Yesterday, the U.S. Health and Human Services Department released the following information on the first round of Texas employers that are taking part in the Early Retiree Reinsurance Program.

The Early Retiree Reinsurance Program provides $5 billion in financial assistance to employers and unions to help them maintain coverage for early retirees age 55 and older who are not yet eligible for Medicare. Businesses, other employers, and unions that are accepted into the program will receive reimbursement for medical claims for early retirees and their spouses, surviving spouses, and dependents. Savings can be used to reduce employer health care costs, provide premium relief to workers and families, or both. Applicants who are approved into the program receive reinsurance for the claims of high-cost retirees and their families (80 percent of the costs from $15,000 to $90,000). The program ends on January 1, 2014 when State health insurance Exchanges are up and running.

HHS has approved the following sponsors from Texas. More applications are being approved each day.

• Alcon Laboratories, Inc.
• Alon USA Energy, Inc.
• American Airlines Inc.
• Anadarko Petroleum Corporation
• AT&T Inc
• Atmos Energy Corporation
• Babcock and Wilcox Technical Services Pantex, LLC
• Basell North America, Inc.
• Bexar County Hospital District
• BHP Hawaii, Inc
• BJ Services Company, U.S.A.
• Boy Scouts of America
• Broken Hill Proprietary (USA) Inc.
• Cameron County
• CEMEX, Inc.
• CenterPoint Energy, Inc.
• City of Arlington
• City of Austin
• City of Beaumont
• City of Bryan
• City of Corpus Christi
• City of Dallas
• City of El Paso
• City of Fort Worth
• City of Garland
• City of Grand Prairie
• City of Grapevine
• City of Greenville
• City of Houston
• City of Laredo
• City of Lewisville Health Benefit Trust
• City of Midland
• City of North Richland Hills
• City of Plano
• City of Port Arthur
• City of San Angelo
• City of Tyler
• City of Waco
• Comerica Incorporated
• County of Galveston
• County of Jefferson
• Dresser Inc
• Dresser-Rand Company
• Ector County Hospital District
• El Paso Corporation
• Employees Retirement System of Texas
• Enbridge Employee Services, Inc.
• Energy Future Holdings Corp.
• First Victoria National Bank
• Fluor Corporation
• GuideStone Financial Resources of the Southern Baptist Convention
• H. E. Butt Grocery Company
• Harris County
• Hewlett-Packard Company
• Holly Corporation
• Houston Refining LP
• Huntsman International LLC
• Lyondell Chemical Company
• Midland County
• Millennium America Holdings Inc.
• National Oilwell Varco, L.P.
• NCH Corporation
• Port Terminal Railroad Association Employee Benefit Plan
• Public Utilities Board of the City of Brownsville,
• Rio Algom Mining LLC
• Rowan Companies, Inc.
• RRI Energy, Inc.
• Sabre Inc.
• San Antonio Water System
• Sasol North America Inc.
• Scott and White Memorial Hospital
• Shell Oil Company
• Sky Chefs, Inc.
• Solvay America, Inc.
• South Texas Project Nuclear Operating Company
• Southern Methodist University
• Southwest Airlines Co.
• SuperMedia Inc.
• Sysco Corporation
• Teacher Retirement System of Texas
• Temple-Inland Inc.
• Texas Instruments Incorporated
• The Coteau Properties Company
• The Falkirk Mining Company
• The North American Coal Corporation
• The Sabine Mining Company
• The Texas A&M University System
• TMC Group Health & Welfare Plan
• TML Intergovernmental Employee Benefits Pool
• Total Finance USA, Inc.
• University of Texas at Austin, Office of Accounting
• Valero Energy Corporation
• Zachry Group, LLC
• Zachry Holdings, Inc.

Implementation Road Show

• New Events!

Update on Health Reform Implementation

• Consumer Assistance Grants
• New Pre-Existing Condition Plan
• Update on Health Insurance Exchanges
• Consumer Appeal Rights
• Support for Health Reform Growing

Resources

• From the Kaiser Family Foundation
• State Legislator’s Checklist for Health Reform Implementation
• Small Employer Tax Credits
• Families USA’s “Virtual Patient”
• New Resources on Health Insurance Exchanges

IMPLEMENTATION ROAD SHOW

Texas Voice for Health Reform is hitting the road to educate Texans about health reform implementation.  As we confirm events we will update our online calendar with all the details.  Look for the events in blue!  If you don’t see an event in your area and would like to host one, please contact Dunkelberg@cppp.org!

Confirmed Events:

• August 11th: El Paso
• August 12th: El Paso
• August 24th: La Grange
• September 2nd: Corpus Christi

UPDATE ON HEALTH REFORM IMPLEMENTATION

Grants available to states for health insurance consumer assistance

Federal HHS announced $29 million in grants available to states to establish a health insurance consumer assistance or ombudsman program through: the insurance department, attorney general, independent consumer assistance agency, or a contract or partnership with one or more non-profit organizations. To qualify, states must explain how the program will demonstrate independence, assist people with all types of coverage, collect data about any problems and questions, and provide assistance in a culturally appropriate manner.  Each state is eligible for only one grant award based on population (Texas’ award should be around $2.3 million).  Applications are due from states on September 10, 2010.  For more information:

• 2-page summary of the grant announcement
• Full grant announcement (24 pages)

New Pre-existing Conditions Insurance Plan available

Texans who have been uninsured for at least 6 months and have a pre-existing condition can now enroll in the new Pre-existing Condition Insurance Plan established by the health reform law. Rates for the new plan are based on an enrollee’s age:

• Ages 0 to 34: $323
• Ages 35 to 44: $387
• Ages 45 to 54: $495
• Ages 55+: $688

Full information on the plan benefits, provider networks, and links to applications (starting on 8/1, people can also apply online) is at www.pciplan.com.

Texas also has an existing, state-administered high risk pool – the Texas Health Insurance Pool.  CPPP released a report  in July that explains both programs—how they are similar and different—to help people who can’t get regular coverage because of pre-existing conditions better understand their options.

Two New Announcements on Health Insurance Exchanges

Federal HHS announced $51 million in grants to states (up to $1 million for each state) to help states start the research and planning necessary to create a health insurance Exchange. The new health reform law creates Exchanges, which will allow individuals and small businesses to do “one-stop-shopping” to compare and purchase health insurance coverage.  States have the option to establish and operate their own Exchange or partner with other states to create a regional Exchange.  Should a state choose not to operate an Exchange, HHS will run one for that state. Exchanges must be operational by January 1, 2014. Applications are due on September 1.  Additional rounds of grants will be available to states in the future as states continue planning and start creating their Exchanges.

HHS also announced a request for comments from states, consumer advocates, employers, insurers, and other interested stakeholders, asking for input as HHS develops rules and standards for Exchanges.

Consumer appeal rights strengthened

Federal HHS has proposed rules to implement stronger consumer appeal rights passed in health reform.  Details on appeal rights are available in this fact sheet.  The new rules guarantee that health plan enrollees can appeal rescission of coverage and claims denials directly to insurers and then to an independent, external review board, if necessary.  The rules set standards for appeals processes that will help deliver a full and fair review for consumers.

Tracking polls show support for health reform growing

The Kaiser Family Foundations monthly tracking poll for July showed the highest approval level for health reform since it was passed into law in March.  Fifty percent of the public reported a favorable view of the law, with 35 percent opposed (down from 41 percent the previous month).  Fourteen percent reported no opinion.

RESOURCES

Kaiser Family Foundation, Expanding Medicaid to Low-Income Childless Adults Under Health Reform: Key Lessons From State Experiences

This report examines lessons learned from past state experience with expanding coverage to childless adults.  Many best practices for enrolling parents and children in Medicaid will apply to childless adults, but successful efforts will also require new strategies and messages given their historic ineligibility for Medicaid, limited connection to public programs, fluctuating incomes and language and cultural barriers. Given the significance and size of the expansion, it will be imperative for states to be ready and prepared with the necessary systems, technology, and administrative capacity in place to process enrollments and coordinate coverage and care with the new Health Insurance Exchanges.

National Conference of State Legislatures, State Legislators’ Check List for Health Reform Implementation FY 2010

Families USA, A Helping Hand for Small Businesses, Small Employer Tax Credits
The report finds that 81% of Texas small businesses (those with 25 of fewer employees), or over 248,000 Texas businesses will qualify for new small business tax credits this year to help them purchase health insurance.

Families USA, Learn more about what improved access to preventive services will mean for you.  Thanks to the new health care law, Americans will get timely preventive services that will allow them to stay healthy both now and in the future.  Families USA’s new ‘virtual patient’ will help you learn what this means for you.

And several new resources about Exchanges….

Robert Wood Johnson Foundation, “Health Benefit Exchanges:  An Implementation Timeline for State Policymakers”
The timeline sets out the tasks that are needed to get an exchange up and running so that coverage begins in January 2014.

The Commonwealth Fund, Health Insurance Exchanges and the Affordable Care Act: Key Policy Issues
This report identifies issues that came up in earlier attempts to create Exchanges, key policies to overcome those problems, and ACA’s provisions related to Exchanges.

Consumer advocates provide testimony on health insurance Exchanges
The National Association of Insurance Commissioner held an interim meeting in Washington, DC July 22-23 to hear from stakeholders on health insurance Exchanges.  Consumer advocates provided testimony on important Exchange functions and consumer protections as well as enrollment procedures and coordination with Medicaid and CHIP

Contact:
Brian Stephens 512-320-0222, ext. 112
Stacey Pogue 512-320-0222, ext. 117

Starting Today Texans With Pre-existing Conditions Have New Access to Quality, More Affordable Health Coverage

Applications available on new consumer web site featuring full range of insurance options for Texans

(AUSTIN, Texas)— An important reform of the 2010 Patient Protection and Affordable Care Act launched today when Texans who have been without health coverage for at least six months and who have been denied coverage because of pre-existing health now have access to more affordable, quality coverage. They will receive it through a new Pre-existing Condition Insurance Plan created by the U.S. Department of Health and Human Services (HHS).

To find the new coverage available in Texas and information about the complete range of health coverage options available for consumers by ZIP code through a Web site set up by HHS, see www.healthcare.gov . Beginning today applications to the Pre-existing Condition Insurance Plan are available at www.healthcare.gov for coverage beginning as early as August 1.

The new Web site is the first to provide consumers and small businesses with information about private insurance, Medicaid, the Children’s Health Insurance Program, Medicare, and other coverage options in one place.  Federal officials are emphasizing that the Pre-existing Condition Insurance Plan is not the long-term solution to the insurance industry’s practice of denying coverage based on pre-existing conditions; instead, it will serve as a bridge to 2014, when the reform law bans denials of coverage based on pre-existing conditions.

The Pre-existing Condition Insurance Plan is a separate program from Texas’ existing “high-risk” pool—the Texas Health Insurance Pool. In the existing Texas Health Insurance Pool, premiums are set by state law at twice the standard individual market rates.  But in the new Pre-existing Condition Insurance Plan, premiums will be similar to standard (average) individual market premiums charged to healthy people in Texas.

Stacey Pogue, senior policy analyst with the Center for Public Policy Priorities, says this new program offers concrete help right now to uninsured Texans who’ve been denied coverage because they have a pre-existing condition.

“This vital coverage provides a bridge to 2014 when insurance companies will no longer be able to deny coverage to people with health conditions,” says Pogue.

Pogue is available for comment.

─ CPPP ─

Implementation Road Show

Update on Health Reform Implementation

• Applications for the Pre-existing Condition Insurance Program (PCIP) start today!
• Federal Government Launches www.healthcare.gov
• Early Retiree Reinsurance Program
• Patient’s Bill of Rights
• Prevention and Public Health Fund

Resources

• Analysis of the PPACA by the National Health Law Program
• New Health Reform Implementation Guides

IMPLEMENTATION ROAD SHOW

Texas Voice for Health Reform is hitting the road to educate Texans about health reform implementation.  As we confirm events we will update our online calendar with all the details.  Look for the events in blue!  If you don’t see an event in your area and would like to host one, please contact Dunkelberg@cppp.org!

Confirmed events:

• July 8th: Fort Worth
• July 12th: Houston
• August 2nd: Universal City (north San Antonio)

UPDATE ON HEALTH REFORM IMPLEMENTATION

Starting on Thursday, July 1, applications for the Pre-existing Condition Insurance Program (PCIP), the new federally-mandated state high risk pools, will be available online at www.pcip.gov. The new high risk pool will operate separately from Texas’ current high risk pool and will be available to Texans who have been denied coverage because of a pre-existing condition and who have been uninsured for at least six months.  Those who enroll in July could receive coverage as early as August.  Premiums for the new program will not be available until July 15, but the estimated premium for a 50-year old will be between $491 and $600 per month.

A new consumer-focused website with health coverage options, www.healthcare.gov, also launches on July 1. It will help consumers locate both private and public coverage options that may be available to them based on where they live.  The site guides consumers through a few simple questions (Are you disabled, a young adult, a senior? Are you pregnant? Are you losing job-based coverage?) to produce a list of possible coverage options based on the consumer’s situation. The site also has clear information on the new health reform law.

Included in the PPACA is the Early Retiree Reinsurance Program that could provide federal funds to state and local governments to assist with the costs of health coverage to early retirees. The provision establishes a reinsurance program, which will be in effect from June 1, 2010 until 2014 when the major coverage provisions in health reform take effect. The program provides reimbursement to employers including state and local governments of up to 80 percent of claims for health benefits between $15,000 and $90,000 incurred by retirees who are 55 and older and who are not eligible for Medicare. Claims on behalf of spouses, surviving spouses and dependents are also covered. Reimbursements received under the reinsurance program must be used to lower the costs of the health plan either by reducing the employer’s costs or to reduce premium contributions, deductibles, co—payments or other charges for plan participants.  Employers must submit applications to participate in the program, and $5 billion has been appropriated for the program. See this fact sheet to learn more.  The U.S. Department of Health and Human Services started accepting applications for the program as of June 29, 2010.

Three federal agencies released a package of rules last week that they have identified as the Patient’s Bill of Rights.  Included in this rule package are provisions that prohibit health plans from applying pre-existing conditions exclusions to children in plan years that begin after September 23, 2010.  Visit this Fact Sheet to learn how the new rules will affect you.

In June, the U.S. Department of Health and Human Services announced the investment of $500 million this year made available through the new Prevention and Public Health Fund in health reform to prevent disease, detect it early, better manage conditions, and improve health.
Half of the funding has been allocated to increase the number of primary care providers by creating additional primary care residency slots; training new physician assistants and nurse practitioners; establishing new nurse-practitioner led clinics; and helping states plan for and implement strategies to meet primary care workforces needs.

The other half of the funding has been allocated to support prevention activities and develop public health infrastructure, including the integration of primary care services into publicly funded community-based behavioral health settings; obesity prevention and fitness; tobacco cessation; data collection; and public health workforces training.

RESOURCES

Analysis of the PPACA and Reconciliation health care reform laws by the National Health Law Program (3 parts)

• Part 1 includes an analysis of the private insurance reforms and state-based exchanges
• Part 2 includes an analysis of changes to the Medicaid program; and
• Part 3 analyzes selected provisions from other titles of the PPACA and Reconciliation law.

New Implementation Guides!

Implementing Health Reform: Key Questions for States, by the Georgetown Center for Children and Families

Delivering on the Promise, by TexPIRG “shows how state policy makers can implement and improve on the law to ensure it offers the best deal to consumers.”

Navigating Health Care Reform-An Employers Guide, by United Healthcare “… are designed to assist [employers] by highlighting some of the changes made by the legislation, and setting out general timelines.”

• Small Group Guide
• Large Group Guide

Implementation Road Show

• New dates and events!

Update on Health Reform Implementation

• First Medicare Prescription Drug “Donut Hole” Cost Reductions Start
• New KFF Report Provides State-Level Data on Coverage Gains and Costs of the Medicaid Expansion in Health Reform
• New Texas Comptroller’s Report on Health Reform Economic Implications
• Rate Review Grants Announced

Resources

• No, you will not be taxed for your employer’s contribution to your health plan (TVHR Blog)
• Help for Americans with Pre-Existing Conditions (Families U.S.A.)
• Impact of programs like The Daily Show and the Colbert Report on health reform debate (Drew Altman’s Pulling It Together)
• Health Reform Implementation Resources from the Democratic Policy Committee

IMPLEMENTATION ROAD SHOW

Texas Voice for Health Reform is hitting the road to educate Texans about health reform implementation.  As we confirm events we will update our online calendar with all the details.  Look for the events in blue!  If you don’t see an event in your area and would like to host one, please contact Dunkelberg@cppp.org!

Confirmed events:

• June 8th: Nacogdoches
• June 9th: Tyler
• June 10th: Longview
• June 14th: Dallas
• June 28th: San Antonio
• June 30th: Austin, hosted by One Voice of Central Texas, 8:30am to 11:30am at Goodwill Industries, 1015 Norwood Park Boulevard, Austin, Texas 78753 (General presentation 8:45-10:15am; more detailed conversation on the impact on nonprofits and their clients 10:30-11:30am).
• July 8th: Fort Worth, First United Methodist Church, 7-9pm; additional details TBA.
• July 12th: Houston
• August 2nd: New Braunfels/Universal City

UPDATE ON HEALTH REFORM IMPLEMENTATION

First Medicare Prescription Drug “Donut Hole” Cost Reductions Start

Starting next week, Medicare enrollees with high drug costs will get some relief as health reform starts to close the Medicare prescription drug “doughnut hole.”  This year, seniors who hit the doughnut hole will receive a $250 check.  Next year, they will get a 50% discount on brand names drugs in the doughnut hole. Further reductions are phased in each year until the doughnut hole is fully closed in 2020.

The first round of checks will be mailed on June 10.  Checks will be mailed monthly after that.  About 4 million Medicare enrollees are expected to get the $250 rebate this year.  Seniors do not have to apply to get this benefit.  Eligibility is determined automatically by Medicare.  The federal government has warned of scams in which seniors get “applications” for the benefit that ask for personal information.

The doughnut hole was created when Congress created the Medicare prescription drug benefit (Medicare Part D) in 2003.  Under the typical Part D plan in 2010, enrollees must pay premiums averaging about $39 a month and a $310 deductible.  After meeting the deductible, enrollees pay 25% of drug costs and Medicare picks up the remainder until total drug costs reach $2,830.  At that point, enrollees enter the doughnut hole where they must pay 100% of drug costs until they’ve spent another $3,610 out of pocket.  Catastrophic coverage kicks in for enrollees who reach this point (total enrollee out-of-pocket costs of $4,550), in which enrollees must pay 5% of drug costs and Medicare picks up the remainder for the rest of the year.

New KFF Report Provides State-Level Data on Coverage Gains and Costs of the Medicaid Expansion in Health Reform

The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) released a state-by-state analysis on the level impact of the expansion of Medicaid under the new health reform law.  The analysis, performed by John Holahan and Irene Headen of the Urban Institute for KFF, is among the first to estimate for all 50 states and the District of Columbia the distribution of new Medicaid enrollees and costs, as well as the impact on the uninsured.

CPPP has received questions regarding the reason for the large difference between the Kaiser/Urban projections and numbers released by the Texas HHSC.  Here are several of the top reasons the numbers differ—and why they really can’t be compared:

• KFF/UI looks only at costs of the mandated Medicaid expansion in 2014 to 133% of the FPL; whereas HHSC looks at all potential costs to HHSC budget, including provider reimbursement effects and higher take-up rates by kids, whose eligibility is NOT affected by the new reform law.
• KFF/UI’s report models both the Congressional Budget Office-like assumption of about 57% take-up rate by uninsured, plus the researchers’ higher 75% take-up assumption; whereas HHSC assumes 91-94% take-up rates by all Medicaid populations.
• KFF/UI’s report models costs for the CBO’s official bill scoring period of ten years from enactment (2010-2019); whereas HHSC models 2014 (when the Medicaid expansion begins) to 2023 Medicaid costs.
• Essentially, HHSC uses many (though not every possible) highest-cost assumption throughout its projection, so it yields a sort of “worst-COST” estimate.

New Texas Comptroller’s Report on Health Reform Economic Implications

The state Comptroller’s office released a report late Friday June 4 with the CPA’s preliminary estimates of health reform effects on the state’s budget, citizens, businesses, and economy.  The CPA notes that “many factors are still unknown as the supporting rules have not been written by the federal government,” and identified 78 major provisions, of which there were 50 for which the fiscal impact could not be determined at this time.  This new report breaks down cost by year for 2010-2019.  Some notable estimates include (bold/italics indicate gains for Texas):

Penalties on individuals for no insurance: ($2.2B)

• Penalties on employers ($9.3B)
• Subsidies (premiums and cost sharing help) in exchange: $43.5B
• Small biz tax credits $1.9B
• New Medicare tax on high income earners ($15.8B)
• Medicaid new GR costs: ($5.8B)
• Medicaid federal funds to TX: $76.3B
• Reduction in Medicare Rate Increases: ($13.2B)
• Medicare Advantage payment reductions: ($6.5B)

We look forward to reviewing the CPA’s report in greater detail and will share any special kudos or concerns soon.

Rate Review Grants Announced

The new health reform law establishes a process for the federal and state government to annually review health insurance premiums to help protect consumers from unreasonable increases. The federal government is still developing regulations that will define the threshold for an unreasonable increase, but is releasing the first round of grants now to help states begin or enhance their rate review process this year.

Under health reform, insurers must report all unreasonable rate increases to federal and state regulators and must submit justifications for unreasonable rate increases before they take effect.

All states are eligible to apply for the grants.  Each successful state will be awarded $1 million to enhance their rate review process this year.  A second round of grants will be available at the end of 2001, after federal regulations on rate review have been released.

RESOURCES

No, you will not be taxed for your employer’s contribution to your health plan, Stacey Pogue, TVHR Blog

In their new report, Health Reform: Help for Americans with Pre-Existing Conditions , Families USA examines the number of Americans diagnosed with pre-existing conditions, who—absent reform—would be at risk of being denied coverage in the individual insurance market.

What is the impact of television programs like Jon Stewart’s The Daily Show and Stephen Colbert’s The Colbert Report on the health reform debate.  The Kaiser Family Foundation’s President and CEO Drew Altman explores this question in his latest Pulling it Together column REPOR(t)

The Democratic Policy Committee has released a special report entitled Health Reform Implementation Resources intended to provide a centralized, organized listing of resources regarding health insurance reform implementation, and will be updated as necessary.

(click on the city for more details)

• June 8th: Nacogdoches
• June 9th: Tyler
• June 10th: Longview
• June 14th: Dallas

Check out the calendar for all of our events.  Don’t see your city listed?  Contact Anne Dunkelberg, dunkelberg@cppp.org, if you’d like to organize a health care implementation forum in your community.

• The health reform law requires employers to include employer-paid health insurance to workers’ W-2 forms for information only.  The purpose of this change is to help people get a better understanding of the full cost of their health insurance benefits.  Typically, employees pay part of the cost of insurance.  On average in Texas, employers cover 68% of premiums for family coverage and employees pick up the other 32%.
• The value of the employer’s health insurance contribution printed on the W-2 will not be counted as taxable income for workers.  Health reform does not make you pay income tax on your employer’s contribution toward your health insurance.

Want the complete story?  FactCheck.org exposes the truth about this myth.

CPPP's Anne Dunkelberg and Stacey Pogue explain the provisions in the new health care law

CPPP’s Texas Voice for Health Reform team is traveling across the state to help Texans learn about the new health reform law. We know from polling that many Americans still know little about the law, and that support for the new law is high when people learn about what reform will do.

Beyond that, we can help Texans prepare to make the most of health reform, inform them about the role our state government will play in shaping access to insurance, and let them know how to get involved in making sure Texas does the best possible job of implementing health reform.

Last week we kicked off the tour with a presentation in Fort Worth, co-hosted by Tarrant County Public Health, United Way of Tarrant County, Area Agency on Aging of Tarrant County, and the Aging and Disability Resource Center of Tarrant County.  View our Power Point presentation to see the information that our team presented.

Check our calendar to see when we’re coming to your community.  Don’t see an event in your area?  Contact dunkelberg@cppp.org to organize one!  Check out photos from the Fort Worth event, courtesy of Al Roy of Tarrant County Public Health

Action

• Be the Face of Health Reform
• Texas Voice for Health Reform is hitting the road

Update on Health Reform Implementation

• Young adults can now stay on parents’ plan until age 26
• Consumer principles and recommendations on health reform implementation
• CPPP Comments on two new accountability measures in health care law

Resources

• StateHealthFacts.org goes mobile
• Center on Budget and Policy Priorities’ new series on health reform

ACTION

Be a Face of Health Reform

This September, many key provisions from the historic health reform law will take effect. That means people who have insurance cannot be dropped because they got sick and young adults can stay on their parent’s insurance until they turn 26.

But between now and late September, millions of people will remain vulnerable. Fortunately, a handful of insurance companies have decided to do the right thing, voluntarily implementing key provisions of the bill before the mandatory deadline.

To say thanks, we’re collecting photos for a mosaic of people helped by health reform. Our mosaic will show these companies who they’re helping and encourage other companies to follow their lead. Add your photo and help us show the insurance industry the Faces of Health Reform.

Implementation Road Show

Texas Voice for Health Reform is hitting the road to educate Texans about health reform implementation.  As we confirm events we will update our online calendar with all the details.  Look for the events in blue!  If you don’t see an event in your area and would like to host one, please contact Dunkelberg@cppp.org!

Confirmed events:

• May 22nd: Fort Worth
• May 27th: Austin
• June 12th: Houston
• June 14th: Dallas
• June 28th: San Antonio
• June 30th: Austin

UPDATE ON HEALTH REFORM IMPLEMENTATION

As of  September 23, 2010, the health reform law allows young adults to stay on their parent’s health insurance until their 26th birthday. The U.S. Department of Health and Human Services released this fact sheet which explains how the new coverage opportunity works.  It also lists the insurance companies that have agreed voluntarily to extend coverage to young adults before the September 23rd deadline.

A group of consumer advocates currently serving as consumer representatives to the National Association of Insurance Commissioners released a report with consumer principles and recommendations related to the initial phase of implementation of the health reform law. Issues covered in the report include rate review, grandfathered plans, the prohibition on denials of children for pre-existing conditions, and more.

The federal health reform law establishes new accountability measures for unreasonable health insurance premium increases and “medical loss ratios”—a measure of how insurers spend premium dollars. CPPP recently submitted public comments to a request for information from federal agencies developing health reform regulations on these topics. The center has done research on rate review and medical loss ratios in Texas, and submitted comments to the federal agencies encouraging strong standards that benefit consumers.

RESOURCES
Statehealthfacts.org Goes Mobile

Statehealthfacts.org is now optimized for use on your mobile device. Now, when you are on the road or in a meeting and need to know how many Texas residents are uninsured, or how many children are covered through Medicaid, just go to www.statehealthfacts.org on your mobile device and easily find the answer. Data for more than 700 indicators are accessible on the mobile site.

Moving Forward with Health Reform

Our national partner, the Center on Budget and Policy Priorities, has released an excellent series of two-page briefs, Moving Forward With Health Reform, that set the record straight on some of the key points about the new law.

Pieces in the series explain:

• why health reform is a good deal for the states
• why an individual mandate is necessary for the law’s key insurance market reforms to work
• the law’s voluntary new long-term health care insurance program, and
• how health reform will affect employers.

They are all available on the CBPP health reform page

Action

• Conference Call with Texas Attorney General Gregg Abbott
• Sign-On Letter for Young Adult Coverage

Update on Health Reform Implementation

• New High-Risk Pools
• Texas House hearing on health reform
• Insurers Agree to Stop Dropping Sick People from Coverage Early
• Request for Comments Related to Rate Review and Medical Loss Ratios
• Sunset Commission Review of the Department of Insurance
• Health Reform Implementation Road Show
• Grassroots Groups Poised to Ensure Effective, Efficient Implementation of New Health Care Reform Law in Texas

Resources

• Health Reform GPS
• 3 Steps to the Small Business Health Insurance Tax Credit
• New Implementation Resources from Families U.S.A.
• New Resources from the Center on Budget and Policy Priorities

ACTION

Conference Call with Texas Attorney General Gregg Abbott

Texas Attorney General Greg Abbott is working to defeat “Obamacare” by preparing to file a lawsuit against the federal government to challenge the constitutionality of the new law.  We believe that Abbott’s interpretation of the new law is mistaken and have made our own point in the following opinion pieces:

• Scott McCown: Health Care Challenge
• AG Should Drop Lawsuit

On Thursday, May 6, Empower Texans is inviting all Texans to participate in a conference call with Gregg Abbott “to learn more about the lawsuit and what it means for Texans, and then put your questions and comments directly to Mr. Abbott.”

We encourage you to register for this call and share your comments with Mr. Abbott.  It important that he and other Texans know how important “Obamacare” is to you.

Sign-On Letter for Young Adult Coverage

A critical provision in the health care bill allows young adults to stay on their parent’s plan until their 26th birthday. This law starts on September 23, but several insurance companies have decided to start the rule early. So, young adults who are graduating from college this May and are on their parents’ plan, may be able to keep their coverage up to their 26th birthday. With about 3.2 million students graduating from college this May, and 67% of those on their parents’ plan, this is a very big deal. Young Invincibles, a national youth advocacy group focused on health reform, put together a letter asking all the major insurance carriers to take similar steps and go even farther.  Read the letter

UPDATE ON HEALTH REFORM IMPLEMENTATION

Now that health reform has passed in Congress, state governments will be working with the federal government to implement new reforms.  To reflect the new “post-reform” environment, we will be using this space to provide information on various aspects of the implementation process, including updates from the Hill, from the Texas Capitol, and from federal and state agencies.

New high-risk pools

Last Friday Governor Rick Perry informed the U.S. Department of Health and Human Services that Texas will not create its own temporary high-risk pool, which means that the federal government will now contract with private insurers to create one for us.  Although Texas already has its own high-risk pool, premiums in the Texas high-risk pool can be as much as twice the standard market price, making it very expensive for Texans with serious medical conditions to get coverage.  The new temporary high-risk pools, which are required in every state under the new health reform law, will be subsidized over four years to make coverage in the pool more affordable for those who cannot gain coverage under other plans because of their medical conditions.

More information:

• Governor Perry says Texas won’t run high-risk health insurance pool
• Texas won’t run required insurance pool, governor decide

Texas House hearing on health reform

You can see Texas HHSC, Legislative Budget Board, and TDI presentations from their 4/22/2010 hearing on health reform implementation at http://www.hhsc.state.tx.us/news/presentations/2010/HouseSelectFedHlthReform.pdf and http://www.tdi.state.tx.us/reports/documents/fedhlthreform4222010.ppt ; http://www.lbb.state.tx.us/Federal_Funds/Other_Publications/Federal_Healthcare%20Reform_Presentation_0410.pdf . While the HHSC materials provided were only slightly more detailed than those presented at the March Senate hearing, the agency did provide members with some additional details about their projections. CPPP will prepare a brief update on the HHSC assumptions soon.

Insurers Agree to Stop Dropping Sick People From Coverage Early

Starting in September, the health reform law prohibits insurers from retroactively canceling enrollees’ coverage if they get sick (a practice known as rescission).  This week, insurers agreed to stop rescissions early, staring in May, due in part to recent revelations that some insurance companies specifically targeted women newly diagnosed with breast cancer and HIV-positive individuals for recession.

Requests for Comments Related to Rate Review and Medical Loss Ratios

Federal agencies implementing health reform have requested public comments to help them develop regulations that clarify the new health reform law. This is one of the first opportunities to ensure that regulations are both effective and consumer-friendly.

The first request is for comments on medical loss ratio requirements, that is, how insurers spend premium dollars. The second request is for comments on premium review.

Families USA has released helpful reports that explain both medical loss ratios and rate review.

Sunset Commission Review of the Department of Insurance

The Texas Department of Insurance and Office of Public Insurance Counsel—two of the key agencies that will implement health reform in Texas—are under Sunset review.  Generally this process entails a broad public and legislative review of the need for the agency as well as the effectiveness of its structure and functions. However, this review of TDI and OPIC is limited in scope.  They had a full review last session, but are back again because the bills to re-authorize the agencies for 12 years got hung up at the end of session and did not pass. The scope of the limited “re-review” may not include big questions about how TDI and OPIC are equipped to implement health reform. The Sunset Advisory  Commission’s public hearing on TDI and OPIC is May 25-26, and the staff report was released last week.

Health Reform Implementation Road Show

Planning for our Implementation Road Show is well under way and we’ll be hitting the road in just a few weeks.  We still have room in our schedule to hit more communities, so if you’re interested in hosting a Road Show event in your area please contact dunkelberg@cppp.org.  Currently we have scheduled events in the following locations:

• May 21, Fort Worth
• June 10,  Longview
• June 14,  Dallas
• July 8, Fort Worth

Grassroots Groups Poised to Ensure Effective, Efficient Implementation of New Health Care Reform Law in Texas

Last week Texas Voice for Health Reform participated in a panel discussion and press conference on the success of grassroots organizing in the fight for the passage of national health reform, and the need to harness the organizing momentum to ensure effective and efficient implementation.  State Representative Garnet Coleman, one of the most visible state-level officials working at the national level on behalf of Texans, joined us in the celebration and also committed his efforts to implementation and supporting grassroots organizing in Texas.

RESOURCES

Health Reform GPS The purpose of this web site is to track health reform from enactment through implementation, through notes, expert and public commentary and key documents.  This site will grow and expand as the legislation and its implementation unfolds.

3 Steps to the Small Business Health Insurance Tax Credit If you are a small employer (business or tax-exempt) that provides health insurance coverage to your employees, this simple step-by-step worksheet from the IRS can help you determine whether you qualify for the Small Business Health Insurance Tax Credit.

New Implementation Resources from Families USA

• What Will the Health Reform Law Do in the First Year?
• The First 90 Days: A State Advocate’s To-Do List
• Early Medicaid Expansions Under Health Reform
• Efforts to Halt Health Reform: Playing Politics with our Health

New Resources from the Center on Budget and Policy Priorities

• Health reform is a good deal for states
• Employer responsibility in health reform