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Window to Washington

An inside-the-beltway look at the legislative and regulatory process.
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By Jessica Zigmond and Rich Daly
 

Add Michigan, Nevada to CO-OP list

2 pm, May. 18

Michigan and Nevada on Friday became the latest states to receive Consumer Operated and Oriented Plan, or CO-OP, loans from the CMS, bringing the award total to more than $982 million for these not-for-profit insurers created by the Patient Protection and Affordable Care Act.

Directed by customers, CO-OPS are supposed to offer both small businesses and individuals more-affordable health insurance options and will be offered through the health insurance exchanges or in plans outside the exchanges starting on Jan. 1, 2014. The program gives low-interest loans to not-for-profit groups that then establish these entities.

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Move over Hallmark—Mom's got a health reform card

10:15 am, May. 16

What's more endearing than mom and motherhood?

How about a federal law that creates and distributes Happy Mother's Day wishes.

In the latest marketing idea from a White House team still scrambling to improve the public's approval of the healthcare overhaul two years after its enactment, comes a heartwarming description of future benefits the law hopes to offer:

“Happy Mother's Day From

The Affordable Care Act

Being a Mom isn't a pre-existing condition

It's a joy

Prior to the passage of the Affordable Care Act, insurance companies could deny coverage for women with pre-existing conditions like breast cancer or pregnancy, and women could be charged higher premiums simply because of their gender.

Starting in 2014, it will be illegal to deny coverage to anyone with a pre-existing condition, or charge women more than men for health insurance.”

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Civic, family ties prompt Sebelius to address Catholic university grads

A love of government work and family apparently drove HHS Secretary Kathleen Sebelius' controversial decision to accept an invitation to address a graduating class at one of the nation's highest-profile Roman Catholic universities.

Sebelius accepted an invitation earlier this week to address graduates of the Georgetown Public Policy Institute on May 18. The invitation has spawned protests by Catholic groups upset about a HHS healthcare reform mandate earlier this year that initially required Catholic universities and hospitals to provide birth control coverage to which they view as violating their core moral beliefs.

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Strange poll results for policymakers to chew on

2 pm, May. 8

Many of the healthcare polls bouncing around Washington on any given week can potentially give federal policymakers the pulse of the nation on policy matters under consideration. But also buried in these polls are sometimes head-scratching questions and findings.

The latest example came from a telephone health survey of 1,000 Americans released this week by Reader's Digest and the insurer Humana.

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Don’t bet on a doc-payment formula repeal

3:30 pm, May. 4
Tags: Policy

With the Kentucky Derby just a day away, the nation’s physicians might be in a betting mood. But by now, doctors know better than to raise their hopes that the sustainable growth rate formula will be repealed—before the November elections, during the lame-duck session or pretty much at any point during their lifetimes.

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‘Free money' and insurance industry warnings

Insurance coverage is nice but nothing beats free money.

At least, that's the apparent political thinking that has elevated new estimates on expected rebate checks to the marquee position whenever senior Democrats—including the president—have commented on the healthcare law in recent days.

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The evolution of Medicare fraud

Apparently, Medicare fraudsters are working harder—and smarter—for the billions of dollars they pilfer every year from the massive federal healthcare program.

Federal officials told a Senate panel this week they see a trend away from the “lazy man's fraud” of charging Medicare for phantom durable medical equipment toward more complex scams involving home healthcare and other outpatient treatment.

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Coburn touts concierge plan for Medicare

3 pm, Apr. 24

After a panel discussion at the American Enterprise Institute in Washington on Tuesday, obstetrician and Oklahoma Sen. Tom Coburn, a Republican, had some guidance for the nation's physicians.

"Go into concierge medicine," Coburn said, adding that this option will result in doctors "enjoying medicine better and they can do that with Medicare patients."

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Forget the Supreme Court, the public is against the ACA

12:15 pm, Apr. 20

It's unknown whether President Barack Obama's unusual call earlier this month for the Supreme Court to uphold the Patient Protection and Affordable Care Act made much of an impact on the justices, but it appeared to fall flat for another important group.

Contrary to the president's exhortations in an April 3 speech to a gathering of news editors for the court to uphold the 2010 healthcare law, a plurality of voters, 49%-38%, want the court to strike it down, according to the latest Quinnipiac University poll released this morning. The telephone poll of 2,577 registered voters was taken April 11-17, the week after the president's widely covered address.

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Ryan defends budget at safety net hearing

3 pm, Apr. 17

House Budget Committee Chairman Paul Ryan (R-Wis.) defended his budget plans for Medicaid in his panel's hearing Tuesday to examine the nation's safety net programs.

Ryan opened the hearing by noting that welfare reform in the mid-1990s established meaningful work requirements, set time limits, and gave states the ability to design effective programs. According to Ryan, poverty in female-headed households dropped to 39.3% in 2001 from 55.4% in 1991. He then put the nation's current debt troubles in context by saying that if a crisis hits, those in the safety net will be hit hardest.

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