EdLabor Journal

Big news yesterday as the nation's largest senior citizen group AND the nation's largest organization of doctors both offered support for the Affordable Health Care for America Act.

The Los Angeles Times reports:

The [AARP], which has been pushing for a health overhaul for more than a year, had withheld a formal endorsement of any of the healthcare bills being developed by congressional Democrats.

That endorsement was followed by an announcement at about 10 a.m. Pacific time from the American Medical Assn. in which the nation's largest doctors group voiced its support for the measure.

AARP Executive Vice President Nancy LeaMond said today that the group saw the House Democratic bill as the most promising proposal.

...

The AMA's support for the House bill comes ahead of a critical policymaking meeting of its House of Delegates in Houston that begins Saturday. The organization is being asked by some constituencies, at the eleventh hour, to back away from supporting healthcare reform.

"These bills go far beyond what is necessary to fix what is broken with our healthcare system, and they grant the federal government considerable new powers and authority, which could ultimately amount to a complete government takeover of healthcare, and which is anathema to doctors and patients," reads a resolution introduced by the American Assn. of Neurological Surgeons, the American Society of General Surgeons and the American Academy of Facial Plastic and Reconstructive Surgery. The resolution was also supported by AMA delegations from Georgia and Washington, D.C.

Learn why these groups and many, many others support the Affordable Health Care for America Act at our clearinghouse page.

Earlier today, Chairman Miller and Rep. Lynn Woolsey, chair of the Workforce Protections Subcommittee, announced emergency temporary legislation today that will guarantee five paid sick days for a worker sent home or directed to stay home by their employer for a contagious illness, such as the H1N1 flu virus.

The Wall Street Journal reports, "House Education and Labor Committee Chairman George Miller said his bill would ensure that workers wouldn't miss out on wages if they contract the illness. The employer would be required to pay for the sick leave, and there would be no cost to the taxpayer, Mr. Miller said.

The bill wouldn't oblige employers to pay for workers' time off. It would tell them that, if they intend to send employees who are ill home, they must then pay for them to have up to five days' leave.

Mr. Miller said his panel would hold a hearing on the legislation the week of Nov. 16. If the bill is successfully enacted by Congress, it would take effect 15 days after being signed into law, and expire in two years."

Explaining why this bill is needed, Contra Costa Times quotes Chairman Miller, "Sick workers advised to stay home by their employers shouldn’t have to choose between their livelihood, and their co-workers’ or customer’s health. This will not only protect employees, but it will save employers money by ensuring that sick employees don’t spread infection to co-workers and customers, and will relieve the financial burden on our health system swamped by those suffering from H1N1.”

And the next steps according to Reuters are, "Miller said the committee would hold a hearing the week of November 16 and he would press to have a full vote as soon as possible.

Miller said at least 50 million American workers are not paid for time taken off sick, 'many in lower-wage jobs that have direct contact with the public such as the food-service and hospitality industry, schools and health care fields.'"

For more background on who does and doesn't get sick leave, see this post on the New York Times' Economix blog.

Ezra Klein at the Washington Post passes along a new academic paper by MIT health economist Jon Gruber. Mr. Gruber has looked at the health care proposals being considered by Congress and has found that the reforms will lower insurance premiums.

One of those states is Massachusetts, which passed health-care reform similar to the one contemplated at the federal level in mid-2006. The major aspects of this reform took place in 2007, notably the introduction of large subsidies for low-income populations, a merged nongroup and small group insurance market, and a mandate on individuals to purchase health insurance. And the results have been an enormous reduction in the cost of nongroup insurance in the state: The average individual premium in the state fell from $8,537 at the end of 2006 to $5,143 in mid-2009, a 40 percent reduction, while the rest of the nation was seeing a 14 percent increase.

You can read the rest of Mr. Gruber's paper here.(MS Word document)

The New York Times ran an editorial on Saturday discussing individual mandates and affordability. It covers the key areas of:

• Why is a mandate necessary? [Those without coverage drive up costs for those with coverage]
  
• Will premiums go up or down? [They would go down]
  
• Will there be help? [Yes]
  
• What's affordable? [The House bill provides affordability tax credits for families of 4 up to $88,000]
• Has it been tried? [Yes, successfully]
  
• Which version is more affordable? [The House bill]
  

See the editorial for a complete explanation of how this would work and how it would improve access to quality, stable, affordable health care.

In another column today, E.J. Dionne correctly points out that, while the mandates and subsidies don't start until 2013, there are 14 benefits that start immediately.

That's why the most important document House Democrats released when they unveiled their bill last week was a list of 14 benefits that would be created immediately.

These include insurance reforms to ban lifetime limits on coverage and an end to "rescissions," under which insurers abruptly nullify patients' policies after they file claims. One of the most popular reforms in the bill -- barring insurers from denying coverage to those with pre-existing conditions -- wouldn't take effect until later. So the House bill creates an interim high-risk pool to help those who need coverage in the meantime.

There are also particular benefits for Medicare recipients, including an immediate reduction in drug costs, and a very popular provision that would allow parents to keep their children on the family health plan through age 26.

Especially important are new investments in community health centers and in efforts to increase the number of primary care doctors. As millions more people get access to decent care, the system will have to provide more doctors, nurses and facilities to treat them.

"People will be excited about 2013," said Rep. George Miller, chairman of the House Education and Labor Committee, which shares jurisdiction on the health-care bill. "But there are enough benefits between now and then to keep them engaged and to keep them favorably disposed."

Learn more about the Affordable Health Care for America Act [H.R. 3962] and how reform will slow the growth in out-of-control costs, introduce competition into the health care marketplace to keep coverage affordable and insurers honest, protect people’s choices of doctors and health plans, and assure all Americans access to quality, stable, affordable health care.

This morning, Rep. George Miller published an op-ed in the Vacaville Reporter about the need for affordable health care for everyone. Below it is excerpted in its entirety.

Readers of this paper will know that, for much of this year, Congress and President Obama have grappled with one of the most important and complicated issues affecting our nation's economy and our community: health insurance reform.

I am proud to announce that on Thursday we introduced revised legislation that addresses many concerns raised about reform and brings us closer than ever to delivering on the long-held promise of quality and affordable health care for each of us.

I am a principal co-author of the bill.

Since three House committees passed a bill this summer, we have worked hard to incorporate changes and improvements suggested by people from across the political spectrum. Our revised bill directly addresses the needs of American families. It will:

• Not increase the deficit.
• Curb out-of-control costs that are bankrupting families and employers.
• Strengthen Medicare for seniors, in part by closing the prescription drug "donut hole" and by making the program sustainable for years to come.
• Protect people against discriminatory insurance company practices. We eliminate so-called "pre-existing" condition denials, stop insurance companies from dropping coverage if you get sick, and establish yearly caps on what you will pay out-of-pocket.
• Keep premiums affordable and insurance companies honest by ensuring competition in the health care marketplace through inclusion of a public consumer option. People in California will be able to choose from multiple private options, such as Blue Shield, Kaiser Permanente and others, or choose a public plan that offers the best quality at the best price -- just as they do on Expedia.
• Offer affordability credits to ensure that low-income and middle-class families can pay for coverage, and ensure that small businesses can actually help cover their employees.

One of the biggest concerns I heard throughout this process was about the bill's cost. Let me be clear: Our reforms are fully paid for and will not increase the federal deficit. In fact, our revised bill will reduce the deficit by at least $30 billion over the next 10 years.

The nonpartisan Congressional Budget Office estimates the cost of our reforms at $894 billion. More than half of this cost will be offset through a combination of savings generated by making Medicare and Medi-Cal more efficient and implementing new technology, but we do not cut services for seniors or low-income individuals. We improve care for people served by these critical programs.

The rest of the bill's costs are paid for by a surcharge on the wealthiest 0.3 percent of U.S. households-- married couples earning over $1 million dollars and individuals earning more than half a million dollars annually.

For the past 70 years, Americans have battled hard for the right to quality, affordable health care. While we still have hard work ahead, next week the House will vote on our truly historic legislation and get us closer than ever to achieving what generations of Americans have been fighting for.

Today's New York Times editorial, The House Health Reform Bill, is strongly in favor of the Affordable Health Care for America Act because, among other things, it would:

require insurers to allow young people through age 26 to remain on their parents’ policies. It would provide immediate help to people who have been uninsured for several months or denied coverage because of pre-existing conditions. It would speed elimination of a gap in drug coverage for Medicare beneficiaries (the so-called doughnut hole) and would give the government power to negotiate drug prices on behalf of Medicare beneficiaries, a promising way to reduce costs.

The bill would take a long stride toward universal coverage while remaining fiscally responsible.

We strongly encourage you to read the entire editorial and to learn more about the Affordable Health Care for America Act.

For the first time in U.S. history, all Americans would have access to quality, affordable health care under updated health insurance reform legislation unveiled by House Democrats.

The Affordable Health Care for America Act [H.R. 3962], which blends and updates the three versions of previous bills passed by the House committees of jurisdiction in July, embodies President Obama’s key goals for health reform. It will slow the growth in out-of-control costs, introduce competition into the health care marketplace to keep coverage affordable and insurers honest, protect people’s choices of doctors and health plans, and assure all Americans access to quality, stable, affordable health care.

The key components of the Affordable health Care for America Act include:

Increasing choice and competition. The bill will protect and improve consumers’ choices.

• If people like their current plans, they will be able to keep them.
• For individuals who aren’t currently covered by their employer, and some small businesses, the proposal will establish a new Health Insurance Exchange where consumers can comparison shop from a menu of affordable, quality health care options that will include private plans, health co-ops, and a new public health insurance option. The public health insurance option will play on a level playing field with private insurers, spurring additional competition.
• This Exchange will create competition based on quality and price that leads to better coverage and care. Patients and doctors will have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind. The legislation will ensure that Americans have portable, secure health care coverage – so that they won’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the Exchange will have a plan that includes standardized, comprehensive and quality health care benefits.
• It will end increases in premiums or denials of care based on pre-existing conditions, race, or gender, and strictly limit age rating.
• The proposal will also eliminate co-pays for preventive care, and cap out-of-pocket expensesto protects every American from bankruptcy.

Improving quality of care for every American. The legislation will ensure that Americans of all ages, from young children to retirees have access to greater quality of care by focusing on prevention, wellness, and strengthening programs that work.

• Guarantees that every child in America will have health care coverage that includes dental, hearing and vision benefits.
• Provides better preventive and wellness care. Every health care plan offered through the exchange and by employers after a grace period will cover preventive care at no cost to the patient.
• Increases the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
• Strengthens Medicare and Medicaid and closes the Medicare Part D ‘donut hole’ so that seniors and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. The bill will ensure that individuals, employers, and the federal government share responsibility for a quality and affordable health care system.

• Employers can continue offering coverage to workers, and those who choose not to offer coverage contribute a fee of eight percent of payroll.
• All individuals will generally be required to get coverage, either through their employer or the exchange, or pay a penalty of 2.5 percent of income, subject to a hardship exemption.
• The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.

Protecting consumers and reducing waste, fraud, and abuse. The legislation will put the interests of consumers first, protect them from problems in getting and keeping health care coverage, and reduce waste, fraud, and abuse.

• Provides transparency in plans in the Health Exchange so that consumers have the clear, complete information, in plain English, needed to select the plan that best meets their needs.
• Establishes consumer advocacy offices as part of the Exchange in order to protect consumers, answer questions, and assist with any problems related to their plans.
• Simplifies paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers, and employers will all encounter a streamlined, less confusing, more consumer friendly system.
• Increases funding of efforts to reduce waste, fraud and abuse; creates enhanced oversight of Medicare and Medicaid programs.

Reducing the deficit and ensuring the solvency of Medicare and Medicaid. The legislation will be entirely paid for – it will not add a dime to the deficit. It will also put Medicare and Medicaid on the path to a more fiscally sound future, so seniors and low-income Americans can continue to receive the quality health care benefits for years to come.

• Pays for the entire cost of the legislation though a combination of savings achieved by making Medicare and Medicaid more efficient – without cutting seniors’ benefits in any way – and  revenue generated from placing a surcharge the top 0.3 percent of all households in the U.S.(married couples with adjusted gross income of over $1,000,000) and other tax measures.
• The Congressional Budget estimates the bill will reduce the deficit by at least $100 billion over ten years.
• Estimates also show the bill will slow the rate of growth of the Medicare program from 6.6 percent annually to 5.3 percent annually.

According to a preliminary review by the USA Today, the American Recovery and Reinvestment Act has created or saved more than 388,000 jobs so far this year.That number is only for jobs created directly by the stimulus package and doesn't include jobs created indirectly by workers spending their new earnings.

While jobs were created across all sectors of the economy, the USA Today highlights some jobs created in the education sector.

The states' reports suggest the biggest impact has been at schools. Twenty-three states that have reported school job numbers said more than 156,000 jobs had been created or saved.

Carol Bingham, director of fiscal policy for the California Department of Education, estimated the stimulus saved about 20,000 teaching positions. But she and others warn that precisely counting saved jobs has proved almost impossible. "It was intended to be a count. The way it was done, I think it's going to end up being an estimate," she said.

Indiana officials reported that the stimulus had created or saved about 13,000 school jobs. Asked whether he had any idea how many layoffs the plan had prevented, state Education Department spokesman Cam Savage replied: "I really don't."

Learn more about the American Recovery and Reinvestment Act and read Chairman Miller's statement about the Administration's estimates on education jobs.