Archive: September 2011

Urban Institute research links successful BHP implementation with more affordable coverage

Posted on September 30, 2011

The Urban Institute’s paper, “Using the Basic Health Program to Make Coverage More Affordable to Low-Income Households: A Promising Approach for Many States,” discusses how proper implementation of Basic Health Programs (BHPs) under the Affordable Care Act (ACA) could create more affordable coverage for low-income households. By implementing a BHP to provide Medicaid-like coverage, modified to add cost-sharing typical of the Children’s Health Insurance Program (CHIP), States could substantially reduce coverage costs and expand the number of insurance enrollments. Additionally, successful BHP execution would reduce the burden placed on the health insurance Exchanges and Medicaid.

For more information on the Basic Health Program, click here.

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Proposed Disclosure Rules Regarding Summary of Benefits and Coverage

Posted on September 30, 2011

The Affordable Care Act (ACA) included a new requirement that health plans in the group and individual markets disclose plan information to consumers in a standardized, accessible format in order to facilitate comparison of plans and improve understanding of plan terms. On August 22, 2011, several federal agencies jointly issued a notice of proposed rulemaking (NPRM) setting forth proposed disclosure requirements, including templates for the disclosures. Comments are due on October 21, 2011.

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New Kaiser/HRET report shows premium costs rose during 2011

Posted on September 30, 2011

In their 2011 Employer Health Benefits survey, the Kaiser Family Foundation (KFF) and the Health Research & Educational Trust (HRET) found that annual insurance premiums for family coverage were over $15,000 this year, which is up more than 9% since last year. This increase is also significant because it outpaced both general inflation and workers’ wages. The survey also found that 1 in 4 workers (23%) are members of health insurance plans that changed their cost sharing requirements for preventive services as a result of the Affordable Care Act (ACA), and 31% of workers are enrolled in plans that changed the preventive services offered because of the ACA. Additionally, 2.3 million young adults have been added to their parents’ insurance plans in accordance with the provision in the ACA allowing children to be covered on their parents’ plans until age 26.

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Supreme Court formally asked to review health reform law

Posted on September 30, 2011

The National Federation of Independent Business (NFIB) and Virginia Attorney General Ken Cuccinelli have formally petitioned the Supreme Court to hear their challenges to the Affordable Care Act (ACA). Because of differing opinions within the federal appelate courts, the Supreme Court is expected to take up the case in the 2011-2012 term. This means a decision can likely be expected by June 2012.

For more information on legal challenges to the ACA, click here.

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HHS extends public comment period on exchange rules

Posted on September 27, 2011

The U.S. Department of Health and Human Services (HHS) has extended the public comment period for two proposed rules involving the Health Insurance Exchanges under the Affordable Care Act (ACA). The rules affected by this change were released by HHS in mid-July, and pertain to Exchange implementation and State standards for reinsurance and risk adjustment. The original comment period that was set to close on September 28th, 2011 will now close October 31, 2011.

For a more detailed analysis of the rules themselves, click here.

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GAO paper recommends improved health care price transparency

Posted on September 24, 2011

Consumers are responsible for increasing proportions of their health care costs. Health care price information that is available before consumers receive care, or transparent, may help consumers anticipate such costs. In a recently released report, the U.S. Government Accountability Office (GAO) examined 1) how various factors affect the availability of health care price information for consumers and 2) the information selected public and private health care price transparency initiatives make available to consumers. GAO reviewed price transparency literature, interviewed experts, and examined eight federal, state, and private insurance company health care price transparency initiatives. The report recommends that the Department of Health and Human Services (HHS) determine the feasibility of making complete cost estimates of health care consumers available to consumers.

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Update: Legal Challenges to the Affordable Care Act

Posted on September 23, 2011

Since the enactment of the Affordable Care Act (ACA), at least 27 lawsuits have been filed challenging the constitutionality of various provisions of the law. While nearly half of the lawsuits have been dismissed on procedural grounds, three district courts have found provisions challenged to be constitutional, and three have found them to be unconstitutional. Previous HealthReform GPS Implementation briefs/updates have discussed these lower court decisions. Following appeals of each of these rulings, the United States Courts of Appeals in the Fourth, Sixth, and Eleventh Circuits have now issued decisions as well. Most importantly, the appellate decisions continue to reflect a split in judicial opinion regarding the constitutionality of the Affordable Care Act’s individual mandate. Other important issues addressed by the appellate rulings concerned the constitutionality of the ACA Medicaid expansion and the question of whether the trial court in the Virginia cases (Liberty University v. Geithner and Commonwealth of Virginia v. Sebelius) had the authority to hear the cases at all.

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Obama’s deficit reduction proposal to super committee includes health savings

Posted on September 20, 2011

President Obama sent “Living Within Our Means and Investing in the Future: The President’s Plan for Economic Growth and Deficit Reduction,” his plan to jumpstart economic growth and job creation, to the Joint Committee yesterday. The plan proposes additional savings on top of those signed into law under the Budget Control Act. Specific to health savings, the President recommended cuts to erroneous and wasteful spending under Medicare and Medicaid. He stressed that he would “veto any bill that takes one dime from the Medicare benefits seniors rely on without asking the wealthiest Americans and biggest corporations to pay their fair share.”

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GOP issues report on CLASS Act

Posted on September 16, 2011

House and Senate Republicans have issued a new report on the Community Living Assistance Services and Supports (CLASS) program, a long-term care insurance program created by the Affordable Care Act (ACA). The report, “CLASS’ UNTOLD STORY: Taxpayers, Employers, and States on the Hook for Flawed Entitlement Program,” was issued by the bicameral Repeal CLASS Working Group, and calls for the repeal of the CLASS program due to questions surrounding its financial sustainability.

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Health Affairs Blog warns of medical necessity definition discrimination

Posted on September 16, 2011

A new Health Affairs Blog by Professor Sara Rosenbaum, a frequent contributor to HealthReformGPS.org, points out an issue with the medical necessity definition proposed in a glossary section of insurance terms that must be disclosed to consumers under the Affordable Care Act (ACA). The glossary is part of a larger proposed rule on Summary of Benefits and Coverage information that must be disclosed to consumers by insurance companies. The rule defines medical necessity as “[h]ealth care services or supplies needed to prevent, diagnose, or treat an illness, injury, disease or its symptoms and that meets accepted standards of medicine,” and could be viewed as discriminatory toward persons with disabilities because it omits the word “condition.”

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