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Healthcare Reform Update - September 17-23, 2009

 

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Compiled by La Vonda DeWitt*

September 23, 2009

Republican Wish List Has Stark Differences And Surprising Similarities To Democratic Proposals
September 17, 2009

The Republican leadership lacks a flagship health reform plan, but a variety of ideas and proposals have emerged from rank-and-file members that outline the party's reform principles, Kaiser Health News reports. The GOP proposals share much with Democratic plans, but also focus on other approaches. They won't pass, but they could shape the debate.

Key ideas include: replacing the tax break for employer-sponsored insurance with a tax credit to each individual or family; replacing Medicaid with subsidies for low-income people to buy private insurance; capping malpractice awards; adding a competitive pricing feature to Medicare Advantage plans, effectively lowering their prices by forcing them to compete; and, allowing individuals and small businesses to form groups to buy insurance (Appleby, 9/16).

One of the leading GOP proposals, authored by Sen. Tom Coburn, R-Okla, also features a surprising idea, Kaiser Health News separately reports. It would create a commission responsible for "conducting and supporting research into the effectiveness, quality, outcomes and costs of medical services, as well as recommending guidelines and standards and making public its findings."

That mission is not very different from a comparative effectiveness panel Democrats established in the stimulus bill, drawing criticism from conservatives. Michael Cannon, of the Cato Institute told Kaiser Health News, "A Republican price, quality and transparency panel could easily be morphed into a Democratic comparative effectiveness panel and easily morphed into a Sarah Palin death panel" (Appleby, 9/16).

Republicans denounced the most recent Democratic health reform plan, which was released Wednesday, after months of thus far botched efforts to gain bipartisan support, Kaiser Health News reports in a third, related story. However, the bill, "unveiled Wednesday by chairman Max Baucus, D-Mont., contains several provisions that were inspired by Republicans, including testing new ways to handle medical malpractice cases, creating avenues for consumers to cross state lines to buy insurance and immediately launching a high-risk pool that would cover people with pre-existing medical conditions (Pianin and Appleby, 9/16).

Baucus Plan Gives A Nod To GOP Ideas
September 17, 2009

KHN reports that "[t]he Senate Finance Committee bill unveiled Wednesday by chairman Max Baucus, D-Mont., contains several provisions that were inspired by Republicans, including testing new ways to handle medical malpractice cases, creating avenues for consumers to cross state lines to buy insurance and immediately launching a high-risk pool that would cover people with pre-existing medical conditions" (Pianin and Appleby, 9/17).

21. Health Policy Experts Urge Congress To Abandon Ideological Differences On Overhaul
September 18, 2009

Kaiser Health News reports that a group of "leading economists, analysts and health care administrators" are urging lawmakers to set aside ideological differences and take "action to create broad based changes in the nation's health care system." The group wrote an open letter to Congress, "which was signed by more than 400 health care leaders and identified eight specific policy changes that the leaders said are central to effective health reform legislation. Those changes include efforts to expand coverage to the uninsured, promote competition in health insurance, assure affordability and cover preventive services" (Marcy, 9/17).

Confusing Insurance Jargon Prompts Call For Reform
September 21, 2009

Kaiser Health News, in collaboration with the Los Angeles Times , reports on the challenges consumers confront in trying to understand insurance industry jargon. "Insurance industry critics say some insurers intentionally make their policies and procedures confusing, and some policy experts believe Congress should require standardized plan information as part of any overhaul of the health system" (Meyer, 9/21).

Coverage Issues: Some People Have Too Little While Others Have Very Generous Plans
September 22, 2009

Health reformers are confronting two challenges that seem to conflict: Those with no insurance, and those with very generous coverage. Twenty-somethings have the highest uninsured rate of any group, with roughly 1-in-3 lacking coverage, TIME magazine reports. These "young invincibles" run the obvious risk of an unforeseeable illness or serious accident interfering with their otherwise good health.

But, "Young people's willingness to forgo insurance, it turns out, is a major problem for the entire health-care system, which needs them on the rolls to help spread out risk and keep older Americans' premiums from going even higher." To curb the problem, lawmakers are crafting plans that would allow insurers to market bare-bones policies with low premiums, high deductibles and preventive care coverage to young adults. Those who don't buy in, would face fees up to $950 a year, just a bit less than the cost of coverage (Pickert, 9/22).

On the other end of the spectrum, some policyholders have costly "Cadillac" plans, which are "usually defined by the total cost of premiums, rather than what it might cost the patient to get health care," Kaiser Health News/NPR reports. Cadillac plans usually have low deductibles and excellent benefits that cover even the most expensive treatments, "but this is not always the case." Some with this coverage face high rates due to age, location, health status and other factors--critics say the most generous plans "encourage overuse of medical care."

A proposal to tax the plans with premiums higher than $8,000 for individuals and $21,000 for families would both raise revenue to expand coverage and discourage the plans, effectively working to lower medical costs. There are concerns however, that the tax will hurt middle-class people. If health costs continue to rise much faster than inflation, more and more plans would be subject to the tax (Gold, 9/22).

This information was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery. © Henry J. Kaiser Family Foundation. All rights reserved.

*We wish to thank La Vonda R. DeWitt, Esquire (Parks IP Law, Atlanta, GA), for selecting the articles for this week's update.

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