boehner (R-OH) pledged “we have to do everything we can to try to repeal this bill and replace it with common-sense reforms that'll bring down the cost of health insurance.” Of course, no one can really tell what the future holds but here's a sampling of what some experts think about the future of health reform. A benefits consultant’s view. From a lead...

Feds Battle For Hearts And Minds The federal government continues the battle for the hearts and minds of health care consumers in a new report stressing Medicare savings due to the Patient Protection and Affordable Care Act. Average Medicare beneficiary savings in traditional (fee for service) Medicare will be approximately $3,500 over the next ten years because of changes made by the Patient Protection and Affordable Care Act (ACA), according to a report released on Nov. 4 by the Department of Health and Human Services. Beneficiaries who have high prescription drug spending will save much more – as much as $12,300 over the next 10 years. In comparison, Medicare beneficiaries with low drug costs will save an average of $2,400 over 10 years. (HHS previously released a statement by Don Berwick, administrator of the Centers for Medicare and Medicaid Services, that beneficiaries in the Medicare Advantage program would have an average reduction in cost of 1% for 2011.) The analysis on ...

Despite the well-publicized discontent with health reform among employers, those few companies that continue to sponsor pre-65 retiree health care plans have moved quickly to cash in on the Early Retiree Reinsurance Program established by the Patient Protection and Affordable Care Act. The Department of Health and Human Services (HHS) on October 28 released a list of additional employers and unions accepted into the EERP. Nearly 700 additional large and small businesses, state and local governments, educational institutions, nonprofit organizations, and unions have been accepted into the program i the last month, which reimburses employers for a portion of the cost of health benefits for early retirees' and their families. This brings the total number of organizations participating in the program to nearly 3,600 (click here for earlier accounts of ERRP’s popularity). In 2009, only 28% of all employers with 500 or more employees even offered retiree health care to pre-65 retirees...

Grandfathered health plans under the Patient Protection and Affordable Care Act (ACA) can comply with the required disclosure requirement if they include the model disclosure language whenever a summary of the benefits under the plan is provided to participants and beneficiaries, according to the most recent questions and answers released by the Department of Labor’s Employee Benefit Security Administration. This is the fourth in a series of frequently asked questions (FAQs) released by EBSA in order to “answer questions from stakeholders with a view to helping people understand the new law and benefit from it” (see Part I , Part II , Part III , and Part IV ). EBSA and other agencies increasingly are turning to FAQs and other non-regulatory releases to provide guidance that helps employers and individuals comply with federal laws and regulations (see here , for example). In “FAQs About the Affordable Care Act Implementation, Part IV,” this question is posed, “Must a grandfathered hea...