Happy New Year & 2010 NYBGH Events

NYBGH wishes all of its supporters, colleagues, collaborators, friends, and family a healthy, successful, and happy 2010!

Highlighting our 2010 series of events is a conference on how health reform will affect New Jersey employers as well as an exclusive Q&A Session with Ken Shachmut, Senior Vice President of Strategic Initiatives, Health Initiatives and Re-Engineering at Safeway, Inc., an industry leader in containing health benefits costs.

The first four scheduled NYBGH events of 2010 are as follows:

Total Health Management: "On the Verge"
Tuesday, January 26, 2010
8:00 am - 10:30 am
NYBGH Members & Non-Members: Complimentary
Union League Club
38 East 37th Street (at Park Avenue)
New York, NY

Healthcare Reform: What's in Store for New Jersey Employers
(Open to HR Professionals and Fund Administrators Only)
Thursday, February 4, 2010
8:00 am - 11:00 am
NYBGH Members: Complimentary
Non-Members: $125
New Jersey Performing Arts Center
One Center Street
Newark, New Jersey

The Safeway Experience: Q&A with Kenneth Shachmut, Senior Vice President of Strategic Initiatives, Health Initiatives & Re-engineering, Safeway, Inc.
Wednesday, February 10, 2010
8:00 am - 10:30 am
NYBGH Employer Members: Complimentary
NYBGH Non-Employer Members: $50
Non-Members: $75
University Club of New York
One West 54th Street
New York, NY

Innovative Engagement Strategies: Driving Shared Responsibility with Your Employees
(Open to HR Professionals and Fund Administrators Only)
Monday, March 22, 2010
9:00 am - 10:30 am
NYBGH Members & Non-Members: Complimentary
Location TBA

To view the full listing of NYBGH events and to register, visit: www.nybgh.org/calendar/index.html

Business Pushes to Modify Health Care Bill

As Congress begins its preliminary work on merging the Senate and House health care reform bills, business organizations continue to urge lawmakers to modify provisions that directly affect employers. Of most concern are new taxes; a lack of overall cost containment and delivery system reform; and a public option that escaped the Senate's modifications to the bill.

For The Wall Street Journal story, click here.

Hormonizing Medicare Payment Policy with the Private Sector

Peter Lee, JD, Executive Director of National Health Policy for the Pacific Business Group on Health, along with Bob Berenson, MD of the Urban Institute and John Tooker, MD, MBA of the American College of Physicians recently published an article in the New England Journal of Medicine describing the importance of harmonizing Medicare payment policies with those in the private sector. While Medicare is the country's largest purchaser of health care, it accounts for only 19% of total health spending. The authors note that in order to achieve a higher-value system overall, Medicare needs to help lead the charge in changing how all public and private payers reimburse for services. To achieve this, four recommendations are made and these, along with the rest of the article, can be found by clicking here.

EBRI/MGA 2009 Consumer Engagement in Health Care Survey

The Employee Benefit Research Institute (EBRI) 2009 Consumer Engagement in Health Care Survey reports that enrollment in CDHPs remains relatively low, but is showing growth and consumers are becoming increasingly more cost conscious. CDHP enrollees are also more likely to be enrolled in employee wellness programs, have higher incomes, and be in better health than enrollees in traditional health insurance plans. Financial incentives, in addition, are shown to be a crucial component in encouraging employees to participate in wellness programs and other consumer engagement initiatives.

For the complete report from EBRI, click here.

Happy Holidays from NYBGH!

New York Business Group on Health wishes all of our followers, readers, supporters, colleagues, collaborators, friends, and family a very happy holiday season and a healthy 2010.

As we take a break from health reform debate and negotiations for a few weeks, check out, in the meantime, Kaiser Health News's article on commonly asked qeustions about health reform and you, an American consumer of health care.

Senate Passes Health Bill

Thursday morning, as expected and as promised by Senate majority leader Harry Reid (D-NV), the Senate approved their version of health reform legislation by a vote of 60-39. The bill now heads to Conference Committee to hash out differing provisions of the two bills. The public option, for instance, is included in the House bill, but was rejected during debate in the Senate. Financing reform is another contentious issue that both chambers will have to resolve.

For additional coverage from major U.S. newspapers, click on the following links:

The Hill
The Wall Street Journal
The New York Times
CQ Politics

Health Bill Set to Pass Out of Senate and Into Conference Committee with House

Senate Democrats are poised to pass historic health care reform legislation out of their chamber and into Conference Committee with the House Thursday morning at 7:00am. The final procedural hurdle was passed Wednesday when a cloture vote of 60-39 ended debate on the underlying bill. All 58 Democrats and two Independents have remained united throughout the week and are expected to do the same on Christmas Eve. Unlike procedural votes aimed at ending filibusters, Thursday's vote requires only a simple majority of 51 yeas. Thursday's roll call will mark the 25th straight day the Senate has been in session, only one day short of matching the record of 26 set in 1917 as Congress, and the country, prepared to enter World War I.

The vote was originally scheduled for 7:00pm Thursday, but was eventually moved to the morning to allow Senators and their staffs time to make it home for the Christmas holiday. On Wednesday, the Senate rejected a number of points of order, one of them questioning the bill's constitutionality, introduced by Republicans and designed to stall the process even further.

To read more, click for articles from The Hill, The Wall Street Journal, and The New York Times.

Obama Approves COBRA Subsidy Extension

On Monday, President Obama signed into law the Fiscal Year 2010 Defense Appropriations Bill (H.R. 3326), which includes provisions affecting the federal COBRA subsidy program. The bill extends the 65 percent subsidy duration period to eligible individuals from nine to 15 months and also extends the COBRA coverage eligibility date from December 31, 2009 to February 28, 2010. Eligible workers - those involuntarily terminated between September 1, 2008 and December 31, 2009 and formerly covered under an employer's group health plan - now include those who are laid off between January 1 and February 28, 2010.

The Wall Street Journal reports that, "the subsidy is provided in the form of a payroll tax credit to employers with 20 or more workers."

For more coverage, clickto visit the Wall Street Journal article or an article from USA Today.

Senate Votes to Adopt Manager's Amendment and Limit Debate on Substitute Amendment - 3 Down, 3 to Go

Early Tuesday, the Senate voted twice, both times along party lines, to move health care reform legislation closer to passage. First, they voted to adopt the manager's amendment introduced by majority leader Harry Reid (D-NV) last Saturday. Second, casting aside another parliamentary delay maneuver, Democrats voted to invoke cloture, or limit debate, on a substitute amendment, thus clearing the way for the final three votes that need to pass if Democrats want to pass health reform legislation by Christmas Eve. The next vote is scheduled for 1:00pm Wednesday, with the final vote slated to occur around 7:00pm Christmas Eve.

To read more, visit a related article from The Hill.

CQ Politics also reports on the votes in this article.

Senate Ends Debate on Manager's Amendment; 1 Down, 5 to Go

Early Monday morning, around 1:00am EST, Senate Democrats voted 60-40 to end debate on the manager's amendment to the health insurance reform bill that was introduced early Saturday morning. This marks the first of six crucial votes that need to occur on the Senate floor for the bill to pass into conference committee with the House health bill that was passed in early November. Majority leader Harry Reid (D-NV) intends on holding the sixth and final vote around 7:00pm Thursday night.

To read the related stories, visit the New York Times or the Wall Street Journal websites.

Senate Democrats Cut a Deal; Reach 60 Votes

Early Saturday morning, Senate majority leader Harry Reid (D-NV) released a 383-page manager's amendment to the Senate health insurance reform proposal, indicating that he has secured the 60 votes needed to pass the legislation by Christmas. Senate Republicans immediately invoked the first of many delay tactics by requiring the Senate Clerk to read the entire bill aloud. Appeasing the last Democratic holdout, Sen. Ben Nelson (D-NE), Mr. Reid modified language that does not require or forbid health insurance plans from covering abortion services, but does include an exemption that allows states to prohibit abortion coverage in the insurance markets or the exchanges, where most plans would be sold. Nebraska will also receive, under the amendment, a substantial increase in federal matching dollars that support the state's Medicaid program - the federal-state entitlement program that provides coverage to the poor.

This version of the Senate bill will cost, according to an analysis by the nonpartisan Congressional Budget Office, $871 billion and reduce the federal deficit by $132 billion over ten years, The Hill reports. Costing $22 billion more than its original version, the bill is predicted to cover an additional 31 million Americans.

The complete manager's amendment can be found on the Senate Democrats' website or by clicking here.

Coming only a day after a public opinion poll released by the Kaiser Family Foundation indicated that public support for reform is weakening, Mr. Reid has scheduled six votes to pass the legislation by Christmas. The first one, the next move in the process, is a 1:00am vote early Monday morning to end debate on the manager's amendment. All six procedural moves can be found at a post to the New York Times Prescriptions Blog or by clicking here.

A New York Times article discussing the changes made to key components of the legislation can be found by clicking here.

COBRA Extension Bill Up for Vote

Around 1:00am Friday morning, the Senate voted to limit debate on the 2010 defense spending bill (H.R. 3326). Buried deep inside the bill are provisions that would extend federal COBRA subsidies to February 28, 2010. A full Senate vote is expected at 7:30am Saturday morning.

Current law provides subsidies only to those who are involuntary terminated and lose health insurance coverage by December 31, 2010. Proposed in the defense spending bill are provisions that would extend the 65% subsidy to 15 months and would be offered to those who become eligible by February 28, 2010. Other provisions of the bill include:

• Clarification that only the date of the qualified event relating to the COBRA coverage (e.g. the involuntary termination of employment) will determine eligibility for the COBRA subsidy - and not the date the individual becomes covered by COBRA

• An opportunity for those individuals who lost eligibility for the subsidy (i.e. when the subsidy expired on November 1, 2009) and then lost COBRA coverage due to non-payment of premiums, to retroactively continue COBRA coverage and the subsidy by paying the premium within the later of 60 days from the date of enactment, or 30 days from notification. This also extends to those individuals who lost eligibility for the subsidy but retained their COBRA coverage by paying the full premium

• New and updated notification requirements, including providing a notification within 60 days of enactment that describes the new subsidy provisions to those individuals who were assistance eligible individuals (AEIs) or became AEIs on or after October 31, 2009. In the case of a qualifying event that occurs after enactment, this notice will be provided as part of the COBRA election notice

• Treating the new requirements as having been included as part of the original language contained in the American Recovery and Reinvestment Act of 2009.

The text of the bill can be read on the House Appropriations Commitee website at http://appropriations.house.gov/.

Source: USI Insurance, Littler Mendelson "Washington DC Employment Law Update"

Communicating Benefits Information via Social Media

Employee Benefit News features an article on using social media to communicate benefits news to employees. Using venues such as Facebook, Twitter, YouTube, Wikis, and blogs, among other things, HR professionals can creatively engage employees to communicate short, quick bits of information.

A recent study by Watson Wyatt, the article describes, found that:

"almost two-thirds of companies plan to increase their use of social media in 2010. Of the 328 companies surveyed from across the globe, 78% have increased their electronic communication in the last 24 months, and 55% have increased face-to-face communication. However, nearly half (48%) have diminished their print communication over the past 24 months."

To read the complete article, click here.

Do Patients Continue to See Physicians Who Are Removed From a PPO Network?

In this article from the American Journal of Managed Care, Rosenthal, Li, and Milstein report on their findings from a study investigating how often patients visit their doctor once he/she is dropped from their network. Using claims data, the researchers found that:

"network narrowing reduced the odds of continuing to see an excluded physician (odds ratio, 0.18; P <.001). Patients who continued to see excluded physicians reduced their office visits by a mean of 0.9 visits per year, 0.8 visits more than comparison patients (P <.001). There were no significant changes in emergency department visits or admissions for patients of excluded physicians compared with a matched cohort.

The complete article can be read by clicking here.

Democrats Drop Medicare Plan

On Monday evening, in a reversal of a highly controversial plan to expand Medicare to those aged 55 and older, Senate Democratic leaders announced that they would be dropping the plan from their proposed bill that is currently being debated on the floor.

The announcement comes only hours before President Obama is scheduled to meet with Senate Democrats Tuesday morning. This comes in response, seemingly, to threats made by two centrists, Sen. Ben Nelson (D-Ne.) and Sen. Joe Lieberman (I-Ct.), to not vote for the bill if it includes the Medicare expansion. Majority leader Harry Reid, along with Mr. Obama, have made it clear that they want a vote on the bill come Christmas and, as evidenced by this latest development, are willing to make all the deals needed.

Read the complete story at The New York Times or the Wall Street Journal.

NYBGH Tribute to Leadership - Dec. 14th

Join NYBGH at our 15th Annual Tribute to Leadership on Monday, December 14th! This year's honorees are Mark Wagar, CEO of Empire Blue Cross Blue Shield along with Pitney Bowes CEO Murray Martin.

More information can be found at nybgh.org.

Medicare Expansion Faces Challenges

As Senate Democrats consider expanding Medicare, the federal health program for the elderly, as part of a public option compromise, myriad political obstacles stand in their way. First, many Republicans oppose the idea, claiming the slippery slope to a government-run, single-payer system it would spark would be worse than the one a public option would have began. Second, three centrists - Sens. Joe Lieberman (I-CT), Ben Nelson (D-NE), and Olympia Snowe (R-ME) have voiced their opposition to the plan that would expand coverage, through a buy-in mechanism, to those between the ages of 55 and 64.

To read more on the issue, click here.

First Wave of COBRA Subsidies Nearing End

Kaiser Health News reports on the soon-to-expire federal COBRA subsidy for workers involuntarily terminated between September, 2008 and December, 2009. As the end of the first wave of subsidies approaches, many workers face the challenge of paying for health insurance coverage, and perhaps forgoing important medical treatment. President Obama has stated that he thinks Congress should make extending the subsidy period a priority, but the issue has not been marked for consideration on the calendars of either chamber. There are, however, two proposed bills waiting to be debated.

Read the complete article by clicking here.

Further coverage, from the New York Times, can be found here.

Mercer Survey Shows Employers May Cut Benefits to Avoid Excise Taxes

A recent survey by Mercer showed that nearly two-thirds of employers would cut health benefits in order to avoid the excise tax proposed by the Senate health bill. The 40% non-deductible tax is expected to apply to about one-fifth of all employers.

The complete story can be read by clicking here.

HealthPass in Crain's New York Business

This week's Crain's New York Business features NYBGH subsidiary HealthPass in its Executive Inbox section. HealthPass is a health insurance exchange with a 10-year track record of providing affordable health insurance and quality customer service to small businesses in NYC, Long Island, Westchester County, Putnam County, Rockland County, and Dutchess County. One legal and structural component central to the success of HealthPass has been New York State's community rating law.

Find the complete article by clicking here.