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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
Posts tagged Breaking News from Modern Healthcare
 

Window to Washington Blog: Baucus, Sebelius keep focus on implementation, not outreach

When Sen. Max Baucus (D-Mont.), chairman of the powerful Senate Finance Committee, told HHS Secretary Kathleen Sebelius that he worried Obamacare’s implementation was headed for a “train wreck,” she publicly promised to bring him into the loop.

Turns out that Sebelius kept her word and has been giving Baucus one-on-one briefings on the law’s implementation every other week since his very public April 17 complaint about a lack of information. (Her staff promised synchronized press briefings implementation and has since declined to provide those.) The White House also has chipped in, sending Chief of Staff Denis McDonough to brief Baucus on the healthcare overhaul’s implementation (along with other issues) on alternating weeks from Sebelius’ briefings, according to his staff.

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Blog: Insurance exchanges a growing problem for feds

The CMS has a growing health insurance exchange problem.

The authors of the 2010 federal healthcare overhaul never intended the federal government to operate most health insurance exchanges. But as the nation gears up for an expected 7 million new beneficiaries to make use of exchanges — about 85% of whom will require complex subsidies — 26 states have left their operations to the federal government.

And it’s beginning to look like the number of states hankering for a federal takeover could grow. A number of state-led exchanges are way behind schedule.

Are the feds up to the task, given that running something for more than half the country is a lot more complex than launching any one state exchange? Experts say local insurance market variations will stop the federal exchange builders from using cookie cutter economies of scale.

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Blog: Tardy regs will have lingering effect

The administration has shrugged off attacks for its delays on issuing Obamacare regulations. But you'd think they would have been more timely on the Basic Health Program regs, whose postponed implementation will have a major impact on the law's coverage expansion.

The BHP was designed to provide coverage assistance program for people with incomes too high for Medicaid but who cannot afford exchange coverage, even with subsidies. An HHS guidance document released this week put off proposed rules until sometime later this year and implementation of the program until 2015. That's a year later than originally planned.

The delay will hit coverage expansion for people the law was supposed to benefit the most: the low-to-moderate income uninsured.

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Blog: More budget battles coming fast

1:15 pm, Jan. 8

Healthcare providers still weary from the most recent drawn-out budget battle in Washington could have the next fiscal fight on their hands sooner than they think.

Experts have warned that it's the next round of deficit-reduction negotiations that the healthcare industry should be worried about, and it could hit providers in a couple of ways. Federal lawmakers must tackle the sequester, the automatic spending cuts that Congress postponed for two months in last week's fiscal-cliff legislation. (Medicare providers would not have seen their cuts kick in until early February, according to the Congressional Budget Office).

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Blog: Sandy Hook tragedy drives pressure for action on mental healthcare

Moments after gunman Adam Lanza's mass murder of 26 people—including 20 children—at Sandy Hook Elementary last week, President Barack Obama called on the nation's leaders to set politics aside and take “meaningful action” to prevent future tragedies like the one in Newtown, Conn.

In less than a week's time, those efforts are taking shape in Washington as some lawmakers have made a connection between the nation's recent spate of shooting sprees and the need for stronger mental healthcare services—and adequate federal funding for those services—in America.

Two days after the massacre, Sen. Joseph Lieberman (I-Conn.) appeared on “Fox News Sunday” calling for a federal commission on mass violence. “It's like the slogan we use in Homeland Security: 'See something; say something,'” Lieberman said. “If you see a younger person that really looks like they are really troublesome, get them mental health help,” he continued. “Is there enough mental health help available for these kids?”

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Blog - Dems fret: AARP gone missing on Medicaid

The charge that AARP's lobbying is driven primarily by the profits it derives from its Medigap insurance plans, which supplement standard Medicare coverage, has been a staple of congressional Republicans since the seniors group threw its considerable weight behind passage of Patient Protection and Affordable Care Act.

Now some high-ranking Democrats are joining in the attack. Sen. Jay Rockefeller (D-W.Va.) blasted the powerful seniors' group Tuesday for basing its Washington lobbying priorities on its financial profits. The chairman of the Finance Committee's Health Subcommittee accused the 20-million strong seniors group of failing to back congressional Democrats' efforts to block Medicaid changes as part of a major year-end debt deal.

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Blog: Not exactly a ringing endorsement

1:15 pm, Nov. 28

Elections have consequences, right?

Although Democrats and their allied organizations have spent the weeks since the Nov. 6 election crowing that President Barack Obama's re-election decisively endorsed his approach to healthcare policy, some polls might cloud that picture.

For instance, a new Gallup poll taken after the election found a first-time outright majority opposing the federal government ensuring all Americans have health insurance. Fifty-four percent of Americans opposed such a government role, while 44% supported it.

The opposition to such federal action has grown 23 percentage points since 2000, while support for it plummeted by 22 percentage points. The drop in support for a federal health coverage role included a 10 percentage point decline since just 2008.

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Blog: Stark falls to fellow Democrat; opening created on health panel

One of the casualties from last week's congressional elections is a familiar face in the healthcare industry: Rep. Pete Stark, the California Democrat who currently serves as the Ways and Means Health Subcommittee's ranking member and is widely known for the three-part physician self-referral law that bears his name.

A longtime champion of a single-payer healthcare system, Stark—who has served in the U.S. House of Representatives in the 8th, 9th and currently 13th district of California since 1973—was beaten by Eric Swalwell, a fellow Democrat, to represent the Golden State's 15th district. In the healthcare industry, Stark's influence largely stems from his work drafting legislation that governs physician self-referral in the Medicare and Medicaid programs. The first phase prohibited physician self-referral for clinical lab services in Medicare starting in 1992, and additional phases became effective in 1994 and 2007, as the law eventually expanded to other healthcare services and also applied to Medicaid.

From 2007 to 2010, Stark served as the subcommittee's chairman. His departure now leaves open the health subcommittee ranking-member spot on the hugely influential panel that makes tax law.

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Blog: Obama outlines 'middle-class bargain,' plans for second term

Affordable health insurance is part of the “middle-class bargain” that President Barack Obama is promising all Americans if he's elected to another term on Nov. 6.

That message was included in The New Economic Patriotism: A Plan for Jobs & Middle-Class Security (PDF), a 20-page booklet of second-term plans that the president's campaign released Tuesday along with a new video ad. Pledging to build an “economy from the middle class out,” the agenda offers the president's objectives for American manufacturing, small business, education, healthcare, retirement security and the deficit. Not surprisingly, the section on healthcare touts the Patient Protection and Affordable Care Act and how the administration would ensure the controversial law's continued implementation in a second term.

“It is up to you whether we go back to a healthcare system that lets insurance companies decide who to cover, when to cover it, whether they can drop you from your coverage whenever you need it most, or whether we keep moving forward with a law that is already cutting costs and covering more people and saving lives,” the president says in it.

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Blog: Report on reform's free-market roots is puzzling to some

A new study from the left-leaning Urban Institute says the Patient Protection and Affordable Care Act relies on market-based principles to achieve its goals, which opponents of the law say they find puzzling.

Released Friday, the brief report from authors Randall Bovbjerg and Stan Dorn (PDF) starts with the premise that although critics of the 2010 law refer to it as a government takeover of the U.S. healthcare system, it is actually based on pro-competitive reforms reminiscent of the Reagan era.

“The argument that the ACA is market-based when the opponents say the market can't address healthcare is perplexing,” says Sean Riley, director of the health and human services task force at the American Legislative Exchange Council, a not-for-profit organization in Washington centered on free-enterprise principles and federalism at the state level.

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