Obama Shifts Priorities, Not Gears During State of the Union Address
Jan. 28, 2010 – Instead of announcing a renewed effort to conclude contentious national health care reform, President Barack Obama during last night’s annual State of the Union address announced a change in priority to getting Americans back to work more so than revamping the nation’s $2.5 trillion-a-year health care system.
But Obama didn’t give up on his pet domestic policy that recently has rankled many Americans out of their prior apathy and cost Democrats a key U.S. Senate seat.
“Let us find a way to come together and finish the job for the American people,” Obama said during his national address delivered in the U.S. House of Representatives chamber.
In the wake of last week’s stunning Massachusetts U.S. Senate election loss to Republican Scott Brown, House Majority Leader Nancy Pelosi essentially announced current health care reform efforts were dead now that Democrats no longer have the votes necessary to prevent a Republican filibuster of health care bills in the U.S. Senate. Pelosi said she does not have the votes necessary to approve the version of health care already passed in the U.S. Senate without amending it and sending it back to the Senate – at which point Republicans likely would initiate a filibuster Democrats would be powerless to prevent.
Moderate House Democrats, such as Michigan’s Bart Stupak, oppose the abortion-funding measure in the bill already passed by the Senate. The version approved by the House does not allow federal funding of abortions, but Senate Republicans can filibuster that bill, as well. The Senate version also includes a tax on health care benefits opposed by House Democrats as being too hard on America’s middle class families.
During his 70-minute State of the Union Address, Obama cited a lack of communication with U.S. voters as the reason for floundering national health care reform, but he suggested those efforts will be renewed.
“I take my share of the blame for not explaining it more clearly to the American people,” Obama said. He signaled a coming cooling down period to allow lawmakers and voters time to reassess health care reform efforts the President wants renewed.
“As temperatures cool, I want everyone to take another look at the plan we’ve proposed,” Obama told lawmakers. “Do not walk away from [health care] reform. Not now. Not when we are so close.”
Obama said he won’t give up on trying to reform the U.S. health care system but added improving the nation’s economy and creating jobs would be his “number one focus” this year. To what extent national health care reform will be a part of Obama’s economic reform efforts remains to be seen as members of Congress enter a mid-term election year that already has seen Democrats lose one U.S. Senate seat and several House Democrats make the nearly unheard of move of changing membership from the majority Democratic Party controlling both houses of Congress as well as the White House to the minority Republican Party.
Making Health Insurance More Affordable for Individuals
Oct. 15, 2009 – Group health insurance plans generally are more cost-effective and accepting of individuals with pre-existing medical conditions, but most people with no health insurance coverage don’t realize they can qualify for group health insurance benefits in a number of ways other than through job providers.
The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires insurers to cover people with pre-existing medical conditions if previously covered by a group health insurance plan within a predetermined period of time – usually about 6 months. But even with no prior health insurance coverage, individuals obtaining group health insurance coverage can have their conditions covered after a standard waiting period of between 12 and 18 months.
While HIPAA offers protection for individuals with group health insurance – where about 60 percent of Americans obtain health insurance coverage, it only applies to group health insurance and not individual health insurance plans. People who are self-employed, work part-time or are unemployed typically don’t have group health insurance benefits. And the Kaiser Family Foundation indicates about 21 percent of people applying for individual health insurance are refused coverage, charged higher premiums or provided a plan excluding their pre-existing medical conditions.
But what many don’t realize is in a dozen states an individual can qualify as a “group” to obtain health insurance, and in all other states any two or more individuals can form a “group” and obtain more affordable and effective group health insurance.
As federal lawmakers grapple with various national health care reform proposals, health insurers have said a meaningful federal mandate requiring all Americans to purchase health insurance coverage would be enough to enable insurers to provide health coverage at lower costs and cover people with pre-existing medical conditions.
But the measures recently approved by two U.S. Senate committees propose a maximum annual tax of $750 charged to individuals incapable of proving they have health insurance coverage while requiring health insurance providers to cover people with pre-existing conditions. Health insurers say the potential penalty is too low and would only result in fewer people purchasing health insurance while increasing costs for those whose premiums ultimately would be increased to offset the additional cost of covering people with pre-existing conditions.
Colorado, Connecticut, Delaware, Florida, Hawaii, Maine, Massachusetts, Mississippi, New Hampshire, North Carolina, Rhode Island and Vermont are states allowing individuals to form “groups of one” for the purpose of purchasing group health insurance plans, according to the Kaiser Family Foundation. All other states and the District of Columbia require at least two individuals to qualify for group health insurance coverage. States allowing groups of one have varying regulations defining the types of coverages available to them.
As the nation’s unemployment rate has risen, more people have lost their employer-provided group health insurance benefits but have the option of continuing them for a period of time through the federal COBRA law, but they are responsible for all premium costs, including what their former employers’ paid to provide group insurance for an individual and his or her family. Often times, the COBRA costs are too high for people drawing unemployment, forcing them to drop their health insurance coverage.
If an individual loses health insurance coverage, he or she can apply for coverage with another health insurer within 63 days of losing group benefits and still be covered for pre-existing conditions with no waiting period. And every state has a designated “insurer of last resort,” which must accept individuals if they apply within 63 days of losing their prior health insurance coverage. The “Catch 22” is that in some states, there are no limits on the amount of premiums charged and deductibles can be very high.
Many professional organizations also offer group health insurance plans for their members, who often are self-employed.
Regardless their situation, for people lacking health insurance coverage, waiting for meaningful and effective federal health care reform could take years. But taking some initiative could result in immediate savings while ensuring their families’ health care will be covered.