Ohio Health Policy Review

Healthy Americans Act estimated to be budget neutral by 2014

The Congressional Budget Office and Joint Committee on Taxation released a preliminary financial assessment on a modified version of the Healthy Americans Act, U.S. Senate bill 334 (Source: "Letter to Honorable Ron Wyden and Honorable Robert Bennett," Congressional Budget Offce and Joint Committee on Taxation, May 1, 2008).  According to this assessment, "Overall, our preliminary analysis indicates that the proposal would be roughly budget-neutral in 2014....More specifically, under your proposal, most health insurance premiums that are now paid privately would flow through the Federal budget. As a result, total Federal outlays for health insurance premiums in 2014 would be on the order of $1.3 trillion to $1.4 trillion. Those costs would be approximately offset by revenues and savings from several sources: premium payments collected from individuals through their tax returns; revenue raised by replacing the current tax exclusion for health insurance with an income tax deduction; new tax payments by employers to the Federal government; Federal savings on Medicaid and SCHIP; and state maintenance-of-effort payments of their savings from Medicaid and SCHIP."

The Healthy Americans Act is a bi-partisan, universal coverage bill wth 7 Republican and 7 Demoract co-sponsors in the U.S. Senate.  Its principal sponsors are Senator Ron Wyden, D-Oregon and Sentator Robert Bennett, R-Utah.  Some of the key features in this legislation are:

• An individual mandate that everyone must have health insurance
• All citizens and permanent residents, with a few exceptions, must enroll in a Healthy American Private Insurance plan (HAPI).
• A HAPI plan is required to provide at least a minimum benefits package benchmarked to the actuarial value of the Federal Employees Health Benefits (FEHB) Program standard benefit option BlueCross/Blue Shield plan for 2011
• The cost growth of HAPI plans will be indexed for subsequent years by the per capita increase in gross domestic product (GDP), rather than medical cost growth.
• Establishment of health help agencies in each state to assist with the selection of health plans to serve in a given area
• Premium subsidies for people with incomes below 400 percent of poverty, with no premium required for people with incomes below 100 percent of poverty and a sliding scale premium for people with incomes between 100 and 400 percent of poverty
• Community rating for the premium, with differences in premiums only because of geography and smoking status
• Replacement of the current tax deduction for employer-sponsored health insurance coverage with a health care standard deduction
• A health care tax on employers ranging from 3 to 26 percent of the national average premium for the minimum benefits package for each employee, depending on firm size and amount of gross revenues per employee
• Elimination of all Medicare DSH payments and 90 percent of Medicaid DSH payments

Senator Voinovich promotes his Health Partnership Act

Senator George Voinovich released a new article on health care today.  In his article, "Healing our health care crisis," Senator Voinovich reaffirms his commitment to his Health Partnership Act (Source: Voinovich Views, April 18, 2008).

In his article Senator Voinovich states, "My legislation would allow state and local governments the freedom to explore health care reform options through a federal grant system – much like we did in successfully reforming welfare. The grants would support state-based efforts to reduce the uninsured and the cost of health care, improve quality and access to care and expand information technology. In other words, it would let states experiment with proposals currently bottled up in Congress and reward them when they achieve results.  I want to do this because I know that solutions often come far way from Washington, D.C."

Senator Voinovich becomes cosponsor of the Universal Health Care Choice and Access Act

Senator George Voinovich has agreed to be a co-sponsor of Senator Coburn's Universal Health Care Choice and Access Act (Source: "Senator Voinovich Co-Sponsors Universal Health Care Choice and Access Act," Press Release, April 16, 2008.  This legislation aims to make private health coverage for affordable and accessible, including providing for MediChoice tax rebates ($2,000 for individuals and $5,000 for families) for people who buy their own insurance.

The legislation also seeks to bring greater focus on prevention, on transparency, on creating more competition among health plans serving older adults; and enhanced flexibility for designing Medicaid programs tailored to the particular needs of different people and different states.

According to Senator Voinovich's letter to Senator Coburn, "It is clear that you have seriously explored the issues surrounding the increasing cost of health care and the growing number of uninsured Americans. I agree with you that we must make it a priority to provide access to quality, affordable health care for every individual, and I believe your legislation is a step in that direction."    

Kaiser releases new online tool that compares opinion polls on health care issues

The Kaiser Family Foundation released a new online resource that allows comparison among different public opinion polls on health care issues across time.  This new resource, Kaiser Public Opinion Spotlight, "provides in-depth analysis of public opinion on a variety of health care and health policy topics. Each Spotlight uses public opinion data from Kaiser surveys and other sources to examine current views and trends."

The April Spotlight includes a comparison between 1990 and 2008 on the percent of Americans naming  health care as one of the two most important issues for government to address.  The current 22 percent response rate is the highest rate since 1995. 

This Spotlight also includes the following comparisons:

The Public’s Assessment of the State of the U.S. Health Care System
Party Trust in Dealing with Health Care
Issues Are Only One Part of What Determines Votes
Health Care as an Election Issue in Exit Polls 1992-2006
Health Care in the 2008 Democratic Presidential Primaries
Where Is Health Care Likely to Rank in the 2008 General Election?
Issues Voters Want to Hear About in the 2008 Campaign
What Role Does Health Care Play in Voters’ Concerns About the Economy?
Health Care Costs and People’s Personal Economic Situations
Views on the Potential Impact of Changes in Health Care Costs and Coverage on
the Economy Overall
Differences in Health Care as a Voting Issue by Political Party
Differences in Health Care as a Voting Issue by Age
Specific Health Care Issues in the 2008 Campaign
Groups to Watch in the 2008 Presidential Election: Political Independents
Political Independents: Variation in Opinion
Groups to Watch in the 2008 Presidential Election: Health-Focused Voters
Health-Focused Voters: Health Care Issue Preferences
Groups to Watch in the 2008 Presidential Election: The Uninsured
The Uninsured and Voting
Historical Perspective: Specific Health Care Issues in the 2006 Presidential
Election
Historical Perspective: Specific Health Care Issues in the 2004 Presidential
Election
Historical Perspective: Specific Health Care Issues in the 2002 Congressional
Election
Historical Perspective: Specific Health Care Issues in the 2000 Presidential
Election
Historical Perspective: Health Care in the 1998 Congressional Election
Historical Perspective: Health Care Reform and the 1992 Presidential Election

Angie's List to begin rating physicians and other health care professionals

Angie's List, the national online service that lets subscribers rate contractors, plumbers, and others, will soon begin allowing people to also rate their health care experiences. (Source: "Angie's List to rate doctors, other medical practitioners," Plain Dealer, March 27, 2008.) The ratings will include "other patients' reviews of family doctors, surgeons, neurologists, cardiologists, plastic surgeons and more. Also on the list: chiropractors, dentists, pharmacists, nursing homes, urgent care centers and hospitals." Among the specific areas physicians and others will be rated on is office cleanliness, wait times and how well they listen.

Angie Hicks, who founded Angie's List in Ohio a number of years ago, is quoted in the Plain Dealer article as saying "This is probably one of the more common things customers have been asking us for over the years." The new rating system is expected to be operational in about a month.

Commonwealth Fund releases health care analysis for journalists

The Commonwealth Fund has released an evidence-based publication to help journalists understand both the fundamental problems plaguing the health care system in the United States and the policy options under consideration for addressing these problems. The publication, "Health Policy Reform: Beyond the 2008 Elections," originally ran as a supplement to the March/April 2008 issue of the Columbia Journalism Review. While the publication is aimed at journalists, others with an interest in health care reform will also find it useful.

National Health Council meeting on Feb. 28 in Columbus

The National Health Council, in partnership with the Alzheimer's Association, will sponsor a town hall meeting and news conference on Thursday, February 28, 2008 in Columbus. The event starts at 10:00 am and ends at 11:30 am and will take place in the Clinton Room of the Fawcett Center at The Ohio State University, 2400 Olentangy River Road. For more information, please contact Joseph LaMountain at joseph.lamountain@gmail.com or 202-288-5124.

Feds: New Patient Safety Organizations aim to improve health care quality

The United States Department of Health and Human Services (HHS) announced regulations on Feb. 12 to establish  Patient Safety Organizations (PSOs), which will be private entities that collect and analyze patient safety events as reported by health care providers. (Source: HHS Press Release Date, Feb. 12, 2008.) PSOs will "allow for the voluntary reporting of patient safety events without fear of new tort liability. In addition, they would encourage clinicians and health care organizations to voluntarily share data on patient safety events more freely and consistently. Under the proposal, PSOs can collect, aggregate and analyze data, and provide feedback to help clinicians and health care organizations improve health care quality." More information on PSOs can be found on the AHRQ website.

Survey by AARP Ohio examines Ohio attitudes toward health care reform

A new survey by AARP Ohio finds that health care reform is at the forefront of many Ohioans' minds. (Source: Ohio Health Care: A Study of Current Challenges and the Support for State Reform, AARP Ohio, Feb. 2008.) Key findings from the survey of 800 randomly selected Ohio residents ages 18-64, completed by Woelfel Research during December 2007, include:

• Almost seven in ten respondents believe that Ohio is either in a state of crises or has major problems with health care. While 19% of respondents were uninsured, 83% indicate it is extremely or very important that the state work to reduce the number of uninsured residents.
• One-third of respondents are not confident that they will be able to maintain their current level of health care coverage in the next five years, and seven in ten cite rising health care costs as a major problem for the state.
• Nine in ten respondents say it is extremely or very important for Ohio to make health care more affordable for all residents, and 82% strongly agree that all Ohioans should have access to affordable, quality health care coverage. Almost half of respondents identify ensuring affordable health care as the issue most important for the Governor and State Legislature to address.

Report examines family violence and prevention efforts in Ohio

A new report commissioned by the Anthem Foundation of Ohio with support from the Health Policy Institute of Ohio examines family violence in Ohio, providing an in-depth look at the issue and recommendations on how to improve prevention efforts. According to the White Paper on Improving Family Violence Prevention in Ohio, last year in Ohio more than

• 64,000 children were abused or neglected;
• 166,000 people were physically or sexually assaulted by an intimate partner;
• 29,000 elders were abused or neglected.

Among all Ohio residents, at least 14% of children will be maltreated at some point before age 18. In addition, nearly one in four women will be a victim of intimate partner violence in her lifetime, while at least 3 percent of elders will be abused. Each year family violence directly costs Ohio more than $1.1 billion in health care and social services. Moreover, family violence is linked to a surprisingly wide range of outcomes, from lost worker productivity and housing instability, to smoking, obesity and chronic disease.

The white paper was created by the Ohio Family Violence Prevention Project, a group of academic researchers, agency personnel and practitioners with decades of experiences in dealing with family violence. Project directors were Kenneth Steinman, assistant professor at The Ohio State University College of Public Health, and Timothy Sahr, Director of Research at the Health Policy Institute of Ohio. For more information on the project and paper, please see the related press release or download the paper and executive summary.