With the November congressional and presidential elections a little more than three months away, provider advocates have ramped up their campaign giving—with one notable exception.
Provider political action committees already have taken in and distributed millions of dollars to both incumbents and challengers, but the largest such provider group—run by the American Hospital Association—has spent less than half of the money it has collected from members in the current election cycle.
The AHA PAC collected $3,140,010 by the end of June but spent only $1,318,569, according to the political campaign contribution tracking site OpenSecrets.org.
The American Health Care Association PAC actually has spent more than AHA, even though it has collected only about half as much: $1,658,281.
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As Congress' five-week summer recess approaches, it remains uncertain whether lawmakers will act on an HHS appropriations bill for next year.
Last week, the House Appropriations Committee's Labor, Health and Human Services, Education and Related Agencies subcommittee voted 8-6 to pass the full committee's fiscal 2013 spending bill for the HHS, Labor and Education departments that includes $68.3 billion for HHS. The legislation would also defund the Patient Protection and Affordable Care Act and end HHS' Agency for Healthcare Research and Quality as of Oct. 1.
But it's unclear when—or if—that bill will move beyond its passage at the subcommittee level. In a statement Monday, Rep. Rosa DeLauro (D-Conn.), ranking minority member on the subcommittee, released a statement that said the bill cuts $6.8 billion from last year's budget and will result in “obliterating” programs that provide healthcare, educate children, prevent the spread of disease and make sure seniors receive Social Security in a timely manner. DeLauro also accused her Republican colleagues of trying to hide their plans to cut these programs by not having a broader public discussion of the bill.
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Will they or won't they?
The potential complexities surrounding state decisions over whether to expand their Medicaid programs now that the Supreme Court justices have eliminated fiscal penalties for not doing so continue to emerge. The law required Medicaid eligibility for all people with incomes up to 133% of the federal poverty level with a 5% leeway up to 138%.
The latest wrinkle in the expansion question was highlighted Tuesday by Matt Salo, executive director of the National Association of Medicaid Directors. He reminded attendees at a Washington health policy event that regardless of what various governors decide to do with their states' Medicaid programs, any decision may be countermanded by their legislatures.
But as a starting point to understanding where states are headed on the size of their Medicaid programs, Modern Healthcare recently contacted all 50 governors about their plans, as they stand now.
We asked whether states were planning to expand; planning to not expand; or undecided on expansion.
Here are the positions of the 26 governors' offices that responded, including several that specified they were waiting for the outcome of the November presidential and congressional elections.
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With much of the national attention focused on the largest moving parts of the 2010 federal healthcare overhaul, it's easy for the numerous smaller provisions to get lost in the shuffle. But the ongoing political battle over the fate of the law also has affected those initiatives.
One such small part of the 2,700-page law but big to providers was the new National Health Care Workforce Commission.
The first federally appointed advisory body fully focused on the healthcare workforce had its inaugural 15 members appointed by the comptroller general last year. But nothing else has happened with the group since then because Congress never approved any operational funds for it.
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There must be something about the July heat in Washington that gets House Republicans fired up about the Independent Payment Advisory Board, a yet-to-be appointed panel the 2010 healthcare reform law created to control the per-capita growth rate in Medicare.
A year ago this week, HHS Secretary Kathleen Sebelius testified before two House committees to answer questions about the purpose and merits of the 15-member board. And this week—on the same day the House voted a second time to repeal the entire Affordable Care Act—Rep. Phil Roe (R-Tenn.), a physician, sent a letter to the AARP that asked the organizations representing America's seniors to publicly support repealing the board.
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After the U.S. Supreme Court's ruling last week on the healthcare reform law, providers and payers can resume their focus on pending federal regulations. But they shouldn't hold their breath that HHS will release those rules before the November elections.
Voters will visit the polls in four months, which doesn't leave much time for HHS to issue some of the complicated regulations that healthcare providers and payers have anticipated. I spoke about this issue recently with Anne Hance and Eric Zimmerman, partners at the Washington office of law firm McDermott, Will and Emery. As Hance explained, these regulations include a proposed or final rule on essential health benefit packages that the Affordable Care Act requires of health plans. HHS has released two bulletins to offer the industry some guidance on essential health benefits, but they were not actual regulations and they generated many questions for the industry.
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