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An Uncertain Future For Medicare and Medicaid

From Politico:

The Obama administration could be faced with obligations to spend cash it  doesn’t have.

By J. LESTER FEDER| 7/21/11 10:47 PM EDT

A default scenario is so unthinkable that not too many people have thought about what happens to Medicare and Medicaid if a deal isn’t reached.

One longtime Washington health hand said he had not contemplated the overall picture of what happens after Aug. 2 without a deal because, “I think it’s unlikely, but it’s also kind of [too] horrible” to think about.

But people are getting nervous enough that it’s time to give the issue real thought, said Julius Hobson, former congressional affairs director for the American Medical Association.

“I think up until last week people were buying into that usual, conventional wisdom that they’d get that grand deal, and now they’re being disabused of that notion,” he said.

So what does happen? Does Medicare keep making payments? If Social Security checks continue to go out, will Medicare premiums be withheld? Will states get their Medicaid dollars? Continue reading

Repeal Benefits Blue Cross Blue Shield

From The Post and Courier:

By Renee Dudley–Sunday, July 3, 2011

In 2006, the South Carolina Legislature repealed a decades-old insurance code, stripping the state’s authority to regulate discounting in contracts between hospitals and insurers.

The deletion allowed the state’s biggest health insurance company, Blue Cross Blue Shield, to negotiate contracts that could cripple its competitors and raise costs for consumers. And Blue Cross was among the special-interest groups lobbying for the repeal, according to a legislator who requested it.

Although the state apparently had not enforced that section of the law, the repeal stripped regulators of authority to step in if it became necessary to regulate anticompetitive activities.

The code appears to have forbidden types of “most-favored-nation” contracts with hospitals and doctors, which some economists said have played a significant role in driving up health care costs in South Carolina. Continue reading

AMA Votes In Support of Individual Mandate

From The Hill:

By Sam Baker – 06/20/11  

The AMA’s House of Delegates voted 326-165 to support the law’s requirement that most people buy insurance. The coverage mandate is at the center of several lawsuits challenging the new law’s constitutionality.AMA President Cecil Wilson said the “overwhelming” vote shows that doctors still believe a mandate is necessary to achieving universal coverage.He emphasized that the AMA — the country’s largest trade association for doctors — backed the individual mandate before the debate over healthcare reform. Many members of the traditionally conservative group wanted to see that position reassessed at the AMA’s annual meeting this week in Chicago.
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Hicks: Health-Insurance Fat Cats Driving S.C. To Poor House

From The Post & Courier:

By Brian Hicks

bhicks@postandcourier.com

Wednesday, May 4, 2011

These days it really pays to have health insurance.

But it pays much better to sell it.

Renee Dudley’s story in Sunday’s editions of The Post and Courier said that Blue Cross Blue Shield of South Carolina saw its profits rise 46 percent from 2009 to 2010, a time when most people were, well, bleeding money. Right now, Blue Cross Blue Shield has $1.7 billion in capital, nine times what is required by state law to pay for a large-scale disaster.

It’s great that they are doing so well — most customers would want them to have a better cushion than the state minimum. Of course, that might explain why so many board members and executives at the company got six-figure raises last year.

But it also raises another question: With that kind of cash in the bank, why has the insurance company seen fit to increase its premiums an average of 17 percent in the last four years?

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S.C. Blue Cross Swimming In Cash, Screwing Over Our State

From The Post & Courier:

As premiums have risen, so has executives’ pay.

By Renee Dudley

Blue Cross Blue Shield of South Carolina, which has generated hundreds of millions of dollars in profits over the past five years, has boosted the pay of board members and top executives while sticking policyholders with ever-higher premiums, a Post and Courier review found.

The nine members of the company’s board of directors have more than doubled their reported salaries in the past year, financial filings show. In 2010, two executives earned more than $1 million in salary and bonus pay, and another earned more than $2.2 million, according to the filings.

As top earners’ salaries have surged, an April financial analysis showed the insurer is sitting on excess capital reserves, money that instead should have been returned to policyholders through rebates or lowered premiums, consumer watchdogs said.

The health insurer also has been accused of having a vise on the state’s insurance market, stifling competition and leaving its 1-million-plus South Carolina customers with few health care alternatives.

To make matters worse, soft state oversight of the insurance industry leaves South Carolinians exposed to continual rate increases, a recent report on insurance industry regulation nationwide showed.

The high cost of premiums has put health coverage beyond the reach of an estimated 1 million South Carolinians, said Sue Berkowitz, who heads the Appleseed Legal Justice Center, a Columbia advocacy group for disadvantaged residents.

“People are struggling to afford health care even as industry profits continue to grow,” Berkowitz said.

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