Health reform implementation

Democrats say they'll use the repeal debate to attack Republicans for wasting time and money.

Because of GOP objections, funding for the healthcare reform law is noticeably absent from a bill keeping the government running.

For first time since enactment, Rasmussen survey shows most voters think healthcare law will be repealed.

Funding for the new healthcare reform law is noticeably absent from a bill to keep the government running through March 4, after Republicans objected to an earlier proposal because they said it funded reform.

The continuing resolution (CR) provides a small increase of $1.16 billion over fiscal 2010 levels, but does not fund reform law measures included in an earlier, comprehensive spending proposal.

Republicans had singled out measures in the failed 2,000-page proposal that would have funded a new Prevention and Public Health Fund, an “adjustment” to the Centers for Medicare and Medicaid Services’s Program Management account, an increase to the Health and Human Services Department (HHS) to enforce new mandates and regulations, and a national healthcare workforce commission. Senate Majority Leader Harry Reid (D-Nev.) scrapped the proposal last week when Republicans raised concerns about reform funding and earmarks included in the bill.

The new 36-page CR mentions only one HHS program, which ensures that the department designates the same amount for Low Income Home Energy Assistance Program funding as it did during the same period during fiscal 2010.

The Senate is expected to vote on a procedural motion Tuesday morning to advance the CR to a final vote. The government is currently running on a three-day CR that will expire Tuesday.

A left-leaning public policy group issued new recommendations Monday morning on how to structure accountable care organizations (ACOs), promoted by the new healthcare reform law, to deliver better quality at lower costs.

Under the reform law, an ACO is a group of physicians and hospitals collaborating to provide efficient and quality care for a certain group of patients.

The Center for American Progress (CAP) report said ACOs should follow three major principles:

• "On payment reform, we encourage the development of physician-led accountable care groups alongside hospital-led organizations. The Centers for Medicare and Medicaid Services can encourage these organizations by tying financial rewards to reduction of preventable inpatient and emergency care, as well as providing organizational and technical support to physician-led organizations.

• "On payment incentives, we suggest a payment system that first optionally and then as a requirement leads providers to share in the financial risks of overspending as well as in the savings from underspending, relative to spending targets.

• "On rights and responsibilities, we believe that consumers should be active partners in improving the quality of their care. That means consumers should decide whether to join an ACO, and if they do, they should be able to count on rules for consumer protection and creative ways to benefit financially from seeking quality care at lower costs."

To help ACOs reach full potential, CAP said, healthcare providers must gather the right data on what patients need and how to best deliver those services. The estimated $30 billion for health information technology in last year’s stimulus package will help ACOs better share information, the CAP report said. Further, payment incentives must change to reward better care instead of paying for more services.

The CAP echoed concerns voiced by the Medicare payment advisory body earlier this month that ACOs might receive the same public backlash experienced by managed care organizations in the 1990s. 

The Department of Health and Human Services is expected to issue regulations on ACOs early next year.

Republicans will control the House, and incoming Speaker John Boehner (R-Ohio) plans to pass a repeal of the healthcare law.

In the three district court cases that have been decided so far, the law's supporters have a 2-1 edge.

Republicans’ claim that the new healthcare reform law is a government takeover was the year’s biggest lie, according to a political watchdog site.

The “government takeover” claim, which played an important role in shaping public opinion about the reform law, is  completely false, according to Politifact, which fact-checks political statements.

“It's true that the law does significantly increase government regulation of health insurers,” Politifact said. “But it is, at its heart, a system that relies on private companies and the free market.”

Republicans say the reform law is a government takeover because the plan increases federal regulation and includes an individual mandate to purchase health insurance by 2014. However, Politifact said that most Americans will still be covered by private insurers, which actually benefit from the law.

“It will bring new business for the insurance industry: People who don’t currently have coverage will get it, for the most part, from private insurance companies," it said.

A pair of attorneys general challenging the new healthcare reform law made their case in separate op-eds Friday morning, wrapping up a busy week in the legal fight over the healthcare overhaul. 

Florida Attorney General Bill McCollum, who’s leading a 20-state lawsuit challenging the reform law’s individual mandate, and Virginia Attorney General Ken Cuccinelli, who led the first successful challenge against the mandate, explained their positions in The Washington Post.

Oral arguments were held yesterday for the 20-state lawsuit — also filed by the National Federation of Independent Business — contending that Congress does not have the constitutional power to compel individuals to purchase health insurance, which the reform law requires by 2014. On Monday, a federal judge in Virginia became the first to strike down the individual mandate, reaching a decision opposite of two federal judges in the past few months.

Cuccinelli criticized the Justice Department’s decision not to fast-track its appeal of the Virginia ruling to the Supreme Court.

“There is simply too much at stake to allow final resolution to be unnecessarily delayed,” Cuccinelli said. “There is financial uncertainty for state governments, employers and citizens inherent in not knowing whether the law will still exist two years from now."

Both attorneys general called the individual mandate an overreach that would set a dangerous precedent for future action by Congress.

“If Congress has the power to force Americans to buy goods and services, where is the limit?” McCollum wrote.

Welcome to The Hill's evening roundup of the day's health policy news and advance look at tomorrow's schedule.

Thursday's health news:

Pitts, Burgess named at top of E&C health panel: Rep. Fred Upton (R-Mich.), chairman-in-waiting of the powerful Energy and Commerce Committee, announced on Thursday the chairs and vice-chairs on his committee.

As predicted, abortion rights foe Rep. Joe Pitts (R-Pa.) got the chairmanship of the health subcommittee in a sop to conservatives who bitterly opposed Upton because he has not supported efforts to enact parental notification laws, defund embryonic stem cell research and oppose "partial-birth" abortion. In addition, Rep. Michael Burgess (R-Texas), an obstetrician, will serve as vice-chairman of the subpanel.http://bit.ly/fE9PFE

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