This Week’s News

Washington Post – Insurance regulators miss early deadline on premium spending rules

– The national assembly of insurance commissioners ( NAIC) announced they were unable to meet the deadline for creating the rules to ensure 8-% to 85% of premium dollars are spent on:

  • Medical claims
  • Other expenses that improve healthcare

– Law aims to limit spending on marketing, admin, overhead, salaries, and dividends

– Dispute over which expenses should qualify including nurse hotlines, utilization review programs, etc.

– Law calls for the rules to be finished by Dec 31 but HHS Secretary Sebelius wanted them by Tuesday

– Proving how hard it will be to implement the rules of reform.

Wall Street Journal – Revolving door at the hospital

– Yale University study of Medicare heart failure patients shows as hospitals work to get patients out faster, more are returning for additional care within the first 30 days

– Reducing length of stay is a key component of cost reform (and healthcare insurance reform)

– Study did not look at cost but readmissions cost more in the long run


New York Times – Graduates may see coverage gap after all

– Dozens of national health insurers agreed to allow dependent children under age 26 stay on their parents health plan

– Law does not go into effect until September 23 (or new plan year begins)

– Many employers who offer insurance (self insured) are not accelerating the timeframe

– Employers do not have tom comply until the plan year becomes effective (usually January 1)

– For insurance companies, it is more revenue, for employers it’s more expense as they cover the direct cost of medical claims

– Mercer study of 800 employers which said only 25% of those that already offer dependent coverage will offer the benefit early

– 33% said they are considering plan changes to cover costs

– Charging more for family coverage

– Charging for each kid rather than “family”


KHN Healthcare – Tax credit comes with benefits, strings attached for small businesses

– Small businesses with <10 FTEs and wages <25,000 eligible for 35% credit on providing employee coverage

– Decreases as employers reach 25 FTEs and wages of 50,000 or more

– Between 1.8 and 4M businesses are estimated to be eligible.

– Credits need to be calculated individually

– Critics say it’s too complicated and does not address the underlying problem of providing health insurance:  rising costs

– If it’s too expensive, many will not offer insurance

– Family owned businesses that employ family members are not allowed to count employees that are family members


New Poll on Healthcare Reform – NBC/Wallstreet Journal Poll and AP

– Public against reform 44-38%

– 36% believe the quality of their healthcare will get worse – 17% said better

– But respondents said by a 55 to 44% margin said they would pick a congressional candidate willing to the law a chance (rather than repeal)

– Associated Press/GFK Poll found in May found 47-39% of Americans favored Democrats in handling healthcare over Republicans

– Polls also shows 46-39% against healthcare reform

{jcomments on}

Write a Comment

Pre-existing Conditions Exclusions

When HealthCare Reform goes into full effect starting January 1, 2014 no healthplan, either sold privately or through the …

Health Insurance Exchange Markets: What You Need To Know

By Susan E. Matthews, Everyday Health Staff Writer MONDAY, September 30, 2013 — Congress may still be debating particulars …

Important healthcare benefit information for federal employees

  Federal Employee Health Benefits and Healthcare Reform As it stands today only those federal employees who are members …