A new report released today by the U.S. Department of Health and Human Services (HHS) shows that few families without health insurance have the financial assets to pay potential hospital bills. On average, uninsured families can only afford to pay in full for approximately 12-percent of hospital stays they may experience – and even higher income uninsured families are unable to pay for most potential hospital stays. Hospital stays for which the uninsured cannot pay in full account for 95-percent of the total amount hospitals bill the uninsured. Other studies have estimated that the bills for all types of health care that the uninsured cannot pay – the uncompensated cost of care – is up to $73 billion a year, a significant portion of which is shifted into higher costs for Americans with insurance and their employers.
“One of the most enduring myths in American health care is that people without health insurance can get care with little or no problem. Nothing could be farther from the truth,” said HHS Secretary Kathleen Sebelius. “The result is families going without care – or facing health care bills they can’t hope to pay. When the uninsured cannot afford the care they receive, that cost must be absorbed by other payers. This is why expanding access to affordable health insurance under the Affordable Care Act is so important.”
Approximately 50 million Americans are uninsured. The report found that most uninsured people have virtually no savings. In fact, the median financial assets for all uninsured families are just $20. Even among higher income families, assets are low. Half of families with income at 400-percent of the Federal Poverty Level (FPL), or $89,400 a year for a family of four in 2011, have financial assets below $4,100.
Every year, nearly 2 million uninsured Americans are hospitalized. With 58-percent of these hospital stays resulting in bills of more than $10,000, most uninsured people are unable to afford potential hospital bills. Even the top 10-percent of uninsured families with the most assets are estimated to be able to pay the full bill for only half of potential hospital stays. Uninsured families can, on average, afford to pay the full bills for only about 12-percent of the hospital stays they might experience, bills that account for just 5-percent of the total amount hospitals bill them.
“Health insurance is critical in helping protect families from unexpected hospital costs,” said Sherry Glied, HHS assistant secretary for planning and evaluation. “This report shows that even higher income uninsured families are struggling to meet the high costs of health care. No family should bear the burden of being one illness or accident away from bankruptcy.”
The high cost of hospitalization means that lacking health insurance poses a greater risk of financial catastrophe than lacking car insurance or homeowner’s insurance. Although people are 50-percent more likely to have car accident than to be hospitalized in a given year, the average bill for a hospital visit is over two and a half times higher than the average loss for a car accident. And, while the bill for a single hospitalization is about the same as the average loss from a house fire, a person is ten times more likely to be hospitalized than to experience a house fire.
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Showing posts with label report. Show all posts
Showing posts with label report. Show all posts
Tuesday, May 10, 2011
Wednesday, January 12, 2011
New Study: Medicaid Pays Nursing Homes Less Than Minimum Wage
/PRNewswire/ -- A new study released today finds that Medicaid programs in states across the country underfunded nursing facility care by $5.6 billion in 2010, paying on average $7.17 per hour per patient, less than the nation's current minimum wage of $7.25 per hour. A lifeline for many elderly and disabled, Medicaid funds 64 percent of the care provided in America's skilled nursing facilities nationally.
"This report reveals a truth many would not believe – today's nursing facilities are paid less than the minimum wage," stated Mark Parkinson, President & CEO of the American Health Care Association (AHCA). "That must change if we ever hope to serve the needs of a Baby Boom generation that will only stress our care delivery system further."
Compiled by the research group Eljay -- a nationally-recognized expert in long term care -- the report identifies which states are most affected by the rising pressure on state Medicaid budgets, both in terms of highest aggregate Medicaid underfunding and highest per patient per day underfunding. States topping those lists are New York, Illinois, Massachusetts, Minnesota, New Jersey and Wisconsin.
Nursing home providers are often forced to rely on funding from other sources – primarily Medicare – to fill in the funding gaps resulting from inadequate Medicaid payments. With so many of the nation's governors facing difficult choices surrounding budget cuts, Parkinson cautioned at the danger of allowing an already squeezed Medicare system to prop up Medicaid payment rates.
"There is a vast gap between the actual cost of providing quality eldercare and what the Medicaid program truly finances," Parkinson stated. "As Baby Boomers begin to ponder their long term care needs in the future, it is simply unsustainable for Medicare to continue filling that financial gap. As current trends indicate, this problem will only grow worse in the coming years."
The following charts highlight the states with the largest aggregate Medicaid underfunding and largest per patient per day underfunding:
Largest aggregate Medicaid underfunding
1. New York - $1,396,494,595
2. Illinois - $378,779,709
3. Massachusetts - $310,871,237
4. New Jersey - $304,430,314
5. California - $288,599,289
6. Pennsylvania - $277,609,403
7. Ohio - $248,513,290
8. Wisconsin - $181,237,562
9. Minnesota - $151,611,752
10. Missouri - $137,412,649
Largest Medicaid per patient day underfunding:
1. New York - $47.95
2. New Hampshire - $31.25
3. Massachusetts - $31.22
4. New Jersey - $29.29
5. Washington - $28.18
6. Wisconsin - $26.54
7. Minnesota - $24.70
8. Wyoming - $23.67
9. Delaware - $22.86
10. Illinois - $21.95
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"This report reveals a truth many would not believe – today's nursing facilities are paid less than the minimum wage," stated Mark Parkinson, President & CEO of the American Health Care Association (AHCA). "That must change if we ever hope to serve the needs of a Baby Boom generation that will only stress our care delivery system further."
Compiled by the research group Eljay -- a nationally-recognized expert in long term care -- the report identifies which states are most affected by the rising pressure on state Medicaid budgets, both in terms of highest aggregate Medicaid underfunding and highest per patient per day underfunding. States topping those lists are New York, Illinois, Massachusetts, Minnesota, New Jersey and Wisconsin.
Nursing home providers are often forced to rely on funding from other sources – primarily Medicare – to fill in the funding gaps resulting from inadequate Medicaid payments. With so many of the nation's governors facing difficult choices surrounding budget cuts, Parkinson cautioned at the danger of allowing an already squeezed Medicare system to prop up Medicaid payment rates.
"There is a vast gap between the actual cost of providing quality eldercare and what the Medicaid program truly finances," Parkinson stated. "As Baby Boomers begin to ponder their long term care needs in the future, it is simply unsustainable for Medicare to continue filling that financial gap. As current trends indicate, this problem will only grow worse in the coming years."
The following charts highlight the states with the largest aggregate Medicaid underfunding and largest per patient per day underfunding:
Largest aggregate Medicaid underfunding
1. New York - $1,396,494,595
2. Illinois - $378,779,709
3. Massachusetts - $310,871,237
4. New Jersey - $304,430,314
5. California - $288,599,289
6. Pennsylvania - $277,609,403
7. Ohio - $248,513,290
8. Wisconsin - $181,237,562
9. Minnesota - $151,611,752
10. Missouri - $137,412,649
Largest Medicaid per patient day underfunding:
1. New York - $47.95
2. New Hampshire - $31.25
3. Massachusetts - $31.22
4. New Jersey - $29.29
5. Washington - $28.18
6. Wisconsin - $26.54
7. Minnesota - $24.70
8. Wyoming - $23.67
9. Delaware - $22.86
10. Illinois - $21.95
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Monday, November 29, 2010
State-Run Property Insurers Lose Customers but Gain Risk
/PRNewswire/ -- Florida and Louisiana have reduced the number of high-risk policyholders covered by their state-run property insurers of last resort since 2008 while still leaving non-coastal property owners vulnerable to paying for these same insurers' potential coastal losses, according to the Insurance Information Institute's (I.I.I.) recently updated Residual Market Property Plans: From Markets of Last Resort to Markets of First Choice.
Florida Citizens Property Insurance Corporation, the largest property insurer of last resort in the U.S., provides insurance to residential and commercial property owners unable to purchase coverage in the standard market. Yet Florida Citizens saw the number of its total policies in force drop to 1.2 million at year-end 2009, down 14 percent from 1.4 million at year-end 2008. Meanwhile, Louisiana Citizens Property Insurance Corporation, the fourth largest state-run property insurer of last resort in the U.S. in terms of total policies in force behind Texas and Massachusetts, has seen an even more dramatic reduction in its total policy count. Louisiana Citizens had about 165,000 policies in force in June 2008, a figure that dropped to 127,000 policies as of June 2010, a reduction of around 40 percent.
"However, this year's report by the Insurance Information Institute, like the reports of the last two years, records the ongoing growth in the exposure base of the residual market property insurers along with the still-precarious financial condition of some plans. This growth comes despite a collapse in the housing sector that has brought development in many catastrophe-prone areas to a near standstill," write the report's co-authors, Dr. Robert Hartwig, president of the I.I.I. and an economist, and Claire Wilkinson, vice president of Global Issues at the I.I.I.
The I.I.I. estimates that, even as the number of policyholders in Florida, Louisiana and the 32 other Fair Access to Insurance Requirements (FAIR) Plans for which data are available dropped to 2.47 million from 2.62 million between 2008 and 2009, their cumulative exposure to loss grew to $614.9 billion in 2009 from $612.7 billion in 2008. The nation's FAIR plans account for by far the majority of policies and exposure in the U.S. overall residual property market. But when the FAIR Plan exposures are added to those incurred by Beach and Windstorm Plans, such as those in place in states such as Alabama and Mississippi, the U.S. residual market exposure to loss grows to $703 billion (2009) from $696 billion, according to the Property Insurance Plans Service Office (PIPSO).
"As long as [these] plans continue to grow, state finances will remain under threat and ultimately taxpayers, many of whom live nowhere near the coast, will continue to face the prospect of increased assessments in the years ahead," Dr. Hartwig and Ms. Wilkinson state.
Since state property insurers of last resort often charge premium rates that do not reflect the risk they are incurring on the policyholder's behalf, the claims paying capacity of FAIR, Beach or Windstorm Plans is relatively limited, and often exhausted quickly in the event of a severe storm. Should this occur, a number of capital-raising options are available to state-run property insurers. The two main options—levying assessments on all policyholders and issuing bonds that must be paid back by all state taxpayers—often result in higher costs for all of the state's policyholders, no matter where they live, as these costs are passed along in the form of premium surcharges or higher taxes. Every homeowners insurer doing business in a particular state is generally a member of a state-run residual market program, just as auto insurers join forces to spread the risks involved in covering problematic drivers through assigned risk programs.
"Increasingly plans are being bailed out by a diversion of tax revenues," the I.I.I. report states, pointing to the fact that in 2008, after Hurricane Ike struck the Texas coastline, $230 million of the $430 million in assessments incurred by the Texas Windstorm Insurance Association's (TWIA) member insurers were subject to premium tax credits. TWIA is the state's insurer of last resort for wind and hail coverage in 14 coastal Texas counties and parts of Harris County.
The report also notes that Mississippi enacted legislation in 2007 to allow a one-time diversion of $80 million in federal and state funds to the Mississippi Windstorm Underwriting Association (MWUA), one of the state's two residual market plans, to boost the MWUA's reserves for windstorm damage claims and protect MWUA policyholders against rate increases.
The I.I.I. report also offers a detailed analysis of the residual market plans in North Carolina and South Carolina, as well as the states cited previously, a list which includes Florida, Louisiana, Massachusetts, Texas, Alabama and Mississippi. Policymakers and other interested parties seeking an update on the pending federal pieces of legislation on the issue of natural catastrophe risk should consult the I.I.I. report's Appendix, which can be found on the final two pages of the 51-page document.
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Florida Citizens Property Insurance Corporation, the largest property insurer of last resort in the U.S., provides insurance to residential and commercial property owners unable to purchase coverage in the standard market. Yet Florida Citizens saw the number of its total policies in force drop to 1.2 million at year-end 2009, down 14 percent from 1.4 million at year-end 2008. Meanwhile, Louisiana Citizens Property Insurance Corporation, the fourth largest state-run property insurer of last resort in the U.S. in terms of total policies in force behind Texas and Massachusetts, has seen an even more dramatic reduction in its total policy count. Louisiana Citizens had about 165,000 policies in force in June 2008, a figure that dropped to 127,000 policies as of June 2010, a reduction of around 40 percent.
"However, this year's report by the Insurance Information Institute, like the reports of the last two years, records the ongoing growth in the exposure base of the residual market property insurers along with the still-precarious financial condition of some plans. This growth comes despite a collapse in the housing sector that has brought development in many catastrophe-prone areas to a near standstill," write the report's co-authors, Dr. Robert Hartwig, president of the I.I.I. and an economist, and Claire Wilkinson, vice president of Global Issues at the I.I.I.
The I.I.I. estimates that, even as the number of policyholders in Florida, Louisiana and the 32 other Fair Access to Insurance Requirements (FAIR) Plans for which data are available dropped to 2.47 million from 2.62 million between 2008 and 2009, their cumulative exposure to loss grew to $614.9 billion in 2009 from $612.7 billion in 2008. The nation's FAIR plans account for by far the majority of policies and exposure in the U.S. overall residual property market. But when the FAIR Plan exposures are added to those incurred by Beach and Windstorm Plans, such as those in place in states such as Alabama and Mississippi, the U.S. residual market exposure to loss grows to $703 billion (2009) from $696 billion, according to the Property Insurance Plans Service Office (PIPSO).
"As long as [these] plans continue to grow, state finances will remain under threat and ultimately taxpayers, many of whom live nowhere near the coast, will continue to face the prospect of increased assessments in the years ahead," Dr. Hartwig and Ms. Wilkinson state.
Since state property insurers of last resort often charge premium rates that do not reflect the risk they are incurring on the policyholder's behalf, the claims paying capacity of FAIR, Beach or Windstorm Plans is relatively limited, and often exhausted quickly in the event of a severe storm. Should this occur, a number of capital-raising options are available to state-run property insurers. The two main options—levying assessments on all policyholders and issuing bonds that must be paid back by all state taxpayers—often result in higher costs for all of the state's policyholders, no matter where they live, as these costs are passed along in the form of premium surcharges or higher taxes. Every homeowners insurer doing business in a particular state is generally a member of a state-run residual market program, just as auto insurers join forces to spread the risks involved in covering problematic drivers through assigned risk programs.
"Increasingly plans are being bailed out by a diversion of tax revenues," the I.I.I. report states, pointing to the fact that in 2008, after Hurricane Ike struck the Texas coastline, $230 million of the $430 million in assessments incurred by the Texas Windstorm Insurance Association's (TWIA) member insurers were subject to premium tax credits. TWIA is the state's insurer of last resort for wind and hail coverage in 14 coastal Texas counties and parts of Harris County.
The report also notes that Mississippi enacted legislation in 2007 to allow a one-time diversion of $80 million in federal and state funds to the Mississippi Windstorm Underwriting Association (MWUA), one of the state's two residual market plans, to boost the MWUA's reserves for windstorm damage claims and protect MWUA policyholders against rate increases.
The I.I.I. report also offers a detailed analysis of the residual market plans in North Carolina and South Carolina, as well as the states cited previously, a list which includes Florida, Louisiana, Massachusetts, Texas, Alabama and Mississippi. Policymakers and other interested parties seeking an update on the pending federal pieces of legislation on the issue of natural catastrophe risk should consult the I.I.I. report's Appendix, which can be found on the final two pages of the 51-page document.
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Thursday, July 22, 2010
AHRQ State Snapshots Expanded To Include New Data on Health Insurance Coverage
Editor Note: According to this new database, Georgia has improved its health care quality from "weak" to a low "average."
/PRNewswire/ -- The Agency for Healthcare Research and Quality's annual release of state-by-state quality data has been expanded to include new data on health insurance, including data on health care quality categorized by source of payment, including private insurance, Medicare, Medicaid and those without insurance.
The new health insurance section allows users to compare payer-specific quality rates as well as differences among payers. For example, a state can compare the quality of care received by Medicaid or uninsured patients with that received by these same patients nationally. In addition, a state can assess whether its insurance-related disparities are larger or smaller compared with the nation as a whole.
The 2009 State Snapshots provide state-specific health care quality information, including strengths, weaknesses and opportunities for improvement. State-level information used to create the State Snapshots is based on data collected for the 2009 National Healthcare Quality Report. Overall, states get mixed reviews for the quality of care they provide. As in previous years, AHRQ's 2009 State Snapshots show that no state does well or poorly on all quality measures.
Maine, Maryland, Wyoming, South Carolina and the District of Columbia showed the greatest improvement. The five states showing the smallest improvement were North Dakota, Texas, West Virginia, Nebraska and Washington State. For each state, specific clinical conditions could be identified that account for different rates of improvement.
"The addition of the insurance information to the State Snapshots adds one more dimension to the picture of health care quality and disparities in individual states and regions," said AHRQ Director Carolyn M. Clancy, M.D. "The 2009 State Snapshots continue to evolve into an invaluable resource for state officials and other stakeholders."
The 2009 State Snapshots summarizes health care quality in three dimensions: types of care (preventive, acute and chronic care), settings of care (hospitals, ambulatory settings, nursing homes and home health care) and clinical conditions (cancer, diabetes, heart disease, maternal and child health and respiratory disease). There are also special focus areas on diabetes, asthma, Healthy People 2010 objectives, clinical preventive services and disparities.
Additional features in the 2009 State Snapshots provide more ways to analyze the quality of health care for each state compared with all states, as well as with states in the same region. New and enhanced features include enhanced sections on asthma care, diabetes care and health care disparities.
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/PRNewswire/ -- The Agency for Healthcare Research and Quality's annual release of state-by-state quality data has been expanded to include new data on health insurance, including data on health care quality categorized by source of payment, including private insurance, Medicare, Medicaid and those without insurance.
The new health insurance section allows users to compare payer-specific quality rates as well as differences among payers. For example, a state can compare the quality of care received by Medicaid or uninsured patients with that received by these same patients nationally. In addition, a state can assess whether its insurance-related disparities are larger or smaller compared with the nation as a whole.
The 2009 State Snapshots provide state-specific health care quality information, including strengths, weaknesses and opportunities for improvement. State-level information used to create the State Snapshots is based on data collected for the 2009 National Healthcare Quality Report. Overall, states get mixed reviews for the quality of care they provide. As in previous years, AHRQ's 2009 State Snapshots show that no state does well or poorly on all quality measures.
Maine, Maryland, Wyoming, South Carolina and the District of Columbia showed the greatest improvement. The five states showing the smallest improvement were North Dakota, Texas, West Virginia, Nebraska and Washington State. For each state, specific clinical conditions could be identified that account for different rates of improvement.
"The addition of the insurance information to the State Snapshots adds one more dimension to the picture of health care quality and disparities in individual states and regions," said AHRQ Director Carolyn M. Clancy, M.D. "The 2009 State Snapshots continue to evolve into an invaluable resource for state officials and other stakeholders."
The 2009 State Snapshots summarizes health care quality in three dimensions: types of care (preventive, acute and chronic care), settings of care (hospitals, ambulatory settings, nursing homes and home health care) and clinical conditions (cancer, diabetes, heart disease, maternal and child health and respiratory disease). There are also special focus areas on diabetes, asthma, Healthy People 2010 objectives, clinical preventive services and disparities.
Additional features in the 2009 State Snapshots provide more ways to analyze the quality of health care for each state compared with all states, as well as with states in the same region. New and enhanced features include enhanced sections on asthma care, diabetes care and health care disparities.
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Thursday, December 03, 2009
Sebelius Statement on Benefits of Health Insurance Reform for Businesses
HHS Secretary Kathleen Sebelius today highlighted the benefits of health insurance reform for businesses and released a new fact sheet regarding a recent analysis from the Congressional Budget Office.
"Businesses across the country are struggling under the weight of high health care costs," Secretary Sebelius said. "Health insurance reform will help lift this burden, help businesses prosper, and ensure workers have the affordable, quality health care they need."
A fact sheet regarding the analysis is included below.
Fact Sheet: New CBO Analysis Confirms Benefits of Health Insurance Reform for Businesses
American businesses know the health care status quo is unacceptable. Since 2000, premiums have more than doubled, a rate three times faster than the growth in wages. Between 2000 and 2009, the percentage of firms offering coverage fell from 69 to 60, with much of that drop occurring in the past year alone. Small businesses in particular struggle under the current health care system. For firms employing less than 10 workers, the erosion in coverage is striking -- from 57 percent offering coverage in 2000 to 46 percent offering coverage in 2009. If we do nothing, over the next ten years, health care costs for large businesses are projected to reach $28,530 per employee, a 116 percent increase from 2009.
A new analysis by the Congressional Budget Office (CBO) affirms that businesses' health insurance costs will be lower under health insurance reform -- even though the analysis does not take into account the full range of policies that will benefit businesses.
Health Insurance Premiums for Businesses According to CBO. In a November 30 letter to Senator Evan Bayh, CBO assesses the impact of the Patient Protection and Affordability Act on premiums for the individual, small-group, and large group markets. In 2016, CBO estimates that 159 million or 83 percent of privately insured people will be insured through employers.
Premiums for small business will go down. Small businesses are likely to see premiums drop by 1 to 4 percent under the proposal due to lower prices. These lower prices come from:
-- Lower administrative overhead. Right now, each small business
has to consult with a broker or hire someone to collate plan
information, assist employees with decisions, and handle issues as they
arise. Under reform, in the exchange, there will be people whose job it
is to provide plan information and facilitate enrollment. The exchange
centralizes what is otherwise a process that is extremely duplicative,
streamlining administrative costs and lowering premiums.
-- Greater competition. CBO attributes savings to "providing a
centralized marketplace in which consumers could compare the premiums of
relatively standardized insurance products." This includes competitive
pressure from a public health insurance option.
-- Administrative simplification. Physicians spend on average about
140 hours and $68,000 a year just dealing with health insurance
bureaucracy. By simplifying and standardizing paperwork and
computerizing medical records, doctors will be able to focus on caring
for their patients instead of dealing with bureaucracy. CBO estimates
nearly $20 billion in Federal savings over 10 years, with additional
savings accruing to businesses and families.
Up to 3 percent premium savings as the risk pool for employer-based coverage improves. Today, businesses have seen their premiums skyrocket every year, with many facing double digit percentage increases in their premiums. Health insurance reform will stop this trend.
With nearly 30 million additional Americans gaining health insurance, the purchasing pool for businesses will expand and, largely, improve. Big businesses will save from 0 to 3 percent on premiums due to the changing risk pool while small businesses could save 1 percent on
premiums.
Better options for small businesses. Small businesses would gain access to the health insurance exchanges and new benefit options and tax credits under reform.
-- 3.6 million small businesses could qualify for a tax credit to
help pay their premiums.[vii] An estimated 12 percent of people insured
through small businesses will qualify for tax credits that lower
premiums by 8 to 11 percent. This translates into $620 to $860 for
individuals and $1,540 to $2,120 for families assuming that the coverage
is comparable to what they get today.
-- Today, small businesses often have coverage that has high
deductibles and gap-ridden benefits. The legislation offers such
businesses better options that CBO assumes businesses will take. Such
better coverage has premiums that are 0 to 3 percent higher than the
average plans today, but will save money for employees by ensuring they
are not forced to pay high out-of-pocket costs for services not covered
by their current insurance.
-- In the current health insurance system, small businesses may see
premiums skyrocket if just one or two workers fall ill and accumulate
high medical costs. Health insurance reform will prevent insurance
discrimination based on health status, meaning that small businesses
will no longer be unfairly penalized if a worker falls ill.
9 to 12 percent premium savings for high-premium plans under current law. By assessing high-cost plans, the excise tax encourages businesses and individuals to streamline coverage, leading to lower premiums over time.
-- CBO estimates that the 19 percent of people in employer-coverage
in high-cost plans today will pay 9 to 12 percent less under reform.
This translates to premium savings of at least $835 for single and
$2,070 family policies.
-- This could yield increases in workers wages, by around $70
billion in 2019.
Nearly $10 billion in savings for small businesses.
-- Under current law, CBO estimates premiums to be $7,800 for
single policies and $19,300 for families in the small group market.
-- Small businesses that opt for comparable coverage under reform
could save up to $390 for single policies and $965 for family policies.
Assuming all 25 million people insured through small business save at
least $390 (more for families), this will yield nearly $10 billion in
savings in 2016 alone.
-- Additional savings will accrue to low-wage, small businesses
that newly offer coverage in the exchange. CBO estimates that roughly
12 percent of people in the small group market would get the credit
which would reduce premiums by about 10 percent in 2016. Multiplying
this by the population and average premiums in the report, this suggests
that about one and a half million people would save roughly $780 per
person on premiums in 2016.
-- Even those that CBO estimates will "buy-up" will save, paying
$100 less per family for coverage that is more protective.
At least $13.4 billion in savings for large businesses.
-- Under current law, CBO estimates premiums to be $7,400 for
single policies and $20,300 for families in the large group market.
-- CBO estimates that, under reform, large business premiums will
drop by $100 per single policy and $200 per family policy. With 134
million people enrolled in such coverage, this translates into at least
$13.4 billion in savings in 2016 alone.
Businesses can keep what they have.
-- CBO affirms that any proposed benefit mandates would not affect
the small or large group markets: "The requirement would have relatively
little effect on premiums in the small group market, however, because
most policies sold in that market already cover those services and would
continue to cover them under current law."
-- CBO also affirms the effectiveness of the grandfather policy:
"Further, small group policies that are maintained continuously would be
grandfathered under the proposal."
-- In the large group market, CBO affirms that "[Benefit]
requirements would have no significant effect on premiums in the large
group market."
No cost-shifting to the employer-based insurance market.
-- CBO states: "... CBO's assessment is that the legislation would
have minimal effects on private-sector premiums via cost shifting."
Additional Policies To Benefit Businesses. CBO does not include in its analysis several additional policies in the Patient Protection and Affordable Care Act that would benefit businesses.
Reinsurance for businesses that cover early retiree plans.
-- The proportion of employers that offer retiree coverage has been
declining precipitously over time, from 66 percent in 1988 to 29 percent
in 2009.
-- The proposal would provide a time-limited, Federal reinsurance
program to cover some of the cost of covering early retirees. This
translates to savings of up to $1,200 off the premium of every family
plan offered by that company.
Policies to slow health care cost growth.
-- Insurance oversight: In recent years, several states' insurance
commissioners have rejected unjustifiably high premium increases in the
small group and individual insurance markets. Health insurance reform
will allow insurance commissioners to continue to play this important
role and require transparency and oversight of premium increases.
-- Delivery system reform. Health insurance reform will invest in
care innovations such as accountable care organizations, make healthcare
providers more accountable and efficient through value-based purchasing,
and improve quality and patient safety, including reducing preventable
readmissions. A recent report by the Business Roundtable found that if
many of the delivery system reforms were adopted by the private sector,
large businesses could save $3,000 per employee by 2019.
-- Lowers expensive drug costs. Biologic drugs are some of the most
expensive drugs on the market, and yet there is no streamlined avenue to
get generics on the market to provide lower-cost alternatives. Reform
will create an expedited process to make generic biologic drugs
available, significantly lowering drug costs.
Immediate benefits. While the CBO report provides savings estimates for 2016, several of the policies discussed above would take effect immediately, including early retiree reinsurance, administrative simplification, small business tax credits, and increased oversight of the insurance industry.
Benefits to Businesses Beyond Lower Costs. CBO focused exclusively on health insurance premiums which are critical to businesses. There would be other benefits of health reform for businesses as well.
Improved workplace productivity.
-- The Institute of Medicine found that lost productivity due to
untreated illness among uninsured workers cost businesses between $75
billion and $150 billion per year. Expanding coverage to the uninsured
will create a more productive workforce.
-- Current job-lock (inability to leave current employment if it
will result in loss of health insurance) has been demonstrated to hurt
the economy through reduced productivity, and prevents an employee from
taking a job with potentially higher wages. By ending limitations on
coverage based on pre-existing conditions and expanding portable
coverage options through the health insurance exchange, reform will
increase the flexibility and productivity of the workforce.
New jobs.
-- Bringing down the cost of healthcare will enable investments in
business and job creation. The President's Council of Economic Advisers
(CEA) estimated that if the annual growth rate of health spending slows
by 1.5 percentage point, new jobs could rise by 500,000.
-- The health insurance exchange will expand options for coverage,
making small businesses a more attractive place for people to work, and
encouraging people to start up businesses of their own.
-- Health insurance reform could save 80,000 jobs in the small
business sector by 2019 and increase take-home pay by almost $30
billion.
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"Businesses across the country are struggling under the weight of high health care costs," Secretary Sebelius said. "Health insurance reform will help lift this burden, help businesses prosper, and ensure workers have the affordable, quality health care they need."
A fact sheet regarding the analysis is included below.
Fact Sheet: New CBO Analysis Confirms Benefits of Health Insurance Reform for Businesses
American businesses know the health care status quo is unacceptable. Since 2000, premiums have more than doubled, a rate three times faster than the growth in wages. Between 2000 and 2009, the percentage of firms offering coverage fell from 69 to 60, with much of that drop occurring in the past year alone. Small businesses in particular struggle under the current health care system. For firms employing less than 10 workers, the erosion in coverage is striking -- from 57 percent offering coverage in 2000 to 46 percent offering coverage in 2009. If we do nothing, over the next ten years, health care costs for large businesses are projected to reach $28,530 per employee, a 116 percent increase from 2009.
A new analysis by the Congressional Budget Office (CBO) affirms that businesses' health insurance costs will be lower under health insurance reform -- even though the analysis does not take into account the full range of policies that will benefit businesses.
Health Insurance Premiums for Businesses According to CBO. In a November 30 letter to Senator Evan Bayh, CBO assesses the impact of the Patient Protection and Affordability Act on premiums for the individual, small-group, and large group markets. In 2016, CBO estimates that 159 million or 83 percent of privately insured people will be insured through employers.
Premiums for small business will go down. Small businesses are likely to see premiums drop by 1 to 4 percent under the proposal due to lower prices. These lower prices come from:
-- Lower administrative overhead. Right now, each small business
has to consult with a broker or hire someone to collate plan
information, assist employees with decisions, and handle issues as they
arise. Under reform, in the exchange, there will be people whose job it
is to provide plan information and facilitate enrollment. The exchange
centralizes what is otherwise a process that is extremely duplicative,
streamlining administrative costs and lowering premiums.
-- Greater competition. CBO attributes savings to "providing a
centralized marketplace in which consumers could compare the premiums of
relatively standardized insurance products." This includes competitive
pressure from a public health insurance option.
-- Administrative simplification. Physicians spend on average about
140 hours and $68,000 a year just dealing with health insurance
bureaucracy. By simplifying and standardizing paperwork and
computerizing medical records, doctors will be able to focus on caring
for their patients instead of dealing with bureaucracy. CBO estimates
nearly $20 billion in Federal savings over 10 years, with additional
savings accruing to businesses and families.
Up to 3 percent premium savings as the risk pool for employer-based coverage improves. Today, businesses have seen their premiums skyrocket every year, with many facing double digit percentage increases in their premiums. Health insurance reform will stop this trend.
With nearly 30 million additional Americans gaining health insurance, the purchasing pool for businesses will expand and, largely, improve. Big businesses will save from 0 to 3 percent on premiums due to the changing risk pool while small businesses could save 1 percent on
premiums.
Better options for small businesses. Small businesses would gain access to the health insurance exchanges and new benefit options and tax credits under reform.
-- 3.6 million small businesses could qualify for a tax credit to
help pay their premiums.[vii] An estimated 12 percent of people insured
through small businesses will qualify for tax credits that lower
premiums by 8 to 11 percent. This translates into $620 to $860 for
individuals and $1,540 to $2,120 for families assuming that the coverage
is comparable to what they get today.
-- Today, small businesses often have coverage that has high
deductibles and gap-ridden benefits. The legislation offers such
businesses better options that CBO assumes businesses will take. Such
better coverage has premiums that are 0 to 3 percent higher than the
average plans today, but will save money for employees by ensuring they
are not forced to pay high out-of-pocket costs for services not covered
by their current insurance.
-- In the current health insurance system, small businesses may see
premiums skyrocket if just one or two workers fall ill and accumulate
high medical costs. Health insurance reform will prevent insurance
discrimination based on health status, meaning that small businesses
will no longer be unfairly penalized if a worker falls ill.
9 to 12 percent premium savings for high-premium plans under current law. By assessing high-cost plans, the excise tax encourages businesses and individuals to streamline coverage, leading to lower premiums over time.
-- CBO estimates that the 19 percent of people in employer-coverage
in high-cost plans today will pay 9 to 12 percent less under reform.
This translates to premium savings of at least $835 for single and
$2,070 family policies.
-- This could yield increases in workers wages, by around $70
billion in 2019.
Nearly $10 billion in savings for small businesses.
-- Under current law, CBO estimates premiums to be $7,800 for
single policies and $19,300 for families in the small group market.
-- Small businesses that opt for comparable coverage under reform
could save up to $390 for single policies and $965 for family policies.
Assuming all 25 million people insured through small business save at
least $390 (more for families), this will yield nearly $10 billion in
savings in 2016 alone.
-- Additional savings will accrue to low-wage, small businesses
that newly offer coverage in the exchange. CBO estimates that roughly
12 percent of people in the small group market would get the credit
which would reduce premiums by about 10 percent in 2016. Multiplying
this by the population and average premiums in the report, this suggests
that about one and a half million people would save roughly $780 per
person on premiums in 2016.
-- Even those that CBO estimates will "buy-up" will save, paying
$100 less per family for coverage that is more protective.
At least $13.4 billion in savings for large businesses.
-- Under current law, CBO estimates premiums to be $7,400 for
single policies and $20,300 for families in the large group market.
-- CBO estimates that, under reform, large business premiums will
drop by $100 per single policy and $200 per family policy. With 134
million people enrolled in such coverage, this translates into at least
$13.4 billion in savings in 2016 alone.
Businesses can keep what they have.
-- CBO affirms that any proposed benefit mandates would not affect
the small or large group markets: "The requirement would have relatively
little effect on premiums in the small group market, however, because
most policies sold in that market already cover those services and would
continue to cover them under current law."
-- CBO also affirms the effectiveness of the grandfather policy:
"Further, small group policies that are maintained continuously would be
grandfathered under the proposal."
-- In the large group market, CBO affirms that "[Benefit]
requirements would have no significant effect on premiums in the large
group market."
No cost-shifting to the employer-based insurance market.
-- CBO states: "... CBO's assessment is that the legislation would
have minimal effects on private-sector premiums via cost shifting."
Additional Policies To Benefit Businesses. CBO does not include in its analysis several additional policies in the Patient Protection and Affordable Care Act that would benefit businesses.
Reinsurance for businesses that cover early retiree plans.
-- The proportion of employers that offer retiree coverage has been
declining precipitously over time, from 66 percent in 1988 to 29 percent
in 2009.
-- The proposal would provide a time-limited, Federal reinsurance
program to cover some of the cost of covering early retirees. This
translates to savings of up to $1,200 off the premium of every family
plan offered by that company.
Policies to slow health care cost growth.
-- Insurance oversight: In recent years, several states' insurance
commissioners have rejected unjustifiably high premium increases in the
small group and individual insurance markets. Health insurance reform
will allow insurance commissioners to continue to play this important
role and require transparency and oversight of premium increases.
-- Delivery system reform. Health insurance reform will invest in
care innovations such as accountable care organizations, make healthcare
providers more accountable and efficient through value-based purchasing,
and improve quality and patient safety, including reducing preventable
readmissions. A recent report by the Business Roundtable found that if
many of the delivery system reforms were adopted by the private sector,
large businesses could save $3,000 per employee by 2019.
-- Lowers expensive drug costs. Biologic drugs are some of the most
expensive drugs on the market, and yet there is no streamlined avenue to
get generics on the market to provide lower-cost alternatives. Reform
will create an expedited process to make generic biologic drugs
available, significantly lowering drug costs.
Immediate benefits. While the CBO report provides savings estimates for 2016, several of the policies discussed above would take effect immediately, including early retiree reinsurance, administrative simplification, small business tax credits, and increased oversight of the insurance industry.
Benefits to Businesses Beyond Lower Costs. CBO focused exclusively on health insurance premiums which are critical to businesses. There would be other benefits of health reform for businesses as well.
Improved workplace productivity.
-- The Institute of Medicine found that lost productivity due to
untreated illness among uninsured workers cost businesses between $75
billion and $150 billion per year. Expanding coverage to the uninsured
will create a more productive workforce.
-- Current job-lock (inability to leave current employment if it
will result in loss of health insurance) has been demonstrated to hurt
the economy through reduced productivity, and prevents an employee from
taking a job with potentially higher wages. By ending limitations on
coverage based on pre-existing conditions and expanding portable
coverage options through the health insurance exchange, reform will
increase the flexibility and productivity of the workforce.
New jobs.
-- Bringing down the cost of healthcare will enable investments in
business and job creation. The President's Council of Economic Advisers
(CEA) estimated that if the annual growth rate of health spending slows
by 1.5 percentage point, new jobs could rise by 500,000.
-- The health insurance exchange will expand options for coverage,
making small businesses a more attractive place for people to work, and
encouraging people to start up businesses of their own.
-- Health insurance reform could save 80,000 jobs in the small
business sector by 2019 and increase take-home pay by almost $30
billion.
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Friday, October 30, 2009
Policymakers Have Many Options to Make Social Security Both Solvent and More Adequate
/PRNewswire/ -- Social Security, the foundation of economic security for millions of America's seniors and working families, can be made more adequate and solvent for the long term, according to a new report released today by the National Academy of Social Insurance (NASI).
The report, Fixing Social Security: Adequate Benefits, Adequate Financing, outlines approximately 30 options for putting the program's finances into 75-year balance and more than 10 ways to make Social Security more adequate for those who rely on it. All options have long-range cost estimates from Social Security actuaries.
"Fixing Social Security is a manageable job. While Social Security does not need more money now, policymakers could act now to make funds available in the future when the money will be needed," said Virginia Reno, co-author of the report and Vice President for Income Security at NASI.
"We also need to consider the adequacy of Social Security benefits," said Janice Gregory, president of NASI. "Long-term shifts in private retirement plans are placing more risks on individual workers. Recent losses in jobs, home equity, and individual savings are weakening all other sources of financial security in retirement. Only Social Security has held its value. Yet benefits remain modest for all, and inadequate for some especially vulnerable populations."
Benefit adequacy options in the report target such financially vulnerable groups as:
-- The oldest beneficiaries (over 85 years);
-- Widowed spouses of low-earning couples;
-- Low-paid workers generally;
-- Workers with gaps in paid work due to childcare; and
-- Students in college or vocational school who have lost parental
support due to death or disability.
Other adequacy options would increase benefits across the board for current and future beneficiaries.
Options to balance Social Security's future finances include:
-- Lifting the cap (now $106,800) on the earnings from which workers and
employers pay Social Security taxes;
-- Broadening the base for Social Security taxes;
-- Scheduling modest rate increases in the future when funds will be
needed;
-- Dedicating progressive taxes to pay part of Social Security's future
cost; and
-- Gradually lowering some future benefits.
A recent survey conducted by the Benenson Strategy Group (BSG) for NASI and the Rockefeller Foundation found that Americans want to preserve and improve Social Security, even if it means paying higher taxes to do so. "Even before the recession, fear of an insecure retirement was among Americans' top economic concerns," said Danny Franklin of BSG. "Those fears have only intensified in the past year. Americans today are willing -- even eager -- to invest in the peace of mind that Social Security provides."
The NASI project receives support from the Ford Foundation's initiative on Economic Fairness and Opportunity and the Rockefeller Foundation's Campaign for American Workers.
The National Academy of Social Insurance (NASI) is a non-profit, nonpartisan organization made up of the nation's leading experts on social insurance. Its mission is to promote understanding of how social insurance contributes to economic security and a vibrant economy.
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The report, Fixing Social Security: Adequate Benefits, Adequate Financing, outlines approximately 30 options for putting the program's finances into 75-year balance and more than 10 ways to make Social Security more adequate for those who rely on it. All options have long-range cost estimates from Social Security actuaries.
"Fixing Social Security is a manageable job. While Social Security does not need more money now, policymakers could act now to make funds available in the future when the money will be needed," said Virginia Reno, co-author of the report and Vice President for Income Security at NASI.
"We also need to consider the adequacy of Social Security benefits," said Janice Gregory, president of NASI. "Long-term shifts in private retirement plans are placing more risks on individual workers. Recent losses in jobs, home equity, and individual savings are weakening all other sources of financial security in retirement. Only Social Security has held its value. Yet benefits remain modest for all, and inadequate for some especially vulnerable populations."
Benefit adequacy options in the report target such financially vulnerable groups as:
-- The oldest beneficiaries (over 85 years);
-- Widowed spouses of low-earning couples;
-- Low-paid workers generally;
-- Workers with gaps in paid work due to childcare; and
-- Students in college or vocational school who have lost parental
support due to death or disability.
Other adequacy options would increase benefits across the board for current and future beneficiaries.
Options to balance Social Security's future finances include:
-- Lifting the cap (now $106,800) on the earnings from which workers and
employers pay Social Security taxes;
-- Broadening the base for Social Security taxes;
-- Scheduling modest rate increases in the future when funds will be
needed;
-- Dedicating progressive taxes to pay part of Social Security's future
cost; and
-- Gradually lowering some future benefits.
A recent survey conducted by the Benenson Strategy Group (BSG) for NASI and the Rockefeller Foundation found that Americans want to preserve and improve Social Security, even if it means paying higher taxes to do so. "Even before the recession, fear of an insecure retirement was among Americans' top economic concerns," said Danny Franklin of BSG. "Those fears have only intensified in the past year. Americans today are willing -- even eager -- to invest in the peace of mind that Social Security provides."
The NASI project receives support from the Ford Foundation's initiative on Economic Fairness and Opportunity and the Rockefeller Foundation's Campaign for American Workers.
The National Academy of Social Insurance (NASI) is a non-profit, nonpartisan organization made up of the nation's leading experts on social insurance. Its mission is to promote understanding of how social insurance contributes to economic security and a vibrant economy.
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Thursday, October 29, 2009
New Report Highlights How Health Insurance Reform Will Reduce Costs for Small Businesses
HHS Secretary Kathleen Sebelius today released a new report, "Lower Premiums, Stronger Businesses: How Health Insurance Reform Will Bring Down Costs for Small Businesses." The report outlines the many ways health insurance reform will lower health care costs for small
businesses and is available now at www.HealthReform.gov.
"Small businesses drive our economy and create jobs, but they are struggling as health care costs continue to rise," Secretary Sebelius said. "The high cost of care is making it difficult or impossible for these businesses to offer care or grow their business. Health insurance reform will bring costs down and give small businesses the relief they need."
The report notes:
* Small businesses, the backbone of job creation in our economy,
are disproportionately burdened by the financial strains caused by
rising health care costs. On average, small businesses pay up to 18
percent more than large firms for the same health insurance policy. This
difference is due in part to high broker fees (which can be up to 10
percent of premiums), and health plan administrative costs that are
three times those in the large group market.
* In a recent national survey, nearly three-quarters of small
businesses that did not offer benefits cited high premiums as the
reason.
* Nearly half of workers covered by a small business employer have
insurance that limits the total amount the plan will pay for medical
care and nearly one in ten small business workers have a health plan
that does not offer prescription drug coverage.
* Workers in small firms are more likely to shoulder burdensome
out-of-pocket health care costs. Thirty-six percent spent more than 10
percent of their household income on out-of-pocket medical expenses in
2007, compared with 27 percent of workers in larger firms.
Health insurance reform will bring down costs for small businesses by creating a health insurance exchange, providing a small business tax credit, ending the "hidden tax" on small businesses that provide health insurance and preventing arbitrary premium hikes. Reform will also ensure Americans have stable, secure insurance coverage, limit out-of-pocket spending and eliminate caps on benefits.
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businesses and is available now at www.HealthReform.gov.
"Small businesses drive our economy and create jobs, but they are struggling as health care costs continue to rise," Secretary Sebelius said. "The high cost of care is making it difficult or impossible for these businesses to offer care or grow their business. Health insurance reform will bring costs down and give small businesses the relief they need."
The report notes:
* Small businesses, the backbone of job creation in our economy,
are disproportionately burdened by the financial strains caused by
rising health care costs. On average, small businesses pay up to 18
percent more than large firms for the same health insurance policy. This
difference is due in part to high broker fees (which can be up to 10
percent of premiums), and health plan administrative costs that are
three times those in the large group market.
* In a recent national survey, nearly three-quarters of small
businesses that did not offer benefits cited high premiums as the
reason.
* Nearly half of workers covered by a small business employer have
insurance that limits the total amount the plan will pay for medical
care and nearly one in ten small business workers have a health plan
that does not offer prescription drug coverage.
* Workers in small firms are more likely to shoulder burdensome
out-of-pocket health care costs. Thirty-six percent spent more than 10
percent of their household income on out-of-pocket medical expenses in
2007, compared with 27 percent of workers in larger firms.
Health insurance reform will bring down costs for small businesses by creating a health insurance exchange, providing a small business tax credit, ending the "hidden tax" on small businesses that provide health insurance and preventing arbitrary premium hikes. Reform will also ensure Americans have stable, secure insurance coverage, limit out-of-pocket spending and eliminate caps on benefits.
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Friday, October 23, 2009
Sebelius Releases New Report on Benefits of Health Insurance Reform for Women with Breast Cancer
As Americans mark breast cancer awareness month, Secretary of Health and Human Services Kathleen Sebelius today released a new report, Health Insurance Reform and Breast Cancer: Making the Health Care System Work for Women. The report details how health insurance reform will help women diagnosed with breast cancer and is available now at www.HealthReform.gov.
"Thousands of women and their families are impacted by breast cancer," Secretary Sebelius said. "We are fighting for health reform that will help improve treatment for women with breast cancer and doing all we can to encourage women to take the simple steps that can help prevent this disease."
The new report highlights the problems in the health care status quo that significantly impact women who are diagnosed with breast cancer or are breast cancer survivors. The report notes:
* Breast cancer is the second leading type of cancer among women.
The disease will affect one in eight American women during their
lifetime, with treatment costs totaling $7 Billion in 2007.
* Breast cancer patients with employer-based insurance had total
out-of-pocket costs averaging $6,250 in 2007, higher than out-of-pocket
spending for patients with asthma, diabetes, chronic obstructive
pulmonary disease (COPD), or high blood pressure.
* Breast cancer patients, even when in remission, are unlikely to
find meaningful insurance coverage in the individual insurance market. A
full 11 percent of individuals with any cancer said they could not
obtain health coverage in the individual insurance market.
"Today, breast cancer patients incur thousands of dollars in debt, and breast cancer survivors struggle to get the affordable care they need," Sebelius added. "Health insurance reform will bring costs down, make care more affordable and prevent insurance companies from discriminating against breast cancer survivors."
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"Thousands of women and their families are impacted by breast cancer," Secretary Sebelius said. "We are fighting for health reform that will help improve treatment for women with breast cancer and doing all we can to encourage women to take the simple steps that can help prevent this disease."
The new report highlights the problems in the health care status quo that significantly impact women who are diagnosed with breast cancer or are breast cancer survivors. The report notes:
* Breast cancer is the second leading type of cancer among women.
The disease will affect one in eight American women during their
lifetime, with treatment costs totaling $7 Billion in 2007.
* Breast cancer patients with employer-based insurance had total
out-of-pocket costs averaging $6,250 in 2007, higher than out-of-pocket
spending for patients with asthma, diabetes, chronic obstructive
pulmonary disease (COPD), or high blood pressure.
* Breast cancer patients, even when in remission, are unlikely to
find meaningful insurance coverage in the individual insurance market. A
full 11 percent of individuals with any cancer said they could not
obtain health coverage in the individual insurance market.
"Today, breast cancer patients incur thousands of dollars in debt, and breast cancer survivors struggle to get the affordable care they need," Sebelius added. "Health insurance reform will bring costs down, make care more affordable and prevent insurance companies from discriminating against breast cancer survivors."
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Sunday, August 09, 2009
New State-by-State Reports Show How Health Insurance Reform Will Benefit All Americans
HHS Secretary Kathleen Sebelius August 7 released Stable and Secure Health Care for America, a series of new state-by-state reports outlining how health insurance reform will improve health care for all Americans. Sebelius announced the availability of the new reports as part of a
Webcast -- "Health Insurance Reform: What's In It For You?" -- where Sebelius and top HHS officials took questions from the American people and discussed the importance of health insurance reform. The new reports are available at www.HealthReform.gov.
"These reports show how health insurance reform will help Americans save money, get better care, strengthen their insurance if they already have it, and afford insurance if they don't," said Sebelius. "Every American will benefit when we pass health insurance reform."
The reports released today show reform will:
* Lower health care costs;
* Increase health care choices by protecting what works and fixing
what's broken; and
* Assure quality, affordable care for all Americans.
Friday's reports are the second in a series of state-by-state reports on health care across the country. Earlier this summer, Sebelius released The Health Care Status Quo in Your State, a series of state by state reports on the current state of health care in America. The reports are
available at http://www.healthreform.gov/healthcarestatus.html.
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Webcast -- "Health Insurance Reform: What's In It For You?" -- where Sebelius and top HHS officials took questions from the American people and discussed the importance of health insurance reform. The new reports are available at www.HealthReform.gov.
"These reports show how health insurance reform will help Americans save money, get better care, strengthen their insurance if they already have it, and afford insurance if they don't," said Sebelius. "Every American will benefit when we pass health insurance reform."
The reports released today show reform will:
* Lower health care costs;
* Increase health care choices by protecting what works and fixing
what's broken; and
* Assure quality, affordable care for all Americans.
Friday's reports are the second in a series of state-by-state reports on health care across the country. Earlier this summer, Sebelius released The Health Care Status Quo in Your State, a series of state by state reports on the current state of health care in America. The reports are
available at http://www.healthreform.gov/healthcarestatus.html.
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