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 demonstrating they would have sufficient votes to deny Dr. Donald Berwick’s confirmation as CMS administrator. Because Republicans would only need 41 votes to block the confirmation, Politico reports that Senate Democrats likely will give up on confirming Dr. Berwick.
On Thursday, March 3, in response to the Department of Justice’s request that U.S. District Judge Roger Vinson clarify his earlier ruling, Judge Vinson issued a stay on his ruling that the health care overhaul is unconstitutional to give the Obama Administration time to appeal. Alaska Governor Sean Parnell, who had said implementing the Affordable Care Act would be unconstitutional given Vinson’s earlier ruling, will now begin implementing the law in Alaska. Though Judge Vinson granted the Department of Justice’s request for a stay, in order to get the stay, the Administration must file a notice of appeal within seven calendar days and seek an expedited appellate review.
After its most recent series of waiver approvals on Friday, March 4, the Obama Administration has now granted over 1,000 organizations temporary waivers from a coverage requirement of the Affordable Care Act.
This week several sources expressed that President Obama’s February 28 announcement that states could have more flexibility implementing health reform was merely a political maneuver. The Hill and The Wall Street Journal suggested that the Obama Administration does not actually believe there are better ways to meet the law’s requirements than those outlined in the Affordable Care Act, and thus the flexibility will not amount to much. Though the Administration has granted states more “freedom” in determining how to achieve various requirements, the requirements remain the same.
In response to repeated Republican proposals to eliminate the “maintenance of effort” provisions of the Affordable Care Act, which give states increased Medicaid funding if they agree not to reduce eligibility requirements below their February 2009 levels, several hospital associations cautioned in a letter Tuesday, March 1, to HHS Secretary Kathleen Sebelius that relaxing these maintenance-of-effort provisions would move many low-income Americans out of the Medicaid programs, increasing the number of uninsured.
In the states this week:
1) The Tennessee Senate passed the Tennessee Health Freedom Act, which protects the freedom of Tennessee patients to make their own health care choices notwithstanding any federal health care action. The legislation does not intend to nullify the Affordable Care Act, but rather to acknowledge the rights of Tennesseans to choose not to participate in government-run health insurance.
2) North Carolina Democratic Governor Beverly Perdue vetoed a Republican-backed challenge to Affordable Care Act, which would have blocked the provision that required most individuals to buy health insurance or face a penalty.
3) In Maryland, three Howard County delegates are co-sponsoring legislation that seeks to bring the single-payer health care system to Maryland. The Maryland General Assembly has scheduled a public hearing on the bill for March 9, beginning at 1 p.m.
4) In Washington State, the Senate approved a bill that will establish a health insurance exchange.
5) In California, Blue Shield is teaming with five health care providers to form two accountable care organizations in San Francisco.
6) In Illinois, the state’s Health Reform Implementation Council released initial recommendations. The Council urged the creation of a health insurance exchange, and suggested that state regulators be given the authority to approve or deny health insurance rate increases and insurance companies be required to spend at least 80 percent of premium dollars on health care for policy holders.
7) In Colorado, Republican state legislative leaders introduced The Healthcare Opportunity and Patient Empowerment Act, an interstate compact that would allow the state to opt out of the federal health care overhaul if other states agree to do the same. Democratic state lawmakers in Colorado are ignoring this proposal and pressing ahead with plans to implement the Affordable Care Act.
8) In Alabama, a bill was passed by a House committee that would give Alabama voters the opportunity to vote on a constitutional amendment, which would prohibit the Affordable Care Act from being implemented in the state.
9) Utah Governor R. Herbert defended Utah’s health care solutions and discussed the relationship between federal and state governments before two House committees in Washington, D.C.
10) The Wyoming House voted to approve a bill that puts up $1 million to expand a health care pilot program the legislature created last year. The Senate then voted to concur with the House amendments. The bill will now go to Governor Mead.
11) In Georgia, a House subcommittee unanimously approved a bill that would create the Georgia Health Exchange Authority, an arm of the state government that would run a state-based insurance exchange.
On Thursday, March 3, The House Judiciary Committee voted 23-14 in favor of H.R. 3, the No Taxpayer Funding for Abortion Act. H.R. 3 seeks to prohibit federal funding of abortion by permanently codifying an array of protections against government subsidies for abortions.
According to a new report by the Government Accountability Office, "Medicare: Program Remains at High Risk Because of Continuing Management Challenges," the federal government loses $48 billion a year, or 10 percent of Medicare payments, in improper payments, in part because of CMS' failure to adopt more money-saving tactics.
On Thursday, March3, the House of Representatives passed H.R. 4, the Small Business Paperwork Mandate Elimination Act. The eliminated tax reporting provision would require businesses to file tax forms each time they spend more than $600 with a vendor.
On Tuesday, March 1, a new report from a joint congressional GOP panel, “Medicaid Expansion in the New Health Law: Costs to the States,” showed that the Affordable Care Act will cost more than twice the Congressional Budget Office estimate through 2021.
This week, the Senate Homeland Security and Governmental Affairs Committee will hold a hearing titled "New Tools for Curbing Waste and Fraud in Medicare and Medicaid." On Thursday, March 10, and Friday, March 11, the Labor, Health and Human Services, Education and Related Agencies Subcommittee of House Appropriations Committee will hold hearings on proposed fiscal 2012 appropriations for departments, agencies and programs under its jurisdiction. On Friday, March 11, the Alliance for Health Reform and the Kaiser Family Foundation are sponsoring a luncheon briefing to discuss Medicare's role in the health care system, its administration, cost and financing, beneficiaries and relationship to the Affordable Care Act.
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.