Senate Democrats have reached an agreement that creates a health insurance "exchange," a new entity intended to produce a more organized and competitive market for health insurance. The Healthy Families Insurance Exchange will offer enrollees a choice of private health insurance plans, including at least two national insurance plans modeled after those offered to federal workers.
The Exchange will provide consumers with transparent information about plan provisions such as premium costs and covered benefits and assist consumers who encounter billing or access problems with their plans. The Exchange will also coordinate enrollment shifts between Medicaid and SCHIP, and private coverage for people with changing incomes.
The Exchange will work with small businesses to determine eligibility for and administer income-related subsidies. Employers with 25 or fewer workers and average wages of $50,000 or less would qualify for tax credits for up to six years. The amount, up to 50 percent of premium costs, phases out as businesses grow and average wages increase.
Sunday, December 20, 2009
Sunday, December 6, 2009
Health Care Reform, A Lost Opportunity
With over 48 million Americans currently uninsured, what is the strategy in New York and California? Sadly, there is none. We know that premiums purchased by private businesses have increased much faster than premiums negotiated through Medicaid and the State Children's Health Insurance Program (SCHIP) over the last ten years.
In California, premiums paid by private businesses increased by over 138 percent between 1999 and 2008 while Medicaid premiums increased by 23 percent and SCHIP premiums rose by only 38 percent. Medicaid and SCHIP continue to rank among the few health care programs nationwide that have been successful in controlling health insurance costs.
As Congress and the Obama Administration argue about whether to include a public option in the final health reform package, any overhaul of the current health care system must include a discussion about controlling costs. New York's Child Health Plus and California's Healthy Families have enrolled over 1.4 million children while controlling cost by contracting with private insurers.
By providing health insurance to previously uninsured children, both states have reduced their overall health care costs. Now, severe budget restraints threaten to reverse those gains in 2010, as rising unemployment and a decline in personal incomes add 6.9 million Americans to the ranks of the uninsured. Health care reform should not be held hostage to partisan bickering, the lost opportunity is just too great.
In California, premiums paid by private businesses increased by over 138 percent between 1999 and 2008 while Medicaid premiums increased by 23 percent and SCHIP premiums rose by only 38 percent. Medicaid and SCHIP continue to rank among the few health care programs nationwide that have been successful in controlling health insurance costs.
As Congress and the Obama Administration argue about whether to include a public option in the final health reform package, any overhaul of the current health care system must include a discussion about controlling costs. New York's Child Health Plus and California's Healthy Families have enrolled over 1.4 million children while controlling cost by contracting with private insurers.
By providing health insurance to previously uninsured children, both states have reduced their overall health care costs. Now, severe budget restraints threaten to reverse those gains in 2010, as rising unemployment and a decline in personal incomes add 6.9 million Americans to the ranks of the uninsured. Health care reform should not be held hostage to partisan bickering, the lost opportunity is just too great.
Thursday, December 3, 2009
Support our Troops in Afghanistan and Iraq
We honor the service of, Major Megan McClung, of Coupeville, Washington, Specialist Vincent Pomante, of Westerville, Ohio, and Captain Travis Patriquin, of Lockport, Illinois, who were killed in action, December 6, 2006, in Al Anbar province, Iraq.
Monday, November 2, 2009
Healthy Families and the Middle Class
Already struggling in a tough economy, many families in California are about to face another big hit: noticeably higher increases in health-insurance premiums. The clearest evidence of higher premiums comes directly from insurers themselves. As they released second-quarter earnings in recent weeks, Kaiser Permanente and Anthem Blue Cross reported less aggressive pricing by their competitors, making it easier to charge premiums that would assure a solid profit.
The Healthy Families program can help offset the large increases in premiums facing middle class families. By raising the income eligibility from 250 percent to 400 percent of the Federal Poverty Level, 300,000 children would become eligible for health, dental, and vision insurance. The annual income eligibility for a family of three would be increased from $46,000 to $73,000. There would also be an exemption for parents who can no longer afford the cost of private coverage if it exceeds 5 percent of their monthly income.
The cost to expand Healthy Families to middle class families would be approximately $450 million. The Federal government would pay $300 million, using the formula of a two-to-one federal/state match. A tax surcharge on health insurance companies under contract to MRMIB would add $50 million. Monthly premiums paid by parents would bring in an additional $100 million, making the expansion to 400 percent of the Federal Poverty Level, revenue neutral. All children in California should have access to affordable health insurance. It's the right thing to do.
The Healthy Families program can help offset the large increases in premiums facing middle class families. By raising the income eligibility from 250 percent to 400 percent of the Federal Poverty Level, 300,000 children would become eligible for health, dental, and vision insurance. The annual income eligibility for a family of three would be increased from $46,000 to $73,000. There would also be an exemption for parents who can no longer afford the cost of private coverage if it exceeds 5 percent of their monthly income.
The cost to expand Healthy Families to middle class families would be approximately $450 million. The Federal government would pay $300 million, using the formula of a two-to-one federal/state match. A tax surcharge on health insurance companies under contract to MRMIB would add $50 million. Monthly premiums paid by parents would bring in an additional $100 million, making the expansion to 400 percent of the Federal Poverty Level, revenue neutral. All children in California should have access to affordable health insurance. It's the right thing to do.
Sunday, October 25, 2009
David Paterson versus the Terminator
In California, Governor Arnold Schwarzenegger is ending his term in office as one of the least popular governors in California history. Political pundits are even starting to talk about him in the past tense, as if his administration is already over. In New York, there's an ongoing debate on whether a face-off between Governor David A. Paterson and Attorney General Andrew M. Cuomo would open the door to a Republican victory in 2010. While only about a fifth of New Yorkers say Mr. Paterson is doing a good or excellent job, he has insisted that he has no intention of abandoning the race for governor next year.
One major difference in the respective performance of each Governor is health care. Gov. Paterson increased the income eligibility for Child Health Plus to 400 percent of the Federal Poverty Level, making approximately 70,000 additional uninsured children eligible for the State Children's Health Insurance Program (SCHIP). In California, Gov. Schwarzenegger used his line-item veto authority to eliminate $50 million from the Healthy Families program, placing more than 75,000 eligible children on a waiting list for health insurance. He also vetoed a bill that would have prevented health insurance companies from continuing rescission policies that denied health insurance to thousands of their own customers.
In July, Gov. Paterson signed into law three bills that will make health insurance more affordable for New Yorkers. The first extends COBRA coverage from 18 to 36 months; the second allows families to cover children through age 29 under their employer-based insurance; the third enacts a series of managed care reforms to improve access to health care. Gov. Schwarzenegger vetoed two bills that would have expanded public health insurance programs for children. One bill would have raised income eligibility limits while the other bill would have allowed the use of a single form to determine SCHIP eligibility. The clear winner in this contest is Mr. Paterson, the Governor from New York.
One major difference in the respective performance of each Governor is health care. Gov. Paterson increased the income eligibility for Child Health Plus to 400 percent of the Federal Poverty Level, making approximately 70,000 additional uninsured children eligible for the State Children's Health Insurance Program (SCHIP). In California, Gov. Schwarzenegger used his line-item veto authority to eliminate $50 million from the Healthy Families program, placing more than 75,000 eligible children on a waiting list for health insurance. He also vetoed a bill that would have prevented health insurance companies from continuing rescission policies that denied health insurance to thousands of their own customers.
In July, Gov. Paterson signed into law three bills that will make health insurance more affordable for New Yorkers. The first extends COBRA coverage from 18 to 36 months; the second allows families to cover children through age 29 under their employer-based insurance; the third enacts a series of managed care reforms to improve access to health care. Gov. Schwarzenegger vetoed two bills that would have expanded public health insurance programs for children. One bill would have raised income eligibility limits while the other bill would have allowed the use of a single form to determine SCHIP eligibility. The clear winner in this contest is Mr. Paterson, the Governor from New York.
Sunday, October 18, 2009
Greed and California Health Insurers
The Merrian-Webster dictionary defines deafness as an unwillingness to hear or listen. There is a sobering deafness coming from two large health insurers in California this summer. After a study from UC-Berkeley's School of Public Health revealed that premiums paid by employers in California increased by 138% between 1999 and 2008, Kaiser Permanente announced that second quarter net income had increased to $620 million from $351 million in the second quarter of last year and Anthem Blue Cross reported second-quarter net income of $693.5 million.
When President Obama said, "that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest.”, Anthem Blue Cross CEO Angela Braly stated that she remained opposed to a government-run health plan. The deafness of Kaiser Permanente and Anthem Blue Cross, even after losing $3 billion due to reckless investments in 2008 and paying $15 million in fines for rescission policies that denied health insurance to thousands of their own customers, is disturbing and counter-productive.
When President Obama said, "that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest.”, Anthem Blue Cross CEO Angela Braly stated that she remained opposed to a government-run health plan. The deafness of Kaiser Permanente and Anthem Blue Cross, even after losing $3 billion due to reckless investments in 2008 and paying $15 million in fines for rescission policies that denied health insurance to thousands of their own customers, is disturbing and counter-productive.
Tuesday, September 15, 2009
Healthy Families and Small Businesses
Already struggling in a tough economy, many small employers in California are about to face another big hit: noticeably higher increases in health-insurance premiums. Some premium increases being quoted to employers are double those quoted just a few months ago. The clearest evidence of higher premiums comes directly from insurers themselves. As they released second-quarter earnings in recent weeks, Kaiser Permanente and Anthem Blue Cross reported less aggressive pricing by their competitors, making it easier to charge premiums that would assure a solid profit. Kaiser Permanente announced that their second quarter net income had increased to $620 million from $351 million in the second quarter of last year, while Anthem Blue Cross reported second-quarter net income of $693.5 million.
For many small businesses, the higher premiums couldn't come at a worse time. A study from UC-Berkeley's School of Public Health showed that premiums paid by private businesses in California increased by 138 percent between 1999 and 2008. Because small-business employees make up a disproportionate share of the country's uninsured, 15 percent of U.S. residents, or about 46 million people, were uninsured in 2008. Meanwhile, more than a third of workers at small businesses with fewer than 25 employees were uninsured in that year, and 21 percent of employees at firms with 25 to 99 workers had no coverage, according to the Kaiser Family Foundation. Traditional health insurance last year cost on average $382 a month per employee at businesses with fewer than 200 workers, according to Kaiser.
As the Obama administration works on getting comprehensive health-care legislation through congress, some local organizations are finding creative ways to help cover one of the most affected groups -- employees of small businesses. These programs typically involve collaboration between business owners, nonprofit groups and local hospitals, which offer enrollees a range of medical services at a reduced rate. One type of plan is called 3-Share, because employers and workers each pay a third of the cost with nonprofit groups using funds from government, foundations and hospitals for the balance. Family members are not covered under 3-Share plans. But small businesses can enroll their employees children in the Healthy Families program, which provides health, dental, and vision insurance to children under the age of 19 for less than $16 per month for one child or $48 per month for three or more children.
For many small businesses, the higher premiums couldn't come at a worse time. A study from UC-Berkeley's School of Public Health showed that premiums paid by private businesses in California increased by 138 percent between 1999 and 2008. Because small-business employees make up a disproportionate share of the country's uninsured, 15 percent of U.S. residents, or about 46 million people, were uninsured in 2008. Meanwhile, more than a third of workers at small businesses with fewer than 25 employees were uninsured in that year, and 21 percent of employees at firms with 25 to 99 workers had no coverage, according to the Kaiser Family Foundation. Traditional health insurance last year cost on average $382 a month per employee at businesses with fewer than 200 workers, according to Kaiser.
As the Obama administration works on getting comprehensive health-care legislation through congress, some local organizations are finding creative ways to help cover one of the most affected groups -- employees of small businesses. These programs typically involve collaboration between business owners, nonprofit groups and local hospitals, which offer enrollees a range of medical services at a reduced rate. One type of plan is called 3-Share, because employers and workers each pay a third of the cost with nonprofit groups using funds from government, foundations and hospitals for the balance. Family members are not covered under 3-Share plans. But small businesses can enroll their employees children in the Healthy Families program, which provides health, dental, and vision insurance to children under the age of 19 for less than $16 per month for one child or $48 per month for three or more children.
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