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Home > Public Strategies > Affordable Care Act Databook

Cozen O’Connor Public Strategies has been following the Affordable Care Act since before it became law in 2010, tracking its journey through the courts, in the agencies, on Capitol Hill, and in the states. You can sign up to receive the alerts we send out, as well as a compilation of the week’s news and updates, in the red box to your right.

 

 

Recent Implementation Updates

Health Care Reform Implementation Update November 5, 2014
Looming midterm elections have made the past several months difficult for Democrats and Republicans alike when it comes to the Affordable Care Act. With most of the midterm elections now wrapped up, lawmakers can turn their attention to concerns they have with the law. Even with control of both the House and the Senate, Republicans will not be able to repeal the entire Affordable Care Act. They may, however, push to repeal or improve parts of it... View Entire Update
Health Care Reform Implementation Update August 12, 2014
August recess has begun on Capitol Hill. Congressmen and women and senators are home in their districts and states, and Capitol Hill staffers are catching up on piled up work. Nonetheless, last week Congressman Kevin Brady (R-Texas) released a discussion draft of a bill that intends to stem waste, fraud and abuse in Medicare. The Centers for Medicare and Medicaid Services (CMS) released final payment rules for inpatient hospitals and hospice... View Entire Update
Health Care Reform Implementation Update August 4, 2014
Congress begins its summer recess this week, but last week legislators were busy holding hearings on management issues regarding HealthCare.gov, introducing legislation to increase payments to primary care doctors under Medicaid, and voting to support House Speaker John Boehner’s lawsuit challenging President Obama’s constitutional authority to delay the employer mandate. Also last week, the Centers for Medicare and Medicaid Services... View Entire Update
Health Care Reform Implementation Update July 28, 2014
Last week, two courts issued contradictory rulings on the authority of the federal government to provide subsidies in states using the federal exchange. The House held hearings regarding the Affordable Care Act's (ACA) effects on Medicare Advantage plans, a Government Accountability Oversight (GAO) report on ACA subsidy applications, and whether or not a lawsuit against President Obama should move forward. At the agencies,... View Entire Update
Health Care Reform Implementation Update July 21, 2014
Last week the Senate debated a bill to reverse the Supreme Court’s contraception mandate decision, a group of House Republicans introduced a bill to replace Affordable Care Act (ACA) cuts to the Medicare home health benefit with a measure that would instead base payments of value of care delivered, the Department of Health and Human Services (HHS) announced a new contract solicitation for managing Healthcare.gov  and the House... View Entire Update
Health Care Reform Implementation Update July 10, 2014
On June 30, in one of the most highly anticipated cases affecting the Affordable Care Act (ACA), the Supreme Court ruled that closely held companies could assert a “religious objection” to the ACA contraceptive coverage mandate. Members on the Hill reacted both positively and negatively, with some calling for legislative action. The Centers for Medicare and Medicaid Services (CMS) released annual payment rate and... View Entire Update
Health Care Reform Implementation Update June 27, 2014
Secretary Burwell continues to settle in to her new position as the Department of Health and Human Services (HHS), this week making a number of management changes at the department; CMS released the long awaited proposed rule on Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Program; and CMS also announced that it would create a five-star ratings program for hospitals, home health agencies and... View Entire Update
Health Care Reform Implementation Update June 11, 2014
The Senate confirmed Sylvia Burwell as the new Secretary of Health and Human Services (HHS) on June 5, and she was sworn in on Monday. Also this week, the Centers for Medicare and Medicaid Services (CMS) announced that 18 of the states using the federal exchange for their small business health options program (SHOP) will be permitted to delay the employee choice requirement until after 2016. ON THE HILL Sylvia Burwell was... View Entire Update
Health Care Reform Implementation Update June 3, 2014
Affordable Care Act (ACA) action on Capitol Hill this past week centered on investigations into improper ACA subsidy payments, a potential constitutional amendment proposal, and support for an appeal of the ACA in favor of a Republican-sponsored replacement. At the agencies, a high-level official departed the Department of Veterans Affairs amidst controversy, and the Centers for Medicare and Medicaid Services (CMS) announced... View Entire Update
Health Care Reform Implementation Update May 27, 2014
Congress held several hearings last week ranging from Sylvia Burwell’s nomination for Secretary of the Department of Health and Human Services (HHS), to Medicare payment oversight, to post-acute care in Medicare. The Centers for Medicare & Medicaid Services (CMS) released final and proposed rules on the use of electronic health records, Medicare payments for medical devices, and new requirements for health plans wishing to... View Entire Update
Health Care Reform Implementation Update May 5, 2014
Congress returned from its Spring recess and got right to work on a number of Affordable Care Act (ACA) related issues including a bipartisan bill regarding health insurance for Americans living abroad, Medicare oversight, reports on ACA enrollee data and meetings with Health and Human Services (HHS) Secretary nominee Sylvia Burwell, whose first confirmation hearing is scheduled for next Thursday before the Senate Health,... View Entire Update
Health Care Reform Implementation Update April 25, 2014
This week, the Centers for Medicare and Medicaid Services (CMS) announced that in May Jonathan Blum would be leaving his post as Deputy Administrator for CMS and Danielle Moon who leads CMS’ Medicare Advantage division would be leaving as well. Though Congress has been recess, the wheels of the Affordable Care Act (ACA) continued to turn this past week. On April 21, Senator Ron Johnson (R-Wis.) filed a lawsuit against the Obama... View Entire Update
Health Care Reform Implementation Update April 21, 2014
On April 14, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) reported their findings that show a smaller rise in insurance premium costs under the Affordable Care Act (ACA) than previously expected. The CBO also released findings on the same day that show a rise in the cost estimate for permanent repeal of the sustainable growth rate formula (SGR), which is the Medicare formula used to determine... View Entire Update
Health Care Reform Implementation Update April 14, 2014
Last Thursday Kathleen Sebelius resigned from her post as Secretary of Health and Human Services (HHS). On Friday President Obama nominated Sylvia Matthews Burwell, the Office of Management and Budget (OMB) Director.  As March came to a close, the first official open enrollment period since the individual mandate went into effect and the health insurance exchanges began operating came to a close, and the Obama administration... View Entire Update
Health Care Reform Implementation Update March 26, 2014
On Sunday, the Affordable Care Act (ACA) turned four. Unsurprisingly, Democrats celebrated the law’s birthday by touting its many successes and Republicans used it to highlight the problems the law has faced, as well as caused. The Department of Health and Human Services (HHS) extended the ACA’s hardship exemption until 2016; an Office of Management and Budget (OMB) report effectively exempted exchange subsidies from sequestration;... View Entire Update
Health Care Reform Implementation Update March 7, 2014
This week President Obama released his Fiscal Year 2015 Budget Proposal, which provides useful information on his priorities for the year but, as is normally the case, is not likely to gain much traction; the administration announced a two-year extension for individuals whose health insurance plans would have been canceled due to the Affordable Care Act (ACA); Ways and Means Chairman Dave Camp released a comprehensive tax reform plan, which also... View Entire Update
Health Care Reform Implementation Update February 26, 2014
Though Congress was in recess this past week, congressional staff was hard at work continuing to consider ways to prevent a cut to Medicare providers’ payment rates that will be triggered by the sustainable growth rate formula on March 31, the Department of Health and Human Services (HHS) in conjunction with the Employee Benefits Security Administration and Internal Revenue Service, released proposed rules on the 90-day waiting period... View Entire Update
Health Care Reform Implementation Update February 14, 2014
This week the Obama administration announced that it would delay the employer mandate, which requires that businesses with more than 50 full-time employees provide full-time employees with health insurance or pay a penalty, for some businesses until 2015, marking the second time the mandate has been delayed.  The House and Senate passed a measure to raise the country’s debt limit, averting the Treasury Department’s projected... View Entire Update
Health Care Reform Implementation Update February 10, 2014
Last week the Congressional Budget Office (CBO) released a report on the Affordable Care Act (ACA), in which it projected a decline in the number of full-time-equivalent hours worked; the Senate Finance, House Ways and Means, and House Energy and Commerce committees released a joint sustainable growth rate (SGR) repeal and replace proposal without offsets on the same day Finance Committee Chairman Max Baucus (D-Mont.) was confirmed to be the... View Entire Update
Health Care Reform Implementation Update January 31, 2014
This week the Congressional Budget Office (CBO) provided new scores for the three sustainable growth rate (SGR) repeal proposals from the Senate Finance, House Ways and Means, and Energy and Commerce Committees; a list of potential offsets for SGR legislation circulated Washington; the president discussed the already positive developments from the Affordable Care Act (ACA) in his State of the Union address; Utah announced its intention to expand... View Entire Update
Health Care Reform Implementation Update January 23, 2014
In a high-stake but relatively uneventful series of negotiations, the House and Senate passed a continuing resolution to fund the government through September, averting another government shutdown. Also over the past week, the Director of the Center for Consumer Information and Insurance Oversight (CCIIO) Gary Cohen testified before the House Committee on Energy and Commerce subcommittee on oversight that he was confident HealthCare.gov was... View Entire Update
Health Care Reform Implementation Update January 13, 2014
With only a few days remaining before the current Continuing Resolution (CR) expires, House and Senate Appropriations Committee leaders are trying to quickly negotiate remaining issues in the omnibus spending bill; however, they may have to buy themselves more time to finalize it by extending the current CR by a few days. Also on Capitol Hill, Republicans advanced two new Affordable Care Act (ACA) bills, one which would require the Department of... View Entire Update
Health Care Reform Implementation Update January 3, 2014
The new year kicked off this week with all eyes watching not only Winter Storm Hercules, but also how the new Affordable Care Act (ACA) coverage will work. According to the Centers for Medicare and Medicaid Services (CMS), more than a million people have signed up in the federal exchange. The president signed into law a two-year budget deal, that creates a three-month “doc fix” (a physician payment patch so that SGR payment... View Entire Update
Health Care Reform Implementation Update December 19, 2013
The deadline to enroll in coverage for January 1 was officially extended by a week, but the new December 23 deadline is fast approaching, and premium payments are required to be paid by the last day of 2013 for January 2014 coverage. Last week, both the Senate Finance Committee and the House Ways and Means Committee advanced legislation to permanently repeal the sustainable growth rate (SGR) formula, which is used to determine Medicare... View Entire Update
Health Care Reform Implementation Update December 9, 2013
The Obama administration announced that it met the November 30 deadline for fixing HealthCare.gov’s problems; however, there are some concerns that information submitted by consumers is not properly transmitting to insurers, and many continue to question issues with the site’s security, as well as Affordable Care Act (ACA) concerns more generally, such as cancelled health policies and the inability to keep your doctor. Both the... View Entire Update
Health Care Reform Implementation Update November 25, 2013
Though administration officials are now downplaying the date, the November 30 deadline government consultants set for fixing HealthCare.gov is this week. Some Democrats who have gone to the mat for the Affordable Care Act (ACA), especially those who are up for reelection, are getting worried the deadline will not be met, and Wall Street analysts are predicting November 30 to be a telling day, not only in terms of how Congress will treat the law... View Entire Update
Health Care Reform Implementation Update November 14, 2013
Earlier today, President Obama announced that health insurers will be able to extend existing plans for individuals through 2014 that would have been otherwise canceled due to changes under the Affordable Care Act. This proposed fix does not guarantee that extensions will be available, but rather allows insurers to offer the extension and for state regulators to approve it. The administration has now released enrollment numbers for the... View Entire Update
Health Care Reform Implementation Update November 5, 2013
Criticism of the Affordable Care Act’s exchange rollout continued this past week. The main line of attack has moved from the malfunctioning website to canceled plans despite President Obama’s repeated promise that those who liked their health plans could keep them. The Secretary of the Department of Health and Human Services (HHS), Kathleen Sebelius, and the Administrator of the Centers for Medicare and Medicaid Services (CMS),... View Entire Update
Health Care Reform Implementation Update October 29, 2013
Repair work to Healthcare.gov is underway, and White House advisors are now pledging that it will be functioning smoothly by the end of November. However, the system was met with new problems over the weekend when the website’s online data center crashed on Sunday night. In addition to the tech surge to solve the health insurance exchanges, the Department of Health and Human Services (HHS) continues to work on implementing the many... View Entire Update
Health Care Reform Implementation Update October 22, 2013
After 16 days of government shutdown, Congress voted to reopen the government and avert default without defunding the Affordable Care Act, delaying the individual mandate, stripping the medical device tax from the law or requiring members of Congress and their staffs to join the ACA exchanges and lose their federal subsidies. The legislation does include a small change to income verification for determining eligibility for exchange... View Entire Update
Health Care Reform Implementation Update October 10, 2013
It is now the second week the exchanges have been open and the second week the government has been partially closed. The exchanges still have glitches, and Congress still has not agreed on a way to fund the government, although some evidence of cooling among leading participants was becoming evident as this update was finalized, signaling a temporary way out of at least the dreaded default possibility. The possibility of temporarily raising the... View Entire Update
Health Care Reform Implementation Update October 4, 2013
Open enrollment began this week, making it possible for the first time to enroll in Affordable Care Act (ACA) online marketplaces. Technical glitches were widespread, but the problems were overshadowed by the shutdown of the federal government. After several rounds of House-Senate exchanges with a continuing resolution (CR) to keep the government open, October 1 came and went with no agreement. Knowing that this opportunity is one... View Entire Update
Health Care Reform Implementation Update September 24, 2013
With a week until a potential government shutdown and a week until open enrollment begins, the Affordable Care Act (ACA) is in the limelight. On September 20, the House voted for a continuing resolution that funds the government past the end of September while defunding the ACA. This week, the continuing resolution will move to the Senate, where Democrats have pledged to add ACA funding back into the legislation, at which point it would be sent... View Entire Update
Health Care Reform Implementation Update September 17, 2013
Congress has been back for a week, and already the president and Democrats are engaged in a contest with Republicans to see who will blink first. Additional spending legislation needs to be passed to keep the government running past September 30, and the debt ceiling could be hit as soon as mid-October. Expecting that a deal will not be made until the last minute, Congress is already considering canceling the September recess. At least 43 House... View Entire Update
Health Care Reform Implementation Update September 11, 2013
After spending the past month in their home districts listening to constituents, this week House and Senate members are back in Washington and Congress is back in session. Though the attention of many has turned to back-to-school, back-to-football, and to remembering the events of September 11 and making difficult decisions on Syria, it is not far from anyone’s mind that open enrollment begins in less than one month. The Obama... View Entire Update
Health Care Reform Implementation Update September 3, 2013
There is only one week left of Congress’ summer recess. While the members have been in their home districts, the agencies in Washington have been finalizing Affordable Care Act (ACA) regulations on everything from the individual mandate to eligibility appeals, and rallies have raged across the country both by those who oppose and those who support the ACA. Arguments continue about whether the exchanges will be ready by October 1, and... View Entire Update
Health Care Reform Implementation Update August 26, 2013
In response to security concerns about personal information in the health insurance exchanges, the Centers for Medicare and Medicaid Services (CMS) released a new security agreement for the data hubs where this information will be stored. Opposition to the Affordable Care Act (ACA) continues to be voiced from many directions. Some lawmakers who oppose the ACA are pushing for answers on the employer mandate delay or encouraging the law’s... View Entire Update
Health Care Reform Implementation Update August 19, 2013
With less than 50 days until open enrollment begins, tensions in Washington and around the country are high among health care stakeholders.  Businesses, individuals and even some in the government are concerned about whether all the pieces of the Affordable Care Act (ACA) will come together in time for individuals to enroll in exchange plans come October 1. The administration is working around the clock to ensure health reform works,... View Entire Update
Health Care Reform Implementation Update August 12, 2013
The House Energy and Commerce Committee voted unanimously on legislation that would repeal the sustainable growth rate (SGR) formula that has historically led to annual decreases in physician payments that are fixed at the last minute each year; the Centers for Medicare and Medicaid services (CMS) announced a temporary moratorium on the enrollment of new home health provider and ambulance supplier enrollments in Medicare, Medicaid and the... View Entire Update
Health Care Reform Implementation Update July 30, 2013
Some Republicans are threatening not to pass any debt ceiling deal that does not defund the Affordable Care Act and Democrats say they will not pass any deal that does; the full House Energy and Commerce Committee is slated to vote on legislation that would repeal the Sustainable Growth Rate (SGR) formula that historically has led to annual decreases in physician payments that Congress ultimately corrects, however offsets from other areas,... View Entire Update
Health Care Reform Implementation Update July 23, 2013
With only two weeks before Congress’ August recess and just a little more than two months before October open enrollment begins, Washington is busy sorting through, implementing and, in some cases, fighting the Affordable Care Act (ACA). The Department of Health and Human Services released final rules for navigators, non-navigator assistance personnel and certified application counselors, all of whom will help connect people with health... View Entire Update
Health Care Reform Implementation Update July 16, 2013
Affordable Care Act Takes Ones Step Back: Employer Mandate Delayed Until 2015 Business Relieved; Congress Seeks Answers, Seeks Similar Relief for Individuals Capitol Hill and the agencies went back and forth last week on the impact and consideration involved in delaying the Affordable Care Act’s (ACA) employer mandate; votes in the House are expected this week on it, as well as a vote to repeal the individual mandate; the Centers for... View Entire Update
Health Care Reform Implementation Update July 3, 2013
The Obama administration announced yesterday it was delaying the Affordable Care Act’s (ACA) Employer Mandate, which requires employers with 50 or more full-time workers to provide affordable health insurance to its employees or pay a fine; the House Committee on Energy and Commerce released a more detailed legislative framework on repealing Medicare’s sustainable growth rate (SGR), which is the reimbursement formula for Medicare... View Entire Update
Health Care Reform Implementation Update June 27, 2013
The countdown is on now. Less than 100 days until the Affordable Care Act’s (ACA) main provisions go into effect, and Organizing for Action and Enroll America kicked outreach efforts to the uninsured into high gear last week. Also in the past week, Sens. McCaskill and Coburn lobbied their peers for support of the Hospital Payment Fairness Act, which addresses the wage-index adjustments made by the ACA; the House Ways and Means... View Entire Update
Health Care Reform Implementation Update June 18, 2013
Last week the House Committee on Ways & Means Health Subcommittee held a hearing on Medicare overhaul proposals affecting post-acute care; the Congressional Budget Office (CBO) wrote to House Budget Committee Chairman Paul Ryan announcing that it will not update its 10-year budget baseline in August, which extends the low cost estimate of the Medicare Sustainable Growth Rate from February; the Medicare Payment Advisory Commission (MedPAC)... View Entire Update
Health Care Reform Implementation Update June 12, 2013
Discussions around reforming Medicare’s sustainable growth rate (SGR) continued this week as the Committee on Energy & Commerce held a hearing to solicit input on a draft bill for replacing the current SGR formula; the Ways and Means Committee noticed a hearing on post-acute care reform for Friday 6/15; the House of Representatives approved track and trace legislation; Dr. Gilfillan’s departure from the Centers for Medicare &... View Entire Update
Health Care Reform Implementation Update June 4, 2013
Medicare Trustees released their annual report finding that the Medicare trust fund will be exhausted in 2026, two years later than was predicted last year; over the past two weeks, as Washington has investigated the Internal Revenue Service’s (IRS) use of targeting, lawmakers have been working to ensure similar targeting cannot occur at the agencies implementing the Affordable Care Act (ACA); with bipartisan support Marilyn Tavenner... View Entire Update
Health Care Reform Implementation Update May 15, 2013
Last week the Senate agreed to vote on Marilyn Tavenner’s nomination to lead the Centers for Medicare and Medicaid Services (CMS); the Department of Health and Human Services (HHS) announced an initiative that will give consumers information on what hospitals charge and posted an initial set of data on CMS’ website; two major Medicare authorizing committees launched significant sustainable growth rate (SGR) reform initiatives; HHS... View Entire Update
Health Care Reform Implementation Update May 6, 2013
Last week the Centers for Medicare & Medicaid Services (CMS) issued new proposed regulations on FY 2014 payment updates and regulatory policy changes for inpatient and long term care hospitals, skilled nursing facilitates, hospices and inpatient rehabilitation facilities; the Internal Revenue Service (IRS) released a proposed rule on the minimum value of coverage employers must provide to their employees; the Center for Consumer Information... View Entire Update
Health Care Reform Implementation Update April 26, 2013
Marilyn Tavenner received bipartisan support from members of the Senate Committee on Finance in her confirmation hearing to lead the Centers for Medicare and Medicaid Services (CMS) though a full Senate vote is being held up, the president released his FY 2014 budget proposal with health care reform and specified reimbursement reductions to providers and manufacturers totaling $400 billion over 10 years sprinkled throughout it, and Department of... View Entire Update
Health Care Reform Implementation Update April 12, 2013
While Congress was in recess, the Centers for Medicare and Medicaid Services (CMS) surprised many when it changed course on Medicare Advantage payment rates – switching from a 2.3 percent reduction to a 3.3 percent increase, the Department of Health and Human Services (HHS) announced a one-year delay for the small business health options program exchange to offer multiple health plans, and HHS released a final rule detailing the expanded... View Entire Update
Health Care Reform Implementation Update March 26, 2013
Last week, as the Affordable Care Act turned three, the drumbeat of concern over Medicare Advantage cuts grew louder when Senate Finance Committee Chairman Max Baucus and Ranking Member Orrin Hatch – as well as 98 house members – wrote to the Centers for Medicare and Medicaid Services (CMS) expressing concern about rates for Medicare Advantage plans, MedPAC released its March report to Congress, the House and Senate passed a... View Entire Update
Health Care Reform Implementation Update March 14, 2013
Last week, the Department of Health and Human Services (HHS) conditionally approved state partnership marketplaces in Iowa, Michigan, New Hampshire and West Virginia; Accountable Care Organizations wrote to the Centers for Medicare & Medicaid Services (CMS) arguing that the quality targets set by the Center for Medicare & Medicaid Innovation (CMMI) were arbitrary; and legislation implementing Medicaid expansion in Florida struggled to... View Entire Update
Health Care Reform Implementation Update March 4, 2013
No deal was reached to avert the sequester, federal agencies issued more than 700 pages of health care guidance, and New Jersey announced it would expand its Medicaid program.   AT THE AGENCIES On Friday (3/1), the Department of Health and Human Services (HHS) issued final regulations providing detail and parameters related to the risk adjustment, reinsurance and risk corridors programs; cost-sharing reductions; user fees for... View Entire Update
Health Care Reform Implementation Update February 27, 2013
As Washington and the rest of the country brace for cuts from the sequester to kick in on March 1, Florida Gov. Rick Scott surprised many and confirmed others' predictions by announcing his state will expand its Medical program, and the Department of Health and Human Services (HHS) issued long-awaited final rules on essential health benefits, as well as pre-existing conditions and premium rate bands. AT THE AGENCIES On Friday (2/22), HHS... View Entire Update
Health Care Reform Implementation Update February 19, 2013
Last week another marketplace deadline came and went, Illinois became the 21st state approved to operate a health insurance marketplace, and U.S. senators pressed the HHS official responsible for the bulk of exchange implementation for information.   AT THE AGENCIES On Friday (2/15), the Obama administration said the state-based high-risk pools from the ACA will close to new applicants in the next few days or weeks as funding is beginning... View Entire Update
Health Care Reform Implementation Update February 13, 2013
In the past week, the Congressional Budget Office (CBO) released an updated federal budget to account for new regulations from the Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS), President Obama formally renominated Marilyn Tavenner to lead the Centers for Medicare and Medicaid Services (CMS), the Obama administration proposed eliminating outdated and burdensome Medicare requirements, and Mississippi became... View Entire Update
Health Care Reform Implementation Update February 4, 2013
Several agency actions on the Affordable Care Act out of HHS and Treasury last week include proposed regulations detailing exemptions from the shared responsibility tax, such as an exemption for those who would qualify for expanded Medicaid but live in states that choose not to expand the program; a final rule that addresses the meaning of affordability with respect to employer-provided coverage; and a proposed rule to guide nonprofit religious... View Entire Update
Health Care Reform Implementation Update January 23, 2013
In the past week, the health insurance exchanges were rebranded as “health insurance marketplaces;” HHS extended the deadline for states to opt into administering their own marketplaces and announced $1.5 billion in new grants to states for building them; and CMS released a proposed rule that details eligibility standards for marketplaces, Medicaid and CHIP.   AT THE AGENCIES On Monday (1/14), Sec. Sebelius announced that the... View Entire Update
Health Care Reform Implementation Update January 14, 2013
The Obama administration gave eight more states conditional approval to operate health insurance exchanges, bringing the total number of fully or partially approved exchanges to 20; HHS approved 106 new accountable care organizations; and Congress reached a deal on the fiscal cliff that includes a “doc fix,” cuts the Community Living Assistance Services and Supports Program (CLASS), and slashes funds for the Consumer Operated and... View Entire Update
Health Care Reform Implementation Update December 27, 2012
The extended deadline for states to submit plans to run their own insurance exchanges is now behind us.  A total of 18 states submitted blueprints to run their own exchanges.  The 32 remaining states have until February 15, 2013 to indicate they want to set up a partnership exchange.  The states that do not submit partnership applications will have federal exchanges.  HHS has now conditionally approved 11 states and the... View Entire Update
Health Care Reform Implementation Update December 12, 2012
As the year’s end approaches, the Hill is a flurry of activity with representatives from various health groups trying to ensure that whatever solution Congress finds to the fiscal cliff problems does not negatively affect them and those they represent.  More proposed rules were published this week – among them, one on reducing incentives for insurers to avoid enrolling unhealthy people and another on establishing a multistate... View Entire Update
Health Care Reform Implementation Update December 4, 2012
HHS is quickly moving to implement the Affordable Care Act.  Rules are out in the past two weeks that charge insurance companies to participate in federal exchanges, prohibit discrimination based on pre-existing conditions, detail essential health benefit requirements, and expand employment-based wellness programs.  In addition, in response to Liberty University’s request, the Supreme Court ordered the 4th Circuit to examine the... View Entire Update
Health Care Reform Implementation Update November 20, 2012
Acknowledging that many states are not prepared to meet deadlines, HHS Sec. Sebelius extended health care exchange deadlines twice in the past week so that states now have until December 14 to decide whether to run their own exchanges and February 15 to decide they would prefer to work in partnership with the federal government.  Notwithstanding the new decision deadlines, many states announced their intentions this week.  Buried in... View Entire Update
Health Care Reform Implementation Update November 12, 2012
The election results mean that the Affordable Care Act is here to stay.  There may be compromises and tweaks to the reform as it was originally laid out, but it’s clear that much of the law will remain.  As deadlines approach, states, insurers, providers, hospitals and employers are drilling down on what they need to do to implement and comply with the law of the land, the Affordable Care Act.   AT THE AGENCIES CMS approved... View Entire Update
Health Care Reform Implementation Update November 1, 2012
In less than two weeks, we will know not only who our president will be for the next four years, but also what our health insurance system is likely to look like. With the election so near, there was little implementation of ACA last week, but supporters and opponents of the law are waiting in the wings to begin taking action in November.   IN THE COURTS A proposed settlement of a class action lawsuit filed on October 16 in U.S. District... View Entire Update
Health Care Reform Implementation Update October 23, 2012
With the election less than three weeks away, states officials, congressmen, health care providers and insurers continue to tread water as they wait for the answers the election will provide. Congressional Republicans sent letters to Secretary Sebelius pointing to the wastefulness in the design of the Electronic Health Record incentive program – a program that if Romney were elected and there was Republican support in Congress would... View Entire Update
Health Care Reform Implementation Update October 17, 2012
Last week, the D.C. Health Benefit Exchange voted to combine its exchange markets for individuals and businesses with fewer than 50 employees, Ohio began the process of seeking approval to decrease the size of the pool of adults eligible for Medicaid under ACA, and Biden and Ryan battled over Medicare reform in Thursday night’s vice presidential debate.   AT THE AGENCIES Though the essential health benefits deadline passed earlier... View Entire Update
Health Care Reform Implementation Update October 8, 2012
As the congressional and presidential candidates continue to debate the merits and dangers of the Affordable Care Act, the deadline for states to let HHS know whether they will build and run their own exchanges is quickly approaching, and other provisions of the Affordable Care Act continue to go into effect. AT THE AGENCIES As part of the Partnership for Patients Initiative, CMS is partnering with organizations in seven states on a new... View Entire Update
Health Care Reform Implementation Update September 26, 2012
Over the past several days, a bill that would amend two medical loss ratio provisions of the Affordable Care Act was passed by the House Energy and Commerce Committee, a federal court said that Gov. Phil Bryant and other Mississippi residents were premature in their challenge to the federal law requiring people to buy health care insurance, and Oklahoma Attorney General Scott Pruitt asked a federal judge to rule that the individual mandate is... View Entire Update
Health Care Reform Implementation Update September 17, 2012
Over the past several days, HHS announced that the Affordable Care Act has already saved consumers about $2.1 billion through rebates and lower premiums; the Kaiser Family Foundation and the Health Research and Educational Trust released the 2012 employer Health Benefits Survey, which found that annual premiums for employer-sponsored family health coverage rose by 4 percent; and  the U.S. Census Bureau released the 2011 findings on health... View Entire Update
Health Care Reform Implementation Update September 5, 2012
Over the past week, the IRS issued a notice addressing how employers should determine whether employees are full time or part time; the IRS, Department of Labor and HHS jointly released a notice addressing how the 90-day waiting period limit for employment-based health insurance enacted by PPACA would be applied; and CMS awarded Connecticut a $107 million Level-Two Establishment Grant. AT THE AGENCIES New Hampshire Gov. John Lynch said the... View Entire Update
Health Care Reform Implementation Update August 30, 2012
Last week, CMS announced 500 provider practices in seven regions to participate in The Comprehensive Primary Care Initiative; HHS released a final “blueprint” to help guide states as they apply to operate health insurance exchanges; and Maryland, Michigan and Washington, D.C., took big steps in insurance exchange implementation. AT THE AGENCIES The Centers for Medicare and Medicaid Services is moving forward with The Comprehensive... View Entire Update
Health Care Reform Implementation Update August 24, 2012
Last week, CMS announced 500 provider practices in seven regions to participate in The Comprehensive Primary Care Initiative; HHS released a final “blueprint” to help guide states as they apply to operate health insurance exchanges; and Maryland, Michigan and Washington, D.C., took big steps in insurance exchange implementation. AT THE AGENCIES The Centers for Medicare and Medicaid Services is moving forward with The Comprehensive... View Entire Update
Health Care Reform Implementation Update August 16, 2012
This week, HHS began a series of regional meetings to discuss insurance exchanges with states reluctant to implement them, the deputy administrator and director of the CMS Center for Medicaid and CHIP Services said that states could accept ACA’s Medicaid expansion initially and opt out later, and Republican lawmakers on the House Ways and Means Committee requested that the GAO investigate reform implementation spending. AT THE AGENCIES HHS... View Entire Update
Health Care Reform Implementation Update August 1, 2012
Over the past week, analysts at the Congressional Budget Office said they expect that the Supreme Court’s decision, which struck down the requirement that states expand their Medicaid programs, will result in 3 million more uninsured and reduce costs by $84 billion; and the House Appropriations Committee released its fiscal 2013 budget for HHS, allocating $68.3 billion to the agency and defunding the Affordable Care Act. AT THE AGENCIES On... View Entire Update
Health Care Reform Implementation Update August 1, 2012
Over the past week, analysts at the Congressional Budget Office said they expect that the Supreme Court’s decision, which struck down the requirement that states expand their Medicaid programs, will result in 3 million more uninsured and reduce costs by $84 billion; and the House Appropriations Committee released its fiscal 2013 budget for HHS, allocating $68.3 billion to the agency and defunding the Affordable Care Act. AT THE AGENCIES On... View Entire Update
Health Care Reform Implementation Update July 18, 2012
Last week the House of Representatives voted to repeal the Affordable Care Act, but several Republican governors expressed willingness to expand their states’ Medicaid programs in accordance with the Act if their states could be granted control over how the dollars would be spent, and Kentucky committed to joining 15 other states and the District of Columbia in establishing a health insurance exchange under the Act. ON THE HILL The House... View Entire Update
Health Care Reform Implementation Update July 11, 2012
Following the Supreme Court’s decision to uphold the Affordable Care Act, lawmakers in the House of Representatives voted to repeal most of the law, several states said they would not implement portions of the law, and numerous lawsuits focused on smaller provisions of the Act are resuming or being launched. ON THE HILL House Majority Leader Eric Cantor introduced a new bill called The Repeal of Obamacare Act, H.R. 6079, for debate in the... View Entire Update
Health Care Reform Implementation Update July 3, 2012
The Supreme Court upheld the Patient Protection and Affordable Care Act in a landmark 5-4 decision, which prompted many in business, the administration and states around the country to proceed with the Act’s implementation, while others are preparing for a major political effort to repeal the law. IN THE COURTS In a landmark decision, the Supreme Court upheld much of the Patient Protection and Affordable Care Act on Thursday (6/28),... View Entire Update
Health Care Reform Implementation Update June 22, 2012
While business and government leaders awaited the Supreme Court’s decision on the Affordable Care Act, major Act implementation developments occurred around the country, including Rhode Island’s decision to proceed with health insurance standards, New Hampshire’s decision to block the implementation of a health insurance exchange, and CMS’s announcement that 14 million Americans have already been served by Affordable Care... View Entire Update
Health Care Reform Implementation Update June 15, 2012
The Supreme Court may not yet have decided the Affordable Care Act's fate, but several major health insurers have pledged to adopt many of the law‘s reforms regardless of the Court‘s decision, HHS has reported that more than 200,000 people have already gained access to care because of just one program within the law, and CMS has established a new data center to help it transition per the law‘s intent. AT THE AGENCIES HHS... View Entire Update
Health Care Reform Implementation Update June 7, 2012
While the Supreme Court makes its decision on the Affordable Care Act, lawmakers in Washington, D.C., are driving forward repeal-oriented legislation and simultaneously talking about reinstating elements of the Act should the whole thing be struck down, while HHS, CMS, and the IRS all released new or proposed rules on how to implement elements of the Act, and states like California and Oregon moved closer to full implementation of the Affordable... View Entire Update
Health Care Reform Implementation Update May 31, 2012
While the nation awaits the Supreme Court’s decision on the Affordable Care Act, the University of Notre Dame and other Catholic institutions filed 12 new suits against the administration; the GAO found that the NFIB was largely correct in its claim that many small businesses likely would not seek Affordable Care Act tax credits in order to provide coverage for employees; and congressional Republicans introduced legislation to repeal a 2.3... View Entire Update
Health Care Reform Implementation Update May 23, 2012
Last week, HHS set November 16 as the deadline for states to submit their insurance exchange plans, CMS granted CO-OP loans to Michigan and Nevada, and the Massachusetts Senate passed a bill to create a new state agency responsible for reining in in long-term health care costs.  AT THE AGENCIES HHS established November 16, 2012 as the deadline by when state governments must submit proposals for how they intend to operate their exchanges... View Entire Update
Health Care Reform Implementation Update May 16, 2012
Last week, HHS announced the first round of 26 Health Care Innovation Awards, CMS published the names of providers that have demonstrated meaningful use of electronic health records, and New Jersey Governor Chris Christie vetoed a bill to establish a health insurance exchange in his state. AT THE AGENCIES CMS published the names of Medicare providers that have demonstrated meaningful use of electronic health records and received incentive... View Entire Update
Health Care Reform Implementation Update May 8, 2012
Last week, the Obama administration announced that it would likely give Oregon $1.9 billion to get a new Medicaid initiative started and that it would provide $10.4 million to 70 grantees for rural health care and $728 million to more than 400 community health centers. Also last week, Massachusetts House leaders released their first version of legislation to reform the state's health care financing system by setting a target for the rate at... View Entire Update
Health Care Reform Implementation Update May 1, 2012
Last week, the Medicare Board of Trustees released its annual report, the House of Representatives voted to take money from the healthcare overhaul to extend low interest rates for federal student loans, and the House Energy and Commerce Committee approved a proposal package that aims to save the federal government about $114 billion over 10 years by repealing several Affordable Care Act provisions. AT THE AGENCIES On Monday (4/23), the Medicare... View Entire Update
Health Care Reform Implementation Update April 24, 2012
Last week, the House Ways and Means Committee marked up a proposal that calls for those who receive tax subsidy overpayments due to the Affordable Care Act to repay them, and a new study by The Commonwealth Fund shows that 26 percent of American adults were uninsured at some point in 2011. IN THE COURTS The Maine Equal Justice Partners and the American Civil Liberties Union of Maine Foundation brought a lawsuit in Maine on behalf of a man who... View Entire Update
Health Care Reform Implementation Update April 19, 2012
This past week CMS announced 27 accountable care organizations that will participate in the Shared Savings Program, New York Governor Andrew Cuomo issued an executive order to establish a health insurance exchange in New York, and some parties celebrated the six-year anniversary of Massachusetts health reform. IN THE COURTS A number of newspapers and online news networks published an AP article this week, which highlights a possible... View Entire Update
Health Care Reform Implementation Update April 12, 2012
Last week President Obama said he was confident the Supreme Court would not take the “unprecedented, extraordinary step” of overturning the Affordable Care Act.  A conservative judge from the U.S. 5th Circuit Court of Appeals requested that the Obama administration explain these comments, and Attorney General Holder responded in a memo. IN THE COURTS On Monday, President Obama said he was confident the Supreme Court would not... View Entire Update
Health Care Reform Implementation Update April 3, 2012
Last week, while hundreds of people gathered outside the Supreme Court to march, chant, debate and even play music, the justices heard arguments on the Affordable Care Act’s constitutionality. On Friday, the justices voted privately on the issues before them, however, the best answers the rest of us have are what we can read into the questions the justices asked publicly. In other news, a host of health care associations and organizations... View Entire Update
Health Care Reform Implementation Update March 26, 2012
Today the Affordable Care Act went before the Supreme Court.  Oral arguments will continue tomorrow and run through Wednesday.  Last Friday, the Affordable Care Act turned two, and the U.S. House voted to repeal the Independent Payment Advisory Board. IN THE COURTS Today marks the first day of oral arguments before the Supreme Court on challenges to the Affordable Care Act’s constitutionality.  Today, the court is... View Entire Update
Health Care Reform Implementation Update March 20, 2012
Last week, HHS issued final rules on health insurance exchanges, CBO provided new estimates on the cost and coverage of health reform, and the Supreme Court rejected calls to televise next week’s oral arguments.  This week marks the Affordable Care Act’s two-year birthday. IN THE COURTS There is now one week until the Supreme Court hears Florida v. Department of Health and Human Services. On Friday (3/16), the Supreme Court... View Entire Update
Health Care Reform Implementation Update March 14, 2012
In the past week, HHS released the final rule for health insurance exchanges; the White House coordinated events to be held outside the Supreme Court during the March 26-28th arguments; and New York State warned health insurers that they would lose state contracts if women on Medicaid were denied their choice of higher-cost, brand-name contraceptives. IN THE COURTS On Wednesday (3/7), White House officials summoned leaders of nonprofit... View Entire Update
Health Care Reform Implementation Update March 8, 2012
In the past week, HHS reported that the Affordable Care Act has eliminated lifetime limits on coverage for more than 105 million Americans; a U.S. House subpanel approved a measure to repeal the Independent Payment Advisory Board (IPAB); and House Ways and Means Committee Chairman Rep. David Camp (R-Mich.) requested that the Obama administration explain the additional $111 billion it has requested to implement health reform. IN THE... View Entire Update
Health Care Reform Implementation Update February 29, 2012
Last week, CMS released a proposed rule about Stage 2 requirements for the Medicare and Medicaid Electronic Health Record Incentive Programs; HHS announced that it is sending $229 million in grants to ten states to help them establish insurance exchanges, and the Supreme Court added 30 minutes to the March health reform arguments, which will now span six hours.   IN THE COURTS Seven state attorneys general, a nun, a Catholic missionary and... View Entire Update
Health Care Reform Implementation Update February 22, 2012
In the past week, President Obama released his FY 2013 budget, which includes cuts to Medicare and Medicaid benefits and expands health care tax credits; CMS announced that it is accepting comments on its proposed guidelines for Medicare Advantage and prescription drug plans; and lawmakers agreed on a “doc fix,” which will stave off payment cuts to Medicare doctors for 10 months. IN THE COURTS On Friday (2/17), Oregon Attorney... View Entire Update
Health Care Reform Implementation Update February 14, 2012
Last week, President Obama announced a compromise in the dispute over whether to require religious organizations to provide contraception insurance, HHS issued regulations requiring health plans to describe coverage in terms that will be understandable to consumers, and CMS rejected California’s plan to require cost sharing from Medi-Cal beneficiaries. AT THE AGENCIES On Friday (2/10), President Obama announced a compromise in the dispute... View Entire Update
Health Care Reform Implementation Update February 7, 2012
Over the past week, the Obama administration announced that 3.6 million people enrolled in Medicare saved $2.1 billion on prescription drugs; thousands of Catholic parishioners across the country were read a letter from their priests announcing that the church would not comply with the Affordable Care Act; and the Congressional Budget Office announced that if Congress used the nation’s war savings to address the sustainable growth rate... View Entire Update
Health Care Reform Implementation Update January 31, 2012
This week HHS released a preview of its essential benefit requirements, House Republicans indicated they would be prepared with a “replacement” health care package regardless of the Supreme Court’s ruling, and President Obama’s State of the Union Address failed to pay much attention to health reform.  IN THE COURTS On Friday (1/27), California Attorney General Kamala Harris led 10 states in filing an amicus brief... View Entire Update
Health Care Reform Implementation Update January 23, 2012
Last week, the Supreme Court agreed to allow two private citizens to join the health care lawsuit on the side of the 26 states, Secretary Sebelius ruled that religiously affiliated nonprofit organizations would have to offer birth control coverage to their female employees but can have an extra year to comply with the rule, and the House Ways and Means Committee voted 23-14 to repeal the CLASS program.   IN THE COURTS Following news that... View Entire Update
Health Care Reform Implementation Update January 20, 2012
In the past week, twenty-six states asked the Supreme Court to overturn the health reform law’s mandatory state expansion of the Medicaid program, an HHS study found that 5% of Americans are responsible for close to half the country’s medical spending, and state attorneys general from 11 states and the District of Columbia filed an amicus brief in support of the Affordable Care Act.  IN THE COURTS On Tuesday (1/10), twenty-six... View Entire Update
Health Care Reform Implementation Update January 10, 2012
Parties to the health care reform case filed opening briefs with the Supreme Court, CMS announced the final list of health plan waiver recipients, and a bipartisan House-Senate committee was appointed to reconcile the differences dividing Congress on the doc fix legislation. IN THE COURTS On Wednesday (1/4), the National Federation of Independent Business (NFIB), a small business group fighting the health care law, asked the Supreme Court for... View Entire Update
Health Care Reform Implementation Update December 22, 2011
During the past two weeks, the Supreme Court scheduled dates for the health care arguments in March, HHS outlined guidelines for the states on essential benefits requirements, CMS announced the selection of 20 health systems and 12 physician groups to participate in a “Pioneer” Accountable Care Organization initiative, and Rep. Paul Ryan and Sen. Ron Wyden released a bipartisan Medicare proposal. IN THE COURTS On Monday (12/19),... View Entire Update
Health Care Reform Implementation Update December 14, 2011
Season’s greetings and welcome to this year-end edition of our weekly health care reform update.  Our Alert is 14 months old, having been launched in October 2010 in the wake of the Affordable Care Act. We hope you have found it informative and look forward to resuming our regular Alerts next week.  This week we wanted to take a timeout and look back at where we’ve been; look around at where we are; and take a shot at... View Entire Update
Health Care Reform Implementation Update December 6, 2011
This week HHS released a final regulation implementing the medical-loss-ratio provision of the Affordable Care Act, 13 more states received grants to implement insurance exchanges, and HHS rejected Indiana and Louisiana’s requests for temporary exemptions from the medical-loss-ratio requirements. IN THE COURTS There was no citation of Virginia's challenge to the Affordable Care Act in documents released by the Supreme Court on Monday... View Entire Update
Health Care Reform Implementation Update November 28, 2011
This past week, CMS administrator Dr. Don Berwick stepped down from his position, state insurance regulators approved a resolution calling for changes to the Affordable Care Act’s medical loss ratio provision, and the Super Committee failed to reach a deal, which, according to the Budget Control Act of 2011, will trigger, among other things, a 2 percent reduction in Medicare spending that must come from payments to hospitals, doctors,... View Entire Update
Health Care Reform Implementation Update November 22, 2011
In the past week, the Supreme Court granted certiorari in the challenge to the Affordable Care Act brought by 26 states, the National Federation of Independent Business and two individual plaintiffs from the 11th Circuit; CMS announced that it will award up to $1 billion in grants to implement ideas that can quickly deliver cost saving and quality of care benefits to the Medicare program; and members of the Supercommittee reported that it is... View Entire Update
Health Care Reform Implementation Update November 14, 2011
The Supreme Court granted certiorari in the challenge to the Affordable Care Act brought by 26 states and the National Federation of Independent Businesses; the District of Columbia ruled that the individual mandate of the Affordable Care Act is not unconstitutional; CMS released its Medicare Shared Savings program application, which will offer hospitals and medical groups financial incentives to reduce costs and improve quality for Medicare... View Entire Update
Health Care Reform Implementation Update November 8, 2011
This week the Obama administration filed a document with the Supreme Court urging it not to review Virginia’s case against the Obama administration because the state lacks standing, Vermont estimated a price for its single-payer plan established last May, and a new poll by the Kaiser Family Foundation reports that 51 percent of Americans now hold an unfavorable view of PPACA while 34 percent hold a favorable view – the lowest level... View Entire Update
Health Care Reform Implementation Update November 2, 2011
The Supreme Court is scheduled to decide how to handle the multiple Affordable Care Act challenges at a private conference on November 10, HHS announced that 2012 Medicare Part B premiums will be lower than projected, and the House of Representatives voted to change the Affordable Care Act’s definition of income, such that modified adjusted gross income would not exclude the portion of Social Security benefits that are not subject to... View Entire Update
Health Care Reform Implementation Update October 25, 2011
This week, the Obama administration released its final rules for Accountable Care Organizations, both parties in the Florida case ruled on by the 11th Circuit Court of Appeals sped up their filings to the Supreme Court so the legal proceedings may advance more swiftly, and HHS launched its new Innovation Advisors program, which will select 200 health care experts to work with providers on developing methods to improve the health care delivery... View Entire Update
Health Care Reform Implementation Update October 20, 2011
This week the Obama administration discontinued the CLASS Act, Liberty University became the latest party to request that the Supreme Court hear its case against the Affordable Care Act, and the U.S. House of Representatives approved legislation to prohibit funding for abortion coverage in the Affordable Care Act. IN THE COURTS On Monday (10/10), Liberty University, a private Christian university in Virginia, became the latest party to request... View Entire Update
Health Care Reform Implementation Update October 12, 2011
This week Virginia petitioned the Supreme Court to hear its case, appealing the 4th Circuit Court of Appeals’ ruling dismissing the state’s challenge to the Affordable Care Act; the Obama administration released a framework for a federally designed basic benefits package for millions of privately insured Americans; and President Obama started embracing the name, “Obamacare.” IN THE COURTS States and health care... View Entire Update
Health Care Reform Implementation Update October 5, 2011
On Wednesday (9/28), the Justice Department filed a petition asking the Supreme Court to review the 11th Circuit Court of Appeals' decision that PPACA's individual mandate is unconstitutional.  Monday (10/3) marked the last day for professionals eligible for Stage 1 of the EHR incentive program to begin their 90-day reporting period.  The Center for Medicare & Medicaid Innovation has begun a new initiative, the... View Entire Update
Health Care Reform Implementation Update September 29, 2011
The U.S. Court of Appeals for the District of Columbia Circuit gave PPACA a mixed reception during oral arguments, the White House began downsizing the office charged with implementing the CLASS Act, and a Senate subcommittee approved a $70.18 billion budget for fiscal year 2012. IN THE COURTS On Friday (9/23) during oral arguments, two of three judges of the U.S. Court of Appeals for the District of Columbia Circuit said a ruling upholding the... View Entire Update
Health Care Reform Implementation Update September 20, 2011
President Obama submitted jobs legislation to Congress on Monday that would make health plans provided by employers partially taxable for couples making more than $250,000 and individuals making more than $200,000 a year.  Also this week, a federal judge in Harrisburg, Pa., ruled that the individual mandate exceeded the Commerce Clause powers, HHS announced $10 million in PPACA funding for 129 community health centers, and CMS Administrator... View Entire Update
Health Care Reform Implementation Update September 13, 2011
A day after President Obama unveiled his new jobs package, federal officials announced more than $700 million in new building and facility upgrade grants made possible by the Affordable Care Act, as a means to create jobs.  The Fourth Circuit Courts of Appeals handed down its much-anticipated ruling on the Virginia case against the Affordable Care Act.  The court held that Virginia lacked the necessary standing to bring the suit and so... View Entire Update
Health Care Reform Implementation Update September 8, 2011
Employers nationwide added no new jobs in August according to recent headlines, but the health care sector added 29,700 this past month, and a total of 205,100 new jobs since the start of 2011.  CMS’s final rule on electronic prescribing was published in the Federal Register this week.  A federal judge will allow a lawsuit filed in Mississippi and challenging the Affordable Care Act to continue. AT THE AGENCIES On Wednesday... View Entire Update
Health Care Reform Implementation Update September 1, 2011
There is now a circuit split over the constitutionality of the Affordable Care Act’s requirement that most people buy health insurance or face a penalty after the 11th Circuit ruled on August 12th that the requirement was unconstitutional while on June 29th the 6th Circuit upheld the law’s constitutionality. Over the past few weeks, HHS and CMS: 1) proposed a new payment structure for Medicare, under which payments for care would be... View Entire Update
Health Care Reform Implementation Update August 11, 2011
The impact of the debt-ceiling deal on health care reform is yet to be determined. Medicare and Medicaid beneficiaries are off the table but providers are most certainly not safe. Also, some but not all of the Affordable Care Act's programs are in play. And that's IF the joint committee agrees on cuts. If it fails, then Medicare automatically drops 2 percent across the board. The bottom line is that in the next few months nearly every... View Entire Update
Health Care Reform Implementation Update August 2, 2011
In the wake of the 6th Circuit’s decision to uphold the constitutionality of the Affordable Care Act in the Thomas More Law Center’s lawsuit, the Thomas More Law Center has filed a petition for certiorari.  A new report from CMS’ Office of the Actuary has received much publicity this week.  The report said that the rate of growth in U.S. health care spending is expected to increase so that by 2020, health care... View Entire Update
Health Care Reform Implementation Update July 20, 2011
HHS released proposed insurance exchange regulations, which the agency says will provide states with considerable flexibility in implementation. Democrat and Republican leaders spent last week behind closed doors attempting to negotiate a deal on the federal deficit and debt limit. Some are pushing for the main points of compromise to be in the Medicare, Medicaid and Social Security programs. These discussions continue to develop... View Entire Update
Health Care Reform Implementation Update July 11, 2011
On the Hill, supporters and opponents of the Independent Payment Advisory Board gear up for this week’s debate; CMS is busy issuing proposed rules and reading comments in response to them; and in the states, officials are not implementing insurance exchanges quickly enough to be on track for the 2014 deadline.   IN THE COURTS On Tuesday (7/5), a federal district court for the Northern District of Ohio ruled that it was bound by the... View Entire Update
Health Care Reform Implementation Update July 5, 2011
The Obama administration achieved a major victory this week in the Sixth Circuit. Not only did the appeals court come down in favor of the Affordable Care Act, but the deciding vote was cast by a Bush appointee.  Though the Sixth Circuit gave the Obama administration a green light, other groups continue to fight the law provision by provision.  Two hundred seventy health care groups wrote to Congress urging repeal of the Independent... View Entire Update
Health Care Reform Implementation Update June 28, 2011
59-year-old James Verone had never been in trouble with the law until two weeks ago when he robbed a bank in Gastonia, N.C., for one dollar. Rather than flee, Verone told the teller she should call the police while he waited on the couch in the bank for them to come.  Why would anyone do this?  Unemployed and in need of medical care, Verone thought he had a better shot at receiving medical attention in prison than out.  Verone... View Entire Update
Health Care Reform Implementation Update June 21, 2011
This week the Government Accountability Office released a report showing that the now 1,372 groups to which HHS has granted waivers were chosen in a neutral (non-partisan) manner. The report was released less than three days before the Obama Administration announced it was shutting down the program that provided these waivers. After September 22, no new applications will be accepted. Meanwhile, a House Appropriations subcommittee approved a... View Entire Update
Health Care Reform Implementation Update June 13, 2011
With dozens of challenges to the Affordable Care Act making their way into court and the courts’ holdings falling strictly along party lines – judges appointed by Democratic presidents find the individual mandate constitutional, and judges appointed by Republican presidents find the mandate (or in Judge Roger Vinson’s case, the whole law) unconstitutional – the case to watch may be the one in the 11th Circuit, for which... View Entire Update
Health Care Reform Implementation Update June 6, 2011
Summer begins. Reform continues. Reminder: for those of you commenting on the ACO regs, today's the deadline. Expect CMS to modify the draft rules. Lots of blowback coming in the comments. IN CONGRESS Seven members of the Senate Finance Committee have requested that CMS withdraw the accountable care organization proposed rule. The seven members are Sens. Tom Coburn (R-OK), Jon Kyl (R-AZ), Mike Crapo (R-ID), Mike Enzi (R-WY), John Cornyn... View Entire Update
Health Care Reform Implementation Update May 17, 2011
We have added section headers to the update this week to help you organize your review of the week's events. Hope it helps eliminate any confusion with the update. The confusion in the health care world at large is above our pay grade to resolve. IN THE COURTS On Tuesday (5/10), a federal court of appeals heard oral arguments in two cases challenging the Affordable Care Act, one by Liberty University and the other by Virginia Attorney... View Entire Update
Health Care Reform Implementation Update May 5, 2011
Another week, another step towards reformation of the Medicare reimbursement model. Quality, not quantity, of services is to be the basis for hospital payments. Better care - and it should cost less too. Time will tell but none should doubt the determination of HHS to change the way it does business. On Friday (4/29), CMS announced its final regulation for the Hospital Value-Based Purchasing Program, which will reward hospitals for the quality... View Entire Update
Health Care Reform Implementation Update April 28, 2011
Supreme Court declines expedited review of ACA, as noted below. Not noted below or in most media reports is the decision by Justice Kagan not to recuse herself. That's one more vote to uphold the Act for those of you keeping score at home. In the days since President Obama announced a strengthened role for the Independent Payment Advisory Board (IPAB), the Medicare oversight panel created by the Affordable Care Act, there has been... View Entire Update
Health Care Reform Implementation Update April 22, 2011
Supreme Court. HHS. Department of Labor. CMS. FTC. Minnesota. Oklahoma. Oregon. The list goes on. And all in one week. ACA is indeed a big deal. On Monday (4/18), the Supreme Court released the list of cases it will consider this session. Notably missing from the list was Virginia's challenge to the Affordable Care Act, which Virginia Attorney General Cuccinelli had petitioned the Court to take (bypassing the appeals process). The Affordable... View Entire Update
Health Care Reform Implementation Update April 14, 2011
Last week saw a surge of activity, culminating with a Friday night budget deal that eliminated two ACA provisions that most people didn't even know existed. Health care remains front and center. The budget deal reached in Congress on Friday (4/8), would affect two provisions of the Affordable Care Act. It would 1) eliminate the provision that enables low-income workers to opt out of employer-offered health insurance to shop for more... View Entire Update
Health Care Reform Implementation Update April 7, 2011
A judicial update. A legislative update. The big administrative story was of course the issuance of the ACO regulations, which we already shared with you separately, and more activity both pro and con in the states. Let's see what this week brings. This week the Obama Administration formally responded to Judge Vinson’s ruling that the individual mandate of the Affordable Care Act exceeded Congress’s power to regulate interstate... View Entire Update
Health Care Reform Implementation Update March 31, 2011
A friend wondered recently whether these updates should be less frequent given that some weeks are slower than others.  This past week wasn't one of those slower ones. See below. With administrative, legislative and judicial activity at the federal and state levels, we don't expect this pace to abate for more than a random week here and there so we'll keep reporting. Please let us know if you stop reading. Last Wednesday, March... View Entire Update
Health Care Reform Implementation Update March 24, 2011
Happy Birthday ACA.  And many, many more? One year after President Obama signed the Affordable Care Act into law, public opinion remains split, Republican congressmen are attempting to withhold funding for implementation and judicial threats loom. According to a Kaiser Family Foundation survey, public opinion has changed very little over the course of the past year. The survey found that a plurality has an unfavorable impression of the... View Entire Update
Health Care Reform Implementation Update March 17, 2011
The Senate Finance Committee held a hearing yesterday titled "Healthcare Reform: Implementation So Far." Secretary Sebelius testified. They could have found all the answers just as easily by reading this weekly update. On Thursday, March 10, HHS proposed new waiver rules designed to give states more freedom in developing their health care systems and policies. These regulations would implement the Affordable Care Act’s... View Entire Update
Health Care Reform Implementation Update March 9, 2011
ACA survives Judge Vinson's "clarification" and the 11th Circuit now joins the 4th in setting a schedule for deciding the future of health care reform. Meanwhile, the implementation/not seesaw continues, and continues, and continues. The following is the Health Care Reform Implementation Update for the week of March 7, 2011. In a letter released Thursday, March 3, 42 Republican senators wrote to the Obama Administration... View Entire Update
Health Care Reform Implementation Update March 3, 2011
The plot thickens. The president endorses amendment of the Affordable Care Act (ACA) to encourage innovation by the states while his administration implements and innovates at an unabated pace. Interesting times. The following is the Health Care Reform Implementation Update for the week of February 28, 2011. A new tracking poll from the Kaiser Family Foundation shows that only 52 percent of Americans know that the ACA is still law, while 22... View Entire Update
Health Care Reform Implementation Update February 24, 2011
The more things change . . . This week's update brings the same ying-yang that has characterized 2011 so far. Ds implementing and Rs de-funding. No end in sight to this seesaw. The following is the Health Care Reform Implementation Update for the week of February 21, 2011. On Friday (2/18) the Republican-led House attached several measures to a spending bill, which would prevent enactment of the Affordable Care Act. The House passed: 1) a... View Entire Update
Health Care Reform Implementation Update February 7, 2011
And so we enter 2011 with health care reform on two antagonistic tracks. As set forth below, implementation by the Administration continues unabated and resistance by the opposition continues undeterred as well. Stay tuned. The Centers for Medicare & Medicaid Services (CMS) will release its proposed accountable care organization rule any day now. Though Dr. Berwick is not yet permitted to talk specifically about what will be included in this... View Entire Update
Health Care Reform Implementation Update - February 2, 2011
As Yogi Berra would say, "It's déjà vu all over again." 2010 began with Washington obsessed with health care reform and the election of Scott Brown on January 20 - a year to the day after President Obama's inauguration. Now, despite passage of the Affordable Care Act ten months ago, 2011 begins with the House of Representatives repealing the "job-killing" health care bill. Looks like we are in for... View Entire Update
Health Care Reform Implementation Update January 11, 2011
Majority Leader Eric Cantor (R-VA) postponed the House’s legislative agenda this week, including the vote on repeal of the Affordable Care Act, after Saturday’s Arizona shooting, which left six dead and 14 injured.  Among those injured was Congresswoman Gabrielle Giffords (D-AZ), who remains in critical condition. Republicans expect to pass the legislation easily in the House but privately acknowledge that the measure faces an... View Entire Update
Health Care Reform Implementation Update December 15, 2010
The following is the Cozen O'Connor Public Strategies Healthcare Reform Implementation Update for the week of December 13, 2010. On Monday, December 13, a federal court in Virginia ruled that key parts of the Patient Protection and Affordable Care Act (PPACA) are unconstitutional. U.S. District Judge Henry E. Hudson, a George W. Bush appointee, said PPACA’s requirement that most Americans carry insurance by 2014 or pay a fine... View Entire Update
Health Care Reform Implementation Update December 9, 2010
On Friday, December 3, the Medicare Payment Advisory Commission (MedPAC) released its draft recommendations for fiscal year 2012. MedPAC recommends that hospitals receive a 1 percent net increase in inpatient and outpatient payment rates and a 1 percent increase in physician payments. The commission will vote on these and other recommendations in mid-January before releasing its report to Congress on March 15.Last week President Obama signed... View Entire Update
Health Care Reform Implementation Update December 2, 2010
December 2, 2010On Monday, November 29, the Senate failed to repeal the new tax reporting rules of the Patient Protection and Affordable Care Act (PPACA) even though both Democrats and Republicans agreed they needed to be abandoned to prevent businesses from being overwhelmed with undue tax paperwork. Caught in a partisan dispute over how to proceed with eliminating new tax reporting rules, the Senate twice was unable to reach an agreed-upon... View Entire Update
Health Care Reform Implementation Update November 24, 2010
On Monday, November 22, 2010, the Department of Health and Human Services (HHS) issued its long-awaited regulations on medical payouts required under the health care law, a standard known as the medical loss ratio (MLR). The new rules say that HMOs must spend 80% (for individuals) or 85% (for groups) of all premium dollars, net of taxes, on health care. So if one pays $15,000 a year for family coverage, on average, $12,000 must go to doctors,... View Entire Update
Health Care Reform Implementation Update November 17, 2010
On Wednesday (11/10), an official with the National Governors Association told insurance executives at a conference hosted by America''s Health Insurance Plans that the challenges states face in creating health insurance exchanges, coupled with the changed political landscape, may lead a number of states to delay legislative action to create health care marketplaces until 2012. In keeping with this prediction, this week, Wisconsin''s Governor-elect... View Entire Update
Health Care Reform Implementation Update November 11, 2010
In the week following the midterm elections, House and Senate Republicans have made known their intent to “repeal and replace” the Patient Protection and Affordable Care Act (PPACA). Senate Minority Leader Mitch McConnell said Republicans in Congress should “repeatedly” seek votes on “straight repeal” of Democrats’ health care overhaul. He said that because Republicans could not expect the president to... View Entire Update
Health Care Reform Implementation Update November 2, 2010
Much of the health care news this week focused on the effect the election may have on PPACA. Many think major Republican gains could mean significant hold-ups in the legislation’s implementation, or possibly even repeal. Democratic pollsters warned Republicans that if they interpret the midterm results to be a directive to repeal and replace health care law, they would suffer for it in 2012.PPACA requires that all states have health... View Entire Update
Health Care Reform Implementation Update October 27, 2010
Last Monday, a federal judge in Virginia said he would rule before the end of the year on whether the health reform legislation violates the Constitution. The judge conceded that his ruling would likely be just a small step on the legislation’s way to the Supreme Court.HHS said it will award nearly $30 million in consumer assistance grants to help states and territories either establish or strengthen programs that provide direct services... View Entire Update
Health Care Reform Implementation Update August 21, 2014
The Centers for Medicare and Medicaid Services (CMS) made announcements this week regarding the Open Payments system and the availability of Affordable Care Act (ACA) Consumer Assistance Program grant funds, issued a request for additional information to ACA enrollees with inconsistent data on their applications, and posted the responses it received to its Request for Information (RFI) regarding the evolution of the Accountable Care... View Entire Update
Health Care Reform Implementation Update September 9, 2014
As summer rolls to a close, the agencies continue to make announcements and roll out additional regulations. The Department of Health and Human Services (HHS) introduced the new CEO of Healthcare.gov, awarded grants to 147 health centers across the country, and released new rules regarding nonprofit religious organizations and the Affordable Care Act (ACA) contraception mandate. The Centers for Medicare and Medicaid Services (CMS) issued a final... View Entire Update
Health Care Reform Implementation Update September 15, 2014
Congress is back in session, and work on a Continuing Resolution is underway. The Affordable Care Act (ACA) is back center stage with House Republicans attaching a medical device tax repeal provision to a jobs package set for a floor vote this week and the House Ways and Means Committee holding a hearing to discuss the status of the ACA’s implementation with CMS Deputy Administrator Andy Slavitt and IRS Commissioner John Koskinen. On... View Entire Update
Health Care Reform Implementation Update September 23, 2014
Last week, the House and Senate passed post-acute care legislation; the House Oversight and Government Reform Committee held a hearing on the Affordable Care Act (ACA) exchanges, enrollment and information security; the GAO released a report regarding improper coverage of abortion services by many ACA plans; and the Centers for Medicare & Medicaid Services (CMS) announced that certain individuals who failed to provide immigration documents... View Entire Update
Health Care Reform Implementation Update October 3, 2014
Congress is in recess and therefore much of the action surrounding the Affordable Care Act (ACA) is at the agency level. However, Congressman Darrel Issa (R-Calif.) did subpoena the U.S. Department of Treasury for their records on the Internal Revenue Service (IRS) regulation regarding ACA subsidies. The Department of Health and Human Services (HHS) reported on hospital savings under the ACA and touted the increase in number of... View Entire Update
Health Care Reform Implementation Update October 15, 2014
In the past week, CMS has released several advisories including updates to the rating system for nursing homes, premium and deductible information for Medicare Part B and Part D for 2015, Pioneer ACO results, payment dispute settlements, and insurance fee FAQs. Even though they are out of session, a group of congressional members asked the Government Accountability Office (GAO) for a legal opinion regarding the risk corridor program under the... View Entire Update
Health Care Reform Implementation Update October 27, 2014
The Centers for Medicare and Medicaid Services (CMS) began sending reminders last week that open enrollment begins on November 15; CMS’s Marketplace CEO, Kevin Counihan, said that end-to-end testing of HealthCare.gov was encouraging but that the Department also has a variety of backup plans in case HealthCare.gov does not function properly during open enrollment. CMS announced the Accountable Care Organization (ACO) Investment Model,... View Entire Update

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