Health Care
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November 30, 2010
How State Exchanges Could Restrict Access to Health Care
Active Purchaser or Active Rationer…?
Over the next year, many state legislatures will consider legislation establishing insurance exchanges to implement the health care law. These legislative debates will revolve around whether governments can or should limit the insurance plans available to consumers—and in so doing, potentially restrict access to life-saving but costly treatments. -
November 10, 2010
If You Like Your Current Plan...
Given several articles today, and in recent weeks, surrounding employers’ and insurers’ responses to the health care overhaul, it’s worth highlighting the numerous caveats being added retrospectively to candidate Obama’s promise that “You will not have to change plans. if you have insurance now, nothing will change under the Obama plan – except that you will pay less.” But now, nearly eight months after the law passed, that promise has been turned into “If you like your current plan…” -
November 5, 2010
Rhetoric vs. Reality: Health Care "Reform" and Jobs
CLAIM: “So this bill is not only about the health security of America. It's about jobs. In its life it will create 4 million jobs -- 400,000 jobs almost immediately.”
-- Speaker Pelosi at the White House health summit
FACT: Memorial Hospital in South Bend, Indiana this week announced it would be cutting about fifty jobs due to the health care overhaul, and specifically the low reimbursement rates included in the law’s Medicaid expansion.
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October 25, 2010
AP Story: "Employers Looking at Health Insurance Options"
Following Tennessee Governor Phil Bredesen’s op-ed in last Thursday’s Wall Street Journal, the Associated Press has a story noting that “corporate number crunchers are looking at options that could lead to major changes” in health insurance plans for workers. Among the quotes from benefits managers in the piece:
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October 21, 2010
Democrat Governor Explains Why Employers WILL Drop Insurance
An op-ed in this morning’s Wall Street Journal by Tennessee Governor Phil Bredesen – a Democrat – explains very succinctly why employers will drop their existing coverage options once the federal insurance subsidies and exchanges come online in 2014. Gov. Bredesen notes that Tennessee could drop coverage for its state employees, pay the $2,000 per employee penalty/tax to the federal government, give their workers cash raises to compensate for the loss in health benefits, and STILL come out at least $146 million per year ahead. Of course, federal taxpayers would not come out ahead, as they would be “on the hook” for the $146 million-plus in benefits that Tennessee shed on to the federal fisc – meaning that if many employers follow the Governor’s lead, the promised deficit reduction from the health care law will evaporate in a New York minute. -
October 4, 2010
WSJ: "3M to Change Health Plan Options for Workers"
The Wall Street Journal reports this morning that manufacturer 3M “informed retirees and workers it will stop offering a group health insurance plan to retirees not old enough for Medicare by 2015, citing the federal health overhaul as a factor.” Specifically, Medicare-eligible retirees will be converted to a health reimbursement arrangement (HRA) in 2013, and retirees not yet eligible for Medicare will be converted into an HRA beginning in 2015, once the insurance Exchanges and subsidies are scheduled to come online in 2014. The memo to employees notes that “health care reform has made it more difficult for employers like 3M to provide a plan that will remain competitive.” -
October 1, 2010
Another Carrier to Exit Insurance Markets; 840,000 to Lose Their Current Coverage
Both the New York Times and the Wall Street Journal have stories this morning on the exit from the health insurance marketplace of Principal Financial Group, which currently covers about 840,000 lives. All these individuals will have to change their current coverage in the coming months as their policies expire.
More troubling however are the concluding paragraphs of the Times piece, which suggests that Principal’s decision may be one of many made by smaller carriers to exit the health insurance marketplace thanks to the health care law:
More insurers are likely to follow Principal’s lead, especially as they try to meet the new rules that require plans to spend at least 80 cents of every dollar they collect in premiums on the welfare of their customers. Many of the big insurers have been lobbying federal officials to forestall or drastically alter those rules.
“It’s just going to drive the little guys out,” said Robert Laszewski, a health policy consultant in Alexandria, Va. Smaller players like Principal in states like Iowa, Missouri and elsewhere will not be able to compete because they do not have the resources and economies of scale of players like UnitedHealth, which is among the nation’s largest health insurers.
Mr. Laszewski is worried that the ensuing concentration is likely to lead to higher prices because large players will no longer face the competition from the smaller plans. “It’s just the UnitedHealthcare full employment act,” he said.
Democrats claimed that their unpopular health care law would protect Americans from abuses by “Big Insurance.” But if the overhaul leads to industry consolidation – and higher prices as a result – how effective can it be?
RPC Analyst Chris Jacobs
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September 30, 2010
For McDonald's Employees -- And Others -- An Unhappy Meal...?
The big story last night – beyond Congress’ pre-election adjournment – centered around the Wall Street Journal’s article indicating that McDonald’s may be dropping health coverage for its workers, given that the limited benefit plans it currently offers will likely be unable to meet the minimum medical loss ratio requirement to pay 85 percent of premiums back in medical claims (due in part to high turnover among employees, which raises administrative costs). Reuters has a separate story on the Journal piece here. -
September 29, 2010
Fact Check on Insurance Premium Increases
Sen. Harkin claimed on the floor recently that analysis of the new regulations taking effect this year would only raise premiums by 1-2 percent. Despite multiple articles and studies finding that premiums will rise by more than 2% next year as a result of the law, whether premiums rise by 2 percent or 22 percent due to PPACA misses the point. The real point is that President Obama repeatedly promised an average $2,500 reduction in family insurance premiums – and, by admitting that the law will raise premiums by *only* one or two percent, Democrats have implicitly admitted this promise will not be kept. -
September 14, 2010
Update on 1099 Amendments
Politico has two articles this morning on the 1099 amendment votes expected today: One outlining the state of play of the Johanns and Nelson amendments, and a second on an Administration letter sent to the Hill yesterday supporting Nelson and opposing Johanns. The letter from Secretaries Sebelius and Geithner opposes the Johanns amendment’s reduction in funding for the Prevention and Public Health Fund, which some have characterized as a source of wasteful federal spending on pork projects like jungle gyms. Perhaps most notably, a Wall Street Journal article quotes a Treasury official as stating the Administration wants to “keep the [1099] proposal…as a means to ensure tax compliance,” while slightly mitigating its impact on small businesses. (The news that the Administration does not want to repeal the 1099 reporting requirement outright may come as a surprise to the 239 House Democrats who voted for a complete repeal of the new requirement back in July.) Meanwhile, small businesses themselves continue to highlight the problems that this onerous new reporting requirement will cause, while advocating for the complete repeal of the 1099 provision: The NFIB sent a key vote letter supporting Johanns and opposing the Nelson side-by-side, while US Chamber of Commerce Executive VP Bruce Josten has a Roll Call op-ed on the issue.
RPC Analyst Chris Jacobs
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September 2, 2010
Administration Advisor: Only 1% of Americans Will Receive Small Business Tax Credit
The Washington Post has an article this morning discussing a Commonwealth Fund study about the impact of health “reform” on small business. While the study attempts to trumpet the claim that 16.6 million workers are employed by small businesses eligible for the tax credit created by the law, the reality is that the credit’s impact will be much smaller. An estimate developed for Commonwealth by paid Administration advisor Jonathan Gruber found that only 3.4 million workers are in firms that will actually receive the credit between now and 2014. According to the Census Bureau’s population estimates, that means that only 1.1% of all Americans, and 1.7% of those with private health insurance, will receive any benefit from the small business tax credit – a paltry showing by most measures.
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August 31, 2010
Health Care Law MORE Unpopular
Key take-aways from this month’s Kaiser Tracking Poll, released this morning:
•The health law became more unpopular in August, with approval falling seven points to 43%, and disapproval rising by ten points, to 45%. -
August 19, 2010
CBO Admits: Health Care Law Will REDUCE Labor Supply
Earlier this morning the Congressional Budget Office released its annual mid-session update on the economy and federal budget. While most of the report deals with fiscal policy generally, one section in particular contains new information about the impact of Democrats’ health care law. A section on pages 66-67 of the PDF (pages 48-49 of the hard copy version) discusses the “effects of recent health care legislation on labor markets.” -
August 18, 2010
Democrats' Health "Reform:" Higher Costs, Less Coverage
The National Business Group on Health released a survey this morning outlining trends going into the 2011 plan benefit year. The survey of large employers, which took place in May and June of this year, shows that companies are looking for relief from the higher costs likely to hit as a result of the health law’s passage. -
August 17, 2010
Why a Medicaid Card Doesn't Guarantee Health Coverage...
The New York Times has a story this morning about a new report issued by the Centers for Disease Control giving detailed statistics on nationwide emergency room usage in 2007, the most recent year for which data are available. The study found that Medicaid patients comprised more than a quarter (25.2%) of all ER visits nationwide; because the Census Bureau estimates that in 2007, 14.1% of all households had Medicaid coverage, these data mean that Medicaid patients are disproportionately likely to visit the emergency room for care. The study also found that Medicaid patients were more likely to present at the ER with semi-urgent or non-urgent symptoms than those with Medicare or private insurance – and nearly as likely to present with semi-urgent or non-urgent symptoms as the uninsured. -
August 12, 2010
Dem Pollster: Health Care Bill "A Disaster for the Party"
More news over the past several days about the political headache the unpopular health care law has become for Democrats:
- Democrat pollster Doug Schoen has an op-ed in Politico where he outlines the impact of the health care “disaster” on his party: “There may well be no single initiative as unpopular as the Administration’s health care reform bill,” which “has created big problems for both President Barack Obama and the Democratic Party.” And while the Administration keeps claiming the problem with the legislation lies in the White House’s poor messaging, on the substance, “there remain substantial doubts that the Administration’s health care reform measure is what the people wanted.”
- A Wall Street Journal blog posting by Quinnipiac University pollster Doug Brown analyzing recent polling data calls the health law “a political loser in most of the country….At this point, the White House predictions that the law would be a boon for Democrats in the voting booth come November looks [sic] to be more rhetoric than reality.”
- The NBC News/Wall Street Journal poll notes that only 39% of Americans believe the President has “lived up to expectations” when it comes to health care; 55% believe he has “fallen short” of his rhetoric.
- Likewise, Gallup’s new survey out today shows the President’s approval rating on health care at only 40%, with 57% disapproval (a -17 point margin).
Speaker Pelosi famously claimed that “We have to pass the bill so that you can find out what is in it.” But more than four months after the legislation was enacted into law, the health care overhaul remains as unpopular as ever. When will the majority admit that their government takeover of health care is the furthest thing from the “reform” most Americans wanted?
RPC Analyst Chris Jacobs
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August 10, 2010
An Alternative Reality: Administration’s Actuary Calls Official Medicare Estimates Unrealistic
Last week, the Medicare trustees issued their annual report examining the state of the program’s finances. In that report, the Chief Actuary of the Centers for Medicare and Medicaid Services (CMS) provided clear indications that the “Patient Protection and Affordable Care Act”[i] will be anything but affordable. In an unprecedented move,[ii] the non-partisan Chief Actuary used his statement of actuarial opinion on the trustees report to warn that the unrealistic cost reductions mandated in the law will threaten access to care for seniors, thus likely resulting in higher federal spending than projected. The actuary went so far as to release an alternative scenario to quantify more realistic projections for federal Medicare spending.[iii] -
August 4, 2010
First Referendum on PPACA: Voters 1, Health Care Law 0
This morning’s big news comes from the “Show Me State,” where Missouri voters overwhelmingly approved a ballot measure designed to block the introduction of an individual mandate to purchase health insurance. Upwards of 70 percent of voters approved the measure, which passed by a margin of more than 2 to 1. (While supporters of the health care law, and thus opponents of the referendum, will claim that turnout in yesterday’s primaries was low and therefore skewed, it’s worth pointing out that the referendum occurred in August and not November largely because Democrats in the state Senate insisted on holding the vote now.) -
August 2, 2010
FactCheck.org: Mayberry Misleads on Medicare
Factcheck.org has weighed in on the Administration’s new health care promotional campaign. It dubs as misleading the claim that benefits in Medicare will remain the same, particularly for those seniors in Medicare Advantage plans, and accuses the Administration of using “weasel words” to try and make its point. As the article concludes: “Currently, about 1 in every 4 Medicare beneficiary is enrolled in a Medicare Advantage plan. For many of them, the words in this ad ring hollow, and the promise that "benefits will remain the same" is just as fictional as the town of Mayberry was when Griffith played the local sheriff.” -
August 2, 2010
Setting the Facts Straight on Medicare
Today the Administration is preparing to release a “report” regarding the health care law’s impact on Medicare. The report doesn’t contain much in the way of new information, instead merely summarizing various provisions in the law that the Administration believes will reduce Medicare costs. The Administration claims nearly $8 billion in short-term savings to the Medicare program – but as an AP story points out, “Medicare Advantage cuts account for $5.3 billion through 2011, more than 60 percent of the total estimated two year savings.”
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July 30, 2010
Responses to New CMS Advertising Campaign
In case you missed it, this afternoon’s web chat with CMS Administrator Donald Berwick included the unveiling of a new advertising campaign intended to promote the health care law’s “enhancements” to Medicare. Video of the ad featuring Andy Griffith can be found here; according to a CMS release, it will “begin running immediately on national cable television stations.” -
July 30, 2010
Democrats in Retreat Over 1099 Tax Reporting Requirements
The Wall Street Journal this morning reports on the troubles that the 1099 business tax reporting requirements included in Section 9006 of the health care law are causing for Democrats in Congress. Under the provision, vendors and small businesses are required to file Forms 1099 for any goods purchases that total over $600 in the aggregate over the course of a year – which will force all businesses, including small businesses, to file tax forms listing the amount of their annual transactions with vendors like their paper supplier, bottled water distributor, caterer, etc. The National Taxpayer Advocate has noted this provision will affect 40 million businesses – ten times the number of firms the Administration asserts will benefit from small business tax credits – and has called the paperwork requirements “disproportionate” and “burdensome”. -
July 27, 2010
New York Times on Berwick's Continuing "Struggles"
Robert Pear has an article in this morning’s edition highlighting the controversy surrounding Donald Berwick’s recess appointment to head the Centers for Medicare and Medicaid Services (CMS): “Two weeks after taking office, Dr. Berwick is still struggling to tamp down a furor over past statements in which he discussed the rationing of health care and expressed affection for the British health care system.” The article repeats several of Dr. Berwick’s former quotes regarding rationing, bureaucrat-imposed medical guidelines, and his “romance” with Britain’s National Health Service. Regarding these and other quotes, “Dr. Berwick never had a confirmation hearing and has not responded publicly to critics. The White House declined to make him available for an interview.” -
July 26, 2010
Don Berwick and Two Visions of Health Care
Two interesting stories over the weekend about Britain’s National Health Service (NHS) speak volumes about the choices facing the American health care system. The Sunday Telegraph reported that some local primary care trust bureaucracies within the NHS were planning to ration access to treatments like hip replacements, and “reduc[e] length of stay” in hospital for those terminally ill. In some cases, terminal cancer patients might be told “to manage their own symptoms if their condition worsens at evenings or weekends.” These moves were called “astonishingly brutal” by patient advocates, who noted that “it was ‘incredibly cruel’ to draw up savings plans based on denying care to the dying.”