Health Care Reform Implementation Update - July 30, 2013

by Cozen O'Connor

Some Republicans are threatening not to pass any debt ceiling deal that does not defund the Affordable Care Act and Democrats say they will not pass any deal that does; the full House Energy and Commerce Committee is slated to vote on legislation that would repeal the Sustainable Growth Rate (SGR) formula that historically has led to annual decreases in physician payments that Congress ultimately corrects, however offsets from other areas, particularly from healthcare, are still needed to pass the bill off the House floor; and the Obama administration is meeting with groups throughout the country including many celebrities to promote the Affordable Care Act (ACA).


The Affordable Care Act is becoming the center of a debate that threatens to shut the federal government down this fall. Some Senate and House Republicans are proposing to block any continuing resolutions that would keep the federal government running if they do not defund Obamacare. More than 60 House Republicans have signed on to a letter being circulated by Rep. Mark Meadows (R-N.C.) urging House Republican leadership to defund implementation and enforcement of the ACA.

On July 22, a group of congressional Republicans, led by the Senate Health, Education, Labor and Pensions Committee ranking member Lamar Alexander (R-Tenn.) and House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) along with Sens. Mike Enzi (R-Wyo.), Johnny Isakson (R-Ga.) and Richard Burr (R-N.C.), and Reps. Tim Murphy (R-Pa.) and Joe Pitts (R-Pa.) wrote to HHS Secretary Sebelius requesting disclosure of potential exchange insurance rates in 34 states.

On July 23, two House Education and the Workforce subcommittees (the Subcommittee on Health, Employment, Labor, and Pensions and the Subcommittee on Workforce Protections) held a joint hearing on potential fallout from the Obama administration’s decision to delay the ACA’s employer mandate. The hearing is archived here.

On July 25, Rep. Pat Meehan (R-Pa.) introduced a bill that would delay “the implementation, operation, and coordination of a Federal Data Services Hub or any similar database system for determining or verifying eligibility under the Patient Protection and Affordable Care Act.”

On July 23, the House Energy and Commerce Health Subcommittee approved its draft Sustainable Growth Rate (SGR) repeal legislation with one technical amendment from last week. A vote for the full Energy and Commerce Committee is scheduled for July 31.

Also on July 23, House Energy and Commerce Chairman Fred Upton (R-Mich.) announced that CMS Administrator Marilyn Tavenner will testify on August 1 at a committee hearing examining the implementation of the Affordable Care Act.

On July 25, Chairman Dave Camp (R-Mich.) announced that the Ways and Means Committee will hold a hearing on August 1 on the current status of the Obama administration’s efforts to implement the ACA. The committee will hear testimony from Daniel Werfel, principal deputy commissioner and deputy commissioner for services and enforcement at the Internal Revenue Services (IRS) and Gary Cohen, deputy administrator and director at the Center for Consumer Information and Insurance Oversight within the Centers for Medicare & Medicaid services.


HHS Deputy Director Chiquita Brooks-LaSure, speaking at a Small Business and Entrepreneurship Committee hearing, said that the small business exchanges would be up and running by October 1.


The Obama administration continues its outreach on the Affordable Care Act. On July 22, President Obama met with members of Organizing for Action, made up of volunteers who worked on his campaigns, and with celebrities interested in helping promote health reform and requested their help in making sure the Affordable Care Act is properly put in place. On July 23, Michelle Obama appealed to Latinos to enroll in health insurance plans in a speech to the National Council of La Raza, which is the largest national Hispanic civil rights and advocacy organization in the United States. The Obama administration has also recruited the Washington Nationals baseball team mascot, Teddy Roosevelt, and CVS Caremark to help with enrollment outreach.


Louisiana Governor Bobby Jindal wrote and published in The Times-Picayune an op-ed titled “Why I opposed Medicaid expansion.” Gov. Jindal makes a six-part argument that 1) moving individuals currently enrolled in private plans to government-run plans will discourage self-sufficiency and undermine the safety-net purpose of Medicaid, 2) policies should be designed so that “more people are pulling the cart than riding in the cart,” 3) Medicaid expansion could cost Louisiana taxpayers up to $1.7 billion in the first 10 years of implementation, 4) states should retain the ability to make the policy and budgetary decisions for themselves, 5) there are better ways to improve health care outcomes for the uninsured in a cost-effective way, and 6) it is bad economic policy to borrow money from China.

A committee of Michigan state senators issued a Medicaid expansion blueprint, including long-term eligibility limits on enrollees that are the least poor. This limitation follows the Michigan House’s lead. The Medicaid expansion legislation that passed in the Michigan House set a 48-month lifetime limit for people earning between 100 and 133 percent of the poverty level.

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

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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