Week In Review: High-Risk Insurance Pools Rules Stoke Abortion Politics; Seniors Perplexed About The Impact Of Health Reform

For the third consecutive week, the question of whether abortion would be covered by the new health law’s high-risk pools was high on news outlets’ radar — creating a certain degree of drama in the run up to Thursday’s release by the Obama administration of regulations on this and other issues.

Kaiser Health News examined the rules. “Elective abortions will be prohibited and people with pre-existing conditions will be able to get comprehensive benefits without paying any more than healthy people, under new federal regulations for high-risk health insurance pools.” These state-based pools, which are among the new law’s highest-profile features taking effect this year, “allocate $5 billion to create plans to cover people who have been uninsured for at least six months and have a pre-existing health condition” (Galewitz, 7/30).

Modern Healthcare: “Nancy-Ann DeParle, director of the White House Office of Health Reform, writing on the Obama administration’s official website, said that an interim final rule, released today, breaks no new ground when it comes to long-standing policies on abortion. ‘The program’s restriction on abortion coverage is not a precedent for other programs or policies given the unique, temporary nature of the program and the population it serves,’ DeParle said” (DoBias, 7/29).

Before the regulations were released, The Washington Times reported that a group of Republican senators was threatening “to force changes to the new national health care law unless the Obama administration does more to ensure that federal dollars won’t be used to pay for elective abortions.” The issue had “flared as several states began to write regulations for the high-risk insurance pools” (Lengell, 7/28).

Politico offered more analysis, noting that abortion-rights groups were “caught completely off-guard” when some Republicans and anti-abortion advocates successfully mobilized to pressure the Obama administration to keep states from allowing abortion coverage in the insurance pools” (Kliff, 7/30).

(For more detailed news summaries related to these high-risk insurance pools, read KHN’s Morning Edition for July 30 and July 27.)

Meanwhile, the Department of Health and Human Services issued a clarification this week to address health insurers’ concerns about the new law and children’s coverage. As a result, the insurers appear to be stepping away from decisions “to pull out of the child-only coverage market,” according to The Hill. “HHS made it clear that plans are free to set up specific enrollment periods for their insurance plans if allowed under state laws. … Health plans had raised concerns that without the enrollment periods, parents could wait until their children get sick before seeking coverage, making it impossible for insurers to stay profitable” (Pecquet, 7/29). The Associated Press noted that insurers “were concerned the new health care law would allow parents to sign their kids up in emergency rooms while the child is in the middle of a health crisis. The administration now says insurers can limit the sign-up to an ‘open enrollment’ period, for example, December 1 to December 31 for plans that start January 1” (7/28).

(For more detailed news coverage, read KHN’s Morning Edition for July 29.)  

In other news, two polls this week highlighed confusion among a significant number of seniors on how the overhaul affects them, but one also offered evidence that opposition to the health law is decreasing.  

The Washington Post on Thursday reported on the Kaiser Family Foundation’s July tracking poll, noting that “opposition to the landmark health care overhaul declined over the past month, to 35 percent from 41 percent. … Fifty percent of the public held a favorable view of the law, up slightly from 48 percent a month ago, while 14 percent expressed no opinion about the measure.” The Post also noted this “approval level was the highest for the legislation since it was enacted in March, after a divisive year-long debate” (Hilzenrath, 7/29). According to The Hill, “the positive numbers play heavily into this fall’s impending midterm elections, in which Republicans and Democrats will jockey over the reforms in the healthcare bill” (O’Brien, 7/29).

The Washington Post’s Behind The Numbers Blog, concluded the poll “shows that senior citizens remain more negative than younger adults toward the health care overhaul passed earlier this year and are more apt to say that the bill will have a negative effect on Medicare and those in their age group” (Agiesta, 7/29). Kaiser Health News notes that seniors, who are a key target of both political parties this election season, “are unaware of many of the Medicare provisions in the overhaul and have been left with erroneous perceptions by the bitter legislative debate” (Verdon, 7/29). (KHN is a program of the foundation).

The other poll, this one conducted by the National Council on Aging and released Monday, also advanced the idea that, as reported by The Hill, the “majority of the nation’s seniors have little understanding of what the Democrats’ newly enacted healthcare law actually does.” This survey found that only “14 percent of respondents … knew that the new reforms don’t include cuts to doctors treating Medicare patients” (Lillis, 7/26). NPR’s Shots Blog offered strong words: “a new poll that shows just how little Grandma and Grandpa know about it must be giving the new law’s supporters a serious case of heartburn. That’s because seniors are not just a key voting bloc in the upcoming mid-term elections, but a group that’s been showered with some sweet upfront benefits – like $250 checks as a downpayment to close the notorious Medicare drug benefit ‘doughnut hole'” (Rovner, 7/26). 

(For detailed news coverage related to these polls, read KHN’s Morning Edition on July 27 and July 29.

And, with an eye on the fall midterm elections, Democrats and Republicans are offering different views on how health reform votes will play out in the voting booth. The Hill reports that Senate Majority Leader Harry Reid is saying that health reform will end up helping Democrats this November. “Reid … said public opinion is shifting in favor of the new healthcare law … and predicted more and more voters would reject Republicans’ calls for repealing the legislation.” But Republicans “note that polls have been much more mixed than Reid had argued” (O’Brien, 7/26).  Roll Call reported on the GOP’s plan for attack: “criticizing four aspects of the new law and introducing legislation to partially repeal it. With just more than three months until Election Day, Republicans remain confident that their unanimous opposition to the law will help them pick up seats in the midterm elections” (Drucker, 7/29).

According to Politico, “health insurers are also planning to play big in November. … Both America’s Health Insurance Plans (AHIP) and its Coalition for Medicare Choices are expected to play a major role in the messaging, along with individual companies. But neither group, according to sources, plans to directly attack Democrats, which would risk infuriating the White House as it writes reform regulations as well as the Blue Dog Democrats who opposed the legislation.” Likely ads include those targeted to seniors in the Medicare Advantage program “explaining it was health reform – not insurers – that is responsible for their higher bills and slashed benefits, one industry official said” (Cummings and Frates, 7/28).

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