Posts Tagged ‘Congress’

Setting the Record Straight on Medicaid

Friday, July 8th, 2011

Earlier today, Community Catalyst joined 118 groups representing consumers, people of faith, and health care providers in 34 states to raise our collective voices in support of Medicaid.

Together, we sent a response to the letter that Senator Hatch and Congressman Upton wrote to Governors last month. Their letter attacked Medicaid, falsely claiming that it provides poor quality care, lamenting its enrollment growth over the past decade, and blaming it for federal and state budget crises. Our letter sets the record straight:

• Medicaid provides high-quality care that is uniquely suited to meet the needs of the vulnerable Americans it serves. Medicaid is certainly not perfect, and there is always room to improve care. But studies consistently show that Medicaid beneficiaries get care that is equal to – and sometimes better than – the care they would get in private coverage. Just yesterday a new study was released documenting the positive impact Medicaid has on its vulnerable beneficiaries’ health and financial security.

• Medicaid plays an essential role in reducing the number of uninsured. Of the 46 million low-income children and parents that rely on Medicaid, the majority are in working families without access to private coverage. Policies that scale back on Medicaid eligibility for this population – like those promoted by Senator Hatch – would drive up the ranks of the uninsured, leaving vulnerable Americans without access to the health care they need.

• Medicaid is markedly more cost-effective than private coverage. If the low-income children and parents on Medicaid were insured instead on the private market, national health care expenditures would be significantly higher.

We felt particularly compelled to respond because Hatch and Upton’s letter perpetuates a larger anti-Medicaid narrative that would:

• Reduce the deficit on the backs of those with least political clout. Responding to their mandate from the tea-party, Republican Congressional leaders are insisting on trillions of dollars in spending cuts in exchange for their votes to lift the debt-ceiling (a vote Congress must take in early August to avoid going into default on our nation’s debt). It’s nearly impossible to achieve that level of savings without making devastating cuts in the “big three” entitlements that take up 40 percent of the federal budget: Social Security, Medicare, and Medicaid. But Social Security and Medicare are fiercely guarded by a well-organized political constituency – seniors – which makes cuts in those programs politically unpalatable. That leaves Medicaid, which serves a much more vulnerable and less politically empowered population, as the sacrificial lamb.

• Undermine the Affordable Care Act. The attacks against Medicaid also play into a second tea-party-driven agenda to repeal the Affordable Care Act (ACA.) Since Congressional Republicans don’t have the votes for repeal, they’re trying the next-best approach: weakening the law’s foundations. Medicaid accounts for nearly half of the coverage gains expected under national health reform, so inflicting dramatic cuts on the program would jeopardize the ACA before its even been implemented.

But Medicaid is not a political chit. It’s a lifeline for millions. It provides long-term care to our nations’ seniors, enables people with disabilities to get the care they need to live independently and helps low-income children see the doctor when they’re sick.

The 118 consumer, faith-based and provider organizations from across the country who signed onto our letter know the value of Medicaid in their communities and why it’s worth protecting. And polls show that the overwhelming majority of the American public does too. Is Congress listening?

-Katherine Howitt, Policy Analyst

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Congress moves to make food safer, should focus now on drug supply

Thursday, December 9th, 2010

(cross-posted from PostScript)

Among the food that has been recalled for contamination risks since the 111th Congress convened:

-Eggs (500,000,000+)
-spinach
-peanuts/peanut butter
-pistachios
-tomatoes
-jalapenos
-70,000 lbs of cheese

Among contaminated or recalled drugs suspected of safety problems since the 111th convened:

-Heparin
-millions of Tylenol, Motrin, Benadryl bottles, child and adult formulations
-Lipitor
-Paxil
-Bactroban
-Tagamet
-Kytril
-IV antibiotics

This week, the Senate finally passed a food safety bill (the House passed a version this summer). The bill, if signed, will give FDA resources to inspect manufacturing plants and farms and give the agency authority to recall food it considers unsafe (right now, a company must initiate a recall voluntarily.) With a little red tape between here and the President’s desk, the bill is on the verge of making much-needed and overdue reform to the way we protect and oversee our increasingly globalized food sources.

Our drug supply faces the same need. Our drugs are increasingly made from materials from all over the world, and GAO reports suggest thousands of plants that potentially manufacture raw materials for prescription and over-the-counter drugs on American pharmacy shelves go uninspected each year. Right now, manufacturers aren’t held accountable enough for ensuring all those materials are safe.

This year saw a record number of drug recalls for Good Manufacturing Practice (GMP) violations, signaling the FDA is marshaling its resources well to step up vigilance. But it also suggests that there are big and perhaps growing quality problems plaguing the supply chain that manufacturers don’t have a handle on yet. Bills and a discussion draft before Congress now would give the FDA mandatory recall authority, as the agency will have now for food, and would establish more stringent supply chain management requirements for drug makers that regulators could use to better enforce drug quality and safety, both in the drug application and post-market phase.

The tools are there, and so is the urgency. We hope before this Congress adjourns that it moves to protect the drugs in American medicine cabinets the way it acted this week to protect the food on our tables.

For more on how to secure America’s drug supply, follow SafeRxWatch on twitter and Facebook, and visit Community Catalyst’s Prescription Access and Quality resources.

–Kate Petersen, PostScript blogger

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Can Medical Bills Ruin Your Credit?

Friday, May 21st, 2010

Ever been puzzled by bills from a doctor or hospital?  Not sure which services you were supposed to pay for and the amount owed?  Unclear on whether to pay the provider or wait for your insurance company to do so?  If you answered yes to any of these questions, you are not alone.

A recent study found that nearly 40 percent of Americans do not understand their medical bills.  Nearly one-third of respondents admitted to letting a medical bill go to collection, as a result.

And though millions of Americans believe that medical debt is not used in calculating a credit score, it often is.  (A credit score, to refresh, is a three-digit number used by banks and other lenders to determine the likelihood that a borrower will repay a loan.) Even paying off a medical bill in collection does not prevent medical debt from being used as a factor in a credit score.

In fact, an estimated 31 million Americans have medical accounts in collection on their credit reports.  So the widely-misunderstood consequences that medical debt have on credit scores, and whether those consequences are fair, or reasonable, are important ones.

A study published in the Federal Reserve Bulletin found that more than half of accounts in collection are medical accounts.  The study raised questions about the predictive value of such accounts since such accounts often involve disputes with insurance companies over liability for the accounts or because the accounts may not indicate future performance on loans.

This current system is stacked against consumers.  It penalizes the sick and injured.  Even when one pays off a medical collection bill in full, current law allows for that account to remain on a person’s credit report for up to seven years. (One mortgage lender’s recent simulation to remove zero-balance medical accounts from a group of credit scores saw the clients’ scores increase by 50 to 100 points.) Such inaccuracies in credit reports slow America’s economic recovery.  They increase the cost of a loan or result in an outright denial. It’s a system that harms hardworking Americans.

A recent hearing and new bill suggest that Congress is working to change this unfair and all-too-common practice.  (Here’s the link to the hearing and testimony.)

At this hearing before a House Financial Services Subcommittee,  several industry representatives testified that they did not believe that medical debt had predictive value or bearing on a client’s future overall creditworthiness. However, the dominant scoring agency, FICO, admitted that medical debt is used in their scoring algorithm.

Rep. Mary Jo Kilroy, a Committee member from Ohio, has introduced  legislation – HR 3421,  The Medical Debt Relief Act -  to address this important problem.  Her bill requires medical accounts that have been fully paid or settled – accounts with a zero balance -  to be removed from a credit report within 30 days.  This proposal enjoys bipartisan support and has more than 90 co-sponsors in the House. And momentum is growing: Sen. Jeff Merkley (D-OR), a member of the Senate Banking Committee, is reportedly planning to introduce a Senate bill within the next week.

By passing HR 3421, Congress would protect families and ensure them that they will no longer be compromised after doing the right thing and paying their outstanding medical bills.  This straightforward proposal will provide relief for millions of Americans and Congress should act promptly to ensure its passage.

–Mark Rukavina, director of The Access Project

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Charity Care: Still A Hospital’s Best Kept Secret?

Friday, May 7th, 2010

Back in 2005, [Manny] Lanza was diagnosed with arteriovenous malformation, a serious brain condition. He had been working 50 hours a week at a fast food restaurant, but his job was considered part-time and his employer did not offer him health insurance. He was referred to St. Luke’s-Roosevelt Hospital in Manhattan for treatment, where they reportedly refused to perform a needed procedure unless he was insured.

Manny’s family attempted to enroll him in Medicaid, but the delay in treatment proved deadly. In 2005, at the age of 24, Manny died in his bedroom at home from causes related to his brain disorder.” (full article here.)

At the time Manny died, New York hospitals were receiving $1 billion every year from the state to care for uninsured and underinsured patients. But there were no conditions attached to that money—they didn’t have to offer free or discounted care to actual patients, and they didn’t have to tell them about financial assistance.

Manny’s Law, passed in 2007, now requires New York hospitals to notify patients of charity care upfront.

Non-profit hospitals get tax breaks, and they’re expected to provide “benefit to the community”—including charity care—in return.

But despite Congressional investigations, a prevalence of stories in the press, and similar laws in a handful of states, a new report released this week from The Access Project and Community Catalyst shows non-profit hospitals still failing to inform patients in need about charity care.

Congress, in the recently-passed federal health care reform law, inserted a provision requiring non-profit hospitals to establish clear financial assistance policies—in writing—that specify eligibility criteria and widely publicize these policies. It also prohibits hospitals from taking extraordinary collection actions before making a reasonable effort to determine if patients are eligible for financial assistance

That’s good news for people who find themselves in Manny’s position: uninsured or underinsured, needing health care they know they can’t afford.  But is the problem solved?

Our report suggests it isn’t. The Access Project wanted to know whether patients who needed hospital care and weren’t able to pay could easily find information about charity care.

Using hospital websites and phone calls, researchers surveyed 99 randomly selected non-profit, AHA-member hospitals in the summer of 2009 to see whether hospitals were complying with the AHA’s voluntary guidelines on hospital charity care. Did hospitals:

  • –Make information on hospital-based charity care policies and other known programs of financial assistance available to the public?
  • –Communicate this information to patients in a way that is easy to understand, culturally appropriate, and in the most prevalent languages used in their communities?
  • –Have understandable written policies to help patients determine if they qualify for public assistance programs or hospital-based assistance programs?

The results were pretty grim. Though 85 hospitals mentioned the availability of charity care, fewer than half of these (42) provided application forms, and only about a quarter of the hospitals (26) provided information about who qualified for charity care. Moreover, only about one-third (34) provided information in a language other than English.

And that’s just one survey. From California to Texas to North Carolina, surveys show that hospital notice and provision of charity care is uneven. While it’s true many hospitals do exemplary work to reach out and meet community needs, others just aren’t pulling their weight.

The new requirements for non-profit hospitals go into effect this year.  But given these results, it seems like hospitals have a long way to go to comply.

(Next week, we’ll look at the hospital industry’s response to the report.)

–Jessica Curtis, director, Hospital Accountability Project

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Worth the Wait

Thursday, September 10th, 2009

For days, the tension has been mounting over what President Obama would say when he addressed the nation on health care.  Last night, with an eloquent prime time address to a joint session of Congress, the President powerfully rebooted the debate on health care.

The President challenged critics to engage in a more civil and fact-based discourse – a challenge that many Republican Congressmen failed to meet.  In an unusual breach of protocol, Republicans sometimes booed the President, and one Republican Congressman even shouted out “you lie!”  In his response to the President’s speech, Congressman Boustany reiterated unsubstantiated charges of “government takeover” and “rationing” that the president had refuted just moments before.  The net effect of all of this was to make Obama seem more reasonable and unflappable – utterly Presidential – in the presence of some of his more vociferous (and less self-possessed) critics.

Coming into the evening, the President had to achieve several big goals.  He needed to reassure a nervous public, explain what he was proposing, and reenergize his base both in Congress and in the nation.

President Obama did that and more. He came across as both passionate and calmly reasoned – again, a sharp and welcome contrast to the wilder critics that have dominated the cable news media.  At same time, the President staked out the high ground in the debate by reaching out and embracing ideas from Republicans.

He also successfully navigated the treacherous political waters around the “public option.”  While he made a clear case for a public option and took on the scare-mongers directly, he also strongly cautioned the left against making the public plan a litmus test for reform.

President Obama did not shy away from engaging with opponents.  He directly addressed the most common charges made against reform, giving special attention to issues affecting seniors.  He clearly restated his commitment to allow people to keep the coverage they have, to protect the Medicare program and to make sure health care reform does not add to the deficit.

Recent polls show that most Americans are confused by the debate. After last night’s speech, the key elements of reform–including insurance reforms, individual and employer responsibility and sliding scale subsidies—should be much clearer to the public. The President also reiterated the need for an exemption for those who still could not afford coverage. However, he did not engage on a crucial question for many low- and moderate-income households: Just what constitutes affordable coverage?

The President’s closing words speak for themselves:

That large-heartedness — that concern and regard for the plight of others — is not a partisan feeling.  It’s not a Republican or a Democratic feeling.  It, too, is part of the American character — our ability to stand in other people’s shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand; a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise….

I understand that the politically safe move would be to kick the can further down the road — to defer reform one more year, or one more election, or one more term.

But that is not what the moment calls for.  That’s not what we came here to do.  We did not come to fear the future.  We came here to shape it.

(You can read the full remarks here.)

–Michael Miller, Director of Strategic Policy

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