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 affordable coverage; and 2) cut $2.2 billion in funding from a program that would encourage development of health-care cooperatives. Also included in the deal was a guarantee by Senator Reid to Republicans that he would allow a vote in the Senate on defunding the Affordable Care Act.
The Obama Administration filed a new brief with the 4th U.S. Circuit Court of Appeals in Richmond, challenging Virginia's standing to sue HHS over the Affordable Care Act's constitutionality. The DOJ disputes Attorney General Cuccinelli's argument that Virginia's claim against the government stems from legislation filed in the state, which declares the state’s residents out of the individual mandate's reach. In its new filing, the administration responds that a similar rationale could allow states to legislate their residents out of Social Security or the obligation to be called into service under federal war powers.
On April 8, a coalition of six industry groups (the American Hospital Association, the Association of American Medical Colleges, the Catholic Health Association, the Federation of American Hospitals, the National Association of Children’s Hospitals, and the National Association of Public Hospitals and Health Systems) representing hospitals and health systems filed a friend-of-the-court brief with the 11th Circuit Court of Appeals in Atlanta arguing the judge in Pensacola, Florida should not have struck down the Affordable Care Act. On Monday (4/11), Missouri Attorney General Chris Koster, a Democrat, also filed a friend-of-the-court brief in the 11th Circuit urging the federal judge to invalidate a key provision of the Affordable Care Act.
Private health plans that service Medicare payments will receive lower reimbursement increases than expected. In February, the CMS announced that Medicare Advantage plans could expect payment increases averaging 1.6%. Because payments to Medicare Advantage plans are tied to overall program spending, and because Medicare spent less than administrators expected, Medicare Advantage payments to private U.S. health insurers will only increase by an average of 0.4% (rather than 1.6%) in 2012.
Dr. Farzad Mostashari will succeed Dr. David Blumenthal (who announced his departure in February) as the head of the Office of the National Coordinator for Health Information Technology at HHS. Mostashari has served as the deputy national coordinator for programs and policy at the ONC and the assistant commissioner for the primary-care information project at the New York City Health and Mental Hygiene Department.
HHS unveiled an action plan and a national stakeholder strategy intended to reduce health disparities among racial and ethnic minorities. The Action Plan has five major goals: 1) transform healthcare; 2) strengthen the national health and human services workforce; 3) advance the health and wellbeing of the public; 4) implement a new health data collection and analysis strategy; and 5) increase efficiency, transparency and accountability of HHS so that assessments of effect on health disparities will be incorporated into HHS decision making. The National Stakeholder Strategy also expresses five goals: 1) transform healthcare; 2) strengthen the national health and human services workforce; 3) advance the public’s health and well-being; 4) increase efficiency, transparency and accountability so assessments of programs and policies will be made during the HHS decision-making process; and 5) improve data availability, coordination, utilization and diffusion of research and outcomes.
On Wednesday (4/4), CMS announced that it will now make public hospital-acquired condition (HAC) data. The American Hospital Association is opposed to the release of HAC data, and has repeatedly questioned the formula CMS uses to determine error rates. Since 2008, Medicare has banned reimbursements for treatment to patients who suffer from HACs. The Affordable Care Act requires these reimbursement bans going forward as well.
In the states:
1) On Wednesday (4/4), the Alaska Health Freedom Act, which is intended to block the individual mandate of the Affordable Care Act, moved out of the House Judiciary Committee.
2) On Tuesday (4/5), the Rhode Island Senate voted 31-6 to pass legislation, which will create a state health insurance exchange.
3) Last month the Alabama House voted on a proposed constitutional amendment to exempt Alabamans from the individual mandate of the Affordable Care Act, but did not have enough votes to pass it. On Tuesday (4/3), the House voted again, this time passing the bill that will let Alabama residents vote on the constitutional amendment.
4) The Idaho Senate voted 24-11 to approve legislation intended to block "discretionary provisions" in the Affordable Care Act.
5) One month after Washington State cut 17,000 people from its subsidized health care program, a state resident who has been fighting breast cancer has filed a potential class-action lawsuit. The plaintiff challenges that the cut is a violation of the Constitution's equal-protection clause because it disqualifies some legal immigrants while serving others. Of the 17,000 people dropped, 7,300 have appealed and over 4,100 of them have been reinstated.
This week: On Wednesday (4/13) at 1:00 p.m., Massachusetts Governor Deval Patrick will speak at the Center for American Progress about lessons from Massachusetts' experience in expanding coverage and the state's current efforts to address health care costs. On Wednesday (4/13) at 10:00 a.m. in 2175 Rayburn, the House Education and Workforce Committee will hold a hearing titled "Policies and Priorities of the U.S. Department of Health and Human Services." On Friday (4/15) at 12:15 p.m. in 106 Dirksen, the Alliance for Health Reform and the Robert Wood Johnson Foundation will sponsor a luncheon briefing titled "Community Coalitions: Pursuing Better Quality Health Care One Locality at a Time."
As always, please feel free to contact us with any questions.
To view our compilation of this week's health care reform implementation news, click here.