WellPoint

When President Obama signed the Affordable Care Act two years ago, the law's proponents (including me) were confident of two things: That it would become more popular with time and that it would make our health care system more humane and efficient. History has not been kind to the first prediction. Most of the law’s components command broad support: Overwhelming majorities still support the requirement that insurers cover people with pre-existing conditions, for example. But overall the Affordable Care Act is unpopular.

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With all of the focus on efforts to repeal the Affordable Care Act, another story about health care reform has gone largely unnoticed. The Obama Administration has been working furiously to draft the rules by which the new health care system will work. So far, they seem to be doing pretty well. But wouldn't you know it? The Republicans want to put a stop to that. To get a sense of the work that's going on, take a closer look at the draft regulation the administration released on Tuesday.

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This is the second of a five-part series explaining, in remarkable detail, how Obama and the Democrats came to pass health care reform. (Click here to read part one.) Be sure to come back Monday for the third installment, which examines just how nasty negotiations got in Congress—bruised egos, threatened careers, the works.   Workhorses It was an intimate gathering at Ted Kennedy’s home in Washington—just the senator, his colleague Max Baucus, and three senior staffers who worked with them on health care.

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How They Did It

When the president and his closest advisers huddled in the Oval Office last August, they had every reason to panic. Their signature piece of legislation, comprehensive health care reform, was mired in the Senate Finance Committee and the public was souring on it. Unemployment was on the march, and all this talk about preexisting conditions and insurance exchanges barely registered above the Fox News pundits screaming, “Death panel!” Suddenly, health care reform was under attack everywhere—even in the West Wing. All week, the group had debated whether to scale back the reform effort.

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Health care reform would not have happened without the political skill and tenacity of House Speaker Nancy Pelosi, or without the last minute round of arm twisting by President Barack Obama. But equally important was the energetic public campaign that Obama and liberal and left-wing organizations waged on behalf of it. This campaign altered the chemistry of the debate within Congress and among Democrats.

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Tangled up in Blue

When Alma Dickson slipped on an icy sidewalk in Dallas, Texas, she knew she was hurt. But she wasn’t sure that she could pay for the medical care she needed. The year was 1929 and Dickson, a schoolteacher, didn’t make enough money to pay for x-rays and treatment on her own. But Dickson had recently signed up for something new: A plan under which she paid a monthly premium in exchange for a promise of care at a local Dallas hospital.

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Ezra Klein has a big exclusive: He's gotten hold of a consulting firm's report projecting that Wellpoint insurance would be the big winner if health care reform fails to pass. It's not hard to see why, as Ezra explains: Wellpoint's business model is uncommonly concentrated in the individual and small-group markets. Those are the exact markets that health-care reform will drastically change. Those are the markets where people get rejected for preexisting conditions, where insurers spend 30 cents of every premium dollar on administration and where rate hikes are volatile and constant.

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Where Was Barack?

  I have assumed that the real purpose of today’s health care summit was to rally public support for comprehensive health care reform – the kind of reform sketched out in the president’s own proposal this week – and that by rallying the public, the administration hoped to allay the fears of wavering Senators and House members that they would suffer retribution in the fall if they voted for the bill. It was part of what I’d like to call the White House’s “outside” game. But I wonder whether the White House really gets it. Yesterday, on the eve of the summit, when Henry Waxman’s House committee

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Why This Summit Matters

On one end of Pennsylvania Avenue yesterday, administration staffers were busy making preparations for an event that will likely determine whether comprehensive health care reform goes forward. And on the other end of Pennsylvania Avenue, their counterparts in Congress were busy making the case for why it should. For several hours, members of the House Energy and Commerce Committee grilled the chief executive officer of Wellpoint, to see why the company's California subsidiary was raising health insurance premiums by nearly 40 percent for some customers.

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Sticker Shock

When it comes to health care reform, many Americans are still asking: What’s in it for me? They should put that question to Californians who have individual insurance coverage from Anthem Blue Cross--and just learned their premiums will be going up by almost 40 percent this year. Beneficiaries started learning about the rate hikes last week, according to the Los Angeles Times, which first reported the story.

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