US Representative Charles Rangel to Speak at NYBGH Event

During this year's February Congressional District Work Period, U.S. Representative Charles B. Rangel (D-NY) will be speaking about health reform at an NYBGH legislative event. Representing New York's 15th Congressional district, which comprises Northern Manhattan, Harlem, and parts of Queens, Representative Rangel is the chairman of the House Ways and Means Committee, the principle Congressional body responsible for issues related to government revenue.

At the event, Rep. Rangel is expected to speak about the prospects for health reform as well as how reform will affect tri-state area employers.

The event will be held on Wednesday, February 17th from 8:30am to 10:30 am at a location to be determined.

Please stay tuned for more information.

Research Suggests Value-Based Insurance is Effective

A research group led by Harvard's Michael Chernew and the University of Michigan's Mark Fendrick recently published an article in the journal Health Affairs asserting that value-based insurance design program can be effective and do not increase total systemwide medical spending.

The authors investigated one particular value-based insurance design program and found that it led to reduced use of nondrug health care services, offsetting the costs associated with additional use of drugs encouraged by the program.

Click here to access the complete article.

COBRA and Form 550 Compliance Webcasts

The Department of Labor and the Employee Benefits Security Administration recently hosted two compliance webcasts designed to provide plan administrators guidance on administering COBRA premium reduction subsidies and filing the 2009 Form 5500.

Both archived webcasts can now be found online on the EBSA website.

To access the webcast on COBRA premium reduction subsidies, click here.

Click here to view the 2009 Form 5500 webcast.

Whole Foods Launches Healthy Eating Campaign for Workers and Customers

National organic grocery store chain Whole Foods Market recently announced the launch of its new Health Starts Here initiative aimed at improving the health of both employees and customers alike. By partnering with two healthy eating organizations, The Engine 2 Diet and Eat Right America, Whole Foods is offering in-store education so consumers can identify healthy, nutrient-dense foods. Employees are now offered increased discounts for participation in worksite wellness programs and more direct health and wellness education.

Click here to read more.

Why Wellness Incentives Belong in the Workplace

In a recent Health Affairs blog post, Jaan Sidorov asserts that wellness programs first belong in the workplace, and secondly, offering incentives for both attainment and participation is a feasible and effective component of an overall strategy.

In his post, Mr. Sidorov briefly points out a recent meta-analysis released by researchers at Harvard University that reveals the ROI of workplace wellness to be $3.27. He also points out a contrasting study recently published in the New England Journal of Medicine contending that offering incentives in wellness programs is unfair and unattainable for some segments of the population.

To access the post, click here.

DOL Webinars on 2009 Form 5500 and COBRA Premium Reduction Extension Provisions

The Employee Benefits Security Administration (EBSA) is hosting two upcoming webinars. On Thursday, January 21st at 1:00pm Eastern, staff members from EBSA and the Department of Labor (DOL) will provide plan sponsors with assistance in understanding the changes to the form and filing process. In addition, they will introduce users to the new EFAST2 electronic filing website. And, a representative from the Internal Revenue Service (IRS) will discuss filings that now will be submitted only to the IRS. The webinar can be access by clicking here.

At 1:00pm Eastern time on Friday, January 22nd, DOL and EBSA staffers will discuss the extension and provide assistance in complying with the new requirements, including the model notices and transition period. This webinar can be access by clicking here.

GOP Brown Victorious in Massachusetts

In a special election to fill the late Senator Ted Kennedy's US Senate seat, Republican Scott Brown, formerly a little-known Massachusetts state senator, claimed victory in a tight, momentum-shifting race late Tuesday night. Claiming 52 percent of the vote, Mr. Brown now will head to Washington, DC to be sworn in as Massachusetts's junior Senator and will be faced with a number of issues pressing not only GOPs, but the entire Senate, most notably health care reform. Displacing Democrats' fillibuster-proof 60 votes, Mr. Brown now forces the White House and a Democrat-controlled Congress to figure out how and when they will pass what stands to be President Obama's signature domestic policy initiative, historic health reform legislation. As Washington anxiously, or soberly, awaits Mr. Brown's arrival into the Senate, news outlets are reporting that Democratic leaders are now scrambling to salvage health reform before it gets torn and tattered by GOPs, misguided by midterm election concerns, or other pressing policy issues.

To read more on Mr. Brown's landmark victory, click on the following major media outlet links:

The Hill - Brown Snags Massachusetts Senate Seat in Stunning Upset Win for Republicans
The New York Times - GOP Takes Massachusetts Senate Seat
The Wall Street Journal - GOP Victory Upends Senate
Kaiser Health News - Republican Brown Wins Senate Seat

Health Policy Brief on Employer Mandates

In a Health Affairs Health Policy Brief published January 15th, the background and current activity surrounding employer mandates are explained and put into the context of health reform being pushed through Congress. The current state of employer-based health insurance coverage is first briefly explained, an explanation of the history of mandate proposals and the current proposals emerging from both chambers of Congress follows, and the brief closes with arguments in favor and opposed to an employer mandate.

The complete brief can be found by clicking here.

Workplace Wellness Programs Can Generate Savings

In a Health Affairs article published January 14th, Katherine Baicker, David Cutler, and Zirui Song, all of Harvard University, contend that workplace wellness programs can generate savings that outweigh costs in addition to improving health outcomes and employee productivity. This meta-analysis examines costs and savings data from studies on workplace wellness and prevention programs and concludes that medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent.

For the complete Health Affairs article, click here.

Congressional & Administration Leaders Close to Health Care Deal

Throughout the week, top White House officials, Congressional Democratic leaders, and Democratic committee chairmen have been furiously working on negotiating a final health care reform bill. At issue and receiving significant mainstream media attention are, among other things, disagreements over the role of states in health insurance exchanges, subsidy levels to make insurance more affordable for middle-class Americans, an excise tax on high-priced insurance plans, the ability of the bills to contain overall health costs, and the Massachusetts special election to replace the late Sen. Ted Kennedy.

On Thursday, January 14th, media outlets reported that House Democrats had issued statements that a deal on the financing portions of the bill had been struck. The revised bill is slated to be sent to the Congressional Budget Office on Saturday to receive a cost analysis. Congressional Democrats are increasingly feeling a sense of urgency over next week's special election in Massachusetts. Republican State Senator Scott Brown, as of today, holds a slight lead, albeit within the margin of error, over his Democratic opponent, Massachusetts Attorney General Martha Coakley. Mr. Brown has indicated that if elected and present for the vote on the health bill, he would vote against it, thereby foiling Democrats' hopes of passing historic health reform.

To read more, click here for the story from The Hill.

Late Thursday, labor leaders reported that a deal had been struck on the proposal to tax high-priced "Cadillac plans". According to The New York Times, in a conference call with reports, AFL-CIO President Richard Trumka provided additional details:

• The threshold for the tax would be $24,000 for families and $8,900 for individuals. The Senate bill called for a threshold of $23,000 for families and $8,500 for individuals.
• The threshold would be increased each year by the amount of the rise in the Consumer Price Index plus 1 percent — that’s the same rate of indexation called for in the Senate bill.
• The formula will be adjusted for inflation from 2010 to 2013. The initial inflation threshold period will be adjusted upward if inflation increases above current assumptions.
• For high risk professions, the threshold would increase to $27,000.
• There would also be adjustments creating higher thresholds for employee groups whose health premiums are higher because the groups contain a disproportionate percentage of older workers and women. Those two groups tends to have higher health premiums than other workers. There would also be adjustments for those living in high-cost states.
• As of 2015, dental and vision costs would not be counted toward the threshold.
• Collective bargaining plans were to have been excluded from the exchange. Starting in 2017, collective bargaining agreements at all levels will be able to participate in the exchanges.

The New York Times also reports that "workers covered by collective bargaining agreements, as well as state and local employees, will be exempted from the tax until 2018."

For more on this, click here to access The New York Times story.

Tax on "Cadillac" Plans Likely to Survive

The Hill reports that labor leaders have conceded that the excise tax on "Cadillac", or high-cost, health plans will survive negotiations between the House and Senate on their respective health reform bills. Andy Stern, president of the Service Employees International Union (SEIU), along with other union and labor leaders have lambasted the proposed 40% tax on the cost of insurance policies worth greater than $8,400 for individuals and $23, 000 for families.

Vocal opposition to the tax has emerged as of late and some see the proposed tax as a broken promise to the American people. In his presidential campaign, Mr. Obama asserted that he would not raise taxes on anyone making less than $250,000. Others worry that including the tax in the final bill would give Republicans political ammunition, something that Democrats want to avoid in this mid-term election year.

For more on this, visit The Hill.

Additional information on this issue can be found by clicking here (Roll Call) and here (New York Times).

Health Reform's Impact on Retiree Health Benefits

The Employee Benefit Research Institute's January Issue Brief highlights the potential implications of health reform on retiree health benefits.

The report cites that the issues impacted most by reform are anticipated to be: the reinsurance program for early retirees, Medicare drug benefits, tax treatment of employer subsidies under the Medicare Modernization Act of 2003, and post-retirement benefit changes.

EBRI reports that

"The proposals’ provisions will have a mixed impact on retiree health benefits: In the short term, the reinsurance provisions would help shore up early retiree coverage and Medicare Part D coverage would become more valuable to retirees. In the longer term, insurance reform combined with new subsidies for individuals enrolling for coverage through insurance exchanges, the maintenance-of-effort provision affecting early retiree benefits, increases to the cost of providing drug benefits to retirees, and enhanced Medicare Part D coverage, would all create significant incentives for employers to drop coverage for early retirees and drug coverage for Medicare-eligible retirees."

Click here to access the complete report.

Ping Pong, Anyone?

To ensure the delivery of a health reform package to President Obama's desk in time for his State of the Union Address and to deflect any further Republican delay tactics, Democrats have indicated that party leaders will informally resolve the differences between the two bills rather than under the rubric of a formal conference committee. In this process, known as "ping-pong", leaders from each chamber would negotiate to resolve a number of the differences in the bill and then send their updated version to the other chamber until both have adopted identical bills. Media outlets are estimating that there may be only one volley, with the House adopting the Senate language and sending it back to the Senate for final approval. With a Senate vote of 60-39, just enough to pass the legislation, the final bill is predicted to reflect the Senate version more than the House version for the sake of maintaining enough votes.

The Hill reports that C-SPAN is in talks with Democrats to publicly televise the behind closed doors negotiations. Conference Committee proceedings would normally be televised, especially on such a hot-button issue, and C-SPAN wants to ensure the public access.

To read more, visit The New York Times, The Wall Street Journal, or The Hill.

Health Insurance Exchanges - Point, Counterpoint

Today's USA Today provides a point counterpoint take on the proposed health insurance exchanges in the pending health reform legislation. As both chambers of Congress head into committee to resolve differences between the two pieces of legislation, health insurance exchanges seem to be a mainstay, but intergovernmental issues are at issue. Some argue that state-based exchanges are the way to go, while others rail that one federal-based exchange would be best suited for best meeting the legislation's intent.

To access the pro-state-based argument, click here. The pro-federal-based argument can be found by clicking here.

For more information on HealthPass, a health insurance exchange in downstate New York operating for more than 10 years and covering more than 30,000 lives, click here.