Health Reform & Early Retirees (05/05/2010 Web chat)

HI I'M JENNY BACKUS, ACTING ASSISTANT SECRETARY FOR PUBLIC AFFAIRS HERE AT HHS, AND WELCOME
TO OUR SIXTH WEBCHAT ON HEALTH REFORM. THE AFFORDABLE CARE ACT CONTAINS REALLY IMPORTANT
BENEFITS FOR YOU BUT IT CAN BE CONFUSING AND THERE'S LOTS OF MISCONCEPTIONS OUT THERE.
WE CREATED THESE WEB CHATS AS A WAY TO ANSWER YOUR QUESTIONS AND HOPEFULLY CLEAR UP SOME
OF THE CONFUSION. SINCE WE FIRST BEGAN OUR CHATS WE DISCUSSED
MANY FACETS OF THE AFFORDABLE CARE ACT. THIS WEEK WE'LL FOCUS ON AN IMPORTANT BENEFIT
FOR BUSINESSES AND THEIR EMPLOYERS WHICH THE PRESIDENT ANNOUNCED YESTERDAY.
WILL YOU STILL HAVE AFFORDABLE HEALTH INSURANCE AND WHAT ABOUT BUSINESSES WHO WANT TO HELP
YOU WITH INSURANCE WHEN YOU RETIRE? WE WILL HIT THOSE QUESTIONS TODAY.
WE INVITED YOU TO SUBMIT YOUR OWN PERSONAL QUESTIONS ON THIS ISSUE AND OTHERS AND WE
RECEIVED HUNDREDS OF QUESTIONS. IF YOU WANT TO SEND US A QUESTION DURING OUR
CHAT, WE ENCOURAGE YOU TO DO IT
AT TWITTER.
TWITTER:@HHSGOV. OR YOU CAN E MAIL US AT:
HEALTHREFORM@HHS.GOV. PLEASE KEEP YOUR QUESTIONS SHORT SO WE CAN
SAVE TIME. IF YOU DON'T GET TO US TODAY, CHECK OUR WEB
SITE AT HEALTHREFORM .GOV. WE'LL TRY TO ANSWER THEM THERE, AND WE REVIEW
POSTINGS EVERY DAY. SO JOINING US TO EXPLAIN IS SECRETARY SEBELIUS
AND JERRY LOCKEX. YOU SENT A LET TORE GOVERNORRORS AND STATE
INSURANCE COMMISSIONERS ASKING THEM TO DO A COUPLE OF DIFFERENT THINGS CAN YOU TELL
BUS THAT? >> SURE.
FIRST OF ALL I WANT TO THANK SECRETARY LOCKE FOR BEING HERE TODAY.
HE'S A GREAT EFFORT IN THIS PARTNER AND OUTREACH TO BUSINESS.
WE SENT A LET TORE MY FORMER COLLEAGUES AND GOVERNOR AND INSURANCE COMMISSIONERS TO TELL
THEM THAT WHEN, WELL POINT INSURANCE COMPANY WITHDREW THEIR 39% RATE INCREASE IN CALIFORNIA,
IT WAS IN PART DUE TO THE FINDINGS OF THE CALIFORNIA INSURANCE COMMISSIONER THAT THEIR
CALCULATION OF WHY THE RATES NEEDED TO GO THAT HIGH WAS JUST WRONG.
THEY USED A WRONG FORMULA AND THIS WAS A LETTER URNLGING GOVERNORS IN OTHER STATES WHERE WELL
POINT OPERATES TO LOOK AT THEIR OWN RATE FILINGS BECAUSE INCREASES WERE FILED ACROSS THE COUNTRY
TO MAKE SURE THEY WERE ACCURATE AND THAT THERE ACTUARS LOOK AT THE TREND LINES.
BUT ALSO TO REMIND INSURANCE COMMISSIONERS AND GOVERNORS THAT IN SOME STATES THE AUTHORITIES
ARE ALREADY IN PLACE FOR PRIOR APPROVAL. INSURANCE COMPANIES COMING TO THE DOESN'T,
THE DEPARTMENT LOOKING AT THE RATES, THE NUMBERS, BEFORE A RATE GOES INTO EFFECT OR IN CALIFORNIA.
WHERE THEY DON'T HAVE PRIOR APPROVAL. THE RATE ACTUALLY GOT FILED AND IT WASN'T
UNTIL THE COMMISSIONER TOOK ACTION AFTER THE FACT THAT THE RATE GOT WITHDRAWN.
SO WE WANT TO REMIND FOLKS THEW EVEN IN THE THAT EVEN IN THE NEW AFFORDABLE CARE ACT.
IT'S ASSUME THAD STATES WILL DO RATE REVIEW. IT'S EFFECTIVE, IT HELPS TO LORE THE COST
WHEN INSURANCE COMMISSIONERS PAY ATTENTION TO WHAT COMPANIES ARE FILING AND THAT IF THEY
DON'T HAVE THE AUTHORITY, WE'RE HOPING IT WILL GO TO THE LEGISLATURES AND GET THE AUTHORITY
TO ACTUALLY DO THE KIND OF RIGOROUS RATE REVIEW THAT'S REQUIRED.
>> NOW YOU'RE BOTH FORMER GOVERNORS, YOU TALK A LOT ABOUT HOW FREQUENTLY THIS BILL IS.
WE WILL TALK LATER IN THE SHOW ABOUT HIGH RISK POOLS WHICH IS AN ISSUE THAT GOVERNORS
ARE TALKING ABOUT. SEE THIS BILL IS NOT ONLY STATE FRIENDLY IT'S
BUSINESS FRIENDLY. SO THAT'S WHY WE HAVE OUR FIRST TIME WITH
SECRETARY LOCKE, CAN YOU TELL US ABOUT WHAT THE PRESIDENT ANNOUNCE WIDE IT COMES TO THE
EARLY RETIREE INSURANCE PROGRAM. >> WELL, FIRST OF ALL THANK YOU FOR HAVING
ME ON YOUR WEBCAST AND IT'S ALWAYS A PLEASURE TO BE WITH SECRETARY SEBELIUS, WE WORK TOGETHER
AS GOVERNORS AND WE LEARN A LOT ABOUT THE NEEDS OF BUSINESSES WITHIN OUR STATES AND
THERE'S A LOT OF MISPERCEPTION ABOUT THE HEALTHCARE BILL THAT WAS PASSED.
FIRST OF ALL, THERE ARE INCREDIBLE BENEFITS FOR SMALL BUSINESSES TO OFFER HEALTHCARE INSURANCE
TO THEIR EMPLOYEES, CONTRARY TO MISPERCEPTIONS THERE'S NO REQUIREMENT FOR A SMALL BUSINESS,
A COMPANY WITH LESS THAN 50 EMPLOYEES TO OFFER HEALTHCARE INSURANCE TO THEIR EMPLOYEES, NO
PENALTIES IF THEY DON'T, BUT IF THEY DO, THEY'RE ELIGIBLE FOR HUGE TAX CREDITS TO OFFSET THE
COST OF PROVIDING HEALTHCARE COVERAGE TO THEIR EMPLOYEES AND ANOTHER MORE BUSINESS FRIENDLY
FEATURE WAS JUST ANNOUNCED BY THE PRESIDENT YESTERDAY.
WHICH ALLOWS COMPANIES TO BASICALLY RECOOP SOME OF THE INCREASED COSTS THAT THEY OR THEIR
INSURANCE COMPANIES WOULD HAVE TO PAY FOR THE HEALTHCARE COSTS OF THEIR EARLY RETIREES.
RETIREES WHO ARE OLDER THAN 55, BUT NOT YET ELIGIBLE FOR MEDICARE, IT'S KIND OF A REINSURANCE
PROGRAM AND BASICALLY WHAT IT DOES IS IT JUST SAYS THAT SOME OF THE INCREASE COSTS THAT
YOUR INDIVIDUAL RETIREES MIGHT INCUR, BASED ON HEALTHCARE, WHETHER FOR THEMSELVES OR MEMBERS
OF THEIR FAMILIES IF THE FAMILIES ARE COVERED BY THE COMPANY THAT THE FEDERAL GOVERNMENT
WILL PROVIDE UP TO FIVE BILLION DOLLARS TO PAY FOR SOME OF THESE COSTS AND THAT MEANS
IT'S GOING TO REDUCE THE COST OF HEALTHCARE FOR THESE COMPANIES THAT OFFER HEALTHCARE
COVERAGE TO THESE EARLY RETIREES BEFORE THEIR ELIGIBLE FOR MEDICARE.
>> YOU WORK TOGETHER AND BUSINESSES LIKE THIS PROVISION, RIGHT?
>> WELL, GEN WHAT HE WE SEE IS THAT A LOT OF COMPANIES HAVE PEOPLE WHO RETIRE BEFORE
THEY GET TO 65, BEFORE THEY'RE ELIGIBLE FOR THE MEDICARE PROGRAM AND THEN, YOU KNOW MIGHT
HAVE A HEART ATTACK OR MIGHT BE DIAGNOSED WITH CANCER.
VERY EXPENSIVE ILLNESSES AND IN SOME CASES, EMPLOYERS ARE REALLY STRUGGLING TO FIGURE
OUT IF THEY CAN KEEP THEIR RETIREE PROGRAM IN PLACE WITH THOSE RISING COSTS AND I THEN
IS AN EFFORT BY THE PRESIDENT AND CONGRESS TO NOT ONLY RECOGNIZE THAT THERE ARE SOME
HIGH COSTS ASSOCIATED WITH THIS, BUT ALSO WANTING TO STABILIZE THE PRIVATE INSURANCE
MARKET, TO KEEP PEOPLE OFFERING THIS KIND OF COVERAGE, TO NOT UNINSURE EARLY RETIREES,
BUT TO KEEP THAT IN PLACE, HAVING SOME ADDITIONAL FEDERAL HELP FOR THE HIGHEST COST, CLAIMS,
I THINK WILL HELP STABILIZE THIS MARKET AND IT IS VERY HELPFUL TO BUSINESS OWNERS WHO
ARE, I THINK RIGHT NOW, CAUGHT. THEY WANT TO DO THE RIGHT THING.
THEY WANT TO KEEP INSURANCE IN PLACE FOR THEIR CURRENT EMPLOYEES AND FOR RETIREES BUT AS
COSTS GO UP, THEY'RE TRYING TO FIGURE OUT HOW IN THE WORLD THEY CAN DO THIS.
THIS IS HELPED TO STABILIZE THAT MARKET. >> LET ME JUST SAY, I DON'T THINK EVERYBODY
QUITE UNDERSTANDS THIS, IS FEDERAL DOLLARS, RIGHT.
>> THE COMPANIES DON'T HAVE TO PAY FOR IT. >> IT'S FIVE BILLION DOLLARS THAT'S AVAILABLE
FROM THE FEDERAL GOVERNMENT TO OFFSET THE COST OF THAT PRIVATE COMPANIES THROUGH THEIR
INSURANCE COMPANIES WOULD HAVE TO PAY OR IF THEY'RE SELFFUNDED, SELFINSURED THAT THEY
WOULD PAY DIRECTLY. AND IT'S AN INCREDIBLE REALLY VERY BENEFICIAL
PROGRAM AND THE COMPANIES WOULD APPLY FOR IT AND THEN THE FEDERAL GOVERNMENT WOULD REIMBURSE,
LET'S SAY, IF THE COMPANY SELFINSURES, REIMBURSES THE COMPANY DIRECTLY OR WILL GO THROUGH THE
COMPANY TO THE INSURANCE COMPANY. THEY'RE PRIMARY INSURANCE COMPANY.
>> YEAH. >> AND IT'S REALLY, I THINK AIMED AT AGAIN
THOSE HIGH COST CLAIMS. YOU KNOW THIS ISN'T THE EVERYDAY BENEFIT BUT
RECOGNIZING THAT, WHEN YOU GET TO BE 55, BETWEEN MEN AND MEDICARE ELIGIBILITY, YOU'RE MORE
LIKELY TO HAVE HEALTH CONDITIONS THAN IF YOU'RE 25.
SO, TWO ENCOURAGE EMPLOYERS TO KEEP THIS COVERAGE IN PLACE, AND RECOGNIZING THAT, THERE ARE
SOME FOLKS IN THAT EARLY RETIREE GROUP WHO HAVE EXPENSIVE HEALTH CLAIMS AND DON'T REALLY
HAVE A PLACE TO SHOP ON THE OPEN MARKET, YOU KNOW?
AND SO KEEPING THIS IN PLACE WITH SOME HUNDRED PERCENT FEDERAL DOLLARS TO HELP PAY THE HIGHEST
COST CLAIMS WILL BE A HELP TO BUSINESS OWNERS. >> NOW WHEN I'M GOING THROUGH THE QUESTIONS
AND I'M GOING THROUGH SPECIFIC ONES IN A SECOND, I WAS STRUCK OVER AND OVER AGAIN BY MY THOUSANDS
OF RETIREE MORE MY HUSBAND DIED, DOES THIS APPLY TO FAME MEMBERS OF OTHER RETIREES?
>> IT DEPENDS ON THE COMPANY OR THE EMPLOYER'S HEALTH PLAN.
SO IF THE COMPANY PROVIDES THE EARLY RETIREE WITH HEALTH INSURANCE BUT ALSO COVERS THE
SPOUSE OR THE DEPENDENT THEN THAT WOULD THE CLAIMS OF THAT ENTIRE FAMILY UNIT WOULD BE
COVERED. SO BASICALLY WHAT HAPPENS IS THAT THE INSURANCE
COMPANY OR THE EMPLOYER'S SELFINSURED, THEY PICK UP CERTAIN AMOUNT OF THE FIRST COSTS
AND THEN IT'S THE EXTRA COST THAT THE FEDERAL GOVERNMENT WILL PICK UP.
BASICALLY TO KEEP THE COSTS OF THE OF PROVIDING HEALTH INSURANCE FAIRLY LOW AND REALLY HAVING
THE FEDERAL GOVERNMENT STEP IN BASICALLY LIKE A SECOND INSURANCE COMPANY FOR THE VERY, VERY,
HIGH COST AND THAT WAY THE EMPLOYER WILL CONTINUE TO HAVE LOW RATES, EITHER CHARGE BY THE INSURANCE
COMPANY SORE NOT HAVE TO PAY SO MUCH TO SET ASIDE SO MUCH FOR THEMSELVES THEMSELVES IF
THEY SELFINSURE. >> NOW WE ONE THAT 180 MILLION AMERICANS HAVE
THEIR COVERAGE THROUGH THEIR EMPLOYER. SO THIS IS REALLY HELPING THAT MARKETPLACE.
IT ALSO IS NOT ONLY PRIVATE BUSINESS OWNERS BUT, GOVERNMENTS WHO PROVIDE COVERAGE FOR
RETIREE PROGRAM, LABOR UNIONS, THIS IS >> OR NONPROFITS.
THINGS LIKE THAT. JUSTICE ABOUT ANY EMPLOYER.
>> ALL RIGHT. NOW, WHEN IS THIS GOING INTO EFFECT, END OF
2011 OR IT'S JUNE, RIGHT? >> IT'S JUNE OF THIS YEAR.
>> APPLICATIONS WILL BE OUT BY THE END OF JUNE, BUT THE PROGRAMS, PEOPLE CAN COME AND
GET INFORMATION RIGHT NOW ON THE WEB SITE, BUT THERE'LL BE SPECIFIC RULES, READY TO GO
BY JUNE OF 2010. SO THIS IS ONE OF THE IMMEDIATE DELIVERABLES,
THIS WILL BE SOME HELP THIS YEAR. >> IN ACT IT'S ACTUALLY MADE AVAILABLE SOONER
THAN WAS EXPECTED THANK TOTS GREAT WORK OF YOUR DEPARTMENT.
>> ALL RIGHT. BEFORE WE GET INTO SPECIFIC QUESTIONS, THE
VERY LAST QUESTION THAT'S OUT THERE, I'VE NOT SEE IT IN TODAY'S QUESTION BUT IN OTHER
ONES CAN WE CLEAR UP THE MISCONCEPTION ABOUT EMPLOYER MANDATES.
WE GET LOTS AND LOTS OF QUESTIONS SAYING MY COMPANY HAS TO OFFER WHETHER YOU'RE SMALL
BUSINESS OR BIG BUSINESS, CAN WE JUST CAN YOU ADDRESS THAT OR BOTH OF YOU ADDRESS THAT?
>> AT LEAST FOR SMALL BUSINESSES, COMPANIES WITH LESS THAN 50 EMPLOYEES THERE'S NO REQUIREMENT
THAT COMPANIES OFFER HEALTH INSURANCE TO THEIR EMPLOYEES AND NO PENALTY FIST THEY DENTE OFFER
IT, IF THEY HAVE LESS THAN 50 EMPLOYEES, IF THEY DO, THEY'RE ACTUALLY ELIGIBLE FOR VERY
LARGE TAX CREDIT TO OFFSET THE COST OF HEALTHCARE INSURANCE THAT THEY'RE PROVIDING, BASICALLY
REWARDING THOSE SMALL BUSINESS OWNERS WHO ARE DOING THE RIGHT THING AND OFFERING HEALTH
INSURANCE TO THEIR EMPLOYEES. >> AND THERE WILL BE A REQUIREMENT ONCE THE
NEW MARKET IS SET UP FOR LARGER EMPLOYEES TO EITHER OFFER COVERAGE OR TO PAY INTO THE
GOVERNMENT PLAN FOR SUBSIDYS, THAT THEIR EMPLOYEES, MAY BE RECEIVING TO GO SHOP FOR INSURANCE
ELSEWHERE, IT'S A FAIRNESS DEAL. EITHER YOU CAN STEP UP AND HELP YOUR EMPLOYEES
GET COVERAGE, BUT IF TAXPAYERS ARE HELPING YOUR EMPLOYER GET COVERAGE, YOUR EMPLOYEE
GET COVERAGE THROUGH A SUBSIDY, THEN YOU HAVE TO REIMBURSE BASICALLY FOR THAT, FOR THAT
EMPLOYEE COVERAGE. IT'S IT'S KIND OF A PERSONAL RESPONSIBILITY
EMPLOYER RESPONSIBILITY PIECE BUT IT DOES NOT APPLY AS SECRETARY LOCK SAID TO SMALL
BUSINESS OWNERS. THOSE WITH LESS THAN 50 EMPLOYEES AND THAT
DOESN'T EVEN INCLUDE THE 50, DO NOT INCLUDE SEASONAL EMPLOYEES OR PART TIME EMPLOYEES,
SO ABOUT 95% OF SMALL BUSINESSES REALLY DO NOT FALL UNDER THE CATEGORY OF NEEDING TO
PROVIDE INSURANCE ONCE THE NEW MARKET GETS UP AND RUNNING.
>> I THINK THERE'S MORE INFORMATION FOR ALL OF YOU OUT THERE ON BOTH OF THESE PROGRAMS
ON OUR WEB SITE, SO IF YOU HAVE SOME SPECIFIC QUESTIONS OR YOU WANT TO KNOW HOW TO APPLY
FOR THOSE TAX CREDITS, HEALTH INFO .GOV HAS THE INFORMATION ON THERE.
LET'S GO TO THE QUESTIONS HAVE YOU SENT N. WE HAVE A LOT ON THE REINSURANCE ISSUE BUT
ANOTHER IN THE HIGH RISK POOLS SO WE'LL START TO TAKE YOUR QUESTIONS NOW AND AGAIN FEEL
FREE TO SEND REQUEST QUESTIONS IN VIA TWITTER OR E MAIL AND WE'LL TRY TO GET TO THEM.
OKAY WE TOUCHED ON THIS A LITTLE BIT BUT DARLENE WANTS TO KNOW:
HOW DOES ONE APPLY FOR THE REINSURANCE FOR EARLY RETIREES PROGRAM?
IT'S NOT REALLY THE INDIVIDUAL, IT'S THE BUSINESS. >> THE BUSINESS MAKES THE APPLICATION AND
IT COVERS THE COST OF THE EXTRA INSURANCE OR MEDICAL CARE, THE HIGH COST OF MEDICAL
CARE FOR THE INDIVIDUAL, THE RETIREE OR THE EMPLOYER COVERS THE DEPENDENTS IN THE SPOUSE
AND THEN IT WOULD ALSO APPLY TO THEM AND WE COVER MOST OF THE COST OF THAT EXTRA COST.
AND IT'S FOR COSTS STARTED OR INCURRED AFTER JUNE 1 BUT THE EMPLOYER MAKES THE APPLICATION
AND THEN THE REIMBURSEMENT WILL GO EITHER TO THE EMPLOYER IF THEY SELFINSURE OR EVENTUALLY
TO THE INSURANCE COMPANY THAT PROVIDES THE BENEFITS FOR THAT COMPANY.
>> I THINK THE RULES WILL BE CLEARLY OUT WITHIN A COUPLE OF WEEKS.
WE'RE TALKING IN EARLY MAY, WE'RE TALKING ABOUT STARTING THIS IN JUNE.
SO HEALTHREFORM .GOV WILL ANSWER THOSE QUESTIONS. AND NOW WE HAVE AN EARLY RETIREE, 63 YEARS
OLD HOW DO I KNOW THAT MY EMPLOYER WILL APPLY FOR THE BENEFITS FOR EARLY RETIREE AND ARE
THEY REQUIRED TO DO SOMETHING? >> I THINK A COUPLE OF THINGS, DAVID.
FIRST OF ALL, YOUR EMPLOYER MAY OR MAY NOT OFFER RETIRING COVERAGE.
AND SECONDLY INDIVIDUAL RETIREES DON'T HAVE TO APPLY.
THIS REALLY IS TO HELP THE EMPLOYER WHO IS CURRENTLY PAYING AN EMPLOYER SHARE OF YOUR
RETIREE INSURANCE COSTS, HELPING THEM PAY FOR THE EXTRAORDINARY HIGH COSTS OF SOME INDIVIDUAL
CARE SO RETIREES DON'T HAVE TO APPLY FOR ANYTHING NOTHING WILL COME INDIVIDUALLY FOR THE RETIREE.
IT'S TO HELP THE EMPLOYER KEEP THAT COVERAGE IN PLACE.
OKAY, SO GLORIA FROM ARIZONA HAS A QUESTION. SO THERE ARE PEOPLE WHO'S COMPANIES OFFER
THESE BENEFITS. GLORIA WANTS TO KNOW I'M A EARLY RETIREE WHO
RETIRED AT AGE 62 BUT WASN'T AFFILIATED FOR A COMPANY WHAT CAN I DO AND HOW CAN I GET
BENEFITS? SO IT DOESN'T LOOK LIKE THIS APPLIES TO HER
BUT THERE MAY BE MORE COMING IN 2014? >> RIGHT NOW GLORIA IS IN THE INDIVIDUAL MARKET
AND IF SHE HAS A PREEXISTING CONDITION SHE MAY BE ELIGIBLE FOR THE NEW HIGH RISK POOL
PROGRAM BECAUSE SO MANY PEOPLE WHO ARE 62 WHO MAY BE A DIABETIC OR SUFFER HAVE HAD CANCER,
CAN'T BE INSURED ANYWHERE. SO THERE WILL BE A HIGH RISK POOL THAT GLORIA
MAY BE ELIGIBLE FOR, STANDARD RATE AND THAT APPLICATION SHOULD BE AVAILABLE ABOUT THE
FIRST OF JULY DEPENDING ON WHAT ESTATE SHE LIVED IN BUT OTHER THAN THAT GLORIA NEEDS
TO HAVE INSURANCE COVERAGE ON HER OWN UNTIL SHE GETS TO BE MEDICARE ELIGIBLE.
THIS DOESN'T SET UP NEW PLANS FOR RETIREES. IT REALLY IS AIMED AT HELPING TO KEEP IN PLACE
THE RETIREE COVERAGE THAT'S THERE RIGHT NOW. >> YOU MENTION HIGH RISK POOL, I'M GOING WE
HAVE A BUNCH OF QUESTIONS FROM DIFFERENT PEOPLE ABOUT HIGH RISK POOLS.
SOME OF THEM ARE STATE SPECIFIC SO I WOULD ENCOURAGE PEOPLE TO LOOK AT THE WEB SITE BECAUSE
WE POSTED A LIST OF SORT OF HOW PEOPLE ARE DOING THINGS.
BUT, THERE'S BEEN NEWS, ABOUT THE FEDERAL GOVERNMENT RUNNING POOLS IN SOME STATES AND
ABOUT STATES RUNNING THEIR OWN POOLS OR PROGRAMS. CAN YOU TELL ME ABOUT WHAT THE GOAL WAS WHEN
YOU SET THIS UP? >> LTHE LAW BASICALLY INDICATED THAT WE SHOULD
HAVE THIS BRIDGE STRATEGY, HIGH RISK POOL AVAILABLE FOR THOSE INDIVIDUALS WHO CURRENTLY
HAVE A PREEXISTING HEALTH CONDITION AND REALLY CAN'T GET INSURANCE IN THE PRIVATE MARKET.
STEP ONE WAS TO REALLY SAY TO STATES, DO YOU WANT TO RUN YOUR OWN POOL IN UTAH, IN COLORADO,
IN CONNECTICUT, AND WE FEEL GIVE YOU FEDERAL DOLLARS TO HELP DO THAT AND WE'LL GIVE YOU
TECHNICAL ASSISTANCE. ABOUT 30 GOVERNORS AND THE DISTRICT OF COLUMBIA
HAVE DECIDED YES, THEY WANT TO RUN THEIR OWN POOLS.
IN OTHER AREAS, THEY'VE SAID NO, WE'RE REALLY NOT GOING TO TRY TO PUT TOGETHER A POOL AT
THE STATE AND WE HERE AT HHS WILL HAVE A BACK UP PLAN.
SO, WHEREVER YOU LIVE IN THE COUNTRY, THERE WILL BE AN AVAILABLE HIGH RISK POOL FOR PEOPLE
WHO HAVE BEEN UNINSURED FOR AT LEAST SIX MONTHS WHO HAVE SOME KIND OF PREEXISTING HEALTH CONDITION
AND THOSE VERY SPECIFIC RULES WILL BE OUT BY JULY 1.
>> THERE'S NOTHING BAD OR SUBJECTIVELY BETTER ABOUT ONE OR THE OTHER, IT'S JUST WHATEVER
WORKS BET FOR THAT STATE? >> A LOT OF STATES ARE RUNNING A HIGH RISK
POOL ALREADY AND THAT'S AGAIN WHEY WOULD REMIND PEOPLE, THAT DEPENDING ON WHERE YOU LIVE,
CALL YOUR INSURANCE DEPARTMENT AND ASK IF RIGHT NOW THERE IS A HIGH RISK POOL AVAILABLE.
THEY'RE ABOUT 34 STATES IN THE COUNTRY THAT HAVE CURRENT HIGH RISK POOLS, THIS IS AN ADDITIONAL
POOL FOR FOLKS WHO HAVE NOT HAD INSURANCE FOR AT LEAST SIX MONTHS AND AGAIN WILL PROVIDE
AN ADDITIONAL BRIDGE STRATEGY WHEN WE GET TO 2014 WITH THE NEW MARKETS AND THE HEALTH
EXCHANGES, ALL THE INDIVIDUALS ARE TALKING ABOUT HOPEFULLY WE'LL HAVE SOME OFORDABLE
AVAILABLE CHOICES BUT THIS IS A STEP TO GET US THERE.
>> OKAY, MORE FUBBING QUESTIONS WE HAD THEM EARLIER ABOUT RETIREE INSURANCE, NOW JOSH
WANTS TO KNOW: WON'T STATES GIVE UP THE MONEY IF THEY CHOOSE TO RUN THE PROGRAM FOR HIGH
RISK POOLS? >> NO.
>> SO THIS IS AGAIN LIKE RETIRE HE EARLY INSURANCE IT'S A HUNDRED% FEDERAL DOLLARS, THERE IS
NO STATE MARCH AND THE DOLLARS HAVE BEEN ALLOCATED ACCORDING TO A FORMULA, THAT HAS BEEN USED
TO DISTRIBUTE OTHER FEDERAL HEALTH PROGRAMS, THE CHILDREN'S INSURANCE PROGRAM SO STATES
HAVE A SHARE OF THE MONEY FOR THE HIGH RISK POOL AVAILABLE TO THEM AND IF THEY DON'T CHOOSE
TO USE IT, WE WILL USE IT HERE AT HHS TO HELP PROVIDE INSURANCE COVERERAGE FOR INDIVIDUALS
IN THAT STATE. >> OKAY, MARY FROM SOUTH CAROLINA, SORRY SECRETARY
>> THERE TH IS A VERY IMPORTANT TOPIC AND IT'S IT COVERS
>> A FORMER GOVERNOR YOU >> THOSE PEOPLE WHO HAVE PREEXISTING CONDITION
WHO IS CANNOT PURCHASE HEALTH INSURANCE ON THEIR OWN AND THIS IS A VALUABLE BRIDGE UNTIL
2014. >> THIS IS ACTUALLY A LOT OF THE QUESTIONS
WE'VE BEEN SEEINGOT WEB SITE FROM SOUTH CAROLINA. I QUALIFY FOR THE FEDERAL HIGH RISK POOL BUT
I LIVE IN SOUTH CAROLINA WHERE GOVERNOR SAN FORD DECLINED TO PARTICIPATE IN THE PROGRAM.
DOES THIS MEAN THAT THE FEDERAL PROGRAM IS NOT AVAILABLE TO ELIGIBLE CITIZEN IN OUR STATE?
>> IN SOUTH CAROLINA, THERE WILL BE AN OPTION AVAILABLE TO YOU RUN BY HHS, WHETHER WE DO
IT AT A REGIONAL BASIS OR STATE SPECIFIC BASIS, THOSE DECISIONS ARE BEING MADE BUT THERE WILL
BE AN OPTION FOR QUALIFIED INDIVIDUALS IN SOUTH CAROLINA TO PARTICIPATE IN A HIGH RISK
POOL. >> OKAY.
I'M GOING TO THERE'S TWO MORE QUESTIONS ON THE HIGH RISK POOL SO THERE'S GENERAL QUESTIONS
ABOUT THE RETIREE INSURANCE. >> I CAN JUST JUMP IN HERE.
>> EXACTLY. >> LET'S TALK ABOUT THIS IS A QUESTION FOR
BOTH OF CHU IS WHEN ARE SOME OF THE PROGRAMS WHEN ARE SOME OF THESE PROGRAMS GOING TO BE
UP AND RUNNING. WHAT WILL HAPPEN THIS YEAR WITH THE AFFORDABLE
CARE ACT. TALK ABOUT EARLY RETIREE INSURANCE AND HIGH
RISK POOLS, IS THERE >> FOR INSTANCE RIGHT NOW, THE TAX INCENTIVES,
TAX CREDITS ARE AVAILABLE RIGHT NOW AND RETROACTIVE TO THE BEGINNING OF 2010.
AGAIN, SMALL COMPANIES WITH LESS THAN 50 EMPLOYEES ARE NOT REQUIRED TO OFFER HEALTH INSURANCE
TO THEIR EMPLOYEES, IF THEY DON'T, NO PENALTIES, NO FINES, NOTHING, BUT IF THEY DO, THEY ARE
ELIGIBLE FOR THESE TAX CREDITS THAT ARE RETROACTIVE TO JANUARY 1, 2010.
THIS IS TO REWARD COMPANIES FOR DOING THE RIGHT THING AND OFFERING HEALTH INSURANCE
TO THEIR EMPLOYEES, IT'S ALSO A COMPETITIVE ISSUE, A LOT OF COMPANIES, SMALL COMPANIES
OFFER HEALTH INSURANCE TO THEIR EMPLOYEES. THEIR COMPETITORS DON'T SO THOSE THAT DON'T
OFTEN TIMES CAN CHARGE LOWER PRICES FOR THEIR PRODUCTS OR SERVICES AND THAT'S UNFAIR.
SO THE FEDERAL GOVERNMENT THROUGH THE HEALTHCARE REFORM ACT IS GIVING A FINANCIAL INSEBTIVE
TO THOSE COMPANIES FOR REWARDING THEM FOR DOING THE RIGHT THING.
>> WE'RE IN MAY, GRADUATION TIME, GOOD NEWS FOR A LOT OF FAMILIES, THEIR CHILDREN UP TO
THE AGE OF 26 CAN STAY ON A FAMILY INSURANCE PLAN.
LOTS OF PEOPLE HAVE THAT SITUATION WHERE THE CHILD MAY BE IN THE JOB MARKET BUT NOT IN
A ELIGIBLE THAT HAS HEALTH INSURANCE SO THAT'S GOOD NEWS.
THAT HIT THIS IS YEAR AND IT'S AVAILABLE AND COMPANIES ARE ACTUALLY STEPPING UP EARLY AND
OPENING THOSE PLANS UP. >> THIS YEAR, SENIORS WHO HIT THE SO CALLED
DO NUT HOLES, A GAP IN COVERAGE FOR PRESCRIPTION DRUGS WILL GET CHECKS.
SOME OF THEM WILL GET A CHECK IN JUNE IF THEY'VE ALREADY BEEN PAYING A HUNDRED% OUT OF POCKET.
OTHERS IN SEPTEMBER, SENIORS DON'T NEED TO APPLY.
WE WILL MONITOR THE BILLINGS HERE AT MEDICARE AND ACTUALLY SEND CHECKS TO SENIORS.
THAT HITS THIS YEAR AND THE HIGH RISK POOLS WILL BE IN PLACE THIS YEAR.
THE EARLY RETIREE PROGRAM, HELP FOR BUSINESS OWNERS WILL BE IN PLACE THIS YEAR.
AND THEN A NUMBER OF OUR PREVENTIVE SERVICES HIT THIS YEAR.
SO PLANS WILL BE OFFERING PREVENTIVE AND WELLNESS CARE WITHOUT A FINANCIAL CO PAY THAT WILL
HELP PEOPLE GET MAMMOGRAMS AND CANCER SCREENINGS WITHOUT HAVING TO WORRY ABOUT, DO I HAVE ENOUGH
MONEY IN MY POCKET TO MATCH THE INSURANCE COMPANY BILL, SO ALL THOSE GO INTO PLACE THIS
YEAR? >> YOU JUST SAID SOMETHING THAT STRUCK ME
AND I HAVE TWO GOVERNORS HERE SO I WANT TO TAKE ADVANTAGE OF HAVING YOU BOTH.
YOU ARE GIVING ADVICE TO SENIORS ABOUT DON'T GIVE AWAY YOUR PERSONAL INFORMATION.
YOU BOTH HAVE RUN STATES, YOU'VE BEEN AN INSURANCE COMMISSIONER, THERE'S LOTS OF MISINFORMATION,
LOTS OF SCAMS THAT ARE HAPPENING OUT THERE. I KNOW THE COMMERCE DEPARTMENT, THROUGH THE
BETTER BUSINESS BURRO, I KNOW YOU HAVE WRITTEN LETTERS WHAT ARE IMPORTANT MESSAGES THAT EVERYDAY
AMERICANS NEED TO HEAR ABOUT THE AFFORDABLE CARE ACT AND WHAT THEY CAN DO IF THEY HEAR
SOMETHING THAT SOUNDS A LITTLE STRANGE TO THEM.
>> IF IT DOES I THINK THE BASIC RULE IS IF IT SOUNDS TOO GOOD TO BE TRUE, IT'S PROBABLY
NOT TRUE VENLT AND COME ON TO THE HHS WEB SITE.
FIND OUT MORE INFORMATION. TALK TO REPUTABLE ORGANIZATIONS LIKE AARP.
TALK TO YOUR OTHER FAMILY MEMBERS, CONOTHER PEOPLE BEFORE YOU MAKE SOME DECISION TO SIGN
UP FOR SOMETHING OR SOMEBODY CALLING YOU ON THE PHONE, TELEMARKETER OR PEOPLE KNOCKING
ON YOUR DOOR. THE SAME THING OCCURS WITH THE CENSUS, THE
CENSUS THIS YEAR HAS ONLY 10 QUESTIONS SO IF ANYBODY CALLS AND SAYS THEY NEED YOUR SOCIAL
SECURITY NUMBER, NEED CREDIT CARD NUMBERS OR ANYTHING LIKE THAT.
IT'S NOT TRUE. >> WELL, I THINK THAT IT'S IMPORTANT, THE
HHS WEB SITE, HEALTHREFORM .GOV, IS A GREAT SOURCE OF INFORMATION.
OUR MEDICARE HOT LINE ONE 800 MEDICARE. TOLL FREE AND GET QUESTIONS ANSWERED.
INSURANCE IS NOT SOLD DOOR TO DOOR, SO IF SOMEBODY SHOWS UP AT YOUR DOOR SAYING, HAVE
I GOT A DEAL FOR THEM. THANK THEM, CLOSE THE DOOR AND CALL SOMEBODY
BECAUSE THAT TYPICALLY, WE WILL NOT BE SELLING MEDICARE BENEFITS DOOR TO DOOR.
WE WILL NOT BE SENDING PEOPLE OUT TO QUALIFY PEOPLE TO GET THE CHECKS FOR THEIR PRESCRIPTION
DRUGS DOOR TO DOOR. DO NOT GIVE MEDICARE INFORMATION TO ANYBODY.
IT'S VERY VALUABLE, YOUR I.D. NUMBER ON MEDICARE IS VERY VALUABLE, IT'S WORTH SOMETHING WHICH
IS WHY PEOPLE WANT TO GET IT JUST LIKE THEY MAY WANT TO GET YOUR SOCIAL SECURITY NUMBER.
DON'T GIVE IT AWAY. DON'T SHARE IT, DON'T LEND IT.
AND CERTAINLY REPORT ANYTHING WE HAVE CURCH GREAT HELP JENNY AS YOU KNOW FROM SENIORS
ALL OVER THE COUNTRY WHO ARE PART OF OUR MEDICAID FRAUD CONTROL.
WE DON'T LIKE FOLK WHO IS TRY TO STEAL MONEY FROM THE MEDICARE SYSTEM.
WE ARE GETTING VERY SERIES WITH THE ATTORNEY GENERAL AND ME WORKING TOGETHER UNDER THE
PRESIDENT'S DIRECTION TO GO AFTER THESE AND CRIMINALS BUT HAVING SENIORS BE VERY ALERT
AND REPORTING ANYTHING THAT SEEMS SUSPICIOUS. SOMEBODY WHO'S TRYING TO SELL SOMETHING THAT
DOESN'T SOUND QUITE RIGHT. SOMEBODY ASKING TO YOU KNOW TAKE YOUR MEDICARE
CARD. REPORTING THAT RIGHT AWAY, GIVES US A HEAD
START. LETS US GO AFTER THE BAD GUYS AND THAT'S REALLY
HELPFUL. >> THAT'S GREAT.
WE WILL HAVE TWO MORE QUESTIONS JUST CAME IN AND THEN WE WILL ASK YOU FOR CLOSING THOUGHTS,
SO WE'RE GOING BACK TO THE TOPIC OF EARLY RETIREE REINSURANCE.
JANET FROM CALIFORNIA SAYS, ARE ONLY COMPANIES THATTURENTLY OFFER RETIREE INSURANCE ENTITLED
TO THE PROGRAM? WHAT IF OUR COMPANIES DECIDED TO OFFER RETIREE
HEALTH BENEFITS WOULD WE BE ELIGIBLE AT SOME POINT FOR THE REINSURANCE PROGRAM?
>> YES, IF THE COMPANY'S OFFERING COVERAGE FOR EARLY RETIREES UNTIL 2014 FTHIS PROGRAM
IS IN PLACE AND IT'S AGAIN, TO CONTINUE TO PROVIDE INCENTIVES TO CONTINUE TO PROVIDE
HEALTH INSURANCE FOR EARLY RETIREES AND TO REDUCE THE COST OF DOING SO.
ESPECIALLY WHEN A COUPLE OF THOSE RETIREES MAY HAVE VERY LARGE HEALTH CLAIMS EXCEEDING
A CERTAIN AMOUNT AND THIS GOVERNMENT PROGRAM OF FIVE BILLION DOLLARS WILL COVER THOSE EXTRA
COSTS ABOVE AND BEYOND THE NORMAL COST AND IT WILL KEEP THE PREMIUMS LOW SO THAT COMPANY
CONTINUES AND WILL REWARD THAT COMPANY FOR OFFERING HEALTH INSURANCE TO THE EARLY RETIREES.
BARBARA WANTS TO KNOW, IT SAYS AN EMPLOYER DOESN'T OFFER EARLY RETIREE COVERAGE WHAT
ARE THE OTHER OPTIONS OUT THERE FOR. EES TO GET COVERAGE?
>> WELL, AGAIN AS JANET SAID, MAYBE THE EMPLOYER WILL LOOK AGAIN BEING AFRAID OF ONE OR TWO
HIGH COST CASES MAY HAVE KEPT THEM FROM OFFERING RETIREE COVERAGE SO THIS MAY BE AN INCENTIVE
FOR PEOPLE TO LOOK AT IT. AGAIN IN 2014, THERE WILL BE A NEW MARKET.
A LOT OF PEOPLE 55 TO 65 ARE REALLY STRUGGLING WITH WHERE THEY GET COVERAGE RIGHT NOW, AND
THE INSURANCE EXCHANGES WILL BE SET UP, BUT IN THE MEAN TIME, THERE MAY BE A HIGH RISK
POOL ALREADY OPERATING IN YOUR OWN STATE THERE. 'S A NEW HIGH RISK POOL THAT WILL BE IN PLACE
TO TRY AND PROVIDE SOME STEPS TOWARD MEDICARE OR AFFORDABLE COVERAGE IN 2014 WITH THE NEW
HEALTH INSURANCE EXCHANGING. >> OKAY, LAST PARTING THOUGHTS BEFORE WE END
FOR TODAY? SECRETARY LOCKE IS IS THIS SOMETHING YOU'VE
BEEN TALKING ABOUT A LOT, PROBABLY NOT AS MUCH AS MY BOSS BUT TALKING ABOUT IT A LOT.
IS THERE ONE THING YOU WANT PEOPLE TO KNOW ABOUT SINCE THE LAW IS ENACTED ABOUT HOW THE
LIVE SYSTEM GOING TO CHANGE? >> WELL ONE OF THE IMPORTANT MESSAGE SYSTEM
THAT THERE'S SO MANY PROVISIONS OF THIS HEALTHCARE REFORM ACT THAT WILL SLOW DOWN THE COST OF
HEALTHCARE. PRIZES ARE GOING UP WHETHER IT'S MELK OR BREAD
OR EGGS AND FOR A LOT OF BUSINESSES, THEY'VE SEEN RATES GOING UP BY 30 OR 40% EVERY YEAR.
NO BUSINESS CAN SURVIVE WHEN HEALTH INSURANCE RATES ARE GOING UP BY THAT AMOUNT.
SO THE TAX INCENTIVES, THE ACTUAL TAX CREDITS, TAX REFUNDS OR OFFSETS IN TERMS OF WHAT THE
COMPANY WOULD OTHERWISE HAVE TO PAY BY WAY OF INCOME STAKESS AS WE WARDS FOR OFFERING
HEALTHCARE INSURANCE TO THEIR EMPLOYEES IF THEY HAVE LESS THAN 50 FULL TIME EMPLOYEES,
THESE ARE ASTRONOMICAL AND OF GREAT BENEFIT, AND THEN OF COURSE, THE INCENTIVES WITH THE
FIVE BILLION DOLLARS AVAILABLE FROM THE FEDERAL GOVERNMENT TO PICK UP SOME OF THE EXTRA COSTS,
SOME OF THE HIGHER COSTS OF HEALTHCARE FROM EARLY RETIREES, I THINK WE'LL REWARD COMPANIES
FOR DOING THAT. AND PROVIDE AN INCENTIVE FOR THEM TO CONTINUE
TO PROVIDE THAT HEALTH INSURANCE FOR RETIREES AND KEEP THAT COST LOW.
>> THAT'S THE WHOLE POINT OF THIS HEALTHCARE REFORM ACTION, A LOT OF BENEFITS FOR BUSINESSES.
>> OKAY, AND SECRETARY, YOU OUT THERE A LOT. YOU GETS OF LOTS OF QUESTIONS WHAT'S THE THING
YOU WANT TO STRAIGHTEN UP FOR THIS WEEK? >> WELL, I THINK THAT PEOPLE HAVE A LOT OF
QUESTIONS ABOUT THE NEW BILL AND WE UNDERSTAND THAT THEY NEED TO KNOW WE'RE WORKING REALLY
HARD AND IN THE NOT TOO DISTANT FUTURE WITHIN THE NEXT COUPLE OF MONTHS WE ARE GOING TO
HAVE A CALL CENTER, AVAILABLE TO ASK QUESTIONS AND GET ANSWERS ON A VERY REGULAR BASIS AND
SOME WEB INFORMATION WHICH WILL BE EASY TO ACCESS AND EASY TO USE.
I KNOW PEOPLE ARE ANXIOUS TO HAVE THAT RIGHT NOW.
WE WANT TO MAKE SURE WE GET THE RIGHT ANSWERS PUT TOGETHER BEFORE WE ACTUALLY LAUNCH THE
CALL CENTER AND GET THE PEOPLE TRAINED AND GET THEM UP AND RUNNING BUT THAT'S COMING
AND IN THE MEAN TIME TUNE INTO THE WEB CHAPT CHATS HEALTH.GOFF OR IF THE QUESTIONS ARE
ABOUT MEDICARE AND ADVANTAGES THAT WILL COME ABOUT BECAUSE OF THE BILL, THAT WILL HELP
MEDICARE ELIGIBLE CITIZEN GO TO OUR ONE EIGHT 00 MEDICARE NUMBER.
WE'RE TRYING TO GET AS MUCH INFORMATION AS WE CAN BECAUSE THERE'S A LOT OF GOOD NEWS
COMES PHOTS WAY. >> ALL RIGHT, I I THANK TO THANK YOU BOTH
FOR JOINING US TODAY.
KATHLEEN SEBELIUS, SECRETARY OF HEALTH & HUMAN SERVICES…AND GARY LOCKE, SECRETARY
OF COMMERCE. WE HOPE WE GOT TO MOST OF YOUR QUESTIONS OR
THOSE THAT ARE APPLICABLE TO YOU. IF YOU WANT TO REVIEW THE SHOW OR PASS IT
ALONG TO THE A FRIEND WE'LL MAKE IT AVAILABLE ON DEMAND AND THEN WE'LL ARCHIVE IT ON THE
WEB SITE.
WWW.HEALTHREFORM.GOV. OOH I'M JENNY BACKUS AND WE'LL BE BACK WITH
ANOTHER CHAT ON HEALTH REFORM. SEE YOU THEN!
[¶ MUSIC ¶]