The Washington Times (8/17, Cunningham, P W) reports that “Massachusetts’ uninsured rate plunged to the lowest in the nation, from 6.4 percent to 1.9 percent.” This has been attributed to Gov. Mitt Romney’s groundbreaking health care legislation that was enacted in 2006. It may be noted that “[T]he rest of the nation averages close to 17 percent.” The report states that “nearly every child has coverage, and more businesses are offering insurance plans.” The legislation aimed to extend insurance coverage to most residents and the aim has been realized but “with costs rising faster than inflation, lawmakers face the challenge of how to pay for it all.” At the same time, health care premiums continued to outpace inflation by rising to “an average of 5 percent to 10 percent each year.” Analysts now say that the only lasting solution to ballooning costs is to change “the way consumers shop for health care.” In this situation the report adds the comment of Jon Hurst, president of the Retailers Association of Massachusetts as saying that “the law was a great success for low-income consumers.” However, he called “it a failure on costs and for small businesses who don’t have the leverage of larger companies.” Now, analysts say that both Obama’s and Romney’s plans face questions over how to pay for their reforms over the coming decades.
Summary Of Benefits And Coverage Would Help Consumers To Understand Plans
New York Times (8/17, Pear, R) reports that the Obama administration proposed new rules on Wednesday that health insurance companies and employers would provide “summary of benefits and coverage” to consumers and employees “in plain English.” Kathleen Sebelius, the secretary of health and human services, commented that this “would make it easier for consumers to shop for insurance and compare plans.” It is expected that these documents will help consumers come out of the act of deciphering “mind-boggling variety of configurations” of different insurance policies. Although insurers said “they supported the goal of the new rule, to educate consumers about their choices,” Robert E. Zirkelbach, a spokesman for America’s Health Insurance Plans, a trade group, said that “compliance could be expensive for insurers.” According to him, insurers and employers have to “create tens of thousands of different versions of this new document” as there will be many different packages. It is estimated by the administration that “it would cost insurers and employers $50 million a year to compile and disseminate the required information.” In the summary of benefits and coverage, the basic questions will be answered and there will also be a “glossary offering standard, government-approved definitions of more than 40 terms commonly used in health insurance coverage.” If insurers and employers fail to send the required disclosure form, they can be fined up to $1,000 for each policyholder or employee.
Medicare Part D Cost To Go Down, Sebelius Says
Politico (8/5, Nocera) reports that according to new data about Medicare “seniors have saved $460 million in prescription drugs since the health care law came into effect.” Administration officials commented that this happened due to drug discounts and doughnut hole rebates. New data from HHS states that “more than 1 million seniors have taken advantage of free preventive wellness visits under the health reform law” and “beneficiaries in the doughnut hole saved more than $200 million in the month of June alone.” Moreover, premiums for private Part D benefits in 2012 have been calculated to be at average $30 million which is less than that in 2011. In this connection officials said, “The approval of generic versions of brand-name drugs and market competition contributed to the decrease.” The report states that insurers also praised the market competition working behind the success in Part D. In this scenario AHIP President Karen Ignagni commented, “Taxpayers are also saving billions of dollars as the total cost of the program continues to be far below original projections.”
Premiums For Medicare Prescription Drug Plans Won’t Go Up In 2012
Bloomberg News (8/4, Armstrong, D) reports that “premiums for Medicare prescription drug plans run by private insurers won’t go up in 2012.” The report states that in 2012 beneficiaries will pay $31.08, on average, for access to the drug plans; whereas, this amount is $30.76 in 2011. Medicare Administrator Donald Berwick said that the largely unchanged premiums combined with drug discounts in the 2010 health overhaul are going to “lower out-of-pocket spending by Medicare beneficiaries.” In this connection Berwick said, “It’s a competitive market and we’re seeing the effect of good competition among Part D plans take its effect.” Moreover, Berwick and Sherry Glied, the assistant secretary for planning and evaluation at the Department of Health and Human Services commented that “increased use of generic drugs and drugs coming off of patent protection” are also some driving forces. It may be mentioned that Pfizer’s top-selling drug Lipton which is accounted for the second-most spending in Medicare in 2009 loses patent in November.
‘Flexibility’ To Meet Health-Care Law Makes Political And Practical Sense
The Washington Post (7/12, Aizenman) reports that the Obama administration has proposed rules redefining what “ready” means as “many states may not be ready to meet a crucial requirement of the federal health-care law passed last year.” According to the health-care law, federal officials must decide by Jan. 1, 2013 whether each state will be capable of getting its insurance marketplaces up and running by 2014. In case of failing to do so, the federal government would “step in with its own version.” It may be noted “that 10 states have enacted legislation to set up exchanges, six others are moving forward without new laws, and the ranks of these early adopters include Republican-led states.” In this scenario, “the regulations proposed Monday address that issue by trading the club of federal intervention for the carrot of increased ‘flexibility’.” States may get “conditional approval” of their plans if they “appear likely to have their exchanges operational by 2014.” States with only “some of the pieces in place would be able to create partnerships that draw on the federal versions.” Now the analysts on all sides of the debate comment that “the move makes political and practical sense.”
Obama Administration Eased Some Requirements On Insurance Exchanges
The Los Angeles Times (7/12, Levey) reports that the Obama administration proposed regulations on Monday “that will give states wide latitude in deciding how to regulate insurance companies that sell plans in their exchanges” as creating the exchanges has proven a major challenge in many statehouses nationwide. Dr. Don Berwick, head of the Center for Medicare and Medicaid Services, which is in charge of overseeing the exchange regulations said, “Flexibility is the name of this game and we are going to work very hard to meet the needs of each and every state.” This action “drew praise from consumer groups, including Small Business Majority, an advocacy group for small employers.” With the regulations, “small employers with fewer than 100 employees also will be able to use the exchanges, which will have to offer plans with a minimum level of coverage. No plans will be able to deny coverage to people with pre-existing conditions.” The report comments that “[t]hese state-based exchanges are intended to make buying a health plan comparable to shopping the Internet for an airline ticket or a hotel room.”
Obama Administration Unveiled Standards For Insurance Marketplaces
The New York Times (7/12, A12, Pear, Subscription Publication) reports that the Obama administration now unveiled standards “for insurance marketplaces that will allow individuals, families and small businesses in every state to shop for insurance, compare prices and benefits and buy coverage” so that the new health care law can be carried out. This came in the scenario “where more than two dozen states are challenging the constitutionality of a requirement for most Americans to carry insurance.” Kathleen Sebelius, the secretary of health and human services, commented that the insurance exchanges “will offer Americans competition, choice and clout.” Although both liberals and conservatives support the exchanges in principle, they disagree on how the exchanges should be configured. The regulations issued Monday “were welcomed by consumer groups, patient advocates and some business lobbyists.” In fact, the Congressional Budget Office predicts that by 2019, about 24 million people will have insurance through exchanges and “people with incomes up to four times the poverty level (about $89,000 a year for a family of four) will be eligible for subsidies to make insurance more affordable.” New flexibility in the regulations would allow for “conditional approval” for any state that “was on track to operate an exchange by January 2014,” Ms Sebelius said.
Another Congressional Democrat Opposes President Obama On IPAB
The Daily Caller (7/12, Boyle) reports that along with others, Rep. Allyson Schwartz of Pennsylvania and Rep. Michael Capuano of Massachusetts, now Virgin Islands non-voting Del. Donna Christian-Christensen “became the eighth congressional Democrat to oppose President Obama on the Independent Payment Advisory Board (IPAB) on Monday.” It may be added that “IPAB is a 15-member board, appointed by the president, slated to go into effect in 2014. It will recommend how much money Medicare recipients, including seniors, can get for health care.” Rep. Phil Roe, Tennessee Republican, who introduced the legislation, is “pleased” about the “growing bipartisan support to repeal the IPAB” because he thinks “it will lead to rationing of care by government bureaucrats.”
Moreover, on FNC America’s Newsroom (7/11, 9:00 a.m. EST), Dr. Marc Siegel argued that IPAB would institute government rationing and commented that “Medicare is the torch bearer. In other words, once Medicare decides that it’s not going to cover a service, then the private insurers always follow suit,” and eventually this would make the situation “a lot worse.”
Rebel Senators Propose Monthly Increase In Premiums To Save Medicare
The AP (6/28, Espo, D) reported that two senate rebels Sen. Joseph Lieberman, I-Conn and Sen. Tom Coburn of Oklahoma proposed “to raise the age of Medicare eligibility to 67 and increase monthly premiums for millions of current beneficiaries.” In this connection Sen. Joseph Lieberman, I-Conn commented, “We can only save Medicare if we change it.” Obviously, the Democrats responded with criticism of the proposal but Republicans “betrayed no sign of support either.”
The report comments that “the response underscored the difficulty of legislative free-lancing at a time the Obama administration and congressional leaders are struggling to negotiate a compromise that cuts future deficits and clears the way for an increase in the nation’s $14.3 trillion debt.” It may be added that the most recent report by the Medicare trustees says that “the giant program’s insurance fund is projected to run out of money in 2024, five years earlier than last year’s estimate.” The plan by Lieberman and Coburn “includes a gradual increase over the next five years in the monthly premium that seniors pay for doctor and other non-hospital services.” This increase has been translated into a “monthly increase of $15 to $20 initially.” This plan would preserve Medicare as a government program and so it won’t be like the House GOP proposal that would require millions of future beneficiaries to purchase coverage from private insurance companies.
By VIRGINIA RANSBOTTOM
South Bend Tribune Staff Writer
3:04 p.m. EDT, May 4, 2011
PLYMOUTH — The Indiana State Department of Health’s Immunization Division has issued new childhood and adult eligibility policies for publicly funded vaccines that will go into effect July 1.
According to Indiana State Health Commissioner Gregory Larkin, many community physicians are referring patients with adequate health insurance to local health departments for vaccinations that are intended only for residents who are without insurance or who are under-insured and unable to pay for the immunizations.
Misapplications of these state and federally funded vaccinations will lead to premature depletion of vaccination supplies in local health departments, according to reports.
Appropriately using both private and public resources will best assure broader community immunizations, Larkin said in a written communication.
The guideline changes for free immunizations at all local health departments for children age birth through age 18 are as follows:
You are not eligible if:
Your insurance covers vaccinations partially or fully. Contact your medical provider for vaccine needs.
You are eligible if:
Your insurance cap on vaccines has been met.
Your insurance does not cover vaccinations.
Your children are covered by Medicaid.
You are uninsured.
You are Native American or Alaskan Native