January 27, 2010

This Week in Health Reform–Federal Legislative Overview

House and Senate
Republican Scott Brown’s victory over Massachusetts Attorney General Martha Coakley (D) in the January 19 special election to fill the seat of the late Senator Edward Kennedy (D) is proving to be a game-changer for the health care reform debate.   It is now unclear what Democrats can do to pass President Obama’s most important legislative agenda item.   Even though the Democrats held a majority in the House and Senate this year, they failed to coalesce around a strategy to pass this legislation.   Initially after Brown’s win, there were two options under discussion for moving forward on the current legislation.

Have the House take up the Senate-passed bill and use the “reconciliation” bill process to “fix” several of the provisions the House finds unacceptable (e. g. , the “Cadillac” tax, etc. ).   If the House passes the Senate bill, it will go directly to the President for his signature, with no further action needed in the Senate.   A “reconciliation” bill, which would need only 51 votes in the Senate, could be passed either in tandem with the Senate bill or follow soon after.
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Scale back the health care reform bill. A scaled-back bill could include health insurance reforms, exchanges, as well as several other provisions and possibly could attract bipartisan support.   While many Democrats are likely to view this approach as a major lost opportunity, leadership may determine this is the most viable approach.

However, Speaker of the House Nancy Pelosi (D-CA) publicly stated on January 21 that the House does not have the 218 votes needed to pass the Senate version of the health care reform bill, which takes option number one (above) off the table.

While numerous private discussions are reportedly being held on the matter, at the outset it seems that Democrats’ only option for keeping the current legislation alive is to reach across the aisle to their Republican counterparts, most notably, moderate Senator Olympia Snow (R-ME).   That would mean a more conservative bill, which could anger rank and file Democrats who are supportive of the legislation.

Although no plans have emerged for how to move forward, it now looks like Democrats will have to modify their plans.   On the night of Scott Brown’s win in Massachusetts, Rep. Anthony Weiner (D-NY) – one of the biggest proponents for a single-payer health care system – said: “The only way to go forward is to take a step back. If there isn’t any recognition that we got the message and we are trying to recalibrate and do things differently, we are not only going to risk looking ignorant but arrogant.   I don’t think it would be the worst thing to take a step back and say we are going to pivot to do a jobs thing,” and include elements of health care reform in it, he said.

Rep. David Camp (R-MI), Ranking Member on the House Ways and Means Committee, declared Democrats’ health care overhaul legislation “dead” and said that instead of full-scale change Congress should take a “first step toward comprehensive reform” of the nation’s health care system.

Issue Overview: Nebraska Medicaid Deal
While key elements of the health care reform legislation remain in flux, the Congressional Budget Office (CBO) released its cost estimate of the expansion of the State of Nebraska’s Medicaid Deal, negotiated by Senator Ben Nelson (D-NE) who then voted for the Senate’s Patient Protection and Affordable Care Act, HR 3590.

The letter responds to a request from Rep. Paul Ryan (R-WI)), Ranking Member, House Committee on the Budget, asking if the cost estimate of the Senate health reform bill would change if all states received the same level of federal assistance for Medicaid as Nebraska receives under the bill.

The CBO stated on January 21 that the net spending for the Senate legislation would increase by $35 billion over ten years if all states received the same level of assistance as Nebraska.

Under the Senate’s provisions, non-elderly individuals with incomes below 133 percent of the federal poverty level would be eligible for Medicaid beginning in 2014.    The federal government would pay the cost of covering newly eligible enrollees through 2016; and federal spending would be about 90 percent by 2019.   The Senate legislation states that it would pay all Medicaid expansion costs to Nebraska beginning in 2014.

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One cannot deny the importance of having a health insurance in today’s times where incidences of illnesses and diseases are constantly on the rise. This is applicable for all regions around the world and Texas is no exception. This need to have a health insurance becomes even more essential if you are forced to visit any doctor for an illness of any magnitude or nature and are unable to pay the medical bill. Once you realize the importance of procuring cheap health insurance Texas for you and your family, you must do some research in terms of the best Texas health insurance quotes that are provided by insurance companies in this region.

It is true that every health insurance policy has its own set of advantages and disadvantages. It is quite difficult to find something that would be the ideal choice for you and your family. Yet it always better to make an informed decision rather than an ignorant one. If you are looking for the best Texas health insurance quotes in order to procure cheap health insurance Texas, you should first know that are two basic plans or policies for health care that you can consider opting for. These are broadly classified into the ‘Fee-for-Service’ plans and the ‘Managed Care Health’ plans.

The plans falling under the category of Managed care essentially function through a network of reputed doctors. This entails that you will receive medical coverage if you visit any hospital or doctor that is mentioned in the list of this plan’s network. On the other hand, the plans belonging to the category of fee-for-service or indemnity plans, give you the liberty to visit any hospital or doctor of your individual choice or preference. These plans are more expensive but provide greater flexibility to the patients. Thus, before obtaining Texas health insurance quotes in order to locate cheap health insurance Texas, you should select the type of insurance that will suit you best.

To obtain cheap health insurance Texas, you can also consider ordering Texas health insurance quotes online. If you do some research online, you will find countless websites that advertise prices and quotes of different heath plans that their company offers. You will not only find details about the various prices and plans, but also be provided with guidance in terms of the most feasible and suitable option for your individual requirements. You can consider ordering brochures of the best insurance companies and make a comparison between their co-payments, deductibles, coinsurance, premiums, preventive care, diseases they seek to cover and the coverage that they will provide in the case of prescription drugs.

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Health Savings Accounts offer tax deductions for medical expenses, and the opportunity to set up an additional retirement account. But regardless of any other positive benefit of HSAs, lower premiums are the primary reason that thousands of Americans have chosen Health Savings Accounts as the best way to protect their family’s health and assets. Here are some key suggestions on how to keep your health insurance premiums low.
1. Choose an HSA-qualified plan for lower rate increases.
Average group health insurance premiums rose by 9. 6% last year and rose over 10% for each of the previous six years. Individual plans went up even more. Yet it is expected most HSA plans will experience much lower rate increases. A very large study was recently published showing that rate increases over the past year for consumer-driven plans such as HSA plans was only 3. 4%. Blue Cross of Minnesota has reported that its HSA customers spent 8% less than their traditional insurance clients. Humana has reported claims’ costs of 4. 9% for consumer-driven plans, versus a 19. 2% increase in claims for other plans. In fact, average HSA premiums for individuals have actually dropped 19. 5% over the last two years.

The reason these plans have lower rate increases is that people who have HSA-qualifying high-deductible health plans are likely to pay closer attention to costs, and take better care of their health. For instance, an HSA owner offered a statin drug to lower her cholesterol may be more likely to request a generic version, or ask her doctor if inexpensive nutritional supplements such as niacin or fish oil may be a solution. These actions save the insurance company money and should result in lower rate increases.
2. Raise your deductible as your HSA account grows.
When you fund your account you build up a financial “cushion” which allows you to raise your deductible as your account grows. Every time you raise your deductible, your premium should go down.
By the way, don’t forget that every time you fund your account you get an instant tax-deduction. When you offset the tax savings against your premiums, you’ll find your net cost for an HSA plan can be very low.
The maximum allowable contribution goes up every year with the rise of the Consumer Price Index. Currently, the individual contribution limit is $2,700, and the family limit is $5,450. So each year you can deposit greater amounts into your HSA and continue to raise your deductible, if you choose.

3. Stay healthy, so you can switch plans.
All health insurance plans have rate increases, and weve even seen premiums jump on some HSA plans. If a rate increase happens to you, you can switch to a different insurance company but only if you pass their underwriting requirements. If chronic disease develops, you may be stuck with your current plan, and its accompanying rate increases, for eternity. Or at least it may seem that long
If you pay attention to the pharmaceutical commercials, you learn lifestyle really has nothing to do with disease, and it is natural and healthy to be on many medications for the rest of your life, which will then solve your health problems.
If you pay attention to the science, you know the truth is quite different. It appears lifestyle is probably 95% of the picture, and we know the occurrence of degenerative disease can be dramatically reduced and even prevented.
Fortunately, most HSA owners are interested in health, wellness, and disease prevention. After all, theyre paying for their own doctor visits if they do get sick. HSA owners are also “forward thinking” people, and like to plan for their future both financial and physical. You can improve your odds of excellent health with just a few key habits:
Eat very high quantities of fresh vegetables and fruits. Shoot for 35% of your calories. This will lower your risk for diabetes, high blood pressure, heart disease, cancer, and much more.

Limit your intake of sugar and starchy carbohydrates like bread and pasta. The majority of health problems in the U. S. are related to metabolic diseases that involve insulin resistance.
Exercise and lift weights. Exercise guru Jack La Lanne turns 93 on September 26, and he says if you have muscles you never feel old.
4. Compare your plan to other available plans at least once a year, or whenever you get a rate increase.
Often-times people keep their plan much longer than they should, and end up paying too much. If your rates go up, you should compare a wide variety of plans to determine if you are in the right plan for your needs and budget.
By using these four strategies, the typical family can save thousands of dollars in health insurance premiums and still protect themselves against unexpected major medical expenses.

Below are a few insurance companies that have done a great job setting up specific health insurance plans that will fit the needs of health_insuranceresidents within the State of Ohio.

Blue Cross Blue Shield of Ohio:-The (BCBSA), Blue Cross & Blue Shield Association, is the national federation of thirty-nine independent, locally operated Blue Cross / Blue Shield companies. The (BCBS) of Ohio online resource offers loads of information including the ability to obtain quotes, physician searches and information packed webinars. This company is also one of the top 100 employers in Ohio. With this being said the Blue Cross and Blue Shield has made a significant employment impact in Surrounding Ohio cities including Akron, Cincinnati, Canton, Cleveland, Columbus, Toledo, Dayton and Youngstown. With well over 6,000 insurance Agents in the state of Ohio, you will have no problem finding answers to any health coverage related questions you may have.

Humana One Insurance:-Humana One’s online resource has a user friendly interface with the, “Plan Pointer”, a tool to help you locate the right health insurance plan for you. Humana One has networked physicians statewide.

Golden Rule of Ohio:-Health Insurance by Golden Rule of Ohio provides both health and dental health plans available to residents within the State of Ohio. Golden Rule in Ohio also offers (HSA’s) health saving accounts. Golden Rule also has health agents and a wide variety of networked physicians Statewide as well as nationwide.

Other Health Option for Ohio Residents:-Sometimes existing conditions can be a pain when searching for a health insurance plan that can fit your personal needs. There are State subsidized programs available for uninsurable individuals. In June 2005, Ohio completed their high-risk pool feasibility study. While these particular health plans to develop the high-risk pool are still in an active state, the pool itself may not be fully completed until 2011 or later.

For almost 35 years, the law of the land has been an explicit prohibition against federal taxpayer dollars being used to pay for elective abortions, known as the Hyde amendment, after the late great Illinois congressman. This is a policy supported by the majority of the American people.

In fact, this hard-fought explicit ban was included in the health care bill that passed the House last year. Regrettably, the Senate did not follow suit and instead passed a bill that would allow hard-earned taxpayer dollars to pay for elective abortion. That is a simple fact. Unfortunately, in a mad rush to secure enough votes, leading House Democrats now intend to take up the Senate-passed bill, arguing that the Senate language prohibits federal funding of abortion. Besides that fact that this simply not true, it also demonstrates the lengths the president and his allies will take to pass this bill against the will of the American people.

Just this week, Cardinal Francis George, president of the U. S. Conference of Catholic Bishops, issued a statement saying, “Notwithstanding the denials and explanations of its supporters, and unlike the bill approved by the House of Representatives in November, the Senate bill deliberately excludes the language of the Hyde amendment. It expands federal funding and the role of the federal government in the provision of abortion procedures. “

First, the Senate bill allows elective abortions to be offered through the newly-created individual state health insurance exchanges and multi-state health plans administered by the Office of Personnel Management (OPM), and through federally-subsidized plans in already-existing community health centers.

Second, there is nothing in this legislation that requires any of these programs to live up to both the spirit and letter of the Hyde amendment that Congress has included each year in spending bills that fund the government. This not only prevents federal funding of elective abortions, but also erects an iron-clad firewall against any private money for abortion being mixed with any federal or state health program receiving federal dollars. This applies, for example, to Medicaid, a health program for the economically disadvantaged that is funded by both federal and state governments. If any resources are used for elective abortions that money must be kept completely separate from Medicaid. This is sound policy that must be maintained.

Regrettably, the Senate-passed bill doesn’t include this firewall. Anyone who doesn’t earn enough money would qualify for a federal subsidy to help pay for their health plan in the state exchanges, including plans offering elective abortion coverage. Some argue that under the Senate-passed bill, federal funding would be “segregated” so no federal money would pay for abortions. But this is a violation of the Hyde amendment, which also prevents the federal funding of insurance that covers elective abortion.

Furthermore, it is entirely possible that there would only be one health plan in any given state that does not include elective abortion. And even if you are opposed, you may well be railroaded into choosing a plan that covers it, because you might be looking for the best plan to treat a sick child or your own health condition.

What’s more, passing a new state law is the only way an individual state could truly ensure that elective abortions are not included in the plans offered through a state insurance exchange. That would be easier in some states than in others, but that’s unfair to those who are morally opposed to federal funding of abortion and happen to live in states where passing such a law would be extremely difficult.

Lastly, under this proposal, community health centers would receive a dedicated stream of money outside the annual congressional process to fund the government which is where the Hyde prohibition is maintained. So that means that for the first time federal money could be used to fund abortion at a community health center.

Those are the facts, and anyone who thinks the Senate abortion language is strong enough should think again. That is because, regardless of one’s position on this controversial issue, it is entirely reasonable to expect that a person who is fundamentally and morally opposed to abortion should not have to sanction its use with their hard-earned tax payer dollars.

Q: What is home health care?
A: Home health care is a service that permits patients to receive personalized health care, maintaining their quality of life in the privacy and comfort of their homes.

Q: Why home health care?
A: Home health care is a cost-effective option for receiving health care services. Returning to one’s home and family can quicken recovery and improve the quality of life for both patient and family or caregiver.

Q: Who pays for home health care?
A: Most health insurance companies, HMOs, PPOs and Workers Compensation cover home health care. In addition, Medicare and Medicaid pay for home care services. Some insurance providers do not cover all home health services. Our staff will verify health coverage for the patient.

Q: What criteria are required for Medicare to approve services?
A: The following criteria are used to meet Medicare requirements:
• The patient is a Medicare recipient.
• The patient must be homebound. This is defined by Medicare as “normal inability to leave the home and that leaving the home requires considerable and taxing effort. ”
• The skilled care must be medically necessary as determined by the physician.

Q: What if I have a problem at night or on the weekend?
A: We have registered nurses on call 24 hours a day, 7 days a week.

Q: Do I need a physician’s order for home health care?
A: Yes, all health care provided in the home occurs under direct order and supervision of the patient’s physician.

Q: What types of services can be provided at home?
A: Many medical conditions that previously required hospitalization can safely be treated in the home. Home care services may include but are not limited to:

Skilled Nursing:
• Observation and assessment of condition
• Patient and family education of disease process
• Management and evaluation of patient care plan
• Medication education and management
• Dressing changes
• Home safety education
• Wound care
• Catheter care
• Injections
• IV therapy
• Ostomy care
• Pain management
• Diabetic care
• Nutritional support

Assistance with Daily Living:
• Bathing/dressing
• Transfer/ambulation
• Light meal preparation
• Light housekeeping
• Grocery shopping
• Medication reminder
• Laundry
• Companionship/Conversation
• Reading/writing
• Pet sitting/walking
• Escort to appointments
• Live-ins
• Respite
• Exercise therapy assistance

Q: How does Paloma Home Health Care, Inc. ensure quality care in the home?
A: Providing continuous quality care to patients is paramount to all we do. All patients are given a patient satisfaction survey that is incorporated into our ongoing evaluation process to continually increase our patient satisfaction. New programs and processes are developed through our quality improvement team to promote favorable outcomes.

Q: How do I find out more about home health care?
A: Please call our office to learn more about how you can benefit more about the service, at 972 346 2013

Q: What services can Paloma Home Health Care, Inc. offer?
A: Our services include but are not limited to:
• Supportive Care Education of Disease Process
• Individual and Family Counseling
• Management and Evaluation of Patient Care
• Observation and Assessment
• Home Safety and Emergency Education
• Medication Education
• Assistance with ADLs
• Nutrition Education
• Restorative Therapy (Physical, Occupational and Speech)

Week of January 25, 2010

The sudden halt to health care reform’s steady march forward came as a shock to many who saw an upset win by Republican Senator-elect Scott Brown in Massachusetts as all but impossible. But if many took delight in the election outcome’s impact on health reform legislation, Aetna Chairman Ronald A. Williams made it clear in a New York Times story last week that the country still needs meaningful health care reform – reform that addresses access as well as affordability. Everyone benefits by health reform that gets at the factors driving soaring health care costs and the loss of coverage for so many Americans. While Congress thinks carefully about its next steps, Aetna will continue to support meaningful health care reform and continue to offer responsible solutions to legislative leaders.

Federal

The election of Republican Scott Brown as the new senator from Massachusetts has derailed the Congressional health care reform train, less because Brown denies Democrats the 60th filibuster-proof vote, though that is certainly a major result, and more because it collapsed the Democratic political house of cards by highlighting the power of independent voters and the frustrated anti-incumbent mood of the electorate. Whether Democrats can regroup from this wake-up call will consume their leadership from now until the November off-year elections. How Democrats handle, and how Republicans respond to, health care reform in the short term and other key priorities – such as jobs, the economy, energy and security – over the rest of the session will underscore all Congressional decisions from now until the first Tuesday in November. In short, the 2010 elections started in earnest with Brown’s victory.

Once Democrats get past the shock of losing Kennedy’s seat, they will have to grapple with health care reform, one way or the other. The early favorites, including passing the Senate bill “as is” in the House, have been dropped for now as Democrats recognize the political cost of ramming through something unpopular propelled by political muscle only. Passing a smaller, less invasive and mostly Democratic bill has only a slightly better chance, as Republicans are not too likely to “crossover” quite yet. There is a growing interest in using reconciliation (the 51-vote tactic) down the road to pass a Democratic-only bill, once the House and Senate Democratic leadership can agree to a single bill. And, there is the outside chance that Democrats will see the Massachusetts election as an imperative to craft a bipartisan bill with Republicans that can secure 70-plus votes in the Senate. Wednesday’s State of the Union speech, followed by the party issues retreats later in the week, will go a long way toward determining which path will be pursued.

As you review the different health care options available in Georgia, you’ll note that there are options from several major national providers. In reviewing pros and cons, you’ll want to make sure your choice is financially sound, ranks well, and provides access to the health care professionals or organizations that you prefer. Another method for choosing well is to review ratings from third parties. US News and World Report recently ran rankings of some of the health insurance providers who operate in Georgia; they evaluated responses from consumers, physicians, and their own reviewers to come up with ratings and scores

United Health Plan performed fairly well, just two-tenths of a point behind their competition, Aetna, on the ratings report, with an overall score on a 100 point scale of 82. 3. Like the national competition in Gerogia, United Health has NCQA accreditation; this means that they’ve gone through a rigorous screening process to meet 60 separate standards checks and must annually renew and prove that they are meeting increasing tough standards of quality in order to retain this prestigious distinction. Think of the NCQA as the “Good Housekeeping” seal of approval, for insurance plans. For more information on NCQA, an independent not-for-profit group, visit their site—ncqa. org.

United Health Care performed particularly well with regard to treatment options—specifically, for asthma medication and treatment. They have strong support for other treatment needs as well (mental and behavioral health, alcohol and/or drug awareness, and testing for children and adolescents). The balance of their scores were average or above average, in most categories.

One of United Health Care’s biggest initiatives on a national level—especially relevant for Georgians who live in rural areas or who may not have access to every specialty, within their local area, is a new partnership with Cisco to present “Connected Care”. Connected Care takes advantage of technology to offer access to health care providers and resources online, in a one-on-one format, with secure conversations possible between patient and doctor (minus the office visit). There is an accompanying mobile access clinic (again, to increase access in rural communities) and the initiative, just launched, is gaining momentum. Imagine—being at work, and being able to spend  5 minutes one-on-one chatting with your doctor about a problem or question—without taking 90 minutes from your day to drive to the doctor, wait, meet with him/her, drive back…online access means quick answers, less worry, and better communication. And access to specialists in faraway places is that much easier.