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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: wlcnyc who wrote (11220)	11/10/2009 1:25:01 PM
From: Peter Dierks	1 Recommendation Respond to of 42652

Effort to Assist Older Voters May Raise Costs for the Young NOVEMBER 10, 2009. By ANNA WILDE MATHEWS A provision in the House health-care bill sets up a stark choice for Democrats between the interests of younger voters and older ones. The bill would limit how much insurers can vary premiums based on the age of the person buying the policy. The narrower the range, the lower the premiums for older people, a help to those who currently pay some of the highest rates for insurance and often need coverage the most. But such a limitation tends to raise premiums for younger folks, who are sometimes reluctant to buy coverage. In the House bill, the ratio can only be as much as 2 to 1, meaning older people could pay no more than twice what the youngest customers are charged. Senate Democrats, who haven't yet unveiled the bill that will go to the floor there, will have to decide whether to echo the House's ratio or use a different one. Lobbyists say one possibility might be 3 to 1, the average of two earlier Senate bills. Currently, the range isn't capped in most states and older people may pay five or six times as much. It's tough to project the exact impact of the new age ratio because the bills contain other provisions affecting premiums. Still, a calculator on the Kaiser Family Foundation Web site gives a rough sense. It suggests that under the House's 2-to-1 cap, a 20-year-old would pay $3,169 in annual premiums and a 60-year-old would pay $6,339 for comparable plans, if they both had incomes above the subsidy-eligible level. Under a bill passed by the Senate Finance Committee, which had a 4-to-1 age-rating ratio, the 20-year-old would pay $2,258 and the 60-year-old would pay $8,357. The House bill also requires almost all Americans to carry health insurance or pay a fine. Republicans say the combined effect will be to make some young people buy expensive policies they don't want. "We are going to tell every young American who has decided that they don't want to pay those premiums, they want to save up to get married or to buy a home, that, by golly, they are going to have to take insurance. And they are going to pay three to four times what they would under the current system because there is only a 2-to-1 ratio," said Rep. Joe Barton (R., Texas) during the weekend House debate. Democrats, who relied on the youth vote in their 2008 election victories, counter that the bill helps young people by allowing them to stay longer on their parents' insurance plans and offering subsidies for coverage to lower-income Americans, many of whom are young people in low-paying jobs. A spokeswoman for Rep. Henry Waxman (D., Calif.) chairman the House Energy and Commerce Committee, said the House bill will help level "the playing field so that regardless of age, gender, financial or health status, individuals and families are able to afford coverage." The impact of the premium-age ratio would be felt most directly by those buying their own health plans. Based on Congressional Budget Office projections, after 10 years, about 30 million people would be buying individual insurance under the House bill, roughly double the current figure. Merlyn Lawrence, a 64-year-old retiree in Scottsdale, Ariz., pays around $230 a month for a high-deductible insurance plan she bought through eHealthInsurance.com. Living with her daughter and relying on her Social Security income for expenses, she has to dip into her savings to make the monthly payments and can't always afford her prescriptions, she says. "At our age, we don't have the option of a job and bringing in a monthly income," she said. "Between that age of 50 and 65, I really feel like people need to be given a break." On the other end of the spectrum, Tyler Routson, 23, of Los Angeles, works as a runner for a recording studio and is forced to rely on his parents to help pay the premiums for his roughly $140-a-month health plan. Though he is willing to help subsidize older people's costs as a "good Samaritan gesture," he said, he is also financially stretched and hoping a health bill will bring down the price of his coverage. "I know very few people who are my age who have money to help a 50-year-old person," he said. The seniors' lobby AARP has pushed for the narrower age-rating band, arguing that older people would otherwise be priced out of the insurance market. "Our overriding concern is affordability," said John Rother, an executive vice president with the group. Industry officials argue that if young people are asked to pay more, fewer of them will buy insurance, and many may opt instead to pay the penalty for being uninsured. "That makes the premiums for everyone else increase," said Alissa Fox, senior vice president of the Blue Cross and Blue Shield Association. Write to Anna Wilde Mathews at anna.mathews@wsj.com online.wsj.com

To: wlcnyc who wrote (11220)	3/13/2010 11:52:32 AM
From: Peter Dierks	1 Recommendation Read Replies (1) \| Respond to of 42652

Report: Bill would reduce senior care Medicare cuts approved by House may affect access to providers By Lori Montgomery Washington Post Staff Writer Sunday, November 15, 2009 A plan to slash more than $500 billion from future Medicare spending -- one of the biggest sources of funding for President Obama's proposed overhaul of the nation's health-care system -- would sharply reduce benefits for some senior citizens and could jeopardize access to care for millions of others, according to a government evaluation released Saturday. The report, requested by House Republicans, found that Medicare cuts contained in the health package approved by the House on Nov. 7 are likely to prove so costly to hospitals and nursing homes that they could stop taking Medicare altogether. Congress could intervene to avoid such an outcome, but "so doing would likely result in significantly smaller actual savings" than is currently projected, according to the analysis by the chief actuary for the agency that administers Medicare and Medicaid. That would wipe out a big chunk of the financing for the health-care reform package, which is projected to cost $1.05 trillion over the next decade. More generally, the report questions whether the country's network of doctors and hospitals would be able to cope with the effects of a reform package expected to add more than 30 million people to the ranks of the insured, many of them through Medicaid, the public health program for the poor. In the face of greatly increased demand for services, providers are likely to charge higher fees or take patients with better-paying private insurance over Medicaid recipients, "exacerbating existing access problems" in that program, according to the report from Richard S. Foster of the Centers for Medicare and Medicaid Services. Though the report does not attempt to quantify that impact, Foster writes: "It is reasonable to expect that a significant portion of the increased demand for Medicaid would not be realized." The report offers the clearest and most authoritative assessment to date of the effect that Democratic health reform proposals would have on Medicare and Medicaid, the nation's largest public health programs. It analyzes the House bill, but the Senate is also expected to rely on hundreds of billions of dollars in Medicare cuts to finance the package that Majority Leader Harry M. Reid (D-Nev.) hopes to take to the floor this week. Like the House, the Senate is expected to propose adding millions of people to Medicaid. The Centers for Medicare and Medicaid Services administers the two health-care programs. Foster's office acts as an independent technical adviser, serving both the administration and Congress. In that sense, it is similar to the nonpartisan Congressional Budget Office, which also has questioned the sustainability of proposed Medicare cuts. In its most recent analysis of the House bill, the CBO noted that Medicare spending per beneficiary would have to grow at roughly half the rate it has over the past two decades to meet the measure's savings targets, a dramatic reduction that many budget and health policy experts consider unrealistic. "This report confirms what virtually every independent expert has been saying: [House] Speaker [Nancy] Pelosi's health-care bill will increase costs, not decrease them," said Rep. Dave Camp (Mich.), the senior Republican on the House Ways and Means Committee. "This is a stark warning to every Republican, Democrat and independent worried about the financial future of this nation." Democrats focused Saturday on the positive aspects of the report, noting that Foster concludes that overall national spending on health care would increase by a little more than 1 percent over the next decade, even though millions of additional people would gain insurance. Out-of-pocket spending would decline more than $200 billion by 2019, with the government picking up much of that. The Medicare savings, if they materialized, would extend the life of that program by five years, meaning it would not begin to require cash infusions until 2022. "The president has made it clear that health insurance reform will protect and strengthen Medicare," said White House spokeswoman Linda Douglass. "And he has also made clear that no guaranteed Medicare benefits will be cut." Republicans argued that the report forecasts an increase in total health-care spending of more than $289 billion. washingtonpost.com