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New Analysis of Health Reform Bills Highlights Similarities, Differences, Costs
Gastroenterology and Hepatology News Richard Peek and K. Rajender Reddy, Section Editors
New Analysis of Health Reform Bills Highlights Similarities, Differences, Costs
A
new Commonwealth Fund report released on October 23rd, 2009, analyzes the similarities, differences, potential impacts, and costs of current bills passed by the 5 committees of jurisdiction in the United States Congress: Finance Committee and Health, Education, Labor, and Pensions Committees in the Senate and the US House of Representatives’ Ways and Means, Education and Labor, and Energy and Commerce committees. The report, “Provisions of Comprehensive Health Reform Bills of 2009: Health Insurance, Delivery System, and Financing,” notes all of the bills include provisions that: ●
seek to expand and improve health care coverage by building on the strongest aspects of the United States’ mixed public–private system— employersponsored insurance and Medicaid and the Children’s Health Insurance Program—while reorganizing and regulating the
New Law Allows the VA to Plan Budget in Advance
W
hen President Obama signed the Veterans Health Care Budget Reform and Transparency Act into law last October 22, it allowed the Department of Veterans Affairs (VA) for the first time to plan its budget one year in advance. In the East Room event, Mr. Obama noted that delays and uncertainty often have plagued funding for veterans’ health care. Over the past 2 decades, the VA budget has been late almost every year, often by months, he said, adding that the VA was operating without a budget at that very moment.
GASTROENTEROLOGY 2010;138:4 –5
individual and small group insurance markets; ●
establish requirements for insurers to offer coverage to all Americans who apply and prohibit them from denying coverage or charging more based on overall health;
●
create a new health insurance exchange or exchanges;
●
set an essential benefit standard for health insurance;
●
provide subsidies to help people afford insurance premiums and out-of-pocket costs;
●
require all individuals to have health insurance;
●
have employers share responsibility for financing coverage;
●
improve health care quality and outcomes while controlling costs;
●
invest in primary care and provide more funding for prevention and wellness; and
The report also points to differences among the bills as to how reform would be financed, and what actions would be taken to control costs and expand coverage, including: ●
choice of a public health insurance plan option to be offered through new insurance exchanges in addition to private plans;
●
exemptions from the individual requirement to have health insurance;
●
requirements for employers to provide coverage or contribute to a health insurance fund;
●
the level of subsidies to purchase health insurance and cost-sharing subsidies; and
●
the degree to which revenues to pay for reforms are derived from highincome households or from insurers and device manufacturers.
test innovative provider payment methods.
The group says their report will be updated continually as legislation evolves. For more details, go to www. commonwealthfund.org.
“It’s frustrating for them and it’s frustrating for our vets who pay the price when budgets are delayed: the new doctors, nurses, and critical staff that aren’t hired; the new medical equipment that isn’t purchased; the construction of new facilities and clinics that isn’t started; the new programs for medical care that are delayed.” The VA provides health care for ⬎23 million American veterans; as many as a quarter of the nation’s population qualifies for VA coverage, either as veterans or family members of veterans. Before signing the new law, also known as “advanced funding,” the president said he was taking special
pride in this legislation because as a senator he had co-sponsored the bill while serving on the Senate Veterans Affairs Committee and during the campaign, he had promised to pass it. “With this legislation we’re fundamentally reforming how we fund health care for our veterans,” President Obama said. “With advance appropriations, veterans’ medical care will be funded a year in advance. For the VA, this means timely, sufficient and predictable funding from year to year. For VA hospitals and clinics, it means more time to budget, to recruit high-quality professionals, and to invest in new health care equipment . . . . And most of all, for our veterans it will mean better access to
●
New Analysis of Health Reform Bills Highlights Similarities, Differences, Costs
A
new Commonwealth Fund report released on October 23rd, 2009, analyzes the similarities, differences, potential impacts, and costs of current bills passed by the 5 committees of jurisdiction in the United States Congress: Finance Committee and Health, Education, Labor, and Pensions Committees in the Senate and the US House of Representatives’ Ways and Means, Education and Labor, and Energy and Commerce committees. The report, “Provisions of Comprehensive Health Reform Bills of 2009: Health Insurance, Delivery System, and Financing,” notes all of the bills include provisions that: ●
seek to expand and improve health care coverage by building on the strongest aspects of the United States’ mixed public–private system— employersponsored insurance and Medicaid and the Children’s Health Insurance Program—while reorganizing and regulating the
New Law Allows the VA to Plan Budget in Advance
W
hen President Obama signed the Veterans Health Care Budget Reform and Transparency Act into law last October 22, it allowed the Department of Veterans Affairs (VA) for the first time to plan its budget one year in advance. In the East Room event, Mr. Obama noted that delays and uncertainty often have plagued funding for veterans’ health care. Over the past 2 decades, the VA budget has been late almost every year, often by months, he said, adding that the VA was operating without a budget at that very moment.
GASTROENTEROLOGY 2010;138:4 –5
individual and small group insurance markets; ●
establish requirements for insurers to offer coverage to all Americans who apply and prohibit them from denying coverage or charging more based on overall health;
●
create a new health insurance exchange or exchanges;
●
set an essential benefit standard for health insurance;
●
provide subsidies to help people afford insurance premiums and out-of-pocket costs;
●
require all individuals to have health insurance;
●
have employers share responsibility for financing coverage;
●
improve health care quality and outcomes while controlling costs;
●
invest in primary care and provide more funding for prevention and wellness; and
The report also points to differences among the bills as to how reform would be financed, and what actions would be taken to control costs and expand coverage, including: ●
choice of a public health insurance plan option to be offered through new insurance exchanges in addition to private plans;
●
exemptions from the individual requirement to have health insurance;
●
requirements for employers to provide coverage or contribute to a health insurance fund;
●
the level of subsidies to purchase health insurance and cost-sharing subsidies; and
●
the degree to which revenues to pay for reforms are derived from highincome households or from insurers and device manufacturers.
test innovative provider payment methods.
The group says their report will be updated continually as legislation evolves. For more details, go to www. commonwealthfund.org.
“It’s frustrating for them and it’s frustrating for our vets who pay the price when budgets are delayed: the new doctors, nurses, and critical staff that aren’t hired; the new medical equipment that isn’t purchased; the construction of new facilities and clinics that isn’t started; the new programs for medical care that are delayed.” The VA provides health care for ⬎23 million American veterans; as many as a quarter of the nation’s population qualifies for VA coverage, either as veterans or family members of veterans. Before signing the new law, also known as “advanced funding,” the president said he was taking special
pride in this legislation because as a senator he had co-sponsored the bill while serving on the Senate Veterans Affairs Committee and during the campaign, he had promised to pass it. “With this legislation we’re fundamentally reforming how we fund health care for our veterans,” President Obama said. “With advance appropriations, veterans’ medical care will be funded a year in advance. For the VA, this means timely, sufficient and predictable funding from year to year. For VA hospitals and clinics, it means more time to budget, to recruit high-quality professionals, and to invest in new health care equipment . . . . And most of all, for our veterans it will mean better access to
●