Here's a great article from Investor's Business Daily detailing the health reform costs small businesses face.

Health Reform Would Bury Small Business
By Sally C. Pipes

November 6, 2009

President Obama recently delivered a special address aimed at quelling small-business owners' concerns about Democratic plans for health care reform.

The legislation, he assured, would "benefit millions of small businesses" and was "being written with the interests of Americans like you and your employees in mind."

That's a nice sentiment. But it's not backed up by the facts. Several new studies show that ObamaCare will dramatically increase health costs for most small businesses.

One study relied on actuarial data from WellPoint, a large health insurer that provided customer data in 14 states where it operates Blue Cross plans. The report concluded that 70% of small businesses would experience higher health insurance premiums if the Democrats' health plan passes.

For the average small employer in New York City, the increase in premiums would be modest — just 6%. But in Franklin County, Ohio, a typical small business would be hit with an 86% increase. Similarly sized businesses in Louisville, Ky., and Richmond, Va., would see their premiums go up 20% and 25%, respectively.

These findings align with the results of a different study, produced by Blue Cross Blue Shield and the consulting firm Oliver Wyman. It estimated that the average small business would experience a 19% jump in premiums within the first five years of ObamaCare's passage.

A third study, from America's Health Insurance Plans and PricewaterhouseCoopers, found that the reform bill approved by the Senate Finance Committee would result in a 28% increase in premiums for firms with fewer than 50 workers by 2019.

Simply put, the Democrats' reform plans would raise the cost of insurance for small businesses. A quick look at the various elements of their legislative package shows why.

For starters, the Democrats' proposal would require every insurance policy to cover a minimum set of benefits, even if the customer doesn't want or need them. At the state level, such benefit mandates can increase the cost of a basic insurance plan by 20% to 50%.

Why? Insurers price their products based on how much they might have to pay out in claims. The more treatments an insurer is on the hook for, the more costly it is to cover each customer, and therefore the higher the premium.

The Democrats' package would also institute a federal "guaranteed-issue" law, which would prohibit insurers from denying coverage to customers based on pre-existing conditions.

This reform is well-intentioned. But it ensures that many people will wait until they get sick to buy health insurance. Insurers' risk pools will dry up until only those with chronic health problems remain. Companies will respond by jacking up premiums. Indeed, states that have implemented guaranteed-issue laws have seen premiums jump 227%.

Of course, rising health-insurance prices hurt all employers — big and small. But the bigger ones have the luxury of spreading those costs among many workers. They can also use their purchasing clout to negotiate lower rates with carriers.

Small businesses don't have these advantages. That's why, on average, they pay 18% higher premiums than their large counterparts, according to the Commonwealth Fund.

Even without the Democrats' "reforms," small-business health premiums were expected to go up, on average, by 15% over the next year. And to add insult to injury, the House would also impose a 5.4% surtax on individuals with annual incomes of more than $500,000 and families of more than $1 million.

The tax would not be adjusted for inflation, so more and more small-business owners would be ensnared by it each year.

Managers would likely compensate for these new costs by discontinuing health benefits, cutting wages, holding off on new hires or even laying off workers. Can the Democrats' efforts really be called "reform" if they'd leave workers and businesses alike worse off?

The administration has dismissed accounts critical of its health reform plan out of hand. But the facts don't lie. The Democrats' reform package will make health insurance more expensive for small firms. If the president and his congressional allies are serious about defending the interests of small businesses, they need to get a new plan.

Sally C. Pipes is president and CEO of the Pacific Research Institute and author of The Top Ten Myths of American Health Care <http://www.amazon.com/Top-Myths-American-Health-Care/dp/1934276111/

House Health Reform Bill Includes Public Option

Pelosi starts clock on House health bill By: Patrick O'Connor and Chris Frates October 29, 2009 11:01 AM EST

House Speaker Nancy Pelosi unveiled a $894 billion health care bill Thursday that would extend coverage to 36 million Americans through a mix of subsidies, tax incentives and penalties on individuals and small businesses, but the final package falls short of the more liberal vision of a public health insurance option. Party leaders would like to start debate on the bill next week and hope to have a final vote before Veteran's Day on Nov. 11. The long-awaited introduction of a combined House health care bill produced few major surprises. After weeks of public hand-wringing, leaders – and party liberals – bowed to political reality by allowing doctors and hospitals to negotiate their rates with the government under the public plans. Unveiling the bill at the Capitol, Pelosi said the bill would meet the goals of “affordability of the middle class, security for our seniors, responsibility to our children. It reduces the deficit, meets President Obama’s call to keep the costs under $900 billion over 10 years and it insures 36 million more Americans.” “The bill is fiscally sound, will not add one dime to deficit as it expands coverage, implements key insurance reforms and promotes prevention and wellness across the health system,” Pelosi said. The bill would cut the deficit by about $30 billion over the next 10 years. Pelosi, however, backed down from a deal granting liberals a vote to establish single-payer government-run health care. She cut the deal with New York Rep. Anthony Weiner to break a last-minute logjam on the Energy and Commerce Committee. But, in the end, party leaders were concerned the final cost would be astronomical and the vote would fail to garner votes from even half the caucus. The legislation would require health insurers to offer broader coverage and end practices that discriminate against higher-risk individuals. It would also establish a national insurance exchange with subsidies to lower- and middle-income households to make coverage more affordable. The Congressional Budget Office offered Pelosi and her team some good news and some bad news. The good news is that the bill shouldn’t add to the deficit over the first decade after its enactment. The bad is that the legislation is projected to create deficits over the second five years, a fact that should give budget hawks plenty to worry about. Pelosi’s decision to strip a $245 billion package of doctors’ payments also threatens to anger party moderates. The so-called “docs’ fix,” which would fill a long-standing shortfall under Medicare reimbursement rates, would put the overall cost of the bill well over $1 trillion and create more than $200 billion in red ink for the federal government over the next 10 years – two big “no-nos” from President Barack Obama’s perspective. The bill should cause plenty of headaches for the industries impacted. The legislation imposes as much as $150 billion in Medicare cuts on the prescription-drug industry – almost double the $80 billion cuts in the Senate bill. It imposes a 2.5 percent tax on medical device manufacturers, a quietly influential force on Capitol Hill, And health insurers, who have already agreed to end many of the practices banned by the bill, would have to compete with a government-run insurance vehicle that would put pressure on them to lower premiums. In addition, businesses with a combined annual payroll exceeding $750,000 will be forced to pay penalties for its uninsured workers. As expected, the House bill generates most of its income by imposing a graduated surtax on married couples who make more than $1 million and individuals whose adjusted gross income exceeds $500,000. The initial income thresholds were $350,000 for couples and $280,000 for individuals. Democrats leaving a meeting with their leaders Thursday morning sounded bullish about the prospects for the vote. "I think it's probably going to be our best-faith effort at health reform in the House," said first-year Virginia Rep. Gerry Connolly. "I'm looking forward to being supportive." Congressional Democrats are now calling on Obama to put his finger on the scale. "I guess the time has come for the President of the United States to get in here a little bit,” Weiner said after emerging from a closed-door caucus meeting Thursday. “I understand the idea of letting the legislature work its will, but unless we have the president in there putting his finger on the scale and his hands on the shoulders of some of my colleagues we are not gonna be successful with our red-zone offense." Jonathan Allen and Jake Sherman contributed to this article.

© 2009 Capitol News Company, LLC

Senate Health Reform Bill will have Public Option

From Bloomberg.com....

Reid Backs Health-Care Public Option, Letting States Opt Out

By Laura Litvan

Oct. 26 (Bloomberg) -- Senate Democratic Leader Harry Reid announced his support for establishing a government-run health- insurance program that would allow states to opt out.

Reid said the so called public option with the opt out provision is the “fairest way to go.”

Reid, speaking at a press conference in Washington, said he’ll send health-care legislation to the Congressional Budget Office today for a cost estimate.

The Nevada Democrat said that even though Senator Olympia Snowe, the only Republican to vote for a health-care bill, opposes the public option, he still hopes to get her vote.

Reid also said non-profit health-care cooperatives will be included in the legislation.

To contact the reporter on this story: Laura Litvan in Washington at llitvan@bloomberg.net

Senate Finance Rejects Public Option

Fate of Government-Run Health Insurance May Rest in Obama's Hands

Once touted by the president as essential in "keeping insurance companies honest," the so-called "public option" was blasted by Senate Republicans and moderate Democrats in the Senate Finance Committee on Tuesday.

FOXNews.com

Wednesday, September 30, 2009

http://www.foxnews.com/politics/2009/09/30/fate-government-run-health-insurance-rest-hands-obama/

The fate of a government-run health insurance plan may rest in President Obama's hands after the Senate Finance Committee rejected amendments that would include the so-called "public option" in its version of health care reform legislation.

Liberal Democrats failed twice on Tuesday to include a government-run insurance option in the legislation before the committee, the last of five congressional panels completing work on the president's top domestic priority.

Once touted by Obama as essential in "keeping insurance companies honest," the government plan was blasted by Senate Republicans and moderate Democrats, some of whom argued it would lead to a single-payer system.

The vote to strike down two separate amendments underscored the disagreement among Democrats over the necessity of a public option. Whether Obama will continue to fight for it remains to be seen.

The first amendment, proposed by Sen. John D. Rockefeller of West Virginia, was rejected 15 to 8. The second, penned by Senator Chuck Schumer of New York, was defeated 13 to 10.

Rockefeller had proposed a plan modeled on Medicare, the federal health care program for senior citizens, in which the government would set what it pays doctors, hospitals and other medical providers. Schumer proposed a government plan that would look more like a private insurance company and negotiate payment rates with providers.

Sen. John Ensign, D-NV, was quick to pounce on Rockefeller's amendment, arguing that his idea for a public option would deny doctors participation in Medicare for two years if they choose not to participate in a new government program.

Others, including Sen. Kent Conrad, D-ND, who has crafted an alternative plan that would set up a series of non-profit health care cooperatives, blasted Rockefeller's plan, saying, "The devil is in the details." He said if the amendment is implemented, "every major hospital goes broke."

The White House has been backtracking on its commitment to a public option. Obama made "universal health care" a centerpiece of his presidential campaign, but he later said a government-run program was not essential to reform.

"The public option, whether we have it or we don't have it, is not the entirety of health care reform," the president said at a town hall meeting in Colorado on Aug. 15. "This is just one sliver of it, one aspect of it."

Health Secretary Kathleen Sebelius has said that the public option "is not the essential element" and has suggested that non-profit cooperatives would be a viable alternative.

Supporters of a government-run plan have vowed to keep up their fight as the bill moves toward the Senate floor, and then to negotiations with the House. Democratic leaders in both chambers are pushing for floor votes in the fall.

House Speaker Nancy Pelosi, a strong supporter of a government plan, said Tuesday there's no rush on passing a House bill, especially since the legislation won't take effect until 2013.

"I believe we will have a public option in our bill," Pelosi said during a briefing Tuesday with reporters.

But senior Senate Democratic aides told FOX News that Majority Leader Harry Reid, D-NV, will not include a public option in a health care reform bill he will create once the Finance Committee completes its action this week.

After shooting down the two amendments, the committee will reconvene Wednesday to debate a number of other important issues in health care legislation, including thorny issues like abortion and insurance coverage for illegal immigrants.

FOX News' Trish Turner and the Associated Press contributed to this report.

Senate Finance Committee's "America's Healthy Future Act"

Yesterday, Senator Baucus released his bill on reforming health care. The bill does not contain a government-run public option. This is a step in the right direction!

However, this legislation will be modified and changed as it moves through Congress. CAHR members need to be aware that the Committee is still considering "trigger" provisions that create a new government plan based on affordability. We continue to strongly oppose the inclusion of any government plan no matter how it is structured.

Also, there are some new insurer fees and excise taxes in the proposal that are problematic and would increase the cost of insurance for employers and employees. We will share information about these provisions with you soon.

Look for a new Action Alert to arrive in your mailbox soon!

CAHR Expands to 65 Members!

In the past weeks we've added 15 new members. Check out our complete membership list below to see all the chambers across the country united against a government-run public option.

Albany Area Chamber of Commerce
Albany-Colonie Regional Chamber or Commerce
Androscoggin County Chamber of Commerce
Ashland Area Chamber of Commerce
Blair County Chamber of Commerce
Buffalo Niagara Partnership
Camden County Chamber of Commerce
Chamber Colorado Springs
Chamber of Commerce of Southwest Indiana
Chamber of Southern Saratoga County
Charleston Metro Chamber of Commerce
Columbia Montour Chamber of Commerce
Columbus Area Chamber of Commerce
Daytona Beach/Halifax Area Chamber of Commerce
Detroit Regional Chamber
Eau Claire Area Chamber of Commerce
Erie Regional Chamber and Growth Partnership
Exton Regional Chamber of Commerce
Fond du Lac Area Chamber of Commerce
Fort Collins Area Chamber of Commerce
Fox Cities Chamber of Commerce & Industry
Grand Rapids Area Chamber of Commerce
Greater Cedar Valley Alliance
Greater Cheyenne Chamber of Commerce
Greater Columbia Chamber of Commerce
Greater Indianapolis Chamber of Commerce
Greater Lafayette Chamber of Commerce
Greater Lehigh Valley Chamber of Commerce
Greater New Haven Chamber of Commerce
Greater Oklahoma City Chamber of Commerce
Greater Pittsburgh Chamber of Commerce
Greater Rome Chamber of Commerce
Greater Shreveport Chamber of Commerce
Greater Spokane Incorporated
Greater Woodland Park Chamber of Commerce
Green Bay Area Chamber of Commerce
Harrisburg Regional Chamber
Harrison County Chamber of Commerce
Harrisonburg-Rockingham Chamber of Commerce
Jefferson Chamber of Commerce
Kalamazoo Regional Chamber of Commerce
Lansing Regional Chamber of Commerce
Louisiana Association of Business & Industry
Lubbock Chamber of Commerce
Lynchburg Regional Chamber of Commerce
Macomb County Chamber of Commerce
MetroHartford Alliance
Metropolitan Milwaukee Association of Commerce
Michigan Chamber of Commerce
Middlesex County Chamber of Commerce
Monroe Chamber of Commerce
Natchitoches Area Chamber of Commerce
Northern Kentucky Chamber of Commerce
Pensacola Bay Area Chamber of Commerce
Rochester Business Alliance
Saint Paul Area Chamber of Commerce
Salina Area Chamber of Commerce
Salt Lake Chamber
Savannah Area Chamber of Commerce
Springdale Chamber of Commerce
St. Tammany West Chamber of Commerce
Temple Chamber of Commerce
Vail Valley Partnership
Warren County Regional Chamber of Commerce
Williamsport/Lycoming Chamber of Commerce

CAHR Reaches 50 Members!

Below you will find a complete list of our coalition partners in the fight against the government-run public option. Thanks to all of you for your support.

Please feel free help us spread the word to other chambers across the country.

Albany Area Chamber of Commerce
Albany-Colonie Regional Chamber or Commerce
Androscoggin County Chamber of Commerce
Ashland Area Chamber of Commerce
Blair County Chamber of Commerce
Chamber of Southern Saratoga County
Daytona Beach/Halifax Area Chamber of Commerce
Detroit Regional Chamber
Eau Claire Area Chamber of Commerce
Erie Regional Chamber and Growth Partnership
Exton Regional Chamber of Commerce
Fond du Lac Area Chamber of Commerce
Fort Collins Area Chamber of Commerce
Grand Rapids Area Chamber of Commerce
Greater Cedar Valley Alliance
Greater Cheyenne Chamber of Commerce
Greater Columbia Chamber of Commerce
Greater Indianapolis Chamber of Commerce
Greater Lehigh Valley Chamber of Commerce
Greater New Haven Chamber of Commerce
Greater Oklahoma City Chamber of Commerce
Greater Pittsburgh Chamber of Commerce
Greater Rome Chamber of Commerce
Greater Shreveport Chamber of Commerce
Greater Spokane Incorporated
Greater Woodland Park Chamber of Commerce
Green Bay Area Chamber of Commerce
Harrisburg Regional Chamber
Harrison County Chamber of Commerce
Harrisonburg-Rockingham Chamber of Commerce
Kalamazoo Regional Chamber of Commerce
Lansing Regional Chamber of Commerce
Louisiana Association of Business & Industry
Lubbock Chamber of Commerce
Lynchburg Regional Chamber of Commerce
Macomb County Chamber of Commerce
MetroHartford Alliance
Michigan Chamber of Commerce
Natchitoches Area Chamber of Commerce
Northern Kentucky Chamber of Commerce
Rochester Business Alliance
Saint Paul Area Chamber of Commerce
Salina Area Chamber of Commerce
Salt Lake Chamber
Savannah Area Chamber of Commerce
St. Tammany West Chamber of Commerce
Temple Chamber of Commerce
Vail Valley Partnership
Warren County Regional Chamber of Commerce
Williamsport/Lycoming Chamber of Commerce

Who Are the 13 Senate Democrats Holding Out On the Public Option?

http://tpmdc.talkingpointsmemo.com/2009/08/who-are-the-13-senate-democrats-holding-out-on-the-public-option.php?ref=fpb

Who Are the 13 Senate Democrats Holding Out On the Public Option?

Brian Beutler
August 27, 2009

Two crucial questions hang over the Senate. Will it pass Democrat-only health care reforms? And can a public option survive the whims of the so-called budget reconciliation process?

If the answer to both questions is yes, then the public option could survive in the stasis-oriented upper chamber. But if the answer to the second question is "no," then the Democrats will a lot of whipping to do. Below are the key hold outs.

One thing that's striking about this the list is how reluctant senators are to take a firm position. Compare that to the situation in the House, where dozens of liberals have vowed that they'll oppose any health care bill without a public option, and it casts some doubt on the conventional wisdom that health care reform will pass without a public option after the Congressional Progressive Caucus caves to pressure from Democratic leadership and conservatives in their own party.

The Waverers

Sen. Max Baucus (D-MT) has perhaps more power than any single person in Congress to shape the direction health care reform will take. And though he tells his supporters in Montana that he "wants a public option," he's also been at the helm of negotiations over legislation that will almost certainly not include a public option.

By all accounts, Sen. Tom Carper (D-DE) would support a health care bill with a public option--but he's not about to make a big fuss if the final legislation doesn't create one.

Sen. Jon Tester (D-MT), like his Delaware colleague, isn't a public option foe--but nor is he a particularly staunch ally. "I don't need it either way," Tester told the Associated Press today. "I could either support it or not support it. It's all in the design."

Sen. Mark Warner (D-VA) isn't particularly eager to see a public option--but like so many Senate centrists, he doesn't rule it out. However, Warner, like Tester, enjoyed a lot of electoral support from the progressive grassroots, and so tends to obscure the issue when asked whether he'd support a government run insurance plan.

Late update: A Warner spokesman tells me that the senator would vote for a bill with a public option in it, as long as the reform package lowers costs.

Sen. Blanche Lincoln (D-AR) has a problem. Though a well known pol in Arkansas, she's up for re-election next year and, according to recent polls, she's running in a statistical dead heat with two relatively unknown Republicans. So though she's articulated an openness to a public option in the past, she's also suggested she might just vote against the whole package.

Sen. Mark Pryor (D-AR), unlike his Arkansas colleague, is not up for re-election next year, and so says, "A public option plan is something that is still on the table and something [I] could support, but it should be designed in a way that increases and does not eliminate competition."

Sen. Evan Bayh (D-IN) hasn't said much about the public option lately. Several months ago he insisted he was "agnostic" about it. But progressives are concerned that he'll be influenced by his wife, who sits on the board of Wellpoint--one of the country's largest insurance companies.

The Mysteries

Nobody really knows where Sen. Bill Nelson (D-FL) will fall on the question of the public option. According to the website Open Left, he told them he's a maybe. But that's not good enough for the DNC's political arm Organizing for America, which recently held events outside his offices around the state of Florida.

Like the other Nelson, Sen. Ben Nelson (D-NE) is an unknown quantity. He has voiced both opposition and support for the public option and has by and large avoided the question since the Senate Finance Commitee began moving away from endorsing one.

Sen. Mark Begich (D-AK): An unknown quantity who's been about as liberal as you can expect for a Democrat from Alaska.

Sen. Kent Conrad (D-ND) is like bad cop to Baucus' good cop. He refuses to announce a personal position on the public option because he views it as "moot"--a measure that doesn't stand a chance in the Senate. So though nobody knows for certain how he'd vote--procedurally or otherwise--on a bill or a conference report with a public option in it, he's been the loudest voice in the Senate in calling for a system of privately run, non-profit health care co-operatives--a compromise House progressives regard as a non-starter.

The Haters
On the day the country mourned the death of health reform giant Ted Kennedy, Sen. Mary Landrieu (D-LA) said that there are very few circumstances under which she could support a public option.

Sen. Joe Lieberman (I-CT) says he's a no.

Check out Dick Blouse's editorial in today's Detroit News!

Friday, August 21, 2009

Commentary

'Public option' injures health reform efforts

Richard E. Blouse Jr.

While Congress struggles over its approaches to health reform, many are singing the praises of the "public option," a government-run health insurance plan to compete with private insurers. Supporters of the public option argue it will keep the private sector honest by acting as a "legitimate" competitor. As proposed, the public option is anything but a legitimate competitor and will have the disastrous effect of exacerbating cost shifting to the private sector and dismantling the employer-based system.

The public option would have tremendous advantages over private plans in the marketplace. Under the public option, private insurance companies would be forced to compete with an entity that both owns the competition and sets the rules for the insurance industry. The government would effectively act as team owner and referee.

The government also has obvious cost-of-capital and tax advantages. A government plan, unlike an employer-sponsored plan, can exempt itself from federal taxes and state regulations and compel hospitals to accept submarket reimbursements. I don't know any business that could survive this sort of "legitimate" competition.

The consulting firm Milliman found that annual employer premiums are almost $1,800 per family higher today because providers shift costs to the privately insured to compensate for underpayments by Medicare and Medicaid. A new government plan with artificially low rates would compound this problem due to a massive shift from the private sector to the public sector.

The Lewin Group, a leading health consulting firm, estimates that 114 million people would move from private to public insurance almost immediately because the government would use Medicare payment rates that are 20 percent to 30 percent below private payment rates. With fewer privately insured consumers to cover the real cost of health care, employer premiums will skyrocket, employers and employees will drop coverage, the employer system will evaporate and the government plan will quickly become the only affordable option for health coverage. With only a select few able to afford private coverage, those in the government plan would face longer waits and less access to care.

Real health reform needs to include reforms to the delivery system. Just as our automakers are innovating and reinventing themselves, our health care system needs the freedom to improve quality and rein in costs.

Government, usually with good reason, is not set up to move quickly in the marketplace. Legislative and regulatory processes, influenced by political pressure, can sometimes yield bizarre outcomes. In contrast, private health plans have the flexibility to respond quickly to changing market conditions and consumer demands.

We have an historic opportunity to make comprehensive health reform improvements. The public option would create an expensive, unnecessary new entity that would be a huge diversion from the needed goals of health reform: reining in the cost of health care, improving quality and expanding access. The most effective way to improve our health care system is to build on the employer-based system -- which already provides coverage to more than 160 million people.

Richard E. Blouse Jr. is president and CEO of the Detroit Regional Chamber. E-mail: letters@detnews.com

Find this article at:
http://www.detnews.com/article/20090821/OPINION01/908210325/-Public-option--injures-health-reform-efforts

Health Insurance Co-ops: Are they the solution?

Everyone's talking about health insurance cooperatives, but no one has really defined what they will look like or how they will compete with private insurers. We will continue to keep you posted as more details are released. In the meantime, this piece from Reuters provides some useful background.

Q+A-Co-ops in focus in U.S. healthcare debate

Mon Aug 17, 2009 - Reuters

WASHINGTON, Aug 17 (Reuters) - Lawmakers debating an overhaul of the U.S. healthcare system are focusing on proposals that would form healthcare cooperatives to help provide medical coverage.

The co-op idea gained currency this week after statements from senior White House officials that the Obama administration might be willing to drop its insistence on a government-run health insurance option in favor of nonprofit co-ops.

Here are some questions and answers about how health insurance co-ops would work:

Q: WHY HEALTHCARE COOPERATIVES?

A: Senate Finance Committee Chairman Max Baucus, a Democrat, is trying to forge an agreement with Republicans on the healthcare overhaul. But the two parties strongly disagree on one major item sought by President Barack Obama: a new government plan that would compete with private insurers.

Democrats strongly support the public option plan, saying it would inject much-needed competition into the insurance market. Republicans strongly oppose it, saying it would drive private insurers out of the market and lead to a government takeover of all U.S. healthcare.

Senator Kent Conrad, a Democrat, proposed creating nonprofit, member-operated health cooperatives to compete with insurers. The idea has gained strength and is likely to be part of the package that is being drafted.

Q: HOW WOULD IT WORK?

A: The government would offer start-up money -- Conrad said $6 billion would be needed -- in loans and grants to help doctors, hospitals, businesses and other groups form nonprofit cooperative networks to obtain and provide healthcare.

The cooperatives could be formed at the national, state and local levels. A temporary government board would help get things started. Conrad said only about 25,000 members would be needed to make a cooperative financially viable. But in order to negotiate competitive rates with health providers, a cooperative would need at least 500,000 members, he said.

Co-op membership would be offered through state insurance exchanges where small businesses and individuals without employer-sponsored plans would shop for health coverage.

The co-ops would function as a mutual insurance company where policyholders would have some ownership rights. Conrad said co-ops could quickly bring health insurance to some 12 million people, which would make this the third-largest insurer in the country.

Q: WHAT ARE THE ADVANTAGES?

A: Democrats say co-ops would will provide more competition to private insurers and help drive down premiums. For Republicans, they offer a non-government-run means of providing more choice in the insurance market. Some centrist Democrats would be more comfortable voting for the health cooperative idea than a new government plan.

Co-ops operate throughout the U.S. economy. Credit unions are member-owned cooperatives that compete with commercial banks. Co-ops have also been used to provide electricity and other services to rural areas. Conrad notes that dairy food producer Land O'Lakes, Ace Hardware, and the outdoor gear retailer REI are all co-ops. Washington state has a Group Health cooperative with more than 500,000 members and others operate in California and Minnesota.

Q: WHAT ARE THE DISADVANTAGES?

A: Many Democrats worry that co-ops would be too weak to provide any real competition to the private insurance industry. Public plan advocate Senator John Rockefeller points out that healthcare cooperatives have been tried in the past to provide medical care to rural areas. Thousands were formed and almost all of them failed.

Conservative critics argue that the co-operatives would just be another form of government-run insurance because of the role the government would play in setting them up and overseeing their operations.

Public Option: it's not over yet!

Although the Obama Administration may be signaling compromise on the government-run public option, there is no guarantee that the House agrees. See the below article from Politico.

Health concession fuels blowback By: Mike Allen August 17, 2009 09:47 AM EST

House Democratic officials say a public option will remain in their version of a health reform bill, even now that the White House has acknowledged it may be dropped later. “This is just for the Senate,” a House leadership official said about the administration’s concession on a public option. “There is no way it passes the House the first time around without a public option. “The liberals (around 100+) won’t allow it. It if comes back from conference committee without public option and there is the right pitch that it is this or nothing, then it may pass the House.” Leaders now say the House will put off a vote on health reform until the end of September — to provide a cooling-off period from the raucous town meetings and to give strategists a better sense of where the Senate is headed. The White House said the media frenzy was prompted partly by bored reporters who haven’t been paying attention to what the administration has been saying for weeks. Linda Douglass, communications director of the White House Office of Health Reform, e-mailed: “Nothing has changed. The president has always said that what is essential is that health insurance reform must lower costs, ensure that there are affordable options for all Americans and it must increase choice and competition in the health insurance market. He believes the public option is the best way to achieve those goals. But liberal and progressive Democrats reacted with disappointment, and administration officials rushed to reassure them. Howard Dean, the former Democratic National Committee chairman, went so far as to say Democrats should try to “tackle health reform another time.” “You can’t really have reform without a public option,” Dean said on CBS News’s “The Early Show. “If you don’t want to have the public option, … just do a little insurance reform … and then we’ll tackle health reform another time. But let’s not pretend we’re doing reform without a public option. And strategist James Carville became the first leading Democrat to suggest publically that there might be political advantage in letting Republicans “kill” health care. “Put a bill out there, make them filibuster it, make them be what they are, the party of no,” Carville said. “Let them kill it. Let them kill it with the interest group money, then run against them. That's what we ought to do.” This weekend’s comments by White House officials simply acknowledged the long-obvious reality that the idea of a government-run insurance plan was partly a bargaining chip. But the new public stance has caused heartburn throughout the party. Liberal Democrats are upset that one of their touchstones is already being downplayed. And some conservative House Democrats feel sold out after they spent recess defending an unpopular idea. The Atlantic’s Marc Ambinder blogged: “If you equate health care reform with a public option, then, well, health care reform is dead to you. There are a lot of angry liberals tonight. They are within their rights to feel aggrieved. ” NBC News’ “First Read” reported that White House Deputy Chief of Staff Jim Messina sent a message Sunday to some leading progressive and liberal leaders, arguing that the media was overhyping any position switch on a public option. House Democratic leadership aides say they expect a public option will remain in the version of the bill that comes to the floor at the end of September. House staff is working this week to combine three committee bills on health reform into one bill for the floor vote. The three started out as one bill, and the staff estimates that they’re still 80 to 85 percent the same. The end of September is not a hard deadline for a floor vote, but leaders say it’s going to be a pretty firm target because they want it to pass this year and don’t want it to hang out there too long. On the Senate side, leaders plan to try to enforce a Sept. 15 deadline President Barack Obama and Finance Committee Chairman Max Baucus (D-Mont.) have set for the committee to come up with a deal. But Sen. Kent Conrad (D-N.D.) said told PBS’s Charlie Rose: “More important than any artificial deadline is getting this right.” Democratic strategists want to move forward at mid-September, in part to preserve the option of using a process called reconciliation to pass health care with a simple Senate majority, rather than the usual 60 votes. A possible plan for Senate floor action would be to schedule a break for Columbus Day, which falls on Oct. 12. Leaders would schedule a vote right before getaway day. Then a conference committee would start the laborious, heavily lobbied process of melding the two floor bills. So Obama was being optimistic when he said Saturday at his town hall in Grand Junction, Colo.: “Even if everything goes perfectly and we pass legislation, let's say, in October, we're still going to have another three months of debate about this, then we're still going to have several years of implementation.”

© 2009 Capitol News Company, LLC

Chances Dim for Public Plan

AUGUST 17, 2009 - Wall Street Journal

White House Opens Door to Compromise on Government Role in Health Overhaul

By ELIZABETH WILLIAMSON and AUGUST COLE

The Obama administration gave its strongest signal yet that it would be willing to compromise on plans to expand the government's direct role in health-insurance coverage as it fights a growing crescendo of opposition to its effort to overhaul health care.

Health and Human Services Secretary Kathleen Sebelius said Sunday that a new, government-run health-insurance program wasn't the "essential element" of any overhaul plan.

Robert Gibbs, the president's press secretary, said President Barack Obama wants "choice and competition" in the insurance market. Mr. Obama "has, thus far, sided with the notion that can best be done through a public option," or government-run plan, Mr. Gibbs said Sunday on CBS's "Face the Nation." However, he said the bottom line is simply that "what we have to have is choice and competition in the insurance market."

A day earlier, President Obama defended the public option at a town-hall meeting in Grand Junction, Colo., while leaving the door open to alternative approaches that expand coverage and reduce costs, but don't increase the federal deficit.

The public option, "whether we have it or we don't have it, is not the entirety of health-care reform," Mr. Obama said. "This is just one sliver of it, one aspect of it."

The comments come after a bruising two weeks in which the president's call for a public plan to "keep insurance companies honest" has been interpreted by Republican opponents and some members of the public as a push to drive private insurers out of the marketplace.Insurance companies have fought a public plan, objecting specifically to one that would use the government's buying power to negotiate rates. The worry is that hospitals and doctors would charge private companies more to make up for being underpaid by the government. Concerns have also been raised that insurers would be unable to compete with such a plan, and that the public option would be a precursor to national health care.

The implications for consumers of nonprofit health-insurance cooperatives, one alternative way to help individuals and small businesses get coverage, are unclear. Much will depend on how and how quickly the co-ops can organize -- a daunting task that could involve setting up the equivalent of new insurers on a state or regional basis. The savings wrung from this extra competition could help cash-strapped patients, though it is unlikely that the co-ops would bring prices down as significantly as the government could.

Obama administration officials have indicated before that they could support a health-care overhaul without a government-run insurance option. "Nothing has changed. The president has always said that what is essential is that health-insurance reform must lower costs, ensure that there are affordable options for all Americans and it must increase choice and competition in the health-insurance market. He believes the public option is the best way to achieve those goals," Linda Douglass, communications director for the White House's health-reform office, said Sunday.

But as the debate over Mr. Obama's ideas for a health-system overhaul grows more shrill, proponents have indicated willingness to drop some controversial elements in order to get a plan passed.

Aides to Senate Minority Leader Mitch McConnell (R., Ky.), an opponent of the public option, labeled Ms. Sebelius's comments a "shift" on the issue in an email pointing out various occasions on which President Obama had said a health plan should include a public option.

Some liberal advocates interpreted the administration's position as a shift in emphasis, but not away from the public option. Mr. Obama wants to "broaden the conversation so people understand that health-care insurance reform is bigger than just one element," said Jacki Schechner, spokeswoman for Health Care for America Now, a grass-roots campaign for health-care reform.

Ms. Sebelius's comments come as some senior Democrats in the Senate are urging the administration to give up on the idea of a public plan run directly by the government. The House has already passed a bill with a robust public option. But House Democrats might be reluctant to vote for a final bill that includes a government-funded plan -- exposing themselves to attacks from the right -- if the White House appears willing to bargain that away too quickly.

The insurers set to breathe the biggest sigh of relief if the public plan is dropped are Wellpoint Inc., which operates Blue Cross and Blue Shield plans in 14 states, and the dozens of other not-for-profit Blue plans across the country. They are currently the biggest sellers of individual health policies, the kind that would compete with new public or co-op plans. Companies such as Aetna Inc. and Cigna Corp. have less to lose from a public plan as they market mostly to employers.

Robert Laszewski, a consultant at Health Policy & Strategy Associates, said nonprofit co-ops aren't necessarily an easy victory for insurers, though. If they don't work down the road, and the government has to bail them out, they might be a precursor to a stronger government role in health care, he said.

He pointed out that the barriers to entry for new insurers are high: They need to set up information-technology infrastructure, build networks of providers and raise significant capital to hedge against catastrophic claims. A co-op that doesn't navigate those challenges smoothly runs the risk of being shunned by potential customers.

America's Health Insurance Plans, the lobbying group that represents the industry, is also cautious about the idea of co-ops, saying it hasn't seen any details on how such a system would operate. Robert Zirkelbach, a spokesman for the group, said that reforms the insurers have proposed -- such as accepting patients with pre-existing conditions -- are enough to fix the health-care system. "If we do those things, a government-run plan -- including a co-op -- is not necessary," he said.

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Pres. Obama Weekly Address re: Health Care

Below is a press release issued by the White House and describing the President's address in their words.

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THE WHITE HOUSE
Office of the Press Secretary
________________________________________________________________
EMBARGOED UNTIL 6:00 AM ET, SATURDAY, August 15, 2009

WEEKLY ADDRESS: President Obama Says Health Reform Will Put Patients’ Interests Ahead of Insurance Company Profits

WASHINGTON – In his weekly address, President Barack Obama described just how dysfunctional the current health insurance system is and how reform will fix it. Right now, the American people have a system that works better for the insurance industry than it does for them. Reform will put an end 14,000 Americans losing their insurance everyday and provide everyone with the security and stability missing today. It will stop insurance companies from creating annual or lifetime caps on coverage and will limit how much people can be charged for out-of-pocket expenses. Reform means lower costs, more choices, better coverage, and stronger businesses and families.

The full audio of the address is HERE. The video can be viewed online at http://www.whitehouse.gov/.

Remarks of President Barack Obama
Weekly Address
Saturday, August 15th, 2009

This week, I’ve been traveling across our country to discuss health insurance reform and to hear directly from folks like you – your questions, your concerns, and your stories.

Now, I know there’s been a lot of attention paid to some of the town hall meetings that are going on around the country, especially those where tempers have flared. You know how TV loves a ruckus.

But what you haven’t seen – because it’s not as exciting – are the many constructive meetings going on all over the country where Americans are airing their hopes and concerns about this very important issue.

I’ve been holding some of my own, and the stories I’ve heard have really underscored why I believe so strongly that health insurance reform is a challenge we can't ignore.

They’re stories like Lori Hitchcock’s, who I met in New Hampshire this week. Lori’s got a pre-existing condition, so no insurance company will cover her. She’s self-employed, and in this economy, she can’t find a job that offers health care, so she’s been uninsured for two years.

Or they’re stories like Katie Gibson’s, who I met in Montana. When Katie tried to change insurance companies, she was sure to list her pre-existing conditions on the application and even called her new company to confirm she’d be covered. Two months later, she was dropped – after she’d already gone off her other insurance.

These are the stories that aren’t being told – stories of a health care system that works better for the insurance industry than it does for the American people. And that’s why we’re going to pass health insurance reform that finally holds the insurance companies accountable.

But now’s the hard part. Because the history is clear – every time we come close to passing health insurance reform, the special interests with a stake in the status quo use their influence and political allies to scare and mislead the American people.

As an example, let’s look at one of the scarier-sounding and more ridiculous rumors out there – that so-called “death panels” would decide whether senior citizens get to live or die. That rumor began with the distortion of one idea in a Congressional bill that would allow Medicare to cover voluntary visits with your doctor to discuss your end-of-life care – if and only if you decide to have those visits. It had nothing to do with putting government in control of your decisions; in fact, it would give you all the information you need – if you want it – to put you in control of your decisions. When a conservative Republican Senator who has long-fought for even more far-reaching proposals found out how folks were twisting the idea, he called their misrepresentation, and I quote, “nuts.”

So when folks with a stake in the status quo keep inventing these boogeymen in an effort to scare people, it’s disappointing, but it’s not surprising. We’ve seen it before. When President Roosevelt was working to create Social Security, opponents warned it would open the door to “federal snooping” and force Americans to wear dog tags. When President Kennedy and President Johnson were working to create Medicare, opponents warned of “socialized medicine.” Sound familiar? Not only were those fears never realized, but more importantly, those programs have saved the lives of tens of millions of seniors, the disabled, and the disadvantaged.

Those who would stand in the way of reform will say almost anything to scare you about the cost of action. But they won’t say much about the cost of inaction. If you’re worried about rationed care, higher costs, denied coverage, or bureaucrats getting between you and your doctor, then you should know that’s what’s happening right now. In the past three years, over 12 million Americans were discriminated against by insurance companies due to a preexisting condition, or saw their coverage denied or dropped just when they got sick and needed it most. Americans whose jobs and health care are secure today just don’t know if they’ll be next to join the 14,000 who lose their health insurance every single day. And if we don’t act, average family premiums will keep rising to more than $22,000 within a decade.

On the other hand, here’s what reform will mean for you.

First, no matter what you’ve heard, if you like your doctor or health care plan, you can keep it. If you don’t have insurance, you’ll finally be able to afford insurance. And everyone will have the security and stability that’s missing today.

Insurance companies will be prohibited from denying you coverage because of your medical history, dropping your coverage if you get sick, or watering down your coverage when it counts – because there’s no point in having health insurance if it’s not there when you need it.

Insurance companies will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or lifetime, and we will place a limit on how much you can be charged for out-of-pocket expenses – because no one in America should go broke just because they get sick.

Finally, we’ll require insurance companies to cover routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be saving lives and dollars by catching diseases like breast cancer and prostate cancer on the front end.

That’s what reform means. For all the chatter and the noise out there, what every American needs to know is this: If you don’t have health insurance, you will finally have quality, affordable options once we pass reform. If you do have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care that you need. And we will deliver this in a fiscally responsible way.

I know there’s plenty of real concern and skepticism out there. I know that in a time of economic upheaval, the idea of change can be unsettling, and I know that there are folks who believe that government should have no role at all in solving our problems. These are legitimate differences worthy of the real discussion that America deserves – one where we lower our voices, listen to one another, and talk about differences that really exist. Because while there may be disagreements over how to go about it, there is widespread agreement on the urgent need to reform a broken system and finally hold insurance companies accountable.

Nearly fifty years ago, in the midst of the noisy early battles to create what would become Medicare, President Kennedy said, “I refuse to see us live on the accomplishments of another generation. I refuse to see this country, and all of us, shrink from these struggles which are our responsibility in our time.” Now it falls to us to meet the challenges of our time. And if we can come together, and listen to one another; I believe, as I always have, that we will rise to this moment, we will build something better for our children, and we will secure America’s future in this new century.

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Sen. Conrad (D-ND) Won't Support Govt Run Plan

Conrad says he won’t support government-run health care program

By: Katie Ryan, The Jamestown Sun

CARRINGTON, N.D. — Sen. Kent Conrad, D-N.D. presented his cooperative health care proposal here Thursday and told an audience of 100 that he would not vote for a government-run health care program.

Conrad stopped in Carrington as part of his a statewide tour touting the Senate Finance Committee’s cooperative health care proposal. The proposal has received bipartisan support for several reasons, he said. The cooperative would offer a non-profit insurance option to compete with private health care. It would not be government run, he said. Individuals, families and small business owners could stick with their current provider, or they could opt for the cooperative plan.

Health care issues are a concern in the country and North Dakota, Conrad said. A North Dakota family of four currently pays more than $11,000 for health insurance. By 2016, Conrad predicted health insurance costs could almost double to more than $20,000 for a family of four. “The government itself cannot afford the direction we’re going,” he said. Those attending the meeting also voiced their concerns regarding health care reform.

Carrington Mayor Don Frye said his concern was the importance of health care in rural areas. He feared health care reform could impact rural facilities like the Carrington Health Center. “Our community’s strength is only as strong as the health care system in place,” he said.

Medicare and Medicaid reimbursements are handled unfairly, Conrad said. The reimbursements punish states like North Dakota whose work is more efficient. He said he won’t vote for any reform plan that doesn’t make reimbursements more equitable. Dr. Todd Schaffer, a family practice doctor who works at Carrington Health Center, said patients should be treated without regard to costs. That, however, doesn’t always happen. “The health care that we give is sometimes not what we want,” Schaffer said.

Matt Paulson, pharmacist at Carrington Drug, said health care reform needs accountability. And it needs time to create the best solution. “When things are rushed in our daily lives, things get missed,” he said.

Conrad agreed. He said he and the Senate Finance Committee have yet to submit a final proposal. The proposal needs more time and shouldn’t be rushed, he said.

President Barack Obama had originally set an August deadline for the House and Senate to pass health care reform. That target is too rushed, Conrad said. “I don’t think an arbitrary timetable fits with an issue of this complexity,” he said. Conrad said he would not vote for any health care reform that funded abortions, care for illegal immigrants or a plan that mandates end-of-life counseling.

AMERICA'S HEALTH INSURANCE PLANS - Statement on Status of Health Care Reform

AMERICA'S HEALTH INSURANCE PLANS

AHIP Statement on Status of Health Care Reform

Washington, DC - Karen Ignagni, President and CEO of America's Health
Insurance Plans (AHIP), gave the following remarks at a media
teleconference this morning:

"At this point in the summer of 2009, the country should be in the midst
of a transformative national conversation about health care reform.
Instead, a campaign has been launched to demonize health plans and the
men and women who work hard every day in their communities to provide
health insurance coverage to more than 200 million Americans.

"For a country that is trying to accomplish what it has failed to do for
a century - pass health care reform - the same old Washington politics
of 'find an enemy and go to war' is a major step backward, not a step
forward. Indeed, this is the playbook of consultants, not consensus.

"Attacking our community will not help get anyone covered, nor will it
help our country bend the cost curve and make care more affordable for
working families and small businesses. These are the issues that should
be the focus of a national conversation this summer. That is what the
country expected. Not politics as usual, but an effort to forge the
consensus that will be necessary to get reform passed.

"For our part, we will set the record straight about our community's
contribution to the reform effort. It was with the hope of helping to
create a more constructive climate that health plans began three years
ago to develop a set of reform proposals linked by common themes - to
build on the strengths of the current system, provide all Americans with
health security, ensure that no one falls through the cracks, and put
the entire health care system on a financially sustainable path.

"In recent days, policymakers have embraced health insurance reform -
the concept we proposed in 2008. Health plans were the first of the
stakeholders to come to the table with a comprehensive proposal to
reform our own sector. Our proposal brings everyone into the system,
guarantees coverage for all Americans, does away with pre-existing
condition limitations, and ends rating based on health status and
gender.

"We also pledged to earn a seat at the table and our members have been
good faith participants in every significant reform effort involving
stakeholders from across the spectrum.

"That did not mean that we would sit at any table in silence when
confronted with proposals we knew to be flawed. For months, we have
explained why we believe a government-run plan would dismantle
employer-based coverage, bankrupt local hospitals, and break the promise
that if you like your present coverage, you can keep it.

"A government-run plan would inevitably rely on its price-setting
ability to offer artificially low premiums - effectively subsidized by
the private sector through cost shifting. This would force employers to
drop their coverage, creating a death spiral for private insurance and
financial catastrophe for many hospitals and doctors.

"Physicians, hospitals, employers, and concerned citizens have joined us
in voicing these concerns. As the American people have learned the
facts, support for a government-run plan has plummeted. In response,
there has been an all-out effort to make support of a government-run
program the litmus test for reform.

"If the intent is to place the nation on a path to a single-payer
system, as some have recently acknowledged, then that question should be
debated candidly and openly.

"We believe that is not the path that the American people support.
Instead, they want policymakers to recognize that neither the government
nor the private sector can fix health care alone and that the stakes are
too high to revert to the usual Washington poll-driven playbook that has
been a barrier to progress and could create another missed opportunity
to achieve health care reform.

"The country is at a critical juncture. August will be the month when
the country decides whether it supports reform and what shape it should
take. It is crucial that the American people understand the broad
consensus that exists on the essential building blocks for bipartisan
reform.

"With that in mind, there are five facts we believe all Americans should
know:

* Health plans have proposed comprehensive health care reform to
cover all Americans, make care more affordable, and improve quality.

* Health plans proposed health insurance reform last year.

* Health plans have proposed far-reaching initiatives to bend the
health cost curve and make care more affordable for individuals,
families, and employers.

* Health plans are advocating and advertising in support of
bipartisan reform.

* Out of every dollar the nation spends on health care, one penny
goes to health plan profits.

"Our community includes thousands of dedicated, conscientious Americans
who are working hard across the country to try and improve health care.
They are ordinary Americans from all walks of life who are raising their
families and contributing to their communities. They do not deserve to
be demonized or vilified as part of a campaign to distract attention
away from the sinking support for a government-run program."

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America's Health Insurance Plans - Providing Health Benefits to More
Than 200 Million Americans

Chamber Alliance for Health Reform (CAHR)

Welcome to the Chamber Alliance for Health Reform blog.

We'll periodically update friends and members on the activities of our coalition as we fight for
comprehensive healthcare reform that will rein in the cost of healthcare, improve quality, and expand access.

What we don't support:

We are concerned that many in Washington want to create a new government plan option that would undermine the real goals of reform.

As envisioned in many proposals, a new government health plan that is modeled after the Medicare program would “compete” with private plans. The federal government would determine benefits, premiums, and payment to healthcare providers.

Congress should reject proposals to create a new government plan, which would unravel the existing employer-based system where more than 160 million people currently get their coverage.

A new government plan option is unnecessary to achieve comprehensive reform and would lead to serious negative consequences for millions of Americans. A government program would:
Result in millions of people losing their employment provided coverage. The government plan would exacerbate current cost-shifting that already inflates employer family coverage by nearly $1800 a year. Expanding these underpayments to a new public program would cause private premiums to skyrocket—making the government plan the only affordable option.

The Lewin Group estimates that more than 130 million people would be shifted into a government plan almost immediately because the government would use Medicare payment rates that are 20 to 30 percent below private payment rates.

Create an expensive, unnecessary new entity that would be a huge diversion from the needed goals of health reform: expanding coverage and reining in costs.

Likely to be very expensive and require large federal subsidies because of adverse selection (e.g. the employer groups most likely to enroll in a government plan are those with much higher than average medical costs).

CAHR is committed to enacting meaningful healthcare reforms that work for everyone and Congress should oppose a government plan option as it would likely result in consumers losing the coverage they have and thwart efforts to reform our delivery system.