URGENT-IT'S CRUNCH TIME

Dear Members:

This Friday, Assembly Bill 162 is slated to be discussed in the Senate. It has already passed the House and WILL pass unless we take action. The hearing will be simulcast at the Grant Sawyer Building at 555 E. Washington Ave. at 1:30pm. I am asking EVERY member to contact their legislator and also contact EVERY client to have them do the same and voice your opposition to this discriminatory bill. Better yet, if you or your clients can attend the hearing that's even better.

Autism is a public policy issue and should be treated as such. AB162 puts the sole burden on individuals, small businesses and fully-insured plans. It EXEMPTS Unions, State employees, Self-funded (read: Casinos), SCHIP and Medicaid from having to provide coverage. Rates are estimated to go up $30 a head for those affected; small businesses who hire a parent with an autistic child will be forced to drop their plans when their experience rating hits the maximum upon renewal. Autism costs $50,000 a year to treat and doesn't discriminate. ANYONE can have an autistic child, so EVERYONE should be a part of the solution. You can find your legislator by clicking here: http://mapserve.leg.state.nv.us/website/lcb/viewer.htm

You can voice your opposition by clicking here: https://www.leg.state.nv.us/75th2009/opinions/vwComments.cfm

and go to SUBMIT AN OPINION, Scroll down the drop box marked Select Bill and go to AB162 (be sure it is AB and not SB), then click on Against and fill in the Comments box asking your legislator to vote NO. Be sure to hit 'Submit' when done.

There is strength in numbers, and we need large numbers of individuals to oppose this bill or it WILL pass.

Thank you.

Dan M. Heffley
Leg Chair

HUPAC Challenge- Become a 365 sponsor

What a wonderful, productive, and educational time this year’s Cap Conference was. It didn’t hurt that the weather was beautiful and the cherry trees were in bloom. It’s hard not to feel patriotic when you visit our nation’s capitol, with the austere beauty of the Washington monument reaching for the heavens, the majestic authority of the Lincoln Memorial, the bustling activity in the city itself. So much history here, you can feel it in the air. There are many pages in our country’s history that has helped define who and what America represents. It is a page from our nation’s history that serves as a warning for everything that we, as health underwriters, believe in and is forever immortalized in the following poem by Henry Wadsworth Longfellow.

Listen, my children, and you shall hear
Of the midnight ride of Paul Revere,
On the eighteenth of April, in Seventy-Five;
Hardly a man is now alive
Who remembers that famous day and year

It was 224 years ago this month that Paul Revere made his famous ride informing the American Colonists that “The British are coming! The British are coming!” which subsequently awakened them from their slumbers and allowed them to repel the British Troops. Imagine, for a moment, if the colonists had not responded. It was, after all, past midnight; they could have just as easily rolled over and went back to sleep, thinking someone else was going to take care of it. Good thing they didn’t. We might be singing “God Save the Queen”.

I bring this up to draw attention to the urgency we as Health Underwriters now face. On a positive note, our state was well represented at Cap conference with both Southern and Northern Nevadans attending. In between all the facts, figures, speakers and meetings, however, one fact emerged that was less than flattering. It seems that out of all the regions, Region 8, our region finished second-to-last in number and volume of HUPAC contributions per member. What made it worse was that California, which is also in Region 8, had the highest per diem contribution in the Nation! I’ll leave you to draw your own conclusions about what that says about Nevada. If you don’t know, HUPAC stands for Health Underwriters Political Action Committee. HUPAC’s purpose is to raise funds from NAHU members for the purpose of supporting the political campaigns of candidates who believe in private sector solutions for the health and financial security of all Americans. This also helps us to get face-time with the legislators in Washington so that our views can be heard. Your membership dues cannot go towards HUPAC by law.

I won’t mince words. From commission disclosure legislation, insurance connector formations, the threat of public healthcare, our industry is under attack as the American people are screaming for blood. Worse, our current administration is listening to them. In these tight economic times, we need to demonstrate our value to America’s healthcare system, that we are not simply salespeople who take a percentage of premiums that could be used elsewhere. Our only line of defense is to properly educate the decision makers who ultimately decide on which laws to pass. In this tumultuous year, it is gratifying to know that our National Association has the ears and eyes of the various legislative bodies. Although it was a successful Conference, NAHU was among those organizations that didn’t survive the cut for one particular committee meeting in Washington. We should be represented at EVERY meeting. In order to continue our relationship with the legislators and be at the table, we need funds. I would personally challenge each and every one of us to become a 365 sponsor (or $1 a day), but even $5 or $10 a month will help. Times are tough; but without funding, they will get a lot tougher and then we won’t have to worry about it because we won’t have a job. At this critical time in our industry, we can’t afford to hit the snooze button. That’s why I’m shouting at the top of my lungs, “the Socialists are coming, the Socialists are coming!” (tongue-NOT-in-cheek).

Dan Heffley
Legislative Chair

The Stimulus Package and Obama's Speech

Tonight, President Obama unveiled his vision for healthcare reform. As such, he referred to the successes thus far and his hopes for the future. As most of you know, both SCHIP and ARRA have been passed. While certainly not simple, SCHIP is fairly straightforward in that it directly addresses health insurance reforms as it relates to children and pregnant women. ARRA (aka the Stimulus Package), on the other hand, comprises many items in addition to the many healthcare reforms. The reforms that will directly impact our industry and our clients are many-fold. Cobra, the federal law that allows employees to continue their healthcare coverage after termination of employment has been expanded and will be subsidized for 9 months in certain instances. Funding for a host of disease research, among them heart disease, Alzheimer’s, Parkinson’s Disease and cancer research, (now the leading cause of death of Americans), was included in this bill. During the President’s speech, he alluded to this and his hope that cancer will be ‘cured within our time’. Funding for Health IT systems are a big part of the package as well, with healthcare providers being mandated to have electronic records by 2015. This item has certainly generated some controversy, however the codification of the National Coordinator of Health Information Technology and the Comparative Effectiveness provision have become the ‘cause celebre’ in the media and has led to a ‘feeding frenzy’ by radio talk shows and print media. Even our own Las Vegas Review Journal, in it’s Sunday, February 22, 2009 editorial, voiced concerns about misuse of the legislation to deny claims. Nothing could be further from the truth. The law is specifically written with consumer protections in mind. The Coordinator position was actually created during the Bush Administration; the new legislation simply clarifies and officially recognizes it. With so much misinformation out there, your clients look to YOU, their agent, to provide the voice of reason amidst this storm. NAHU and CCAHU provide the answers and training you need to properly inform and advise your clients. One of the ways we can do that by attending our monthly luncheons. Always pertinent and informative, at our March 10th luncheon the various provision of the ARRA will be thoroughly discussed. Now is the time to reserve your seat for the luncheon so you can be better informed to answer your clients’ question

Day on the Hill

For those of you that were able to attend “Day on the Hill” in Carson City this past week, congratulations. For those of you who weren’t able to attend, the event can only be described as “electric”. From our first day attending a tour of the Carson City DOI to an after-hours dinner party sponsored by Nevadans for Affordable Health Care, to the final day attending the 75th Legislative Session at which Senator Harry Reid spoke, I think I speak for all that attended that it was very informative and productive. Your CCAHU (and the concerns of our industry) were very well represented, with the legislators and lobbyists very receptive to our input as the country moves closer to comprehensive healthcare reform. It is events like these that help your CCAHU and our industry as a whole maintain a seat at the table of healthcare reform. Next month CCAHU will be in Washington, DC at Cap Conference, advocating reforms that directly affect you and you clients. It is important to support these activities directly by attending these important events, and/or indirectly through your contributions to HUPAC and State HUPAC. Hope to see you at Cap Conference !

Stimulus Package Set to Become Law

On Friday, February 13th, lawmakers signed HR-1, commonly know as the stimulus bill. Next, it will go to President Obama for his signature, Monday February 16th. A number of compromises were struck, most importantly on the House version's expansion of the Medicaid program. Instead of expanding the Medicaid Program, lawmakers agreed on language giving $87 billion in matching funds to the states through December 31rst, 2010.

Next is a provision allowing workers that were/will be involuntarily terminated between 9/1/2008 through 12/21/2009 to receive a 65% subsidy for COBRA for 9 months. After 9 months, the worker could still continue COBRA for the remaining 9 or 27 months but without the subsidy. The total cost for this provision is estimated to be $24.7 billion.

The remainder of the bill gives $19 billion to doctors and hospitals to help them institute electronic medical records, $1.1 billion for comparative effectiveness technology, $1 billion for wellness and preventive programs and finally, also included in the legislation is an expansion of Trade Adjustment Assistance (TAA) programs and the Health Coverage Tax Credit.

Obama Reverses Bush CHIP directive

On the heels of President Obama signing expanded SCHIP legislation into law, a memo reversing certain restrictions placed upon SCHIP by the Bush administration in an August 2008 letter was released Thursday, 2/5/09. Specifically the memo sought to eliminate the following restrictions, which was proving to be unenforceable and resulted in certain states filing legal challenges against it.

Children in families with incomes greater than 250% of the federal poverty level first must verify that 95% of eligible children in families below 200% of the poverty level are enrolled in the program. HHS also required states to verify that children in families with incomes above 250% of the poverty level have been uninsured for one year before qualifying for CHIP. The memo sought to clear up any potential confusion over SCHIP implementation and to allow the new SCHIP law to proceed without interference.

The entire memo can be viewed at this link : http://politics.theatlantic.com/02-04-09%20CHIP%20Presidential%20Memorandum.pdf

President Obama Signs SCHIP bill

As of 1:30 pm PST (4:30 EST) today, February 4th, President Obama signed the House's bill HR2 into law. The bill was unchanged from the Senate version passed last week so the Senate's amendments were included. The law contains premium subsidies long advocated by NAHU, which is believed to help mitigate potential "fall-out" (whereby individuals opt out of other coverage to go onto the SCHIP plan) by allowing states to create, expand and improve premium-assistance programs for employer-coverage. Going forward, NAHU expects to develop model legislation to help create new premium assistance programs in states that don't already have programs in place and to improve upon states' plans that are already in place.

SCHIP News

The Senate has passed an expansion of the State Children’s Health Insurance Program for another 4 ½ years on January 29th. Since the House voted and passed their version of an expansion, they now go to a conference committee. The plans are nearly identical, with most of the funding coming from tobacco tax increases as well as expanding eligibility to children and pregnant women who are legal immigrants, but without a five-year waiting period.

Region 8 legislative report

The Region 8 Legislative Report has been received and with it some items of interest come with it. The following affects not only those agents with licenses in those states, but possibly every agent or broker in the health field. Since most legislative sessions are just starting, there isn’t much activity yet as the states are concerned with budget issues. Some of the activity:

1) California—New bill to reform and improve CA’s broker safety net health plan for uninsurable. State funding will be needed. Sixty to seventy healthcare reform bills are expected to be introduced before 2/27deadline. Expected to be funded by new costs and rules for health insurance industry.
2) Oregon—HB2009 introduced by Rep. Greenlick would establish Health Insurance Exchange and Health Authority.

NAHU is monitoring the situation.

Chamber calls for PEBP changes

On January 26th, a week before the start of the 2009 Legislative session, the Las Vegas Chamber of Commerce held a press conference, whereby they called for reform of the Public Employees’ Benefit Program (or PEBP). While also addressing other issues, the applicable healthcare provisions were as follows:

1) Eliminate the PEBP retiree health care subsidy for all new employees.
2) Reduce the PEBP retiree health care cost for all current employees.
3) Eliminate PEBP retiree health care subsidy for all current employees when they become eligible for Medicare.

The Chamber’s call for reform follow a series of fiscal analysis reports performed by Jeremy Aguero of Applied Analysis and Guy Hobbs of Hobbs, Ong & Associates, whose purpose according to the Chamber was to “provide a factual foundation from which the Chamber can make informed public policy recommendations.”

House Moves Forward with Stimulus Bill

The House Ways and Means Commerce Committee voted 24-13 on Jan. 22 to approve its part of the stimulus package to provide tax, health and unemployment relief to families while also urging businesses to create new jobs. Three areas are of great interest to NAHU.

1) COBRA subsidization and expansion: The bill provides for $30.3 billion to subsidize COBRA premiums. Additionally, workers aged 55 or older who have at least 10 years employment with their last employer would be allowed to keep their COBRA until Medicare eligibility or until they get other coverage.

2) Medicaid expansion: The bill also provides $8.6 billion so states could receive 100 percent federal matching funds to provide optional state Medicaid coverage, through 2010, for certain individuals who are involuntarily unemployed.

3) Health information technology incentives: The House proposal also includes $20 billion in spending to encourage the adoption of health information technology, with payments to doctors of $40,000 to $65,000 who can demonstrate that they are meaningfully using electronic data, such as through the reporting of quality measures.

NAHU's Position: Nahu has serious concerns regarding the proposed extension of COBRA eligibility and the potential Medicaid expansion with no subsidies for any other coverage option except for COBRA. However, the proposed means to administer the subsidy through the employer (or their administrative designate) for COBRA administration is exactly as NAHU recommended.

Senate Democrats are working on their own version of a stimulus package with the overall goal of having a bill finalized for President Obama’s signature by mid-February. NAHU is working with key Senate offices on the COBRA provisions of concern as well as the Health IT privacy enforcement issues.

Senate passes SCHIP legislation

By a 12-7 vote, the Senate Finance Committee on Thursday approved SCHIP reauthorization and expansion legislation that could add four million children to the program, the AP/Boston Globe reports (AP/Boston Globe, 1/16). The bill, introduced by committee Chair Max Baucus (D-Mont.), would expand the program by $31.5 billion over four-and-one-half years. The House passed a similar bill (HR 2) on Wednesday. The bill now goes to the floor, where Senate leaders are expected to amend Baucus' language into the House-passed bill and send it to conference to resolve any differences.

Health Opportunity Accounts

The Deficit Reduction Act allows 10 state Medicaid programs to set up five-year demonstration projects to provide Medicaid recipients with Health Opportunity Accounts (HOAs), similar to Health Savings Accounts (HSAs) used in the private sector.168 Proponents hope these accounts will create an awareness of health care costs and inject an element of consumerism into the purchase of medical services. The states that choose to participate will receive federal matching funds to contribute up to $1,000 per child and $2,500 per adult into the HOAs. HOAs can be used to purchase a variety of medical goods and services, and unused funds will be available for future use by participants. Moreover, if patients become ineligible for Medicaid, they have up to three years to use up to 75 percent of their HOA balances to purchase private health insurance.169 South Carolina, which had already applied for a HIFA waiver to restructure its Medicaid program, has applied to become one of the 10 states.

House votes Yes on SCHIP Expansion

The U.S. House of Representatives passed bill HR 2 today which expands the State Children's Health Insurance Program, which was slated to expire March 31rst. The bill calls for funding, primarily through cigarette taxes, through September 2013. A Senate version of the bill is scheduled for mark up by the Senate Finance Committee on Thursday. President-elect Obama has stated he will sign new legislation into law once he takes office.