Health Care Reform Implementation Update May 1, 2012

Last week, the Medicare Board of Trustees released its annual report, the House of Representatives voted to take money from the healthcare overhaul to extend low interest rates for federal student loans, and the House Energy and Commerce Committee approved a proposal package that aims to save the federal government about $114 billion over 10 years by repealing several Affordable Care Act provisions.


On Monday (4/23), the Medicare Board of Trustees released its annual report. The report shows that the hospital trust fund, or Medicare Part A, has an insolvency date of 2024. The trustees said that without the Affordable Care Act, the insolvency date would be 2016.

On Tuesday (4/24), CMS released a proposed rule that updates payments to acute-care and long-term-care hospitals for 2013 and includes several provisions that aim to improve quality. The American Hospital Association expressed disappointment that CMS used outdated data and a flawed methodology to implement coding cuts and also said CMS failed to account for the sequester, which is scheduled for January.

According to a final rule issued by CMS on Tuesday (4/24), all providers and suppliers who qualify for a National Provider Identifier (NPI) will be required to include the NPI on any enrollment applications to Medicare and Medicaid. An NPI is a 10-digit number that identifies a health care provider. CMS says that this requirement will save Medicare about $1.6 billion over 10 years. According to CMS, this rule will enable it and the states to link provider claims to the ordering or certifying physician or eligible professional and to check for suspicious ordering activity.


On Friday (4/27), the House of Representatives voted mostly along party lines to take money from the health care overhaul to extend low interest rates for federal student loans. The House sent the measure to the Senate, where Democrats are likely to reject it.

On Wednesday (4/25), the House Energy and Commerce Committee approved a proposal package that aims to save the federal government about $114 billion over 10 years by repealing several Patient Protection and Affordable Care Act provisions. Some of the proposals included in the package would repeal the law’s Prevention and Public Health Fund, repeal HHS’ unlimited direct appropriation to establish state health exchanges, cut funding for the Consumer Operated and Oriented Plan program, which would provide government loans to nonprofit health plans and repeal Medicaid maintenance-of-effort requirements.

On Thursday (4/26), Republicans on the House Energy and Commerce Committee released a report titled "Higher Costs, More Confusion, Less Coverage." The report says that some companies anticipate their health care costs will increase because of higher taxes, fees and administrative burdens under the reform law. House Democrats accused Republicans of creating a "fundamentally misleading" report.

On Monday (4/23), the GAO released a report saying that the Medicare Advantage demo is expensive, poorly run and should be canceled. CMS responded to the GAO report saying that the demo "will lead to faster and larger quality improvements" and that the project has helped the agency to improve its star-rating system so that it places "greater emphasis on clinical outcomes and beneficiary experience measures."


Colorado is beginning to expand its Medicaid roles. It is one of the few states that is expanding the program before 2014, when the Affordable Care Act requires it.  Beginning in mid-May, Colorado will start offering Medicaid to those at 10 percent of the federal poverty level. It will not, however, be able to enroll everyone who meets this threshold in the program.  Those who can become Medicaid beneficiaries will be chosen by a lottery in each county.


One of the first Affordable Care Act provisions to go into effect is the "medical loss ratio" provision, which requires that insurers spend at least 80 percent of every premium dollar on medical costs. U.S. health insurers will pay $1.3 billion in rebates to consumers and employers this year due to this provision. According to a new report from the Kaiser Family Foundation, almost a third of people who bought their own health insurance last year will get rebates averaging $127.


On Friday (5/4) at 1:00 p.m. in Brookings’ Falk Auditorium, the Brookings Institute’s Campaign 2012 project will hold a discussion on health care reform, the fifth in a series of forums to identify and address the 12 most critical issues facing the next president.

On Friday (5/4) at 12:15 p.m. in 902 Hart, the Alliance for Health Reform and the Centene Corporation will sponsor a luncheon briefing to address the question, "Behavioral Health: Can Primary Care Help Meet the Growing Need?"

To view our compilation of recent health care reform implementation news, click here.

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Posted in Articles, Health Care Reform Implementation Updates, Washington, D.C.

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