Cornyn Falsely Claims That Rural Areas Of Texas Have Greater Access To Doctors»

Sen. John Cornyn (R-TX) is disputing the Houston Chronicle’s characterization of his claim that the Texas health care system — despite having the highest uninsured rate in the country — should serve as a model of reform:

Needless to say, the headline did not accurately reflect Senator Cornyn’s views…Instead, while relating several reasons why Texas’s economy is in better shape than most other U.S. states, he mentioned the 2003 law reforming medical malpractice law in Texas [Proposition 12]. Since its passage, doctors and medical school graduates have been flocking to Texas, providing health care services in underserved areas and improving patient access in others.

But as the Boston Globe points out, even as “doctors move into Texas in far greater numbers, they tend to locate in the same urban areas - undercutting one of the strongest arguments for Proposition 12.”

Indeed, while the number of physicians practicing in Texas has increased, “under-served areas” remain under-served:

During debate over the proposition, proponents of cutting jury awards in malpractice claims argued that “malpractice laws were responsible for shortages of doctors in rural” and specifically highlighted “152 counties that did not have an obstetrician.” But as of September 2007, “the same number of counties remains without one… [and] 124 counties have no obstetrician, neurosurgeon, or orthopedic surgeon.”

In ‘Jubilation’ She’s Not: Baby Cecilia Denied Coverage In Individual Market»

Acid reflux, a benign condition which afflicts about 50 percent of infants, can exempt otherwise healthy babies from coverage in the individual insurance market place, the Pittsburgh Post Gazette reports.

Consider the story of Cecilia Kownacki, a 7-month old baby (pictured on the right), who was denied coverage by a Pittsburgh insurer because she was unable to digest milk and often spit up:

Cecilia Kownacki found out the hard way. The denial letter from Highmark arrived last month: “Dear Ms. Kownacki: [We] are sorry to inform you that your application does not meet our underwriting criteria for approval,” the letter said…Her parents, Frank and Susan Kownacki, were considerably more distraught. Their baby daughter was uninsured, starting Friday.

“When we got the rejection letter,” said Mrs. Kownacki, of the North Side, “I was in tears.”

[…] whether you’re 70 years old or 7 months young, when you move away from one plan and try to enroll in an individual plan, you can be subject to health screenings if you want to enjoy a low-premium policy.

Unfortunately, Cecilia is not the exception; nearly 90 percent of people seeking coverage in the individual market “never end up buying a plan, finding it either very difficult or impossible to find one that met their needs or is affordable.” From a recent Commonwealth study:

In “most states, individuals with preexisting conditions are denied coverage, have conditions excluded, or face much higher and often unaffordable premiums.” Insurance companies will disqualify patients from coverage for undergoing caesarean sections, or “for just taking certain medicines because of the possibility of future costs, including common drugs as Lipitor, Zocor, Nexium, and Advairpre.”

As Julia Eisman of Stand Up For Health Care notes, “when the insurance company practice of cherry-picking the healthiest among us is so picky not even baby Celia can get coverage, there’s something wrong with this picture.”

McCain’s Plan To Tax Health Insurance»

Our guest blogger is James Kvaal, a Senior Fellow at the Center for American Progress Action Fund.

Earlier today, McCain advisor Douglas Holtz-Eakin answered critics of McCain’s health care plan, who say it could raise taxes on millions of middle-class families. He said:

[The McCain plan] is a transformation of the tradition of a tax subsidy to private insurance to make sure that subsidy is fair, both in the sense that it is available to every American regardless of the source of their private insurance and that every person gets the same amount — $5,000 for a family, $2,500 for an individual. The Obama campaign has chosen to characterize only one piece of a comprehensive health care reform as a tax policy and thus try to hit John McCain with it. It is classic political rhetoric at odds with the reality of dealing with an important problem, like the underinsured in America.

Actually, considered as a whole, McCain’s plan will raise taxes on millions of workers for two reasons. First, his plan would tax workers’ health benefits, which are largely tax-free today. Although he also creates a new tax credit for insurance premiums, many workers will pay more in taxes on their insurance then they get from the new credit.

Second, the value of McCain’s credit will erode quickly. While health care premiums are expected to grow by 7 percent a year, McCain’s credit will increase by only about 2 percent a year. In contrast, current tax benefits keep up with rising premiums.

More details on the tax implications of McCain’s health care plan are available here.

The McCain Campaign’s Latest High-Risk Pool Variation»

During Douglas Holtz-Eakin’s appearance on CNBC’s Squawk Box yesterday, John Harwood questioned Sen. John McCain’s (R-AZ) ability to provide insurance for individuals whose pre-existing conditions disqualify them from coverage in the individual marketplace. Harwood argued that McCain’s proposal to federally subsidize high-risk pools to the tune of $7 to $10 billion is not “really adequate to get those at-risk into health insurance.” Holtz-Eakin begged to differ:

The Senator’s commitment was to devise a best practice…so his idea was let’s look at the practices, get the one that works and make the commitment to fund it. ‘Cause you know, in the end these are high-cost patients who might need more money. So his 7 to 10 estimate, it was a ballpark estimate. It could be higher. The commitment is to get the job done…It could be $20 billion and you could make it work if you do the rest of the reforms in the McCain plan. The important thing is to change the cost of care, and there’s a long list of reforms that the Senator’s proposed. It means changing incentives.

Watch it:

Holtz-Eakin is spinning his wheels as the McCain campaign scrambles to explain how their individual-market centric health care proposal would deliver health coverage to the millions of Americans with chronic illnesses.The McCain health care plan has been a patchwork of conflicting proposals from the very beginning:

- In April, Elizabeth Edwards, a Senior Fellow at The Center for American Progress Action Fund, astutely noted that McCain’s plan offered nothing for the sickest Americans.

- In response to her criticism, McCain offered his current high-risk pool enhancement plan, G.A.P.

- Seven days ago, senior adviser Carly Fiorina floated the idea of establishing “a nonprofit corporation that would contract with insurers” and “partner with other state plans to broaden insurance pools” and cover the sickest Americans.

Holtz-Eakin’s funding boost is the latest inadequate variation. As the Tax Policy Center pointed out, McCain’s high-risk pools would need about $100 billion a year to “prevent large losses in insurance coverage among the sick and needy.”

Implementing “the rest of the reforms in the McCain plan” would only overburden high-risk pools. As The Wonk Room previously pointed out, McCain’ plan to deregulate the insurance industry and push healthy Americans into the individual market could shift sick people — who can’t find coverage in the individual market or afford the increasing cost of insurance in their old risk pools once the healthy people have opted out — into high-risk pools.

These programs don’t spread risks and costs across a mixed pool population of healthy and sick people and would force millions of Americans with pre-existing conditions to pay astronomical insurance premiums and deductibles.

Thus, while McCain’s proposals have changed, his message has remained the same: don’t get sick.

Humana CEO McCallister Endorses Univeral Health Care»

On Monday, during an appearance on Fox Business News’ Countdown to the Closing Bell, Humana CEO Mike McCallister endorsed the progressive prescription of universal health insurance:

HOST: Can we cover everybody, Michael? Is that possible, universal health care?

MCCALLISTER: We can. It’s heavy lifting. And there is no simple, silver bullet answer to that…. we don’t have the right economic model because not everyone is in the risk pool, as we say in our industry. So it’s possible, the money is there. It’s going to take a real concerted effort and it’s not simple….getting everyone in the risk pool or getting them covered is the right thing to do. We’re wealthy nation, we should find a way to do that.

Watch it:

McCallister joins the majority of Americans who already support universal coverage. According to an ABC News/Washington Post poll from June, 66% of Americans believe that “providing health care coverage for all Americans” is more important “even if it means raising taxes.”

Similarly, a Quinnipiac University poll from May found that 61% of Americans “think it’s the government’s responsibility to make sure that everyone in the United States has adequate health care.”

CNN Is Wrong: McCain’s Plan Would Do Little To Insure Chronically Ill Americans»

Today, while reporting on a new study that found that nearly one-third of the 47 million Americans without health insurance suffer from chronic conditions, CNN implied that the “16 million people in this country with a chronic condition but no insurance to pay for medical care” could use Sen. John McCain’s (R-AZ) proposed tax credits or money saved in Health Care Savings Accounts to purchase health insurance with “tax-free dollars”:

You know, this problem has been around forever and lots of great minds have opined about what to do about it. The two candidates are no exception…Now senator McCain wants to do this more through the private sector. He wants to give tax breaks to people so that, if they have more money, because they’re not using it for taxes, they could use it to buy insurance and also help savings accounts so that people could help pay for medical expenses with tax-free dollars. It’ll be interesting to see which solution the voters like better.

Watch it:

But McCain’s solution doesn’t solve the problem. While McCain would give $2,500 to individuals and $5,000 to families to buy health insurance in the individual market place, most insurance companies won’t provide insurance to the so-called uninsurables or individuals who “have conditions like cardiovascular disease, hypertension, and diabetes.”

Secondly, as Health Care For America Now points out, health care savings accounts would not work for those with chronic conditions because such plans “by definition favor the wealthy and/or the healthy”:

For those that never go to the doctor, or who can afford the high out-of-pocket costs incurred when using health savings accounts (you need to pay $1,050 as an individual or $2,100 for a family before your insurance will cover the rest), health savings accounts are great….For the rest of us, however, health savings accounts don’t work. If we get sick and see the doctor often, we have to pay those huge costs often; that means we have to save a lot of money in that health savings account. For those on fixed incomes, or even those just barely scraping by (and that’s a lot of us in today’s economic climate), putting away even $4,000 in a health savings account is out of the question.

As CAPAF Senior Fellow Peter Harbage and Director of Health Policy Karen Davenport argue in a new report, until the uninsured are part of the health care system, there will be no way to get a handle on their health care spending. Thus, “policies aimed at achieving savings while also improving quality would be even more effective in improving overall health system performance if they were combined with a policy to extend affordable health insurance coverage to everyone in the United States.”

Unfortunately, rather than analyzing the effects of McCain’s plan on the uninsured, CNN regurgitated McCain talking points. Such vapid reporting will not help voters decide “which solution [they] like better.”

UPDATE: The New Health Dialogue adds:

The challenge of chronic disease is intricately related to the goals of sustainable health reform. Both will require a comprehensive approach—one that provides access to care for all Americans and ensures that such care is delivered in an integrated system where providers are paid for the quality, and not just the quantity of care.

California To Provide Greater Access To Individual Health Insurance»

California wants to take on the largely unregulated individual health insurance market — a system within which insurance companies impose waiting periods for pre-existing conditions, offer less comprehensive benefits than employer-based coverage, charge higher premiums and deductibles, successfully exclude high-risk individuals form coverage, charge higher rates to higher-risk patients, offer a limited range of benefits, and spend a relatively small proportion of premiums on actual medical care.

California is proposing new rules to regulate the ‘wild-west‘ environment that is the individual health insurance market:

- The new rules “would set a maximum amount patients would have to pay each year toward their bills” and “restrict insurers’ ability to cancel policies retroactively.”

- Another proposal would “limit cancellations to the first 18 months of coverage and require insurers to obtain approval from regulators before revoking a policy.”

- Schwarzenegger would have “independent arbitrators decide whether an insurer could cancel a policy.”

- State regulators “would sort policies into categories based on the benefits they offer and establish minimum benefits for each category. Presumably, that would allow consumers to compare what competing companies offer.”

- Insurers may be “be required to spend at least 85% of the premiums they collect on medical care, limiting the amount they keep as profit and for administrative expenses.”

The new rules come out of necessity, not regulatory zeal. Nationally, 89% of applicants are unable to find an individual health care plan that meets their needs.

The new rules would provide patients “with preexisting conditions and other medical problems” greater “access to quality, affordable health care” and begin to establish the individual market place as a viable source of insurance for the millions of Americans who are currently denied coverage.

Note To McCain: Small Businesses Don’t Agree With You On Health Care»

Yesterday, Sen. John McCain (R-AZ) suggested that requiring employers to share the costs of expanding access to health insurance would add “$12,000 to the cost of employing anyone with a family” and lead to greater unemployment and lower wages:

Small businesses are the job engine of America, and I will make it easier for them to grow and create more jobs. My opponent wants to make it harder by imposing a ‘pay or play’ health mandate on small business.

But the rising costs of health insurance are already making it harder for small businesses to “grow and create more jobs.” According to a recent study from the Institute of Medicine, “the lost human capital related to lack of health insurance - including lost earning potential and the value of extra years of life - is as much as $170 billion.”

As the Small Business Majority points out, the current system is broken. Small businesses either “pay the overblown and disproportionate costs in purchasing and administering a health care plan or, worse, offer no health care plan at all and suffer the competitive disadvantage in attracting and retaining talented labor.”

To ensure that small businesses aren’t overwhelmed by the growing costs of health care, “all interest groups — business owners, employees, the health care community and government” must step-up and contribute through the concept of shared responsibility. Such an approach would save small businesses from the inadequacies of the current system.

Small businesses are willing “to pay their fair share“:

When part of a larger solution that includes pooling, cost controls and government subsidies, [employer] mandates offer useful tools in building comprehensive reform…Small businesses are prepared to pay their fair share: nothing less, nothing more.”

But unfortunately, McCain’s rhetoric suggests that he doesn’t understand the cost of doing nothing. McCain’s proposals don’t address the out-of-control costs of providing health care coverage and do nothing to ameliorate the current crisis. Progressives would control costs and provide new opportunities for small businesses to purchase affordable coverage.

McCain’s Tax Credit Still Keeps Health Insurance Out Of Reach For Millions Of Families»

This is part two in a series of blog posts explaining the findings of John McCain’s Radical Prescription for Health Care, a new paper from the Center for American Progress Action Fund. For more, check out part one.

John McCain’s health care plan would create a new health insurance tax credit worth $2,500 tax credit for individuals and a $5,000 credit for families.

But according to a new study, the one-size-fits-all tax credit fails to make insurance affordable for millions. It falls far short of covering premium costs for low income families and it ignores the higher premiums faced by individuals with existing illnesses, who are approaching middle age, or who live in states with higher medical costs.

For millions of families, it’s a five foot rope for a ten foot hole.

A $5,000 tax credit for a low income family is not enough to cover the average price of an insurance policy costing around $14,000. Many poor or near poor families would fail to use the credit at all because they wouldn’t be able to make up the difference in premium costs.

Additionally, older Americans, and those with pre-existing conditions, face much higher premiums in the private market, but John McCain’s credit does nothing to address this.

In fact, an analysis of CBO premium data finds that McCain’s credit would cover only a third of the premiums for individuals who need insurance the most:

McCain’s $5,000 and $2,500 tax credits seem like a simple proposal: but it’s also simplistic and insufficient for the vast majority of Americans. It’s one-size-fits-nobody.