The Department of Health and Human Services released the Interim Final Rules for Relating to Status as a Grandfathered Health Plan under the Patient Protection and Affordable Care Act.

The IRS, Department of Treasury, Employee Benefits Security Administration, Department of Labor, and Department of Health and Human Services released interim final rules for group health plans and health insurance issuers relating to dependent coverage of children to age 26. 

The interim final rules are effective 60 days from the date of publication in the Federal Register (May 13, 2010).  Comments on the rules are due 90 days from the date of publication. 

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In his weekly address, President Obama discussed the implementation of health care reform and the benefits of the legislation to young adults, retirees, and families.

Source: http://www.whitehouse.gov/blog/2010/05/08/weekly-address-health-reform-starts-kick

House Passes Health care Reform Legislation

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A historic 219-212 vote in the House of Representatives late last night sent the health care reform bill to the President’s desk for his signature. John Jonas, head of the health care policy group at Patton Boggs, discusses:

• The mechanics of last night’s House passage
• Challenges involved in Senate passage this week of the “sidecar” reconciliation package
• The implementation challenges of the bill
• Prospective next steps on more reform legislation, and
• What last night means for the political capital of President Barack Obama and Congressional Democrats.
  

Today House Democratic Leadership released the legislative text of the Reconciliation Act of 2010, sponsored by House Budget Chairman John Spratt.  The bill amends a number of provisions in the Senate-passed “Patient Protection and Affordable Care Act,” including:

• Provides additional subsidies to improve the affordability of coverage for individuals with incomes up to 400 percent of the federal poverty level;
• Imposes additional requirements for coverage of non-dependent children up to age 26;
• Closes the Medicare Part D donut hole by 2020 by offering seniors an immediate $250 rebate and subsequently increasing discounts on brand-name drugs;
• Strikes the controversial 100-percent federal Medicaid matching rate for Nebraska (known as the “Cornhusker kickback”);
• Delays the annual cap on contributions to health flexible spending accounts (FSAs) by two years until 2013;
• Delays the excise tax on high-cost health plans to 2018, increases the dollar thresholds and indexes them to inflation;
• Delays the industry fee on sales of brand name pharmaceuticals by one year to 2011 but increases revenues raised by $4.8 billion;
• Delays the medical device tax on manufacturers by two years until 2013 and switches the industry fee to an excise tax on the first sale for use of medical devices at 2.9 percent rate; and
• Delays the health insurance industry fee by three years to 2014.

House Majority Leader Steny Hoyer announced that the House would convene at 1:00 pm on Sunday, but the final vote on the reconciliation bill would likely not begin until later in the day to comply with the Democratic Leaders’ promise to give Members 72 hours to review the final bill text.  The House is expected to approve the Senate-passed health reform bill using a “deem-and-pass” procedure that Republicans protest as unconstitutional.

 Since the bill’s release, several House members have switched their previous ‘no’ vote to a ‘yes’ – including Reps. Bart Gordon (D-TN), Luis Gutierrez (D-IL), Betsy Markey (D-CO), and Mike Arcuri (D-NY).  Additionally, Rep. Dennis Kucinich (D-OH) announced yesterday that he will now vote in favor of the bill.

As discussions continue about moving incremental health care reform bills, changes to health insurance practices remain in the mix. However, whittling down the massive health care reform proposals is not without challenges.   

The New York Times outlines several areas of possible consensus: (1) insurers could not deny coverage to children under the age of 19 on account of pre-existing medical conditions; (2) insurers would have to offer policyholders an opportunity to continue coverage for children through age 25 or 26; (3) the federal government would offer financial incentives to states to expand Medicaid to cover childless adults and parents; (4) the federal government would offer grants to states to establish regulated markets known as insurance exchanges, where consumers and small businesses could buy coverage; (5) the federal government would offer tax credits to small businesses to help them defray the cost of providing health benefits to workers; and (6) if a health plan provided care through a network of doctors and hospitals, it could not charge patients more for going outside the network in an emergency. Co-payments for emergency care would have to be the same, regardless of whether a hospital was in the insurer’s network of preferred providers.

NPR describes how such an approach with a focus on insurance reform could anger insurers and potentially result in increased premiums.   

Mark McClellan, former CMS Administrator under President George W. Bush, suggests that some insurance reforms are possible without great expense. He asserts that the starting point should be a ban on denying coverage to children with medical conditions, prohibition on insurers from canceling policies of individuals who become sick, and limiting the amount that insurance companies can spend on items other than medical care.