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 that the Supreme Court hear its case. The Liberty University case addresses, not only the individual mandate, but also, the employer mandate of PPACA.
On Friday (10/14), a federal judge blocked a request for more documents to be produced relating to Justice Kagan's role in developing the Affordable Care Act while she was an Obama administration official.
AT THE AGENCIES
On Friday (10/14), the Obama administration discontinued the CLASS Act, the long-term care program outlined in the Affordable Care Act. Administration officials realized that unless a significant number of healthy people signed up during their working years for this voluntary program, the needs of disabled beneficiaries would drive premiums so high they would destabilize the program.
CMS rated Medicare Advantage plans, and on Wednesday (10/13) it announced that only 12 of the 446 plans rated achieved a five-star rating. A five-star rating qualifies the plans for a cut of an estimated $3 billon in bonus payments in 2012. It also grants them permission to enroll members throughout the year rather than only during the seven-week Medicare enrollment period. The five-star Medicare Advantage plans announced are: Martin's Point Health (Maine), Advocare (Wisconsin), Dean Health Plan (Wisconsin), Group Health Cooperative (Washington), Gunderson Lutherand Health Plan (Iowa and Wisconsin), Health New England (Massachusetts), and Kaiser Permanente (California, Colorado, Hawaii, Oregon, and Washington).
Medicare enrollment began Saturday (10/15), which is earlier than in past years, and will run until December 7.
ON THE HILL
On Thursday (10/13), the U.S. House of Representatives approved legislation to prohibit funding of abortion coverage in the Affordable Care Act. If passed by the Senate as well, the Protect Life Act would amend PPACA to bar federal funds from being used for any part of health care costs that cover abortion. Under the new law, providers that offer abortion coverage would have to set up identical plans without abortion coverage in order to participate in health insurance exchanges.
On Thursday (10/13), members of the House Ways and Means Committee approved a measure to change the definition of income used in the Affordable Care Act. The statute currently uses a uniform definition of modified adjusted gross income to determine eligibility for insurance exchange subsidies, Medicaid, and the Children's Health Insurance Program.
IN THE STATES
California Gov. Jerry Brown signed three health care bills into law. One will make it illegal for teenagers under 18 to use tanning beds. Another will let children as young as 12 be vaccinated against HPV without their parents' consent. The third requires insurance coverage for autism.
The Connecticut House Speaker Christopher Donovan is convening a new group to examine issues facing small firms trying to purchase health insurance for their employees and families. The group will review insurance regulations affecting small businesses and barriers that small businesses face when trying to purchase affordable coverage.
Illinois is moving forward in implementing its health insurance exchange. Gov. Quinn announced the selection of InterSystems Corporation to assist the state in developing Illinois' electronic health information exchange.
THIRD PARTIES
According to a new study by the Kaiser Family Foundation, health insurers face "modest" competition in many states' individual and small group markets.
The Commonwealth Fund has a new report out. "Ensuring Equity: A Post-Reform Framework to Achieve High Performance Healthcare for Vulnerable Populations" lays out a three-pronged policy framework to 1) ensure sufficient access to health care and financial protection; 2) strengthen the health care system's ability to care for vulnerable populations; and 3) support coordination between the traditional health care system and the resources outside of the health care system, upon which vulnerable groups rely.
The American Medical Association is requesting that Medicare pay doctors for four types of coordination services to avoid more expensive hospital care for hospitals down the line. The four services are: responding to telephone calls seven days or more after a patient sees the doctor, educating and training patients to better manage their own health, managing anticoagulation drugs better, and spending time coordinating team-based care when the patient is not present.
THIS WEEK
On Tuesday (11/18) at 11:30 a.m., The Commonwealth Fund issued its results from its national scorecard on U.S. health system performance.
On Tuesday (10/18) at 11:30 a.m. in 2168 of the Capitol Building, Main Justice sponsored a discussion on what it means when prosecutors become de facto regulators of health care and pharmaceutical companies.
On Tuesday (10/18) at 1:00 p.m., Families USA hosted a teleconference to release a report that will spotlight how the health overhaul law will benefit both health coverage and personal finances.
To view our compilation of recent health care reform implementation news, click here.