Many states to form new high-risk insurance pools

The health insurance reform bill passed in March included a program to help states form new insurance pools to cover people with pre-existing conditions until 2014. April 30 was the deadline for states to inform the federal Department of Health and Human Services whether they planned to participate. As of Friday afternoon, officials in 28 states had announced plans to create new high-risk pools, while officials in at least 15 states (listed here) had declined to participate for fear that federal funds may be insufficient to cover the operation of these pools until 2014.

Here are more details about the program:

Consumers will be eligible for the new pools if they have a pre-existing medical condition and have not had insurance for at least six months.

They will pay premiums that parallel rates being offered by commercial insurers to healthy people on the individual market. Many existing high-risk pools charge such high premiums that many people cannot afford the coverage. Today, high-risk pools in 34 states cover only about 200,000 people.

Individuals who sign up for the new pools also will not have to pay more than $5,950 a year out of their pockets for medical care, according to the legislation.

In Iowa, Democratic Governor Chet Culver hailed the new pools as a step toward giving uninsured people access to affordable coverage. Experts from the Iowa Policy Project have estimated that the new high-risk pool could serve more than ten times the number of people enrolled in Iowa's current high-risk pool, which has operated since 1987.

CORRECTION: Although the Iowa Policy Project estimated that more than 30,000 Iowans might be eligible for the new program, the Des Moines Register quoted HIPIOWA Executive Director Cecil Bykerk and State Senator Jack Hatch as saying federal funding will allow only about 1,000 people to be covered in the new high-risk pool before 2014.

All three Republican candidates for Iowa governor oppose our state's participation in the new federal program. The Des Moines Register quoted Rod Roberts directly and spokesmen for Terry Branstad and Bob Vander Plaats. I don't know how quickly the new pool will be up and running, but I'd like to see the Republican nominee for governor explain to Iowans with pre-existing conditions why they should have to go without affordable insurance coverage until 2014. If I were Culver's campaign manager, I'd consider running ads on this issue in the fall.

Share any relevant thoughts in this thread.

An Interview With Jack Conway

By now you’ve no doubt heard of Jack Conway. He’s the young, articulate, and progressive Attorney General for the state of Kentucky, and he’s running for Senate in the Democratic primary against Dan Mongiardo, the state’s conservative, allegedly corrupt Lieutenant Governor. The Conway campaign has taken off in recent weeks, going from 18 points down to 3 points down externally and ahead internally.

Conway, part of the MyDD “Going on Offense” Act Blue page, was able to give us an interview last Friday afternoon. He promised 15 minutes and graciously talked to me for 30. Our interview was pretty wide ranging. He began with a Howard Dean-esque quote, stating that it's time Democrats act like Democrats. We talked about electoral strategy, Wall Street reform, filibuster reform, health insurance reform, energy and climate legislation, coal mining, his successful record as Attorney General, and more. Here are some key quotes:

On LGBT rights: “Admiral Mullen had it right when he said to Congress that it’s wrong to ask someone to lie about who they are to defend their country…  I look forward to casting a vote to end Don’t Ask, Don’t Tell.”

On health care and the tea parties: “I try to be responsible here. The folks in the tea party crowd wanted Attorneys General to file a lawsuit without merit. I thought traditionally Republicans loved to rail against meritless lawsuits… I sort of say to them, look, don’t take my word for it; take the word of Ronald Reagan’s former Solicitor General, who said his copy of the Constitution doesn’t contain the right not to be insured.”

On mining reform: “It seems like we’ve gotten into a system where the ability of the mining companies to [delay and appeal] and fail to take remedial action outweighs the safety of the miner… My concern is that some of these mines put profits before the safety of the miners, and when that happens, inspectors need to have the ability to shut the mine down.”

On Netroots support: “You are keeping some of the wind at our backs right now, and a Senate seat is a Senate seat is a Senate seat, whether it’s in New Hampshire or Missouri or Kentucky… It’s the work of volunteers and the Netroots that sustains us, and we’re going to win this thing.”

The full interview is below the fold. I consider Jack Conway one of the brightest and most articulate politicians I’ve ever spoken with, right up there with Barack Obama and Cory Booker, so I hope you’ll read the full interview and consider supporting his campaign.

There's more...

Sebelius warns insurers on denying coverage to sick kids

Health and Human Services Secretary Kathleen Sebelius wrote to the head of the insurance industry's lobbying arm yesterday warning against efforts to continue to deny coverage to children with pre-existing conditions. Excerpt from the letter, which you can download as a pdf file at Greg Sargent's blog:

Health insurance reform is designed to prevent any child from being denied coverage because he or she has a pre-existing condition. Leaders in Congress have reaffirmed this in recent days in the attached statement. To ensure that there is no ambiguity on this point, I am preparing to issue regulations in the weeks ahead ensuring that the term "pre-existing condition exclusion" applies to both a child's access to a plan and to his or her benefits once he or she is in the plan. These regulations will further confirm that beginning in September, 2010:

*Children with pre-existing conditions may not be denied access to their parents' health insurance plan;

*Insurance companies will no longer be allowed to insure a child, but exclude treatments for that child's pre-existing condition.

I urge you to share this information with your members and to help ensure that they cease any attempt to deny coverage to some of the youngest and most vulnerable Americans.

A spokesperson for House Speaker Nancy Pelosi sent Sargent the following statement:

The intent of Congress to end discrimination against children was crystal clear, and as the House chairs said last week, the fact that insurance companies would even try to deny children coverage exemplifies why the health reform legislation was so vital. Secretary Sebelius isn’t going to let insurance companies discriminate against children, and no one in the industry should think otherwise.

Let's hope this works. I wouldn't be surprised to see insurance companies challenge the new regulations in court. They were probably counting on that loophole.

Founding Father signed health insurance mandate into law

State attorneys general have filed two federal lawsuits challenging the individual mandate to purchase health insurance, which President Barack Obama signed into law last week. Those lawsuits look like pure political posturing to me, given the well-established Congressional powers to regulate interstate commerce and taxation.

It turns out that precedent for a health insurance mandate is much older than the 1930s Supreme Court rulings on the Commerce Clause. Thanks to Paul J. O'Rourke for the history lesson:

In July, 1798, Congress passed, and President John Adams signed into law “An Act for the Relief of Sick and Disabled Seamen,” authorizing the creation of a marine hospital service, and mandating privately employed sailors to purchase healthcare insurance.

This legislation also created America’s first payroll tax, as a ship’s owner was required to deduct 20 cents from each sailor’s monthly pay and forward those receipts to the service, which in turn provided injured sailors hospital care. Failure to pay or account properly was discouraged by requiring a law violating owner or ship's captain to pay a 100 dollar fine.

This historical fact demolishes claims of “unprecedented” and "The Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty...”

Perhaps these somewhat incompetent attorneys general might wish to amend their lawsuits to conform to the 1798 precedent, and demand that the mandate and fines be linked to implementing a federal single payer healthcare insurance plan.

O'Rourke posted the full text of the 1798 legislation as well.

I'm not one to claim American's "Founding Fathers" could do no wrong. After all, President Adams also signed the Sedition Act, which violated the First Amendment. But Republican "strict constructionists" say we should interpret the constitution only as 18th-century Americans would have understood it. Some claim judges should cite only 18th-century sources when interpreting the constitution. Well, Congress enacted and the president signed a health insurance mandate less than a decade after the U.S. Constitution went into effect.

I don't expect these facts to affect Republican rhetoric about health insurance reform. Thankfully, Iowa Attorney General Tom Miller is not wasting our state's money on this frivolous lawsuit. So far I haven't heard any Republicans demand his impeachment, as some GOP legislators are doing in Georgia.

House passes revised reconciliation bill

It wasn't nearly as suspenseful as Sunday's vote, but the House of Representatives passed the revised budget reconciliation bill tonight by a vote of 220-207 (roll call). The bill contains changes to the health insurance reform President Obama signed into law on Tuesday, as well as a student loan reform that replaces subsidized private loans with direct lending by the government. The Senate had approved the bill earlier today, but minor changes were made in the section regarding Pell grants, which is why the House had to vote on the new version.

Here's your laugh for the day: MSNBC's Chris Matthews still thinks he was right and Representative Alan Grayson was wrong about whether changes to the health care bill could be passed using the budget reconciliation process.


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