Posts Tagged ‘State-based healthcare exchanges’

GOP Proposes Putting Seniors on Congressional Healthcare Plan

Tuesday, July 3rd, 2012

In a highly controversial move, Republicans critical of Medicare have proposed opening up the Federal Employee Health Benefits Plan (FEHBP) to Medicare patients.  “We are going to offer a plan that would give all senior citizens in the country the same congressional healthcare plan that we have,” said Senator Rand Paul (R-KY).  “We are not willing to wait until after the next election to fix the entitlements.”

The National Active and Retired Federal Employees Association (NARFE) warned that the plan could shake the federal program, while asking seniors to pay more for healthcare.  “This is a kill-two-birds-with-one-stone kind of proposal that would both bring down Medicare as we know it and threaten the stability of the FEHBP,” Joseph A. Beaudoin, NARFE president, said.  Beaudoin said seniors should examine the proposal closely, because it throws open the doors of a stable healthcare program to millions of seniors currently enrolled in Medicare.  “Given the current environment of budget attacks on federal employees, retirees and Medicare, the federal workforce and all Americans should be wary of plans like the one proposed today,” he said.

Called the Congressional Health Care for Seniors Act (CHCSA), the plan’s supporters claim that it would save taxpayers $1 trillion in the first 10 years as well as provide enhanced healthcare benefits, choice, quality and outcomes by moving seniors into the FEHBP.

How would it work?  Federal employees can now choose from approximately 250 plans participating in FEHBP, including 20 nationwide plans.  The large selection provides access to better doctors, better quality healthcare, and the ability to pick plans that best suit the person’s individual needs.  The rationale also is that because Congress uses the plan, it must be the best in the country.  Additionally, the legislation would set up a “high risk pool” for the costliest patients within the FEHBP.  The federal government will directly reimburse healthcare plans for enrolling the most expensive five percent of patients, which keeps premiums low while allowing high-risk patients to get the same quality healthcare as every other enrollee – federal employees and seniors alike.  If the legislation is passed, seniors could enroll in FEHBP starting in 2014.

There is some bipartisan support for this proposal.  In 2004, Senator John Kerry (D-MA) proposed allowing uninsured people, not seniors, to enroll in FEHBP.  “Entitlements are broken,” said Paul.  “It’s not Republicans’ fault; it’s not Democrats fault.  I tell people, ‘It’s your grandparents’ fault for having too many kids and then your fault for not having enough kids.’  It’s a demographic problem.”

Paul said the plan “means-tests the benefits and gradually allows the age of eligibility to go up.”  Currently, Medicare eligibility age is 65; Paul’s plan would gradually increase it to 70 by 2034.  “There is means-testing in this — and the reason you have to do that is: we’re spending more on Medicare than is coming in.”  According to Senator Lindsey Graham, (R-SC), “What I would tell the person near retirement is don’t fear change, embrace it, because you’ll have more doctors available to treat you and your family.  “Think about not just what happens to you…think about where we’ll be as a nation if something doesn’t change pretty quickly with these big programs.”

Virtually everyone in Washington agrees that the federal government must control its deficits and rising debt by finding a way to reduce entitlement spending.  President Bill Clinton’s former budget director, Leon Panetta, now defense secretary, who reproached the Senate Budget Committee: “You can’t meet the challenge that you’re facing in this country” by only cutting discretionary spending, which is less than a third of all spending.  “If you’re not dealing with the two-thirds that is entitlement spending, if you’re not dealing with revenues, and you keep going back to the same place, frankly you’re not going to make it, and you’re going to hurt this country’s security.”

Paul acknowledges that adding seniors to the federal program would drive costs up for its current 8.5 million enrollees by approximately 24 percent.  “Federal employees are the one group of people who may have a legitimate argument with the Congressional Health Care Plan for Seniors,” according to Paul’s synopsis.  “Asking them to share their healthcare with the elderly will cause their premiums to increase.”  Not surprisingly, as soon as the legislation was announced, the National Active and Retired Federal Employees Association expressed concerns that the bill would destabilize the federal workers’ program.

Beaudoin notes that “As for the senators’ notion that America’s seniors should be in the same healthcare system as America’s elected officials, they seem to have forgotten that starting in 2014, members of Congress will no longer be covered by the FEHBP but will be in state-based healthcare exchanges.”

Oklahoma Just Says “No” to ObamaCare At a Price of $54 Million

Monday, May 2nd, 2011

The state of Oklahoma has turned down a $54.6 million grant to establish the state-based healthcare exchange system required in the Patient Protection and Affordable Care Act (ACA).  Governor Mary Fallin said the move “accomplishes my goal from the very beginning:  stopping the implementation of the president’s federal healthcare exchange in Oklahoma.”  In February, however, Fallin characterized the federal assistance as “consistent with our (healthcare) mission” and a “step in the right direction.”  According to Wikipedia, in 2009 fully 18.1 percent of Oklahomans lacked healthcare coverage.

Several states have refused grants of $1 million from the federal government to build healthcare exchanges — an online “marketplace” that consumers can use to compare and purchase insurance plans — but the Oklahoma grant is the largest that has been rejected to date.  The ACA r requires each state to establish a healthcare exchange by 2014.  If a state opts to not set up its own exchange, the Department of Health and Human Services (HHS) is required to create one for the state.  Oklahoma lawmakers are refusing to let that happen. Fallin said that Oklahoma will use state and private money to establish its own exchange, even though the state faces a $500 million budget shortfall in the upcoming fiscal year.  “We are working together to address the concerns that have been expressed by some by adding very specific language in the bill to prevent the implementation of federal healthcare exchange in Oklahoma while creating an Oklahoma-based solution,” Fallin said. The state exchange will be named the Health Insurance Private Enterprise Network, and create a public trust governed by a seven-member board made up of health insurance carriers, agents, providers, employer groups and consumers.

In fact, Fallin favors repeal of the healthcare reform law. “We all support the repeal and the replacement of the federal healthcare bill.  We do believe it is unconstitutional,” Fallin said.  A former member of Congress, Fallin voted against the healthcare bill in 2010 and supports a lawsuit filed by Oklahoma Attorney General Scott Pruitt that favors repeal.  Insurance Commissioner John Doak is returning a $1 million federal healthcare grant.  “This is a fulfillment of my campaign promise to oppose ObamaCare every way I could,” Doak said.  “I remain deeply committed to a free-market system that relies on licensed agents and brokers as the frontline of consumer protection.”

Not everyone in Oklahoma agrees with Fallin’s actions.  “We are $500 million in the hole and the Republicans have decided to turn away $54 million in federal money,” said Senate Democratic Caucus Chairman Tom Ivester.  “I don’t understand how this makes sense.”  Oklahoma is likely to have $500 million less to spend during fiscal year 2012.

“When we have our disasters in Oklahoma, we are the first ones to reach out and ask the same government for help,” said State Senator Judy Eason McIntyre.  “Just two weeks ago, Governor Fallin defended her decision to accept $54 million from the federal government to implement the state health exchange by arguing that the money was not tied to President Obama’s healthcare plan and that the state could not afford to do it on our own,” said House member Scott Inman.  “Now, just days later, Governor Fallin admits that the funding is in fact a part of Obama’s healthcare plan and that somehow, despite our $500 million shortfall, we can afford to do it without these funds. The question I have is, was Governor Fallin wrong then or is she wrong now?”