NYBGH Health Reform Resources

NYBGH has added health reform resources for employers to its home page. Under the "What's New" section, two PDF documents, one summarizing the new law and another outlining its implementation timeline, are available.

Visit www.nybgh.org to access these resources.

As always, NYBGH staff is available to help answer any health reform-related concerns our members may have. For more, please contact Shawn Nowicki, Director, Health Policy at snowicki@nybgh.org or 212.252.7440 x227.

Large Employers Immediately Feeling the Effects of Health Reform

A number of major employers, such as Caterpillar, AT&T, AK Steel, 3M, John Deere, and Valero Energy, have indicated that a provision in the new health law relating to retiree prescription drug benefits will cost them millions of dollars this year alone. Attempting to raise revenue to pay for the new bill, the legislation includes a provision that repeals a tax deduction that employers receive for offering prescription drug benefits to their retiree population. When Medicare Part D was passed in 2003, the federal government began offering a 28% tax deduction for employers that offered prescription drug coverage that is, at minimum, actuarially equivalent to coverage offered in Medicare Part D. As a result of the legislation, employers will still receive the subsidy for providing this service to their retirees, but they no longer will be able to benefit from a tax deduction.

While the provision does not go into effect until 2013, employers will have to immediately begin accounting for it in their books. Last week AT&T announced that it would take a $1 billion charge because of the provision. John Deere's parent company, Deere & Company announced a $150 million charge and their competitor Caterpillar is predicting a $100 million charge.

Click here to read more from the New York Times.

What Does Health Reform Mean to You?

Kaiser Health News has compiled a number of "explainers" that examine how health reform will affect different populations. In addition to explaining the provisions of the new law, the site also includes the full text of both the reconciliation and Senate health bills.

Click here to access the stories.

Pelosi Signs Reconciliation Bill, Puts Punctuation Mark on Debate

Congressional Democrats put a punctuation mark on the over year-long health care reform debate when House Speaker Nancy Pelosi (D-CA) signed the reconciliation "fixes" bill Thursday after it was approved by a 220-207 vote.

Members of Congress now leave Washington for a two week district work period where Democrats will be selling (and trying to explain) the benefits of the new legislation and Republicans are predicted to malign aspects of the bill as part of their campaign to win back the majority.

For more, click here to access the New York Times story.

Senate Passes Reconciliation Bill: Now Heads Back to House

Following an hours long "vote-o-rama", Senate Democrats approved the health care reconciliation "fixes" bill by a vote of 56-43, with Republicans unanimously opposed. Republicans successfully challenged some provisions related to the higher education portions of the bill, and thus were struck out by the Senate parliamentarian. One struck provision would have prevented any annual decrease in the maximum amount of Pell grants for students from low-income families. Democrats indicated they would omit the disputed provisions and expressed overall happiness with the outcome of the debate because they were able to successfully hold back 40 Republican amendments.

The legislation nonetheless will advance through Congress and now heads back to the House for one final vote, which is expected to occur Thursday evening. Final approval from the House is needed, in this case, because changes were made to the reconciliation package they approved.

For more, click here for a New York Times article.

President Obama Signs Health Reform Bill

At a ceremony in the White House this morning, President Obama signed into law the Senate health reform bill that was passed by the House of Representatives late Sunday night by a vote of 219-212. The bill is expected to cost $940 billion over the next ten years and is estimated to cover 32 million additional Americans by 2019.

The reconciliation bill that was passed by the House following the passage of the Senate reform bill is now headed to the Senate for debate. Because the measure is a reconciliation bill, special Senate debate rules apply. First, debate is limited to only 20 hours and filibusters are prohibited. Second, the Byrd Rule applies, which states that any provision that does not relate directly to the federal budget must be stricken from the bill. If Republicans are successful in challenging the bill through either a point of order or with an amendment, the bill will be sent back to the House for a final vote.

To read more about today's White House signing ceremony, click here.

New CBO Score on Health Reform Bill

The non-partisan Congressional Budget Office (CBO) this morning released a cost analysis of Democrats' recently revised health reform package. Keeping in step with President Obama's commitment to keep the price of reform below $1 trillion, this package, set to be advanced through Congress using the budget reconciliation process, is estimated to cost $940 billion over 10 years and reduce the federal deficit by $130 billion.

House Democrats are expected to use a "deem and pass" parliamentary tactic that would allow House members to avoid giving an "up or down vote" on the reform bill. By using this maneuver, the original Senate-passed health reform bill would automatically be considered passed if the reconciliation bill is passed. A memo released by the Senate parliamentarian earlier this week indicated that this tactic is indeed valid in this particular case, angering Republicans who have characterized this strategy as unrepresentative of fair and proper parliamentary procedure. The next step in enacting the health reform package would be to introduce the reconciliation bill in the Senate where only a simple majority of 51 votes would be needed to approve it. Senate Republicans are expected to delay the momentum of the bill by introducing numerous amendments and having the Senate clerk read each one.

Click here for more from the New York Times.
Additional coverage is provided by The Hill and can be accessed by clicking here.

Mental Health Parity Page

The Partnership for Workplace Mental Health has created a "Parity Page" that contains a wealth of information on the 2008 Mental Health Parity and Addiction Equity Act of 2008.

A resource for learning more about how to comply with the new federal requirements, the page includes a timeline of the parity law, an outline of the associated interim final rules, results from an employer survey on parity, and a research issue brief.

To access the parity page, click here.

COBRA Extension Fact Sheet Released

The federal Employee Benefits Security Administration (EBSA) recently updated a fact sheet on the COBRA premium reduction program. Reflecting changes made by the Temporary Extension Act (TEA) passed on March 2, 2010, the fact sheet outlines requirements to be eligible to receive the 65 percent premium reduction subsidy, among other things.

Click here to view the complete fact sheet.

March 18 Health Reform Deadline in Question

House Majority Leader Steny Hoyer (D-MD) yesterday pushed back against the President's insistence that an "up or down vote" on health reform be made before Mr. Obama leaves for an overseas trip on March 18th. In a story in The Hill newspaper, Hoyer is reported as claiming that the March 18th deadline imposed by the White House will be difficult to meet, but is not by any means an absolute deadline.

For more, click here.

HealthPass to Offer Oxford Small Group

HealthPass, a health insurance exchange serving small businesses and sole proprietors, is now offering UnitedHealthcare's Oxford small group plans. Eligible employers must have 2-50 workers and can enroll immediately for coverage effective April 1, 2010. Oxford sole proprietor plans will still continue to be offered through HealthPass.

An innovative partnership between the New York Business Group on Health, the City of New York and the health insurance industry, HealthPass provides small businesses with an array of Fortune 500-quality healthcare options through an insurance exchange.

HealthPass enables eligible employees of small businesses to individually choose a healthcare plan that fits their medical needs and budgets. There are more than 25 different coverage options from New York's leading carriers - EmblemHealth, GHI, HIP Health Plan of New York and Oxford - as well as two dental plans and a bundled product offered through Guardian. With more than 200,000 providers, HealthPass affords greater network access than any single plan. For more information, please visit www.healthpass.com

COBRA Subsidy Extended and Medicare Doc Fix Delayed

On March 2, President Obama signed into law “Temporary Extension Act of 2010,” (H.R. 4961) staving off the expiration of federal COBRA subsidies for 30 days while also delaying a 21% cut in Medicare provider payments. After the House had approved this bill last week, Senator Jim Bunning (R-KY), voicing his objections to how the bill would be financed, initiated and wouldn't back down from a filibuster until late Tuesday night.

Aimed at extending COBRA and unemployment insurance even further, the Senate is set to begin debate on a $150 billion bill introduced by Sen. Max Baucus (D-MT). The bill would extend these benefits through December 31, 2010.

For more on these development, click here to access the Kaiser Health News story.

Obama Summit Follow-Up Reaches Out to GOP

In a follow-up letter to last week's health care summit, President Obama yesterday signaled to the Congressional Republican leadership that he is open to considering four GOP health reform ideas. Specifically, they are:

1. Sending undercover federal agents to physician practices that accept reimbursements from government health program to conduct investigations to combat fraud and abuse
2. Allocating $50 million to launch demonstrations of alternatives to resolving medical malpractice disputes, including health courts
3. Increasing Medicaid provider reimbursements in a fiscally responsible manner
4. Expanding the use of Health Savings Accounts (HSA) by offering high-deductible health plans in health insurance exchanges
   

Immediately, Senators Grassley (R-IA) and McConnell (R-KY) renounced the letter as merely a show. Mr. McConnell moreover warned Democrats that if they insist on jamming a comprehensive health reform, they would surely pay for it in this year's mid-term elections.

For more, click here for a story from the New York Times.
And, to read the President's letter, click here.

Consumer Experience with a Tiered Physician Network

A recent article in the American Journal of Managed Care by Harvard researchers Meredith Rosenthal and Anna Sinaiko examines consumers' experiences with a tiered physician network, a cost-saving and quality-spurring approach used by many employers. Surveying individuals enrolled in health plans offered by the Massachuetts Group Insurance Commission, the authors find that half (49.5%) of the respondents had prior knowledge of the tiered networks in the health plans and that those who saw a specialist in the last year and those who used the Internet for health information were more likely to be aware of this special network arrangement. In addition, 35.5 percent of those surveyed did not trust the tiers to indicate which physicians were better than others. While stratifying provider networks holds promise, the authors suggest that greater success requires enhanced consumer awareness and trust in health plans.

Click here to read the complete article.