Alan Katz is a past president of both the National and the California Associations of Health Underwriters. Previously Alan served as a Senior Vice President at WellPoint, Inc., the nation's largest commercial health insurer. In 2007 he formed the Alan Katz Group which, among other initiatives, published the findings of the Trailblazed Sales Project identifying the attitudes, practices and behaviors of successful sales professionals.
Alan Katz
During the 2010 election Republicans promised to “Repeal and Replace” the Patient Protection and Affordable Care Act. Having gained a majority in the House of Representatives they quickly passed a bill to do just that (joined by three Democrats). Having failed to gain a majority in the Senate the repeal process is all but over.
Republicans are expected to put repealing the Patient Protection and Affordable Care Act to a vote on Wednesday. Proving yet again that Kabuki is alive and well in Washington, D.C. Which makes what is about to unfold in Congress relatively straightforward to predict with a reasonable degree of confidence.
Before I worked for a carrier I’d often wonder if the folks who write health plan benefit descriptions go to a special school that teaches them how to write these documents in as confusing and obtuse a manner as possible. After all, each carrier writes documents in their own way sometimes using the same or similar terms to mean something different.
Two items of interest concerning health care reform: one concerning repeal of an unpopular provision of the Patient Protection and Affordable Care Act; the other a bi-partisan effort to allow states to opt-out of some of the health care reform law’s provisions.
The Patient Protection and Affordable Care Act does a great deal to address insurance industry practices. The new health care reform law, however, has been rightly criticized as failing to directly and forcefully attack rising medical costs, the primary driver of insurance premiums.
Individual health insurance policies don't stay on the books with a particular carrier for long. There's a variety of reasons for this lack of persistence, but the most common reason for a policy lapsing is that the insured has been offered coverage through their job.
The Medical Loss Ratio requirements contained in the Patient Protection and Affordable Care Act take effect on January 1, 2011. Even though the Department of Health and Human Services has yet to certify the recommendation concerning how carriers should calculate the percentage of premium they pay toward medical care and health quality measures, the carriers have to be managing their businesses to hit the MLR targets on January 1st.
Much of the debate over the Patient Protection and Affordable Care Act's medical loss ratio provisions have focused on what expenses are to be considered claims and quality improvement spending, which are to be treated as administrative costs, and what carrier expenditures should be removed from the MLR calculation altogether.
Healthcare reform ain’t pretty and it ain’t cheap. (Of course, neither was America’s healthcare system before the passage of the Patient Protection and Affordable Care Act, but that’s not the point). Someone has to pay for the new law and there’s a host of fees, taxes and the like to foot the bill.
The 2010 mid-term elections were one of those elections. One that changes everything...forever. We haven’t had one of these game changing elections since, well, 2008. Which apparently defines "forever" as meaning "two years." So before the next tsunami/landslide/other metaphor for lots of changes election in 2012, what will be the 112th Congress' impact on health care reform?