In an e-letter sent out to many New Yorkers today, Governor Patterson introduces a new health insurance product that he say help New York comply with federal healthcare reform.

” My Fellow New Yorkers,

I am writing to you today to let you know about a new temporary statewide insurance option for uninsured legal residents who have medical conditions. This new plan, called the NY Bridge Plan, is New York’s version of the Pre-Existing Condition Insurance Plan that was created under federal health care reform. The NY Bridge Plan is a valuable product of health care reform in that it provides health insurance coverage at a lower price than other options currently available in the individual market. Through the NY Bridge Plan, premiums will be $362/month for residents of upstate counties and $421/month for residents of downstate counties. A list of upstate and downstate counties is available in the NY Bridge Plan brochure.

Health insurance coverage is essential to having access to care. Through this program, more New Yorkers who need medical care will be able to receive it. The NY Bridge Plan covers a broad range of services, including primary and specialty care, inpatient and outpatient hospital care, and prescription drugs, as well as assistance from professional nurses and caseworkers to help members manage chronic conditions and maintain overall health. Coverage for a pre-existing condition begins right away, with no waiting period. Eligibility for this program is not based on income. To be eligible to apply, individuals must:

· Be a legal U.S. resident;
· Be a resident of New York State;
· Have a pre-existing medical condition;
· and not have had health care coverage for the last six months.

Applications are available now. Enrollment is on a first-come, first-served basis. If the NY Bridge Plan reaches capacity, a waiting list will be established. Coverage will be effective October 1, 2010, and will be available until January 2014, when more health insurance coverage options become available through a new Health Insurance Exchange.

More information on the NY Bridge Plan, including the application and brochure, is available through www.healthcarereform.ny.gov. I encourage you to apply for this program if you are eligible, and to also help us spread the word about this new health insurance option to your uninsured family and friends.

Best,

David A. Paterson
Governor of New York State

Julian Pecquet writes in the Healthwatch section of TheHill.com - “Insurance agents and brokers, afraid of being rendered irrelevant in the post-health reform world of simplified insurance shopping, are fighting for their very survival.

The agents want lawmakers’ and regulators’ support in getting the Obama administration to recognize their role in the federal insurance Web portal, which lets consumers compare coverage options online.

They’ve also been making their case to the National Association of Insurance Commissioners (NAIC), which is tasked with ironing out the details of many of the insurance market reforms required by the healthcare law.”

To read more click here.

According to Ben Smith of Politico.com - “Key White House allies are dramatically shifting their attempts to defend health care legislation, abandoning claims that it will reduce costs and deficit, and instead stressing a promise to “improve it.”

The messaging shift was circulated this afternoon on a conference call and PowerPoint presentation organized by FamiliesUSA — one of the central groups in the push for the initial legislation. The call was led by a staffer for the Herndon Alliance, which includes leading labor groups and other health care allies. It was based on polling from three top Democratic pollsters, John Anzalone, Celinda Lake, and Stan Greenberg.”

To read more click here.

The New York State Conference of Blue Cross and Blue Shield Plans (NYSCOP) has updated its analysis of health insurance taxes, entitled, “The Facts About Taxes on New York’s Privately Insured.”

According to the report, New Yorkers with private health coverage pay more than $4.1 billion in state health insurance taxes. With employers paying most of the private health insurance premiums, the state tax on private coverage is nothing more than a “hidden” business tax. Among all business taxes levied by the State, when totaled, the taxes imposed on the privately insured would rank as New York’s single highest business tax.

The report highlights the four state taxes which directly affect the cost of your premium.
They are:

• Premium taxes on those who receive health coverage from commercial insurers: $353 million.
• “Assessments” on all health plans to fund the State Insurance Department operations: $270 million.
• A 9.63 percent tax on “sales” hospital and other health care services: $2.33 billion.
• A tax on health plans for each covered life that they insure, known as the Covered Lives Assessment: $1.16 billion.

What does this mean for the average New Yorker? A typical family coverage premium for small businesses in the Albany region will pay $1,885 in taxes per year. A similar business in New York City will pay $3,600 per year in taxes. These payments are included in their annual premiums.

“Increasing state taxes on health insurance will increase premium rates which in turn will force individuals to drop coverage – increasing the number of uninsured,” said Deborah Fasser, spokeswoman for NYSCOP. “These taxes are a tremendous burden on the cost of coverage and are completely inconsistent with both our state and nations goal of trying to decrease the number of uninsured New Yorkers.”

To view the latest version on this report, please visit www.nysblues.org and go to the Fact Sheet section.

A recent WRGB-CBS 6 report points out the newly enacted prior approval law will not affect as many New Yorkers as one of the bills sponsors thought it would.

To see the video click here.

New York state employers responding to a Business Council survey have once again overwhelmingly identified employee health care as their top cost-of-doing-business concern. The new survey also showed strong employer concern about business taxes and economic development incentives.

To read more about how Business Council member firms ranked various public-policy issues within each of two areas: cost-of-doing business and economic development click here.

The Associated Press reports in the Boston Herold about a new health care reform measure passed in the Bay State, that has some wondering will this be the next thing in health care reform in other states. The bill like so many other before it, is supposed to lower costs and improve services for small businesses and their employees. Oh, and they create a new tax to do it.

“Massachusetts lawmakers say a new health care bill they approved will help small businesses combat rising health care costs and force insurers to spend more on medical care and less on administrative costs.

The legislation passed Saturday allows small businesses to form cooperatives to strengthen their purchasing power. It also requires insurers to promote low-cost health care providers in their networks.

Supporters estimate the bill would help small businesses save 10 percent on health care premium costs. They also say it sets the stage for further reforms in the next legislative session that starts in January.”

To read more click here.

A Poughkeepsie Journal editorial questions New York’s highest in the nation Medicaid spending.

The paper writes: “The state clearly has some explaining to do as federal authorities, at last, want to know why New York spends so much on Medicaid compared to the national average for some services.

The federal government is zeroing in on Medicaid payments to nine state institutions for the developmentally disabled, following a Poughkeepsie Journal investigation into the matter. That investigation revealed the facilities — including the Wassaic campus of the Taconic Developmental Disabilities Service Organization — had reimbursement rates of $4,556 per day for each of 1,400 residents.

That’s about four times the national average and tops in the nation, according to a University of Minnesota survey.

The state’s justification for this to date simply doesn’t pass the sniff test.”

Read the editorial.

Robert Pear of the New York Times writes - “The federal government issued new rules Tuesday that will reward doctors and hospitals for the “meaningful use” of electronic health records, a top goal of President Obama.

The rules significantly scale back proposed requirements that the health care industry had denounced as unrealistic.

The Department of Health and Human Services said doctors and hospitals could receive as much as $27 billion over the next 10 years to buy equipment to computerize patients’ medical records. A doctor can receive up to $44,000 under Medicare and $63,750 under Medicaid, while a hospital can receive millions of dollars, depending on its size.

Starting in 2015, hospitals and doctors will be subject to financial penalties under Medicare if they are not using electronic health records.’

To read more click here.

Gloria Park writes in Politico that many states are resisting federal attempts to set health insurance rates.

‘Some state insurance commissioners are pushing back against a renewed effort on the Hill to centralize the authority of health insurance premium rate reviews under the secretary of Health and Human Services.

The Health Insurance Rate Authority Act, introduced by Sen. Dianne Feinstein (D-Calif.) on March 4, would grant the HHS secretary the power to approve, deny or modify premium rate increases in states — 23 at the moment — where insurance commissioners do not already have that regulatory authority. Feinstein has crusaded for this cause since the omission of an amendment in the recently signed health care law.

“This legislation we have introduced simply creates a federal fallback,” Feinstein said in a June 21 speech on the Senate floor, emphasizing the limited jurisdiction of her bill. “In some states, insurance commissioners already have that authority, and that is fine. The bill doesn’t touch them.”

California, which would be affected by Feinstein’s proposal, opposes the measure, according to Darrel Ng, press secretary for the California Department of Insurance. “First of all, our insurance commission is Republican and opposes prior approval for health insurance rates at a philosophical level.”

On a practical level, he added, federal prior approval would not be a welcome idea. “The people who are in charge of making sure companies have enough money to pay their claims should be the same people that review premium rates.”

California has a bifurcated regulatory system in which the Insurance Department regulates preferred provider organization policies, while the Department of Managed Health Care oversees health maintenance organization policies. The Insurance Department has been in the limelight after Anthem Blue Cross increased its premium rate by 39 percent.

Industry lobby America’s Health Insurance Plans opposes centralizing rate review authority in the federal government as well, said spokesman Robert Zirkelbach.

“States have the infrastructure, experience and expertise to review premiums,” said Zirkelbach, citing Massachusetts as a replicable scenario if premium rates cannot keep up with “skyrocketing medical costs and the impact of younger and healthier people dropping their insurance during a weak economy” — the driving factors behind rate increases, according to Zirkelbach.

Read the article.