Healthcare Tuesday

What's in a medical cost? That's the question on everyone's mind as the National Association of Insurance Commissioners (NAIC) wraps up its seasonal conference in Seattle on Tuesday. The group was assigned, under the new healthcare reform law, to establish standards dictating insurers' medical loss ratios (MLRs) — a gauge of how much of each premium dollar plans spend on healthcare services as opposed to marketing, salaries, shareholder dividends and other administrative costs.

Private insurers are lobbying hard to broaden what items qualify as medical services for the purpose of crunching MLRs. In particular, the companies want to have all state and federal taxes deducted from premium revenue — an allowance that would bolster their profits considerably. But top Democrats in both chambers say that was never their intent, clarifying last week that only "federal taxes and fees that relate specifically to revenue derived from [healthcare reform]" should qualify as deductible.

Who wins? It's up to the NAIC.

The business community vs. healthcare reform, take one: The business lobby is fighting new rules determining how existing healthcare plans get to keep their coveted grandfather status. The guidelines, the U.S. Chamber of Commerce argued Monday, are so strict that employees won't be able to remain in the plans they've got. http://bit.ly/aC20nQ

The business community vs. healthcare reform, take two: The business lobby is also fighting new tax filing requirements, which will force businesses, beginning in 2012, to submit a 1099 form when they purchase goods exceeding $600 from another company, even a corporation. More than 1,100 groups — including 31 national organizations — wrote to Congress Monday urging a full repeal of the requirement. 

"When the United States is depending on the private sector to generate jobs and stimulate economic growth, lawmakers are directing precious time and resources to collecting volumes of information and filling out mounds of new paperwork for the government," the groups wrote.

Aside from the U.S. Chamber, signatories included the Associated Wire Rope Fabricators, Critters Pet Shop of St. Charles, Ill., and the Changing Tides Inn of Klawock, Alaska. http://bit.ly/d6tx88

An issue of compliance: Liberal analysts at the Center on Budget and Policy Priorities defended the new 1099 tax-filing requirements with the question: Since when did it become intrusive to ask businesses to pay the taxes they owe? http://bit.ly/9qZkfN

The Old Dominion eyes healthcare reform: They might be suing over the individual mandate, but GOP officials are also moving forward with healthcare reform implementation. Gov. Bob McDonnell (R) on Monday designated the members of a task force designated to facilitate the new reform law. http://bit.ly/de2chH

Get in the pool: UnitedHealth is courting a group known to be young, healthy and unable to afford health insurance: restaurant workers. http://bit.ly/bhVWec

On the Gulf Coast: BP gives Louisiana $15 million to treat mental illness. http://bit.ly/aD6mq1

Where are those prison rape guidelines? Human rights advocates will gather Tuesday morning at the Press Club to pressure the Justice Department to get moving on national guidelines to protect inmates and juvenile detainees from institutional rape. The guidelines were due out in June, but Attorney General Eric Holder has delayed the process, citing pressure from the prison industry over the cost of implementation.

The business community vs. healthcare reform, take three: Also at the Press Club this week, the National Business Group on Health will release results of a new survey indicating what changes big businesses will make to their healthcare plans in response to the arrival of the new healthcare law. The event is scheduled for Wednesday.