Pressure now on White House to offer more healthcare reform-law guidance

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While President Barack Obama's victory Tuesday night ensured the continued implementation of the Patient Protection and Affordable Care Act, it also added pressure on the administration to offer healthcare interest groups more clarity on several provisions of the landmark 2010 law.

Ilisa Halpern Paul, managing government relations director at Drinker Biddle & Reath in Washington, said she thinks the U.S. healthcare industry can expect the Obama administration to release a wave of policies and regulations quickly, especially as states have just until the end of next week to decide if they will establish a health insurance exchange. Until now, states have been "working with a blindfold on," Halpern Paul said, so it's important for HHS to issue a final rule on the insurance exchanges. She expects that rule to be among the first regulations released. Also expected to be issued are a rule on essential health benefits and guidance for employers about what constitutes part-time and full-time employees, as employers will face penalties for not offering coverage to their workers.

The major tasks now are to enroll millions of uninsured Americans in new healthcare coverage and expand states' Medicaid programs, said Ron Pollack, executive director of consumer health group Families USA. “To enable this to happen, the federal government is providing unprecedented fiscal support to the states: 100% funding of expansion costs in the first three years and never less than 90% thereafter,” Pollack said in an e-mailed statement. "This guarantee is essential for governors as they decide whether their programs should cover more low-income adults. It is therefore crucial that upcoming federal budget decisions give governors clear assurances that this funding is stable and won't be reduced."

Meanwhile, there are still provisions of the law—such as a tax on medical devices and the Independent Payment Advisory Board—that not only were repealed in the House of Representatives but also were unpopular with both political parties, said Halpern Paul. As she explained, the nation's economic circumstances and the close election could find the president and lawmakers needing to compromise.

"I do think you will see the most unpopular provisions repealed outright," Halpern Paul said, "or modified."



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