SPECIAL SECTION: Health Insurance Reform This page provides answers to frequently asked questions (FAQ) regarding the The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148) and Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) and the vital role of state insurance departments in protecting insurance consumers. Health Care Reform Frequently Asked Questions (FAQ) Consumers | Employers Looking for a Quick Straightforward Explanation of What Health Care Reform Is All About? Kaiser Family Foundation video (9 mins) explaining challenges with the current health care system, the changes taking place now, and the changes coming in 2014 (posted with permission from Kaiser Family Foundation) When will the health care reform law take effect? The health insurance reforms adopted as part of the Patient Protection and Affordable Care Act (PPACA), and the subsequent reconciliation bill, are phased-in over 5 years. Will I be required to give up my current coverage? No. How will my benefits be impacted by the law?
HHS Clarifies Women's Preventive Health Safe Harbor Bulletin August 17, 2012 On August 16, 2012, the Department of Health and Human Services (HHS) clarified its February 10, 2012 bulletin outlining a safe harbor until August 1, 2013 for certain non-profit employers to comply with the preventive care women's health amendment. As part of the Patient Protection and Affordable Care Act (PPACA), affected employers are those who, based on religious beliefs, do not currently provide contraceptive coverage in their health plans, but do not qualify for the full exemption. In particular, HHS clarified: * The updated bulletin is available on the Department of Health and Human Services' Center for Consumer Information and Insurance Oversight (CCIIO) website.
Mayo opposes key health reform provision The Mayo Clinic says it will not be part of a critical piece of national health care reform under the government's proposed rules. The prestigious Rochester clinic is raising questions about accountable care organizations, or ACOs, which are supposed to be updated -- and better -- versions of health maintenance organizations. Approved as part of the 2010 health care law, they are designed to improve care and cuts costs by over half a billion dollars a year. But Mayo says the proposed regulations from the federal Centers for Medicare and Medicaid Services (CMS) conflict with the way it runs its Medicare operations, which treat about 400,000 patients a year. Dr. At this point, Mayo's reluctance to be part of a crucial piece of health care reform is predictable, said Elliott Fisher, director of population health and policy at Dartmouth Institute in New Hampshire. "Every affected stakeholder said it's not good enough yet," Fisher said. CMS declined to comment on Mayo's concerns.
Health Care Reform Impact: More Insured Americans Compared to 18 Months Ago, BusinessOne Technologies, Inc., Reports BENSALEM, Pa.--(BUSINESS WIRE)--Health insurance expanded to cover nearly 13 million more individuals in June 2012 compared with 18 months prior, according to new research from BusinessOne Technologies, Inc. This 5.4 percent increase in total managed lives between Jan. 2011-June 2012 is due in part to already-implemented health care reform measures that are driving greater access to health care and prescription drugs ahead of the 2014 “individual mandate” roll-out. “The combination of health care reform and a sluggish economy will have a dramatic effect on the movement of lives to state insurance exchanges, Medicaid and Medicare. These measures include dependent-child coverage up to age 26, small business tax credits, and early Medicaid expansion by some states. Managed Lives Trends in the Current Health Care Reform Environment is the third in BusinessOne’s series of annual managed lives trend reports. Among the top 10 states in insured lives by channel:
Health Care Reform Update | Consumer Reports A set of rules that take effect Jan. 1, 2014, will make shopping for health insurance a completely different experience for those who buy it on their own—or are uninsured today. These are the biggies: Guaranteed issue. Health insurance marketplaces. It’s expected that most consumers will shop on their state’s marketplace online, but they can also shop by phone, through brokers, or with the personal assistance of trained helpers called Navigators. Individual subsidies. For instance, a family of four with an income of 200 percent of poverty, or about $46,000, will pay no more than $235 a month for health insurance. Individual mandate. Penalty. Because the vast majority of people will already have qualifying health insurance, few will confront the choice of buying a plan or paying a penalty. Medicaid expansion.
When the Affordable Care Act Becomes Unaffordable The New York Times reports that U.S. President Barack Obama's administration is encouraging Republican-led states to follow Arkansas’s lead and use Medicaid expansion dollars to buy private insurance for people with low incomes. This is going to make a lot of people happy. But it's not good for taxpayers or for the project of making medical costs sustainable. Many Republicans are drawn to the Arkansas plan because, though it is an expansion of government-funded health care, it works through private channels. The only losers will be everyone else. If the administration starts letting other states take the Arkansas route, it’s hard to see how we don’t end up with a privatized Medicaid expansion in 50 states, for the same reason that some sort of Medicaid expansion in every state is inevitable. Now, maybe that will make the plan moot. The appeal of privatized Medicaid won’t be limited to red states. It’s even possible that privatized Medicaid is a good idea.
The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice Why is state health and human services spending growing so fast? Getting a grasp on state budget numbers is at least as mind-boggling for most of us as trying to understand just how far Earth is from the sun -- 93 million miles, btw. Which should make it no surprise that Gov. Mark Dayton’s current request for $11.5 billion for health and human services over the next two years had state House Speaker Paul Thissen gasping, “It’s going to swallow up our entire budget,” and DFL leaders in both the House and Senate wanting to downsize the number by $150 million. The HHS budget aids the needy, providing such services as food assistance, health care and childcare. Thissen talked of serving the poor and the vulnerable but finding “reforms” and “efficiencies in the system” and worried the HHS budget was growing too quickly to keep up with revenues coming in. Such comments left Republicans like Rep. The 2012-2013 HHS biennium budget tallies at $10.65 billion and HHS expenditures make up the second-largest budget category after education. “They have to,’’ he said.
Obesity and health-care reform: Public vs. private responsibility Obesity and health-care reform: Public vs. private responsibility Since everyone has been paying for everyone else's healthcare for decades now through the constantly increasing insurance premiums that gave us an unsustainable Cadillac healthcare system, don't you think that all these intrusive steps taken to reduce the need for healthcare are just a smoke screen for the out of control healthcare bubble? Sure, you can reduce your cost of gasoline by never using your car, just like you can reduce your cost of healthcare by never needing it; but then why even have it? Morgan Downey : We all need or will need health insurance. – September 21, 2010 12:02 PM Public schools -- any hope for renewed focus/effort from them? Congress is working on an expanded school lunch bill to encourage better lunches. – September 21, 2010 12:04 PM BMI is Ridiculous The "science" underpinning this entire discussion is incredibly flawed. The BMI is a great tool but mainly for population-level assessments. Sure.
Replicating Cleveland Clinic's Success Poses Major Challenges Like The U.S., Europe Wrestles With Health Care : Shots - Health News hide captionA patient is treated at the Nord Hospital in Marseille, France, in February. European countries have also been engaged in intense debates on the future of their health care systems, where universal coverage is the norm. Anne-Chrisine Poujoulat/AFP/Getty Images A patient is treated at the Nord Hospital in Marseille, France, in February. European countries have also been engaged in intense debates on the future of their health care systems, where universal coverage is the norm. The U.S. has been absorbed by the Supreme Court case this week on the future of health care. Several European nations, where universal health care has been the norm for decades, have been waging their own intense debates as they also deal with aging populations and rising costs. Britain passed a new health care measure earlier this month, after more than a year of rancorous debate. Ham is the chief executive of The King's Fund, an independent health policy think tank in London. The British Debate
Top 10 Healthcare Quality Issues for 2011 Here are the top quality challenges healthcare providers will face in 2011—many, such as imaging exposure effects, central line infections, and medical data breaches dominated headlines in 2010. 1. Imaging Scan Radiation Exposure and Overutilization This issue caught the number one spot for several reasons. Concerns about overutilization of imaging involving radiation, especially the use of CT, have been snowballing over the last two years. In July, David J. "Radiation exposure from medical radiographic imaging is comparatively unregulated; this is in striking contrast to radiation exposure in occupational settings, which is stringently regulated despite it contributing a far smaller population exposure," he and his colleagues said in their research. They noted that the average radiation dose to which persons in the U.S. are exposed to has doubled in 30 years, and that while background doses have not changed, "the average radiation dose from medical imaging has increased more than 6-fold."
Modern Healthcare: Are medical homes worth the investment? Droves of providers and payers are setting up patient-centered medical homes—but Modern Healthcare's Andis Robeznieks notes that there's limited evidence that the models effectively reduce costs and improve care. Long-term investment or not worth the investment? Transforming a practice into a medical home can be a costly investment—requiring new staff and new electronic health records (EHR) systems—and most research shows that the model generates only modest savings at best, Robeznieks writes. HHS's $4.1 million study into how 14 medical homes functioned found that nearly all had difficulty measuring any financial impact, and that some had unexpected difficulties, such as lowered staff morale. How do you compensate physicians in a Medical Home? Part of the problem is that it is difficult to measure the impact of medical home models in the short term, experts say. Early successes For every $1 invested in their medical homes, Geisinger reaped $1.70, according to officials.