Tag Archives: Health Care Reform

Graph of the Day: Health Care Reform Timeline

Although the commentary could be done without, take a look at this timeline graphic (from the Health Insurance Providers):
Health Care Reform


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Social Justice and Allowing Youth to Stay on Their Parents’ Plan

After the signing of the health care reform bill David Leonhardt of the New York Times called the move the, “federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.” While he is right in “nearly every major aspect of the health bill” (now law) does push toward economic equity– one key area where this is far from the case is the popular provision that allows children to stay on their parent’s plan till the age of 26.

The provision in the law enables children to claim dependent status under their parents’ health insurance till the age of 26.  The major reason this provision is in the bill is purely political.  Probably one of the most popular and least controversial ideas, it is a reform that goes into effect immediately.  Voters able to participate will immediately see the benefits of their children being covered. There are two schools of thought regarding the implications of this provision.

President Barack Obama and Democratic leadership will tell you the story of children graduating from college only to find no insurance available because of the poor economy and difficulty finding a job.  There is security in knowing that these recent college graduates can stay on their parents’ plans and are able to get their feet on the ground.  Most importantly they are covered in case of an emergency.

However, the long term implications of the policy and the impact it will have on low income populations is of great concern.  The population that is most effected by this are upper income and upper-middle income families.  These are the populations that are most likely to have health insurance offered by their employer, health insurance with dependent coverage, and parents that are able to pay the additional cost of dependent coverage.

The fear comes in the assumption that this is a majority of the population.

Of concern, coverage in the university setting is threatened if college administrators begin to assume college students will opt for parent coverage.  While it is true that many plans currently cover children still enrolled in college, the additional burden of proving college enrollment and the low cost of the college plans often draw many away from the parent coverage and on to university plans.  College plans are very low cost due to the fact the insurance pool is made up of largely young, healthy individuals. As more college students go to their parents’ plans this may raise the costs for older enrolled students.

The impact this provision will have on employer benefits is also of concern.  If employers begin to assume young people will be covered by their parents we face a situation where employer sponsored coverage is further threatened. For large employers, the desire to bring young, healthy individuals into the insurance pool and keep costs lower will out way the desire not to cover young people, but professions geared at young adults and smaller businesses may opt not to cover.  Because of other provisions in the health care reform bill, young adults have more options of purchasing insurance coverage, however, employer sponsored coverage is preferable under our current health care system.

Most importantly, as mentioned, these provisions benefit upper income individuals and neglect assisting lower income individuals– further creating social inequities.  While there is no doubt that the health care reform law has moved our country in a direction of social equity, voters today will not accept a purely social justice bill.  The dependent coverage provision is designed to provide middle to upper income voters with the security of knowing their own children are protected, potentially at the detriment of less advantaged young people.


update (3-28-10 2:30pm): Read this article in the Washington Post about this issue.


Filed under Health Policy

The Thirty Year History Of Republicans Supporting the Individual Mandate

Over the course of the White House summit on health care reform, Republican members of Congress repeatedly reminded Americans of their opposition to the controversial individual mandate or requirement to purchase insurance. Senator Chuck Grassley (R-IA) said, “The high cost of this bill comes from a non-constitutional mandate.” Minority Leader John Boehner also attempted to bring up the constitutionality of the mandate in a discussion on the deficit.

In August, Grassley laid out a strong defense of the policy by saying, “through an individual mandate and that’s individual responsibility and even Republicans believe in individual responsibility.” A long time supporter of the policy, again in June he said, “there isn’t anything wrong with it [an individual mandate], except some people look at it as an infringement upon individual freedom.”

Republican support for the individual mandate policy goes back further than this health care reform discussion. Earlier this month, Julie Rovner profiled a history of the policy dating back to the 1980’s

In fact, says Len Nichols of the New America Foundation, the individual mandate was originally a Republican idea. “It was invented by Mark Pauly to give to George Bush Sr. back in the day, as a competition to the employer mandate focus of the Democrats at the time.”…

“We called this responsible national health insurance,” says Pauly. “There was a kind of an ethical and moral support for the notion that people shouldn’t be allowed to free-ride on the charity of fellow citizens.”

The policy was originally included in many Republican proposals including the proposals during the Clinton administration. The leading GOP alternative plan known as the 1994 Consumer Choice Health Security Act included the requirement to purchase insurance. Further, this proposal was based off of a 1990 Heritage Foundation proposal outlined a quality health system where “government would require, by law every head of household to acquire at least a basic health plan for his or her family.”

More recently, the Heritage Foundation continued to support the proposal under the Massachusetts health care reform effort passed into law while Mitt Romney was governor. While the proposal did change over the course of the reform process in the state, and Romney and Heritage tried to walk back their support, as Romney admitted this weekend it is, “the ultimate conservative plan.”

The questions raised by tenther individual mandate opponents have largely been debunked by constitutional law experts. Grassley and other Republican are appealing to conservative voters with their recent opposition rather than the constitutional questions. If there had been problems with the legality of the requirement, the argument would have been raised at one point in the last thirty years.

By Emma Sandoe


Filed under Health Policy

China: A Failed Experiment in Private Health Care

Long lines, waits for care, endless bureaucracy: this is what happens when you move to socialized medicine, right? Wrong. For years, the Republicans in Congress have argued a socialized, government run health care system would lead to all of these things, but as China recently found out– moving from a socialized system to a private market system, like we have here, has caused increased problems of accessing medical care.

A recent column by David Pierson in the LA Times is well worth a read and outlines the growing problems of the health care system in China.

Appointments for the best doctors are normally snapped up before sunrise. Lines begin forming in front of the hospital’s six registration counters at least a day in advance.

Communist China had a socialized health care system, but as many things in the country has been shifting toward a Western style with limited government involvement in recent years. This has created large disparities in access to medical care between the wealthy and the poor and between urban and rural populations.

China is taking action. The government has launched a campaign aimed at rural areas which will invest $124 billion in rural services.  However, it may already be to late. Thousands of rural residents have migrated into the cities citing the broken rural health care system.

Rationing is unfortunately part of the health care system no matter the level of government involvement.  When put simply, there are a limited number or resources and at times the demand overwhelms the supply.  It is unfair to say a shift from a private system to a system with greater government envolvement will solely cause a nightmare situation.  As we have seen, encouraging the private market causes rationing and long lines.  The real trick is balancing the government involvement and ability to reduce disparities in access with the beneifits of the private market system.

By Emma Sandoe

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Obama Administration Action on Anthem Blue Cross Insurance Increases

As reported earlier, Anthem Blue Cross of California is raising insurance rates as much as 39% for California consumers.  Today it is reported, Secretary of the Department of Health and Human Services, Kathleen Sebelius,  wrote a letter to the company asking to “provide a detailed justification for these rate increases to the public.”

Sebelius also addressed an issue important to the Senate health care reform bill, Medical Loss Ratios- or the amount an insurer spends on care in comparison to profits, administration and advertising.  “Additionally, you should make public information on the percent of your individual market premiums that is used for medical care versus the percent that is used for administrative costs.” As Jake Tapper reports, Anthem earned $2.7 billion and sales rose 26% in just the last quarter of 2009.  Under reform if a company were to see large profits without significant increases in health care costs, consumers would be reimbursed for their premium payments rather than see premiums skyrocket.

The Obama administration has been criticized in recent weeks about the slow response to addressing health care reform since the election of Scott Brown. This move is perhaps a signal from the administration that they are readying to become aggressive about health care reform.  Coupled with President Obama’s announcement yesterday of a February 25th summit with GOP leaders about health proposals, the White House appears to be going on the offensive to speeding the health care reform process.

By Emma Sandoe


Filed under Health Policy

Why the Insurance Market Needs Health Care Reform

Yesterday the LA Times reported some individual insurance policies in the state are rising premium rate increases of over 39%.  With the health care reform bill stalled in Congress, this story illustrates one of the many reasons for reform.

Anthem Blue Cross is telling many of its approximately 800,000 customers who buy individual coverage — people not covered by group rates — that its prices will go up March 1 and may be adjusted “more frequently” than its typical yearly increases.

The individual insurance market is the main culprit of many of the egregious practices health care reform would correct.  Preventing pre-existing condition exclusions, lifetime and annual limits, and other abuses are the core hallmarks of the legislation.  The bills before Congress would greatly reduce the number of people enrolling in individual market plans.  Instead of signing up for these high cost, low benefit plans, individuals can join together in a broader pool within the health insurance exchange to lower costs.  There would also be a minimum standard of benefits that would be required to ensure all plans provide quality coverage.

As the numbers of uninsured continue to grow, obstructing needed health insurance reform will only make more individuals subject to these inane practices. The Republican party and Scott Brown’s (R-MA) election has allowed these practices to continue.

Thus far, the President has not yet put urgancy on Congressional leaders to find the procedural avenues to pass health care reform.  Telling the Democratic National Committee “Just in case there is any confusion out there, I’m not going to walk away from health insurance reform.” is different than actually finding the specific path to do it, or sitting down Congressional leaders until a solution is reached.

By Emma Sandoe


Filed under Health Policy

An Open Letter To Health Care Reform Supporters and Advocates

I get it.  You’re deflated, feel as though health reform is out of your control, like everything you’ve done could mean little, and you don’t need a young idealist telling you what to think.  Well as that young idealist– now is not the time to give up.

One of the highlights of the presidential campaign was the youth involvement and excitement over the political process.  If health care reform is not given a full, need I say comprehensive, final push, Democrats are at risk disillusioning this generation. Whatever the result may be, young people need political heroes now more than ever.

Today, President Obama told Senate Democrats to ignore what they hear on the blogs, cable television or other media.  However, this is the time when what is reported in the media, through advocacy organizations, and supporters in the public matters the most.  If leaders begin to feel a lack of support, they will drop like flies.  You, as supporters of health care reform, should be beating the drum louder than ever before.  And you should be paying attention to what is written too.  Believe it or not, there is good news out there.

The White House finally seems to be getting behind a strategy. It was reported today that the administration privately supports the House passing the Senate bill and nearly simultaneously the Senate passing improvements through the reconciliation process.  Nancy Pelosi and Harry Reid are meeting with the president to discuss strategy – and actually communicate – tomorrow.

Hundreds of reformers have been working on this effort for over a year, we are all tired.  Health reform has been the professional goal of so many policy gurus.  It is easy to say we are closer than ever before and that we’ve worked hard.  It is easy to say the story is old and that there is nothing left to write about. But it’s not right. We are far from the end of what can be written on health care reform.  Although no health care reform bill would be a professional loss and personal defeat, must we be reminded why we are here?

The millions of Americans without access to health insurance, the small businesses that are crushed by increasing costs, the horror stories, and the daily accounts of frustration– we are fighting to improve the country.  We are fighting to make the lives of others better.

Mistakes have been made along the way.  Politicians make mistakes. But they are not acting alone.  It is the job of advocates to ensure these mistakes don’t put reform on “life support.”

No one wants to live with regrets.  At these crucial stages, one action can make a significant difference.  It is time to dig in your heels, push that extra mile, and become that hero that is needed by all generations.

By Emma Sandoe


Filed under Health Policy