WGA InsureBlog

For good or bad, the Federal model contains several similarities to the Massachusetts Health Reform Law. If they would bother to look north, Washington could learn a thing or two about the effectiveness and pitfalls of poorly designed reform. The Massachusetts model, now three years in, has hit its coverage goals of 97% but is quickly devolving in to a financial burden for all involved. In the past year, several urban hospitals have been forced to sue the state for under reimbursement; the Governor has artificially capped the medical premiums to a point that may bankrupt some insurers; the insurers in turn are suing the state Read more…

National Health Care Reform, as signed into law this week, will lead to steeper growth in health insurance costs for businesses. The federal government had an opportunity to finally address the unsustainable costs in healthcare and the burden placed on US businesses, and chose instead to develop a trillion dollar program which does little to address costs; and instead layering further pressures on a private system in crisis. By developing a political strategy of vilifying the insurance industry, low hanging fruit no doubt, the administration lost sight of the real problem in our system, the eighty five to ninety cents of every premium dollar that are attributable to the cost of services. One need only look to the Massachusetts model to realize Obamacare will not work. Read more…

The House Committee on Rules has just released the 153 page amendment to the Health Reform Bill. The release of these revisions clears the way for a Sunday vote in the House and the potential of passage of Federal Health Care Reform through the controversial reconciliation process. Preliminary CBO scoring is projected at $940 Billion over ten years.

Upon a quick read of the amendments, I wanted to provide a brief summary of a few of the changes to the Senate bill as was passed on Christmas Eve. Read more…

Hospital charges in Massachusetts are out of control. I have long argued that the health care reform debate should have been about actual cost of care and not a broad indictment on the insurance industry. Close to 90% of every dollar of medical premiums paid in Massachusetts go towards paying hospitals and doctors and, until now, little attention has been given to how those rates are established. A recently released report by the Massachusetts Attorney Generals office should be raising the ire of every company who purchases health insurance for their employees in Massachusetts. The findings are troubling. And the report is a must read for every employer who purchases healthcare for their employees. Read more…

The election of Scott Brown to the US Senate will have a profound impact on the White House strategy to move health care reform through Congress. But while many in the press and infact the halls of Congress are declaring Health Care Reform DOA, insiders are providing glimpses of how President Obama plans to move forward given the new landscape. The White House and leadership have determined that passing nothing would be a worse political outcome than using a series of complex maneuvers to pass something. Here are the possible options. Read more…

As discussions with my clients shift from “if” to “when” will health reform pass, CFOs and HR managers are expectedly anxious and concerned about protocols and penalties associated with the new rules under Obamacare. For Massachusetts companies, many of the plan design and credible plan requirements were resolved way back in 1996 under small group reform or recently under the 2007 Mass Health reform law. In fact, much of what we are seeing in both the House and Senate versions of reform mirror the Mass reform program in many respects. There is however a potential catch-22 involved with the cost of having a compliant plan; that issue is the Senate pay-for “Cadillac” tax. Read more…

Senator Reid has lined up a Senate vote for Saturday at 8:00 p.m. Republicans have backed off of a threat to require that the 2,000 page bill be read aloud before a vote to proceed with debate is allowed. This concession will allow the Senate to go home for Thanksgiving and has set a Saturday schedule of 12 hours of debate and an 8 p.m. vote, that if passed, will allow debate to begin in the weeks and months to come on the $900 billion Senate Bill Reid introduced this week. Read more…

For months I have worried that the battle over health reform would devolve into a partisan and political battle, pitting ideologies against one another, all the while losing sight of the larger goal. President Obama campaigned on a promise of reducing health care premiums by $2,500 for every family in America. That message appears lost in the bills working their way through Congress. Read more…