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Healthcare Policy

Comment from thebrackpipe.com:  More fallout from Obama’s poor understanding of how businesses and economies work.

Article below by Sherrie Conroy as it appeared in MedTech Insights:

Now that the medical device tax has been implemented and device makers have already made their first payment to the IRS, the focus has turned to getting this thorn in their side repealed.  They have gained some support in that effort, and AdvaMed says that legislation introduced in the US House of Representatives shows the growing bipartisan support for repealing the medical device tax.

“The momentum from the last Congress is carrying over with a broader array of champions working to defeat this terrible tax,” says AdvaMed president and CEO Stephen J. Ubl.  “On both sides of the aisle, members of Congress know the device tax hurts our economy, kills jobs, and slows the march of medical progress needed to fight disease and reduce long-term health costs.  The medical technology industry is united in its commitment to repeal this tax and appreciates the leadership shown in Congress to continue the effort.”

Reps. Erik Paulsen (R-MN) and Ron Kind (D-WI) reintroduced the House repeal bill with more than 175 co-sponsors, including 20 Democrats.  Ubl praised Paulsen and Kind for working together on the repeal effort.  “Patients, the healthcare system, and the American economy are winners when legislators work together like this.  America’s medical technology industry looks forward to assisting in this important repeal effort,” Ubl says.

According to AdvaMed, the tax has already led to layoffs, reductions in planned facility expansions, and other cost-cutting measures, which the association blames for stunting economic growth, impeding innovation, and affecting patient care.  Studies show the tax threatens up to 43,000 jobs nationwide.

The medical technology industry helps employ more than 2 million people in the U.S., and salaries in this sector are 40 percent higher than the national average.

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Comment from thebrackpipe.com:  Hmmm, not quite sure what to think about this one.  I’m concerned that the insurance companies were so influential in getting this fee added… for employers or beneficiaries to absorb.  Thoughts?  Please comment.

Article below by Janet Adamy of the Wall Street Journal:

Employers are bracing for a little-noticed fee in the federal health-care law that will charge them $63 for each person they insure next year, one of the clearest cost increases companies face when the law takes full effect.

Companies and other plan providers will together pay $25 billion over three years to create a fund for insurance companies to offset the cost of covering people with high medical bills.

The fees will hit most large U.S. employers, and several have been lobbying to change the program, contending the levy is unfair because it subsidizes individually purchased plans that won’t cover their workers.  Boeing Co. and a union health plan covering retirees of General MotorsFord Motor Co. and Chrysler, among other groups, have asked federal regulators to exclude or shield their insurance recipients from the fee.

Insurance companies, which helped put the fee in the law, say the fee is essential to prevent rates from skyrocketing when insurers get an influx of unhealthy customers next year.  The fee is part of a new insurance landscape created by the health law that will forbid insurers from denying coverage to people with pre-existing conditions.

The $63 fee will apply to plans covering millions of Americans in 2014.  It applies to employers that assume the risk for workers’ medical bills, and many private plans sold by insurers.  The fee will be smaller for 2015 and 2016, though regulators haven’t set those amounts.

Few noticed the fee when the 2010 Affordable Care Act passed.  Employers have spent recent months trying to peel it back, but final regulations published Monday in the Federal Register left it largely intact.

“It’s caught most employers, if not all employers, by surprise,” said Steve Wojcik, vice president of public policy at the National Business Group on Health in Washington, which represents large employers.  “They’re very upset about it.”

The fee comes on top of other costs employers expect to face.  Proponents of the law say it eventually will lower employers’ health costs by expanding insurance coverage to 30 million Americans, meaning employers won’t subsidize their unpaid medical bills.

Administrators for employee health plans have warned federal regulators they could pare insurance benefits to absorb the fee.  Some benefits experts expect employers will at least partially pass on the $63 to workers.

Boeing estimates the fee will apply to about 405,000 workers and dependents it insures, costing the Chicago-based plane maker an estimated $25 million in 2014.  The company spends $2.5 billion annually on health and insurance-related benefits.

Doug Kight, a Boeing vice president of strategy, compensation and benefits, told Health and Human Services Secretary Kathleen Sebelius in a December letter the aircraft maker was “concerned about the significant cost impact” of the fee.  Among other things, he effectively asked her to reduce the levy to account for the fact that Boeing’s workers aren’t part of the insurance system that can tap the reimbursement fund.

The UAW Retiree Medical Benefits Trust, which covers 806,000 retirees of General Motors, Ford, Chrysler and their dependents, asked HHS to exempt all its beneficiaries from the levy.  It argued the trust, which is independent from the auto makers, shouldn’t face the fee because its plans operate under terms set in federal district and bankruptcy courts in 2009.

The top lobbying groups for large employers, including the U.S. Chamber of Commerce and the Business Roundtable, also voiced concerns about the fee and asked regulators to delay its collection.

In the regulations published Monday, HHS declined to whittle down the levy for firms such as Boeing, citing the law’s requirements.  It said the fee wouldn’t apply to the plans of retirees whose primary coverage is Medicare, which would exclude many retired autoworkers, but it declined to categorically exempt workers in court-structured benefits plans.

A Boeing spokesman said the final regulations don’t appear to address the major issues it raised with regulators.  A spokeswoman for the UAW trust declined to comment.

Federal regulators say they have heeded employers’ complaints about the fee and tweaked details of the program.  They opted to collect the levy nationally instead of through each state, moved the collection date to the end of next year and calculated the fee on a per capita basis instead of as a percentage of premiums.

“We’ve tried to really work with the employers and issuers in trying to make the application of this program as least burdensome as possible,” said Michael Hash, director of the HHS Office of Health Reform.

In 2014, insurers will be able to tap part of the $25 billion to offset medical costs from high-risk individual-market consumers that total between $60,000 and $250,000 a year.  Employers and other insurance issuers will pay $63 in 2014 for every worker, spouse, child and certain retirees they cover.

Of the fees collected, $20 billion will go toward paying high medical claims.  HHS says the remaining $5 billion will be used to retroactively offset an earlier program that reimbursed employers insuring early retirees through 2011.  Under that program, Boeing received $50 million and the UAW trust received $387 million, according to a federal summary of the payouts.

A Boeing spokesman said the retiree program “was not advertised as a program prefunded by the government to be paid back at a later time,” and that the law’s net financial impact on Boeing is negative.  The UAW trust declined to comment.

HHS says the high-risk program will lower premiums for people who buy plans through the individual insurance market by between 10% and 15%.  For insurance plans overall, the fee is expected to raise premiums next year by about 1%, and less in the subsequent two years of the program.

Insurance companies defend the fees, saying they will indirectly benefit employers. Companies subsidize the cost of caring for the uninsured by paying higher medical and insurance prices for workers.  Moving high-risk consumers into insurance policies will minimize that problem, they say.

These uninsured “had been the individuals going to the emergency room,” said Karen Ignagni, president of America’s Health Insurance Plans, an insurer trade group in Washington.  “The employers definitely were picking that up.”

Other health plans that tried and failed to win a federal exemption from the fee include so-called multiemployer insurance plans, which are jointly run by unions and employers.  About 20 million Americans are covered by such plans.  Federal regulators told these plans they lacked the authority to exclude them from the levy.

Those who sought an exemption include several benefit funds covering New York home-care workers, dietary aides and nursing assistants who belong to the Service Employees International Union.  The funds, which insure 331,000 people, predict the fee will cost them $21 million next year.

Eliminating life insurance and vision benefits would offset only half the fee, the funds said in a December letter to federal regulators.  Trustees would have to eliminate the entire durable-medical-equipment benefit to come close to offsetting the additional cost.

“The funds would be bearing additional costs without gaining any additional protections,” said Mitra Behroozi, executive director of 1199 SEIU Benefit and Pension Funds, in her letter to regulators.  Through a spokeswoman, Ms. Behroozi said the fund won’t follow through on cutting benefits, and that regulators addressed some of their concerns.

The benefit fund for 1199 SEIU received $4 million from the health law’s early retiree program.  Ms. Behroozi said through the spokeswoman that “the funds will still pay millions of our members’ dedicated health-care dollars in fees to the individual health-insurance market that would otherwise be used for their own coverage.”

Justices in the Supreme Court’s conservative majority said Wednesday it would be difficult to figure out which parts of the Obama health-care law should survive if one part of it is judged unconstitutional.

In an afternoon session Wednesday, the justices also were unexpectedly receptive to the challengers’ argument that the law’s expansion of the federal-state Medicaid program for the poor unconstitutionally coerces states to spend more on the program.

With six hours of argument complete, it was clear that the justices gave the government a hard time on multiple fronts, leaving the fate of President Barack Obama’s legislation unclear. The court’s decision is expected by the end of June.

READ FULL ARTICLE AT WSJ.COM

FULL ARTICLE HERE

“There is no technical substitute for common sense. And clever men can always use words to overpower men not as clever to show anything they want. Cleverness should serve principle, not vice versa…

Demonstrations are taking place nationwide to drive home to the American people, and hopefully to the nine Supreme Court justices, that Obamacare, passed in 2010 through procedural gymnastics, and without a single Republican vote, blatantly violates our core principles of human liberty.

One wave of protest in which I am taking part, giving a keynote address in Washington, DC, focuses on the violation of religious liberty by application of the employer mandate to provide “free” contraceptives, sterilization and abortion pills as part of health insurance.

Specifically, how can anyone who cares about fidelity to the principles of our Declaration of Independence fathom an America in which government forces religious institutions to violate their religious convictions or pay a fine?

An America in which Catholic organizations, or any religious organizations, are forced to finance the very behavior that their religion prohibits is a different America than originally founded and that the Constitution was written to preserve and secure.

No clear, honest reasoning can conclude that among the rights with which we are endowed by our Creator is a right to use government to force third parties to pay for the contraceptives of others. Particularly if this violates the religious convictions of that third party.” – Star Parker

“The irony is that had the accident occurred in Canada, her family would not be having to come up with more than half a million dollars to pay for her care,” wrote Potter, an analyst for the Center for Public Integrity. “Her care would have been covered because, unlike the U.S., Canada has a system of universal coverage.”

Huffington Post article here

Kerstin Johnsson commented:  I find this very odd. If I need health care while abroad, my private insurance covers the costs regardless where in the world I am. So, if the Canadian government is officially every Canadian’s health care provider, why then do they not cover citizens abroad in the same way? My guess — it would be far too expensive. This is yet another reason why universal health care sucks for all involved!

Of course, the liberal media ignores this significant down side to universal health care (as well as many others), opting instead to turn it into a story bemoaning the lack of universal health care in the US. Ironic indeed.

Koy T commented:  If you can afford health care, access in the US is tops. I can’t say our outcomes are the best in the world. Burke’s vertebral artery injury is a devastating condition that would likely have left her a combination of paralyzed, blind, or speechless. Potter seems to think her care would have been free. The internal cost would have been not as much as here but a nine day stay in the ICU with neurosurgical care as well as interventional neuroradiology care would have driven the cost well over 100000. Moreover, should a public good such as universal health care be held responsible for a person engaged in risky behavior? Universal health care is generally a good thing, but the US is unable to prevent gaming the system which is one of the reasons why Canada has clamped down on immigration of parents and older relatives of Canadian residents. They drive up costs without increasing tax receipts. Canadians overseas carry their own insurance for cost reasons. No government is willing to pay for health care for nonrevenue generating citizens. I think Potter wishes to make amends for his past career as an insurance executive. Potter should pick a new line of work.

Jack F. Stuart II commented:  Thanks, Andrew, for the article highlighting the worldview of the whacked. As for the clown act that authored it, he is totally out of touch with reality. The role of incentives in the marketplace — yes, even [actually, especially] the healthcare marketplace — cannot be understated. Whether Potter knows it or not, he is of a mind with the “99%, Occupy-the-Planet” crowd: he wants something for nothing. Yet another reason the U.S. is $15+ trillion in debt and counting …