Pacific Progressive

High Risk Pools for People with Medical Issues Start Slowly

This article was published by Kaiser Health News.

By Michelle Andrews

This summer, new health insurance programs aimed at people with preexisting medical conditions began accepting applications around the country. The plans target one of the key promises of the health-care overhaul: Everyone, even people with checkered medical histories that may make them uninsurable under the current system, can get coverage.

Now the plans are up and running in every state. So far, the response has been modestand reviews are mixed. For some, the new preexisting-condition insurance plans -- PCIPs, also known as high-risk pools -- have offered a lifeline that has enabled them to afford crucial treatment that they otherwise would have skipped or had to pay for themselves. Others, however, have been frustrated by strict eligibility rules that have shut them out of the plans, and still others find the coverage too expensive.

The pools are intended to act as a stopgap until the state-based health insurance exchanges created under the health-care overhaul are up and running in 2014. (At that time, anyone without affordable job-based coverage will be able to buy insurance on one of the exchanges.) For the period between now and then, the new law established a $5 billion insurance program for up to an estimated 6 million people with preexisting medical conditions.

State Regulators Recommend New Health Insurance Rules

This article was published by Kaiser Health News.

By Julie Appleby

KHN Staff Writer 

Insurance regulators unanimously recommended controversial rules Thursday governing how much insurers must spend on patients’ medical care – without adopting any of several last-minute amendments some consumer advocates had feared would gut key provisions.

The rules, which involve an important provision of the new health overhaul law, now go to Health and Human Services Secretary Kathleen Sebelius, who has final say.

Leaders of the National Association of Insurance Commissioners voted after months of meetings and debate involving industry and consumer representatives. The recommended rules center on the "medical loss ratio," which is how much insurers spend on medical care versus administration and profit.

The health overhaul law approved by Congress in March requires insurers to spend at least 80 percent of revenue on direct medical care, starting next year, or issue rebates to consumers if they fail to hit the target.

During the debate leading to the recommendations, insurers pushed for the broadest possible definition of what constitutes medical spending, including such things as the cost of paying claims, signing up doctors to their networks or running customer service call centers. The final recommendations are narrower, which is what consumer groups had urged.

Republican's Controversial Proposal to Mend Medicare

This article was published by Kaiser Health News.

By Marilyn Werber Serafini

Cat food wasn't on the menu at a recent book launch party for "Young Guns: A New Generation of Conservative Leaders." But that didn't stop representatives of the labor-backed Alliance for Retired Americans from handing out cans of the stuff to arriving party-goers at the fashionable Johnny's Half Shell, just a few blocks from the U.S. Capitol. The less than subtle protest targeted Republican proposals in the book to privatize Social Security and turn Medicare into a voucher program.

"We'll all be eating cat food when we're old and gray," Frank Clemente, manager of the Strengthen Social Security Campaign, screamed to cheering protesters who hoisted cat food and chanted "young gun chow" and "Ryan retirement meal." The Campaign, also union-backed, is affiliated with the Alliance.

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Trouble in the Suburbs: Poverty Rises in Areas Outside Cities

This article was published by the Center for American Progress.

By Alexandra Cawthorne 

The suburbs were once considered by many to be a retreat from poor economic and social conditions in cities. Now, however, they’re home to nearly one-third of our nation’s poor—and rising. The last decade set in motion this shift in the map of poverty, but the recession exacerbated key economic trends that rapidly increased the growth rate of suburban poverty to more than double that of central cities.

Federal and state governments should take note: This emerging trend calls for a corresponding shift in poverty policies that includes a more regional, all-encompassing approach.

New data show large increase in suburban poverty since 2000

The numbers are startling. Analysis from the Brookings Institute found that since 2000 the number of poor people in the suburbs jumped by more than 37 percent to 13.7 million—also outpacing the national growth rate of 26.5 percent. In a reversal from the beginning of the decade 1.6 million more poor people lived in the suburbs of the nation’s largest metro areas last year than in inner cities. Making matters worse, social service providers are often spread thin in suburban areas, and many have been forced to turn away more poor people as the need grows.