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Four Reasons Why Meaningful Health Reform is Unlikely To Pass This Year
Les Masterson, Senior Editor-Managed Care

Similar to any other political issues, as more specifics have emerged about health reform fewer people are behind it. The possibility of a large health reform bill getting approved this year grows dimmer by the week—even though President Barack Obama is pushing the reform as a major administration initiative. Here are four major reasons why large-scale health reform is unlikely to happen in 2009. [Read More]
  September 30, 2009

 
Editor's Picks
Senate Panel Defeats Public Option Amendments
Health insurers may actually get their wish. The Senate Finance Committee rejected two separate public insurance option amendments on Tuesday, which could signal the beginning of the end for the public option this year. Many House members, including Speaker Nancy Pelosi, have spoken in favor of a public option, but a majority of the Senate Finance Committee shot down the idea. Republicans have said a public option should not be part of a health reform plan, and Sen. Max Baucus (D-MT), chairman of the Finance Committee, said the only way to get 60 votes in the Senate is to not include the public option in a reform plan. [Read More]
In some states, a push to ban mandate on insurance
An individual mandate that would require Americans to have health insurance is seen by many as the only way to get the 47 million uninsured to buy health insurance, but opponents see the idea as government taking away a person's choice. As a way to derail the individual mandate, more than a dozen states are looking at state constitutional amendments that would disallow the idea. Some constitutional scholars, however, say that the state measures would fail in a court case and are little more than a symbolic protest. [Read More]
Baucus health bill would let private group write rules
Consumer advocates are speaking out about a Senate Finance Committee provision that would move rule-making authority to state insurance commissioners, which critics charge are too close to the health insurance industry. Under the bill by Sen. Max Baucus, the National Association of Insurance Commissioners would craft a model rule governing "health insurance rating, issuance, and marketing requirements" that would become "the new federal minimum standard without any further congressional action." States would be permitted to deviate from the standards only by appealing to the Department of Health and Human Services. [Read More]
Mandate minus price controls may increase healthcare costs
Health insurance industry critics are concerned that health reform legislation doesn't do enough to protect individuals against skyrocketing premiums. This is happening at the same time that health insurers are pushing for an individual mandate to require that all Americans have health insurance. Many are also charging that higher premiums will lead to higher costs to taxpayers, who will have to pay higher subsidies to cover low-income Americans. [Read More]
Fight over Medicare cuts intensifies
The Medicare Advantage fight is just beginning as Americans United for Change released a Halloween-themed ad protesting Republican "fear mongering" on proposed Medicare Advantage cuts. The ad comes after CMS launched an investigation about Humana sending letters to Medicare Advantage beneficiaries and asking them to protest possible payment cuts. CMS has since asked health insurers to not send those kinds of letters to beneficiaries. [Read More]
 
Managed Care Headlines
Poll: Support for government health insurance declines a bit
New York Times, September 29, 2009
NAIC Warns Health Insurers Against Scare Tactics
John Commins, for HealthLeaders Media, September 28, 2009
Insurers tally up Baucus bill provisions
Wall Street Journal, September 28, 2009
Workers to pay 10% more for healthcare in 2010, study predicts
Chicago Tribune, September 28, 2009
Massachusetts health system popular, but backing dips
Boston Globe, September 28, 2009
Health Plan Members Pleased with Their HSAs
John Commins, for HealthLeaders Media, September 25, 2009
Anthem Blue Cross is ordered to repay customer $7,300
Los Angeles Times, September 25, 2009
Healthcare System Works with Supermarket Chain to Promote Health, Wellness
Janice Simmons, for HealthLeaders Media, September 28, 2009

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PBM Improves Medication Compliance

Edmund Pezalla, MD, MPH, national medical director and chief clinical officer at Aetna Pharmacy Management, speaks about how pharmacy benefit managers can receive higher levels of medication adherence. [Sponsored by Emdeon] [Listen Now]
 
Health Forum
Are Healthcare Co-ops the Next Fannie Mae?

Congress attempted to achieve a social objective—higher homeownership rates—on the cheap by using Fannie Mae to acquire mortgages. The subsidy, in the form of an implicit guarantee of Fannie Mae's capital, meant that Fannie did not need to hold the levels of capital required to support the explosion in mortgage lending that resulted. The results are plain for all to see. Fast forward to the healthcare debate: Congress is now proposing to repeat the trick with health insurance cooperatives. [Read More]
 
From HealthLeaders Media
Are we at the Tipping Point for Health Costs?

As businesses balance rising health costs and declining profits on the backs of individuals, employee contributions to their healthcare are inching closer to 50% of healthcare costs. Have we reached a point at which the insured will drop coverage in great numbers because they simply can't afford it or find it's not worth the costs? [Read More]
 
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