Oregon Study Shows Benefits, and Price, for Newly Insured
By ANNIE LOWREY
PORTLAND, Ore. — When Wendy Parris shattered her ankle, the emergency room put it in an air cast and sent her on her way. Because she had no insurance, doctors did not operate to fix it. A mother of six, Ms. Parris hobbled around for four years, pained by the foot, becoming less mobile and gaining weight.
But in 2008, Oregon opened its Medicaid rolls to some working-age adults living in poverty, like Ms. Parris. Lacking the money to cover everyone, the state established a lottery, and Ms. Parris was one of the 89,824 residents who entered in the hope of winning insurance.
With that lottery, Oregon became a laboratory for studying the effects of extending health insurance to people who previously did not have it. Health economists say the state has become the single best place to study a question at the center of debate in Washington as the Supreme Court prepares to rule, likely next week, on the constitutionality of President Obama’s health care law: What are the costs and benefits of coverage?
In a continuing study, an all-star group of researchers following Ms. Parris and tens of thousands of other Oregonians has found that gaining insurance makes people feel healthier, happier and more financially stable. The insured also spend more on health care, dashing some hopes of preventive-medicine advocates who have argued that coverage can save money — by keeping people out of emergency rooms, for instance. In Oregon, the newly insured spent an average of $778 a year, or 25 percent, more on health care than those who did not win insurance.
Recalling the Nixon-Kennedy health plan
When Richard Nixon was a teenager, he watched two of his brothers die. His little brother went first, at age 7, of a sudden and mysterious illness. Then his big brother died at age 22, after a long battle with tuberculosis. It was the 1920s. Health insurance hardly existed. The sicknesses sapped his parents’ meager resources. His mother stopped baking pies for the family’s little grocery store to care full time for her ailing son. Nixon worked as a janitor to earn extra money, and turned down a scholarship to Harvard because it didn’t cover room and board.
When Nixon, a staunch Republican, became president in 1969, he threw his weight behind health care reform.
“Everybody on his cabinet opposed it,” recalled Stuart Altman, Nixon’s top health aide. “Nixon just brushed them aside and told Cap Weinberger ‘You get this done.’ ”
Truth Test: Summers off-base on the costs of Obama's health care law
"And, as if all of this was not enough, the largest federal program ever devised, Obamacare, is now poised to take control of (one-fifth) of our economy." - Secretary of State Charlie Summers' campaign "message" web page
TRUTH TEST is a regular feature of MaineToday Media’s campaign coverage in which we cast a critical eye on the truthfulness of advertising and public comments by political candidates.
There's no way around it: The Republican nominee to replace Olympia Snowe in the U.S. Senate deviates wildly from authoritative analyses on the subject.
A Congressional Budget Office estimate in March said that from 2012 to 2022, the law's insurance provisions should have a net cost of just over $1.2 trillion after certain offsets. On a yearly basis, the expected annual cost averages out to about $154 billion from 2016 to 2022.
In March 2011, the Congressional Budget Office's director testified that the law will likely reduce the federal deficit by $210 billion because of changes "in direct spending and revenues" from 2012 to 2021.
But it could be less of a reduction because the CLASS Act, a long-term care insurance program, accounted for $86 billion of savings in the 2011 estimate. Later that year, the Obama administration said it wouldn't implement that portion of the act.
So to recap, the Affordable Care Act, often referred to as Obamacare, is costly, but it may be offset enough to reduce spending. But is it, as Summers said, the biggest federal program ever?
It can't be.
Mainers to receive $2.6M in health insurance rebates
Posted June 22, 2012, at 5:30 p.m.
Some Maine residents who work for larger employers are expected to receive $2.6 million in rebates from insurance companies this summer as a result of the federal health reform law.
The rebates will benefit 10,600 individuals in Maine, according to a press release from the U.S. Department of Health and Human Services. The average benefit for the 5,600 Maine families receiving the rebates will be $463.
The premium rebates are part of more than $1.1 billion that will be paid out to nearly 13 million Americans under the Patient Protection and Affordable Care Act.
The health reform law requires health insurers to spend at least 80 cents of every premium dollar on medical care and quality improvement. The other 20 cents can go to administrative costs.
Insurers that don’t meet this so-called “80/20 rule” must send their customers a rebate for the difference no later than Aug. 1. Insurance companies are required to notify policyholders whether they have met the 80/20 rule and, if not, how much of a rebate they will receive.
Unlike most other states, Maine will see rebates paid out only by insurers offering policies through the large group market, which serves bigger employers. Insurers dedicated to the individual market, or people who buy health insurance on their own, were exempted from the 80/20 rule last year.
The federal government granted insurers a waiver, holding the spending at Maine’s existing rate, which requires 65 cents of every premium dollar to go toward medical costs.
Former insurance superintendent Mila Kofman requested the waiver after Megalife, one of just three health insurance companies that sells individual, nongroup coverage in Maine, indicated it might leave the market in Maine if the 80/20 rule was implemented.
While the nation waits for an overdue Supreme Court decision that will decide the fate of President Obama’s Affordable Care Act, another health care drama with wide implications for universal health care is just starting in Vermont.
Prodded by a strong grassroots movement, the Vermont legislature voted last year for a single-payer state health care system where every citizen will eventually be eligible for publicly funded health care.
The new system will take five or six years to fund and implement, however, between phasing out existing insurance arrangements, overcoming legal obstacles, dealing with provisions of the Affordable Care Act, and finding the money to pay for it all.
Meanwhile, the local business community, private insurance companies, and right-wing PACs have regrouped and counterattacked, with non-stop advertising. They’re doing their well-funded best to make sure that single payer never happens in this state or any other. They know that a lot can change, politically and in the state budget, between now and final implementation of Vermont’s health care law, particularly in a state with two-year gubernatorial terms.
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