As the congressional and presidential candidates continue to debate the merits and dangers of the Affordable Care Act, the deadline for states to let HHS know whether they will build and run their own exchanges is quickly approaching, and other provisions of the Affordable Care Act continue to go into effect.
AT THE AGENCIES
As part of the Partnership for Patients Initiative, CMS is partnering with organizations in seven states on a new initiative to improve quality of care and reduce hospitalizations among skilled nursing facility residents. The Alabama Quality Assurance Foundation, Alegent Creighton Health in Nebraska, the Curators of the University of Missouri, the Greater New York Hospital Foundation, HealthInsight of Nevada, Indiana University and UPMC Community Provider Services in Pennsylvania will work with nursing facilities in those states and state Medicaid programs to improve the quality of care and work towards lowering rehospitlizations.
On Monday (10/1), several Affordable Care Act provisions went into effect. One penalizes hospitals if patients are re-admitted to the hospital within one month of a visit for a condition that should have been dealt with on the first trip. Another, the Value-Based Purchasing Program provision aims to redistribute higher Medicare payments to those hospitals that deliver better care. A third requires insurance companies to provide user-friendly guides with explanations of plan benefits in a clear and understandable way. Still another noteworthy provision that went into effect on the first includes changes that standardize billing and requires health plans to begin adopting and implementing rules for the use of health IT for secure, confidential, electronic exchange of health information
IN THE STATES
On Wednesday (9/26), South Dakota Gov. Dennis Daugaard said his state will not set up its own health insurance exchange and will instead defer to the federal government to operate and pay for its exchange. South Dakota received $6.8 million in grants from the federal government, which it used to hire a national firm to evaluate the cost of a state health insurance exchange. The firm's analysis, which demonstrated that it would cost South Dakota between $6.3 million and $7.7 million annually to operate an exchange, led the state to its decision to defer to the federal government.
California Gov. Jerry Brown signed legislation into law that implements the Affordable Care Act but vetoed two bills targeting the state's individual health insurance market. The bills Gov. Brown signed include a measure to define essential health benefits for the state and a reform of the small employer market to keep small businesses from having to endure health premium hikes if employees get sick. The provisions Gov. Brown vetoed would have prevented insurers from discriminating for pre-existing conditions in the individual market.
In Arizona, Gov. Jan Brewer is strongly against the Affordable Care Act but is nonetheless working to put a framework in place to meet the November 16 deadline for states to commit to running an exchange.
A health care exchange bill, very similar to the one Gov. Christie vetoed in May, was advanced by a Senate Committee in New Jersey on Monday (10/10). In May, Christie said the exchange bill was "premature" because the Supreme Court had not yet ruled.
IN THE COURTS
The Supreme Court opened its new term on Monday (10/1). One of the first things on the Court's agenda was a request from Liberty University (in Virginia) to rehear its complaint against the Affordable Care Act. The Supreme Court requested input from the Department of Justice on the matter.
IN THIRD PARTIES
Two large employers, Sears Holdings and Darden Restaurants (which oversees Olive Garden, Red Lobster and other restaurant chains) announced that beginning January 1, they will provide a fixed-sum payment to employees for health insurance. The employees can use the payments to obtain coverage through an online marketplace. Sears and Darden say the shift is intended to give employees more control over their health benefits.
A new report from the liberal advocacy group Families USA says that families would pay twice as much for non-group health insurance under a Romney administration than an Obama administration.
The American Hospital Association and Premier health care alliance submitted comments to the IRS asking that nonprofit hospitals be granted flexibility to meet new tax-exemption requirements under Section 501(r) of ACA.
IN THE ELECTION
Health care was a major topic in Wednesday's (10/3) debate. Governor Romney spoke favorably of the bipartisan health care plan in Massachusetts but highlighted that it was not meant to serve as a model for the country. President Obama pushed Romney to provide details on the ways he would reform health care, and Romney said it would include a free market system. The two also exchanged barbs on Medicare – Romney pressed Obama on the $716 billion in Medicare cuts and argued that they would cause providers to leave Medicare altogether, and Obama explained the dangers of Romney’s plans to turn Medicare into a voucher system.
To view our compilation of recent health care reform implementation news, click here.