Carter's Benefits

 

news releases

February 15-2012

Lawmakers Arrive At "Tentative Deal" To Block Medicare Payment Cuts To Physicians.

The Los Angeles Times (2/15, Mascaro) reports, "One day after House Republican leaders made a major concession on the payroll tax cut, congressional negotiators struck a tentative deal that also would extend long-term unemployment benefits and prevent drastic reductions in doctors' Medicare payments."

The AP (2/15, Fram) reports that the deal would "block a 27 percent cut in reimbursements for doctors who treat Medicare patients. Overall, the legislation would cost roughly $150 billion." The AP adds, "Participants said the Medicare payments to doctors would be paid for by reducing Medicare reimbursements to hospitals and by cutting in half an $8 billion program under Obama's health care overhaul aimed at battling obesity and smoking."

Single-Payer Advocates File Brief With SCOTUS Arguing Against Individual Mandate.

CQ (2/15, Subscription Publication) reports, "Opponents of the health care law gained some allies when doctors who advocate a single-payer health care system announced Tuesday that they have filed a brief with the US Supreme Court arguing that Americans shouldn't be required to get insurance." According to CQ, "two nonprofit groups, Single Payer Action and It's Our Economy, and the doctors say they believe the United States should have a national, publicly financed system of health care, in which one entity handles billing and administrative functions for consumers."

Groups File Amicus Brief In Healthcare Reform Case. The Daily Caller (2/15) reports, "Four free market advocacy groups filed a 39-page amicus brief to the Supreme Court this week supporting the 11th Circuit Court of Appeals decision that the individual mandate in President Obama's health care reform law is unconstitutional." The brief was filed by the Pacific Research Institute, Benjamin Rush Society, Docs 4 Patient Care and the Galen Institute.

Haslam Says Federal Health Reform Law Is Unconstitutional. The Nashville Business Journal (2/15, Reisinger, Subscription Publication) reports, "Gov. Bill Haslam is weighing in on the national debate over federal health care reform, providing a window into his thinking as Tennessee wrestles with how to deal with its impact on local markets." Haslam, a Republican "announced...that he was supportive of a brief the Republican Governor Public Policy Committee has filed with the US Supreme Court, arguing that President Obama's health care law is unconstitutional."

Individual Mandate's Conservative Roots Noted. Michael Cooper, in the New York Times (2/15, Subscription Publication), says, "The provision in President Obama's health care law requiring all Americans to buy health insurance has its roots in conservative thinking. ... The individual mandate...was seen then as a conservative alternative to some of the health care approaches favored by liberals -- like creating a national health service or requiring employers to provide health coverage."

February 14-2012

GOP Senators File Brief Against Individual Mandate.

CQ (2/14, Norman, Subscription Publication) reports, "Republican senators on Monday filed a brief with US Supreme Court saying that 'Congress acted without constitutional authority' when it approved the requirement in the health care law that all Americans must have health insurance." According to Senate Minority Leader Mitch McConnell (R-KY) and others, "the individual mandate included in the law has damaged the legitimacy of Congress as an institution and triggered conflicts between the states and the federal government."

Texas Lags On Establishing Insurance Exchange.

The Houston Chronicle (2/14, Kever) reports, "Texas is almost alone among the nation's largest states in failing to start work on a key piece of the Affordable Care Act (ACA), as legislators and state agencies follow Gov. Rick Perry's dictum to delay action until after a Supreme Court ruling and the November election." The article cites the Kaiser Family Foundation as identifying Texas as "one of nine states...having made 'no significant progress' toward establishing an exchange."

Researchers Look At Impact Of ACA On Healthcare For Young Adults.

MedPage Today (2/14) reports that according to research by Alexander B. Blum, MD, MPH, of Mount Sinai School of Medicine in New York City, and colleagues published in Pediatrics, "laws expanding the upper age limit for parents' insurance to cover their children improve healthcare modestly for young adults." The researchers wrote, "The ACA is likely to increase insurance uptake more than state laws because it supersedes ERISA [an act that exempts self-insured employers from state insurance regulation], broadens eligibility to nonstudents and married dependent children, and allows children access to the same benefits as their parents and siblings." The piece notes, "Blum reported ties to the National Institutes of Health through the American Association for the Advancement of Science and paid consulting to the Committee of Interns and Residents of the Service Employees International Union."

HealthDay (2/14) reports, "The study authors compared US Centers for Disease Control and Prevention data before (2002-2004) and after (2008-2009) 34 states enacted laws permitting young adults to remain on their parents' health insurance."

February 13-2012

Groups Concerned About Proposed Minimum Coverage Standards.

American Medical News (2/13, Trapp) reports, "Physician organizations are expressing concerns that minimum health coverage standards proposed by federal health officials to start in 2014 might not cover children adequately or provide sufficient drug coverage, among other issues." In December, "HHS proposed letting each state choose an existing health plan operating in the state to serve as a benchmark for the mandatory minimum coverage." But, "many of the potential benchmark plans that states could choose do not cover some medically necessary care for children, including rehabilitative and habilitative treatment, according to letters submitted to HHS in late January by the American Medical Association and the American Academy of Pediatrics."

February 10-2012

New Regulations Require Easy-To-Understand Summaries Of Health Coverage.

The Obama Administration issued regulations Thursday "requiring health plans to describe what they cover in clear, standardized language that is understandable to consumers," the Los Angeles Times (2/10, Levey) reports. The regulations are part of the Administration's effort to "implement a much-anticipated consumer protection in the new healthcare law." Beginning in the fall, "insurers and employers that offer health coverage will have to provide a six-page form that summarizes basic plan information, such as deductibles and co-pays, as well as costs for using in-network and out-of-network medical services."

Bloomberg News (2/10, Armstrong) reports that "the form currently provides examples on how much it might cost a patient to get treated for Type 2 diabetes, as well as a normal delivery of a baby." However, "the final draft removed a section providing an example on how much it would cost a patient to be treated for breast cancer, bowing to arguments made by the lobby group America's Health Insurance Plans that the condition was too complex to be easily summarized."

The Wall Street Journal (2/10, Radnofsky, Subscription Publication) reports that the deadline for insurance companies to produce the documents and make them available to consumers is Sept. 23. The Journal also adds that while employers and insurance providers say the requirement may be expensive and could lead to confusion, it is popular with consumers. Given the pre-election deadline and the popularity of the provision, the Journal notes that Democratic candidates may tout it on the campaign trail.

CQ (2/10, Bunis, Subscription Publication) reports, "On a conference call with reporters Thursday, Steve Larsen, head of the Office of Consumer Information and Insurance Oversight, said that the new effective date would still be in time for most consumers to review the summaries before they had to make decisions about their health insurance for 2013 and that there would be enough time to get the materials ready."

In a story carried by more than 140 news sources, the AP (2/10, Alonso-Zaldivar) quotes Medicare chief Marilyn Tavenner, who said, "If an insurance plan offers substandard coverage in some area, they won't be able to hide it in dozens of pages of text." The piece notes that "one shortcoming is that the summaries won't include premiums" because "administration officials said they ran into logistical problems trying to do that," although "premiums should be easily available anyway, either from their employer or directly from a health plan."

Modern Healthcare (2/10, Subscription Publication) reports, "the disclosure requirements, mandated by the Patient Protection and Affordable Care Act, aim to simplify consumer comparisons of various insurance plans, which have used marketing materials to sometimes obfuscate their details, according to HHS officials." Modern Healthcare also points out that during "a call with reporters," Tavenner said, "Markets work best when people have the information they need to make informed decisions."

UnitedHealth To Base Physician Payments On Quality Of Care.

Bloomberg News (2/10, Frier, Armstrong) reports, "UnitedHealth Group Inc. (UNH), the largest US health insurer by sales, will pay doctors based on the quality of their care in a cost-cutting effort that also benefits the company's consulting business." The insurer "expects to save twice as much as it would spend on incentive payments for doctors because patients will be healthier, according to company documents forwarded by spokeswoman Cheryl Randolph." This "program may cover as much as 70 percent of the insurer's commercial members by 2015, from less than 2 percent now, the company said."

February 09-2012
Insurers Increasingly Basing Out-Of-Network Reimbursements On Medicare Rates.
USA Today /Kaiser Health News (2/9, Appleby) discusses "a new twist" to the cost of out-of-network healthcare: "a growing number of insurers have changed the way they calculate reimbursements to shift more of the expense to patients. Now, instead of paying a percentage of the 'usual and customary' charges from physicians and other providers, insurers are basing reimbursements on a percentage of what Medicare pays, which can be much less." Insurers argue that "the new approach offers greater consistency and thwarts efforts to game the system," citing cases "'where 98% of the physicians would charge $5,000, but some outlier would decide to charge $50,000,' which would drive up the average."

February 08-2012

Court: Social Security Beneficiaries Cannot Reject Right To Medicare Benefits.

The Hill (2/8, Pecquet) reports in its "Healthwatch" blog, "Americans who are eligible for Medicare benefits can't give them up, a federal appeals court ruled Tuesday. The unusual case was brought by five people who would prefer not to be on Medicare because their private insurer limits hospital coverage for customers who are entitled to the government health program." The plaintiffs, "who include former House Majority Leader Dick Armey (R-Texas), sued to stop their automatic enrollment into Medicare," but the court explained in its decision that the plaintiffs "seek a legal declaration that Medicare Part A benefits cannot be paid on their behalf" and concluded that the law "does not provide a mechanism for beneficiaries to opt out."

The AP (2/8) reports, "'We understand plaintiffs' frustration with their insurance situation and appreciate their desire for better private insurance coverage,' Judge Brett Kavanaugh wrote in a majority opinion joined by Douglas Ginsburg, both Republican appointees. But they agreed with the Obama administration that the law says those over age 65 who enroll in Social Security are automatically entitled to Medicare Part A, which covers services including hospital, nursing home care, hospice and home health care." Meanwhile, attorney Kent Brown, "who argued the case for the plaintiffs, says they want to keep their Social Security because they believe they earned it, but none of them want Medicare Part A," and he vowed to appeal the ruling, calling it "outrageous" and contending that it was never intended by Congress to be unable to "decline Medicare Part A and not opt out of Social Security."

Survey Finds Economic Disparities Underlying Insurance Coverage Gaps.

The Washington Post (2/8, Kliff) "Ezra Klein's Wonkblog" reports, "The Commonwealth Fund is out today with a new report on the economic disparities that underlie gaps in insurance coverage in the United States. It finds that the majority of 'low-income' families -- those making less than $29,726, or 133 percent of the Federal Poverty Line, spent some time uninsured in the past year. That figure drops to 12 percent among those earning $89,400, or 400 percent of FPL."

MedPage Today (2/8, Walker) reports, "The survey also found that adults in low-earning families without insurance often lack recommended preventive health screenings. Just 10% of low-income uninsured adults over the age of 50 had received the recommended screening for colon cancer, just one-third of low-income uninsured women ages 40 to 64 had received a mammogram, and just one-third of adults with low and moderate incomes had had their cholesterol checked in the past five years."

Insured, Poor Adults May Still Often Use Emergency Department Instead Of Primary Care. CQ (2/8, Bristol, Subscription Publication) reports, "While expanded coverage under the health care overhaul will increase health care access, primary care improvements will still be necessary to make sure people can see a medical provider in a timely way instead of relying on a hospital emergency room, findings from a Tuesday Commonwealth Fund survey indicate." Research showed that "44 percent of adults with incomes under 133 percent of the federal poverty line, with or without insurance, said they went to an emergency room during the evening or on weekends, compared with 23 percent of adults with incomes above 400 percent of poverty." The authors concluded that "income-related differences in people's ability to access care may continue even after insurance enrollment is increased," and that "bolstering the primary health care system, in particular, the large expansion and resources for community health centers" may improve access to care.

February 07-2012

States, Business Group Urge Supreme Court To Strike Down Healthcare Mandate.

The Hill (2/7, Baker) reports in its "Healthwatch" blog, "The opponents of President Obama's healthcare law told the Supreme Court on Monday that upholding the law's individual mandate would mark a 'revolution' in government power." The Hill continues, "Twenty-six state attorneys general and the National Federation of Independent Business filed briefs with the high court Monday on the central question of whether the mandate is constitutional. The Obama administration filed its merits brief on the mandate last month."

The Washington Times (2/7, Cunningham) reports, "In a brief filed with the court, the National Federation of Independent Businesses charged that the law essentially forces citizens to subsidize insurance companies that must provide far-broader coverage than under previous rules. 'The mandate is an unprecedented and draconian regulation that fails to accommodate the states' traditional regulatory role and compels individuals to subsidize legal strangers through economically disadvantageous contracts,' the business federation said in its brief." Also covering the story are Reuters (2/7), CQ (2/7, Norman, Subscription Publication), and another CQ (2/7, Norman, Subscription Publication) article.

House Democrats Question States' Role In Determining "Essential Health Benefits."

The Hill (2/7, Pecquet) reports in its "Healthwatch" blog that House Democrats, in a letter to HHS Secretary Kathleen Sebelius, said that "the Obama administration risks giving insurers too much power to determine Americans' healthcare benefits if it turns that decision over to the states." They "are concerned that too much flexibility could provide 'even further discretion to insurers.'"

Columnist Says Supreme Court Must Tackle Insurance Mandate.

David Lazarus writes in his column for the Los Angeles Times (2/7), noting that the healthcare reform "law includes a provision halting insurers' practice of denying coverage to anyone deemed to represent a greater financial risk because of a past or present medical condition." Lazarus adds, "But to prevent people from simply waiting until they get sick before buying insurance, the law also requires nearly everyone to join the risk pool by purchasing at least a minimum amount of coverage. ... But Republican attorneys general at the state level have objected to the so-called mandate, arguing that Congress lacks the authority to impose such a requirement on a nationwide basis. That's a key question the Supreme Court must tackle."

February 06-2012
Bill Would Exempt Insurance Agents, Broker Commissions From MLR Calculations.
CQ (2/4, Subscription Publication) reported, "Sen. Mary L. Landrieu, D-La., has introduced legislation (S 2068 ) that would exempt insurance agent and broker commissions from 'medical loss ratio' (MLR) calculations under the health care law." The bill's co-sponsors are "Sens. Ben Nelson, D-Neb., Johnny Isakson, R-Ga., and Lisa Murkowski, R-Alaska."

States May Model Essential Health Benefits On Existing Small Business Plans.

CQ (2/4, Norman, Subscription Publication) reported that "during a discussion on essential health benefits sponsored by the nonpartisan Alliance for Health Reform," Christopher Koller, "the Rhode Island insurance commissioner, predicted Friday that many states may opt to use existing small-business plans in their states as models for their essential benefits packages under the health care law." Koller also predicted, "There will be a 'strong impetus to default to the small-group options because they are the ones commercial regulators know the best.'" In addition, "Janet Trautwein of the National Association of Health Underwriters, said the vast majority of insured people today are covered by large and small employers. And she said that coverage in both markets is 'extremely comprehensive,' despite fears by some that the small-business model won't be adequate."

Texas Reviewing Two Health Insurance Companies' Rate Increases.

The Austin (TX) American-Statesman (2/6, Eaton) reports, "Under the 2010 federal health care reform law, Texas is reviewing medical insurance companies' rate increases of at least 10 percent to determine whether they are justified, but even if reviewers find a problem, they have no way of heading it off or even letting the public know about it. ... John Greeley," a spokesman for the Texas Department of Insurance, "said in a statement Friday that the agency is developing a process to provide consumers with information about rate increases." Two increases under review are Trustmark Life Insurance and the Connecticut General Life Insurance Company, which would affect 8,201 and two Texans, respectively, "according to the US Department of Health and Human Services."

CMS Anti-Fraud Program To Begin In June.

Modern Healthcare (2/4, Daly, Subscription Publication) reported, "Two CMS anti-fraud programs, whose Jan. 1 launch was scrubbed because of provider concerns, will start in June instead, according to the agency." The piece adds, "A pilot program to require prior authorization for scooters and power wheelchairs prescribed for Medicare beneficiaries was supposed to launch Jan. 1, but the CMS announced shortly before the scheduled start date that it was temporarily suspending the program." CMS "agency announced that a 'significantly' redesigned version of the program will launch in seven states-including several with the largest Medicare populations and highest rates of erroneous billing-on June 1."

February 03-2012

GOP Asks AARP For Specific Medicare Reform Proposals.

A letter sent to AARP by congressional Republican physicians requesting specific Medicare reform proposals from the organization is discussed in several Capitol Hill news sources. While two sources portray the GOP lawmakers' request as an implicit criticism of AARP for its role in the Medicare debate thus far, another source suggests it engages the group with a more conciliatory tone than used in previous interactions.

CQ (2/3, Ethridge, Subscription Publication) reports, "GOP members of the House and Senate challenged AARP on Thursday to join their efforts to overhaul Medicare, as House Republicans investigate the powerful advocacy group for possible financial conflicts of interest. The 18 lawmakers -- all medical providers -- wrote to AARP chief executive A. Barry Rand that politics must be put aside in order to find ways to financially bolster Medicare, and they asked the group to identify detailed policy proposals that it would support." AARP Executive Vice President Nancy A. LeaMond "said that the group appreciated the letter and that the lobby would soon ramp up its role in the debate about the future of Medicare."

The Hill (2/3, Baker) reports in its "Healthwatch" blog that the GOP lawmakers' letter states, "Unfortunately, as long as politicians obscure the Medicare program's prognosis for political benefit and stakeholders like AARP fail to publicly challenge these political calculations by educating their membership on the structural financing challenges facing the program, a national conversation about how best to save the Medicare program will not move forward." Furthermore, the Republican doctors "said AARP should have a stronger focus on Medicare's looming insolvency," and want to know "what specific proposals -- in concrete details -- AARP would support to protect its members and the Medicare program." The Hill (2/3, Baker, Pecquet) also reports the story in another "HealthWatch" blog post.

Meanwhile, Politico Pulse (2/3, Millman, DoBias) refers to the Republican lawmakers' approach as "an olive branch" extended to AARP, noting that in April, House Republicans "lit into" the organization "for its endorsement of a popular Medicare supplemental insurance policy." Emphasizing the change in tone, Politico says that in the letter sent Thursday to AARP Chief Executive Barry Rand, Rep. Phil Gingrey (R-GA) and Sen. Tom Coburn (R-OK), both physicians, "struck a more cooperative note." Politico also links to the letter.

Human Rights Groups File Brief In Support For Healthcare Overhaul.

The Madison (WI) Times (2/3, Johnson) reports, "Last Friday, the NAACP Legal Defense Fund (LDF), the American Civil Liberties Union, and the Leadership Conference on Civil and Human Rights filed an amicus brief with the US Supreme Court expressing their support for the constitutionality of President Barack Obama's health care reform." The groups express "that they believe that the inability to obtain access to health care limits the personal liberty of people to simply live healthy lives and that it is imperative that the government work to make the lives of the people they serve better."

CMS Urged To Ensure MLR Regulations Are HSA-Compatible.

LifeHealthPro (2/3, Bell) reports, "The health savings account (HSA) community is trying to persuade the Centers for Medicare & Medicaid Services (CMS) to make the final minimum medical loss ratio (MLR) regulations friendlier to HSA-compatible health insurance plans." J. Kevin McKechnie, executive director of the HSA Council, noted that the "likely result" of not accommodating HSA-compatible insurance plans, "is a future market dominated by more expensive plans." McKechnie also emphasized that "shutting out bronze-level plans also could lead to a significant increase in the amount of subsidies the federal government would have to pay to help low-income and moderate-income consumers buy coverage through the new health insurance exchange system."

February 02-2012
Feinstein Supports Initiative To Regulate Health Premium Increases.

The Los Angeles Times (2/2, Lifsher) reports that US Sen. Dianne Feinstein (D-CA) "has come forward as the chief spokeswoman and No. 1 booster of a proposed initiative to regulate hikes in health premiums. ... The proposed ballot question is backed by the political arm of Consumer Watchdog, the Santa Monica activist group that passed California's landmark Proposition 103 automobile insurance rate control initiative in 1988." The initiative, named the Insurance Rate Public Justification and Accountability Act, "would require health insurance companies to publicly justify their rates before rate hikes take effect."

Groups Object To HHS' Essential Health Benefits Proposal.

CQ (2/2, Norman, Subscription Publication) reports, "A tide of objections and worries rolled in just before Tuesday's deadline for health groups to react to a Department of Health and Human Services proposal on essential health benefits." While "input from health interests and consumers on the benefits 'bulletin' is not being made public by the Obama administration," several "groups - including hospitals, the AARP, a business and health insurers coalition, and patient advocacy groups - are distributing their comments to the media." For example, "the Essential Health Benefits Coalition told HHS it's worried about the cost of the benefit packages for small employers and individuals under the health care law."

January 31-2012
AHA Says Essential Health Benefits Proposal Doesn't Ensure Comprehensive Package.
CQ (1/31, Norman, Subscription Publication) reports, "The American Hospital Association says that a federal proposal on essential health benefits tilts too far in favor of affordability for consumers, rather than ensuring a comprehensive package of benefits." In a letter to Health and Human Services officials, the hospitals say, "What is missing is an approach that matches the individual's needs for a range of services grounded in evidence-based guidelines."

January 30-2012
HHS Rejects Texas Request For Waiver.

The AP (1/28, Tomlinson) reports HHS "rejected a request by Texas to be excluded from a new law that limits how much health insurance companies can spend on overhead." HHS officials said Texas "did not prove that the state's insurance market would be destabilized by the new law. As a result, Texas health insurers will likely pay out $476 million in rebates over the next three years, said Gary Cohen, acting director of oversight at the agency."

The Austin (TX) American Statesman (1/30, Lindell) reports that officials with the Texas Department of Insurance "said the decision places an undue burden on insurers, particularly small and midsize firms that may have to write fewer policies or leave the individual market altogether." In turn, "consumer groups praised the federal ruling, saying an estimated $160 million will have to be repaid this summer."

The Fort Worth Star Telegram (1/30, Fuquay) reports, "The amount of money actually refunded will depend on 2011 results, which have not been reported." Bloomberg News (1/30, Wayne), CQ (1/30, Norman, Subscription Publication), and The Hill (1/30, Baker) "Healthwatch" blog also report this story.

DOJ Says SCOTUS Need Not Toss Out Entire Healthcare Law.

Politico (1/28, Haberkorn) reports Justice Department lawyers wrote in a brief to the Supreme Court "that if the justices rule that the health reform law's mandate is unconstitutional, they don't need to get rid of the entire law." Just "two provisions -- those requiring insurers to accept everyone regardless of health status and to apply 'community rates' -- must go if the mandate is knocked down," DOJ attorneys argued. They wrote, "Other provisions can operate independently and would still advance Congress's core goals of expanding coverage, improving public health and controlling costs even if the minimum coverage provision were held unconstitutional."

Reuters (1/30) quotes Karen Harned of the National Federation of Independent Business, who responded that the entire law still must go. She said, "To argue otherwise would be like arguing a house can stand after its foundation has crumbled." CQ (1/30, Norman, Subscription Publication) also reports this story.

Americans Would Like It to Find the Mandate Unconstitutional
This month’s Kaiser Family Foundation poll on health reform focused on the upcoming Supreme Court case of NFIB v. Sebelius. According to the latest survey, the requirement that everyone obtain health insurance or pay a fine continues to be unpopular. This month's poll finds the public more than twice as likely to have an unfavorable rather than favorable view of the provision (67% to 30%), very much in line with findings of previous Kaiser polls. Read More

 

January 27-2012

AMA Calls For Halt To Insurance Codes Switch.

The Hill (1/27, Pecquet) reports in its "Healthwatch" blog that the American Medical Association "has sent House Speaker John Boehner (R-Ohio) a letter urging him to halt a federal requirement forcing doctors to switch to new insurance codes in 2013," as it "will require doctors' offices to deal with some 68,000 codes, more than five times the current 13,000," and "cost medical practices anywhere between $83,290 and more than $2.7 million, depending on size." AMA CEO James Madara writes that the move will "create significant burdens on the practice of medicine with no direct benefit to individual patient care."

Modern Healthcare (1/27, Conn, Subscription Publication) reports that in Madara's letter, he said that "the timing of the transition 'could not be worse as many physicians are currently spending significant time and resources implementing electronic health records (EHR) into their practices.'" In addition, he "said more needs to be done to synchronize three key federal health information technology programs: those pertaining to electronic prescribing, the meaningful use of EHR systems and the physician quality reporting system." Health Data Management (1/27) also reports this story.

Poll Shows Most Americans Think Individual Mandate Will Be Struck Down.

Sarah Kliff writes in the Washington Post (1/27) "Wonkblog" that most Americans "expect" the US Supreme Court to rule against the Affordable Care Act's provision requiring people to purchase health insurance, according to a new Kaiser Family Foundation poll released yesterday. Less than a third of respondents think that piece of the legislation will be upheld, "and that number drops to 17 percent when individuals are asked about how they would personally rule on the issue," Kliff writes.

Politico (1/27, Nather) reports the poll indicates the American public wants to keep the law in place, but lose the individual mandate. "The survey found that 54 percent of Americans want the Supreme Court to get rid of the requirement that nearly all Americans buy health insurance. But only 40 percent want the law to be repealed completely or replaced with a Republican alternative."

CQ (1/27, Subscription Publication) reports "the pessimistic outlook on the court decision on the individual mandate, combined with continuing lackluster approval ratings for the overall law, would seem to show that in the nearly two years since the law was passed the Obama administration has stopped short of closing the sale when it comes to a sweeping plan for changing the nation's health care system."

The Wall Street Journal (1/27, Radnofsky) reports the poll could shape the upcoming Republican primary and presidential elections. The Journal notes that GOP disapproval of the law is more intense than Democratic support for it. The poll found that 57 percent of Republicans hold a very unfavorable view of the legislation, while only 35 percent of Democrats said their view was very favorable. According to the Journal, the poll also found that a plurality of Republican voters don't view the state healthcare legislation passed by former Massachusetts Gov. Mitt Romney as being too similar to the 2010 Federal law. Thirty percent of Republicans said they thought Romney's position on healthcare is similar or very similar to President Obama's; 49 percent said the two positions are different or very different.

January 26-2012

NAHU Official Expects Landrieu To Author Medical Loss Ratio Legislation.

CQ (1/26, Reichard, Subscription Publication) reports, "Health insurance industry sources said Wednesday they expect Sen. Mary L. Landrieu of Louisiana to be the prime author of the Senate version of legislation that would exempt insurance agent and broker commissions from 'medical loss ratio' calculations under the health care law." Citing the National Association of Health Underwriters (NAHU) annual meeting, the piece notes that one NAHU official "said Landrieu would be joining with fellow Democratic Sen. Ben Nelson of Nebraska and Republican Sen. Johnny Isakson of Georgia in sponsoring the bill."

LifeHealthPro (1/26, Postal) reports, "NAHU CEO Janet Trautwein said "that the bill that will be introduced in the Senate" and "will have Sen. Mary Landrieu, D-La., Sen. Ben Nelson, D-Neb., and Sen. Johnny Isakson, R-Ga., as sponsors." John Greene, NAHU vice president of congressional affairs, said the Senate bill will have several changes from the legislation exempting agent commissions from the MLR as introduced in the House as H.R. 1206."

NAHU Conference Touches On Prevention, Healthcare Cost Drivers. LifeHealthPro (1/25, Festa) reports, "At the National Association of Health Underwriters Capitol Hill conference discussion on keeping health care cost affordable Tuesday morning, one of the recurrent themes was preventive care, not squeezing coverage or limiting access." Dr. Mark McClellan, Senior Fellow in Economic Studies and chair in health policy studies at the Brookings Institution, "talked about efforts to stay healthier and have government services concentrate on preventive services, noting the efficacy of a pilot program to prevent diabetes with a program to start tracking blood sugar, and the like." Meanwhile, "Bill Hoagland, public policy and government affairs director of Cigna, noted that there are many costs driving higher health costs, but half of it is driven by technology." Hoagland added that Medicare and Medicaid "are the biggest single fiscal issue in America."

GOP To Present Healthcare Reform Law Alternative After Supreme Court Ruling.

Politico (1/26, Haberkorn) reports that House Energy and Commerce health subcommittee chairman Joe Pitts (R-PA) "said GOP lawmakers will put forward an alternative to the health care reform law after the Supreme Court rules on the constitutionality of the law." He "pointed to several health policy ideas that Republicans have routinely supported that are likely to be in the plan, such as giving the tax break for health insurance to the employee instead of the employer, medical liability reform, creating high-risk medical 'pools' and allowing insurers to sell their products across state lines."

The Washington Times (1/26, Cunningham) quotes Pitts, who said, "We'll have a window of opportunity, with everyone looking, to explain that the Affordable Care Act is not fully implemented yet. A lot of people think it is already. They don't know what's coming." The Hill (1/26, Baker) "Healthwatch" blog also reports on the GOP plan.

Panel To Address FDA, Medicare Issues. In previewing other panel topics to be addressed this year, CQ (1/26, Subscription Publication) reports, "The panel has already scheduled three hearings in February on reauthorizing the law (PL 110-85) that helps fund the Food and Drug Administration's review process for drugs and medical devices." Meanwhile, "as for the perennial issue of scheduled cuts to Medicare reimbursement rates for physicians, Pitts said his subcommittee would explore permanently replacing the sustainable growth rate formula, which dictates the cuts, and how to pay for it." The panel also "plans to act on legislation regarding conscience clauses within the health care overhaul."

Consumer Groups Support Requirement For Simple Health Plan Summaries.

The AP (1/26, Alonso-Zaldivar) reports, "Consumer groups are scrambling to salvage a popular provision of President Barack Obama's health care overhaul that suddenly seems to be in question." The measure is "a requirement that health plans provide simple, standard summaries of coverage and costs to help consumers pick benefits that are right for them." Supporters "say they fear the administration may heed industry complaints that the regulation as proposed last summer is too costly, burdensome and intrusive." Among the groups supporting the measure are the American Diabetes Association, the American Cancer Society, the American Heart Association, AARP and Consumers Union. In response to a letter from those groups, "administration officials said they can't comment on the specifics of regulations under review, but they sought to reassure the consumer groups."

The Hill (1/26, Pecquet) reports in its "Healthwatch" blog, "Groups representing seniors and consumers are urging the Obama administration to stick with the healthcare law's tough requirements for health plans to disclose coverage information to consumers." Specifically, "the groups wrote in a letter to the president, the final regulation should" be "be implemented as soon as possible," apply "to all plans in all markets," require "plans to give multiple coverage examples," and "include premium information." The letter was signed by AARP, Union, the American Heart Association, the American Diabetes Association and the American Cancer Society.

January 25-2012

Gallup Data Show Increase In Number Of Uninsured Adults.

The Hill (1/25, Baker) reports in its "Healthwatch" blog on Gallup data that shows "the number of uninsured adults has risen steadily during the Obama administration," which Republicans used "to argue that his healthcare law has failed." But, "Tuesday's Gallup figures also show that the law has helped more young adults gain access to coverage," which "Gallup attributed...to a provision in the healthcare law, already in effect, that allows children to stay on their parents' healthcare plans through age 26."

CQ (1/25, Adams, Subscription Publication) reports that in a news release, House Ways and Means Chairman Dave Camp (R-MI) said, "Add this to the bad news that health insurance premiums continue to rise and the looming threat of an unconstitutional mandate to purchase coverage Americans can't afford, and you have to wonder, was this the 'change' America was hoping for? Probably not." Rep. Pete Stark (D-CA) responded, "Thanks to my Republican colleagues on Ways and Means for accidentally making our case for health reform." Stark noted that several ACA provisions will take effect in 2014. Politico (1/25, Tau) also reports this story.

January 24-2012

Study: States With Least Progress On Exchanges To Gain Most From ACA.

CQ (1/24, Norman, Subscription Publication) reports on an Urban Institute study, which found that "the uninsured residents in the 15 states that have made the least progress in setting up health benefit exchanges are the ones with the most to gain under the benefits of the health care overhaul." The study notes that these states "will gain the most from the Medicaid expansion and will receive the most federal subsidy dollars per capita."

SCOTUS Will Not Hear Arguments On Kagan's Healthcare Challenge Recusal.

The AP (1/24) reports that the Supreme Court "won't hear arguments from a conservative watchdog group that wants Justice Elena Kagan disqualified from deciding the constitutionality of President Barack Obama's national health care overhaul. Freedom Watch asked the high court for time to demand Kagan's recusal or disqualification during arguments on the Patient Protection and Affordable Care Act."

Politico (1/24, Haberkorn) reports, "Freedom Watch, a group led by Larry Klayman, asked the court for permission to file a brief on Kagan's participation in the case. The court on Monday denied the request without comment, though it did note that Kagan did not participate in the discussion."

The Hill (1/24, Baker) reports in its "Healthwatch" blog, "Her absence from Monday's order does not indicate that Kagan is likely to heed calls for her recusal. She has taken part in all of the procedural decisions related to the healthcare challenge itself. Conservative groups say Kagan should sit out the case because she led the office that began preparing the Obama administration's healthcare defense before she was tapped for the high court."

Experimental Treatments Often Not Covered By Insurers.

Reuters (1/24, Stroud) discusses patients running into insurance companies being unwilling to pay for experimental treatments. Hastings Center research scholar Dr. Michael K. Gusmano pointed out that sometimes, experimental drugs come at huge cost but for a small benefit. However, Dr. Nancy Berlinger at the Hastings Center pointed out that extending a life by six months may be valuable for the individual. Barby Ingle, who was denied coverage for radiofrequency ablations to treat Reflex Sympathetic Dystrophy, argues that companies should not be allowed to refuse paying for FDA-approved treatments.

Columnist Expresses Approval, Concern For "Wellness" Incentives In Health Insurance.

Columnist Beth Kassab writes in the Orlando Sentinel (1/24), "Employers are trying to lower their soaring health-care costs, and wellness is the industry's favorite new antidote." Kassab predicts, "more and more companies are laying the groundwork to eventually charge people who are fit and healthy less for health insurance than those who are obese or have unhealthy blood pressure" and writes in approval, asking, "Why should a person who eats right, exercises, doesn't smoke and rarely visits the doctor pay as much as a person who has a two-pack-a-day habit, has Type 2 diabetes and is constantly seeing a doctor?" However, Kassab has some "reservations," such as whether there will still be protection for genetic information, under the Genetic Information Nondiscrimination Act which currently "prohibits employers from firing us, or insurance companies from dumping us, because we are genetically predisposed to cancer."

January 23-2012

Some Small Insurers Concerned About Increased Scrutiny From HHS.

The Chicago Tribune (1/21, Frost) reports, "A week after the Obama administration slapped Lake Forest-based Trustmark Life Insurance Co. for what it called an 'excessive' rate increase, small insurers like United Security fear they may be the next in line for a public shaming." Some "critics say the administration's stepped-up reviews and heightened scrutiny are more about showcasing the value of the new health law in the run-up to the 2012 elections, a charge the Department of Health and Human Services denies." Meanwhile, "some small insurers and industry observers also complain that the added scrutiny could be harmful for small and midsize carriers." The piece cites HHS Secretary Kathleen Sebelius' press release regarding Trustmark.

Obama To Take Different Tone On Healthcare In State Of The Union.

President Obama is expected to "adopt a much different tone" on the issue of healthcare reform in his State of the Union Address on Tuesday, after offering to work with Republicans to revamp the healthcare reform law, The Hill (1/23, Pecquet) reports in its "Healthwatch" blog. While it is "unclear how much Obama will address healthcare reform" in the address, the "battle lines this year are even more sharply drawn ahead of the Supreme Court's ruling on the law's constitutionality." An Administration official "declined to discuss the contents of Obama's speech on Tuesday, but said, 'We've worked diligently to implement the Affordable Care Act and we're making incredible progress. Thanks to the new law, 2.5 million more young adults have health insurance, millions of seniors have cheaper prescription drugs and we've ended the worst insurance company abuses."

January 20-2012

Siegel: Doctors Becoming "Wary" Of Healthcare Reform Law.

In USA Today (1/19), Marc Siegel, an associate professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center, writes, "The final verdict may not be in yet, but some of the early returns on 'ObamaCare' are not good. Indeed, many doctors are becoming wary of the law at a time when only one in three Americans support it." Siegel argues, "We're two years into this experiment, and the realities of the law - more regulations, more patients with low-paying insurance, higher costs but lower payments to doctors - are sinking in."

 

January 19-2012

Report: More Than Half Of States Taking Steps Toward Establishing Exchanges.

Bloomberg News (1/19, Wayne) reports that a Department of Health and Human Services report has found that "more than half of US states have taken steps to create marketplaces for selling health coverage to the uninsured required under the 2010 health-care law." Specifically, "Fourteen states and the District of Columbia have enacted legislation or executive orders creating so-called insurance exchanges," while "another 14 have indicated they plan to follow suit."

The AP (1/19, Alonso-Zaldivar) reports that even though the "healthcare overhaul is on track in many states," the Administration is said to be "preparing a federal backstop anyway for states in which opposition to the new law has blocked planning." On the White House blog, deputy chief of staff Nancy-Ann DeParle wrote, "No matter where you live, on Jan. 1, 2014, an exchange will be up and running."

The Washington Post (1/19, Kliff) reports in its "Wonkblog" that "the Obama administration has spent $729 million laying the groundwork for health insurance exchanges," and "that number will likely tip over $1 billion in the coming months, as states continue setting up the new marketplaces where Americans will shop for health insurance beginning in 2014."

CQ (1/19, Norman, Subscription Publication) adds, "The report also gives a rundown on how the government is moving ahead with the federally facilitated exchanges," and "it promises that HHS has the capacity to ensure that every American will be able to purchase health insurance as of Jan. 1, 2014, and points out that HHS last fall issued contracts for information technology, financial management and marketing." Also reporting this story are the Wall Street Journal (1/19, Radnofsky) "Washington Wire" blog, The Hill (1/19, Pecquet) "Healthwatch" blog, the Las Vegas Sun (1/19, Demirjian), the Reading (PA) Eagle (1/19, Kelly), the Pittsburgh Post-Gazette (1/19, Toland), the Detroit Free Press (1/19, Anstett), the South Florida Sun-Sentinel (1/19, Gibson), Reuters (1/19) and Modern Healthcare (1/19, Lee, Subscription Publication).

Walker To Return Federal Healthcare Exchange Grant. The AP (1/19) reports Wisconsin Gov. Scott Walker said his state "will turn down $37 million from the federal government that had been awarded to help implement health care exchanges" through a Early Innovator Grant, arguing "it didn't make sense to commit to reforms that could have a devastating economic impact." In response, "the American Cancer Society called the Republican governor's action a move backward" and state Rep. Sandy Pasch "accused Walker of playing politics 'with the health of our communities.'"

Milwaukee (WI) Journal Sentinel (1/19, Stein) reports Walker's move follows "sustained criticism of Walker by conservatives who oppose the health law passed by President Barack Obama and Congress in 2010." Walker previously "said that he wanted the state to develop its own plan for the marketplace so Wisconsin would have more control over how the law is implemented."

The Milwaukee (WI) Business Journal (1/19, Hess) adds Walker said he plans to "repeal the executive order that created the Office of Free Market Health Care created by Gov. Jim Doyle."

Minnesota Task Force Debates Exchange Principles. The Minneapolis Star Tribune (1/19, Crosby) reports, "A 13-member government task force on Wednesday debated a list of basic principles for a Minnesota health care exchange, highlighting strongly divergent views about the role health insurance plans and brokers should play." The piece notes, "Industry representatives argued that their expertise in health care will bring efficiencies to the process, while community-based panel members worried about conflicts of interest and leaving out consumers and marginalized communities."

Siegel: Doctors Becoming "Wary" Of Healthcare Reform Law.

In USA Today (1/19), Marc Siegel, an associate professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center, writes, "The final verdict may not be in yet, but some of the early returns on 'ObamaCare' are not good. Indeed, many doctors are becoming wary of the law at a time when only one in three Americans support it." Siegel argues, "We're two years into this experiment, and the realities of the law - more regulations, more patients with low-paying insurance, higher costs but lower payments to doctors - are sinking in."

 

January 18-2012

Thomson Reuters Releases List Of Top US Health Systems.

Healthcare IT News (1/18, Bouchard) reports, "The top healthcare systems in the United States have lower 30-day mortality rates finds Thomson Reuters' fourth annual study naming the top 15 health systems in the country. The measures used to score the top systems are underpinned by health information technology." The list, "released Jan. 16, singles out those hospital health systems that have achieved superior clinical outcomes."

The Windsor (CO) Beacon (1/18) reports that the "researchers looked at eight areas including mortality, medical complications, patient safety and average length of stay." The article points out that "Banner Health and Poudre Valley Health System were named to" the list.

The Asheville (NC) Citizen-Times (1/18) reports, "Mission Health has been named among the top 15 health systems in the US in the annual study done by Thomson Reuters."

The Carrollton (GA) Times-Georgian (1/18, Jones) reports that "Tanner Health System has been named one of the 15 Top Health Systems in the nation," according to the Thomson Reuters list.

Supreme Court Cases Could Transform Medicaid.

Politico (1/18, Feder) reports, "Two cases before the Supreme Court have the potential to effectively do what Republican lawmakers have tried and failed: transform Medicaid into a block grant program for states with few enforceable federal rules about how they provide health coverage for the poor." For example, a case "arising from a dispute over California Medicaid payment rates to health care providers, could give states even more latitude to run their programs by limiting individuals' right to argue in court that a state Medicaid policy violates federal law." The piece notes, "The Obama administration shocked advocates for Medicaid beneficiaries and Democrats on Capitol Hill by filing an amicus brief backing California's claim that patients and doctors have no right to sue over its pay rates. ... The president ultimately endorsed that position despite a lobbying campaign by Health and Human Services Secretary Kathleen Sebelius, according to Capitol Hill and advocates involved in the effort."

States Using High-Risk Pool Funding More Quickly Than Anticipated.

CQ (1/18, Adams, Subscription Publication) questions whether giving "more money to states that are close to exhausting their allocations" for high-risk pool programs will cause other states "to lose some funding." Brian Chiglinksy, a spokesman for the federal Center for Consumer Information and Insurance Oversight, remarked, "This is an ongoing process and we continue to work with other states to meet their needs. We will adjust each state's yearly allotment as necessary." CQ notes that "the reason why some states are using their funding more quickly than expected is largely due to higher medical costs than anticipated."

January 17-2012

Election May Impact Healthcare Law More Than High Court.

Politico (1/16, Haberkorn) reported that November's election will have a larger impact on President Obama's healthcare law than the Supreme Court. While the court is expected to issue a decision on the law at the end of its term, "most legal observers doubt that it will strike down the whole of the Affordable Care Act, even if it finds the mandate unconstitutional." Rather, most analysts "say that if the court strikes down anything, it would either get rid of the mandate alone or, at most, the mandate with some of the insurance industry reforms and regulations." Meanwhile, all of the Republican presidential candidates "are all on record as promising to scrap the whole thing."

CMS Moves Closer To Sunshine Provisions In ACA.

The New York Times (1/17, A1, Pear, Subscription Publication) reports on its front page, "To head off medical conflicts of interest, the Obama administration is poised to require drug companies to disclose the payments they make to doctors for research, consulting, speaking, travel and entertainment." According to "the new standards, if a company has just one product covered by Medicare or Medicaid, it will have to disclose all its payments to doctors other than its own employees." The Times noted that "the new requirements, or something very similar, will take effect soon; in fact, they are overdue."

MedPage Today (1/16, Walker) reported, "As reported last year by MedPage Today and again Monday by the New York Times, the 'Physician Payment Sunshine' provisions of the Affordable Care Act (ACA), require that drug, medical device, biologic, and medical equipment manufacturers that produce any products covered by Medicare or Medicaid or the Children's Health Insurance Program must report all payments made to doctors and hospitals." The pieced added, "The government will post the financial relationship information on a public website where patients and anyone else can check what ties to the medical industry a given doctor has. The Centers for Medicare and Medicaid Services will accept comments on the proposal until Feb. 17, 2012, and will respond to them in a final rule to be published later this year."

January 13-2012
Sebelius Orders Health Insurer To Justify Rate Increases.

The New York Times (1/13, A11, Pear, Subscription Publication) reports, "The Obama administration said Thursday that rate increases sought by" Trustmark Life Insurance Company "were unreasonable, and it ordered the insurer to rescind them or justify its refusal to do so." HHS Secretary Kathleen Sebelius "issued the finding against the carrier" and "said that 'the excessive rate increases' would affect nearly 10,000 people in Alabama, Arizona, Pennsylvania, Virginia and Wyoming." The Times notes, "The action fits in with White House efforts to demonstrate the value of the new health care law and to portray President Obama as fighting for the economic interests of middle-class families in this election year."

The Norfolk (VA) Virginian-Pilot (1/13, Jeter) reports, "In Virginia, 766 people will be affected by the Trustmark rate increase, which went into effect for renewals after Sept. 1, according to healthcare.gov, a website managed by the US Department of Health and Human Services. Members are required to pay an additional $48 a month, for a total monthly rate of $421."

Bloomberg News (1/13, Wayne) quotes Sebelius, who said, "It's time for Trustmark to immediately rescind the rates, issue refunds to consumers or publicly explain their refusal to do so." The company responded, "As a smaller carrier, our loss ratios can vary significantly from year-to-year, and we take that volatility into consideration."

CQ (1/13, Norman, Subscription Publication) reports that "Sebelius said in a blog post on the White House website that the action against Trustmark shows how the health care law is working." She wrote, "Thanks to health reform, if your insurance company wants to hit your wallet with a major increase, they have to tell you why. And if you don't like what they have to say, you can take your business elsewhere."

Kaiser Health News (1/13, Carey) quotes Trustmark spokesman Patton Hollow, who "said company officials 'respectfully disagree' with the government's 'assumptions and conclusions,' and would go ahead with the rate hikes." He "added that the company 'will continue to be in compliance with all aspects' of the health law."

The AP (1/13) includes the news release of the announcement. Also covering the story are the Washington Times (1/13, Cunningham), the Pittsburgh Tribune-Review (1/13, Nixon), and The Hill (1/13, Baker) "Healthwatch" blog.

January 12-2012
Report Shows 1% Of Americans Account For 22% Of Healthcare Costs.

USA Today (1/12, Kennedy) reports on an Agency for Healthcare Research and Quality report, which found that "just 1% of Americans accounted for 22% of health care costs in 2009." Meanwhile, "Five percent accounted for 50% of health care costs, about $36,000 each, the report said." Lead author Steven Cohen noted that "the report's findings can be used to predict which consumers are most likely to drive up health care costs and determine the best ways to save money."

NYT: Healthcare Reform Law Has Had Little Impact On Total Spending. The New York Times (1/12, A26, Subscription Publication) editorializes, "So far, the health care reform law has had little impact on total spending even though some of its provisions, like prescription drug rebates for Medicare beneficiaries, have already kicked in," and "the real impact will come in 2014 when there will be an expansion of Medicaid and a new federal subsidy program for low- and middle-income Americans." The Times argues that "as the population ages, controlling spending will require reforms that coordinate delivery of services, reduce unnecessary care and spur innovations that improve quality and curb medical costs."

Government Healthcare Spending Growing. The Washington Post (1/12, Kliff) reports in its "Wonkblog" that government spending on healthcare has not slowed. "A new analysis from the McKinsey Center for US Health System Reform shows that state and federal spending on health care has grown by 55 percent since 2003, nearly twice as fast as private spending growth." The Post notes, "The overall health care spending slowdown actually masks two divergent trends - one, private health care spending accounts for an increasingly smaller chunk of the $2.6 trillion that the United States spends on health care, and two, government programs foot a larger part of the tab."

Medicare Plans Offering Fitness Memberships To Draw Healthier Patients.

Bloomberg News (1/12, Frier) reports that "UnitedHealth Group Inc. (UNH) and Humana Inc. (HUM) are among insurers offering fitness memberships with their Medicare programs as a way to draw healthier and less costly patients, said a report in the New England Journal of Medicine." What's more, "35.3 percent of new enrollees in a fitness membership benefit plan reported 'excellent' or 'very good' health, compared with 29.1 percent in the group without the benefit." Researchers expressed concern that "in doing so, the companies may try to 'cherry pick' members who are more likely to be healthy using the fitness memberships." A spokesperson for Cigna, which "has a Medicare Advantage HMO plan in Arizona that offers a program that reimburses $200 for fitness classes," countered that the goal is to help patients "improve their health, well-being and sense of security." The study was funded by the National Institute on Aging.

NAIFA President: Health Law's MLR Provision Hurting Insurance Agents, Consumers.

In a Christian Science Monitor (1/12, Miller) op-ed, Robert Miller, president of the National Association of Insurance and Financial Advisors (NAIFA), writes that the federal health law's "medical loss ratio (MLR) provision" has "had the effect of radically reducing what health insurance agents earn. That, in turn as greatly restricted their ability to help million of Americans navigate the maze of approvals needed for medical procedures and processing claims." Miller concludes, "Treating agents' compensation as a pass-through item and thereby removing it from the MLR equation would be a huge improvement and a first step toward ensuring that Americans continue to have access to the essential support and customer service that professionally trained and licensed agents provide."

January 11-2012

States Ask High Court To Overturn Medicaid Expansion.

Twenty-six states have asked the Supreme Court to overturn the healthcare reform law's mandatory expansion of the Medicaid program. Politico (1/11, Haberkorn) reports that the states argue "the federal government can't force them to expand the Medicaid program." Further, they claim the 2010 healthcare law "fundamentally changed the program" in ways states "never imagined when Congress created the voluntary Medicaid program in 1965." Politico notes that the Medicaid issue "is thought to be the toughest climb for the law's challengers." A ruling in favor of the states "could limit whether the federal government can use money as an incentive for the states to act on any issue."

Reuters (1/11, (Vicini) lists the Supreme Court cases: National Federation of Independent Business v. Sebelius, No. 11-393; U.S. Department of Health and Human Services v. Florida, No. 11-398; and Florida v. Department of Health and Human Services, No. 11-400. The Hill (1/11, Baker) "Healthwatch" blog and CQ (1/11, Norman) also report this story.

CBO: Raising Medicare Eligibility Age Could Save $148 Billion.

The National Journal (1/11, McCarthy, O'Donnell, Subscription Publication) reports that the Congressional Budget Office has announced that "the federal government could save $148 billion over 10 years by increasing Medicare eligibility two years to age 67." While "the savings may not significantly cut the budget deficit...they could pay for a program such as the 'doc fix.'"

The Hill (1/11, Baker) reports in its "Healthwatch" blog, "CBO also said the effects of raising the Medicare eligibility age would be 'less onerous' if President Obama's healthcare reform law remains in place." CQ (1/11, Reichard) also reports this story.

January 10-2012

CMS Report Analyzes Trends In US Healthcare Spending.

Many print media sources covered a CMS report showing that US healthcare spending rose 3.9 percent in 2010, the lowest in many years.

The New York Times (1/10, A16, Pear, Subscription Publication) reports, "National health spending rose a slight 3.9 percent in 2010, as Americans delayed hospital care, doctor's visits and prescription drug purchases for the second year in a row, the Obama administration reported Monday. The recession, which lasted from December 2007 to June 2009, reined in the growth of health spending as many people lost jobs, income and health insurance, the government said in a report, published in the journal Health Affairs."

According to the Los Angeles Times (1/10, McGinley), "analysts said spending was likely to pick up as the economy improved and the healthcare law passed under President Obama begins to expand coverage to millions of people now uninsured."

The National Journal (1/10, McCarthy, Quinton, Subscription Publication) reports, "Health insurance companies saw the largest increase in spending, earning a net 8.4 percent more from insurance premiums in 2010 than 2009. ... 'Premiums grew faster than benefits for the first time in seven years, and benefits grew at their slowest rate in the history of the accounts,' Anne Martin, a CMS economist, said on a conference call. Martin said this was because private health insurance companies lost enrollees as people lost jobs, people moved to cheaper health insurance plans, and cost-sharing increased."

The AP (1/10, Alonso-Zaldivar) reports that the 3.9 percent increase is "the lowest measured in 51 years," and added that "health care as a share of the economy leveled off at 17.9 percent, the first time in a decade there's been no growth."

The Miami Herald (1/10, Newspapers) reports, "Retail prescription drug spending -- the third-largest share of health spending, behind hospital care and physician and clinical services -- grew only 1.2 percent in 2010, the lowest annual growth rate ever. Along with fewer drugs consumed, the continued use of cheaper generic medications and the loss of patent protection on certain brand-name drugs drove spending downward. In addition, fewer new drugs were introduced in 2010."

CQ (1/10, Bristol, Subscription Publication) reports, "The study says the health care overhaul...had little effect on growth figures. ... The act 'had a negligible impact on total spending or shifted the distribution of spending without affecting the overall rate of growth,' the analysis says." Rather, analysts believe that "lower spending for hospital care and physician and clinical services, as well as 'record low growth' in prescription drug costs" were behind the trend.

According to HealthDay (1/10, Preidt), the report "found that federal, state and local governments paid for about 45 percent of the nation's health bill in 2010, up from 41 percent in 2007. The federal government's share of health costs rose significantly between 2007 and 2010, from 23 percent in 2007 to 29 percent in 2010," while states' and local governments' share "decreased from 18 percent to 16 percent." In contrast, "the share of the nation's health costs paid by private business declined from 25 percent in 2001 to 21 percent...in 2010," and the share "paid for by households reached a historic low of 28 percent...in 2010."

MedPage Today (1/10, Walker) points out, "Despite the sluggish growth in healthcare spending, the US spends about one-sixth of the gross domestic product (GDP) on healthcare. ... Most of the nation's overall spending on healthcare goes toward hospitals (31%), physician and clinic services (20%), and prescription drugs (10%); the spending growth in all three areas slowed in 2010." In addition, "fewer people were admitted to the hospital in 2010 than in 2009, and growth slowed for emergency room visits, outpatient visits, and outpatient surgeries." Physician office visits also declined in 2010.

Some Healthcare Reform Measures Became Effective In 2010. Modern Healthcare (1/10, Zigmond, Subscription Publication) adds, "Analysts said that while the most prominent provisions of 2010's Patient Protection and Affordable Care Act will not be implemented until 2014, there were some measures that were effective in 2010, including changes to Medicare provider rates (effective Oct. 1, 2009), the Medicare prescription drug rebate for beneficiaries in the "doughnut hole," and small-business tax credits for offering employer-sponsored insurance (effective Jan. 1, 2010). Researchers concluded that the projected net effect of the law's provisions on health spending growth in 2010 was about 0.2 percentage points, because without the law's provisions, the growth rate would have been 3.7%." Modern Healthcare also notes that "the CMS' Office of the Actuary prepares the report each year."

White House Says Results Show Healthcare Costs May Be Contained, Touts Reform. According to the Wall Street Journal (1/10, A2, Radnofsky, Subscription Publication), White House official Nancy-Ann DeParle wrote in a blog post that these statistics demonstrate that "health-care cost growth can be kept down." However, former John McCain advisor Douglas Holtz-Eakin was quoted as countering that the White House "really can't claim any credit unless it's to say, 'We broke the economy and you can thank us for that.'"

The Hill (1/10, Pecquet) "Healthwatch" blog reports, "The Obama administration on Monday cheered new evidence that the President's healthcare reform law isn't making healthcare more expensive. ... 'The report released today found no spike in health care costs due to health reform,' White House Nancy Ann DeParle deputy chief of staff wrote in a blog post. DeParle added that the law's reforms -- including anti-fraud measures, care coordination and disease prevention -- are 'helping to keep health care cost growth low.'" DeParle also "points out that the law's medical loss ratio requirement will ensure that insurers give rebates back to their customers if they collect too much in premiums."

Also covering the story are Reuters (1/10, Morgan), the NPR (1/10, Rovner) "Shots" blog, Kaiser Health News (1/10, Serafini), and Medscape (1/10, Lowes).

Special Lawyers: Postpone Healthcare Law Ruling.

CQ (1/10, Norman, Subscription Publication) reports that the Supreme Court could "allow implementation" of the healthcare law "and remove it as an issue in the presidential campaign" which, "from a policy point of view...might be preferable for those who back the law and believe it will become more popular the longer it's in place and as states move further down the path of establishing exchanges and the rest of the law's framework." But, "It could also muffle the volume of the debate over the law in the presidential and congressional campaigns if there's no final court decision on the merits of the measure to defend or attack." The piece notes that court-appointed special lawyers said "justices should indeed pursue a third way and postpone a ruling on the overhaul."

January 09-2012
HHS Says 1,231 Companies Have Received Healthcare Law Waivers.

The Hill (1/6, Baker) reports HHS said Friday that 1,231 companies "received waivers from part of the healthcare reform law. ... Friday marks the last time HHS will have to update the total number of waivers, putting to rest a recurring political firestorm. The department had been updating its waiver totals every month." The Daily Caller (1/6) says labor unions "continued to receive the overwhelming majority of waivers. ... Documents released in a classic Friday afternoon news dump show that labor unions representing 543,812 workers received waivers from President Barack Obama's signature legislation since June 17, 2011." Also covering the story are CQ (1/9, Reichard, Subscription Publication), Modern Healthcare (1/9, Daly, Subscription Publication), and McKnight's Long Term Care News (1/9).

Administration Submits Written Defense Of Healthcare Law To SCOTUS.

The AP (1/6) says the Obama Administration on Friday submitted to the US Supreme Court a written defense of the healthcare overhaul, an issue with the potential to impact President Obama's re-election. The Administration urged the high court to uphold the healthcare law, particularly the so-called individual mandate, which the filing deemed an "appropriate response to a 'crisis in the national healthcare market.'" The Administration said the healthcare requirement "falls within Congress' power under the Constitution's Commerce Clause because healthcare is an issue of supreme national importance that consumes nearly 18 percent of the US economy. ... 'Congress found that the cost of tens of billions of dollars in uncompensated care provided to the uninsured is passed on to insured consumers, raising average annual family premiums by more than $1,000,' the administration said."

Bloomberg News (1/6, Stohr) quotes US Solicitor General Donald Verrilli: "Congress has wide latitude when deciding how best to achieve its constitutional objectives, and its decision to adopt a minimum-coverage provision was eminently reasonable." Opponents of the law, "including a group of 26 states led by Florida, contend that Congress exceeded that authority by requiring people to buy insurance even if they say they want to pay their own health expenses or don't plan to ever seek medical care. ... Those opponents today told the court that a decision striking down the mandate should prompt the justices to invalidate the entire measure, known as the Affordable Care Act."

Politico (1/6, Haberkorn) quotes from the 130-page brief -- the first filed by the DOJ since the high court agreed to review the healthcare law: "The uninsured shift tens of billions of dollars of costs for the uncompensated care they receive to other market participants annually. That cost-shifting drives up insurance premiums, which, in turn, makes insurance unaffordable to even more people." In a conference call, one senior Administration official said the so-called individual mandate doesn't break new ground, rather it adds to other mandates the federal government imposes -- "From having to answer the census, to having to turn in your gold coinage in 1934, the draft ... If you buy a car, it has to have seatbelts in it."

The Hill (1/6, Baker) says the Administration argued that the Supreme Court "would have to break with clear precedent to strike down the law's insurance mandate." Administration officials also "said they haven't changed their answer on the key question of how far Congress's power extends," and they claim that they do not need to define a limit in their briefs. An Administration official said: "All the limits are satisfied here, and the fact [they are] satisfied here has no bearing on whether someone could dream up some way they could be satisfied in some hypothetical situation."

The Washington Post (1/7, Barnes) reports, "Congress was 'well within' its constitutional powers when it decided that the way to resolve a crisis in healthcare costs and coverage was to mandate that Americans obtain insurance or pay a fine, the Obama administration told the Supreme Court on Friday." Also reporting this story are the Wall Street Journal (1/7, Kendall, Maltby, Subscription Publication), the Washington Times (1/8, Cunningham), CQ (1/9, Bunis, Subscription Publication), Modern Healthcare (1/9, Subscription Publication), and MedPage Today (1/9, Frieden).

Republicans File Friend-Of-Court Brief. Roll Call (1/9, Sanchez, Subscription Publication) reports, "Senate Minority Leader Mitch McConnell (Ky.) and 35 other Senate Republicans today weighed in on the latest fight over President Barack Obama's two-year-old health care reform law, filing a friend of the court brief urging the Supreme Court find it unconstitutional." In a release, McConnell said, "We believe the mandate is not severable from the PPACA because the law will not function as its Congressional proponents intended or achieve their objectives without the presence of the mandate."

Insurers, Employers May Spur Formation Of Private Insurance Exchanges.

CQ (1/9, Reichard, Subscription Publication) reports, "Insurers and employers may be on the verge of spurring the formation of private insurance exchanges around the United States - a move that could make government exchanges less attractive to consumers." The piece notes that "private-sector interests see an opening to creating exchanges that are more to their liking. To the extent that these private exchanges pop up around the country and siphon off customers, particularly healthy people with few medical expenses, the health plans sold through government exchanges may not be as affordable to consumers."

Suderman: Sebelius Fails To Mention Health Insurance Premium Prices.

In the Reason (1/9) "hit & run" blog, Peter Suderman cites HHS Secretary Kathleen Sebelius' Washington Post op-ed, where she "touts ObamaCare's alleged cost-control provisions, noting that 'one of the major reasons we passed the Affordable Care Act was to bring down costs.'" He writes, "You'll notice, however, that there's something missing from the op-ed: any mention of actual health insurance premium prices." Suderman argues, "The possibility of savings is all they really have. And they don't even really have that, because the evidence suggests that the policies the administration is counting on to produce those savings probably won't have the desired effect."

January 06-2012

Study Shows Insurance Companies Have "Thrived" Since Healthcare Overhaul.

Bloomberg News (1/6, Frier) reports on a Bloomberg Government study, which shows that even though insurance companies opposed the healthcare overhaul, arguing "it would raise costs and disrupt coverage," but "instead, profit margins at the companies widened to levels not seen since before the recession." Peter Gosselin, the study author and senior health-care analyst for Bloomberg Government, remarked, "The industry that was the loudest, most persistent critic of this law, the industry whose analysts and executives predicted it would suffer immensely because of the law, has thrived. There is a shift to government work under way that is going to represent a fundamental change in their business model."

The National Journal (1/6, Quinton, Subscription Publication) reports that "Republican critics have described the law as a 'government takeover of health care,' but the Bloomberg report suggests the opposite: Since the law was passed, private insurers have become more and more involved in managing public health insurance programs." The Washington Post (1/6, Kliff) "Wonkblog" also reports this story.

January 05-2012
CMS Measures Aim To Answer Questions, Boost Quality Of Care.

CQ (1/5, Reichard, Subscription Publication) reports on the release of quality of care measures by the Centers for Medicare and Medicaid Services, which aim to "generate lots of data to help pinpoint the problems." The measures are said to be "part of a new 'Medicaid Quality Measurement Program,' which is also responsible for developing and testing additional measures."

January 03-2012
HHS Releases Medicaid Quality Measures.

Modern Healthcare (1/4, McKinney, Subscription Publication) reports, "HHS has issued a final notice containing an initial set of 26 quality measures for Medicaid-eligible adults" that "cover areas such as prevention, care coordination and chronic disease management," and "will be used for quality reporting." The piece notes that "CMS collaborated with HHS' Agency for Healthcare Research and Quality to identify the measures."

Healthcare Reform Law Fee Blasted By Republicans.

The Hill (1/4, Baker) reports in its "Healthwatch" blog, "Republicans on Tuesday attacked a new fee under the healthcare reform law that is set to take effect this week for many consumers." The piece notes, "The Senate Republican Policy Committee contrasted the fee with Obama's opposition, during the 2008 campaign, to taxing employer-based health benefits. That debate centered around the tax exclusion for healthcare coverage, but the committee said the comparative effectiveness fee is still a tax on insurance."

January 03-2012
Medicare's Future An Important Economic Issue For Baby Boomers.
The AP (1/2, Alonso-Zaldivar) reported, "With more than 1.5 million baby boomers a year signing up for Medicare, the program's future is one of the most important economic issues for anyone now 50 or older. Health care costs are the most unpredictable part of retirement, and Medicare remains an exceptional deal for retirees, who can reap benefits worth far more than the payroll taxes they paid in during their careers." However, "Medicare's giant trust fund for inpatient care is projected to run out of money in 2024." What's more, "researchers estimate that 20 to 30 percent of the more than $500 billion that Medicare now spends annually is wasted on treatments and procedures of little or no benefit to patients."

Roberts Defends Colleagues In Decision To Hear Healthcare Reform Law Challenge.

A front-page story in the New York Times (12/31, Liptak, Subscription Publication) reported, "In the face of a growing controversy over whether two Supreme Court justices should disqualify themselves from the challenge to the 2010 health care overhaul law, Chief Justice John G. Roberts Jr. on Saturday defended the court's ethical standards." In his annual state of the federal judiciary report, Roberts wrote, "I have complete confidence in the capability of my colleagues to determine when recusal is warranted. They are jurists of exceptional integrity and experience whose character and fitness have been examined through a rigorous appointment and confirmation process." USA Today (1/3, Biskupic) and the AP (12/31) also reported this story.

Texas Consumer Health Assistance Program Shutting Down Due To Lack Of Funding.

The Washington Post (1/1, Kliff) reported that the Texas Consumer Health Assistance Program, which was launched last January to help the public find affordable healthcare, is now "preparing to shut down, a victim of Congress's inability to agree on a federal budget for next year." The article notes that consumer advocates say funding for programs such as this one are needed especially now because "the federal health reform law has left more Americans with questions about how health insurance is changing." While Texas decided to shut down their assistance program, other states "are exploring how they might be able to move forward without federal funding."

Insured Adults Increasingly Enrolled In High-Deductible Plans.

American Medical News (1/3, Berry) reports, "Enrollment in high-deductible plans rose from 14% of insured adults in 2010 to 16% in 2011, according to the Employee Benefits Research Institute, which surveyed 4,703 adults from age 21 to 64 who had employer-based insurance." In addition, research showed that "as of 2011, 38% of those with a high-deductible plan, or an estimated 7.3 million people, were eligible" for a paired health savings account, but did not open one. Teresa Gutierrez, president-elect of the Health Underwriters Association of North Carolina, noted that because employers can't open HSAs for employees, and "because employers don't want their workers to avoid preventive care, more are turning to health reimbursement arrangements, because those are opened and funded by the employer, but otherwise work like an HSA."

Employee-Based Plans Still Most Common Form Of Coverage. The Columbus (OH) Dispatch /McClatchy (1/3, Stafford) reports, "The Employee Benefit Research Institute said that employment-based health benefits remain the most common form of health insurance in the United States, with 59 percent of the under-65 population having that coverage." However, "seven percent of individuals last year had consumer-directed accounts -- up from five percent in 2010 and one percent in 2006." The survey also suggested that "individuals in these consumer-directed plans 'were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors,'" such as asking for generic medications and having to "budget to manage health-care expenses."

Millions To Remain Uninsured After Health Law Reforms Take Effect In 2014.

American Medical News (1/2, Trapp) reported, "The national health system reform law is expected to reduce the nation's uninsured population to what could be an all-time low." However, "even after the major reforms take effect starting in 2014, millions will remain without coverage," for reasons including "income, insurance costs, employment, legal status and personal choice." The federal health "law's coverage expansion will vary somewhat by state, but each region of the US is expected to see its uninsured population shrink by roughly half, according to a March 2011 analysis by the Urban Institute."

Older News of Importance

November 15-2011
Supreme Court To Review Healthcare Reform Law In March.
The Supreme Court's announcement that it would take up the challenges to healthcare reform drew heavy print and broadcast coverage, including nearly 7 and a half minutes of coverage on network newscasts (it was the lead story on NBC Nightly News) and several stories that appeared on the front pages of major newspapers. Most reports place the arguments, scheduled for March, against the backdrop of a politically charged presidential year.

ABC World News (11/14, story 3, 2:15, Sawyer) reported, "Word today that the Supreme Court will weigh in on a lightning rod issue, whether the President's healthcare law is constitutional. A question that spawned heated debates on both sides. A Supreme Court ruling being heralded as the most important since Bush vs. Gore in 2000. Not to mention, the decision will come during the heat of the presidential race."

The CBS Evening News (11/14, story 7, 2:05, Pelley) reported, "The case is so complex the court has scheduled arguments for more than five hours." Twenty-six "states joined forces and sued the federal government to block the law. The 11th Circuit Court of Appeals in Atlanta agreed and struck it down."

NBC Nightly News (11/14, lead story, 3:05, Williams) reported, "As for how the ideologically divided court might rule, legal experts say it might not be the usual 5-4 split. Some of the conservatives have been willing to uphold broad uses of federal power in the lives of individual citizens."

USA Today (11/15, Biskupic) reports, "The Supreme Court's announcement Monday that it will hear challenges to the Obama-sponsored health care law opens the most important chapter in the legal battle over the law, amid the tumult of election-year politics." USA adds, "A ruling could determine the federal government's power to address the most pressing social problems, specifically how to ensure medical coverage nationwide. The decision is likely to be handed down in late June, right before the Republican and Democratic conventions for the 2012 presidential election."

The Washington Post (11/15, A1, Barnes), on its front page, reports, "As a mark of the importance of the case to the court headed by Chief Justice John G. Roberts Jr., justices said they will hear 5 1/2 hours of oral arguments on the constitutional question and related issues." The Post notes that the White House "welcomed the court's announcement. 'We know the Affordable Care Act is constitutional and are confident the Supreme Court will agree,' White House spokesman Dan Pfeiffer said in a statement."

A front-page story in the New York Times (11/15, A1, Liptak, Subscription Publication) reports, "Appeals from three courts had been vying for the justices' attention, presenting an array of issues beyond the central one of whether Congress has the constitutional power to require people to purchase health insurance or face a penalty through the so-called individual mandate." The court "agreed to hear appeals from just one decision, from the United States Court of Appeals for the 11th Circuit, in Atlanta, the only one so far striking down the mandate. On Monday, the justices agreed to decide not only whether the mandate is constitutional but also, if it is not, how much of the balance of the law, the Patient Protection and Affordable Care Act, must fall along with it."

The Los Angeles Times (11/15, Savage) reports, "The Republican governors and state attorneys who challenged the law argued that the power to regulate commerce does not extend to requiring unwilling buyers to purchase insurance. They also allege that the law's expansion of Medicaid will force the states to take on extra burdens. Sponsors of the law estimate that it will extend health coverage to 16 million more children and low-income adults through expanding Medicaid."

Politico (11/15, Haberkorn) reports that the court "also signaled that it could punt a decision on the individual mandate until 2014. In accepting the challenges to the law, the court said it would devote an hour of the arguments to the effect of the Anti-Injunction Act - a law that, in the view of some courts, could prohibit a ruling on the individual mandate until the mandate goes into effect in 2014. That could provide an escape clause if the court wants it."

Bloomberg News (11/15, Stohr) reports, "Both sides said they were pleased the court agreed to take up the case. US Health and Human Services Secretary Kathleen Sebelius said a high court ruling would clear up legal uncertainty that might interfere with implementing the law's central provisions by 2014. 'We're eager to have states, who may be sitting on the sidelines, engage fully in putting together these exchanges,' she said."

Poll Shows Falling Support For Law. A front-page story in the Wall Street Journal (11/15, Bravin, Subscription Publication) reports that although public opinion about the new law appeared fairly evenly split for more than a year, a poll released last month by the Kaiser Family Foundation found 51 percent of respondents now have an unfavorable opinion of the law, while only 34 percent held a favorable view.

Effects Of New Law Would Be Difficult To Reverse. The New York Times (11/15, Abelson, Harris, Pear, Subscription Publication) reports, "No matter what the Supreme Court decides about the constitutionality of the federal law adopted last year, health care in America has changed in ways that will not be easily undone. Provisions already put in place, like tougher oversight of health insurers, the expansion of coverage to one million young adults and more protections for workers with pre-existing conditions are already well cemented and popular." Meanwhile, "a combination of the law and economic pressures has forced major institutions to wrestle with the relentless rise in health care costs."

More Commentary. In an op-ed for the Wall Street Journal (11/15, A19, Subscription Publication), David B. Rivkin and Lee A. Casey, attorneys who served in the Justice Department during the Reagan and George H.W. Bush administrations and have represented the 26 states in their challenge to the healthcare reform law before trial and appellate courts, argue that the law's individual mandate is unconstitutional because only the states have the authority to impose individual regulations of this type. Rivkin and Casey also attack several other provisions of the law on legal grounds, and urge the court to rule the entire law unconstitutional.

In an editorial, the Wall Street Journal (11/15, A18, Subscription Publication) also puts the individual mandate under tight legal scrutiny, and applauds the court for showing courage in taking up this contentious issue during an election year.

The New York Times (11/15, A30, Subscription Publication) reports, "If the court follows its own precedents, as it should, this case should not be a close call: The reform law and a provision requiring most people to obtain health insurance or pay a penalty are clearly constitutional."

In the Los Angeles Times (11/15), Erwin Chemerinsky, dean of the UC Irvine School of Law, writes that "what complicates the decision and makes the result unpredictable is whether the justices will see the issue in terms of precedent or through the partisanship that has so dominated the public debate and most of the court decisions so far."

USA Today (11/15) editorializes, "In recent years, judges increasingly have come to be seen not as independent, fair-minded interpreters of the law and the Constitution, but as politicians in robes. The health care case gives the court an extraordinary opportunity to help clean up that tarnished image." According to USA Today, "Simply because the case is so politically contentious, a lopsided ruling in either direction would send an encouraging message that the court is what Chief Justice John Roberts once said it should be: an honest umpire."

January 31-2011
Judge strikes down healthcare reform law.
Reuters

(1/31, Brown) reports U.S. District Judge Roger Vinson struck down President Barack Obama's landmark healthcare overhaul as unconstitutional on Monday, in the biggest legal challenge yet to federal authority to enact the law.

Washington Post (01/31) reports In ruling against President Obama‘s health care law, federal Judge Roger Vinson used Mr. Obama‘s own position from the 2008 campaign against him, arguing that there are other ways to tackle health care short of requiring every American to purchase insurance.

“I note that in 2008, then-Senator Obama supported a health care reform proposal that did not include an individual mandate because he was at that time strongly opposed to the idea, stating that ‘if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house,’” Judge Vinson wrote in a footnote toward the end of the 78-page ruling Monday.

December 29-2010
Key Provisions Of Healthcare Law To Take Effect Jan. 1.

The Hill (12/29, Millman) reports in its "Healthwatch" blog, "Key parts of the new healthcare law will go into effect on Jan. 1, just before a Republican-controlled House returns to Washington." Democratic lawmakers "frontloaded the law with a number of consumer-protection related provisions that they expect will boost support for the overhaul," such as "a requirement for healthcare plans that spend less than 80 percent of premiums on healthcare services to provide rebates to customers," and help for seniors who fall into the Medicare "donut hole." In fact, over "20 provisions of the reform law go into effect in 2011," but "Republicans taking over the House have vowed to repeal the healthcare law," or at least "try to withhold funding for the new law, which could impede its implementations." The Wall Street Journal (12/28, Hobson, subscription required) also covered the story.

September 30-2010
Principal Financial Group prepares to exit the medical insurance business.
MINNETONKA, Minn. – Sept. 30, 2010 – UnitedHealthcare today announced it has entered into an agreement to renew medical insurance coverage for The Principal Financial Group's (The Principal®) medical plan customers as The Principal completes its plans to exit the medical insurance business. The Principal will continue to offer life insurance, dental, disability, vision and wellness programs.

The Principal selected UnitedHealthcare to provide an easy and attractive transition option for its customers to renew their health plans. The Principal currently covers customers in 31 markets nationwide, predominantly throughout the Central United States, where UnitedHealthcare offers an extensive network of physicians, hospitals and other health care providers.

"UnitedHealthcare provides a broad range of coverage options to meet customers' needs. By working with UnitedHealthcare, a proven leader and long-term player in the business with an extensive local and national network, we will ensure a smooth transition for customers and brokers," said Dan Houston, president – Retirement, Insurance & Financial Services at The Principal. source: UnitedHealthcare "Special Edition" press release dated September 30, 2010

September 23-2010
Major Provisions In Healthcare law Take Effect Today, Thursday September 23, 2010

NBC Nightly News (9/22, story 6, 0:30, Williams) reported, "One more note on healthcare reform. It's been six months now since Congress passed the Obama plan," and several of its major provisions "go into effect tomorrow. Among them, dependents will now be covered under their parent's insurance plans up to age 26. Children under age 19 can no longer be denied coverage because of preexisting medical conditions. And insurers will no longer be allowed to put lifetime limits on coverage." read more