Great Article from Humana about Healthcare Reform

Washington's week

This week and next should be relatively quiet in Washington, with the members of the House and Senate back in their districts for an Easter break. They aren't due back in the Capitol until May 1. Meanwhile, President Obama is scheduled to travel to several U.S. cities to promote his framework for cutting the deficit.

Before leaving Washington, the House and Senate ended months of haggling over the 2011 budget. They agreed to legislation that cut about $39 billion. Bipartisan majorities in both chambers voted to override both the conservative complaints that the budget didn't cut enough spending, and liberal complaints that it cut too much from social programs for the needy. "Welcome to divided government," House Speaker John Boehner, R-Ohio, said. Steny Hoyer, the minority leader, quoted Henry Clay: "If you can't compromise, you can't govern."

Here are a few of the cuts that affect health care:

• $2.2 billion eliminated for the implementation of health insurance cooperatives
  
• $78 million from research on health costs, quality and outcomes
  
• $600 million from community health centers
  
• $35 million from rural health programs
  
• $119 million from the building/facility budgets of the National Institutes of Health and the Centers for Disease Control and Prevention

A number of health-related bills also were introduced last week, including these (many bills are introduced that are never seriously considered):

• Repeal the health insurance industry tax established by the health reform law (introduced by a House Republican)
  
• Repeal the CLASS program, a voluntary insurance program established in the health law to help seniors pay for services and supports (introduced by a Senate Republican)
  
• Require private insurers and federal health programs to cover medically necessary food (introduced by a House Democrat)
  
• Repeal the part of the health reform law that eliminated the Medicare open enrollment period for January, February and March (introduced by two House Democrats and two House Republicans)

Meanwhile, on Monday, the Supreme Court decided to wait to decide whether to fast-track Virginia's lawsuit against the health reform law. Virginia Attorney General Ken Cuccinelli has asked that the case be allowed to skip the lengthy appeals process and go directly to the high court so the states won't spend a lot of time and money implementing a law that may be declared unconstitutional.

But the biggest topic of conversation in recent weeks has been the 2012 budget. That conversation is likely to be long and arduous, since it has many big parts – for example, competing visions of government, of what makes America great, of the social contract – and a difference of opinion over the superiority of various economic models.

HealthCare Reform Breakdown CONT.

More from Mike Vogel's Florida Trend article:

"NEW REGULATIONS

Closed Counter
Before: Employees could use their health savings account, flex savings account or health reimbursement account money to pay for over-the-counter meds.

Now: If workers want to spend their money on over-the-counter purchases, they’ll need a doctor’s prescription.

Implication: Employees and doctors won’t bother with prescriptions for runny noses, so employees will ratchet down the money they park in accounts.

Class Distinctions
Before: Businesses could put their employees in different “classes” with different coverage for each class. A restaurant company, for instance, might put wait staff in one class and chefs, administrative staff and executives or owners in another.

Now: All are treated equally — or companies will pay significant penalties down the road if they “discriminate” in favor of highly paid employees. That raises concerns that some companies may drop coverage altogether rather than absorb the cost of adding dozens of employees, says Robert Pariseau, president of West Florida operations in Tampa for benefits company AGIS.

Exception: Companies can grandfather their existing plans — and avoid the penalties — provided they don’t make substantive changes to the plans such as increasing the share of the premium employees pay for coverage by more than 5%. That rule against major changes could force employers to give up grandfather status rather than absorb rising insurance costs. How many companies will seek or maintain grandfather status is unclear. The rules aren’t finished and the size of the penalties won’t be announced until the middle or later part of this year, giving companies a year to decide what to do. “Penalties could be huge,” Barber says. Some companies, if they can’t offer key talent a better plan or some healthcare perk, instead pay bonuses so high-value employees can obtain the coverage they want on their own. “They’re having to think outside the box to maintain their competitive advantage in recruiting talent,” Farmer says.

Care Standards
New: Small-business insurers must pay out 80 cents of every premium dollar for patient care. Insurers of larger employers have to pay out 85%.

Implication: Insurers will see margins pressured and so may cut back on broker commissioners, administrative costs or services to businesses and their employees. “I don’t see how the service gets better if they have to cut the administrative costs, maybe drastically,” Pariseau says. “It’s a low-margin business anyway.”

Tax Credit
New: A tax credit for small companies of up to 35% of their premium cost. “It’s a good deal. It’s better than a deduction,” Barber says. "

HealthCare Reform Breakdown CONT.

Continuation of Mike Vogel's article from FloridaTrend.com...

"NEW HEALTHCARE MANDATES

Kid CoverageBefore: No government mandate on how old an employee’s children can be before coverage expires.

Now: If a plan covers employees’ kids, coverage must be offered up to age 26.

Ounce of PreventionBefore: Employers and their insurers settled how much of preventive care — checkups and the like — was covered.

Now: Insurance has to cover 100% of certain preventive care.

Pre-ExistingBefore: People with pre-existing conditions could have treatment of that condition excluded from coverage under certain circumstances.

Now: No exclusions for pre-existing conditions up until age 19 and no exclusions over 19 starting in 2014.

Caps
Before: Companies could cap the maximum benefits they would pay. Typical plans capped employee coverage at $1 million to $5 million lifetime.

Now: Unlimited lifetime maximum for “essential” benefits.

The Bottom LineNew mandates raised rates 1.5% to 4% this year. “It’s obviously a factor,” says Steven Barber, an employee benefits lawyer and partner with Shutts & Bowen in Tampa, but “if nothing had happened, the costs would have gone up anyway.”

Indeed, the law-related increases came atop a 10% to 13% increase attributed to medical care cost rises. Employers responded with maneuvers such as raising deductibles and out-of-pocket maximums. That kept their cost increases to 6% to 9%. .."