Medicaid Program Investigation: Hearings Before the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce, House of Representatives, One Hundred Second Congress, First Session, Part 2

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Page 458 - Retirement Income Security Act (ERISA) which, among its detailed provisions, preempted state employer mandates. After long court challenges, special Federal legislation was passed in 1983 which allowed the Hawaii mandate to continue. The exemption, however, used as its base the 1974 law. Since that time, Hawaii's health care environment has changed but the state lacks the ability under the exemption to amend the Act to reflect these changes. While the 1974 Act still serves us well, we would benefit...
Page 14 - The UAW believes that employers should not have to compete on the basis of their health care costs. There should be a "level playing field, ** with all employers sharing equally in the costs of providing a basic level of health care protection to all Americans. All employers currently pay the same contribution (ie , the same percentage of wages) to Social Security in order to provide a basic level of retirement and disability income to workers. The same principle should be applied to the financing...
Page 51 - Barring change, we believe health costs will exceed $2 trillion by the year 2000 and absorb over 20 percent of our Nation's GNP. Health costs are growing far faster than family income, than business income, than local, State or Federal Government income (ie, tax receipts). The result: a steady reduction in citizens...
Page 49 - Medicare or any other population, you can get instant gratification. The key is to create a process where citizens can choose where they want to spend their resources. The alternative to a budget is not to have one ... to have no control on spending.
Page 465 - ... sector. Government subsidizes insurance premiums for those unable to pay. Insurance companies provide the coverage and the already existing health care providers deliver direct care. This is essentially the model adopted by the State of Washington in its pilot Basic Health program. Benefits Benefits of SHIP are heavily weighted toward preventive and primary care, with health appraisals and related tests, well baby and well child coverage and accident coverage fully covered. Twelve physician visits...
Page 466 - This fee scale is based upon ability to pay. Persons below the poverty level pay no fee and the monthly charges for those above poverty increase with income level. Co-payment at the time of a non-prevention visit is $5 and is required for all subscribers. SHIP Carriers SHIP insurance is delivered through contracts with the State's two largest insurers Hawaii Medical Services Association (HMS A), which has about 60% of all health insurance in Hawaii and Kaiser Permanente, which has about 17%.
Page 458 - As you can see, our employer mandate has not had an overall negative effect on small business in Hawaii. ERISA AND PREPAID HEALTH CARE The Prepaid Health Care Act was passed just months before the Federal government passed the Employee Retirement Income Security Act (ERISA), which among its detailed provisions preempted state employer mandates. After long court challenges, special federal legislation was passed in 1983 which allowed the Hawaii mandate to continue. The exemption, however, used as...
Page 357 - In most areas of governmental concern, the States uniquely possess the constitutional authority, the resources, and the competence to discern the sentiments of the people and to govern accordingly. In Thomas Jefferson's words, the States are "the most competent administrations for our domestic concerns and the surest bulwarks against antirepublican tendencies.
Page 470 - While this approach could be criticized as being "anti-business," it actually is in accord with America's faith in the free enterprise system to find cost-effective solutions to complex problems. Through an employer mandate, government defines the extent of coverage and uses the competitive marketplace to provide that coverage cost effectively and efficiently. By requiring employers to cover their employees, an employer mandate avoids complex governmental bureaucracies and allows business to get...
Page 471 - What is also quite clear is that an employer mandate helps to ensure that insurance reforms are successful. It is only fair that a mandate be accompanied by affordable insurance rates, which are possible in Hawaii through community rating, and the appropriate prohibition of exclusionary practices. Our community rating is voluntary, a likely product of the important role of our two large non-profit insurance providers in Hawaii's market This voluntary modified community rating system works to keep...

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