Tag Archives: Health Care

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

Bad Day for Massachusetts, Bad Day for America

Martha Coakley lost the special election to replace Ted Kennedy in Massachusetts today.  This leaves not only the future of health care reform up in the air, but the future of other progressive ideas and movements.  It’s time to dig in the heels, roll up the sleeves, and work even harder and learn from Kennedy to accomplish reform.

The twitter trending topics say it all:

*#masen is twitter code for Massachusetts (MA) Senate (Sen)=MASen


Filed under Economy, Health Policy

Enrollment and Eligibility In Health Care Reform

After health care reform passes it’s final hurdle and is passed into law, the next major problem facing reformers will be implementing the bill so that before the next several elections it appears to be a success.  Success means the number of uninsured will be reduced and the benefits promised will get to the individuals in need.  Unfortunately, the current versions of the bill do not make this process simple.

The Urban Institute released a report yesterday that highlights the key changes that can be made to the House and Senate bills that will make enrollment, eligibility determination, and retainment in Medicaid and to receive subsidies in the exchange easier.  Some of their recommendations include:

The streamlining provisions contained in Section 1413 of the Senate bill,

which require a single application form and eligibility system for all subsidies

under reform (Medicaid, CHIP, and subsidies in the exchange) and which

take other steps to base eligibility on government data whenever possible,

thereby reducing the need for consumers to complete forms before receiving

or retaining coverage;

The corrections to that section contained in Senate Amendment 3167,

which apply to Medicaid the same streamlined procedures for eligibility and

enrollment that are planned for the exchange; and

A compromise between annual eligibility periods in the Senate bill and

“real time” eligibility updates in the House bill that establishes annual

subsidy eligibility, as a general rule, while making exceptions for essential

mid-year adjustments.

While these provisions may appear to be minor in comparison to the top-line provisions such as abortion, taxes, and the national exchange currently plaguing Congressional leaders, making the enrollment process simple is the key to the bill’s success.  The Medicaid expansion equates to 41% of the newly insured.  States will need assistance in ensuring that as many of the newly eligible for Medicaid sign up for the state based program.  Whether the exchange is national or state based, the administration and determination of eligibility for subsidies must be easy for the consumer.

Without a streamlined and efficient process for individuals to participate in the new and expanded programs created by the bill, the work of reformers is wasted.


Filed under Health Policy

Graphs of the Day: Public Insurance Replacing Private Insurance

One of the main impetuses in passing health care reform is the desire to reverse the decline in employer sponsored insurance that our nation has seen over the past decades.  Health care reform would essentially bolster the employer sponsored private insurance system by providing incentives for large employers to continue coverage and subsidies to small employers to offer coverage.

At the same time, 15 million more Americans are expected to receive fully public financed Medicaid and CHIP health insurance. Also, 20 million individuals will have their private health insurance subsidized by the federal government in form of subsidies which people will use to purchase insurance in the exchange.

The Center for Disease Control and Prevention tracks trends in public vs. private health insurance coverage.  This graph shows the how near poor children have fared over the last decade.

Similarly, this graph illustrates the trend for near poor adults.  With the new reforms will these trends continue?

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Filed under Health Policy

The Case for the CLASS Act

With the public option no longer the point of contention in the Senate health care reform debate, and with the reform looking to pass its final senate vote tomorrow, Senate Republicans have turned their attention to the CLASS Act.  Rather than discuss taxes or clinging to Medicare cuts, the GOP declared this long-term care insurance program the “new government entitlement” that the public option once was. In fact, this program is not only necessary, it is one of the more progressive aspects of the bill.

The Community Living Assistance Services and Support (CLASS) Act is a long-term care insurance program.  Individuals would have the option to purchase insurance for services needed once they are elderly or disabled.  Once an individual needs assistance with activities of daily living (dressing, eating, and general hygiene), the insurance would pay for individuals and centers that help with these services.

Interestingly, the program is run through a national insurance pool.  Additionally, every employed individual would be enrolled in the program through payroll taxes unless they chose to opt out of the program. Kaiser Family Foundation has a good summary:

Establish a national, voluntary insurance program for purchasing community living assistance services and supports (CLASS program). Following a five-year vesting period, the program will provide individuals with functional limitations a cash benefit of not less than an average of $50 per day to purchase non-medical services and supports necessary to maintain community residence. The program is financed through voluntary payroll deductions: all working adults will be automatically enrolled in the program, unless they choose to opt-out.

The Manager’s Amendment limited the act by no longer allowing purchase of the insurance within the exchange.  Aside from that, the House and Senate versions of the program are very similar, although the Senate version starts a year later.

When it comes down to it, our country is on the verge of a fiscal crisis in long term care.  As the baby boomer generation gets older and individuals live longer, cost to both our federal and state governments as well as the costs to individuals increases dramatically.

With new research by the MacArthur Foundation study found life expectancy will be higher than current government estimates.  The Census Bureau and Social Security Administration estimate the average life expectancy to be 85.3 for females and 80.9 for males by 2050. This study indicates true life expectancy will be up to 93.3 for women and up to 85.9 for males. This 8 year increase could cost Medicare and Social Security $3.2-$8.3 trillion more than current projections.

We must address this problem before it destroys our country’s finances. People must invest in care that will be necessary in the future. The CLASS Act is an insurance program that will not only protect our federal finances, it will protect our seniors.

By Emma Sandoe

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Filed under Health Policy