...the Obama administration is investigating the activities of health insurance giant Humana--a participant in Medicare Advantage that's been telling its aging consumers that the government plans to slash benefits as it reforms the U.S. health care system, and urging them to tell Congress not to touch the program.
Medicare Advantage plans are private health care plans that seniors can buy into with federal assistance in lieu of participating in traditional Medicare, and under terms the government erected, those insurers face strict limits on how they communicate to beneficiaries. The regulations exist to protect seniors from acting under the pressures of their insurers, who control their benefits. In response to a request from Sen. Max Baucus (D-MT), the Center for Medicaid and Medicare Services has demanded the lobbying effort cease, and is investigating the company to determine whether it violated those rules. Senate Minority Leader Mitch McConnell, who represents Humana's home state of Kentucky, and has received tens of thousands of dollars from the company over the years, called the CMS actions a "gag order"--a characterization that has been echoed by House Minority Leader John Boehner and Rep. Dave Camp (R-MI)--ranking member on the House Ways and Means Committee--who fired off an angry letter to CMS acting administrator Charlene Frizzera. Read more at TPMMuckraker
U.S. health insurers whine about being "gagged" after being told not to violate marketing rules or improperly use protected Medicare mailing lists.
The Centers for Medicare & Medicaid Services (CMS), which oversees the Medicare program for the elderly and disabled as well as privately run Medicare alternatives, said on Monday it was investigating a letter Humana Inc (HUM.N) sent enrollees about efforts to overhaul the nation's healthcare system.
Humana's letter, sent in an envelope citing important plan information, told customers the Democrats' bills could hurt "millions of seniors and disabled individuals who could lose many of the important benefits and services that make Medicare Advantage health plans so valuable," according to CMS.
The agency also warned other insurers against sending potentially misleading health reform mailings to customers. REad it all at Reuters
by Lee Fang
Earlier this week, the Wall Street Journal reported that AHIP — the multimillion dollar lobbying juggernaut for the health insurance industry — has mobilized 50,000 employees to lobby Congress to defeat the public option. ThinkProgress has learned that AHIP’s grassroots lobbying is being managed by the corporate consulting firm Democracy Data & Communications. DDC has made a name for itself as one of the most effective stealth lobbying firms. Earlier this summer, DDC was caught by reporters using a front group called “Citizens for a Safe Alexandria” to attack the Obama administration for seeking to prosecute Guantanamo Bay prisoners in Alexandria, VA. According to the server-information hub Domaintools.com, the AHIP grassroots outreach website AHIPAdvocacy.org is hosted on a server owned by DDC. Though DDC conceals the hosting of its other websites using a service called DomainsByProxy, ThinkProgress has obtained a list of the domains hosted on DDC servers. A review of this data shows that DDC maintains the grassroots outreach websites for large health insurance companies, but also for big tobacco and Koch Industries: – phillipmorrisusaactioncenter.org (Altria)
– tobaccoissues.com (Altria)
– kochpac.com (Koch Industries)
– aetnavotes.com (Aetna)
– healthactionnetwork.org (WellPoint)
– humanapartners.com (Humana)
– ahipadvocacy.org (AHIP)
DDC is a firm that promises “high impact” outreach programs to not only influence the grassroots, but “change attitudes for the long term.” As the Washington Post explains, DDC pays over 500 contract workers to “spend much of their day telephoning people around the country and asking them to sign letters to Congress that press for legislation.” The firm helped orchestrate “grassroots” support for President Bush’s push to privatize Social Security, and helped manage online efforts for the right-wing attack group Freedom’s Watch. DDC is headed by B.R. McConnon, a former associate of Jack Abramoff’s lobbying partners, and a former employee of the Koch-funded astroturf organization known as Citizens for a Sound Economy. Citizens for a Sound Economy — which has also received funds from private health insurers in the past and played a critical astroturf role in killing reform under Clinton — eventually split, with one wing forming Americans for Prosperity in 2003, and another forming FreedomWorks in 2004. Both organizations, which are still funded by the Koch Industries empire, were instrumental in organizing the anti-Obama tea party protests, and have been spreading misinformation and anger at the current health reform effort. Americans for Prosperity’s anti-health reform front group, Patients United, has hosted speakers comparing the House health reform bill to the Holocaust. Curiously, DDC servers also host anti-health reform letters from the Chamber of Commerce and Rep. Charles Boustany (R-LA), as well as continual news updates about the reform debate. All three documents are under a subsection titled WellPoint. Given the stealthy nature of astroturf lobbying firms, it is difficult to discern the extent to which DDC is managing AHIP’s efforts. UnitedHealth, another large insurer, was caught recently using a call center to direct people to a radical tea party anti-health reform protest outside of the offices of Rep. Zach Space (D-OH). Already, the health insurance industry has flexed its muscle to water down reform. After spending millions on lobbying, advertising, and direct contributions to lawmakers, the Senate Finance Committee made a major concession allowing insurers to reimburse only 65% of medical bills (down from the 76% proposed requirement). And indeed, although AHIP has made grandiose promises of self regulation, many insurers have recently broke promises made by AHIP President Karen Ignagni. On June 16, despite Ignagni’s pledges of commitment, insurance executives from UnitedHealth Group, Assurant, and WellPoint specifically refused to “commit” to ending the controversial practice of rescinding coverage after an applicant files a medical claim. With DDC’s stealth lobbying assistance, AHIP may well kill the public option too.
Source: AlterNet
The insurance industry is facing new heat from House Democrats as Rep. Dennis Kucinich (D-Ohio), chairman of the Oversight and Government Reform subcommittee on Domestic Policy, on Wednesday requested that six top insurance company executives appear before his panel to explain how they do business.
Kucinich in his letter said the Sept. 17 hearing will examine “the nature, cost/benefit, and impact of administrative measures and protocols used by the health insurance industry to determine coverage for doctor-prescribed health care treatments, as well as costs of administrative measures undertaken by doctors to interface with insurance companies.”
The missive went to CEOs of Aetna, WellPoint, Cigna, Humana, Hemingway Health Care and UnitedHealth. It follows a request earlier this month that Energy and Commerce Chairman Henry Waxman (D-Calif.) and Rep. Bart Stupak (D-Mich.), chairman of that panel’s Subcommittee on Oversight and Investigations, sent to 52 insurance companies requesting reams of potentially embarrassing financial information. Waxman and Stupak are seeking details of executive compensation packages, conferences and retreats they sponsored, and the profitability of their products. Read it all at Roll Call
A doctor writes . . . : Recently, however, Mr. Alipate had received in the mail a glossy booklet explaining that he now had 'more choices' for his health care coverage. He reviewed the booklet with the assistance of his American-born nephew but, confused by the options, called the 'help' number for assistance. He only had one fundamental question of the choices: Could he continue to see his personal physician and the specialists I recommended? Reassured by the agent at the other end of the line he elected an HMO Medicare Advantage Plan offered by Humana.
The problem is, the agent was wrong, or misleading. I am not in their network. Indeed, in our heavily populated suburban community there are only two physician practices within a five mile radius of my office which are contracted to see Humana Medicare Advantage patients.
Medicare advantage plans, a privately administered version of Medicare, were created by offering private companies an average 12% premium over the average costs of treating Medicare patients. They in turn use a portion of this premium payment to "enhance" the traditional Medicare benefit package to lure patients into their programs.
The problems with this arrangement, however, are manifold: Although this has resulted in enhanced benefit packages, the marketing of these enhanced benefits has been focused upon the healthiest of Medicare recipients, thus "creaming" the Medicare program and contributing to its financial difficulties. Those enhancements which are offered do not in total equal in value the increased cost to Medicare; a substantial portion of the 12% premium payment is retained for corporate profits and bureaucratic infrastructure. The basic structure is unfair: If there is to be an enhancement to Medicare, why should it accrue only to those who manage to sign up with a Medicare advantage plan? Finally, the "enhancements" may be misleading: As in Mr. Alipate's case..... there is always a dramatic reduction in choice of physicians when one signs on to a Medicare Advantage plan. It is easy to see that even a prominent spokesman for Obamaesque health care reform really knows that only single payer reform can solve our nations health care crisis, he just finds it politically unfeasible.
Political infeasibility is no excuse for failing to advocate for the best solution to our problems. I am struck in my daily practice of medicine by how the overwhelming majority of my diverse patient population supports the kind of change I and untold others are advocating.
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