The New York Times has the story:

Three new surveys, including two released on Wednesday, show that adults under 26 made significant and unique gains in insurance coverage in 2010 and the first half of 2011. One of them, by the Centers for Disease Control and Prevention, estimates that in the first quarter of 2011 there were 900,000 fewer uninsured adults in the 19-to-25 age bracket than in 2010.

This was despite deep hardship imposed by the recession, which has left young adults unemployed at nearly double the rate of older Americans, with incomes sliding far faster than the national average.

The Obama administration, intent on showcasing the benefits of a law that has been pilloried by Republicans, attributes the improvement to a provision of the Affordable Care Act that permits parents to cover dependents up to their 26th birthdays. Until that measure took effect one year ago this week, children typically had to roll off their parents’ family policies at 18 or 21 or when they left college.

Some twentysomethings adopted a posture of “young invincibility,” forgoing health insurance they could afford while gambling that they would not incur steep medical expenses. But others, like Kylie R. Logsdon, who credits the provision for enabling her heart transplant in July, were living with chronic or life-threatening conditions and had no prospects for coverage.

Before the new program, workers’ incentive to shop around was limited because they had no idea — or any easy way to find out — that prices for many types of medical treatments varied widely. A test at one center might be $3,700, while “right down the street they could get it for $900,” says Gardner, the vice president of benefits at Prodigy, which provides benefit management for self-insured employers.

Other employers and insurers are pursuing the same strategy, experimenting with ways to slow rapidly rising spending on medical care. Some, like Prodigy, are going beyond simply offering high-deductible insurance to being more directive, using financial incentives to promote doctors, hospitals or medications they’ve deemed more cost efficient.

Safeway employees in the San Francisco Bay Area, for example, face higher payments if they choose centers that cost more than $1,500 for a routine colonoscopy. And in January, the giant California Public Employees’ Retirement System (Calpers) said it would not pay more than $30,000 toward knee or hip replacement. Workers who choose a hospital that costs more pay the difference. Next year, the program will be expanded to outpatient colon cancer tests, as well as some surgeries, including cataract repair for the 345,000 people enrolled in Calpers’ preferred provider plans.

In a big step to carry out the new health care law, the Obama administration unveiled standards on Monday for insurance marketplaces that will allow individuals, families and small businesses in every state to shop for insurance, compare prices and benefits and buy coverage.

Kathleen Sebelius, the secretary of health and human services, said the insurance exchanges, the centerpiece of the new law, “will offer Americans competition, choice and clout.”

In theory, the exchanges will pool insurance risks and premiums so that individuals and small businesses will have “the same purchasing power as big businesses,” Ms. Sebelius said.

Issuance of the proposed rules shows how President Obama is moving inexorably to carry out his health care overhaul, despite attacks on the new law in Congress and the courts, where more than two dozen states are challenging the constitutionality of a requirement for most Americans to carry insurance.

In principle, liberals and conservatives support the exchanges, which they see as a way to increase the purchasing power of individuals and small businesses, but they disagree on how the exchanges should be configured. The regulations issued Monday, which provide a fair amount of latitude to states, were welcomed by consumer groups, patient advocates and some business lobbyists.

But they may not satisfy liberals who argue that the exchanges should tightly regulate insurance and contract with selected health plans that offer the best deals. And they may not satisfy conservatives who want the exchanges to be wide open to any insurers that want to participate and meet minimum federal standards.

For the rest of the story, read The New York Times

Carolyn Johnson’s monthly health-insurance premiums nearly doubled this month, from $313 to $600 – a tough jump for a laid-off legal assistant who lives with her retired father and gets by on unemployment benefits.

In this case, the staggering 92 percent rate increase was not imposed by an insurance company but by the state of Pennsylvania. Johnson’s coverage is equivalent to the adultBasic plan provided by the state’s Insurance Department, headed by a commissioner who has been active in pushing for sweeping changes to the nation’s health-care system.

“You are not going to find me defending this as a good choice,” said Insurance Commissioner Joel Ario, who sat next to President Obama at a recent White House conference on insurance.

“Among the horrible choices, this is the least obscene,” Ario said, blaming the increase on the rising costs of medical care.

Pennsylvania’s adultBasic is a state-run health-insurance program for the unemployed and financially distressed. That’s what makes this increase so onerous, said Jonathan Stein, a lawyer with Community Legal Services and a frequent critic of insurance companies.

“Essentially the state and [the nonprofit Independence Blue Cross] are acting like a for-profit insurance company, pricing people who are needy out of insurance,” he said.

In February 2007, Johnson, 53, lost her job as a legal assistant. She eventually went on the waiting list for Pennsylvania’s subsidized adultBasic plan.

The program, administered in this area by Independence Blue Cross, is partly funded by payments to the state from the four Blue Cross insurance companies that sell policies in Pennsylvania.

Independence Blue Cross paid $61 million last year, of which $36.6 million underwrites the adultBasic program, Independence Blue Cross spokeswoman Elizabeth Williams said.

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CALVIN WOODWARD

The Associated Press

WASHINGTON – Health insurers insist they are still committed to getting a health-care bill passed this year. But all around Washington, people are wondering if – or when – the industry will change its mind and try to kill it.

The industry’s chief lobbyist, Karen Ignagni, said yesterday that insurers “can continue to make a major contribution” to the overhaul effort. She told a gathering of the trade group America’s Health Insurance Plans: “Yes, we can achieve reform.”

But her comments came amid mounting tension between her industry and majority Democrats, and on the heels of months in which President Obama and Democratic leaders have painted insurers as a chief villain.

The Democrats have just fired their biggest guns at the insurance industry, but unfortunately they are shooting very loud blanks.

That’s what they did Wednesday, when the Senate Judiciary Committee held a hearing titled Prohibiting Price Fixing and Other Anticompetitive Conduct in the Health Insurance Industry.

There is no way in the world that health insurance companies are going to allow Congress to repeal the McCarran-Ferguson Act, which gives them a pass from federal antitrust enforcement. The insurance industry is the only one, other than Major League Baseball, to enjoy this exemption.

But don’t expect the majority in Congress to play ball with those who are serious about getting rid of that exemption, even though the ever-quotable Sen. Chuck Schumer (D-N.Y.) called it “one of the worst accidents in American history.”

It was no accident at all. McCarran-Ferguson has been with us since 1945, when the industry got Washington’s willing lawmakers to reinstate the industry’s immunities from federal regulation after the Supreme Court had, a year before, overturned the apple cart of special treatment insurers had gotten since right after the Civil War.

Because of McCarran-Ferguson, they must be regulated state by state, which is an ineffective patchwork compared with one national set of standards.

The result is that the insurance behemoths don’t have to pay attention to the antitrust restrictions that prevent normal companies from colluding and engaging in their other anti-competitive practices.

That’s why Americans can’t take their business elsewhere when their health insurer cheats them. There are no real alternatives. When it comes to abusive practices, the companies are allowed to all be in this together.
Understandably, they cherish this exemption. Since it has meant they could accumulate limitless wealth, all they have to do is shower a little bit of it into the campaign coffers of this generation’s pliant politicians, and they will keep the advantage that lies at the heart of health care dysfunction in this country.

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WASHINGTON – House Speaker Nancy Pelosi warned insurance companies yesterday that a health-care overhaul could cost the industry dearly through new fees, fewer regulatory protections, and fresh competition from the federal government.

The blunt admonition followed a round of harsh statements this week from senior Senate Democrats, and came in response to the insurance lobby’s aggressive campaign to block reform legislation from advancing.

An internal industry study released this week said the Senate bill would cause premiums to rise sharply, but the report’s findings have been widely disputed.

The tactic now appears to have backfired, as Democrats vow to redouble their efforts to crack down on insurers’ practices. Health-care negotiators are working behind closed doors to merge different pieces of legislation into separate bills that are expected to reach the House and Senate floors next month.

“It is absolutely clear that it is an unsustainable situation as we go forward, and it is well known to the public that the health-insurance companies are the problem,” Pelosi said.

She said the House may adopt a Senate provision that would assess a flat fee on insurance companies that is expected to generate about $40 billion over 10 years, as a way to pay for its reform bill.

She also advocated House language that would require health-insurance companies to spend 85 cents of every dollar they collect in premiums on benefits.

And she singled out the antitrust exemption that has protected the industry since 1945, the McCarran-Ferguson Act that allows states to regulate insurance without federal interference.

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Eric Aycox wasn’t feeling well on Nov. 18, 2006, but he didn’t have health insurance so he went to an emergency room, where he was sent home with a prescription for codeine and an antibiotic.

But he didn’t have money to fill the prescriptions, and he later died of a bacterial infection that morphed into menigitis. He was only 44.

Yesterday, his mother, Joan Kos-loff, and his father, Frank Aycox, gathered with members of Healthcare for America Now, the American Federation of Labor and Congress of Industrial Organizations, the Service Employees International Union, and the United Food and Commerical Workers, Local 1776, to protest and demand that Cigna Insurance Co. stop blocking health-care reform.

Yesterday’s local protest was one of about 95 nationwide gatherings for a national day of action dubbed “Big Insurance: Sick of It.”

About 400 supporters of health-care reform gathered yesterday at City Hall, some with signs reading, “Healthcare for all is a basic human right” and “Insure people, not profits,” for a rally before marching to Cigna’s Center City headquarters at 16th and Chestnut streets.

Read more at the Philadelphia Daily News.

About half of the surplus decline since 2007 can be attributed to the economic downturn, while the rest represents a planned reduction of the surplus through community investment initiatives and other programs.

Blue Cross of Northeastern Pennsylvania is considered by the state Insurance Department to have an “efficient” surplus, the same category it was in at the end of 2008 when it posted a $338.6 million surplus, but less than the “sufficient” surplus it had at the end of 2007.