Expert Perspective by Grahall’s OmniMedia Editorial Board

Richard Alonso-Zaldivar’s article, Could overhaul undermine employer health coverage?, for The Associated Press published by MSNBC October 24, 2010 defiantly raises the issue of possible unintended (or maybe even intended) consequences of Heath Care Reform.  He writes: “The new health care law wasn’t supposed to undercut employer plans that have provided most people in the U.S. with coverage for generations. But some employers are weighing the options.” 

Frankly, if we had the luxury to “start from scratch” with Heath Care in this country it is certain that all the experts would steer away from a system that is employer based. 
Continue reading “Consequences of Heath Care Reform” »

Expert Perspective by Grahall’s OmniMedia Editorial Board

Of course we all know there is no requirement that employers offer their employees heath care insurance or pensions or any of those once imagined “entitlement benefits”.  McDonalds, for all they might be contributing to the obesity epidemic in our country is a company that takes care of its restaurant workers.  The fact that they provide health insurance to restaurant workers is remarkable especially since their workforce tends to be transient.  
Continue reading “Unintended Consequences: Could McDonald’s Demand for Reduce MLR Launch a Public Option?” »

Expert Perspective by Grahall’s OmniMedia Editorial Board

It likely didn’t come as a surprise to anyone that the Kaiser Family Foundation Employer Health Benefits 2010 Survey, according to the article September 2, 2010 article in the New York Times by Reed Abelson (Employers Push Costs for Health on Workers), found that “Workers’ share of the cost of a family [health insurance] policy jumped an average of 14 percent, an increase of about $500 a year. The cost of a policy rose just 3 percent, to an average of $13,770… Since 2005, while wages have increased just 18 percent, workers’ contributions to premiums have jumped 47 percent, almost twice as fast as the rise in the policy’s overall cost.”

Clearly there are forces at play here that have been around for a long, long time. Health care reform is supposed to fix some of those problems.  But with little happening before 2014, companies and consumers are left to wonder what reform will mean for the overall health of Americans and that of their wallets. 
Continue reading “Prevention may still better (and cheaper) than the cure even with Health Care Reform” »

Expert Perspective UPDATE by Robert Cirkiel of UHY and a member of Grahall’s Editorial Board 
Wednesday May 26, 2010

Robert Cirkiel writes: “Since publishing the blog Health Care Reform Redux (below), “interim final regulations” have been issued regarding the age 26 dependent coverage requirement.  These are not proposed regulations, and the “interim final” tag means that they are final but the agencies are accepting comments. 

If you think this means that comments will have no impact and therefore commenting is a waste of time I can’t disagree. 

Regardless, my actuarial group will be issuing a comment letter nonetheless, as we believe we have uncovered a number of potential “unintended consequences”.  Also, if the use of “interim final” is a portent of things to come, it means that the time honored process of issuing regs in proposed form that are subject to change may be curtailed. Stay tuned.”

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Expert Perspective by Grahall’s Editorial Board
Monday May 24, 2010 

In his May 15, 2010 New York Times article Health Insurance Companies Try to Shape Rules  author Robert Pears writes:  “Health insurance companies are lobbying federal and state officials in an effort to ward off strict regulation of premiums and profits under the new health care law. The effort is, in some ways, a continuation of the battle over health care that consumed Congress last year. Insurance lobbyists are trying to shape regulations that will define “unreasonable” premium increases and require them to pay rebates to consumers if the companies do not spend enough on patient care… The health care overhaul provides a classic example of how the impact of a law depends on regulations needed to interpret it.”

Weighing in at over 900 pages in length, the Patient Protection and Affordable Care Act provides little insight, however, into what employers, insurers and individuals must do to comply.  (For a little “light reading” you can access the bill at http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf). 

With such limited information and ambiguity in the bill, the regulations will be key to how both providers and users of healthcare are impacted.  Regulators have a long way to go to get the regulations drafted. Even for those elements of the bill with 2010 effective dates , there has been nothing provided other than some narrow  “guidance.”  And like any other regulatory process, once regulations are drafted, comment periods, hearings and redrafting will follow, based on input from constituent groups.    And lobbying will be part of this process.

Let’s take a closer look at the two areas that Health Insurance providers find so unpalatable: regulating premium increases and increasing medical loss ratio (MLR) requirements.  What’s the problem with these two areas as far as Health Insurance companies are concerned? 
Continue reading “UPDATE: Heath Care Reform Redux” »