WeeklyFinancingNewsPulseNationalEditionfinal20091204.pdf (PDF | 336.18 kb)
SAMHSA222s Weekly Financing News Pulse: National Edition December 4, 2009 12/4/09 1 SAMHSA222s Weekly Financing News Pulse: National Edition National News Senate Begins Votes to Amend the Patient Protection and Affordable Care Act Update: Senate Passes Veterans Health Bill Poll Finds Americans Pessimistic About Health Reform, Favor Public Option Update: ARRA COBRA Subsidy Expires for First Recipients Studies Released CBO Report Examines Impact of Senate Democrats222 Health Reform Bill on Insurance Premiums MIT Economist Finds Senate Health Care Reform Bill Will Lower Non Group Premiums CBO Report Finds Promotional Spending on Prescription Drugs Remains Constant MedPAC Report Finds Regional Variation in Medicare Service Utilization and Spending AHRQ Releases Program Brief on Mental Health Research Findings Mercer Survey Finds Employers Would Reduce Benefits to Avoid 223Cadillac224 Tax Families USA Report Examines Expiring ARRA COBRA Subsidies Watson Wyatt Report Finds Increased Health Plan Utilization, Continued Emphasis on Employee Health Offerings Small Businesses Report Reluctance to Switch to a Public Plan KFF Releases Analyses of Health Care Reform Legislation Study Examines Lessons Learned from California222s Parity Law for National Parity Implementation Around the Hill: Hearings on Health Financing To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Financing224: https://service.govdelivery.com/service/multi_subscr ibe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx For questions or comments, please contact Kevin Hennessy ( kevin.hennessy@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: National Edition December 4, 2009 12/4/09 2 National News Senate Begins Votes to Amend the Patient Protection and Affordable Care Act: On November 30, the Senate began debate on the Democrats222 Patient Protection and Affordable Care Act of 2009 ( HR 3590 ), debating for three dates before agreeing on procedural rules to govern the amendment process ( Kaiser Health News, 12/3 ). On December 3, the Senate voted on four proposed amendments, approving two and rejecting two: On a 6139 vote, Senators Olympia Snowe (R ME), Susan Collins (R ME) and David Vitter (R LA) joined 58 Democrats and Independents to approve Senator Barbara Mikulski222s (D MD) $1 billion amendment requiring insurers to provide certain preventative services for women without any copayments or deductibles. The Senate also rejected an alternate version of the amendment proposed by Senator Lisa Murkowski (R AK) ( New York Times, 12/3 ; Politico 12/3 ). On a 4258 vote, with Senators Ben Nelson (D NE) and Jim Webb (D VA) joining all the Republicans in favor, the Senate defeated Senator John McCain222s (R AZ) amendment to send the entire bill back to the Senate Finance Committee to remove $400 billion in Medicare cuts. The Senate voted unanimously in favor of an amendment proposed by Senator Michael Bennet (D CO) restating that Medicare cuts included in the bill will not adversely affect seniors ( Politico, 12/3 ; Kaiser Health News, 12/3 ). In an effort to pass health care reform legislation before the end of 2009, Senate Majority Leader Harry Reid (D NV) said the Senate will work weekends and possibly convene the week of December 28 ( Kaiser Health News, 12/2 ). While the amendment process continues on the Senate floor, Senate Democrats and senior Obama Administration Officials continue to meet privately to broker a deal on the public plan option capable of garnering 60 votes ( Kaiser Health News, 11/30 ; Kaiser Health News, 12/3 ; AP, 12/4 ). Update: Senate Passes Veterans Health Bill: After striking a deal with Senator Tom Coburn (R OK), the Senate approved the Caregivers and Veterans Omnibus Health Services Act of 2009 ( SB 1963 ) in a 980 vote on November 19. The bill, which provides benefits to caregivers of veterans from the wars in Iraq and Afghanistan and expands veterans222 services in rural areas, was referred to the House Committee on Veterans222 Affairs ( Kaiser Health News, 11/30 ). Poll Finds Americans Pessimistic About Health Reform, Favor Public Option: A Thomson Reuters poll conducted November 9 to 17 asked respondents to identify which key health care reform goals they believe will be accomplished within one year. In the next year, only 18 percent of respondents expect to spend less on health care, 21 percent anticipate an increase in quality, 18 percent believe health care will be a better value, and 23 percent believe that access to care will be increased. In addition, the same poll found that 60 percent of respondents favor including a public option in health care reform legislation ( The Hill, 12/3 ; Reuters, 12/3 ). Update: ARRA COBRA Subsidy Expires for First Recipients: Individuals who began receiving the 65 percent ARRA COBRA subsidy in March started rolling off the program this week as their nine months of subsidy eligibility expired. In addition, the last date for newly laid off individuals to apply for the subsidy is currently December 31, 2009. Democrats are pursuing legislation ( HR 3930 , SB 2730 ) to expand the COBRA subsidy and the White House has expressed interest in the expansion; however, neither body has passed legislation ( Kaiser Health News, 12/1 ). Studies Released SAMHSA222s Weekly Financing News Pulse: National Edition December 4, 2009 12/4/09 3 CBO Report Examines Impact of Senate Democrats222 Health Reform Bill on Insurance Premiums: On November 30, the Congressional Budget Office (CBO) released a report estimating that the Senate Democrats222 Patient Protection and Affordable Care Act of 2009 ( HR 3590 ) would have mixed effects on health insurance premiums. The CBO estimated that non group premiums will increase 10 to 13 percent by 2016; however, for the 57 percent of non group purchasers receiving federal subsidies, premium cost would drop to roughly 56 to 59 percent of their current premiums. In addition, the CBO found that premiums paid by large employers would hold constant or drop as much as 3 percent while small employers222 premiums would see a larger variety of effects, ranging from a 1 percent increase to 3 percent decrease among most small businesses and an 11 percent decrease among certain lowwage small businesses.The report also notes that increased coverage requirements will account for some of the premium increases ( CQ Today, 11/30 ) Kaiser Health News, 11/30 ; Kaiser Health News, 11/30 ; Kaiser Health News, 12/1 ). MIT Economist Finds Senate Health Care Reform Bill Will Lower Non Group Premiums: A memo authored by Massachusetts Institute of Technology economist Jonathan Gruber and released November 27, uses CBO data to assess the effects of the Patient Protection and Affordable Health Care Act ( HR 3590 ) on non group health insurance premiums. Gruber222s memo concludes that the bill would yield savings ranging from $200 for individuals to $500 for families, before accounting for government subsidies ( Politico, 11/28 ). CBO Report Finds Promotional Spending on Prescription Drugs Remains Constant: A report released by the CBO on December 2, examines promotional spending for prescription drugs in the United States, finding that, though spending remains largely stable, spending on detailing to health care professionals has increased as direct to consumer (DTC) marketing has decreased. The report tracks trends in DTC marketing, detailing to health care professionals, journal advertisements, and meetings/events. The report also considers the implication of pharmaceutical marketing to the broader health care financing landscape ( Kaiser Health News, 12/3 ). MedPAC Report Finds Regional Variation in Medicare Service Utilization and Spending: A report released by the Medicare Payment Advisory Commission (MedPAC) on December 1 examined regional variations in Medicare service utilization and spending, finding that, though both vary by region, the two are distinct because service utilization is not the sole determinant of program spending. In addition, MedPAC found that service utilization varies substantially by region but significantly less than regional Medicare spending. The report notes that service utilization in higher use areas is roughly 30 percent greater than in lowuse areas, though MedPAC speculates that fraud and abuse may account for some of the difference. The report also provides state level data on service utilization and spending ( New York Times, 12/1 ; Kaiser Health News, 12/2 ; Kaiser Health News, 12/2 ). AHRQ Releases Program Brief on Mental Health Research Findings: The Agency for Healthcare Research and Quality (AHRQ) released a program brief detailing the findings of AHRQ supported mental health research published between 2007 and 2009. The report includes research on: abuse, access to care, cognitive impairments, cost of care, depression, disparities, health IT, pharmaceuticals, and substance abuse. Mercer Survey Finds Employers Would Reduce Benefits to Avoid 223Cadillac224 Tax: A survey conducted by Mercer found that 63 percent of employers would reduce employee health benefits to SAMHSA222s Weekly Financing News Pulse: National Edition December 4, 2009 12/4/09 4 avoid paying a 40 percent excise tax on 223Cadillac224 insurance plans included in the Senate Democrats222 Patient Protection and Affordable Health Care Act ( HR 3590 ). The bill would impose a 40 excise percent tax on insurers for plans with annual costs above $8,500 for an individual or $23,000 for a family; however, insurers are expected to pass on the additional costs to enrollees and employers through premiums. Of the 63 percent of respondents who reported that they would cut benefits, 75 percent said they would raise deductibles or copayments to reduce premium costs, 40 percent said they would add lower cost health plans to their offerings, and 19 percent said they would no longer make employer contributions to HSAs or FSAs ( Kaiser Health News, 12/2 ). Families USA Re port Examines Expiring ARRA COBRA Subsidies: On December 1, Families USA released a report examining the nine month 65 percent COBRA subsidy passed as part of the ARRA. With the subsidy beginning to expire for individuals who entered the program immediately after the legislation passed, Families USA222s report finds that average COBRA premiums will rise from $389 per month to $1,111 per month for individuals losing subsidy eligibility.The report also finds that the $1,111 average premium constitutes 83.4 percent of the average unemployment check while, in nine states (Alabama, Alaska, Arizona, Delaware, Florida, Louisiana, Mississippi, South Carolina, and Tennessee), unsubsidized COBRA premiums would exceed unemploymentbenefits ( AP, 12/1 ; Reuters, 12/1 ). Watson Wyatt Report Finds Increased Health Plan Utilization, Continued Emphasis on Employee Health Offerings: Watson Wyatt has released its 2009/2010 North American Staying@Work report , finding that 42 percent of employers have seen increased utilization of company health plans and 47 percent of employers report increased use of Employee Assistance Programs (EAPs). However, the report also found that over 67 percent of companies have added or enhanced their existing health and productivity programs or plan to do so within the next year ( Washington Business Journal, 11/30 ). Small Businesses Report Reluctance to Sw itch to a Public Plan: A survey of 831 companies conducted by VerticalResponse found that, on average, only 16 percent of small business would cancel their current employer sponsored health insurance to enroll in a public option for which they were eligible.The survey found some differences between businesses with 1 to 10 employees and larger small business with up to 100. Notably, smaller companies were less likely to provide health care, with only 28 percent of very small businesses offering coverage compared to 76 percent of businesses with up to 100 employees ( Inc., 12/3 ). KFF Releases Analyses of Health Care Reform Legislation: The Kaiser Family Foundation (KFF) released summaries of proposed health insurance coverage changes under HR 3590 and HR 3962 , a brief outlining Medicaid and Children222s Health Insurance Program (CHIP) provisions under both bills, summaries of key Medicare provisions under both bills, and an analysis of the bills222 effects on Medicare savings. In addition, KFF updated its health care reform legislation comparison tool . Study Examines Lessons Learned from California222s Parity Law for National Parity Implementation: An article published in Psychiatric Services examines California222s experience implementing parity for a select group of mental health conditions between 2000 and 2005, seeking guidance for the upcoming implementation of the Wellstone Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The study concludes that implementation of the federal parity SAMHSA222s Weekly Financing News Pulse: National Edition December 4, 2009 12/4/09 5 law should include monitoring health plan performance across numerous fields including, access to care, quality of care, scope of coverage, and cost. In addition, the authors suggest implementing an education campaign to inform consumers about their new benefits ( Los Angeles Times, 12/1 ). Around the Hill: Hearings on Health FinancingHouse Veterans Affairs Committee : VA Health Care Funding December 2, 10:00 a.m., 334 Cannon Senate Indian Affairs Committee : Dental Health Care for Indians December 3, TBA, 628 Dirksen Senate Indian Affairs Committee : Underfunding of Indian Health Services December 3, TBA, 628 Dirksen House Oversight and Government Reform Committee : Health Care in New Orleans Post Katrina December 3, 10:00 a.m., 2154 Rayburn Senate Indian Affairs Committee : Indian Youth Suicide Prevention: Indian Health Care December 3, 2:15 p.m., 628 Dirksen
