Legislation and Policy
Sebelius: GOP Governors Will Accept Medicaid
Expansion.
USA Today   (3/22, Kennedy) reports that HHS
Secretary Kathleen Sebelius said in an interview Thursday that Republican
governors and Republican-controlled legislatures "will eventually decide
to expand Medicaid in their states because the financial benefits are too big
to ignore." Sebelius said, "It not only would bring more people
into the health care system, but it would dramatically reduce unpaid medical
costs." Sebelius "said governors are talking with hospital and
patients groups within their states and beginning to understand the economic
advantages of Medicaid expansion."
Sebelius, Other Leaders Mark Third Anniversary Of Affordable
Care Act. Thursday marked the third anniversary of the passage of the
Affordable Care Act, and HHS Secretary Kathleen Sebelius gave a series of
interviews discussing the wide-ranging effects of the law. USA Today (3/22, Kennedy) reports that HHS
Secretary Kathleen Sebelius said in an interview Thursday, marking the ACA's
third anniversary, that Republican governors and Republican-controlled
legislatures "will eventually decide to expand Medicaid in their states
because the financial benefits are too big to ignore." Sebelius said,
"It not only would bring more people into the health care system, but it
would dramatically reduce unpaid medical costs." Sebelius also
"said governors are talking with hospital and patients groups within
their states and beginning to understand the economic advantages of Medicaid
expansion."
Several other pieces mark the anniversary. For example, the AP (3/22, Alonso-Zaldivar) reports
that "three years, two elections, and one Supreme Court decision after
President Barack Obama signed the Affordable Care Act, its promise of health
care for the uninsured may be delayed or undercut in much of the country
because of entrenched opposition from many Republican state leaders."
The piece then looks into the varying levels of adoption of ACA provisions,
namely Medicaid expansion and insurance exchanges, and what challenges and
opportunities exist to get the word out about coverage under the law.
The Washington Times (3/22, Howell) reports that on the
third anniversary of the Affordable Care Act's signing, lawmakers from both
parties agree the healthcare law "could use some changes. While GOP
critics say that means scaling back, for Democrats it means expanding the law,
which they see as a 'work in progress' that will eventually include the kinds
of coverage they had to forgo the first time around."
Lawmakers Tout, Slam ACA On Anniversary. Other
leaders heralded, or decried, the law on its anniversary. For example. The Hill (3/22, Viebeck)
"Healthwatch" blog reports that to mark the Affordable Care Act's
third anniversary, Federal health officials are touting "its savings for
people on Medicare." According to HHS, "seniors have saved more
than $6.1 billion on prescription drugs since the law's passage," with
the officials "crediting discounts that are helping close Medicare's
'doughnut hole' coverage gap." As HHS Secretary Kathleen Sebelius said
in a statement, "By making prescription drugs more affordable, the
Affordable Care Act is improving and promoting the best care for people with
Medicare."
Similarly, the Los Angeles Daily News (3/22, Scauzillo) reports that,
according to the Federal government, "the cost of prescription drugs for
people on Medicare is actually going down as a result of discounts from
pharmaceutical companies mandated by the Affordable Care Act, combined with
increased use of less costly generic drugs." HHS Secretary Kathleen
Sebelius notes that, "in California, people purchasing prescriptions
through the Medicare Part D coverage program saved $485 million during the
three years the law has been in effect." Jonathan Blum, CMS Acting
Principal Deputy Administrator and Director, "across the country, 6.3
million people on Medicare saved about $6.1 billion on prescription drugs
since the healthcare law, also known as ObamaCare, was enacted." The New Haven (CT) Register (3/22, Farrish) reports on the
Connecticut-specific figures.
In a related account, The Hill (3/22, Cox) "Floor
Action" blog reports that Senate Majority Leader Harry Reid (D-NV)
marked the third anniversary of the Affordable Care Act's passage on the
Senate floor Thursday. He said, "Three years ago, President Barack Obama
signed into law the greatest single step in generations toward ensuring
access to quality, affordable healthcare for every American - the Affordable
Care Act." After listing several benefits, which included savings, Reid
continued, "But health reform is not only saving money - it's saving
lives. And I am proud that this law, which we worked so hard to pass, is
already ensuring the care of human life remains the first object of this
government."
In the first of a series of accounts of Republican leaders knocking the law, The Hill (3/22, Baker)
"Healthwatch" blog reports that House Republicans "told the
Obama administration on Thursday that it needs to get moving on a study of
how the Affordable Care Act will affect wages." The law "requires
the Labor Department to study whether new regulations under the law will lead
to a reduction in workers' pay." Representatives John Kline (R-MN) and
Phil Roe (R-TN) said, "The Department of Labor has a legal obligation to
study how the health care law will affect workers' wages, yet it has failed
to do so. Meanwhile, the federal bureaucracy is busy implementing the law at
a time when wages are stagnant and 12 million [people] are searching for
work."
Similarly, The Hill (3/22) "Healthwatch" blog
reports that on Thursday, Representative Charles Boustany (R-LA) pushed the
IRS to "reveal how much money it has received from the Health and Human
Services (HHS) Department for [ACA] implementation since 2010."
The Hill (3/22, Kasperowicz) "Floor
Action" blog reports that on Thursday, Representative Michelle Bachmann
(R-MN) marked the ACA's third anniversary by slamming the law for hurting
women and children. She explained that "women are two and a half times
more likely to rely on their spouses for health insurance compared to men,
and said business decisions to stop insuring families will fall hardest on
women and their children."
The Washington Post (3/22, Blake) "Post
Politics" blog also reports on Bachmann's comments that the Affordable
Care Act "would kill women, children and senior citizens -
'literally.'" She said, "That's why we're here: Because we're
saying let's repeal this failure before it literally kills women, kills
children, kills senior citizens." Bachmann said, "Let's not do
that. Let's love people. Let's care about people. Let's repeal it now while
we can."
The Washington Times (3/22, Howell) "Inside
Politics" blog reports that "members of the House GOP Doctors
Caucus on Thursday marked the three-year anniversary of President Obama's
health care law with a renewed call for a full repeal while acknowledging
that a piecemeal effort to 'chip away' at the reforms is more politically
feasible." Caucus co-chairman Representative Phil Gingrey of Georgia, an
obstetrician, said, "That is the most viable option."
Opinion Pieces Blast ACA On Third Anniversary. In a
piece for USA Today (3/22, Danner), Dan Danner,
president and CEO of the National Federation of Independent Business, Bruce
Josten, executive vice president for government affairs at the US Chamber of
Commerce, and Matthew Shay, president and CEO of the National Retail Federation,
write that on the third anniversary of President Obama's signing of the
Affordable Care Act, "the law is not living up to its moniker."
They argue, "The law has increased costs and added profound complexity
to an already confusing system; higher taxes and thousands of pages of new
regulations are having a tremendous impact on the small-business community
and have contributed to the slow recovery of Main Street."
Senior editorial writer Conn Carrol blasts the "pathetic third
anniversary" of the Affordable Care Act in a piece for the Washington Examiner (3/22), writing, "Virtually
nothing has gone right for plan since it became law." He lists what he
sees as the law's failures, including the canceled CLASS Act and suspended
high-risk pools, and a high amount of disapproval from the public. He concludes,
"According to the latest Kaiser Health Tracking Poll, only 37 percent of
Americans have a favorable view of Obamacare. As Obama's signature domestic
accomplishment continues to rack up more failures, that number will only go
down."
Representative Paul Broun (R-GA) argues for a continued push to repeal the
Affordable Care Act in an op-ed for The Hill (3/22) "Congress Blog."
He writes, "As the Affordable Care Act approaches its third anniversary,
it further proves itself to be unaffordable and ineffective. ObamaCare is
already killing jobs, taking away our freedom of choice, and completely
eroding the quality of healthcare in this nation."
Michael F. Cannon, director of health policy studies at the Cato Institute,
argues that the Affordable Care Act is far "more vulnerable" than
its "supporters care to admit," in an op-ed for the Daily Caller (3/22). He explains that HHS is
threatening to withhold funds if states do not comply with provisions of the
law, writing, "These are not the actions of an administration that feels
its health care law is secure." And finally, he lists parts that have
already been repealed, including the "long-term care program known as
the CLASS Act."
In Symbolic Vote, Senate Passes
Repeal Of ACA Medical Device Tax.
The Wall Street Journal (3/22, A4, Peterson, Subscription
Publication) reports that in a largely symbolic move, the Senate passed a
measure repealing the Affordable Care Act's tax on medical devices. Though it
will have no legal thrust, the 79-20 vote suggests the Democrat-led body is
willing to chip away at parts of the law seen to be unfavorable by
constituents. The bill was introduced by a group of bipartisan Senators
including Orrin Hatch (R-UT), Elizabeth Warren (D-MA), and Amy Klobuchar
(D-MN).
The Minneapolis Star Tribune (3/22, Spencer) reports that the
vote "make[s] it a priority to repeal a newly implemented tax on medical
devices." The 79-20 vote "was only a sense-of-the-Senate
measure," and a "separate bill will be required to actually put the
repeal in motion." Moreover, "that bill must find a way to replace
the $20 billion to $30 billion the tax is expected to raise over the next
decade. Nevertheless, supporters of the repeal, including Minnesota Sens. Amy
Klobuchar and Al Franken, said they believe Thursday night's vote was a major
symbolic victory."
The Washington Times (3/22, Howell) notes that Senate
Minority Leader Mitch McConnell said of the vote, "Today's bipartisan
vote to repeal the medical device tax is an important step in the right
direction. Unfortunately, Obamacare remains a job-killer that grows the government
and slows the economy, which is why it's important to repeal the whole
thing."
The Hill (3/22) "Blog Briefing
Room" also reports.
Budget Votes Could Shed Light On ACA Repeal Efforts. CQ (3/22, Attias, Subscription
Publication) reports, "Votes on eliminating provisions of the health
care law as part of the Senate budget debate could offer a glimpse into what
repeal efforts, if any, have the most potential for making their way through
Congress." Republicans have so far targeted the law's individual
mandate, the employer mandate, and the tax on insurers. According to the
article, "the proposal that could attract the most attention is an
amendment from Utah Republican Orrin G. Hatch to repeal the law's 2.3 percent
excise tax on medical devices, which took effect in January," and has
the backing of some Democrats.
Both Parties Hope To Make
Changes To ACA.
The Washington Times (3/22, Howell) reports that on the
third anniversary of the Affordable Care Act's signing, lawmakers from both
parties agree the healthcare law "could use some changes. While GOP critics
say that means scaling back, for Democrats it means expanding the law, which
they see as a 'work in progress' that will eventually include the kinds of
coverage they had to forgo the first time around." House Minority Leader
Nancy Pelosi and President Obama "want to mandate that drug companies
give Medicare better rebates on prescription drug purchases - a move the
White House says would save the federal program for the elderly some $156
billion over 10 years." Republicans "have made it clear that a full
repeal of 'Obamacare' remains their ultimate goal." On Thursday,
"they were able to pass a bipartisan budget amendment...that would
repeal a sales tax on medical devices."
ACA Said To Fall Short Of Its Name. In a
piece for USA Today (3/22, Danner), Dan Danner,
president and CEO of the National Federation of Independent Business, Bruce
Josten, executive vice president for government affairs at the US Chamber of
Commerce, and Matthew Shay, president and CEO of the National Retail
Federation, write that on the third anniversary of President Obama's signing
of the Affordable Care Act, "the law is not living up to its
moniker." They argue, "The law has increased costs and added
profound complexity to an already confusing system; higher taxes and
thousands of pages of new regulations are having a tremendous impact on the
small-business community and have contributed to the slow recovery of Main
Street."
CR Includes Healthcare Cuts, No
Extra Funds For ACA Implementation.
Modern Healthcare (3/22, Zigmond, Subscription
Publication) reports that "Federal lawmakers averted a government
shutdown after the House of Representatives approved a $984 billion spending
bill...that will keep the government operating through Sept. 30 and maintains
the sequestration cuts that will hit Medicare providers starting on April
1." According to the article, "the Senate version added more
dollars for healthcare than the initial spending bill the House passed in
March. For instance, the final bill added about $71 million for research
under the National Institutes of Health. With both chambers approving the
measure, it now moves to President Barack Obama's desk for his
signature."
CQ (3/22, Adams, Subscription
Publication) reports that Congress has "officially refused" to
grant the Obama Administration the nearly $1 billion it requested to further
implement the Affordable Care Act. The President had asked in his budget for
an additional $949 million for the Centers for Medicare and Medicaid Services,
but both the House and the Senate left the funds out of their versions of the
continuing resolution to fund the budget through the rest of the fiscal year.
According to "administration allies," a "significant portion
of the funds for CMS would have gone to outreach and enrollment
assistance."
House Passes 2014 Budget With Steep Medicaid, NIH Cuts. The AP (3/22) reports, "The
Republican-controlled House passed a tea party-flavored budget plan Thursday
that promises sharp cuts in safety-net programs for the poor and a clampdown
on domestic agencies, in sharp contrast to less austere plans favored by President
Barack Obama and his Democratic allies." According to the article, the
measure's "deep cuts to programs for the poor like Medicaid and food
stamps and its promise to abolish so-called 'Obamacare' are nonstarters with
the president, who won re-election while campaigning against Ryan's prior
budgets." The piece notes that in the budget, cuts to the National
Institutes of Health "could approach 20 percent when compared with
levels agreed to as part of a hard-fought budget deal from the summer of 2011."
GOP Budget Amendments Would
Force Obama, Biden Into Health Exchanges.
The Hill (3/22, Baker) reports in its
"Healthwatch" blog that Sens. Susan Collins and Kelly Ayotte have
offered amendments to the Senate budget proposal that would "require
President Obama and Vice President Biden to get their medical care through
the new exchanges created by Obama's signature healthcare law." The Hill
notes that while lawmakers and most of their staff members "already have
to purchase coverage through an exchange, thanks to a provision Sen. Charles
Grassley (R-Iowa) added to the healthcare law," the White House and its
staff "aren't covered by that provision."
Politico (3/22, Cheney) notes that if Obama
"wants to make good on a promise to become one of Obamacare's first
customers, he'll have to take a route most Americans are unlikely to choose.
He'll have to enroll in a health plan that lacks a taxpayer subsidy, even though
he has access to generous coverage through his day job." Politico notes
that Obama "seems poised to make good on his promise to join an
exchange. Asked repeatedly whether the president planned to follow through,
White House officials deferred to the statement published three years ago by
USA Today" in which an Administration spokesman said the President
"will participate in the exchange."
Hill Lawmakers, Staffers To Be Covered By ACA. Politico (3/22, Haberkorn) reports that the
Affordable Care Act includes provisions which ensure that members of Congress
and their staff must buy insurance on the law's exchanges, but "vague
language in this part of the law...has led to a slew of quirks and
questions." The article explains, "Staffers who work in lawmakers'
personal offices go into exchanges - but those who work for committees don't.
And the lawmakers themselves get Obamacare - unless they are among the
roughly 40 senators and 115 House members on Medicare."
The Atlantic Wire (3/22, Reeve) sums it up:
"President Obama, members of Congress, and their aides will have to
enroll in Obamacare's health exchanges next year - Congress because they
legally have to, and Obama because he publicly promised to."
FDA Says Medical Device Tax
Won't Apply To Smartphones.
The Hill (3/22, Goad) reports in its
"Regwatch" blog that the FDA said on Thursday that "it has no
plans to subject smartphones and tablets to a controversial tax in President
Obama's healthcare law. Republican members of House Energy and Commerce
Investigations subcommittee this week seized on reports that the agency could
extend the healthcare law's tax on medical devices to iPhones, BlackBerrys
and Android devices. But an agency official assured lawmakers on Thursday
that smartphones will be exempt from the tax."
CQ (3/22, Ethridge, Subscription
Publication) reports, "Christy Foreman, director of the Office of Device
Evaluation at the FDA's Center for Devices and Radiological Health, tried to
reassure lawmakers that the agency intends to regulate only a narrow subset of
mobile medical applications. Those applications must meet the definition of
'device' under FDA law, and either serve as an accessory to an
already-regulated medical device or turn a mobile platform into a regulated
device. She also said the agency's policy would not involve regulation of
smartphones or other platforms for mobile medical apps."
Reuters (3/22, Clarke) reports that back in
July 2011, the FDA published draft guidelines which said it would regulate
any mobile app deemed a medical device. Foreman said that while the FDA was
not responsible for taxation, a mobile app that it deemed to be a medical
device subject to the medical tax, though it would be exempt if it were sold
to consumers through retail stores.
The Washington Post (3/22, Tsukayama) reports, "An
official from the Food and Drug Administration said in a Thursday hearing
before the House subpanel on oversight and investigation that the agency will
release final guidance on its regulation of mobile apps by the end of the
fiscal year." Foreman "testified that the agency intends to closely
regulate only a small subset of apps - namely those that act with or
replicate the functions of devices already regulated by the FDA."
The Modern Healthcare (3/21, Subscription Publication)
reports that the FDA "plans to issue final guidance about how it will
regulate medical mobile applications before Oct. 1, an agency official told a
House Energy and Commerce subcommittee Thursday."
Editorial Supports Raising
Charitable Spending For Non-Profit Hospitals.
In an
editorial, the Palm Springs (CA) Desert Sun (3/22) states, "Eisenhower
Memorial Hospital is an enormous asset to the Coachella Valley...However, we
also believe that legislation to require not-for-profit hospitals, such as
Eisenhower, to raise charitable spending to 5 percent of revenue is a reasonable
idea." The issue has the California Nurses Association fighting for the
bill, while the California Hospitals Association is opposing it. The
Institute for Health and Socio-Economic Policy released a report which
"said that in 2010 California's private not-for-profit hospitals got
$1.8 billion more in government subsidies and benefits from their tax-exempt
status than what they provided in charitable care." CNA co-president,
Malinda Markowitz, said that in 2010 not-for-profit hospitals made $4.5 billion
in profits, with Sutter Health and Kaiser Permanente making the most.
Roy: Administration
Increasingly Worried About ACA Implementation.
Forbes (3/22) contributor Avik Roy writes
that "increasingly, officials in the Obama administration are worried
that the rollout of the [Affordable Care Act] exchanges will be chaotic, given
the law's complexity and unrealistic deadlines." To back up this claim,
Roy quotes Henry Chao, deputy chief information officer at the Centers for
Medicare and Medicaid Services, who recently said at a conference, "We
are under 200 days from open enrollment. I'm pretty nervous - I don't know
about you." At the same conference, Gary Cohen, another CMS official
involved in exchange implementation, said, "It's only prudent to not
assume everything is going to work perfectly on day one," said Cohen.
"As we move closer to October, my hopes are the range of things that
could go wrong gets narrower and narrower."
Public Health and Private
Healthcare Systems
Insurers Warn Premiums Will Rise For Many Next
Year As ACA Kicks In.
On its
front page, the Wall Street Journal (3/22, A1, Mathews, Radnofsky,
Subscription Publication) reports that in meetings with brokers and agents,
health insurers are projecting significant increases in premiums for many
individuals and small businesses next year, which the article notes is
important evidence that the Affordable Care Act may be leading to an increase
in prices for consumers. For example, UnitedHealth Group, the country's
largest insurance company, said in private presentations last month that
premiums could rise over 100% for some individuals, and 25%-50% for some
small businesses. The Journal points out that these figures are in contrast
to what the Obama Administration is predicting, as HHS insists the law will
"make health-care coverage more affordable and accessible."
In 2012, 45 Million Americans Uninsured.
The Huffington Post (3/21, Young) reported, "More
than 45 million US residents didn't have health insurance during the first
nine months of last year, according to survey findings released Thursday by
the Centers for Disease Control and Prevention. Even more people, 57.5 million,
were uninsured for at least part of the 12 months before being polled."
As the article noted, the Affordable Care Act aims to cover a large portion
of the uninsured population, and "according to the Congressional Budget
Office, health care reform will reduce the number of uninsured people by 27
million between next year and 2023."
HealthTap Allows Users To Post More Personal But
Non-Identifying Data.
The Washington Post (3/22, Kolawole) reports in its
"Ideas@Innovations" blog, "Medical data repository HealthTap,
which collects questions from anonymous users and feeds them to a collection
of 35,000 licensed doctors, announced Thursday that it will allow users to
tag their queries to licensed physicians with even more personal though
non-identifying details" including "gender, pre-existing conditions
and prescribed medications." The site also allows users "for a
fee" to "interact with doctors one-on-one," yet "doctors
are not allowed to diagnose the user at any point, either one-on-one or in
their public responses." The blog calls it a "step" towards a
"a seamless, secure universal medical records database," while
saying it is still "a far cry" from that.
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