Politics and Healthcare – Nothing Is Easy

Pink cherry blossom and magnolia trees blooming at the White House in Washington, DC during the springtime

I had the pleasure of spending the day on Tuesday in Washington to discuss my favorite legislative topic – healthcare. First stop, the White House, where I met with the Special Assistant to the President for Health Policy. This was a lively discussion which covered rising drug prices, the opioid crisis, mental health parity and… [Read More]

What We Can Expect From Trump on Healthcare

Reshaping Healthcare in the United States

Maybe this won’t be so bad. I think I have him figured out. Donald Trump seems to operate like the mob. On every issue he comes out of the gate with guns (and Twitter) blazing. This evokes fear and intimidation of foes and even allies – and sets the stage for a more moderate compromise…. [Read More]

Healthcare Costs Rise Above Projections

Healthcare Costs Rise Above Projections

I received an interesting email earlier this week from CareConnect, the new health insurer owned by the North Shore Hospital System. Apparently, New York State required rates 5% higher than CareConnect had requested. For the past two years, the New York regulators slashed requested rate increases, and then they were hit with a black eye… [Read More]

Rubber Hits the Road


After over six years of waiting, employers are finally getting their first documented taste of the employer mandate and its implications. At the end of June, HHS began sending letters to employers informing them of the names of employees who enrolled in exchange coverage and received subsidies. There are several reasons an employee can gain… [Read More]

More Bad News for the Individual Exchanges

healthcare exchange

In what came as no surprise to the insurance world, Aetna announced it is losing money in its individual exchange business. This comes on the heels of both UnitedHealthcare and Anthem Blue Cross announcing they had lost money in this segment. As we have chronicled in the past, the exchanges are enrolling fewer people than… [Read More]

The Government Wants to Tell Us How Much to Pay Our Doctors


You should take note of an article appearing in Capital New York. In March 2015, they discuss how Albany politicians want to take control of changing healthcare delivery by using their authority to set health insurance premiums. Did you read that right? Yes…you did! A similar “value-based payment” proposal has been espoused by the Department of… [Read More]

Guaranteed Issue: A Brave New World for Individuals and Small Groups


In insurance parlance, “guaranteed issue” is one of the most venerated terms. Its simple meaning is that an insurance company will guarantee it will offer coverage without any concern for the underlying health risk or other underwriting considerations. Guaranteed issue is the holy grail of insurance provisions, as it eliminates coverage seekers’ fear that they… [Read More]

For ACA-Stressed HR Staff: Now There’s DOMA Repeal


This is getting ridiculous.  No doubt the arguments for the repeal of DOMA are strong, as states throughout the US align in support of same-sex unions. But give the overburdened HR professional a break! Last Wednesday, the Supreme Court overturned the Defense of Marriage Act. Signed into law by President Clinton in 1996, DOMA defined marriage as… [Read More]

This Skeptic Is Still Hopeful about Healthcare Reform


As I write these blog entries, I often ask myself, “Am I one of those negative people? Do I always see the downside?”  For more than a year I have been writing with a cautionary, skeptical tone about whether the Obama Administration has bit off more than it can chew with federal healthcare reform. I really… [Read More]

The Insurance Exchange: If You Build It, Will They Come?

Recently the President and his head of HHS met with insurance industry executives to reaffirm the commitment to the insurance exchanges. The exchanges, a significant part of the ACA legislation, are intended to help individuals and small businesses more easily procure less-costly healthcare. Like many pieces of the ACA, exchanges are off to a rocky start. Many states have opted not to establish a… [Read More]