Health Care Reform in Nevada

Nevada Senator Harry Reid has helped the President accomplish the greatest social overhaul since President Roosevelt.  In July, Heath Care begins to reshape this country by providing benefits to those who were previously denied access to health care.  As with the creation of social security, more Americans can live with the security of health care.

As provided for in the Patient Protection and Affordable Care Act, on July 1, 2010, the Department of Health and Human Services launched the website www.HealthCare.gov to make accessing and choosing health insurance easier. By providing consumers with many informative health resources, this website will allow you to take control when making decisions regarding your health care coverage.

 How Health Insurance Reform Is Benefitting You

Pre-Existing Condition Insurance Plan – Nevada residents who are uninsured and have been denied coverage because of a pre-existing condition can apply for the Pre-Existing Condition Insurance Plan (PCIP) created by the Patient Protection and Affordable Care Act. PCIP will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available, even to treat a pre-existing condition. To learn more about the PCIP program and apply please visit www.HealthCare.gov.

Early Retiree Reinsurance Program – The rise of health insurance costs have made it difficult for some employers to continue to provide health insurance for their retirees. At the same time, Nevada’s early retirees who are not yet eligible for Medicare face serious difficulties in obtaining coverage in the individual market. In order to enable employers who are offering retiree coverage to continue to do so in these tough times, the Patient Protection and Affordable Care Act provides assistance for employers starting this year. To learn more about this program and to download the application please visit www.HealthCare.gov.

Money for Rate Review - Under the Patient Protection and Affordable Care Act, the Secretary of Health and Human Services will work in conjunction with state insurance commissioners across the country to place additional oversight on health insurance companies so that people are assured of value for the premiums they pay. While the new law will take over time, PPACA provided $250 million in funding to states from 2010-2014 to ensure they have the resources they need to review insurance premium increases. With this money, states can review premiums, and take action if insurance companies are not able to justify increases. This funding will provide the participating states the tools they need to work with consumers when examining health insurance premiums while we transition to a reformed health system. 

The Health Care in Jeopardy

The Brain Injury Association of America reports the following legislative update.

CALL THE CAPITOL SWITCHBOARD AT 800-828-0498

Over the past week, you may have seen news reports suggesting that health care reform is in serious jeopardy. WE MUST INSIST THAT CONGRESS COMPLETE HEALTH CARE REFORM NOW!

Too many Americans with disabilities and chronic conditions are not well served by the current system and will make tremendous gains through enactment of health care reform.
Take action NOW! Starting TODAY and continuing until the final votes on legislation, call your members of Congress and tell them NOT TO GIVE UP ON AMERICANS WITH DISABILITIES AND CHRONIC CONDITIONS! TELL THEM THAT YOU WANT THEM TO CONTINUE FIGHTING FOR HEALTH CARE REFORM!!!

•Health care reform will end discrimination based on health status in the private market - discrimination that currently leaves millions of vulnerable Americans uninsured
•Health care reform will include new, affordable voluntary long term care insurance coverage—the CLASS Act—and expand Medicaid coverage for home and community based services
•Health care reform will expand Medicaid eligibility and provide subsidies in the private market, creating more affordable coverage for people with disabilities
•Health care reform will prohibit annual and lifetime limits on coverage so that individuals with serious conditions will not be forced into medical bankruptcy

CALL THE CAPITOL SWITCHBOARD AT 800-828-0498. (If you can't get through on the 800 number, call the Capitol switchboard (202-224-3121) or your member's district office.)

 Tell your Senators and Representatives that NOW is the time for Congress to complete meaningful health care reform that prevents discrimination against people with pre-existing conditions, includes the CLASS Act and expands coverage of Medicaid home and community based services.

 People with disabilities and their families cannot wait any longer for relief!
 

What Now for Health Care?

Frankly, I am not one of those bleeding heart plaintiff lawyers.  I absolutely believe in compensation for preventable injuries, too often mislabeled "accidents."  But I also believe in accountability and reasonable expectation of risk assumption when engaging in many of life's activities.  In essence I believe the pendulum swings both ways - too far one way is no good nor too far the other.

My biggest upset about the Massachusette's election of a Republican Senator to replace long time Democrat Senator Kennedy is not the "shift in power."  Rather it is the amount of time, money and energy that went into crafting health care bills in the House and Senate which, by many accounts, will all be for naught.  That is a shame.  Health Care reform could have failed, but it was never given a chance.  What has failed is the time, money and energy that was expended and wasted by one election.

Politics suck.

That said, here is the latest from the Wallstreet Journal:

 JANUARY 25, 2010, 9:19 A.M. ET

Democrats Focus on Key Elements of Health Bill

By JANET ADAMY

WASHINGTON—The White House, with its health-care initiative in doubt, on Sunday zeroed in on several elements it hoped would survive, including measures to extend the life of Medicare, lower prescription drug costs for seniors and cap consumers' out-of-pocket medical expenses.

As Democrats regroup on plans to overhaul the health-care system after a Republican win in last week's Massachusetts Senate election, comments Sunday indicated that any revamped legislation would likely focus on the least-controversial elements of earlier proposals.

White House officials notably didn't emphasize that any revised legislation should include a major expansion of health insurance. Expanding coverage to the uninsured was the key plank of the separate health bills passed by the House and Senate last year, but such efforts largely accounted for the about $1 trillion cost of the bills, and Republicans decried them as too costly.

President Barack Obama spoke with congressional leaders over the weekend to determine how to move forward on the issue. Now that the Democrats no longer have a filibuster-proof 60-vote majority in the Senate, they are likely to need Republican support to pass any new legislation, something they weren't able to win last year. Officials stressed that discussions were still going on, and Democrats are also looking at ways to salvage the current legislation.

White House adviser David Axelrod, appearing on ABC News's "This Week," said the president didn't want to abandon several elements of the current bills. These include extending the life of the Medicare insurance program for the elderly, which the bills propose to do through payment cuts to health providers, and issuing tax breaks to help small employers provide insurance. Medicare will become insolvent by 2017 without more funding or payment cuts.

Mr. Axelrod also cited assistance to help seniors pay for prescription drugs. The bills would help close a gap in Medicare Part D insurance that forces some seniors to pay thousands of dollars a year for medicine. He also said the overhaul should help people with pre-existing health conditions buy insurance and cap out-of-pocket medical costs. He didn't discuss how these measures would be paid for.

A White House aide said Sunday those were just some of the provisions, among others, that the administration hoped to include in a final package.

Republicans agree that Medicare needs to become more sustainable, but argue that the Democrats' proposed payment cuts are the wrong way to do it. Some Democrats also fear they are too deep.

While Republicans have also emphasized helping small businesses and lowering consumers' out-of-pocket costs, their approaches have been different.

Senate Minority Leader Mitch McConnell (R., Ky.) said Sunday that Republicans wanted to start over and craft a plan that did more to lower the growth of health costs.

Mr. McConnell, speaking on NBC's "Meet the Press," said the plan should change the tax code to allow individuals who buy policies without the help of an employer to get the same tax break that companies get. He said the overhaul should also reduce the number of medical malpractice lawsuits and allow insurers to sell policies across state lines.
The Democrats' bills contain no substantive changes to the malpractice system and they don't make insurance tax-free for individuals, as is the case for companies.

Malpractice is one area where Democrats could show more flexibility in any revamped legislation. Reducing unnecessary lawsuits is an area that resonates with voters, regardless of party affiliation, and Democratic leaders have already added some malpractice provisions into the current bills, though they remain largely symbolic.
Mr. Obama signaled shortly after the Massachusetts election that he might be willing to sign a scaled-down version of the House and Senate measures. In addition to the provisions Mr. Axelrod outlined, revamped legislation could include new restrictions on insurance companies, such as limits on the amount they can reap in profit and a revocation of their decades-old antitrust exemption.

Congressional Democrats are also weighing several options aimed at salvaging the current bills. One idea is to make a series of modifications to the Senate bill, aimed at addressing House Democrats' concerns. Changes likely would include minimizing a tax on high-value insurance plans and stripping out sweeteners aimed at winning Senate votes, such as a deal to fund Nebraska's Medicaid expansion, Democrats have indicated.
The Senate would need fewer votes to pass the changes—a simple majority compared with the 60 they would need to block a filibuster—and the House could pass the package of modifications with the Senate bill.

But many Democrats consider that a complicated scenario that would be difficult to pull off.
Democrats are also still considering some mechanisms to expand insurance coverage, such as by broadening the Medicaid federal-state insurance program for the poor, and by allowing young adults to stay on their parents' insurance policies until they reach their late 20s.

Write to Janet Adamy at janet.adamy@wsj.com
 

Health Care Update

The BIAA has posted this Health Care Update:

On December 24, 2009, the Senate advanced its version of health care reform, opening the doors for negotiation with the House to reconcile differences between the two bills.
This week, negotiators worked to arrive at an agreement in principle to meld the bills, in the hope that a product be brought to the House floor this month. (CQ)
BIAA continues to fight to preserve several provisions from the House bill that are important for people with brain injury. Specifically, BIAA is working to ensure that insurance rating based on health status or pre-existing conditions and annual or lifetime limits on medical spending are prohibited. Also, BIAA is advocating to keep important consumer protections, including internal and external appeal requirements, provider network adequacy requirements, and greater transparency by insurance companies, in the final product.