Health

Add David Blatt, who maintains the OK Policy Blog, to the growing list of people who find flaws with proposed legislation that would allow outside health insurance companies to sell coverage exempt from state mandates.

Blatt argues Senate Bill 2046, introduced by state Sen. Bill Brown, a Broken Arrow Republican, is part of a national effort to create interstate competition when it comes to health insurance coverage. But the problem is Brown’s bill has the potential to “gut consumer protection.”

Blatt’s post points out fallacies in the logic behind interstate health insurance sales:

A second fallacy is that insurers are subject to a vast number of onerous mandates. In reality, there are only a dozen or so benefits that must be offered in Oklahoma, and half of those apply only to group coverage or to specific categories of the population, such as children, seniors, or post-partum women. Most studies have found that the impact of mandates on the cost of coverage is quite minimal.

Jeff Raymond, who operates OKWatchdog.org, a consumer protection organization, also finds flaws with interstate insurance sales. In a recent op-ed in The Oklahoman, Raymond argues:

. . . interstate insurance sales would trigger a race to the bottom. Healthy Oklahomans may see lower prices and more choices. Older Oklahomans, those with medical conditions and small-business owners, however, would find insurance harder — if not impossible — to come by, with higher prices because of healthy people leaving the risk pool.

The bill has been passed by a Senate committee and now heads for a full vote in the chamber.

Many progressives may wish it contained a public option and less pandering to insurance companies, but most people—even opponents—can’t dispute the health care reform bill passed by the U.S. Senate is truly groundbreaking legislation.

Perhaps the most historic aspect surrounding the bill is that Senate Democrats were able to overcome vicious and desperate right-wing attacks based on distortions or downright falsehoods and actually pass a bill of such magnitude.

Sarah Palin, the former Republican vice presidential candidate, defined the right-wing static when she posted this on Facebook: “The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

The health care legislation now under consideration does not create death panels or anything like them and Palin’s statement was later voted the biggest political lie of the year by Politifact.com. Her comments show just how far the right-wing will go to prevent health care reform.

But the Democrats were able to cut through the noise and get a bill passed. So it’s a time to recognize what’s good in the U.S. Senate bill and hope the final legislation—the bill must be reconciled with the House bill passed earlier—will be even better.

Here are some positive outcomes the bill would produce:

An additional 30 million Americans would be ensured by 2014.

insurance companies could no longer drop coverage for preexisting conditions.

Medical coverage would be expanded to low-income people.

insurance companies would have to pay more for actual medical costs by reducing their overhead.

The deficit would be reduced and health costs should go down.

Some progressive have argued that bill panders to insurance companies because they will benefit from getting more customers, some of whom will buy their insurance using federal subsidies. They also wanted some type of nonprofit public option that would compete against private insurers. I share these concerns. Yet the insurance industry has fought against reform efforts ostensibly because of the added regulations, which shows the legislation does have some teeth. A final bill, once passed, could also be adjusted down the road.

President Barack Obama sent out a public email about the “historic” legislation shortly after the bill passed. Here’s a portion of the email:

Although it's Christmas Eve, I wanted to share some exciting news: The Senate just passed a historic health reform bill.

In all the back and forth, it's easy to lose sight of what this incredible breakthrough really means. But consider this: This Christmas, there are millions of Americans without health insurance who risk losing everything if they get sick.

There are mothers and fathers who wonder how they'll provide for their children because an illness has wiped out their savings. There are small business owners who worry that they'll have to lay off a long-time employee because the cost of insurance is rapidly rising.

If we finish the job, all this can change. We will have beaten back the special interests who have for so long perpetuated the status quo. We will have enacted the most important piece of social policy since the Social Security Act in the 1930s, and the most important health reform since Medicare in the 1960s.

In Oklahoma, of course, the right-wing bastion was out in full force voicing their displeasure with the bill.

The Oklahoman editorial page, of course, criticized the bill without mentioning the state’s massive problems when it comes to medical outcomes. It also never mentioned how health care reform can specifically help Oklahoma.

According to Healthreform.gov, thousands of Oklahomans would benefit from reform efforts. In Oklahoma, according to the Healthreform.gov site:

639,000 residents who do not currently have insurance and 142,000 residents who have nongroup insurance could get affordable coverage through the health insurance exchange.

319,000 residents could qualify for premium tax credits to help them purchase health coverage.

575,000 seniors would receive free preventive services.

102,000 seniors would have their brand-name drug costs in the Medicare Part D “doughnut hole” halved.

45,600 small businesses could be helped by a small business tax credit to make premiums more affordable.

But The Oklahoman editorial page doesn’t want to engage with this type of information.

Meanwhile, three Republican legislators floated a legislative proposal that would allow Oklahoma to opt out on any reform plan.

It’s unlikely the state can legally ignore a federal mandate and a final bill hasn’t even been passed, but that’s not stopping the right-wing here from participating in typical partisan politics.

As Oklahoma’s budget crisis grows larger, mental health advocates are warning of a potential backlash because of program cuts.

Karina Forrest, a former director of the Oklahoma chapter of the National Alliance on Mental Illness, argues the state pays “dearly” for people who go untreated. Forrest, posting on Blue Oklahoma, writes:

Mental Illness and addiction strikes one in five individuals in our state. We pay dearly for individuals left untreated. In addition to many other examples, our tax dollars fund Medicaid for emergency room visits, the Department of Corrections if these individuals end up in the criminal justice system, the foster care system if these illnesses separate parents from their children, and most importantly, in loss of life and quality of life for our state's citizens.

Her insightful comments came at the same time state officials announced that state agencies would have to endure 10 percent cuts in their budgets this month because of declining revenues. State Treasurer Scott Meacham reported November revenues were down $139 million. That’s 25.1 percent below estimates and 30 percent lower than last year. Meacham said agencies might face 10 percent cuts next month as well.

In response to earlier budget cuts, the state announced it will close the Norman Alcohol and Drug Treatment Center. Other cuts were also announced by the Oklahoma Department of Mental Health. Given the most recent budget news, more major cuts will likely be proposed soon.

Jeff Tallent, a co-founder of Oklahoma Federation of Families, recently wrote in The Oklahoman:

Health care for people with mental illness or disabilities is one of those life-or-death issues. The consequence of waiting to act on mental health services is not inconvenience; it is potential productivity dissipated and lives lost.

Public education, which has also seen a decline in revenues from a dedicated funding source, is also facing dramatic cuts.

It’s a bleak picture, and Oklahoma leaders could be making a wrong, long-term decision by not considering small tax hikes or even temporary surcharges on the state’s wealthiest citizens to keep vital programs available. Even when the state finally dips in the Rainy Day Fund, budget cuts will be needed. Recent income tax cuts that primarily benefited the state’s richest citizens are at least partially responsible for the budget crisis.

The cost to the state in terms of human suffering, poor educational outcomes and higher incarceration rates down the road will be enormous unless the economy recovers quickly. It could have a cyclical effect, creating more budget demands and stress. Most everyone laments the steep drop in revenues, but few major state leaders have stepped forward to specifically and urgently address the long-term damage the budget crisis could inflict on Oklahoma. It’s the political, not the fiscal, reality driving the current discussion about the budget crisis. How bad must it get before Oklahoma’s Republican-dominated legislature finds ways to increase revenues?