Pallone Discusses Legislation to Improve Medicare Benefits and Update Enrollment Process at Keansburg Senior Center

FOR IMMEDIATE RELEASE
October 13, 2016


LONG BRANCH, NJ – Today at the Bayshore Senior Center in Keansburg, Congressman Frank Pallone, Jr. (NJ-06) outlined his newly introduced Medicare Affordability and Enrollment Act, which would improve Medicare coverage for all seniors and those with disabilities and modernize the enrollment system to help facilitate easier enrollment. The legislation seeks to make several key improvements to Medicare by establishing a maximum out-of-pocket spending cap for traditional Medicare, expanding access to premium and out-of-pocket payment assistance for low-income beneficiaries, and updating and improving the current Medicare enrollment process.

“As a growing number of Americans begin to enroll in Medicare, we have to make sure the program continues to meet their needs and provides affordable, high-quality health coverage,” said Pallone. “This bill would help simplify Medicare for seniors, make coverage more affordable for more Americans, and enable individuals with disabilities to obtain their coverage without a waiting period. This bill reaffirms our commitment to ensure the program works for all Americans who paid into it.”

The bill would:

· Set a maximum out-of-pocket cap of $5,500 for medical services under traditional Medicare, which exists today for Medicare Advantage and most commercial insurance plans;
· Significantly expand the number of low-income beneficiaries eligible for financial assistance to cover premiums and out-of-pocket costs;
· Reduce cost-sharing for “near-poor” beneficiaries who are not eligible for any assistance today;
· Eliminate the arbitrary two-year waiting period for people with disabilities to enroll in Medicare;
· Modernize the Medicare enrollment system to facilitate easier enrollment, allow people to begin coverage earlier and reduce arbitrary late-enrollment penalties that today are paid for over a lifetime;
· Extend cost-sharing assistance for Part D enrollees for their prescription drugs in Puerto Rico, which is currently offered to all other eligible Medicare beneficiaries; and,
· Increase and extend permanent funding for low-income Medicare beneficiary outreach and education activities.

The bill has been endorsed by the following organizations: National Coalition on Aging, Medicare Rights Center, The Arc, AFSCME, Justice in Aging, Dialysis Patient Citizens, National Committee to Preserve Social Security and Medicare, Center for Medicare Advocacy, Families USA, and the National Consumer Voice for Quality Long Term Care.

Middletown Cuts The Hours of Part-Timers To Avoid Obamacare: Joins The Likes Of Greedy Corporate CEO's From Papa John's, Applebees and Red Lobster

We can now add the name of Middletown Township NJ to the likes of Papa John's, Applebees, Deny's,  Red Lobster and the many other similar corporate institutions that have decided that it is better to cut employee hours (and livelihoods) than give its hard working, part-time employees health care coverage under the guidelines of the Affordable Care Act, aka Obamacare.

According to the Asbury Park Press at this past Monday night's Middletown Township Committee meeting (I'll post the video when it becomes available), the township administration announced that rather that provide health benefits to 25 part-time employees under the guidelines of the Affordable Care Act, they have instead cut the hours of those employees to avoid paying the extra premiums. 

For the companies named above the additional costs of providing health care coverage to their employees equates as little as 10 cents or less per menu item, to their bottom line. Those costs can easily be added onto a customer's bill with very little notice or trouble from the clientele, as a matter of fact, according to many polls conducted in the past year, customers would be more than happy to pay the few cents more added on to their bill knowing that the additional costs were going to provided health coverage to those that prepare and serve their meals.

In the case of Middletown, providing health care coverage to those 25 part-timers, who live in Middletown and just might be some of our friends and neighbors, would equate to little more than $6 per tax paying township property owner per year. To some of you out there that may sound outrageous but keep in mind, these people are our hardworking friends and neighbors who just might need those extra few hours of pay each week to make ends meet at the end of the month.

Middletown's reasoning for not wanting to provide health coverage to its part-time help is somewhat understandable if you believe that the cost of providing coverage to those employees is indeed $31,000 per individual or family as the township states. That's outrageous! How can it be so much? It doesn't make sense.

I know how much it cost my employer to provide me with an HMO family plan through Cigna Health Care and it is nowhere near $31,000 a year. I think it's about time Middletown starts fessing up as to what real costs are available to them and not try to make excuses.

Whenever the cost of township health insurance premiums are brought up at a public meeting or in the media those on the dais and the administration point to the fact that Middletown is self-insured and as a result of being self-insured, the overall costs of health care coverage is less as compared to enrolling current and retired employees in the state's various coverage plans.  It's obvious to me and many others that this just isn't so.

I've stated it before and I'll state it again, there has been a great many current and former Middletown employees who have told me in the past that they are/were afraid to speak out against their employer (the Township) because Middletown was self-insured. It seemed to them that whenever they would complain to much or too loudly about different work related conditions or insurance benefits, they would notice a slowdown in how their claims or benefits were processed or distributed.

Of course they and I know that that sort of behavior by an employer  is illegal. You can't intimidate or knowingly go out of your way to harass a current or former employee because you are unhappy with them. However those that have talked to me about it feel just that, and believe the only reason why the township is still self-insured is so that Middletown controlled them and demand their loyalty and silence

New Jersey Consumers Save Big On Insurance Premiums Thanks To ObamaCare

For Immediate Release:
Wednesday, September 12th, 2012

Affordable Care Act saved $2.1 billion for American consumers

(NEW JERSEY) - “ As a result of ObamaCare, Americans have already saved an estimated $2.1 billion on health insurance premiums. Once again, the Affordable Care Act is protecting consumers from excessive costs.

1. In every state, insurance companies must submit a justification for public review if they want to raise premiums by 10% or more. This protects consumers from excessive “ and unjustified -- rate increases. Rate reviews have helped save an estimated $1 billion for American consumers.
2. The 80/20 rule ensures that insurance companies spend at least 80% of premium dollars on patient care. Those companies failing to meet these spending requirements must write checks back to their customers for the difference. Consumers have received rebate checks for $1.1 billion thanks to the 80/20 rule.

"Thanks to Obamacare, New Jerseyans are now saving millions of dollars on healthcare premiums," said Joshua Henne, New Jersey spokesman for Know Your Care. "For the first time ever, millions of consumers across the country are actually getting money back from their insurance companies. These new rules are bringing transparency and accountability to the healthcare marketplace."

To assist in this effort, the Affordable Care Act provides states with Health Insurance Rate Review Grants to enhance their rate review programs and bring greater transparency to the process. 42 states have used their rate review grant funds to make the rate review process stronger and more open. The rate review report released yesterday is available at: http://www.healthcare.gov/law/resources/reports/rate-review09112012a.html.

New Jersey is using their grant funding in several key ways:

• New Jersey improved its review of health insurance rate increases. Prior to receiving the grant funding, filing of comprehensive medical rates electronically in the individual, small group, and large group markets was optional and not widely observed. Today, all rate filings are now received electronically, which has helped New Jersey maintain filing information.
• Additionally, in an effort to standardize filing submissions, for rates filed on or after July 1, 2012, carriers in New Jersey will be required to submit two worksheets and a checklist to ensure all documents are properly submitted and in the correct format.
• Finally, New Jersey has partnered with the Rutgers Center for State Health Policy to engage stakeholders in a series of forums to better understand the impact of rate increases and the type of information wanted by consumers.

****
The Affordable Care Act was signed into law by President Barack Obama on March 23rd, 2010. Over the past two years, it has been a tremendous help to millions of Americans as this real reform lowers costs and guarantees more choice for consumers. As additional provisions are implemented, ObamaCare will continue to benefit millions more people.

HOLT SUPPORTS HOUSE HEALTH CARE REFORM PROPOSAL IN COMMITTEE; PLEDGES TO IMPROVE BILL AS PROCESS CONTINUES

FOR IMMEDIATE RELEASE
July 17, 2009

As Member of House Committee on Education and Labor, Holt Works to Strengthen Public Option, Small Business and Health Care Employment Training

(Washington, DC) – Rep. Rush Holt (NJ-12) today voted for – in the House Committee on Education and Labor – the America’s Affordable Health Choice Act, legislation introduced in the House, with the intention of extending coverage to all Americans, improving the quality of care, expanding preventative care, and reducing the health care costs that Americans pay. The reform proposal would build on the existing system, so that if people are happy with the insurance they have, they can keep it. While helping to pass the bill in Committee, Holt noted that this is an intermediate step in the legislative process and that he wants to continue to improve the bill, strengthening the parts providing for a public option, small business benefits, and training for health care workers.

In June, Holt hosted a group of Central New Jersey primary care and patient advocates in Washington to hear their experiences on the front-line of health care and meet with leaders in health reform. For example, a pediatrician shared her story that primary care providers like her are struggling to see more patients, while receiving lower payments from insurance companies for her primary care services. On Monday, Holt held a roundtable at the Henry J. Austin Health Center in Trenton. Participants included small business owners, patient advocates, health care providers, doctors and nurses.

“We no longer can accept the status quo. I believe this year we will reform our broken health care system, but I know this will not be easy,” Holt said. “Since Teddy Roosevelt was President, the Congress has tried to pass universal health reform. However, with Presidential leadership, a supportive Congress, and an American public that understands what is at stake, the table is set for historic reform. As primary care providers and patients from Central New Jersey have told me, we must fix our health care system to keep individuals healthy, prevent diseases, and provide health security for all Americans. Today we have taken an important, though not final, step.”

A summary of the legislation can be found at http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BILLSUMMARY-071409.pdf.

In supporting the bill in Committee, Holt highlighted two features: creating a public health insurance plan and increasing the resources devoted to primary care. Holt argued that a public health insurance plan needs to be included to lower costs and improve health care delivery. In addition to increasing competition, Holt said, a public plan would provide a way to inject innovative strategies to deliver higher-quality and lower-cost health care, such as encouraging integrated medical care and increasing primary care. Holt also noted that the legislation includes several proposals to improve primary care by increasing the workforce and enlarging community health centers.

“In 2009, health care spending is projected to reach $8,160 per person, an amount sufficient to provide excellent care for everyone, yet 46 million Americans lack insurance and millions more have coverage that doesn’t meet their needs. Without health reform, businesses’ costs will continue to increase, families’ out-of-pocket costs will rise, and American workers will not receive the health care they need,” Holt said.

In addition to these provisions, Holt succeeded in adding two amendments to the legislation. One amendment would provide additional job training in order to expand the health care workforce. The White House Council on Economic Advisors released a report this week noting that the number of health care practitioner jobs, such as physicians and nurse practitioners, will grow by 35 percent between 2000 and 2016. Demand for health care support occupations, including medical records and health information technicians, clinical laboratory technicians, and physical therapists are expected to increase by 48 percent.

The bill would creates a competitive National Health Workforce Online Training Grant program for universities, community colleges, non-profits, workforce investment boards, and others to increase the number of online training programs for individuals seeking health care jobs. Grant recipients would be required to reach out to workforce investment boards, local governments, educational institutions, and other workforce training organizations to disseminate their knowledge. The bill also would establish an online health professions training program clearinghouse, which would collect and nationally disseminate the best practices learned by grantees.

The online job program would support programs similar to one offered by Rutgers University and the New Jersey Department of Labor and Workforce Development. The Director of the Rutgers Center for Women and Work, Dr. Eileen Applebalum, and Assistant Professor and Senior Research Scientist, Dr. Mary Gatta commended Holt for including the amendment.

“As so much research, including our own, has demonstrated online learning provides significant benefits and advantages to dislocated and incumbent workers in developing and expanding their skills to compete in our economy,” Appelbaum and Gatta wrote in a letter. “Online learning provides accessible, flexible, cost-effective, and most-up-to date training. This is particularly important in the healthcare fields, as there are significant shortages of skilled workers in several fields, and existing workers must ensure that their skills are compatible with job demands.”

Another amendment, which Holt cosponsored with Subcommittee Chair Rob Andrews and Reps. Phil Hare and Donald Payne would create small employer benefit arrangements (SEBAs), which provide a new way for affiliated small businesses to join together to offer health insurance and other benefits to their employees.

Holt first learned about SEBAs from Wilson H. Beebe, Jr., Chairman, the Alliance for Employee Benefit Cooperatives and Executive Director, New Jersey State Funeral Directors Association. Beebe regonized the work of Holt and others for including the amendment in the legislation.

“We appreciate all of their hard work and are lucky to have such effective legislators representing us in Washington,” Beebe said. “Self-governed SEBAs will assist small businesses in taking advantage of the opportunities provided by national health reform. By allowing SEBAs to negotiate premium and plan design on the basis of occupational demographics and administrative economies of scale, we expect to further reduce premium costs. Moreover, we can provide professional evaluation of the plan options available in the market-place suitable to our membership and workforce.”

Cost of uninsured adds $1,100/year to premiums of insured families.

I often get into heated debates with a co-worker of mine over the need for some sort of universal health care coverage for all U.S. citizens.

My co-worker is dead set against it, he argues that health care would be rationed and he would have to wait to see a doctor. He tell of how his cousins from Canada came across the border to seek medical treatment because they had to wait so long to be treated in Canada for what ailed them.  

He buys into the old GOP argument that government bureaucrats would  be deciding what was best for himself and family rather than his doctors.

I show him the irony to his argument by pointing out that instead of government bureaucrats making health care decision for us, we have insurance companies making those decisions for us today.    

When I point out to him that there is close to 100 million people in this country that have no health insurance at all and because of this, we and our employer pay for it through our insurance premiums, he says he does not care, he is only interested in the facts. Sometimes I wonder why I even bother to discuss thing with him.

So for my co-worker, here are some facts. I found this information on Think Progress's  The Wonk Room. The study was done by the Center for American Progress:

When the uninsured cannot pay for the care they receive, health care providers shift costs to Americans with insurance in the form of higher premiums. A new report from The Wonk Room’s Ben Furnas and Peter Harbage concludes that a failure to continuously cover all Americans accounts “for roughly 8 percent of the average health insurance premium“:

This cost-shift amounts to $1,100 per average family premium in 2009 and $410 per average individual premium. By 2013, assuming the cost shift remains the same percentage of premium costs, the cost shift will be approximately $480 for an individual policy and $1,300 for a family policy.

Read the full report>>>Here