Search the News Archive

Health Reform: Reinventing the Wheel, Health Affairs Blog, October 12th, 2006, and Comment

Excerpt: The American health care systems perform impressively, producing what they are designed to deliver: cost inflation, inefficiency, and inequity. [Alan Maynard writes on Porter and Teisberg's reinvention of the health care system wheel.]  MORE >>

Regarding the Recent Article on Massachusetts Health Reform: What Were They Thinking at Health Affairs?

Based on telephone surveys, the authors declare that RomneyCare 'continued to fare well in 2010.' This is an important finding, as the authors consider RomneyCare 'the template for the federal Affordable Care Act of 2010.' Unfortunately, in several cases the authors fail to inform readers that their results are contradicted by other, possibly more reliable, sources of information. They also neglect to put some of their results in proper context.

MORE >>

Department of Veterans Affairs Leads in Changing the Telehealth Landscape

"As a general rule, most telehealth practitioners are required to comply with various and state-specific licensing, registration, and certification requirements in order to render health care services via telehealth ... [T]he VA is exercising its authority as a federal agency to preempt conflicting state laws relating to the practice of medicine or other health care services via telehealth."  MORE >>

Testimony of IRS Commissioner Koskinen Before the Senate Homeland Security and Governmental Affairs Committee on Implementation of the ACA

"While the operation of these Marketplaces is overseen by the Department of Health and Human Services (HHS), the IRS has the limited role of providing Marketplaces with data and computational services for use in their determinations about eligibility for financial assistance.... The IRS, through this computational service, provides the Marketplace with a single figure: the maximum advance premium tax credit for which the applicant may be eligible based on those data inputs.... During the 2015 open enrollment period, the IRS processed more than 25 million requests for federal tax return data and more than 17 million computational requests, with an average IRS response time of less than five seconds."  MORE >>

Text of Veterans Affairs Rewrite Project: Compensation and Pension Regulations

"The Project responds to a recommendation made by the VA Claims Processing Task Force in [October 2001] .... and to criticisms by the U.S. Court of Appeals for Veterans Claims. The Task Force recommended that VA reorganize its regulations in a logical, coherent manner. The Court referred to the current regulations as a 'confusing tapestry' and criticized VA for maintaining substantive rules in its Adjudication Procedures Manual ... Although VA does not intend to complete this rulemaking in the near future, we request public comments on the consolidation of the prior proposed rules ... and on the changes made to those proposed rules."  MORE >>

Coalition Comment Letter to Office of Information and Regulatory Affairs, on Default Electronic Disclosure by Employee Pension Benefit Plans Under ERISA (PDF)

"Instead of carefully considering how to make the disclosures more useful for participants, we believe DOL bypassed this goal and went straight to a proposed rule to mandate e-delivery as the default method of delivery for these critical documents.... The experience with online access of Social Security benefit statements and the proxy voting process for investments regulated by the SEC are but two examples showing steep declines in readership and participation following conversion to online distribution."  MORE >>

Testimony of SEC Chairman to Senate Committee on Banking, Housing and Urban Affairs: 'Oversight of the SEC'

"The SEC's mission to protect investors, maintain fair, orderly and efficient markets and facilitate capital formation is deeply engrained throughout our offices and divisions.... [O]ur analysis starts and ends with the long-term interests of the Main Street investor; or as I call them, 'Mr. and Ms. 401(k).' At a time when greater responsibility is shifting to Main Street investors to save for their own retirement, I am confident that this is the correct metric for our analysis of success in meeting our tripartite mission. If Mr. and Ms. 401(k) are able to invest in a better future, then the SEC is serving them and our markets well."  MORE >>

Joint Letter to Office of Information and Regulatory Affairs on Proposed Update to Mortality Tables (PDF)

16 pages. "A thorough economic analysis is needed, with a focus on at least these four major issues: [1] The need for an 18-month deferred effective date. [2] A review of the speculative assumption that mortality will improve on average 1% indefinitely. [3] The introduction of unprecedented volatility into the mortality tables. [4] The erroneous assumption that Treasury must rely on tables prepared by the Society of Actuaries given that an expanded reliance on other sources is statutorily permitted and very much warranted from a practical perspective. There is a need for an announcement immediately that the new mortality tables will not apply for plan years beginning in 2018."  MORE >>

Testimony of IRS Commissioner Koskinen Before the Senate Homeland Security and Governmental Affairs Committee on Implementation of the ACA

"The IRS has been charged with implementing the numerous tax-related provisions of the ACA. This testimony will focus on two major provisions that took effect last year -- the premium tax credit and the individual shared responsibility provision. In preparation for the 2015 filing season, the IRS did substantial work to ready our business processes and systems to facilitate return filing and compliance with these two provisions, and to ensure that taxpayers would know how these two provisions would affect them at tax time.... [A]ll the work the IRS has done and continues to do to implement the major tax-related provisions of the ACA has occurred in the absence of funding that had been requested for this effort."

MORE >>

New York City Department of Consumer Affairs Provides Guidance Regarding the Earned Sick Time Act

"Under the rules, any sick leave policy must be in writing and must meet the following requirements: Minimum daily increment ... Advanced notice ... Medical documentation ... Employee verification ... Front-loading ... Payout of unused sick leave ... Donation of unused sick leave ... Other leave policies."  MORE >>

In the UK, DB Industry Calls Time Out on Its Love Affair with Equities

"[O]ver the next 12 months, 41% of UK pension schemes expect to reduce their exposure to UK equities, with 28% planning a reduction in allocations to global equities throughout 2013. However, some pension schemes said that they see equities as a buying opportunity indicating the traffic is not all one-way."  MORE >>

Generation Y Facing Retirement As Go-It-Alone Affair

"Roughly between 18 and 34 years old, [Generation Y's] table is wobbling on its last two legs: a job and a 401(k), which are co-dependent. Thus instead of protection, Gen Yers have inherited a great deal of pressure. More than ever, they know they better be employable, and they better be skilled 401(k) investors. The trouble is, it is quite difficult to do this when faced with high unemployment, and ever-higher student loan debt."

MORE >>

Text of American Academy of Actuaries Testimony at Governmental Affairs Hearing on DB Plans (PDF)

17 pages, 9/15/2003. Testimony of John P. Parks, EA, FCA, MAAA, MSPA. (!)  MORE >>

American Benefits Council Says Pension Bill Deters Plan Sponsorship and Puts Plans Into Domestic Affairs (PDF)

Excerpt: S. 2707 would fundamentally change the way defined contribution plans (such as 401(k) plans) operate. It would impose on these plans the complicated spousal consent regime ... S. 2707 would upset the carefully developed QDRO regime by requiring employers to obey court orders that are (1) issued subsequent to divorce proceedings, (2) may not originate from the same court that considered the divorce and the original QDRO, and (3) do not follow the QDRO format.

MORE >>

Defined Contribution Health Insurance Products: Development and Prospects

From the Jan./Feb. 2002 issue of Health Affairs. Excerpt: In this paper we contrast several [Defined Contribution Plans, or DCPs] with respect to their characteristics and development processes ... The DCPs generally agree with this assessment and believe that they need to diffuse rapidly over the next three to five years, or they will be preempted by look-alike products offered by existing health plans. They have several factors in their favor.

MORE >>

Implementing Health Reform: Data Hub Security and Other Issues

"The hub will verify data provided by applicants against information in existing and secure federal and state databases, such as those of the [IRS], [SSA], the Department of Veterans Affairs, Medicare, and others. It will provide one highly secure connection to these databases rather than requiring each exchange to set up its own connections. The hub has several levels of protection to mitigate security risks. It employs a continuous monitoring model to rapidly identify and take action against irregular behavior and unauthorized system changes that could indicate a potential incident."  MORE >>

The BPC Health Care Reform Plan: A Response to Coulam, Feldman and Dowd

"We commend Robert Coulam, Roger Feldman, and Bryan Dowd for bringing attention to competitive bidding in Medicare ... However, we believe the authors missed the mark in their recent Health Affairs Blog analysis of the Bipartisan Policy Center's (BPC) proposal. Most notably, they failed to consider the political realities surrounding competitive bidding.... We believe the BPC approach provides a stronger means to achieve key goals of premium support -- increased competition and promoting the creation of more integrated systems of care -- by not focusing exclusively on competitive bidding and including other significant reforms."  MORE >>

States Are Exceeding Their Health Care Cost Growth Targets. What Does It Mean?

"[E]ight states ... have taken an important first step by developing and maintaining health care cost growth targets. However, these programs demonstrate that while targets and transparency can reveal the sources of spending growth, complementary policies are necessary to meaningfully bend the cost curve."  MORE >>

Dynamic Copay Health Plans, AI-Enabled Price Transparency, and Member Experience

"[N]ew emerging 'dynamic copay' plans ... translate negotiated price variation into provider- and service-specific dollar copays displayed pre-service, often through app-based tools ... [The authors] examine the operational pre-requisites for 'copay integrity,' likely effects on out-of-pocket (OOP) predictability and spending in light of peer-reviewed evidence on tiered designs, and the constraints imposed by health insurance literacy ... [P]airing dynamic copays with reference pricing, layered onto a tiered network, may better address these limitations by strengthening steerage, improving OOP predictability and aligning member shopping incentives with higher-value care."  MORE >>

National Health Care Spending Increased in 2024 as Utilization Remained Elevated

"Health care spending in the US reached $5.3 trillion and increased 7.2 percent in 2024, similar to growth of 7.4 percent in 2023 ... As in 2023, the use and intensity of health care goods and services continued to grow rapidly in 2024, particularly for hospital care, physician and clinical services, and retail prescription drugs.... Health care spending growth continued to outpace overall economic growth in 2024, and as a result, the health care share of the economy increased from 17.7 percent in 2023 to 18.0 percent in 2024."  MORE >>