Insurance Audit Information

This Week in Health Reform: November 6, 2009

As we near the end of a busy week in Congress, WellPoint sent a letter to Congressional Members highlighting the detrimental impact of current legislation on our health care system. The letter focuses on the potential impact of the Affordable Health Care for America Act (HR 3962) currently being debated in the House of Representatives.

WellPoint also provided Congress with a point-by-point response to the White House Blog’s criticism of its actuarial analyses released late last week.

And, earlier this week, The Wall Street Journal published alead editorial highly critical of House Speaker Nancy Pelosi (D-CA) and the House bill. In addition, House Republicans proposed their own health care reform legislation.

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URGENT ACTION IS NEEDED

On Saturday, November 7, the House of Representatives is scheduled to vote on health care reform legislation that would force individuals to purchase coverage through the government health care exchange. Section 202(c) of HR 3962 prohibits individual coverage from being sold outside of the government health care exchange.

Forcing individuals to purchase coverage through the exchange reflects a sharp departure from the current system, and we believe Americans should have the choice of not buying coverage through the government exchange if they choose not to do so.

We encourage you to take action and contact your Congressional Member today.

House and Senate Negotiations

House Republicans Offer Health Care Reform Plan: On Tuesday, House Republican Leader John Boehner (R-OH) described key aspects of the newly proposed health care reform bill that focus more on controlling health care costs than on expanding coverage. The proposed bill will:

* cap medical malpractice damages;

* increase incentives for people to open health savings accounts;

* allow insurance companies to sell insurance across state lines;

* allow trade associations and guild members to band together to purchase group insurance , and

* create state-based, high-risk insurance pools for individuals who have difficulty obtaining health care coverage.

The bill does not bar insurance providers from denying coverage based on pre-existing conditions, nor does it create individual or employer mandates. It also does not raise taxes. The media suggest that Republicans may galvanize around their newly introduced bill. However, the media also speculate that the proposed legislation may make Republicans more vulnerable to criticism. Late Wednesday, the Congressional Budget Office (CBO) indicated that the bill would only cover 3 million additional people at a cost of $60 billion through 2019.

Biofuel Tax Credit Restrictions Added to House Health Care Reform Legislation: A measure introduced by Rep. Chris Van Hollen (D-MD), a member of the House Democrat leadership, would save the federal government $24 billion in biofuel tax credits over 10 years.

The measure would restrict the paper industry from claiming tax incentives for use of a fuel known as “black liquor.” The tax credit savings could be used to offset costs of the health care bill, Van Hollen said.

Abortion and Immigration Issues May Imperil House Legislation: As House Speaker Nancy Pelosi works to shore up 218 votes for the House health care reform legislation introduced last week, two key contentious issues remain at the center of debate – funding for abortions and coverage for illegal immigrants . This week, anti-abortion Democrats circulated legislation to strengthen prohibitions in the bill against federal funding of abortion. It is also still up for debate as to whether or not illegal immigrants would be allowed to shop for insurance within the new exchange.

Senate Leader Signals Delay: Senate Majority Leader Harry Reid (D-NV) signaled Tuesday that Congress may fail to meet the end-of-year deadline for health care reform imposed by President Barack Obama. Senators are currently waiting for CBO cost estimates on their health care reform proposal, which may not come until late next week. Given this timeline and the upcoming Thanksgiving holiday, a bill may not reach the Senate floor until December.

Public Option Developments

CBO Indicates House Bill Would Attract Less Healthy: According to the CBO, the House health care reform legislation would attract less healthy enrollees in its version of the public option and would subsequently result in higher health care costs. In addition, the CBO predicted that of the 30 million Americans likely to purchase insurance through the insurance exchanges, one fifth would purchase insurance from the public option.

Looking Ahead

President Obama indicated that he will visit Capitol Hill late this week to address House Democrats and encourage a final push towards health care reform legislation. While House leaders plan to hold a rare Saturday vote on their proposed measure, Senate leaders still await a CBO cost estimate.

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