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National DI & LTC Program Proposed Key senators and House members introduced legislation July 10 that would create an insurance program financed by voluntary payroll deductions for adults who become functionally disabled. Senators Edward M. Kennedy (D-MA) and Tom Harkin (D-IA), and Representatives John D. Dingell (D-MI) and Frank Pallone Jr. (D-NJ) introduced "The Community Living Assistance Services and Supports" (CLASS) Act of 2007. The CLASS Act will establish a national insurance program, financed by voluntary premium payments to be collected through payroll withholding and placed in a “National Independence Fund.” The Department of Health and Human Services will manage the Fund as a new insurance program, and may enter into contractual agreements with those entities that states direct to assume administrative/program implementation roles.
The monthly case benefit will be posted monthly to a debit account or a “Choice Account”. Individuals who do not use the full monthly amount may roll it over from month to month, but not year to year. Health Care Cost Growth Expected to Ease Private health care costs in 2008 are expected to continue growing but at a slower pace than in 2007, with projected growth dipping into single digits, according to a study released by PricewaterhouseCoopers. The report, Behind the Numbers: Healthcare Cost Trends for 2008, predicted health care costs will rise 9.9 percent for health maintenance organizations, point of service plans, and exclusive provider organizations, as well as preferred provider organizations. Costs of consumer-direct health care plans are expected to rise 7.4 percent. In 2007, all three categories were expected to rise over 10 percent.
Whether these costs trends will extend into premium cost trends is unclear because of outside factors, such as the rising number of uninsured Americans, the study said, adding that premiums costs likely will decelerate. Wyden-Bennett Health Care Reform Bill Wins Key New Support The unique health reform plan (S.334) that requires individuals to buy health insurance from private insurers got a significant boost last week when on June 26 the leaders of the Senate Budget Committee came out in favor of the measure. Budget Committee chairman, Senator Kent Conrad (D-ND) and ranking member Senator Judd Gregg (R-NH) said the Healthy Americans Act “got the basic structure right.” Senator Conrad added, “It’s not government-controlled, but there is a role for the government.” The Budget Committee leaders were particularly “intrigued” by S.334’s universal coverage, the fact that it builds on the current, private sector system, and its portability. S.334, introduced by Senator Ron Wyden (D-OR) and cosponsored by Senator Bob Bennett (R-UT), requires each individual (with certain exceptions) to purchase private health insurance. The bill includes subsidies for those who can’t afford the premiums, changes the tax treatment of health insurance at both the individual and employer levels, includes requirements for a basic benefits package, and creates a state-based system of regulation and oversight over the new system.Senate HELP Committee Approves Health IT Bill The Senate HELP Committee approved S.1693, a health information technology bill, by voice vote on June 27. The bill authorizes $163 million in the next two years for grants and loans to health care providers and states to spur adoption of health IT. It also creates a public-private partnership tasked with recommending health IT initiatives, creates a National Coordinator of Health IT, authorizes a demonstration project to integrate health IT into clinical education, and includes health care records privacy and security rules. Health IT legislation has a better than even shot at becoming law this year.SCHIP Reauthorization and Expansion The Senate Finance Committee has agreed to a roughly $35 billion package to reauthorize and expand the State Children's Health Insurance Program funded almost exclusively by a cigarette tax increase. There is general agreement in the Senate Finance Committee on a framework for SCHIP expansion that calls for spending $35 billion on the program over the next 5 years with payment coming from an increase on the 39-cent federal cigarette tax to $1 per pack. Some Democrats in the House want to come up with more funding for SCHIP by cutting funding for the Medicare Advantage program. The House proposal would also add authority to cover legal immigrant children, pregnant women and older children who are still in school. It would also include prenatal care in the scope of SCHIP coverage. The President, like AHIA, believes instead of encouraging people to drop private coverage for government programs, basic private health insurance should be made affordable for all Americans. The Centers for Medicare & Medicaid Services (CMS) has recently added new functionality to MyMedicare.gov to help beneficiaries track their preventive services eligibility and utilization. CMS now will send beneficiaries who have provided their email address an email reminder when they are eligible for one of their preventive services. This enhancement will notify beneficiaries that they are soon due for their preventive service. CMS is hopeful that the notification will encourage more Medicare beneficiaries to utilize the preventive services that are covered by Medicare. For more information about signing up for mymedicare.gov see our latest brochure:
In addition, CMS is working in conjunction with the Office of e-Health Standards & Services on a CMS Personal Health Record (PHR) pilot study involving Medicare Advantage and Part D plans. People who are enrolled in one of the plans participating in this pilot study and who are MyMedicare.gov users will see a new section on the website around PHRs. This section will display their Plan Name, PHR Name, PHR Phone # and PHR Website link providing them the option to sign up for their plan’s PHR. The four plans that are currently participating in this study are HIP USA, Humana, Kaiser Permanente and University of Pittsburgh Medical Center. For more information, you can review the following article: http://www.fcw.com/article103093-06-25-07-Web&newsletter=yes The next presentation in the My Health. My Medicare series of audio-conference training sessions sponsored by CMS will be held: Tuesday, July 24, 2007 These sessions are designed to give Medicare partners — like AHIA — the most up-to-date information on the Medicare program. Calls feature CMS policy experts who provide in-depth information and answer questions from callers on topics of current interest impacting people with Medicare. You can download the PowerPoint slides for this session on the morning of the call by visiting the National Medicare Training Program website at www.cms.hhs.gov/NationalMedicareTrainingProgram. Find and click Audio-Conference Training in the menu on the left, scroll down to Downloads, and click on the Handouts for the date of the call. Health Care Costs Must be Constrained Senate Budget ranking member Judd Gregg (R-N.H) hailed a Congressional Budget Office (CBO) study recently released showing that if health care costs continue to increase as quickly as they have over the past 40 years, tax rates will have to increase as high as 92 percent to fund the government. CBO examined what levels of taxation would be needed to fund increased health care spending, if tax increases were the only strategy used to deal with those costs. The report concluded that alternative ways for resolving the nation’s long-term budget problems carry different implications for the economy, but those economic differences pale in comparison to the economic costs the nation would face in the long run if federal debts were allowed to grow faster than the economy for extended period of time. If the budget was on a sustainable track, real GDP could more than double between now and 2050, CBO estimates. Failing to achieve fiscal sustainability, however, could put the long-run growth of the economy at risk—so moving the budget toward a sustainable track provides substantial economic benefits in the long run. Much of the pressure on the budget stems from the fast growth of the cost of federal spending on health care. No spending path can grow faster than the economy forever; at some point, the costs will exceed the resources than can be extracted from the economy, and changes in policy will have to be made. Although it is uncertain how high spending will be in any given future year, it is certain that if the growth of spending does not eventually slow down, at some point financing that spending will become infeasible. Given the nature of the nation’s long-term fiscal challenge, constraining the growth of federal health care costs seems a key component of reducing the deficit over the next several decades. A variety of evidence suggests that opportunities exist to constrain health care costs both in the public programs and in the overall health care system without adverse health consequences, although capturing those opportunities without harming health outcomes involves many challenges. Save Health Care Dollars with eDocAmerica AHIA has recently partnered with eDocAmerica to make their unique service available to you and your employees along with your clients and prospects. For over a decade eDocAmerica has been the nation’s leader in providing consumers with internet access to hassle free answers from board certified physicians and licensed psychologists to all of their health related questions. Physician responses are normally received within 2-4 hours and guaranteed within 24 hours. Enrolled participants choose a screen name and password so health information always remains confidential between the participant and the physician. Once participants complete a brief medical profile, they have unlimited access to e-mail a physician at eDocAmerica.com as often and whenever they wish. Instead of searching the Internet for important medical information only to find out that it is difficult to determine which of the thousands of sites and articles apply to a given situation, eDocAmerica participants can e-mail a physician. The physician will provide the information needed and links to information sites that they have already reviewed for application to a given personal situation. AHIA members receive preferred pricing of $1.05 a month per employee. AHIA members may decide the resale price on a case by case basis for maximum flexibility. For example, Client Burger World may be charged $1.25 per employee and Client Sally Shop may be charged $1.30 per employee. Not only are you able to provide clients with a valuable service for their employees, you are eligible to earn commissions for your assistance. Agents are paid the difference in the contracted amount of $1.05 and the amount charged to the employer. eDocAmerica takes care of the accounting, electronic collection of payment and distribution of commissions. You can begin earning commissions by following these simple steps:
Agents, agencies and client companies each have their own protected webpage to track enrolled employees, review cost per employee and resources to explain and promote the employee benefit. Agent and agencies can also view the commissions earned. A recent independent study concluded that there was a statistically significant reduction in health care costs of the client when the eDocAmerica system was used. Individual users in the study experienced annual claims averaging $89 less than non-users. AHIA Executive Committee, 2006-2007
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