Health Care Blog
Health Reform: Help for Families in 2010
Posted by on December 17, 2009 at 12:51 PM EDTCongress is on the verge of an historic achievement for which the American people have been waiting for decades: The passage of real health insurance reform that will bring stability and security to Americans with insurance and provide affordable options to those who don’t. It will protect individuals and families from unfair and arbitrary insurance practices and will at last shift the power away from insurance companies and into the hands of consumers.
Enactment of these historic reforms will be a monumental accomplishment and will be a victory for the interests of consumers against ferocious opposition from the insurance industry and others invested in the status quo. And while there are parts of reform that will take some time to get up and running, there are a great many benefits that will kick in during the very first year to help families and small businesses get control over their health and their health insurance costs.
If you or somebody in your family has a pre-existing condition, you’ll get help in 2010: Both the Senate and House bills will make it illegal for insurance companies to drop coverage for Americans who get sick. Insurance companies will also be barred from limiting the total benefits Americans can use over the course of a year or over their lifetimes. Affordable insurance coverage options will also be made immediately available through a high-risk pool for Americans who have been uninsured and have been denied coverage because they have a pre-existing condition. These options will serve as a bridge until the new health insurance marketplaces, or exchanges, are up and running.
If you or your family has insurance, you'll get help in 2010: The scales will no longer be tipped against you in your relationship with your insurance company. More of your money will start going towards your care instead of excessive insurance company profits or TV ads. Between 2010 and 2013, insurance companies will be required to report the proportion of premium dollars that are spent in areas other than medical care – including profits. If a company isn’t spending enough of its premium dollars providing benefits, it will be required to issue rebate checks to its customers to make up the difference. Insurance companies will also immediately have to begin creating effective appeals processes for customers who have been denied claims ---including independent reviews---and the legislation provides grants for states to create ombudsmen to act as consumer watchdogs on health insurance coverage.
If you want to keep your family from getting sick in the first place, you’ll get help in 2010: All insurance plans will have to begin covering preventive services. That means all Americans who purchase insurance on their own will receive preventive care from their doctor without paying a co-pay.
If you’ve got kids, you’ll get help in 2010: Insurance plans that cover dependents will also have to provide benefits to adult children up to age 26, covering young Americans at a time when they’re most likely to lack coverage.
If you’re an early retiree with coverage from your former employer, your premiums will be reduced: Employers and their retirees between 55 and 64 years of age will have lower premiums from new re-insurance helping to ensure the continuation of these essential benefits
If you’re a senior, you'll get help in 2010: Major help on prescription drug costs will begin kicking in, with dramatic reductions on the costs of brand name prescription drugs for seniors. In addition, the coverage gap, or “doughnut hole” in the Medicare Prescription Drug Program will be closed over the next few years.
So as we come to the end of this debate, it’s important to take stock of what American families and small businesses will get from reform:
- Reforms that will generate the largest deficit reduction in 12 years;
- Reforms that will rein in insurance companies and shift power to patients, doctors, nurses and American families.
- Reforms that will actually reduce premiums and save money for American families and small businesses;
- Reforms that will strengthen the financial health of Medicare while closing the prescription drug doughnut hole – the most significant boost to Medicare's solvency in more than a decade.
- Reforms that will make quality affordable health care available to tens of millions of Americans – the most significant action since Medicare.
We are on the verge of the most historic improvement in American health care in half a century.
Let's get it done.
Nancy-Ann DeParle is Director of the Office of Health Reform
Learn more about Health CareThe Truth on Health Care Reform and Taxes
Posted by on December 16, 2009 at 5:15 PM EDTAs we move into the final stage of the historic push for health reform, opponents of reform are testing the age old adage that if you only say something enough times you can somehow make it true. Yesterday, we heard a new version of the old, tired refrain that the health reform bills in Congress would raise taxes on the middle class.
So let's set the record straight:
- First, the health insurance reform bill being considered in the Senate does not raise taxes on families making less than $250,000 – in fact it is a substantial net tax cut for American families. The bill being considered represents a substantial net tax cut for middle income families. According to the independent Joint Committee on Taxation, the bill will provide nearly $450 billion in individual income tax cuts over the next 10 years.
- Second, the excise tax levied on insurance companies for high-premium plans, the so-called "Cadillac tax," will affect only a small portion of the very highest cost health plans – a total of 3% of premiums in 2013. The vast majority of health plans fall below the thresholds set in the Senate plan and would be completely unaffected by the provision. And those that are above the threshold would only face an excise tax on the generally small portion of the plan that exceeds the threshold. As a result, based on analyses by the Joint Committee on Taxation, only about 3% of premiums will be affected by this provision in 2013. In addition, the Senate plan provides special protections to plans held by workers in high-risk professions – like police and firefighters – as well as by those over 55.
- Third, for the small sub-set of plans that are affected, the primary impact of this provision will be to increase workers' wages. Getting a pay raise is not what most people would call a tax increase. Economists agree by taxing the highest cost plans this provision will lead insurance companies to be more efficient and provide quality care to consumers at lower prices (see this endorsement in a letter from a group of prominent economists – including three Nobel laureates and previous members of both Democratic and Republican administrations and this analysis by CBO 2009). Even a report commissioned by the insurance industry's trade association acknowledged that: "[w]e expect employers to respond to the tax by restructuring their benefits to avoid it." [PWC, 2009]. As a result, employers will be in a position to increase workers' take home pay.
- Finally, supporters of the status quo are supporters of continuing the hidden tax of $1,000 that the millions of Americans who get insurance through their job or buy it on their own are already paying each year to cover the costs of caring for those without insurance. Even if you believe that some of the tax on insurance companies is passed along, it would be more than outweighed by the benefits middle-class families would get from not only hundreds of billions of dollars in health care tax credits but from reducing the hidden tax they currently pay for the uninsured. Supporters of the status quo would not only deny middle-class families the tax cuts proposed in the Senate legislation, they would also continue this unfair hidden tax.
Jason Furman is Deputy Director of the National Economic Council
Learn more about Health Care, TaxesA Dream for Insurance Companies? Must Be News To Them
Posted by on December 16, 2009 at 2:40 PM EDTRecently, a somewhat perplexing new line of argument has emerged about health insurance reform, with some folks suggesting the Senate bill is a "dream" for insurance companies.
If that's the case, though, it must be news to them. The insurance industry has been leveraging its considerable resources in a ferocious effort to defeat this bill, including producing a report the day before the Senate Finance Committee vote that was so misleading the firm behind it had to walk away from it. And that's not surprising, because this bill will finally wrest power away from the insurance industry and put it in the hands of American consumers.
- Among the many provisions to end insurer abuses, lower premiums, and hold insurance companies accountable:
- Insurance market reforms will prohibit abuses such as denying coverage for pre-existing conditions, charging exorbitant premiums based on gender, age, or health status, dropping coverage when people are sick, and imposing lifetime limits on benefits.
- Consumer rights will be enhanced by requiring all insurers to provide effective appeals procedures including outside, independent review of appeals
- New insurance exchanges will reduce premium increases by lowering administrative costs and increasing the leverage of individuals and small businesses in this insurance market.
- Competition will also be enhanced by providing consumers comparative information on available insurance options giving them the tools to make more informed decisions and drive competition based on value and service.
- Insurers will be held accountable for excessive overhead costs fueled by unreasonable executive compensation and profits.
- Insurers will also be required to compete against cost-effective national plans selected by the federal Office of Personnel Management.
- Wasteful taxpayer overpayments to insurance companies through private Medicare Advantage plans will be eliminated.
- A new $6.7 billion annual fee will be levied on insurance companies to ensure that they pay their fair share of coverage costs.
It’s also important to remember that, while none of us are shedding any tears for the insurance industry, the primary goal of health insurance reform isn’t to punish insurers – it’s to give every American the ability to find affordable coverage while controlling the unsustainable cost growth in our current health care system that is crushing families and businesses. On that front, this bill is hugely successful. This bill will bring stability and security to people who have insurance and provide affordable options to those who don’t. It will protect against arbitrary insurance company rules and will lower premiums for American families and businesses. And it will take a big chunk out of the national deficit.
Dan Pfeiffer is White House Communications Director
Learn more about Health CareThe Health Reform Rumor Mill Targets Nebraskans
Posted by on December 15, 2009 at 7:31 PM EDTProving that they will leave no stone unturned in their efforts to undermine health reform, some blogs opposing reform are now trafficking an absurd rumor that Nebraska's Offutt Air Force Base is being threatened over Senator Ben Nelson's vote on the Senate reform bill.
To be perfectly clear: these rumors are completely baseless and false.
Thanks for your time.
Dan Pfeiffer is White House Communications Director
Learn more about Health CareAARP Announces Support for Senate Health Reform Bill
Posted by on December 15, 2009 at 2:13 PM EDTFor decades, Americans have talked about fixing our broken health care system. Presidents from Truman to Nixon to Clinton have attempted and come up short. Now, though, we’re far closer than ever before to signing into law real health insurance reform – reform that will give insured Americans unprecedented stability and security, make quality, affordable insurance available to every American, and lower costs for American families, businesses, and the country as a whole.
And today the health insurance reform effort gained even more critical momentum as the AARP announced that it is supporting the Senate reform legislation.
This announcement is truly a big deal. For decades, the AARP has been on the front lines of the fight to cut health care costs and improve coverage for America’s seniors. They're supporting the passage of this bill because they know it will do just that. It will add years to the life of Medicare, reduce out of pocket costs – including for preventive care and prescription drugs – and ensure higher quality care for our seniors.
"This bill will strengthen Medicare by eliminating cost barriers to preventive care, reform Medicare's payment and delivery system to promote care coordination, and reduce hospital infections and preventable readmissions," AARP CEO A. Barry Rand wrote in a letter to Senate Majority Leader Harry Reid. “Moreover, through critical insurance market reforms and the establishment of exchanges, this bill will give the uninsured and small businesses access to quality affordable plans. The legislation also includes important provisions to strengthen home and community-based care and to assist individuals in saving to meet future long-term care needs.”
But the AARP’s support doesn’t just say a lot about what the bill will do. It says a lot about what the bill won’t do. It reaffirms that, for all the scary myths being spread by defenders of the status quo, nothing in reform will cut the Medicare benefits that have been guaranteed to America’s seniors.
It's safe to say that the AARP would not be supporting reform if it wasn’t a good deal for seniors.
Here's the money quote: "With your commitment to closing the doughnut hole in conference, consistent with the President's pledge, and the many positive features referenced above, AARP is pleased to support your efforts to obtain cloture, and urges timely passage of this legislation by the Senate."
So next time you hear the usual scary stories, it’s worth keeping this announcement in mind.
Learn more about Health CareReality Check: Another Day, Another Deceptive "Analysis" from the Insurance Industry
Posted by on December 14, 2009 at 3:50 PM EDTFor months, the insurance industry has been involved in study after study that purports to "analyze" health insurance reform (see here, here, here and here). For all their efforts, they have succeeded in proving one thing: If you selectively use some facts while ignoring others, you can get an "analysis" that reaches your predetermined conclusions.
Today's skewed study comes from the Lewin Group, owned by a subsidiary of the largest insurance carrier in the United States.
In addition to cherry-picking provisions to analyze, the Lewin Group uses an innovative new technique: analyzing legislation with "assumptions" that blatantly contradict what actually appears in either the House or Senate bills.
Among the many points this study conveniently ignores or deliberately misstates:
- Differs significantly from the predictions of the Congressional Budget Office. The analysis differs significantly from the non-partisan Congressional Budget Office on at least 2 other fronts.
- Contradicts CBO on deficit effects. While the Lewin analysis states that the Senate bill would increase federal deficits in the second decade, this runs counter to the CBO, which predicts that the Senate bill would decrease federal deficits in the second decade,
- Significantly higher public plan enrollment. The Lewin analysis estimates 15 million people going into the public plan – 5 times the estimate of CBO. This calls into question the model that Lewin uses.
- Incorrect implementation date. The Lewin Group analysis contains assumptions that do not mirror the actual legislation, for instance that reforms will be fully implemented by 2011. The House bill implements the exchanges in 2013, while the Senate implements the exchanges in 2014.
- Does not consider savings from the Exchanges. The Lewin analysis does not mention any administrative savings from the creation of the health insurance exchanges – savings which the Congressional Budget Office has estimated to reduce premiums for people in the individual market by 7 to 10% alone.
- Examines only select aspects of the reform bills. The Lewin analysis does not consider the effects of various delivery system reforms, including bundling payments, introducing value-based purchasing, and reducing preventable readmissions – reforms which numerous bipartisan economists have cited as critical to cost-containment, and which the Business Roundtable has estimated would contribute to a $3,000 reduction in health care costs per employee.
Linda Douglass is Communications Director for the White House Office of Health Reform
Learn more about Health Care- Differs significantly from the predictions of the Congressional Budget Office. The analysis differs significantly from the non-partisan Congressional Budget Office on at least 2 other fronts.
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