Health reform implementation

The healthcare reform law enacted one year ago today promises to get more rural Americans insured, improve their access to doctors and cut their medical costs, two former governors of rural states said in a newspaper editorial and during a national media conference call Wednesday.

"As former governors, we know that no matter where they chose to live, residents in rural areas need access to affordable, quality health care," Agriculture Secretary Tom Vilsack of Iowa and Health and Human Services Secretary Kathleen Sebelius of Kansas write in an editorial for the McClatchy-Tribune News Service. "Today, the Affordable Care Act is moving that vision forward. It is supporting rural caregivers and bringing new doctors and nurses to rural communities. It is holding insurers accountable. And it is giving rural Americans more affordable options for better quality coverage."

The Obama administration says the law will help reverse long-standing healthcare disparities between rural Americans and their urban counterparts. Rural Americans, according to a government report, pay more out of pocket (40 percent vs. 33 percent), have less access to primary-care physicians and specialists (half as many specialists per 100,000 people and a third the number of psychiatrists) and are more likely to defer care because of cost (15 percent vs. 13 percent).

Pennsylvania’s Republican governor, who sued to block healthcare reform last year when he was the state’s attorney general, told lawmakers on Wednesday the Obama administration should fast-track challenges to the law to the Supreme Court. 

Gov. Tom Corbett, who joined with 12 other attorneys general to challenge the law last year just hours after President Obama signed it, said the numerous lawsuits again healthcare reform have caused widespread confusion about states' obligations to implement the overhaul.

"Pennsylvania and all other states need clarity," Corbett told two Pennsylvania House members Wednesday morning during a field hearing in the state.

As attorney general last year, Corbett’s decision to join in a multi-state lawsuit clashed with then-Gov. Ed Rendell’s (D) support of the law. In the end, 26 states joined the lawsuit before a federal judge in Florida struck down the entire law in January.

The Florida judge ruled against the constitutionality of the law’s requirement for individuals to purchase insurance and said the whole law must be struck down because the so-called “individual mandate” could not be severed from the rest of it. Another federal judge earlier this year struck down only the individual mandate in a case brought by Virginia Attorney General Ken Cuccinelli (R). Meanwhile, three federal judges have upheld the mandate.

Corbett’s request will likely fall on deaf ears, however. The administration recently urged the Supreme Court to let the Cuccinelli challenge play out through the normal appeals process, arguing that there’s plenty of time before the individual mandate becomes effective in 2014. The administration also noted that some appeals courts are already hearing the challenges on an accelerated timeline. 

Republicans remain united in their desire to defund healthcare reform despite a public split over stopgap budget bills that contain money for implementation, the leader of the Republican Policy Committee said Wednesday.

Committee Chairman Tom Price (R-Ga.) and Rep. Bill Cassidy (R-La.), both doctors, hosted a press call Wednesday to mark the first anniversary of the Democrats' law. They defended House Republicans' decision to pass several stopgap budget bills that provide money for the law's implementation, which some conservatives believe violates the GOP's pledge to do all it can to kill the law.

"At every single turn where we're able to get to the funding of the legislation itself, we will," Price said in answer to The Hill's questions. "The Speaker's committed to doing that, we're committed to doing that, the chairmen of the committees are committed to doing that, and so at this point I think we're all on the same page wanting to make certain that the law never has the funding that it needs."

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A year after President Obama signed healthcare reform into law, supporters and opponents made their cases in editorial pages across the country on Wednesday.

First lady Michelle Obama focused on the preventive healthcare benefits included in her husband’s signature legislative achievement.

“Thanks to the Affordable Care Act, preventive services like mammograms, colonoscopies, cervical screenings and treatment for high blood pressure are available in new plans without any out of pocket costs,” she wrote on Yahoo. “We know that these kinds of preventive services will go a long way in preventing chronic illnesses like diabetes, heart disease, and high-blood pressure, which touch the lives of millions of Americans.”

House Speaker John Boehner (R-Ohio) and Senate Minority Leader Mitch McConnell (R-Ky.) said Republicans are continuing to fight for repeal of the law.

“[T]he contents of this law are even worse than anyone expected,” they wrote in a Cincinnati Enquirer joint op-ed. “And that's saying something.”

Sen. Orrin Hatch (R-Utah), the Finance Committee’s top Republican, argued for replacing the law with a strategy that puts states in control of reform.

"One year later and you don’t need a Ph.D. in economics to know that this law is a budget-buster that raises taxes, increases already out-of-control health costs, puts Washington in charge — all while putting our already fragile entitlements on an even worse fiscal footing,” Hatch wrote in the Salt Lake Tribune.

It will take time to build political support for healthcare reform, a top House Democratic advocate of President Obama's law said Wednesday.

Rep. Debbie Wasserman Schultz (Fla.), the Democrat in charge of promoting the new reform law, said on that law's one-year anniversary that voters are "reserving their judgment" on the measure.

"It is going to take some time to educate people about all the details and benefits," Wasserman Schultz said on a conference call organized by the Democratic National Committee (DNC).

"I think the polls show right now that the American people are reserving their judgment," she said later in the call.

The law turned a year old on Wednesday, and a variety of Republicans have promise to undo it.

A CNN/Opinion Research poll released Wednesday to mark the anniversary found that 37 percent of U.S. adults support the legislation, and 59 percent oppose it. Five percent expressed no opinion. Those numbers are roughly consistent with the bill's poll numbers a year ago.

Other polls have suggested that, at the same time, Americans don't favor repealing the legislation, as Republicans in Congress have repeatedly sought, and GOP presidential candidates have promised they'd do if they're elected in 2012.

"I don't really think you can go by the polls," Wasserman Schultz said. "They have been pretty steady. But if you poll the subset of people who have begun to benefit ... you would find that polling in those segments is higher than just the 50/50 for the American people."

The Florida Democrat defended the healthcare law's poll numbers by pointing to the fact that it wasn't doing worse, given the millions spent in opposition to it.

"If you ask me, the opponents of healthcare reform have really thrown a lot of money down a black hole," she said.

Crossroads GPS is seeking access to documents detailing how HHS decides who can get waivers from the healthcare reform law.

Healthcare reform proponents are using the one-year anniversary to build support for the law, The Washington Post writes.

If elected president, Mitt Romney will immediately dismantle healthcare reform, the Boston Globe reports.

Polls show the public is still very split on the law, according to The New York Times.

Insurers were the big winners in healthcare reform’s first year, MarketWatch reports.

A new study finds that consumers are losing $363 billion in the “hidden” costs of healthcare, such as taking time off to care for elderly parents, CNNMoney writes.

Anniversary day: After two weeks of solid buildup from lawmakers and interest groups, Wednesday marks the one-year anniversary of healthcare reform's enactment. There will be no shortage of events to mark the day.

For reform:

• Rep. Anthony Weiner (D-N.Y.) speaks to the Center for American Progress at 10 a.m.
• Sebelius and Agriculture Secretary Tom Vilsack mark the anniversary in a call with the press.
• Health Care for America Now hosts about three dozen events across the country celebrating the law.
• HHS Assistant Secretary for Health Howard Koh is attending an event with faith leaders.
  

Against reform:

• Sen. Orrin Hatch (R-Utah) will discuss "the trust impact and cost" of healthcare reform with a small-business owner in his home state.
• Georgia Gov. Nathan Deal (R) and Georgia Republican Reps. Phil Gingrey, Tom Price and Rob Woodall reflect on the law at the state capitol building.

Coffee and pancakes: Republicans seized on a news interview from Starbucks CEO Eric Schultz, in which he said healthcare reform puts too much pressure on small businesses. Schultz had been seen as one of the biggest corporate backers of healthcare reform.

House Speaker John Boehner's (R-Ohio) office, unable to resist the opportunity for a solid pun, said the Schultz interview is proof that healthcare reform is a "Venti job-crusher." Meanwhile, the Heritage Foundation posted a video interview with the owner of 12 IHOP restaurants who fears healthcare reform will hurt his expansion plans.

Read the Schultz interview here.

Republicans on the House Small Business panel Tuesday demanded to know how federal officials went about approving more than 1,000 healthcare reform waivers.

The panel is a little late to the party — their colleagues on the Energy and Commerce and oversight committees have already held hearings on the issue. Still, this week, panel chairman Sam Graves (R-Mo.) and Health subcommittee chairwoman Renee Ellmers (R-N.C.) wrote to Health and Human Services Secretary Kathleen Sebelius to ask her to answer 13 questions about the waiver process — including how it was developed, what legal authority the department has to grant the waivers and what outreach federal officials have conducted to "apprise small business owners of the opportunity to apply."

"With the increased pressure on employers to offer insurance, and the continued sharp rate of premium increases, small businesses are under even greater financial and competitive constraints," Graves and Ellmers wrote. "We want to ensure that all entities, particularly small businesses, have been treated fairly and equitably in the waiver process."

The waivers are temporary exemptions from a single provision of the 2,700-page healthcare reform bill: the $750,000 minimum annual cap on benefits for 2011. Republicans have been eager to make political hay of the process, however, saying the waivers are being used to reward political allies or are proof the law is fatally flawed.

Seniors have saved nearly $40 million in brand-name drug costs through a Medicare provision of the healthcare reform law, the Obama administration announced Tuesday morning.

About 48,000 Medicare enrollees saved a combined $38 million on brand-name drugs thanks to a new 50 percent discount on meds that fall in the so-called doughnut hole, the Department of Health and Human Services said. Further, about 4 million seniors who fell in the Medicare drug coverage gap last year received a one-time check of $250.

The doughnut hole has been one of the most controversial elements of Medicare prescription coverage since it launched in 2006. In 2010, beneficiaries paid 25 percent of their drugs costs until they reached $2,830. Seniors were then responsible for the next $3,610 worth of drugs, and the government picked up 95 percent of the tab for anything over $6,440.

Seniors in 2011 started receiving a 50 percent discount on drugs that fell into the doughnut hole, and the discount will be ratcheted up to 75 percent within 10 years.

The announcement comes on a day when the administration plans to highlight healthcare reform’s benefits for seniors. HHS Secretary Kathleen Sebelius and Administration on Aging chief Kathy Greenlee are meeting with seniors in Pittsburgh and Missouri, respectively.

“For too long, many seniors and people with disabilities have struggled to choose between paying for needed prescription medication and other necessities, like food, rent and utilities,” Sebelius said in a statement. “The Affordable Care Act is delivering more affordable prescription drugs to seniors and giving everyone on Medicare better benefits.”