Managed Healthcare Executive - January 2009 - (Page 14)

“What’s an exciting paradox is that this economic downturn might force the United States to do some really creative and innovative things in healthcare,” says Georganne Chapin, president and CEO of Hudson Health Plan, a managed-care Medicaid provider in New York. For insurers, the goal is to expand coverage by making health insurance more a ordable, particularly in the growing individual market. Increased coverage will boost access to care, reduce cost-shifting to private payers and soften criticism about rising premiums and copays. Enrollment in commercial health plans has been stagnant, except in Medicare Advantage and Part D drug plans, so the current interest in expanding coverage provides plans a desirable opportunity for new business. Howard Dean, chairman of the Democratic National Committee told e-Health Initiative conference attendees last month that some of the billions allotted to economic stimulus programs should support expanded government health programs, subsidies for individuals and small businesses purchasing coverage, and improvements in the nation’s health infrastructure. “This is the best time for reform,” he says. “If we can a ord $150 billion for AIG, we can a ord $150 billion for healthcare coverage.” President-elect Barack Obama is less blunt, but equally supportive. In announcing the nomination of former senator Tom Daschle to head the Department of Health and Human Services (HHS), Obama said healthcare reform was critical for making U.S. corporations globally competitive. “If we want to overcome our economic challenges, we must also nally address our healthcare challenge,” he said during the announcement. Daschle’s intimate knowledge of the legislative process is a clear asset in leading the reform e ort and dealing with turf wars on Capitol Hill. 14 JANUARY 2009 petition between commercial plans and a Medicare-like public plan. Senator Edward Kennedy (DMass.), chairman of the Senate Health, Education, Labor and Pensions ComPossible implications mittee (HELP), resigned his seat on of the Obama era the Senate Judiciary Committee last State initiatives will continue to month in order to devote full attenbe testing grounds tion to enacting health reform legislation this year. Kennedy will seek a Two-thirds of the uninsured consensus bi-partisan bill that will atstand to gain coverage tract 70 to 80 votes in the Senate and Nearly 40% of the previously hopes a fundamental reform of the uninsured would gain coverage system will be his public legacy. through employers Although Senate Democrats have More employer-sponsored taken the lead, House leaders plan to coverage would reverse the craft their own bill, says Rep. Henry current declining trend Waxman (D-Calif.), new chairman of the House Energy and Commerce Some crowd out could ocCommittee. He says that the time is cur with as many as 4.5 million people trading their private coverripe for enacting legislation that “seage for subsidized coverage cures the goals of universal coverage, sensible controls on cost, and assurA coverage mandate initially ance of quality care,” and that he will would include all children work closely with the House Ways & More than one-third of the cost Means Committee to build support. of reforms could come from The legislative process will be existing funding shaped by the economic stimulus bill Primary care shortages could before Congress. State governors want become more apparent $30 billion to bolster state Medicaid programs. Democrats might try to rePublic-private efforts could authorize the State Children’s Health increase care and lower costs Insurance Program (SCHIP) and proApproximately 30 million people vide $10 billion to support health incould gain coverage formation technology. Ways & Means Health Subcommittee Chairman Pete Source: PricewaterhouseCoopers’ Health Research Institute Stark (D-Calif.) has pressed for added subsidies for people who lose their jobs and want to buy insurance. CONGRESS ON TASK A generous bailout bill now would Senate Finance Committee Chairman set the stage for broader health reform Max Baucus (D-Mont.) is crafting leg- legislation later in the year. islation based on a universal coverage plan he unveiled in early November. PAY-GO POLICY EXAMINED Similar to Obama’s campaign proposal, Congressional Democrats anticipate the Baucus plan retains the employer- considerable exibility in the usual based bene t system but requires large requirement to o set the full cost of employers to play or pay. Individuals legislation with comparable savings. and small businesses would receive They and Obama both talk about sliding-scale subsidies to purchase cov- dropping Congress’ “pay-go” policy erage through a new health insurance for expenditures related to health reexchange, which would promote com- form, based on the expectation that

Table of Contents Feed for the Digital Edition of Managed Healthcare Executive - January 2009

Managed Healthcare Executive - January 2009 Contents Editorial Advisors For Your Benefit News Analysis Politics & Policy Letter of the Law Managed Care Outlook New Day 5 New Realities of Disease Management Pharmacy Best Practices Health Management Technology State Report: Hawaii MHE Resource Ad/Edit Index

Managed Healthcare Executive - January 2009

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