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Archive: July 2012

U.S. District Court for Colorado rules against birth control mandate

Posted on July 30, 2012

On Friday, July 27, the U.S. District Court for Colorado barred the Obama administration from requiring a Colorado air-conditioning company to provide contraceptives to its employees without a co-pay, as the Affordable Care Act (ACA) directs. Hercules challenged the mandate by arguing that it violates the First Amendment and the Religious Freedom Restoration Act. The injunction is specific to the air-conditioning company, however, and thus is not a sweeping victory for opponents of the contraceptive mandate. The case, Hercules v. Sebelius, was brought to the Court by four siblings who own Hercules Industries. The siblings oppose contraceptives and “seek to run Hercules in a manner that reflects their sincerely-held religious beliefs.”

The ACA’s requirement to cover contraceptives without co-pay comes into effect on August 1, 2012. Religious institutions that primarily serve individuals of their one faith may opt to delay implementation of this provision for one year. Hercules did not fall into that category.

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House Ways and Means Health Subcommittee holds hearing on how to reform Medicare physician payment system

Posted on July 30, 2012

House Ways and Means Health Subcommittee held a a hearing at 1o a.m. on July 24, 2012 in the Longworth House Office Building to explore physician organization efforts to promote high quality patient care. The goal of the hearing was to inform Subcommittee members regarding how to reform the Medicare physician payment system. The Subcommittee heard from organizations representing the physicians at the forefront of patient care.

Physicians told the House panel that…

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CMS releases FAQs on Medicare Shared Savings Program

Posted on July 30, 2012

The Centers for Medicare & Medicaid Services (CMS) released frequently asked questions (FAQs) regarding the Medicare Shared Savings Program, a program established by the Affordable Care Act (ACA). Specifically, the guidance addresses Accountable Care Organizations (ACOs). ACOs are formed by providers that have agreed to work together to better coordinate patient care.

Information included in the FAQs include general facts regarding ACOs, the ACO participant list form CMS-588 electronic funds transfer, and governing body background.

On July 9, CMS announced 89 new ACOs had been selected to participate in the second wave of the Medicare Shared Savings Program.

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Romney signs pledge to repeal ACA

Posted on July 26, 2012

Republican presidential candidate Mitt Romney signed a pledge yesterday to repeal and defund the Affordable Care Act (ACA). Although Romney has consistently vowed to repeal “Obamacare” if elected, many conservatives question his dedication to this commitment given that the presidential candidate passed a very similar health care law during his tenure as governor of Massachusetts. The pledge states: “I would now and will for the duration of my presidency, promote and sign all measures leading to (the law’s) defunding, deauthorization, and repeal.”

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KFF releases brief on Medicaid expansion’s impact eligibility and coverage

Posted on July 26, 2012

Beginning in 2014, the Affordable Care Act (ACA) provides for the expansion of Medicaid eligibility to adults with incomes up to 138% FPL ($15,415 for an individual or $26,344 for a family of three in 2012), which would make millions of currently uninsured adults newly eligible for the program. The Supreme Court ruling maintains the Medicaid expansion, but limits the Secretary’s authority to enforce it—if a state does not implement the expansion, the Secretary can withhold federal ACA expansion funds, but not existing federal program funds. This change in enforcement authority may impact state decisions to implement the expansion. A brief recently released by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured provides an overview of current Medicaid eligibility for adults and data on uninsured adults to provide greater insight into the implications of the ACA Medicaid expansion on coverage for adults across states.

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NEJM releases two reports on Medicaid expansion

Posted on July 26, 2012

Two new reports, released by the New England Journal of Medicine, analyze the impact of Medicaid expansion under the Affordable Care Act (ACA). “The Supreme Court and the Future of Medicaid,” authored by Timothy Stoltzfus Jost and Sara Rosenbaum, reviews both the Supreme Court’s majority and dissenting Medicaid expansion arguments and addresses three outstanding questions regarding the ruling.

On June 28th…

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Deloitte survey finds 1 in 10 U.S. employers to drop health coverage

Posted on July 26, 2012

In the 2012 Deloitte Survey of U.S. Employers: Opinion about the U.S. Health Care System and Plans for Employee Health Benefits, nine percent of companies, which represent three percent of the workforce, anticipate dropping health insurance coverage sometime within the next three years. The survey reported that 81 percent of companies, which represent 84 percent of the workforce, plan to continue offering employer-sponsored health insurance. Ten percent of companies, which represent 13 percent of the workforce, reported that they were unsure whether or not they would keep employee health benefits.

According to the survey, many employers are considering sending their employees to participate in the Affordable Care Act’s (ACA’s) Exchanges. Small employers are the most likely to be interested in such an option. Deloitte’s report collected the results of a web survey of 560 randomly selected employers with 50 or more employees. Participants included chief executive officers, chief financial officers, and chief human resources officers.

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Commonwealth article addresses the first wave of Exchanges

Posted on July 26, 2012

Health insurance exchanges form the backbone of the private insurance reforms called for in the Affordable Care Act (ACA), as they will create a marketplace in each state for small employers and individuals without job-based health insurance to buy comprehensive health coverage, with premium subsidies available for those with low or moderate incomes. As of May 2012, 13 states, together with the District of Columbia, had taken legal action to establish exchanges, through legislation or executive order. State implementing laws are essential to the translation of broad federal policies into specific state and market practices. Overall, the laws in the 14 jurisdictions vary, but they tend to show a common approach of according exchanges much flexibility in how they will operate and what standards they will apply to the insurance products sold. In all states, these “threshold policies” will be followed by policy decisions, expressed through regulations, guidelines, and health plan contracting and performance standards. A new Commonwealth Fund issue brief analyzes the choices being made by the jurisdictions to begin establishing exchanges.

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Physician Payment Sunshine Act

Posted on July 25, 2012

Drug companies and medical device manufacturers commonly collaborate with physicians when developing or modifying drug or devices. These collaborations may include consulting arrangements in which physicians provide input and guidance related to drug or device development, participation in clinical trials testing the efficacy and effectiveness of the drug or device, or educational programs to train and teach physicians about the benefits of a new drug or in the case of a medical device, how to use the device effectively. In return for their services and expertise, physicians often receive payment or other items of value such as an honorarium and/or travel expenses. These financial relationships between manufacturers and physicians, while largely beneficial, raise concerns…

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CBO re-scores ACA in light of SCOTUS decision

Posted on July 24, 2012

The Congressional Budget Office (CBO) and the Joint Committee on Tax (JCT) have revised their estimates of the total cost of the Affordable Care Act (ACA) as a result of the Supreme Court’s ruling that essentially makes State expansion of Medicaid eligibility optional. CBO and JCT now estimate that the coverage provision in the ACA will cost $84 billion less over 10 years, coming in at $1,168 billion over the 2012–2022 period. This is down from their original score of $1,252 billion, issued in March of 2012.

In a separate analysis, CBO and JCT have also scored H.R. 6079, a bill to fully repeal the ACA. If enacted as currently written, CBO and JCT estimate that H.R. 6079 will reduce spending by $890 billion and reduce revenues by $1 trillion over the 9 year period of 2013-2022, for a total of $109 billion added to the federal deficit during that time.

Stay tuned to for additional in-depth analyses of the CBO estimate.

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