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Tag Archive | "Repeal"

House Action on Health Care Reform Repeal

Last night, the House of Representatives voted 245-189 to pass the the “Repealing the Job-Killing Health Care Law Act” (H.R. 2).  At this time, the Senate has no plans to take up consideration of the bill, which would be unlikely to pass and would almost certainly face a Presidential veto if it were to.

The House will next take up consideration of H.Res. 9, instructing House Committees to recommend measures to replace the reform law. Specifically, the resolution directs Committees to “proposing changes to existing law” that address many of their chief concerns with the health law including: provisions that spur economic growth and create jobs; lower health premiums; preserve patients’ ability to keep their health plan; provide people with pre-existing conditions access to coverage; reform medical malpractice; increase the number of insured; protect the doctor-patient relationship; provide States with more Medicaid flexibility; expand personal responsibility; prohibit taxpayer funding of abortions; eliminate waste; and do not accelerate the insolvency of entitlement programs.

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Capital Thinking Podcast

After a solemn week in the House of Representatives devoted to recognizing and remembering the victims of the Arizona shootings, the White House has instructed that Congress get back to work and on with its legislative business.  Therefore, Majority Leader Eric Cantor announced that the House will resume “thoughtful consideration” of the health care reform repeal bill this week.  Beginning Tuesday, seven hours of debate will be allowed on the bill with the final vote to occur on Wednesday.  The rules will also allow for one Democratic amendment by Rep. Jim Matheson (D-UT) that would provide for a permanent fix to Medicare’s sustainable growth rate formula, preventing dramatic cuts in physician reimbursements under Medicare.  Congressional Democrats were vocal in their opposition to the repeal bill, noting that it would eliminate important consumer protections, leave millions without insurance, and add to the deficit. Preliminary analysis by the Congressional Budget Office supported this position by determining that repealing the overhaul bill would cost $230 billion over ten years.  It is largely expected to pass due to the Republican majority, but will likely not gain any traction in the Senate.  On Thursday, House Republicans plan to bring up their bill instructing the committees to draft replacement legislation.  Committee organization is also expected to resume, and announcements on Democratic Members’ placement on Committees and subcommittees should be announced this week.

Analysis from the Institute of Medicine’s public meeting last week on what constitutes the definition of “essential benefits” is expected to be a hot topic.  The health reform law required that the IOM analyze and develop criteria for a definition of benefits that all plans sold through an insurance exchange will have to offer.  The IOM will likely publish a report of its findings in September.  However, the process is still in its early stage.  The Bureau of Labor and Statistics is required to find out what the typical employer-sponsored health plan covers, while the Department of Health and Human Services will ultimately determine the final definition.

Last week the Medicare Payment and Advisory Commission (MedPAC) finalized its recommendations for its upcoming March report to Congress.  Of note, the Commission voted to recommend to Congress that inpatient and outpatient Medicare hospital payments rise by 1 percent in fiscal 2012, that payment rates under the physician fee schedule should increase by one percent, and backed a first-ever co-pay for home health care services, despite concerns about the financial burden it might affect beneficiaries.  Chairman Glenn Hackbarth noted that there is ample evidence that the use of co-pays deter over-use of a service. Home health use has increased by 50 percent since 2001 and Medicare spent $19 billion on home health services in 2009. 

Finally, it is also important to note that the National Quality Forum (NQF) has opened a Call for Nominations for organizations and individual subject matter experts to serve on the advisory workgroups of the Measure Applications Partnership (MAP).  MAP will provide recommendations to the Department of Health and Human Services on selecting measures for public reporting and performance-based payment programs.

The multistakeholder workgroups will advise the MAP Coordinating Committee on quality issues and the use of measures to encourage improvement for specific care settings, care providers, and patient populations.  Although the workgroup structure will need to be flexible to respond to the needs of HHS, NQF anticipates the potential for as many as four advisory workgroups in the following areas: clinician, hospital, post-acute care/long-term care, and dual eligible beneficiaries. All nominations must be submitted by Monday, February 7, at 6:00 pm ET.

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Capital Thinking Podcast

As Congress returned from the August recess, lawmakers and stakeholders geared up for the first public meeting of the Budget Control Act’s Super Committee meeting on September 8.  In preparation for the Committee’s work, the House Ways and Means Committee Democrats released a list of potential health care specific cuts that the Super Committee could consider.  The compiled list was an accumulation of pay-fors that have been offered in various deficit reduction plans.  The list totals more than $500 billion over 10 years and staff confirmed the offsets have not been officially endorsed by Members.  The list included mostly Medicare focused cuts, such as accelerated home health rebasing ($3 billion) and a new home health copay ($40 billion), post acute provider market basket freeze ($14-28 billion), increased SNF cost-sharing ($21.3 billion), elimination of the rural health hospital add-on payment ($62 billion), GME cuts ($15 billion), new cost-sharing for clinical lab services ($24 billion), new Part D rebate for dual eligible and LIS beneficiaries ($120 billion), increased cost-sharing on beneficiaries with Medigap coverage ($12-53 billion), raise Medicare eligibility age to 67 ($124 billion), freeze income thresholds for high income beneficiaries and raise premiums ($13 billion) and chained CPI ($7 billion).   In a jobs-focused speech to a Joint Session of Congress, President Obama called on the Super Committee to come up with additional cuts to pay for his newly proposed American Jobs Act, such as through “modest adjustments” to Medicare and Medicaid.

As for committee action this past week, the Senate Appropriations Committee approved the Agriculture-FDA spending measure on Wednesday (HR 2112) and the Senate Health, Education, Labor and Pensions Committee advanced two health bills in a markup on Wednesday – reauthorization measures for graduate medical education at children’s hospitals (S 958) and autism research (S 1094).  Next week the Senate Committee on Health, Education, Labor and Pensions will hold a hearing on Wednesday, September 14 “Securing the Pharmaceutical Supply Chain” and the House Energy and Commerce Subcommittee on Health has scheduled a hearing on Thursday, September 15 titled, “Cutting the Red Tape: Saving Jobs from PPACA’s Harmful Regulations.”

The Obama Administration welcomed good news last week when a Virginia-based U.S. District Court of Appeals threw out two challenges to the health care reform law, the Affordable Care Act.  In a high profile case filed by the Commonwealth of Virginia by Attorney General Ken Cuccinelli, the court said that Virginia lacked standing to bring suit against the law.   The Attorney General filed the suit the day the Affordable Care Act was signed into law.  In the second case, filed by Liberty University of Lynchburg, Va., the appeals judges set aside a district court decision that the law is constitutional and ordered that the lawsuit be dismissed because the district court does not have jurisdiction to hear the challenge.  The Supreme Court is still likely to consider the constitutionality of the Affordable Care Act in the near future.

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Capital Thinking Podcast

Newly-elected Republicans have moved quickly to attempt a repeal of the health care reform legislation. Last week, the Senate voted on an amendment to the Federal Aviation Administration reauthorization bill that would have repealed the Affordable Care Act. The effort failed by a vote of 47-51. Senators voted along party lines with all Republicans voting for the repeal and all Democrats along with Independent Sen. Bernie Sanders voting against it. Sens. Joe Lieberman, an Independent, and Mark Warner, a Democrat, did not vote. This vote comes two weeks after the House successfully voted to repeal ACA. The Senate approved by a wide margin an amendment to eliminate the 1099 reporting requirement mandated by the Affordable Care Act. This followed the introduction of three separate bills to repeal the unpopular provision. The health care reform law requires that all businesses issue Form 1099 to vendors from which they purchase $600 or more of goods annually and file the information report with the Internal Revenue Service. The requirement is effective for payments made after December 31, 2011, and was included in health care reform as a revenue raising provision. The timing for repeal of the 1099 reporting requirement in the House is unclear; however, on February 17, the House Ways and Means Committee plans to mark up legislation to repeal the 1099 reporting requirement.

On January 31, a Federal judge in Florida issued a ruling declaring the entire health reform law – and the individual mandate, in particular – unconstitutional under the Commerce Clause and therefore “void.” The judge dismissed a separate claim challenging the legality of the Medicaid expansion. According to U.S. District Court Judge Roger Vinson, “Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void. This has been a difficult decision to reach, and I am aware that it will have indeterminable implications.” The Obama Administration has signaled that it will appeal the decision, and most experts believe that the case will be heard by the Supreme Court in the next couple of years.

On Thursday, CMS Administrator Don Berwick will make his debut on the Hill in appearing before the House Ways and Means Committee at a hearing examining the Affordable Care Act’s impact on Medicare beneficiaries. Richard Foster, Chief Actuary at the Centers for Medicare and Medicaid Services, will also testify at the hearing. During the week of February 14, Department of Health and Human Services Secretary Sebelius and White House Office of Management and Budget Director Jack Lew are scheduled to testify before the Committee about the President’s Fiscal Year 2012 Budget proposal.

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Capital Thinking Podcast

Last week, the House voted on the “Repealing the Job-Killing Health Care Law Act” (H.R. 2). The final vote on the bill was 245-189, with three Democrats – Reps. Dan Boren (OK), Mike McIntyre (NC), and Mike Ross (AR) – voting with the Republicans in favor of repeal. At this time, the Senate has no plans to take up consideration of the bill, which would be unlikely to pass and would almost certainly face a Presidential veto if it were to move successfully.

The House also took up and also passed H.Res. 9, instructing House Committees to recommend measures to replace the reform law. Specifically, the Resolution directs Committees to “proposing changes to existing law” that address many of their chief concerns with the health law including: provisions that spur economic growth and create jobs; lower health premiums; preserve patients’ ability to keep their health plan; provide people with pre-existing conditions access to coverage; reform medical malpractice; increase the number of insured; protect the doctor-patient relationship; provide States with more Medicaid flexibility; expand personal responsibility; prohibit taxpayer funding of abortions; eliminate waste; and do not accelerate the insolvency of entitlement programs. Along with the Resolution, the House adopted an amendment instructing lawmakers to permanently fix the Medicare physician payment formula.

The Committees will turn their attention this week to oversight hearings. The Ways and Means Committee will convene a hearing on Wednesday examining the economic and regulatory burdens resulting from the enactment and implementation of Affordable Care Act. Specifically, the Committee will consider the law’s impact on jobs stemming from the new taxes and new federal regulatory requirements and the impact of the employer mandate on job creation. The Senate Health, Education, Labor and Pensions Committee will hold a hearing on Thursday to discuss the impact of health care reform on consumers. Last week, the House Energy and Commerce Committee announced an investigation into the Office of Consumer Information and Insurance Oversight waiver process that House Republicans believe shield some entities from parts of the health care reform law. These activities foretell House Republicans’ clear focus on oversight of the Affordable Care Act during the 112th Congress.

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CBO Provides Analysis of ACA Repeal Legislation

Today, the Congressional Budget Office (CBO) sent a preliminary budget analysis of the “Repealing the Job-Killing Health Care Law Act” (H.R. 2) to House Speaker John Boehner.

 

The CBO estimates that enacting the legislation to repeal the Affordable Care Act would increase the budget deficit by $145 billion over 2012-2019. The repeal would also result in having 32 million fewer nonelderly people being insured in 2019 equating to a total of 54 million nonelderly individuals being uninsured.

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