The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Posts Tagged ‘Kaiser Family Foundation’

Which Health Care Reform Provisions are Ready for 2010 Debut?

Posted by Alan on October 25, 2009

Most of the major provisions of the health care reform proposals circulating through the halls of Congress won’t take effect until 2013 or later (the major exception being some of the taxes created by the reforms). There’s a huge political problem with that: opponents of the reform will throw every rock, pebble and boulder they can find at the reform package. If voters have to wait three or four years to see any of the benefits of the reforms lawmakers are taking the better part of a year to resolve, they’re going to be sorely disappointed. In fact, a Kaiser Family Foundation poll indicates that nearly half of the respondents expect to see insurance company reforms take effect within a year.

So it’s not surprising Democrats are searching for ways to implement elements of their reform package as soon as possible – preferably before the November 2010 elections. As Carrier Budoff Brown puts it in a posting on Politico.com, “Democrats are pushing Senate leaders and the White House to speed up key benefits in the health reform bill to 2010, eager to give the party something to show taxpayers for their $900 billion investment in an election year.”

What matters, of course, is what parts of the bill are implemented sooner than later. Starting the taxes right away is critical for making the financial numbers work. Yet they are likely to increase medical costs (and, consequently, insurance premiums) in the near term. Some provisions, like requiring carriers to allow families to cover young adults until they reach age 26 offer little downside. The same with creating a fund to cover catastrophic claims of early retirees (those aged 55-through-64) who receive coverage their employer. Requiring health care companies (for example insurers and hospitals) to be more transparent in reporting their costs may embarrass some companies and force them to quickly set up reporting processes, but are won’t harm the system overall. These are some of the items the Politico.com post identifies as under consideration.

What would be damaging is requiring carriers to guarantee issue individual health insurance coverage (accept all applicants regardless of their health conditions) in 2010 while delaying the mandate on individuals to obtain coverage. As I’ve written about frequently, an imbalance between requiring carriers to sell and consumers to buy health insurance will price the cost of health insurance beyond the means of many Americans.

Moving the benefits of health care reform forward makes political sense without abusing common sense. If it’s done the right way. Whether lawmakers will have the patience to find that way, is still uncertain, but they appear to be making the effort.

Posted in Health Care Reform, Healthcare Reform, Politics | Tagged: , , | 1 Comment »

Health Care Reform 2009: Even More Required Reading

Posted by Alan on August 11, 2009

Welcome to the third edition of health care reform 2009’s required reading list. (The previous editions were Health Care Reform 2009: Required Reading and Health Care Reform 2009: More Required Reading). What I try to do in these cleverly titled posts is to pull together the articles and web sties offering meaningful insights into the current health care debate. I don’t always agree with the authors facts, reasoning or conclusion, but having them available can be a useful guide to what people are saying and thinking.

  1. If folks are going to argue over what’s in the House Energy and Commerce Committee’s legislation (the “America’s Affordable Health Choices Act“) we might as well all read the darn thing. And the various press releases, summaries and white papers associated with it. The Committee’s site has it all and more.
  2. When the Congressional Budget Office talks people listen. (To be precise, when the CBO writes, people read — especially lawmakers, public policy wonks, the media and the political groups seeking to sway the outcome of the health care reform debate). One of their most read pronouncements concerned the impact of a government-run health plan to compete with private carriers or through a health insurance exchange under the Energy and Commerce Committee’s bill. The CBO concluded enrollment in a public plan or exchanges would be relatively modest — by 2016 they project “nearly 3 million Americans who would be covered under an employment-based plan under current law … would choose instead to obtain coverage in the exchanges because the employer’s offer would be deemed unaffordable and they would therefore be eligible to receive subsidies via an exchange…”  When part-time workers are added in, the CBO estimates that the private carriers would lose approximately 9 million people to the exchange by 2016. Estimating that a public plan would offer premiums approximately 10 percent lower than typical private plans offered in the exchange,  the CBO concludes the public plan would have a “limited effect on the the proposal’s net budgetary impact,” implying enrollment would be modest. The CBOreport is a thorough analysis well worth an investment of time.
  3. When it comes to polling, trends often matter as much as the actual numbers. The Kaiser Family Foundation has been tracking the public’s attitude toward health care reform since March 2007.  Their July 29th Public Opinion on Health Care Issues finds a majority of Americans continue to believe “it is more important than ever to take on health care reform now.” While the percentage has declined since October 2008 from 62 percent to 56 percent, that’s still a striking result given the rhetoric surrounding the debate. Of course, it all depends on who you talk to: roughly 70 percent of Democrats believe this is the time for health care reform while approximately 60 percent of Republicans state “we cannot afford to take on healthcare reform right now.” Independents split 54 percent-to-42 percent in favor of moving forward with change now.
  4. Just because you see it on television doesn’t mean it’s true. Partisans on the left, right and middle have a tendency to misstate the facts. FactCheck.org, a project of the Annenberg Public Policy Center is an excellent source for the real scoop. They take on liberals and conservatives with equal fervor, for instance, debunking the euthanasia claims of the right and challenging President Barack Obama’s claim that health insurance companies are raking in “record profits.” 
  5. During the presidential campaign, one of Obama campaign’s most potent weapons was a site called “Fight the Smears.” It allowed the campaign to quickly respond to and debunk unfounded rumors. The White House is launching a similar site, called “Reality Check” to counter attacks on the president’s health care goals. The justifications are not surprisingly skewed to the Administration’s positions, but as a single source for President Obama’s positions on controversial issues it’s a great resource.
  6. Keeping the health plans straight without a program is nearly impossible. Even with a program it’s darn tough. The National Association of Health Underwriters offers a useful comparison between the Senate Health, Education, Labor and Pensions Committee legislation and the House of Representative’s legislation (HR 3200). In fact, NAHU has a wide range of useful legislative information of particular interest to health insurance brokers. (If you’re a broker and not a member of NAHU, now is the time to join. No other organization is as engaged or effective at representing the perspective of professional insurance brokers.) The Kaiser Family Foundation ahs a great tool for comparing various health care reform proposals as well.
  7. Health care reform is critical importance to state governments. They simply cannot afford the burden of increasing medical costs for programs like Medicaid (Medi-Cal in California). California Arnold Schwarzenegger made this point very clear in a letter to Congressional leaders urging them to pass health care reform, but warning against pushing the financial burden onto state governments. It’s an aspect of health care reform that is not receiving a great deal of attention, but is of critical importance. The letter does an excellent job of explaining the issue. 

Of course the most important document to read is the Senate Finance Committee’s compromise proposal. Unfortunately, it doesn’t exist yet, although there are plenty of stories on what it is likely to contain. Until it sees the light of day, however, reports on its provisions are merely conjecture, trial balloons or both. In the meantime, these sites and publications should provide some pleasant summer reading.

Posted in Barack Obama, Health Care Reform, Healthcare Reform, Politics | Tagged: , , , , , , , , , | 11 Comments »