For the nation's hospitals, the cost of doing nothing in health reform translates into tens of billions of dollars each year in medical bills that go unpaid by patients with little or no insurance, the New York Times reports. Nationwide, the cost of unpaid care for hospitals, which includes charity care as well as money that could not be collected from patients, was around $36 billion in 2008, and is expected to get higher. The number of people without insurance in the U.S. could increase to as high as 58 million by 2014, from about 49 million now, according to an estimate by the Urban Institute.
Spending by private insurers tends to be higher when the hospital market is less competitive, a new study finds. The study compared geographic patterns of Medicare spending, using the Dartmouth Atlas data, with spending by big employers that cover their workers. The researchers suggest that when a small market has just one or a few big hospital systems, employers spend more than they do in large cities where there's more competition, an issue that does not generally affect government health payers like Medicare.
California insurance regulators asked Anthem Blue Cross to delay controversial rate increases of as much as 39% for individual policies, hikes that have triggered widespread criticism. And in a rare step, the Obama administration called on Anthem to justify its rate hikes, saying the increases were alarming at a time when subscribers face skyrocketing healthcare costs. In a letter to Anthem's president, Health and Human Services Secretary Kathleen Sebelius voiced serious concern over the higher premiums, which go into effect March 1 for many of the insurer's estimated 800,000 individual policyholders, the Los Angeles Times reports.
Some Tennessee hospitals are considering paying more taxes to head off steep cuts to TennCare that could take more than $1.5 billion from the state's medical system. Representatives for the hospital industry have suggested bringing back the hospital tax, which expired in 1994 when TennCare was created, to reduce or stave off cuts in state funding proposed by Gov. Phil Bredesen. Those cuts would save the state $380 million, according to one analysis. But they would cost Tennessee two to three times as much in federal aid, amplifying the effect on hospitals and other healthcare providers far beyond the state's savings, The Tennessean reports.
California regulators are trying to rein in discount health and dental plans that officials say frequently overstate benefits, offer little if any savings, and promise access to doctors who aren't part of the system. Some of the discounters fraudulently market themselves as insurance, while preying on the poor, the elderly, and others who urgently need care, officials told the Los Angeles Times.
Legislatures in more than two-thirds of the states are objecting to health reform requirements that everyone buy health insurance. Supporters of the mandate argue that requiring everyone to have health insurance is essential to making insurance affordable, even as the government provides some people with subsidies. But opponents say that people should not be forced to buy something they do not want or cannot afford, and that trying to make them do so would be unconstitutional, the New York Times reports.