Sunday, March 14, 2010

Weekend update

The President has delayed his Asian trip from March 18 to March 21 in the hope (expectation?) that Congress will enact general health care reform this week.  The AP reports that

The House's chief Democratic headcounter [Rep. James Clyburn (D SC)] said Sunday he hadn't rounded up enough votes to pass President Barack Obama's health care overhaul heading into a make-or-break week, even as the White House's top political adviser said he was "absolutely confident" in its prospects.

White House spokesman Robert Gibbs predicted House passage this week, before Congress takes a two-week break and Obama travels to Asia, a trip he postponed to push for the bill.
The Politico published an email from Rep. Chris Van Hollen (D Md) projecting a schedule for this week that begins with a House Budget Committee hearing tomorrow and ends with a vote on Friday or Saturday.  The Wall Street Journal reported yesterday that under health care reform, members of Congress and their staffs will receive health benefits coverage through the state health insurance exchanges, rather than the FEHB Program. 

Meanwhile, we keep inching toward the date on which the Office of Personnel Management will issue its annual call letter for FEHB carrier 2011 benefit and rate proposals. In last year's letter, OPM encouraged carriers to develop value based benefit designs. Kaiser Health News reports on a value based benefit design that five different health insurance carriers are offering to Oregon employers. The article explains that the design works as follows:

Just as in more traditional insurance plans, workers would pay an annual deductible of about $250 before coverage kicks in. Doctor office visits would cost workers $10 to $20. Employees would pay 20% of the cost of hospital care, up to an annual maximum of $1,500 for individuals and $3,000 a year for family coverage.

But employees with certain conditions — asthma, congestive heart failure, diabetes, depression, heart disease, chronic bronchitis or emphysema — would get prescription drugs and visits with physicians free or at greatly reduced rates. High blood pressure, another common condition, would qualify for low-cost care if it was part of an overall diagnosis of heart disease.

Conversely, they’d pay much more if they have a treatment or test from a list of about 20 broad categories, including knee or hip replacement, cardiac bypass surgery, artery-opening stents, hysterectomies, high-tech-imaging exams or emergency room visits. In those cases, they’d pay double the annual deductible, double the amount they’d normally pay for an office visit and up to half the cost of hospital or ER visit, up to the $1,500/$3,000 maximums.
Along the same lines, the Associated Press reported last week on over-utilized medical tests.

Speaking of OPM, the agency posted its 2010-2015 Strategic Report on Friday. There are no big changes to the FEHB Program reported there.

Finally, last week, PCMA, the prescription benefits manager trade association, released the results of a survey of 305 federal employees from the DC area. The survey found that "Seventy-four percent of those enrolled in the Federal Health Benefits Program (FEHBP) oppose a new effort by Congress to change the program’s prescription drug benefits,"

No comments: