As we begin a new year, Congress is starting a new session with a significant shift in power. The Republicans have gained a majority in the House of Representatives and they claim that they will repeal the Healthcare Reform Bill as one of the first pieces of legislation that they will tackle. While the Republicans can vote to repeal the Healthcare Reform Bill in the House, and they probably will, the Democrats still control the Senate and as such, any bill in an attempt to repeal Healthcare Reform will very likely not even come out of committee. Even if the Senate would pass a bill repealing the Healthcare Reform Legislation, president Obama would veto it. The Republicans don’t have enough votes in either the House or the Senate to override the presidential veto. Any actual legislation that the Republicans in the House may pass regarding the repeal of Healthcare Reform will end up being symbolic in nature. About all that any attempt to repeal the Healthcare Reform Bill will accomplish is the political goal of getting legislators to either vote for or against the repeal. This vote can then be used in political campaigns in 2012 as an issue that voters can use to help form their opinion on a specific candidate.
The real power that the Republicans in the House can wield is control over funding of any legislation. All spending bills must originate in the House, and the Republicans can withhold funding from any project or piece of legislation, if they have the will to do so. By cutting the funding for increased spending on the thousands of agents that will be required to enforce the legislation, there will not be the money in the system to enforce the provisions within the bill, and it will lose its punch.
On a related note, Jesse Jackson is claiming that since the Healthcare Reform Bill has passed the number of uninsured Americans has risen to 54 million and that insurance premiums have increased. This is the exact opposite of what it was touted to accomplish when it was passed. So, either Jesse Jackson is not telling the truth now, or the proponents of the bill were lying then. Funny how that works.
Also related to the funding the bill, Democrats are now saying that if it is repealed, then the deficit will increase even further, so it must not be repealed in order to help maintain fiscal responsibility. If this were true, then there are several serious problems! The amount of taxes raised by the legislation is greater than the increased expenditure required by the bill. Is this really what we want a Healthcare Reform Bill to accomplish?
If Healthcare Reform is designed to reduce the Federal deficit, then the bill must be taxing people more than it spends on healthcare. If the proponents of Healthcare Reform were truly interested in providing healthcare for uninsured Americans, then the bill would be revenue neutral, making is more readily defendable as humanitarian. When the bill becomes something else, (a way to increase taxes, for example) then the proponents of the bill lose some of their moral authority to promote it.
Once all the political maneuvering is out of the way over the next couple of weeks, then maybe Congress can get to work actually trying to accomplish true reform. If Congress really wanted to help Americans afford healthcare, then it needs to address the following conditions within the healthcare industry.
- Tort reform to reduce defensive medicine
- Insurance portability when people switch jobs
- Remove barriers to insurance companies selling policies across states lines
- Encourage personal responsibility for healthcare
There are enough savings to be had throughout the healthcare industry to provide healthcare for the Americans who truly need help with healthcare problems. Congress needs to have the courage to tell most Americans that they are responsible for their own healthcare. I am willing to bet that most Americans are willing to help the few who have serious healthcare problems that they cannot afford, but that most Americans are fed up with having to provide healthcare for those Americans who only want a hand out for healthcare.
There are several changes in Medicare that are required by the Healthcare Reform Bill, which take effect on January 1st, 2011. These changes largely affect the amount paid by Medicare recipients for drugs and doctors’ services. Here is a brief recap of the changes which will occur on January 1st, 2011
1) Free annual wellness check-up for all Medicare Part B participants. Currently, Medicare Part B participants are allowed the wellness check-up only on enrollment and this exam is subject to deductible regulations.
2) No ‘out-of-pocket’ expenses for specified preventative exams for Medicare Part B participants.
3) Closing of the ‘donut hole’ medication gap. Requires manufacturers of brand name drugs to reduce the cost of covered drugs by 50% in 2011, increasing the deduction to 75% by 2020. Generic drug cost will be reduced in the Medicare Part D drug coverage from 7% in 2011 to 75% by 2020.
4) There will be premium surcharge for wealthy Medicare Part D participants, which will be gradually increased over the next few years.
5) The limit on income, on which participants pay a surcharge for Part B (and Part D in 2012), will not be indexed to inflation through 2019. As incomes rise due to inflation, more seniors will be subject to the surcharge.
Medicare Advantage plans will be under pressure to meet some of the requirements set forth by the Healthcare Reform Bill for 2011. The bill requires that
- All Medicare Advantage plans must cap participants’ annual out-of-pocket costs.
- Co-payments for services such as Medicare Part B drugs and durable medical supplies cannot be higher than what Medicare requires of patients.
- Subsidies from Medicare to Medicare Advantage plans will be the same as in 2010, even though the cost of providing medical services may have increased for the plans.
Democrats in Congress are concerned that Medicare Advantage plans will increase premiums in order to cover the additional costs incurs to comply with the new mandates required by the Healthcare Reform Bill. In a letter to Health and Human Services secretary Kathleen Sebelius, they asked her to use her authority ”To promote stability in the program, the health reform legislation protected 2011 plan payment rates and took care to phase in future payment changes to minimize disruption. Any effort by MA plans to increase beneficiary premiums or reduce benefits next year should be carefully evaluated in light of these payment protections”.
Senator Rockefeller of West Virginia summed up the sentiment of many Democrat Congressmen, when he stated that, “Seniors on fixed incomes shouldn’t be subjected to exorbitant health care premium increases…..and….The Federal Government must continue to crack down on the unscrupulous practices of private health insurers.”
The review process for Medicare Advantage plans was conducted behind closed doors, so insurance companies and the public at large didn’t know the outcome until October, when plan details were released. (Who are the ‘unscrupulous’ ones, Senator Rockefeller?).
In 2011, Home Health services will see a reduction in Medicare Payments averaging about 4.75% as compared to 2010. This reduction is based on a formulate which rates differing types of service provided, but the bottom line is that Home Healthcare providers will receive about $900 million. If the goal of the Healthcare Reform Bill is to reduce the cost of medical care, then one significant way to reduce costs would be to increase home healthcare services and allow patients to recover at home, rather than in a hospital.
Private insurance premiums and reimbursements often take their cues from Medicare reimbursement rates. If Medicare continues to reduce payments for medical procedures and requirement for drug companies to reduce the cost of drugs, it won’t be long before the same requirements become common in private insurance. This is not good news for healthcare providers or drug companies.
First and foremost today, I’d like to thank all the veterans for their service and helping to keep the rest of us safe and free.
If you’ve been listening to any of news programs on TV or the radio this past week, then you already know that the Republicans are planning to dismantle or repeal the Healthcare Reform Bill that was passed this spring. Some elected Republicans are claiming that they will repeal the entire bill, while others want to modify the existing bill. Let’s look at what the Republicans can actually achieve, versus what they may want to achieve.
The Republicans only gained control of the House of Representatives, not the Senate or Presidency. The House may well pass a bill repealing the Healthcare Reform Bill, and the Senate may go along and also pass the bill, but President Obama will veto the bill. The Republicans do not have enough votes to override the President’s veto, so the possibility that the entire bill will be repealed is very remote.
Some Republicans want to repeal specific aspects of the Healthcare Reform Bill. They are more likely to have success with this approach, but not with any of the major portions of the bill. A repeal of the provision requiring businesses to send 1099 forms to any business and the IRS for any purchase of $600 or more from any vendor should be passed, and will probably be approved by President Obama. This provision had no business being included in any healthcare reform in the first place, and repealing it will save millions of dollars in accounting costs, not to mention a small forest of trees. Removing the portion that changes the funding of the student loan program will probably also pass. This provision has absolutely nothing to do with healthcare reform.
(Editor’s note: Changing the funding of the student loan program from the Federal government guaranteeing private loans from banks to direct funding of student loans by the government, and including it into the Healthcare Reform Bill, clearly indicates that the main thrust of the entire Healthcare Reform Bill is to socialize as much of the American economy as possible)
Another tactic, which would actually work, that the Republicans are discussing, is to defund the Healthcare Reform Bill. All spending bills originate in the House of Representatives. One way that the Healthcare Reform Bill can be derailed or delayed is for the congress to refuse to allocate funds to implement the Healthcare Reform Bill. One specific tactic that has been mentioned is not to provide the funds which would be required to hire the additional 16,000 IRS agents which would be required to enforce the provision which requires everyone to buy healthcare insurance. If the government does not have the manpower to enforce the mandatory purchase of healthcare insurance, then the public will be able to skirt the law. This is no different than local police precincts not enforcing certain ordinances, because they don’t have the manpower to enforce the ordinance. (Think illegal immigration as an example)
Sadly, missing in any discussion concerning the Healthcare Reform Bill is any true healthcare reform. We need to be having discussions on tort reform, expanding HSA’s, removing the restrictions on insurance companies from selling across state lines, custom tailoring healthcare insurance policies to meet the needs of individuals, and performing cost-benefit analyses of individual medical procedures. Any, or all, of these reforms will help to accomplish the stated goal of healthcare reform, which is to make healthcare affordable to all Americans. None of these true healthcare reforms are addressed in the current Healthcare Reform Bill. Let’s follow the will of the people and scrap this entire Healthcare Reform Bill, and start over with healthcare reforms that actually benefit the American people, which can be accomplished with far less intrusion into people’s lives.
