Our Health Policy Matters

I have never been the biggest fan of the Affordable Care Act.  I believe that since the government is already paying over 70% of our nation’s health care bill and we’re paying another 12% out of pocket, this colossal effort to preserve the small share financed by privately-funded private insurance without bankrupting the nation may not have been worth the effort.  Medicare-for-all would have been a much better approach. But now that an emerging group of at-risk Democratic senators have joined the Republican chorus to delay the individual mandate , I want to offer an opposing view to theirs.  Obamacare has been compromised enough. Since it was enacted in 2010, Obamacare has undergone the following significant changes: The minimum medical loss ratio requirements were delayed in several states. The long-term care insurance program has been repealed. The prevention fund has been raided. The reductions in payments to providers have been put off. The...

I have never been the biggest fan of the Affordable Care Act.  I believe that since the government is already paying over 70% of our nation’s health care bill and we’re paying another 12% out of pocket, this colossal effort to preserve the small share financed by privately-funded private insurance without bankrupting the nation may not have been worth the effort.  Medicare-for-all would have been a much better approach. But now that an emerging group of at-risk Democratic senators have joined the Republican chorus to delay the individual mandate , I want to offer an opposing view to theirs.  Obamacare has been compromised enough. Since it was enacted in 2010, Obamacare has undergone the following significant changes: The minimum medical loss ratio requirements were delayed in several states. The long-term care insurance program has been repealed. The prevention fund has been raided. The reductions in payments to providers have been put off. The...

Special Note:  The Supreme Court's decision on the Affordable Care Act is expected soon, and when it comes there will be implications for us all.  The OHPM publication schedule may change that week to provide timely analysis, and may publish more than once. I remember how surprised I was the time I was told that a member of my family had hit his lifetime limits on some of his health insurance benefits.  He had about sixty more years of life expectancy!  I knew then that capping health insurance benefits could be a cruel and bankrupting blow to those who need them the most. That’s why Monday’s announcement by UnitedHealthcare that, no matter what the Supreme Court decides, it will keep in place some of the new  Affordable Care Act-mandated consumer protections was good news. As reported in Kaiser Health News , the nation’s largest health insurer said that it would keep free preventive services, allow children up to age 26 to stay on parents’ plans...

Special Note:  The Supreme Court's decision on the Affordable Care Act is expected soon, and when it comes there will be implications for us all.  The OHPM publication schedule may change that week to provide timely analysis, and may publish more than once. I remember how surprised I was the time I was told that a member of my family had hit his lifetime limits on some of his health insurance benefits.  He had about sixty more years of life expectancy!  I knew then that capping health insurance benefits could be a cruel and bankrupting blow to those who need them the most. That’s why Monday’s announcement by UnitedHealthcare that, no matter what the Supreme Court decides, it will keep in place some of the new  Affordable Care Act-mandated consumer protections was good news. As reported in Kaiser Health News , the nation’s largest health insurer said that it would keep free preventive services, allow children up to age 26 to stay on parents’ plans...

If you run a small business in Florida, are self-employed in Texas, or work for a large corporation in New Jersey ( see an update below ), then your state insurance regulators probably haven't been working for you. The news that 15.8 million people can expect $1.3 billion in rebates from insurers this year because of the Affordable Care Act (ACA) underscores how weak health insurance regulation has been in states across the country.  It may come as no surprise that Florida and Texas, two leaders in the fight against ACA, have been exposed as anti-consumer.  But they are not the only states with an anti-consumer bias. First, the good news: last week, the federal government announced that three-quarters of us will get letters beginning on July 1 telling us that our insurance plans paid out at least 80 to 85 cents in benefits for every premium dollar they collected. This means that under ACA they met the minimum standard for a reasonable benefit payout (which i...

If you run a small business in Florida, are self-employed in Texas, or work for a large corporation in New Jersey ( see an update below ), then your state insurance regulators probably haven't been working for you. The news that 15.8 million people can expect $1.3 billion in rebates from insurers this year because of the Affordable Care Act (ACA) underscores how weak health insurance regulation has been in states across the country.  It may come as no surprise that Florida and Texas, two leaders in the fight against ACA, have been exposed as anti-consumer.  But they are not the only states with an anti-consumer bias. First, the good news: last week, the federal government announced that three-quarters of us will get letters beginning on July 1 telling us that our insurance plans paid out at least 80 to 85 cents in benefits for every premium dollar they collected. This means that under ACA they met the minimum standard for a reasonable benefit payout (which i...

Babies crawl before they walk.  c. Microsoft Office Image The Affordable Care Act (ACA) marks its first birthday this week.   It may not be off to a running start, but it isn’t exactly sitting still either.   The most debated provisions, like the individual mandate and the Medicaid expansions, are still three years in the future. In the first year, ACA’s biggest developmental milestones have affected older Americans, people with mental and physical disabilities, and consumers in general.   Which of these populations is making the most progress? Medicare recipients and early retirees have taken the most steps forward .     As of January 1 st , all Medicare Part B recipients are entitled to a free annual physical, with free cancer, cardiovascular, and skeletal screenings, and free flu shots.   150,000 beneficiaries had taken advantage of this through February 23 rd .   This number will grow, to many millions before the end of the year. Also, over ...

Babies crawl before they walk.  c. Microsoft Office Image The Affordable Care Act (ACA) marks its first birthday this week.   It may not be off to a running start, but it isn’t exactly sitting still either.   The most debated provisions, like the individual mandate and the Medicaid expansions, are still three years in the future. In the first year, ACA’s biggest developmental milestones have affected older Americans, people with mental and physical disabilities, and consumers in general.   Which of these populations is making the most progress? Medicare recipients and early retirees have taken the most steps forward .     As of January 1 st , all Medicare Part B recipients are entitled to a free annual physical, with free cancer, cardiovascular, and skeletal screenings, and free flu shots.   150,000 beneficiaries had taken advantage of this through February 23 rd .   This number will grow, to many millions before the end of the year. Also, over ...

Why should Floridians care if members of its House of Representatives delegation vote to repeal all the provisions of health reform this week? Because even though the Senate and the President have said they will stop the measure dead in its tracks, a vote to repeal is a vote against the interests of Floridians . If every provision of health reform were to be repealed, here are just some of the people of Florida who would be affected : 86,300 young adults who would lose insurance coverage through their parents’ health insurance plans; 182,672 Medicare recipients in the donut hole who would be charged at least $250 more for their prescription drugs in 2011 than they were in 2010; Early retirees of 190 Florida employers – including the University of Miami, Stetson University, Eckerd College, the PGA Tour, Inc., The Wackenhut Corporation, Tampa General Hospital, the Archdiocese of Miami, the Escambia County Sheriff’s Office, the Florida Firefighters Insurance Trust Fund, Duvall Coun...

Why should Floridians care if members of its House of Representatives delegation vote to repeal all the provisions of health reform this week? Because even though the Senate and the President have said they will stop the measure dead in its tracks, a vote to repeal is a vote against the interests of Floridians . If every provision of health reform were to be repealed, here are just some of the people of Florida who would be affected : 86,300 young adults who would lose insurance coverage through their parents’ health insurance plans; 182,672 Medicare recipients in the donut hole who would be charged at least $250 more for their prescription drugs in 2011 than they were in 2010; Early retirees of 190 Florida employers – including the University of Miami, Stetson University, Eckerd College, the PGA Tour, Inc., The Wackenhut Corporation, Tampa General Hospital, the Archdiocese of Miami, the Escambia County Sheriff’s Office, the Florida Firefighters Insurance Trust Fund, Duvall Coun...

If you watched HBO’s Real Time with Bill Maher on November 12th, you heard Mike Huckabee propose a public option as part of a health reform fix.   With “repeal, revise, and replace” stories in the news every day, shouldn’t this be worth at least one national headline?   Governor Huckabee didn’t just flirt with the public option; he married it to his opposition to requiring insurers to cover people with pre-existing conditions.      Defending his position, Huckabee argued “when you buy insurance you’re buying something in the private sector.   Now maybe there’s a place to say if you’re really, really sick and you can’t access a traditional marketplace then should we have some form of safety net?   Yeah. I’ve said that; I did that when I was Governor.”    He called for “a partnership between government and the private sector” to insure people with pre-existing conditions. So what did Mr. Huckabee propose?   He cited the Arkansas TEFRA pro...