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OVERNIGHT HEALTH: State regulators endorse controversial MLR changes
State insurance regulators on Wednesday approved a controversial resolution calling for changes to the healthcare reform law’s medical loss ratio provision. The resolution calls on Congress to "consider" bills that would exempt insurance agents’ commissions from the requirement that plans spend at least 80 percent of premiums on care or give consumers a discount, and it says the Department of Health and Human Services should do everything in its power — such as not implementing the MLR requirements — to protect insurance agents and brokers.
"I think going too far in this resolution puts our credibility in jeopardy, and I think in the long run we all could suffer the consequences of that," Kansas Insurance Commissioner Sandy Praeger said during an National Association of Insurance Commissioners conference call.
Despite those concerns, the resolution passed 26-20. Healthwatch’s Sam Baker has more.
Rapid response: Insurance commissioners immediately got an earful from consumer advocates.
"This is a significant setback in the struggle to protect consumers and provide better health insurance values," National Association of Insurance Commissioners consumer representative Lynn Quincy said in a statement. She said the move puts more than $1 billion in consumer rebates at risk.
"The commissioners who supported this proposal are tone-deaf to the skyrocketing health premium costs of average Americans," HCAN Executive Director Ethan Rome said in a statement. "Instead of voting on the facts, the insurance commissioners buckled under pressure from the health insurance brokers and agents who made claims that weren’t supported by NAIC data."
The Independent Insurance Agents & Brokers of America, meanwhile, applauded the resolution.
"The Big 'I' applauds the NAIC for its recognition of the detrimental impact the MLR calculation has had on independent insurance agency small business owners, consumers, and their agents and brokers," President and CEO Robert Rusbuldt said. "If the MLR formula is not corrected soon, consumers will suffer the prospect of losing the professional, licensed guidance of insurance agents during this time of great change in the health insurance market."
Kagan, continued: Rep. Lamar Smith (R-Texas), the chairman of the House Judiciary Committee, is still pressing the Justice Department for records about Supreme Court Justice Elena Kagan’s role in preparing the Obama administration to defend its healthcare law in court. Smith said the Justice Department has withheld relevant documents and witnesses, and reiterated his request for fuller access. Read the Healthwatch story.
By the numbers: Automatic Medicare cuts triggered by the congressional supercommittee’s failure would hit hospitals harder than any other health industry, according to an analysis from Avalere Health. Sequestration includes a 2 percent, across-the-board cut to Medicare provider payments. Inpatient hospital care would absorb about 32 percent of the total cut, according to Avalere, followed by Medicare Advantage plans at 15 percent. Healthwatch has the full breakdown.
Some cuts to health law: Although the trigger mechanism largely the Affordable Care Act, its cuts would affect certain subsidies. The biggest chunk of subsidies — tax credits to help people buy coverage through an exchange — is protected. But the health law also provides separate subsidies to help with cost-sharing. They’re about 15 percent of the law’s total subsidies, and would be cut under sequestration.
Lobbying registrations
Arnold & Porter / Sigma-Tau Pharmaceuticals
Hogan Lovells US / Research!America (federal funding of medical research)
State by state
California Republicans (quietly) embrace health law's Medicaid expansion (Kaiser Health News).
Federal regulators raise concerns with Tennessee's proposal to allow Medicaid managed care plans to offer limited-enrollment plans in the state's health insurance exchange (Inside Health Policy).
A panel of experts appointed by Republican Gov. Nathan Deal of Georgia is urging the state to create a state-run insurance exchange despite conservative opposition to moving forward with any provisions of the healthcare reform law (Kaiser Health News).
Reading list
A New York malpractice program that puts judges in charge of directing negotiations is being touted as a national model, Kaiser Health News reports.
Levels of the chemical BPA soar after a lunch of canned soup, NPR reports.
Four medical associations filed a lawsuit challenging the state's 10-percent cut to Medicaid provider payments that the Obama administration approved last month, The Associated Press reports. The plaintiffs are the California Medical Association, the California Dental Association, the California Pharmacists Association and the National Association of Chain Drug Stores.
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