Category: Defending PPACA

Medicare to Expand Competitive Bidding on Equipment – NYTimes.com:

Medicare officials estimated that competitive bidding for home medical equipment would save more than $42 billion in the next 10 years — $17 billion for beneficiaries and $25.7 billion for the Medicare program.

Ms. Sebelius said the savings showed the value of the health care overhaul signed into law by President Obama in 2010.

The competitive bidding program was established, with support from many Republicans, under a 2003 law that added a prescription drug benefit to Medicare. In 2008, Congress temporarily delayed the program and terminated supplier contracts that were in effect. The 2010 law expanded the program.

Medicare has historically used a fee schedule to pay suppliers. Officials gave this example of the savings: Under the fee schedule, Medicare would have paid $2,080 for an oxygen concentrator last year, and the beneficiary would have paid 20 percent, or $416. By contrast, with competitive bidding, Medicare paid about $1,395, and the beneficiary paid $279.

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Off the Charts Blog | Center on Budget and Policy Priorities | “Double-Counting” Canard Quacks Again:

Former Bush Administration official Charles Blahous has garnered some media attention by gussying up old, discredited arguments about the budgetary effects of health reform. But his paper adds nothing new to the debate.

Blahous claims the Congressional Budget Office’s cost estimate for the health reform law “double-counts” a considerable portion of the law’s Medicare savings. By subtracting these savings, Blahous asserts that — contrary to CBO — health reform increases the deficit.

But there’s no double-counting involved in recognizing that Medicare savings improve the status of both the federal budget and the Medicare trust funds. The outlooks for the budget and for the Medicare trust funds are two different things; some changes in law may affect one and not the other, but other changes affect both.

CBO estimates that health reform will modestly reduce the federal budget deficit. The Medicare actuary says that health reform will extend the solvency of the Hospital Insurance trust fund by eight years.

That’s no different than when a baseball player hits a home run: it adds to his team’s score and also improves his batting average. Neither situation involves double-counting.

CBO has accounted for deficit reduction in exactly the same way in previous Congresses, under both political parties. Until opponents of health reform latched onto the notion, no one accused CBO of faulty accounting.

For example, the Balanced Budget Act of 1997 and the Deficit Reduction Act of 2005 — both of which Republican Congresses approved — included Medicare savings that were counted as reducing the deficit and improving Medicare’s financial outlook. The Senate Republican Policy Committee rightly claimed credit for this result, and no one made charges of double-counting.

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Hurray for Health Reform – NYTimes.com:  Paul Krugman

We all know how the act’s proposal that Medicare evaluate medical procedures for effectiveness became, in the fevered imagination of the right, an evil plan to create death panels. And rest assured, this lie will be back in force once the general election campaign is in full swing.

For now, however, most of the disinformation involves claims about costs. Each new report from the Congressional Budget Office is touted as proof that the true cost of Obamacare is exploding, even when — as was the case with the latest report — the document says on its very first page that projected costs have actually fallen slightly. Nor are we talking about random pundits making these false claims. We are, instead, talking about people like the chairman of the House Republican Policy Committee, who issued a completely fraudulent press release after the latest budget office report.

Because the truth does not, sad to say, always prevail, there is a real chance that these lies will succeed in killing health reform before it really gets started. And that would be an immense tragedy for America, because this health reform is coming just in time.

As I said, the reform is mainly aimed at Americans who fall through the cracks in our current system — an important goal in its own right. But what makes reform truly urgent is the fact that the cracks are rapidly getting wider, because fewer and fewer jobs come with health benefits; employment-based coverage actually declined even during the “Bush boom” of 2003 to 2007, and has plunged since.

What this means is that the Affordable Care Act is the only thing protecting us from an imminent surge in the number of Americans who can’t afford essential care. So this reform had better survive — because if it doesn’t, many Americans who need health care won’t.

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New rules for health plans require clear summaries of benefits – Los Angeles Times:

Moving to implement a much-anticipated consumer protection in the new healthcare law, the Obama administration issued regulations Thursday requiring health plans to describe what they cover in clear, standardized language that is understandable to consumers.

Starting this fall, insurers and employers that offer health coverage will have to provide a six-page form that summarizes basic plan information, such as deductibles and co-pays, as well as costs for using in-network and out-of-network medical services.

The forms will also include estimated out-of-pocket costs for two basic examples of care: delivering a baby and managing Type 2 diabetes.
The changes are designed to allow consumers to assess how much their care would cost under different insurance policies, and to simplify the process of evaluating health plans, a task that now can involve reviewing hundreds of pages published by insurers.
“One of the primary purposes of this is to ensure this apples-to-apples comparison across plans,” said Steve Larsen, the senior Department of Health and Human Services official overseeing insurance regulation.
The simplified forms, known as the summary of benefits and coverage, were mandated by the healthcare law signed by President Obama in March 2010.
Many consumer groups and patient advocates feared that the administration would back away from the requirement after insurers and employer groups complained that developing the forms would be costly and burdensome.

Found this via a post from Wendell Potter at Huffington Post. He notes that some advocates are calling for an illustrative case of cancer in the examples as well. I agree, as this can be among the most devastating events to a family, in every way including financially.

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