Pink Fire Pointer Healthcare Reform Update – 10June2010

Healthcare Reform Update – 10June2010

This update includes the following:
  • New York Enacts Landmark Rate Review Law

  • HHS Announces $51 Million in Grants to Enhance Health Insurance Premium Rate Review

  • HHS Clashes with Medicare Insurers on Rates

  • White House Launches Campaign to Build Up Health Law

  • Republicans put health reform on primary ballot in push to turn out conservatives

New York Enacts Landmark Rate Review Law
  • On Wednesday the Governor of New York signed legislation granting the state authority to review and approve health insurance premiums before they take effect, and increasing medical loss ratio percentages, with which insurers in the state must comply.

  • The new law, which covers about three million people enrolled in small-employer or individually purchased plans, requires insurance companies to apply to the state Insurance Department before they can raise premiums. The state then has 60 days to determine whether the rates are justified.

  • In early May, Health and Human Services Secretary Kathleen Sebelius sent a letter to governors and state insurance commissioners urging them to review the authority they have under their state laws to determine whether they have all of the regulatory tools needed to approve health insurance rates before they take effect.

  • Several provisions in the healthcare reform law strengthen government oversight of insurance premiums and rate hikes, including grants for states to help create or strengthen reporting and review processes.

  • Read more:

HHS Announces $51 Million in Grants to Enhance Health Insurance Premium Rate Review

  • Health and Human Services Secretary Kathleen Sebelius announced the availability of $51 million in Health Insurance Premium Review Grants funded by the new healthcare reform law.

  • This is the first round of grants available to states through a new $250 million grant program to create and strengthen insurance rate review processes.

  • All 50 states and the District of Columbia are eligible for the grants. To receive a grant, a state must submit a plan for how it will use the funds to develop or enhance its process of reviewing and approving, disapproving, or modifying health insurance premium requests. States with successful applications will receive a $1 million grant during the first round.

  • Several provisions in the healthcare reform law strengthen HHS’ and states’ oversight of insurance premiums and rate hikes. For example, the law requires that insurers in the individual and small group markets spend at least 80 percent of their premiums on healthcare, and insurers in the large group market spend at least 85 percent of their premiums on healthcare. The law also requires insurers to justify unreasonable premium increases to state regulators and the Secretary of Health and Human Services.

  • The grants that will be available in 2010 are only the first in a five-year grant program. HHS will take applications for a second round of state grants beginning in 2011, after new regulations regarding rate review take effect.

  • Read the press release:

HHS Clashes with Medicare Insurers on Rates

  • Insurance companies and the Obama administration are currently battling over how much seniors should pay for their privately-run Medicare plans next year.

  • In a letter to WellPoint Inc., Cigna Corp., BlueCross BlueShield Association and Health Care Service Corp., HHS Secretary Kathleen Sebelius warned the companies not to increase premiums and co-payments for seniors.

  • On Monday, insurers that sell Medicare Advantage plans had to submit their 2011 bids to the government.

  • Many insurers are planning to increase costs for a range of services for seniors next year. Dozens of Medicare Advantage providers plan to cut back vision, dental and prescription benefits. Some plans are eliminating free teeth cleanings and gym memberships, and raising fees for hearing aids, eye glasses and emergency-room visits.

  • According to the insurers, the cuts are necessary because the rate the government will pay private insurers to run the plans is frozen for 2011 at 2010 levels, while medical costs are expected to increase an average of at least 6 percent. The price increases and benefit reductions will help them recoup that difference.

  • Read more:

White House Launches Campaign to Build Up Health Law

  • President Obama and his allies are launching an elaborate campaign to sell the public on the healthcare reform law, including a new tax-exempt group that will spend millions of dollars on advertising to counter attacks on the measure and Democrats who voted for it.

  • The first evidence of the public relations offensive came Tuesday, when Obama traveled to Wheaton, Md. to conduct a nationally-televised question-and-answer session.

  • In Wheaton, Obama touted the distribution of $250 rebate checks for senior citizens who reached the “doughnut hole” in Medicare's drug coverage during 2010, one of the law's first benefits.

  • At the same time, he announced a new initiative to cut in half the amount of waste, fraud and abuse in the Medicare program by the end of 2012. This ambitious goal would require the federal government to recover as much as $18 billion.

  • Read more:,0,6844577.story

Republicans put health reform on primary ballots in push to turn out conservatives

  • South Carolina and Missouri added health reform questions to their primary ballots.

  • Arizona, Florida and Oklahoma will give voters a chance in November to amend their state constitutions to say residents of those states can’t be forced to pay a penalty if they don’t buy health insurance.

  • The amendment seeks to nullify the individual mandate, which consistently polls as one of the law’s most unpopular provisions.

  • Proponents of the law are launching a five-year, $125 million campaign to defend health reform.

  • Read more:

Other related articles that may be of interest:

According to a USA Today article, a growing number of US doctors are attempting to bring in extra profits by charging patients new fees for services they say insurance doesn't cover.

The New York Times ran an article highlighting dependent eligibility audits and the increasing number of employers using them to drop non-qualified dependents from the company plan.

A CNN story discusses a rising trend in hiring – employers are beginning to add more temporary or contract-based positions, rather than traditional full-time jobs with benefits. With unemployment remaining close to 10 percent, employers have their pick of workers willing to accept less secure positions.