Health Care Reform Implementation Update

Much of the health care news this week focused on the effect the election may have on PPACA. Many think major Republican gains could mean significant hold-ups in the legislation’s implementation, or possibly even repeal. Democratic pollsters warned Republicans that if they interpret the midterm results to be a directive to repeal and replace health care law, they would suffer for it in 2012.

PPACA requires that all states have health insurance exchanges, through which consumers can compare insurance plans and purchase coverage, by the year 2014.  The exchanges are intended to make it simpler for individuals and small companies to buy health insurance and determine if they qualify for PPACA’s tax credits or other state assistance, such as Medicaid.  States see this project as a tremendous undertaking because it requires them to design a system, develop information technology and put it in action in just three years. Due to these concerns, HHS unveiled a new competitive grant program that will give five states money to develop Internet-based insurance exchanges. Funding will go to states that are willing and able to lead the race in developing IT systems that can support this activity.

HHS said it will award nearly $30 million in consumer assistance grants to help states and territories either establish or strengthen programs that provide direct services to patients related to their health insurance.  HHS Secretary Kathleen Sebelius announced the grants to 35 states, four territories and the District of Columbia at a news conference.
Donald M. Berwick, administrator for the Centers for Medicare & Medicaid Services said recently that the planned Center for Medicare and Medicaid Innovation (CMI) has the potential to be the “jewel in the crown” of the Patient Protection and Affordable Care Act.  The CMI, established by PPACA and expected to be in place by January, will be dedicated to testing innovative approaches to improving healthcare delivery, payment and quality.

HHS also announced this week 1) nearly 700 additional employers and unions will receive help providing coverage to early retirees and their families, bringing the total number of organizations participating in this program to nearly 3,600; 2) the availability of up to $335 million to boost access to primary health care in community health centers; and 3) the availability of $3.9 million to support families of children with special health care needs.

A panel of experts advising the government will meet in November to begin considering what kind of family planning preventive care should be covered for women at no cost to the patient, as required under PPACA. Sen. Barbara Mikulski (D-MD),  author of the women’s health amendment, says the clear intent was to include family planning. The debate is over whether birth control should be considered preventative medicine. U.S. Catholic bishops and the National Catholic Bioethics Center argue that pregnancy is not an illness, but rather a healthy condition, and that birth control is not a form of health care, but rather a lifestyle choice. Planned Parenthood is leading the free birth control initiative.
 
 

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