Tag Archive | "Health Reform"

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Court Grants Reprieve to Doctors

HARTFORD — Thousands of doctors working with UnitedHealthcare received a reprieve from losing their jobs after a federal judge late Thursday issued an injunction.

Federal Court Judge Stefan Underhill issued a decision granting the members of the Fairfield County Medical Association and Hartford County Medical Association a preliminary injunction preventing UnitedHealthcare from unilaterally cutting their jobs.

But the fight is not over to save more than 2,250 physicians who were informed in November that United Healthcare would cut them from the insurer’s Medicare Advantage Network.

The two medical associations filed the legal challenge in early November seeking to block UnitedHealthcare from terminating as many as 2,250 physicians, or approximately 20 percent of its entire doctor network in Connecticut.

According to the Associations, about 20,000 to 30,000 Medicare patients could be impacted by UnitedHealthcare’s decision to axe that many physicians in Connecticut.

In a statement to the press, President of the Fairfield County Medical Association Dr. Robin Oshman responded to the judge’s decision:

“Both the Fairfield and Hartford County Medical Associations took this bold step for our patients and for our member physicians,” Oshman said. We won’t let UnitedHeathcare get away with interfering with the doctor-patient relationship. While this is one huge step in the right direction, the journey is far from over.”

The preliminary injunction order prohibits UnitedHealthcare from terminating any of the Associations’ members from the Medicare Advantage Network, notifying their Medicare Advantage customers/insured that certain providers will be terminated from Medicare Advantage Network as of Feb. 1, 2014; and removing or failing to advertise/market the Association’s affected physicians in UnitedHealthcare’s 2014 directories for the Medicare Advantage Network.

“This major ruling by Judge Stefan Underhill is proof that the voices of our patients and the 1800 member physicians were heard loud and clear!  As physicians we are first and foremost advocates for our patients and for their access to the medical care they deserve.  That will continue to be our focus moving forward,” said Dr. Bollepalli Subbarao, President of the Hartford County Medical Association.

Attorney Roy W. Breitenbach of Garfunkel Wild, PC, served as the attorney for the Fairfield and Hartford County Medical Associations. Breitenbach said the preliminary injunction protects the state’s most vulnerable patients, mainly the elderly, disabled and some of whom have terminal illnesses.

“This is a victory for not only the 3,300 plus member physicians of Fairfield and Hartford County Medical Associations,” he said. “it also speaks clearly to the importance of not allowing health insurance companies to place profits ahead of patient care.”

UnitedHealth Care did not respond to request for comments.

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Connecticut and Other States Seek “Best Practices” to Implement Health Care Reform


As the deadline to fully implement the Affordable Care Act nears, health care professionals gathered in Hartford on Monday to unpack mountains of data wrapped in regulations attached to the first major overhaul of the U.S. healthcare system since 1965.

This Act, also known as “Obamacare,” became a reality when President Barack Obama signed it into law on March 23, 2010. If implemented thoroughly, the Act would expand healthcare access and increase health coverage, key components to mitigate health disparities, experts say.

Enrollment for the program is set to begin Oct. 1, 2013. Medical coverage is to begin Jan. 1, 2014.

Some contend this Act could significantly address health disparities.

healthbeatlogo“I think it could have a major impact of health disparities because proportionally to the population, individuals who are more likely to be affected by the Affordable Care Act are people of color,” said Dennis P. Andrulis, a senior research scientist at the Texas Health Institute. Andrulis was one of about 200 public health researchers, policy makers, practitioners and other stakeholders who attended the Institute of Medicine’s daylong conference entitled, Achieving Health Equity via the Affordable Care Act: Promises, Provisions, and Making Reform a Reality for Diverse Patients, at the Mark Twain House on April 22.

Of the 6.8 million newly eligible Medicaid recipients, about 45 percent would be people of color, a figure that mirrors the demographics in the country. Consequently, more than 60 provisions in the ACA are related to race, ethnicity, language and cultural competency to reduce disparities in urban and rural America, Andrulis said.

The work to see this ACT implemented, which will cost $5.1 billion, includes community outreach. It also includes materials to be developed for people with limited English proficiencies, low medical literacy and low reading skills. And already resistance, manifested at various levels, has begun.

In Texas, Andrulis said, discussions are centered on how to navigate the penalties for opting out.  Already, 14 states have opted out. And 12 states are undecided. Since it was signed into law, the U.S. House Republicans voted 39 times to repeal Obamacare. In the coming months, health advocates expect there will be persistent attempts by conservatives to dilute the potential of the law. Of course, Andrulis said, it’s in the Obama administration’s best interest to ensure effective implementation of this act.

To implement this sweeping act, it will be necessary to engage communities at the grassroots level, said U.S. Rep. John Larson (D-1st), who with Gov. Dannel Malloy and Lt. Nancy Wyman gave opening remarks at the daylong conference.

Connecticut is one of several states that have already opted in and have begun to expand Medicaid. Malloy said that the legislature has just started deliberating over this “monumental task” of expanding access by setting up health care marketplace to sell insurance to about 242,000 uninsured people in Connecticut.

Part of delivering services to traditionally underserved population also includes diversify the workforce that serves them. Groups such as Access Health CT have also begun that process, according to Access CEO Kevin J. Counihan.

It’s uncertain, however, how much progress has been made toward implementing networks to engage health consumers in Connecticut. But officials said they are working to ensure health equity, a term bandied about by stakeholders.

And what exactly is health equity?

According to Medical Director of Community Benefit at Kaiser Permanente Winston F. Wong, health equity is the proposition that people in the United States should achieve optimum health without barriers related to their social status, such as income, race, ethnicity, immigration, sexual orientation and other social factors.

Such has been the case for decades, said Wong.

“If you look at the mortality among African American men, their risk ratio is 1.8 times that of their white male counterpart,” he said. “And that pattern has been there for more than 50 years. So we haven’t actually made much progress, particularly around African American males.”

Wong added that with the growing Asian and Latino populations, there is also a reflection of continued disparities, such as diabetes among Hispanics. According to a recent report, up to 50 percent of Hispanics will develop diabetes in the next generation.

So between now and October, there is an emphasis on reaching these population with new information that would help mitigate acute health disparities.

Ignatius Bau, a health researcher, and other health advocates said officials at the top must have meaningful engagement with communities of color, to not just tack their logos on websites as “nice partners” but to also provide significant financial support to have impact. Additionally, there needs to be robust efforts to inform these communities in a timely manner, not close to major deadlines.

Bau also suggested that to truly address the existing health disparities among patient centered health homes and clinics, state officials and other high-level stakeholders should consider the following recommendations:

  • Educate and engage diverse and vulnerable patients, families, caregivers about medical homes
  • —Sponsors/payers for medical home initiatives can highlight opportunities for disparities reduction/health equity, including additional requirements and payments
  • —Monitor standards specific to health equity for compliance and improvement
  • Develop and disseminate technical assistance to medical home practices  on achieving health equity

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Obama Has Mojo–Health Reform’s Lessons for Immigration Reform

New America Media, Interview with Frank Sharry, Sandip Roy, Posted: Mar 28, 2010

Editor’s Note: An estimated 200,000 people showed up at the National Mall last weekend calling for immigration reform. But the march was overshadowed by the dramatic passage of health care reform. What are the lessons from health care reform for those pushing for a reform of the country’s immigration laws? New America Media Editor Sandip Roy spoke with Frank Sharry, executive director of the Washington, D.C.-based immigration advocacy group America’s Voice.


What lessons are you drawing from how health care reform eventually came to pass?

One, the president has mojo after all. He had to contend with scared Democrats, obstinate Republicans and fractious constituency groups. And he persevered, and as a result they made history. That’s pretty much the same formula we need on immigration reform. Obviously the delay in health care reform compresses the calendar for us to get it done and this is an election year, but we think the window of opportunity is open for a few months.

Lindsey Graham, R-S.C., the co-sponsor of the Schumer-Graham immigration bill, said before the bill was signed, ‘The first casualty of the Democratic health care bill will be immigration reform. If the health care bill goes through this weekend, that will, in my view, pretty much kill any chance of immigration reform passing the Senate this year.’ What is your reaction?

I think what he is saying is that the toxic atmosphere of partisanship on Capitol Hill will make it difficult to move on legislation like immigration reform that needs bipartisanship. But I doubt if a spat over a procedural matter will end all chances of immigration reform. But if Republicans do stand in the way, they will once again be blamed for blocking immigration reform and putting themselves behind the eight ball politically with the fastest growing group of new voters in the country. I think it’s more bluster and bluff. And I think we have a good chance of seeing a bipartisan bill being introduced in April.

Do you really think the Democrats have the stomach for another protracted fight?

I think many Democrats have realized after health care reform that they were elected to take on the tough issues and they are going to be judged, come November, on their record of accomplishment, not on how many post offices they named. Look, the Democrats and Obama inherited a huge mess. The country wants change. They voted for change. And if they don’t get change, they will keep voting for change.

Our advice to Democrats – lean into these issues, take them on, fight hard for them and let the politics take care of itself. The politics of immigration are so misunderstood inside the Beltway. The pundits say it’s too hard, maybe it mobilizes Latinos, but it hurts you with swing voters and arouses the right in a way that will make health care look like a garden party. The fact is, I think the immigration debate will look a lot more like the Judge Sonia Sotomayor’s confirmation fight, where nine Republicans voted for her confirmation. I think we will see Tea Partiers on the outside but we may see more of a Sotomayor-like tone on the inside.

Is that why you released an internal poll of Latinos and the 2010 elections? Did you make it public to put pressure on the parties?

Exactly. We have been saying immigration reform is a threshold issue for Latino voters, with tremendous intensity among Latino immigrant voters. Many in the political class say, ‘No, they don’t really care that much.’ But what I think you saw a demonstration of on Sunday, March 21 is 200,000 people saying this issue is what defines whether the political class is respecting us or not. This is what Katrina was for many African-American voters. If [Democrats] do lean into this issue, Republicans will have to deal with something that divides them. So Democrats would be wise to do that, rather than hide behind their desks until November.

Since no Republicans voted for health care, would they be on the defensive when it comes to immigration reform? As in, they would look even more like the party of ‘no’ if they also oppose immigration?

It looked like a good strategy when health care reform was on the ropes. It does not look like such a good strategy now when what they have done is said no to covering 32 million people. Many people are divided about whether the reform package is good or not, but polling shows people are quite pleased Congress is actually doing something. I think Republicans are going to have to stand up to the far right and say, ‘This is an issue we have to get off the table and that we should share credit with. If we wait too long, it will be too late for us.’

In 2006, 23 Republican senators voted for a version of comprehensive immigration reform. Despite a more right-leaning bill in 2007, that was essentially written with the help of the Bush White House, only 12 Republican senators voted for it. Take a look at it now. What’s our universe of possible gettable Republican senators – probably in the neighborhood of 10. I think the Republican Party has made a historic mistake in losing the advantages that were built up with George W. Bush reaching out to this community. Now they are on the verge of looking like the party of ‘no,’ not just on all manner of issues, but to Latino voters.

Health care as it finally passed was very different from health care reform as was proposed. While you don’t want the perfect to be the enemy of the good, are you satisfied with the Schumer-Graham proposal as the starting point here? Is there enough room for compromise as there definitely will have to be?

They have issued a blue print. It’s not highly detailed yet. It has the right elements. Sure, they couch it in very conservative terms, law and order terms. The solution to the problem of unauthorized immigration is you combine some smart targeted enforcement, in particular going after employers who are unscrupulous, with a way people here illegally can get on the path to citizenship, get to the back of the line, etc.

But grassroots groups are saying the Schumer-Graham bill is much more onerous on people trying to legalize themselves, that it could mean waiting 20 years outside the United States.

None of those details are known yet. What has been represented to us is the legalization program will have low fees, a six or seven year period of conditional status. What’s onerous is the current situation in which every day people are being picked up, detained and deported. The Obama administration is on track to surpass the Bush administration’s record of deporting some 400,000 people a year. This is a human rights crisis in immigrant communities.

Insurance companies and chambers of commerce spent millions trying to defeat health care reform. Is the hope for immigration reform that a lot of business is in support of it?

The best part is we won’t have zillions of dollars being spent against it, as they did in health care reform, by the business community. Businesses generally are in favor or not opposed. The opposition comes from a virulent and visible anti-immigrant movement that is very effective at mobilizing people who want to deport 11 million people and keep the people who look different out of the country. I don’t think we will be facing zillions of dollars in ads but we will be facing millions of faxes from angry people

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