The new healthcare reform law will have only a modest impact on the insurance premium hikes projected to hit employers next year, an independent research group reported this week. 

Hewitt Associates, a global consulting firm, said the most immediate reforms under the law — including the new protections known collectively as the Patient's Bill of Rights — will contribute "approximately 1 percent to 2 percent of the 8.8 percent projected increase for 2011."

The tougher pill to swallow will be for employees, whose premiums will go up at even higher rates in 2011 (12.4 percent), as employers shift more health costs on their workers, Hewitt reported.  

The issue has been a contentious one on Capitol Hill, where Republicans — echoing the message of insurers — have slammed the reform law as the leading driver behind the premium increases projected to hit next year.

"ObamaCare represents everything that’s gone wrong with our government," House Minority Leader John Boehner (R-Ohio) said recently. 

The White House was quick to trumpet Hewitt's findings as evidence that Boehner and the other critics have got it wrong. 

"The study confirms our own analysis," Stephanie Cutter, assistant to the President for special projects, wrote Monday on the White House blog. "And it’s important to remember that any increases will be offset by a number of provisions in the new law that will save money for consumers and employers." 

Earlier in the month, Health and Human Services Secretary Kathleen Sebelius warned the insurance industry that the agency would have "zero tolerance" for "unjustified rate increases" — or for companies that blame the law for the hikes.  

"According to our analysis and those of some industry and academic experts, any potential premium impact from the new consumer protections and increased quality provisions under the Affordable Care Act will be minimal," Sebelius wrote to Karen Ignagni, head of America's Health Insurance Plans, a trade group. 

"We estimate that that the effect will be no more than one to two percent."

A mine industry group has been lent an advance look at a long-anticipated study gauging the cancer risks facing underground miners, the Center for Public Integrity (CPI) reported Monday.

The move has raised the eyebrows of mine safety advocates, who say the early glance gives the companies an undue advantage to mold a response and release it quickly when the findings are made public. 

 "Government researchers do studies all the time and publish them in peer-reviewed journals," Celeste Monforton, former work-safety official in the Labor Department who’s now at George Washington University, told CPI. "This is the only example I know of where an industry group gets access to the information before anybody else does.

"As soon as the study is published [the industry] will already have another paper prepared that will dissect it and explain away any risks that are identified.”

The study — conducted by researchers at the National Cancer Institute and the National Institute for Occupational Safety and Health (NIOSH) — is designed to determine the extent to which diesel exhaust affects lung cancer rates among workers in non-coal, underground mines.

The findings are intended to help labor and health officials finalize new rules designed to protect workers from diesel exhaust.

“When there is uncontrolled diesel equipment in an underground mine, it is like working in the tailpipe of a city bus,” Mike Wright, health and safety director for the United Steelworkers, told CPI. 

The mining lobby isn't thrilled about the undertaking. And one industry group — the Methane Awareness Resource Group Diesel Coalition — hired a prominent Patton Boggs attorney, Henry Chajet, to make its case, CPI reported. 

In turn, Chajet filed legal arguments claiming that the two health agencies were acting “unfairly, unjustly and unreasonably” toward the industry by not allowing the companies an early glance at the study, according to CPI.

In June, a federal judge agreed, requiring the agencies to turn over their findings 90 days before publication, CPI wrote. 

The study is scheduled to be published next month. 

Sen. Charles Grassley (R-Iowa) said Monday that he wants proof that the purchasing intermediaries that buy medical products for hospitals actually save the government money.

Grassley said there is no empirical data that Group Purchasing Organizations provide any savings to the Medicare and Medicaid programs, which reimburse the hospitals for the care they provide to their beneficiaries. The ranking member on the Senate Finance Committee also released reports from the Government Accountability Office and his staff which he said reached the same conclusion.

"Whether Group Purchasing Organizations are able to help save money on medical supply costs, or not, impacts federal health care spending," Grassley said. "There’s no data with which to independently verify the effect, one way or another, and that’s a shortcoming in the current system."

GPOs have been under scrutiny before. In 2002, lawmakers questioned their administrative fees and sole-source contracting, among other things.

Health and Human Services Secretary Kathleen Sebelius will testify before a Senate panel this week on the agency's readiness to respond to bioterrorism attacks.

Her appearance is part of a larger examination by the Senate Appropriations health subcommittee, chaired by Sen. Tom Harkin (D-Iowa), into HHS' strategy for developing treatments to tackle public health threats, which also include things like pandemic flu.

Three other witnesses are scheduled to appear: Randall Larsen, CEO of The Weapons of Mass Destruction Center; Eric Rose, co-chairman of the Alliance for Biosecurity; and Andrew Pavia, infectious disease specialist at the University of Utah.

Sarah Palin is urging voters in conservative-leaning districts to vote out Democrats who supported healthcare reform. Read more...

Florida's 14-member insurance advisory board has unanimously passed a resolution to seek a waiver from the health reform law's medical loss ratio.

An official with the Florida Office of Insurance Regulation tells The Hill that the board's vote means it's a "done deal" that the state will formally seek some kind of waiver but the board is gathering public input through Oct. 8. The resolution was adopted Friday during a hearing on the medical loss ratio, requested by Insurance Commissioner - and board chairman - Kevin McCarty.

Florida would become the third state to request a waiver, following Maine and Iowa. The health reform law requires health plans to spend at least 80 percent of premiums (85 percent in the large-group market) on care or give consumers rebates starting in 2012.

McCarty called the evidentiary hearing with the stated purpose of gathering ammunition for a formal waiver request. He said federal regulators demanded detailed testimony if they're going to entertain granting a waiver or phase-in.

"I am concerned that the Medical Loss Ratio requirements included in the Affordable Care Act could cause disruptions in the Florida health insurance marketplace," McCarty (R) said in a statement. "I am especially concerned about how the MLR requirements will affect the role of health care agents who are critically necessary to help consumers in this increasingly complicated health care landscape."

Representatives from Aetna, AvMed Health Plans, Golden Rule (a subsidiary of United Healthcare) and U.S. Health Plans testified, as did the agent trade group National Association of Insurance and Financial Advisors. The Florida Alliance for Retired Americans offered a lone voice of support for the medical loss ratio, defending it as an important tool to help control healthcare costs.

The House this week is scheduled to take up legislation to prevent paid medical debts from affecting consumers' credit scores.

Sponsored by Rep. Mary Jo Kilroy (D-Ohio), the proposal would prohibit credit-rating agencies from considering past medical debts when calculating those scores.

"People shouldn’t have their credit worthiness suffer because they got sick or injured,” Kilroy said in introducing the bill last year. "It is outrageous that bills for as little as a one-dollar dispute with insurance companies are driving up the mortgages of my constituents.”

Roughly 72 million working-age Americans (41 percent) owed medical debt in 2007, up from 34 percent just two years earlier, according to the Commonwealth Fund. 

On top of that, 7 million seniors were also paying accumulated medical debts that year, the researchers found. Although the trend affected low and moderate income families disproportionately, all income levels saw rising debts.  

More than 60 percent of the patients with debt were insured at the time they received treatments, the Commonwealth Fund reported.  

Kilroy's proposal is one of 63 bills on the House suspension calendar this week. 

A Senate companion bill, sponsored by Sen. Jeff Merkley (D-Ore.), is idling in the Banking Committee. 

The Department of Health and Human Services on Monday announced $68 million in grants to support community living for seniors and individuals with disabilities. The grants are funded through the healthcare reform law.

"The funds will be used to help seniors and individuals with disabilities and their caregivers make more informed decisions about their health and long-term care," according to HHS. "Specifically, the funds will be used to help families: understand their Medicare and Medicaid benefits, including coverage for preventive services; navigate options for long-term care including community-based services that can help individuals remain in their homes; and assist those transitioning from nursing or rehabilitation facilities back home to put the supports in place to make that transition successful."

The grants focus on four areas:

- Medicare outreach: 50 states and territories and 125 tribal organizations funded to provide outreach and assistance to Medicare beneficiaries on their benefits, including coverage for preventive services ($40 million). Additionally, $5 million goes to the National Center for Benefits Outreach and Enrollment for technical assistance;

- Counseling grants: 20 states funded to strengthen programs of the Aging and Disability Resource Centers for community-based health and long-term care services ($10 million);

- Transition grants: 24 state Medicaid agencies helped to transition individuals from nursing homes to community-based care ($10 million);

- Home-care grants: 16 states funded to coordinate and continue to encourage evidence-based care transition models that help older persons or persons with disabilities remain in their own homes after a hospital, rehabilitation or skilled-nursing-facility stay ($3 million).

Childhood nutrition fight looms: With the federal childhood nutrition program ending Thursday and just one week left on the House calendar, lawmakers will be under intense pressure all week to reauthorize the law. Children's advocates want the House to pass the Senate's $4.5 billion bill, but liberal Democrats and some anti-poverty advocates are balking at a $2 billion future cut in food stamps to pay for the bill. http://bit.ly/8ZbmLa

Late last week, the Society for Nutrition Education wrote to House Education and Labor Committee Chair George Miller (D-Calif.) to defend the reauthorization as a key tool to fight childhood obesity - the goal espoused by First Lady Michelle Obama in her Let's Move campaign.

"We strongly encourage the House to take action this week to pass this important legislation," reads the letter. "Not only will this bill increase access, it will improve the quality of meals in schools, set the stage for strong standards so that soda and candy are not readily available to school children in vending machines and schools stores, and, it will give local school agencies more tools and resources to strengthen school wellness policies to improve physical activity and nutrition education."

Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, argues that the bill does not cut but rather sunsets a temporary increase in the food stamp program five months earlier than anticipated (in October 2003 instead of March 2004). She points out that Democrats already advanced the sunset date by an entire three years to pay for state Medicaid aid in August.

"With the September 30 deadline quickly approaching, the House of Representatives is running out of time to pass child nutrition legislation and improve the health and well-being of our nation’s children," she told The Hill over the weekend. "If Congress resorts to an extension for the programs, important advances for child nutrition may be lost for good. Our kids simply can’t wait."

HHS updates guidance on children's policies: The Department of Health and Human Services has updated its guidance on regulations governing children's policies after several health plans announced they would no longer sell new policies because the health reform law bans them from turning down children with pre-existing conditions. Regulations already allow open enrollment periods, in compliance with state law, to prevent families from waiting until children are sick before enrolling them but HHS clarified Friday that it may adopt a nationwide policy. http://bit.ly/91zBmn

"To require a uniform open enrollment period for child-only policies would require a change in the existing regulations," reads the updated guidance. "The Administration would consider making such a change if it would result in issuers continuing to sell child-only plans."

The new guidance also clarifies that the following actions are not precluded by existing regulations:

- Adjusting rates for health status only as permitted by State law;

- Permitting child-only rates to be different from rates for dependent children, consistent with State law;

- Imposing a surcharge for dropping coverage and subsequently reapplying if permitted by State law;

- Instituting rules to help prevent dumping by employers to the extent permitted by State law;

- Closing the block of business for current child-only policies if permitted by State law; and

- Selling child-only policies that are self-sustaining and separate from closed child-only books of business if permitted by State law.

The guidance also states that the administration "would welcome" legislation being considered by some states requiring individual-market issuers that offer family coverage to also offer child-only policies.

Regulatory free-for-all: Insurance plans, patient advocates and the health industry will be preparing their comments throughout the week after having had time to digest the National Association of Insurance Commissioners' (NAIC) draft medical loss ratio regulations. The healthcare reform law mandates that health plans spend at least 80 percent of premiums on medical care (85 percent in the large-group market) and the state insurance commissioners are tasked with ironing out the details. Comments are due by Oct. 4.

The big questions: Will the insurance industry get some flexibility towards allowing aggregated ratio and counting fraud prevention and utilization review as medical expenses? Will House and Senate Democrats get the commissioners to change their minds and deduct only healthcare taxes when calculating the ratio? http://bit.ly/bV9qjD

Phase-in requested: Even as the health sector weighs in on state commissioners, the NAIC itself is trying to persuade federal regulators to allow a phase-in period for the individual market. Florida Insurance Commissioner Kevin McCarty held an evidentiary hearing Friday to help make the case for a phase-in by gathering oral and written testimony and affidavits from insurance companies as to how the medical loss ratio requirement would disrupt the market. http://bit.ly/clCdmG

Here to explain it all: Rep. Michael Burgess (R-Texas) invites Brian Webb of the NAIC and Janet Trautwein of the National Association of Health Underwriters (the industry group for insurance agents and brokers) to explain the medical loss ratio during Tuesday's meeting of his Health Care Caucus. http://bit.ly/dy1JAf

White House strategy: Meanwhile, the Obama administration continues to try to sell the health reform law ahead of the mid-term elections. Today, Health and Human Services Secretary Kathleen Sebelius will be in Henderson, Nev. promoting the law along with the state's two Democratic House members, Dina Titus and Shelley Berkley. http://bit.ly/c6K3cY

Titus, a first-term lawmaker, is running neck-and-neck with Republican challenger Joe Heck in the race for Nevada's 3rd District seat. http://bit.ly/bhLsia. Health reform is becoming a major factor less than six weeks before the election, with Heck calling for repeal of the law (http://bit.ly/d2MvpI) and Titus taking to her campaign Web site to defend health reform's consumer protections and deficit reduction (http://bit.ly/cOSuW2).

The race for the U.S. seat, meanwhile, is still a toss-up between Senate Majority Leader Harry Reid (D) and Sharron Angle (R). http://bit.ly/9pcp5Q

In other polling news: Voters who say the new health reform law was too conservative outnumber by 2 to 1 those supporting repeal, according to a poll released Saturday. About 40 percent of respondents said the law was too timid in overhauling the nation's healthcare system, while 20 percent said they'd like to see it scrapped, according to the survey, commissioned by the Associated Press. http://bit.ly/czR9Yc

Administration's response on antibiotics anticipated: Two senior Democrats are expecting answers from Agriculture Secretary Tom Vilsack after controversial comments regarding efforts to restrict the use of antibiotics in animal agriculture. Sen. Dianne Feinstein (D-Calif.) and Rep. Louise Slaughter (D-N.Y.) say Vilsack mischaracterized both their legislation and the position of his own department in comments he made about one of their bills to the National Cattlemen's Beef Association. http://bit.ly/c07eut

Fight over Medicare Advantage heats up: A quartet of Senate Republicans is calling on Medicare's top accountant to release the numbers behind his analysis of health reform's impact on the Medicare Advantage (MA) program. The lawmakers — Sens. Charles Grassley (R-Iowa), Jon Kyl (R-Ariz.), Orrin Hatch (R-Utah) and Mike Crapo (R-Idaho) — say the steep cuts to MA under the new reform law will cause many plans to fold, while many others will be forced to drop benefits to remain profitable. http://bit.ly/aCKcjK

College health plans under scrutiny: Many college health plans not only offer paltry coverage, reports the Wall Street Journal, but also managed to avoid many of the new regulations of the healthcare reform law - perhaps even permanently. http://bit.ly/dw0QiG