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ECONOMY WEEKLY August 20, 2010
$46 Million in Grants to Help States Crack Down on Unreasonable Health Insurance Premium Hikes
45 States and the District of Columbia to Receive $1 Million Each to Make Health Insurance Markets More Consumer-Friendly and Transparent;”>
HHS Secretary Kathleen Sebelius today announced grant awards of $46 million to 45 States and the District of Columbia. These Affordable Care Act grants will be used to help improve the oversight of proposed health insurance premium increases, take action against insurers seeking unreasonable rate hikes, and ensure consumers receive value for their premium dollars.
For too long, insurance companies in many States have increased health insurance premiums with little oversight, transparency, or public accountability. Health insurance premiums have doubled on average during the last 10 years, much faster than wages and inflation, putting health coverage out of reach for millions of Americans and business owners. Today, just 26 States and the District of Columbia have the authority to reject a proposed increase that is excessive, lacks justification or otherwise exceeds State standards. Many States that have the authority lack resources to exercise it meaningfully. This lack of authority and resources for States has unfortunately contributed to unjustified premium increases in some States.
“The Affordable Care Act puts in place critical market reforms to improve quality and reduce the cost of health care for employers and individuals. Increased competition, lower insurance overhead, and better risk pooling in health insurance Exchanges in 2014 are expected to reduce premiums in the individual market by anywhere from 14-20 percent according to the Congressional Budget Office,” said Secretary Sebelius. “Between now and then, we will continue to work with States to ensure consumers are receiving value for their premium dollars and to avoid the kind of double digit premium increases seen recently. The State proposals approved today demonstrate the need and desire for new resources and tools to help them protect against unjustifiable premium increases.”
The Affordable Care Act provides States with $250 million in Health Insurance Premium Review Grants over five years to help create a more level playing field by improving how States review proposed health insurance premium increases and holding insurance companies accountable for unjustified premiums increases. Applications for the first round of Health Insurance Premium Review Grants were made available on June 7.
The grants build on the Obama Administration’s work with States to implement the Affordable Care Act. Earlier this year, Secretary Sebelius called on certain insurance companies to justify large premium increases and encouraged State and local officials to obtain stronger health insurance premium review authorities under State laws. This increased scrutiny by the Administration and by several States has led to the withdrawal or reduction of several proposed health insurance premium increases that in some cases turned out to be based on faulty assumptions and data.
States have proposed to use this funding in a variety of ways.
- Additional Legislative Authority: 15 States and the District of Columbia will pursue additional legislative authority to create a more robust program for reviewing or requiring advanced approval of proposed health insurance premium increases to ensure that they are reasonable;
- Expand the Scope of Health Insurance Premium Review: 21 States and the District of Columbia will expand the scope of their current health insurance review, for example by reviewing and requiring pre-approval of rate increases for additional health insurance products in their State.
- Improve the Health Insurance Premium Review Process: All 46 State grantees will require insurance companies to report more extensive information through a new, standardized process to better evaluate proposed premium increases and increase transparency across the marketplace;
- Make More Information Publicly Available: 42 States and the District of Columbia will increase the transparency of the health insurance premium review process and provide easy-to-understand, consumer friendly information to the public about changes to their premiums; and
- Develop and Upgrade Technology: All State grantees will develop and upgrade existing technology to streamline data sharing and put information in the hands of consumers more quickly.
“States will use these grant dollars in the way that makes the most sense for their insurance consumers,” said Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight. “As we continue to implement the new health insurance reform law, we will continue to work with States to ensure they have the tools they need to ensure the stability of the marketplace, keep costs low and provide consumers with increased transparency, choice and quality they need to make the best health care decisions for their businesses and families.”
A chart summarizing how each State will use the new resources can be found at http://www.healthcare.gov/news/factsheets/rateschart.html.
The Health Insurance Premium Review Grants are one element of a broad effort under the Affordable Care Act to reduce the unreasonable premium increases proposed by some insurers today. Additional resources from this $250 million program will be available in subsequent years to further strengthen State health insurance premium review procedures. Other statutory provisions designed to improve affordability include:
- In 2011, the Affordable Care Act allows the Secretary of the U.S. Department of Health and Human Services to review justifications for unreasonable increases in premiums and make them public;
- In 2011, insurers will generally be required to spend at least 80 percent of premium dollars on medical care services and quality-improvement activities and limit their spending on overhead, marketing, CEO salaries, and profits; and
- In 2014, the Affordable Care Act empowers States to exclude health plans that show a pattern of excessive or unjustified premium increases from the new health insurance Exchanges.
The Affordable Care Act includes a wide variety of provisions designed to promote a high-quality, high-value, health care system for all Americans and to make the health insurance market more consumer-friendly and transparent. Some of the provisions that take effect by the end of next year, or are already in effect, include prohibitions on pre-existing condition exclusions for children; prohibition on lifetime dollar limits in all health plans; extended access to insurance for many young adults; and an unprecedented level of transparency about health insurance through www.HealthCare.gov.
To read more about the grants, visit http://www.healthcare.gov/news/factsheets/rates.html.
To read more about how each State will use its grant funding, visit http://www.healthcare.gov/center/grants/index.html.
US world’s largest stockpile of Cluster Munitions weapons, has not signed the treaty,
International: Cluster Munitions Convention in Effect
To link to this article, copy this persistent link:
http://www.loc.gov/lawweb/servlet/lloc_news?disp3_l205402148_text
(Aug. 09, 2010) On August 1, 2010, the Convention on Cluster Munitions came into force (text available from the Convention website, http://
www.clusterconvention.org/pages/pages_ii/iia_textenglish.html . Adopted in Dublin, Ireland, on May 30, 2008, and signed several months later in Oslo, Norway, on December 3, the Convention has been ratified by 38 countries. The first meeting of the parties to the treaty will be held in November 2010 in Vientiane, Laos.
The Convention prohibits the use, stockpiling, production, and transfer of all cluster bombs, which are weapons that come apart into large numbers of smaller explosive components that can spread out before detonating. In addition, the treaty calls for the supplies of such weapons to be eliminated and unexploded bombs to be cleared in the next ten years. These weapons are considered to be especially hazardous for civilians. (Erin Bock, Cluster Munitions Treaty Goes into Effect, PAPER CHASE NEWSBURST (Aug. 1, 2010), http://
jurist.org/paperchase/2010/08/cluster-munitions-treaty-goes-into-eff
ect.php.)
U.N. Secretary-General Ban Ki-moon, speaking about the treaty’s coming into force, said it was “a major advance for the global disarmament and humanitarian agendas.” In addition to expressing his pleasure that the Convention came into force in just over two years after its adoption, Ban stated: “[t]his highlights not only the world’s collective revulsion at these abhorrent weapons, but also the power of collaboration among governments, civil society and the United Nations to change attitudes and policies on a threat faced by all humankind.” (UN Hails Entry into Force of Global Pact Banning Cluster Munitions, UN NEWS CENTRE (July 30, 2010), http://
www.un.org/apps/news/story.asp?NewsID=35479&Cr=weapon&Cr1pan>.)
Amnesty International called the Convention a “crucial step towards protecting civilians, during and after armed conflict, from this cruel and indiscriminate weapon.” The organization urged all nations that have not yet done so to sign and implement the treaty, comparing it to the 1997 pact on land mines. (Cluster Bomb Ban Treaty Takes Effect Worldwide, Amnesty International website (Aug. 1, 2010), http://
www.amnesty.org/en/news-and-updates/cluster-bomb-ban-treaty-takes-ef
fect-worldwide-2010-08-01.) In recent weeks, both Norway and Moldova have destroyed their cluster munitions, and the United Kingdom has begun the process. (PAPER CHASE NEWSBURST, supra.)
The United States, which has the world’s largest stockpile of these weapons, has not signed the treaty, arguing that a ban on the weapons would hurt humanitarian work by discouraging cooperation between countries that have and have not signed. The U.S. policy, adopted in June 2008, is designed to protect civilians and civilian infrastructure following a conflict, while allowing for the retention of what is considered to be “a legitimate and useful weapon.” (Id.; Memorandum, U.S. Secretary of Defense, DoD Policy on Cluster Munitions and Unintended Harm to Civilians (June 19, 2008), http://
www.defense.gov/news/d20080709cmpolicy.pdf.)
Social Security & Medicare Report
Statement by Secretary Geithner on the Releases of Social Security and Medicare Trustees Reports
Statement by Secretary Geithner on the Releases of Social Security and Medicare Trustees Reports
For the Social Security Report, visit link below.
For the Medicare Report, visit link below.
The Social Security and Medicare Boards of Trustees met this afternoon to complete their annual financial review of the programs and to transmit their Reports to Congress. I welcome my fellow Trustees. I also want to acknowledge the hard work and dedication of the chief actuaries, Stephen Goss and Richard Foster, and their staffs, who worked especially hard this year to incorporate the effects of health care reform in the reports.
Seventy-five years ago this month, President Roosevelt signed the Social Security Act into law, creating the program that tens of millions of Americans now rely on to help them retire with economic security. Thirty years later, President Johnson signed amendments to that law creating Medicare, providing health insurance for our older Americans. And this year, President Obama signed the Affordable Care Act, giving Americans more control over their healthcare decisions, ending insurance company abuses, and taking major steps to bring down health care costs over the long term.
The impact of health care reform is made clear by the Trustees Reports, which show some very positive developments for Social Security and especially Medicare. But they also remind us that we must continue to make progress addressing the financing challenges facing the long-term solvency of these programs.
When we delivered our Reports last spring I argued that it was imperative that we gain control of Medicare costs by delivering health care services more efficiently, and that doing so requires a larger effort to control health care costs and improve quality more generally. With the recent enactment of the Affordable Care Act (ACA), we have taken a huge step in that direction. This new law gives Americans more control over their healthcare decisions, ends insurance company abuses and will bring down health care costs over the long term.
The Affordable Care Act has dramatically improved projected Medicare finances. Medicare’s Hospital Insurance (HI) Trust Fund is now expected to remain solvent until 2029, 12 years longer than was projected last year, which is a record increase from one report to the next. In addition, the 75-year financial shortfall for HI has been reduced to 0.66 percent of taxable payroll from 3.88 percent of taxable payroll in last year’s report, and the projected costs for the Medicare Supplementary Medical Insurance (SMI) program over the next 75 years, expressed as a share of GDP, are down 23 percent relative to the projections in the 2009 report Nearly all of these improvements in projected Medicare finances are due to the Affordable Care Act President Obama signed into law in March.
As impressive as these achievements are, there is still work to be done. Although HI financing is projected to be sufficient until 2029, the HI Trust Fund balance is expected to fall below one year’s projected expenditure beginning in 2012, which means the test for short-range financial adequacy is not met. And it is projected that SMI will continue to put increasing pressure on the federal budget and beneficiaries in the years ahead, though to a much lesser extent than was projected last year, prior to the passage of the Affordable Care Act. Over the next 75 years, SMI costs are expected to average 3.3 percent of GDP, which is 1.4 percentage points higher than the SMI cost share of GDP was in 2009, so additional reform measures will be needed. Those measures will be informed by experiments with alternative provider payment mechanisms and patient care models that are authorized in the ACA, as well as by the recommendations of the newly created Independent Payment Advisory Board.
The Affordable Care Act also improves Social Security’s finances. Starting in 2019, a new tax on high-cost health care plans is expected to result in a shift in labor compensation from health insurance to earnings, which are subject to Social Security and Medicare taxes. This factor more than accounts for the reduction in Social Security’s actuarial deficit to 1.92 percent of taxable payroll from 2.0 percent of taxable payroll projected last year.
The recession has, however, somewhat worsened Social Security’s very near term outlook. Benefit payments are expected to exceed tax revenue for the first time this year, six years earlier than was projected last year, but the improving economy is expected to result in rough balance between Social Security taxes and expenditures for several years before the retirement of the baby boom generation swells the beneficiary population and causes deficits to grow rapidly. It is projected that tax and interest income will be sufficient to pay benefits through 2024, after which the Trust Fund will be drawn down until depleted in 2037, the same date of Trust Fund exhaustion projected last year. After 2037, it is expected that tax income will be sufficient to finance more than three quarters of scheduled benefits.
Despite the projection that Social Security can continue to pay full benefits for nearly 30 years, the sooner action is taken the more options for reform will be available and the fairer reforms will be to our children and grandchildren. Now that we have taken meaningful steps to put Medicare on a sustainable path and moved quickly and aggressively to rescue our economy and put us a path to continued future growth, we must work to address the other intermediate- and long-term fiscal imbalances that the federal government faces as well.
To that end, the President has proposed some important steps to put us on a fiscally responsible path. First, the Administration’s Budget puts a three-year freeze on non-security discretionary funding. The President reinstated pay-as-you budgeting that helped lead to the economic prosperity of the 1990s. And the President has appointed a bipartisan Fiscal Commission which will make further recommendations by the end of the year. These measures, along with further healing of our economy, will help make sure we have strong and sustainable growth that will benefit all Americans.
LINKS
Top Ten Bills In Congress Week of August 5 2010
Top Weekly Bills in THOMAS
August 5th, 2010 by Andrew
Since the January enhancements to THOMAS, I’ve been looking at the statistics on user searches and creating a list of the most searched legislation. Health care legislation has dominated the list since then, jumping around but always somewhere within the top ten.
The current top ten includes:
- H.R. 3590
Patient Protection and Affordable Care Act- H.R. 4899
Supplemental Appropriations Act, 2010- H.R. 4173
Restoring American Financial Stability Act of 2010- H.R. 4213
American Jobs and Closing Tax Loopholes Act of 2010- H.R. 5297
Small Business Jobs and Credit Act of 2010- H.R. 3534
Consolidated Land, Energy, and Aquatic Resources Act of 2009- H.R. 847
James Zadroga 9/11 Health and Compensation Act of 2010- H.R. 2267
Internet Gambling Regulation, Consumer Protection, and Enforcement Act- H.R. 5175
Democracy is Strengthened by Casting Light on Spending in Elections Act- H.R. 4872
Health Care and Education Reconciliation Act of 2010
Our enhancements are primarily based on user feedback. The Tip of the Week was created because people would ask for a particular feature for THOMAS that was already there. We took the Tip of the Week one step further with the June enhancements. Now there is an archive of the tips, an RSS feed, and an email alert.
U.S. Stockpiles Cluster Munitions
UN hails entry into force of global pact banning cluster munitions
30 July 2010 – United Nations officials have expressed their delight at Sunday’s entry into force of the international convention banning the manufacture, use and stockpiling of cluster munitions, calling it a “major advance for the global disarmament and humanitarian agendas.”
However; the USA refuses to give up it’s stockpiles. Sighting from the US Secretary of States website:
Cluster munitions have demonstrated military utility. Their elimination from U.S. stockpiles would put the lives of its soldiers and those of its coalition partners at risk. Moreover, cluster munitions can often result in much less collateral damage than unitary weapons, such as a larger bomb or larger artillery shell would cause, if used for the same mission.
Billions of these weapons – which are considered particularly dangerous, despite their lack of precision – are believed to exist around the world and many have been used in recent conflicts, killing or maiming countless civilians.
FACTS:
Cluster bombs have killed and injured thousands of civilians during the last 40 years and continue to do so today. They cause widespread harm on impact and yet remain dangerous, killing and injuring civilians long after a conflict has ended. One third of all recorded cluster munitions casualties are children. 60% of cluster bomb casualties are injured while undertaking their normal activities.
Among the seven makers of the weapon and components were diversified manufacturer Textron (TXT.N), aerospace and defence group Alliant Techsystems (ATK.N), and defence contractor Lockheed Martin (LMT.N), all U.S. based.
Thirty ratifications were needed to make the pact, which prohibits explosive remnants of war known either as cluster munitions or unexploded ordnance (UXO), a part of international law. That milestone was reached in February when Burkina Faso and Moldova both submitted their instruments of ratification of the Convention on Cluster Munitions at UN Headquarters in New York.Some 98 per cent of victims are civilians and cluster bombs have claimed over 10,000 civilian lives, 40 per cent of whom are children.
The convention, Secretary-General Ban Ki-moon said in a statement on Friday, “will help us to counter the widespread insecurity and suffering caused by these terrible weapons, particularly among civilians and children.”
He is particularly pleased, the statement continued, that the pact will enter into force on 1 August, just over two years after it was adopted by 107 States in Dublin, Ireland.
“This highlights not only the world’s collective revulsion at these abhorrent weapons, but also the power of collaboration among governments, civil society and the United Nations to change attitudes and policies on a threat faced by all mankind,” the Secretary-General emphasized.
The convention – negotiated by States that represent past and current producers, stockpilers and victims of cluster munitions – establishes important commitments regarding assistance to victims, clearance of contaminated areas and destruction of stockpiles.
To date, 37 countries have ratified the pact, which also has 107 signatures.
First used in the Second World War, cluster munitions contain dozens of smaller explosives designed to disperse over an area the size of several football fields, but often fail to detonate upon impact, creating large de facto minefields.
The failure rate makes these weapons particularly dangerous for civilians, who continue to be maimed or killed for years after conflicts end. Some 98 per cent of victims are civilians and cluster bombs have claimed over 10,000 civilian lives, 40 per cent of whom are children.
Recovery from conflict is also hampered because the munitions place roads and lands off-limits to farmers and aid workers.
The pact represents “a major advance for the global disarmament and humanitarian agendas,” Mr. Ban noted in his statement, a theme echoed by Daniël Prins, chief of the conventional arms branch of the UN Office for Disarmament Affairs (ODA).
“This is a great step forward – here we have a treaty at the nexus of disarmament and humanitarian efforts,” Mr. Prins said in an interview with the UN News Centre.
He noted that the convention is not merely symbolic, but contains many practical measures, such as requiring States to provide assistance to victims, engage in clearance operations and conduct awareness campaigns so that children do not inadvertently set off explosions.
The first meeting of States parties to the convention will be held this November in Laos, which Mr. Ban said is a country “that has suffered tremendously from the impact of cluster munitions.”
Clearance operations are still ongoing in the South-East Asian nation more than 30 years after conflict left 75 million unexploded cluster bomblets across the country.
Mr. Ban called on all Member States to take part in the November meeting to express their support for the convention, while also urging those nations which have yet to accede to the pact “to do so without delay.”
Cluster munitions have been used in conflicts around the world in recent years, including in the Middle East, South-Eastern Europe, the Caucasus, the Horn of Africa and Central Africa.
The UN Mine Action Service (UNMAS) has been coordinating the removal of cluster munitions in many countries, including Cambodia, Chad, Laos, Lebanon, Tajikistan and Zambia.
Max Kerley, the Director of UNMAS, said he hoped the convention will now gather the kind of support enjoyed by the Anti-Personnel Mine Ban Treaty and receive more ratifications in the months ahead.
Keeping Social Security Strong another 75 Years
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ECONOMY WEEKLY July 19, 2010
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Leadership Of Change
Hoyer Delivers Speech on the Economy and Job Creation
New Tool to Help Fight Health Care Fraud in Florida
HHS Secretary Sebelius and Attorney General Holder to Co-Host Fraud Prevention Summit Tomorrow in Miami
U.S. Health and Human Services Secretary Kathleen Sebelius announced today that health care fraud fighters in the state of Florida will now have additional funding to help find potential fraud and abuse in the state’s Medicaid program through the use of Medicaid claims data.
Today, Secretary Sebelius approved Florida’s Medicaid waiver request to help fund a demonstration program that will allow the state’s Medicaid Fraud Control Unit (MFCU) to “mine” Medicaid Management Information System (MMIS) data to identify cases of potential Medicaid fraud.
Medicaid billing for many health care services in South Florida is disproportionately high compared to other parts of the country. Although significant progress has been made, fraudulent billing health care fraud continues to cost Medicaid millions of dollars.
“To fight health care fraud, we need to coordinate all of the resources and data we can muster,” said Secretary Sebelius. “By allowing the state of Florida to use more information to find potential fraud in Medicaid, this waiver will improve Florida’s ability to effectively identify and combat fraud and abuse.”
The announcement comes in advance of the Department of Health and Human Services and Department of Justice’s first Regional Health Care Fraud Prevention Summit being held tomorrow at the Knight Center in Miami, Fla.
The summit, which will feature keynotes remarks by U.S. Attorney General Eric Holder and Secretary Sebelius, kicks off the first in a series of day-long summits bringing together a wide array of federal, state, and local partners, beneficiaries, providers, and other interested parties to discuss innovative ways to eliminate fraud within the U.S. health care system.
As part of its efforts to coordinate the fight against fraud across the nation’s health care systems, including Medicaid and Medicare, data mining will allow Florida’s MFCU to sort electronic claims through the use of statistical models and intelligent technologies to uncover patterns and relationships. Using the identified patterns, investigators can review Medicaid claims activity and history to find abusive or abnormal use of services and billing that may be potentially fraudulent. Data mining is done with software programs which include algorithms that automatically analyze the MMIS data.
Currently, state MFCUs are prohibited from using federal Medicaid matching funds to detect potential fraud through routine claims review procedures such as screening of claims, analysis of billing practice patterns, or routinely verifying that billed services were actually received by patients, since these functions are a primary program operation function of the state Medicaid agency.
Instead, MFCUs generally rely on referrals from the State Medicaid agency. The waiver approved today will allow the Florida MFCU to use federal matching funds to apply sophisticated electronic data mining tools that are beyond the scope of the claims review activities normally performed by the State Medicaid agency to identify potential fraud.
The Centers for Medicare & Medicaid Services (CMS) expects the MFCU to work closely with AHCA to ensure their collective efforts are effective. CMS will monitor the progress of this waiver in conjunction with the HHS Office of Inspector General, which has oversight of MFCUs.
“The demonstration approved today will allow Florida’s Medicaid Fraud Control Unit to take full advantage of their expertise in detecting and investigating Medicaid fraud,” said CMS Administrator Don Berwick, M.D.
