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Positions and Views on Other Issues where Information is Available: |
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| Medical Insurance |
Positions and Views |
| Health Insurance, a General Statement |
Biden: Most Americans, 60 percent, receive health insurance through their employers. But employers are scaling back benefits as the cost of health insurance and health care rises. Millions of workers no longer receive insurance from employers – 70 percent of the uninsured are employed. Around 5 percent of people with the greatest health care costs account for half of health care spending in this country. Just one employee with high medical expenses can push premiums up for all and make insurance unaffordable. The top 1 percent of spenders – those with expenses above $50,000 a year -- account for 22 percent of health care spending. In contrast, the 50 percent of the population with the lowest expenses accounted for only 3 percent of overall U.S. health care spending with annual expenses of $664 per person. Those in the top 5 percent of costs spend on average 17 times as much as the bottom 50 percent of spenders. In addition, 57 percent of the top 5 spenders are under the age of 65: 18 percent between the ages of 55-64, 15 percent between 45-54, 10 percent between 35-44, 9 percent between 19-34 and 5 percent 18 and younger.
Sen. Biden believes that families and their doctors should make medical decisions, not insurance companies. That is why he has taken on HMOs to prevent them from limiting needed treatment options or prescriptions. He has also supported stopping hospitals and banks from profiting on personal information. Medical records should be kept private between doctors and patients, not sold to salesman and marketers.
Source: www.joebiden.com Date: 11/30/2007 |
| Universal Medical Care / Insurance |
Biden: Joe Biden’s highest priorities – along with ending the war in Iraq – are universal health care and education. He will convene a national gathering of key health care stakeholders from labor, business, health care and government within the first 90 days of his administration to seize the historic opportunity created by the recognition from organizations ranging from Fortune 500 companies, the Business Roundtable and the AMA to the labor movement that the time has come for universal, affordable health care.
Too often the debate over health care centers around whether we’re spending enough on health care in this country – when the reality is that the US spends more on medical services than any other developed nation, including those countries that provide health insurance for all. We can afford to provide universal health care in this country – and we can help pay for it with a national agenda of sensible steps to get skyrocketing health care costs under control.
Source: www.joebiden.com Date: 11/30/2007 |
| Medically Uninsured or Underinsured |
Biden: While insuring all children must be our top priority, it is also important to offer uninsured adults access to health care. Only 59.3 percent of uninsured near-elderly manage to be able to see a doctor, compared to 87.7 percent and 84.2 percent of privately and publicly insured near-elderly respectively. Giving the uninsured near-elderly the opportunity to enroll in Medicare at an earlier age can improve the number of people able to see a doctor and treat any medical conditions they have that would be more expensive to treat if they had to wait until they were 65 to enroll.
Source: www.joebiden.com;biden.senate.gov/issue Date: 04/22/2008 |
| Employers' Medical Insurance |
Biden: No Response |
| Employers vs Employees As Chief Health Care Buyer |
Biden: No Response |
| Coverage of Children |
Biden: No Response |
| State Children's Health Insurance Program (SCHIP) |
Biden: Expand the State Children’s Health Insurance Program to at least 300 percent of the federal poverty level ($61,950 for a family of four). More than 80 percent of uninsured children are in families below 300 percent of the poverty level:
Under 100 Percent of FPL ($20,000) – 2.9 million or 31.8 percent
Between 100 and 199 percent of FPL ($40,000) – 2.9 million or 32.1 percent
Between 200 and 299 percent of FPL ($60,000) – 1.7 million or 18.4 percent
Over 300 percent of FPL ($60,000+) – 1.6 million or 17.6 percent
Allow all families to buy into SCHIP with sliding scale premiums and co-payments based on family income.
Extending coverage to at least age 21 (as states can choose to do in Medicaid)
Automatically enroll eligible uninsured children at birth, school registration or through other income-tested programs like WIC
Source: www.joebiden.com Date: 11/28/2007 |
| Free Market Health Care |
Biden: No Response |
| Health Insurance Purchase Choices |
Biden: No Response |
| Portable Medical Insurance |
Biden: No Response |
| State Plans |
Biden: No Response |
| Health Savings Accounts (HSAs) |
Biden: No Response |
| Market-Based Medical Insurance |
Biden: No Response |
| Medical Insurance Block Grants |
Biden: No Response |
| Medicare |
Biden: Politicians need to understand what it’s like for people on Medicare, who are lying in bed staring at a ceiling wondering if they are going to be able to pay the bills. We need to understand their concerns and aspirations if we are going to reshape Medicare in the 21st Century.
Joe Biden will allow people between 55 and 64 to buy in to the Medicare program. Like the FEHBP buy-in proposal, the federal government will provide a subsidy for low-income individuals in this age group to afford to purchase early coverage in the Medicare program.
While the federal government would invest money now to allow uninsured individuals between 55 and 64 to buy into Medicare, this proposal could save money for the Medicare program in the long run. By the time people become eligible for Medicare at age 65, many are already dealing with numerous chronic health conditions. Only 59.3 percent of uninsured near-elderly manage to be able to see a doctor, compared to 87.7 percent and 84.2 percent of privately and publicly insured near-elderly respectively. Giving the uninsured near-elderly the opportunity to enroll in Medicare at an earlier age can improve the number of people able to see a doctor and treat any medical conditions they have that would be more expensive to treat if they had to wait until they were 65 to enroll.
Senator Biden wants to stabilize the way Medicare determines reimbursement rates for physicians and other providers. As such, the Senator wants the Medicare Payment Advisory Commission to study and report to Congress on replacing the use of the sustainable growth rate as a factor in determining the update for such payments with a factor that more fully accounts for changes in the unit costs of providing physicians' services.
When the future of Medicare came under attack and was threatened with its gradual demise, Senator Biden stood steadfast in defense of Medicare.
Source: www.joebiden.com Date: 12/01/2007 |
| Medicaid |
Biden: Joe Biden knows from caring for his own parents how important home care workforces can be in providing stable, experienced care to the growing number of senior citizens who wish to stay in their homes. Joe Biden supports expanding access to home healthcare and hospice services and co-sponsored the Community Choices Act, which would help disabled Americans get Medicaid coverage for at-home care.
Senator Biden has worked to:
Allow disabled patients in Medicaid to receive care in the least restrictive setting possible and to direct their own treatment plan.
Support increased federal Medicaid funding when states are faced with a fiscal crisis.
He also fought to allow low-income families with disabled children to buy in to the Medicaid program.
Source: www.joebiden.com;biden.senate.gov/issue Date: 04/22/2008 |
| TRICARE Health Insurance |
Biden: Joe Biden has supported numerous measures to allow federal civilian and military retirees to pay TRICARE health insurance on a pre-tax basis; and has supported extending TRICARE coverage to Reservists who have no other source of health insurance.
Source: www.joebiden.com Date: 12/01/2007 |
| Medical Insurance Discrimination |
Biden: Insurance companies often discriminate against people who need insurance the most –those with pre-existing conditions and those with high-risk factors for certain diseases. For individuals who do not have access to employer-sponsored insurance, the high cost of individual insurance policies simply forces them to go without health insurance.
Joe Biden would allow insurers that offer individual policies to access the reinsurance pool if they agree not to turn people away because of pre-existing conditions or risk of them. And to protect against genetic discrimination by prohibiting employers and insurance companies from collecting or using genetic information when making decisions about hiring, providing health coverage, or discriminating in the pricing of an insurance policy.
Source: www.joebiden.com Date: 11/30/2007 |
| Misuse of Health Records |
Biden: Senator Biden knows how important it is to patients that their personal medical information be kept private. He supports:
Making sure individuals’ medical information is not used against them or unknowingly sold for commercial profit.
Ensuring that as we move toward more efficient, cost-saving electronic medical records, privacy interests remain a priority.
Preventing the use of predictive genetic information, such as whether someone carries the gene for breast cancer, from being used to discriminate against persons in decision-making related to employment or health insurance.
Source: biden.senate.gov/issues Date: 04/22/2008 |
| Medicare Reimbursement Formulas |
Biden: Senator Biden has consistently fought to ensure an adequate supply of physicians and other Medicare providers for our nation’s seniors by opposing arbitrary caps on reimbursement and working to reform the provider payment system. He also has worked to preserve Medicare indirect medical education payments to teaching hospitals, as many of these facilities provide crucial care to Medicare beneficiaries.
Joe Biden wants to stabilize the way Medicare determines reimbursement rates for physicians and other providers. As such, he wants the Medicare Payment Advisory Commission to study and report to Congress on replacing the use of the sustainable growth rate as a factor in determining the update for such payments with a factor that more fully accounts for changes in the unit costs of providing physicians' services.
To ensure Medicare beneficiaries received proper treatment, Senator Biden fought to prevent arbitrary monetary limits on Medicare coverage of physical, occupational, and speech therapy services.
Joe Biden supports treating mental health services the same as other health services and increasing the amount the government pays from 50 percent to 80 for outpatient psychiatric services under the Medicare program.
Source: biden.senate.gov/issues/;www.joebiden.com Date: 04/22/2008 |
| Uniform Billing and Claims |
Biden: Administrative costs account for roughly 30 percent of all health care expenditures in the United States. One of the reasons for high administration costs are the numerous insurance claims forms that providers must fill out to get paid for their services. The State of Utah recently tackled this problem by getting all insurers and providers to use a standardized, electronic claim form designed to eliminate claim disputes and loads of paperwork. Every procedure on the form is listed the same way and patients no longer receive notices titled "This is Not a Bill."
When the Utah Health Information Network (UHIN) was created in 1994, health officials there estimated the state could save $100 million to $200 million per year by switching to a common system for medical billing. UHIN created a computer system that allows the many different billing systems used by doctors, insurers and hospitals to communicate with one another. But the network also required substantial cooperation from Utah's competing insurers. They agreed, for example, to cut a list of 900 codes for accepting or denying medical claims down to 90 and also agreed on common definitions.
The cost of health insurance has remained flat in Utah while it has increased an average of 13 percent per year in the rest of the United States. Several states are already studying what Utah was able to accomplish. Like federal investment in health information technology, the federal government should help states in their efforts to reduce administrative costs in medical billing.
To support the movement to a uniform billing system, Joe Biden will:
Provide federal funding to support state initiatives to adopt Utah-like insurer agreements to create one claim form used by all insurers with a goal of moving to a uniform system on a national level.
Require insurers participating in federal programs to shift to “paperless” uniform billing and claims forms.
Source: www.joebiden.com Date: 11/30/2007 |
| Paperless Claims |
Biden: No Response |
| Federal Employee Health Benefit Plan (FEHBP) Buy-In |
Biden: Senator Biden would allow uninsured Americans to buy into an insurance program that mirrors the Federal Employee Health Benefit Plan (FEHBP) – the program that provides health insurance to members of Congress, their staff, and federal employees.
While the program will contain the same carriers and the same plan offerings, the new program will have its own insurance pool. Carriers in the FEHBP program would have to offer plans in the universal buy-in plan, but would have access to reinsurance to help with catastrophic costs for enrollees with greater than usual health costs. The buy-in program could also have an age-adjusted “payment” or “bonus” for plans that enroll older and less healthy people to help carriers avoid the effects of adverse selection.
People would be permitted to buy-in on a sliding scale based on income.
Small businesses would be allowed to participate in the program to help provide insurance for their employees. For companies that buy into the plan, employers, employees and the government would share the cost of the premium. Firms with a high proportion of low-wage workers would get a larger subsidy from the federal government than would firms with higher-wage workers.
Source: www.joebiden.com Date: 11/30/2007 |
| Federal Reinsurance Medical Pool |
Biden: Joe Biden would establish a federal reinsurance pool to reimburse employers, insurers or associations (including voluntary employee benefit associations) for 75 percent of catastrophic health costs (those exceeding $50,000 per individual) for active and retired employees and their families.
To participate in the rebate program, employers would have to cover all employees and apply best practices to chronic disease management.
Private insurers in the individual market would have to demonstrate that they operate an effective high cost case management system.
Source: www.joebiden.com Date: 11/30/2007 |
| Chronic & Catastrophic Illnesses |
Biden: By creating a federal reinsurance system for catastrophic costs, the risk and burden of covering all patients are spread among the general population, instead of smaller subgroups of employees.
In addition to helping families and business avoid financial disasters, a catastrophic coverage plan (often times called a stop-loss plan) can help lower administrative costs and reduce the variation in health care costs. Ken Thorpe, a professor at Emory University, has estimated that a stop-loss plan that pays 75 percent of claims above a catastrophic threshold would, on average, reduce the variance in claims costs by more than 50 percent. Reducing the risk factor for health plans would translate into lower health insurance premiums.
Providing this type of coverage is not a new role for the federal government in the private insurance market. Indeed, the federal government currently assumes the risk for high-cost cases in several other private markets. For instance, the Federal Emergency Management Agency (FEMA) plays a key role in providing financial assistance for the private sector (households and businesses) facing catastrophic losses.
Source: www.joebiden.com Date: 11/30/2007 |
| Health Maintenance Organizations (HMOs) |
Biden: Emphasizing wellness and prevention by eliminating co-payments for physicals, vaccinations, vision and hearing screenings and preventive dental check-ups for children of any income level.
Source: www.joebiden.com Date: 11/28/2007 |
| Medical Malpractice Reform |
Biden: No Response |
| Medical Malpractice Lawsuit Limitations |
Biden: No Response |
| Business Tax Credits for Employee Health Coverage |
Biden: No Response |
| Tax Credit / Deductible for Medical Insurance |
Biden: No Response |