ACA: The Slow Dance of Reform 4

There is positive news about  ACA, and an indication so far things are moving in the right direction. But you won’t hear about it on the front page of any newspaper or on an evening news cast, no it is information you must seek out yourself. Whether you believe in insurance or not, a Public Option was merely an insurance company run by the government, meaning it is fully regulated by the government, in essence this will be no different, when ACA is fully implemented, insurance companies will be heavily regulated by the Federal Government. There is very little difference between this and a program run by the federal government. Each is a middle man who pays health care providers through premiums collected.

There are some positive results happening and they are a direct result of the legislation.

1.  As reported June 6th, in the Washington Post, some health insurance premiums are going down.

“In May, insurer Aetna received approval from Connecticut regulators of its request to reduce premiums on individual policies by an average 10 percent, starting in September. Yes, you read that right: reduce the premium. The decrease, which affects some 15,000 consumers, will save those policyholders $259 annually, on average.”

I think most people know, but maybe not, under the new law, insurers must spend 80% of what they receive in premiums on medical claims or quality improvement efforts. Administrative costs and profits must be 20% or less of a premiums collected.  According to the Post what Aetna did is a preemptive strike, so that they will not be responsible for rebates to consumers, because they’ve already lowered individual premiums.  Effectively, this caps administrative costs. For consumers this is a positive sign.

2. Implementation of a National Prevention Strategy, the goal of the strategy will move us from being a system of sick care to one that is based on wellness and prevention. Preventative care is what the uninsured lack, of course many people who are uninsured eventually end up in an emergency room to treat a problem, but this system lacks  long term care and prevention.

3. 5.5 million seniors have taken advantage of  free preventive services. One aspect of medicare many people who are not on medicare don’t understand, it a yearly check up was not covered before the implementation of ACA, it is currently mandated in the reform. This of course plays right into the National Prevention Strategy

4. Affordable Care Act helps fight unreasonable health insurance premium increases because as of May 19th, the HHS.

HHS has issued a final regulation to ensure that large health insurance premium increases will be thoroughly reviewed, and consumers will have access to clear information about those increases. Combined with other important protections from the Affordable Care Act, these new rules will help lower insurance costs by moderating premium hikes and provide consumers with greater value for their premium dollar. In 2011, this will mean rate increases of 10-percent or more must be reviewed by state or federal officials.

The average premium increases imposed on individual plans were nearly 20%, with no rhyme or reason as reported by the Kaiser Family Foundation. Patients were essentially left with three Hobson choices: lose coverage altogether, pay the premium increase, or switch to a plan that covered less. None good, each with dire consequences. This is why rate review is so important.  Rate review does has two important goals,  scrutinizing directing some sunlight premium increases. and mandating the insurance companies justify the increases with information and data.

5.  One result has been the California Assembly has voted to crack down on insurance rates. This was a major step taken by the Assembly to overhaul the way health insurance companies are regulated by the state. AB 52 allows the California State Insurance Commissioner to and the California Dept of Managed Care to block any premium increases. and it would require Insurers to get permission to raise rates.

These are all positive achievements of ACA so far. There will be more. Let’s not allow the Republicans and others with an agenda to continue to claim ACA has no benefits for Americans. We can’t allow Republicans to pull grants that will allow many other people to obtain health insurance. It might not be the bill you want, but it is a positive step in the correct direction.

There are some excellent blogs out there that cover this issue. One is a blog called Heath Care Reform Updates. It’s good, take a gander.

Crossposted at DAGblog