Health reform implementation

Health reform implementation

News bites: Feds take over rate regulation

The New York Times's Robert Pear reports on the government's plan to take over insurance rate review in 10 states.

Louisiana's Medicaid program is moving to managed care, Kaiser Health News reports.

Tighter Medicaid restrictions could be part of a debt-ceiling deal, reports Modern Healthcare.

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CBO predicts high savings, small drawbacks to healthcare reform fix

Budget scorekeepers said legislation to fix a "glitch" in the healthcare reform law would cause fewer than one million people to lose access to Medicaid while saving $13 billion over the next 10 years, greatly helping chances of passage.

Republicans in the House and Senate have introduced bills to count Social Security benefits when calculating eligibility for Medicaid and insurance subsidies under the law. The White House has also said it wants to change the law, which would cause some people to look richer and lose federal subsidies.

The glitch has become a powerful argument for Republicans to criticize the law because it allows middle-income early retirees between the ages of 62 and 65 to sign up for Medicaid, which is meant to be for the poor.

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News bites: Some providers like ACOs

ThinkProgress's Igor Volsky warns against bringing the individual insurance mandate into debt-ceiling negotiations.

Newspapers in Iowa and Kentucky explain their states' medical loss ratio adjustments.

Some healthcare providers ae embracing accountable care organizations, USA Today reports.

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Pioneer ACO draft leaked

The Hill has obtained a copy of a draft proposal for Pioneer Accountable Care Organizations under consideration by the Centers for Medicare and Medicaid Services.

The healthcare reform law seeks to incentivize more efficient healthcare delivery by rewarding hospitals, physicians and other providers who work more closely together to care for patients. One provision of the law calls for the creation of so-called Accountable Care Organizations (ACOs) that increase Medicare payments for health systems that offer better care through collaboration.

To kickstart the ACOs, the administration in May announced the creation of a Pioneer ACO model aimed at organizations that have already started coordinating care for patients.

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OVERNIGHT HEALTH: Families could be shut out of healthcare law's subsidies

Family fuss: The healthcare reform law is in danger of making health insurance unaffordable for thousands of families because of a glitch in how the eligibility for subsidies is calculated, The Hill has learned.

The problem is a huge headache for the Obama administration and congressional Democrats, because it could leave families unable to buy affordable health insurance when the healthcare law requires that everyone be insured starting in 2014. 

Some of the administration's closest allies on healthcare reform warn this situation could dramatically undercut support for the law, which already is unpopular with many voters and contributed to Democrats losing the House in the 2010 midterm elections. Healthwatch's Julian Pecquet has the story.

Pay-for-delay moves: The Senate Judiciary Committee cleared bipartisan legislation that would severely curtail pharmaceutical industry deals to delay the entry of low-cost generic drugs on the market. The so-called "pay-for-delay" legislation passed 10-8 and is on its way to the Senate. Read the Healthwatch story.

The Federal Trade Commission applauded the move, saying it could save consumers $3.5 billion a year in lower drug costs. Drugmakers dispute that.

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News bites: Florida rejects more healthcare money

Florida is rejecting another round of federal money tied to the healthcare law, this time for child-abuse prevention, the Miami Herald reports.

Kaiser Health News says hospice companies are increasingly focused on nursing homes.

Ohio Gov. John Kasich signed new abortion restrictions into law Wednesday, Reuters reports.

Some options for Medigap reform would raise costs for enrollees, according to Modern Healthcare.

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Public input sought on healthcare reform law

A body of experts on Wednesday began seeking public input on the type of research that should be conducted under the auspices of the healthcare reform law. 

The law created an independent nonprofit — known as the Patient-Centered Outcomes Research Institute, or PCORI — tasked with conducting "patient-centered outcomes research." The institute is now asking the public to help determine what exactly that means.

"There are different opinions about what patient-centered outcomes research includes," PCORI Executive Director Joe Selby said in a statement. "A work group within our Methodology Committee has created a working definition, so that we can have a shared understanding to guide our work. Now we’re seeking input from the public to make sure we have it right."

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OVERNIGHT HEALTH: IOM recommends mandatory coverage for contraception

Contraception gets a boost: A panel of healthcare experts said Tuesday that the federal government should require insurance plans to offer coverage for contraception without co-pays.

The healthcare reform law requires plans to cover certain preventive care without charging a co-pay. An Institute of Medicine committee on Tuesday issued a highly anticipated report that recommends eliminating co-pays for eight categories of women’s health services, including contraception.

Healthwatch's Sam Baker has the story.

While some women's groups called the recommendations "a great step forward for women," the Family Research Council tells NPR that it opposes the mandatory coverage because of concerns about artificial contraception and abortion.

IPAB light? A bipartisan deficit-cutting plan unveiled Tuesday would require lawmakers to keep federal healthcare costs from growing faster than a target rate, not unlike a provision of the healthcare reform law that Republicans have denounced as a "rationing board." Read the Healthwatch post.

Latinos' health at risk: Latinos would be disproportionately affected by deep cuts to Medicaid that are under discussion as part of debt-ceiling negotiations, according to a new report from Families USA and the National Council of La Raza. The state-by-state breakdown shows provides an in-depth look at the number of Latinos, a key voting demographic, covered by Medicaid nationally and in each state.

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Women's health advocates praise IOM recommendations

A panel of healthcare experts said Tuesday that the federal government should require insurance plans to offer free coverage for contraception.

The healthcare reform law requires plans to cover certain preventive care without charging a co-pay. An Institute of Medicine committee on Tuesday issued a highly anticipated report that recommends eliminating co-pays for eight categories of women’s health services, including contraception.

Judy Waxman, vice president for health and reproductive rights at the National Women’s Law Center, said the recommendations represent a “great step forward for women.”

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