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AHIP: Reform will add $4,000 per year to health care premiums

Monday, October 12th, 2009

As the Senate Finance Committee prepares for a Tuesday vote on health care reform legislation, the private insurance trade group under the America’s Health Insurance Plans (AHIP) has gone on the offensive saying Max Baucus‘ America’s Healthy Future Act would actually escalate the already skyrocketing rise in health insurance premiums. In a report issued by PriceWaterHouseCoopers and commissioned by AHIP, researchers found that insurance premiums could go up by as much $4,000 per year (an 111-percent increase) if Congress adopts the plan now know as BaucusCare versus a 79-percent increase if no reforms are adopted.

Key Findings

Health reform could have a significant impact on the cost of private health insurance
coverage.

There are four provisions included in the Senate Finance Committee proposal that could
increase private health insurance premiums above the levels projected under current law:
o Insurance market reforms coupled with a weak coverage requirement,
o A new tax on high-cost health care plans,
o Cost-shifting as a result of cuts to Medicare, and
o New taxes on several health care sectors.

The overall impact of these provisions will be to increase the cost of private insurance
coverage for individuals, families, and businesses above what these costs would be in
the absence of reform.

On average, the cost of private health insurance coverage will increase:
o 26 percent between 2009 and 2013 under the current system and by 40 percent
during this same period if these four provisions are implemented.
o 50 percent between 2009 and 2016 under the current system and by 73 percent
during this same period if these four provisions are implemented.
o 79 percent between 2009 and 2019 under the current system and by 111 percent
during this same period if these four provisions are implemented.

(From PriceWaterHouseCoopers’  Potential Impact of Health Reform on the
Cost of Private Health Insurance Coverage)

The timing of this new report couldn’t be worse for the White House and Congressional Democrats as three key members of the Finance Committee - Democrats Kent Conrad and Blanche Lincoln along with Republican Olympia Snowe , have yet to announce their intended votes on the bill but have all expressed concern over the potential costs to consumers if Americans are forced to purchase health insurance via an individual mandate which is included in not only the Baucus bill but all five of the bills currently being considered on Capitol Hill.

“This is a self-serving analysis from the insurance industry, one of the major opponents of health insurance reform,” White House spokesman Reid Cherlin said. “It comes on the eve of a vote that will reduce the industry’s profits. It is hard to take it seriously,” he added. (From Reuters’ White House blasts health insurance sector report.)

Democrats Jay Rockefeller and Ron Wyden have also expressed concern that the Finance bill’s lack of a government-run public option insurance plan will leave tens of millions of Americans without an affordable insurance option should Baucus’ cooperatives approach to reform be adopted in a final Senate bill and have refused to throw their support behind the bill ahead of the vote.

If the Finance Committee fails to pass a bill out of committee during tomorrow’s vote - or the vote is postponed due to a lack of support, health care reform could very well be off the table for 2009.

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Women, health care reform and 2010 …

Friday, October 9th, 2009

Soccer moms … Security moms … Health care moms?

If Democrats in Congress have their way, health care moms may be the buzz word of the 2010 midterm elections. As Democrats scramble to find a way to rationalize poll numbers that show Americans soundly rejecting the idea of government-run health care but split on reform in general, making reform a women’s issue could prove the solution to voting for an unpopular bill and retaining a Democrat majority in Congress in next year’s elections.

Nearly ninety-years after passage of the Nineteenth Amendment guaranteed women the right to vote, women have become a powerful voting bloc in American politics. President Obama’s landslide election in 2008 was in no small part due to his ability to carry 56-percent of the female vote (according to exit polls) in contrast to Republican John McCain’s 43-percent support from women voters. Presidents Bill Clinton and George W. Bush are said to owe their elections to soccer moms and security moms, respectively. So, could Democrats use health care moms to secure reform in 2009 and win re-election in 2010?

Yesterday, the women of the Democrat Party took to the floor of the United States Senate to make the case that a vote against health care reform is a vote against women. They related stories of women being unfairly treated by a health care system that seemingly discriminates against women’s health issues and called upon members of both parties to support American women by voting “yes” on health care reform. (Read the New York Times story “Democratic Women in Senate Speak on Behalf of Health Legislation“.)

Discriminatory practices in our health care system disproportionately affect women. And in all but 12 states, insurance companies are allowed to charge women more than they charge men for coverage. The great irony here is that mothers, the people who care for us when we’re sick, are penalized under our current system. (Democrat Senator Kay Hagan.)

In a now infamous exchange during the Senate Finance Committee debate on Max Baucus‘ America’s Healthy Future Act, Republican Jon Kyl incurred the wrath of Democrat Debbie Stabenow over whether including maternity care in health care reform would drive up the costs of insurance for men.

“I don’t need maternity care,” Mr. Kyl said. “And so requiring that to be in my insurance policy is something that I don’t need and will make the policy more expensive.”

Ms. Stabenow interjected: “I think your mom probably did.”

Three of the most significant votes in the Senate - moderate Republicans Olympia Snowe and Susan Collins and Democrat Blanche Lincoln, belong to women with Snowe and Lincoln reportedly undecided on how they will vote in next week’s Finance Committee showdown over health care reform.

Tying health care reform to women - and perhaps more importantly to their ability to care for their children, could be a winning strategy as Democrats try to unite their own party on health care reform and force the hands of Republican women who don’t want to look disconnected from the constituencies at a time when the nation is split on health care reform.

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Reid: Finance Committee will vote on Baucus bill next Tuesday

Thursday, October 8th, 2009

A day after the Congressional Budget Office released its latest scoring of Finance chairman Max Baucus‘ effort at health care reform, Senate Majority Leader Harry Reid announced that the Senate Finance Committee has scheduled a vote on the America’s Healthy Future Act when the Senate returns from Columbus Day weekend next Tuesday, October 13. While Democrats Kent Conrad and Blanche Lincoln have yet to announce whether they will vote in favor of the bill, the estimated price tag of  $829 billion is expected to be satisfactory to Democrats on the committee and put the bill in the hands of Reid in anticipation of a floor debate.

The Finance Committee bill is the only health care reform effort produced this year that has scored under President Obama’s declared veto threshold of $900 billion and is the only bill that does not include the politically charged government-run public option insurance plan. Both of those facts make it a favorite for approval by the United States Senate, but also set up a showdown between Senators and House Speaker Nancy Pelosi who earlier today promised that any bill passed by the House would include a public option.

Most pundits agree that a health care reform bill void of a public option will not garner the votes necessary to pass muster in the more liberal House Democrats. Yet, of the four public option driven bills currently being considered by Congress (three in the House alone), none have scored under $1 trillion dollars. Baucus’ cooperatives plan - which has drawn suspicion from conservatives for being a wolf in sheep’s clothing,  is therefore the best chance Democrats have of sending a reform bill to Obama’s desk in 2009 but is far from guaranteed to even make it out of the Senate.

Under the plan, 94 percent of Americans are expected to have health insurance by 2019 and revenues raised under the legislation - primarily through the introduction of new taxes, could actually reduce the budget by as much as $81 billion over the same time period.

  • According to CBO and JCT’s assessment, enacting the Chairman’s mark, as amended, would result in a net reduction in federal budget deficits of $81 billion over the 2010–2019 period.
  • By 2019, CBO and JCT estimate, the number of nonelderly people who are uninsured would be reduced by about 29 million, leaving about 25 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants). (For the complete CBO analysis, click here.)

To the most liberal of Democrats, these cost savings come at the expense of approximately 16 million Americans (and another 8 million illegal immigrants) going without health insurance who they believe would be covered under a public option.To Republicans, the costs are too high to ensure too few and represent the single largest expansion of government entitlement programs in nearly four decades.

This is most likely why Reid has yet to back off of his threat to invoke the nuclear option of budget reconciliation should whip counts not provide the 60 votes he needs to get the bill through a full Senate floor debate. But, Reid has less than 48 hours after the Finance Committee votes to meet the October 15 deadline for invoking reconciliation. So, look for a Reid-authored Senate heath care reform bill to leak out well before the Finance Committee reconvenes next week.

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HCAN: Health insurers criminally responsible for deaths of 45,000 Americans

Tuesday, October 6th, 2009

Earlier this morning, the liberal health care reform advocate HCAN (Health Care for America Now) launched its latest Internet attack on health insurance companies naming them criminally responsible for the deaths of 45,000 Americans every year due to our “broken health care system.”

They take your money. They deny you care you paid for. Because of our broken health care system, 45,000 die every year. By any standard, the actions of insurance companies should be criminal.

While not out of character for HCAN, these accusations are hardly based in fact. The e-mail cites a study by Harvard Medical School researchers that does not in fact accuse health insurance companies of killing anyone, but instead blames 45,000 deaths a year on a lack of insurance coverage for an estimated 46 million people living in the United States. While the Harvard study does cite “cost or lack of employer-sponsored coverage” for 90-percent of the uninsured in America, there is nothing in the study to support or suggest criminal acts on the part of the insurance industry.

According to the e-mail (full text below), HCAN anticipated nationwide publicity stunts throughout the day today during which HCAN supporters would wrap local health insurance offices in crime scene tape to draw attention to their “criminal” activity. Those protests either failed to inspire even the most liberal members of HCAN’s mailing list or have failed to garner numbers significant enough to grab the attention of local media outlets. But, HCAN did manage to mock-up screen grabs of the websites of major insurance companies and cover them with the aforementioned police tape for people to view online.

From: Levana - Health Care for America Now <hcan@healthcareforamericanow.org>
Date: Tue, Oct 6, 2009 at 10:02 AM
Subject: Criminals

Dear Supporter:

They take your money. They deny you care you paid for. Because of our broken health care system, 45,000 die every year.1 By any standard, the actions of insurance companies should be criminal.

Today across the country, thousands of people will be showing up at insurance company offices and wrapping them with crime scene tape and exposing their actions, because it’s a crime to deny our care.

We’ve created a little website to drive the point home, and I thought you might like it. Just choose your insurance company below:

Click here if your insurance company is CIGNA

Click here if your insurance company is WellPoint or Blue Cross

Click here if your insurance company is UnitedHealth

Click here if you don’t know your insurance company, or if you’re uninsured

I hope you’ll call your Senators today at 1-877-264-HCAN and share this website with your friends. Just use the tools on the right of the page to spread the word.

We must make sure that the American people and Congress understand that if the insurance companies win, we lose.

To your health,

Levana Layendecker
Health Care for America Now

1. Study: 45,000 Uninsured Die a Year - CBS

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WashPost: Wyden and Rockefeller may vote against Finance bill

Monday, October 5th, 2009

In today’s Washington Post, Ceci Connolly reports that Senate Democrats Ron Wyden and Jay Rockefeller “have refused to pledge support” for the Senate Finance bill expected to come to a vote this week. Should the two liberal Dems vote “no” on the amended America’s Healthy Future Act, health care reform would be dealt a serious blow as Finance chairman Max Baucus would be forced to reopen negotiation on the final bill needed to move the reform debate into the next phase.

“More needs to be done to hold insurance companies accountable, to hold premiums down for the American people,” Wyden said in an interview Sunday. “I want to continue these discussions.” (From Democrats Wyden, Rockefeller Withhold Support of Panel’s Bill in the Washington Post.)

Wyden and Rockefeller’s opposition comes as a result of Finance Committee defeats of public option amendments proposed by Rockefeller and Democrat Chuck Schumer. The Baucus bill is currently the only one of five bills in Congress that does not include some form of a government-run public option health insurance plan.

As things stand, Harry Reid is running out of time and options in the getting a bill through the Senate. He has yet to retract his promise to go nuclear and attempt to pass a health care reform bill via budget reconciliation, but in order to do so he must invoke that process no later than October 15. If the Finance Committee is forced to reopen debate, there is little chance the Congressional Budget Office could score a new bill in time for Finance to hold another vote and give Reid a bill to merge with the late Ted Kennedy’s HELP (Health, Education, Labor and Pensions) Committee over the next 10 days.

It was thought that Democrat proponents of the public option would allow the Finance Bill to pass out of committee and lobby Reid to drop the bill’s cooperatives in favor of Kennedy’s public option proposal before a floor vote in the Senate, but Wyden and Rockefeller have seemingly joined House Speaker Nancy Pelosi in her ‘public option or bust’ approach to health care reform.

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Baucus aims for Tuesday vote on Senate Finance bill. Snowe’s vote still in question.

Sunday, October 4th, 2009

After a summer full of fits and starts, the health care reform debate is about to adopt a frenetic pace. As Republicans and Democrats wait for the last of the five health care reform bills to be scored by the Congressional Budget Office, Senate Finance Committee chairman Max Baucus is anticipating a Tuesday or Wednesday vote on an amended America’s Healthy Future Act.

As recently as a week ago, the CBO was calling for at least two weeks to score an amended bill as the Finance Committee prepared to debate 564 amendments, but the Baucus bill escaped the mark-up process relatively unscathed, so there is no telling how long it will take CBO to produce its analysis. Most notably, Democrats failed to pass amendments by Jay Rockefeller and Chuck Schumer which would have put a government-run public option health insurance plan at the center of the bill and thereby fundamentally changing its initial CBO score of $774 billion by 2019. President Obama has promised to veto any health care reform bill that costs more than $900 billion.

While there is little doubt the bill will pass out of committee as a result of the Democrats 13-10 edge in membership, there is still a great deal of uncertainty as to which way Republican Olympia Snowe will vote on the Baucus bill. Unlike many of her Republican colleagues who have repeatedly called on Democrats to “start over” on health care reform, Snowe has committed herself to finding a way to work with Democrats to get affordable health care into the hands of Americans as soon as possible.

Snowe’s vote for the Finance bill may have been won over when she and Schumer successfully passed an amendment late Thursday night which exempts from the individual mandate (and the penalties related to it) any American who cannot find a health insurance plan that costs less than eight percent of their annual income.

Exemptions from the excise tax will be made for individuals where the full premium of the lowest cost option available to them (net of subsidies and employer contribution, if any) exceeds eight percent of their AGI. (From page 35 of the amended bill.)

The individual mandate - which requires Americans to obtain and maintain a minimum standard of health insurance - and the public option were the primary obstacles to a “yes” vote on reform in the mind of Snowe. With no public option and a lowered threshold for the individual mandate, Snowe could very well break with her party and join Democrats in voting the bill out of committee.

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Finance Committee wraps up reform debate. Vote expected next week.

Friday, October 2nd, 2009

Shortly after 2 a.m. this morning, the Senate Finance Committee wrapped up debate on the America’s Healthy Future Act and sent the bill back to committee staffers to put into final form and to the Congressional Budget Office for scoring in anticipation of a committee vote sometime next week. Notably, the bill does not include the highly controversial government-run public option insurance plan that  has caused rifts between Republicans and Democrats and within the Democrat party. That did not, however, stop the White House from praising Finance for a two week debate in which they considered and voted on hundreds of the 564 amendments filed to the bill.

Thanks to the unyielding commitment of Senator Baucus and members of the Senate Finance Committee, we have reached another milestone in our effort to pass health insurance reform. Over the past two weeks, the Committee has engaged in long hours of thoughtful deliberation and vigorous debate. They have considered hundreds of amendments, and incorporated many of the best ideas from both parties. And they have shown a spirit of civility, a seriousness of purpose, and a willingness to compromise that embodies our democratic process at its very best. (President Barack Obama in a statement released by the White House.)

Barring any unforeseen complications in CBO scoring, the bill should easily make its way out of committee as Democrats hold a 13-10 advantage over Republicans. From there things become a bit more complicated as the Senate Budget Committee, led by Democrat Kent Conrad must merge the Finance bill with that of the late Ted Kennedy’s HELP (Health, Education, Labor and Pensions) Committee before a final bill can be debated and voted on by the full Senate.

The Budget Committee promises to be the next major battle ground as liberal Democrats look to force through a bill that is centered on a public option. Interestingly, it is Conrad who will likely lead the fight against the public option in hopes of protecting the cooperatives scheme currently proposed by the Finance bill.

Should the Budget bill include a public option - and make it out of committee by October 15th, look for Senate Majority Leader Harry Reid to invoke the nuclear option of budget reconciliation as that is seemingly the only way Democrats can limit debate and garner enough votes to pass a public option bill to conference with Nancy Pelosi and House Democrats. Of course, any Senate floor debate will provide Republican Olympia Snowe the opportunity to introduce her trigger amendment which could delay implementation of a public option until private insurance companies have been given an opportunity to “clean up their acts” - something Republicans might be willing to support if forced into a corner.

All in all, it looks like the health care reform debate has only just begun to heat up on Capitol Hill.

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Fate of public option rests with Snowe

Wednesday, September 30th, 2009

After Democrats on the Senate Finance Committee failed - not once but twice - to pass amendments inserting the controversial government-run public option insurance plan into Finance chairman Max Baucus‘ America’s Healthy Future Act, the fate of the public option - and quite possibly health care reform itself, now rests with Republican Olympia Snowe. Snowe’s trigger amendment now represents the last real chance to insert a public option into a Senate bill that stands any chance of passing on the Senate floor.

Short Title: Provision of Safety Net fallback plan to ensure access to affordable coverage

Description of Amendment: This amendment establishes a non-profit government corporation through which a “safety net” plan would be provided in any state in which affordable coverage was not available in the Exchange to at least 95% of state residents. An individual would be deemed to have affordable access if either of two conditions is met. First, two or more plans are offered with premiums – the cost of which does not exceed a specified percentage of the individual‘s adjusted gross income (AGI), after deducting any available tax credit or employer subsidy from the cost of such premium. The percentage contribution shall range from 3 percent of AGI at 133 percent of the Federal Poverty Level, to 13 percent at 300 percent and above.
Assessment of affordability shall follow submission of plan premiums filed one year in advance of the first day of each policy year, and should a state be found to not meet the 95% threshold, plans would be permitted to submit of any revised premium filings, after which a second assessment of affordability shall be performed. If, after that second assessment, a state still be deemed as not meeting the affordability standard, the safety net plan shall be offered within that state, and shall be available at the pending open season enrollment.

For weeks now, Snowe’s vote on reform has been the target of speculation and intense lobbying by Democrats including President Obama, but there is now renewed interest as to whether Snowe will decide to offer her trigger amendment as a means of ensuring Americans forced into an individual mandate can in fact afford health insurance. While the threat of a public option amendment loomed, Snowe’s trigger seemed like a potential life-saver for Republicans and a headache for Democrats. Those roles have been reversed in light of yesterday’s public option showdown in the Senate Finance Committee.

The question now is not only if but when Snowe might propose her trigger amendment.

I offered the trigger many months ago as an idea or alternative to the public option and I mentioned that to the President at that time. He didn’t reject it in the ensuing conversations I’ve had with him and with others. They indicated they would be flexible on that point. I think now the question is whether or not or at which to point to address that issue and I think we’ll have to determine whether or not it’s in the committee or on the floor and how we build a consensus at that point in addition to the other issues. (From Olympia Snowe sets the record straight on her health care positions on HealthCareHorseRace.com)

Should Snowe offer her amendment in Committee, it seems likely that she’d get no support from her Republican colleagues but should be able to enlist all of the Democrats who voted for the Schumer public option in addition to Baucus - who has said he favors a public option but will only support one that can get 60 votes on the Senate floor. The only questionable Democrats are Budget Committee chairman Kent Conrad and Blanche Lincoln - who voted against both public option amendments offered yesterday.

While Snowe could therefore pass an amendment 12-11 in committee, Conrad’s vote is significant. As chairman of the powerful Senate Budget Committee, Conrad will play a central role in merging any bill that comes out of Finance with that already passed out of the late Ted Kennedy’s HELP (Health, Education, Labor and Pensions) Committee. Winning Conrad over to the trigger option would go a long way towards ensuring the trigger and not a pure public option is the centerpiece of a bill voted on by the entirety of the Senate.

Of course, should the Baucus bill pass out of committee with its proposed cooperatives fully intact, Conrad and his committee would have to choose between cooperatives - something Republicans would clearly prefer - and Kennedy’s public option. If the Budget Committee bill included the public option, Snowe would have the opportunity to introduce the trigger amendment during a floor debate which would likely garner significant Republican support at the time.

Snowe is clearly in the drivers seat as the health care reform debate moves into its final weeks. The trigger concept has already garnered various degrees of support from key Democrat leaders including Obama, a begrudging Senate Majority Leader Harry Reid and even former president Bill Clinton. And, despite statements to the contrary, House Speaker Nancy Pelosi would be hard-pressed to come out swinging at the only public option that has any shot at making its way to Obama’s desk.

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Schumer public option amendment fails 10 -13

Tuesday, September 29th, 2009

A second public option amendment to the America’s Healthy Future Act - this one introduced by Democrat Chuck Schumer - failed to pass the Senate Finance Committee by a vote of 10 - 13.

Again, Finance Committee chairman Max Baucus was joined by fellow Democrats Kent Conrad and Blanche Lincoln and a unanimous voting block of 10 Republicans on the committee in defeating the amendment.

While a closer vote than than the 8-15 drubbing of a similar amendment from Democrat Jay Rockefeller earlier in the day, the result was the same and demonstrates a clear schism within the Democrat party over the controversial government-run insurance concept. Many Democrats - including Baucus, believe the inclusion of a public option would prevent a health care reform bill from garnering the 60 votes necessary to pass the Senate.

During debate over the bill, Schumer vowed that proponents of the public option would continue to push for it when health care reform is debated on the floor of the Senate.

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Finance Committee takes up Schumer public option amendment

Tuesday, September 29th, 2009

Following one defeat for liberal Democrats calling for a government-run public option insurance plan as the centerpiece of health care reform, the Senate Finance Committee has begun debate on the second public option amendment of the day. After Democrat Jay Rockefeller’s public option amendment was defeated 8-15 with five Democrats voting against it, Democrat Chuck Schumer put his own amendment to the America’s Healthy Future Act on the table.

Schumer Public Option Amendment

Short Title: Level Playing Field Public Option
Description of Amendment: Strike Title I, Subtitle E, Health Care Cooperatives and replace with a national “level playing field” public health insurance option with negotiated reimbursement rates to enhance competition for consumers within the Exchange.
The new national level playing field public option must adhere to the same rules (actuarial reporting, community rating and guaranteed issue) as all other plans in the Exchange and must be self-sustaining with premiums and copayments covering claims. Like private plans, the “level playing field” public option would also be required to establish a reserve fund. Aside from covering some initial start-up costs, general revenues or annual appropriations may not support the ongoing operation of the plan.
The government must not use existing programs like Medicare as a stick to compel providers to participate in the public option. Instead, doctors and hospitals should be able to voluntarily opt-in to participate in the public option.

Schumer’s amendment is expected to garner a much closer vote than that of Rockefeller but it is still expected to be opposed by Democrats including Finance chairman Max Baucus and Kent Conrad.

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