Urban Institute: ACA Will Not Cause Employer Flight from HI Coverage

Many have predicted that the ACA will provide incentives for employers, especially small ones, to drop their health insurance benefits. Not so fast says the UI:

http://healthreformgps.org/wp-content/uploads/RWJ-URBAN.pdf

Good FAQ on Selling Insurance Across State Lines

Selling insurance across state lines is a major Republican solution for those seeking affordable individual coverage. But w/o suggesting a minimum benefits package, this solution could ber just a race to the bottom.

http://www.kaiserhealthnews.org/Stories/2010/September/30/selling-insurance-across-state-lines.aspx

BCBS of MA Pushing Global Payments

This really is the major way to contain health care costs:

http://www.boston.com/business/healthcare/articles/2011/01/23/blue_cross_ceo_says_providers_must_control_health_care_costs_or_else/?p1=Well_MostPop_Emailed4

Vermont to Examine Moving Towards Single Payor

This really should be interesting:

http://www.bloomberg.com/news/2011-01-19/consultant-vt-could-do-single-payer-health-care.html

The system covering all Vermonters would provide what Hsiao called an "essential benefit package," paying at least 87 percent of each Vermonter's medical and mental health expenses and 77 percent of his or her drug expenses. He said those targets were derived from the averages now covered by private plans.

He said the system would expand coverage for dental and vision over levels offered now, emphasize prevention and primary care, and provide "financial risk protection" against catastrophic health expenditures that otherwise can cause impoverishment.

If it could clear all the hurdles listed by Hsiao and run the gauntlet of concerns sure to be raised by insurers, hospitals and others, Vermont would be the first state to adopt the sort of single-payer health care system long seen as a key goal of the American left.

First-term Gov. Peter Shumlin, who made the creation of such a system a cornerstone of his campaign, said Wednesday that he wanted a system that would "provide universal access, contain costs and treat health care as a right and not a privilege."

Shumlin was president pro-tem of the Senate when the Legislature hired Hsiao last year. In their first phone conversation, Hsiao told him he had "given up on America," Shumlin recalled.

"I told him we are Vermonters," the governor said. "We think independently. We take care of each other, and we do things that others dare not do."

Hsiao said the system he envisioned would include at least two key components:

— An independent board, set up to minimize the influence of politics and lobbying over its process, that would set reimbursement rates each year for doctors, hospitals and other health providers. The board would be made up of provider and consumer representatives who would negotiate with each other and make recommendations to the Legislature.

— A single entity to process insurance claims and adjudicate disputes. Hsiao said the state could hire a private company to handle this task or create a quasi-public agency to bid against the private ones and help keep costs low.

The Cost of Obesity in the United States

According to McKinnsey, it is $450B:

http://www.mckinseyquarterly.com/newsletters/chartfocus/2011_01.htm

Concerns About HHS' Role in Rate Review

As I noted in a previous post, HHS has determined any increase in the small or individual market 10% or more as unreasonable and therefore subject to review. Will this cause issues for health insurers? This article discussews the possibilities:

http://www.kaiserhealthnews.org/Stories/2011/January/20/insurance-mandate-health-law-repeal-expert-QA.aspx

Alternatives to the Individual Mandate

Of all the provisions of the ACA, the one that attracts the most attention and opposition is the individual mandate. Is there a better alternative? This article provides some ideas:

http://www.kaiserhealthnews.org/Stories/2011/January/20/insurance-mandate-health-law-repeal-expert-QA.aspx

My biggest concern w/the individual mandate is that many people will ignore it and just pay the minimal penalties for doing so.