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Posted by Alexandra Sifuentes on October 25, 2009
By Reed Abelson / New York Times

As Congress nears votes on legislation that would overhaul the health care system, many small businesses say they are facing the steepest rise in insurance premiums they have seen in recent years.

Insurance brokers and benefits consultants say their small business clients are seeing premiums go up an average of about 15 percent for the coming year — double the rate of last year’s increases. That would mean an annual premium that was $4,500 per employee in 2008 and $4,800 this year would rise to $5,500 in 2010.

The higher premiums at least partly reflect the inexorable rise of medical costs, which is forcing Medicare to raise premiums, too. Health insurance bills are also rising for big employers, but because they have more negotiating clout, their increases are generally not as steep.

Higher medical costs aside, some experts say they think the insurance industry, under pressure from Wall Street, is raising premiums to get ahead of any legislative changes that might reduce their profits.

The increases come at a politically fraught time for the insurers, as they try to fight off the creation of a government-run competitor and as they push their case that they have a central role to play in controlling the nation’s health care costs.

President Obama, in his Saturday radio address, said the Democrats’ health insurance overhaul would help small businesses and stimulate the economy by providing relief from “the crushing costs of health care — costs that have forced too many small businesses to cut benefits, shed jobs, or shut their doors for good.”

The insurance industry has already been under sharp attack by Democratic lawmakers who favor creating a government-run insurance plan that would compete with private insurers. Without that competition, proponents say, insurers will continue to price coverage beyond the reach of many Americans.

Small businesses, which employ about 40 percent of the private labor force, are a big constituency for both parties.

The House speaker, Nancy Pelosi of California, said the sharp rise in premiums for small businesses offered the latest evidence that Congress must act swiftly on health care legislation.

“This underlines the urgent need for health insurance reform, including a public option,” she said in an interview. “We need to have competition for the insurance companies to keep premiums down.”

Insurers say there is no need for a government-run insurance plan and argue that their health plans are already responsible for many of the initiatives, like programs to coordinate care for chronic conditions, that ultimately lower costs.

Insurers’ “profits are not responsible for increased health care costs,” said Robert Zirkelbach, a spokesman for the industry’s trade group, America’s Health Insurance Plans.

Like the insurers, Republican lawmakers, who portray themselves as champions of small business, argue that the proposed legislation would raise premiums across the board because sick people would be more likely to enroll than healthy people.

They also say the taxes and other ways of paying for the program would be passed on to employers in higher premiums, only making matters worse for small businesses.

The Senate minority leader, Mitch McConnell of Kentucky, said in a response to the president’s radio address, “We can’t support a bill that will raise premiums.” The big insurance companies declined to comment.

With negotiations over next year’s premiums still under way, data on rate increases are mostly anecdotal. Formal surveys have not yet been completed by the health benefits consultants who track the figures. And in some parts of the country, experts say rates are not overly high.

But benefits consultants say there is no doubt that premiums are soaring for many small businesses. Edward Kaplan, a consultant with the Segal Company, said his clients were seeing renewals for coverage at prices 15 to 23 percent higher this year. Last year, he said, they typically faced increases of 7 to 12 percent.

The brokers and consultants say the price jumps seem hard to justify. “Frankly, I’m mystified by the size of the increases,” said one broker, Charles J. Newman, who works with small employers in the New York area.

Some say the threat of an overhaul may be at least part of the reason. Joshua Miley, a consultant with HighRoads, which analyzes benefit information for employers, said the “undercurrent of health reform is driving part of the renewal increases.”

HighRoads projects that premiums will rise 14.4 percent for an individual in a health maintenance organization plan at a typical small employer.

There is no question that insurers are under pressure from Wall Street. In recent years, insurers were often not quick enough to raise their premiums well above the rising cost of medical care.

But they have heard from angry investors disappointed by the companies’ earnings.

“There’s no one out there who hasn’t had to do a mea culpa to Wall Street,” said Sheryl Skolnick, an analyst for Pali Capital who follows the companies. While the industry is particularly vulnerable now in Washington, she said, “it seems like they’re more afraid of Wall Street.”

Michael A. Turpin, a former senior executive for UnitedHealth, the insurer, and now a top official at USI Holdings, an insurance brokerage firm, said insurers were now “under so much pressure to post earnings, they’re going to make hay while the sun is shining.”

Along with many Republican lawmakers, the insurers say the current Congressional proposals do too little to address the underlying reasons for high premiums — the unabated rise in medical costs and effects of a weak economy. Hospitals, for example, have been treating greater numbers of people who have lost their jobs and their insurance, and they are passing along some of those costs by charging higher prices to private insurers.

The industry also points to low government payments to hospitals and doctors, which insurers say result in higher prices for employer-based coverage to make up for the shortfall.

In an analysis released two weeks ago by America’s Health Insurance Plans, insurers said premiums would rise even faster under the legislation under study in Congress — an assessment fiercely disputed by Democratic Congressional leaders and some health care economists but shared by many Republicans.

Small businesses, besides having less negotiating leverage than big employers, tend to pay more for the same coverage because they cannot spread the cost of expensive medical conditions or hospitalizations over large numbers of workers. Premiums can be especially high if they have sick or older workers.

Owners of small companies say the lack of options is why they have been paying increasingly higher premiums for less and less coverage — this year perhaps more than ever.

In August, when Walter Rowen, who owns Susquehanna Glass in Columbia, Pa., sought to renew his company’s coverage for two dozen employees, he said his insurer demanded a 160 percent rate increase. Mr. Rowen said he was told his work force was “getting too old and very expensive.”

Mr. Rowen said his insurance broker found that any other health plan was likely to charge 30 to 50 percent more than he paid last year. He chose a less generous plan from a different carrier for 44 percent more.

David M. Herszenhorn contributed reporting.
Posted by Vincent M. Perez on October 12, 2009
The Brookings Institution

Audrey Singer, Senior Fellow, Metropolitan Policy Program 
Andrew Reamer, Fellow, Metropolitan Policy Program

Preparations for April’s 2010 Census are well underway. The federal government’s largest ever peacetime operation, the 23rd decennial headcount is a tightly choreographed effort involving years of planning, $14 billion and 700,000 staff.

After some fits and starts, the Census Bureau is ready to deliver an accurate census. However, an appropriations amendment just introduced by Sens. David Vitter (R-LA) and Robert Bennett (R-UT) could derail that outcome. The Senators want to bar the Census Bureau from conducting the census unless it adds questions on each person’s citizenship and immigration status.

It’s difficult to overstate the importance of the 2010 Census. Census results will drive congressional and Electoral College apportionment; legislative redistricting; voting and civil rights enforcement; the annual distribution of $500 billion in federal funds to U.S. communities; the siting of roads, health centers, and schools; response to disasters; and the location and hiring decisions of millions of businesses from mom-and-pop to Wal-Mart.

The census aims to count everyone, regardless of citizenship and immigration status. The amendment’s sponsors complain that the current approach to congressional apportionment is skewed because unauthorized immigrants are included. They want the census to identify the unauthorized in order to exclude them from the apportionment process.
 
But they are ignoring the Constitution itself. It requires a count of all “persons” residing in the United States, not just citizens or legal residents. The framers intended the census to be an inclusive count and so avoided the term “citizen” used elsewhere throughout the Constitution.

Additionally, the Census Bureau doesn’t ask about a person’s legal status to avoid intimidating immigrants, authorized and unauthorized, from participating in the census. While Census Bureau employees are held to strict standards of confidentiality, under threat of criminal penalty, many immigrants may still be reluctant. Charged with getting a full count of the U.S. population, the Census Bureau can’t afford additional risk that a significant number of people will not fill out the form.

In a country of 308 million people, getting a complete headcount is a gargantuan undertaking even when the number of questions (now ten) is small. Add a bitter politicized environment around immigration and it’s understandable why many immigrants, even those legally present, may not want to stand up to be counted.

In addition to compromising census accuracy, the Vitter-Bennett amendment would wreak havoc with census timing and cost.

Due to additional needs for testing, printing, and training, changing the census questionnaire would delay the census well beyond the congressionally mandated date of April 1, 2010. This, in turn, would postpone the Census Bureau delivery of population figures to states for apportionment and redistricting beyond April 1, 2011, as required by law. Ironically, in their fervor to deny congressional representation to non-citizens, Senators Vitter and Bennett would disrupt the entire apportionment process.

Then there is the added cost to taxpayers. Extending and remaking the massive census operation over many months will create, in the words of Sen. Barbara Mikulski (D-MD), Commerce-Justice-Science Appropriations Subcommittee chair, a “financial challenge that borders on . . . a nightmare.” The Vitter-Bennett amendment would waste hundreds of millions of dollars already spent on testing, printing, training, and advertising and require spending hundreds of millions more.

Barring a constitutional amendment to alter practices in place since 1790, if Sens. Vitter and Bennett wanted to add new census questions, they should have said so in 2007—when the Census Bureau, as required by law, gave Congress the opportunity to review the questionnaire. Congress put this review process in place precisely to avoid the disastrous consequences of the eleventh-hour changes now being proposed.

The Vitter-Bennett attempt to remake the census less than six months before Census Day might have one positive impact. It provides Congress with further incentive to undertake major reform to the nation’s immigration policy. Congress should do so without the collateral damage of a delayed, less accurate, more costly census.
Posted by Alexandra Sifuentes on October 06, 2009
In the October issue of the AARP Bulletin, a number of experts go on the record in support of the reforms to Medicare included in America’s Affordable Health Choices Act and decry attempts to scare seniors in an effort to derail insurance reform.

REFORMS WILL STRENGTHEN MEDICARE (Excerpts from the AARP Article):

“Experts who have studied the proposals now being debated generally say the changes actually aim to strengthen Medicare and improve beneficiaries’ care and access to physicians…

“All the reform proposals so far include around $500 billion in savings carved from future growth in Medicare spending over a 10-year period. Although that sounds like a huge sum, it’s actually only a small fraction of the $6.4 trillion expected to be spent on Medicare from 2009 to 2019. Still, where will the money come from?
 
“The savings are expected to be achieved mainly by: reducing fraud and waste more aggressively; reducing government subsidies to private Medicare Advantage plans; paying doctors more for practices that improve quality of care and save money; and paying providers (notably hospitals and home health agencies) a little less of an increase each year in an effort to gradually trim the rate at which Medicare costs climb over time – aka ‘bending the cost curve.’”
 
EXPERTS AGREE: 

“Medicare beneficiaries are the most satisfied of any Americans with their health coverage, so it’s natural for them to worry about any changes that might alter it, especially when they’re being lied to in a deliberate attempt to make them feel anxious.”

– Jonathan Oberlander, professor of social medicine and health policy at University of North

Carolina, Chapel Hill, and a historian of Medicare
                                                                                            
“It’s not about saving money itself. It’s about making the program better…These steps are win-win. It’s not about squeezing money out of Medicare and putting it somewhere else in health care reform. It’s about changing the way we pay so that we all [government and beneficiaries] get more for the dollars we spend.”

– Mark McClellan, Engelberg Center for Health Reform at Brookings Institution and former head of the Centers for Medicare and Medicaid Services under President George W. Bush

“Gradually eliminating these excess payments will permit good plans to continue and put pressure on others to offer better value to their enrollees… That’s what fair competition is supposed to do.”

– John Rother, AARP executive vice president of policy
Posted by Vincent M. Perez on September 24, 2009
The City Council on Tuesday weighed in on another national controversy, this time passing a nonbinding resolution supporting health-care overhaul.

The resolution, sponsored by Rep. Susie Byrd, calls for creating an affordable health-care option for people without insurance. It also calls for allowing individuals to keep their existing insurance if they're happy with it.

"We often weigh in on federal matters, particularly those that impact our community," Byrd said Wednesday in an interview. "We've taken a position on comprehensive immigration reform, the border wall and the drug war."

The council voted 8-0 at the end of a five-hour meeting Tuesday to support Byrd's resolution calling on Congress and President Obama to enact health-care reform. There was no debate.

Byrd said she attended the recent Labor Day breakfast at which U.S. Rep. Silvestre Reyes, D-Texas, spoke in favor of Obama's efforts to reform the nation's health-care system.

"I realized after hearing him speak so passionately that we had yet to weigh in on the issue," Byrd said.

More than 46 million Americans, including 232,000 El Pasoans, don't have health insurance, said Vincent Perez, Reyes' press secretary.

In the past 10 years, Perez said, El Paso taxpayers have spent $400 million in property taxes to pay for health care for people who can't afford it and who get services at University Medical Center, formerly Tho mason Hospital.

"This is a problem that costs those who have

health insurance and those who don't," Perez said.

Michael Moore, chairman of the El Paso County Republican Party, said his big concern is the cost of health-care reform.

"Who's going to pay for it?" he said. "You can only steal from the rich so much. Eventually, all of us will pay for it. We'll pay for it with less care, longer waits and more taxes."

Moore said any health-care reform package needs to include tort reform. "If there is medical malpractice, that needs to be paid for," he said. "But it's not a lottery win."

The El Paso County Commissioners Court also voted unanimously Monday to support a similar resolution that was sponsored by Commissioner Veronica Escobar. "Even our Republican, Dan Haggerty, signed on," Escobar said.

The county resolution added a line asking that any health-care reform be deficit-neutral, meaning that cuts in spending would have to be made elsewhere in the federal budget, Escobar said.

"Local property taxpayers shoulder the burden of funding the uninsured and we do it through the most expensive way there is -- the emergency room," Escobar said.

Private hospitals and nonprofit groups are also feeling the pinch and pass along higher health-care costs to people who have insurance, she said.

David Burge may be reached at dburge@elpasotimes.com; 546-6126.
Posted by Alexandra Sifuentes on September 22, 2009

      RISING COSTS

    Kaiser’s annual survey this year found that premiums for employer-sponsored health insurance for family coverage have risen 131 percent in the last ten years and went up five percent this year alone.  Health care costs are rising more than three times faster than wages.  (http://ehbs.kff.org/?CFID=6795253&CFTOKEN=89101180&jsessionid=6030c62237720e199cc6155b59454e133d60)

    A report from the Business Roundtable released this month concluded that if nothing is done, annual health care costs per employee will increase by 166 percent to nearly $29,000 over the next decade.  (http://www.businessroundtable.org/sites/default/files/BRT_Hewitt_HC%20Reform%20Report_Sept2009_FinalONLINE.pdf)

    The average premium for family coverage is now $13,375, nearly equivalent to the annual earnings of a minimum wage job.  (http://ehbs.kff.org/?CFID=6795253&CFTOKEN=89101180&jsessionid=6030c62237720e199cc6155b59454e133d60)

    We have by far the most expensive health care system in the world.  We spend 50 percent more per person on health care than the next most costly nation.  (OECD Health Data 2009, Frequently Requested Data. http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html)

    The United States spent approximately $2.2 trillion on health care in 2007, or $7,421 per person.  The government projects that by 2010, we will be spending $2.6 trillion or $8,459 per person on health care in this country.  That’s an extra $400 billion in just three years.  (CMS National Health Expenditure Accounts, http://www.cms.hhs.gov/NationalHealthExpendData/downloads/proj2008.pdf)

    We are now spending roughly one in every six dollars on health care.  If we do nothing, in 30 years, one out of every three dollars in our economy will be tied up in the health care system.  (CBO, The Long-Term Outlook for Health Care Spending, November 2007)

    According to some estimates, health care expenditures in the U.S. could grow from $2.5 trillion in 2009 to more than $7 trillion in 2025.  (Analysis of CMS estimates on National Health Expenditures from June 2009)


THE AMERICAN WORKER

    Nearly one-third of the uninsured – 13 million Americans – work for medium to small companies with fewer than 100 employees.  (U.S. Census Bureau, Current Population Survey, March 2007)

    Americans who get insurance through an employer are spending more and more out of pocket.  Total out of pocket health care spending for Americans with employer-sponsored insurance increased 30 percent between 2001 and 2006.  This is an extra $900 dollars for each person.  (Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2001-2006)

    Among firms offering benefits in 2009, 21 percent say they cut benefits or asked workers to pay more out of pocket.  Fifteen percent report that they increased the worker’s share of the premium.  (http://ehbs.kff.org/?CFID=6795253&CFTOKEN=89101180&jsessionid=6030c62237720e199cc6155b59454e133d60)

    Americans these days are less likely to be offered coverage at work than in the past because the percentage of firms offering health insurance coverage is declining.  Between 2000 and 2009, the percentage of firms offering coverage shrank from 69 to 60.  Much of that happened the past year alone, when the number of firms offering health insurance dropped from 63 percent in 2008 to 60 percent in 2009.  (http://ehbs.kff.org/?CFID=6795253&CFTOKEN=89101180&jsessionid=6030c62237720e199cc6155b59454e133d60)

    Small businesses in particular are struggling under the current health care system.  For firms with fewer than 10 workers, the erosion in coverage is striking.  Fifty-seven percent offered health insurance in 2000.  Less than half – 46 percent – do now.  (http://ehbs.kff.org/?CFID=6795253&CFTOKEN=89101180&jsessionid=6030c62237720e199cc6155b59454e133d60)


HEALTH SPENDING AND THE FAMILY BUDGET
   
                       
   A recent a survey found that nearly 60 percent of Americans, with and without insurance, cut back on health care due to cost.  Many relied upon home remedies, skipped recommended treatment, cut pills in half or skipped doses, or took other steps forced upon them by high costs.  (http://www.kff.org/kaiserpolls/upload/7891.pdf)  

    Seventy percent of adults with an existing health problem who were not covered through an employer and tried to buy health insurance in the individual market in 2007 were not able to because they could not afford it.  (http://www.commonwealthfund.org/Content/News/News-Releases/2009/Jul/New-Report-Individual-Health-Insurance-Market-Failing-Consumers.aspx)

    According to a new study, in 2007, more than one third of Americans who had coverage through the individual insurance market had expensive medical bills for services not covered by their plan.  (http://www.commonwealthfund.org/Content/News/News-Releases/2009/Jul/New-Report-Individual-Health-Insurance-Market-Failing-Consumers.aspx)


AMERICAN BUSINESSES

    Small businesses say high health costs are impeding their ability to compete, expand and hire more workers.  In one survey, among small businesses that offer coverage, 40 percent report spending more than 10 percent of their payroll on health costs.  (The Main Street Alliance.  Taking the Pulse of Main Street: Small Business, Health Insurance, and Priorities for Reform.  January 2009.  http://mainstreetalliance.org/wordpress/wp-content/uploads/2009_01_15_Taking_the_Pulse_of_Main_Street.pdf)

    Because they lack bargaining leverage, small businesses pay 18 percent more than larger businesses for the same health insurance plan.  (Gabel, Jon, R. McDevitt, L. Gandolfo, J. Pickreign, S. Hawkins, and C. Fahlman.  “Generosity and Adjusted Premiums in Job-Based Insurance: Hawaii is Up, Wyoming is Down.”  Health Affairs, 2006, 25(3): 832-843.)


THE UNINSURED

    Even for people with health insurance, all it takes is one stroke of bad luck to become one of the millions of uninsured – or the millions who have coverage, but can’t afford health care.

    Every day that goes by, 14,000 people lose their health insurance.  (http://www.americanprogressaction.org/issues/2009/02/health_in_crisis.html)

    In an analysis released this month, the Treasury Department found that half of non-elderly Americans under 65 will find themselves without coverage at some point in the next decade.  (http://www.treas.gov/press/releases/docs/final-hc-report092009.pdf)

   American families who get health insurance through their employer pay a hidden tax of $1,000 to pay for the cost of caring for the uninsured.  (http://www.familiesusa.org/resources/publications/reports/hidden-health-tax-findings.html)

    A 2002 study by the Institute of Medicine, a branch of the National Academy of Sciences, found that the lack of health insurance causes 18,000 unnecessary deaths a year.  That’s one person dying every half hour in this country because they don’t have health insurance.  (http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/Jun/Front-and-Center.aspx)

    Twenty percent of adults with individual insurance coverage lack coverage for prescription drugs.  (http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2009/Jul/Failure%20to%20Protect/1300_Doty_failure_to_protect_individual_ins_market_ib_v2.pdf)

    From 2004 to 2007, 12.6 million adult Americans – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were denied coverage, charged a higher rate or otherwise discriminated against because of a pre-existing condition, according to a recent national survey.  (Coverage Denied: How the Current Health Insurance System Leaves Millions Behind, http://www.healthreform.gov/reports/denied_coverage/index.html, citing Doty MM, Collins SR, Nicholson JL et al. Failure to Protect: Why the Individual Insurance Market is not a Viable Option for Most US Families.  The Commonwealth Fund, July 2009)

    In another survey, one in 10 people with cancer said they could not get health coverage, and six percent said they lost coverage after they were diagnosed with the disease.  (Coverage Denied: How the Current Health Insurance System Leaves Millions Behind, http://www.healthreform.gov/reports/denied_coverage/index.html, citing USA Today/Kaiser Family Foundation/Harvard School of Public Health.  National Survey of Households Affected by Cancer.  November 2006.  http://www.kff.org/kaiserpolls/upload/7591.pdf)

    In nine states, insurance companies can deny coverage to survivors of domestic violence, citing the history of domestic violence as a pre-existing condition.  (Coverage Denied: How the Current Health Insurance System Leaves Millions Behind, http://www.kff.org/kaiserpolls/upload/7591.pdf National Women’s Law Center.  Nowhere to Turn: How the Individual Health Insurance Market Fails Women, 2008)


INSURANCE BUREAUCRACY

    If you work for a small business or have an individual policy, more than 26 cents of every dollar of your health insurance premium goes for administrative costs, things like executive compensation, bonuses, marketing, underwriting, and paperwork.  (Congressional Budget Office (CBO).  December 2008.  Key Issues in Analyzing Major Health Insurance Proposals.  Washington, DC)

    A recent study found that doctors spent on average 142 hours a year interacting with health plans at an average cost of $68,274 per physician per year.  (Lawrence P. Casalino and others, “What Does It Cost Physician Practices to Interact with Health Insurance Plans?”  Health Affairs web exclusive, May 14, 2009, p. w533–w543)

Posted by Vincent M. Perez on September 15, 2009
Survey Shows Cost of Health Benefits Expected to Rise
By David S. Hilzenrath
Washington Post Staff Writer
Tuesday, September 15, 2009 10:58 AM

Many Americans with health benefits face an erosion of coverage next year under the existing health-care system, according to a new survey, as employers continue to cut costs.

Forty percent of employers surveyed said they are likely to increase the amount their workers pay out of pocket for doctor visits. Almost as many said they are likely to raise annual deductibles and the amount workers pay for prescription drugs.

Nine percent said they plan to tighten eligibility for health benefits; 8 percent said they plan to drop coverage entirely. Forty-one percent of employers said they were "somewhat" or "very" likely to increase the amount employees pay in premiums -- though that would not necessarily mean employees are paying a higher percentage of the premiums. Employers could simply be passing along the same proportional share of the overall increase that they did in 2009.

The annual survey released Tuesday was conducted by the Kaiser Family Foundation and the Health Research & Educational Trust. Leaders of the organizations said their findings underscore the need for reform that reins in costs.

The survey is one of several new reports providing fresh ammunition to President Obama as he struggles to overhaul the nation's health-care system, and to convince wary Americans who are satisfied with their health-care coverage. Obama has argued that, without reform, people who currently have insurance could lose coverage or find it increasingly difficult to afford.

That possibility was driven home by a report issued Tuesday by a major business lobby, which said that if current trends continue, annual health-care costs for employers will rise 166 percent over the next decade -- to $28,530 per employee.

"Maintaining the status quo is simply not an option," said Antonio M. Perez, chief executive of Eastman Kodak and a leader of the Business Roundtable. "These costs are unsustainable and would put millions of workers at risk," Perez said in a statement.

Rather than letting current trends go unchecked, employers are likely to impose a variety of cost-saving measures, said Helen Darling, president of the National Business Group on Health, an alliance of corporations. Those steps could include giving employees strong financial incentives to participate in weight-loss programs and buy prescriptions by mail, she said. In addition, workers could be required to view videos or receive briefings that cover both the downside and the upside of costly procedures such as back surgery before choosing the operation, Darling said.

"I think we're going to repeat the early '90s -- the late '80s, early '90s, when the country turned to managed care," Darling said.

The Mercer consulting firm, which helps companies manage employee benefits, issued preliminary results of a corporate survey last week predicting that next year many employers will shift costs to employees.

"In 2010, nearly two-thirds of all respondents (63 percent) will again ask employees to pay a greater share of health plan costs, most commonly by requiring them to pay a higher portion of the monthly premium (40 percent of respondents)," Mercer reported. Similar numbers of employers plan to raise deductibles, co-payments, or limits on the sums employees could be required to pay out-of-pocket, Mercer said.

The Kaiser Family Foundation survey released Tuesday obtained in-depth responses from more than 2,000 private firms and non-federal public employers. The foundation focuses on health issues. Its collaborator, the Health Research & Educational Trust, is affiliated with the American Hospital Association. The survey was conducted from January through May.

Annual premium increases for families, which totaled 13 percent in 2002 and 2003, have held steady at 5 percent since 2007, the groups reported. Premiums for single coverage did not rise significantly in 2009, breaking a long-standing trend. Kaiser Vice President Gary Claxton said it is unclear why the increases have moderated.

However, premiums have continued to rise faster than workers' wages and overall inflation, the groups reported. While family premiums for 2009 rose 5 percent, general inflation fell 0.7 percent during the 12-month period ending in April, the survey said.

Since 1999, premiums have gone up 131 percent, while workers' wages have gone up 38 percent, the survey said.

The survey found that 60 percent of employers offered health benefits this year, which was statistically unchanged from 63 percent in 2008.

There was a wide disparity between large businesses and small businesses: 98 percent of large firms offered health benefits in 2009, while 59 percent of firms with three to 199 workers provided coverage.

Companies that went out of business are not reflected in the results.

For some companies surveyed, researchers said, the effect of the economic crisis on health benefits might not show up until next year.
Posted by on September 11, 2009
12:00 AM CDT on Friday, September 11, 2009

Texas again leads the nation in the percentage of residents without health insurance, according to U.S. Census Bureau figures released Thursday.

Martin Estrada holds his year-old nephew Alberto Estrada, and his wife, Consuelo Soto (third from left), holds their 1-month-old son, Alexander, while waiting for a newborn checkup at Plano Children's Medical Clinic, which only takes patients without insurance.

More than one of every four Texans – 25.1 percent – were uninsured, based on a two-year average for 2007-08. That's up from 24.1 percent for 2005 and 2006, although analysts agreed the recession hit Texas late, holding down what could have been a bigger increase.

The report comes just as the debate over national health policy heats up, with backers and detractors of President Barack Obama's plan brandishing the data as fresh ammunition.

Obama, speaking to nurses Thursday in Washington, stressed that the number of uninsured Americans rose last year to 46.3 million, up 682,000 from a year earlier.

Though the percentage of Americans who were uninsured for all of last year – 15.4 percent – did not change significantly, Obama said updated surveys show that "the situation has grown worse."

Bureau official David Johnson, explaining why the national rate was unchanged, said a record 29 percent of Americans had government-provided insurance, offsetting an eight-year decline in the number of people who get coverage through jobs – now 58.5 percent.

In Texas, conservative and liberal experts clashed over what's really at work in the numbers and what lessons to draw.

John Goodman, president of the National Center for Policy Analysis, which is based in Dallas and advocates free-market solutions to social problems, said the percentage of the U.S. population lacking insurance has been stuck at about 15 percent over the past decade. Enrollment in Medicaid and various states' Children's Health Insurance Programs has grown but has barely put a dent in the rate, he said.

"As we have expanded free, government-provided insurance in the public sector, the private sector has contracted because employers find that their employees would rather have wages if they can sign up for free coverage from the government," Goodman said.

"So the Medicaid program and the S-CHIP program are crowding out private insurance. We keep adding to the taxpayer burden, but we're not reducing the percent of the population that's uninsured."

But former Texas Medicaid program official Anne Dunkelberg said that nationally the government programs saved the day.

"There's no doubt that our national rate would be much worse" without Medicaid and CHIP, said Dunkelberg, associate director of the Center for Public Policy Priorities. It advocates for low- and middle-income Texans.

Dunkelberg noted that Texas Medicaid rules bar coverage for an able-bodied adult who makes more than $188 a month and is not pregnant.

"In Texas, the only offsets are for children," she said. "We simply don't have any public coverage option for adults. And our uninsured rate has gotten worse over the last decade in Texas. So the suggestion that employers are dropping coverage of their workers because their workers' children might be able to get [CHIP] coverage is not very logical."

The Census Bureau's report, based on a survey of about 100,000 households taken last spring, came out just hours after a South Carolina congressman called Obama a liar for saying illegal immigrants wouldn't gain coverage under the president's plan.

Johnson, of the Census Bureau, said the survey doesn't pinpoint whether people are in the country illegally, although it showed that 21 percent of the nation's 46.3 million uninsured people last year were noncitizens, both legal and illegal.

In Texas, 1.56 million of the state's 6 million uninsured people – or 26 percent – were noncitizens. In New York and California, two other states with large immigrant populations, noncitizens accounted for 26.4 percent and 37.3 percent, respectively, of people without health coverage.

California still has the highest number – not percentage – of uninsured residents. It had 6.7 million uninsured people, about 700,000 more than Texas in a two-year average ending last year.

But Texas had more uninsured children under 18 – more than 1.2 million last year, compared with 998,000 in California.

Once again, Texas had the nation's highest percentage of children under 18 without coverage – 17.9 percent. Nationwide, the percentage was 9.9 percent.

Goodman, of the right-leaning Dallas think tank, said none of that is surprising.

"We have a large low-income population, we have a large Hispanic population," he said. "It tends to be true that at every level of income, the Hispanics have a higher rate of uninsurance."

Goodman said many lower-wage workers are uninsured for only brief periods. They would be best helped with tax breaks on their individual health insurance premiums similar to those for workers who get coverage through their jobs, he said.

He warned that penalties for employers who don't cover their low-wage workers – proposed by Senate Finance Committee Chairman Max Baucus, D-Mont. – would discourage hiring and needlessly prolong the recession.

But Dunkelberg, of the left-leaning Austin think tank, said it's foolish to "think that we can get to health reform without everyone contributing something."

A plan moving in the U.S. House is "awfully forgiving because it exempts the vast majority of small businesses from any responsibility and then starts with a very graduated contribution that would be required that is dramatically lower than the cost of actually providing coverage to your employees," she said.

The census report underscores how Texas "stands to gain more than any other state" from a national overhaul, she said.
Posted by Vincent M. Perez on August 06, 2009

Congressman Silvestre Reyes will host a live telephone town forum with El Pasoans to discuss health insurance reform legislation pending in the U.S. Congress on Thursday, August 13, from 6:30 p.m. to 7:30 p.m.  All El Pasoans are invited and encouraged to participate!  To participate in the call, dial 1-877-269-7289.  When prompted for a pin number, dial 13318.  The call is free for all participants!  

With over 230,000 uninsured people in El Paso, health insurance reform is critical for the El Paso community.  In June and July Congressman Reyes hosted a series of telephone town forums with local residents to discuss health insurance reform and answer questions from participants.  Over 5,000 El Pasoans participated in these live forums! 
Posted by Vincent M. Perez on August 06, 2009

Congressman Reyes with join radio talk show host Barbara Perez on KHRO 1150 talk radio to discuss health insurance reform on Thursday, August 13, from 10:00 a.m. to 12:00 p.m.  All El Pasoans are encouraged to listen and call in!  To call in to the Barbara Perez show, call (915) 880-4376. 

Posted by Luis Torres on August 03, 2009
Summer program teaches youths skills
By Ed Shugert / El Paso Times
Posted: 08/02/2009 12:00:00 AM MDT

EL PASO -- Part of the stimulus package passed by Congress in February is providing summer jobs for more than 2,800 El Paso youths and valuable training that could lead the participants to worthwhile careers, organizers say.

The programs, being conducted at El Paso Community College, the University of Texas at El Paso and La Fe, are part of Workforce Solutions Upper Rio Grande's summer youth program, an annual effort. But more than $1.1 million in stimulus money has allowed the agency to expand the scope of the summer jobs program.

The areas of study include computers, engineering and health sciences. Participants in the summer jobs program ranged in age from 14 to 24.  More than 2,800 youth were certified in the Summer Youth Program in the six-county region served by Upper Rio Grande. Upper Rio Grande pays the students and pays for equipment, which the schools provide the instruction.

Thursday, more than 20 students, ages 14 to 17, were installing new software on computers they had built themselves at El Paso Community College Valle Verde Campus. A total of 44 students selected by Upper Rio Grande are learning computer skills in an eight-week program, which instructors said will give them the knowledge and skills to take the A-plus certification examination for entry-level computer technicians.

"This program teaches the kids how to be tenacious, how to develop, plan and follow through with it," said Jaime D. Farias, dean of the Education and Career Technical Education programs at the EPCC Valle Verde Campus. The program "requires the students to use a lot of analytical skills and technical skills, but the motivation comes from each student."

At the end of the class "they will be able to recognize each component in the computer, they will be able to assemble a computer, diagnose and recognize what's wrong and repair it," said Delfina Najera, professor and coordinator for the campus' information technology systems.

Just a few weeks ago, 15-year-old Rachel Quezada thought computers were "all guys stuff" and wanted to go to cosmetology school after high school. But the program is causing the sophomore at Ysleta High School to adjust her plans.  "I'm probably going to stay with this in my future. I've learned a lot of new stuff."

Alan Bernal, 15, and his sister, Ana, 14, are working in the program. Alan said he has already fixed his grandmother's computer with the skills he has gained from his training.  "For my future, I want to be an architect," said the El Dorado High School sophomore. "From here, I've learned how to use many more programs that should help me in the future."

Najera has had the idea for this computer class for some time. The stimulus money and Upper Rio Grande's summer youth jobs program provided the opportunity to implement it.  "I had the idea if we get to these kids early enough it will simplify their lives and education," Najera said. "These days, learning is an ongoing process. Technology today demands that you stay current."  Najera has been at EPCC for 15 years and spent 16 years working as an information systems manager for Farah Manufacturing when it was an industry apparel giant.

"I've seen big changes in the IT field and I like where it's going," she said. "To think one of these small computers almost has the power of one of those mainframes" she used to work with at Farah. "... Hopefully, we'll get to continue this, I love this."

The training programs at area campuses are full, but Lauren Macias-Cervantes of Upper Rio Grande said the program still has slots available. There are family income limits for youths to qualify.

Information on the summer jobs is available at 887-2000.

The stimulus money enabled Upper Rio Grande to help about 10 times as many students find summer employment as it usually helps.  "Typically, we're able to serve 200 to 300," Macias-Cervantes said. "With the stimulus program we were able to help nearly 3,000."  The agency opened an office at the Bassett Place mall to help recruit youth for the program.  "We opened the Bassett office and we hired 20 new staff," she said.  Outreach staff went out to schools during the week and on Saturdays certified students' applications for the program, she said.

Ed Shugert can be reached at eshugert@elpasotimes.com; 546-6352

Computer jobs
Information technology jobs with the greatest growth forecast from 2006 to 2016, with percentage of growth and total jobs forecast by 2016:
# Network systems and data communications analysts: 53.4 percent, 402,000.
# Computer software engineers, applications: 44.6 percent, 733,000.
# Computer systems analysts: 29 percent, 650,000.
# Computer software engineers, systems software: 28.2 percent, 449,000.
Source: 30 fastest-growing occupations, 2006-2016, Bureau of Labor Statistics.


In El Paso
Schools providing training, number of students, cost of training and pay for participants in summer jobs program organized by Work force Solutions Upper Rio Grande:*
# EPCC Information Technology:"44, $80,520, $36,696.
# EPCC Customer Service: 2,000, $62,340, $222,400.
# EPCC Health: 100, $65,010, $83,400.
# UTEP: 210, $182,780, $262,710.
# Sul Ross: 20, $17,360, $16,680.
# La Fe: 90, $49,840, $75,060.
# Total:"2,464, $457,850, $696,946.
Source: Workforce Solutions Upper Rio Grande
*Note: More than 300 youths were placed in jobs with private employers.