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House GOP asks CMS to address outstanding regulations and RGA questions

Posted on August 21, 2012 | No Comments

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Implementation Briefs

In a letter to the Centers for Medicare & Medicaid Services (CMS), House Energy and Commerce Committee Chairman Fred Upton and Health Subcommittee Chairman Joe Pitts asked the agency to address its questions about the status of outstanding Affordable Care Act (ACA) regulations and the Republican Governors Association’s and the National Association of Medicaid Directors’ (NAMD) questions regarding Medicaid.

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Yesterday, the Republican Governors Association sent a letter to the White House with requests regarding state-implementation of the Affordable Care Act (ACA). The Republican Governors, who will lead 60% of states starting in January 2013, asked for more time to decide whether they want to establish a state-run health exchange and for a meeting with the administration officials to discuss concerns regarding ACA implementation. Secretary Sebelius of the U.S. Department of Health and Human Services (HHS) sent a letter to all 50 governors immediately following the election extending the deadline for state-federal partnership or federal-run exchange establishment. However, states still must notify HHS by November 16 whether they plan to pursue a state-run exchange. The Republican governors requested more time to finalize their plans. They also posed 20 questions regarding exchange implementation and 14 regarding Medicaid expansion and stated that they would not be able to move forward unless the questions were addressed by HHS.
The Republican Governors Public Policy Committee, a branch of the Republican Governors Association (RGA), released the proposal, "A New Medicaid: A Flexible, Innovative and Accountable Future," which refers the super committee to 31 ideas for saving and reforming Medicaid. Specifically, the governors support block grants and capped allotments outside of a waiver and the reform of multiple federal programs including workforce training programs. The RGA report opposes cost shifting and tax increases. Key areas of agreement between the GOP report and the Democratic governors include the support of "dual-eligible" health care reform and an opposition to cost shifting proposals such as "blended rates."
In NFIB v Sebelius the United States Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (ACA or the Act). At the same time, the decision adds a new dimension to the implementation of §2001(a) of the Act, which establishes expanded Medicaid eligibility for certain low-income people. This Implementation Brief begins with a discussion of exactly what the Court held in its Medicaid ruling. It then discusses the significance of the majority conclusion, as well as the key implementation questions that arise in the wake of this opinion.