Here are the policy updates featured in our December Newsletter.
Medical Loss Ration Provision Fends Off Insurance Industry Lobby
On December 2, HHS released the final rule on the Affordable Care Act's Medical Loss Ratio provision – the provision that requires Insurance companies to spend 80-85% of collected premiums on patient care. If insurers fail to do that, they will be required to provide rebates to their subscribers. The effectiveness of the provision was recently challenged by insurance industry lobbyists who claimed that the commissions earned in the selling of policies should count as part of the 80-85% going to medical care. The recent HHS ruling knocked that effort down, clearly specifying what can or cannot qualify as legitimate medical expenditure in the medical loss ratio.
Doctors for America members have consistently advocated against huge insurance company profits and overhead that are taking resources away from patients and patient care. In this month’s ruling HHS upheld the spirit of the medical loss ratio requirement, sending a clear message that patients’ interests would supercede special interests on this issue.
The Affordable Care Act provides $200 million dollars to fund innovative school-based health centers across the country. HHS Director Kathleen Sebelius announced on December 8, 2011 that more than $14 million was awarded to 45 of these innovative centers to expand their services. These centers already serve over 100,000 children in health maitenace, screening and disease prevention, and it is estimated that the additional funding will add another 56,000 children to the rolls and create additional jobs in the process.
Super Committee and Health Care
The 12-member Congressional Super Committee announced last month that they were unable to reach a bipartisan deal to reduce the federal deficit by $1.2 trillion. That means no new cuts to Medicare, Medicaid, or the funds needed to keep the Affordable Care Act on track . . . for now. The political fight is far from over. A 2% Medicare provider cut in 2013 is still on the slate -- to be parceled out to insurance companies, pharmaceuticals, device companies, hospitals, and physicians.
Doctors for America members have remained clear in our response to deficit reduction plans with our insistent message to Congress: "Innovate, Don't Amputate." The election season will continue to put pressure on health care, spotlighting misguided proposals to cut federal spending by reducing benefits and shifting costs to our patients. Doctors know that the best way to control costs is by improving the quality and effectiveness of care. There has never been a more urgent time to make our voices heard.