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Health Insurance Stocks Rally With Release Of Baucus Health Bill

Earlier this morning Senate Finance Committee Chair Max Baucus (D-MT) unveiled his committee’s health care bill, which has no public option and mandates that everyone buy insurance. While Baucus has failed to garner support from any congressional Republicans and has outraged progressives, there has been one very positive response to his proposal.

Following Baucus’ announcement, HealthNet shares increased by 3%, United Health Group Inc shares rose by 2.7%, Humana Inc. grew by 2.6%, Wellpoint stock gained 1.7% and Aetna Inc rose 1.6%:

InsurerProfits

Earlier this week, ThinkProgress interviewed Wendell Potter — a former health insurance executive — who pointed out that “every time there is an article in a big newspaper questioning the success of progressives in getting a good bill passed, the stock will go up.” “The analysts/investors don’t think any good reform is going to happen, or anything that would happen that would adversely affect the insurance companies,” he said. Watch it:

In fact, since the President signaled that he is backing away from the public option, health insurance stocks have been on the rise. “Health-care investors are starting to breathe a sigh of relief as they feel the worst case could be averted,” John Sullivan, director of research at Leerink Swann, told the Wall Street Journal in August. “Health-care stocks have risen 22% since late February, when President Barack Obama began his push for an overhaul; the overall market is up 38%” between late February and August.

How Does The Baucus Mark Handle The Most Contentions Issues Of Reform?

BaucusBillAfter months of delay, Sen. Max Baucus (D-MT) has finally released the chairman’s mark to the Senate Finance Committee’s health bill without Republican support. “The $856 billion dollar package will not add to the federal deficit. The Finance Committee will meet to begin voting on the Chairman’s Mark next week,” Baucus wrote in a press release.

Rockefeller has expressed his opposition to the mark and other Democrats have since criticized the bill’s affordability standards and financing mechanisms.

Meanwhile, Sens. Chuck Grassley (R-IA) has issued a statement alleging that the bill “does not meet the shared goals for affordable, accessible health coverage that we set forth when this process began” and expressed disappointment that the White House did not assure him that the bill would not change in conference. Both Grassley and Sen. Mike Enzi (D-WY) — two members of the so-called Gang-of-Six — have indicated that they favored smaller bill that does not impose fees on health insurance companies, establishes a five-year waiting period for legal immigrants to obtain coverage, and strictly prohibits “the use of federal money to pay for abortion.” Meanwhile, Sen. Olympia Snowe (R-ME) signaled Tuesday “she is unlikely to immediately support” Baucus’ bill, “but emphasized strongly that she is prepared to jump on board in the coming days.” “I’ll issue my statement tomorrow. But that’s not the end of the process, tomorrow. It’s just the beginning. So, I wouldn’t read too much into it,” Snowe told reporters.

So did Baucus’ mark meet Republican demands? Below is a summary of some of the most contentious issues in the Baucus bill:

Would federal dollars be used to fund abortion? No. Federal subsidies cannot be used to cover abortions that do not involve rape or incest. All abortion procedures would have to be financed through private premiums.

Are illegal immigrants eligible for coverage and government subsidies? Illegal immigrants are exempt from the mandate and would not be eligible to purchase coverage within the Exchange; they’re relegated to the individual market (which would shrink but would presumably have the same protections as the Exchange.) Legal permanent residents with incomes below 100% of the federal poverty are ineligible for Exchange subsidies and (presumably, following existing law) have to wait five years before qualifying for Medicaid. Thus, for the first five years of their residency, most legal immigrants may remain uninsured.

What are the verification requirements? To obtain coverage within the Exchange, an applicant’s “name, social security number, and date of birth will be verified with Social Security Administration (SSA) data.” “For individuals who do not claim to be U.S. citizens but claim to be lawfully present in the United States, if the claim of lawful presence is consistent with Department of Homeland Security (DHS) data then the claim will be considered substantiated”

Is tort reform part of the bill? Yes, states are encouraged “to develop and test alternatives to the current civil litigation system as a way of improving patient safety, reducing medical errors, encouraging the efficient resolution of disputes, increasing the availability of prompt and fair resolution of disputes, and improving access to liability insurance, while preserving an individual‘s right to seek redress in court.”

Who will finance Medicaid expansion? Beginning in 2014, “additional Federal financial assistance would be provided to all states to defray the costs of covering newly-eligible beneficiaries.” The Federal government would pay states on a sliding scale. “States that offer minimal or no coverage of the newly-eligible population currently would receive more assistance initially than those states that currently cover at least some non-elderly, non-pregnant individuals.” The states that already cover more than 133% FPL (like Maine, for instance) would still receive extra federal assistance, but they would see less money than states that just offer the bare minimum Medicaid coverage.

Update

The Baucus bill saves money on subsidies by reducing the actuarial value of the different benefit tiers. The actuarial values actually decreased between the Baucus framework and the Baucus mark:

Bronze: 65% in framework >> 65% in mark

Silver: 73% in framework >> 70% in mark

Gold: 81% in framework >> 80% in mark

Platinum: 90% in framework >> 90% in mark


Update

,At his press conference unveiling the bill, Baucus explained that combined with the FMAP increase, increase in drug rebates, CHIP flexibility (states can move their CHIP applicants into the Exchange), states will see an average increase in costs of 0.89 percent.

Rockefeller Explains What’s Wrong With The Baucus Health Care Bill

RockefellerYesterday, during a conference call with reporters, Sen. Jay Rockefeller (D-WV) expressed his strong opposition to the Senate Finance Committee’s health care bill. “I have sat by Max Baucus for 25 years on the Finance Committee, probably his best friend on the Finance Committtee…but I cannot agree with him on this bill,” Rockefeller explained.

“The public option is one factor, Medicaid is a huge factor. The Children’s Health Insurance Program (CHIP) has been relegated to the Exchange, and affordability. So according to my current understanding, and it changes a lot, of the Finance bill, there is no way in its present form that I would vote for it.”

Along with Professor Jacob Hacker, Rockefeller laid out his criticism’s of Baucus’ legislation:

- Replacing The Public Option With Co-Ops That Won’t Work: “There are only about 4 to 7 [Co-ops] that exist [nationwide]. And I’m very skeptical… of starting up a system that doesn’t work.”

- Insurers Will Pass Tax Onto Beneficiaries: [Baucus] “would impose a 35% excise tax on insurance companies in 2013, when this kicks in. Over $8,000 for singles, and $21,000 for families. Now that raises $200 billion, so I understand the temptation. But …every single coal miner is going to have a big big tax put on them because the tax will be put on the company, the company will immediately pass it down in lower benefits…and probably higher premiums to coal miners who are getting very good health care benefits for a very good reason and that’s because like steel workers and others, they are doing about the most dangerous job that can be done in America [and are therefore expensive to insure]. So that’s not a very smart idea, in fact it’s a very dangerous idea.

- Employers Not Required To Provide Any Coverage: Rockefeller highlighted his concern that self-insured plans “escape all regulation, which is being contemplated for others with insurance under the Baucus plan.” Hacker argued that the free-rider provision (which only requires employers to pay for the subsidies their workers receive through the Exchange) “will encourage firms to offer bare bones coverage so they can avoid having to pay those subsidies and would discourage them from hiring those who are eligible for subsidies in the first place.”

- CHIP Folded Into Exchange, Children Could Lose Special Benefits: “A governor obviously has a low budget and is going through the problems that everybody else is and if he can knock some kids out of CHIP or cut down on Medicaid, many of them are perfectly content to do that because most people aren’t all that sympathetic and these people don’t have voice they can collectively raise.” “[C]hilren had to have special types of benefits, for example, we have mental, we have dental. We do not have, because of what’s in the bill, EPSDT, and you all know what that is, early screening… What Sen. Baucus did is put the children’s health insurance program out of the Medicaid defined package category and put it into the Exchange where it’s just there to compete with anybody else and all of the particular parts to children probably will get ignored because the benefits will change. Kaiser News Network has more on this concern.

- Have To Ensure That Coverage Is Affordable: Hacker pointed out a public option would save approximately $150 billion over 10 years and allow the government to invest those savings into better and stronger subsidies. Other critics have also argued that private insurers could charge older individuals up to five times more for coverage. “You’re just using age as a proxy for health status,” Uwe Reinhardt, an economics professor at Princeton University told the New York Times. Reinhardt estimates that “Senator Baucus’s age-rating plan would allow insurers to cover roughly 70 percent of the additional risk they’d take on by being required to accept all comers, regardless of health.” As the Washington Post explained yesterday, “under the Baucus plan, subsidies would be offered to people who earn up to 400 percent of the poverty level ($43,000 for an individual or $88,000 for a family of four)… The credit would be calibrated on a sliding scale to ensure that people at the bottom of the income range paid no more than 3 percent of their earnings for premiums while those at the top would be liable for as much as 13 percent.” “That would amount to more than $700 a month for a family of four making $66,000 a year — significantly more than most people at the same income level now pay, according to research conducted by Linda Blumberg, a senior fellow in the Health Policy Center at the Urban Institute.” For a full affordability chart, click here.

Finally, other critics have argued that the rules of the Exchange offer insurers too much flexibility for benefits design. The Baucus bill requires insurers participating in the Exchange to offer plans in four different tiers. Each plan an insurer offers would have to meet a different actuarial-value. In the silver tier, insurers would have to cover 73% of the health care expenses of an average population; the remaining 27% would be picked up by individuals.

But Sarah Lueck at the Center on Budget and Policy Priorities warns that “an actuarial-value standard on its own” would not prevent insurers from designing packages that would attract healthier applicants and deter “enrollment by those in poorer health.” “For example, insurers could offer a benefits design that omits or severely limits services needed by people with serious medical conditions, while offering richer benefits in other areas such as vision care or health-club memberships. In that way, an insurer could meet an actuarial standard while designing a package calculated to deter sicker people (by failing to cover basic services they need) and attract healthy ones.” Insurers could offer cheaper preventive services without any cost sharing but cover more expensive services only after a high deductible is satisfied.

Lueck concludes that “many enrollees still are likely to end up underinsured for key health services unless an actuarial-value standard is combined with…[the] requirement that all plans offer basic comprehensive coverage.” She writes that policy makers should establish “limits on the degree of variation in different benefit designs to prevent insurers in an exchange from creating benefit packages designed to deter less-healthy enrollees and attract only individuals in good health.”

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