Health, Medicine & Nutrition
Iowa's health care waiver approved PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Grassley Press   
Tuesday, 26 July 2011 13:17

Friday, July 22, 2011

For your information, a copy of the letter sent today from the U.S. Center for Medicare and Medicaid Services to the Iowa Insurance Commissioner is attached.

As described in the letter, the federal government has approved Iowa’s request for a waiver from the medical loss ratio requirements of the Affordable Care Act of 2010.

The new health care law basically requires states to change the requirement of plans in their states to spend more money on care and less on administration and reserves.  As a practical matter, it could run small carriers out of the state.  The potential market disruption has led a number of states to seek waivers of the medical loss ratio requirement until 2014.  Maine and New Hampshire already have waivers.  Today North Dakota was turned down.  Kentucky was effectively turned down, as well.  Iowa was partially approved.

Here is a comment from Sen. Grassley:

“The purpose of this waiver is to allow Iowa to have different medical loss ratios for insurers than would have been required under the health care overhaul enacted last year.  Without this waiver, because of the mandates in the new law, insurers likely would have left the state, leaving Iowans with fewer health coverage options.  The need for this kind of waiver emphasizes that it should be up to states to regulate their insurance markets.  The 2010 health care needs to be repealed and replaced with policies that allow coverage that fits the needs of different marketplaces.”

Here is a fact sheet from the Centers for Medicare and Medicaid Services:

Medical Loss Ratio: Getting Your Money's Worth on Health Insurance

 Thanks to the Affordable Care Act, consumers will receive more value for their premium dollars because insurance companies are required to spend 80-to-85% of premium dollars on medical care and health care quality improvement, rather than on overhead costs. If they don’t, the insurance companies will be required to provide a rebate to their customers starting in 2012. This policy is known as the “medical loss ratio” (MLR) provision of the Affordable Care Act.

Medical loss ratios apply to all health insurance plans, including job-based coverage and coverage sold in the individual market. However, insurance plans in the individual market often spend a larger percent of premiums on administrative expenses and non-health related costs than job-based health plans do.

Recognizing the variation in local insurance markets, the Affordable Care Act allows States to request a temporary adjustment in the MLR ratio for up to three years, to avoid disruptions to coverage in the individual market. This flexibility allows consumers to maintain the choices currently available to them in their State while transitioning to a new marketplace where they will have more options for coverage and more affordable health insurance through State-based Health Insurance Exchanges. This is one of many ways the Affordable Care Act is building a bridge from today’s often disjointed and dysfunctional markets to a better health care system.

HHS has set up a transparent process for how States can apply for an MLR adjustment and what criteria will be used to determine whether to grant those requests. States must provide information to the Department of Health and Human Services (HHS) showing that requiring insurers in their individual market to spend at least 80 percent of their premiums on medical care and quality improvement may cause one or more insurers to leave the market, reducing access to coverage for consumers. States must also show the number of consumers likely to be affected if an adjustment is not granted and the potential impact on premiums charged, benefits provided, and enrollee cost-sharing. All State application materials are posted on the HHS website.

The Iowa MLR Adjustment

Iowa’s Department of Insurance requested an adjustment of the 80 percent MLR to a 60% MLR standard for 2011, 70% for 2012, and 75% for 2013. 

Three of Iowa’s dominant issuers, Wellmark, Time and American Family –with 88% of Iowa’s individual market share- are not expected to be impacted by the 80% MLR standard.  Wellmark and American Family both had a 2010 MLR of well above 80% and while Time had a 2010 MLR below 80%, it does not expect to owe rebates in 2011 or beyond.  Enrollees in these plans will not be affected by the new 80% MLR standard.

However, the remaining three smaller issuers that would owe rebates in 2011, Golden Rule, Coventry, and American Republic – comprising 5.4% of the market share - have MLRs of 48% to 68%.  These three smaller issuers also reported relatively high commissions, validating Iowa’s concern that they may have difficulty adjusting their business models to meet an 80% standard as a result of being locked into binding multi-year agent commission and provider contracts.  Some or all of these three issuers could be impacted by meeting an 80% standard and could withdraw from the market, potentially leaving roughly 15,000 enrollees without coverage.

At the same time, the information provided in Iowa’s application makes it clear that issuers can meet a higher MLR than it requested for 2011, 2012 and 2013.

Of the six issuers expected to owe rebates in 2011, five have MLRs above Iowa’s requested 2011 adjustment to 60%, and three of those 5 have MLRs above 67%.

Iowa has an additional 13 issuers that cover between 300 and 1,000 lives each, and thus are not expected to owe rebates in 2011, but may become subject to rebate provisions in 2013 even if they do not grow their business.[1]  However, nine have MLRs above 75%, which is well above Iowa’s requested 60% for 2011 and 70% for 2012.

For these reasons, Iowa is granted an alternative adjustment of 67% for 2011, 75% for 2012, and 80% thereafter.  This approach creates a glide path for compliance with the 80 percent standard and balances the interests of consumers, the State and the issuers in accordance with the principles underlying the MLR provision

In Iowa’s Interest: Marking the 21st Anniversary of the ADA PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Harkin Press Office   
Tuesday, 26 July 2011 13:14
By Senator Tom Harkin

July 26th, 2011 marks the 21stanniversary of the landmark legislation, the Americans with Disabilities Act (ADA), which helped change the lives of millions of people across the United States.  In its simplest description, the ADA improved accessibility and inclusion, and prohibited discrimination against people with disabilities. I consider passage of the ADA legislation the proudest moment of my career.

During hearings here in Washington D.C. 21 years ago, I remember listening to stories about people having to crawl up staircases on their hands and knees, being unable to go swimming or even buy a pair of shoes because of their disability. Smart, capable Americans were unable to achieve the American Dream. My late brother Frank, who lost his hearing at a very young age, was also prevented from enjoying the things in life most Americans take for granted. Today, with the help of ADA, those individuals have the necessary tools to live a full and prosperous life, unburdened by the architectural and attitudinal barriers of life before ADA.  Today with the ADA, all Americans, with or without disability, have the opportunity to fulfill their potential.

So much has changed over the last 21 years. It is hard to imagine a world without accessible entrances and restrooms, curb cuts, ramps, and a vast number of examples of universal design features that make the United States more accessible to all of its citizens. Before the passage of the ADA, people with disabilities routinely encountered physical barriers – such as stairs or not having enough room to park their specialized vehicles. Today, public buildings, sports stadiums, hotels, sidewalks, theaters, and transportation options are routinely accessible to individuals with disabilities, and auxiliary aids and services are available to provide equal access to every American.

We mark the 21stanniversary of the ADA, mindful of the significant progress that we have made to date.  The United States now has more accessible areas and activities for individuals with disabilities than anywhere else in the world. Not only has the physical world changed, but opportunity has increased dramatically and discrimination has decreased.  Americans are recognizing that every individual has the potential to make a difference and improve the nation in their own distinct way.  We continue to advance the four great goals of the ADA:  equal opportunity, full participation, independent living and economic self-sufficiency.

Tell me how the ADA has impacted your life by visiting my website at or my Facebook page at

A PDF version of the column is available by clicking here.

Governor Quinn Announces Appointments to State Health Improvement Plan Council PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Laurel White   
Friday, 22 July 2011 22:49

Group Will Develop Strategies to Improve the Health of Illinois Residents

CHICAGO – July 21, 2011. Governor Pat Quinn today announced 25 appointments to the State Health Improvement Plan (SHIP) Implementation Coordination Council. Today’s action is the latest in a series of appointments the Governor is making as he continues to fulfill his commitment to improving the health of all Illinois residents. The interdisciplinary council is tasked with developing implementation strategies for the state’s SHIP. The SHIP council will work collaboratively with the Governor’s Health Care Reform Implementation Council to promote statewide improvements in public health.

Effective immediately, Governor Quinn named Joseph Antolin, Patricia Canessa, Jenifer Cartland, Greg Chance, Edwin Chandrasekar, Margaret Gadon, Cathy Grossi, Martin Hatlie, Roger Holloway, Kevin Hutchinson, Ahlam Jbara, Robert Kieckhefer, Tammy Lemke, Janine Lewis, Hong Liu, David McCurdy, Maureen McHugh, James Nelson, Sharon Post, Jose Sanchez, Clarita Santos, Patricia Schou, Terry Solomon, Janna Stansell and Christina R. Welter to the SHIP Implementation Coordination Council.

“This council brings together a diverse group of health care professionals that are leaders in their respective fields,” said Governor Quinn. “We want a comprehensive approach to make sure the people of Illinois are healthy, and that means bringing everyone to the table. I look forward to the council’s work, and the results they will help us achieve in public health.”

The SHIP is a framework to address public health issues through an interdisciplinary approach that utilizes the strengths of the entire public health system. Under law, the state of Illinois must complete a SHIP every four years with the goal of creating a system that ensures optimal physical, mental and social well-being for all people in Illinois through a high-functioning public health system. The most recent SHIP was updated in August 2010 to reflect federal health care reform and other state health policies.

In July 2010, the Governor signed into law legislation creating a Governor-appointed council to implement the SHIP, which was one of the one of the recommendations of the SHIP planning team. The group will provide further definition of priorities and action steps, engage stakeholders to enact SHIP objectives, and promote the plan as a common agenda across the public health system.

The SHIP calls for the state to improve access to comprehensive health-related services, enhance data and information technology in the health care sectors, address the social factors affecting health and health disparities, manage and improve the public health system, and ensure sufficient workforce in the health care and public health fields. The SHIP is prevention-focused and centered on the following priority health concerns: alcohol/tobacco, use of illicit drugs/misuse of legal drugs, mental health, environment, obesity (including nutrition and physical activity), oral health, patient safety and quality, unintentional injury and violence.

In addition to the appointed council members, representatives of 12 state agencies and the chair of the State Board of Health, Dr. Javette Orgain, will participate in the SHIP Implementation Coordination Council.  These agencies all play a critical role in the implementation of the SHIP recommendations and will be working with the council to ensure that the goals of the SHIP are achieved. The council co-chairs will be appointed by the Governor.

Information regarding the new council members is attached.


Braley Statement on Institute of Medicine’s Report on Women’s Health PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Kira Ayish   
Tuesday, 19 July 2011 18:24

Washington, DC – Today, Congressman Bruce Braley (IA-01) released the following statement regarding the Institute of Medicine’s decision supporting women’s comprehensive health care:

“I commend the Institute of Medicine for their recent report supporting women’s access to comprehensive health care. I have long fought for women’s rights, and I believe this would be a groundbreaking step to ensure that women have full control over their reproductive lives. By requiring that health insurers provide birth control at no cost, this important action would remove major financial obstacles for women who are seeking contraceptives.”


Governor Quinn Signs Legislation to Protect Good Samaritans Performing CPR PDF Print E-mail
News Releases - Health, Medicine & Nutrition
Written by Laurel White   
Monday, 18 July 2011 22:37

New Law Updates Legal Protections for Citizens Helping in Emergencies

CHICAGO – July 18, 2011. Governor Pat Quinn today signed legislation to help protect good Samaritans who provide cardiopulmonary resuscitation (CPR) to a person having a heart attack or suffering cardiac arrest. Governor Quinn signed House Bill 1549, which amends the Good Samaritan Act in order to provide liability protection to individuals who are trained in CPR in accordance with either American Red Cross or American Heart Association standards.

More than 300,000 people suffer sudden cardiac arrest in the U.S. every year. According to the American Heart Association, less than 8 percent of people who suffer cardiac arrest outside the hospital survive. CPR provided immediately after sudden cardiac arrest by a trained bystander can double or triple a victim’s chance of survival.

“Citizens who have been trained in CPR should not be reluctant to use their training to help another person in an emergency,” said Governor Quinn. “CPR saves lives, and we want those who are able, to step up and help their fellow citizens in a crisis without fear of a lawsuit. This law protects good Samaritans and will protect lives.” 

Previously, legal protections covered ‘certified’ rescuers; the updated law amends language so that all ‘trained’ rescuers are protected from lawsuits. Public confusion about who would be protected from civil liability under the Good Samaritan Act decreased the number of people willing to provide CPR to someone in emergency situations.

Updated training methods from the American Red Cross and American Heart Association focus on hands-only CPR, in which chest compressions are delivered to a victim of sudden cardiac arrest. Hands-only CPR has been shown to be as effective as traditional CPR, and is easier to master and perform than mouth-to-mouth ventilation.

House Bill 1549, sponsored by Rep. Jil Tracy (R-Quincy) and Sen. A.J. Wilhelmi (D-Joilet), was an initiative of the American Red Cross and supported by the American Heart Association. The law takes effect immediately.


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