Giant retailer Wal-Mart stated in an open letter that it supports employer responsibility as a component of health reform:

We are for shared responsibility. Not every business can make the same contribution, but everyone must make some contribution.

The announcement was made jointly with the Service Employees International Union (SEIU) and the Center for American Progress - liberal groups that have been historically critical of Wal-Mart's policies. It came as a welcome surprise to health reform proponents.

Not five years ago, Wal-Mart fought tooth and nail to overturn a Maryland state law that imposed an employer mandate, which required large employers to either cover workers or pay a fee. Now, America's largest employer says that such a requirement is a necessary part of a health care overhaul.

According to Jonathan Cohn,

After all of these years, Wal-Mart has suddenly found itself in the same situation its competitors once did: Dealing with unpredictable health costs and facing new competition from businesses that have found ways to spend even less on employee health benefits.

The Wal-Mart letter argues that,

From a business perspective, health reform could not be more critical. Premiums are expected to rise by 20 percent in less than four years ... costing 3.5 million workers their jobs, and cutting insured workers' average annual incomes by $1,700.

While the letter is short on details, Wal-Mart's support for employer responsibility pushes the debate in a favorable direction. The momentum Wal-Mart has lent health reform yesterday should not be underestimated.

Key Senate Democrats Trim Cost of Health Care Bill -AP

EXCLUSIVE: The *Real* HELP Bill. And it's much better. -The New Republic

A few weeks ago, the Senate Health, Education, Labor and Pensions set off an uproar when it submitted a work-in-progress for scoring by the Congressional Budget Office. The bill was missing major pieces, including a requirement that employers contribute towards the cost of their workers' coverage.

A Pitch on Health Care to Virginia and Beyond -The Washington Post

President Obama offered a wonkish defense of his embattled health-care reform effort during an hour-long town hall meeting in Northern Virginia yesterday that featured seven questions, including one sent via Twitter and several from a handpicked audience of supporters.

President Pushes Health Plan as an Economic Boom -The New York Times

President Obama returned to the familiar trappings of a political campaign on Wednesday, holding a town-hall-style meeting where he sought to heighten the urgency surrounding the health care debate and dismissed critics who say the issue is too complex to tackle during his first year in office.

Will Obama Tax Employer-Provided Benefits? -Time

As lawmakers continue to struggle to find a way to pay for a health reform that could cost $1 trillion or more over the next decade, Barack Obama seems to be opening the door a little wider to an approach that he rejected soundly when John McCain proposed it during last year's presidential campaign: taxing the health benefits that employers provide their workers. "This argument has evolved," he said Wednesday at a town hall meeting on health care in Annandale, Virginia. And it appears that Obama has, too.

The Congressional Budget Office (CBO) made headlines recently when it "scored" health reform proposals generated in the Senate. The CBO numbers - and thusly the headlines - weren't favorable, and left many lawmakers and health care advocates scratching their heads.

In just a couple of days in mid-June, the CBO seemed to rain hard on the whole health reform parade when it made back-to-back announcements that (1) the first draft of the Senate Health, Education, Labor and Pensions (HELP) Committee's bill would cost $1 trillion over 10 years and would only cover 16 million people, and that (2) the first draft of the Senate Finance bill would cost $1.6 trillion over 10 years.

So this begs a few questions....

What is the CBO? The CBO provides Congress economic data and analyzes the costs and impacts of legislation.

Are there any issues with CBO scores of health reform proposals? Many health policy wonks complain that the CBO doesn't score savings that may be wrung from the health system at the national level. As Politico reported,

Programs like disease prevention will save money, but the practices are more recent and have not yet been fully incorporated by the conservative CBO, said Ken Thorpe, a professor of health policy at Emory University.

Why do CBO scores matter? While the CBO's analyses are imperfect, they represent our best guess at what will happen if a particular piece of legislation is implemented, and in the era of pay-go (short for "pay as you go"), it's important to get a good score. This recent CBO score debacle demonstrates that, if the numbers come out higher than bill sponsors anticipated, it looks bad. And health reform opponents will make hay of it.

But what's a good score? There is no magic number. As a response to CBO's cost estimate, Senator Baucus has implied that $1 trillion over 10 years is his goal for the final Finance Committee bill.

Advocates need to keep a close watch on this process to ensure that consumers don't get the short end of the stick as lawmakers craft fiscally responsible legislation. Stay tuned for more news on this after the July 4^th recess of Congress.

Attention, all employers: It is time for you to pay. Or play!

The pay or play system will accomplish two things, both important for health reform:

1. It will give employees peace of mind, assuring them that they will not lose their insurance coverage

2. It will provide an affordable insurance option to those employees who are not yet covered by their employer.

Many employers have offered their employees health care coverage since World War II, when wages were frozen and the only way to compete for workers was to provide fringe benefits. Currently, 61 percent of non-elderly Americans obtain health care coverage through their employers.

In the current health care debate, some are calling on employers to share in the responsibility of providing health care coverage to Americans. Most large employers already provide insurance to their employees, so requiring the rest of employers to do the same would level the playing field while allowing those employees who are satisfied with their coverage to keep it.

Families USA recently issued a paper about the advantages of shared responsibility that requires employers to provide insurance. Here are some of the major points:

How employer responsibility works: Employers would provide health insurance to their employees or pay a fee that would be used to help subsidize the cost of their employees' health care. This is called "pay or play." Under such a system, some small employers will receive tax credits to help them pay for coverage for their workers, and if they still can't afford to either pay or play, they will be exempt from such a responsibility.  

Why is it a good system? Without such a requirement, employers might be tempted to drop coverage for their workers. Employers currently pay around $360 billion in premiums a year. If employers stop providing coverage, it would be almost impossible for employees to cover this amount. Employees already pay an average of $3,354 per year for family coverage and $721 per year for individual coverage. These employees can't afford to pay more.

Past experiences have shown that such a system works: Both the State of Massachusetts and the City of San Francisco have implemented such a system with much success. Due to a pay or play provision in Massachusetts's 2006 health care reform legislation, 159,000 Bay Staters have gained insurance through their jobs in the last two years. San Francisco's Healthy San Francisco program has also helped to provide 32,804 additional people with employer-based coverage.

This idea is also supported by President Obama, who believes that "every business has a responsibility to provide health insurance for its workers."

Update: View EPI's analysis here.

Insured, but Bankrupted by Health Crisis -NY Times

Health insurance is supposed to offer protection - both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured.

Barack Obama Continues Pushing Health Care Reform -Politico

Obama is staying close to home till he heads out on a foreign trip next week - but he's still pushing health care. On Wednesday, POTUS will head to Northern Virginia Community College in Annandale for a town hall with a live audience. But the president will also take questions via Facebook, You Tube and Twitter.

Wal Mart says it Backs Mandate on Insurance -NY Times

Wal-Mart, the nation's largest private employer, joined hands with a major labor union Tuesday to endorse the idea of requiring large companies to provide health insurance to their workers, a move that gives a boost to President Obama as he is pushing for health legislation on Capitol Hill.

Religious Groups' Radio Ads Back Health Overhaul -USA Today

Liberal-leaning religious groups are launching radio ads in five states this week in which local pastors urge senators to back efforts to overhaul the nation's health care system.

PhRMA, Families USA Launch Ad Campaign -Politico

The pharmaceutical industry and one of the country's leading consumer health care groups on Tuesday launched a multimillion-dollar national television advertising campaign to urge lawmakers to pass quality, affordable health care reform

White House senior adviser David Axelrod says President Barack Obama would like to have a public option – or government-run insurance plan – as part of a health reform package, but will not insist on it.

State of Play: Congress Breaks, White House Motors On

Congress will be out this week, so the White House is filling the health-care space with a series of events — in person and over the Internet — to keep the spotlight on the president’s top domestic priority.

White House Won't Rule Out Benefits Tax

President Obama's top political adviser declined yesterday to rule out the possibility that the White House would agree to a tax hike on health insurance plans that would hit middle-income Americans.

The Key to Fixing Health Care and Energy: Use Less

Our health-care crisis and our energy crisis are complex dilemmas made of many complex problems. But our biggest problem in both health care and energy is essentially the same simple problem: we use too much. And in both cases, there's a simple explanation for much of the problem: our providers get paid more when we use more.

Those words rang out at a huge rally Thursday, June 25, sponsored by the coalition Health Care for America NOW (HCAN). The rally took place right by the Capitol, close enough for all to see the massive dome on top of Capitol Hill.

Thousands of people from around the country-the young, the old, labor activists, health activists, and other community leaders-gathered to support the need for health care reform this year.

High profile speakers-ranging from politicians such as Senator Schumer from New York, Senator Menendez from New Jersey, and Howard Dean to labor, religious, and medical leaders-expressed a common and unified message:

People with insurance are facing higher and higher premiums.

People have to make difficult decisions every day about whether to pay for their prescription drugs or to pay for their household bills.

People who are doing everything right and have insurance often have their care denied or delayed by insurance companies.

Citizens also shared their emotional stories about how the health care system has affected their lives. One small business owner talked of her fear that she would no longer be able to provide coverage for her employees. A single mother without insurance worried that she might get ill and be unable to care for her children. Stories like these were echoed by thousands of people throughout the day.

Seth Michaels of the AFL-CIO also attended the rally and caught some great quotes from members of Congress pushing hard for reform alongside the American public. Pennsylvania Rep. Allyson Schwartz said,

This is such an important issue for all of us. It's always been a moral responsibility, but it's increasingly an economic imperative.

Sen. Chuck Schumer touched on how far along we've come and symbolically pointed to the Capitol behind him as he remarked,

We can't do this alone. We need to do this together. We need all you to hold everybody in that building's feet to the fire.

Attending the rally and seeing the enthusiasm for change gave the attendees confidence that reform can happen this year. Change doesn't occur without people coming out and fighting for what they believe in.

That fight was clearly seen this day.

So, let me again ask you two questions: What do we want? And when do we want it?

Health equity has become a key issue in the current health reform debate, and lots of groups are chiming in.

Over the last few months, the Obama Administration has made a special effort to bring health disparities into the health reform discussion, most recently inviting stakeholders to attend a meeting at the White House and releasing a health disparities report. The disparities community has embraced the opportunity to educate policy makers and the public about the differences in health and health care experienced by different groups of people - think tanks are releasing reports and advocacy groups are releasing recommendations.  Now, the health insurers have something to say.

Earlier this month, the nation's largest not-for-profit health insurer, Kaiser Permanente, released a series of ads in Capitol Hill publications that bring attention to health disparities. The ads are headlined "Health Care in America Is Too Often Unequal" and feature individuals who are African American, Asian American, Latino, and Pacific Islander. 

Each ad calls for universal coverage, pointing out that more than 50 percent of uninsured Americans are people of color. The ads call that statistic a "national disgrace," particularly since the uninsured are more likely to forgo care and the U.S. spends the most out of any nation on health care - more than two trillion dollars in 2008.

In order to develop the comprehensive solutions that will eliminate racial and ethnic health disparities, ALL the stakeholders have to be at the table. Kaiser Permanente is taking steps to make sure their concerns are heard.  What about you?

Senate Democrats Say Cost of Health Care Bill Can be Trimmed -NY Times

Senate Democrats said Thursday that they had found ways to pare the cost of a health care bill by more than a third - to $1 trillion over 10 years - while still covering nearly all Americans.

Baucus' ‘Coalition of the Willing' -Politico

Senate Finance Chairman Max Baucus (D-Mont.) calls them the "coalition of the willing," a group of four Republican and three Democratic senators, including himself, that may well determine health care reform in the Senate.

Falco Urges Health Care Overhaul at Capitol Rally -AP

Award-winning actress Edie Falco, cable television's no-nonsense "Nurse Jackie," delivered a stern message to lawmakers Thursday: fix health care.

Finance Senators Vow to Keep Negotiating on Health Care -Roll Call

Health Care Reform Asked and Answered -The White House Blog

Congress Suspends Health Care Debate as Crowds Rally for Plan - Daily Me

Senators who are negotiating how to overhaul the nation's health care system broke off formal talks Thursday until after the Fourth of July holiday, saying they lack consensus on how to pay for the $1 trillion or more that the changes could cost over the next decade. Thousands of their constituents rallied outside the Capitol to show their support for change, and the Obama administration called for action.

Obama's Townhall: Open Up and Say Aaaah -Time

Soon after ABC announced it would devote a day to covering President Obama's healthcare proposals, including a primetime townhall, Republicans began complaining that the program would be an "infomercial" for the President's plans. And the event started on an auspicious note for the President's argument that the healthcare system needed to be overhauled: in a show of hands, almost no one in the audience agreed that the system should be left as is. "Let's stop now!" Obama joked. But what the President largely got from his questioners afterward was, in doctor's parlance, a probing examination.

Obama Wants Health Care ‘Compromise' -Politico

President Barack Obama signaled a new willingness Wednesday to tax health benefits, inching further away from his staunch opposition to the idea during the presidential campaign. "There is going to have to be some compromise," Obama said at an ABC News town hall on health care televised from the White House.

Obama: More Health Care should be based on Science -CBS News

In a town hall forum broadcast from the White House Wednesday night, President Obama said "government, whether you like it or not, is already going to be involved" in administering health care and implementing changes in the system.

Finance Furiously Working towards Health Care Compromise -Roll Call

While the Senate Health, Education, Labor and Pensions Committee continued Wednesday to mark up its health care reform bill, the Senate Finance Committee was hunkered down in negotiations on its version, with Finance Chairman Max Baucus (D-Mont.) shuttling between closed-door meetings to try to reach a consensus.

U.S. Hospitals Feeling the Squeeze -Forbes

From David Seaman's point of view, the recession couldn't be more brutal for the hospital industry. As executive vice president of the Michigan Health and Hospital Association, a membership organization representing the state's community hospitals, he's watched closely as revenue has plummeted; cash-strapped patients are skipping visits and under-compensated cases are increasing.

States Assert Place in Health-Care Debate ­­-The Washington Post

A bipartisan group of governors told President Obama yesterday that they share his urgent desire to restructure the nation's health-care system but warned that any changes should not place more burdens on strained state budgets or eliminate innovative programs they already have in place.

Talking Points Memo released Senator Reid's "realities," a set of talking points for health reform advocates to use in the war against misinformation. Here are some of the highlights:

Rhetoric: Some Republican lawmakers claim that health reform will result in millions of Americans losing their coverage. Since most people who have health insurance currently get coverage through their employer, this plays into misguided fears that with health reform, they will be cut off from their job-based coverage and left without any choices.

Reality: Senator Reid points out that the option to choose what works best for you is what health reform is all about. If you like your coverage you can keep it. If you'd prefer to opt into an affordable public insurance plan, you can do that as well. You have the right to choose the plan that works best for you under the proposed health reform legislation.

Rhetoric: Another GOP tactic is to use the term "government takeover" to spook the public. They say that decisions about your health will be taken away from you and your doctor and instead placed in the hands of "some bureaucrat in Washington." This is simply not true.

Reality: The federal government does not want to, and will not, assume control over Americans' health care. A public plan option, according to HHS Secretary Kathleen Sebelius, is not designed to create a monopoly, but instead to encourage competition. We repeat: The government does not want to take over your health care decisions.

Rhetoric: Senate Republicans have consistently stated that health reform "could' increase premiums. They argue that reform would cost taxpayers "trillions of dollars" and lead to high premiums. Once again, they've twisted the facts.

Reality: With health reform, not only will you have more choices, but when you choose a plan you will pay less and get more. Employers, the federal government, and individuals will all see more bang for their buck -- and more in their bank account to boot.

Opponents of health reform will continue to dial up their rhetoric like this as we get closer and closer to health reform. It's important to tune in the facts and tune out the fiction as we move ahead.

With your help, misinformation will only be a tiny pothole that we patch up as we move along on the road to health care reform.

The goal of health reform is to provide every American affordable health care coverage. That means people with insurance who pay too much out of pocket to see a doctor or to buy prescription drugs should see some relief.  

Currently, the elderly, like millions of other Americans, are struggling with their prescription drug bills.

Medicare Part D, which was instituted in 2006, was supposed to take care of this problem. The Medicare Part D program was established to help cover prescription drugs for the elderly and provide necessary relief to all seniors. However, there's a problem.

There is a huge hole in prescription drug coverage for the elderly-known as the "doughnut hole." With the Medicare Part D program, drug coverage stops as soon as someone spends $2,700 and it doesn't begin again until the tab reaches $6,100. And while people are in this "doughnut hole," they have to cover the entire cost themselves! This means that the sickest seniors have to make painful choices - or go without life-saving prescription drugs.

Luckily for seniors, President Obama is here to help.

On June 22^nd, the President presented a solution to this problem in front of members of the AARP.

The President said,

"I'm pleased to report that over the weekend we reached an understanding that will help close the notorious "doughnut hole" in Medicare Part D. This is a significant breakthrough on the road to health care reform -- one that will make the difference in the lives of many older Americans."

By stuffing the "doughnut hole," the President will finally help to make the Medicare Part D program work better for all seniors.  

His actions are right on cue- since restoring fairness to the health care system is what health reform is all about.

HHS Secretary to Press Lawmakers on Health Care- The Boston Globe

Health and Human Services Secretary Kathleen Sebelius told lawmakers Wednesday that President Barack Obama is willing to listen to suggestions on how to pay for a health care overhaul, as long as they don't increase the deficit.

Baucus Grabs Pacesetter Role on Health Bill -NY Times

Obama Says Government Insurance Plan Would Not Hurt Private Insurers -NY Times

President Obama made a detailed case on Tuesday for a new government-administered health insurance plan, but he did not rule out signing a bill that lacks such an option if he cannot win enough support from Democrats in Congress.

An Interview with Atul Gawande -The Washington Post

Atul Gawande's New Yorker article comparing the medical systems of El Paso and McAllen, Tex., has been a definitional piece in the health reform conversation. President Obama has repeatedly invoked it. Senators have talked about it. The media have embraced it.

Obama Touts Prescription Drug Plan -Politico

President Barack Obama appeared with AARP chief Barry Rand Monday morning to announce an agreement among pharmaceutical companies to cut prescription drug costs for seniors - and inject some energy into his efforts at comprehensive health care reform.

Americans Struggle to Pay for Health Care: Study -Reuters

Americans are struggling to pay for healthcare in the ongoing economic recession; with a quarter saying they have had trouble in the past 12 months, according to a survey released on Monday.

This blog is brought to you by the word "rationing." If we had a nickel for every time right-wingers claimed health reform will result in the government rationing care, we'd probably have enough money to... well, reform our broken health care system.

We've heard this tired old rhetoric time and time again. Frank Luntz, the master puppeteer behind conservatives' attack on health care reform, encouraged right-wing groups to use terms like "delayed care," "rationing," and "takeover." These are little more than words designed to scare the American public into thinking reform is a bad thing.

A writer for the New York Times took the time to research whether or not claims of government rationed health care actually hold water in the debate over health reform. The title of the article says it all: "Health Care Rationing Rhetoric Overlooks Reality"

David Leonhardt, the author of the article, first defends the concept of rationing in every day life,

In truth, rationing is an inescapable part of economic life. It is the process of allocating scarce resources. Even in the United States, the richest society in human history, we are constantly rationing. We ration spots in good public high schools. We ration lakefront homes. We ration the best cuts of steak and wild-caught salmon.

But applying the government-rationed health care argument to this heated debate, he says, is misleading, since health care is already being rationed in this country:

There is no such thing as a free lunch. The choice isn't between rationing and not rationing. It's between rationing well and rationing badly. Given that the United States devotes far more of its economy to health care than other rich countries, and gets worse results by many measures, it's hard to argue that we are now rationing very rationally.

According to Leonhardt, rationing is currently taking place in our health care system three different ways:

1. As premiums continue to rise, employers who provide coverage are in a tight spot and are relegated to giving only meager pay raises to employees so that they can keep up with rising health costs.

2. Since health care costs are soaring, some employers can't even afford to provide coverage to their employees, leaving them with the tough decision to break the bank or purchase costly individual coverage on their own.

3. Doctors are stretched so thin they don't have time to research and provide patients with the best possible options for them. Even those with insurance see their care being rationed.

In the following months, conservatives will without a doubt continue to throw around terms like "government-run" and "government rationing" to scare the American public. Leonhardt's parting words, however, leave us with our best weapon against misinformation: the truth. He says,

...all the noise about rationing is not really a courageous stand against less medical care. It's a utopian stand against better medical care.

Hidden Costs of Health Care- Politico

With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages.

House Democrats to Open Hearings on Health Bill -AP

House Democrats are pushing forward with a partisan health care bill even as a key Senate Democrat labors to achieve an elusive bipartisan compromise on President Barack Obama's top legislative priority.

Public Option Takes Center Stage -Politico

Judging from the advocacy ads released in the past week, there's nothing else to the health care debate but the public insurance option.

Conrad Moves Closer to Public Health Care after Negotiations -The Huffington Post

Sen. Kent Conrad (D-N.D.) moved sharply toward public health care Monday, saying that he could "absolutely" support major parts of Sen. Chuck Schumer's compromise proposal for a public option after closed-door negotiations.

The Public Insurance Plan is Not Responsible for High CBO Scores -Think Progress

Since the Congressional Budget Office (CBO) issued very preliminary cost estimates of the Health, Education, Labor and Pensions (HELP) committee's health bill and the Senate Finance Committee's draft legislation, Republicans and some in the media have argued that the somewhat higher-than expected price tags undermine the President's contention that a new public heath insurance plan would lower health care spending:

Health Care Survey: Costs Out of Control, Need for Reform Urgent -AFL-CIO

Out-of-control health care costs are forcing working families to forgo needed medical care and shredding family bank accounts, while private health insurance companies deny claims and, far too often, refuse to provide coverage.

Late last week, the chairmen of three key House committees came together to release draft health reform legislation. The significance of this moment bears emphasizing. As Jonathan Cohn wrote,

Committee turf battles helped kill reform in 1993 and 1994. Now we have all three committees with jurisdiction acting as one, putting forward the same piece of legislation and vowing to go forward in continuing partnership.

What's more, the chairmen served up a very appetizing bill for health care consumers. What's in it?

• A Health Insurance Exchange for individuals and small businesses;

• A Public Plan option as an alternative to private insurance plans;

• Subsidies to families earning less than 400% of poverty (or $88,200/year for a family of four);

• The end of insurance company discrimination - no more cherry-picking, no more pre-existing condition exclusions, no more outrageous premiums based on less-than-perfect health;

• Good benefits, as determined by the Surgeon General and an independent team of experts;

• A cap on out-of-pocking spending to prevent medical debt and related bankruptcies and foreclosures;

• Federally-funded Medicaid expansion to 133% of poverty (or $29,400 for a family of four) for kids, parents, and childless adults;

• Improvements to Medicare, including reducing the bite of the notorious doughnut hole;

• Employer and individual responsibility; and

• Tax credits for small businesses that want to provide coverage.

The complete summary is available here.

This is an encouraging first step for the process in the House. House Speaker Nancy Pelosi said,

Americans need to know that President Obama's promise is our promise too: If you like your health plan and your doctor-you can keep them.  It's that simple.  But we will fix what's not working-reducing costs, improving quality, and covering more Americans. 

Of course, there is still a great deal of work to be done - on the Hill, and at home. Lawmakers need to identify financing sources. And consumer advocates need to go out and get their communities on board for health reform.

AARP to Endorse Offer of Drugmaker Price Cuts -The Washington Post

AARP, the nation's largest seniors lobby, will give its blessing today to an offer by drug manufacturers to contribute $80 billion over the next decade to reduce the cost of comprehensive health reform, in part by discounting the price of Medicare prescriptions.

Obama to Appeal to Public on Health Care as Senate Struggles ­-Bloomberg

President Barack Obama will take his case to the American people this week on a plan to overhaul the U.S. health-care system as Congress struggles to find a bipartisan way to approve his top domestic priority.

Small Businesses Have Big Impact on Health Care; Many Favor Public Insurance -NY Daily News

There are pundits and politicians who repeat - as if it were an article of faith - that business owners oppose President Obama's proposal to give people the choice of a public health insurance plans. Don't believe it.

House Democrats Release 852-Page Health Care Draft -Roll Call

House Democratic chairmen on Friday released an 852-page health care draft that they said would ensure 95 percent of Americans are covered by insurance, although some details, including the cost, are still to be determined.

In Poll, Wide Support for Government-Run Health -New York Times

Americans overwhelmingly support substantial changes to the health care system and are strongly behind one of the most contentious proposals Congress is considering, a government-run insurance plan to compete with private insurers, according to the latest New York Times/CBS News poll.

Early Word on the House Bill: So Far So Good -The New Republic

In a week of discouraging developments on health care reform, the House of Representatives has stepped up and offered reform advocates reason for optimism.

Democracy and the House Reform Bill -The Washington Post

To make one metapoint, the legislation previewed by the health reform committees in the House of Representatives also offers an interesting political contrast with the legislation being considered in the Senate. In particular, this is what legislation looks like from politicians with more to fear from voters.

This week, health insurance executives testifying before the House Subcommittee on Oversight and Investigations demonstrated their willingness to put profits before patients, to the horror of the Congressmen present.

Three executives testified at the Subcommittee's hearing on Tuesday, addressing its revelation that their companies collectively,

canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

Insurance companies have come under fire in recent years for routinely identifying policyholders in the individual market who have expensive health conditions, and then digging back into their medical history to find grounds to rescind their policy. Though insurers insist that they only rescind coverage when individuals omit important medical information from applications for coverage, canceled individuals have stepped forward with stories that undermine that claim. For example, we reported this story in a report last year:

Maria from Connecticut had insurance (a Fortis plan from Assurant) when she went to the doctor with what she thought was a pinched nerve and was diagnosed with non-Hodgkin's lymphoma. Assurant denied payment for the cancer-related bills, saying that she had this condition before she bought her policy, and she should have sought treatment. "If I thought I had cancer the previous month, why wouldn't I have gone to the doctor then? They expected me to be clairvoyant," Maria said.

The abusive practice leaves sick individuals uninsured and uninsurable, with huge medical bills. According to the LA Times, the House Subcommittee investigation revealed that,

policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

Harsh admonition came from both sides of the aisle. Said Representative Michael C. Burgess, Republican of Texas,

No one can defend, and I certainly cannot defend, the practice of canceling coverage after the fact.

Despite the lashings, the LA Times reports that, in the most stunning moment of the hearing, the executives flatly refused to stop the abusive practice within their respective companies:

Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show ‘intentional fraud.'

The answer from all three executives:

"No."

Video footage of this is here.

The testimony of the industry executives is a baffling throwback to the days before the President and Congress were dedicated to enacting comprehensive health care reform. And, it's a reminder of the need for strong private market regulation. According to the Families USA report, Failing Grades, current law in most states does not prohibit the practice: In 29 states and the District of Columbia, insurers are allowed to deny legitimate claims of policyholders who are up-to-date with their premium payments by digging back years into their medical history and alleging that they failed to disclose, or should have known about, a pre-existing condition. Lest we forget, we need the federal government to step in as a watchdog for health care consumers.

EXCLUSIVE: The Finance Committee's Health Reform Outline -The Washington Post

A Senate source just passed me the latest outline of the Senate Finance Committee's health reform proposal. This is the post-CBO revision. Apparently, after the committee staff received the scores, they dug deep and quickly developed this proposal to circulate among members and then send back to CBO. It was presented earlier today at a closed-door meeting.

On Health Care, Obama Tries to Seize the Moment -The New York Times

In their heart of hearts, few in the Obama administration would have predicted late last year that they would be this well positioned by June to achieve a major victory on health care. As the economy faltered, and attention focused on Wall Street and Detroit, it seemed unthinkable that Congress would be ready to devote the summer of 2009 to the costly proposition of providing health coverage for all, a goal that has eluded presidents since Theodore Roosevelt.

Bipartisan Health Reform is Possible -Politico

To understand the profound political difficulties inherent in reforming our health care system, one need only turn to recent headlines in POLITICO: "Dems vs. Dems on Health Bill"; "A Moderate Bloc on Health Care?"; "Health Plans Abound for GOP." Clearly, reaching consensus on health care reform is a significant challenge, but we can no longer afford to wait.

Key Challenges in Health Care Debate -The New York Times

After insisting that he would leave the details to Congress, President Obama this month intensified his push to overhaul health care. Democrats, Republicans and special interests are battling to shape the legislation as it begins its journey through Congress.

In Health-Care Reform, Language Matters -NY Times Economix Blog

Sitting at breakfast last Sunday morning and listening to my soliloquy on President Obama's radio address of the previous day, my wife impatiently interrupted me to administer a tongue lashing on my sloppy use of English.

Obama Promotes Health Care Overhaul in Green Bay, Wis. -LA Times

Facing a sharpening healthcare debate on Capitol Hill, President Obama urged participants at a town hall meeting here Thursday to keep up the political pressure for a health overhaul or face the consequences of inaction.

Health Reform Hits Senate Speed Bumps ­­-Politico

Health care reform hit a serious setback Wednesday, with the Senate Finance Committee blowing its own deadline for a bill and the Health Committee breaking sharply along partisan lines - developments that place President Barack Obama's August deadline for passing a bill in doubt.

Report: Health Care Costs to Rise 9 pct in 2010 - AP

Employers who offer health insurance coverage could see a 9 percent cost increase next year, and their workers may face an even bigger hit, according to a report from consulting firm PricewaterhouseCoopers.

Some Common Ground Emerges in Health Battle -USA Today

At the same time partisan divisions over health care are becoming increasingly stark, Democrats and Republicans in Congress are finding consensus on ideas that ultimately could be included in a final plan.

Heal or No Heal ­-The Daily Show

John Stewart: Barack Obama warns that if the American government doesn't fix its health care system, Americans could get a multi-million dollar bailout.

Debate on Health Care Hits Snag at the Start -The Washington Post

The debate over a sweeping overhaul of the nation's health-care system got off to a rocky start in the Senate yesterday as lawmakers delayed action on one key bill and engaged in partisan sniping over another.

Spend More, Get Less? The Healthcare Conundrum - NPR

In "The Cost Conundrum," his latest article for The New Yorker, staff writer Dr. Atul Gawande reports from McAllen, Texas, a border-town with the dubious distinction of spending more per person on health care than almost any other market in America.

Is now the time for health care reform? Well, it depends who you ask, but the majority of Americans answered "yes." It's nice time for proponents to become too confident, however, because when it comes to health reform, the public's opinion may be easily swayed.

According to a new poll by the Kaiser Family Foundation, a "solid majority" of Americans believe that now is the time for health care reform, despite our current economic woes. The study also finds that depending on which arguments the subjects hear (pro-reform or anti-reform), the number changes drastically.

The report says asked Republicans, Moderates and Democrats a series of questions ranging from the general to the specific (i.e. "Do you favor raising taxes to subsidize an insurance mandate?") Most people voted along party lines with liberals leaning towards reform and conservatives leaning toward the status quo, but the study shows that their opinions aren't set in stone.

According to Kaiser,

It's worth noting that the overall proportion "strongly" in favor of any of these reform approaches rarely goes above fifty percent, suggesting that ... there is a layer of support which is malleable.

This means that when health reform takes center stage on Capitol Hill this summer, it is more important than ever to us to keep the momentum going and keep the arguments for reform strong.

As we get down to the wire, we have to let our representatives know loud and clear that we want health reform this year. We can't let people like Rick Scott and Frank Lutz scare our friends, family and neighbors with misleading information.

Health reform in America means keeping what you have if you like it, including your doctors and your plan. It also means having the peace of mind knowing that you will have quality, affordable health care no matter what. And during a time of economic upheaval, this is exactly what Americans are looking for. 

Make no mistake: Women have disproportionately less access to quality, affordable health care. Unfortunately, for women of color, this picture is only worse. In fact, women of color are more than twice as likely to be uninsured compared with white women. Nearly 30 percent of women of color are uninsured. More shockingly, women of color have an AIDS case rate more than 11 times that of white women.

These are just a few of the striking statistics highlighted in the report recently released by the Kaiser Family Foundation (KFF), Putting Women's Health Care Disparities on the Map: Examining Racial and Ethnic Disparities at the State Level .The report analyzes health disparities on 25 indicators between white women and women of color, including: rates of diseases such as cancer and cardiovascular disease as well as rates of health insurance coverage and access. The report is unprecedented as it moves beyond national figures to analyze state-by-state variations in disparities. For example, the report reveals that 43 percent of Hispanic women in Oklahoma have not had a mammogram compared to 14.5 percent in Massachusetts. In some states, the disparities are quite large; and in others the disparities are much narrower. Social determinants, including poverty and high school drop-out rates, as well as the varying scope of states' public programs contribute to some of the disparities across the states.

Health disparities are particularly egregious for American Indian and Alaskan Native women. More than one in four American Indian/Alaskan native women receive delayed prenatal care. More than two million American Indians/Alaskan Natives live in the U.S., yet this population is one of the most overlooked of all racial and ethnic groups.

We must continue to work to improve the lives of all women of color and ensure they have access to quality, affordable health care they need and deserve. Health reform at the local, state, and national levels must not ignore specific minority communities, which often have different health needs and health statuses.

Democrats Work to Pare Cost of Health Care Bill -NY Times

Senate Democrats worked feverishly on Tuesday to pare the costs of legislation to overhaul the health care system, and were considering a reduction in proposed subsidies to help uninsured Americans buy coverage.

Private Muscle and the Public Option in Health Care -The Huffington Post

We're headed into the end game for health care reform. The president has put himself in the arena. The insurance lobby is unleashing the scare campaign. A strong bill will pass the House. But at this point, too many Senators are still standing in the way.

GOP Sticks to Script on ‘Washington Takeover' of Health Care -The Washington Post

In the political rhetoric of health reform, reality may be irrelevant. The New York Times Magazine offered a glimpse behind the curtain recently when Deborah Solomon interviewed Republican pollster and communications adviser Frank Luntz. For Luntz, the accuracy of an attack line seemed beside the point.

Rick Scott's Ad is the Real Joke -Media Matters

On June 16, 2009, Rick Scott and his group, Conservatives for Patients Rights, released a new ad titled "Old Joke."  The only joke in the ad is how few facts are included in the 32-second spot.

Health Care Rationing Rhetoric Overlooks Reality -NY Times

Rationing. More to the point: Rationing! As in: Wait, are you talking about rationing medical care? Access to medical care is a fundamental right. And rationing sounds like something out of the Soviet Union. Or at least Canada.

HHS Secretary: Public Plan Will Survive -USA Today

The insurance lobby won't be able to block a public health plan because most Americans realize they would be better off if the industry had competition, HHS Secretary Kathleen Sebelius said Tuesday as congressional committees worked to shape legislation.

Dems Pledge Lower-Cost Health Bill -Politico

Stung by Republican criticism of the $1.3 trillion price-tag on Sen. Ted Kennedy's health bill, Democrats involved in Senate Finance Committee negotiations pledged Tuesday night to release a plan that keeps costs lower - but still about $1 trillion over 10 years.

Obama Touts Health Care Overhaul to AMA -San Francisco Chronicle

President Barack Obama went before a convention of receptive but wary doctors on Monday to make the economic case for health care overhaul, both for the nation and for the physicians' own bottom lines.

Dean Rejects Conrad's Health Care Co-Op Proposal: ‘This is Not a Real Compromise' -Think Progress

Last week, Sen. Kent Conrad (D-ND) floated a health care proposal intended to mollify conservatives who are upset over the possible creation of a public health insurance plan. Instead of offering consumers a government-run option similar to Medicare, Conrad suggests giving individuals and very small businesses the option to buy into a plan that would be run by a non-profit cooperative. The idea has gained the support of Democratic senators, including Max Baucus (D-MT).

Senate near Bipartisan Consensus on Health Reform-Baucus -Reuters

The U.S. Senate is near agreement on a broad bipartisan plan to revamp the costly healthcare system, and legislation is very likely to pass, a leading senator said on Monday.

A Plan to Boost America's Fiscal Health -Financial Times

As the healthcare debate picks up in the US, there has been much discussion about how to pay for it. Coinciding with this debate are vocal concerns about the country's underlying fiscal position - which some have suggested as a reason to delay healthcare reform.

CBO Cost Estimates Offers Good News, Bad News for Reform Proponents -The Washington Post

The first cost-estimate for health-care reform is out from the Congressional Budget Office, and it's hard to tell what it bodes for the Obama administration's signature initiative.

The CBOs Assumptions -Ezra Klein

Yesterday, the Congressional Budget Office returned a fairly devastating estimate of Sens. Ted Kennedy (D-Mass.) and Chris Dodd's (D-Conn.) Affordable Health Choices Act. According to the agency, the bill would cost a hefty trillion dollars over 10 years and extend insurance to a mere 16 million people. That's a lot of money to spend if you're only going to achieve a third of your goal. Frankly, I was pretty surprised by the results.

Just a few short years ago, those who owned and operated small businesses throughout the country were the perfect example of people achieving the American dream. Now, those same hard-working people are realizing their dream may be in jeopardy as they struggle to keep their businesses alive due to, you guessed it, the cost of health insurance.

An article in the Wall Street Journal chronicles how high health-care premiums, coupled with reduced profits have forced many small business owners to drop health insurance to stay afloat:

Sheryl Weldon, owner of Commerce Welding & Manufacturing Co., saw health-insurance payments increase to more than $800 monthly per employee from about $200 five years ago. With monthly revenue down 10% since December, Ms. Weldon stopped providing health coverage to employees, including one being treated for prostate cancer, for the first time in the 64-year-history of the Dallas sheet-metal company.

Every day, more and more companies are forced to make similar cuts, according to the article,

About 10% of small businesses are considering eliminating coverage over the next year, up from 3% in 2005, according to a recent survey by National Small Business Association.

Many business owners say they cancel employer-sponsored insurance as an alternative to firing employees when profits are down. They look at the decision to eliminate coverage as the lesser of two evils, but they know their decision affects families who depend on their employer to receive coverage.

Some of our previous blogs have highlighted that when employers cannot provide good benefits for their workers, it hurts their ability to retain healthy productive employees. That's not good for morale and that's not good for the already struggling American economy.

Furthermore, the Small Business Majority has just put out a study that shows that more than any other sector of the economy, small businesses could benefit the most from health reform.

It's time to step in and help small businesses subsidize employer-sponsored coverage for their workers. If we wait too long, more companies could go under and more Americans will be without insurance and without a job. Let's work to keep the American dream alive and well.

Consumer Reports recently examined individual health insurance policies and found that, by and large, they don't provide adequate coverage for serious medical problems. According to the Washington Post,

Many people who believe they have adequate health insurance actually have coverage so riddled with loopholes, limits, exclusions and gotchas that it won't come close to meeting their expenses if they fall seriously ill.

The report offers some survival tips for consumers tossed into the Wild West individual insurance market, like:

• Avoid caps on annual or even lifetime expenditures. Health care costs more than you think;

• An unusually low premium probably signals a thin benefits package;

• If your policy outline doesn't explicitly state that your plan covers a benefit, the benefit is probably excluded;

• Look for policies with a single deductible for all services and an out-of-pocket maximum.

But, as a Center for American Progress report pointed out recently, it's difficult to even see a detailed Explanation of Coverage (EOC) before enrolling in a policy.  And, individual market policies are notoriously opaque and confusing. According to the CAP report,

Once obtained, the EOC remains a complicated legal document that includes technical terms and sometimes vague, confusing, or contradictory language.... According to one insurance industry survey ... less than one-quarter were certain they understood the terminology used in their health insurance policy.

Which begs the question: Why would we leave anyone in the wilderness of the individual insurance market? Even the savviest consumer would struggle out there among the sharks. The government needs to adopt the role of watchdog in the market to prevent consumers from becoming minnows.

Barack Obama Takes His Case to the American Medical Association - Politico

President Barack Obama will attempt to convince a skeptical American Medical Association Monday to drop its resistance to the most controversial element of his health reform effort, a government insurance plan

Affordable Health Insurance Elusive in Rural U.S. -NPR

Larry Harbour is celebrated in Nebraska as a model entrepreneur. But the 33-year-old owner of LB Custom Chrome and Detail in rural Broken Bow, Neb., is an illness or injury away from losing his business.

GOP Senators Question Obama's Health Reform -NY Times

Republicans on Sunday continued to express strong concerns over the Obama administration's plan to reform health care and its call for a public insurance option.

Un-Cooperative: The Trouble With Conrad's Compromise -The New Republic

In the fast-moving debate over health care, no idea invites more admiration or ire than the "public health insurance option"--or what I've been trying to get people to describe as "public plan choice". The idea is overwhelmingly popular with Americans, garnering 85 percent support in a new independent poll from the Employee Benefit Research Institute.

Obama Open to Reigning on Medical Suits - NY Times

The American Medical Association has long battled Democrats who oppose protecting doctors from malpractice lawsuits. But during a private meeting at the White House last month, association officials said, they found one Democrat willing to entertain the idea: President Obama.

Can Conrad's Cooperative Compromise Meet the Goals of a Public Health Care Plan? -Think Progress

In yesterday's interview with the Washington Post's Ezra Klein, Sen. Kent Conrad (D-ND) suggested that his proposal to replace the public health insurance option with a non-profit consumer-driven health cooperative, might allow the new plan to bargain with hospitals and doctors.

Last week, researchers at Harvard and Ohio University published new data revealing that, in 2007, 62% of all bankruptcies were related to medical debt. According to the report,

An American family filed for bankruptcy in the aftermath of illness every 90 seconds; three quarters of them were insured.

Since 2001, when the authors last performed this study, "the proportion of all bankruptcies attributable to medical problems has increased by 50%." This trend is unsettling to say the least.

People with health insurance were not protected from medical bankruptcy; in fact, insured Americans made up the majority of medical bankruptcies. Families USA found recently that 82.5% of Americans in families that spend more than 10% of income on health care have health insurance. Dr. David Himmelstein, the lead author, told reporters:

For middle-class Americans, health insurance offers little protection. Most of us have policies with so many loopholes, co-payments, and deductibles that illness can put you in the poorhouse. Unless you're Warren Buffett, your family is just one serious illness away from bankruptcy.

Americans like Linda and Jeffrey Somach can attest to that. According to the Los Angeles Times,

[The Somachs] say $800 a month for health insurance. But the Staten Island, N.Y., couple filed for bankruptcy a month ago when their out-of-pocket medical expenses surpassed $40,000. Linda Somach, a psychologist, can earn $80,000 a year if she sees patients full time. But she had to scale back to care for Jeffrey, who has terminal brain cancer. That reduced their income.

The good news? Leaders in Congress and President Obama recognize the urgency of the situation, and they're working overtime to deliver comprehensive health care reform to Americans. President Obama sent a letter to Senators last week that included this assertive message:

Health-care reform is not a luxury. It's a necessity we cannot defer. Soaring health-care costs make our current course unsustainable. It is unsustainable for our families, whose spiraling premiums and out-of-pocket expenses are pushing them into bankruptcy and forcing them to go without the checkups and prescriptions they need.

Democrats Target a Dozen GOP Senators in Quest for Health Reform Deal - Kaiser Health News

Senate Finance Committee Chairman Max Baucus and other Democratic leaders are targeting more than a dozen moderate and conservative Republicans as they pursue a bipartisan deal to extend health care coverage to nearly 46 million uninsured Americans.

Obama Takes His Health Care Case to the Public -NY Times

President Obama, taking his case for a health care overhaul directly to the American people, on Thursday vigorously defended his call for a government-sponsored health plan to compete with private insurers. But back in Washington, a leading Senate Democrat seemed to be looking for a compromise that would limit government involvement.

US Small Firms Seen Benefiting from Health Revamp -Reuters

Small businesses would benefit significantly from an overhaul of the U.S. healthcare system even if they were required to help pay for the medical coverage of their employees, a study release on Thursday said.

Fact Checking Karl Rove's Attack against the Public Option -Think Progress

Today, Karl Rove penned an editorial in the Wall Street Journal attacking the public health care option. Rove's ‘myths' echo the poll-tested talking points of Frank Luntz and other conservatives determined to protect the private insurer's monopoly over coverage and deny Americans choice. Below is a fact-check of Rove's assertions.

Health Care Reform Provides an Estimated $855 Billion in Small Business Savings -Entrepreneur Magazine

Comprehensive healthcare reform will save the small business sector $855 billion over the next 10 years, according to a report released this morning by the nonpartisan Small Business Majority. The study, titled The Economic Impact of Healthcare Reform on Small Business, noted that a system of shared responsibility among the healthcare industry, businesses, government and individuals would be critical to successful reform.

Has Kent Conrad Solved the Public Plan Problem? An Interview -The Washington Post

Earlier today, Sen. Kent Conrad, the North Dakota Democrat who chairs the Senate Budget Committee, introduced a "potential compromise" on the public plan: A system of federally-chartered co-ops that could offer a non-profit alternative to the for-profit insurance industry. In this telling, the co-ops preserve the central feature of the public plan -- they're a competitor to the traditional insurance industry -- but are free from the baggage of government control.

Yesterday, I had the privilege of participating in the White House Stakeholder Discussion on Health Disparities and I wanted to tell you about it.

For someone who has been working on the issue of disparities for the greater part of my career, I found it encouraging to see so many familiar faces alongside our new leaders in the Administration: HHS Secretary Kathleen Sebelius, Nancy-Ann Min DeParle, and Tina Tchen. Even more heartening, though, was the feeling that this was just one of many conversations with the Administration about how to make sure the care you receive is not determined by the color or your skin, your zip code, or your income.

The conversation focused heavily on identifying solutions: from expanding access and coverage to diversifying the health care workforce to improving data about which groups are healthy and which aren't (particularly for often-overlooked populations). But one thing was clear: We have an amazing opportunity to close the gap and move closer to the ultimate goal of health equity.

Many in the room agreed the "health care reform has been a long time coming." In the next few weeks, our leaders in Congress and the Administration will work out the details of how to improve our health care system and make sure it's accessible to everyone. And while all of us in the room acknowledged that the fight for health equity will continue long-after the President signs on the dotted line, we know this stage of the fight is critical, and we're ready.