Georgia State Senator Jack Hill of the Fourth District took these notes last week at the Capitol in Atlanta.
BY STATE SENATOR JACK HILL
4th District
January 22, 2010
Budget Briefings
Governor Sonny Perdue released his amended FY10 and FY11 budget recommendations to the General Assembly on Friday, January 15, 2010. During Senate and House Appropriations Committee hearings last week, lawmakers heard presentations from state agencies regarding their individual budgetary concerns and the impact that can be expected in FY10 and FY11.
In July, Governor Perdue announced a $900M reduction in the revenue estimate for the FY 2010 Budget due to the sharp drop in revenues the last 6 months of FY09. The 2010 Amended budget presented by Governor Perdue raises that reduction to $1.44B.
2010 AMENDED BUDGET PROPOSALS
The FY10 Amended revenue estimate is 7.3% below FY09 actual revenues and 8.5% below the original FY10 General budget revenue estimate of $16.99B. The FY10 Amended revenue estimate represents a 23% decline from the original FY09 General budget ($20.1B) proposed by Governor Perdue just 2 short years ago. Governor Perdue is now projecting a $1.44B shortfall for FY10.
To combat this shortfall, Governor Perdue has proposed an additional 3 furlough days for state employees and teachers, bringing the total to 6 for this fiscal year. This measure alone would save the state nearly $245M. For additional funds, the Governor has chosen to liquidate $140M from the Other Post Employment Benefit reserve fund designated for the health benefits of future retirees. The budget also proposes to shift the State Health Benefit Plan to a cash basis using $67M in funds set aside for bills that are funded from “Incurred but Not Reported” (IBNR).
Education
Governor Perdue has allocated an additional $92.8M to the QBE formula to fund K-12 enrollment growth of 0.67%. Although this is an increase, the Governor’s recommended budget reduced the QBE formula by $188M for the 6 furlough days. This paired with a $281M across the board reduction brings the total QBE base funding to a -5.6% reduction, although partially offset by federal stimulus funds to local systems.
The Governor has called for a $9.7M reduction in Georgia’s school nutrition program and a $4M reduction to its Special Needs Scholarship Fund. Pupil transportation would also be cut by $24.7M and the Equalization formula would decrease by 4% or $17.5M.
To meet increased growth in enrollments, the FY10 HOPE program includes an increase of $146,963 for the HOPE GED, $49.3M for the HOPE Grant, $2.1M for private school HOPE Scholarships, and $26.9M for public school HOPE Scholarships.
Higher Education
The Amended budget recommends a net cut of 7.76% to the Regents funding formula, a net cut of 7.48% to the Technical Colleges funding formula, and the elimination of the Guaranteed Educational Loans Program. $33.7M in Lottery funds would supplant State General Funds to finance the HERO Scholarship, Leveraging Educational Assistance Partnership Program (LEAP), North GA Military Scholarship Grants, North GA ROTC Grants, and Tuition Equalization Grants.
Medicaid, Peachcare, and Public Health
Governor Perdue has designated $20.3M in additional funds to the Department of Behavioral Health for state hospital improvements and $8.6M in state matching funds for private hospitals to assist in indigent and uncompensated care.
The Governor has also called for an 11% reduction in Low Income Medicaid, a 3% reduction to the Medicaid Aged Blind and Disabled fund, and a 9% reduction to Georgia’s Public Health Grant in Aid, generating the state nearly $90M in savings.
Corrections
The FY10 Amended budget recommends the closure of Scott State Prison (closed August 2009), Bostick State Prison (May 2010), and the Bill Ireland Juvenile Facility (January 2010) for a total savings of nearly $20M.
Next week’s column will include a summary of Governor Perdue’s FY2011 General budget proposals.
JOBS PROGRAM FOR EMPLOYERS
The Department of Human Services (DHS) has received nearly $200M in federal stimulus funds to be put towards a temporary, subsidized employment program for 5,000 adults. All families with dependent children and incomes of less than 300% of the federal poverty level (approximately $60,000 for a family of four) are eligible to participate.
Employers who choose to participate in this program will receive an 80% subsidy for employing adult workers for up to six months at minimum wage or above. The subsidy expires September 30, 2010.
For more information regarding eligibility requirements please send all inquiries to:
Employers: TANF-Employers@dhr.state.ga.us
Job Seekers: TANF-Jobseekers@dhr.state.ga.us
I may be reached at
234 State Capitol, Atlanta, GA 30334
(404) 656-5038 (phone)
(404) 657-7094 (fax)
E-mail at Jack.Hill@senate.ga.gov
Or Call Toll-Free at
1-800-367-3334 Day or Night
Reidsville office: (912) 557-3811
Angela Touhy
Senate Appropriations
234 State Capitol
Atlanta, Georgia 30334
404-656-5038
All About Developmental Disabilities (AADD) is Atlanta's preeminent resource on developmental disabilities, providing support services to families for more than 55 years. We are often the one place where people with developmental disabilities can go to achieve personal empowerment, family stability and community participation. AADD provides family support; public policy and advocacy; and community engagement.
Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts
Monday, January 25, 2010
Friday, January 22, 2010
Georgia Legislators Mull Health Care Fees
By Shannon McCaffrey
Associated Press
Athens Banner-Herald
January 22, 2010
ATLANTA - Facing a massive gap in Medicaid funding, Georgia's top health official urged state legislators Thursday to raise taxes on hospitals and health care plans.
The state is staring down a $506 million shortfall in Medicaid funds for the fiscal year that begins July 1, according to state Health Commissioner Rhonda Medows.
The recession has caused enrollment in the health program for the needy to soar. Medicaid rolls for low-income residents have jumped 7.7 percent since June to more than 1 million people.
Meanwhile, hundreds of millions of dollars in federal stimulus money is about to dry up.
The state has few options. To participate in Medicaid, it must provide services to the aged, blind and disabled and to low-income children. And because Georgia accepted stimulus cash from Washington, it cannot cut back eligibility on optional programs such as dental coverage and prescription drugs, Medows said.
"We are in a box," Medows told a joint budget panel of state legislators Thursday. "I cannot find $506 million to fill that hole through cuts, program reductions, layoffs."
Gov. Sonny Perdue has put forward a proposal that would charge hospitals and health insurance plans a 1.6 percent fee on their total revenues.
Perdue has been careful to label it a fee, but Medows on Thursday called it a tax - a word that's not popular in the Republican-led Georgia General Assembly.
It's the second year Perdue has pushed the proposal, which would leverage additional federal matching dollars. Last year the plan died amid opposition from conservative Republicans. But federal money also came to the rescue.
This year, unless Congress approves another infusion of federal cash, Georgia will be left to fend for itself.
State Rep. Mickey Channell, R-Greensboro, who oversees health spending on the House Appropriations Committee, said legislators are looking at possible alternatives to Perdue's so-called bed tax.
"The need for additional revenue is real," Channell said. "Our options are all pretty painful." Channell did not elaborate on potential alternatives, but one idea raised in the past was to increase the tax on tobacco products.
Federal and state governments share the costs for Medicaid, the health program for needy residents, and Medicaid spending accounts for 9.8 percent of all state general revenue spending in Georgia.
The recession is straining social service programs at the same time state coffers are running dry.
State Human Services Commissioner B.J. Walker told the legislative budget panel Thursday that in the past two years, Georgia has seen a 39 percent jump in demand for social services programs such as Medicaid, food stamps and welfare.
Originally published in the Athens Banner-Herald on Friday, January 22, 2010
http://www.onlineathens.com/stories/012210/gen_553013236.shtml
© 2010 OnlineAthens • Athens Banner-Herald • Morris Digital Works
Associated Press
Athens Banner-Herald
January 22, 2010
ATLANTA - Facing a massive gap in Medicaid funding, Georgia's top health official urged state legislators Thursday to raise taxes on hospitals and health care plans.
The state is staring down a $506 million shortfall in Medicaid funds for the fiscal year that begins July 1, according to state Health Commissioner Rhonda Medows.
The recession has caused enrollment in the health program for the needy to soar. Medicaid rolls for low-income residents have jumped 7.7 percent since June to more than 1 million people.
Meanwhile, hundreds of millions of dollars in federal stimulus money is about to dry up.
The state has few options. To participate in Medicaid, it must provide services to the aged, blind and disabled and to low-income children. And because Georgia accepted stimulus cash from Washington, it cannot cut back eligibility on optional programs such as dental coverage and prescription drugs, Medows said.
"We are in a box," Medows told a joint budget panel of state legislators Thursday. "I cannot find $506 million to fill that hole through cuts, program reductions, layoffs."
Gov. Sonny Perdue has put forward a proposal that would charge hospitals and health insurance plans a 1.6 percent fee on their total revenues.
Perdue has been careful to label it a fee, but Medows on Thursday called it a tax - a word that's not popular in the Republican-led Georgia General Assembly.
It's the second year Perdue has pushed the proposal, which would leverage additional federal matching dollars. Last year the plan died amid opposition from conservative Republicans. But federal money also came to the rescue.
This year, unless Congress approves another infusion of federal cash, Georgia will be left to fend for itself.
State Rep. Mickey Channell, R-Greensboro, who oversees health spending on the House Appropriations Committee, said legislators are looking at possible alternatives to Perdue's so-called bed tax.
"The need for additional revenue is real," Channell said. "Our options are all pretty painful." Channell did not elaborate on potential alternatives, but one idea raised in the past was to increase the tax on tobacco products.
Federal and state governments share the costs for Medicaid, the health program for needy residents, and Medicaid spending accounts for 9.8 percent of all state general revenue spending in Georgia.
The recession is straining social service programs at the same time state coffers are running dry.
State Human Services Commissioner B.J. Walker told the legislative budget panel Thursday that in the past two years, Georgia has seen a 39 percent jump in demand for social services programs such as Medicaid, food stamps and welfare.
Originally published in the Athens Banner-Herald on Friday, January 22, 2010
http://www.onlineathens.com/stories/012210/gen_553013236.shtml
© 2010 OnlineAthens • Athens Banner-Herald • Morris Digital Works
Georgia Expects $608 Million Medicaid Deficit
By Craig Schneider
The Atlanta Journal-Constitution
January 22, 2010
Georgia is projecting a $608 million deficit in Medicaid, and Gov. Sonny Perdue is proposing a tax on hospitals and managed care insurers to help bridge the gap, officials said Thursday.
The Medicaid gap is largely due to the reduction of $506 million in money from sources that include the federal stimulus program and the national settlement with tobacco companies.
In addition, the recession has spurred a projected 7.7 percent increase in enrollment in the state's Medicaid health program for the needy from July 2009 to June of this year. That program is expected to grow an additional 2 percent in the following budget year, said officials of the state Department of Community Health.
DCH Commissioner Rhonda Medows discussed the Medicaid problem Thursday during a series of state budget hearings on health and human services.
The hearings at the state Capitol also featured discussion on the proposed budget for the state mental health agency, which is slated to receive an additional $70 million over the next 18 months.
The $608 million Medicaid deficit is projected for fiscal year 2011, which begins in July. Medows said her agency does not have the means to make up for the Medicaid deficit without generating new revenue.
To help bridge the gap, Perdue's proposed budget calls for a 1.6 percent tax on net patient revenue of hospitals and premium revenue on managed care insurers. The two fees would generate $345 million annually, officials said.
Perdue had floated a similar fee proposal a year ago, and it was not well-received.
Medows said that if the new taxes are not approved, her agency would have to decrease Medicaid reimbursement payments to hospitals, doctors and other health providers by 16.5 percent.
Rep. Mickey Channell (R-Greensboro), chairman of the House Appropriations health subcommittee, said he opposed the hospital tax because it would benefit some hospitals and not others.
He noted that federal restrictions prevent the state from tinkering with the eligibility requirements on Medicaid, which is funded by both the state and federal governments. He said he was open to discussing the fees on the managed care companies.
Medows said Perdue's proposed budget also planned for increases in the premiums state employees pay into their health benefit program. The health plan -- which covers 689,000 state employees, their dependents and retirees -- would increase 10 percent across all options, officials said.
For the employee on the state HMO program, the most popular plan, the cost would increase about $10 a month for a single person and about $25 a month for a family.
Officials from the state Department of Behavioral Health and Developmental Disabilities said their agency may be the only one to receive more money in the state budget.
The agency has agreed to a settlement with the U.S. Department of Justice to improve treatment and conditions at the state's mental hospitals. Perdue has proposed adding $20 million to the agency's budget from January through June. After that, Perdue has proposed adding an additional $50 million to the agency's $1 billion annual budget.
The additional money would be used to hire more staff for those mental hospitals that are understaffed, increase training, transfer paper records into electronic form, and increase community-based services, officials said.
http://www.ajc.com/health/georgia-expects-608-million-280428.html?cxtype=rss_news_128746
© 2010 The Atlanta Journal-Constitution
The Atlanta Journal-Constitution
January 22, 2010
Georgia is projecting a $608 million deficit in Medicaid, and Gov. Sonny Perdue is proposing a tax on hospitals and managed care insurers to help bridge the gap, officials said Thursday.
The Medicaid gap is largely due to the reduction of $506 million in money from sources that include the federal stimulus program and the national settlement with tobacco companies.
In addition, the recession has spurred a projected 7.7 percent increase in enrollment in the state's Medicaid health program for the needy from July 2009 to June of this year. That program is expected to grow an additional 2 percent in the following budget year, said officials of the state Department of Community Health.
DCH Commissioner Rhonda Medows discussed the Medicaid problem Thursday during a series of state budget hearings on health and human services.
The hearings at the state Capitol also featured discussion on the proposed budget for the state mental health agency, which is slated to receive an additional $70 million over the next 18 months.
The $608 million Medicaid deficit is projected for fiscal year 2011, which begins in July. Medows said her agency does not have the means to make up for the Medicaid deficit without generating new revenue.
To help bridge the gap, Perdue's proposed budget calls for a 1.6 percent tax on net patient revenue of hospitals and premium revenue on managed care insurers. The two fees would generate $345 million annually, officials said.
Perdue had floated a similar fee proposal a year ago, and it was not well-received.
Medows said that if the new taxes are not approved, her agency would have to decrease Medicaid reimbursement payments to hospitals, doctors and other health providers by 16.5 percent.
Rep. Mickey Channell (R-Greensboro), chairman of the House Appropriations health subcommittee, said he opposed the hospital tax because it would benefit some hospitals and not others.
He noted that federal restrictions prevent the state from tinkering with the eligibility requirements on Medicaid, which is funded by both the state and federal governments. He said he was open to discussing the fees on the managed care companies.
Medows said Perdue's proposed budget also planned for increases in the premiums state employees pay into their health benefit program. The health plan -- which covers 689,000 state employees, their dependents and retirees -- would increase 10 percent across all options, officials said.
For the employee on the state HMO program, the most popular plan, the cost would increase about $10 a month for a single person and about $25 a month for a family.
Officials from the state Department of Behavioral Health and Developmental Disabilities said their agency may be the only one to receive more money in the state budget.
The agency has agreed to a settlement with the U.S. Department of Justice to improve treatment and conditions at the state's mental hospitals. Perdue has proposed adding $20 million to the agency's budget from January through June. After that, Perdue has proposed adding an additional $50 million to the agency's $1 billion annual budget.
The additional money would be used to hire more staff for those mental hospitals that are understaffed, increase training, transfer paper records into electronic form, and increase community-based services, officials said.
http://www.ajc.com/health/georgia-expects-608-million-280428.html?cxtype=rss_news_128746
© 2010 The Atlanta Journal-Constitution
Thursday, January 21, 2010
Press Release: Governor Perdue to Introduce Legislation to Improve Access to Home-based Care
STATE OF GEORGIA
OFFICE OF THE GOVERNOR
Sonny Perdue, GOVERNOR
For Immediate Release
Wednesday, January 20, 2010
ATLANTA – Governor Sonny Perdue announced today that State Representative Jimmy Pruett, one of the Governor’s House floor leaders, will introduce legislation to improve access to home-based care. Amending the Nurse Practice Act will allow an unlicensed person who is trained by a Registered Nurse (RN) to provide a defined set of skilled services to a specific person, as long as those services are ordered by a physician, dentist or podiatrist for a person who is disabled.
“Right now there are thousands of people in Georgia who could be cared for at home, but under current law their care must be provided by a licensed nurse,” said Governor Perdue. “This amendment to the Nurse Practice Act would open the door to allow people to remain at home and in their community. This will make healthcare more convenient, more affordable and more accessible to Georgians with disabilities.”
Under current law, no skilled service can receive reimbursement unless the caregiver is a licensed health care provider. Expanding the pool of caregivers will make community care more affordable for both Medicaid and private payers. The training must be for a specific individual and does not allow the unlicensed person to serve others without separate, specific training. The changes to the Nurse Practice Act have also been approved by the Georgia Board of Nursing.
“This bill will increase choice for Georgia’s elderly and disabled,” said Rep. Pruett. “It will help many people stay in their community, rather than go to an institutional setting.”
“This legislation will give families more options to potentially expand services they receive based on their own choices,” said Frank Shelp, M.D., Commissioner of the Department of Behavioral Health and Developmental Disabilities.
###
OFFICE OF THE GOVERNOR
Sonny Perdue, GOVERNOR
For Immediate Release
Wednesday, January 20, 2010
ATLANTA – Governor Sonny Perdue announced today that State Representative Jimmy Pruett, one of the Governor’s House floor leaders, will introduce legislation to improve access to home-based care. Amending the Nurse Practice Act will allow an unlicensed person who is trained by a Registered Nurse (RN) to provide a defined set of skilled services to a specific person, as long as those services are ordered by a physician, dentist or podiatrist for a person who is disabled.
“Right now there are thousands of people in Georgia who could be cared for at home, but under current law their care must be provided by a licensed nurse,” said Governor Perdue. “This amendment to the Nurse Practice Act would open the door to allow people to remain at home and in their community. This will make healthcare more convenient, more affordable and more accessible to Georgians with disabilities.”
Under current law, no skilled service can receive reimbursement unless the caregiver is a licensed health care provider. Expanding the pool of caregivers will make community care more affordable for both Medicaid and private payers. The training must be for a specific individual and does not allow the unlicensed person to serve others without separate, specific training. The changes to the Nurse Practice Act have also been approved by the Georgia Board of Nursing.
“This bill will increase choice for Georgia’s elderly and disabled,” said Rep. Pruett. “It will help many people stay in their community, rather than go to an institutional setting.”
“This legislation will give families more options to potentially expand services they receive based on their own choices,” said Frank Shelp, M.D., Commissioner of the Department of Behavioral Health and Developmental Disabilities.
###
Wednesday, January 20, 2010
Drug Companies Threatening to Oppose Health Bill
By ALAN FRAM - Associated Press Writer
WASHINGTON -- The drug industry is threatening to end its support for President Barack Obama's health overhaul effort because of a rift with the administration over protecting brand-name biotech drugs from low-cost generic competitors.
In an e-mail obtained Friday by The Associated Press, the president of the Pharmaceutical Research and Manufacturers of America told the trade group's board members that "we could not support the bill" if the industry is given less than 12 years of competitive protection for the expensive products.
Obama and House Energy and Commerce Committee Chairman Henry Waxman, D-Calif., are leading the drive to shorten that period, which proponents argue would be a boon to consumers.
"Please activate immediately all of your contacts," said the e-mail from Billy Tauzin, the group's president.
The pharmaceutical industry has been a crucial supporter of Obama's health effort, having spent many tens of millions of dollars on advertising and lobbying in support. Drug companies should profit from the millions of additional people who would be able to afford health coverage under the legislation.
The threat comes with White House officials and Democratic congressional leaders nearing an agreement on compromise legislation reshaping the nation's health care system.
With a deal so close, it was unclear whether the partnership between drugmakers and the administration was truly in jeopardy, or if the e-mail represented an effort by the industry to pressure the White House to drop its effort to shorten the period of competitive protection for biotech drugs.
Any compromise bill, though, will face a nail-biting trip through Congress, where Democrats got barely enough support when they pushed initial versions of the bill through the House and Senate. If the drug industry decided to pour money into advertising opposing the legislation, that could give some lawmakers second thoughts about supporting the bill.
Ken Johnson, a senior vice president of PhRMA, declined to comment on the e-mail. But in a written statement, he said, "Fair data protection of at least 12 years for new, innovative biologic medicines is critically important to the future of medical progress in America."
In a written statement, Waxman said the overhaul should be "to help struggling families, not to enrich the drug companies."
Last June, the industry agreed to actively support Obama's health overhaul in an agreement with the White House and Senate Finance Committee Chairman Max Baucus, D-Mont., to limit the cost to drugmakers to $80 billion over next decade.
But as Democrats craft their compromise health bill, they have begun looking for additional sources of revenue to pay for changes they are making. That has included pressing the drugmakers to contribute an additional $10 billion - another factor that might be part of PhRMA's decision to threaten to withdraw its support.
Biotech drugs, manufactured from live tissue, are a fast-growing share of sales for pharmaceutical companies worldwide and are seen as a pivotal part of that industry's future.
The House and Senate versions of the health legislation give biotech drugs 12 years of protection from generic competitors. Brand name companies say they need that period to recoup their investments in the products, which can be very expensive to develop.
The Obama administration has said seven years would be a reasonable compromise. Some lobbyists have said Waxman was pushing to reduce the 12 years to 10 years or less.
A lobbying war on the issue has kicked into high gear.
Among groups whose members are calling the White House and congressional leaders in support of the 12 years was the Massachusetts Biotechnology Council, representing about 350 biotech firms.
Massachusetts is where a Republican is threatening to capture the Senate seat long held by the late Sen. Edward Kennedy, D-Mass., in next Tuesday's special election. That could make Obama reluctant to support a policy that could anger employees of one of that state's most important industries.
Senior presidential adviser David Axelrod said that Massachusetts Gov. Deval Patrick called White House officials to raise concerns about shortening the products' protections, "but he did not tie it to the election at all."
http://www.macon.com/266/story/987120.html
Macon.com copyright notice
Material published on Macon.com, including articles, photos, graphics, videos, bulletin board postings and other content, is copyrighted by The Telegraph or by other information providers who have licensed their content for use on Macon.com. The entire contents of Macon.com are also copyrighted as a collective work under the United States copyright laws.
WASHINGTON -- The drug industry is threatening to end its support for President Barack Obama's health overhaul effort because of a rift with the administration over protecting brand-name biotech drugs from low-cost generic competitors.
In an e-mail obtained Friday by The Associated Press, the president of the Pharmaceutical Research and Manufacturers of America told the trade group's board members that "we could not support the bill" if the industry is given less than 12 years of competitive protection for the expensive products.
Obama and House Energy and Commerce Committee Chairman Henry Waxman, D-Calif., are leading the drive to shorten that period, which proponents argue would be a boon to consumers.
"Please activate immediately all of your contacts," said the e-mail from Billy Tauzin, the group's president.
The pharmaceutical industry has been a crucial supporter of Obama's health effort, having spent many tens of millions of dollars on advertising and lobbying in support. Drug companies should profit from the millions of additional people who would be able to afford health coverage under the legislation.
The threat comes with White House officials and Democratic congressional leaders nearing an agreement on compromise legislation reshaping the nation's health care system.
With a deal so close, it was unclear whether the partnership between drugmakers and the administration was truly in jeopardy, or if the e-mail represented an effort by the industry to pressure the White House to drop its effort to shorten the period of competitive protection for biotech drugs.
Any compromise bill, though, will face a nail-biting trip through Congress, where Democrats got barely enough support when they pushed initial versions of the bill through the House and Senate. If the drug industry decided to pour money into advertising opposing the legislation, that could give some lawmakers second thoughts about supporting the bill.
Ken Johnson, a senior vice president of PhRMA, declined to comment on the e-mail. But in a written statement, he said, "Fair data protection of at least 12 years for new, innovative biologic medicines is critically important to the future of medical progress in America."
In a written statement, Waxman said the overhaul should be "to help struggling families, not to enrich the drug companies."
Last June, the industry agreed to actively support Obama's health overhaul in an agreement with the White House and Senate Finance Committee Chairman Max Baucus, D-Mont., to limit the cost to drugmakers to $80 billion over next decade.
But as Democrats craft their compromise health bill, they have begun looking for additional sources of revenue to pay for changes they are making. That has included pressing the drugmakers to contribute an additional $10 billion - another factor that might be part of PhRMA's decision to threaten to withdraw its support.
Biotech drugs, manufactured from live tissue, are a fast-growing share of sales for pharmaceutical companies worldwide and are seen as a pivotal part of that industry's future.
The House and Senate versions of the health legislation give biotech drugs 12 years of protection from generic competitors. Brand name companies say they need that period to recoup their investments in the products, which can be very expensive to develop.
The Obama administration has said seven years would be a reasonable compromise. Some lobbyists have said Waxman was pushing to reduce the 12 years to 10 years or less.
A lobbying war on the issue has kicked into high gear.
Among groups whose members are calling the White House and congressional leaders in support of the 12 years was the Massachusetts Biotechnology Council, representing about 350 biotech firms.
Massachusetts is where a Republican is threatening to capture the Senate seat long held by the late Sen. Edward Kennedy, D-Mass., in next Tuesday's special election. That could make Obama reluctant to support a policy that could anger employees of one of that state's most important industries.
Senior presidential adviser David Axelrod said that Massachusetts Gov. Deval Patrick called White House officials to raise concerns about shortening the products' protections, "but he did not tie it to the election at all."
http://www.macon.com/266/story/987120.html
Macon.com copyright notice
Material published on Macon.com, including articles, photos, graphics, videos, bulletin board postings and other content, is copyrighted by The Telegraph or by other information providers who have licensed their content for use on Macon.com. The entire contents of Macon.com are also copyrighted as a collective work under the United States copyright laws.
Friday, January 15, 2010
Georgia Medicaid Deficit Could Exceed Half-Billion Dollars
By Morris News Service
Savannah Morning News
January 15, 2010
ATLANTA - More bad news, in advance of the expected release at noon today of Gov. Sonny Perdue’s budget proposal. Thursday, Community Health Commissioner Rhonda Medows announced that the state’s Medicaid shortfall for Fiscal 2011 will be in the neighborhood of $635 million.
That’s a 33 percent increase over the $477 million shortfall the state faced last year.
One observer noted that when combined with the temporarily enhanced 3:1 federal match for Medicaid expenditures, this amounts to a total $2 billion shortfall. The result could be “devastating” for the state’s hospitals and health care providers, the source said.
House Appropriations Chairman Ben Harbin said Friday morning the news could make funding for other government services harder to find.
“If I spend money on something that looks good, it has to come from somewhere,” the Evans Republican told a conference of social-program advocates. “Is it coming from our K-12 education? It could be. Is it coming from out healthcare needs, as we saw this morning with the downturn in the economy and the larger-than-expected deficit in Medicaid? Is it going to come from there?”
The increasing burden on the Medicaid system also reflects the state’s tough economic position. It’s being driven up as more Georgians join the poverty rolls.
http://savannahnow.com/latest-news/2010-01-15/georgia-medicaid-deficit-could-exceed-half-billion-dollars
Morris Communications All files and material © Savannah Morning News, 2009
Savannah Morning News
January 15, 2010
ATLANTA - More bad news, in advance of the expected release at noon today of Gov. Sonny Perdue’s budget proposal. Thursday, Community Health Commissioner Rhonda Medows announced that the state’s Medicaid shortfall for Fiscal 2011 will be in the neighborhood of $635 million.
That’s a 33 percent increase over the $477 million shortfall the state faced last year.
One observer noted that when combined with the temporarily enhanced 3:1 federal match for Medicaid expenditures, this amounts to a total $2 billion shortfall. The result could be “devastating” for the state’s hospitals and health care providers, the source said.
House Appropriations Chairman Ben Harbin said Friday morning the news could make funding for other government services harder to find.
“If I spend money on something that looks good, it has to come from somewhere,” the Evans Republican told a conference of social-program advocates. “Is it coming from our K-12 education? It could be. Is it coming from out healthcare needs, as we saw this morning with the downturn in the economy and the larger-than-expected deficit in Medicaid? Is it going to come from there?”
The increasing burden on the Medicaid system also reflects the state’s tough economic position. It’s being driven up as more Georgians join the poverty rolls.
http://savannahnow.com/latest-news/2010-01-15/georgia-medicaid-deficit-could-exceed-half-billion-dollars
Morris Communications All files and material © Savannah Morning News, 2009
Thursday, January 14, 2010
Perdue Calls for Mental Health Spending in State of the State Address
By Walter Jones
Savannah Morning News
Savannahnow.com
Home / Latest News
January 13, 2010
ATLANTA - Gov. Sonny Perdue announced few legislative proposals this morning during his State of the State Address to a joint session of the General Assembly, other than a $70 million increase in spending for the disabled.
He spent most of the 45-minute oration reminding legislators that the country had seen tougher times than the after-effects of the recent recession. And he offered praise for teachers and state workers who were working harder despite the budget cuts and layoffs that have hit every agency.
The only area of spending increase announced is in the Department of Behavioral Health which was created last year. The current budget will rise $20 million and the budget for the fiscal year beginning July 1 will jump another $50 million.
“Yes, it will cost more money, but I am confident that it will result in better outcomes for patients and we will all sleep better at night,” he said. “We have a moral obligation to serve those with disabilities.”
He acknowledged that the federal government has warned the state that its operation of the state’s seven mental hospitals violates standards. He said the problems began before his term started seven years ago.
To state workers, he told them to continue serving the public even though their resources are limited.
“I have noticed it, and more importantly your fellow Georgians have noticed it,” he said. “Thank you, thank you, thank you.”
The speech didn’t outline details of his budget recommendations, despite lagging tax collections that could require cuts of as much as $1.5 billion. He said he will release his spending blueprint Friday.
http://savannahnow.com/latest-news/2010-01-13/perdue-calls-mental-health-spending-state-state-address
Savannahnow.com, Savannah Morning News ©2010 Morris Communications, LLC.
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January 13, 2010
ATLANTA - Gov. Sonny Perdue announced few legislative proposals this morning during his State of the State Address to a joint session of the General Assembly, other than a $70 million increase in spending for the disabled.
He spent most of the 45-minute oration reminding legislators that the country had seen tougher times than the after-effects of the recent recession. And he offered praise for teachers and state workers who were working harder despite the budget cuts and layoffs that have hit every agency.
The only area of spending increase announced is in the Department of Behavioral Health which was created last year. The current budget will rise $20 million and the budget for the fiscal year beginning July 1 will jump another $50 million.
“Yes, it will cost more money, but I am confident that it will result in better outcomes for patients and we will all sleep better at night,” he said. “We have a moral obligation to serve those with disabilities.”
He acknowledged that the federal government has warned the state that its operation of the state’s seven mental hospitals violates standards. He said the problems began before his term started seven years ago.
To state workers, he told them to continue serving the public even though their resources are limited.
“I have noticed it, and more importantly your fellow Georgians have noticed it,” he said. “Thank you, thank you, thank you.”
The speech didn’t outline details of his budget recommendations, despite lagging tax collections that could require cuts of as much as $1.5 billion. He said he will release his spending blueprint Friday.
http://savannahnow.com/latest-news/2010-01-13/perdue-calls-mental-health-spending-state-state-address
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Friday, January 08, 2010
Are Doctors Ready for Virtual Visits?
By PAULINE W. CHEN, M.D.
The New York Times
January 7, 2010
For over a decade now, health care experts have been promoting telemedicine, or the use of satellite technology, video conferencing and data transfer through phones and the Internet, to connect doctors to patients in far-flung locales. But are doctors ready for this form of technology?
Skip to next paragraph Telemedicine has the potential to improve quality of care by allowing clinicians in one “control center” to monitor, consult and even care for and perform procedures on patients in multiple locations. A rural primary care practitioner who sees a patient with a rare skin lesion, for example, can get expert consultation from a dermatologist at a center hundreds of miles away. A hospital unable to staff its intensive care unit with a single critical care specialist can have several experts monitoring their patients remotely 24 hours a day.
But despite its promise, telemedicine has failed to take hold in the same way that other, newer, technologies have. Not because of technical challenges, expense or insufficient need. On the contrary, the most daunting obstacle to date has been a deeply entrenched resistance on the part of providers.
New technologies in health care always require a reassessment of how patients and doctors best relate to one another, a judgment call on whether the relationship, and care, is helped or harmed by e-mailing instead of calling, updating Web sites instead of mailing out notifications, blogging and posting updates to Twitter instead of publishing in medical journals. And while most doctors believe that technology can help to strengthen the doctor-patient bond, that’s not the case for telemedicine. Indeed, for many doctors, telemedicine seems to depersonalize the relationship and sabotage trust.
But are doctors resisting telemedicine based on truth or on fear? And if we are afraid, how can we address or adjust those fears in a way that might better help patients?
A recent study by researchers at the University of Texas Medical School in Houston looked at the impact of telemedicine on patients in the intensive care unit. Although the researchers had initially set out to study telemedicine’s effect on mortality, complications and the length of stay of patients in five different hospitals, they inadvertently discovered the extent to which clinicians were reluctant to incorporate this technological change.
Every I.C.U. patient in the study received the usual on-site care throughout the study, as well as all the additional audiovisual and vital signs monitoring offered by a remote critical care specialist 24 hours a day. In addition, each patient’s physician could choose the degree to which the remote specialists would be involved in delivering direct care — that is, giving orders and intervening from afar.
If the patient’s physician wanted only minimal remote direct involvement, the remote clinicians would offer care only during unexpected life-threatening emergencies, like sudden drops in blood pressure or acute bleeding. If the regular physicians wanted maximum involvement, the remote clinicians would work together with the on-site doctors and give routine orders and change treatment plans.
Clearly for an I.C.U. patient there are potential advantages to having an “extra set of eyes” at all times, eyes that might notice a disconnected monitor or an errant passing, but potentially recurrent, lethal heart rhythm. And at least anecdotally, many patients seemed to welcome the additional monitoring. “Families seemed to be very accepting of the technology because they felt that someone was always looking in on the patient,” said Dr. Bela Patel, the senior author of the study and executive medical director of critical care at the Memorial Hermann Hospital-Texas Medical Center.
Despite the seemingly obvious advantages and patient willingness, however, the majority of doctors in the study chose to have as little remote involvement for their patients as possible.
Many were worried about telemedicine’s effect on their relationships with patients and that it might adversely affect care.
“Certainly some of the doctors were just skeptical,” said Dr. Eric J. Thomas, a lead author of the study and director of the University of Texas-Memorial Hermann Center for Health Care Quality and Safety, “but others were hesitant because of how they felt about their relationship with their patients.”
“Some physicians felt we were being too intrusive,” Dr. Patel added. “We would recommend changing the ventilator settings, for example, but it wouldn’t be how they practiced. The doctors would respond, ‘It’s my patient; leave me alone.’ They did not want 20 people looking in on their patient and seeing if anything else could be done.”
And doctors were not the only ones who resisted this technology; nurses did, too. “Some of the nurses felt that somebody was looking over their shoulder all the time,” Dr. Patel commented. “And someone was. In the right context that would have been helpful; but if all that the nurses were hearing from the remote clinicians was that their patient’s EKG leads were disconnected or that a certain monitor had fallen off again, they ended up frustrated.” While the nurses acknowledged that reminders like these were important, “we were also bothering their workflow. The nurses would say, ‘Stop calling me. I don’t want to hear that again.’ ”
This lack of acceptance made it difficult for the study investigators to assess the impact of telemedicine on patients who were less sick but who had much to gain. “Early recognition of changes in a patient’s status is what really helps in critical care,” Dr. Patel said. “When a patient’s heart stops or a patient is clinically crashing, everyone knows about it. But when a patient’s heart rate goes up slightly, not everyone catches that. If you notice and act upon these kinds of changes early, you can rescue the patient early.”
While the researchers ultimately found that telemedicine could significantly improve survival among the sickest of I.C.U. patients, the resistance of on-site clinicians made it nearly impossible to assess the broad impact of such technology on quality of care. “Perhaps we never reached telemedicine’s full potential in this study because we did not have adequate acceptance,” Dr. Patel reflected. “You can’t just randomly assert some technology. You need a significant infrastructure to use it effectively, and that includes widespread acceptance.”
That acceptance will first require redefining the patient-doctor relationship in light of this new use of technology. Telemedicine and the idea of unseen clinicians in a remote “control room” doling out care is scary. But with dire predictions of physician shortages, particularly in rural regions, and insufficient numbers of critical care specialists even in large metropolitan areas, telemedicine likely has an important role in improving the quality of patient care.
But it will only work if all of us, doctors and patients, accept care from a clinician working in conjunction with a team of providers, each of whom is deeply engaged and committed to the patient, and some of whom, on occasion, may not be anywhere near that patient’s bedside, city or state.
“My view is that we want to provide the highest quality care possible for our patients,” Dr. Thomas said. “In some situations that might be with a remotely located physician; in others, not. I think that as long as we keep our eye on the ball — that ball being the patient — we will be okay in the end.”
“We can divide our work up in new ways and still do what is best.”
http://www.nytimes.com/2010/01/07/health/07chen.html
Copyright 2010 The New York Times Company
The New York Times
January 7, 2010
For over a decade now, health care experts have been promoting telemedicine, or the use of satellite technology, video conferencing and data transfer through phones and the Internet, to connect doctors to patients in far-flung locales. But are doctors ready for this form of technology?
Skip to next paragraph Telemedicine has the potential to improve quality of care by allowing clinicians in one “control center” to monitor, consult and even care for and perform procedures on patients in multiple locations. A rural primary care practitioner who sees a patient with a rare skin lesion, for example, can get expert consultation from a dermatologist at a center hundreds of miles away. A hospital unable to staff its intensive care unit with a single critical care specialist can have several experts monitoring their patients remotely 24 hours a day.
But despite its promise, telemedicine has failed to take hold in the same way that other, newer, technologies have. Not because of technical challenges, expense or insufficient need. On the contrary, the most daunting obstacle to date has been a deeply entrenched resistance on the part of providers.
New technologies in health care always require a reassessment of how patients and doctors best relate to one another, a judgment call on whether the relationship, and care, is helped or harmed by e-mailing instead of calling, updating Web sites instead of mailing out notifications, blogging and posting updates to Twitter instead of publishing in medical journals. And while most doctors believe that technology can help to strengthen the doctor-patient bond, that’s not the case for telemedicine. Indeed, for many doctors, telemedicine seems to depersonalize the relationship and sabotage trust.
But are doctors resisting telemedicine based on truth or on fear? And if we are afraid, how can we address or adjust those fears in a way that might better help patients?
A recent study by researchers at the University of Texas Medical School in Houston looked at the impact of telemedicine on patients in the intensive care unit. Although the researchers had initially set out to study telemedicine’s effect on mortality, complications and the length of stay of patients in five different hospitals, they inadvertently discovered the extent to which clinicians were reluctant to incorporate this technological change.
Every I.C.U. patient in the study received the usual on-site care throughout the study, as well as all the additional audiovisual and vital signs monitoring offered by a remote critical care specialist 24 hours a day. In addition, each patient’s physician could choose the degree to which the remote specialists would be involved in delivering direct care — that is, giving orders and intervening from afar.
If the patient’s physician wanted only minimal remote direct involvement, the remote clinicians would offer care only during unexpected life-threatening emergencies, like sudden drops in blood pressure or acute bleeding. If the regular physicians wanted maximum involvement, the remote clinicians would work together with the on-site doctors and give routine orders and change treatment plans.
Clearly for an I.C.U. patient there are potential advantages to having an “extra set of eyes” at all times, eyes that might notice a disconnected monitor or an errant passing, but potentially recurrent, lethal heart rhythm. And at least anecdotally, many patients seemed to welcome the additional monitoring. “Families seemed to be very accepting of the technology because they felt that someone was always looking in on the patient,” said Dr. Bela Patel, the senior author of the study and executive medical director of critical care at the Memorial Hermann Hospital-Texas Medical Center.
Despite the seemingly obvious advantages and patient willingness, however, the majority of doctors in the study chose to have as little remote involvement for their patients as possible.
Many were worried about telemedicine’s effect on their relationships with patients and that it might adversely affect care.
“Certainly some of the doctors were just skeptical,” said Dr. Eric J. Thomas, a lead author of the study and director of the University of Texas-Memorial Hermann Center for Health Care Quality and Safety, “but others were hesitant because of how they felt about their relationship with their patients.”
“Some physicians felt we were being too intrusive,” Dr. Patel added. “We would recommend changing the ventilator settings, for example, but it wouldn’t be how they practiced. The doctors would respond, ‘It’s my patient; leave me alone.’ They did not want 20 people looking in on their patient and seeing if anything else could be done.”
And doctors were not the only ones who resisted this technology; nurses did, too. “Some of the nurses felt that somebody was looking over their shoulder all the time,” Dr. Patel commented. “And someone was. In the right context that would have been helpful; but if all that the nurses were hearing from the remote clinicians was that their patient’s EKG leads were disconnected or that a certain monitor had fallen off again, they ended up frustrated.” While the nurses acknowledged that reminders like these were important, “we were also bothering their workflow. The nurses would say, ‘Stop calling me. I don’t want to hear that again.’ ”
This lack of acceptance made it difficult for the study investigators to assess the impact of telemedicine on patients who were less sick but who had much to gain. “Early recognition of changes in a patient’s status is what really helps in critical care,” Dr. Patel said. “When a patient’s heart stops or a patient is clinically crashing, everyone knows about it. But when a patient’s heart rate goes up slightly, not everyone catches that. If you notice and act upon these kinds of changes early, you can rescue the patient early.”
While the researchers ultimately found that telemedicine could significantly improve survival among the sickest of I.C.U. patients, the resistance of on-site clinicians made it nearly impossible to assess the broad impact of such technology on quality of care. “Perhaps we never reached telemedicine’s full potential in this study because we did not have adequate acceptance,” Dr. Patel reflected. “You can’t just randomly assert some technology. You need a significant infrastructure to use it effectively, and that includes widespread acceptance.”
That acceptance will first require redefining the patient-doctor relationship in light of this new use of technology. Telemedicine and the idea of unseen clinicians in a remote “control room” doling out care is scary. But with dire predictions of physician shortages, particularly in rural regions, and insufficient numbers of critical care specialists even in large metropolitan areas, telemedicine likely has an important role in improving the quality of patient care.
But it will only work if all of us, doctors and patients, accept care from a clinician working in conjunction with a team of providers, each of whom is deeply engaged and committed to the patient, and some of whom, on occasion, may not be anywhere near that patient’s bedside, city or state.
“My view is that we want to provide the highest quality care possible for our patients,” Dr. Thomas said. “In some situations that might be with a remotely located physician; in others, not. I think that as long as we keep our eye on the ball — that ball being the patient — we will be okay in the end.”
“We can divide our work up in new ways and still do what is best.”
http://www.nytimes.com/2010/01/07/health/07chen.html
Copyright 2010 The New York Times Company
Thursday, January 07, 2010
Insurance Change Bars Thousands of Patients From Grady
By Craig Schneider
The Atlanta Journal-Constitution
January 6, 2010
Thousands of Grady Memorial Hospital patients must find new doctors and a new medical center because a Medicaid insurer has terminated its contract with the hospital.
The disruption of patient care is the result of failed efforts to renew the contract between Grady and Peach State Health Plan, which culminated Friday when the parties severed their relationship.
Patient advocates are concerned some patients will miss care as they search for a new provider.
"People could fall through the cracks," said state Sen. Vincent Fort (D-Atlanta), a leader of the group called The Grady Coalition.
He noted that many doctors and medical facilities don't accept Medicaid patients, which could hamper the patients' search.
Peach State Health Plan is one of three insurers hired by the state of Georgia to handle Medicaid claims. The insurer has contracts with numerous health care providers.
These patients may eventually return to Grady. The hospital still has contracts with the two other insurers that handle Medicaid claims for the state -- WellCare and Amerigroup -- and patients can switch to either one. But most of the patients can only do that on their annual renewal date, and months could pass before that date.
Grady and Peach State disagree sharply on how many patients must find new care. Peach State officials have said the change would affect 2,182 patients at Grady, but Grady officials said the number is about 12,000.
Peach State acknowledged it is only accounting for those patients who have doctors who work exclusively at Grady, and are not counting patients with doctors who work at Grady and elsewhere. Peach State officials say the majority of those patients can continue to see their current physician or another physician in the same practice at other locations.
Many patients have been coming to Grady for years and have long relationships with their doctors. Many also have transportation problems, which could limit going elsewhere, said Grady spokesman Matt Gove.
Peach State spokeswoman Debra Peterson-Smith said the company is working hard to make sure patients find new care quickly. She said the company has sent out letters and made phone calls to patients to help them find other health care providers. Peach State is also helping patients obtain transportation to appointments with their new doctors.
"Peach State is working directly with those members to minimize disruption," she said. "Overall the process is running smoothly."
Patients requiring emergency services can still use Grady or any other hospital, she noted.
Patients who require ongoing care for chronic conditions can continue to be seen at Grady through Jan. 26, she said.
The Southside Medical Center, which accepts Peach State patients, has already accepted 200 to 300 former Grady patients at its offices in metro Atlanta, said executive director Dr. David Williams.
He said while some patients were initially nervous, the transition has gone smoothly at his clinic. He believes there are enough medical centers and hospitals in the area that accept Peach State, and that the Grady patients will have little trouble finding new care.
Peach State officials announced in November that they would terminate their contract with Grady on Nov. 28, but both parties agreed that Grady would continue to accept the patients through the end of the year.
Peach State complained that Grady had already increased its charges by 50 percent last year and was seeking and additional 25 percent this year.
Grady officials said the hospital was attempting to match its charges to market rates.
Grady's Gove said the loss of patients will not hurt the hospital financially, since they represent only a fraction of its patients. Because they were receiving Medicaid, the government was not paying the full cost of their care, he said.
http://www.ajc.com/health/insurance-change-bars-thousands-268598.html
© 2010 The Atlanta Journal-Constitution
The Atlanta Journal-Constitution
January 6, 2010
Thousands of Grady Memorial Hospital patients must find new doctors and a new medical center because a Medicaid insurer has terminated its contract with the hospital.
The disruption of patient care is the result of failed efforts to renew the contract between Grady and Peach State Health Plan, which culminated Friday when the parties severed their relationship.
Patient advocates are concerned some patients will miss care as they search for a new provider.
"People could fall through the cracks," said state Sen. Vincent Fort (D-Atlanta), a leader of the group called The Grady Coalition.
He noted that many doctors and medical facilities don't accept Medicaid patients, which could hamper the patients' search.
Peach State Health Plan is one of three insurers hired by the state of Georgia to handle Medicaid claims. The insurer has contracts with numerous health care providers.
These patients may eventually return to Grady. The hospital still has contracts with the two other insurers that handle Medicaid claims for the state -- WellCare and Amerigroup -- and patients can switch to either one. But most of the patients can only do that on their annual renewal date, and months could pass before that date.
Grady and Peach State disagree sharply on how many patients must find new care. Peach State officials have said the change would affect 2,182 patients at Grady, but Grady officials said the number is about 12,000.
Peach State acknowledged it is only accounting for those patients who have doctors who work exclusively at Grady, and are not counting patients with doctors who work at Grady and elsewhere. Peach State officials say the majority of those patients can continue to see their current physician or another physician in the same practice at other locations.
Many patients have been coming to Grady for years and have long relationships with their doctors. Many also have transportation problems, which could limit going elsewhere, said Grady spokesman Matt Gove.
Peach State spokeswoman Debra Peterson-Smith said the company is working hard to make sure patients find new care quickly. She said the company has sent out letters and made phone calls to patients to help them find other health care providers. Peach State is also helping patients obtain transportation to appointments with their new doctors.
"Peach State is working directly with those members to minimize disruption," she said. "Overall the process is running smoothly."
Patients requiring emergency services can still use Grady or any other hospital, she noted.
Patients who require ongoing care for chronic conditions can continue to be seen at Grady through Jan. 26, she said.
The Southside Medical Center, which accepts Peach State patients, has already accepted 200 to 300 former Grady patients at its offices in metro Atlanta, said executive director Dr. David Williams.
He said while some patients were initially nervous, the transition has gone smoothly at his clinic. He believes there are enough medical centers and hospitals in the area that accept Peach State, and that the Grady patients will have little trouble finding new care.
Peach State officials announced in November that they would terminate their contract with Grady on Nov. 28, but both parties agreed that Grady would continue to accept the patients through the end of the year.
Peach State complained that Grady had already increased its charges by 50 percent last year and was seeking and additional 25 percent this year.
Grady officials said the hospital was attempting to match its charges to market rates.
Grady's Gove said the loss of patients will not hurt the hospital financially, since they represent only a fraction of its patients. Because they were receiving Medicaid, the government was not paying the full cost of their care, he said.
http://www.ajc.com/health/insurance-change-bars-thousands-268598.html
© 2010 The Atlanta Journal-Constitution
Wednesday, January 06, 2010
House Democrats to Pursue Health Bill Changes
By DAVID M. HERSZENHORN
The New York Times
Published: January 5, 2010
WASHINGTON — House Democratic leaders said Tuesday that they would insist on changes to the Senate health care legislation to make coverage more affordable for middle-class Americans and to tighten control over the insurance industry.
But it remains unclear how much leverage the House will have in negotiations given that Senate Democrats cannot spare a single vote without jeopardizing the bill’s chances. The White House will also have a big role in the final product.
The House speaker, Nancy Pelosi, met Tuesday with her top lieutenants and the three committee chairmen directly responsible for the health care bill, as they prepared for negotiations to begin in earnest this week.
Ms. Pelosi and the majority leader, Representative Steny H. Hoyer of Maryland, also met at the White House with President Obama. The top Senate Democrats, Harry Reid of Nevada and Richard J. Durbin of Illinois, joined the meeting by telephone.
Aides said that the White House would convene meetings of House and Senate staff perhaps as early as Wednesday to begin clearing away some of the easier differences between the bills, with Congressional leaders to meet face-to-face next week.
After the meeting at the Capitol, House Democrats said they would push the Senate to provide more generous subsidies to help moderate-income Americans buy insurance, but expressed willingness to drop the idea of a government-run health plan.
The House bill includes a government-run health insurance plan, or public option, to compete with private insurers. The public option was dropped from the Senate bill after centrist Democrats said they would oppose any measure that included it.
House Democrats said they could live without the public option provided that they had sufficient guarantees that other steps would be taken to increase options for consumers and to tighten the clamp on any abuses by private insurance companies.
Representative Chris Van Hollen, Democrat of Maryland and a member of the House leadership, said some of his colleagues would press to end the insurance industry’s exemption from federal antitrust laws, a step strongly opposed by Senator Ben Nelson, Democrat of Nebraska, who has said he would oppose the bill if the House made any changes that he did not like.
“We understand the realities of what happened in the Senate,” Mr. Van Hollen said. But he said House leaders still found aspects of the Senate bill lacking in terms of providing affordable health coverage to people who are now uninsured.
“We don’t think it achieves enough in the way of competition and choice,” he said.
Even as Democrats made plans to reconcile the bills, Republicans renewed their criticism of the legislation, which they have pledged to fight to the end.
Although Congress routinely reconciles major legislation without formal conference proceedings, Republicans seized on a request by C-Span, the public access television network, to broadcast the closed-door talks between House and Senate Democrats as evidence that Democrats were being less than transparent.
The Democrats, including Ms. Pelosi, dismissed that criticism, noting that Republicans were simply out to kill the legislation. And they noted that the full text of the House bill, for instance, has been posted on the Internet since before it was adopted on Nov. 7.
Ms. Pelosi said she was confident that differences between the two measures would be resolved and that a bill would be sent to Mr. Obama for his signature in relatively short order.
“We will reconcile this legislation in a way that is a AAA rating — affordability for the middle class, accountability for the insurance companies and accessibility to many more people in our country to quality, affordable health care,” Ms. Pelosi said.
To help pay for the bill, the House has proposed an income surtax on individuals earning more than $500,000 and couples earning more than $1 million, while the Senate has proposed an excise tax on high-priced insurance policies and an increase in the Medicare payroll tax for individuals earning more than $200,000 and couples earning more than $250,000.
The House bill would cost slightly more than $1 trillion over 10 years, while the Senate bill would cost $871 billion. In each case, the expense would be more than offset by new taxes and fees and reductions in government spending, particularly on Medicare, so the bill would reduce future federal deficits, according to the Congressional Budget Office.
“We think that we have the fairest approach in our bill,” Ms. Pelosi said. “I always say when it comes to tax policy around here, it’s like a mirror. ‘Mirror, mirror on the wall, who is the fairest of them all?’ The Senate thinks theirs is fairer. We think ours is. We’ll see which mirror cracks.”
And even as Senate Democrats do not have a single vote to spare, House leaders warned that they also had careful counting to do.
“I think the Senate should know that we need 218 votes,” said Representative Charles B. Rangel, Democrat of New York.
http://www.nytimes.com/2010/01/06/us/politics/06cong.html
Copyright 2010 The New York Times Company
The New York Times
Published: January 5, 2010
WASHINGTON — House Democratic leaders said Tuesday that they would insist on changes to the Senate health care legislation to make coverage more affordable for middle-class Americans and to tighten control over the insurance industry.
But it remains unclear how much leverage the House will have in negotiations given that Senate Democrats cannot spare a single vote without jeopardizing the bill’s chances. The White House will also have a big role in the final product.
The House speaker, Nancy Pelosi, met Tuesday with her top lieutenants and the three committee chairmen directly responsible for the health care bill, as they prepared for negotiations to begin in earnest this week.
Ms. Pelosi and the majority leader, Representative Steny H. Hoyer of Maryland, also met at the White House with President Obama. The top Senate Democrats, Harry Reid of Nevada and Richard J. Durbin of Illinois, joined the meeting by telephone.
Aides said that the White House would convene meetings of House and Senate staff perhaps as early as Wednesday to begin clearing away some of the easier differences between the bills, with Congressional leaders to meet face-to-face next week.
After the meeting at the Capitol, House Democrats said they would push the Senate to provide more generous subsidies to help moderate-income Americans buy insurance, but expressed willingness to drop the idea of a government-run health plan.
The House bill includes a government-run health insurance plan, or public option, to compete with private insurers. The public option was dropped from the Senate bill after centrist Democrats said they would oppose any measure that included it.
House Democrats said they could live without the public option provided that they had sufficient guarantees that other steps would be taken to increase options for consumers and to tighten the clamp on any abuses by private insurance companies.
Representative Chris Van Hollen, Democrat of Maryland and a member of the House leadership, said some of his colleagues would press to end the insurance industry’s exemption from federal antitrust laws, a step strongly opposed by Senator Ben Nelson, Democrat of Nebraska, who has said he would oppose the bill if the House made any changes that he did not like.
“We understand the realities of what happened in the Senate,” Mr. Van Hollen said. But he said House leaders still found aspects of the Senate bill lacking in terms of providing affordable health coverage to people who are now uninsured.
“We don’t think it achieves enough in the way of competition and choice,” he said.
Even as Democrats made plans to reconcile the bills, Republicans renewed their criticism of the legislation, which they have pledged to fight to the end.
Although Congress routinely reconciles major legislation without formal conference proceedings, Republicans seized on a request by C-Span, the public access television network, to broadcast the closed-door talks between House and Senate Democrats as evidence that Democrats were being less than transparent.
The Democrats, including Ms. Pelosi, dismissed that criticism, noting that Republicans were simply out to kill the legislation. And they noted that the full text of the House bill, for instance, has been posted on the Internet since before it was adopted on Nov. 7.
Ms. Pelosi said she was confident that differences between the two measures would be resolved and that a bill would be sent to Mr. Obama for his signature in relatively short order.
“We will reconcile this legislation in a way that is a AAA rating — affordability for the middle class, accountability for the insurance companies and accessibility to many more people in our country to quality, affordable health care,” Ms. Pelosi said.
To help pay for the bill, the House has proposed an income surtax on individuals earning more than $500,000 and couples earning more than $1 million, while the Senate has proposed an excise tax on high-priced insurance policies and an increase in the Medicare payroll tax for individuals earning more than $200,000 and couples earning more than $250,000.
The House bill would cost slightly more than $1 trillion over 10 years, while the Senate bill would cost $871 billion. In each case, the expense would be more than offset by new taxes and fees and reductions in government spending, particularly on Medicare, so the bill would reduce future federal deficits, according to the Congressional Budget Office.
“We think that we have the fairest approach in our bill,” Ms. Pelosi said. “I always say when it comes to tax policy around here, it’s like a mirror. ‘Mirror, mirror on the wall, who is the fairest of them all?’ The Senate thinks theirs is fairer. We think ours is. We’ll see which mirror cracks.”
And even as Senate Democrats do not have a single vote to spare, House leaders warned that they also had careful counting to do.
“I think the Senate should know that we need 218 votes,” said Representative Charles B. Rangel, Democrat of New York.
http://www.nytimes.com/2010/01/06/us/politics/06cong.html
Copyright 2010 The New York Times Company
Tuesday, December 22, 2009
Democrats Face Challenge in Merging Health Bills
By ROBERT PEAR and DAVID M. HERSZENHORN
New York Times
December 21, 2009
WASHINGTON — Even as the Senate took a significant step toward passing its version of a sweeping overhaul of the health insurance system before Christmas, Democrats were grappling Monday with deep internal divisions over abortion, the issue that most complicates their drive to merge the Senate and House bills and send final legislation to President Obama.
Senate Democratic leaders and the president of the American Medical Association heading on Monday to a press conference where they said the group had endorsed the Senate health plan.
In the House, advocates and opponents of abortion rights and conservative Democrats have made clear that they object, for different reasons, to the Senate’s compromise language on abortion. Interest groups on both sides of the spectrum — Planned Parenthood on the abortion rights side, Catholic bishops for the anti-abortion rights camp — also oppose the abortion provision in the Senate bill, leaving Speaker Nancy Pelosi with a challenge in rounding up the votes she needs in the House.
Ms. Pelosi’s room for maneuvering is limited because any changes to the language in the Senate bill could unravel the deal that provided Democrats with the 60 votes they need to get the legislation through the Senate.
Ms. Pelosi, the Senate majority leader, Harry Reid of Nevada, and the White House will have to find a way forward on abortion even as they confront other big differences between the House and Senate bills, including how to pay to expand insurance coverage to more than 30 million Americans and whether to include a government-run plan to compete with private insurers.
The Senate bill cleared a major hurdle early Monday, when the Senate voted 60 to 40, along party lines, to limit debate on the guts of its measure. Two more votes are set for Tuesday. Calling it a “historic vote,” Mr. Obama said, “The United States Senate knocked down a filibuster aimed at blocking a final vote on health care reform, and scored a big victory for the American people.”
Senate Democrats got another lift on Monday when the American Medical Association endorsed their legislation, which embodies Mr. Obama’s top domestic priority.
“Of all the organizations and individuals that have supported this bill, I rate this one as the most important,” said Senator Christopher J. Dodd, Democrat of Connecticut and a co-author of the bill.
Jubilant and exhausted after winning the 1 a.m. test vote, Democrats on Monday were already thinking ahead to the next stage of the legislative process. The Senate and the House will try to hash out their differences, with members of the House under intense pressure to accommodate the tenuous deals in the Senate despite their ideological qualms. And no issue is shaping up to be more complex than abortion.
Representative Bart Stupak, Democrat of Michigan and the author of the anti-abortion provisions in the House bill, said Monday, “It would be extremely difficult for me to vote for a bill” taking the Senate approach on abortion.
The House, more liberal than the Senate on many issues, would impose more stringent restrictions, barring coverage of abortion by any health plan bought even partly with federal subsidies.
Under the bill that is likely to be approved this week by the Senate, health plans could cover abortion. But people who enroll in such plans would have to write two premium checks, one for abortion coverage and one for everything else. Insurers would have to keep separate accounts, and state officials would police the “segregation of funds.”
Douglas D. Johnson, legislative director of the National Right to Life Committee, said it was difficult to envision a compromise because “people opposed to abortion see it as the taking of innocent human life.”
Senator Barbara Boxer, Democrat of California, said Monday that the compromise she struck last week with Senator Ben Nelson, Democrat of Nebraska, offered a potential road map for successful negotiations on the issue with the House.
In an interview, Mrs. Boxer said the Senate bill created “a firm wall” that would prevent the use of federal money to pay for insurance coverage of abortions, meeting a demand of opponents of abortion rights, while allowing women to use their own money to buy health plans that cover the procedure.
“When you have both extremes saying they’re unhappy, I think it’s a fair compromise,” Mrs. Boxer said. “Because we have this compromise that’s being attacked on either side, I think that gives us momentum going into the final conference.”
Sixty-four House Democrats, representing one-fourth of the House Democratic caucus, voted for stringent restrictions on insurance coverage of abortion. And 41 of them voted for passage of the House bill, so they constitute a crucial bloc. The bill was approved, 220 to 215, on Nov. 7.
But leading supporters of abortion rights in the House said they would not vote for a final bill if it included those restrictions, which they fear would curtail access to abortion for many women who already have insurance.
The House bill would establish a tax surcharge on income over $500,000 for individuals and over $1 million for couples. The Senate bill would tax high-cost employer-sponsored health plans and increase the Medicare payroll tax on individuals with incomes over $200,000 and couples over $250,000.
Lawmakers said they could envision a compromise mixing the two approaches.
More than 190 House members have gone on record against the Senate’s proposed excise tax on “Cadillac health plans,” which is also opposed by organized labor. But the White House and some health economists say the tax could help control health costs by encouraging employers to shop for cheaper policies that would not be hit by the tax.
It is unclear whether the House and the Senate will appoint a formal conference committee or just try to work out their differences in negotiations with Democratic leaders and committee chairmen from the two chambers. In any event, White House officials expect to play a huge role.
The Senate may have the upper hand in negotiations on a government health plan, championed by liberal Democrats.
Senate Democratic leaders dropped the public option after concluding they could not get 60 votes for it. Their bill calls instead for two or more nationwide health plans, to be offered by private insurers under contracts negotiated with the federal Office of Personnel Management.
Ronald F. Pollack, executive director of Families USA, a liberal advocacy group that works closely with the White House, said Monday: “I think we will not have a public option in the final bill. It would be close to impossible to pass it in the Senate.”
On this, as on several other issues, Mr. Pollack said, “the Senate has somewhat greater leverage than the House” because Senate Democrats need 60 votes, the exact number in their caucus, to overcome Republican opposition.
Senator Joseph I. Lieberman, independent of Connecticut, said, “There is a natural tendency to split the difference between the Senate and the House.” But on major issues in the health bill, Mr. Lieberman said, “splitting the difference means you won’t have 60 votes in the Senate.”
In the eyes of consumers and voters, the success of the legislation will hinge, to a large degree, on whether it makes insurance more affordable. One of the most important issues for House and Senate negotiators is how to aid low- and middle- income people.
The House would expand Medicaid to cover people with incomes less than 150 percent of the poverty level ($33,075 for a family of four). The Senate would expand eligibility to 133 percent of the poverty level ($29,327 for a family of four). Many advocates for low-income people prefer the House approach.
http://www.nytimes.com/2009/12/22/health/policy/22health.html?_r=1&hp
Copyright 2009 The New York Times Company
New York Times
December 21, 2009
WASHINGTON — Even as the Senate took a significant step toward passing its version of a sweeping overhaul of the health insurance system before Christmas, Democrats were grappling Monday with deep internal divisions over abortion, the issue that most complicates their drive to merge the Senate and House bills and send final legislation to President Obama.
Senate Democratic leaders and the president of the American Medical Association heading on Monday to a press conference where they said the group had endorsed the Senate health plan.
In the House, advocates and opponents of abortion rights and conservative Democrats have made clear that they object, for different reasons, to the Senate’s compromise language on abortion. Interest groups on both sides of the spectrum — Planned Parenthood on the abortion rights side, Catholic bishops for the anti-abortion rights camp — also oppose the abortion provision in the Senate bill, leaving Speaker Nancy Pelosi with a challenge in rounding up the votes she needs in the House.
Ms. Pelosi’s room for maneuvering is limited because any changes to the language in the Senate bill could unravel the deal that provided Democrats with the 60 votes they need to get the legislation through the Senate.
Ms. Pelosi, the Senate majority leader, Harry Reid of Nevada, and the White House will have to find a way forward on abortion even as they confront other big differences between the House and Senate bills, including how to pay to expand insurance coverage to more than 30 million Americans and whether to include a government-run plan to compete with private insurers.
The Senate bill cleared a major hurdle early Monday, when the Senate voted 60 to 40, along party lines, to limit debate on the guts of its measure. Two more votes are set for Tuesday. Calling it a “historic vote,” Mr. Obama said, “The United States Senate knocked down a filibuster aimed at blocking a final vote on health care reform, and scored a big victory for the American people.”
Senate Democrats got another lift on Monday when the American Medical Association endorsed their legislation, which embodies Mr. Obama’s top domestic priority.
“Of all the organizations and individuals that have supported this bill, I rate this one as the most important,” said Senator Christopher J. Dodd, Democrat of Connecticut and a co-author of the bill.
Jubilant and exhausted after winning the 1 a.m. test vote, Democrats on Monday were already thinking ahead to the next stage of the legislative process. The Senate and the House will try to hash out their differences, with members of the House under intense pressure to accommodate the tenuous deals in the Senate despite their ideological qualms. And no issue is shaping up to be more complex than abortion.
Representative Bart Stupak, Democrat of Michigan and the author of the anti-abortion provisions in the House bill, said Monday, “It would be extremely difficult for me to vote for a bill” taking the Senate approach on abortion.
The House, more liberal than the Senate on many issues, would impose more stringent restrictions, barring coverage of abortion by any health plan bought even partly with federal subsidies.
Under the bill that is likely to be approved this week by the Senate, health plans could cover abortion. But people who enroll in such plans would have to write two premium checks, one for abortion coverage and one for everything else. Insurers would have to keep separate accounts, and state officials would police the “segregation of funds.”
Douglas D. Johnson, legislative director of the National Right to Life Committee, said it was difficult to envision a compromise because “people opposed to abortion see it as the taking of innocent human life.”
Senator Barbara Boxer, Democrat of California, said Monday that the compromise she struck last week with Senator Ben Nelson, Democrat of Nebraska, offered a potential road map for successful negotiations on the issue with the House.
In an interview, Mrs. Boxer said the Senate bill created “a firm wall” that would prevent the use of federal money to pay for insurance coverage of abortions, meeting a demand of opponents of abortion rights, while allowing women to use their own money to buy health plans that cover the procedure.
“When you have both extremes saying they’re unhappy, I think it’s a fair compromise,” Mrs. Boxer said. “Because we have this compromise that’s being attacked on either side, I think that gives us momentum going into the final conference.”
Sixty-four House Democrats, representing one-fourth of the House Democratic caucus, voted for stringent restrictions on insurance coverage of abortion. And 41 of them voted for passage of the House bill, so they constitute a crucial bloc. The bill was approved, 220 to 215, on Nov. 7.
But leading supporters of abortion rights in the House said they would not vote for a final bill if it included those restrictions, which they fear would curtail access to abortion for many women who already have insurance.
The House bill would establish a tax surcharge on income over $500,000 for individuals and over $1 million for couples. The Senate bill would tax high-cost employer-sponsored health plans and increase the Medicare payroll tax on individuals with incomes over $200,000 and couples over $250,000.
Lawmakers said they could envision a compromise mixing the two approaches.
More than 190 House members have gone on record against the Senate’s proposed excise tax on “Cadillac health plans,” which is also opposed by organized labor. But the White House and some health economists say the tax could help control health costs by encouraging employers to shop for cheaper policies that would not be hit by the tax.
It is unclear whether the House and the Senate will appoint a formal conference committee or just try to work out their differences in negotiations with Democratic leaders and committee chairmen from the two chambers. In any event, White House officials expect to play a huge role.
The Senate may have the upper hand in negotiations on a government health plan, championed by liberal Democrats.
Senate Democratic leaders dropped the public option after concluding they could not get 60 votes for it. Their bill calls instead for two or more nationwide health plans, to be offered by private insurers under contracts negotiated with the federal Office of Personnel Management.
Ronald F. Pollack, executive director of Families USA, a liberal advocacy group that works closely with the White House, said Monday: “I think we will not have a public option in the final bill. It would be close to impossible to pass it in the Senate.”
On this, as on several other issues, Mr. Pollack said, “the Senate has somewhat greater leverage than the House” because Senate Democrats need 60 votes, the exact number in their caucus, to overcome Republican opposition.
Senator Joseph I. Lieberman, independent of Connecticut, said, “There is a natural tendency to split the difference between the Senate and the House.” But on major issues in the health bill, Mr. Lieberman said, “splitting the difference means you won’t have 60 votes in the Senate.”
In the eyes of consumers and voters, the success of the legislation will hinge, to a large degree, on whether it makes insurance more affordable. One of the most important issues for House and Senate negotiators is how to aid low- and middle- income people.
The House would expand Medicaid to cover people with incomes less than 150 percent of the poverty level ($33,075 for a family of four). The Senate would expand eligibility to 133 percent of the poverty level ($29,327 for a family of four). Many advocates for low-income people prefer the House approach.
http://www.nytimes.com/2009/12/22/health/policy/22health.html?_r=1&hp
Copyright 2009 The New York Times Company
Statement of Governor Sonny Perdue Regarding the Senate Health Care Bill
STATE OF GEORGIA
OFFICE OF THE GOVERNOR
Sonny Perdue
GOVERNOR
For Immediate Release Contacts: Office of Communications
Monday, December 21, 2009 (404) 651-7774
Statement of Governor Sonny Perdue Regarding the Senate
Health Care Bill
ATLANTA – Governor Sonny Perdue issued the following statement today regarding the latest version of the U.S. Senate’s health care reform legislation.
“I am utterly dismayed and disappointed by the vote buying that has occurred in the United States Senate in order to pass a measure that most citizens are against. If this reform was truly the right policy for our country, we wouldn’t see waffling Senators lining up like game show contestants hoping to win today’s jackpot of a special deal from Harry Reid. This bill places an unsustainable burden on the backs of Georgia’s taxpayers, and will lead to either higher state taxes or massive cuts to basic state services in years to come. I join Governors from around the country of both parties in asking our Representatives and Senators to listen to the public outrage against this bill and stop this mistake before it occurs.”
###
For Immediate Release Contacts: Office of Communications
Monday, December 21, 2009 (404) 651-7774
Statement of Governor Sonny Perdue Regarding the Senate
Health Care Bill
ATLANTA – Governor Sonny Perdue issued the following statement today regarding the latest version of the U.S. Senate’s health care reform legislation.
“I am utterly dismayed and disappointed by the vote buying that has occurred in the United States Senate in order to pass a measure that most citizens are against. If this reform was truly the right policy for our country, we wouldn’t see waffling Senators lining up like game show contestants hoping to win today’s jackpot of a special deal from Harry Reid. This bill places an unsustainable burden on the backs of Georgia’s taxpayers, and will lead to either higher state taxes or massive cuts to basic state services in years to come. I join Governors from around the country of both parties in asking our Representatives and Senators to listen to the public outrage against this bill and stop this mistake before it occurs.”
###
Monday, December 21, 2009
Senate Democrats Clear Hurdle on Health Care Bill
by ERICA WERNER, With The Associated Press
Guest Writer for the Atlanta Journal-Constitution
December 21, 2009
WASHINGTON — Senate Democrats won a crucial test vote on President Barack Obama's health care overhaul, putting them on track for passage before Christmas of the historic legislation to remake the nation's medical system and cover 30 million uninsured.
All 58 Democrats and the Senate's two independents held together early Monday against unanimous Republican opposition, providing the exact 60-40 margin needed to shut down a threatened GOP filibuster.
The vote came shortly after 1 a.m. with the nation's capital blanketed in snow, the unusual timing made necessary in order to get to a final vote by Christmas Eve presuming Republicans stretch out the debate as much as the rules allow. Despite the late hour and a harshly partisan atmosphere, Democrats' spirits were high.
"Today we are closer than we've ever been to making Sen. Ted Kennedy's dream of universal health insurance coverage a reality," Sen. Tom Harkin, D-Iowa, said ahead of the vote, alluding to the late Massachusetts senator who died of brain cancer in August.
"Vote your hopes, not your fears. Seize the moment," Harkin urged colleagues.
Kennedy's widow, Vicki, watched the vote from the visitor's gallery along with administration officials who have worked intensely on the issue. Senators cast their votes from their desks, a practice reserved for issues of particular importance.
The outcome was preordained after Senate Majority Leader Harry Reid, D-Nev., wrangled his fractious caucus into line over the course of the past several months, culminating in a frenzy of last-minute deals and concessions to win over the final holdouts, independent Joe Lieberman of Connecticut and conservative Democrat Ben Nelson of Nebraska.
Obama's oft-stated goal of a bipartisan health bill was not met, despite the president's extensive courtship of moderate Sen. Olympia Snowe of Maine, the only Republican to support the bill in committee. Obama called Snowe to the White House for lengthy in-person meetings both before he left for climate talks in Copenhagen and after his return on Saturday. In the end Snowe said she was "extremely disappointed" in what she called a rushed process that left scant time for her to review, much less amend, the bill.
Even so, the vote represented a major victory for Democrats and Obama, who's now clearly in reach of passing legislation extending health coverage to nearly all Americans, a goal that's eluded a succession of past presidents. The legislation would make health insurance mandatory for the first time for nearly everyone, provide subsidies to help lower-income people buy it, and induce employers to provide it with tax breaks for small businesses and penalties for larger ones.
Two more procedural votes await the Senate, each requiring 60 votes, the first of these set for Tuesday morning. Final passage of the bill requires a simple majority, and that vote could come as late as 7 p.m. on Thursday, Christmas Eve, or the day before if Republicans agree.
Although Democrats are expected to prevail in the votes over the next several days, the final outcome remains unpredictable, because the Senate measure must be harmonized with the health care bill passed by the House in November before final legislation can be sent to Obama's desk.
There are significant differences between the two measures, including stricter abortion language in the House bill, a new government-run insurance plan in the House bill that's missing from the Senate version, and a tax on high-value insurance plans embraced by the Senate but strongly opposed by many House Democrats.
After Monday's vote a number of Senate Democrats warned that the legislation could not change much and expect to maintain support from 60 senators. House Democrats are sure to want to alter it but may have to swallow it mostly whole.
"It took a lot of work to bring this 60 together and this 60 is delicately balanced," Lieberman said.
Republicans are determined to give Democrats no help, eager to deny Obama a political victory and speculating openly that the health care issue will hurt Democrats in the 2010 midterm elections.
"There will be a day of accounting," warned John Cornyn, R-Texas, accusing Democrats of pushing a health overhaul opposed by the public. "Perhaps the first day of accounting will be Election Day 2010."
At their core the bills passed by the House and pending in the Senate are similar. Each costs around $1 trillion over 10 years and is paid for by a combination of tax and fee increases and cuts in projected Medicare spending. Each sets up new insurance marketplaces called exchanges where uninsured or self-employed people and small businesses can compare prices and plans designed to meet some basic requirements. Unpopular insurance practices such as denying people coverage based on pre-existing conditions would be banned, and young adults could retain coverage longer under their parents' insurance plans — through age 25 in the Senate bill and through age 26 in the House version.
Reid cut numerous last-minute deals to get the votes he needed and powerful Democrats also inserted home-state provisions in a 383-page package of amendments Reid filed this weekend to the 2,074-page bill.
Among other items, Senate Finance Committee Chairman Max Baucus, D-Mont., included a provision allowing residents of the town of Libby, Mont., who are suffering asbestos-related illnesses from a mining operation to get Medicare benefits. Nelson won a list of benefits for Nebraska including a commitment for the federal government to pick up the full tab of an expansion of Medicaid. And Sen. Christopher Dodd, D-Conn., who faces a difficult re-election, inserted a $100 million item for construction of a university hospital that his spokesman said he hopes to claim for the University of Connecticut.
AP Special Correspondent David Espo contributed to this report.
Copyright 2009, The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
© 2009 The Atlanta Journal-Constitution
http://www.ajc.com/business/senate-democrats-clear-hurdle-248465.html
Guest Writer for the Atlanta Journal-Constitution
December 21, 2009
WASHINGTON — Senate Democrats won a crucial test vote on President Barack Obama's health care overhaul, putting them on track for passage before Christmas of the historic legislation to remake the nation's medical system and cover 30 million uninsured.
All 58 Democrats and the Senate's two independents held together early Monday against unanimous Republican opposition, providing the exact 60-40 margin needed to shut down a threatened GOP filibuster.
The vote came shortly after 1 a.m. with the nation's capital blanketed in snow, the unusual timing made necessary in order to get to a final vote by Christmas Eve presuming Republicans stretch out the debate as much as the rules allow. Despite the late hour and a harshly partisan atmosphere, Democrats' spirits were high.
"Today we are closer than we've ever been to making Sen. Ted Kennedy's dream of universal health insurance coverage a reality," Sen. Tom Harkin, D-Iowa, said ahead of the vote, alluding to the late Massachusetts senator who died of brain cancer in August.
"Vote your hopes, not your fears. Seize the moment," Harkin urged colleagues.
Kennedy's widow, Vicki, watched the vote from the visitor's gallery along with administration officials who have worked intensely on the issue. Senators cast their votes from their desks, a practice reserved for issues of particular importance.
The outcome was preordained after Senate Majority Leader Harry Reid, D-Nev., wrangled his fractious caucus into line over the course of the past several months, culminating in a frenzy of last-minute deals and concessions to win over the final holdouts, independent Joe Lieberman of Connecticut and conservative Democrat Ben Nelson of Nebraska.
Obama's oft-stated goal of a bipartisan health bill was not met, despite the president's extensive courtship of moderate Sen. Olympia Snowe of Maine, the only Republican to support the bill in committee. Obama called Snowe to the White House for lengthy in-person meetings both before he left for climate talks in Copenhagen and after his return on Saturday. In the end Snowe said she was "extremely disappointed" in what she called a rushed process that left scant time for her to review, much less amend, the bill.
Even so, the vote represented a major victory for Democrats and Obama, who's now clearly in reach of passing legislation extending health coverage to nearly all Americans, a goal that's eluded a succession of past presidents. The legislation would make health insurance mandatory for the first time for nearly everyone, provide subsidies to help lower-income people buy it, and induce employers to provide it with tax breaks for small businesses and penalties for larger ones.
Two more procedural votes await the Senate, each requiring 60 votes, the first of these set for Tuesday morning. Final passage of the bill requires a simple majority, and that vote could come as late as 7 p.m. on Thursday, Christmas Eve, or the day before if Republicans agree.
Although Democrats are expected to prevail in the votes over the next several days, the final outcome remains unpredictable, because the Senate measure must be harmonized with the health care bill passed by the House in November before final legislation can be sent to Obama's desk.
There are significant differences between the two measures, including stricter abortion language in the House bill, a new government-run insurance plan in the House bill that's missing from the Senate version, and a tax on high-value insurance plans embraced by the Senate but strongly opposed by many House Democrats.
After Monday's vote a number of Senate Democrats warned that the legislation could not change much and expect to maintain support from 60 senators. House Democrats are sure to want to alter it but may have to swallow it mostly whole.
"It took a lot of work to bring this 60 together and this 60 is delicately balanced," Lieberman said.
Republicans are determined to give Democrats no help, eager to deny Obama a political victory and speculating openly that the health care issue will hurt Democrats in the 2010 midterm elections.
"There will be a day of accounting," warned John Cornyn, R-Texas, accusing Democrats of pushing a health overhaul opposed by the public. "Perhaps the first day of accounting will be Election Day 2010."
At their core the bills passed by the House and pending in the Senate are similar. Each costs around $1 trillion over 10 years and is paid for by a combination of tax and fee increases and cuts in projected Medicare spending. Each sets up new insurance marketplaces called exchanges where uninsured or self-employed people and small businesses can compare prices and plans designed to meet some basic requirements. Unpopular insurance practices such as denying people coverage based on pre-existing conditions would be banned, and young adults could retain coverage longer under their parents' insurance plans — through age 25 in the Senate bill and through age 26 in the House version.
Reid cut numerous last-minute deals to get the votes he needed and powerful Democrats also inserted home-state provisions in a 383-page package of amendments Reid filed this weekend to the 2,074-page bill.
Among other items, Senate Finance Committee Chairman Max Baucus, D-Mont., included a provision allowing residents of the town of Libby, Mont., who are suffering asbestos-related illnesses from a mining operation to get Medicare benefits. Nelson won a list of benefits for Nebraska including a commitment for the federal government to pick up the full tab of an expansion of Medicaid. And Sen. Christopher Dodd, D-Conn., who faces a difficult re-election, inserted a $100 million item for construction of a university hospital that his spokesman said he hopes to claim for the University of Connecticut.
AP Special Correspondent David Espo contributed to this report.
Copyright 2009, The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
© 2009 The Atlanta Journal-Constitution
http://www.ajc.com/business/senate-democrats-clear-hurdle-248465.html
Tuesday, December 15, 2009
Long-Term Care Stirs Health Care Debate
By ROBERT PEAR
The New York Times
December 13, 2009
WASHINGTON — Embedded in sweeping health legislation passed by the House and being debated on the Senate floor is a major new federal insurance program for long-term care intended to help people like Anne M. Rader.
Skip to next paragraph Ms. Rader, 45, works at Booz Allen Hamilton as a consultant to federal agencies on emergency preparedness. Even though she has cerebral palsy and multiple sclerosis, she leads a full, active life. But she worries that she will lose her independence if her conditions grow worse.
“Having two disabilities, two disabling conditions, I can’t predict what will happen in the future,” said Ms. Rader, who lives alone in a condominium in Arlington, Va.
Advocates for older Americans and people with disabilities see the program as a long-overdue effort to address needs that will explode as baby boomers age. It is meant for people with severe disabilities who want to live in the community, though the benefits could also be used to help pay for nursing home care or assisted living.
But critics say that the program is unsustainable and that it could ultimately create serious fiscal problems for the government.
Senator Edward M. Kennedy, Democrat of Massachusetts, drafted the proposal several years before he died. Barack Obama, as a senator from Illinois, was a co-sponsor. Now, as president, Mr. Obama wants Congress to include it in the health care bill.
Senator Tom Harkin, Democrat of Iowa and chairman of the health committee, said: “This is the next logical step after the Americans With Disabilities Act. It will provide people with security and peace of mind. They won’t have to go to a nursing home or an institution if they become disabled through an accident or an illness.”
The bill would provide cash benefits if a person had a substantial cognitive impairment or was unable to perform two or three “activities of daily living,” like eating, bathing or dressing. The program would be financed with premiums paid by participants, through voluntary payroll deductions, with no federal subsidy. People could qualify for lifetime benefits if they became disabled after paying premiums for at least five years and working for three of those years.
The Congressional Budget Office assumes that premiums would be $123 a month for benefits expected to average $75 a day, or about $27,000 a year. The amount of benefits would vary, depending on the degree of a person’s disability. The secretary of health and human services could increase premiums to ensure “the financial solvency” of the program over 75 years.
The Senate bill says, “No taxpayer funds shall be used for payment of benefits.”
Senator Christopher J. Dodd, Democrat of Connecticut, said the benefits would allow people with disabilities to “live out their lives with decency and dignity.”
“What’s the alternative?” Mr. Dodd asked. “Getting rid of all your assets, impoverishing yourself, relying on your family or friends to take care of you in order to try to survive.”
But Republicans and some fiscally conservative Democrats said they feared that the government would eventually have to bail out the program because it would prove unsustainable.
“It would create a huge new liability down the road,” said Senator John Thune, Republican of South Dakota.
Paradoxically, the proposed new program accounts for more than half of the bills’ deficit reduction in the first 10 years — because the government would pay out far less in benefits than it would collect in premiums. But costs would grow later.
The Congressional Budget Office estimates that the long-term-care insurance program in the Senate bill would reduce federal budget deficits by $72 billion from 2010 to 2019. For the House bill, the comparable figure is $102 billion.
On Dec. 4, the Senate voted 51 to 47 to strip the program from the bill. The Senate had previously agreed to set a 60-vote threshold, so the effort failed, and the program remains in the bill. But it could become a bargaining chip in negotiations over the measure.
The effort to eliminate the program won support from 11 Democrats, including the chairman of the Finance Committee, Max Baucus of Montana, and the chairman of the Budget Committee, Kent Conrad of North Dakota.
Six of those Democrats said the program “would not be fiscally responsible.” The bill would “create a new federal entitlement program with large, long-term spending increases that far exceed revenues,” they said in a letter to the Senate majority leader, Harry Reid, Democrat of Nevada.
Richard S. Foster, chief actuary at the federal Centers for Medicare and Medicaid Services, has expressed a similar concern.
“There is a very serious risk that the program would become unsustainable,” Mr. Foster said, because people who have or anticipate health problems would be more likely to sign up than people in better-than-average health.
Some companies that sell long-term-care insurance are lobbying against the proposal, known as the Community Living Assistance Services and Supports Act, or Class Act.
One big insurer, Genworth Financial, said the program “would give individuals a false sense of security” and could discourage them from buying private insurance to cover the costs of long-term care.
“A government-run program that covers only a small fraction of Americans’ total long-term-care needs will mislead the general public and make it even harder for agents and advisers to encourage their clients to plan for this important retirement protection,” Genworth says on a website for its employees and agents.
Supporters of the program say it will help not only people with disabilities, but also those who care for them as well.
Carolyn A. Martin, 85, has a touch of dementia, kidney problems and severe arthritis. She cannot prepare meals, wash her clothes or bathe herself, and she often has trouble getting out of bed.
She lives in Columbia, Md., with her daughter, Alma M. Gill, who cares for her while holding a full-time job at a nonprofit organization.
“If I had someone to care for my mother four hours a day, it would change her life, and mine,” Ms. Gill said. “I feel guilty about leaving her alone when I go to work. If something were to happen to her, it would be my fault.”
http://www.nytimes.com/2009/12/14/health/policy/14care.html?scp=6&sq=DISABILITIES&st=Search
Copyright 2009 The New York Times Company
The New York Times
December 13, 2009
WASHINGTON — Embedded in sweeping health legislation passed by the House and being debated on the Senate floor is a major new federal insurance program for long-term care intended to help people like Anne M. Rader.
Skip to next paragraph Ms. Rader, 45, works at Booz Allen Hamilton as a consultant to federal agencies on emergency preparedness. Even though she has cerebral palsy and multiple sclerosis, she leads a full, active life. But she worries that she will lose her independence if her conditions grow worse.
“Having two disabilities, two disabling conditions, I can’t predict what will happen in the future,” said Ms. Rader, who lives alone in a condominium in Arlington, Va.
Advocates for older Americans and people with disabilities see the program as a long-overdue effort to address needs that will explode as baby boomers age. It is meant for people with severe disabilities who want to live in the community, though the benefits could also be used to help pay for nursing home care or assisted living.
But critics say that the program is unsustainable and that it could ultimately create serious fiscal problems for the government.
Senator Edward M. Kennedy, Democrat of Massachusetts, drafted the proposal several years before he died. Barack Obama, as a senator from Illinois, was a co-sponsor. Now, as president, Mr. Obama wants Congress to include it in the health care bill.
Senator Tom Harkin, Democrat of Iowa and chairman of the health committee, said: “This is the next logical step after the Americans With Disabilities Act. It will provide people with security and peace of mind. They won’t have to go to a nursing home or an institution if they become disabled through an accident or an illness.”
The bill would provide cash benefits if a person had a substantial cognitive impairment or was unable to perform two or three “activities of daily living,” like eating, bathing or dressing. The program would be financed with premiums paid by participants, through voluntary payroll deductions, with no federal subsidy. People could qualify for lifetime benefits if they became disabled after paying premiums for at least five years and working for three of those years.
The Congressional Budget Office assumes that premiums would be $123 a month for benefits expected to average $75 a day, or about $27,000 a year. The amount of benefits would vary, depending on the degree of a person’s disability. The secretary of health and human services could increase premiums to ensure “the financial solvency” of the program over 75 years.
The Senate bill says, “No taxpayer funds shall be used for payment of benefits.”
Senator Christopher J. Dodd, Democrat of Connecticut, said the benefits would allow people with disabilities to “live out their lives with decency and dignity.”
“What’s the alternative?” Mr. Dodd asked. “Getting rid of all your assets, impoverishing yourself, relying on your family or friends to take care of you in order to try to survive.”
But Republicans and some fiscally conservative Democrats said they feared that the government would eventually have to bail out the program because it would prove unsustainable.
“It would create a huge new liability down the road,” said Senator John Thune, Republican of South Dakota.
Paradoxically, the proposed new program accounts for more than half of the bills’ deficit reduction in the first 10 years — because the government would pay out far less in benefits than it would collect in premiums. But costs would grow later.
The Congressional Budget Office estimates that the long-term-care insurance program in the Senate bill would reduce federal budget deficits by $72 billion from 2010 to 2019. For the House bill, the comparable figure is $102 billion.
On Dec. 4, the Senate voted 51 to 47 to strip the program from the bill. The Senate had previously agreed to set a 60-vote threshold, so the effort failed, and the program remains in the bill. But it could become a bargaining chip in negotiations over the measure.
The effort to eliminate the program won support from 11 Democrats, including the chairman of the Finance Committee, Max Baucus of Montana, and the chairman of the Budget Committee, Kent Conrad of North Dakota.
Six of those Democrats said the program “would not be fiscally responsible.” The bill would “create a new federal entitlement program with large, long-term spending increases that far exceed revenues,” they said in a letter to the Senate majority leader, Harry Reid, Democrat of Nevada.
Richard S. Foster, chief actuary at the federal Centers for Medicare and Medicaid Services, has expressed a similar concern.
“There is a very serious risk that the program would become unsustainable,” Mr. Foster said, because people who have or anticipate health problems would be more likely to sign up than people in better-than-average health.
Some companies that sell long-term-care insurance are lobbying against the proposal, known as the Community Living Assistance Services and Supports Act, or Class Act.
One big insurer, Genworth Financial, said the program “would give individuals a false sense of security” and could discourage them from buying private insurance to cover the costs of long-term care.
“A government-run program that covers only a small fraction of Americans’ total long-term-care needs will mislead the general public and make it even harder for agents and advisers to encourage their clients to plan for this important retirement protection,” Genworth says on a website for its employees and agents.
Supporters of the program say it will help not only people with disabilities, but also those who care for them as well.
Carolyn A. Martin, 85, has a touch of dementia, kidney problems and severe arthritis. She cannot prepare meals, wash her clothes or bathe herself, and she often has trouble getting out of bed.
She lives in Columbia, Md., with her daughter, Alma M. Gill, who cares for her while holding a full-time job at a nonprofit organization.
“If I had someone to care for my mother four hours a day, it would change her life, and mine,” Ms. Gill said. “I feel guilty about leaving her alone when I go to work. If something were to happen to her, it would be my fault.”
http://www.nytimes.com/2009/12/14/health/policy/14care.html?scp=6&sq=DISABILITIES&st=Search
Copyright 2009 The New York Times Company
Monday, December 14, 2009
Microsoft Snags Sentillion
Combination of the two systems will streamline access to medical information
by Lalee Sadighi
December 10,2009
Microsoft on Thursday said it has agreed to acquire health care IT company Sentillion for an undisclosed sum.
Redmond, Washington-based Microsoft has made a number of moves in the health care IT industry in 2009, including a deal with the American Medical Association that gives physicians access to patent records through Microsoft's HealthVault, an online application that allows users to store their medical information.
“Combining Sentillion’s products with Microsoft Amalga Unified Intelligence System (UIS) will make it easier for healthcare professionals to deliver better patient care by streamlining access to multiple IT applications and patient data,” the company said in a statement.
Sentillion, a privately held company located in Andover, Massachusetts, supplies software to health care professionals that integrate various types of clinical, business, and personal productivity applications, regardless of whether they are Web-based or Windows-based.
Sentillion’s software is used in more than 1,000 hospitals, according to the software giant.
Unified with its own Amalga UIS, Microsoft hopes to offer an integrated technology that can help health care providers access patient data from multiple sources.
The sale to Microsoft marks an exit for Sentillion backers Newbury Ventures, Polaris Venture Partners, Split Rock Partners, Merril Lynch Ventures, Wall Street Technology Partners, Intersouth Partners, and First Consulting Group.
Microsoft is not the only company showing interest in IT health care. Google, Intel, and Oracle are some of the other contender in the growing health care IT market.
In 2008, Google launched Google Health, its own online resource for storing personal health information and sending data to doctors and other contacts. It also partnered with Centers for Medicare & Medicaid Services in a program that would allow Medicare recipients to enter their Medicare claims into Google Health.
In July, Intel announced that it would install more connectivity options in its Intel Health Guide, a device that allows patients to record their health history and connect with a physician or health care provider. The company also announced that it would invest $250 million over the next five years to further develop health care IT technologies.
As for Oracle, it has developed the Oracle Healthcare Acquisition Corp., whose principal activity is to be in the business of health care industry through acquisitions, mergers, capital stock exchange, asset acquisition, stock purchases, and other business combinations.
http://www.redherring.com/Home/26253
RedHerring © 2009
by Lalee Sadighi
December 10,2009
Microsoft on Thursday said it has agreed to acquire health care IT company Sentillion for an undisclosed sum.
Redmond, Washington-based Microsoft has made a number of moves in the health care IT industry in 2009, including a deal with the American Medical Association that gives physicians access to patent records through Microsoft's HealthVault, an online application that allows users to store their medical information.
“Combining Sentillion’s products with Microsoft Amalga Unified Intelligence System (UIS) will make it easier for healthcare professionals to deliver better patient care by streamlining access to multiple IT applications and patient data,” the company said in a statement.
Sentillion, a privately held company located in Andover, Massachusetts, supplies software to health care professionals that integrate various types of clinical, business, and personal productivity applications, regardless of whether they are Web-based or Windows-based.
Sentillion’s software is used in more than 1,000 hospitals, according to the software giant.
Unified with its own Amalga UIS, Microsoft hopes to offer an integrated technology that can help health care providers access patient data from multiple sources.
The sale to Microsoft marks an exit for Sentillion backers Newbury Ventures, Polaris Venture Partners, Split Rock Partners, Merril Lynch Ventures, Wall Street Technology Partners, Intersouth Partners, and First Consulting Group.
Microsoft is not the only company showing interest in IT health care. Google, Intel, and Oracle are some of the other contender in the growing health care IT market.
In 2008, Google launched Google Health, its own online resource for storing personal health information and sending data to doctors and other contacts. It also partnered with Centers for Medicare & Medicaid Services in a program that would allow Medicare recipients to enter their Medicare claims into Google Health.
In July, Intel announced that it would install more connectivity options in its Intel Health Guide, a device that allows patients to record their health history and connect with a physician or health care provider. The company also announced that it would invest $250 million over the next five years to further develop health care IT technologies.
As for Oracle, it has developed the Oracle Healthcare Acquisition Corp., whose principal activity is to be in the business of health care industry through acquisitions, mergers, capital stock exchange, asset acquisition, stock purchases, and other business combinations.
http://www.redherring.com/Home/26253
RedHerring © 2009
Wednesday, December 09, 2009
Small-Business Survival a Key Concern at Forum
By ROMI HERRON
For Sun-Times Media
December 9, 2009
Nearly 100 Kane County elder care providers, senior citizens and their advocates discussed federal and state issues relating to elder care during a legislative forum Monday in St. Charles.
The event was sponsored by Kane County Senior Resources, Asbury Gardens, Countryside Care Center, Heritage Woods of Yorkville, and the Northeastern Illinois Area Agency on Aging.
Among challenges discussed were the state of Illinois' lagging Medicare payments to small businesses that provide elder care and services.
Betty Schoenholtz, executive director of Senior Services Associates, said state payments to elder care providers -- many of whom are small-business owners -- have lagged for months because of the state's budget shortages.
"It is of great concern to me what is happening to our (provider) agencies," Schoenholtz said, adding that those funds would help stimulate the economy through purchases made by small businesses. "When the state of Illinois doesn't pay its bills, we can't buy things from small business ... . We hope (state legislators) can step up to the plate and resolve these issues."
She also recommended that legislators change state law to require the Illinois Department of Public Health to allocate at least $750,000 into the ombudsman program, or to implement a "bed fee" similar to Ohio's, which requires a $6-per-bed fee to help offset costs to agencies. Schoenholtz also said the elder abuse program is owed $134,000 from the state and that the figure represents one-third the budget for elder abuse cases.
Lucia Jones, executive director of the Northeastern Illinois Area Agency on Aging, also said she is concerned about how the state's budget issues are impacting service providers.
"The providers are all small-business owners," Jones said. "The numbers they serve are going up tremendously, because of the economy ... . There are hundreds and thousands of families in the state of Illinois in need of elder care; and if the ombudsman program is cut, those people will have to go into long-term care."
AARP spokesperson Heather Heppner also provided an update. "We have spent a very long time advocating to prevent cuts to community-based services. We know it is more fiscally responsible to care for individuals in their homes than in institutions," she said. "We have providers who have not been paid this entire fiscal year ... . Senior services need to have a heightened level of priority."
She also noted that AARP endorsed the Affordable Healthcare for America Act.
"On the House bill side, it was not perfect ... but the bottom line is that our health care system in this country is broken, and the things our AARP members have told us are important issues are addressed in that bill," Heppner said. Older adults were at times paying up to seven times more in insurance rates than younger adults, she said, and the health care act would cap age rating at two to one.
http://www.suburbanchicagonews.com/couriernews/news/1928421,3_1_EL09_14AGING_S1-091209.article
Copyright 2009 Sun-Times Media
For Sun-Times Media
December 9, 2009
Nearly 100 Kane County elder care providers, senior citizens and their advocates discussed federal and state issues relating to elder care during a legislative forum Monday in St. Charles.
The event was sponsored by Kane County Senior Resources, Asbury Gardens, Countryside Care Center, Heritage Woods of Yorkville, and the Northeastern Illinois Area Agency on Aging.
Among challenges discussed were the state of Illinois' lagging Medicare payments to small businesses that provide elder care and services.
Betty Schoenholtz, executive director of Senior Services Associates, said state payments to elder care providers -- many of whom are small-business owners -- have lagged for months because of the state's budget shortages.
"It is of great concern to me what is happening to our (provider) agencies," Schoenholtz said, adding that those funds would help stimulate the economy through purchases made by small businesses. "When the state of Illinois doesn't pay its bills, we can't buy things from small business ... . We hope (state legislators) can step up to the plate and resolve these issues."
She also recommended that legislators change state law to require the Illinois Department of Public Health to allocate at least $750,000 into the ombudsman program, or to implement a "bed fee" similar to Ohio's, which requires a $6-per-bed fee to help offset costs to agencies. Schoenholtz also said the elder abuse program is owed $134,000 from the state and that the figure represents one-third the budget for elder abuse cases.
Lucia Jones, executive director of the Northeastern Illinois Area Agency on Aging, also said she is concerned about how the state's budget issues are impacting service providers.
"The providers are all small-business owners," Jones said. "The numbers they serve are going up tremendously, because of the economy ... . There are hundreds and thousands of families in the state of Illinois in need of elder care; and if the ombudsman program is cut, those people will have to go into long-term care."
AARP spokesperson Heather Heppner also provided an update. "We have spent a very long time advocating to prevent cuts to community-based services. We know it is more fiscally responsible to care for individuals in their homes than in institutions," she said. "We have providers who have not been paid this entire fiscal year ... . Senior services need to have a heightened level of priority."
She also noted that AARP endorsed the Affordable Healthcare for America Act.
"On the House bill side, it was not perfect ... but the bottom line is that our health care system in this country is broken, and the things our AARP members have told us are important issues are addressed in that bill," Heppner said. Older adults were at times paying up to seven times more in insurance rates than younger adults, she said, and the health care act would cap age rating at two to one.
http://www.suburbanchicagonews.com/couriernews/news/1928421,3_1_EL09_14AGING_S1-091209.article
Copyright 2009 Sun-Times Media
Wednesday, December 02, 2009
Report Outlines Deep Cuts If Oregon Tax Measures Fail
By Frank Mungeam and AP Staff
December 1, 2009
SALEM, Ore. -- A new, 100-page report released by the state of Oregon details potential budget cuts if two tax measures are not passed in a January 26, 2010 special election.
Measures 66 and 67 would raise taxes on businesses and high-income households.
Proponents of the pair of tax measures say they will generate $733 million dollars in revenue. If those tax measures fail, a wide range of programs face cuts to make up a projected shortfall in the state budget.
Among the projected cuts: more than 15,000 seniors with disabilities would lose Oregon Health Plan coverage; 3,000 families with two unemployed parents would lose monthly payments; and the Department of Corrections would close three prisons and release 1,600 inmates.
One of the hardest-hit agencies would be the Department of Human Services. The department outlined 16 pages of proposed cuts to make up a 5 percent budget shortfall.
Schools, universities, prisons, state police and courts could all be cut, lawmakers said Monday after releasing the report.
The Legislative Fiscal Office, the Legislature's budget experts, compiled the list from proposals submitted by state agencies for cuts of 5 percent and 10 percent of their current two-year budgets.
"These cuts on top of $2 billion in cuts we made earlier this year would do great harm to our schools, our colleges and universities, and to core services that Oregonians are relying on in these tough times," said House Speaker David Hunt, a Democrat from Gladstone.
But a spokesman for the opposition campaign said the list was compiled to influence the election, which will be Jan. 26.
"It's an effort to create a disaster scenario that says if these measures do not pass, the world as we know it will come to an end," said Pat McCormick of Oregonians Against Job-Killing Taxes.
The $733 million that would be raised if voters approve Measures 66 and 67 amounts to about 5.5 percent of the $13.3 billion state general fund budget.
The tax increases would fall on households earning more than $250,000 on a joint return, or $125,000 for a single filer, and corporations netting more than $250,000.
Small businesses have objected to the restructured corporate minimum tax, which would be raised from $10 to at least $150 and as high as $100,000 on businesses with $100 million in Oregon sales.
Budget cuts could also affect college students by increasing tuition and forcing colleges to cut professors and staff.
Republican Nick Smith labeled the projected cuts "scare tactics" designed to convince voters to approve the tax increases.
http://www.kgw.com/news/local/Report-outlines-deep-cuts-if-Ore-tax-measures-fail-78223297.html
http://www.kgw.com/
Newsxchannel 8
Portland, Oregan
Copyright 2009 KGW.
December 1, 2009
SALEM, Ore. -- A new, 100-page report released by the state of Oregon details potential budget cuts if two tax measures are not passed in a January 26, 2010 special election.
Measures 66 and 67 would raise taxes on businesses and high-income households.
Proponents of the pair of tax measures say they will generate $733 million dollars in revenue. If those tax measures fail, a wide range of programs face cuts to make up a projected shortfall in the state budget.
Among the projected cuts: more than 15,000 seniors with disabilities would lose Oregon Health Plan coverage; 3,000 families with two unemployed parents would lose monthly payments; and the Department of Corrections would close three prisons and release 1,600 inmates.
One of the hardest-hit agencies would be the Department of Human Services. The department outlined 16 pages of proposed cuts to make up a 5 percent budget shortfall.
Schools, universities, prisons, state police and courts could all be cut, lawmakers said Monday after releasing the report.
The Legislative Fiscal Office, the Legislature's budget experts, compiled the list from proposals submitted by state agencies for cuts of 5 percent and 10 percent of their current two-year budgets.
"These cuts on top of $2 billion in cuts we made earlier this year would do great harm to our schools, our colleges and universities, and to core services that Oregonians are relying on in these tough times," said House Speaker David Hunt, a Democrat from Gladstone.
But a spokesman for the opposition campaign said the list was compiled to influence the election, which will be Jan. 26.
"It's an effort to create a disaster scenario that says if these measures do not pass, the world as we know it will come to an end," said Pat McCormick of Oregonians Against Job-Killing Taxes.
The $733 million that would be raised if voters approve Measures 66 and 67 amounts to about 5.5 percent of the $13.3 billion state general fund budget.
The tax increases would fall on households earning more than $250,000 on a joint return, or $125,000 for a single filer, and corporations netting more than $250,000.
Small businesses have objected to the restructured corporate minimum tax, which would be raised from $10 to at least $150 and as high as $100,000 on businesses with $100 million in Oregon sales.
Budget cuts could also affect college students by increasing tuition and forcing colleges to cut professors and staff.
Republican Nick Smith labeled the projected cuts "scare tactics" designed to convince voters to approve the tax increases.
http://www.kgw.com/news/local/Report-outlines-deep-cuts-if-Ore-tax-measures-fail-78223297.html
http://www.kgw.com/
Newsxchannel 8
Portland, Oregan
Copyright 2009 KGW.
Tuesday, December 01, 2009
Strike Forces Target Medicare Fraud
Chuck Neubauer and Jerry Seper
Washington Times
Tuesday, December 1, 2009
Starting in the spring of 2007, federal, state and local law enforcement officials came together in South Florida to hunt down and charge people with defrauding the country's multibillion-dollar Medicare system.
Known as the Medicare Fraud Strike Force and now expanded across the country, the group has since indicted more than 300 health care providers nationwide and has broken up operations that accounted for more than $700 million in fraudulent Medicare claims.
Former U.S. Attorney R. Alexander Acosta, who put a priority on health care fraud cases when he was the government's chief prosecutor in Miami, said the decision in Washington to make such coordinated efforts permanent is starting to have an impact, but that more needs to be done to make a real dent in the kickback and false-billing schemes that plague the national health care program.
"The fight against health care fraud had already begun at the local level, but the strike forces brought additional manpower, expertise and necessary resources," said Mr. Acosta, now dean of the Florida International University College of Law in Miami.
"They put a spotlight on a national problem, allowed us to continue our work and more than doubled the resources available to us," he said. "It has become a very successful partnership for a too-often-ignored problem."
Assistant Attorney General Lanny A. Breuer, who heads the Justice Department's criminal division, told the Senate in May that federal and state spending on Medicare and Medicaid totaled $800 billion a year and that "according to various estimates, somewhere between 3 and 10 percent of this spending is lost to waste, fraud and abuse."
Mr. Breuer told The Washington Times that because criminals are "devising more sophisticated ways of stealing billions of dollars from federally administered health care programs, and they are stealing it faster now than ever before," the Justice Department is committed to shutting them down. "We must stop the bleeding, and we are committed to do so," he said.
Medicare is a government-paid insurance program begun in 1965 that provides health care to about 40 million people 65 and older and 7 million younger people with permanent disabilities.
The program accounted for about 13 percent of the federal budget and 19 percent of the total health care expenditures in 2008.
Health and Human Services Secretary Kathleen Sebelius said the strike force has a "proven record of success," using a data-driven approach to identify unexplainable billing patterns and investigate providers for fraudulent activity.
http://www.washingtontimes.com/news/2009/dec/01/strike-forces-target-multimillion-dollar-medicare-/
© Copyright 2009 The Washington Times, LLC.
Washington Times
Tuesday, December 1, 2009
Starting in the spring of 2007, federal, state and local law enforcement officials came together in South Florida to hunt down and charge people with defrauding the country's multibillion-dollar Medicare system.
Known as the Medicare Fraud Strike Force and now expanded across the country, the group has since indicted more than 300 health care providers nationwide and has broken up operations that accounted for more than $700 million in fraudulent Medicare claims.
Former U.S. Attorney R. Alexander Acosta, who put a priority on health care fraud cases when he was the government's chief prosecutor in Miami, said the decision in Washington to make such coordinated efforts permanent is starting to have an impact, but that more needs to be done to make a real dent in the kickback and false-billing schemes that plague the national health care program.
"The fight against health care fraud had already begun at the local level, but the strike forces brought additional manpower, expertise and necessary resources," said Mr. Acosta, now dean of the Florida International University College of Law in Miami.
"They put a spotlight on a national problem, allowed us to continue our work and more than doubled the resources available to us," he said. "It has become a very successful partnership for a too-often-ignored problem."
Assistant Attorney General Lanny A. Breuer, who heads the Justice Department's criminal division, told the Senate in May that federal and state spending on Medicare and Medicaid totaled $800 billion a year and that "according to various estimates, somewhere between 3 and 10 percent of this spending is lost to waste, fraud and abuse."
Mr. Breuer told The Washington Times that because criminals are "devising more sophisticated ways of stealing billions of dollars from federally administered health care programs, and they are stealing it faster now than ever before," the Justice Department is committed to shutting them down. "We must stop the bleeding, and we are committed to do so," he said.
Medicare is a government-paid insurance program begun in 1965 that provides health care to about 40 million people 65 and older and 7 million younger people with permanent disabilities.
The program accounted for about 13 percent of the federal budget and 19 percent of the total health care expenditures in 2008.
Health and Human Services Secretary Kathleen Sebelius said the strike force has a "proven record of success," using a data-driven approach to identify unexplainable billing patterns and investigate providers for fraudulent activity.
http://www.washingtontimes.com/news/2009/dec/01/strike-forces-target-multimillion-dollar-medicare-/
© Copyright 2009 The Washington Times, LLC.
Monday, November 23, 2009
Tennessee Budget Cuts Could Close Longtime Institution for People with Severe Disabilities
By Chas Sisk
THE TENNESSEAN
November 20, 2009
The only state institution in Middle Tennessee for people with severe intellectual disabilities could be closed under a plan introduced Thursday to cut spending.
The Clover Bottom Development Center, an 86-year-old Donelson institution that at its peak housed more than 1,500 residents, could be targeted for closure in the next fiscal year if Gov. Phil Bredesen were to go forward with plans to slash the state budget by as much as 9 percent.
The closure would save the state $36 million a year, officials from the Division of Intellectual Disabilities Services said. But it would also mean moving the 108 people who still live at the facility on short notice into another state institution in East Tennessee or into private facilities.
"There must be great care taken in how we transition a person," said Debra Payne, the division's director. "I think we've been looking to downsize Clover Bottom, but I don't think the planning process has fully developed a plan."
The plan was revealed on the third day of public hearings in which government officials presented suggestions for how to close a state budget gap that could reach as much as $1.5 billion next year. Previous suggestions have included releasing as many as 4,000 nonviolent felons and curbing benefits for people enrolled in TennCare, the state insurance program for the poor, pregnant women and children.
Bredesen has not yet said which of those proposals he intends to take up, but at Thursday's hearing, he appeared to show some interest in closing Clover Bottom.
"Closing a very old state facility and putting them in another facility … would seem to be a good thing," he said.
Mary Schaffner, an attorney for the Clover Bottom Parent-Guardian Association, said her group would not be opposed to closing Clover Bottom, if its residents were transitioned safely into another state-run facility.
The residents of Clover Bottom have disabilities that are too severe to be placed in group homes, and the care they need is too intensive to be trusted to privately operated facilities, she said.
"With state-run, you always have a system of providing good care," she said. "Private ones go up and down in terms of making money."
The plan would cut about 3.8 percent from the division's budget. Officials offered no other spending cut proposals, so Bredesen asked that they consider renegotiating contracts for other services, pointing out that only three states spend more per patient than Tennessee to care for people with intellectual disabilities.
"I need you to go back and at least tell me if I really have to go there, what do I have to do, he said. "I don't think I'm imposing an impossible challenge."
In another hearing, Bredesen also heard officials from the Department of Safety describe possible cuts to that agency.
Officials said they would have to remove 25 troopers from the state's highways, leaving 13 small counties without a trooper assigned to them, if Bredesen were to ask them to cut their budget by the full 9 percent. Safety officials also said they would have to close six driver license offices and cut staffing at others, increasing the expected wait time for a driver license to as long as two hours from the current 45 minutes.
To read page 2 go here http://www.tennessean.com/article/20091120/NEWS0201/911200365/1009/NEWS02/TN+budget+cuts+could+close+longtime+institution+for+people+with+severe+disabilities
Chas Sisk can be reached at 615-259-8283 or
csisk@tennessean.com.
http://www.tennessean.com/article/20091120/NEWS0201/911200365/1009/NEWS02/TN+budget+cuts+could+close+longtime+institution+for+people+with+severe+disabilities
Copyright © 2009 The Tennessean. All rights reserved
THE TENNESSEAN
November 20, 2009
The only state institution in Middle Tennessee for people with severe intellectual disabilities could be closed under a plan introduced Thursday to cut spending.
The Clover Bottom Development Center, an 86-year-old Donelson institution that at its peak housed more than 1,500 residents, could be targeted for closure in the next fiscal year if Gov. Phil Bredesen were to go forward with plans to slash the state budget by as much as 9 percent.
The closure would save the state $36 million a year, officials from the Division of Intellectual Disabilities Services said. But it would also mean moving the 108 people who still live at the facility on short notice into another state institution in East Tennessee or into private facilities.
"There must be great care taken in how we transition a person," said Debra Payne, the division's director. "I think we've been looking to downsize Clover Bottom, but I don't think the planning process has fully developed a plan."
The plan was revealed on the third day of public hearings in which government officials presented suggestions for how to close a state budget gap that could reach as much as $1.5 billion next year. Previous suggestions have included releasing as many as 4,000 nonviolent felons and curbing benefits for people enrolled in TennCare, the state insurance program for the poor, pregnant women and children.
Bredesen has not yet said which of those proposals he intends to take up, but at Thursday's hearing, he appeared to show some interest in closing Clover Bottom.
"Closing a very old state facility and putting them in another facility … would seem to be a good thing," he said.
Mary Schaffner, an attorney for the Clover Bottom Parent-Guardian Association, said her group would not be opposed to closing Clover Bottom, if its residents were transitioned safely into another state-run facility.
The residents of Clover Bottom have disabilities that are too severe to be placed in group homes, and the care they need is too intensive to be trusted to privately operated facilities, she said.
"With state-run, you always have a system of providing good care," she said. "Private ones go up and down in terms of making money."
The plan would cut about 3.8 percent from the division's budget. Officials offered no other spending cut proposals, so Bredesen asked that they consider renegotiating contracts for other services, pointing out that only three states spend more per patient than Tennessee to care for people with intellectual disabilities.
"I need you to go back and at least tell me if I really have to go there, what do I have to do, he said. "I don't think I'm imposing an impossible challenge."
In another hearing, Bredesen also heard officials from the Department of Safety describe possible cuts to that agency.
Officials said they would have to remove 25 troopers from the state's highways, leaving 13 small counties without a trooper assigned to them, if Bredesen were to ask them to cut their budget by the full 9 percent. Safety officials also said they would have to close six driver license offices and cut staffing at others, increasing the expected wait time for a driver license to as long as two hours from the current 45 minutes.
To read page 2 go here http://www.tennessean.com/article/20091120/NEWS0201/911200365/1009/NEWS02/TN+budget+cuts+could+close+longtime+institution+for+people+with+severe+disabilities
Chas Sisk can be reached at 615-259-8283 or
csisk@tennessean.com.
http://www.tennessean.com/article/20091120/NEWS0201/911200365/1009/NEWS02/TN+budget+cuts+could+close+longtime+institution+for+people+with+severe+disabilities
Copyright © 2009 The Tennessean. All rights reserved
Tuesday, November 03, 2009
Planned Background Checks for In-Home Healthcare Workers Are Criticized
County social service chiefs in California protest the Schwarzenegger administration's plan for prospective health aides, saying they aren't ready to enact the new application process.
By Eric Bailey
The Los Angeles Times
October 28, 2009
Reporting from Sacramento - A storm of protest has erupted over the Schwarzenegger administration's push to require prospective home health aides for the elderly and disabled to begin undergoing criminal background and fingerprint checks next week.
Social service chiefs in counties throughout the state have warned that they aren't ready to begin the time-consuming new application process -- and the delay could mean some elderly and frail patients would go without care.Advocates for the elderly and disabled say the administration's rush to begin the checks, part of an anti-fraud effort Gov.
Arnold Schwarzenegger pushed during last summer's budget negotiations, seems to have an ulterior motive: dissuading new patients and providers from participating in the $5.5-billion government-funded home healthcare program."This is just a disaster in the making," said Deborah Doctor, legislative advocate for Disability Rights California. "I don't want to overdramatize this, but it could have the same effect as cutting people off the program."
A legislative oversight hearing is slated for today to address the concerns and potentially make a push to delay the start of the new process, which would apply starting Monday to all new applicants for home health aide jobs.
The state's more than 376,000 existing care workers would have to undergo the new background checks by June."This has created chaos and uncertainty for frail elderly and disabled people," said Assemblywoman Noreen Evans, who wants a three- to four-month delay.
Administration officials referred queries about the program to the state's Department of Social Services, which has been hustling to start the new application process.Lizelda Lopez, the department's spokeswoman, said the looming deadline was set by the Legislature during budget negotiations and should come as no surprise."Nobody denies these were very aggressive time frames," Lopez said. But she said the department has been working with the counties for months to enact the new procedures. "We didn't start talking to them yesterday."
The In-home Supportive Services program has been caught in a tug-of-war between the Schwarzenegger administration, which contends that it is rife with potential fraud, and Democrats in the Legislature who see it as a humane and cost-effective alternative to nursing homes and other institutionalized care.
Coloring the debate is the fact that the in-home program is a big growth sector for labor unions, which traditionally have supported Democratic candidates and causes while reliably opposing those backed by Schwarzenegger and other Republicans.
Schwarzenegger tried during the summer budget fight to cut aid to 90% of the program's participants, but Democrats kept the program largely funded while going along with the anti-fraud effort."
My question is whether this is an attempt by the administration to do what the Legislature would not allow it to do," Evans said.County officials said the new rules have caused confusion and concern for patients and their healthcare providers."
Our lobbies are flooded, telephones ring continuously, and staff have insufficient information to provide answers," Linda Haugan, assistant administrator for San Bernardino County Human Services, said in a letter to the state. "This has created a major disruption."County officials say there are several key logistical problems.
The new rules require prospective healthcare workers to undergo an orientation session that will require counties to hire new staff and office space. Meanwhile, some counties say the new enrollment forms haven't been provided yet.
Officials in Los Angeles County, where more than 185,000 people receive in-home care, said they received the latest instructions just a day ago, giving them a week to prepare.
With more than 4,000 new applications each month for in-home care workers, the inability to approve new providers "will create an extreme hardship on aged and disabled individuals," Philip L. Browning, director of the county Department of Public Social Services, said in a letter to the state.
http://www.latimes.com/news/local/la-me-home-care28-2009oct28,0,2903112.story
eric.bailey@latimes.com
Copyright © 2009, The Los Angeles Times
By Eric Bailey
The Los Angeles Times
October 28, 2009
Reporting from Sacramento - A storm of protest has erupted over the Schwarzenegger administration's push to require prospective home health aides for the elderly and disabled to begin undergoing criminal background and fingerprint checks next week.
Social service chiefs in counties throughout the state have warned that they aren't ready to begin the time-consuming new application process -- and the delay could mean some elderly and frail patients would go without care.Advocates for the elderly and disabled say the administration's rush to begin the checks, part of an anti-fraud effort Gov.
Arnold Schwarzenegger pushed during last summer's budget negotiations, seems to have an ulterior motive: dissuading new patients and providers from participating in the $5.5-billion government-funded home healthcare program."This is just a disaster in the making," said Deborah Doctor, legislative advocate for Disability Rights California. "I don't want to overdramatize this, but it could have the same effect as cutting people off the program."
A legislative oversight hearing is slated for today to address the concerns and potentially make a push to delay the start of the new process, which would apply starting Monday to all new applicants for home health aide jobs.
The state's more than 376,000 existing care workers would have to undergo the new background checks by June."This has created chaos and uncertainty for frail elderly and disabled people," said Assemblywoman Noreen Evans, who wants a three- to four-month delay.
Administration officials referred queries about the program to the state's Department of Social Services, which has been hustling to start the new application process.Lizelda Lopez, the department's spokeswoman, said the looming deadline was set by the Legislature during budget negotiations and should come as no surprise."Nobody denies these were very aggressive time frames," Lopez said. But she said the department has been working with the counties for months to enact the new procedures. "We didn't start talking to them yesterday."
The In-home Supportive Services program has been caught in a tug-of-war between the Schwarzenegger administration, which contends that it is rife with potential fraud, and Democrats in the Legislature who see it as a humane and cost-effective alternative to nursing homes and other institutionalized care.
Coloring the debate is the fact that the in-home program is a big growth sector for labor unions, which traditionally have supported Democratic candidates and causes while reliably opposing those backed by Schwarzenegger and other Republicans.
Schwarzenegger tried during the summer budget fight to cut aid to 90% of the program's participants, but Democrats kept the program largely funded while going along with the anti-fraud effort."
My question is whether this is an attempt by the administration to do what the Legislature would not allow it to do," Evans said.County officials said the new rules have caused confusion and concern for patients and their healthcare providers."
Our lobbies are flooded, telephones ring continuously, and staff have insufficient information to provide answers," Linda Haugan, assistant administrator for San Bernardino County Human Services, said in a letter to the state. "This has created a major disruption."County officials say there are several key logistical problems.
The new rules require prospective healthcare workers to undergo an orientation session that will require counties to hire new staff and office space. Meanwhile, some counties say the new enrollment forms haven't been provided yet.
Officials in Los Angeles County, where more than 185,000 people receive in-home care, said they received the latest instructions just a day ago, giving them a week to prepare.
With more than 4,000 new applications each month for in-home care workers, the inability to approve new providers "will create an extreme hardship on aged and disabled individuals," Philip L. Browning, director of the county Department of Public Social Services, said in a letter to the state.
http://www.latimes.com/news/local/la-me-home-care28-2009oct28,0,2903112.story
eric.bailey@latimes.com
Copyright © 2009, The Los Angeles Times
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