HMOs and insurance companies

Patient Protection and Affordable Care Act of 2009

hmoroz — Wed, 23 Dec 2009 17:12:07 -0500

Legislation

The middle class

Supports

Video Summary

Injustice Facts

Number of uninsured Americans in 2008: 45.7 million

Estimated number of uninsured Americans after passage of the Affordable Health Care for America Act: 23 million

Percentage growth in the uninsured between 2004 and 2007 that came from lower- and middle-income families: 70

Average annual worker contribution to health insurance premiums in employer-sponsored coverage in 1999: $1,543

Average annual worker contribution to health insurance premiums in employer-sponsored coverage in 2009: $3,515

Savings on premiums to a low-income family from the Patient Protection and Affordable Care Act because they do not have to buy private, nongroup insurance: $10,076

Overview/Summary

Middle Class Position Analysis

Middle Class Supports. Access to health care is a critical component of a middle-class standard of living. Skyrocketing health care costs have created a vicious and destabilizing trap for middle-class Americans in which employer-sponsored coverage is offered less frequently and private coverage is increasingly unaffordable. Meanwhile, successful public programs that effectively cover children (SCHIP), the poor (Medicaid), and the elderly (Medicare) are unavailable to middle-class adults. Almost 46 million nonelderly Americans lack health insurance, the majority of whom are low- and middle-income, and the rate of the uninsured has grown significantly since 2000. At the same time, the average worker’s health care premium has increased 128% (to $3,515) since 1999. One study even found that just shy of two thirds of all bankruptcies are due to medical expenses even though the vast majority of these bankruptcies involve families who have health insurance. Because employers, too, have had to absorb similar premium increases, employer-sponsored insurance – the type of insurance most middle-class Americans obtain – has declined significantly in each of the last eight years. The economic downturn has exacerbated this situation and experts estimate that each percentage point increase in the unemployment rate results in substantial increases in the number of uninsured Americans. Given the high costs of obtaining insurance in the private, non-group market, which is nearly impossible without steady employment, many Americans have simply given up coverage over the last several years. In short, a perfect storm of increasing health care costs and a down economy has undermined the financial stability and endangered the wellbeing of the middle class and the aspiring middle class.

The Patient Protection and Affordable Care Act would do much to relieve the financial stress placed on these households by high health insurance costs while also extending health coverage to millions of Americans. The nonpartisan Congressional Budget Office estimates that the bill would reduce the number of uninsured to 23 million, leaving just 6 percent of the population without health coverage. Expanding Medicaid to cover low-income adults is one of the most effective and cost-efficient means of covering more aspiring middle-class Americans. The expansion would enroll about 15 million individuals in Medicaid, providing an important public backstop for aspiring middle-class families. Indeed, public programs have successfully kept millions of children from becoming uninsured, while the lack of such programs for low-income childless adults has led to increased numbers of the uninsured among this population. Similarly, subsidized coverage in the Health Benefits Exchanges would reduce health care costs for tens of millions of households. Premium savings could be as high as $10,000 for a low-income household of four. Such savings are targeted at the very groups that need the most help.

At the same time as it helps reduce health care costs for middle-class and aspiring middle-class Americans, the Patient Protection and Affordable Care Act greatly improves health coverage by enacting strict requirements for the type of insurance that is offered. The bill prevents the nightmare scenarios of being denied coverage just because you have become sick or being forced to pay higher premiums because of a preexisting condition (in many policies, being a woman is effectively considered a preexisting condition). Eventually, it will define minimum benefits and cost limits that must be included in most health insurance plans, not just ones offered by the Health Benefits Exchanges. And it will ensure that health insurers do not use premiums to pay for administrative costs and profits, instead of medical care. In this way, affordable and adequate health insurance that protects individuals and their families during both normal medical events and extraordinary medical hardship will be available to all aspiring middle-class and middle-class households.

Quotes from Experts

Beyond this Bill

Additional Resources

“Health Reform,” from the Kaiser Family Foundation

“The Treatment,” A Health Care Reform Blog from The New Republic

“Competitive Health Care: A Public Health Insurance Plan That Delivers Market Discipline,” from the Center for American Progress Action Fund

Affordable Health Care for America Act of 2009

hmoroz — Tue, 10 Nov 2009 13:04:32 -0500

Legislation

The middle class

Supports

Video Summary

Injustice Facts

Number of uninsured Americans in 2008: 45.7 million

Estimated number of uninsured Americans after passage of the Affordable Health Care for America Act: 18 million

Percentage growth in the uninsured between 2004 and 2007 that came from lower- and middle-income families: 70

Average annual worker contribution to health insurance premiums in employer-sponsored coverage in 1999: $1,543

Average annual worker contribution to health insurance premiums in employer-sponsored coverage in 2009: $3,515

Savings to a low-income family and a higher-income family, respectively, from the Affordable Health Care for America Act because they do not have to buy private, nongroup insurance: $9,000, $1,260

Overview/Summary

Middle Class Position Analysis

Middle Class Supports. Skyrocketing health care costs have created a vicious and destabilizing trap for middle-class Americans in which employer-sponsored coverage is offered less frequently and private coverage is increasingly unaffordable. Meanwhile, successful public programs that effectively cover children (SCHIP), the poor (Medicaid), and the elderly (Medicare) are unavailable to middle-class adults. Almost 46 million nonelderly Americans lack health insurance, the majority of whom are low- and middle-income, and the rate of the uninsured has grown significantly since 2000. At the same time, the average worker’s health care premium has increased 128% (to $3,515) since 1999. One study has even found that just shy of two thirds of all bankruptcies are due to medical expenses even though the vast majority of these bankruptcies involve families who have health insurance. Because employers, too, have had to absorb similar premium increases, employer-sponsored insurance – the type of insurance most middle-class Americans obtain – has declined significantly in each of the last eight years. The economic downturn has exacerbated this situation and experts estimate that each percentage point increase in the unemployment rate results in substantial increases in the number of uninsured Americans. Given the high costs of obtaining insurance in the private, non-group market, which is nearly impossible without steady employment, many Americans have simply given up coverage over the last several years. In short, a perfect storm of increasing health care costs and a down economy has undermined the financial stability and endangered the wellbeing of the middle class and the aspiring middle class.

The Affordable Health Care for America Act would do much to relieve the financial stress placed on these households by high health insurance costs while also extending health coverage to millions of Americans. The nonpartisan Congressional Budget Office reckons that the bill would reduce the number of uninsured to 18 million, leaving just 4 percent of the population without health coverage. Expanding Medicaid to cover low-income adults is one of the most effective and cost-efficient means of covering more aspiring middle-class Americans. The expansion would enroll about 15 million individuals in Medicaid, providing an important public backstop for low-income families. Indeed, public programs have successfully kept millions of children from becoming uninsured, while the lack of such programs for low-income childless adults has led to increased numbers of the uninsured among this population. Similarly, coverage in the Health Insurance Exchange would reduce health care costs for tens of millions of households: the savings range from more than $9,000 for a low-income household of four which receives payment assistance to $1,260 for a higher-income family making more than $90,000 that does not receive such assistance. Such savings are targeted at the very groups that need the most help. The inclusion of a public option in the Exchange, in which a relatively meager 6 million individuals are expected to enroll, will create competition with the Exchange’s private insurance plans driving costs even lower.

At the same time as it helps reduce health care costs for middle-class and aspiring middle-class Americans, the Affordable Health Care for America Act greatly improves health coverage by enacting strict requirements for the type of insurance that is offered. The bill prevents the nightmare scenarios of being denied coverage just because you have become sick or being forced to pay higher premiums because of a preexisting condition (in many policies, being a woman is effectively considered a preexisting condition). Eventually, it will define minimum benefits and cost limits that must be included in all health insurance plans, not just ones offered by the Health Insurance Exchange. And it will ensure that health insurers do not use premiums to pay for administrative costs and profits, instead of medical care. In this way, affordable and adequate health insurance that protects individuals and their families during both normal medical events and extraordinary medical hardship will be available to all aspiring middle-class and middle-class households.

Finally, the Act contains cost-cutting strategies to reduce the impact of health care costs on the budget deficit and additional measures to reorient health care delivery to quality, preventive care and away from costly and unnecessary overtreatment. Eliminating overpayments to Medicare Advantage, the ill-advised, Bush-era privatization of a chunk of Medicare, and empowering the Secretary of Health and Human Services to negotiate Medicare drug prices are effective ways to cut costs without weakening coverage. The tax surcharge on the wealthiest Americans, who benefited most from the economic growth of the 2000s and who are weathering the current economic downturn best, is a sensible method of increasing access to and the affordability of health insurance coverage in a fiscally responsible manner.

Quotes from Experts

Beyond this Bill

Additional Resources

“Health Reform,” from the Kaiser Family Foundation

“House Health Reform Bill Expands Coverage And Lowers Health Cost Growth, While Reducing Deficits,” from the Center on Budget and Policy Priorities

“Competitive Health Care: A Public Health Insurance Plan That Delivers Market Discipline,” from the Center for American Progress Action Fund

“The Treatment,” A Health Care Reform Blog from The New Republic

Medicare Fair Prescription Drug Price Act of 2007

atraub — Wed, 26 Sep 2007 17:52:29 -0400

Legislation

The middle class

Supports

Video Summary

Injustice Facts

Percentage increase between 2000 and 2006 in the cost of brand-name drugs commonly prescribed to seniors: 53.6

Percentage rate of general inflation during this period: 20.1

Percentage of Americans who support the idea of Congress allowing the federal government to negotiate with drug companies for lower prices on Medicare prescription drugs: 80

Estimated amount taxpayers and Medicare beneficiaries would save in 2008 alone if the federal government negotiated drug prices directly with pharmaceutical companies: $30 billion

Lowest Medicare Part D price in 2006 for a year of treatment with Zocor, a popular drug for patients with high cholesterol: $1,485.96

Lowest VA price in 2006 for a year of treatment with Zocor: $127.44

Overview/Summary

Middle Class Position Analysis

The Middle Class Supports: Often living on fixed incomes, America’s seniors struggle to cope with prescription drug prices that increase every year. The new Medicare prescription drug plan was ostensibly designed to save these seniors money on needed medications. But the plan provides far less savings than it could – both for the seniors it covers and for the taxpayers who bear the costs of the new plan – because it fails to take advantage of the federal government’s ability to negotiate for better prices by buying drugs in bulk. For example, if the federal government were to buy a million pills of cholesterol-lowering medication, enough for every Medicare recipient in the country, they could receive a very low price because of the huge quantity. Instead of realizing these savings, the program relies on individual insurance plans to make drug purchases. Because none of these individual insurers has the purchasing power of the federal government, the result is a less efficient system with higher prices.

Most industrialized countries, including Canada, use the government’s bulk purchasing power to bargain for better drug prices. Domestically, the United States Department of Veterans’ Affairs (VA) also uses this common-sense practice to reduce its costs. Studies suggest that the prices negotiated by the VA for many drugs are substantially lower than those offered under the new Medicare plan. Middle-class Americans, whether they are senior citizens, taxpayers or both, cannot afford to see the federal government squander this opportunity to rein in the ever-escalating costs of prescription drugs.

Quotes from Experts

Beyond this Bill

Additional Resources

“Medicare: Prescription Drugs,” from Families USA

National Legislative Association on Prescription Drug Prices

“Celebrating Pork: The Dubious Success of the Medicare Drug Benefit,” by Dean Baker from the Center for Economic Policy Research

“Price Negotiation Would Dramatically Lower the Cost of Prescription Drugs for Medicare Beneficiaries,” from the National Committee to Preserve Social Security and Medicare

Medicare Prescription Drug Price Negotiation Act of 2007

atraub — Wed, 26 Sep 2007 17:48:40 -0400

Legislation

The middle class

Supports

Video Summary

Injustice Facts

Percentage increase between 2000 and 2006 in the cost of brand-name drugs commonly prescribed to seniors: 53.6

Percentage rate of general inflation during this period: 20.1

Percentage of Americans who support the idea of Congress allowing the federal government to negotiate with drug companies for lower prices on Medicare prescription drugs: 80

Estimated amount taxpayers and Medicare beneficiaries would save in 2008 alone if the federal government negotiated drug prices directly with pharmaceutical companies: $30 billion

Lowest Medicare Part D price in 2006 for a year of treatment with Zocor, a popular drug for patients with high cholesterol: $1,485.96

Lowest VA price in 2006 for a year of treatment with Zocor: $127.44

Overview/Summary

Middle Class Position Analysis

Quotes from Experts

Beyond this Bill

Additional Resources

“Medicare: Prescription Drugs,” from Families USA

National Legislative Association on Prescription Drug Prices

“Celebrating Pork: The Dubious Success of the Medicare Drug Benefit,” by Dean Baker from the Center for Economic Policy Research

“Price Negotiation Would Dramatically Lower the Cost of Prescription Drugs for Medicare Beneficiaries,” from the National Committee to Preserve Social Security and Medicare

Small Business Health Fairness Act of 2004

atraub — Tue, 25 Sep 2007 13:50:01 -0400

Legislation

The middle class

Opposes

Video Summary

Injustice Facts

Number of middle-class households that lack health insurance: 1 in 6
Percentage of small businesses that did not offer health insurance to employees in 2004: 37
Proportion of small businesses that would see their premiums increase under this legislation: 4 out of 5
Predicted increase in the number of uninsured Americans under this legislation: 250,000 to 1 million
Average estimated increase in health care premiums for small business under this legislation: 6%
Average estimated increase in health care premiums for small employers with state-regulated coverage under this legislation: 23%

Overview/Summary

Middle Class Position Analysis

The Middle Class Opposes: Enhancing the ability of small businesses to offer quality health insurance would go a long way towards reducing the number of uninsured Americans. But the devil is in the details: by exempting AHPs from state regulations, this bill increases average health care costs for small businesses and reduces the number of workers with health insurance. For example, state laws prevent insurance plans from cherry-picking only the healthiest people for insurance coverage, allowing businesses with relatively healthy employees to join for less money, while charging higher rates to those with older and sicker workers. This would destabilize the health care marketplace: state-regulated health care plans would see their healthy workers siphoned off to the AHPs, leaving them with a disproportionate number of older and sicker employees who are more expensive to cover. Health care premiums for all small businesses except those with the healthiest workforce would soar, and companies unable to cope with the increased costs would leave their employees at risk of becoming uninsured. For this reason, the Congressional Budget Office has projected that AHP legislation, if enacted, would result in higher premiums for four out of five small employers.

Quotes from Experts

Beyond this Bill

Additional Resources

Small Business Health Fairness Act of 2005

atraub — Mon, 24 Sep 2007 15:13:41 -0400

Legislation

The middle class

Opposes

Video Summary

Injustice Facts

Number of middle-class households that lack health insurance: 1 in 6
Percentage of small businesses that did not offer health insurance to employees in 2005: 41
Proportion of small businesses that would see their premiums increase under this legislation: 4 out of 5
Average estimated percentage increase in health care premiums for small business under this legislation: 6
Average estimated percentage increase in health care premiums for small employers with state-regulated coverage under this legislation: 23
Predicted increase in the number of uninsured Americans under this legislation: 250,000 to 1 million

Overview/Summary

Middle Class Position Analysis

The Middle Class Opposes. Enhancing the ability of small businesses to offer quality health insurance would go a long way towards reducing the number of uninsured Americans. But the devil is in the details: by exempting AHPs from state regulations, studies indicate that this bill would increase average health care costs for small businesses and reduce the number of workers with health insurance. For example, state laws prevent insurance plans from cherry-picking only the healthiest people for insurance coverage, allowing businesses with relatively healthy employees to join for less money, while charging higher rates to those with older and sicker workers. Exemption from these laws would destabilize the health care marketplace: state-regulated health care plans would see their healthy workers siphoned off to the AHPs, leaving them with a disproportionate number of older and sicker employees who are more expensive to cover. Health care premiums for all small businesses except those with the healthiest workforce would soar, and companies unable to cope with the increased costs would leave their employees at risk of becoming uninsured. For this reason, the Congressional Budget Office has projected that AHP legislation, if enacted, would result in higher premiums for four out of five small employers.

Quotes from Experts

Beyond this Bill

Additional Resources

Healthy Mothers And Healthy Babies Access To Care Act of 2004

atraub — Wed, 19 Sep 2007 14:51:38 -0400

Legislation

The middle class

Opposes

Video Summary

Injustice Facts

Percentage of the nation’s health care expenditures made up by medical malpractice premiums: 0.62%
Maximum non-economic damages payable under the provisions of this bill to a baby who will go through life completely paralyzed due to the actions of a negligent doctor: $250,000
Maximum punitive damages under the provisions of this bill imposed on a doctor who has similarly paralyzed seven other newborns through the same negligence: $250,000
Rank of “reducing jury awards in malpractice lawsuits” on the list of health care priorities for Congress and the President in 2005, according to a poll by the Kaiser Family Foundation and the Harvard School of Public Health: 11 out of 12
Number of times President Bush mentioned “junk” or “frivolous” lawsuits during a recent speech on health care policy: 10

Overview/Summary

Middle Class Position Analysis

The Middle Class Opposes: The middle class endorses a "nay" vote on the procedural question and opposes the substance of the bill. This bill, misnamed the Healthy Mothers and Healthy Babies Access to Care Act, places limits on the legal rights of pregnant women and their babies. When a baby is killed, maimed, or brain-damaged because of medical negligence or malpractice, no amount of money can truly make a family whole. Nevertheless, it is the non-economic damages (damages beyond compensation for medical bills and lost income) from a lawsuit that provide some compensation. This bill would have imposed a one-size-fits-all limit on these damages, no matter how devastating the malpractice. This hits the middle class particularly hard. High-income plaintiffs are awarded higher economic damages because they lose more money from being unable to work. Thus for low- and middle-income victims, non-economic damages, which consider pain and suffering and quality of life, make up a larger proportion of the whole award. It is that prospect that enables middle income people to attract legal support that they would be unable to afford if they were required to pay hourly rates. In addition, the threat of significant liability helps deter hospitals from cutting corners on safety and stops pharmaceutical corporations from selling drugs they know to be dangerous. While the bill’s proponents argue that it would lower the cost of malpractice insurance for obstetricians, there is no evidence linking high malpractice insurance premiums to the cost of lawsuits. In fact, insurance industry representatives have said that they would not commit to lowering insurance rates if medical malpractice bills like this one are passed.

HMOs and insurance companies

Patient Protection and Affordable Care Act of 2009

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

Affordable Health Care for America Act of 2009

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

Medicare Fair Prescription Drug Price Act of 2007

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

Medicare Prescription Drug Price Negotiation Act of 2007

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

Small Business Health Fairness Act of 2004

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

Small Business Health Fairness Act of 2005

Legislation

The middle class

Video Summary

Injustice Facts

Overview/Summary

Middle Class Position Analysis

Related Blog: Header

Quotes from Experts

Related Blog: Text

Beyond this Bill

Related Blog: Link

Additional Resources

Healthy Mothers And Healthy Babies Access To Care Act of 2004