. One such item, medical malpractice liability reform, got a hearing last week before the House Judiciary Committee as Republicans paraded several witnesses before the committee to showcase the need for legislation from the physicians’ perspective. Since it is very unlikely that the American Medical Association’s wish list would ever become law, the best result from the committee process would be a bill that skirts the more controversial items (e.g., cap on damages) and focuses on attainable and meaningful reforms, such as health courts, stronger pre-trial evaluation and settlement pathways. This would be a path Aetna would strongly support.
In March 2010, Governor Brewer signed a fiscal year 2011 budget that stripped funding for the state’s Children’s Health Insurance program (KidsCare) and cut $385 million from AHCCCS, effectively repealing an expansion of AHCCCS to childless adults approved by voters in 2000. However, following enactment of the PPACA, the state rescinded the scheduled cuts to comply with the law’s “maintenance of efforts” (MOE) requirement. The MOE requirement prohibits a state from having eligibility standards, methodologies, or procedures for adults that are more restrictive than those in effect on March 23, 2010, until a health insurance exchange in the state is fully operational, and for all children in Medicaid and CHIP through September 30, 2019. The MOE requirement provides an exception for non-pregnant, non-disabled adults earning more than 133 percent of the federal poverty level if a state is projected to have a budget deficit. Arizona faces a mid-year budget deficit estimated at $825 million. A $1.4 billion shortfall is projected for the 2012 fiscal year.
. The high court will review three legal challenges to California’s proposed and adopted reimbursement cuts. The Supreme Court’s ruling on the case could have major implications for efforts to address California’s budget deficit. Last week, Gov. Jerry Brown (D) released a budget proposal that would reduce Medi-Cal payments to health care providers by 10 percent to cut program spending by about $719 million in fiscal year 2011-2012. In addition, the case could have implications for other states seeking to address budget deficits by cutting Medicaid payments. With federal courts in California blocking the cuts, 22 states have joined California in appealing the issue to the Supreme Court. The court is expected to hear oral arguments in the case next fall. A decision is expected in late 2011 or early 2012.
Few details were provided, but the original report recommends that SustiNet become a licensed insurance plan. ”We don’t need health insurance anymore, we need to move towards health assurance — health care that will be there for us, and the SustiNet plan will do that,” Donovan said. Lawmakers will face a $3.7 billion budget deficit by July 1. Rep. Betsy Ritter, D-Waterford, co-chairwoman of the Public Health Committee, said the plan will have to go before multiple legislative committees, with the actual bill some weeks away. A financial analysis on upfront costs is not yet available. Aetna is working with the Connecticut Association of Health Plans (CTAHP) and AHIP to secure an objective fiscal analysis of SustiNet’s, as a public option, true cost to the state, and of the strong, positive impact health insurers have on the state’s economy.
The Governor specifically stated he is open to any and all good ideas for addressing this budget issue. In other news, a joint meeting of the Senate Health Committee and the House Economic Development, Banking, Insurance, and Commerce Committee was convened for an update on the state’s effort to implement health care reform. Rita Landgraf, Secretary of Health and Social Services, along with Bettina Riveros, Health Care Commission Chair, advised legislators the commission will spend the next six to eight weeks holding stakeholder meetings across the state seeking input on establishing a state health insurance exchange.
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: As the head of this workgroup for Governor Perdue is continuing under Governor Deal’s administration, it is likely that there will be some enabling legislation during the 2011 session, though it is unclear what that will be. The legislative session began January 11, 2011 and continues for 40 legislative days.
The General Assembly convened in Des Moines on January 10 and is expected to adjourn on April 29, 2011 In the November elections, Republicans took control of the House and gained a few seats in the Senate, narrowing the Democrats’ majority there. Republican Terry Branstad was sworn in as governor for the second time. Having served in the post from 1983 to 1999, Branstad is the longest-serving governor in Iowa’s history. The state’s budget deficit is projected to be more than $785 million for fiscal year 2012 and will dominate legislative discussions. House Speaker Kraig Paulsen has vowed to remedy the deficit through spending cuts rather than tax increases. The Governor’s proposal to revise the state’s annual budget to a two-year cycle will also be debated.
: . In his order he directs the Indiana Family and Social Services Administration (IFSSA) to cooperate with appropriate state agencies, including the Department of Insurance (IDOI), to establish and operate the exchange. The IFSSA Secretary or the secretary’s designee will serve as the incorporator of the Exchange. If, after careful analysis, the state deems it appropriate to proceed with creation of the exchange, a board of directors will be selected. The board will include representatives of state agencies and the Indiana General Assembly. Standing Committees will be appointed that have stakeholder representation. . HIP, the state’s consumer-directed program for covering the uninsured population, is scheduled to expire in 2012. Daniels notes he has received communication from HHS staff indicating the state plan amendment will be rejected due to HIP’s required level of contribution from participants. The Governor said the state intends to utilize the program for the newly eligible Medicaid population pursuant to PPACA. Daniels cautioned that Indiana does not have the time and financial resources necessary to complete new rigorous requirements for applying for a waiver extension if the amendment is rejected. The current 45,000 enrollees in the program would have to be transitioned into traditional Medicaid.
The 96th General Assembly convened on January 5 and is expected to adjourn on May 30, 2011. With 106 members to the Democrats’ 57, the GOP has the largest number of seats it has ever held in the House and is just three members short of being veto-proof. Given the large Republican majorities in the General Assembly and 70 percent voter support for Proposition C – an effort to turn back health care reform, the legislature will be under pressure to do nothing to move Missouri closer to enactment of federal health reform.
, a bill requiring statutory authorization by the General Assembly to implement PPACA, a bill expanding the autism mandate, an MLR bill for large carriers requiring a 90 percent MLR for Missouri-associated revenues and 85 percent for smaller carriers, a bill requiring the state employee health plan to offer a minimum of three high-deductible options with differing annual deductibles and annual out-of-pocket expenses, a bill prohibiting “Most Favored Nation” clauses, legislation creating transparency and publication of carriers’ fee schedules and requiring carriers to contract with providers willing to meet certain provider participation terms and conditions, and creation of a uniform group application for insurance.
: with six bills relating to implementation or rejection of PPACA introduced to date. Bills of interest include legislation creating an Exchange Task Force, an interim committee for PPACA study, and several bills challenging the individual mandate, prohibition of abortion coverage, and a cochlear implant mandate. In addition, a bill banning discretionary clauses in health and disability income insurance contracts has been introduced. The legislature began its work on January 6 and is tentatively scheduled to adjourn on May 26, 2011.
The legislature convened on January 5, 2011, and is scheduled to adjourn on June 30, 2011. Governor John Lynch will continue as the state Executive; however, Republicans have gained control of both chambers in the legislature. In addition to the state’s budget deficit, implementation of federal health care reform will continue to be a priority for the governor and the legislature. Given the Republican majority and anticipated revenue shortfalls, there will be limited, if any, activity on health insurance issues. The legislature will, however, be paying close attention to federal health reform implementation issues and activities. . In 2010, the state enacted legislation granting certain powers to the commissioner with respect to implementation of PPACA. This legislation also created a legislative oversight committee, to which the Department of Insurance (DOI) must report monthly. This month the DOI submitted a request for a waiver of the 80 percent minimum loss ratio (MLR) requirement for individual health insurance market policies until 2014.
: . One option is to let HHS run the state’s exchange, While that could save money, it would also mean ceding key operational and regulatory issues to the feds. It might also jeopardize existing consumer
Apples & oranges dude! Besides, Obama-care is on life support and hopefully will never pass, in spint of what Nazi Pelosi says.
No. None of us can afford the consequences, and it will be worse for our children and theirs if nothing is done.
I think we ought to have a bipartisan commission study the Canadian system and make recommendations about how to implement it here in the U.S. My Canadian wife is pretty horrified by the system here with my top of the line BCBS plan, after 30 years in Canada. It's not as good as medical care in Canada and it costs more and it's harder to get in and see a doctor when you're sick. And I'm one of the lucky Americans. It's unconscionable that millions can't get health care in such a wealthy country, and I don't think the reason Canada or the UK or France can afford socialized medicine is that they have such remarkably better economies. It can be done here and should be done here as soon as possible.
Please watch the following:
http://www.youtube.com/watch?v=aEXFUbSbg1I
It's an interview John Stossel did with Michael Moore about Universal Health care and a better alternative.
Look at the rates medicaid and medicare pay versus the rates private insurance companies pay.
With universal health care, the paying rates are likely to be at the current medicaid/medicare rates.
The reimbursement rates for anesthesiologist for insurance companies is about 50$ per unit (in network), for medicaid it is around 19$ per unit. So reimbursement cut in just over half, so salaries are likely to be around half.
EDIT: Check with your professors regarding reimbursment rates for the different types of insurances, they should have an understanding of the business side of it. Or if you have taken a practice managment class it should also show you an outline of rates. Despite my thumbs down I am correct on this issue as I do work for an anesthesiologist and can see right here the difference in the values. I don't see the government suddenly doubling the rates they are paying. Billing will be easier as there will be only one payor to fimilarize yourself with rules and you will likely be able to have a smaller staff because of this so that will save you a few bucks. Good luck to you, and don't let politics dictate your profession. I'm really doubting universal healthcare will even pass and if it does there are plenty of doctors and groups willing to work together to get around it and make a liveable profit.
Be prepared for rationed health care and long lines to get seen by your physician when you are ill or injured. And yes, you will be taxed significantly for it. I would anticipate over the next 5 years to pay approximately 45% of your income in taxes. Welcome to Socialism, the only jobs that will exist in the next 20 years to be that of the government.
Private care is also "selective" care as well. The health insurance companies will refuse to pay for many services provided by a doctor.
I know because I see a specialist often for lifetime medical issues and a good portion of the costs always seem to fall outside the insurance coverage, so I end up paying for them out of pocket.
That is money I could be spending on a new car, consumer goods, or work on my house (eg: contractors), which helps keep other Americans employed.
People have been brainwashed by politicians and radio talk show hosts who have been paid off by insurance lobbyists. I can't believe how many times I've heard people, the very people who would benefit the most from Universal Health Care, say, "But that's SOCIALISM!"
I say, so what, bring it on! What's wrong with THAT?????
I can't imagine people would prefer that our president and his cronies and their corporate donors strip each and every tax dollar out of our pockets for their own personal gain at the expense of American citizens, enough tax money to subsidize health care for every man, woman and child in this country. Instead Halliburton gets rich on our tax money and then moves to Dubai. I say, maybe we need a little more Socialism! I say give the American taxpayer's money back to the American people in the form of health care and Social security and education, instead of giving it to some corporation that takes our money and then runs. Everybody owes it to themselves to become educated on this issue.
Don't you think just maybe there are a lot of other factors that play a role in statistics like that? Such as personal lifestyle choices? A lot of countries place more restrictions and controls on their population. I'm not willing to sacrifice even an inch of personal freedom.
Secondly, do you realize just how much medical research is done in the US and how many cutting edge medical technologies we have access to? You don't think that sort of thing plays a big role in health care costs?
Then how about we look at the two existing government medical programs. Both are poorly implemented and failing miserably with trillions in unfunded liabilities. So why exactly after failing twice should anyone trust government to get it right now?
More and more forecasts keep coming in that describe what is expected to happen as Obamacare takes effect:
1. Primary care physicians will be overwhelmed due to the surge of people coming in to access their free care. This will cause a shortage of PCPs.
2. Those on Medicare will find reduced options as PCPs limit the number of Medicare patients they take on to avoid financial loss.
3. Due to the first two things above, emergency rooms across the country will see a significant increase in demand causing both higher costs and longer waits.
Essentially Obamacare will bring us longer waits and higher costs than the existing system. I don't think that's what the people wanted. People wanted lower costs and better care for all, not welfare expansion at the expense of everyone else.
Of course it does…
We have the best health care system in the world because of Capitalism. We have the best technology and are the most innovative because of competition. Why mess around with that? Has anyone who is for this whole universal healthcare scam even had ONE problem with getting proper care, or are you assuming that others need help and think you're doing a good thing.
Doubtful, because I'm afraid to break it to the left extremists/socialists: we already have universal healthcare. Healthcare cannot be denied in this country. Many hospitals are NON-PROFIT and must still help if you cannot pay. It is one of the many reasons that healthcare insurance is often so expensive.
Giving the government any more control is the worst idea in the world. Name ONE thing that the government hasn't screwed up (other than collecting and wasting taxes)?