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Newsletter, What's Going On, December 28, 2010



“Dear Key HR 676 Supporters:

“Happy Holidays and Seasons Greetings!  Rep. John Conyers will be re-introducing HR 676 as soon as we get back in January 2011 for the 112th session of Congress.  The bill maintains the vast majority of the language from the HR 676 of the 111th Congress and adds language from the single-payer amendment drafted by Rep. Weiner in conjunction with many of the leading single-payer advocacy organizations.  We believe this language will strengthen the bill by explicitly quantifying the revenue stream, including a financial transactions tax, which will be used to pay for the Improved and Expanded Medicare For All program.

“Once we get the new draft of the HR 676 bill from the legislative counsels, we will forward the language to you so you can comment on the language before introduction during the first week of the 112th Congress.  We believe that the bill will again have the H.R. 676 number.  

“Below is the summary of the proposed major changes in the bill:

        Rename the bill "The Improved and Expanded Medicare For All Act."    

        H.R. 676 will repeal the new health care law's health insurance provisions (e.g., state exchanges, Medicaid expansion, guaranteed issue and protections for pre-existing conditions, affordability credits for low-income individuals) and replace them with a single-payer insurance system.

        The benefits package will remain the same, but we are expanding the dental benefits package to include oral surgery.

        An 6 percent payroll tax for employees and an 8 percent payroll tax on employers.  The prior bill did not have specific language on the tax, but our HR 676 summaries estimated a 4.75% tax on employers and employees.

        Self employed individuals will pay a modest progressive tax based on their annual income, not the 8 percent payroll tax.  This tax will be determined by the HHS Secretary during implementation.     

        Creates a specific annual budget each year for the Improved Medicare For All Program that increases each year.  This will make the cost of the program clear.  

        Revenue provisions included in the new health care law will be used as revenue raisers for H.R. 676.  

        Adds a new revenue raiser - the financial transactions tax from Rep. Defazio's H.R. 1068.   All revenue from the tax will go into the Program's trust fund.         ·        More specific language on the establishment of  global budgets  from the Weiner Single-Payer Amendment

For more information, please contact Michael Darner, Legislative Director, or Joel Segal, Senior Legislative Assistant at 202 225-5126, or email at Michael.darner@mail.house.gov, or Joel.Segal@mail.house.gov.

This is intended to go to anyone who cares about single-payer health care and the fight to enact H.R. 676.  Please share it with anyone we may have left off of this list*

Mike Darner

Legislative Director

Office of Congressman John Conyers, Jr. (MI-14)

2426 Rayburn House Office Building

Washington, DC 20515

(202) 225-5126 (office)

(202) 225-0072 (fax)

FROM DAVE BEAN, Health Care for All – Colorado.

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The Obama administration plans to announce Monday (yesterday) that it will make $206 million in bonus Medicaid payments to 15 states — with more than a fourth of the total going to Alabama — for signing up children who are eligible for public health insurance but had previously failed to enroll.  Kevin Sack, New York Times. States are required to adopt five of eight measures to simplify the enrollment process, and they are reimbursed according to the number of children enrolled and the costs of enrolling the children. As states grapple with budget deficits, the states receiving the bonuses went "above and beyond the call of duty," said Medicaid Director Cindy Mann.  Jason Millman.  Healthwatch, THE HILL’S Healthcare Blog.    My friend, Carol Hermann Steckel, was Alabama Medicaid Commissioner while the work went on that led to this remarkable reward.  The new governor made it known that he wanted the agency to go ‘in another direction’, so last month Carol left our state for a position in Louisiana Governor Jindal’s administration.  Alabama is the poorer for her departure.  

When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1. Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.  Robert Pear, New York Times.  

As you plan your year-end giving, please keep us in mind.

New health care rules will limit rate hikes, reports N.C. Aizenman: “The Obama administration announced proposed rules Tuesday aimed at curbing large, unwarranted rate hikes by health insurers by subjecting them to mandatory public scrutiny. Under the proposed regulation, which spells out the details of a key provision in the new federal health-care law, next year any insurer seeking a rate increase of 10 percent or more for an individual or small group plan would be required to file financial information justifying the raise with federal and state officials. (Beginning in 2012, the percentage rate increase that triggers the review will be adjusted for each state to reflect its particular market trends.) State authorities would then analyze the data submitted by the insurer to determine if the increase is ‘unreasonable.’”  Federal authorities won’t be allowed to judge whether rates are unreasonable, but will be authorized to intervene if state criteria for ‘reasonableness’ aren’t strict enough, and some Republicans find that federal authority to be a “usurping of states’ rights.”  Avery Johnson at the Wall Street Journal blog has more detail

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In her latest Kaiser Health News consumer column, Michelle Andrews writes: “When examining your health benefits for the new year, you’ll probably notice that your plan has eliminated lifetime and most annual dollar limits on coverage. That was required by the federal health-care overhaul. But for some consumers, coverage may still be restricted: Limits on the number of doctor visits or prescriptions or other services continue to be permitted and can stymie patients’ efforts to get necessary care” (Andrews, 12/21)   Read the column or watch a related video.

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Community Health Centers (CHCs) have the distinction of being one of the few components of the health care delivery system that have consistently impressed both Republicans and Democrats. For over 45 years, CHCs have delivered primary care to a patient population that may not otherwise be able to afford it. Their crucial role was elevated even more in the Patient Protection and Affordable Care Act, with much needed funding to provide the capacity to double the number of patients they serve from 20 million to 40 million by 2015.

However, each state also contributes to the CHC payment formula by providing operational funding and managing Medicaid reimbursement plans. Since 2007, state funding for CHCs has dropped by 42 percent. It now has fallen below 2006 funding levels, which could threaten the ability to serve the expected spike of new patients that health care reform will bring, according to the National Association of Community Health Centers (NACHC).  Dan Peterson.  Change.org Health.   Via Delicious/tag/healthcare 

 Please note the planning meeting.  Details below.

Allen Perkins: Training the Family Physician blog:  The New England Journal of Medicine serves up several articles on Health Care Reform:

………. Wendy K. Mariner, J.D., M.P.H., George J. Annas, J.D., M.P.H., and Leonard H. Glantz, J.D.  Can Congress Make You Buy Broccoli?  And Why That’s a Hard Question.

………. John K. Iglehart Assessing an ACO Prototype — Medicare’s Physician Group Practice Demonstration

………. Robert F. Leibenluft, J.D. ACOs and the Enforcement of Fraud, Abuse, and Antitrust Laws

………. Thomas L. Greaney, J.D. Accountable Care Organizations — The Fork in the Road

………. D.M. Shahian, R.E. Wolf, L.I. Iezzoni, L. Kirle, S.-L.T. Normand Variability in the Measurement of Hospital-wide Mortality Rates

Long-Term Care: Another Tough Subject For The Next Round Of Reform.  This is a big problem. Less than 4 percent of American adults, and only about 10 percent of seniors, possess LTC insurance coverage. ...such policies are costly. So most Americans do not purchase them. And there's a reason why these policies are expensive. The average nursing home stay is 2.5 years. The cost of such care would deplete the finances of most senior citizens, at minimum leading them to seek Medicaid assistance.  Kaiser Daily Health News.

Arizona again (or still). “Gov. Jan Brewer wants the new Republican leadership in Washington to repeal a ban in the federal health care law that keeps Arizona from cutting 250,000 people from its Medicaid program. In a letter to incoming House Speaker John Boehner… The problem, Brewer explained, is the new federal Affordable Care Act requires states to keep their programs at least as liberal as they were when President Obama signed the new health care law last year…” Pete VanVranken, Herndon’s Health Care Media Summary.

Major Health Insurers In California To Resume Offering Individual Policies For Children LA Times by Duke Helfand - a new California law forced the insurers to change course. Beginning Jan. 1, it will prohibit those that abandon child-only coverage from selling new policies in the broader individual insurance market for five years. Pete VanVranken, Herndon’s Health Care Media Summary. 

More small businesses are offering health benefits to workers   Los Angeles Times by Noam N. Levey.  The increase is partly attributed to a tax credit created by the nation's new healthcare law. Some insurers are aggressively marketing the break, which can offset up to 35% of a company's costs   Pete VanVranken, Herndon’s Health Care Media Summary.  The Health Access Blog hopes that this development may reverse the flow of misinformation about the impact of the ACA on small business…one prevalent rumor is that the Act adds costs to small businesses where it actually adds a tax credit. 

The HealthReform GPS Blog notes that the Congressional Budget Office has released a publication, “Selected CBO Publications Relating to Health Reform Legislation, 2009-2010.”  A .pdf file.

Sara Rosenbaum and Ross Marguiles of HealthReform GPS Blog report the publication of a new regulation under the affordable care act intended to force charitable hospitals to act more charitably. Robert C. Louthian III, McDermott Will & Emery LLP, also writing on HealthReform GPS, criticizes the part of the act on which the regulation is based as poorly written.

Number Of Uninsured Americans Soars To Over 50 Million Huffington Post by Amy Lee.  As the Great Recession has sown unemployment and downgraded work even for those people who have held on to their jobs, the number of Americans lacking healthcare has swelled beyond 50 million, according to a sobering new report from the Kaiser Foundation.   Among the report's most troubling findings: The number of Americans without any health care coverage grew by more than four million in 2009. That left almost one-fifth of non-elderly people uninsured. Among those between 19 and 29 years old, nearly one-third lacked coverage.  The study underscores the degree to which the recession has accelerated the loss of basic elements once viewed as inextricable pieces of a middle class life. The number of Americans lacking medical coverage now exceeds the population of Spain…. Pete VanVranken, Herndon’s Health Care Media Summary.

The corporate defrauding of taxpayers (eg. Medicaid and Medicare) and prescription drugs with skyrocketing prices was the subject of a report by Public Citizen's Dr. Sidney Wolfe and his associates (see citizen.org).  Dr. Wolfe's team compiled a total of 165 federal and state settlements since 1991 totaling $19.8 billion in penalties. A key finding is that the drug industry's penalties under the Federal False Claims Act exceed even those assessed against the overcharging defense industry for fraud.  Ralph Nader.  Common Dreams.  

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Tuesday, December 28.  7 PM.  Planning Committee meeting for planning meetings.  Wally Retan’s home, 3105 Warrington Road, Mountain Brook.  Anyone with ideas of what we might discuss, where we ought to meet for the coalition’s monthly meeting is welcome.  Very, very welcome.  Directions: On Hwy 280, at the south end of the Birmingham Waterworks, turn onto Overton Road at the flashing yellow light.  Drive 1.6 miles.  At the Locksley Fire Station, 25 yards short of a stoplight, turn left onto Locksley Road.  Drive 0.6 miles.  At Warrington Road, a cross road,  turn right.  3105 is the house on the right next to the house on the corner. 

Wednesday, December 29, 2010.  Lunch, (social gathering) Nothing but Noodles, Village on Whitesburg Shopping Center, 4800 Whitesburg Drive, Huntsville.  Wednesday before each monthly meeting.

Sunday, January 2 (?),  7PM CDT.  Healthcare-NOW monthly activist phone call. Please use this Dial-in Number 1-218-862-1300 and Conference Code 441086. To mute and unmute the line, please hit *4.

Monday, January 3, 2011 @ 5:30 PM.  North Alabama Healthcare for All Monthly Meeting —Huntsville/Madison County Public Library, 901 Monroe Street  (downtown).  The meeting is in Room AB, on the first floor. After you enter the library’s front door, turn right towards the auditorium.

Thursday, January 6, 2011, 7 PM.  Debate: “That the US Supreme Court will Declare the Individual Mandate Unconstitutional by midnight October 31, 2011.”  David Carpenter vs. (to be determined…where are Republican attorneys when we need them?)  Main meeting room, Emmett O’Neal Library, 50 Oak Street, Mountain Brook.  Brief business meeting precedes the debate, at 6:30 PM, same place. 

Thursday, January 20, 2011.  @5:30 PM.  Third Thursday happy hour (social gathering), at 801 Franklin (Huntsville).

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