House Speaker Nancy Pelosi will unveil a healthcare reform bill that includes a government insurance option and an expansion of Medicaid. Senior Democratic House aides said the bill would likely include a version of the "public option" preferred by moderates and may raise Medicaid eligibility levels to 150% of the federal poverty level for all adults, a steeper increase than in earlier drafts.
Under pressure from moderate-to-conservative members of the House Democratic caucus, Speaker Nancy Pelosi has decided to propose a government-run insurance plan that would negotiate rates with doctors and hospitals rather than using prices set by the government. Pelosi said the public plan would compete with private insurers. The bill from members of the House Democratic leadership team would provide coverage to 35 million or 36 million people at a 10-year cost of expanding coverage that would be less than the $900 billion ceiling suggested by President Obama.
Los Angeles pharmaceutical billionaire Patrick Soon-Shiong announced plans to provide University of California regents with a $100-million guaranty underwriting the county's latest proposal to reopen Martin Luther King Jr.-Harbor Hospital by 2012. Soon-Shiong said he has been invited to address regents Nov. 19 during their three-day meeting at UCLA, when they are expected to vote on the King proposal. The hospital closed inpatient services two years ago after inadequate care led to medical errors and deaths.
The federal government needs to further step up efforts to fight Medicare and Medicaid fraud to generate more savings to help pay for a healthcare overhaul, lawmakers say, and lealth-overhaul legislation moving through Congress contains provisions to beef up the government's antifraud effort. The U.S. loses at least $60 billion to healthcare fraud every year, and some estimates put the cost as high as 10% of the nation's total healthcare spending, which exceeds $2 trillion. Medicare and Medicaid are especially susceptible, the Wall Street Journal reports.
Senate Majority Leader Harry Reid made the decision to include a government-run healthcare plan in the Democrats' bill. While a handful of Democratic moderates don't like the public option, the liberals who support it easily outnumber them and at least some of them warned Reid they would oppose a bill that didn't include the option, the Wall Street Journal reports. Earlier in October, 30 senators sent Reid a letter saying "a strong public option has resounding support among Senate Democrats." and urging that any bill include one.
Lois Quam, an ex-UnitedHealth executive, says insurers are "simply wrong" to fight a federal government role as part of healthcare reform. In a speech at the University of Minnesota's Center for the Study of Politics and Governance, Quam threw her support behind a proposed government-run health insurance plan that would compete with private insurers. She also took on the insurance industry head-on, noting that insurers had opposed the creation of Medicare in the 1960s and opposed healthcare reform during the early years of the Clinton administration, the Minneapolis Star Tribune reports.
WellPoint Inc., which operates in Illinois as UniCare, said it will exit Illinois and Texas, where it has about 400,000 members, in an effort to focus on its other U.S. operations. WellPoint said the subsidiary is profitable, but "there are competitive pressures in Illinois and Texas that have made it increasingly difficult for UniCare to offer quality products that are competitively priced." WellPoint said its Illinois UniCare customers would be guaranteed coverage if they transition to Health Care Service Corp., parent of Blue Cross and Blue Shield of Illinois.
Unionized nurses in Massachusetts are moving toward affiliating with their counterparts in California and more than 20 other states to create the largest nurses union in U.S. history. The move could give the state's nurses more bargaining power with hospitals and aid organizing efforts at nonunion healthcare providers such as Massachusetts General Hospital and Beth Israel Deaconess Medical Center in Boston. But it is being opposed by some nurses at Brigham and Women's Hospital and elsewhere who do not want to pay the added dues needed to finance the organization, the Boston Globe reports.
Employers are blasting the Senate's plan to create a new public health-insurance program, the Wall Street Journal reports. The Business Roundtable, an association of company executives, is calling and visiting lawmakers to persuade them not to include the public plan in the legislation. The U.S. Chamber of Commerce began airing cable-television advertisements in seven states arguing that the public option will lead to higher taxes and increase the national debt.
In a bid to cut healthcare costs, International Business Machines Corp. plans to stop requiring $20 co-payments by employees when they visit primary-care physicians. The company said it believed the move would save costs by encouraging people to go to primary-care doctors faster, in order to get earlier diagnoses that could save on expensive visits to specialists and emergency rooms. One of the nation's largest employers with 115,000 U.S. workers, IBM spends about $1.3 billion a year on U.S. healthcare.
