Medical Malpractice Insurance
Doctors face a liability crisis involving the increases in insurance premiums over the past few years. This medical liability issue must be addressed. The Medical Malpractice Relief Act of 2004 would reach this concern.
The Medical Malpractice Relief Act would allow doctors, hospitals and nursing homes to claim a tax credit for a percentage of the malpractice premiums they are paying and will pay during tax years 2004 and 2005. More specifically, the bill would allow the following credits:
1) Doctors who specialize in an area with increased risk of complications would be eligible for a tax credit equivalent to 20% of their total malpractice premium up to twice the average for a similarly situated doctor.
2) Doctors who practice in lower risk specialties would be eligible for a tax credit equivalent to 10% of their total malpractice premium up to twice the average for a similarly situated doctor.
3) For-profit hospitals and nursing homes would be eligible for a tax credit equivalent to 15% of their total malpractice premium.
4) As many American hospitals and nursing homes are no-profit institutions that do not pay taxes, this legislation would establish a two-year grant program in the Health Resources Services Administration at the Department of Health and Human Services making such providers eligible for grants up to 15% of their malpractice premiums.
Doctors in both the 9th District of Ohio and across the country should not be penalized by the largely unregulated insurance industry in our country. While we work to find an appropriate approach for overhauling the medical liability insurance system, these temporary but immediate tax credits would provide much-needed relief to healthcare providers.
Mental Health Issues
The treatment of mental illness in this country needs improvement. There is a lack of equity between coverage for mental illness and coverage of other medical conditions. Often because mental health disorders are more difficult to diagnosis, health plans typically place a lower annual dollar limit on mental health coverage, cover fewer day both in the hospital, raise deductibles. These trends come at a time when 20% of the Nation’s adolescents have a diagnosable mental disorder and the demand for child and adolescent psychiatry is calculated to increase by 100% by 2020. In addition, close to 40% of adults who suffer from a serious mental illness will at some point come into contact with the criminal justice system, and many of these persons are responsive to treatment, rehabilitation, and support services. There have been several bills which could further aid this issue:
H.R. 953: Senator Paul Wellstone Mental Health Equitable Treatment Act of 2003 (also known as “mental health parity”). Prohibiting certain employee group health plans or related insurances from providing both medical-surgical and mental health benefits from imposing mental health treatment limitations or financial requirements unless comparable limitations and requirements are imposed upon medical-surgical benefits
H.R. 1359: This legislation would increase the number of well-trained mental health service professionals (including those based in schools) providing clinical mental health care to children and adolescents.
H.R. 2387: This bill would create planning and implementation grants for communities to provide treatment to mentally ill legal offenders. All programs must be operated collaboratively by both a criminal justice agency and a mental health agency. In addition, all grant recipients will provide any essential support services, such as housing, education, or job placement, to mentally ill offenders. These grants could be used by communities for a variety of purposes, including establishing mental health courts and other diversion programs, creating or expanding community-based treatment programs, or providing in-jail treatment and transitional services. In addition, grant funds could be used for training for criminal justice system personnel and mental health system personnel who must know how to respond appropriately to this population. Finally, The bill directs the Attorney General and Secretary of Health and Human Services to develop a list of “best practices” for criminal justice personnel to use when diverting mentally ill offenders from incarceration
H.R. 2402: This bill combines a federally financed expansion of Medicaid and SCHIP to cover all those under 100 percent of the federal poverty level with a premium subsidy/tax credit program to help those under 200 percent of poverty buy into various health insurance plans. Further, purchasing arrangements and market reforms will be instituted to make coverage affordable and states will be given the flexibility and dedicated federal funding to develop their own innovative health coverage programs to achieve equal or better outcomes. Finally, this legislation lays the groundwork for an expansion of insurance to the rest of society by the end of the decade.
Associated Health Plans
Associated Health Plans (AHPs), as proposed in H.R. 660 and H.R. 4281, aim to create new health insurance groups for small firms to join and to encourage the growth of existing groups so that small employers can band together to offer coverage to their employees.
This legislation would have unintended negative consequences, negating the benefits that the new groups would create. This concern largely relates to fears that AHPs would increase “cherry-picking” in the small group market for insurance by covering mostly healthy groups, leading to increased instability and higher premiums for other small groups. Also, because AHPs would not be regulated by state insurance regulators, these plans would not have to provide as much coverage as other types on insurance--many would not have to provide anywhere near "mental health parity.”
Small purchasing pools are better addressed by the elements of bill H.R. 2402. This bill highlights refundable tax credits, which provide health plans from either a state purchasing pool or individual insurers. It prohibits participating insurers from limiting or denying coverage or increasing premiums for any specified health factors. Through small purchasing pools, those receiving tax credits are able to receive the same coverage as federal employees. State programs could expand coverage to the poor without unfunded federal mandates or weakening current safety net programs.
Health Savings Accounts
Health Savings Accounts, (as created in H.R. 1 and modified in H.R. 4279.) were created as part of the Medicare/prescription drug reform law, disproportionately aid the wealthy, who are the only ones with extra money to put away in these accounts, which are tax free.
Interesting Links
http://www.cms.hhs.gov/hipaa/hipaa1/default.asp
http://capwiz.com/acp/issues/bills/?bill=5086581
http://www.hhs.gov/
http://www.nih.gov/
http://www.washingtonpost.com/wp-dyn/articles/A43609-2004May20.html
