Mid-week Miscellany

Mid-week Miscellany

  • Tomorrow is President Obama’s health care reform summit. According to Modern Healthcare.com,
    House leaders have pledged at least a half-dozen hearings over the coming weeks to seek out fixes for the nation’s fractured healthcare system, but were less clear on a timetable for a bill. [For instance, the Health Subcommittee of the Energy and Commerce Committee will hold a health care reform hearing on March 10, and the House Ways and Means Committee will hold a health care reform hearing on March 11.

    Rep. Frank Pallone (D-N.J.), chairman of the House Energy and Commerce Health Subcommittee, said that the House does not have an official deadline, but acknowledged that under President Barack Obama’s goal to sign a bill this year, “I would say you have to get it passed by end of summer or early September.”

    This week, Senate Finance Chairman Max Baucus (D-Mont.) said he would target midsummer for a reform package to emerge from the Senate. Baucus, who has emerged as the point person on health reform, said he had met with many lawmakers to help shape the legislative process, including those on the House side.

  • The Davies public relations firm released the results of a 2009 national survey of hospital executive attitudes towards health insurers. According to the firm’s press release,

    Although health plans are rated poorly in a variety of other surveys – including JD Powers and Harris Poll – the DAVIES survey revealed two outliers in the health insurance community. For the first time, hospitals identified a preferred business partner in Aetna. And for the third straight year, UnitedHealthcare stood out dramatically as a bad actor in its ratings.

  • The DC Examiner reports that five federal annuitants have sued the Department of Health and Human Services in DC federal court to block an HHS rule requiring them to enroll in Medicare Part A if they want to receive Social Security benefits. The lead plaintiff had been happily enrolled in the Mail Handlers Benefit Plan’s high deductible plan with a health savings account (“HSA”). However, you cannot contribute to an HSA if you are enrolled in Medicare. There’s the rub that lead to the lawsuit.
  • Up in the Bay State, according to the AP, a group of federal employees who have same sex spouses have sued OPM in Massachusetts federal court in an effort to force OPM to open FEHBP coverage to their spouses. The AP reports that

    The new lawsuit challenges only the portion of the [Defense of Marriage Act] that prevents the federal government from affording Social Security and other benefits to same-sex couples. President Barack Obama has pledged to work to repeal DOMA and reverse the Department of Defense policy that prevents openly gay people from serving in the military.

  • Joe Davidson of the Washington Post reports this morning on a glitch in President Obama’s budget outline. The budget outline projects $9.5 billion in savings over ten years from reductions in postal employee fringe benefits. The budget fails to consider that in those benefits are collectively bargained between the postal unions and the USPS. In contrast, the federal employee unions do not have collective bargaining rights over wages and fringe benefits. Those must be “negotiated” with Congress. Hence the efforts year in and year out to get Congress to increase the Government contribution toward FEHBP coverage for federal employees and annuitants.

Press Coverage of Berry Nomination

Washington Post

While with [House Majority Leader Steny] Hoyer’s office [as his legislative director for ten years], Berry worked on federal government employment issues and helped craft locality pay reform, issues of importance to the Maryland congressman, whose district is home to many federal workers. Those experiences earned him wide praise from Federal workers unions when his name first surfaced as possible OPM director in January.

Govexec.com

“I can think of no better person than John Berry to lead the Office of Personnel Management,” Hoyer said. “John is an incredibly qualified public servant who possesses significant management experience, great knowledge of government, and a high regard for our federal workforce. Anyone who has worked with him knows how very bright and positive a person he is. He is an excellent choice to lead OPM, and I strongly support his nomination.”Sen. Daniel Akaka, D-Hawaii, who chairs the Senate Homeland Security and Governmental Affairs Federal Workforce Subcommittee, which will oversee Berry’s nomination, also had high praise for Obama’s pick.”I know John to be a strong, capable, and passionate leader,” Akaka said. “OPM is key to our government’s ability to perform, because human capital is critical in everything our government does, from national security to financial industry oversight. We need someone like John who can attract talented leaders and maintain quality across federal agencies so management will be at its prime.”

New Republic Blog The Plank

President Obama has just made John Berry, the current director of the National Zoo, the highest-ranking openly gay appointee ever by tapping him to head the Office of Personnel Management (pending Congressional approval). As an assistant secretary at the Interior department under President Clinton, Berry fought to end a wide range of discriminatory policies, including background checks for gay and lesbian applicants for National Park Service law enforcement jobs, and worked to set up a grievance process for employees who were harassed because of their sexual orientation. The Office of Personnel Management might not seem like a bully pulpit for a gay rights advocate like Berry. But, unlike workers at more than half of the Fortune 500 companies, the 1.8 million employees who fill the ranks of the federal government don’t have domestic partnership benefits. Their partners can’t participate in the Federal Employees Health Benefits Program, a plan that’s been considered a potential model for health care reform. They can’t benefit from retirement programs. And if gay federal employees move for work, their partners can’t benefit from relocation programs.

President Obama nominates OPM Director

President Obama today nominated John Berry to serve as Office of Personnel Management Director. Mr. Berry currently is director of the National Zoo in Washington, DC. From the White House press release

On the nomination of John Berry, President Obama said, “From turning around the National Zoo to fostering a more productive work environment at the Department of the Interior, John Berry has a tremendous record of effective management in key public service roles. I’m confident that he will provide that same leadership at OPM to help ensure that government works for the American people the way it should.”

Of course, OPM adminsters the FEHB Program

Fun Fact

From AIS Health Business Daily — “iConecto, the Virginia company that both tracks and sponsors a new Web health gaming site, says the Health eGaming market will reach $7 billion over the coming year.”

Weekend update / Miscellany

  • Press reports indicate that tomorrow President Obama will announce that he is nominating Kansas Governor Kathleen Sebelius to serve as Secretary of the Department of Health and Human Services. Of course, this nomination is subject to Senate approval. This news reminds me that in January there were several press reports that the President intended to nominate National Zoo director John Berry to serve as the OPM Director. I haven’t read any more about the OPM’s Director’s position since the President named Kathie Ann Whipple to serve as acting Director.
  • The Dallas News includes an interview with Darren Rogers, the President of Blue Cross and Blue Shield of Texas. The interview focuses on the tension between physicians and health plans. This is a good exchange —

    I look at this as we’re all in this together and we’ve all got to get along. I think everybody’s heart is in the right place. I don’t think that physicians or hospitals are trying to put me out of business, and I’m certainly not trying to put them out of business. Without them, I have no business. I’m not saying conflict doesn’t exist, because there’s a natural tension. Health plans are an intermediary between the people who are paying for service – which are really the employers – and providers, who want to maximize their incomes. But where would providers be without the commercial health insurance companies? We all pay more than the government programs do. If we’re not there anymore, then they get to live on what Medicare and Medicaid pay them. And certainly there are bad actors. We do have situations where we know that physicians and other providers are harming people, and they get investigated. And there are probably things that health plans do that aggravate them. But you can’t have a free rein on the system or no one would be able to afford anything.

  • The New York Times reports today on the efforts of Aetna and United Healthcare to prepare for the next round of health care reform efforts.
  • The Labor Department has created a useful website on the COBRA continuation coverage subsidy created by the stimulus law. As explained on that site,

    The American Recovery and Reinvestment Act of 2009 (ARRA)[the official name of the stimulus act] provides for a 65% reduction in COBRA premiums for certain assistance eligible individuals for up to 9 months. An assistance eligible individual is a COBRA “qualified beneficiary” who meets all of the following requirements:Has a qualifying event for COBRA coverage that is the employee’s involuntary termination during the period beginning September 1, 2008 and ending December 31, 2009.Those who are eligible for other group health coverage (such as a spouse’s plan) or Medicare are not eligible for the premium reduction. Other limitations may also apply. There is no premium reduction for periods of coverage that began prior to February 17, 2009.

    OPM is in the process of implementing these changes to the FEHBP’s analogous temporary continuation of coverage program.

  • The Blue Cross and Blue Shield Association has published its annual report on state health care initiatives.
  • HHS issued a projection of 2009 health care costs. The report discusses the impact of the current recession on health care spending.

It’s heating up on Capitol Hill

According to the Federal Times, the House of Representatives passed the FY 2009 appropriations bill (HR 1150) discussed in yesterday’s post by a 245-178 vote. The bill moves onto the Senate. Also in the House, according to Govexec.com, a bill was introduced to allow federal retirees to pay their FEHB plan premiums with pre-tax dollars just like employees. This bill has been introduced numerous times without success because Congress has been stymied by the difficulty of giving this benefit to federal retirees but not to private sector retirees. Of course, extending the pre-tax benefit to the whole magillah creates a whopping tax loss. But maybe that doesn’t matter this year.

The health care reform effort is heating up on Capitol Hill according to CQ Politics. The President’s speech left no doubt last night that there will be a push for universal health coverage in 2009. The Washington Post provides an advance report on the health care reform pieces of tomorrow’s FY 2010 budget proposal. The Post reports that

If the budget is approved, drug companies would be required to increase the rebate they now provide for medications sold to Medicaid patients from 15 percent to 21 percent. The proposal would likely spark a ferocious lobbying campaign by the industry, which has argued that the current 15 percent rebate is already cutting into profits.

What the Post fails to mention is that the drug industry maintains its profitability by increasing prices on the private sector health plans whenever Medicaid takes a bigger rebate.

Also it’s interesting to note that the big prescription benefit managers Medco and Express Scripts are staying afloat. Fox Business reports that

Medco Health Solutions reported fourth-quarter net income of $274.4 million, or 54 cents a share, up from $207.6 million, or 38 cents, earned in the final three months of 2007. Quarterly revenue generated by the Franklin Lakes, N.J.-based health-care provider reached $12.96 billion from the prior year’s $11.38 billion. The volume of mail-order prescriptions handled by Medco hit 26.7 million in the latest quarter, up 9.4% and a company record. Medco said revenue growth primarily reflected new client wins and price inflation on brand-name drugs, offset in part by higher volumes of lower-cost generic drugs.

CNN Money reports that

Express Scripts Inc.’s (ESRX) fourth-quarter net income rose 49% as gross margins expanded on wider use of generics, which also helped push revenue slightly lower.

Express Scripts reported net income of $206.8 million, or 83 cents a share, up from $138.5 million, or 54 cents a share, a year ago. The latest quarter included a $7.3 million charge related to a security breach.

Revenue fell 0.9% to $5.51 billion.

I am personally ecstatic about UConn’s win over # 10 Marquette tonight as it was Coach Jim Calhoun’s 800th victory of his illustrious career.

FY09 Appropriations

Last year, Congress enacted and then President Bush signed into law a bill (H.R. 2638) that fully funds national security operations for the fiscal year (FY) 2009 that began October 1, 2008, and generally provides continuing appropriations at FY 2008 levels for other federal government operations until March 6, 2008.

Congress is now considering an omnibus FY 2009 appropriations bill (H.R. 1105). http://www.rules.house.gov/111/LegText/111_omni2009_2.htm The House is expected to vote on the bill this week, and the Senate next week. Under the House rule applicable to this bill, the bill will be given an up or down vote without further amendments H.R. 1105 does include the now standard FEHBP related appropriations provisions — a ban on application of the cost accounting standards to FEHB plan contracts (§611), prescription drug-contraceptive parity (§728), and a prohibition against the expenditure of funds for abortions except in cases of rape or when the health of the mother is at stake (§§613-614).

Weekend update / Miscellany

  • Happy Birthday to George Washington! First in war; first in peace, and first in the hearts of his countrymen.
  • On February 20, OPM finalized in the Federal Register its rule amending the Federal Employees Health Benefits Acquisition Regulation (48 C.F.R. Chap. 16). In response to an adverse decision from the U.S. Court of Appeals for the Federal Circuit, “[t]he rule clarifies the rate setting process for community-rated carriers with respect to Similarly Sized Subscriber Groups (SSSG) and removes the ban on adjustments based on rate reconciliation for the final year of Federal Employees Health Benefits Program (FEHBP) contracts.
  • Also on February 20, the New York Times reported that a healthcare reform “workhorse group” organized by Senator Ted Kennedy is coalescing around an individual mandate to purchase health insurance similar to the Massachusetts Connector program. According to that report,

    The 20 people who regularly attend the meetings on Capitol Hill include lobbyists for AARP, Aetna, the A.F.L.-C.I.O., the American Cancer Society, the American Medical Association, America’s Health Insurance Plans, the Business Roundtable, Easter Seals, the National Federation of Independent Business, the Pharmaceutical Research and Manufacturers of America, and the United States Chamber of Commerce.