Implementation of Health Care Reform Law

The Medicaid and CHIP Payment and Access Commission (MACPAC), established under the CHIP Reauthorization Act of 2009 (CHIPRA) and expanded under the Affordable Care Act (ACA), took a significant step back from its duties on January 28th. Responsible for issuing and voting on recommendations to Congress, HHS, and the states on a range of issues including the implementation of the ACA, MACPAC held a contentious meeting on January 28th after issuing a set of draft recommendations that led many commission members to call for a “do over” due to the complexity and costs of the proposals when states are facing significant budget deficits. It is unclear where the panel will go next, but many members have called for revising the recommendations. More information on MACPAC’s public meetings can be found here. On February 3rd, HHS Secretary Kathleen Sebelius issued a press release that can be found here marking the two-year anniversary of CHIPRA.

On January 31st U.S. District Court Judge Roger Vinson ruled in the multi-state lawsuit led by Florida Attorney General Pam Bondi (R) that the ACA is unconstitutional. Although his ruling against the ACA was expected, Vinson’s ruling was broader in scope than many thought it would be as he determined that the mandate could not be severed from the law, thus finding the entire law void. He stopped short of ordering the government to cease with its implementation of the law, however, and he also ruled against the states claiming that the Medicaid expansion in the law is coercive. The ruling is the second to find the mandate unconstitutional, while over a dozen federal judges have upheld the provision as constitutional. A copy of Vinson’s ruling can be found here.