Health Care Reform Implementation Update July 18, 2012

Last week the House of Representatives voted to repeal the Affordable Care Act, but several Republican governors expressed willingness to expand their states’ Medicaid programs in accordance with the Act if their states could be granted control over how the dollars would be spent, and Kentucky committed to joining 15 other states and the District of Columbia in establishing a health insurance exchange under the Act.


The House of Representatives voted to repeal the Patient Protection and Affordable Care Act. The bill passed 244 – 185, with five Democrats crossing over to support the symbolic repeal legislation. Eyes then turned to the Senate, where Republican Leader Mitch McConnell filed an amendment to force a similar repeal bill in the Senate, but Senate Majority Leader Harry Reid committed to blocking such efforts. As President Obama and others this week noted, this is the 33rd House vote to repeal the health care law.

House Republican Study Committee Chairman Jim Jordan and Congresswoman Michele Bachmann are asking their House colleagues to defund the Affordable Care Act now, not wait until next year and prospective future repeal votes. Jordan and Bachmann’s signature campaign has already put 80 congressmen on record as being willing to defund the law this year.


As a result of the Affordable Care Act’s passage, 12.8 million Americans are now receiving a health insurance rebate, which was announced last month. The rebates average $151 per household and were triggered by the Act’s “medical loss ratio” provision, which caps insurance companies’ administrative costs at 20 percent of their premiums.


At the National Governors Association meeting over the weekend, five Republican governors expressed a willingness to expand their states’ Medicaid programs under the Affordable Care Act if the federal government would give their states the flexibility to use the funds as they see fit. The governors noted that their states – Virginia, Nebraska, Utah, Tennessee, and Wyoming – would prefer to receive Medicaid funds as block grants and disperse them as they believe best. 

In Indiana, a new private health insurance exchange called JA Exchange launched last week. The exchange will offer private insurance alternatives to state-sponsored programs, but it will also incorporate provisions of the Affordable Care Act so consumers can receive a full menu of options as intended by the Act.

While Texas Governor Rick Perry has said his state will not now proceed with establishing a health insurance exchange, Texas Health and Human Services Commissioner Tom Suehs testified that implementing the Affordable Care Act would cost Texans less than he originally predicted. Suehs originally projected the creation of a federal health insurance overhaul would cost $27 billion over 10 years, but now he expects that figure to be more like $15.6 billion.

Kentucky Governor Steven Beshear formally told Health and Human Services Secretary Kathleen Sebelius on Tuesday that he would sign an executive order to create a health insurance exchange, which would meet the requirements of the Affordable Care Act. Kentucky will be the 16th state, plus the District of Columbia, to either have enacted legislation to create an insurance exchange or to have established one by executive order.


Today (7/18) at 2:00 p.m. in 216 Hart, the U.S. Senate Special Committee on Aging will conduct a hearing titled "Examining Medicare and Medicaid Coordination for Dual-Eligibles.”

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