Senate Finance Committee Votes on Health Care Amendments

By Jeralyn, Section Legislation
Posted on Thu Oct 01, 2009 at 07:42:10 PM EST
Tags: health care reform (all tags)

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There was more action today in the Senate Finance Committee on health care. And Sen. Harry Reid addressed the public option:

"I favor a public option. We're going to do our very best to have a public option. But remember, a public option is a relative term," Reid, D-Nev., said Thursday.

Insurance companies aren't waiting for the outcome to announce changes. [More...]

I got a notice from Anthem today that went out to small businesses. It announced new plans and recommended employers like me consider changing to the new plans to save money on premiums. The plans offer reduced benefits. Instead of paying 100% of covered medical and hospital benefits after the deductible is satisfied, they would pay 80%.

Anthem also announced changes in prescription drug coverage for small employer plans. The notice was sent out today and the change goes in today, for all new policies and policies with a renewal date of today or later. Now, instead of paying 100% for prescriptions after the deductible is satisfied, there will be a co-pay, ranging from $15 to $60.00, and for more expensive drugs, up to 30% of the cost of the prescription.

In most of my posts on the health care bill, I've expressed my concern that the insurance companies will respond either by canceling their high-end plans or making them prohibitively expensive. Looks like both are happening already. I won't be happy tomorrow when I drop by the pharmacy to pick up a prescription if I have to shell out $40 or $60, when last week it would have cost me zero. Especially since I'm paying for a plan that promised to pay 100% coverage. (Update: Upon closer reading, the co-pays won't go into effect until the policy renewal date. Apologies to Anthem for misreading that part.) I'll also bet this is just the first of many unpleasant changes coming the way of those with good health insurance policies.

I wouldn't mind so much, and would readily accept the changes, if I knew my money was going to result in a benefit for the greater good, like passage of a public option for those without good health insurance. But it doesn't look like that's going to happen. Is anyone going to benefit from legislation without a public option besides the insurance companies?

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Senate Finance Committee Votes on Health Care Amendments | 17 comments (17 topical)

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From all indications the "public option" (5.00 / 1) (#2)
by MO Blue on Thu Oct 01, 2009 at 07:47:48 PM EST

will be some type of private insurance based plan that the Senate sticks a "faux public option" label on. As "Triggers are a pretty doggone good idea Harry" says:

But remember, a public option is a relative term,"

No, Jeralyn, no one (5.00 / 3) (#4)
by caseyOR on Thu Oct 01, 2009 at 08:00:04 PM EST

is going to benefit from this so-called reform except the insurance companies and other health care industry players like drug companies.

Without a real public option that is tied into the Medicare provider network and the Medicare reimbursement structure, and is open to anyone who wants in, this whole "exercise in democracy" is just a boondoggle for insurance. Oh, and the health industry's Congressional and WH lackeys will benefit, of course. The American people? Not so much.

Without government putting downward pressure (5.00 / 2) (#7)
by MO Blue on Thu Oct 01, 2009 at 08:09:25 PM EST

on premium costs, the insurance industry will continue to raise premiums and pass more and more of the costs off to the consumer. They were going in that direction even before Congress started on their so called health insurance reform.

Also, more employers will either drop employee insurance or offer less coverage while requiring their employees to pick up more of the premium.

That is why some of us have been so vocal on "Anything is not better than nothing." Without controlling costs, the $900 billion give away legislation will do nothing but prop up an unsustainable system.

Can't blame this on HCR (5.00 / 1) (#13)
by FreakyBeaky on Fri Oct 02, 2009 at 12:30:23 AM EST

These changes to your health plan quite likely would have been made anyway. Less coverage for more money is par for the course these days. After all it maximizes profits. That's why we need a real public option.

Maybe (5.00 / 2) (#15)
by lentinel on Fri Oct 02, 2009 at 02:34:30 AM EST

this is an oversimplification - but from what I read - they are planning to make healthcare "universal" by passing a law that people are required to buy it and if they don't or can't, imposing a fine on them.

In other countries, universal healthcare is provided by simply providing it.

Of course, countries like Canada and France are not currently going around occupying and spreading democracy in other countries - so they have a few bucks to spare for the welfare of their citizens.

I think a lot of people with employer-based (5.00 / 1) (#17)
by sallywally on Fri Oct 02, 2009 at 08:56:39 AM EST

insurance who don't feel affected by this debate will be surprised to discover what happens to their insurance in the coming months and years.

As I've said ad nauseam, I'm glad to be turning 65 in three months and onto Medicare. I'm seeing the time on the horizon when my non-retired friends - and the retired ones not on Medicare - will wish they were me!

Then I hope the uprising for a public plan will really see the light of day.

What the insurance companies are running (none / 0) (#1)
by andgarden on Thu Oct 01, 2009 at 07:45:09 PM EST

the risk of is charging a tremendous amount of money for a discount card. And if that happens, we're essentially back to fee-for-service. In a way, the system will have dismantled itself.

I would say that's unsustainable, but then I look at how much education costs. . .

I'd be interested to know more about this (none / 0) (#3)
by nycstray on Thu Oct 01, 2009 at 07:48:31 PM EST

I don't understand how they can legally reduce benefits in the middle of the term of a contract already in force, but I'll bet they have an explanation that would hold up in court.

Sounds like the only thing contracts are good for these days is for companies to swindle us. How the f*ck can they just change your RX pays like that?

Didn't you just renew?

yes, in June (none / 0) (#6)
by Jeralyn on Thu Oct 01, 2009 at 08:08:28 PM EST

and they upped my premiums $250 a month with no age bracket change and no health issues. In June when my renewal comes due, at today's rates, my premium will jump another $400 a month due to my recent birthday. I'm dreading what the increase will actually be by the time June rolls around -- probably far more than an extra $400 a month. I have no doubt I'll be forced into a plan with lesser coverage and it will still cost me more money.

And, like last year, they'll probably send out a note blaming the health care legislation. (When I renewed in June, they said the increase was due to a law passed in Colorado preventing insurance companies from charging unhealthy groups more than healthy groups. They said it required them to raise rates on healthy groups to make up the difference by eliminating the discount previously afforded healthy groups.)


: It's highway robbery (none / 0) (#14)
by shoephone on Fri Oct 02, 2009 at 01:53:38 AM EST

How in the world could most people afford a $250 per month increase, followed by a $400 per month increase?
What does your state's insurance commissioner say about this?

Jeralyn... (none / 0) (#5)
by MileHi Hawkeye on Thu Oct 01, 2009 at 08:03:29 PM EST

...if you want to post (or email me) the appicable contract language from your policy, I'll check and see if they're compliant.

Off the top of my head, it doesn't pass the smell test.

I think you are right (none / 0) (#8)
by Jeralyn on Thu Oct 01, 2009 at 08:17:02 PM EST

Now I think I read it wrong:

We regularly review our benefit plans to see what changes we can make in order to provide stronger health coverage solutions for you and your employees. In addition to the new plans available to small group employers, we've made some changes to our prescription drug benefits. Anthem's current benefit modifications are effective upon renewal for small groups renewing on or after October 1, 2009.

In another place it says:

We've made several benefit changes that become effective for new and renewing small groups with an anniversary date on or after October 1, 2009. The new rates:

Prescription Drug Copayment:
In-network retail pharmacy drugs and specialty pharmacy drugs will continue to be subject to the
deductible. Once the deductible has been satisfied, prescription drug copayments will now apply for in-network retail pharmacy drugs and specialty pharmacy drugs per prescription; up to a 30-day supply.
. Tier 1 - $15 copayment, after deductible
. Tier 2 - $40 copayment, after deductible
. Tier 3 - $60 copayment, after deductible
. Tier 4 - 30% copayment after deductible up to a $250 maximum
These copayments will apply to the modified in-network out-of-pocket maximum as listed below.
Once the new out-of-pocket maximum is satisfied, the copay no longer applies for the remainder
of that benefit year. The copayments do not apply to mail-order pharmacy drugs or out-of-network
pharmacy drugs.

Out of pocket maximum: $3,000/$6,000

Guess I'll find out tomorrow when I visit the pharmacy. Thanks!


: Yeah... (none / 0) (#9)
by MileHi Hawkeye on Thu Oct 01, 2009 at 08:34:47 PM EST

...it appears they doing this at renewal.
If you do go in and find that they are changing benefits off-renewal tomorrow, I'd give the Consumer Affairs folks at the DOI a call.
(303) 894-7490

If insurance companies have to cover (none / 0) (#11)
by BrassTacks on Thu Oct 01, 2009 at 09:57:06 PM EST

everything, for everyone, including dental, eyes, counseling, well baby, pregnancy, pre existing conditions, absolutely everything, then of course we're going to have to pay more. If they can exclude anyone or anything, we will all see big increases in our payments. I can't imagine how else it would work. I'd much rather pay for some of that myself, rather than have my rates go up. I'd rather have the high deductibles but low payments. I'd rather have a policy that's mostly only for catastrophic stuff, but I guess we don't get that kind of choice.

We just can't afford to pay more for our insurance with so many in our family out of work. But if we don't pay, then we get a big fine. Feels like we're screwed no matter what we do.

Thanks Congress!

: Myself, I'd rather (none / 0) (#18)
by sj on Fri Oct 02, 2009 at 11:44:03 AM EST

my giant monthly premiums were taxes earmarked for UHC. My giant premiums ensure that the insurance carrier is making a HUGE profit on me. I'm basically healthy and actually only recently made a dr appt to be told that what I thought was likely arthritis, is, mostly, arthritis and may get worse with time. I made that appt because it seems to me that I ought to get more out of said premiums than an annual physical.
I'm already living without that money. I'd rather pay it in taxes and have UHC.

It really isn't cost effective (none / 0) (#12)
by TeresaInSnow2 on Fri Oct 02, 2009 at 12:08:37 AM EST

to carry so much insurance on the individual (or group of one) market.

It is actually better to find a plan with an increased deductible because you can often find a plan where the increase in deductible is LESS than the decrease in premiums with the higher deductible.

Let me know if you don't understand why that's so and I'll explain tomorrow. I'm really tired tonight.

Nature of business (none / 0) (#16)
by mmc9431 on Fri Oct 02, 2009 at 08:26:37 AM EST

We need to decisively discredit the whole Reaganomic philosphy. It's not the nature of business to have a moral conscience, They're never going to put the good of the nation above the greed for profit. To expect them to act in a socially responsible manner is just moronic.

These are the same politicians that still herald the "trickle economy" philosphy. That's worked real well for us too. Just ask the employees of Walmart about it. Four of the ten richest people in the country are in the Walmart family. Their employess certainly haven't reaped any of the benefits.