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Opinion: One Year On, Health Care Reform Helping S.C.

From The State:

By SUE BERKOWITZ and FRANK KNAPP JR. – Guest Columnists

One year ago, we were warned that national health-care reform would impose new taxes, fees and mandates on small businesses, increasing their health-insurance costs. Under this financial pressure, there would be more uninsured due to massive worker layoffs and small-business failures.

Today the Affordable Care Act turns one year old, and small businesses are now realizing that there are not now nor will there be insurance mandates, new taxes or fees for businesses with 50 or fewer employees (97 percent of all S.C. businesses). The vast majority of the larger businesses (97 percent) already offer insurance.

Insurance companies nationwide are reporting dramatic increases in small businesses offering health insurance to employees because the law provides health-insurance tax credits for companies with fewer than 25 workers (88 percent of S.C. businesses). Economic reports show that most of the job growth in the country this year is coming from small and medium-size businesses, and a recent survey indicates that small businesses plan to add nearly 3.8 million jobs in 2011. Bottom line: There is no negative impact on small-business growth.

But the good news isn’t just for small businesses. The ACA is helping children, adults and seniors too.

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Heads Up: Health Care Reform Hearing Next Week!

Senate Banking and Insurance Committee

March 23, 2011 – 11:00 A.M.
105 Gressette Building


Department of Insurance presentation regarding State compliance with the Affordable Care Act. We will hear from consumer and insurance industry advocates as well.

Good Sandlappers, come on down and give lawmakers your $0.02. Help S.C. get it right!

SC To Study Health Insurance Exchanges, Comply With ACA

By executive decree, Gov. Nikki Haley has ordered the establishment of the South Carolina Health Exchange Planning Committee, an advisory body charged with studying and recommending whether South Carolina should launch a state-based insurance exchange or punt that responsibility to the Feds. Either way, the Affordable Care Act (i.e. the new health care reform law) mandates that such an exchange be open by 2014, giving South Carolinians long-overdue access to affordable health coverage. The committee and its study will be funded through a $1 million Exchange Planning Grant from Uncle Sam. For more specifics, click below and read the governor’s decree.

Executive Order 2011-09_SC Health Exchange Planning Committee

What Happened To S.C.’s $16.8M In Health Care Funds?

From The Spartanburg Herald-Journal:

Rep. Bakari Sellers, marshal of this particular sunshine brigade.

Lawmakers seek answers, say SC quietly taking health care funds

Published: Tuesday, March 15, 2011 at 3:15 a.m.

COLUMBIA — Five state lawmakers led by Rep. Bakari Sellers, D-Bamberg, have requested an audit of the S.C. Department of Insurance to account for dollars that have been awarded to, and perhaps spent by, the state of South Carolina under the federal health care reform act.

“The public is not aware that we’ve received this money,” Sellers said. “Our leadership has shied away from talking about it. This is a quest to shine light on things.”

He added: “I hope we’re not hoarding information as well as hoarding dollars.”

At least $16.8 million has been awarded to the state under the Patient Protection and Affordable Care Act, according to a U.S. Department of Health and Human Services fact sheet. That includes a $1 million grant that was applied for and rewarded in September to plan for health insurance exchanges.

“For a very long time, we heard our state wasn’t accepting federal dollars,” Sellers said. “And come to find out, we received (more than) $15 million. I just wanted to make sure we’re using them for the correct purpose.”

The Governor’s Office said Cabinet agencies had only applied for about $2.4 million of the available money and pointed out that it happened under the administration of former Gov. Mark Sanford.

Of that, only about $17,000 has been drawn down from the federal government — but a recent executive order makes the $1 million available to study exchanges, said Tim Pearson, chief of staff for Gov. Nikki Haley.

“The Legislative Audit Council is always welcome to come in and look at our agencies. We’ve always said that,” he said. “I think they’ll come in and find the Department of Insurance is doing what it’s supposed to do.”

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Study: Proposed Medicaid Cuts Would Cost S.C. 5,000 Jobs

An exclusive from The State:


Friday, Mar. 11, 2011

S.C. hospitals, doctors and other health care businesses could cut 5,000 jobs if legislators approve a proposal to reduce what medical providers are paid to treat poor and disabled patients, according to a University of South Carolina study.

A spending plan for the fiscal year that starts July 1, which the S.C. House will debate next week, would cut about $200 million from the state’s current Medicaid spending.

According to the study by USC’s Moore School of Business, a $228 million cut in Medicaid spending by the state — just slightly more than the House proposes to cut — “would potentially lead to losses of 5,452 jobs and approximately $169 million in incomes.”

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Opponents Of Reform Still Pushing Brazen Distortions

Bachmann’s ‘Bombshell’ – A ‘Hidden’ $105 Billion

NBC – Meet The Press
By Glenn Kessler

“There was a Congressional Research Service report that just was issued in February, and we discovered that secretly, unbeknownst to members of Congress, over $105 billion was hidden in the ‘Obamacare’ legislation to fund the implementation of ‘Obamacare’. This is something that wasn’t known. This money was broken up, hidden in various parts of the bill.”
–Rep. Michele Bachmann, March 6, 2011

“This is a crime against democracy. No one knew that Harry Reid, [Nancy] Pelosi and Obama put $105 billion in spending in the bill. … This is a bombshell.”
–Bachmann, March 8, 2011

You have to give Rep. Michele Bachmann credit. The Minnesota Republican certainly knows how to command attention — and how to liven up a dreary discussion of the federal budget on the Sunday morning talk shows by holding up a sign that declares: “$105,464,000,000.”

Even in Washington, $105 billion is real money.

But her assertion raises questions. Is it possible for a major piece of legislation, carefully analyzed by the Congressional Budget Office before final passage, to “secretly” contain so much spending? Let’s find out.

The Facts

Bachmann is correct that there was a Congressional Research Service report issued in February, titled “Appropriations and Fund Transfers in the Patient Protection and Affordable Care Act.” It is actually an update of an earlier report first issued in October.

In January, former Rep. Ernest Istook (R-Okla.) wrote an analysis of the October report for the Heritage Foundation, decrying what he saw as “an attempt to handcuff the current Congress” with directives on spending in future years. “Obamacare was designed to be the governmental equivalent of kudzu — growing everywhere, propagating by multiple means, and sinking in its roots and becoming impossible to control,” Istook wrote.

Here’s where it gets complicated. There is a total of $105 billion identified over 10 years in the CRS report, though only three programs, worth a little more than $25 billion, are funded the full 10 years.  Most of the other programs listed in the report are funded for just a year or two, or perhaps five years. If Congress wants to alter this spending, it will need to pass a new law.

Istook, in an interview, acknowledged, “Congress has the authority to change this, that’s absolutely right,” but as a former member of the Appropriations Committee he believed it is inappropriate for a bill authorizing new programs to also fund so many of them.

Administration officials and other analysts, however, note that regularly appropriated money — also known as mandatory spending — is common in major pieces of health care legislation involving Medicare, Medicaid and the like. There are many other programs in the bill that are subject to annual appropriations, just not the ones identified in the CRS report.

While Bachmann in her television appearances echoed Istook’s argument that Obama “tied the hands of Congress,” her main points have been that “this money was broken up, hidden in various parts of the bill” — something akin to a “slush fund” — and that it was done “secretly, unbeknownst to members of Congress.”

This is bordering on ridiculous. The Congressional Budget Office, the official arbiter of congressional legislation, conducted extensive analyses of the health-care bill. Many of the specific programs identified in the CRS report were listed and examined in the CBO reports that were regularly issued as the legislation made its way through Congress. The CBO reporting also included estimates of the spending for these programs year by year. For complicated reasons, the numbers in the CRS report and the earlier CBO reports are not always exactly the same, but much of it was there in plain sight.

In fact, Bachmann is only talking about half of the ledger.

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Analysis Shows Insurance Giants Pocketing Huge Profits, Despite Weak Economy

Report Underscores Importance of Blocking New Health Law’s Repeal
Published on Mar 3, 2011 – 7:02:25 AM

By: Health Care for America Now

Washington, DC – The five largest Wall Street-run health insurance companies parlayed the economic meltdown of 2008 and the nation’s subsequent fragile recovery into huge profits in 2010, the last year before market reforms in the AffordableCare Act (ACA) take full effect, according to an analysis by Health Care for America Now (HCAN). The five insurers made combined profits of $11.7 billion by reducing the share of premiums spent on the shrinking membership in private health plans.

Through the recession and its aftermath from 2008 to 2010, combined profits for UnitedHealth Group Inc., WellPoint Inc., Aetna Inc., Cigna Corp. and Humana Inc. increased a breathtaking 51 percent. Last year alone, the five companies’ combined profits grew 17 percent, excluding a one-time $2.2 billion gain from the 2009 sale of a WellPoint subsidiary. On Wall Street, share prices for the five health insurers have risen 15 to 25 percent this year, compared with less than 5 percent for broad market indices.

“While families are struggling to make ends meet and cope with rising health costs in a tough economy, health insurance companies are continuing to make excessive profits,” said HCAN Executive Director Ethan Rome. “The companies made their profits by burdening families and businesses with unaffordable premiums and a bigger share of rising medical costs. The insurance companies’ financial success is the result of a business model that avoids risk and provides less care. While running television ads claiming they care about their customers’ health, the insurers continually devise ways to make more profit by giving inadequate benefits to their shrinking pool of private plan members.”
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Fla. Judge Stays Own Ruling Against Health Care Reform

The Justice Department said it would quickly appeal — as Judge Roger Vinson said it must. | AP Photo
From Politico:

U.S. District Judge Roger Vinson put the health care reform law on a fast track to the Supreme Court on Thursday — giving the Obama administration just seven days to file an appeal and signaling to fellow jurists that the time for a decision is now.

Vinson called his order a stay, but the real message was clear: Hurry up.

“The battle lines have been drawn, the relevant case law marshaled and the legal arguments refined,” Vinson wrote. “It is very important to everyone in this country that this case move forward.”

In one sense, the ruling was a victory for the Obama administration: It ended waves of confusion over whether states should continue working to implement the law. And in the hours after the ruling came down, some of the law’s strongest opponents, including Alaska Gov. Sean Parnell, said that they had no choice but to go along.

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Message To Health Law Critics: It’s Not A Lack Of Flexibility

“The real problem here, in other words, isn’t the lack of flexibility in the health law. It’s the lack of workable ideas from critics on the right.”

From Kaiser Health News:

By Jonathan Cohn, Senior Editor of The New Republic (Mar 01, 2011)

With Republican governors complaining that the Affordable Care Act doesn’t give them enough flexibility, President Barack Obama on Monday offered a compromise: He’d allow them to opt out of the law altogether, just as long as they had an alternative method of providing universal coverage.

Although a few Republican governors responded positively, the party’s more visible leaders were quick to condemn the move as meaningless. “Flexibility,” quipped Sen. Orrin Hatch, R-Utah, “I believe the technical legal term is baloney.” Conservative intellectuals agreed. Obama’s proposal is “not an actual concession,” according to National Review’s Yuval Levin, because “it would allow conservative-leaning governors essentially no freedom to move in the direction of greater competition and more consumer-driven health care.”

Hatch, Levin and the other critics of Obama’s proposal have a point: It wouldn’t allow them to enact the sorts of health care reforms they would prefer. But that’s because their proposals wouldn’t come even close to making health care affordable for all Americans. The real problem here, in other words, isn’t the lack of flexibility in the health law. It’s the lack of workable ideas from critics on the right.

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GOP Govs Cool Toward Offer Of Flexibility On ACA

Gov. Nikki Haley at a meeting of governors hosted by President Barack Obama in the State Dining Room of the White House, Monday. (AP Photo/Charles Dharapak)

From The Wall Street Journal:


WASHINGTON—President Barack Obama on Monday backed a bill in Congress to let states design their own ways to expand insurance coverage sooner under the health-care overhaul, in a nod to governors’ complaints that federal rules are too rigid.

The proposal won cool reviews from Republican governors and doesn’t represent a fundamental change to the overhaul, but it could open the door to more rethinking of health-care policies as states are struggling with large deficits.

Speaking to governors at the White House, Mr. Obama also responded to a wave of pressure from governors who say Medicaid, the federal-state insurance program for the poor, costs the states too much. The president, without giving specifics, said his administration would work to lower states’ Medicaid costs and called for a bipartisan group of governors to craft ideas.

His proposal on increasing state flexibility involves a piece of the health law scheduled to take effect in 2017. It allows states to avoid the major mandates of the law, including the requirement that most people carry insurance or pay a fee, among other rules. To qualify, states must develop an alternate system of comparable coverage that insures as many people as the federal law, without increasing the nation’s deficit.

A bipartisan trio of senators has proposed legislation to allow the exemption in 2014, when most of the rest of the law kicks in. In his speech to the governors, Mr. Obama said he supported moving the date up.

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