July 29, 2009

• Healthcare Reform Update
• Key Provisions of the America's Affordable Health Choices Act (H.R. 3200)
• Former Health Insurance Spokesman Rips Industry Practices
• Court Allows GM To Drop Health Coverage for 55,000 Retirees
• Paxil Users Eligible for Rebate
• Save 25 Percent on Veterinary Care with AFT Pet Assure
• Quote of Note: Healthcare Reform Bill
• Web Site of the Week

HEALTHCARE REFORM UPDATE
House/Senate Healthcare Votes Delayed: Hope is fading for a U.S. House of Representatives vote on healthcare reform before the August recess (July 31). Majority Leader Steny Hoyer (D-Md.) told reporters July 24 that Democratic leaders may put off the healthcare bill until September if they can't get it finished within the next two weeks. U.S. Senate Majority Leader Harry Reid (D-Nev.) said July 22 that the Senate won't pass a healthcare reform bill before it leaves for its August recess (Aug. 7). That same day, President Obama commented that he didn't mind the wait, as long as lawmakers are trying to work out difficult issues associated with the plan. Pushing back from his original August deadline, the president said he wants to sign a bill into law by the end of this year.

AFT Grass-roots Lobbying in Gear: In spite of congressional delay, the AFT continues its campaign for healthcare reform. More than 120 activists came to Washington, D.C., to lobby key senators on July 14 as healthcare reform took center stage at the union's national QuEST conference. The effort generated more than 400 phone calls and more than 1,200 e-mails, AFT president Randi Weingarten told the more than 2,000 QuEST participants. In addition, our union's ACE (Activists for Congressional Education) committees will have met with some 50 key U.S. representatives and senators by the midpoint of the August recess.

Good Healthcare Delivery: Among the attributes that make the Cleveland Clinic a nationally recognized model of effective treatment: a salaried staff, an engineered delivery system, electronic record-keeping, strong interest in the patient's experience, and a work culture committed to self-improvement.

Who Are the Uninsured? Gallup recently released the findings of a June poll detailing the demographics of the uninsured. According to the poll, 41.5 percent of Hispanics, 28.6 percent of people earning less than $34,000 annually and 27.6 percent of people ages 18 to 29 are uninsured.

Obama Opposes Subsidies to Medicare Advantage Plans, Taxation of Health Benefits: On July 20, in a "NewsHour with Jim Lehrer," interview, President Obama said he wants to end the $177 billion in subsidies to insurance companies for the Medicare Advantage program. The previous week, in a meeting with union officials that included AFT president Randi Weingarten, the president reasserted his opposition to taxing employer-sponsored health benefits.

HHS Says Cost of Health Insurance Topped $12,000 Last Year: The U.S. Department of Health and Human Services July 22 said the average annual cost of employer-sponsored insurance for a family of four in 2008 was $12,298, while the cost of an employee-plus-one plan was $8,535. The cost for a single-coverage plan was $4,386. Employees with family plans contributed an average of $3,394 toward their premiums, while employees with an employee-plus-one plan contributed $2,303 and those with single coverage paid $882.

Individually Paid Coverage Unaffordable: A report released July 21 by the Commonwealth Fund found that 57 percent of adults with individual coverage or who tried to buy coverage in the past three years, said it was "very difficult or impossible" to find coverage they could afford, and 47 percent said it was "very difficult or impossible" to find a plan with the coverage they needed. In addition, 36 percent were denied coverage or charged more because of a pre-existing condition, or had the condition excluded from their coverage. According to the report, 64 percent of adults with individual insurance spend $3,000 or more per year on premiums while only 20 percent of those with employer insurance spend that much. On average, those with individual market insurance spend $6,750 annually.

Public Insurance Option Could Reap Administrative Cost Savings: A report released July 16 by the Commonwealth Fund said that including a public health insurance option along with private plans in a health insurance exchange could bring about savings on administrative costs amounting to as much as $265 billion between 2010 and 2020. According to the report, healthcare administrative fees cost the United States $156 billion in 2007, and those costs are expected to double by 2018.

KEY PROVISIONS OF THE AMERICA'S AFFORDABLE HEALTH CHOICES ACT OF 2009 (H.R. 3200)
The U.S. House of Representatives healthcare reform bill includes a three-year reduction in payments to Medicare managed-care plans to fee-for-service payment levels that would begin in 2013. It also would fill in the so-called doughnut hole in coverage under Medicare's drug benefit by 2023. The bill would expand Medicaid coverage beginning in 2013 by establishing a federal floor of eligibility for individuals with annual incomes up to 133 percent of the federal poverty level. The measure's public plan would use payment rates based on Medicare plus 5 percent for providers also participating in Medicare. The link to Medicare payments would be severed after three years; at that point, the Department of Health and Human Services would set its payment rate. The bill also would reform the private insurance market by prohibiting insurers from refusing to offer coverage based on pre-existing medical conditions or an individual's prior health status.

FORMER HEALTH INSURANCE SPOKESMAN RIPS INDUSTRY PRACTICES
Wendell Potter, former chief spokesman for health insurer Cigna Corp., is campaigning for a public health-plan option, targeting what he calls deceptive and dishonest insurance industry tactics in fighting such a plan. Potter, who retired from Cigna in 2008 after 15 years, testified before the Senate Commerce Committee in June that to appease Wall Street analysts and investors, insurers routinely dump policyholders who are less profitable or who get sick. He said a trip two years ago to a rural health fair in Wise County, Va., where people waited in animal stalls to receive medical attention, sparked his about-face on the industry. Potter said competition from a government plan would pressure private insurers to cut administrative expenses and counter Wall Street pressure to avoid paying claims.

COURT ALLOWS GM TO DROP HEALTH COVERAGE FOR 55,000 RETIREES
The Communications Workers, United Steelworkers and the Operating Engineers plan to appeal a bankruptcy judge's recent approval of a plan to allow the new GM, which now is owned primarily by U.S. taxpayers, to take away health coverage from 55,000 GM and GM Delphi retirees. The UAW, whose retirees at GM were able to keep their health coverage, is strongly backing the other unions' efforts. Court documents obtained during discovery show that GM decided to cut retiree healthcare by 87 percent so it could leave executive pension and salaried healthcare largely intact with only 32 percent and 25 percent reductions, respectively. GM chief executive Fritz Henderson testified in January that the company decided to give salaried retirees a $300 a month increase in their pensions to offset what it would cost them to purchase insurance when the company eliminated their medical insurance.

PAXIL USERS ELIGIBLE FOR REBATE
The Alliance for Retired Americans and coalition partner, Prescription Access Litigation, are working to help eligible seniors receive money to which they may be entitled. If you paid for Paxil CR anytime between April 1, 2002, and March 4, 2005, you may be eligible to file a claim worth $50 to $150. Visit the Web site www.SimonetPaxilCRSettlement.com or call 866/458-3186 for a claim form. If you had five or fewer split tablets, you'll be eligible for a minimum claim of $50, no proof of purchase, receipt or other verification needed. If you had more than five split tablets, you can claim $10 for each additional broken tablet, up to $150, but you must provide documentation that you paid for or were prescribed the tablets in that time period. Send claim forms postmarked by Aug. 10, 2009, to: Simonet Paxil CR Claims Administrator, c/o Rust Consulting, Inc., P.O. Box 24661, West Palm Beach, FL 33416.

SAVE 25 PERCENT ON VETERINARY CARE WITH AFT PET ASSURE
Cut the cost of routine veterinary services for the pets in your household. Join AFT's Pet Assure program and save 25 percent every time you visit a veterinarian in Pet Assure's growing network of participating vets. There are no forms, no pet exclusions, and no deductibles. And you'll save up to 30 percent on other pet services such as pet boarding, pet supplies, pet food, pet sitting, pet training and more. Visit www.aft.org/aftplus/discounts/pets.htm for details.

QUOTE OF NOTE: HEALTHCARE REFORM BILL

"When I take this bill to the floor, it will win. This will happen."

Nancy Pelosi, Speaker
U.S. House of Representatives
July 26, 2009

WEB SITE OF THE WEEK:
www.agingresearch.org/content/general/detail/1025

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