HealthLeadersMedia.com - Health Plan News & Analysis

Congress Takes Aim at Insurer Profits

Fri, 06 Nov 2009 13:12:00 GMT

As Congress appears poised, as many on Capitol Hill have been saying lately, "on the verge of a historic moment" with healthcare care reform, it is also preparing to take on the insurance industry over costs and profits—no matter what happens with reform.

Kaiser to open medical facility in South Los Angeles

Fri, 06 Nov 2009 12:25:00 GMT

Kaiser Permanente unveiled plans for a $10-million medical office building that will offer primary care, some specialty care and other services to 80,000 South Los Angeles residents who are members of Kaiser's healthcare plan. Kaiser's 15,000-square-foot South Los Angeles medical offices are expected to open in 2011. A vacant building on the site will be torn down to make way for the new facility and construction is scheduled to begin soon. In recent years, a series of public and private hospitals across South Los Angeles have closed or been scaled back, compounding what civic leaders call South L.A.'s inadequate access to healthcare. About 80,000 of the 3.3 million Kaiser members in Southern California live in South L.A.

AARP endorses House healthcare bill

Fri, 06 Nov 2009 12:21:00 GMT

The AARP, the nation's largest and most influential association of older Americans, endorsed the House healthcare bill Thursday morning and vowed to lobby House members in advance of Saturday's historic vote. AARP Vice President Nancy A. LeaMond said the House package, which would spend more than $1 trillion over the next decade to expand insurance coverage to millions of Americans who lack it, meets the group's chief goals for reform, including strengthening Medicare. LeaMond praised House leaders for including a plan to close the coverage gap in Medicare prescription drug coverage known as the donut hole.

Immigration and abortion issues could cost party crucial votes

Fri, 06 Nov 2009 12:19:00 GMT

House Democratic leaders were struggling Thursday to contain uprisings on the hot-button issues of abortion and immigration that have left them little margin for error as they attempt to push through a massive healthcare reform bill this weekend. Although confident of victory, House Speaker Nancy Pelosi and other Democratic leaders were working to limit defections to the roughly 25 Democrats viewed as "hard no" votes. For party leaders, setting a weekend deadline for passage represented a calculated risk, one that could backfire if the vote—now expected late Saturday or Sunday—fails or must be delayed. But they feared that if members were given more time to consider the legislation, new issues could arise, particularly as lawmakers digest the results from Tuesday's elections.

House Democrats seek allies for health vote

Fri, 06 Nov 2009 12:15:00 GMT

House Democratic leaders worked furiously on Thursday to secure the final votes for weekend approval of a sweeping healthcare overhaul as President Obama threw his weight behind the lobbying effort and Republicans dug in against the health plan. Democratic vote counters said they did not yet have the necessary 218 confirmed supporters. But they said they were confident they would exceed that total in time for a landmark vote set for Saturday on the $1.1 trillion, 10-year health plan that many Democrats have sought for years. Readying for the first floor test of legislation months in the making, top Democrats appealed to undecided lawmakers while trying to quell resistance from Hispanic House members worried the measure was too punitive regarding illegal immigrants and anti-abortion lawmakers who fear that public money could be funneled toward abortions.

Thousands rally to protest healthcare bill

Fri, 06 Nov 2009 12:05:00 GMT

Chanting "Kill the bill," thousands of conservatives rallied at the Capitol on Thursday against the Democrats' healthcare overhaul plan, labeling it a government takeover of the nation's medical system. The protest attracted many of the so-called Tea Party demonstrators angry with increased spending and an expanded government role under the Obama administration. Their signs ranged from the harsh, "Waterboard Congress," to an echo of the rallying cry at August town halls with lawmakers, "Vote no to government-run health care." One protester carried a placard reading, "Bury Obamacare with Kennedy," a reference to Sen. Edward Kennedy, D-Mass., who died of brain cancer this past summer.

New Jersey Pilot Program Insures Newborns Without Coverage

Thu, 05 Nov 2009 16:40:00 GMT

If a pilot program underway in New Jersey is a success, no newborns at participating hospitals will leave the facility without health insurance coverage.

House expected to vote on health bill Nov. 7

Thu, 05 Nov 2009 13:14:00 GMT

House leaders will hold a rare Saturday vote on the expansion of the U.S. healthcare system. Democrats are still locking down support among a handful of holdouts, with the biggest bloc dissatisfied with the measure's handling of abortion. In other news, a bill that Republicans expect to offer as an alternative to the Democratic package received its assessment from congressional budget analysts, who concluded that the proposal would barely dent the ranks of the uninsured.

Public's view of healthcare overhaul has familiar ring

Thu, 05 Nov 2009 13:13:00 GMT

Americans' opinion of the healthcare proposals now before Congress is similar to public sentiment about the Clinton health reform initiatives in 1994, according to an analysis published online in the New England Journal of Medicine. Americans believe the healthcare system needs to be fixed and they like many of the ideas Democrats are proposing, the report found. But they believe the specific proposals taking shape would not benefit them personally, and they fear they could result in more expensive and lower-quality care.

Democrats bet AARP support to seal healthcare

Thu, 05 Nov 2009 13:06:00 GMT

AARP will endorse sweeping healthcare overhaul legislation headed for a vote, officials said. An endorsement from the seniors lobby was critical when then-President George W. Bush pushed the Medicare prescription drug benefit through a divided Congress in 2003. House Democratic leaders are hoping it will work the same political magic for them as they strive to deliver on the health reform issue, the San Francisco Chronicle reports.

Immigrants face hurdles with new Massachusetts care coverage

Thu, 05 Nov 2009 12:37:00 GMT

Although Massachusetts has salvaged health insurance for 28,000 legal immigrants, the company hired to cover this group has been late assigning doctors and sending enrollment information to many patients, health and immigrant advocates say. Even some patients who received the necessary information are facing significant hurdles connecting with the doctors CeltiCare Health Plan of Massachusetts assembled in its new network, which limits the community health centers and hospitals available to patients, the Boston Globe reports.

Insurers Must Pay Promptly or They'll Pay in Other Ways

Wed, 04 Nov 2009 15:04:00 GMT

If your health insurance company is not paying claims promptly, the state may soon come calling.

GOP Offers Reform Alternative, Hoyer Says It Protects Status Quo

Wed, 04 Nov 2009 13:35:00 GMT

House Republicans on Tuesday unveiled their alternative health reform plan to the current bill (HR 3962) making its way to the House floor by the end of the week. Not surprisingly, House Majority Leader Steny Hoyer (D-MD) called the proposal an "effort to protect the status quo while attempting to disguise them as real healthcare reform."

Health bills too timid on cutting costs, experts say

Wed, 04 Nov 2009 13:11:00 GMT

To cut healthcare costs, the Obama administration has advocated moving away from fee-for-service payments, which reward providers for doing more procedures, to a coordinated system that pays doctors and hospitals for doing better. Under that vision, providers would be given a few years to move to performance-based medicine, in which fees and results are published, money is directed to evidence-based therapies, and harmful errors such as preventable infections are reduced. But many are worried that the president's hopes to constrain costs could result in tepid half-measures on Capitol Hill, the Washington Post reports.

Democrats see healthcare timetable slipping

Wed, 04 Nov 2009 13:10:00 GMT

Time is running short for Congress to deliver a health bill to President Barack Obama before the end of the year, prompting lawmakers to prepare for the debate to carry into 2010. Senate Majority Leader Harry Reid indicated that the chamber may not meet its goal of passing a bill in the next several weeks, the Wall Street Journal reports.

Senate moderates flex muscle on healthcare bill

Wed, 04 Nov 2009 13:08:00 GMT

Moderate lawmakers are exerting their influence in the divided Senate to secure changes to healthcare reform legislation, potentially adding more delays to the bill, the Washington Post reports. Moderates have raised numerous concerns about aspects of the bill, including the public insurance option that included an "opt out" provision for states that don't want to participate. Many moderate Democrats prefer a "trigger" mechanism that would allow government-backed coverage only in states where private insurers fail to offer broadly affordable plans.

Children's Hospital Boston, three health plans push cost-control effort

Wed, 04 Nov 2009 13:07:00 GMT

Children's Hospital Boston has agreed to limit increases in fees it charges Massachusetts' major health insurers next year as part of a larger push to control the rise in pediatric healthcare costs. In exchange, the three health plans—Blue Cross-Blue Shield, Harvard Pilgrim Health Care, and Tufts Health Plan—along with the state's Medicaid program, will contribute a portion of their savings, about $10 million in total, to a fund that will enable Children's Hospital to accelerate pilot programs aimed at providing better care at lower costs.

Insurance discounts for healthy habits spur debate in Washington

Wed, 04 Nov 2009 12:45:00 GMT

Some companies are charging lower insurance premiums to workers who meet benchmarks for healthy living, and the Senate's healthcare overhaul legislation would expand the trend. But some patient advocacy and health groups are worried that it could mean higher rates for less-fit Americans, possibly pricing them out of their employers' insurance plans. Critics of the Senate proposal also say that giving special treatment to those who meet a company's fitness standards could undercut one of the promises of the Democrats' proposed overhaul: preventing employers and insurers from discriminating against people on the basis of their health status and preexisting medical conditions.

GOP counters with a health plan of its own

Wed, 04 Nov 2009 12:21:00 GMT

House Republicans have drafted an alternative healthcare bill that would reward states for reducing the number of uninsured, limit damages in medical malpractice lawsuits, and allow small businesses to band together and buy insurance exempt from most state regulation. The Republican bill promises to lower healthcare costs and expand insurance coverage "without raising taxes, cutting Medicare benefits for seniors, adding to the national deficit, intervening in the doctor-patient relationship or instituting a government takeover of healthcare."

Healthcare debate focuses on legal immigrants

Wed, 04 Nov 2009 12:18:00 GMT

The debate over healthcare for illegal immigrants continues to percolate in Congress, with lawmakers in both houses also wrangling over how much coverage to provide for immigrants who have settled in the country legally. Some Republicans favor excluding immigrants who have been legal permanent residents for less than five years, as well as all illegal immigrants. Democrats broadly agree that illegal immigrants should be excluded, but many want all legal permanent residents to be able to participate in proposed health insurance exchanges and receive subsidized coverage if they qualify, the New York Times reports.