health reform


health reform

Insurers Upset About Outcome of First Round in Medical Loss Ratio Determination

Wednesday, August 18th, 2010 - 10:42
Wednesday, August 18, 2010 - 10:05
With a unanimous vote, the National Association of Insurance Commissioners has approved initial recommendations for how the medical loss ratio should be defined under health reform, according to news reports in Politico ( and The Hill's Healthwatch blog ( It appears the first round has gone to consumer advocates, much to the disappointment of insurance companies attempting to achieve an implementation of the health law that is advantageous for them. The Department of Health and Human Services must still sign off on all recommendations.

Use of Health Care Down in Bad Economy -- Are There Any Positives?

Tuesday, August 17th, 2010 - 12:43
Tuesday, August 17, 2010 - 11:38
The demand for routine medical care and elective procedures was down during the economic recession, and significantly more so in the United States than in countries with universal health care systems, The New York Times reported here Tuesday.

Many States Have No Authority to Enforce Health Reform Law

Monday, August 16th, 2010 - 10:28
Monday, August 16, 2010 - 09:49
A New York Times story from over the weekend reported what could be a significant problem for the smooth implementation of health reform: Insurance commissioners in roughly half the states say they have no authority to enforce the health reform law. This revelation comes despite the fact that the law looks to the states to be the primary enforcers of the consumer protections that are at the heart of the overhaul.

An Important Weekend Meeting for the Implementation of Health Reform

Friday, August 13th, 2010 - 13:27
Friday, August 13, 2010 - 12:46
One of the most important implementation decisions regarding health reform will be discussed and voted upon this weekend and early next week in Seattle at a meeting of the National Association of Insurance Commissioners. The commissioners will decide their recommendation on what constitutes medical care for the purpose of calculating the medical loss ratio, one of the cornerstones of health reform designed to get consumers the best bang for their insurance premium buck. The importance of the meeting is underscored by the planned attendance of President Obama on Tuesday.

Scrutinizing Insurance Company Rate Hikes -- Does Health Reform Do Enough?

Thursday, August 12th, 2010 - 13:27
Thursday, August 12, 2010 - 12:53
Under health reform, insurance companies seeking "unreasonable" rate increases must file a justification with regulators. Now, federal regulators have the task of taking rather vague legislation in this regard and turning it into enforceable rules that can be implemented smoothly across the country. What does "unreasonable" mean? What type of information must be included in the justification for an "unreasonable" rate increase? These are two of the big pieces of the law that regulators will have to more substantively define.

Maryland Studying Potential Co-Op to Cover Those Who May Be Left Out in Health Reform

Wednesday, August 11th, 2010 - 12:05
Wednesday, August 11, 2010 - 10:26
The Maryland Nonprofit Health Insurance Co-Op is beginning a year-long study to determine whether it's feasible to form a group to cover people who still may not be able to afford health insurance -- or would rather pay a penalty for not having it -- after health reform takes full effect, according to the Maryland Reporter (

State Government Employment Losses A Threat to Implementation of Health Reform

Tuesday, August 10th, 2010 - 16:10
Tuesday, August 10, 2010 - 16:07
The July employment and unemployment report produced by the US Bureau of Labor Statistics (BLS) verifies my concern that states are losing the work force they will need to implement health reform. At a time when states should be adding jobs to help plan the many new roles and responsibilities they are taking on in the health care field, state and local employment is dropping.

The Medicare Report: Are the "Caveats" More Than Caveats?

Monday, August 9th, 2010 - 16:32
Monday, August 9, 2010 - 15:57
Austin Frakt has an interesting commentary today ( in the Kaiser Health News report that asks whether health care cost cutting solutions are more likely to come from the private sector than the government that ushered in health reform.

Obama Tries to Reach Out to Seniors to Cut Through Clutter on Medicare Changes

Monday, August 9th, 2010 - 12:37
Monday, August 9, 2010 - 11:52
We've written several times on this blog about how senior citizens are less supportive -- and more confused -- about health reform than any other demographic. This was recently demonstrated by a poll of senior citizens by the National Council on Aging.

How Successful Will Penalty Be at Enforcing Individual Mandate Over Extensive Opposition?

Thursday, August 5th, 2010 - 10:22
Thursday, August 5, 2010 - 09:39
Those opposed to the individual requirement to purchase insurance in health reform are hoping that challenges from the state of Virginia and by a conglomeration of states in Florida will destroy the individual mandate as a legal matter. But even if the legal challenges aren't successful -- and many legal experts say they won't be -- might the mandate face an onslaught of individuals who refuse to go along out of a combination of economics and protest?