/PRNewswire/ -- With the House having passed its version of health care reform (H.R. 3962) and the Senate on the verge of passing its version (H.R. 3590), the outline of a final bill is beginning to take shape. In its new Issue Brief, The Concord Coalition looks ahead at the fiscal considerations that will likely be the subject of conference committee discussions and "end game" negotiations. These include the cost of expanding coverage, the methods used to prevent that cost from adding to the deficit, and the prospects for systemic reforms to reduce cost growth over time.
This issue brief gives The Concord Coalition's perspective on how the bills measure up, what the risks are and how these risks could be lessened. We conclude that:
-- Both bills establish an important benchmark by achieving deficit
reduction according to official cost estimates by the Congressional
Budget Office (CBO). However, the fiscal outlook remains on an
unsustainable track even with the modest deficit reduction achieved
under either plan.
-- There are clear risks that some of the methods used to achieve deficit
reduction in the official scores may not hold up over the long-term.
-- The revenue package in the Senate bill holds more promise to reduce
the deficit than the House version because its largest component --
the high-cost insurance excise tax -- will better keep up with the
growth rate of health care spending, and will also work to lower
health care costs.
-- Both bills contain many promising reform strategies to achieve
long-term cost control. However, these strategies remain unproven and
cannot be counted on to produce timely, reliable savings without a
strong cost control mechanism such as the Senate's proposed
Independent Payment Advisory Board (IPAB).
The "Fiscal Risks" mentioned in the discussion include:
-- Doing Nothing
-- Spending offsets that are not maintained over time
-- "Curve benders" that don't pan out or are not adopted more broadly
-- Failure to include an effective cost control mechanism
-- Lagging revenue increases
-- General revenue bailout of the CLASS provision
-- Inadequate premium subsidies, weak penalties, and a poorly designed
exchange
In the conclusion, Concord discuss the possible changes that could be added to the legislation to lessen these risks and further promote fiscal responsibility.
To read the full issue brief, go to: http://www.concordcoalition.org/issue-briefs/2009/1223/health-care-reform-end- game-fiscal-considerations
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Showing posts with label costs. Show all posts
Showing posts with label costs. Show all posts
Wednesday, December 23, 2009
Tuesday, December 15, 2009
The 'Big 3' Fixes for the Weakened Senate Health Reform Bill to Block Full Insurance Co. Take-Over of Health System
/PRNewswire/ -- Consumer Watchdog condemned the removal of the Medicare buy-in provision for those over 55 and the public option from the U.S. Senate health reform bill. But the group said that the Senate must still make three essential fixes to the greatly weakened bill to prevent ceding the entire health care system to the insurance industry.
Without the changes, said the consumer advocacy group, the legislation will fail even to provide basic consumer protections of cost containment, access to necessary care, and protection against bankruptcy when patients get sick and need coverage the most.
Consumer Watchdog said that it is essential that the bill be fixed now because there is a growing belief that a conference committee will be bypassed altogether, and instead the House of Representatives will be pushed to approve the Senate bill with no amendments. The three key fixes, detailed below, are:
1. Remove Provisions that Would Pre-empt More Protective State Laws
2. Bar Insurers From Placing Annual Limits on Medical Payments
3. Make Health Insurance Rate Regulation Real
"If health care reform is really about consumers and patients, then Senators must make these fixes before they pass the bill," said Jerry Flanagan, health policy director of Consumer Watchdog. "Current provisions of the Senate bill requiring Americans to buy insurance policies, while gutting state laws and ineffectively capping what insurers can charge for bare bones coverage, add up to a dream bill for insurance companies."
"Eliminating the public option, pre-empting state health benefit laws and avoiding tough rate oversight is an insurance company hat trick - the top three legislative goals of the insurance industry of the last twenty years," said Flanagan. "If health reform is going to be worth anything to consumers, Senators must fight back on these three points. Without them, health reform is little more than a scheme for health insurers to increase profits at the expense of patients and taxpayers."
The three changes that the U.S. Senate must make to HR 3590 are:
1. Remove Provisions that Would Pre-empt More Protective State Laws
For 60 years, states have been responsible for the oversight of health insurance. States have traditionally been the laboratories of innovation in health care and insurance reform. States also have a greater ability to respond quickly to local needs.
However, provisions in the current bill could replace hard-fought "Patients Bill of Rights" laws with new, weaker federal protections.
For example, section 1333 on page 219 of the Senate bill allow health insurers to avoid strong state patient protection laws under so-called "nationwide plans" and multistate "compacts." Under these provisions, health insurers that sell policies in more than one state would only be regulated by the state where the policy was "written or issued." Therefore, if an insurer "issues" all of its policies from Wyoming, then the laws of Wyoming would control policies sold to consumers in states with more protective laws like California, New York, Texas or Virginia.
Insurers would certainly elect to issue their policies from the states with the weakest laws. As a result, new federal minimum coverage requirements would become the norm. Coverage of AIDS/HIV testing, reconstructive surgery, home health care services, and child delivery and mastectomy minimum hospital stays, for instance, would likely be lost.
The Senate health reform bill should be modeled on existing federal health care laws, which provide for a federal-state partnership rather than federal pre-emption of more protective state standards. Minimum federal standards should set a floor, not a ceiling, on state health care protections. Read Consumer Watchdog's analyses of the pre-emption provisions and the group's letter to Senate Majority Leader Harry Reid at:
http://www.consumerwatchdog.org/patients/articles/?storyId=31197
Read the Los Angeles Times coverage of the pre-emption provisions:
http://www.consumerwatchdog.org/patients/articles/?storyId=31200
2. Bar Insurers From Placing Annual Limits on Medical Payments
A cornerstone of national health reform is to ensure that patients get the care their doctor prescribes when they are sick and need treatment the most. An essential element to reach that objective is to bar insurance companies from placing annual limits on how much health care a patient can receive.
Current caps mean that patients with serious illnesses, including many cancers, can be left without coverage in the midst of treatment. As a result, patients face bankruptcy even though they have insurance. In fact, a Harvard Medical School study released this year found that 62% of U.S. bankruptcies were caused by big medical bills, while 78% of those declaring bankruptcy had insurance.
A loophole in the Senate bill would allow health insurers to impose unspecified "reasonable" annual limits on the annual dollar value of benefits that patient can receive this year. This is a major departure from previous version of the Senate bill, and the House legislation, which bar any annual caps.
The Senate bill cites section 223 of the Internal Revenue Code, which regulates Health Savings Accounts. That section does not define "reasonable" annual limits. As a result, health insurers will be left to define "reasonable" as they see fit. However, for an insurance company, a "reasonable" limit on annual health care costs is one that increases shareholder profits by cutting off access to necessary care.
3. Make Health Insurance Rate Regulation Real
Requiring insurance companies to justify rate increases and seek "prior approval" for those increases are essential components to controlling skyrocketing health insurance premiums, deductibles, and other out-of-pocket costs.
Page 37, section 2794 of HR 3590 provides some additional transparency on insurance premiums and takes some first steps toward limits on insurance company gouging, but does not provide real protections for Americans by, for instance, requiring insurers to seek approval before imposing premium and rate increases.
Consumer Watchdog, which pioneered the most successful insurance premium regulation law in the nation, Proposition 103, calls on the Senate to adopt amendments reflecting key provisions of California's landmark insurance reform law, including:
-- Mandatory justification of any rate increase (including premiums,
deductibles, co-pays), not merely justifications of "unreasonable"
premium increases.
-- Mandatory prior approval, which means requiring insurers to seek
permission from government regulators, in addition to justifying rate
increases, before imposing rate increases. Since 1988, California's
Proposition 103 has saved drivers $62 billion while fostering a
competitive and profitable insurance market.
-- An intervenor system that provides consumers a forum to challenge
unnecessary or excessive rate increases. Since 2003, Consumer Watchdog
has saved the state's consumers $1.7 billion by challenging
unnecessary premium increases using the public intervention process.
-----
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Without the changes, said the consumer advocacy group, the legislation will fail even to provide basic consumer protections of cost containment, access to necessary care, and protection against bankruptcy when patients get sick and need coverage the most.
Consumer Watchdog said that it is essential that the bill be fixed now because there is a growing belief that a conference committee will be bypassed altogether, and instead the House of Representatives will be pushed to approve the Senate bill with no amendments. The three key fixes, detailed below, are:
1. Remove Provisions that Would Pre-empt More Protective State Laws
2. Bar Insurers From Placing Annual Limits on Medical Payments
3. Make Health Insurance Rate Regulation Real
"If health care reform is really about consumers and patients, then Senators must make these fixes before they pass the bill," said Jerry Flanagan, health policy director of Consumer Watchdog. "Current provisions of the Senate bill requiring Americans to buy insurance policies, while gutting state laws and ineffectively capping what insurers can charge for bare bones coverage, add up to a dream bill for insurance companies."
"Eliminating the public option, pre-empting state health benefit laws and avoiding tough rate oversight is an insurance company hat trick - the top three legislative goals of the insurance industry of the last twenty years," said Flanagan. "If health reform is going to be worth anything to consumers, Senators must fight back on these three points. Without them, health reform is little more than a scheme for health insurers to increase profits at the expense of patients and taxpayers."
The three changes that the U.S. Senate must make to HR 3590 are:
1. Remove Provisions that Would Pre-empt More Protective State Laws
For 60 years, states have been responsible for the oversight of health insurance. States have traditionally been the laboratories of innovation in health care and insurance reform. States also have a greater ability to respond quickly to local needs.
However, provisions in the current bill could replace hard-fought "Patients Bill of Rights" laws with new, weaker federal protections.
For example, section 1333 on page 219 of the Senate bill allow health insurers to avoid strong state patient protection laws under so-called "nationwide plans" and multistate "compacts." Under these provisions, health insurers that sell policies in more than one state would only be regulated by the state where the policy was "written or issued." Therefore, if an insurer "issues" all of its policies from Wyoming, then the laws of Wyoming would control policies sold to consumers in states with more protective laws like California, New York, Texas or Virginia.
Insurers would certainly elect to issue their policies from the states with the weakest laws. As a result, new federal minimum coverage requirements would become the norm. Coverage of AIDS/HIV testing, reconstructive surgery, home health care services, and child delivery and mastectomy minimum hospital stays, for instance, would likely be lost.
The Senate health reform bill should be modeled on existing federal health care laws, which provide for a federal-state partnership rather than federal pre-emption of more protective state standards. Minimum federal standards should set a floor, not a ceiling, on state health care protections. Read Consumer Watchdog's analyses of the pre-emption provisions and the group's letter to Senate Majority Leader Harry Reid at:
http://www.consumerwatchdog.org/patients/articles/?storyId=31197
Read the Los Angeles Times coverage of the pre-emption provisions:
http://www.consumerwatchdog.org/patients/articles/?storyId=31200
2. Bar Insurers From Placing Annual Limits on Medical Payments
A cornerstone of national health reform is to ensure that patients get the care their doctor prescribes when they are sick and need treatment the most. An essential element to reach that objective is to bar insurance companies from placing annual limits on how much health care a patient can receive.
Current caps mean that patients with serious illnesses, including many cancers, can be left without coverage in the midst of treatment. As a result, patients face bankruptcy even though they have insurance. In fact, a Harvard Medical School study released this year found that 62% of U.S. bankruptcies were caused by big medical bills, while 78% of those declaring bankruptcy had insurance.
A loophole in the Senate bill would allow health insurers to impose unspecified "reasonable" annual limits on the annual dollar value of benefits that patient can receive this year. This is a major departure from previous version of the Senate bill, and the House legislation, which bar any annual caps.
The Senate bill cites section 223 of the Internal Revenue Code, which regulates Health Savings Accounts. That section does not define "reasonable" annual limits. As a result, health insurers will be left to define "reasonable" as they see fit. However, for an insurance company, a "reasonable" limit on annual health care costs is one that increases shareholder profits by cutting off access to necessary care.
3. Make Health Insurance Rate Regulation Real
Requiring insurance companies to justify rate increases and seek "prior approval" for those increases are essential components to controlling skyrocketing health insurance premiums, deductibles, and other out-of-pocket costs.
Page 37, section 2794 of HR 3590 provides some additional transparency on insurance premiums and takes some first steps toward limits on insurance company gouging, but does not provide real protections for Americans by, for instance, requiring insurers to seek approval before imposing premium and rate increases.
Consumer Watchdog, which pioneered the most successful insurance premium regulation law in the nation, Proposition 103, calls on the Senate to adopt amendments reflecting key provisions of California's landmark insurance reform law, including:
-- Mandatory justification of any rate increase (including premiums,
deductibles, co-pays), not merely justifications of "unreasonable"
premium increases.
-- Mandatory prior approval, which means requiring insurers to seek
permission from government regulators, in addition to justifying rate
increases, before imposing rate increases. Since 1988, California's
Proposition 103 has saved drivers $62 billion while fostering a
competitive and profitable insurance market.
-- An intervenor system that provides consumers a forum to challenge
unnecessary or excessive rate increases. Since 2003, Consumer Watchdog
has saved the state's consumers $1.7 billion by challenging
unnecessary premium increases using the public intervention process.
-----
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Thursday, December 10, 2009
Members of Congress Urge Obama to Adopt 350 Carbon Target
/PRNewswire/ -- As President Obama prepares to travel to the United Nations Climate Change Conference in Copenhagen, 14 members of the U.S. House of Representatives have sent a letter urging the President to seek agreement with world leaders on the need to reduce the level of carbon dioxide in the atmosphere to 350 parts per million.
Climate scientists, led by Dr. James Hansen of NASA's Goddard Space Institute, warn that global temperatures will rise to dangerous levels if the concentration of CO2 remains above 350 ppm for a sustained period of time.
Hansen has said, "If humanity wishes to preserve a planet similar to that on which civilization developed and to which life on Earth is adapted... CO2 will need to be reduced... to at most 350 ppm."
Rep. Bob Filner (D-CA) and Rep. Dennis Kucinich (D-OH) initiated the letter, which advises the President, "there is one singular goal around which all nations must align in order to avert disaster, the concentration of carbon dioxide in the atmosphere. We urge you to... seek agreement with fellow leaders in Copenhagen on the ultimate goal of lowering and maintaining the level of CO2 in the Earth's atmosphere at 350 parts per million."
"If we are serious about combating global climate change we must agree to set a goal that will represent our best shot at averting the worst effects of climate change. The best science tells us that goal is 350 parts per million," said Congressman Kucinich.
Marshall Saunders, Founder and President of Citizens Climate Lobby, urged decision-makers to adopt legislation and policies that will achieve the 350 goal.
"Unfortunately, most of our legislators are operating under the assumption that we can allow CO2 levels to rise to 450 ppm. That would be a disaster. We've crossed the 350 threshold. We're at 390 and we're seeing glaciers recede at an alarming rate and summer sea ice disappearing from the North Pole."
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Climate scientists, led by Dr. James Hansen of NASA's Goddard Space Institute, warn that global temperatures will rise to dangerous levels if the concentration of CO2 remains above 350 ppm for a sustained period of time.
Hansen has said, "If humanity wishes to preserve a planet similar to that on which civilization developed and to which life on Earth is adapted... CO2 will need to be reduced... to at most 350 ppm."
Rep. Bob Filner (D-CA) and Rep. Dennis Kucinich (D-OH) initiated the letter, which advises the President, "there is one singular goal around which all nations must align in order to avert disaster, the concentration of carbon dioxide in the atmosphere. We urge you to... seek agreement with fellow leaders in Copenhagen on the ultimate goal of lowering and maintaining the level of CO2 in the Earth's atmosphere at 350 parts per million."
"If we are serious about combating global climate change we must agree to set a goal that will represent our best shot at averting the worst effects of climate change. The best science tells us that goal is 350 parts per million," said Congressman Kucinich.
Marshall Saunders, Founder and President of Citizens Climate Lobby, urged decision-makers to adopt legislation and policies that will achieve the 350 goal.
"Unfortunately, most of our legislators are operating under the assumption that we can allow CO2 levels to rise to 450 ppm. That would be a disaster. We've crossed the 350 threshold. We're at 390 and we're seeing glaciers recede at an alarming rate and summer sea ice disappearing from the North Pole."
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Tuesday, February 10, 2009
Boehner: Republicans Stand Ready to Work With President Obama on Responsible Plan That Will Create and Protect Jobs
Boehner: Republicans Stand Ready to Work With President Obama on Responsible Plan That Will Create and Protect Jobs – But Democratic Congress Hasn’t Delivered
After a press conference held last evening by President Barack Obama, House Republican Leader John Boehner (R-OH) released the following statement:
“Our nation is in recession, and we applaud President Obama for continuing to make the case for action from Congress to help our economy create and protect jobs. As he said earlier this year and again this evening, both parties in Washington have a responsibility to tackle the challenge before us. In response to the President’s request for input, House Republicans have offered a plan that creates twice the jobs as the Democrats’ proposal – 6.2 million jobs total – at half the cost. Unfortunately, the trillion-dollar plan moving through Congress takes us in the wrong direction, relying on slow-moving and wasteful Washington spending that will pile even more debt on future generations, providing less tax relief than requested by the President, and encouraging dependence on welfare programs that hurt Americans instead of helping them. The American people need our help, and they deserve better than this. It is not too late to craft a bipartisan plan that creates more jobs and helps get our economy back on track, and Republicans stand ready to work with the President to do this.”
NOTE: By letting families, small businesses, home-buyers, and job-seekers keep more of what they earn, the House Republicans’ economic recovery plan will create 6.2 million new American jobs over the next two years, at half the cost of the congressional Democrats’ plan, according to a methodology used by President Obama’s own nominee as Chair of the White House Council of Economic Advisors, Dr. Christina Romer.
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After a press conference held last evening by President Barack Obama, House Republican Leader John Boehner (R-OH) released the following statement:
“Our nation is in recession, and we applaud President Obama for continuing to make the case for action from Congress to help our economy create and protect jobs. As he said earlier this year and again this evening, both parties in Washington have a responsibility to tackle the challenge before us. In response to the President’s request for input, House Republicans have offered a plan that creates twice the jobs as the Democrats’ proposal – 6.2 million jobs total – at half the cost. Unfortunately, the trillion-dollar plan moving through Congress takes us in the wrong direction, relying on slow-moving and wasteful Washington spending that will pile even more debt on future generations, providing less tax relief than requested by the President, and encouraging dependence on welfare programs that hurt Americans instead of helping them. The American people need our help, and they deserve better than this. It is not too late to craft a bipartisan plan that creates more jobs and helps get our economy back on track, and Republicans stand ready to work with the President to do this.”
NOTE: By letting families, small businesses, home-buyers, and job-seekers keep more of what they earn, the House Republicans’ economic recovery plan will create 6.2 million new American jobs over the next two years, at half the cost of the congressional Democrats’ plan, according to a methodology used by President Obama’s own nominee as Chair of the White House Council of Economic Advisors, Dr. Christina Romer.
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Monday, December 15, 2008
WashingtonWatch.com Update: The Auto Bailout, a Retiree Tax Break, and the Blagojevich-Obama Connection
/PRNewswire-USNewswire/ -- This is the WashingtonWatch.com federal legislative update for the week of December 15, 2008.
On the WashingtonWatch.com Blog
Illinois Governor Rod Blagojevich's attempt to sell the Senate seat formerly occupied by Barack Obama has captured the headlines. The WashingtonWatch.com blog has an unusual take on it in a post called "The Blagojevich-Obama Connection."
http://tinyurl.com/5e9emv
Last week, the House of Representatives passed a bill to provide federal support to the "Big Three" automakers.
H.R. 7321, the Auto Industry Financing and Restructuring Act would have provided funding sufficient to cover the costs of up to $14.0 billion in bridge loans or commitments for lines of credit to U.S. auto manufacturers.
The cost of the legislation is a little under $90 per U.S. family. Late in the week last week, it appeared that the Senate would not pass the legislation.
H.R. 7321
The Auto Industry Financing and Restructuring Act
Costs $87.75 per family
What People Think: 27% For, 73% Against
http://www.washingtonwatch.com/bills/show/110_HR_7321.html
Last week, both Houses of Congress passed H.R. 7327, the Worker, Retiree, and Employer Recovery Act of 2008. Along with making technical corrections related to the Pension Protection Act of 2006, the bill waives required minimum distribution rules for certain retirement plans and accounts.
The tax savings in the bill save the average U.S. family about $30. The bill now goes to the President, who is likely to sign it into law.
H.R. 7327
The Worker, Retiree, and Employer Recovery Act of 2008
Saves $30.72 per family
What People Think: 57% For, 43% Against
http://www.washingtonwatch.com/bills/show/110_HR_7327.html
Displayed below are new, updated, and passed items with their cost or savings per family.
New Items
H.R. 7327
The Worker, Retiree, and Employer Recovery Act of 2008
Saves $30.72 per family
http://www.washingtonwatch.com/bills/show/110_HR_7327.html
H.R. 7321
The Auto Industry Financing and Restructuring Act
Costs $87.75 per family
http://www.washingtonwatch.com/bills/show/110_HR_7321.html
Updated Items
S. 3715
The Auto Industry Emergency Bridge Loan Act
Costs $11.59 per family
http://www.washingtonwatch.com/bills/show/110_SN_3715.html
Passed Items
none
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On the WashingtonWatch.com Blog
Illinois Governor Rod Blagojevich's attempt to sell the Senate seat formerly occupied by Barack Obama has captured the headlines. The WashingtonWatch.com blog has an unusual take on it in a post called "The Blagojevich-Obama Connection."
http://tinyurl.com/5e9emv
Last week, the House of Representatives passed a bill to provide federal support to the "Big Three" automakers.
H.R. 7321, the Auto Industry Financing and Restructuring Act would have provided funding sufficient to cover the costs of up to $14.0 billion in bridge loans or commitments for lines of credit to U.S. auto manufacturers.
The cost of the legislation is a little under $90 per U.S. family. Late in the week last week, it appeared that the Senate would not pass the legislation.
H.R. 7321
The Auto Industry Financing and Restructuring Act
Costs $87.75 per family
What People Think: 27% For, 73% Against
http://www.washingtonwatch.com/bills/show/110_HR_7321.html
Last week, both Houses of Congress passed H.R. 7327, the Worker, Retiree, and Employer Recovery Act of 2008. Along with making technical corrections related to the Pension Protection Act of 2006, the bill waives required minimum distribution rules for certain retirement plans and accounts.
The tax savings in the bill save the average U.S. family about $30. The bill now goes to the President, who is likely to sign it into law.
H.R. 7327
The Worker, Retiree, and Employer Recovery Act of 2008
Saves $30.72 per family
What People Think: 57% For, 43% Against
http://www.washingtonwatch.com/bills/show/110_HR_7327.html
Displayed below are new, updated, and passed items with their cost or savings per family.
New Items
H.R. 7327
The Worker, Retiree, and Employer Recovery Act of 2008
Saves $30.72 per family
http://www.washingtonwatch.com/bills/show/110_HR_7327.html
H.R. 7321
The Auto Industry Financing and Restructuring Act
Costs $87.75 per family
http://www.washingtonwatch.com/bills/show/110_HR_7321.html
Updated Items
S. 3715
The Auto Industry Emergency Bridge Loan Act
Costs $11.59 per family
http://www.washingtonwatch.com/bills/show/110_SN_3715.html
Passed Items
none
-----
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