Insurance Option

The Obama administration continued to back away from a government-run insurance option today, with Health and Human Services Secretary Kathleen Sebelius saying it is "not the essential element" of healthcare overhaul. She, and other White House surrogates on the Sunday talk shows, indicated that the public option is not indispensable. But finding a way to keep insurance affordable is. "I think there will be a competitor to private insurers," Sebelius said. "That's really the essential part, is you don't turn over the whole new marketplace to private insurance companies and trust them to do the right thing."

Health insurance for married individuals is complicated enough these days without the pitfalls faced by many same-sex couples nationwide. Silver Lake residents David Michael Barrett and husband Mark Peters were married in 2008 during the brief period in which same-sex marriage was legal in California. And for almost a decade, they considered themselves fortunate to qualify for work-based insurance coverage provided through Peters' employer. But when Peters left his job last month, the couple faced a new round of insurance decisions and questions about eligibility and benefits.

Insurance giant Anthem Blue Cross has reached a confidential settlement with a Porter Ranch doctor who had already won $3.8 million in compensatory damages from the company at a trial this week. The agreement reached late Thursday keeps a Los Angeles jury from levying additional punitive damages against the company Friday, when the trial was scheduled to resume. The 12-person panel ruled Monday that Anthem had improperly barred Jeffrey Nordella, an urgent-care and family-practice doctor, from the company's preferred-provider network in 2010.

Insurance giant Anthem Blue Cross has reached a confidential settlement with a Porter Ranch doctor who had already won $3.8 million in compensatory damages from the company at a trial this week. The agreement reached late Thursday keeps a Los Angeles jury from levying additional punitive damages against the company Friday, when the trial was scheduled to resume. The 12-person panel ruled Monday that Anthem had improperly barred Jeffrey Nordella, an urgent-care and family-practice doctor, from the company's preferred-provider network in 2010.

In his healthcare address Wednesday night, President Obama proposed a new element in his overhaul plan -- the creation of a so-called trigger to prevent higher medical costs from pushing the budget deficit higher. Here is what he is proposing: How would the spending "trigger" work? In broad terms, it would force cutbacks in government outlays if healthcare spending began to get out of control. Specifically, the trigger -- also referred to as a fail-safe -- would kick in if savings that Obama says his plan would create somehow failed to materialize.

President Obama traveled to Capitol Hill on Sunday to rally Democrats on his signature healthcare initiative as the Senate moved closer to addressing two of the biggest land mines in the bill's path: the terms of a new public insurance option and limits on federal abortion funding. A showdown on the abortion issue is scheduled for early this week. An amendment to set stricter limits on federal funding is expected to be defeated. As for the public option, behind-the-scenes Democratic negotiations to satisfy both liberals and moderates quickened Sunday.

President Obama and his congressional allies are entering the next phase of their push to overhaul healthcare with lower expectations of what can be accomplished -- but with far greater certainty that significant legislation will be enacted by the end of the year. After a long summer of raucous protests, discouraging poll numbers and unplanned tactical shifts, administration officials and Democratic leaders now are focusing on their two greatest challenges: scaling back the overall cost, and developing alternatives to the government-run insurance option that liberals have championed.

The Senate on Thursday passed sweeping legislation to change the healthcare system. Here are some questions about what's next as the legislation continues to work its way through Congress: It seems like the healthcare debate has been dragging on for months. When will this end? Most likely in February. All signs point to the House and Senate ironing out the differences between their versions of the healthcare bill in January, with the goal of sending it to the president for his signature sometime around the State of the Union address in early February.

When Abby Berendt Lavoi graduated from college, she got a job in New York making television commercials as a full-time contractor for one of the largest media companies in the world. She was eligible for health insurance only after she had been working there for a year. Ten months into the job, Berendt Lavoi came down with painful stomach cramps. Terrified, she used Google to find a hospital that would accept patients without insurance, and underwent surgery to remove an ovarian cyst the size of a softball.

Undeterred after sinking $50 million of her personal fortune into a failed Senate bid in 2010, Linda McMahon is back on the Connecticut ballot, this time to try to claim the seat of retiring Sen. Joe Lieberman. McMahon, a former World Wrestling Entertainment chief executive, is the clear front-runner to win the Republican nomination in Tuesday's primary after out-spending and out-polling former Rep. Chris Shays.  She'll likely face Rep. Chris Murphy, who appears poised to beat former Secretary of State Susan Bysiewicz in the race for the Democratic nomination.

Undeterred after sinking $50 million of her personal fortune into a failed Senate bid in 2010, Linda McMahon is back on the Connecticut ballot, this time to try to claim the seat of retiring Sen. Joe Lieberman. McMahon, a former World Wrestling Entertainment chief executive, is the clear front-runner to win the Republican nomination in Tuesday's primary after out-spending and out-polling former Rep. Chris Shays.  She'll likely face Rep. Chris Murphy, who appears poised to beat former Secretary of State Susan Bysiewicz in the race for the Democratic nomination.

Honda Motor Co.'s new electric vehicle comes with an unusual option: collision insurance without any deductible. It's the latest enticement to move electric cars off showrooms and narrow the cost gap with less expensive gasoline-powered vehicles. "It is a really interesting marketing tool," said Rebecca Lindland, an analyst with IHS Automotive. Detroit automakers have generally shied away from offering insurance for drivers. General Motors Co. experimented with the concept last year, offering a year of free auto insurance for new-car buyers in Oregon and Washington.

Jay Carey, 23, had the option of going back on his parents' health insurance plan when he left his last job to become a freelance graphics designer. But that didn't mean he should have. His family, and its health insurer, were based in Chicago. That meant a long commute for the Los Angeles-based Carey to see a plan physician. Besides, his dad, who probably would have to pay more for "family" coverage if Carey were to boomerang back onto the policy, wasn't wild about the idea.

Amy Reiley had resigned herself to joining the ranks of the uninsured. The part-time L.A. resident and owner of a boutique cookbook publishing company had a group insurance plan that for three years covered her and another full-time employee. But when Reiley's employee became eligible for Medicare, she lost the group policy and was left to search for insurance on her own. Reiley, in her 30s, has a history of headaches resulting from neck spasms, which she manages with a muscle relaxant.

The Senate on Thursday passed sweeping legislation to change the healthcare system. Here are some questions about what's next as the legislation continues to work its way through Congress: It seems like the healthcare debate has been dragging on for months. When will this end? Most likely in February. All signs point to the House and Senate ironing out the differences between their versions of the healthcare bill in January, with the goal of sending it to the president for his signature sometime around the State of the Union address in early February.

President Obama traveled to Capitol Hill on Sunday to rally Democrats on his signature healthcare initiative as the Senate moved closer to addressing two of the biggest land mines in the bill's path: the terms of a new public insurance option and limits on federal abortion funding. A showdown on the abortion issue is scheduled for early this week. An amendment to set stricter limits on federal funding is expected to be defeated. As for the public option, behind-the-scenes Democratic negotiations to satisfy both liberals and moderates quickened Sunday.

Health maintenance organizations are having a rough time financially. In 1987, the last year for which complete figures are available, only 30% of 722 HMOs studied by American International Healthcare, a Potomac, Md., health care consulting firm, were profitable. In total, HMOs lost about $895 million. Why all the red ink? Fifteen years ago, the federal government created a ready market for HMOs by requiring companies with 25 or more workers to offer membership in a health maintenance organization as an insurance option.

For people who've assumed they'll take the option of continuing their employer-based health insurance -- at their own expense -- if they lose their jobs during 2009, it was sobering news. For those who have lost their jobs, it was painfully unsurprising.

Eastman Kodak Co. has said sayonara to about 22,000 workers over the last five years. Verizon Communications Inc. says it will have handed about 16,000 workers their hats by Dec. 31 -- and it is already looking ahead to the possibility of more layoffs next year. So it took more than a little chutzpah for the chief executives of both companies to go before reporters the other day to denounce a government health insurance plan as being bad for America. Where do they expect all the people they've thrown into the unemployment line to get coverage?

In Southern California, it's sometimes hard to tell that the seasons have changed, but here's a tip that it's fall: Many employers are beginning to send out the information you'll need to re-up for 2010 health insurance if you get your coverage through your job. Time frames vary, but if your firm does its re-enrollment in the fall, you'll probably get the information on next year's costs and options by the beginning of November. Now pay attention: "History tells us that most workers . . . default to their previous year's benefits," says Sara Taylor, health and welfare strategy leader at benefits consulting firm Hewitt Associates in Lincolnshire, Ill. "In doing so, they may be losing out on a huge opportunity to save money and fully maximize the benefits available to them."