U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced that three million Medicare beneficiaries nationwide have received prescription drug cost relief through the Affordable Care Act. To date, three million eligible beneficiaries who fell into the drug coverage gap known as the donut hole during 2010 have been mailed a one-time, tax-free $250 rebate check.
“For too long, many seniors and people with disabilities have been forced to make impossible choices between paying for needed prescription medication and necessities like food and rent,” said Secretary Sebelius. “The Affordable Care Act offers long overdue relief by lowering prescription drug costs each year until the donut hole is closed.”
Eligible beneficiaries who fell into the coverage gap during 2010 are continuing to automatically receive rebate checks. These checks are only the first step in how the Affordable Care Act will reduce prescription drug costs for beneficiaries in the donut hole each year until it is closed in 2020. Starting this year, eligible beneficiaries in the coverage gap will receive a 50-percent discount on covered brand name medications while in the donut hole. In addition, in 2011 Medicare will begin paying 7-percent of the price for generic drugs during the coverage gap.
Also today, Secretary Sebelius released a new video message on the new benefits the Affordable Care Act provides in 2011 for people on Medicare. You can watch the video message here.
The closing of the donut hole is just one of the ways seniors benefit from the Affordable Care Act. In addition to savings on prescription drugs, the law provides new benefits to Medicare beneficiaries when they visit their doctor starting this year:
* As of January 1, 2011, Original Medicare no longer charges out-of-pocket costs for the “Welcome to Medicare” physical exam and, for the first time since the Medicare program was created in 1965, Original Medicare now covers an annual wellness visit with a participating doctor, also at no cost.
* In addition to these annual wellness visits, most people with Medicare can now receive critical preventive services, including certain cancer screenings such as mammograms and colonoscopies, for free.
* Also this year, the Affordable Care Act will provide qualifying doctors and other health care professionals providing primary care to people on Medicare a 10-percent bonus for primary care services. This will help ensure that those primary care providers can continue to be there for Medicare patients.
People with Medicare can learn more about these new benefits, search for participating doctors in their area, and find other helpful information by contacting a trained customer service representative toll-free at 1-800-MEDICARE (1-800-633-4227) or visiting www.Medicare.gov.
Additionally, the Affordable Care Act makes Medicare stronger and more secure for all beneficiaries. These provisions under the new law increase benefits to beneficiaries and help to extend the life of the Medicare Trust Fund by 12 years.
* An analysis issued by the Department of Health and Human Services estimates that under the Affordable Care Act, average savings for those enrolled in traditional Medicare will amount to more than $3,500 over the next 10 years. Savings will be even higher – as much as $12,300 over the next 10 years – for seniors and people with disabilities who have high prescription drug costs. Total savings per beneficiary enrolled in traditional Medicare are estimated to be $86 in 2011, rising to $649 in 2020. For a beneficiary in the donut hole, estimated total savings increase from $553 in 2011 to $2,217 in 2020.
* The Affordable Care Act establishes a new Innovation Center that will research, develop, test, and expand innovative payment and delivery arrangements to improve the quality and reduce the cost of care provided to patient with Medicare, Medicaid or Children’s Health Insurance Program (CHIP) coverage. Innovations that are found to work can be rapidly expanded and applied more broadly—helping to transform the health care system into one that provides better care at lower cost.
· The Affordable Care Act contains important new tools to help crack down on criminals seeking to scam seniors and steal taxpayer dollars. The law strengthens the screenings for health care providers who want to participate in Medicare, Medicaid, or CHIP, enables enforcement officials to see health care claims data from around the country in a searchable database, and strengthens the penalties for criminal wrongdoing. The reduction in waste, fraud, and abuse returns savings to the Medicare Trust Fund to strengthen the program into the future. Seniors are encouraged to contact 1-800-MEDICARE to report any solicitations of personal information or suspected fraud, waste, or abuse, or go to www.StopMedicareFraud.gov.
For more information on how the Affordable Care Act benefits seniors, visit www.HealthCare.gov.
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Showing posts with label sebelius. Show all posts
Showing posts with label sebelius. Show all posts
Friday, January 21, 2011
Monday, August 30, 2010
Sebelius announces 1 million Medicare beneficiaries have received prescription drug cost relief under the Affordable Care Act
U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced that more than 1 million Medicare beneficiaries have received prescription drug cost relief through the Affordable Care Act. As part of the health insurance reform law's step-by-step efforts to close the Medicare Part D prescription drug coverage gap, eligible beneficiaries who fall in this "donut hole" this year are mailed a one-time, tax-free $250 rebate check. More than a quarter of the 4 million checks Medicare expects to distribute have been received by eligible Medicare beneficiaries.
"Many seniors and people with disabilities on Medicare face extraordinary prescription drug costs, and too often stop following the drug regimens that their doctors have recommended as a result," said Secretary Sebelius. "These checks will make a difference in helping seniors continue to get the medications they need, and are one of many ways that the Affordable Care Act is helping seniors."
Nationwide, 1 million Medicare beneficiaries have already been mailed their rebates and more beneficiaries will be receiving checks in the coming months as they enter the coverage gap. Eligible beneficiaries receive these checks automatically in the mail when they reach the donut hole, and they don't have to sign-up to be eligible for the rebates.
Rebate checks will help people with their drug costs this year. Next year, those who fall into the donut hole will receive a 50-percent discount on covered brand name medications while in the donut hole. Every year, the amount Medicare beneficiaries pay in cost sharing will decrease markedly until the coverage gap is closed.
The closing of the donut hole is just one of the ways seniors benefit from the Affordable Care Act. In addition to savings on prescription drugs, the law provides new benefits to Medicare beneficiaries when they visit their doctor. All beneficiaries will receive free preventive care services like mammograms and certain colon cancer tests and a free annual physical starting in 2011 in Original Medicare. Additionally, seniors can expect to save an average of nearly $200 per year in premiums by 2018 compared to what they would have paid without the new law, and most beneficiaries will also see a significant reduction in their Medicare coinsurance as a result of the Affordable Care Act.
The Affordable Care Act also contains important new tools to help crack down on criminals seeking to scam seniors and steal taxpayer dollars. Last week, HHS and the Department of Justice held their second regional fraud prevention summit in Los Angeles that brought together law enforcement experts, providers and seniors to help utilize these new tools to fight fraud and protect seniors.
The Affordable Care Act strengthens the screenings for health care providers who want to participate in Medicaid or Medicare, enables enforcement officials to see health care claims data from around the country into a single, searchable database, and strengthens the penalties for criminals. The reduction in waste, fraud and abuse returns savings to the Medicare Trust Fund to strengthen the program into the future.
Seniors are encouraged to contact 1-800-MEDICARE to report any solicitations of personal information, or go to www.stopmedicarefraud.gov.
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"Many seniors and people with disabilities on Medicare face extraordinary prescription drug costs, and too often stop following the drug regimens that their doctors have recommended as a result," said Secretary Sebelius. "These checks will make a difference in helping seniors continue to get the medications they need, and are one of many ways that the Affordable Care Act is helping seniors."
Nationwide, 1 million Medicare beneficiaries have already been mailed their rebates and more beneficiaries will be receiving checks in the coming months as they enter the coverage gap. Eligible beneficiaries receive these checks automatically in the mail when they reach the donut hole, and they don't have to sign-up to be eligible for the rebates.
Rebate checks will help people with their drug costs this year. Next year, those who fall into the donut hole will receive a 50-percent discount on covered brand name medications while in the donut hole. Every year, the amount Medicare beneficiaries pay in cost sharing will decrease markedly until the coverage gap is closed.
The closing of the donut hole is just one of the ways seniors benefit from the Affordable Care Act. In addition to savings on prescription drugs, the law provides new benefits to Medicare beneficiaries when they visit their doctor. All beneficiaries will receive free preventive care services like mammograms and certain colon cancer tests and a free annual physical starting in 2011 in Original Medicare. Additionally, seniors can expect to save an average of nearly $200 per year in premiums by 2018 compared to what they would have paid without the new law, and most beneficiaries will also see a significant reduction in their Medicare coinsurance as a result of the Affordable Care Act.
The Affordable Care Act also contains important new tools to help crack down on criminals seeking to scam seniors and steal taxpayer dollars. Last week, HHS and the Department of Justice held their second regional fraud prevention summit in Los Angeles that brought together law enforcement experts, providers and seniors to help utilize these new tools to fight fraud and protect seniors.
The Affordable Care Act strengthens the screenings for health care providers who want to participate in Medicaid or Medicare, enables enforcement officials to see health care claims data from around the country into a single, searchable database, and strengthens the penalties for criminals. The reduction in waste, fraud and abuse returns savings to the Medicare Trust Fund to strengthen the program into the future.
Seniors are encouraged to contact 1-800-MEDICARE to report any solicitations of personal information, or go to www.stopmedicarefraud.gov.
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Sunday, July 04, 2010
HHS Secretary Sebelius Announces New Pre-Existing Condition Insurance Plan
The U.S. Department of Health and Human Services (HHS) announced on July 1 the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been unable to obtain health coverage because of a pre-existing health condition.
The Pre-Existing Condition Insurance Plan, which will be administered either by a state or by the Department of Health and Human Services, will provide a new health coverage option for Americans who have been uninsured for at least six months, have been unable to get health coverage because of a health condition, and are a U.S. citizen or are residing in the United States legally.
Created under the Affordable Care Act, the Pre-Existing Condition Insurance Plan is a transitional program until 2014, when insurers will be banned from discriminating against adults with pre-existing conditions, and individuals and small businesses will have access to more affordable private insurance choices through new competitive Exchanges. In 2014, Members of Congress will also purchase their insurance through Exchanges.
“For too long, Americans with pre-existing conditions have been locked out of our health insurance market,” said Secretary Kathleen Sebelius. “Today, the Pre-Existing Condition Insurance Plan gives them a new option – the same insurance coverage as a healthy individual if they’ve been uninsured for at least six months because of a medical condition. This program will provide people the help they need as the nation transitions to a more competitive and fair market place in 2014.”
The Affordable Care Act provides $5 billion in federal funding to support Pre-Existing Condition Insurance Plans in every state. Some states have requested that the U.S. Department of Health and Human Services run their Pre-Existing Condition Insurance Plan. Other states have requested that they run the program themselves. For more information about how the plan is being administered where you live, please visit HHS’ new consumer website, www.HealthCare.gov.
“Health coverage for Americans with pre-existing conditions has historically been unobtainable or failed to cover the very conditions for which they need medical care,” said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight (OCIIO) which is overseeing the program. “The Pre-Existing Condition Insurance Plan is designed to address these challenges by offering comprehensive coverage at a reasonable cost. We modeled the program on the highly successful Children’s Health Insurance Program, also known as CHIP, so states would have maximum flexibility to meet the needs of their citizens.”
In order to give states the flexibility to best meet their needs, HHS provided states with the option of running the Pre-Existing Condition Insurance Plan themselves or having HHS run the plan. Twenty-one states have elected to have HHS administer the plans, while 29 states and the District of Columbia have chosen to run their own programs.
Starting today, the national Pre-Existing Condition Insurance Plan will be open to applicants in the 21 states where HHS is operating the program.
All states which are operating their own Pre-Existing Condition Insurance Plans will begin enrollment by the end of the summer, with many beginning enrollment today.
“The Pre-Existing Condition Insurance Plan is an important next step in the overall implementation of the Affordable Care Act,” said Richard Popper, Director of Insurance Programs at OCIIO. “We have been working closely with the states and other stakeholders to make sure this program reaches uninsured Americans struggling to find coverage due to a pre-existing condition.”
The Pre-Existing Condition Insurance Plan will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. The Pre-Existing Condition Insurance Plan does not base eligibility on income and does not charge a higher premium because of a medical condition. Participants will pay a premium that is not more than the standard individual health insurance premium in their state for insurance that covers major medical and prescription drug expenses with some cost-sharing.
Like the popular Children’s Health Insurance Program (CHIP), the Pre-Existing Condition Plan provides states flexibility in how they run their program as long as basic requirements are met. Federal law establishes general eligibility, but state programs can vary on cost, benefits, and determination of pre-existing condition. Funding for states is based on the same allocation formula as CHIP, and it will be reallocated if unspent by the states. Unlike CHIP, there is no state matching requirement and the federal government will cover the entire cost of the Pre-Existing Condition Plan. While it took more than 6 months for a small number of states to establish their CHIP programs, we anticipate that every state will begin enrolling individuals in the Pre-Existing Condition Plan by the end of August.
Information on how to apply for the Pre-Existing Condition Insurance Plan is available at www.HealthCare.gov. Americans who live in a state where the U.S. Department of Health and Human Services is running the Pre-Existing Condition Plan will be linked directly to the federal application page. Those living in states running their own programs will also find information on how and where to apply on www.HealthCare.gov.
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The Pre-Existing Condition Insurance Plan, which will be administered either by a state or by the Department of Health and Human Services, will provide a new health coverage option for Americans who have been uninsured for at least six months, have been unable to get health coverage because of a health condition, and are a U.S. citizen or are residing in the United States legally.
Created under the Affordable Care Act, the Pre-Existing Condition Insurance Plan is a transitional program until 2014, when insurers will be banned from discriminating against adults with pre-existing conditions, and individuals and small businesses will have access to more affordable private insurance choices through new competitive Exchanges. In 2014, Members of Congress will also purchase their insurance through Exchanges.
“For too long, Americans with pre-existing conditions have been locked out of our health insurance market,” said Secretary Kathleen Sebelius. “Today, the Pre-Existing Condition Insurance Plan gives them a new option – the same insurance coverage as a healthy individual if they’ve been uninsured for at least six months because of a medical condition. This program will provide people the help they need as the nation transitions to a more competitive and fair market place in 2014.”
The Affordable Care Act provides $5 billion in federal funding to support Pre-Existing Condition Insurance Plans in every state. Some states have requested that the U.S. Department of Health and Human Services run their Pre-Existing Condition Insurance Plan. Other states have requested that they run the program themselves. For more information about how the plan is being administered where you live, please visit HHS’ new consumer website, www.HealthCare.gov.
“Health coverage for Americans with pre-existing conditions has historically been unobtainable or failed to cover the very conditions for which they need medical care,” said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight (OCIIO) which is overseeing the program. “The Pre-Existing Condition Insurance Plan is designed to address these challenges by offering comprehensive coverage at a reasonable cost. We modeled the program on the highly successful Children’s Health Insurance Program, also known as CHIP, so states would have maximum flexibility to meet the needs of their citizens.”
In order to give states the flexibility to best meet their needs, HHS provided states with the option of running the Pre-Existing Condition Insurance Plan themselves or having HHS run the plan. Twenty-one states have elected to have HHS administer the plans, while 29 states and the District of Columbia have chosen to run their own programs.
Starting today, the national Pre-Existing Condition Insurance Plan will be open to applicants in the 21 states where HHS is operating the program.
All states which are operating their own Pre-Existing Condition Insurance Plans will begin enrollment by the end of the summer, with many beginning enrollment today.
“The Pre-Existing Condition Insurance Plan is an important next step in the overall implementation of the Affordable Care Act,” said Richard Popper, Director of Insurance Programs at OCIIO. “We have been working closely with the states and other stakeholders to make sure this program reaches uninsured Americans struggling to find coverage due to a pre-existing condition.”
The Pre-Existing Condition Insurance Plan will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. The Pre-Existing Condition Insurance Plan does not base eligibility on income and does not charge a higher premium because of a medical condition. Participants will pay a premium that is not more than the standard individual health insurance premium in their state for insurance that covers major medical and prescription drug expenses with some cost-sharing.
Like the popular Children’s Health Insurance Program (CHIP), the Pre-Existing Condition Plan provides states flexibility in how they run their program as long as basic requirements are met. Federal law establishes general eligibility, but state programs can vary on cost, benefits, and determination of pre-existing condition. Funding for states is based on the same allocation formula as CHIP, and it will be reallocated if unspent by the states. Unlike CHIP, there is no state matching requirement and the federal government will cover the entire cost of the Pre-Existing Condition Plan. While it took more than 6 months for a small number of states to establish their CHIP programs, we anticipate that every state will begin enrolling individuals in the Pre-Existing Condition Plan by the end of August.
Information on how to apply for the Pre-Existing Condition Insurance Plan is available at www.HealthCare.gov. Americans who live in a state where the U.S. Department of Health and Human Services is running the Pre-Existing Condition Plan will be linked directly to the federal application page. Those living in states running their own programs will also find information on how and where to apply on www.HealthCare.gov.
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Tuesday, June 08, 2010
Secretary Sebelius Announces $51 Million in Affordable Care Act Grants to Innovate, Improve and Enhance Health Insurance Premium Rate Review
New grant program providing $250 million to states over next five years will strengthen oversight of insurance premiums and rate hikes
HHS Secretary Kathleen Sebelius today (June 7) announced the availability of $51 million in Health Insurance Premium Review Grants through the Affordable Care Act. These funds are the first round of grants available to states through a new $250 million grant program to create and strengthen insurance rate review processes.
"This is an important step in putting consumers back in control of their health care," said Secretary Sebelius. "These new grants will help states protect consumers and small employers by holding insurers accountable for unreasonable insurance rate increases that have made coverage unaffordable for many American families. By strengthening oversight of insurance premiums, these grants will help put affordable coverage back within the reach for Americans who have been hit hard by skyrocketing costs."
All states and the District of Columbia are eligible for this first round of rate review grants. To receive a grant, a state must submit a plan for how it will use grant funds to develop or enhance its process of reviewing and approving, disapproving, or modifying health insurance premium requests. States with successful applications will receive a $1 million grant during the first round.
"These funds will help states strengthen their oversight capabilities and will allow states that do not currently review rates to establish a program," said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight. "By subjecting rates to new public scrutiny, the oversight of premium increases will ultimately help ensure that consumers receive substantial value for their insurance dollars."
In early May, Secretary Sebelius sent a letter to Governors and State Insurance Commissioners urging them to review the authority they have under their state laws to determine whether they have all of the regulatory tools needed to approve health insurance rates before they take effect.
Several provisions in the Affordable Care Act strengthen HHS' and states' oversight of insurance premiums and rate hikes. These include the Medical Loss Ratio, requiring insurers in the individual and small group markets to spend at least 80 percent of the premium dollar on health care, and insurers in the large group market to spend at least 85 percent of the premium dollar on health care; rate review, requiring insurers to justify unreasonable premium increases to state regulators and the Secretary of Health and Human Services; and grant funds for states to help create or strengthen reporting and review processes.
The Health Insurance Premium Review Grants that will be available during FY 2010 are only the first in a five-year grant program. HHS will take applications for a second round of state grants beginning in Fiscal Year 2011, after new regulations regarding rate review take effect. Second-round grants will allow states to further strengthen their rate review, and begin to provide the Secretary of HHS with the rate data required under the law.
This grant solicitation can be found at grants.gov.
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HHS Secretary Kathleen Sebelius today (June 7) announced the availability of $51 million in Health Insurance Premium Review Grants through the Affordable Care Act. These funds are the first round of grants available to states through a new $250 million grant program to create and strengthen insurance rate review processes.
"This is an important step in putting consumers back in control of their health care," said Secretary Sebelius. "These new grants will help states protect consumers and small employers by holding insurers accountable for unreasonable insurance rate increases that have made coverage unaffordable for many American families. By strengthening oversight of insurance premiums, these grants will help put affordable coverage back within the reach for Americans who have been hit hard by skyrocketing costs."
All states and the District of Columbia are eligible for this first round of rate review grants. To receive a grant, a state must submit a plan for how it will use grant funds to develop or enhance its process of reviewing and approving, disapproving, or modifying health insurance premium requests. States with successful applications will receive a $1 million grant during the first round.
"These funds will help states strengthen their oversight capabilities and will allow states that do not currently review rates to establish a program," said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight. "By subjecting rates to new public scrutiny, the oversight of premium increases will ultimately help ensure that consumers receive substantial value for their insurance dollars."
In early May, Secretary Sebelius sent a letter to Governors and State Insurance Commissioners urging them to review the authority they have under their state laws to determine whether they have all of the regulatory tools needed to approve health insurance rates before they take effect.
Several provisions in the Affordable Care Act strengthen HHS' and states' oversight of insurance premiums and rate hikes. These include the Medical Loss Ratio, requiring insurers in the individual and small group markets to spend at least 80 percent of the premium dollar on health care, and insurers in the large group market to spend at least 85 percent of the premium dollar on health care; rate review, requiring insurers to justify unreasonable premium increases to state regulators and the Secretary of Health and Human Services; and grant funds for states to help create or strengthen reporting and review processes.
The Health Insurance Premium Review Grants that will be available during FY 2010 are only the first in a five-year grant program. HHS will take applications for a second round of state grants beginning in Fiscal Year 2011, after new regulations regarding rate review take effect. Second-round grants will allow states to further strengthen their rate review, and begin to provide the Secretary of HHS with the rate data required under the law.
This grant solicitation can be found at grants.gov.
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Wednesday, May 05, 2010
Secretary Sebelius on New Benefits for Companies and Early Retirees in the Affordable Care Act
The U.S. Department of Health and Human Services today issued regulations establishing the Early Retiree Reinsurance Program in the Affordable Care Act. This temporary program will make it easier for employers to provide coverage to early retirees. You can find more information about this important new program at http://www.whitehouse.gov/the-press-office/fact-sheet-early-retiree-reinsurance-program.
Rising costs have made it hard for employers to provide quality, affordable health insurance for workers and retirees,” said Secretary Sebelius. “As a result, many Americans who retire before they are eligible for Medicare are worried about losing health insurance coverage through their former employers, putting them at risk of losing their life savings due to medical costs. This new program will provide much-needed relief so that employers can provide more retirees with quality, affordable insurance, starting this year.”
The percentage of large firms providing workers with retiree coverage has dropped from 66 percent in 1988 to 31 percent in 2008. The Affordable Care Act includes $5 billion in financial assistance to employers to help them maintain coverage for early retirees age 55 and older who are not yet eligible for Medicare. The program will end in 2014, when Americans will be able to choose from additional coverage options through the health insurance exchanges.
Eligible employers can apply for the program through the Department of Health and Human Services. Applications will be available by the end of June. Both self-funded and insured plans can apply, including plans sponsored by private entities, state and local governments, nonprofits, religious entities, unions, and other employers.
If you want to learn more about how this new benefit could affect you and your company or your family member who is considering early retirement, tune into the next Affordable Care Act web chat at healthreform.gov.
Secretary Sebelius and Department of Commerce Secretary Gary Locke will host a web chat on the new Early Retiree Reinsurance Program Wednesday, May 5, at 11:30 A.M. EDT at www.healthreform.gov
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Rising costs have made it hard for employers to provide quality, affordable health insurance for workers and retirees,” said Secretary Sebelius. “As a result, many Americans who retire before they are eligible for Medicare are worried about losing health insurance coverage through their former employers, putting them at risk of losing their life savings due to medical costs. This new program will provide much-needed relief so that employers can provide more retirees with quality, affordable insurance, starting this year.”
The percentage of large firms providing workers with retiree coverage has dropped from 66 percent in 1988 to 31 percent in 2008. The Affordable Care Act includes $5 billion in financial assistance to employers to help them maintain coverage for early retirees age 55 and older who are not yet eligible for Medicare. The program will end in 2014, when Americans will be able to choose from additional coverage options through the health insurance exchanges.
Eligible employers can apply for the program through the Department of Health and Human Services. Applications will be available by the end of June. Both self-funded and insured plans can apply, including plans sponsored by private entities, state and local governments, nonprofits, religious entities, unions, and other employers.
If you want to learn more about how this new benefit could affect you and your company or your family member who is considering early retirement, tune into the next Affordable Care Act web chat at healthreform.gov.
Secretary Sebelius and Department of Commerce Secretary Gary Locke will host a web chat on the new Early Retiree Reinsurance Program Wednesday, May 5, at 11:30 A.M. EDT at www.healthreform.gov
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Friday, April 30, 2010
Statement from HHS Secretary Kathleen Sebelius on News that California Insurer, Anthem, is Withdrawing Proposed 39 Percent Rate Increase
Today's announcement is good news for the more than 800,000 Californians who could have been hit with massive rate increases and gives them some much-needed temporary relief. Since these rate hikes were first announced, I have heard from countless Americans who have been stretched to the limit by high health insurance premiums. This result was achieved because those who oversee the insurance industry on the state and federal levels heard these voices, held investigations, and demanded action.
The Affordable Care Act will ensure that people across this country have access to the affordable, quality care they deserve. As we implement this law, our Department, and especially our new Office of Consumer Information and Insurance Oversight, will closely monitor the industry, and we will not hesitate to act to prevent exorbitant premium hikes.
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The Affordable Care Act will ensure that people across this country have access to the affordable, quality care they deserve. As we implement this law, our Department, and especially our new Office of Consumer Information and Insurance Oversight, will closely monitor the industry, and we will not hesitate to act to prevent exorbitant premium hikes.
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Wednesday, April 28, 2010
Momentum Building on Sebelius' Challenge to Insurers to Ban Rescission Before Law Takes Effect in September
More insurers are heeding Secretary Sebelius' call to voluntarily implement key provisions of the Affordable Care Act before the law requires them to do so.
Today, UnitedHealthcare announced they will join with other insurers and stop using rescissions - the practice of dropping patients' health coverage. This announcement follows a letter that Secretary Sebelius sent to the nation's largest insurer, WellPoint, after seeing reports that they were targeting women with breast cancer with the goal of canceling their coverage. WellPoint announced yesterday they would stop the practice, and Secretary Sebelius urged other insurers to do the same.
"The days when insurers can drop coverage when patients get sick are coming to an end but insurers don't need to wait to do the right thing," said Secretary Sebelius. "Americans need to be secure in knowing that their health coverage will be there when they need it most. That is why we are working hard to get the benefits of the Affordable Care Act to families everywhere as quickly as possible."
The Affordable Care Act will ban rescissions, except in cases of intentional misrepresentation of fact or fraud, beginning September 23, but Secretary Sebelius continues to urge insurers not to wait until the fall to do the right thing.
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Today, UnitedHealthcare announced they will join with other insurers and stop using rescissions - the practice of dropping patients' health coverage. This announcement follows a letter that Secretary Sebelius sent to the nation's largest insurer, WellPoint, after seeing reports that they were targeting women with breast cancer with the goal of canceling their coverage. WellPoint announced yesterday they would stop the practice, and Secretary Sebelius urged other insurers to do the same.
"The days when insurers can drop coverage when patients get sick are coming to an end but insurers don't need to wait to do the right thing," said Secretary Sebelius. "Americans need to be secure in knowing that their health coverage will be there when they need it most. That is why we are working hard to get the benefits of the Affordable Care Act to families everywhere as quickly as possible."
The Affordable Care Act will ban rescissions, except in cases of intentional misrepresentation of fact or fraud, beginning September 23, but Secretary Sebelius continues to urge insurers not to wait until the fall to do the right thing.
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HHS Secretary Kathleen Sebelius on WellPoint's Decision to Ban Rescissions in Advance of the Affordable Care Act's Requirement
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius released the following statement today on WellPoint's announcement that it intends to end the practice of rescinding patients' coverage in advance of the Affordable Care Act's requirement that insurers stop this practice starting this fall. WellPoint's announcement comes after Secretary Sebelius sent a letter on April 22 urging the company to immediately stop the practice of rescinding coverage for patients who become ill.
The Affordable Care Act will specifically prohibit insurance companies from rescinding policies, except in cases of fraud or intentional misrepresentation of material fact.
STATEMENT OF SECRETARY SEBELIUS
"Last week, when I heard reports of one insurer - WellPoint - targeting breast cancer victims for rescission of their policies, I challenged the company and the rest of the insurance industry to do what they have done with other key insurance reforms in the bill and not wait until September to do the right thing.
The last thing someone who is really sick needs to hear is that they are being dropped by their insurer because they got sick and tried to use the policy they purchased.
I was encouraged to learn today that WellPoint has announced it will act to stop rescissions and no longer engage in this practice as of the end of this week. I urge other insurers to also accelerate the Affordable Care Act's deadline for ending this practice and stop rescinding patients' policies immediately."
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The Affordable Care Act will specifically prohibit insurance companies from rescinding policies, except in cases of fraud or intentional misrepresentation of material fact.
STATEMENT OF SECRETARY SEBELIUS
"Last week, when I heard reports of one insurer - WellPoint - targeting breast cancer victims for rescission of their policies, I challenged the company and the rest of the insurance industry to do what they have done with other key insurance reforms in the bill and not wait until September to do the right thing.
The last thing someone who is really sick needs to hear is that they are being dropped by their insurer because they got sick and tried to use the policy they purchased.
I was encouraged to learn today that WellPoint has announced it will act to stop rescissions and no longer engage in this practice as of the end of this week. I urge other insurers to also accelerate the Affordable Care Act's deadline for ending this practice and stop rescinding patients' policies immediately."
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Wednesday, April 21, 2010
HHS Secretary Kathleen Sebelius on Growing List of Insurers That Will Provide Coverage for Young Adults under Age 26
I welcome the Blue Cross Blue Shield plans, Kaiser Permanente, and Humana to the growing list of insurers who are offering to continue health insurance for young adults graduating from college or aging out of their parents’ plan. This initiative, complementing the permanent policy in the Affordable Care Act, will enable young people to retain insurance coverage at an important moment as they begin their adult lives and launch their careers.
Many young adults under the age of 26 have traditionally had a difficult time getting access to – and affording – health coverage. The Affordable Care Act, and the voluntary actions of insurers to eliminate the coverage gap for young adults on their parents plans, will give greater health security to millions of American families.
Insuring younger Americans is a top priority for the Administration and we will continue working to expand the opportunity for children and young adults to have access to quality, affordable care.
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Thursday, December 17, 2009
States Get Bonuses for Boosting Enrollment in Children's Health Coverage
HHS Secretary Kathleen Sebelius today announced the award of more than $72 million to nine states for making significant progress in enrolling children in health coverage through Medicaid and improving access to children's coverage through Medicaid and the state children's health insurance program.
Funding for the "performance bonuses" was included in the Children's Health Insurance Program Reauthorization (CHIPRA) law. CHIPRA also set performance goals that states must meet to qualify for a bonus.
"Today, we're happy to reward states that have taken important steps to help insure more children and made a real difference in the lives of families across the country," said Secretary Sebelius. "These awards will provide crucial support and help states continue to serve children and families."
States receiving funds today include: Alaska, Alabama, Illinois, Louisiana, Michigan, New Jersey, New Mexico, Oregon, and Washington. (See below for a complete list of state awards.) Awards vary by state according to a formula set out in CHIPRA but total $72.6 million this fiscal year.
To receive these performance bonuses, states had to meet two types of performance goals set forth in the CHIPRA statute. States had to qualify by adopting at least five of eight listed program features-like providing 12 months of continuous eligibility, using a joint application for both Medicaid and the Children's Health Insurance Program (CHIP) and streamlining eligibility renewal processes-that are known to encourage enrollment and retention of eligible children. States also had to document significant increases in Medicaid enrollment among children over the course of the year.
Performance bonuses are not the only federal incentive for states to maintain and expand their Medicaid programs. A short-term boost in Medicaid reimbursement rates authorized by the American Recovery and Reinvestment Act (ARRA) also provided relief to states with suffering economies, enabling them to extend care to eligible children.
"In the midst of the worst economic downturn since the Great Depression, decisive action in ARRA and CHIPRA, along with focused state activity, helped ensure that children got the health care they need," said Cindy Mann, director of the Center for Medicaid and State Operations within the Center for Medicare and Medicaid Services (CMS). "We are pleased to see the success these states have achieved as well as the actions to enroll eligible children taken by other states that we expect may qualify for the bonus next year."
Today's announcement closely follows the release of a study by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured which also credited ARRA and CHIPRA with enabling States to expand access to care for low-income, uninsured children. In a 50-state survey, the Commission concluded that 26 states expanded and/or simplified their Medicaid and CHIP programs in 2009. A copy of the complete report can be found at http://www.kff.org.
State award amounts today are:
Alabama $39.1 million
Alaska $789,000
Illinois $9.1 million
Louisiana $1.5 million
Michigan $3.7 million
New Jersey $4.2 million
New Mexico $5.1 million
Oregon $1.6 million
Washington $7.5 million
Total: $72.6 million
CMS today also released a letter to state health officials providing more detailed guidance on the criteria for qualifying for a bonus payment for 2009 and in future years. That letter will be available on the CMS web site at www.cms.hhs.gov/CHIPRA and also on the Insure Kids Now website at www.insurekidsnow.gov
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Funding for the "performance bonuses" was included in the Children's Health Insurance Program Reauthorization (CHIPRA) law. CHIPRA also set performance goals that states must meet to qualify for a bonus.
"Today, we're happy to reward states that have taken important steps to help insure more children and made a real difference in the lives of families across the country," said Secretary Sebelius. "These awards will provide crucial support and help states continue to serve children and families."
States receiving funds today include: Alaska, Alabama, Illinois, Louisiana, Michigan, New Jersey, New Mexico, Oregon, and Washington. (See below for a complete list of state awards.) Awards vary by state according to a formula set out in CHIPRA but total $72.6 million this fiscal year.
To receive these performance bonuses, states had to meet two types of performance goals set forth in the CHIPRA statute. States had to qualify by adopting at least five of eight listed program features-like providing 12 months of continuous eligibility, using a joint application for both Medicaid and the Children's Health Insurance Program (CHIP) and streamlining eligibility renewal processes-that are known to encourage enrollment and retention of eligible children. States also had to document significant increases in Medicaid enrollment among children over the course of the year.
Performance bonuses are not the only federal incentive for states to maintain and expand their Medicaid programs. A short-term boost in Medicaid reimbursement rates authorized by the American Recovery and Reinvestment Act (ARRA) also provided relief to states with suffering economies, enabling them to extend care to eligible children.
"In the midst of the worst economic downturn since the Great Depression, decisive action in ARRA and CHIPRA, along with focused state activity, helped ensure that children got the health care they need," said Cindy Mann, director of the Center for Medicaid and State Operations within the Center for Medicare and Medicaid Services (CMS). "We are pleased to see the success these states have achieved as well as the actions to enroll eligible children taken by other states that we expect may qualify for the bonus next year."
Today's announcement closely follows the release of a study by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured which also credited ARRA and CHIPRA with enabling States to expand access to care for low-income, uninsured children. In a 50-state survey, the Commission concluded that 26 states expanded and/or simplified their Medicaid and CHIP programs in 2009. A copy of the complete report can be found at http://www.kff.org.
State award amounts today are:
Alabama $39.1 million
Alaska $789,000
Illinois $9.1 million
Louisiana $1.5 million
Michigan $3.7 million
New Jersey $4.2 million
New Mexico $5.1 million
Oregon $1.6 million
Washington $7.5 million
Total: $72.6 million
CMS today also released a letter to state health officials providing more detailed guidance on the criteria for qualifying for a bonus payment for 2009 and in future years. That letter will be available on the CMS web site at www.cms.hhs.gov/CHIPRA and also on the Insure Kids Now website at www.insurekidsnow.gov
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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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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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Thursday, September 17, 2009
New Report Outlines Importance of Health Insurance Reform for Young Americans
HHS Secretary Kathleen Sebelius today released a new report, Young Americans and Health Insurance Reform: Giving Young Americans the Security and Stability They Need. The report highlights the vulnerability young adults face in the current health care system and the urgent need for health insurance reform. The complete report is available at www.healthreform.gov.
"More and more young adults wake up the day after their nineteenth birthday or on graduation day and find themselves uninsured," said Secretary Sebelius. "I've seen this problem first-hand. When my son graduated, he faced the challenge of finding health insurance. Unfortunately, too many of his peers are forced to go without the care they need. Health insurance reform will help insure young Americans have access to the affordable health care they need and deserve."
While seventeen percent of adults (those aged 30-64) are uninsured, thirty percent of young adults do not have health insurance. When young adults lose access to their parents' health insurance, they find it increasingly difficult to afford the high cost of health insurance.
Young adults are often less likely to work for employers who offer health insurance benefits. Nearly half of young people work part-time, and part-time workers are less likely to be offered coverage. Young people are also more likely to work for smaller firms, which tend to offer less coverage. Among young adults working in firms of fewer than 50 employees and who had coverage in 2006, one in four lost that insurance in the following two years - more than twice the rate of older adults.
The report also shows that 33 states allowed insurance companies to charge unrestricted premiums based on age, health status and even gender. In some states, a 22-year-old woman can be charged twice as much for her premium than a 22-year-old man.
The health care status quo is significantly impacting young Americans. In a recent survey, two-thirds who had gaps in healthcare admitted to forsaking health care because of costs including skipping recommended tests and treatment and neglecting to fill a prescription. Even with cost-saving measures, more than one-third of all young adults with coverage report having problems paying medical bills.
Health insurance reform would ensure young adults have access to quality, affordable health coverage, deter mounting health problems and ensure young people are not left with crushing medical debt after an accident or illness. Capping out-of-pocket expenses, co-pays and
deductibles while limiting arbitrary premium increases would provide affordable health care options for young adults as well.
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"More and more young adults wake up the day after their nineteenth birthday or on graduation day and find themselves uninsured," said Secretary Sebelius. "I've seen this problem first-hand. When my son graduated, he faced the challenge of finding health insurance. Unfortunately, too many of his peers are forced to go without the care they need. Health insurance reform will help insure young Americans have access to the affordable health care they need and deserve."
While seventeen percent of adults (those aged 30-64) are uninsured, thirty percent of young adults do not have health insurance. When young adults lose access to their parents' health insurance, they find it increasingly difficult to afford the high cost of health insurance.
Young adults are often less likely to work for employers who offer health insurance benefits. Nearly half of young people work part-time, and part-time workers are less likely to be offered coverage. Young people are also more likely to work for smaller firms, which tend to offer less coverage. Among young adults working in firms of fewer than 50 employees and who had coverage in 2006, one in four lost that insurance in the following two years - more than twice the rate of older adults.
The report also shows that 33 states allowed insurance companies to charge unrestricted premiums based on age, health status and even gender. In some states, a 22-year-old woman can be charged twice as much for her premium than a 22-year-old man.
The health care status quo is significantly impacting young Americans. In a recent survey, two-thirds who had gaps in healthcare admitted to forsaking health care because of costs including skipping recommended tests and treatment and neglecting to fill a prescription. Even with cost-saving measures, more than one-third of all young adults with coverage report having problems paying medical bills.
Health insurance reform would ensure young adults have access to quality, affordable health coverage, deter mounting health problems and ensure young people are not left with crushing medical debt after an accident or illness. Capping out-of-pocket expenses, co-pays and
deductibles while limiting arbitrary premium increases would provide affordable health care options for young adults as well.
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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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