Which Cities Have the Most Housing Stress/Risk?: WSJ Story Includes Oregon Data.

WSJ story HERE includes interactive graphics for 534 areas of the country, using 2009 ACS data on owner cost burdens, health insurance coverage, and "population not working".

Using data I extracted from the WSJ story below is a table with my calculation of the ratings and rankings for Oregon areas

NOTES

1. GRANTS PASS has the highest Oregon risk.
2. Corvallis has the lowest Oregon risk.
3. The population not working is very high for some areas, and IF it includes retirees, the housing stress ratings/rankings could be somewhat distorted.

Oregon Ratings and Rankings for Housing Stress
Area	Spending More than 30% of Income on Housing	Without Health Insurance	Population Not Working	Housing-stress indicator	Housing Stress Rank
Grants Pass	52%	18%	40%	109.90	26
Coos Bay	42%	21%	39%	102.50	59
Bend	49%	18%	35%	101.30	68
Medford	48%	18%	35%	101.10	70
Eugene-Springfield	43%	18%	40%	100.20	72
Roseburg	39%	18%	40%	97.10	87
Klamath Falls	35%	21%	40%	96.50	93
Salem	41%	20%	35%	96.00	100
Albany-Lebanon	37%	16%	38%	91.90	124
Portland-Vancouver-Beaverton	41%	15%	31%	87.00	185
United States	38%	15%	33%	85.70
Pendleton-Hermiston	29%	20%	35%	83.10	244
Corvallis	36%	12%	33%	82.00	258

Originally created and posted on the Oregon Housing Blog.

Off Topic, Health Care Reform: GOT'S to Give It Up to the First Woman Speaker.

I am sure there were many capable men and women who worked tirelessly in the shadows to get HCR done, and the willingness of the President to stake his future on this legislation is admirable.

With all that said, you just GOTS to give it up to Nancy Pelosi, the first woman speaker of the House of Representatives.

Congratulations, Madam Speaker!

(Time magazine backgrounder about Speaker and HCR is HERE).

Originally created and posted on the Oregon Housing Blog.

Off Topic: I Hate to See DeFazio Pulling a Ben Nelson at this Late Hour.

100% Editorial:
Kinda embarassing for Oregonians to see DeFazio acting like Ben Nelson, no? See Huffington Post story HERE.

I believe he is serious, which makes it worse. I guess feds paying for 100% of Medicaid costs for new eligible individuals for next several years, extending Medicare solvency by 9 years, and gradually closing the Medicare prescription "donut hole" is not enough?

I sure hope Health Care Reform bill passes, and without his vote would be even better, IMHO.

Correction, Off Topic: Oregon Kaiser NW Health Insurance Premium Increased by 8.75% Annually Over Last 10 Years.

Correction: My earlier post showed annual increases averaging 13% a year. Because of compounding, the actual annual increase averaged 8.75%/8.74%--these calculations are shown in LAST table in this post below.
----------

In cleaning out some stuff, I discovered an old Federal Employees Health document that included 2000 rates for Kaiser Health Insurance premiums. As I recently reupped for 2010 I thought it might be interesting to compare how much TOTAL premiums have changed over that 10 year period. (Federal employees pay a portion of the premiums so not ALL of these cost are directly paid by them).

The average ANNUAL increase of 8.75/8.74% over the decade helps to understand why health care reform is such a big deal:

Monthly	2010	2000	Change
High Family	$ 1,248.74	$ 539.85	131%
High Self	$ 543.57	$ 235.24	131%

Annually	2010	2000
High Family	$ 14,985	$ 6,478
High Self	$ 6,523	$ 2,823

	HIGH FAMILY	Annual Increase	HIGH SELF	Annual Increase
2000	$ 6,478		$2,823
2001	$ 7,045	8.75%	$3,069	8.74%
2002	$ 7,661	8.75%	$3,338	8.74%
2003	$ 8,331	8.75%	$3,629	8.74%
2004	$ 9,060	8.75%	$3,946	8.74%
2005	$ 9,853	8.75%	$4,291	8.74%
2006	$ 10,715	8.75%	$4,666	8.74%
2007	$ 11,652	8.75%	$5,074	8.74%
2008	$ 12,671	8.75%	$5,517	8.74%
2009	$ 13,780	8.75%	$5,999	8.74%
2010	$ 14,985	8.75%	$6,523	8.74%

Originally created and posted on the Oregon Housing Blog.

Off Topic: Health Reform Subsidy Calculator.

From Kaiser Family Foundation HERE.

Allows input of different variables to compare costs in Senate and House health care bills.

Related Health Care by the Numbers Daily Kos blog post HERE.

Originally created and posted on the Oregon Housing Blog.

Off Topic: New CRS Report - Medicaid and Children's Health Insurance Program (CHIP) Provisions in Health Care Bill.

Report is HERE.

Originally created and posted on the Oregon Housing Blog.

Off Topic: How Baucus Screwed Up Consideration of Wyden Health Care Plan Amendment, at 1 AM Session.

One of the dangers of 1 AM in the morning Committee meetings are screw ups like that described HERE. (I'm not sure Wyden Amendment was good or bad, but I'm sure that exhaustion and amendment fatigue played a role here).

Originally created and posted on the Oregon Housing Blog.

Off Topic: For Federal Employees, Coop Health Care Plan Premiums ARE Lower than Regional HMO AND National Blue Cross Premiums.

Most federal employees get health insurance coverage via the Federal Employee Health Program, FEHB. A recent news story HERE says

1. Federal employee contributions toward premiums are usually about 30%, with government paying remaining 70%. (Federal employees also pay 100% of copay costs).
   
2. Story also says that average premiums will increase 7.4% in 2010, the largest annual increase since 2004.

Question: How Do Premiums for a Health Care Coop Plan Compare With Blue Cross and Kaiser Health Care Premium Costs?
I thought it might be interesting to compare premium costs of a cooperative plan vs a regional HMO and national Blue Cross and Blue Shield plans. I choose to look at Washington state since they have a highly regarded Health Care Cooperative, the Washington Group Health Cooperative.

My single page PDF file HERE shows detailed comparisons of premium costs for the LOWEST level of service available for each provider.

Answer: In Washington State at Least One COOP IS Less Expensive than Blue Cross AND a Regional HMO.

Here are comparative total premium costs for the three health plans:

Washington Group Health Cooperative	$ 4,306	Self
Blue Cross	$ 4,836	Self
Kaiser	$ 5,359	Self
Washington Group Health Cooperative	$ 9,721	Family
Blue Cross	$ 11,327	Family
Kaiser	$ 12,310	Family

1. The total premium cost for the Cooperative Health care plan is anywhere from $531 (11 %) to $1,606 ( 14 %) lower than the nationwide Blue Cross plan, depending on whether the plan is for an individual or a family.
2. The total premium cost for the Cooperative Health care plan is anywhere from $1,053 (20%) to $2,590 (21%) lower than the Seattle Kaiser regional HMO plan, depending on whether the plan is for an individual or a family

Note: All premiums shown are for non postal federal employees. Selection of the lowest level of service available for each plan should make this comparison as fair as possible. However, the FEHB plan comparison tool for 2010 is not yet available on the FEHB website so it is not possible to do a detailed comparison of covered services and co payment costs.

Off Topic: Baucus Health Care Bill Resources.

Thanks to Bespacific:

• Chairman’s Mark - America’s Healthy Future Act of 2009 Scheduled for Markup By the Senate Committee on Finance On September 22, 2009 [223 pages, PDF]
• 9-16-09 JCT Analysis of the America's Healthy Future Act
• 9-16-09: Finance Committee Memo on Estimates of the America’s Health Future Act
• CBO: Preliminary Analysis of Specifications for the Chairman's Mark of the America's Healthy Future Act, September 16, 2009: "..the Chairman’s proposal would establish a mandate for most legal residents of the United States to obtain health insurance; set up insurance “exchanges” through which certain individuals and families could receive federal subsidies to substantially reduce the cost of purchasing that coverage; significantly expand eligibility for Medicaid; substantially reduce the growth of Medicare’s payment rates for most services (relative to the growth rates projected under current law); impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the Medicaid and Medicare programs and the federal tax code...enacting the Chairman’s proposal would result in a net reduction in federal budget deficits of $49 billion over the 2010–2019 period..."

Off Topic: 3 Health Care Items.

Maybe something will finally happen with health care this year.
Three most recent developments.

1. Walmart supports mandatory employer coverage.WaPo story HERE.
   
2. AMA says a "public option" could be part of solution and suggests using federal employees health plan instead of creating new plan. (Editorial comment: FEHB really isn't public plan, but a version of of employer provided health care plan with multiple private sources offering packages at differing costs/features within overall minimum guidelines). CNN story HERE.
   
3. Leak says new CBO letter projects health care reform costs, with public plan, about $600 billion, NOT a trillion. AP story HERE.

Originally created and posted on the OREGON HOUSING BLOG.

Reports Trifecta.

Three unrelated reports I saw this AM:

• Urban Institute report, The Impact of Foreclosure on Families and Communities, is HERE. (Pg.21 table shows estimated costs of foreclosures).
  

• HHS report, Hidden Costs of Health Care, is HERE. Note also new Healthreform.gov website. (Table to left shows relative cost burdens for families at different incomes with employer provided health insurance).
  

"In 2008, the average premium for a family plan purchased through an employer was $12,680.......a person with employer-based coverage paid an average of $1,522 on health care (not including premiums) in 2006, compared with $1,260 in 2001.13 When including the added burden of higher premiums, out-of-pocket costs rose even more sharply, with a 30 percent increase from an average of $2,827 in 2001 to $3,744 in 2006.The economic burden is even more pronounced for people in the individual market purchasing directly from an insurer. Total out-of-pocket costs (including costs of health care used and premium) for these families have increased by 45 percent from an average of $5,008 in 2001 to $7,280 in 2006."

• FHFA Foreclosure Prevention report, HERE, provides information on Fannie and Freddie foreclosure prevention activity:

"Completed loan modifications increased by 57 percent over the prior quarter to 37,300 and more than doubled compared to the first quarter of 2008....Foreclosure starts increased substantially in the first quarter, up by 63 percent over the prior quarter to 243,800, reflecting increases in the number of delinquencies and transitions to later stage delinquency. The increase in the number of foreclosure starts on prime borrowers versus for nonprime borrowers reveals the impact of the deteriorating economy on borrowers who were previously considered higher credit quality. Foreclosure starts on prime borrowers in the first quarter of 2009 were 2.6 times higher than in the same period of 2008. Foreclosure starts on nonprime borrowers were nearly double the number in the same quarter of 2008."

Just Asking: Aren't "Health Co-ops", a GSE by Another Name?

In lieu of a public health plan, the latest compromise being offered is a "Health Co-op" (AP news story HERE).

I'm all for compromise---but isn't a health co-op really a Government Sponsored Enterprise by another name?

Cost Shifting of Uninsured Health Costs.

Readers will recall I occasionally post on health care issues that affect those who are income eligible for HUD programs.

New report from Families USA HERE provides a good summary of who pays for health care costs for uninsured. Summary from the report:

• The uninsured paid for, on average, more than one-third (37 percent) of the total costs of the care they received out of their own pockets.
• Third-party sources, such as government programs and charities, paid for another 26 percent of that care.

To make up for this uncompensated care, the costs were shifted to insurers in the form of higher charges for health services. These higher charges are then passed on to families and businesses as higher premiums. The impact of this hidden health tax on annual premiums for families and individuals in 2008 was as follows:

• For family health care coverage, the hidden health tax was $1,017.
• For health coverage provided to single individuals, the hidden health tax was $368.

CRS Report on Increases in Federal Share of Medicaid Payments to States.

Congressional Research Service report is HERE, discusses several of the proposals to boost federal share of Medicaid reimbursement rates. (AKA "federal medical assistance percentage (FMAP)").

Oregon's current FMAP for FY 09 is 62.45%, as shown on page 6.

On page 14, table indicates that a House passed proposal would boost Oregon's FMAP rate by 9.41 percentage points (to 71.86%).

On page 16 a Senate Finance Committee proposal would boost the Oregon FMAP rate by 8.95 percentage points (to 71.4%).

CBO Testimony on Children Without Health Insurance.

I have previously blogged about health care insurance programs for uninsured children, and notably SCHIP, HERE, HERE, and HERE.

The head of the Congressional Budget Office recently testified about SCHIP HERE. His balanced testimony includes both identification of key issues, as well as accomplishments, of the SCHIP program.

Dumb Government Revisited: Gov Contractors Escape Paying Health Insurance.

Story in WSJ yesterday reminded me of an earlier post HERE where I called the federal government "dumb" because of its failure to collect back taxes from 30,000 federal Medicare providers.

Story yesterday in WSJ HERE, recounts that:

1. Federal government is missing opportunity to require federal contractors to provide health insurance (or dollar equivalent in fringe benefits) to employees by exempting industries from requirement where health insurance is "not typical".
2. Feds also have no system for collecting information on how many of the estimated 5.4 million federal contract employees have employer provided health insurance(or pay dollar equivalents in fringe benefits).
3. $3.16 per hour is currently provided as the fringe benefit equivalent to health insurance. (This seems to me to woefully inadequate to provide anything other than very limited individual [not family] insurance coverage).

With all the commotion about expanding health insurance it strikes me as plain "dumb" to NOT mandate that all government contractors must provide health insurance, or to require a realistic fringe benefit payment sufficient for the employee to pay for privately provided individual insurance, and to track and report health insurance coverage by each government contractor. (It would be equally 'dumb" to allow employees to collect the fringe benefit equivalent, spend it on something other than health insurance, and then enroll [at government expense] in Medicaid).

One way to expand coverage would be to allow private contractors to enroll federal contract employees in the Federal Employee Health Plan, with employees who enroll required to pay a share of the insurance premiums and co-pays just like federal employees, and with employers paying the majority of the insurance premium.