By Marc Tracy
BizBox.Slate.com
Kaiser Health News has a new article detailing how woman-owned or -dominated small businesses tend to get hit particularly hard by high health care premiums. The reason is simple: women, particularly under 55, tend to require more health care than men of the same age, primarily due to maternal and infant care. If you think that means it's okay for women to have to pay more, then we suppose you're entitled. But we don't think that makes it okay, and we suspect more people agree with us than with you.
But even if you feel that way, there is simply no good argument for why so-called "gender rating" should apply to small businesses and not to large ones. You see, under current law, insurance companies are banned from gender rating among large-group markets. So if you have 51 employees, you're okay; if you have 50, you're out of luck. Of course, most of the legislation currently circulating on Capitol Hill would change that, and would establish that the small-group market be treated essentially the same as the large-group one. One more reason to hope for reform's success.
Wednesday, November 25, 2009
How Health Insurance Discriminates Against Female-Heavy Business
Sunday, November 22, 2009
Clipping health costs in the bud
BY CAROL FLETCHER
The Record
As health insurance premiums skyrocket and small businesses struggle to pay them, insurers are pointing to wellness programs as a way to help offset costs.
Through Web sites, health assessments and seminars, wellness programs act as health coaches to turn employees away from smoking and overeating and toward exercising and eating leaner, and to help them track their health data.
"Employers, large and small, who provide [wellness] programs for employees to address such common health challenges as diabetes management, heart disease, smoking cessation and good nutrition, will play a direct role in cutting health care costs," wrote Michael McGuire, chief executive officer of United Healthcare of New Jersey, a division of the health-care insurer based in White Plains, N.Y., in a column about wellness programs.
Such initiatives began emerging a decade ago and the concept has found its way into the health care overhaul debate.
In July, the U.S. Senate's Health, Education, Labor and Pensions Committee approved The Affordable Health Choices Act that requires health insurance policies to include financial incentives rewarding wellness efforts.
Most insurers' wellness programs include Web sites to determine and track health data. UnitedHealthcare's Web site includes a body mass index to determine body fat as well as heart attack calculators.
Newark-based Horizon Blue Cross Blue Shield of New Jersey's Web site allows employees enrolled in any type of health plan to monitor data such as blood pressure, weight and their progress toward quitting smoking, said Peter Morey, director of product development.
In October, Horizon began offering employers with 100 to 499 enrollees onsite health screenings and lunchtime seminars about issues such as weight management or control of diabetes as part of the premium, said Morey, something that previously required an additional cost.
"A lot of wellness activities seem to be concentrated in the higher end of the market — above 500 employees," said Morey, adding that United is offering activities to smaller employers who might not have the resources to do such programs.
He said insurance brokers are excited about the new offering and Horizon is considering it for even smaller employers.
On the topic of whether health screenings and assessments reduced insurance premiums, Morey said savings would come in the long run if conditions such as high blood pressure are caught early.
Employers participating in wellness programs with Amerihealth Insurance Co. of New Jersey in Mount Laurel can get slight premium reductions — up to 1 percent, said Paul Portsmore, vice president-health services.
So the insurer, which focuses on businesses with 50 to 500 employees, does not charge for wellness committees, health expos and onsite health assessments, said Portsmore.
Additionally, it offers discounts for services such as acupuncture and reimbursements for fitness-center memberships, weight-management programs and other efforts. Amerihealth also provides health coaches and online tools.
At UnitedHealthcare, "enrollment in certain wellness products and programs can reduce premiums anywhere from 5 to 15 percent," for employers, said Mary McElrath-Jones, a spokeswoman for the health insurer.
But insurers agree the key factor to making these programs reduce claims is senior management.
"The accountability of the behavior needs to be on the individual and the employer group," said Portsmore. "There's only so much an insurance company will be allowed to do."
Historic health care bill clears Senate hurdle
BY DAVID ESPO
The Record
WASHINGTON — Invoking the name of Edward M. Kennedy, Democrats united tonight to push historic health care legislation past a key Senate hurdle over the opposition of Republicans eager to inflict a punishing defeat on President Obama. There was not a vote to spare.
The 60-39 vote cleared the way for a bruising, full-scale debate beginning after Thanksgiving on the legislation, which is designed to extend coverage to roughly 31 million who lack it, crack down on insurance company practices that deny or dilute benefits and curtail the growth of spending on medical care nationally.
The spectator galleries were full for the unusual Saturday night showdown, and applause broke out briefly when the vote was announced. In a measure of the significance of the moment, senators sat quietly in their seats, standing only when they were called upon to vote.
Republican Sen. George Voinovich of Ohio missed the vote.
In the final minutes of a daylong debate, Majority Leader Harry Reid, D-Nev., accused Republicans of trying to stifle a debate the nation needed.
“Imagine if, instead of debating whether to abolish slavery, instead of debating whether giving women and minorities the right to vote, those who disagreed had muted discussion and killed any vote,” he said.
The Republican leader, Sen. Mitch McConnell of Kentucky, said the vote was anything but procedural — casting it as a referendum on the bill itself, which he said would raise taxes, cut Medicare and create a “massive and unsustainable debt.”
For all the drama, the result of tonight's showdown had been sealed a few hours earlier, when two final Democratic holdouts, Sens. Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, announced they would join in clearing the way for a full debate.
“It is clear to me that doing nothing is not an option,” said Landrieu, who won $100 million in the legislation to help her state pay the costs of health care for the poor.
Lincoln, who faces a tough reelection next year, said the evening vote will “mark the beginning of consideration of this bill by the U.S. Senate, not the end.”
Both stressed they were not committing in advance to vote for the bill that ultimately emerges from next month’s debate. Even so, their announcements marked a major victory for Reid and the White House in a year-end drive to enact the most sweeping changes to the nation’s health care system in a half-century or more.
The legislation would require most Americans to carry insurance and provide subsidies to those who couldn’t afford it. Large companies could incur costs if they did not provide coverage to their workforce. The insurance industry would come under significant new regulation under the bill, which would first ease and then ban the practice of denying coverage on the basis of pre-existing medical conditions.
Congressional budget analysts put the legislation’s cost at $979 billion over a decade and said it would reduce deficits over the same period while extending coverage to 94 percent of the eligible population.
Wednesday, November 18, 2009
While Feds Debate, Small-Biz Health Care Rates Skyrocket
By: Carol Tice
Entrepreneur.com Daily Dose
The whole healthcare-reform debate hit home for me this week. I've been ignoring a large envelope that came from my health insurance agent about a month ago. They left me a sort of ominous-sounding phone message about it, too, but I hadn't had a chance to call back. You know how sometimes when you can smell something bad's up, you just want to avoid it? I was in that mode.
Then I started reading news stories about how small-business healthcare plans were all having their rates jacked up to the sky...and I finally got up the nerve to open the envelope. Then I about fell over.
I'm on a health plan through my local city chamber of commerce through my freelance writing business, for me and my three kids. When I signed up two years ago, I was paying about $450 a month in premiums. This year, that became $560 a month. Guess what they'd like me to pay for the same coverage next year? $840 a month. That's a more than 30 percent increase.
Apparently, it's not just me, though mine seems like it's top of the class for ridiculous rate hikes. The Poynter Institute's Al Tompkins reports the average hike is 15 percent--more like what I saw last year.
Obviously, I'm going to be looking for a new health care plan, and I gather I'm not alone. It'll be interesting to see if this small-business healthcare rate spike has any effect on the ongoing effort to create a national healthcare plan.
Are your rates going up? If so, what's your plan--suck it up, or look elsewhere? Cut benefits?
Does it change the way you feel about national healthcare reform? Leave a comment and let us know.
Obama Backs Mandatory Sick Leave Law
By ROBB MANDELBAUM
New York Times - You're the Boss
This news from our colleague Steven Greenhouse, a Times reporter who posted on the Economix blog. Swine flu, he writes:
has given momentum to Congressional efforts to enact legislation that would guarantee paid sick days to tens of millions of workers — although it is far from clear that such legislation will be enacted. Those legislative efforts received added momentum on Tuesday when the Obama administration backed the Healthy Families Act, which would guarantee seven sick days a year to workers in companies with 15 or more employees.
Separately, and a week earlier, Representative George Miller, the chairman of the House Education and Labor Committee, introduced temporary legislation that would require companies with 15 or more employees to guarantee five paid sick days when the company sends a worker home (or urges the person to stay home). Mr. Miller introduced that legislation, which would sunset after two years, the same day that Mr. Greenhouse reported in another story that a “lack of paid sick days may worsen flu pandemic.”
Not surprisingly, the leading small-business lobbies, like the National Federation of Independent Business and the National Small Business Association, are opposed to mandatory leave, even in the face of the H1N1 virus. ” The impetus behind this legislation is not sensible and lacks understanding of the complex dynamics of small businesses,” the N.S.B.A, wrote (pdf) to Mr. Miller. And: “it is unfathomable that Congress would consider legislation mandating additional costly requirements on small businesses.”
Sunday, November 15, 2009
When health insurance costs rise
What businesses can do:
• Make sure your broker has shopped around for the best price.
• See if you can reduce costs by offering a wellness program.
• Ensure that your broker is analyzing your claims to see where the costs and needs are. There may be a cheaper plan for that pattern.
• Consider cost sharing: increasing deductibles, copayments, employee contributions.
• Talk to other brokers to get different offers.
• See if low-income employees may qualify for state-funded care.
• Evaluate whether it would be cost effective to be self-insured.
Sources: The Employee Benefits Advisors Group; Singer Nelson Charlmers
The Record: In Chronic Pain
Thursday, November 12, 2009
Rothman supports health-care reform
By Susan C. Moeller, Senior Reporter
The Leader
(Nov. 12, 2009) — The U.S. House of Representatives voted for the historic “Affordable Health Care in America Act,” Saturday, Nov. 7, at approximately 11:30 p.m.
Congressman Steve Rothman, who represents the southern section of Bergen County, was one of the 220 legislators to vote for the bill, HR 3962. Another 215 logged “no” votes.
“This is probably the most important domestic policy vote I have cast in my 13 years in Congress,” Rothman stated in a press release after the vote.
“The vast majority” of the constituents who have communicated with Rothman “agree that the status-quo of our dysfunctional, wasteful and unfair health-care system is simply unsustainable,” the congressman continued. “While America’s present health system offers some of the world’s best medical care, ever-increasing millions of Americans are denied access to this care, because they cannot afford it.”
Rothman’s local listening sessions drew crowds of people with passionate opinions about health-care reform, both for and against.
The provisions of the bill will now be debated by the Senate.
A copy of the bill — 1,990 pages long — is available online at http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3962ih.txt.pdf
Or by referencing the bill number at the Library of Congress’ Thomas Web site, Thomas.LOC.gov.
