President Obama submitted jobs legislation to Congress on Monday that would make health plans provided by employers partially taxable for couples making more than $250,000 and individuals making more than $200,000 a year. Also this week, a federal judge in Harrisburg, Pa., ruled that the individual mandate exceeded the Commerce Clause powers, HHS announced $10 million in PPACA funding for 129 community health centers, and CMS Administrator Don Berwick reported that the agency has sufficient money to move forward implementing health insurance exchanges.
IN THE COURTS
On Tuesday (9/14), U.S. District Judge Christopher Conner, a federal judge in Harrisburg, Pa., ruled that Congress exceeded its Commerce Clause powers by forcing all Americans to buy health insurance or face a penalty.
AT THE AGENCIES
On Thursday (9/15), HHS announced that $10 million in PPACA funding would be awarded to help 129 community organizations across the nation establish new community health centers.
On Wednesday (9/14), HHS announced an initiative aimed at recovering $2.1 billion in improper Medicaid payments over five years.
On Monday (9/12), Dr. Berwick said he hoped that "pioneer" accountable care organizations would be launched by the end of the year.
According to Bloomberg News, President Obama is asking lawmakers to tax the health insurance benefits of top earners. The jobs legislation the president submitted to Congress on Monday (9/12) would make health plans provided by employers partially taxable for couples that make more than $250,000 and individuals that make more than $200,000 a year. Currently, all health benefits are exempt from taxation.
The Treasury Department and the IRS have reworked a requirement of the PPACA that large employers calculate whether their insurance policies are "affordable" to their workers. The change, which will be proposed through agency rulemaking, would allow employers to determine affordability by comparing the employee's taxable wages with what the company charges them for insurance.
On Monday (9/12), Dr. Berwick reported that CMS has sufficient money to move forward in establishing health insurance exchanges.
According to The Hill, on Monday (9/12), Jonathan Blum, deputy administrator at CMS, said starting next year, Medicare Advantage plans with five-star ratings will be able to market their policies and enroll new customers all year, while other plans will only be able to market during the open enrollment period. Blum also said that CMS would be changing how it decides which policies receive five-star ratings, placing more weight on outcome and patient satisfaction.
ON THE HILL
On Tuesday (9/13), the Joint Select Committee on Deficit Reduction held its first hearing, at which CBO Director Douglas Elmendorf testified. Discussions focused heavily on the cost of U.S. health care entitlement programs.
IN THE STATES
HHS rejected Delaware's request for a waiver from the medical loss ratio rules of the PPACA because the state did not demonstrate "a reasonable likelihood" that the state's insurance market would be destabilized by them.
The Los Angeles Times reported this week that though California was supposed to be a model of the Affordable Care Act's promise, due to its financial difficulties, it is cutting the health care safety net more aggressively than almost any other state.
On Tuesday (9/13), Vermont Gov. Peter Shumlin announced that Anya Rader Wallack of Calais will chair the five-member panel for the state's single-payer health plan.
According to the Florida Independent, Florida is one of five states that has not made any effort to implement health insurance exchanges.
CMS approved Kentucky's proposal for a statewide, managed care system for its Medicaid program. Kentucky's contracts with three private managed care companies to provide health care services to Medicaid beneficiaries go into effect on October 1st.
Several Republicans legislators in New York are blocking the state from seeking significant federal funds for a state health insurance exchange.
Virginia's Health Reform Initiative Advisory Council, which is made up of state officials, lawmakers, and stakeholders appointed by Gov. McDonnell, approved recommendations to be forwarded to Gov. McDonnell and the General Assembly.
THIRD PARTIES
A new nonprofit group, Enroll America, is planning to publicize the expanded availability of health insurance under the PPACA and to help states make enrollment easier.
The Mayo Clinic, Cleveland Clinic, Geisinger Health System, and Intermountain Healthcare, four health systems considered to be the most promising models of "accountable care organizations," have all declined to apply for the "Pioneer" program, a program intended to reward successful accountable care organizations like these four.
THIS WEEK
The Negotiated Rulemaking Committee on Designation of Medically Underserved Populations and Health Professional Shortage Areas will hold meetings on Tuesday (9/20) from 9:30 a.m. to 6:00 p.m., Wednesday (9/21) from 9:00 a.m. to 6:00 p.m., and Thursday (9/22) from 9:00 a.m. to 3:00 p.m.
On Wednesday (9/21) at 10:00 a.m. in 215 Dirksen, the Senate Finance Committee will hold a hearing titled, "Dually-Eligible Beneficiaries: Improving Care While Lowering Costs." The session will focus on efforts to increase coordination of care for individuals who are enrolled in both Medicare and Medicaid.
On Wednesday (9/21) at 2:00 p.m., the House Ways and Means Subcommittee on Health will hold a hearing on certain expiring Medicare provider payment provisions.
On Wednesday (9/21) from 9:00 a.m. to 2:30 p.m. and Thursday (9/22) from 10:00 a.m. to 3:00 p.m., HHS's National Committee on Vital and Health Statistics will host an Advisory Committee Meeting.
On Thursday (9/22) at 2:30 p.m., the Senate Judiciary Subcommittee on Administrative Oversight and the Courts will hold a hearing titled "Protecting Seniors and Persons with Disabilities – An Examination of Court-Appointed Guardians."
On Thursday (9/22) at 3:00 p.m., the Health Information Technology Standards Committee Implementation Workgroup will host an Advisory Committee Meeting.
To view our compilation of recent health care reform implementation news, click here.