Health Care For America Now

Throughout the health reform debate, the Chamber of Commerce, far from being an independent institution representing its members, instead acted as a front group for the health insurance companies, funneling at least $10 to $20 million through its doors directly from the insurance industry for misleading attack ads in a futile attempt to kill health reform.

Now that health reform has become law, the Chamber is continuing to play the role of insurance company lap dog.

In keeping close to its corporate masters, the Chamber first threw a wrench in the tea party-fueled repeal movement, declaring it won't work for a repeal of the new law. (This issue has split the Republican party wide open, with many prominent Republicans arguing for repeal and many others arguing against it.) It then jumped on board with the insurance industry's game plan: Attempt to duck new responsibilities, which it has so far tried and failed to do surrounding the issue of covering children with pre-existing conditions.

The Chamber signaled its cooperation in a letter dated March 29th from Chamber President Thomas Donohue to the Chamber Board of Directors.

In the letter, Donohue lays out the insurance industry's strategy: Work against implementation of health reform by creating as many holes in regulations as possible:

…we will assign a team of our most skilled and experienced staff to participate in the years-long process of writing the thousands of pages of federal regulations that will implement the many provisions in this legislation.

We will be submitting comments, proposing language, and seeking changes in an effort to minimize the potentially harmful impacts of this bill on our members and the country. Should federal regulators attempt to exceed legislative mandates or try for end-runs around the lawful rulemaking process, Chamber lawyers will take legal action.

But they're not stopping at simply trying to evade laws. The Chamber will also spend $50 million to try and defeat Democrats who voted for health reform in 2010 - mostly on the same type of misleading ads they've been running up until now. This money, like their previous money, likely comes directly from the insurance companies, who are too timid to level their political attacks under their own name.

As I noted yesterday, the spat with insurance companies over covering care for children with pre-existing conditions is just the first test of how the insurance industry will respond to both the letter and spirit of the new law. Through the Chamber, they will endeavor to weasel out of anything and everything they can.

It's up to the Department of Health and Human Services, the President, and Congress to make sure they follow the new law of the land, or to enact new legislation and rules to force them to comply (or introduce, say, a public option to provide a public interest alternative). The health of the American people depends on it.

NEWS

Business Bids to Shape Health Changes - Wall Street Journal

Chamber of Commerce Plans Effort to Challenge New Regulations and Unseat Those Who Voted for Law

Obama takes final steps on reform - Politico

President Barack Obama went across the Potomac River on Tuesday to put the final touches on health care reform and enact a massive overhaul of the nation’s student loan system.

Dem AGs rebuff GOP govs on health-care lawsuits - Washington Post

Republican governors in two western states want to join in legal challenges to recent federal health care legislation, but each is meeting stiff resistance from the same obstacle: an attorney general from the rival party.

GOP leaders temper call for repealing health law, saying jobs, economy are key to fall races - LA Times

Top Republicans are increasingly worried that GOP candidates this fall might be burned by a fire that's roaring through the conservative base: demand for the repeal of President Barack Obama's new health care law.

The health-care law: Answers to frequently asked questions - Washington Post

The health-care bill is more than 2,000 pages long — with hundreds more to come from regulators filling in the details. It will take years before all the details are set and people can see how the plan will affect their situation. But here are some commonly asked questions that can be answered now.

Small businesses fret over details of health law - Washington Post

Small-business owner Joe Ascioti says Massachusetts' 2006 health care law has left him facing $15,000 in fines since it took effect. Now, he's worried the nation's new health care overhaul could bring similar woes to employers nationwide.

Lacking a public option, the major check on insurance company price increases and abuses in the new health reform law is managed competition and regulation. That check is already being put to the test by the insurance companies.

In six months, the new law says children can no longer be denied care for pre-existing conditions. But the insurance companies immediately said they'd found a loophole:

Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.

William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “The fine print differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”

Secretary Sebelius immediately fired back with a letter to Karen Ignagni, head of AHIP, the insurance industry's main lobbying arm. The letter made clear the administration's intention to issue regulations to enforce both the spirit and letter of the new law, including covering children with pre-existing conditions and providing both access to plans and benefits. And today, it seems the insurance industry relented:

In a letter to Health and Human Services Secretary Kathleen Sebelius, the industry's top lobbyist said insurers will accept new regulations to dispel uncertainty over a much-publicized guarantee that children with medical problems can get coverage starting this year.

…

"Health plans recognize the significant hardship that a family faces when they are unable to obtain coverage for a child with a pre-existing condition," Karen Ignagni, president of America's Health Insurance Plans, said in a letter to Sebelius. Ignagni said that the industry will "fully comply" with the regulations, expected within weeks.

It remains to be seen exactly how this particular battle will play out. While insurance companies say they'll comply with regulations to issue policies and provide benefits to children with pre-existing conditions, there is no talk about the cost of such policies. Still, for families currently unable to get coverage for their sick children at any price, even this modest change in practices will be a relief, though the bigger changes - including the subsidies to make insurance not only accessible but affordable - don't go into effect until 2014.

This is the first of what will be many battles with the insurance companies over regulation. The administration and the new regulatory structures put into place by health reform won the first skirmish. But there's no doubt that insurance companies will throw many obstacles in our way as we move towards guaranteed health care for all. We'll have to keep fighting them and their army of lawyers and lobbyists as health reform is implemented and improved upon in the years to come.

It's still true that if the insurance companies win, we lose.

NEWS

Insurance industry agrees to fix kids coverage gap - AP

After battling President Barack Obama's health care overhaul the better part of a year, the insurance industry said Monday it won't try to block his efforts to fix a potentially embarrassing glitch in the new law.

Obama set to sign health care 'fixes' bill - CNN

President Obama is set to claim final victory on his top domestic priority Tuesday by signing into law a package of changes to the newly enacted health care reform bill.

Overhaul Will Lower the Costs of Being a Woman - New York Times

Being a woman is no longer a pre-existing condition. That’s the new mantra, repeated triumphantly by House Speaker Nancy Pelosi, Senator Barbara A. Mikulski and other advocates for women’s health. But what does it mean?

Stimulus stumbles hold lessons for health care sell - Politico

As President Barack Obama  prepares to roll out the health care reform plan, he can look to one recent case study in how not to do it – the economic stimulus package.

Companies Push to Repeal Provision of Health Law - New York Times

An association representing 300 large corporations urged President Obama and Congress on Monday to repeal a provision of the health care overhaul that prompted AT&T, Caterpillar and other companies to announce substantial charges for the current quarter.

Reports continue to stream in of people going out and thanking their Members of Congress for voting YES on health reform.

In Colorado, they visited Senators Bennet and Udall:

In Missouri, they thanked Congressman Carnahan:

In Pennsylvania, they're thanking Congressman Kanjorski:

In Milwaukee, Wisconsin, a large group welcomed home Congresswoman Gwen Moore at the airport:

And Congressman Kagan, also from Wisconsin:

In Washington, they hailed the passage of reform and protested against a planned state lawsuit against the new law:

In Florida, they thanked Congressman Grayson and Congresswoman Kosmas:

In Indiana, they were out thanking Congressman Ellsworth:

In North Dakota, the people were out thanking Representative Pomeroy:

In Arkansas, they were out thanking Representative Snyder:

In Maine, they thanked Congressman Michaud:

In Minnesota, they thanked Representative Walz:

And more to come as health reform becomes the law of the land.

NEWS

Coverage Now for Sick Children? Check Fine Print - New York Times

Just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.

Health-care overhaul leaves Democrats in stable condition - Washington Post

After steering the landmark health-care reform bill through Congress, the Democratic Party's leaders have emerged mostly unscathed, according to a new Washington Post poll, but they have not received a notable boost in approval ratings.

Closing Medicare Drug Gap Helps Democrats Sell Reform - Kaiser Health News

Now that the health overhaul has passed Congress, Democratic lawmakers are hoping to highlight its most immediate benefits. Chief among them: a plan to help millions of elderly and disabled Medicare beneficiaries pay for their medications by gradually eliminating a drug-coverage gap commonly known as the “doughnut hole.”

Health care law becomes personal for Dallas-area families - Dallas Morning News

Even among families that stand to benefit from last week's passage of the health care law, opinions are split.

Like many Democrats, some Dallas-area families see the overhaul as a historic achievement that will lead to better health care for millions of Americans.

GOP views Supreme Court as last line of defense on health reform - The Hill

Republicans view Chief Justice John Roberts and the Supreme Court as a last line of defense against the new healthcare reform law.

Now that Congress has taken final action on its health care reform legislation, the reform debate has now shifted to, of all places, Denver.

The legislation that is now the law of the land was just the first step. Despite its size — more than 2,000 pages — the bill in many cases only lays out Congressional intent. In that sense, it is a framework for reform. The law requires that numerous new regulations be written to govern the way health insurers do business, a responsibility that Congress passed on not only to the U.S. Department of Health and Human Services but also to one very influential non-governmental organization: the National Association of Insurance Commissioners (NAIC). The bill mentions the NAIC — an acronym most Americans probably only see once a year when they renew their cars' license plates — at least 10 times, and it gives the organization some very important assignments.

read more

NEWS

Final Votes in Congress Cap Battle on Health Bill - New York Times

Congress on Thursday gave final approval to a package of changes to the Democrats’ sweeping health care overhaul, capping a bitter partisan battle over the most far-reaching social legislation in nearly half a century.

Barack Obama to GOP: 'Go for it' - Politico

President Barack Obama challenged Republicans Thursday to bring on the debate if they plan to run on a platform of repealing the health care reform bill he signed into law just two days ago.

In Iowa, Obama Calls Health Bill ‘Pro-Business’ - New York Times

President Obama on Thursday began an aggressive White House public relations blitz to sell his newly signed health care overhaul to a skeptical and sometimes confused public, calling the measure “pro-jobs” and “pro-business” and taunting Republicans who are vowing to repeal it.

The First Test Of New Health Law: Covering Hard-To-Insure People - Kaiser Health News

It’s the first and one of the hardest tests of the Democrats’ ambitious plan to overhaul the nation’s health care system: in the next 90 days establishing a federally funded program to cover people turned down by private insurers because they have a pre-existing medical condition.

Students to see impact from health care reform - The Reflector

After months of debate, President Barack Obama signed the health care reform bill Tuesday, creating future changes to health care for the United States.

I've been getting a lot of questions from a lot of places on how insurance regulations and enforcement work in health reform. I reached out to a couple of folks who are experts on the subject to piece together how things work.

After the bill is passed, there are two phases to think about - before exchanges are set up and after they're running in 2014.

Before exchanges are established, the Department of Health and Human Services and other related federal authorities will work with states to implement the law. First, the states will have to bring their state health insurance laws in line with the federal regulations. States are free to go farther than federal regulations if they want, but their laws must be at least as strong as the federal ones.

Every year from 2010 on, insurers will have to make public data on their business practices. The summary of the provision in the bill explains:

…plans seeking certification by Exchanges [must] publicly disclose, in plain language, information on claims payment policies, enrollment, denials, rating practices, out-of-network cost-sharing, and enrollee rights. [They must also] provide information to enrollees on the amount of cost-sharing for a specific item or service.

Using that information, HHS and the states will be required to conduct annual reviews of insurance companies looking for business in the future exchanges. Rate increases must be taken into account during this process under the law and, to gain entry into the exchanges, plans will have to meet minimum standard benefits levels set by the Secretary. Those standards will be developed in a process that the bill says has to be public and accountable to Congress. The benefit package must, by law, be equivalent to coverage you'd get in the large-group market, creating parity in benefits between the individual and large group markets that doesn't exist now.

When it comes time to set up the exchanges, the states must use their annual reviews to determine which insurers get access to the new customers. If a state fails to make progress or follow the law in setting up an Exchange, HHS can step in and set up an exchange under federal authority.

After 2014 when the exchanges are running, HHS continues to play a role in state exchanges.

The states either run the exchanges or contract with a non-profit agency to run them. The Exchange administrators must evaluate insurance companies yearly on quality and price metrics and whether or not the insurers in the exchanges are conforming to the new regulations - no benefit caps, limits on out-of-pocket expenses, no denials for pre-existing conditions, no charging more if you're sick, etc…

The Exchange administrators have the power to deny certification for insurance plans with unreasonable premium increases - in other words, kick them out of the state exchange - and will require a whole new level of transparency from plans, so consumers can understand their rights in plain language. And HHS oversees the operations, making sure state exchanges follow the new law.

NEWS

Byrd Rule To Send Health Care Back To House, Rules Parliamentarian - Huffington Post

Senate Republicans succeeded early Thursday morning in finding two flaws in the House-passed health care reconciliation package. Neither is of any substance, but the Senate parliamentarian informed Democratic leaders that both are in violation of the Byrd Rule.

Lawmakers concerned as health-care overhaul foes resort to violence - Washington Post

The pitched battle over health care has unleashed a rash of vandalism and attacks directed at politicians, with at least 10 House Democrats reporting death threats or incidents of harassment or vandalism at their district offices over the past week.

The Most Ridiculous Amendments To The Health Care Reconciliation Bill - Huffington Post

Republicans know that the health care reform process could be derailed if the Senate decides to adopt any changes in reconciling the bill passed by the House on Sunday.

So, GOP Senators have introduced a variety of provocative — and occasionally outrageous amendments — that Democrats who support the health care bill will be forced to vote against in order to get the reconciliation bill through.

Administration: Health lawsuit 'without merit' - The Hill

The Obama administration on Wednesday blasted as bogus a lawsuit filed by states against the new healthcare law.

Va Democrats liken Cuccinelli suit against health care bill to '50s desegregation fight - AP

Virginia Democrats are drawing parallels between the state's court fight to stop new health coverage mandates and its battle 50 years ago against federal orders to open businesses and schools to black people.

Lieberman, Webb to Vote ‘Yes’ on Reconciliation - Roll Call

Sens. Joe Lieberman (ID-Conn.) and Jim Webb (D-Va.) announced Wednesday that they would support the reconciliation package, although they indicated during floor remarks that they have lingering concerns about the legislation as well as the Senate health care overhaul signed into law by President Barack Obama on Tuesday.

Funds Double for Health Clinics - Wall Street Journal

Federally funded health clinics are set to play an even larger role in the revamped health-care landscape, which expands Medicaid and other insurance coverage and sharply increases funding for the clinics.