Showing posts with label HR 676. Show all posts
Showing posts with label HR 676. Show all posts
Wednesday, March 16, 2011
Wednesday, February 16, 2011
Conyers: Constitutional Text and History Proves the Validity of Health Care’s Minimum Coverage Requirement
Contact: Nicole Triplett (202) 226-5543
Wednesday, February 16, 2011
Conyers: Constitutional Text and History Proves the Validity of Health Care’s Minimum Coverage Requirement
Minimum Coverage is Necessary to Eliminate Insurance Discrimination Against Those With Pre-Existing Conditions and Make Health Care Affordable and Available for All
(Washington)—Today, at the House Judiciary Full Committee’s Hearing on the “Constitutionality of the Individual Mandate,” Ranking Member John Conyers, Jr. (D-Mich.) and his Democratic colleagues stressed how the Affordable Healthcare Act’s foundations are constitutionally sound, invoking the Constitution’s plain language, past Supreme Court cases, and the establishment of federal programs, such as Medicare and Social Security.
Mr. Conyers and other Judiciary Democrats emphasized the critical importance for the minimum coverage requirement to be coupled with efforts to prevent insurance companies from terminating coverage for people with pre-existing conditions. They argued that, without the individual mandate, citizens would pay higher taxes and experience double-digit premium increases.
Below is an excerpt of Mr. Conyers’ hearing remarks:
Indeed, the position that my Republican colleagues are taking is curious. After all, they were for the individual mandate long before they were against it.
Senators Orrin Hatch and Charles Grassley, along with 18 of their Republican colleagues included the idea of an individual mandate in their “Health Equity and Access Reform Today Act of 1993,” their counter to President Clinton’s plan.
Former Massachusetts Governor Mitt Romney featured an individual mandate as part of his successful health care reform law, where it helped reduce insurance premiums by 40 percent while the national average has increased 14 percent.
Given its demonstrated success, and the need to solve our national health care crisis, one would hope that my Republican colleagues would continue to embrace the idea. But instead, they’ve gone on attack, now claiming that the individual mandate is unconstitutional.
Were they wrong then, or are they wrong now?
I believe that they are wrong now – Congress has the clear power under Article I, Section 8, Clause 3 of the Constitution, which gives us authority to regulate commerce between the states. That power is augmented by Article I, Section 8, Clause 18, which grants us discretion to choose the “Necessary and Proper” means of achieving our legitimate regulatory goals. I’d like to explain briefly why our authority here is beyond question and their counter arguments should not carry the day.
First, their core argument, that this regulates “inactivity,” requires us to accept a complete fiction. We all participate in the health care market. No one can credibly claim that they will never get ill or injured and, in this country, we promise emergency care for all who need it. We should be proud of that, but we also must find a better way to pay for it. The cost of uncompensated care was $43 billion in 2008 alone, and those costs are shifted to other Americans who pay higher taxes and increased fees for medical care and insurance premiums. The individual mandate recognizes the reality that we are all “active” in the health care market and regulates how and when we pay for our health care. Doing so is well within Congress’s power.
Second, while some of my colleagues may score political points by making this “inactivity” argument, it is – as President Ronald Reagan’s Solicitor General Charles Fried explained to our Senate colleagues – “in any event irrelevant” as a matter of law.
Solicitor General Fried is not a partisan supporter of the Affordable Care Act, but he is a staunch defender of our Constitution. In his view, the individual mandate is fully constitutional because Congress unquestionably has the power to regulate the interstate health and insurance markets and discretion to choose the “Necessary and Proper” means of doing so. He testified on this before our Senate colleagues and I would like to seek unanimous consent to enter his statement into the record today.
Finally, we have been hearing that this is all about individual liberty, the right to be let alone. But is it really? For example, states can, and do, require citizens to purchase car insurance. And, in Massachusetts, legislation signed by former Governor Romney obligates that state’s residents to purchase health insurance. Many other laws impose affirmative obligations on our citizenry: we must pay taxes, send our children to schools and vaccinate them, contribute to Medicare and Social Security, to name just a few. Surely some citizens would like to avoid these requirements as well. But, aside from religious objectors, who also are excused here, they have no constitutionally recognized right to do so. The liberty interests at stake do not change simply because it is the federal, rather than the state, government that is imposing the requirement. While we can debate whether the Congress has the power to impose this requirement – something I believe we clearly do – we should not scare Americans into believing that how we resolve that question says anything about their individual liberty.
I look forward to hearing from our witnesses today, and hope that they can shed additional light on the points that I have made.
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Thursday, February 3, 2011
Single Payer Health Insurance Pilot Program A Success
Single Payer Health Insurance Pilot Program A Success
This is the look of the future of health insurance. This is it. This is a single payer program.
The single payer is a financial term referring to a single funding source. When there is a single funding source, in the instance of the CHIRPA Medicaid programs for children and families, the ability exists to provide transparency, accountability and oversight through its counter program, and that is the single audit.
In the United States, the Single Audit, also known as the OMB A-133 audit, is a rigorous, organization-wide auditor examination of an entity that expends $500,000 or more of Federal assistance (commonly known as Federal funds, Federal grants, or Federal awards) received for its operations.[1][2][3] Usually performed annually,[4] the Single Audit’s objective is to provide assurance to the US federal government as to the management and use of such funds by recipients such as states, cities, universities, and non-profit organizations. The audit is typically performed by an independent certified public accountant (CPA) and encompasses both financial and compliance components. The Single Audits must be submitted to the Federal Audit Clearinghouse along with a data collection form, Form SF-SAC.
The Single Audit ensures there is efficiency in the delivery of services, there is continuous quality improvement of programs and services, and enforces mandatory compliance with the terms of funding source, reducing fraud, waste and abuse.
With the Electronic Health Records incentive programs, it is only with a click of the button that these single payer programs can be reviewed through auditing programs.
Even more so, there are other codified mechanisms to ensure accountability of single payer programs such as the Sarbanes-Oxley Act.
When there are such oversight mechanisms in place, there is always an improvement in program goals. The goals of any program is to provide care for the health of society. Through the investment in the best interests of the child, the national society profits when the program produces a future taxpaying citizen. The child becomes a health adult. A healthy adult becomes part of a healthy nation. A healthy nation lessens the drain on its economical resources.
The Medicare model of the single payer will eventually be adopted. When it does, there will already be a plan for implementation as its pilot program is dealing with children and families.
Two Year Anniversary of Children’s Health Insurance Law Sees Millions of Newly Insured Children, Families
Two years after President Obama signed the Children’s Health Insurance Program Reauthorization Act, HHS Secretary Kathleen Sebelius today announced that more than two million more children were served by Medicaid or the Children’s Health Insurance Program (CHIP) at some point over the past year.
Together, the two programs serve more than 42 million children who would otherwise not have access to regular medical care.
“The increase in the number of children served by these two vital programs is especially significant in the face of the recent economic downturn states are experiencing,” said Secretary Sebelius. “Even in times of hardship, states have demonstrated their commitment to the health of children by continuing efforts to identify and enroll them in coverage.”
To continue to advance coverage for children, Secretary Sebelius today also announced $40 million in new grants to states, community-based organizations, school systems and others to support their outreach and enrollment activities. The grants will help states further modernize and streamline their administrative systems, as well as create and implement school-based outreach strategies and approaches for identifying children who have historically been hard to reach.
Today’s grant announcement builds on $206 million in enrollment bonuses earned by 15 states last year that increased enrollment above specific target levels. The bonus funds help states cover the cost of enrolling additional children in Medicaid.
“As we mark the second anniversary of one of President Obama’s first actions as President, we can be confident that CHIPRA has proven to be a tremendous success,” said Sebelius. “Now we must build on our accomplishments. Today, I am again calling on leaders across the country – from federal, state and local officials to private sector leaders – to join our effort to insure more children. We all have a stake in America’s children and together, we will ensure millions more children get the care they need.”
States were able to increase enrollment in the two programs in part because of boosts in federal support provided by the American Recovery and Reinvestment Act (ARRA). ARRA temporarily increased federal matching funds for state Medicaid programs during the recession.
While Medicaid and CHIP have helped bring the rate of uninsured children to the lowest level in more than two decades, an estimated five million uninsured children are thought to be eligible for one of these programs, yet not covered.
The Secretary’s Challenge: Connecting Kids to Coverage, launched last year, will continue support efforts to reach more children by providing leaders with critical information and support as they work to insure more children in their communities and by closely monitoring progress.
“States’ continued progress toward enrolling all eligible children in coverage is a significant step in cushioning the recession’s impact on access to health insurance,” said Cindy Mann, director, Center for Medicaid, State and Survey and Certification Operations, within the Centers for Medicare & Medicaid Services (CMS). “As families lose employment or have their hours cut back they may lose the health coverage benefit that came with that job. If not for these two programs, millions more children would go without critical health care services.”
In its second annual report on CHIP and Medicaid enrollment, CMS notes that:
- More than 2 million children gained Medicaid or CHIP coverage during federal fiscal year 2010 (October 1, 2009 – September 30, 2010). In total, Medicaid and CHIP served more than 42 million children last year. This steady increase in enrollment is evidence of the important role that Medicaid and CHIP play for children, especially during economic downturns. The uninsured rate for children continues to decline at a time with the rate for adults is climbing. The increase in children’s enrollment demonstrates that Medicaid and CHIP are serving the purpose for which they were created – providing high quality health coverage for lower-income families.
- Thirteen states implemented eligibility expansions in 2010 and many others simplified their enrollment and renewal procedures. Forty-six states and the District of Columbia now cover children with incomes up to 200 percent of the federal poverty level (FPL) in Medicaid and CHIP; with 24 of those states and the District of Columbia covering children with incomes up to 250 percent of the FPL. Twenty-one states now offer coverage to lawfully residing immigrant children and/or pregnant women, enabling states to receive federal funding for this coverage.
- CHIPRA Performance Bonuses have encouraged states to adopt and augment simplification measures in Medicaid and CHIP. Fifteen states qualified for a total of $206 million in performance bonuses for FY 2010; this is a significant increase over 2009 where 10 states received bonuses totaling $75 million. These bonuses provide additional federal financial support each year to states that successfully boost enrollment above target levels among previously eligible but uninsured children in Medicaid. To qualify, a state not only has to enroll more children, but must also have implemented program features that are designed to promote enrollment of eligible children.
- States are increasing their use of technology to facilitate children’s enrollment and retention. Nearly two-thirds of states (32) have an on-line application that can be submitted electronically; 29 states allow electronic signatures on those applications. Six states have received approval to enroll children through the “Express Lane Eligibility” option created by CHIPRA. Express lane eligibility allows states to use data gathered for other programs such as housing assistance or food stamps to determine Medicaid or CHIP eligibility. And 33 states are utilizing the CHIPRA data matching process provided by the Social Security Administration to confirm U.S. citizenship for children.
- Outreach and enrollment grants have advanced coverage and led to public-private partnerships throughout the country to enroll more children. Sixty-eight grantees across 41 States and the District of Columbia are working diligently to facilitate children’s enrollment in health coverage
Tuesday, January 25, 2011
The American Health Care System
Congressman John Conyers, Jr. explains the National Health Care Act, HR 676, providing health care for all.
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