BizJournals Portfolio

Obamacare 2.0: What's New

Seizing on public outrage over big insurance-rate hikes, President Obama proposes a way to curb increases. Cadillac health plans, fraud, and payoffs for generic drugmakers also are targeted. 

Follow the Leaders Follow the Leaders

Follow some of the biggest players in the health care industry—Humana, Pfizer, WellPoint, and more—by using bizWatch, Portfolio.com's unique content aggregation tool. Read More

The Economics of Biologics The Economics of Biologics

Generic drug companies are eager to get into the business of making biologics, a complicated and costly yet lifesaving class of drugs. But the generic industry faces considerable opposition from Big Pharma and Congress. Does it have a friend in the White House? Read More

What We Learned From Health Reform What We Learned From Health Reform

Here are five things we have learned from the health reform debate, from making the most of a crisis to moving ahead when certain problems can't be fixed. Read More
President Barack Obama

President Obama's $950 billion revised health reform plan attempts to compromise on some controversial aspects of legislation passed through the House and Senate. With the legislation floundering, the president plans to meet with Republicans Thursday.

The big headline from today's announcement: A new national regulator to monitor health insurance rate increases. Obama is trying to tap into public outrage over WellPoint Inc.'s proposed insurance-rate increases. The insurer's Anthem Blue Cross is stirring the most controversy after proposing rate increases of almost 40 percent on some customers. If a rate increase is deemed unwarranted by Obama's proposed Health Insurance Rate Authority, the federal body would require insurers to lower premiums or provide rebates.

Here are five other ways the plan differs from previous versions:

Drug companies are targeted—After striking an $80 billion cost-savings deal with the White House, the drug industry appeared to be free and clear of any other fees or regulation. But Obama's new plan asks for a bit more. First, the pharmaceutical companies would pay an additional $10 billion in fees on brand-name products over a decade to help pay for Medicare drug benefits. Obama also would crack down on deals in which big pharma companies pay generic drugmakers to hold off on competing against branded medicines, which add significantly to the costs for employer insurance plans. The Federal Trade Commission estimates the deals to delay generic drugs cost consumers $35 billion over a decade.

Cadillac plans tax raised—Obama and the Democrats ticked off unions last year by proposing taxes on high-value, so-called Cadillac health insurance plans. The Dems proposed taxes on the plans, only to lower them and delay the time in which union plans would see a tax. Now, Obama proposes raising the tax threshold to family plans valued at $27,500 a year from the Senate's $23,000. The taxes wouldn't go into effect until 2018 for union and non-union plans.

Tax credits—Under the president's plan, both individuals and small businesses would get broader tax credits to help pay for health insurance. The tax credits are key as small businesses pay more for health insurance than larger companies, and individuals would be required to buy health insurance under the Democratic reform. Small businesses would receive $40 billion in tax credits under the president's plan.

The Nebraska benefit expanded—All states would receive additional Medicaid funding like Nebraska was set to receive under a deal Dems cut with pro-life Senator Ben Nelson. In exchange for his vote on the Senate plan, Nelson was assured his state would receive millions in additional funding. Republicans called the deal a bribe. Medicaid funding affects what businesses pay for insurance because the private sector ends up subsidizing the cost that isn't covered by the government.

Sniffing out fraud—The president's plan calls for a number of initiatives to crack down on health care fraud, especially Medicare. Billing agencies would undergo background checks and register with the government. A database full of health care providers sanctioned for past Medicare violations would be created. Again, government fraud drives up costs for the entire health care system. Interestingly, these proposals are adopted from a plan floated by Republican Mark Kirk of Illinois, who is vying for Obama's old Senate seat. The president notes that he's drawing on Republican ideas as he readies for the bipartisan meeting on Thursday.


Brett Chase covers health care for Portfolio.com and writes the blog Heavy Doses.

Comments

If you are commenting using a Facebook account, your profile information may be displayed with your comment depending on your privacy settings. By leaving the 'Post to Facebook' box selected, your comment will be published to your Facebook profile in addition to the space below.

Connect With Portfolio.com

Come on, like us—you know you want to.

Follow us and if you're an innovative entrepreneur, we'll return the favor.

Today's top stories, conversation starters, and the back nine business bites.

spotlight on

People & Ideas

Whisky To-Go-Go

Now there's a company that let's you taste your knowledge of fine blended Scotches by mixing a whisky of your own. Read More