Reform Resources
Posted by on January 12, 2010 at 6:19 AM
Congress is currently working to draft and pass a comprehensive health care reform bill. As this process continues the Campaign for an American Solution will continue to share with you the latest developments surrounding health care reform. This page contains a directory of reform resources that provide in-depth information about the subjects being discussed. This list will be updated frequently, so check back often or follow our blog or Twitter for daily updates.
AHIP Reform Resources:
* Statement on the Release of Proposed Senate Legislation (November 19, 2009)
* Statement on Passage of H.R. 3962 (November 7, 2009)
* Statement on Government-Run Plan (October 26, 2009)
* PricewaterhouseCoopers Report on the Impact of Reform Proposals on Costs (October 11, 2009)
* Statement on Release of Finance Committee Chairman's Mark (September 16, 2009)
* Statement on Health Insurance Reform (August 11, 2009)
* Statement on Status of Health Care Reform (August 4, 2009)
* Statement on Health Care Reform Rhetoric (July 30, 2009)
* Statement on Status of Health Care Reform Process (July 21, 2009)
* Statement on House Health Care Reform Proposal (July 14, 2009)
* AHIP’s comprehensive reform proposal
* AHIP Statement on Senate HELP Bill
* Cost-containment – stakeholders’ proposal to reduce health care costs
* Health Insurance Plan Regulation Chart
* Nationwide Listening Tour Report
* Mandatory Medical Loss Ratio (MLR) Requirements – Impact on the health care system
* Key facts about the McCarran-Ferguson antitrust exemption
* Analysis of CBO report on the Senate health reform bill’s impact on health insurance premiums
Letters and Testimony to Congress:
* Letter to House leadership on small businesses (December 15, 2009)
* Letter to House Leadership (November 5, 2009)
* Letter to Chairman Baucus (September 21, 2009)
* Letter to House Tri-Committee Chairmen (July 16, 2009)
* Letter to Senator Kennedy (July 13, 2009)
* Testimony to Energy and Commerce Committee (June 25, 2009)
* Letter to Senate HELP Committee (June 2009)
* Letter to Senate HELP and Finance Committees (March 24, 2009)
Profits and Perspective:
* Setting the Record Straight on Health Plans' Profits (July 22, 2009)
Cost Trends and Cost-Shifting:
* RAND Health Study: “How Much Is Too Much? An Analysis of Health Plan Profits and Administrative Costs in California” – This study shows that medical costs account for 89% of the rise in health insurance premiums over a five year period from 2002-2006.
* PWC Medical Cost Trends for 2010
* The Lewin Group: The Cost and Coverage Impacts of a Public Plan: Alternative Design Options
* The Heritage Foundation: Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance
* Families USA: Hidden Health Tax: Americans Pay a Premium
* McKinsey: Accounting for the Cost of U.S. Health Care: A new look at why Americans spend more
* The Factors Fueling Rising Health Care Costs 2008: PricewaterhouseCoopers cost study examines the causes of rising health care costs and analyzes how health insurance premium dollars are being spent.
* New Health Insurance Premium Tax – Costs to go up for families, employers
* Small Businesses and Health Care Costs
* Study on the impact of cost-shifting by Milliman
* AHIP Press Release
Polling Data:
* The Campaign keeps track of the latest polling data and posts it on our blog. Check out the Poll Vault.
Individual Market:
The need for a personal coverage requirement:
* Milliman report on the impact of market reforms without a personal coverage requirement: The Impact of Guarantee Issue and Community Rating Reforms on Individual Insurance Markets
AHIP Press Release
* Individual Health Insurance 2006-2007: A Comprehensive Survey of Premiums, Availability, and Benefits
Medicare/Medicaid:
* Reductions in Hospital Days, Re-Admissions, and Potentially Avoidable Admissions Among Medicare Advantage Enrollees in California and Nevada, 2006
* Trends and Innovations in Chronic Disease Prevention & Treatment: An Update on Medicare Advantage Plans
* Medicaid Managed Care Cost Savings – A Synthesis of 24 Studies
Other AHIP Research and Reports:
* Individual Health Insurance 2009: A Comprehensive Survey of Premiums, Availability, and Benefits
The Value of Health Insurance Plans:
* We believe in high value health care
* Innovations in Recognizing and Rewarding Quality
* Innovations in Chronic Care
* Health Plan Innovations in Prevention, Wellness and Risk Reduction
* Trends and Innovations in Health Information Technology
* Ensuring Quality Through Appropriate Use of Diagnostic Imaging
Visit Our Partner Coalitions to Learn More about Health Care Reform and How to Support Specific Coverage Options:
* Medicare Advantage: www.medicarechoices.org
* Health Savings Accounts: www.hsaallianace.org
* Medicare Supplemental Insurance: www.protectmedigap.org
ICYMI: Former Comptroller General David Walker Says Current Reform Bills Fail Four Pronged Test
Posted by The Campaign on January 12, 2010 at 6:02 AM
The former comptroller general of the U.S. David Walker, someone who knows something about the fiscal state of the United States looks at what the reform bills will mean for the till. According to Walker, the bills both fail a four pronged test.
Here are some key highlights:
"Rather than just paying for itself, fiscally responsible health care reform should meet a four-pronged test based on realistic assumptions. First, it should pay for itself over 10 years. Second, it should not add to federal deficits beyond 10 years. Third, it should result in a significant reduction in the tens of trillions of dollars in unfunded health care promises the federal government already has. Fourth, it should result in total health care costs as a percentage of the economy lower than what would occur absent reform."
"Based on independent analyses performed by various government and private-sector organizations, the current bills pending in the Congress do not meet this four-pronged test. In addition, to the extent they allegedly meet any of the tests, they do so by relying on very optimistic assumptions relating to provider reimbursements and other factors."
"In addition to meeting these four tests, any health care reform bill should contain mechanisms to ensure that its projected cost-related outcomes become a reality. Namely, it should have automatic adjustment mechanisms in place if the predetermined cost-related targets are not met. It should also provide for a capable, credible and truly independent group that can help pursue adoption of evidence-based practice and other approaches designed to reduce costs and the rate of increase in such costs. In addition, we need a bipartisan Fiscal Future Commission to engage the American people and make recommendations on a range of tough health care, tax, Social Security and other choices that Washington has been punting on for far too long."
For the full article click here.
ICYMI: NAIC Letter to Capitol Hill Outlines Concerns With Certain Provisions of Reform Legislation
Posted by The Campaign on January 07, 2010 at 2:38 PM
The National Association of Insurance Commissioners (NAIC) sent this letter to Speaker Pelosi and Majority Leader Reid. Here are a few highlights:
· “State insurance regulators have extensive experience and expertise in regulating health insurance. They are also closer to consumers and have a better understanding of the markets they regulate than a single national regulator in Washington, D.C. could have. For these reasons, consumers are best served by insurance regulation that is located firmly at the state level.”
· “Reforms such as guaranteed issue, community rating, and the elimination of preexisting condition exclusions can encourage young, healthy individuals to wait until they get sick to purchase health insurance coverage, especially in the individual market. While both bills include provisions designed to mitigate this risk, we are concerned that overly broad exemptions and insufficient penalties will prompt many to opt out of insurance coverage, endangering the viability of the entire reform package.”
· “ Furthermore, we are concerned that application of rating rules to large group coverage will have the unintended consequence of encouraging these businesses to self-insure in order to evade this provision.”
· “On a related issue, we are concerned that businesses that lack the size and resources to safely self insure may be encouraged to do so in order to avoid these reforms. Failures of these self-insured plans would have a devastating impact on the businesses, employees and health care providers. We urge conferees to consider taking steps to ensure states have authority to protect consumers from this danger.”
· “If federal regulators are given the authority to deny premium increases that are needed to maintain the solvency of a company or to exclude carriers from the marketplace in response to these needed premium increases, the ability of state regulators to ensure the financial stability of companies could be severely compromised.”
· “We are concerned that a loss ratio of 80% in the individual market may not be readily achievable by many insurers. These companies have already entered into contracts with agents and brokers that obligate them to pay specified levels of commissions, and have expenses associated with underwriting and marketing that they will not be able to reduce until guaranteed issue requirements and health insurance Exchanges are implemented.”
· “While promoting competition is an important element of fostering healthy insurance markets, it is unlikely that a repeal of the McCarran-Ferguson antitrust exemption for health and medical malpractice insurers will lead to more competition and lower premiums. The business of insurance, while exempted from federal antitrust law, is still subject to state antitrust enforcement actions.”
· “Many provisions of both the House and Senate bills, if enacted on their own, would cause adverse selection that would raise premiums for all, as younger healthier individuals and businesses forego coverage. It is crucial that the effective dates of these important reforms be coordinated with implementation of the individual mandate and subsidies that will mitigate the risk of adverse selection.”
FACT CHECK: Implementation Timeline and Cost and Disruptions During Transition
Posted by The Campaign on January 05, 2010 at 2:49 PM
As the reform debate continues, it is is important to have a clear understanding of the impacts of certain provisions of the House and Senate reform bills. In particular, when thinking about the transition period between 2010 and 2014 (when the exchanges and coverage requirement go into effect) it is critical to ensure that cost increases and disruptions to people with coverage are minimal.
Please find below links to two important documents:
Important facts and background information about the transition period and how to minimizing cost increases and coverage disruptions during the transition to a reformed health care system.
A timeline of the various provisions and when they go into effect.
ICYMI: New Govt. Data Show Net Cost of Insurance Continues to Decline
Posted by The Campaign on January 05, 2010 at 8:34 AM
CMS today released the latest National Health Expenditure Accounts data showing health care costs continue to grow faster than the overall economy. This means reducing costs will remain a central focus of the reform debate.
One critical part of the new NHE data release is the percentage increase in the cost of private health insurance. Here is the key finding on this component of the NHE data:
"The net cost of private health insurance-the difference between premiums and benefits- declined to $92.0 billion in 2008, a decrease of $2.6 billion from 2007. As a result, the net cost of this insurance continued its recent decline as a share of total premiums from 13.7 percent in 2003 to 11.7 percent in 2008." (p. 153)
For the full report, click here.
POLL VAULT: Polling Continues to Show Americans Concerned about Costs
Posted by The Campaign on January 05, 2010 at 8:02 AM
Public surveys released over the past month have shown that the American people continue to be concerned about health care costs and the impact that reform will have on their health care costs. Here are some recent findings from various polls related to costs:
59% of Americans think their costs will increase vs. 15% of Americans who think their costs will decrease under current reform proposals (Rasmussen, 01/03/10)
53% of Americans think costs are the biggest issue with health care vs. 23% of Americans who think the lack of universal coverage is the biggest problem vs. 13% of Americans who think quality of care is the biggest problem (Rasmussen, 12/28/09)
52% think they will pay more under current reform proposals vs. 7% less (Economist/YouGov, 12/13-15/09)
41% of Americans think lowering costs should be the #1 priority of health care reform vs. 28% ensuring every American has insurance vs. 22% improving quality of health care (Tarrance/Lake Group, 12/6-10/09)
63% think that their health care costs will increase by extending coverage to all Americans vs. 30% who don't think so (Quinnipiac University, 12/1-6/09)
ICYMI: AHIP Statement on National Health Expenditures Data Release
Posted by The Campaign on January 05, 2010 at 5:49 AM
AHIP's Statement on today's release of the National Health Expenditure Accounts data:
AHIP Statement on National Health Expenditure Data
Washington, DC – New National Health Expenditure Accounts data released by CMS show that health spending in the United States grew at 4.4 percent in 2008. Although the recession has brought a reduction in the rate of increase in health care costs, the data show costs continue to grow faster than the overall economy and the portion of GDP devoted to health care continues to increase.
“The latest national health expenditure data demonstrate why health care reform needs to include a long-term strategy to reduce the growth of health care costs. Health care spending continues to rise faster than the economy as a whole, further straining family budgets and crowding out of other urgent domestic priorities, such as education, energy, and the environment,” said Karen Ignagni, President and CEO of America’s Health Insurance Plans (AHIP).
According to CMS, “Despite the slowdown, national health spending reached $2.3 trillion, or $7,681 per person, and the health care portion of gross domestic product (GDP) grew from 15.9 percent in 2007 to 16.2 percent in 2008. These developments reflect the general pattern that larger increases in the health spending share of GDP generally occur during or just after periods of economic recession.”
This is consistent with national data and information received from health plans showing that health care costs are expected to increase even further in 2009 due to the underlying growth in the cost of health care services.
Moreover, surveys from the past month continue to show Americans are concerned about the impact reform will have on their health care costs.
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Providing Health Benefits for Over 200 Million Americans.
ICYMI: Kaiser Family Foundation's Drew Altman on Delays in Benefits in Reform Bill
Posted by The Campaign on December 22, 2009 at 8:34 PM
In an article from the Associated Press entitled "Pain before gain in health care overhaul", the AP quotes Kaiser Family Foundation president Drew Altman saying this about the bill:
"There's going to be an expectations gap, no question about that. People are going to see their premiums and out-of-pocket costs go up before the tangible benefits kick in."
For the full article, click here.
ICYMI: AHIP's Robert Zirkelbach on CNN Discussing the Senate's Vote
Posted by The Campaign on December 21, 2009 at 11:38 AM
AHIP's Robert Zirkelbach appeared on CNN early this morning to discuss the Senate's vote and AHIP's view on health care reform.
CNN:
AHIP's Robert Zirkelbach on Fox News Special Report:
AHIP PERSPECTIVE: AHIP STATEMENT ON SENATE HEALTH CARE REFORM LEGISLATION
Posted by The Campaign on December 19, 2009 at 6:05 PM
AHIP STATEMENT ON SENATE HEALTH CARE REFORM LEGISLATION Washington, DC – Karen Ignagni, President and CEO of America’s Health Insurance Plans (AHIP), released the following statement today on the Senate health care reform legislation: “The debate before us today is not whether insurance market reforms are needed. In fact, health plans proposed and support a complete overhaul of insurance market rules and new consumer protections to ensure all Americans have guaranteed access to affordable, portable coverage. The critical policy questions are whether the current legislation can bend the cost curve and result in a sustainable system. While the bill makes important improvements in access and takes steps towards cost-containment, it lacks accountability to ensure that costs are brought under control. Moreover, this bill includes provisions that will increase costs for families and small businesses and disrupt the quality coverage on which millions of Americans rely today.” Barriers to affordability: · A new $70 billion premium tax that will increase the cost of health care coverage for millions of Americans and fall primarily on small businesses and those who purchase coverage in the individual market. · More cost shifting to patients with private coverage as providers are forced to make up for hundreds of billions in reduced Medicare payments. · New market and rating rules that will increase premiums for individuals and small businesses with coverage today. Disruptions for current policyholders: · New regulatory requirements and benefit mandates that go into effect beginning next year – before access provisions go into effect – that will cause major disruption for millions who have already enrolled in their plan for next year. · A new federal plan that would preclude many high-quality plans from participating and increase complexity in the exchanges. · Arbitrary caps on administrative costs that will undermine essential health care services, such as disease management and care coordination programs, investments in health information technology, programs to root out fraud and abuse in the health care system, and new administrative simplification requirements. · Major cuts in Medicare Advantage benefits beginning next year that will ultimately result in millions of seniors losing their current coverage. “These issues need to be resolved if the country is to make health care coverage more affordable and put the system on a sustainable path. Health plans will continue to work to solve the problems that have been identified.” ###
