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 23, marked the one-year anniversary of the day the Patient Protection and Affordable Care Act was signed into law. The Obama Administration used the anniversary to focus public attention on the parts of the law that have already taken effect. House Speaker John Boehner (R-Ohio) and Senate Minority Leader Mitch McConnell (R-Kentucky) used the occasion to write an op-ed in the Cincinnati Enquirer, in which they state their continuing commitment to repealing the Affordable Care Act.
Several Democratic lawmakers have called an Obama Administration letter that outlines potential cuts in Medicaid to help states balance their budgets “cruel.” The lawmakers worry that the letter will encourage states to provide less coverage to the country’s poorest people at a time when they need it most. States routinely receive matching funds from the federal government for Medicaid costs. Due to the 2009 stimulus bill, states have enjoyed even greater federal Medicaid "matches." For every dollar spent by a state, the federal government spent $2.68. Now, however, the federal government will begin incrementally decreasing this “match.” Beginning April 1, states will lose an average of 21 cents per dollar.
The Obama administration is delaying enforcement of new rules born by the Affordable Care Act intended to protect patients who appeal insurers' decisions to deny or reduce benefits. With minimal fanfare, the Department of Labor posted on its website that it will revise requirements to deal with objections raised by insurers. The appeals rules were originally to go into effect last January. Then last fall, officials revised this schedule such that enforcement would not begin until July. Consumer advocates are concerned the most recent announcement - that the rules will be modified "in the near future" - really means they will not be modified and will not go into effect at all. The specific rules postponed include a reduction in the time an insurance company may have to review a denial of coverage in urgent cases, a requirement that insurers provide information about the denial and appeal process, and a requirement that insurers provide consumers with specific details about which treatments are not covered and why.
In the states this week:
1) On Thursday, March 24, the Vermont House voted to establish a single-payer health care system in the state. The bill will now move on to the Senate.
2) On Friday, March 25, the Idaho House voted 50-15 to return a Department of Insurance appropriation to the Joint Finance-Appropriations Committee due to objections to the $2.5 million in federal government money allocated to help develop insurance exchanges as required by the PPACA.
3) On Wednesday, March 23, in Montana, a Republican proposal to establish a state-regulated health insurance marketplace stalled in the House Business and Labor Committee.
4) On Thursday, March 24, the North Dakota Senate approved a bill that says the Affordable Care Act's mandates do not apply in its state.
5) In Oregon, the Health Systems Transformation Team is recommending an overhaul of Oregon's health care system aimed to reward doctors for keeping patients healthy and out of the hospital.
6) The Alabama House voted 59-28 in favor of a constitutional amendment for the state to withdraw from the Affordable Care Act, however 63 "yes" votes were needed to pass a constitutional amendment.
7) On Monday, March 28, the Arkansas House Insurance and Commerce Committee endorsed a bill that would allow the state to begin creating rules necessary to implement a health insurance exchange as required by the Affordable Care Act.
8) On Wednesday, March 23, Delaware State Rep. Deborah Hudson unveiled a bill, The Delaware Health Freedom Act, which would allow Delawareans to choose their own health insurance plan or opt out of the government plan without facing penalties, and would allow the state to sue the federal government to overturn the Affordable Care Act.
9) On Tuesday, March 22, the Kansas Senate voted 26-10 to prohibit the state government from forcing any individual or employer to buy health insurance.
10) Oklahoma Governor Mary Fallin announced a proposal for an alternative to the Affordable Care Act in a letter she sent to state lawmakers Tuesday, March 22, asking them to pass House Bill 2130, which would create a health insurance exchange under which insurers would compete to promote choices for consumers and the free market would work to lower costs.
11) Alaska's Senate Labor and Commerce Committee sent legislation that would enable the state to create an insurance exchange out of committee on Tuesday, March 22.
12) A bill was introduced in the Colorado House of Representatives on Monday, March 21, that would establish an independent state agency, the Colorado Health Benefits Exchange.
The U.S. Supreme Court will consider Virginia’s petition for the Court to directly hear its challenge to the Affordable Care Act on April 15. Lawyers from the Department of Justice representing the Obama administration have argued the case should proceed through the normal appeals process before being heard by the Supreme Court.
This week, on Wednesday, March 30, the Subcommittee on Health of the House Energy & Commerce Committee will hold a hearing entitled "True Cost of PPACA: Effects on the Budget and Jobs." On Friday, April 1, the Labor, Health and Human Services, Education, and Related Agencies Subcommittee of the House Appropriations Committee will hold a hearing on the current status of implementation of the health care overhaul law. HHS Sec. Sebelius will testify.
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