Reform Update: HHS' reform education effort appears near

A confluence of events signals HHS will launch its anticipated healthcare reform law education and outreach campaign next week.

Since early spring, HHS Secretary Kathleen Sebelius and CMS Administrator Marilyn Tavenner have said the department would kick off a nationwide public outreach effort this summer, although representatives for HHS have not provided a timeline or schedule of events. Why HHS has kept mum on the campaign remains a mystery, given that the success of the campaign relies on getting the word out to tens of millions of Americans. Now a few activities and events—combined with pending regulations and a three-month dash to open enrollment for the insurance marketplaces—suggests that is about to change next week.

This coming weekend marks 100 days until enrollment begins for the exchanges, and Enroll America—which is led by a former Obama administration official—just kicked off its “Get America Covered” campaign to educate Americans about the health insurance benefits available to them under the law.

And in Florida next week, Dr. Renard Murray, a CMS regional administrator, is scheduled to host demonstrations about the new healthcare.gov website and a 1-800 call center for the health insurance marketplaces at the Children's Board Family Support and Research Center in Tampa and the Central Florida Family Health Center in Sanford on June 26. A separate event is scheduled at the Jessie Trice Community Health Center in Miami the following day.

“We've invited all of our community partners—hospitals, families, small businesses—anyone who would really benefit from knowing about the marketplace and how they might help their family with or how they might help their clients,” Susan Nichols, director of development and government affairs at the Central Florida Family Health Center in Sanford, told Modern Healthcare.

Nichols said her group—which operates five federally qualified community health centers and one school-based center—has extended an invitation to about 200 people to hear from the CMS' Murray, who is expected to conduct a PowerPoint presentation on the awareness and outreach tools. She expects between 30 and 50 people to attend the event, which she said her organization agreed to sponsor at the request of Hispanic Health Initiatives, which informs and connects medically underserved families with health education and services where they live.

Meanwhile, these events are happening as three regulations related to the health insurance exchanges—including one about standards for navigators who will help people learn about the law's benefits—are currently under review at the Office of Management and Budget, signaling that the CMS might release those rules in the near future.

“I think they looked at launching this campaign and realized if you're out there to create awareness and there is no product when you run your ad, it may not be that effective of an ad,” said John Barkett, director of health policy affairs at Extend Health, a segment of global professional services company Towers Watson. “I think they've waited this long so not to have these ads come out and lead to confusion about what's supposed to happen.”

The immigration-reform debate continued on Capitol Hill this week as the Senate continued to consider and the non-partisan Congressional Budget Office scored the Senate's Border Security, Economic Opportunity and Immigration Modernization Act. The CBO said the bill would lead to a net increase of 10.4 million people residing in the U.S. by 2023 and estimated that it would decrease federal budget deficits by $197 billion between 2014 and 2023. That figure represents the difference between an increase in federal revenue by $459 billion over that period coupled with an increase in direct spending by $262 billion. “Most of those outlays would be for increases in refundable tax credits stemming from the larger U.S. population under the bill and in spending on healthcare programs—particularly for the Medicaid program and for subsidies provided through insurance exchanges under the Affordable Care Act,” the CBO report said. Meanwhile, Edwin Park, vice president for health policy at the left-of-center Center on Budget and Policy Priorities, penned a blog post that examines an amendment from Sens. Orrin Hatch (R-Utah) and Marco Rubio (R-Fla.) that would leave those workers who gain legal status without health insurance coverage for at least 15 years. Hatch and Rubio's measure would align the five-year waiting period that applies to other federal means-tested programs—such as Medicaid and the Children's Health Insurance Program—to the premium tax credits and cost-sharing subsidies under the Patient Protection and Affordable Care Act.

Sens. Tom Coburn (R-Okla.) and Claire McCaskill (D-Mo.) this week introduced the Medicare Fair Share Act, legislation that lowers Medicare expenditures by raising the premiums that wealthier Medicare beneficiaries pay for Medicare Parts B and D. Today, seniors who have an annual income above $85,000 or more pay higher premiums for Medicare coverage. “The Medicare Fair Share Act would would create a new income bracket for income-related premiums from $50,000 to $85,000, as well as adjust premiums upward accordingly,” said a news release about the legislation, under which wealthier seniors would pay 10% more of program costs.

The nation's hospitals have criticized Medicare's Recovery Audit Contractor program for some time and recently suggested new ways to make RACs more accountable. Next week, the Senate Finance Committee will examine ways to improve the RAC program in a hearing on June 25. Witnesses will include J.J. Carmody, director of reimbursement at the Billings (Mont.) Clinic, and Suzie Draper, vice president of business ethics and compliance at Intermountain Healthcare.

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