Headlines about "Health plans - policy"

Gathered from the web by the editors at BenefitsLink.com.
[Opinion] Comments of American Academy of Actuaries on HHS' Research Brief Entitled 'Actuarial Value and Employer-Sponsored Insurance' (PDF)
"The American Academy of Actuaries' Health Practice Council appreciates the opportunity to provide comments on the recently released [HHS] research brief, 'Actuarial Value and Employer-Sponsored Insurance.' . . . There are additional factors that should be considered when interpreting the results and formulating policies to regulate [actuarial value] calculations for [employer-sponsored insurance]: . . ." (American Academy of Actuaries)

[Opinion] Comments of American Academy of Actuaries on HHS' Essential Health Benefits Bulletin (PDF)
"[T]here are a few implications of allowing the flexibility to create multiple benefit sets that should be considered. Such flexibility in benefit design could create confusion for consumers; result in situations in which insurers design benefit packages to minimize certain risks; and have a material effect on premium rates, particularly in the individual market. . . . Clarification of the use of the terms 'actuarial equivalence' and 'substantially equal' as used in the context of essential health benefits is needed as well." (American Academy of Actuaries)

[Opinion] Health Care Consumers Have Uphill Battle in Pushback Against High Prices
"To an economist it is astonishing that Americans have been content for so long to allow an economic sector that has absorbed an increasing portion of their incomes -- 18 percent of their gross domestic product now and 20 percent before too long -- to operate without any meaningful price transparency." (New York Times; free registration required)

[Opinion] Patients Facing Unaffordable Premiums And Consumer Advocates Launch Historic All-Volunteer Signature-Gathering Effort for Health Insurance Rate Regulation Initiative
"The Insurance Rate Public Justification and Accountability Act will reform an unaccountable insurance industry by requiring health insurance companies to open their books, publicly justify rate hikes, and get approval before an increase can take effect. 35 states have the power to reject unjustified health insurance rate increases but California does not." (Consumer Watchdog)

Providence, R.I., Mayor Proposes Benefit Cuts to Avert Bankruptcy
"Mayor Angel Taveras, a Democrat, outlined plans to reduce pensions for retired municipal workers and vowed to appeal a recent state court ruling preventing the city from forcing its retirees to switch to the federal Medicare health insurance program when they turned 65." (New York Times; free registration required)

Administration and Catholics Tangle Over Mandatory Contraception Coverage
The administration will not reconsider the decision, White House spokesman Jay Carney said yesterday, according to the Associated Press. (AP via Washington Post)

Domestic Policy Council Director's Statements on White House Blog About Contraceptive Mandate
"Over half of Americans already live in the 28 States that require insurance companies cover contraception: Several of these States like North Carolina, New York, and California have identical religious employer exemptions. Some States like Colorado, Georgia and Wisconsin have no exemption at all." (The White House Blog, written by Cecilia Mu?oz, Director of the White House Domestic Policy Council)

[Opinion] Protestants and Jews Declare to White House: We Stand With Catholics
"[M]ore than 40 non-Catholic religious organizations including Protestant-affiliated colleges, National Association of Evangelicals, Focus on the Family, Assemblies of God, Northwest Nazarene University, and Eastern Mennonite University, sent a letter to the White House demanding religious protection against the newly issued HHS contraceptive mandate." (Becket Fund)

Anger Brewing on the Left About Mandatory Contraceptive Coverage for Employees of Religious Employers
"Megan McArdle, senior editor of the Atlantic, wrote yesterday that it might be in Americans' interest to be more flexible with faith-based organizations because they provide such a depth of social services (publicly funded in many cases, of course) . . . ." (Washington Post)

Congressional Budget Office Expects Health Spending to Double in Ten Years
"CBO's economic outlook predicts that federal spending on Medicare, Medicaid and other healthcare programs will climb to $1.8 trillion -- or about 7 percent of the entire economy -- by 2022." (The Hill)

Catholic Bishops Revolt Against Birth Control Rules
"There's a battle going on between U.S. Catholic bishops and the Obama administration over its recent directive requiring religious institutions to offer coverage for contraception in their health care plans. Some have announced they will not comply with the mandate. Others are calling on parishioners to . . . speak out against what they call an intrusion against religious liberty." (National Public Radio)

[Opinion] Health Care Mandates Violate Our Religious Rights
"This mandate treats a healthy pregnancy as a disease in need of 'prevention,' like breast cancer or AIDS or other conditions that require safe, effective prevention and treatment. But pregnancy is not a disease; it is a gift from God. . . . Never in the history of this country has the government forced citizens to purchase a product that violates core moral and religious beliefs." (Concord Monitor)

A Guide to The Supreme Court's Review of The 2010 Health Care Reform Law
"[T]his Kaiser Family Foundation brief serves as a primer on the pending case, which challenges the constitutionality both of the law's individual mandate that requires most Americans to obtain health insurance and of provisions requiring states to expand eligibility for their Medicaid programs. The brief provides an overview of . . . the key constitutional questions, and the legal arguments made by the parties involved . . . and the potential implications of the Court's decisions.' (Kaiser Family Foundation)

Government Health Spending Seen Hitting $1.8 Trillion
"[R]esearchers warned that the longer term prospects for rising healthcare spending could have dire consequences for the U.S. deficit when combined with the cost of Social Security, if current revenue levels remain unchanged." (Reuters)

[Opinion] Over-the-Counter (OTC) Medicine Saves Healthcare System Billions
"[T]he study findings underscore the importance of reversing a provision in the 2010 Affordable Care Act (ACA) that prohibits consumers from using their flexible spending arrangements (FSAs) to purchase OTC medicines without first getting a prescription. At the time this provision was enacted, an estimated 19 million working American families purchased OTC medicines, relying on these accessible and affordable medicines to keep their families healthy." (Consumer Healthcare Products Association)

[Guidance Overview] Supreme Court Recognizes 'Ministerial Exception' to Federal, State Employment Laws
"A 'ministerial exception' shields religious organizations -- including hospitals, schools and corporations with religious affiliations -- from potential liability under state and federal employment laws, the U.S. Supreme Court has ruled [in Hosanna-Tabor Evangelical Lutheran Church & School v. EEOC, decided January 11, 2012]." (Mercer Select)

[Opinion] Aging Groups Argue That Most Health Reform Law Provisions Affecting Seniors Should Not Be Tied To Supreme Court's Ruling on Individual Mandate (PDF)
"The [recently filed amicus] brief . . . highlights the parts of the ACA that greatly benefit people aged 65 and older that should not be affected should the Court decide to invalidate the minimum coverage provision, including: Reduced cost-sharing for Medicare beneficiaries for prescription drugs by substantially reducing the coverage gap or so-called donut hole; Elimination of cost-sharing for annual wellness visits and other screening services; Medicare Advantage plans are prevented from charging higher cost-sharing for chemotherapy and dialysis than permitted under traditional Medicare . . . ." (National Senior Citizens Law Center)

[Opinion] Amicus Brief of AARP and Other Organizations, Arguing in Favor of Severability in Constitutional Challenge to Mandated Health Insurance Coverage (PDF)
56 pages. The brief was filed by AARP; Center For Medicare Advocacy, Inc.; Medicare Rights Center; National Committee to Preserve Social Security and Medicare; National Council on Aging; and the National Senior Citizens Law Center. (AARP)

[Opinion] PBM Merger Would Mean More Bad News for Consumers
"Small and independent pharmacies may not fit into the [pharmacy benefit manager] industry's vision for the future. But community pharmacies and pharmacists are the most affordable and accessible health care provider in many communities -- and underserved communities in particular. Certainly their loss will have an adverse affect on patient care and outcomes." (Eva M. Clayton in the Huffington Post)

[Opinion] Cleveland Clinic: 'Why We Won't Hire Smokers'
"Job candidates are told that the offer is subject to a nicotine-free urine test. If a candidate tests positive for nicotine, the offer is rescinded, and he or she is offered a free tobacco-cessation program and may reapply in 90 days. . . . At Cleveland Clinic, we have a unique perspective on the burden of chronic disease. We not only treat disease, but we also play a vital role in educating patients and employees about lifestyle choices. It is only right to practice what we preach." (USATODAY.com)

[Guidance Overview] Health Care Reform Update, by ML Strategies (PDF)
A succinct listing of recent health care reform legislation, regulations, and initiatives. (ML Strategies, LLC)

Public-private Pay Gap Varies Greatly By Education Level
"Federal civilian workers with only a high school diploma or less fared much better than private sector employees with the same: They earned 21 percent more wages, 72 percent higher benefits and 36 percent more in total compensation. . . . In contrast, among employees with a professional degree or doctorate, federal workers earned 23 percent less in wages and 18 percent lower total compensation, while receiving about the same benefits as the private sector employees with identical degrees." (GovExec.com)

[Opinion] Disregarding Religious Beliefs: Obama's Radical Power Grab on Health Care
"There would have been no controversy at all if President Obama had simply exempted religious institutions and ministries. But the administration insisted that the University of Notre Dame and St. Mary's Hospital be forced to pay for the privilege of violating their convictions. Obama chose to substantially burden a religious belief, by the most intrusive means, for a less-than-compelling state purpose -- a marginal increase in access to contraceptives that are easily available elsewhere." (Michael Gerson in the Washington Post; free registration required)

Catholic Clergy Come Out Swinging Against HHS Regulation Mandating Cost-Free Contraceptives
"Catholics around the country got an earful on Sunday from the pulpit over a new health insurance policy by the U.S. Department of Health and Human Services that forces employers to cover contraception and abortion as part of preventative care regardless of religious beliefs. The use of abortion and contraceptives violates Catholic teachings." (CNN Belief Blog)

[Opinion] Comments of Galen Institute on Medical Loss Ratio Requirements
"The MLR rules as drafted discriminate against Health Savings Accounts (HSAs) and similar high-deductible health plans in a number of ways. These accounts provide employers, employees, and individuals with an option to purchase coverage with a larger deductible so that the polices function more like traditional 'insurance' -- covering medical expenses above a certain threshold. . . . The Galen Institute respectfully requests that HHS exempt HSAs and other high-deductible health plans from the MLR requirement . . . ." (Galen Institute)

Downgrades in Ratings Loom for G20 Nations on Health Costs, S&P Warns
"Ratings agency Standard & Poor's warned it may downgrade 'a number of highly rated' Group of 20 countries from 2015 if their governments fail to enact reforms to curb rising healthcare spending and other costs related to ageing populations." (Reuters)

Are Accountable Care Organizations a Way to Fix a Fragmented and Expensive Health Care System?
"While health reform's primary focus on [Accountable Care Organizations] revolves around Medicare, many insurance carriers now have or are in the process of developing ACO options for the commercial sector. In fact, some ACOs have been around even before they recently began to gain more attention . . . ." (BenefitsPro)

Aging Groups Argue that Most Provisions Affecting Seniors Should Not Be Tied to Supreme Court's Ruling on Individual Mandate (PDF)
"Six national aging groups filed a friend of the court brief with the Supreme Court LAST Friday saying that there are extensive provisions in the Patient Protection and Affordable Care Act (ACA) that are of 'vital importance to the health and well-being of people 65 and older' and that Congress did not intend for any of them to be contingent on whether or not the minimum coverage provision (also called the individual mandate) was constitutional." (National Senior Citizens Law Center)

[Opinion] The Quiet Triumph of Obama Care
"[E]vidence is emerging that the ACA is already improving life for millions of average Americans. It is promoting long-overdue fundamental changes in our dysfunctional medical system. Moreover, because those reforms are starting to directly address heightened economic insecurities of average families - the personal financial conditions that will largely determine this year's election outcomes . . . ." (Washington Monthly)

States Again Ask High Court to Uphold Health Care Law
"The states argued in a previous brief that the minimum coverage provision is constitutional . . ., but said in the current brief that if the court decides otherwise, the remainder of the PPACA -- including measures that have already been implemented -- should remain intact." (PLANSPONSOR.COM)

How Will the Affordable Care Act Affect Small Businesses and Their Employees? (PDF)
"This fact sheet explains the changes that are likely to take place with reform, when they go into effect, and which businesses will be affected." (The Henry J. Kaiser Family Foundation)

[Official Guidance] Second Quarter Update to the 2011? 2012 IRS Priority Guidance Plan (PDF)
"The second quarter update to the 2011-2012 plan reflects 14 additional projects that have become priorities and/or guidance we have published during the period from October 1, 2011 through December 31, 2011 of the plan year. In addition, the update reflects one project we have closed without publication because the statute was subsequently repealed." (U.S. Internal Revenue Service)

Legislative Background of Expiring Federal Tax Provisions, 2011-2022
"The legislative background provided for each expiring provision includes: A brief description of the provision, The public law in which the provision was originally enacted with the original expiration date, A brief description of substantial modifications to the provision, if any, and The public law in which the provision was most recently extended, if any, with the current expiration date." (U.S. Joint Committee on Taxation)

Tracking Employment-Based Health Benefits in Changing Times
"Most Americans obtain their health care coverage through an employment-related plan. The National Compensation Survey (NCS) provides measures of access, participation, and features for those plans This article discusses some of the issues that the implementation of the Patient Protection and Affordable Care Act will present for the NCS." (U.S. Bureau of Labor Statistics)

Device Makers Urge Coverage of Weight-Loss Surgery
"Advocates say it will give obese patients a complete arsenal for fighting the condition that can spur a host of life-threatening illnesses and help save billions of dollars in health care costs for employers and the government." (Reuters via Employee Benefit News)

[Opinion] American Academy of Actuaries Files Amicus Brief with Supreme Court on Health Reform Challenge (PDF)
The brief supports respondents on the severability issue. 'Argument: Should the Court invalidate the individual mandate provision of the Act, it should also invalidate the guaranteed-issue and community rating provisions." (American Academy of Acturaries)

The State of Massachusetts Health Reform, in 3 Charts
"Health Affairs is out . . . with a four-year look back at Massachusetts health reform. It has some good news (coverage has gone up!) and not-so-good news (health care isn't getting any cheaper). With the Massachusetts reforms serving as the model for the federal law, it's worth taking a look at what has and hasn't worked in the Bay State reforms." (The Washington Post; free registration required)

[Guidance Overview] American Health Benefit Exchanges
"In 2014, individuals and small business will be able to purchase private health insurance through state-based Exchanges. This document reflects information and guidance issued through statute, rule, or communications from the federal government concerning the activities and options as they related to the development of a health benefit exchange." (National Conference of State Legislatures)

Health Care Reform Law Requires Greater Collaboration Between HR and Finance Executives
"According to a Towers Watson/Forbes Insights survey of more than 300 HR and finance executives, both groups of respondents see changes ahead in their own roles when it comes to reward programs, as the provisions of the 2010 Affordable Health Care Act take effect." (Human Resource Executive Online)

State of the Union: Time to Trim the Regulatory Fat in Health Care
"As Obama continues to shift away from touting the Affordable Care Act and focus on its implementation, it's clear that streamlining federal regulations will be a top priority for the White House this year. And as one of the nation's most heavily regulated sectors, health care stands to be significantly affected." (California HealthCare Foundation)

ERISA Preemption of Michigan Paid Claims Assessment Act
"Since its enactment, several plan sponsors have wondered whether the Act will be preempted by ERISA. The courts will now weigh in on that issue in Self-Insurance Institute of America v. Snyder . . . . In that case, the Self-Insurance Institute of America, Inc. . . . seeks both a declaration that the Act is preempted by ERISA and an injunction against implementation or enforcement of the Act." (Faegre Baker Daniels LLP)

[Opinion] It Takes a CEO to Save the U.S. Health Care System
"Forget Washington and the political debate over Obamacare. The real battle for the future of health care is being fought in the world of business, where tens of thousands of companies have seen their financial well-being undermined by skyrocketing employee health costs." (Bloomberg L.P.)

CCIIO Illustrative List of the Largest Three Small Group Products by State (PDF)
"This document provides illustrative information to complement the bulletin on essential health benefits (EHB) under the Affordable Care Act released on December 16, 2011. Specifically, it provides a list of the products with the three largest enrollments in the small group market in each State using data from HealthCare.gov. It provides the names of the three largest products in each State ranked by enrollment. In addition, we are providing a list of the top three nationally available Federal Employee Health Benefit Program (FEHBP) plans based on enrollment. This information is being provided to facilitate a better understanding of the intended approach to EHBs." (U.S. Department of Health & Human Services, Office of Center for Consumer Information and Insurance Oversight)

Health Care Reform Update: What's Essential about 'Essential Health Benefits' (PDF)
"The definition of EHB is especially important for small group health coverage, whether offered through or outside of an Exchange; however, this definition is also significant for all types of group health plans subject to ACA, including self-insured plans and plans in the large group market . . . ." (Alston & Bird LLP)

Important New Understanding about Essential Benefits? Not Everyone Thinks So
"[HHS] released a document intended to preview the kinds of benefits most health plans must offer starting in 2014. But one consumer advocate said it does not provide nearly enough information to be helpful." (The Henry J. Kaiser Family Foundation)

Kaiser Tracking Poll on Health Care Reform: January 2012
"The public doubts the Supreme Court renders judgments based solely on the law. Three-quarters (75%) say they think that, in general, Justices let their own ideological views influence their decisions while 17 percent say they usually decide cases based on legal analysis without regard to politics and ideology." (The Henry J. Kaiser Family Foundation)

Report on 2011 U.S. and Canadian Legislative and Regulatory Developments for Health and Retirement Plans
"Much of the activity related to health care in the U.S. was focused on the implementation of the Patient Protection and Affordable Care Act of 2010 . . . . Retirement security garnered attention with U.S. Congressional hearings, governmental reports and initiatives geared to the consumer." (International Foundation of Employee Benefit Plans)

[Opinion] State of The ... Health Care Reform
"President Obama's largest legislative accomplishment to date was the passage of the health care reform law, which has been going into effect in stages, with regulations currently being written for the most substantial changes due to take effect in 2014. So it is odd the President mentioned health care only briefly, and in passing, in his State of the Union address last night." (Forbes)

[Opinion] Obamacare 'Contraceptive' Mandate Made in Bad Faith
"Since the FDA approves, as 'contraceptives,' drugs such as Plan B and Ella that may cause early-stage abortions, the federal government could force nearly every employer in America to pay for abortions and sterilizations. Colleges and universities providing insurance to their students will face the same requirement." (BostonHerald.com)

State Progress toward Health Reform Implementation: Timely Analysis of Immediate Health Policy Issues (PDF)
"In this paper, we combine information from the National Conference of State Legislatures . . . and [HHS] to group states based on their progress toward implementing health insurance exchanges. All designations are current as of January 17, 2011." (Robert Wood Johnson Foundation)

Medical Care Benefits for Private Industry Workers, March 2011
"In March 2011, more than two-thirds of private industry workers had access to medical care benefits, and 51 percent of all workers participated in a medical care plan. Employers paid 80 percent of premiums for single-coverage medical care benefits and 69 percent of premiums for family coverage. Among these workers, access and participation rates varied widely by wage category." (U.S. Bureau of Labor Statistics)

High Court Rejects Request for Debate Over Elena Kagan's Recusal from Health Law Review
"The justices, who are scheduled to hear more than five hours of arguments challenging the health law, turned down the request without comment. Kagan did not participate in the decision." (Kaiser Health News)

Government Report Details Slowdown in U.S. Health Care Expenditures
"U.S. health care expenditures continue to ease, as spending in 2010 rose a modest 3.9%, a dramatic showdown compared with the explosive growth in expenditures of just a few years ago, according to a government report. The report, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary, explores the reasons for the slowdown in costs, as well as details on costs by health care sector." (Business Insurance)

Self-Insured Group Health Plans: Stop-Loss Insurance and Adverse Selection (PDF)
Published October 4, 2011. 'In the course of considering changes to its Stop-Loss Model Act, the National Association of Insurance Commissioners (NAIC) has received formal comments containing substantive inaccuracies regarding self-insured group health plans, stop-loss insurance, and how smaller self-insured group health plans may contribute to adverse selection in the health insurance marketplace. Similar comments have beenmade by federal regulators responsible for implementing the Affordable Care Act (ACA). This White Paper identifies and corrects several inaccurate comments in order to assist policy-makers at both the state and federal level to properly assess legislative/regulatory proposals related to self-insured group health plans." (Self-Insurance Insurance Institute of America, Inc.)

Numerous 'Friend of the Court' Briefs Filed in Support of PPACA's Individual Mandate
"On the central issue of whether the individual mandate / minimum coverage requirements of the PPACA are valid, over two dozen amicus briefs were filed in support of the provisions, including briefs by constitutional law scholars, health law scholars, civil rights organizations . . ., health provider organizations . . ., and small business organizations . . . ." (Deloitte via BenefitsLink.com)

Litigation and Compliance Risks for Plan Sponsors in the New Health Reform Environment
"This article addresses five aspects of [PPACA] that could result in significant costs to a plan sponsor if steps are not taken to ensure compliance: plan design mandates, internal and external claims review, enhanced notification requirements, nondiscrimination, and play or pay." (Paul Hastings LLP)

New Cancer Drugs Affordable By The 1 Percent?
"[A]n economic drama . . . is playing itself out in cancer wards and oncologists' offices across the country. Unaffordable new drugs, even when they're covered by insurance, are being rationed by price as patients, doctors and hospital officials struggle with what is likely to be the most pressing problem for the nation's health care system over the next decade: how to pay for the spectacular rise in the cost of cancer care, especially drugs and diagnostic tests." (The Fiscal Times)

[Opinion] Should Everyone Be Required to Have Health Insurance?
"Uninsured individuals who need care, particularly catastrophically expensive care, generally receive these services anyway. A decision not to pay for insurance -- to become a free rider -- leads hospitals and other providers to charge other patients more to make up the difference. People shouldn't have the freedom to shift the burden to everybody else." (The Wall Street Journal)

Health Plans Launch Own Exchanges Ahead of Public Versions
"The prospect of public insurance exchanges are driving some of the maneuvering. As laid out in the health care law, they will allow consumers and small businesses to comparison shop for health plans. Now, a spate of new privately-run online insurance shopping sites are cropping up to cater to small businesses struggling with rising premiums, including 'My Plan by Medica' in Minnesota." (Minnesota Public Radio)

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