AHIP Questions New Data Available On HHS Insurance Website.

The Hill (10/2, Pecquet) reported in its Healthwatch blog, "New data posted Friday on the government's health insurance Web portal offer consumers a 'pretty good measure' of their chances of being denied coverage, the deputy director of HHS's Office of Consumer Support said." Karen Pollitz said, "It's not perfect...but it gives you a pretty good idea about what to expect in the marketplace today." Meanwhile, Todd Park, chief technology officer at HHS, noted, "Healthcare.gov makes the insurance marketplace more open and more transparent than ever before." The Hill pointed out that the "comments come as America's Health Insurance Plans raises questions about the denial rates that come up on Healthcare.gov when consumers search for insurance in their ZIP code."

        The Wall Street Journal (10/2, Hobson) Health Blog reported that according to Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the denial rates are "misleading." In response, Pollitz acknowledged that this rate "is a hard thing to measure."

Health Reform's High-Risk Pools Confronted With Setbacks.

The AP (10/4, Alonso-Zaldivar) reports, "It's a centerpiece of President Barack Obama's healthcare remake, a lifeline available right now to vulnerable people whose medical problems have made them uninsurable," yet "the Pre-Existing Condition Insurance Plan started this summer isn't living up to expectations." Notably, "some state officials who run their own 'high-risk pools' have pointed out potential problems," such as the fact that "enrollment lags in many parts of the country," and "people who could benefit may not be able to afford the premiums." But, Jay Angoff, director of a new insurance oversight office at HHS, said, "We don't think this is getting off to a slow start. ... We think this is getting off to a good and orderly start." The AP says that "government economists projected as recently as April that 375,000 people would gain coverage this year."

GOP Tactics Could Impede Health Reform Implementation.

The Washington Post (10/4, Aizenman) reports that if Republicans "win the House, and possibly the Senate, they say, among their top priorities will be to undo President Obama's signature legislative achievement," yet, "even in the unlikely event that an outright repeal bill could withstand a filibuster in the Senate, there is little doubt that Obama would veto it." The Post says that "the true battle will probably be fought at the margins, over initiatives Republicans are planning in order to slow or disrupt the administration's preparations for 2014," such as defunding HHS. Yet, if HHS "were not fully funded by the next Congress, it could continue erecting the law's architecture," although HHS Secretary Kathleen Sebelius has said that "the states, certainly, are counting on resources to set up these new marketplaces, and absent those resources, that will be difficult."

Harkin: Patients' Bill Of Rights Protects Americans From Insurers.

Sen. Tom Harkin (D-IA), chairman of the Senate Health, Education, Labor and Pensions Committee, writes in a Politico (10/4, Harkin) op-ed, "Starting this month, health insurance companies can no longer cancel your policy if you get cancer or refuse to cover your child because of a pre-existing condition. A key feature of the new health reform law -- signed by President Barack Obama six months ago -- is a Patient's Bill of Rights," which "cracks down on the worst abuses of health insurance companies and gives Americans important new protections." Harkin says that "health reform is off to a strong start -- ensuring an array of protections and benefits that put people ahead of profits. What's more, Americans now realize that they face a stark choice" between the Patient's Bill of Rights and Republican's pledge to repeal the healthcare law.

Rockefeller Requests Data From McDonald's Insurer.

The Wall Street Journal (10/2, Adamy, subscription required) reported that on Friday, Sen. Jay Rockefeller (D-WV), chairman of Senate Committee on Commerce, Science and Transportation, sent a letter to Scott Beacham, president and CEO of BCS Insurance Group of Oak Brook Terrace, IL, which provides health plans to McDonald's hourly workers. Rockefeller has asked for data from the last five years, which show how much the insurer spent on healthcare and what it charged in terms of premiums. The Journal explained that the letter followed a recent article which said that McDonald's may cease to provide coverage for these employees if it is forced to implement certain requirements in the healthcare law.

Insurers Donating Three Times More To GOP Than Dems This Year.

The Chicago Tribune (10/4, Levey) reports, "Faced with wide-ranging new requirements in the healthcare law, the insurance industry is pouring money into Republican campaign coffers in hopes of scaling back regulations while preserving the mandate that Americans buy coverage." So far this year, "the nation's five largest insurers and the industry's Washington-based lobbying arm have given three times more money to Republican lawmakers and political action committees than to Democrats." The Tribune notes, "That is a marked change from 2009, when the industry largely split its political donations between the two parties, according to federal election filings."

WSJournal: Administration Breaking Health Reform Promises.

In an ongoing exchange with HHS Secretary Kathleen Sebelius, the Wall Street Journal (10/2, A14, subscription required) said that President Obama's promise that Americans could keep their health coverage if they liked it is being tested yet again, this time by McDonald's, which said that meeting a new health reform requirement could result in "a huge disruption" of its workers' coverage, although the government could approve a waiver. The paper added that on Thursday, Sebelius stated that the story reported by the Journal was "flat-out wrong," because McDonald's had said that reports that it planned to drop employee health coverage were "completely false." But, the Journal argued that even if McDonald's does not plan to drop its health plan, the healthcare law is impacting the company, which is why it is seeking a waiver from the Obama Administration.

GAO Commission To Consider US Healthcare Workforce Needs.

CQ HealthBeat (10/2, Reichard, subscription required) reported, "The Government Accountability Office this week named the members of the first-ever commission to advise Congress annually on the healthcare workforce needs of the nation. The announcement came as a new report dramatized the need for better planning on how to handle the millions more people getting insurance and seeking healthcare under the healthcare overhaul." Meanwhile, the "American Association of Medical Colleges (AAMC) said in a statement that according a new analysis by the association, 'there will be a shortfall of 62,900 physicians across all specialties in 2015 as many healthcare reforms take effect. We look forward to working with...the new commission on developing a national strategy to address these and other critical workforce shortages.'"

Schwarzenegger's Healthcare Reform Legacy Discussed.

In an opinion piece in the Los Angeles Times (10/2), Jon Healey wrote, "The GOP's surge across the country has put Obamacare in jeopardy, but California's lame-duck Republican governor has nevertheless signed a series of bills that implement key pieces of the federal healthcare reform law." It's "not exactly the healthcare reform legacy Gov. Arnorld Schwarzenegger envisioned. ... But given how much the federal Patient Protection and Affordable Care Act has in common with Schwarzenegger's initiative, the bills he signed amount to a reasonable consolation prize." Of note, "Schwarzenegger signed two bills (AB 1602 and SB 900) that make California the first state to create an independent insurance exchange for individuals and small businesses to shop for coverage." He "also signed a bill (AB 2244) by Rep. Mike Feuer (D-Los Angeles) that enacts into state law the new federal ban on denying individual policies to children with preexisting conditions."

Medicare Enrollment For 2011 Complicated By Health Reform Requirements.

The New York Times (10/2, B6, Konrad) reported in Patient Money, "Medicare enrollment season is approaching, and many experts say they believe it promises to be a turbulent one -- 'a perfect storm,' said Paul Gada of Allsup, a provider of Medicare plan selection services." Experts point out that "in some areas, there will be dozens, even hundreds, of coverage options," and that current enrollees as well as seniors who are just becoming eligible for Medicare, "must navigate a system that is changing rapidly, in part because of requirements imposed by the new healthcare law. 'It's a complicated year for Medicare beneficiaries,' said Judith Stein, executive director of the Center for Medicare Advocacy." Still, the Times said, "There is good news...on the drug coverage front," because the "new healthcare law eventually will help close the so-called doughnut hole."

HHS Announces $9 Million Grant To Help Seniors Fight Medicare Fraud.

The AP (10/1) reported, "Federal officials are giving millions of dollars to programs around the country that help seniors fight Medicare fraud." HHS Sec. Kathleen Sebelius "will announce the $9 million grant to help Senior Medicare Patrols." The "funds are part of President Barack Obama's mandate to educate seniors and other Medicare patients about how they can help stop the estimated $60 to $90 billion dollar a year problem." CQ HealthBeat (10/2, subscription required) also reported the story.

Georgia Added More People To Medicaid Amid Tough Economy.

The Atlanta Journal-Constitution (10/2, Teegardin) reported, "Georgia's dismal economy pushed the state's Medicaid population up 8.8 percent by the end of 2009 from a year earlier, an increase slightly above the national average," according to a report Thursday by Kaiser Family Foundation's Commission on Medicaid and the Uninsured. The "health insurance plan for the poor added 99,500 children and nearly 18,000 adults to Georgia's program." But "that's a relatively small number compared with the enormous wave that is coming: Under the healthcare overhaul, Georgia's current Medicaid population of about 1.4 million is expected to grow by at least 650,000 between 2014 and 2019."

Pharmacists Slam Wal-Mart's New Medicare Drug Plan.

The Hill (10/1, Lillis) reported that the National Community Pharmacists Association released a statement Friday that "blasted Wal-Mart's latest Medicare prescription drug offering, saying the superstore's joint venture with Humana will penalize seniors who want to buy their drugs from local pharmacies. 'This is simply Walmart's latest loss leader, intended to bring more people through its doors at the expense of patient care and quality customer service,' NCPA President Joseph Harmison said." On Friday, Walmart and Humana announced a partnership to offer seniors a new Part D plan in 2011. The Humana Walmart-Preferred Rx Plan "boasts a national monthly rate of $14.80 per month, but co-payments will vary depending on where seniors purchase their drugs."

Consumers Urged To Consider Health Reform Changes When Selecting New Coverage.

The Atlanta Journal-Constitution (10/3, Teegardin) reported, "The first baby steps of the nation's healthcare overhaul have taken effect," which "means most insurance plans will change, at least slightly, when renewed." Notably, "some consumers who need to be especially alert as the paperwork arrives include: those who use flexible spending accounts for medical expenses, parents of uninsured adult children under age 26, parents of kids with pre-existing conditions and anyone who plans to get preventive care in the coming year." In addition, workers should be aware of health reform changes that affect FSAs, because "starting in 2011, the accounts will no longer pay for over-the-counter medicines unless a doctor writes a prescription for it. And by 2013, contributions to the accounts will be limited to $2,500."

Many Eligible Kentucky Children Lack Health Insurance.

In an op-ed in the Kentucky Post (10/3), Correy Eimer, the community impact associate with the United Way of Greater Cincinnati, wrote that about "2,000 children in Boone, Campbell, Grant and Kenton counties are eligible for Kentucky Children's Health Insurance Program," but "are not enrolled in the program for one reason or another." Eimer says "many families simply assume that their income is too high to qualify for low-cost, state-sponsored health insurance because they are employed full-time." Others may not be "aware of their options" or are "reluctant to enroll" because of "perceived stigma" of the state-sponsored health plans.

Average Federal Health Premium To Rise 7.2%.

Joe Davidson wrote in the Washington Post (10/2) "Federal Diary" that the Office of Personnel Management announced Friday that the average increase for enrollees in the Federal Employee Health Benefits Program will be 7.2%, "significantly more than their average pay raise, which is slated to be 1.4% in 2011. In dollars, federal workers will pay, on average, $5.53 more each pay period for self-only coverage and $11.45 more for family coverage. ... Increased premiums 'will be difficult for federal annuitants to bear in a year when no retirement cost-of-living adjustment is expected and when the federal employee pay raise is anticipated to be minimal or could be cut altogether,' said Margaret L. Baptiste of the National Active and Retired Federal Employees Association."

Health Insurance Coverage May Affect Parental Compliance With Recommended Treatment For Children.

The Los Angeles Times (10/3, Stein) "Booster Shots" blog reported that parental compliance with recommended treatment for children may "have to do with how much health insurance they have," according to a study presented Oct. 3 at the American Academy of Pediatrics conference. After surveying 1,978 parents, researchers found that "about 13%...said they couldn't fulfill at least one of their child's doctor's recommendations in the last year because they couldn't afford it." Specifically, "after controlling for various demographic factors, the authors discovered that having an annual family income between $15,000 and $34,999 was the best forecaster of a child's health taking a hit because the family couldn't pay."

3M Announces Changes To Health Insurance Plan Options.

The Wall Street Journal (10/4, Adamy, subscription required) reports that due to the new federal health regulations, 3M Co. has informed retirees it will no longer offer a group health-insurance plan to retirees not old enough for Medicare by 2015. Beginning in 2015, 3M retirees that are too young to qualify for Medicare will receive financial support through what 3M calls a "health reimbursement arrangement" instead of the group insurance plan.

 

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