WeeklyFinancingNewsPulseNationalEditionfinal20091009.pdf (PDF | 314.17 kb)
SAMHSA222s Weekly Financing News Pulse: National Edition October 9 , 2009 10/ 9 /09 1 SAMHSA222s Weekly Financing New Pulse: National Edition National News CBO Scores Finance Committee222s Health Reform Bill, Committee to Vote Tuesday; House Sends Three Bills for CBO Scoring Sen. Coburn Blocks Approval of House222s Medicare Part B Premium Adjustment Obama Administration Considers Extending COBRA Subsidies President Obama Nominates Pamela Hyde as SAMHSA Administrator CMS Releases Information on 2010 MA Rate Reductions Polls Find Fragmented Opinions on Health Reform, Some Increased Support HHS Secretary Announces $40 Million in Grants to Increase CHIP and Medicaid Enrollment HHS Secretary Sebelius Backs CMS222 Investigation of Humana SAMHSA Awards $25.9 Million in M/SU and Primary Care Integration Grants AHCA Estimates the Effects of CMS222 Nursing Home Rate Adjustments H1N1 Vaccine Arrives, Begins Shipping to Local Distributors Twenty - Five Percent of Office - Based Physicians E- Prescribing Mayo Clinic to Stop Accepting Medicaid Patients from MT, NE U.S. News & World Report Creates List of Best Nursing Homes DOL Seeks Exemption to Facilitate Chrysler Retiree Health Benefits WellPoint to Cut Employee Health Benefits Studies Released Commonwealth Fund Releases 2009 State Scorecard on Health System Performance NCAL Report Finds Medicaid HCBS Spending Nearly Doubled Since 2001 KFF Releases Brief Examining Medicare Part D Plan Availability and Changes Consumers Union Survey Finds Americans Cutting Back on Care MPI Report E xamines the Effects of Health Care Reform on Immigrants Report Outlines Rural Health Care Challenges Survey Finds Mental Health Conditions More Common Among the Unemployed Cocaine Vaccine S hows Promise Around the Hill: Hearings on Health Financing For quest ions or comments, please contact Kevin Hennessy ( kevin.hennessy@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: National Edition October 9 , 2009 10/ 9 /09 2 National News CBO Scores Finance Committee222s Health Reform Bill, Committee to Vote Tuesday; House Sends Three Bills for CBO Scoring : On October 7, the Congressional Budget Office (CBO) released a preliminary analysis of the Senate Finance Committee222s amended Chairman222s Mark of the America222s Health Future Act of 2009 . The CBO found that the amended bill would cost $829 billion over 10 years and lower the deficit by $81 billion through cost offsets while expanding health insurance to 94 percent of Americans. The CBO estimates that 23 million people would obtain coverage through health insurance exchanges while an additional 14 million would enroll in Medicaid and the Children222s Health Insurance Program (CHIP), which the committee voted to maintain last week ( New York Times, 10/5 ) . However, the CBO noted several caveats, including the bill222s failure to account for the proposed Medicare payment increases for doctors, which would cost roughly $200 billion over a decade or require cuts of up to 15 percent in physician reimbursement rates ( Kaiser Health News, 10/8 ). On October 8, Senate Majority Leader Harry Reid (D - NV) and Senate Finance Committee Chair Max Baucus (D - MT) announced that the Finance Committee will vote on the amended bill October 13. Meanwhile, Sen. Reid has already begun working with Sen. Baucus and Senate Health, Education, Labor and Pensions (HELP) Committee Chair Tom Harkin (D - IA), Senator Chris Dodd (D - CT), and the White House to merge the bills from the Finance and HELP committees ( Kaiser Health News 10/8 ; Kaiser Health News, 10/7 ). Senator Charles Schumer (D - NY) also announced this week that any Congressional health care reform bill will contain a public plan, regardless of whether it is included in the Finance Committee222s bill ( Kaiser Health News, 10/5 ). Obama Administration officials, including Director of the White House Office of Health Reform Nancy - Ann DeParle, have also supported a public plan option, holding private meetings with Senate lawmakers to discuss ways of including a public plan in the merged bill that Sen. Reid brings to the Senate floor ( Kaiser Health News, 10/5 ). House Speaker Nancy Pelosi (D - CA) announced October 8, that she will send three versions of the House health reform bill to the CBO, including one with a 223robust224 public option, which would reimburse providers at rates 5 percent higher than Medicare222s rates and two versions including public plans with government - negotiated rates ( Washington Post, 10/8 ). In addition, House Democrats are considering partially funding their bill with a 223windfall profit224 tax on health insurers; however, they plan to wait for the CBO scores prior to assembling a final bill, slated to come to the House floor no sooner than October 19 ( CQ Politics, 10/8 ). Finally, t he Kaiser Family Foundation (KFF) continues to provide detailed legislative tracking, updating its health care reform comparison tool to reflect the Finance Committee222s recent amendments. Sen. Coburn Blocks Approval of House222s Medicare Part B Premi um Adjustment : On October 7, Senator Tom Coburn (R - OK) blocked a unanimous consent request for the Senate to approve a September 24 House measure freezing Medicare Part B premiums (Financing News Pulse 9/25 edition). The legislation would use $2.8 billion from the Medicare Improvement Fund, which the U.S. Department of Health and Human Services (HHS) usually uses to improve Medicare Parts A and B, to prevent rate increases for 27 perc ent of Medicare beneficiaries. Without the legislation, Medicare Part B premium s for new Medicare enrollees, Medicare enrollees with incomes over $85,000 ($170,000 for couples), and dually eligible Medicaid and Medicare enrollees whose Medicare premiums are paid by state222s Medicaid programs would increase from an average of $ 96.40 per month this year to $119 per month in 2010, and $123 per month in 2011. Coburn says that the measure is unsustainable in light o f the country222s entitlement obligations ( Kaiser Health News, 10/8 ). SAMHSA222s Weekly Financing News Pulse: National Edition October 9 , 2009 10/ 9 /09 3 Obama Administration Considers Extending COBRA Subsidies : On October 5, t he Obama Administration announced that it is considering extending the federal COBRA subsidies implemented by the American Recovery and Reinvestment Act (ARRA) (F inancing News Pulse 2/20 edition). Under the ARRA, t he federal government pays 65% of COBRA prem iums for up to nine months for workers who are laid off through the end of this year . A recent Hewitt Associates Inc. survey found that, since the subsidy has been in place, twice as many laid off employees have opted for COBRA insurance ( Kaiser Health News, 10/6 ). President Obama Nominates Pamela Hyde as SAMHSA Administrator : President Barack Obama nominated New Mexico Secretary of Human Services Pamela S. Hyde as Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) . Hyde has held her current position since 2003 and previously served as state mental health director, city housing and human services director, and as CEO of Comcare, a private non - profit managed behavioral healthcare firm. Acting SAMHSA Administrator Rear Admiral Eric Broderick has headed the agency since Former Administrator Terry Cline stepped down last year ( About.com, 10/6 ). CMS Releases Information on 2010 MA Rate Reductions : After announcing a 4 percent average rate reduction for Medicare Advantage (MA) plans effective 2010 (Financing News Pulse 4/13 edition), the Centers for Medicare & Medicaid Services (CMS) released information October 1 outlining the effects of those rate cuts. On average, MA beneficiaries222 premiums will increase $7 monthly; however, the effects will be highly varied by region . Areas with higher Medicare rates, like New York and Miami, will see smaller premium increases and fewer benefit reductions than regions with lower Medicare rates. In addition, about 660,000 seniors 227 7 percent of the MA population227 must change plans or enroll in tradition al fee - for - service (FFS) Medicare because their insurers have discontinued their plans. Most of the affected plans are private FFS plans, which CMS is targeting for much greater regulation due to their high cost. Most MA plans are HMO and preferred provider organization (PPO) plans ( Kaiser Health News, 10/1 ; Wall Street Journal, 10/1 ). Polls Find Fragmented Opinions on Health Reform, Some Increased Support : The latest AP/GfK poll found that 48 percent of respondents approve of President Obama222s handling of health care reform while respondents were evenly split ( 40 - 40 ) in their general approval of health care reform, up from 39 percent approval and 49 percent disapproval one month ago. The AP poll also found that seniors222 opposition to health reform softened, with disapproval dropping from 59 percent to 43 percent ( Kaiser Health News, 10/8 ; Washington Post, 10/7 ). In addition, a Quinnipiac University poll found that 47 percent believe the president will do a better job on health care reform than the GOP while 31 percent believe that Republicans will do a better job . The Quinnipiac poll also found that 51 percent of respondents dis approve of President Obama222s handling of health care reform while 41 percent approve of it and 40 percent support his health plan while 47 percent oppose it. In a more detailed examination, t he Quinnipiac poll found that 61 percent of respondents support a public option, 73 perc ent support an employer mandate, and 50 percent support an individual mandate ( Bloomberg, 10/8 ). Finally , a F OX News poll , conducted September 29 - 30, found that 33 percent of respondents favor the health care reform legislation while 53 percent oppose it, compared with 38 and 48 percent two weeks ago. In addition, the FOX poll notes that r espondents are split along party lines, with 85 percent of Republicans opposing the legislation and 60 percent of Democrats favoring it. The FOX poll also found that 57 percent of independents oppose the legislation while 27 percent favor it ( FOX News, 10/2 ). SAMHSA222s Weekly Financing News Pulse: National Edition October 9 , 2009 10/ 9 /09 4 HHS Secretary Announces $40 Million in Grants to Increase CHIP and Medicaid Enrollment : On September 30, HHS Secretary Kathleen Sebelius announced 69 grants to organizations in 41 states and the District of Columbia to help enroll children in state s222 CHIP and Medicaid programs. The grants, which total $40 million over two years, are part of $100 million allocated under the Children222s Heal th Insurance Program Reauthorization Act of 2009 (CHIPRA) to increase enrollment in the programs. HHS will issue another $40 million round of grants in 2012 in addition to $10 million for tribal organizations and $10 million for a national enrollment outr each effort ( HHS, 9/30 ). HHS Secretary Sebelius Backs CMS222 Investigation of Humana : In a letter to Senate Minority Leader Mitch McConnell (R - KY), HHS Secretary Kathleen Sebelius defended CMS222 investigation into Humana Inc.222s communications with its beneficiaries regarding the effects of Democratic health care reform legislation on Medicare Advantage (MA) plans (Financing News Pulse 9/25 edition). Prominent GOP members alleged that CMS222 investigation was politically motivated, threatened to block Obama Administration HHS appointments, and demanded House hearings; however, Secretary Sebelius contends that CMS is correct to investigate the possible violations and will continue to do so ( Kaiser Health News, 10/7 ). SAMHSA Awards $25.9 Million in M/SU and Primary Care Integration Grants : On October 6, SAMHSA announced $25.9 million in grants for Primary and Behavioral Health Care Integration Programs (PBHCI) to address the needs of people with serious mental illnesses . The grants will fund 13 grantees in AZ, CA, CO, CT, IL, KY, OH, OK NH, and NY for $500,000 annually for up to four y ears to support communities to coordinating and integrating primary care services into publicly funded community mental health and other community - based behavioral health settings ( Media - Newswire , 10/7 ; SAMHSA, 10/6 ). AHCA Estimates the Effects of CMS222 Nursing Home Rate Adjustments : The American Health Care Association (AHCA) estimates that adjustments to Medicare nursing homes, implemented by CMS effective October 1, will reduce federal funding for the facilities by $16 billion over 10 years. Spokesman for the AHCA are urging lawmakers to consider the funding reduction before cutting more funding from Medicare under pending health care reform legislation ( AP, 10/5 ; Kaiser Health News, 10/5 ; PRNewswire, 10/1 ). H1N1 Vaccine Arrives, Begins Shipping to Local Distributors : The first doses of H1N1 (swine flu) vaccine arrived in the U.S. the week of October 5 and the federal government has already begun distributing the vaccine to local jurisdictions responsible for allocating the vaccine to doctors, hospitals, and school systems. As of October 5, 62 states and localities had submitted orders for over 1.7 million doses of vaccine. In addition, a spokesperson from the Centers for Disease Control and Prevention (CDC) noted that the number of swine flu cases has been higher than the average number of flu cases for this time of year; however, that the CDC stressed that such data are not an indication of how severe the flu season will be. In a related story, a CDC spokesman said that the CDC will release an updated report outlining the anticipated effects of H1N1 on minority communities to follow up a September 4 report in which the CDC alluded to the possibility of a greater outbreak in minority communities ( Kaiser Health News, 10/6 ; Kaiser Health News, 10/7 ). Twenty- Five Percent of Office -Based Physicians E -Prescribing : Data from SureScripts , a private company that routes prescriptions from physicians to 85 percent of U.S. phar macies, indicates that SAMHSA222s Weekly Financing News Pulse: National Edition October 9 , 2009 10/ 9 /09 5 143,000227 25 percent 227 of office - based physicians are currently e - prescribing their medications, up from 74,000 in 2008. Experts attribute the increase bonuses paid to e - prescribing doctors through both Medicare and private insurance. Beginning in 2012, physicians not e - prescribi ng will face a Medicare reimbursement cut ( Wall Street Journal, 10/5 ). Mayo Clinic to Stop Accepting Medicaid Patients from M T , NE : Beginning January 1, the Mayo Clinic in Rochester, Minnesota will no longer accept Medicaid patients from Montana or Nebraska because their programs222 reimbursement rates are too low. The Mayo Clinic currently accepts Medicaid patients from Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, and Wisconsin and clinic officials report that the change will only affect 50 clinic patients ( Post - Bulletin, 10/8 ). U.S. News & World Report Creates List of Best Nursing Homes : Using data from CMS222 Nursing Home Compare , which offers information and ratings about all nursing homes accepting Medicare and Medicaid patients, U.S. News & World Report assembled a list of the country222s best nursing homes. U .S. News provides additional detail to supplement CMS222 rankings, which are limited to a 1 - 5 star system. U.S. News222 list is accessible online and searchable by location and nursing home name ( Kaiser Health News, 10/6 ; U.S. News & World Report, 10/ 5 ). DOL Seeks Exemption to Facilita te Chrysler Retiree Health Benefits : On October 2, the U.S. Department of Labor (DOL) announced that it is seeking an exemption to the Employee Retirement Income Security Act (ERISA) to allow the United Auto Workers222 ( UAW ) voluntary employee benefits association (VEBA) to own a 55 percent stake in New Chrysler . The proposed exemption would allow the VEBA hold a large percentage of plan assets as employer securities, allowing New Chrysler to fund the VEBA with a $4.59 billion promissory note ( AP, 10/2 ; CFO, 10/2 ). WellPoint to Cut Employee Health Benefits : In an email to WellPoint Inc.222s 42,000 employees, the company said that it will raise deductibles on two of its three employee health plans and lower its contribution towards employee premiums in some plans. WellPoint covers 82 perce nt of its employees222 health costs, which is over the national average ( Indianapolis Star, 10/5 ). Studies Released Commonwealth Fund Releases 2009 State Scorecard on He alth System Performance : The Commonwealth Fund released the results of the 2009 State Scorecard on Health System Performance on October 8, assessing states222 performance in health care access, quality, cost, and outcomes. The report found that states222 performance continues to vary widely; however, all states face rising h ealth care costs and poor care coordination. The report notes that Vermont, Hawaii, Iowa, Minnesota, Maine, New Hampshire, Massachusetts, Connecticut, North Dakota, Wisconsin, Rhode Island, South Dakota, and Nebraska were the overall highest performers; h owever, the scorecard does not yet reflect the effects of the recession because of a reporting lag ( Chicago Tribune, 10/7 ; Kaiser Health News, 10/8 ; Commonwealth Fund, 1 0/8 ). Data from the report is also available via an interactive online tool . NCAL Report Finds Medicaid HCBS Spending Nearly Doubled Since 2001 : A report released October 6 by the National Center for Assisted Living (NCAL) found that Medicaid spending on home - and community - based services (HCBS) increased 81.5 percent fro m FY2001 to FY2007, while nursing home spending grew 9.8 percent over the same period. The report found that, from 2001 to 2007, Medicaid nursing home spending went from $42.7 billion to $46.9 billion while HCBS spending increased from $9.2 billion to $16.7 billion. In addition, the number of people receiving Medicaid services in SAMHSA222s Weekly Financing News Pulse: National Edition October 9 , 2009 10/ 9 /09 6 licensed assisted living settings increased 44 percent from 2002 to 2009 and HCBS Medicaid waivers now cover services in residential settings in 37 states while an additional 13 states provide coverage directly though the state Medicaid plan ( McKnight222s Long- Term Care News & Assisted Living, 10/7 ). KFF R eleases Brief Examining Medicare Part D Plan Availability and Changes : On October 2, KFF released a brief , compiled in conjunction with researchers at Georgetown University and the National Opinion Research Center at the University of Chicago , examining the Medicare Prescription Drug Benefit Program (Part D) stand alone plans available in 2010. The brief examines plans based on region, premiums, and benefit design and offers an analysis of key plan changes since 2006 ( KFF, 10/2 ). Consumers Union Survey Finds Americans Cutting Back on Care : A Consumers Union su rvey, conducted September 17 - 20, found that Americans are cutting back on health care costs to save money. The survey found that 28 percent of respondents delayed doctors visits, 22 percent put off medical procedures, 20 percent declined medical tests, 20 percent elected not to fill prescriptions, 15 percent took expired medication, and 25 percent reported being unable to pay their medical bills ( Kaiser Health News, 10/8 ; McClatchy, 1 0/7 ). MPI Report Examines the Effects of Health Care Reform on Immigrants : A Migration Policy Institute (MPI) report finds that current health care reform proposals do little to help immigrants, including legal permanent residents. MPI finds that 4.2 million of the 12 million legal immigrants in the U.S. are currently uninsured and notes that many are temporarily barred from state Medicaid programs because of a 1996 law requiring that legal aliens wait five years from the date they obtain their green card before becoming eligible for Medicaid. The report finds that maintaining that restriction and applying it to the government health insurance subsidies for individuals earning up to 400 percent of the federal poverty level (FPL) will limit health insurance access for over 1 million legal immigrants. In addition, the report examines the cost implications of limiting health insurance access for both legal and illegal immigrants under various health reform proposals ( The Hill, 10/5 ; Kaiser Health News, 10/6 ). Report Outlines Rural Health Care Challenges : A report released by the Center for Rural Affairs and the Center for Community Change highlights the unique challenges of rural health care. The report notes that rural communities have a lower rate of employer- sponsored insurance because rural economies rely more heavily on small businesses and self- employment. The repor t also finds that rural areas have twice the rate of underinsurance as urban areas and that rural residents pay 22 percent more for health coverage than those living near metropolitan areas ( Kaiser Health News, 10/2 ). Survey Finds Mental Health Conditions More Common Among the Unemployed: A survey released by the National Alliance on Mental Illness (NAMI) and Mental Health America (MHA) found that unemploy ed people are four times more likely to experience severe mental health issues than those who are employed. The survey also found that 13 percent of unemployed persons reported seriously considering harming themselves ( Philadelphia Inquirer, 10/7 ). Cocaine Vaccine Shows Promise : In a study supported by the National Institute on Drug Abuse (NIDA) and published in the Archives of General Psychiatry , individuals attaining high levels of an anti- cocaine antibody had significantly more cocaine free urine samples than those with lower antibody levels or those taki ng a placebo. Unlike the antibodies produced by other vaccines, which destroy or disable the disease - causing agent, the cocaine antibodies prevent the drug from passing through the SAMHSA222s Weekly Financing News Pulse: National Edition October 9 , 2009 10/ 9 /09 7 blood brain barrier to inhibit the drugs euphoric effects. The study fou nd that the proportion of subjects having a 50 percent reduction in use was significantly greater in those attaining higher antibody levels than those with lower levels. However, only 38 percent vaccinated subjects attained the high antibody levels and si gnificant effects of the vaccine only lasted 2 months ( NIDA, 10/5 ). Around the Hill: Hearings on Health Financing Senate HELP Committee: Department of Labor, Surgeon General Nominations Vote October 7, 10:00 a.m., 430 Dirksen House Energy and Commerce Subcommittee on Health: Breast Cancer Bills October 7, 10:00 a.m., 2123 Rayburn House Oversight and Government Reform Subcommittee on Domestic Policy: Improving Dental Care for Medicaid Eligi ble Families October 7, 2:00 p.m., 2154 Rayburn House Veterans222 Affairs Subcommittee on Disability Assistance and Memorial Affairs: Implications of the VA222s PTSD Rule - Making October 7, 2:00 p.m., 334 Cannon Senate Finance Committee: HHS Nominations October 8, 10:00 a.m., 215 Dirksen Senate Small Business and Entrepreneurship Committee: Health Care Overhaul and Small Business October 8, 10:00 a.m., TBA House Judiciary Subcommittee on Courts and Competition Policy: Health Insurance and Antitrust Oct ober 8, 11:30 a.m., 2141 Rayburn Senate Finance Committee: Health Care Revision October 13, 10:00 a.m., 216 Hart Senate Judiciary Committee: Antitrust and Health Insurance October 14, 10:00 a.m., 226 Dirksen House Veterans222 Affairs Subcommittee on Health: Inappropriate Billing Practices by the VA October 15, 10:00 a.m., 334 Cannon
