Monthly Archive for December, 2010

The new federal rate rules: impact in Washington state

By Megan Howell

The Department of Health and Human Services announced the much anticipated Rate Increase Disclosure and Review proposed rulemaking last week aimed at curbing large, unfounded rate increases for both the individual and small group health insurance markets.

The responsibility for scrutinizing rate increases will rest largely with state insurance regulators as long as those states have adequate systems in place to analyze the requests. Even though the federal government will not have the authority to reject rate increases, it will have the power to review them in states that lack the resources or authority for thorough actuarial reviews. Continue reading ‘The new federal rate rules: impact in Washington state’

Published on December 28, 2010 in Health Care Reform. 2 Comments Tags: , .

Group Health coverage offered through the Health Insurance Partnership

By Karen Merrikin, JD

Group Health was recently announced as a health plan option for small groups purchasing coverage through Washington State’s Health Insurance Partnership (HIP). Applications are being accepted now, with coverage in the program beginning January 1, 2011.  Continue reading ‘Group Health coverage offered through the Health Insurance Partnership’

Published on December 22, 2010 in Access to care and Health Care Reform. 0 Comments Tags: , , .

Health reform in the courts

By Karen Merrikin, JD

This week the U.S. District Court for Eastern Virginia (Judge Henry Hudson) ruled that Congress overstepped its authority to regulate interstate commerce by requiring every American to have health coverage.  Judge Hudson’s ruling brings the tally of federal district court rulings on the constitutionality of the “individual mandate” to three.  The other two rulings, in Michigan and West Virginia, have upheld the health care reform law. Twelve other courts have thrown out similar suits over jurisdictional or standing issues.  A similar case has been filed in Florida involving 20 states, and that court is scheduled to hear arguments this week.  Continue reading ‘Health reform in the courts’

Published on December 17, 2010 in Health Care Reform. 0 Comments Tags: , , .

State budget cuts a taste of more to come

By Diana Birkett Rakow

The Washington State Legislature held a one-day special session on Saturday, Dec. 11, to address an anticipated billion dollar shortfall in the current operating budget. Lawmakers enacted a pre-negotiated set of budget bills that cut the anticipated shortfall by approximately $700 million.

The cuts made in this special session spared some state-funded health care programs from being completely eliminated for now, but that may have to change as lawmakers come back to address an expected $5 billion shortfall in the 2011-2013 budget.  We know the Legislature will have even tougher decisions to make when it reconvenes in January.  Continue reading ‘State budget cuts a taste of more to come’

Published on December 14, 2010 in Health Care Reform, Medicaid and Medicaid. 9 Comments Tags: , .

The U.S. economy and federal debt: How our learning health care system can help

By Eric Larson, MD, MPH

With mid-term elections in the rear-view mirror, lawmakers are now focusing on reducing the national debt. As President Obama’s bipartisan Commission on Fiscal Responsibility and Reform delayed until Friday a vote on their co-chairs’ long-awaited proposal, experts are debating whether further short-term stimulus is needed for economic recovery before the cuts begin. Most agree, however, that in the long run, debt reduction is crucial to our nation’s economic strength.

Why does this matter to Group Health and Group Health Research Institute? Debt reduction is essential to preventing another serious U.S. financial crisis. Continue reading ‘The U.S. economy and federal debt: How our learning health care system can help’

Published on December 3, 2010 in Health Care Reform. 8 Comments Tags: , .

HHS issues rules for MLR

By Megan Howell

On the morning of November 22nd, the Department of Health and Human Services (HHS) announced the release of an interim final rule (IFR) for implementing the medical loss ratio requirements. This much anticipated IFR will help shape the health insurance market beginning in 2011 by requiring carriers to spend a certain percentage of premium costs on expenses directly relating to medical claims. As you may recall in in one of our past blog posts, beginning in 2011 the “medical loss ratio” (MLR) will be set at 85 percent for large groups, and 80 percent for small groups and individual plans. Basically, this means that for every premium dollar, carriers must spend either 80 or 85 cents on expenses directly relating to medical claims. The remaining 15 to 20 cents, depending on plan type, will go toward administration costs, as well as profit (for for-profit carriers) or sales and market costs the carriers incur. Continue reading ‘HHS issues rules for MLR’

Published on December 1, 2010 in Health Care Reform. 0 Comments Tags: .