Fix Health Care Policy

Labor union leaders, who are big supporters of President Obama and were big proponents of his health care reform law, want taxpayer dollars to help pay for the increase in their health care costs due to Obamacare.

There are many provisions in Obamacare that will raise the cost of insurance in both the individual and employer markets. To name just a few of these provisions: no pre-existing condition exclusions, no cost-sharing on certain preventative benefits, children can stay on their parents’ plan until they’re 26, and no cap on medical benefits.

It should surprise no one that adding benefits and restricting cost-sharing adds considerable costs to health plans.

However, it appears the unions were too busy supporting Obamacare to do the math. Unions are now asking for a reprieve from the higher costs in the form of taxpayer subsidies for their lower income workers with employer-sponsored insurance. However, the subsidies are only intended to go to those purchasing coverage in the new exchanges, not to anyone with employer-sponsored insurance.

To be clear, they want taxpayer subsidies to offset the cost of their insurance while non-union workers in the same predicament would not receive help.

This request should insult every American taxpayer. These unions are using their political clout to ask for special treatment under the law at the expense of taxpayers.

Read the rest on The Foundry…

Tags: benefits, Cadillac tax, cost-sharing, health plans, labor unions, ObamaCare, subsidies

Obamacare requires health insurance companies to produce a summary of benefits and coverage (SBC) based on a government-imposed template and glossary. Below is a sampling of the requirements (70 pages) concocted by the Departments of Health and Human Services, Labor, and the Treasury to simplify the task.

1. The summary of benefits and coverage “must be presented in a uniform format, cannot exceed four double-sided pages in length, and must not include print smaller than 12-point font.” It also must “replicate all symbols, formatting, bolding, and shading.”
2. Plans and issuers must provide the summary of benefits and coverage in a “culturally and linguistically appropriate manner.” (The government’s template and glossary are available in “Spanish, Tagalog, Chinese, and Navajo.”)
3. “The items shown on page 1 [of the template] must always appear on page 1, and the rows of the chart [in the template] must always appear in the same order. The chart starting on page 2 must always begin on page 2, and the rows shown in this chart must always appear in the same order. However, the chart rows shown on page 2 may extend to page 3 if space requires, and the chart rows on page 3 may extend to the beginning of page 4 if space requires. The Excluded Services and other Covered Services section may appear on page 3 or page 4, but must always immediately follow the chart starting on page 2. The Excluded Services and Other Covered Services section must be followed by the Your Rights to Continue Coverage section, the Your Grievance and Appeals Rights section, and the Coverage Examples section, in that order.”
4. “The footer must appear at the bottom left of every page.”
5. “The uniform glossary of health coverage and medical terms may not be modified by plans or issuers” (e.g., “Emergency Room Care” is to be defined as “Emergency services you get in an emergency room”; “Physician Services” is to be defined as “Health care services a licensed medical physician provides or coordinates”; and “Prescription Drugs” is to be defined as “Drugs and medications that by law require a prescription.” The glossary is intended to be educational in nature and the definitions may not be the same as definitions used by a plan or issuer.”)

Read the rest on The Foundry…

Tags: benefits, coverage, health insurance companies, ObamaCare, regulations

Medicare—on its current path—cannot be sustained. At a recent hearing held by the Senate Special Committee on Aging, Ranking Member Senator Bob Corker (R–TN) stressed the importance of Medicare reform. According to Corker, in 2011, “The U.S. spent $572 billion on Medicare, and spending is projected to increase to $1 trillion in 2021.”

The relationship between the amount citizens pay in to Medicare and the benefits they receive presents another losing equation for taxpayers. If an average couple combined makes $87,000 a year, they will pay $119,000 (including their employers’ contributions) into Medicare in their lifetimes but receive $357,000 in benefits. This disparity points to a clear structural flaw that must be addressed. As Joseph Antos of the American Enterprise Institute pointed out, “Business as usual with a few tweaks will not be effective in preserving Medicare for the long term.”

Saving Medicare will require transitioning the program to a premium-support system, which would allow seniors to choose a private health plan that works best for them, using a government contribution and requiring insurers to compete for their business like they currently do in Medicare Advantage and Medicare Part D. Heritage’s Saving the American Dream plan outlines how to achieve this.  (Read the rest on The Foundry…)

Tags: AARP, AEI, benefits, Medicare reform, Saving the American Dream, taxpayer subsidies