ABC

Individual mandate

Michael — Tue, 20 Mar 2012 23:18:07 +0000

A major piece of the health care reform act (PPACA) is to assure everyone that they can and should have health insurance. Most would agree that, in addition to insurance carriers being forced to cover people that will cost them way more in claims than the average applicant due to pre-existing conditions, that a whole bunch of currently uninsured healthy people have to step up to the plate to make that viable. A Rand study seems to minimize the impact of a carrier taking on unhealthy risks without the compensating healthy ones. They make clear that the elimination of the mandate on individuals would double government costs for the unhealthy, it would have a relatively small impact on overall premiums. These are really smart people, so I won’t dispute their numbers but it defies logic for me.

Medicare fraud focus

Michael — Tue, 20 Mar 2012 23:17:07 +0000

“This week, the FBI has been cracking down on Medicare fraud. It is estimated that 10% of the Medicare budget, billions and billions of taxpayer dollars, are lost to cheats and scammers.”

Hope and change

Michael — Tue, 20 Mar 2012 23:16:02 +0000

HHS Secretary Kathleen Sebelius’ Washington Post op-ed “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.’” A columnist 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.”

Americans “slowly embrace” key elements of healthcare reform law

Michael — Tue, 20 Mar 2012 23:15:13 +0000

A Harris poll finds “Americans are slowly starting to embrace some key components of the controversial health care reform act signed into law by President Barack Obama nearly two years ago,” even though they “remain sharply divided over the legislation, with slightly more than one-third (36 percent) of adults saying they want the law repealed and 21 percent saying they want it to remain as is.” The notable exception is the individual mandate… which remains deeply unpopular.’” The “slowly embrace” and “deeply divided” parts can’t be too exciting for the administration.

Wellness comes with limits and maybe more forms

Michael — Tue, 20 Mar 2012 23:14:12 +0000

As 50% of our premium dollars pay for people’s lifestyle choices, it would make sense that the PPACA (the first “A” standing for affordable) would include promotion of wellness, as it does. I stay fit, don’t smoke, drink to excess, eat reasonably and don’t want to pay extra for those who choose to ignore contributors to chronic health conditions. Employers are beginning to adopt that approach in providing those willing to get on board with better benefits and/or lower premium contributions than those who won’t. Of course, genetics enters into the equation so they cannot be part of the determining factors as stated 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.”

As if we need more laws, a study at Georgetown University expresses “added consumer protections are especially important because there is not enough evidence to show that workers will take action to improve their health if faced with financial penalties.” They also said, “States might want to promote the use of evidence in workplace wellness programs by requiring that programs report on the amount, timing and duration of any incentives.” Could we possibly take one step toward some sanity without filling out another form?

50,000 previously uninsurable covered

Michael — Tue, 20 Mar 2012 23:13:06 +0000

Almost 50,000 Americans with serious medical conditions have gained insurance coverage thanks to the healthcare reform law, the Obama administration said in a new report.” The new “report focuses on individual stories of people who have been helped by the Pre-existing Condition Insurance Plan (PCIP) program.” Understandably, people who are going to receive more in benefits than they pay in premiums will jump on the bandwagon of guaranteed coverage.

That is the backdrop for a Gallup poll showing “the number of uninsured adults has risen steadily during the Obama administration,” Sounds like contradiction? Premiums continue to rise dramatically causing people to drop coverage if they are not sick.

Attitudes about the individual mandate

Michael — Tue, 20 Mar 2012 23:10:15 +0000

According to a new Kaiser Family Foundation poll, less than one third believe the health care reform act will be upheld by the Supreme Court. Only 17% would rule in favor if they handing down the judgment! 54% would have the court remove the mandate that individuals purchase coverage. A USA Today/Gallup poll found that “nearly two years after President Obama signed his landmark healthcare package into law, three-quarters of registered voters believe the law’s requirement that every American carry health insurance is unconstitutional.” The numbers become more dramatic broken down by party affiliation.

Contraception battles

Michael — Tue, 20 Mar 2012 23:09:19 +0000

In case you hadn’t noticed, the Catholic health care system is not the least bit wild about providing contraception coverage to their employees as it violates one of their closely held tenets. Forcing them to pay for contraception, abortions and sterilization, really? The administration tried to mollify them by shifting the cost to the insurer, stating the Catholics wouldn’t actually have to pay for it. Free? I want some! Sorry, but this is typical of bureaucratic shell games. If their ploy really took wings and worked, you and I end up paying higher premiums so politicians can keep their constituents fat, dumb and happy. It doesn’t matter whether that all “magically” gets paid by us subsidizing premiums or through tax dollars, you and I will pay!

Some states are taking the same position, asking for exemptions for secular groups, also. Apparently, this is not just a “religious” thing. Conservatives are leveraging all this for the upcoming election.

Meanwhile, the Senate voted along party lines to uphold the mandate for contraception. “The 51-to-48 vote illustrated a sharp divide between the parties..” noting that the fight was “politically charged,” and cautions that “despite the vote, Congress is not done with the contraception debate.”

Final rules for opting out of federal mandates

Michael — Tue, 20 Mar 2012 23:07:32 +0000

Yes, states, do, in fact, have an alternative to abiding by the PPACA. In a statement, HHS said that “the clause ‘provides states with additional flexibility to improve health care for their citizens in a way that works for them while retaining the basic protections’ of the federal law.” At this point, I am clueless what that looks like, so stay tuned for more.

Pressure mounts to repeal Independent Payment Advisory Board

Michael — Tue, 20 Mar 2012 23:03:08 +0000

The IPAB would consist of a panel of 15 medical experts appointed by the president to recommend cuts to Medicare if costs grow faster than a targeted rate. Sadly, this was deemed a “death panel” or “rationing board” by some conservatives, foreseeing a worst case scenario. Simple demographics insist that Medicare costs are sure to skyrocket as unprecedented droves of baby boomers are enrolling in Medicare daily. A Senate subpanel vote of 17-5 “underscored the bipartisan support for repealing the board, which Obama has made the centerpiece of his efforts to reduce Medicare spending. It also provided evidence the legislation could have a shot at passing the Senate.” In an election year, the Hill says that if a vote to repeal the panel came to the Senate, many Democrats “would be in a tight spot.”