Washington Watch - July 25, 2012


Washington Watch - July 25, 2012

80/20 Rule: Health Care Rebate Checks Distributed 8/1

Come August 1st, some members of the self-employed community will receive rebate checks from their health insurance companies if they failed to spend 80% of health care premiums on medical care. The 80/20 rule or Medical Loss Ratio rule was included in the Affordable Care Act as a mechanism to ensure transparency and accountability between the consumer and health insurance companies.  It is estimated that a family of four that purchases its own health insurance could receive a rebate up to $151.

Based on data from the U.S. Department of Health and Human Services, it is expected that in total, 12.8 million Americans will receive a rebate check directly (individual plan holders) or indirectly (group plan participants), employers will receive the rebate. For the individual market, the department estimates that 2.6 million households will receive a rebate check, returning nearly $394 million to consumers.  Those living in Mississippi, Alabama, Maryland, and Delaware, are on track to receive the highest rebates, ranging from $651-$461. 

Regardless of a rebate check or not, consumers will learn from their insurance companies if they met, exceeded, or fell below the 80/20 ratio. This will be invaluable information for the self-employed as they weigh their health insurance options for the coming year and decided if they need more or less coverage.

To learn more about the rebate or other provisions of the Affordable Care Act, please visit: www.healthcare.gov. 

Tales of Resilience: Small Business Survival in the Recession

On Wednesday, July 25, 2012, at 1:00 P.M., the Committee on Small Business will conduct a hearing titled, Tales of Resilience: Small Business Survival in the Recession. The purpose of the hearing is to examine how, despite the harrowing recession and tough economy, some small business owners have grown by innovating and strategically adapting their business models in order to find success. The hearing will focus on how certain small firms overcame obstacles created or exacerbated by the economic climate. Further, it will examine methods utilized and cultivated by a portion of small businesses to achieve prosperity, such as: reducing costs, diversifying portfolios, capitalizing emerging industries, and fostering innovation.

Health Care Realignment and Regulation: The Demise of Small and Solo Medical Practices?

The Subcommittee on Investigations, Oversight and Regulations recently held a hearing titled Health Care Realignment and Regulation: The Demise of Small and Solo Medical Practices? The practice of medicine is always evolving, and physician practices are changing, too. New and established physicians in small or solo practices are increasingly joining larger practices or hospitals. Established small practices have reported difficulty in recruiting newly-licensed physicians. Some have speculated that the health care law will accelerate the trend. This hearing provided an opportunity for Members to learn more about these issues and what their impact may be.

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