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 House of Representatives, where it was expected to pass because of House GOP support, but the Senate vowed not to take up the matter and the president promised to veto it should it arrive on his desk. As a technical matter, the symbolic bill would keep alive a subsection of the Affordable Care Act that governs how the House votes on Medicare cuts recommended by the Independent Payment Advisory Board, largely because that subsection prevents the House from changing those rules, even through repeal.
Senate Minority Leader Mitch McConnell said if given the opportunity after the November elections, he would use any legislative tools necessary to repeal the Affordable Care Act, including the procedural process known as reconciliation. He told a group on Monday (7/2), however, that the odds are not on his side “because it’s a lot harder to undo something than it is to stop it in the first place.”
IN THE COURTS
Now that Supreme Court has upheld the Affordable Care Act, lower courts are beginning to revisit cases that were put on hold when the Supreme Court agreed to take up the case on the insurance mandate. Courts are considering, or are likely to soon consider, cases on the Act’s contraception coverage requirement, Independent Payment Advisory Board, limitations on new physician-owned hospitals, and even a possible legal challenge to block the federal government from offering subsidies in a federal health insurance exchange.
IN THE STATES
Texas said on Monday (7/9) that it did not intend to expand Medicaid programs for its citizens or establish a state-health-insurance exchange as required by the Affordable Care Act. The Supreme Court’s recent ruling upheld the mandate to purchase health insurance but struck down the penalty that would have been used to punish states that did not engage in the Act’s Medicaid expansion programs.
Florida also announced it would not implement the Medicaid expansion portions of the Affordable Care Act or put in place a health-insurance exchange before the November 2012 elections. If any legal obligations associated with the Act require Florida to act before the elections, however, Gov. Scott said his state would comply.
Governors in Louisiana, Iowa, South Carolina, and Mississippi also said they object to expanding their Medicaid programs as outlined in the Affordable Care Act, and governors in 25 additional states say that after the Supreme Court ruling, they are considering their options before acting.
After the Supreme Court decision, Hawaii seated 15 permanent board members on its Hawai’i Health Connector, the state’s health insurance exchange established to meet the requirements of the Affordable Care Act.
AT THE AGENCIES
CMS announced 89 new Medicare Accountable Care Organizations, more than doubling the experiment in size. CMS added these new participants to its shared-savings program, which offers medical groups, hospitals and federally qualified health centers financial incentives to improve quality and control costs.
HHS Secretary Kathleen Sebelius took to the pages of The Washington Post to defend the Affordable Care Act from those in Congress seeking to repeal it. She addressed claims that health care costs would rise, small businesses would be hurt, and Medicare benefits would be cut because of the law. Secretary Sebelius pointed out that the average family premium doubled between 2000 and 2009, but between 2009 and 2011 rose at a 25 percent lower rate, generating savings of more than $1,200 per family. She also said the number of small businesses offering health insurance dropped from 70 percent in 2000 to less than 60 percent in 2009, but after the law’s passage, has held steady at 59 percent and is expected to rise soon. Finally, seniors are doing better because of new preventative care assistance and discounts on brand-name medications for those in the “doughnut hole” coverage gap.
To view our compilation of recent health care reform implementation news, click here.