Word: billing
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...health insurance business. Companies that sell coverage consider revenues that go to pay for medical costs "losses,"; minimizing these losses by dropping sick customers and cherry-picking healthy ones is one way insurers currently stay profitable. But thanks to a provision inserted into the Senate health care bill at the last minute, the federal government may soon require insurers to "lose" 80% of premiums collected in the large group market and 85% in the individual and small group market. Insurers who don't operate at or above these thresholds would have to send rebates to customers. (MLRs are generally higher...
...original Senate bill called for lower thresholds - 75% and 80% respectively - while the House bill calls for an 85% limit across the board; crucially, both of those bills would have ended the requirement in 2013, the year much of health reform only begins to take effect, while Reid's new provision would maintain the regulation in perpetuity. Former Democratic National Committee Chairman Howard Dean, who had advocated killing the public option-less Senate bill, said Monday on MSNBC that of the last-minute changes to the Senate bill made by Reid, the strengthening of the MLR regulations was "the most...
...private insurers, says the industry MLR average is 87%, a figure that Rockefeller says is overstated. "They don't always do it accurately," says Rockefeller, calling the insurance industry "the major evil player in the whole health care system." Whatever the actual MLR figures are, the House and Senate bill would represent the first federal regulations of this kind. "The point is to get rid of the high 60s and the low 70s and get it all up into the 80s," says Rockefeller...
...Reid, says Daschle, had no choice but to offer the public option. "He was under intense pressure from the House [which has one in its bill] and the liberals in the caucus to at least make the effort." Also, by including the option, Reid gained a valuable bargaining chip - something he could give up in negotiations to win the votes of more conservative members like Connecticut's Joe Lieberman, an independent who is counted as part of the Democratic caucus, and Nebraska's Ben Nelson...
...finally conceding that the rebels' demands - increased development and the environmental repair of the delta - were justified. "The militants are not asking for anything unusual or extraordinary," Defense Minister Godwin Abbe told TIME at his offices in the capital Abuja earlier this month. Just as significant, a petroleum industry bill was also introduced promising greater transparency in a notoriously opaque business - a sign the government was willing to crack down on the kind of corruption that has served Nigeria so badly, fueling unrest not only in the delta but the north of the country, as well. (See "Nigerian Blood...