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Thursday, September 5, 2013

Health Care Reform Articles - September 5, 2013


Brunswick lawmaker touts single-payer bill at Augusta health care rally

Posted Sept. 03, 2013, at 6 p.m.
AUGUSTA, Maine — Activists assembled at the State House on Tuesday to kick off an eight-state tour of the Northeast in support of health care reform.
The group, called Drive for Universal Healthcare, or “DUH,” bills itself as a “rolling demonstration” of activists in their vehicles, visiting states with pending legislation that would expand health care coverage by instituting some version of single-payer health care.
In Maine, that’s LD 1345, sponsored by Rep. Charlie Priest, D-Brunswick. His bill would transition the state slowly toward a state-run insurance system similar to those established in Canada and much of Europe.
Priest has introduced similar bills in previous legislatures. This time, he said he took his cues from Vermont, which in 2011 approved a law to slowly establish a single-payer system, and is working today toward implementing the law by 2017.
He said single-payer — which proponents say would drastically reduce the cost of health care by eliminating the private profit motivation and overhead costs associated with tracking the myriad insurance payments — was established piecemeal in Canada, and should be approached the same way in the United States.
“It’s going to happen state by state by state until there’s enough momentum for Congress to act,” he told the small group of supporters at the State House Welcome Center.
Proponents of Priest’s bill — it has 51 co-sponsors in the House — will surely be watching as Vermont attempts to implement its law. The state is attempting to bring companies that operate their own insurance plans under the single-payer system.

National group launches universal health care drive in Augusta

By Paul Koenig 
Staff Writer
AUGUSTA — Supporters of a government-funded universal health care system rallied on Tuesday outside the State House for the launch of a 10-day tour of eight cities considering legislation for their cause.
About 10 people gathered along Capitol Street held signs bearing messages such as “People Over Profits,” encouraging passing drivers to honk if they supported universal health care.
Representatives from Maine AllCare, the Maine chapter of Physicians for a National Health Program — a national organization advocating for single-payer health care — joined the Chicago-based Drive for Universal Healthcare at its stop at the State House.
Rep. Charlie Priest, D-Brunswick, who is co-sponsoring a bill to establish a single-payer health care system in Maine by 2017, spoke at a news conference about the proposed legislation before the demonstration outside.
The bill, L.D. 1345, eventually would transition a state exchange under the federal Affordable Care Act into a state-funded health care system, Priest said. He expects the Health and Human Services Committee to take up the bill in February or March.
The legislation’s goal is to provide affordable, quality health care to all Maine people and try to take the burden of employees’ health insurance away from employers, Priest said.
He thinks it’s possible the bill will pass in the Legislature, but it could face a veto from Gov. Paul LePage, who vetoed a bill to expand Medicaid under the Affordable Care Act last session and opted to not take part in the state health insurance exchanges that are part of the federal law.

Clinton Urges Americans to Sign Up for Health Care Exchanges

LITTLE ROCK, Ark. — He chose his home state as the venue, and did not refrain from ticking off several problems he saw with the law. But former President Bill Clinton on Wednesday made a meticulous, if wonkish, case for Americans of all political leanings to embrace the Obama health care law.
“The health of our people, the security and stability of our families, and the strength of our economy are all riding on getting health care reform right and doing it well,” he said.
Less than a month before Americans can start shopping for insurance under the law, the speech comes at a pivotal time for the Obama administration, which needs millions of healthy Americans to buy insurance through new state-based markets in order for the law to work but faces an escalating campaign by Republicans to cut or eliminate the law’s financing. Even supporters of the law have criticized the administration as having done too little to explain and sell it to the public.
Mr. Clinton made the speech at the request of the White House, but on his own terms. He chose to deliver it at the glass building in downtown Little Rock that houses his presidential library. The venue allowed him to lend a hand to Senator Mark Pryor, a Democrat who is facing a difficult re-election fight here, and to start wooing his home state should his wife, former Secretary of State Hillary Rodham Clinton, decide to make a presidential bid in 2016.
The former president avoided soaring rhetoric, even saying at the beginning of the 50-minute speech that he would “try to use very few adjectives” and instead just “explain how this works.”
“I have agreed to give this talk today because I am still amazed at how much misunderstanding there is about the current system of health care, how it works, how it compares with what other people in other countries pay for health care,” Mr. Clinton told the crowd assembled in a hall around the corner from a montage of black-and-white photographs of the 1992 presidential campaign. The audience of about 250 included Gov. Mike Beebe, a Democrat, and Speaker Davy Carter of the Legislature and Michael Lamoureux, president of the State Senate, both Republicans.

Obamacare vs. Romneycare: The Labor Impact

From a tax perspective, the Affordable Care Act is in a different league than the Massachusetts health reform law passed in 2006.
The Affordable Care Act was intended to expand the fraction of the United States population covered by health insurance. The law includes taxes on employers and variousimplicit taxes on employees that go into effect over the next two years. Economic theory suggests that such taxes will contract the labor market in an amount commensurate with the amount of the new taxes.
The federal government and other advocates of Obamacare have dismissed concerns that the coming labor market contraction would be significant, or even noticeable, by pointing to Massachusetts’s experience with its so-called Romneycare system, also designed to expand insurance coverage. Because the Massachusetts labor market did not noticeably contract relative to the rest of the nation after its system went into effect, an official of the federal Department of Health and Human Services told The Washington Examiner that the experience in Massachusetts suggested “that the health care law will improve the affordability and accessibility of health care without significantly affecting the labor market.”
Prof. David Cutler of Harvard recently addressed, on this blog, concerns about possibly adverse tax effects, saying, “Additional data from Massachusetts, where a state law was the precursor to the Affordable Care Act, suggests that the fears are overblown” and “at this point the evidence overwhelmingly suggests no need for major worry.”

Business Owners Say They Have Yet to Figure Out Health Care

At the last meeting of the She Owns It business group, we talked about how, if at all, the owners expect the Affordable Care Act to affect their businesses. Several group members — Alexandra Mayzler, Jessica Johnson, and Susan Parker — were unable to attend the meeting, but they offered their thoughts in individual conversations afterward. (We had also discussed health care in a previous post.)
“I am woefully undereducated about Obamacare,” conceded Deirdre Lord, who owns the Megawatt Hour.
Beth Shaw, the owner of YogaFit, said she felt the same way.
Susan Parker said she doesn’t know how the Affordable Care Act would affect her business, Bari Jay. “I would be shocked if anyone really knows,” she added. She does, however, think premiums will go up and that small-business owners will wind up paying more. Bari Jay pays more than 50 percent of the cost of health insurance for its 16 employees. She doesn’t think any of them are uninsured, though most don’t use the company plan, which she acknowledges isn’t the best.
For Ms. Parker, the anticipated Oct. 1 start of open enrollment for the New York State Health Benefit Exchange raises nothing but questions. For example, how will Bari Jay’s costs be affected if employees choose to get insurance through the exchange instead of the company? Will Bari Jay have to continue paying to cover employees who make that choice? Will it have to contribute for employees who take advantage of a spouse’s plan?
Ms. Lord is also wondering how, or whether, her company will be affected when enrollment opens for the exchange. The Megawatt Hour does not subsidize health insurance for its five employees, but it does offer a plan at what she says she believes are better rates than an individual would get. So far, there have been no takers. The employees are either on their spouse’s plan or their parents’, she said. The company will re-evaluate its plan this fall, as it does every year.
“I would imagine getting the insurance broker out of the way is a huge savings because I think these people are taking a nice piece of the action,” said Ms. Shaw, whose company offers health insurance for its 12 employees and covers 50 percent of the cost. She added that fewer than a quarter of her employees are on the plan. She suspects that’s because the staff is young. “I think they just don’t think about it,” she said.

Medicaid Expansion Battle in Michigan Ends in Passage

CHICAGO — The fierce struggle among Republicans over whether to make Medicaid available to more low-income people played out in Michigan on Tuesday as the Republican governor, Rick Snyder, narrowly succeeded in swaying enough conservative senators in the State Legislature to accept the expansion, which was part of President Obama’s health care law.
Mr. Snyder’s preferred bill — one he had lobbied for intensely for months — initially fell short by one vote, but the governor salvaged a deal hours later. The vote in the Republican-controlled Senate was 20 to 18, with only 8 Republicans in favor. The Michigan House, which had earlier approved a similar measure, will need to vote on the Senate version before Mr. Snyder can sign the bill.
“The Affordable Care Act has probably been one of the most divisive issues that our country has faced in the last few years, and many people do have strong opinions both for and against,” Mr. Snyder said after the vote. “I just ask that all Michiganders step back and look to say this isn’t about the Affordable Care Act. This is about one element that we control here in Michigan that we can make a difference in here in people’s lives.”
While the authors of the federal health care law intended to expand Medicaid, the federal and state health program for poor people, and at least initially pay for the expansion, the Supreme Court ruled in 2012 that states could opt out, setting up a struggle that has played out in the states largely along partisan lines.
Like Mr. Snyder, some Republican governors have found themselves at odds with their own party’s legislative caucuses in state capitals like Lansing that are dominated by Republicans.
In Arizona, which eventually approved an expansion, Gov. Jan Brewer found vehement opposition from some lawmakers. In Florida, legislators have resisted expansion, despite Gov. Rick Scott’s support. And in Ohio, Gov. John R. Kasich’s push for expansion has so far not been successful.
For months, the fight in Michigan, which has the nation’s 10-largest uninsured population, has been intense. Mr. Snyder, a former businessman in his first term, said the expansion would ultimately save money, control medical costs and help the state’s economy. That pitted him against more conservative members of his own party, and led some Tea Party leaders in the state to say he will lose support if he seeks re-election next year.

Studies take early look at health law's premiums

By Ricardo Alonso-Zaldivar / The Associated Press
WASHINGTON — Coverage under President Barack Obama's health care law won't be cheap, but cost-conscious consumers hunting for lower premiums will have plenty of options, according to two independent private studies.
A study released Thursday by the nonprofit Kaiser Family Foundation found that government tax credits would lower the sticker price on a benchmark "silver" policy to a little over $190 a month for single people making about $29,000, regardless of their age.
By pairing their tax credit with a stripped-down "bronze" policy, some younger consumers can bring their premiums down to the range of $100 to $140 a month, while older people can drive their monthly cost even lower — well below $100 — if they are willing to take a chance with higher deductibles and copays.
A separate study released Wednesday from Avalere Health, a private data analysis firm, took a wide-angle view, averaging the sticker prices of policies at different coverage levels.
Before tax credits that act like a discount, premiums for a 21-year-old buying a mid-range "silver" policy would be about $270 a month, the Avalere study found. List-price premiums for a 40-year-old buying a mid-range plan will average close to $330. For a 60-year-old, they were nearly double that at $615 a month.
Starting Oct. 1, those who don't have health care coverage on the job can go to new online insurance markets in their states to shop for a private plan and find out if they qualify for a tax credit. An estimated 4 out 5 consumers in the new markets will be eligible for some level of tax credit.
Financial Times
September 3, 2013
Big US health insurers wary of ‘Obamacare’ exchanges
By Stephanie Kirchgaessner

Some big US health insurers, including Cigna, Aetna and UnitedHealthcare, are steering clear of most of the new state healthcare exchanges amid uncertainty about the kinds of customers they might attract: namely sick ones.

The three companies have said they are taking a cautious approach because they need to evaluate how the markets – set up under the “Obamacare” reforms – will work. They add that they are specialised in providing insurance to big employers, not the individuals and small businesses that will be served by the exchanges.

An Obama administration official said risk adjustment and reinsurance programmes under the law were designed to offer incentives to health insurers to make sure they do not avoid enrolling customers with the greatest needs.

A spokesman for Cigna, which is participating in five of 50 new exchanges, agreed that the provisions would help the company manage risk.

UnitedHealthcare said it would participate in about 12 exchanges initially, but said the exchanges had the “potential to be a growth market” over time.

A spokesman for Aetna said it would participate in up to 14 exchanges. It emphasised that it planned to position itself “for the future”.



How Obamacare compounds inadequacies

By Marc Landry
News and Observer (Raleigh, N.C.), Sept. 3, 2013
With the imminent rollout of open enrollment under Obamacare, we are all going to read and hear a great deal about health care and health insurance in the weeks and months to come.
To gain some international perspective on these issues, I highly recommend reading “The Healing of America” by T.R. Reid.
Reid, a correspondent for The Washington Post, writes of his journey around the world to experience the health care and insurance regimens of other countries. Citing a study from the National Academy of Sciences that claims 22,000 Americans die prematurely each year from treatable medical problems because they cannot afford to see a doctor, he asks the essential question:
“Should our country provide health care to all of its citizens who need it?”
To date, the United States is alone in the developed world to have answered with an emphatic “no.”
It is disgraceful that we allow tens of thousands of our fellow citizens to die prematurely because our decision-makers will not say “yes” to what is essentially a moral question.

Understanding the Right's "Obamacare" Obsession

Tuesday, 03 September 2013 09:31By Joshua HollandMoyers & Company | News Analysis
This summer’s heated battles over the implementation of “Obamacare” are a microcosm of a much larger and longstanding ideological clash over the role of the government in society.
The hard-right is taking a scorched-earth approach, obstructing the law’s implementation by any means necessary and spinning the hiccups and glitches that are inevitable with any complex new system as an unmitigated disaster.
It’s a perfect example of a structural advantage enjoyed by politicians who rail against “big government”: they claim that government is, by definition, hopelessly inept and can’t do anything to improve people’s lives, and when they get into power they have the opportunity to obstruct, cause havoc and ultimately prove the claim.
Meanwhile, the Obama administration, officials in around half of the states and a network of the program’s supporters are desperate to get the new health insurance scheme up and running. It’s shaping up as a particularly ugly fight in an era that’s come to be defined by “crisis governance.”
What does no-hold-barred warfare against a law that’s been settled for three years look like? Some tea party activists are urging Republican lawmakers to shut down the government — or even default on the debt Congress itself ran up — in a quixotic effort to “defund” Obamacare. In refusing to expand Medicaid, legislators in 21 states, most of them “red,” are not only denying their poorest citizens coverage, but also turning away billions of dollars from the federal government. Some members of Congress are refusing to help their own constituents navigate the new exchanges to get the benefits available to them. According to the Washington Post, some state legislators are getting quite creative, “refusing to enforce consumer protections, for example, and restricting federally funded workers hired to help people enroll in coverage.” In Missouri, “officials have been barred from doing anything to help put the law into place.”
And Republicans are refusing to support any efforts to smooth out the law’s rough edges. Even a minor tweak that would fix a glitch in the law that will prevent many church employees from receiving tax credits to help buy coverage — and which may ultimately kill some churches’ insurance plans — is a non-starter. Jim Sargent, the health plan director for the Unitarian Universalist Association, told Religion News Service: “Republicans are trying to undermine it. While that’s going on, there isn’t much you can do to fix the bill.”
The latest strategy to undermine the law’s success is especially pernicious — a major campaign to persuade young people without insurance to pay a penalty, skip the cheap plans they could purchase in heavily subsidized Obamacare exchanges (a young, low-income worker in California will actually be able to get very basic coverage for nothing, according to Sarah Kliff at the Washington Post) and face the risk of a debilitating injury or illness on their own.





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