Health reform implementation

The incoming chairman of the House Energy and Commerce Committee announced 12 new Republican members will join him in his effort to repeal the new healthcare reform law.

Fred Upton (R-Mich.), who won the contentious chairmanship race for the next Congress, also announced that Rep. Greg Walden will return to the committee.

The committee will "immediately" work to repeal and replace the healthcare reform law, Upton said in a Dec. 1 blog for The Hill. 

The new GOP members on the committee include:

Charlie Bass (N.H.)
Brian Bilbray (Calif.)
Bill Cassidy (La.)
Cory Gardner (Colo.)
Morgan Griffith (Va.)
Brett Guthrie (Ky.)
Gregg Harper (Miss.)
Adam Kinzinger (Ill.)
David McKinley (W. Va.)
Cathy McMorris Rodgers (Wash.)
Pete Olson (Texas)
Mike Pompeo (Kan.)
Greg Walden (Ore.)

A liberal advocacy organization is giving heck to an incoming congressman in his hometown because of his campaign to repeal the new healthcare reform law.

Americans United for Change, which has been singling out newly elected Republican congressmen who campaigned on repealing the reform law, put up a new billboard Friday in Las Vegas to call on incoming Rep. Joe Heck (R-Nev.) to drop healthcare benefits available to him as a member of Congress.

“Heck has repeatedly said he would come to Washington to repeal the Affordable Care Act, so it’s time for Heck to show he’ll stay true to his values and reject his government-subsidized health plan or stop trying to deny 32 million Americans access to the same kind of quality, affordable healthcare choices he’ll gets as a member of Congress,” the group said in a statement.

In the past month, the advocacy group also has targeted newly elected Reps. Andy Harris (R-Md.) and Bill Johnson (R-Ohio) over their opposition to healthcare reform.

A Republican congressman voiced his disapproval Thursday of new healthcare reform regulations requiring health insurers to spend most premium dollars on health services.

Rep. John Carter (R-Texas) said the medical loss ratio (MLR) regulations, which require health insurers to spend at least 80 percent of premium payments on providing care (85 percent for large group plans), will “wreck the individual and small group market.”

“Our national goals should be to increase health coverage for all Americans,” Carter said in a statement. “This regulation is heading in the exact opposite direction, and must be stopped before it becomes effective.”

The regulations, “Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient Protection and Affordable Care Act,’’ were issued Dec. 1. Carter introduced H.J. Resolution 103 on Thursday to make his disapproval official.

The Department of Health and Human Services said the MLR provisions will make the insurance market more transparent and prevent insurers from channeling their premium dollars toward administrative costs and profits.

Sen. Tom Coburn (R-Okla.) criticized the continuing resolution (CR) to fund the government through next year.

Health insurers offering so-called “mini med” plans must notify customers in plain language and within 60 days that their insurance plans offer extremely limited benefits, according to new Department of Health and Human Services guidance released Thursday.

“Guidance issued today ensures that consumers in plans with low annual limits are notified of the quality of their health plan so that they can make informed decisions about whether mini-med coverage is right for them,” HHS said.

Many chain restaurants and retailers offer low-cost, low-benefit plans — some worth just $2,000 per year — that will be phased out by the 2014 because their annual limits fall well below requirements included in the healthcare reform law. However, HHS has granted more than 200 waivers exempting these plans from new annual limit requirements under the idea that limited coverage is better than no coverage at all.

However, Sen. Jay Rockefeller (D-W.Va.) criticized the mini-med plans during a Senate Commerce Committee hearing last week, saying that they are falsely advertised as insurance.

“It gives people a false sense of security,” Rockefeller said. “It lets them think they have health insurance when they really don't. By the time they realize they don't have real health insurance, it's too late."

A Republican senator introduced early Thursday a bill that would allow state officials to challenge federal regulations before they go into effect.

The legislation's sponsor, Sen. Roger Wicker (R-Miss.), said the bill is in response to the new healthcare reform law, which Republicans say would create 159 "boards, commissions, bureaus, programs and offices of the federal government."

The Restoring the 10th Amendment Act would allow certain state officials to file a legal brief challenging the constitutionality of proposed regulations during the comment period. The head of the challenged federal agency would then have 15 days to certify the regulation complies with to the 10th Amendment, which states "powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

Wicker told The Hill last week that he did not have high expectations for passing the bill before the lame-duck session.

"I think it's going to take another election, and probably another president, to get this taken care of," Wicker said last week. "But this is a step. It's a salvo."

However, Wicker said today that he hoped to gain support for the bill in the next Congress.

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

Wednesday’s health news:

Senate approves 'doc fix': The Senate passed Wednesday night a one-year, fully paid-for fix to Medicare rates that would avoid a scheduled 25 percent cut to physician payments on Jan. 1.

The bill, which passed the Senate by unanimous consent, taps into subsidies for state-run insurance exchanges created by the new healthcare reform law to pay for the $19.2 billion fix to Medicare physician rates. The bill now moves to the House. http://bit.ly/faTN9O

President supports fix: President Obama gave his blessing to the "doc fix" Wednesday afternoon, even though it would take away funds from the healthcare reform law. He called on leaders to develop a more long-term solution to the physician payment formula over the next year.

“This agreement is an important step forward to stabilize Medicare, but our work is far from finished,” Obama said. “For too long, we have confronted this reoccurring problem with temporary fixes and stop-gap measures. It’s time for a permanent solution that seniors and their doctors can depend on, and I look forward to working with Congress to address this matter once and for all in the coming year.” http://bit.ly/h0baVd

Food safety passes House: The controversial food-safety bill was approved by the House, 212-206, Wednesday night as part of the continuing resolution (CR) to keep the government funded through Sept. 30.

House Democrats moved the food-safety bill into the CR Wednesday morning to avoid expected Republican opposition to the bill. Republicans took to the floor Wednesday afternoon to denounce Democrats for the legislative maneuver.

“This is the sort of nonsense that Americans rejected just a few weeks ago,” said incoming Agricultural Committee Chairman Fred Lucas (R-Okla.) on the House floor.

The bill originally passed the Senate, 73-25, last week, more than a year after the House passed its own, stronger version of the bill. However, a technical error voided the bill, and House Democrats scrambled to rush through the Senate version before the end of the lame-duck session.  

House Dems say bill is good enough: House Democrats said the bill wasn’t perfect, placing blame on the Senate for waiting more than a year to pass its own version of the bill. However, they said the bill was good enough for their support.

Health IT needs more guidance: The federal government must facilitate the widespread adoption of universal standards that will allow healthcare stakeholders to better share electronic health information and maintain patient privacy, according a report from the President’s Council of Advisors on Science and Technology (PCAST). The Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services should develop guidelines to facilitate the adoption of a universal language for assisting the exchange of electronic health information and the transition from paper to electronic health records, PCAST said.

Although leveraging health information technology in the healthcare setting provides numerous benefits, the impact of health IT over the past decade has been “modest,” with nearly 80 percent of physicians lacking basic digital records, PCAST said. Further, electronic health records already in existence are limited in function and cannot be easily shared. Last year’s stimulus package included as much as $27 billion to promote the adoption and use of electronic records. http://bit.ly/eMPuZS

Waxman grabs second spot on committee: Rep. Henry Waxman (D-Calif.), current chairman of the House Energy and Commerce Committee, will be the ranking member in the next Congress.

Declining confidence in access: Americans' confidence in their ability to obtain and afford healthcare dropped by 3 percent in October, according to the Thomson Reuters Consumer Healthcare Sentiment Index released Wednesday.

Over the past three months, consumers said they postponed, delayed or cancelled healthcare treatment significantly more frequently than at any time since May, Thomson said. Over the next three months, consumers predicted a much higher chance of delaying or cancelling elective surgery.

It’s good to be from New England (or Hawaii): Vermont, Massachusetts, New Hampshire and Connecticut and Hawaii were named the healthiest states in America’s Health Rankings 2010 report. Mississippi ranked last, followed by Louisiana, Arkansas, Nevada and Oklahoma.

Global health costs soaring: Healthcare costs in the 20 Organisation for Economic Co-operation countries, as well as Brazil, India and China, will grow by 51 percent over the next decade, according to new estimates from PricewaterhouseCooper’s (PwC) Health Research Institute. Health spending in those countries is rising faster than their gross domestic products, the PwC report said.

California health chief named: Democratic Gov.-elect Jerry Brown selected Diana Doorley, CEO of the California Children’s Hospital Association, to lead the state’s health and human services department. Doorley served as an assistant to Brown during his first stint as governor.

On the agenda for Thursday:

Cloture vote on 9/11 benefits: The Senate delayed a cloture vote on a bill providing health benefits to ground zero first responders until Thursday. If approved, the James Zadroga 9/11 Health and Compensation Act will provide $7.4 billion in health benefits and compensation to workers at the ground zero site in the months following the Sept. 11 terrorist attacks.

Alzheimer’s hearing on the Hill: A House Energy and Commerce subcommittee will hold a hearing on Alzheimer’s Disease. The 11 a.m. session will be held in 2322 Rayburn House Office Building. http://bit.ly/fzCCqu

MACPAC meetings begin: A two-day Medicaid and CHIP Payment and Access Commission meeting kicks off Thursday afternoon at the Renaissance Washington, D.C., Dupont Circle Hotel. http://bit.ly/ftCN6S

“Right to Die” debate: The American Constitution Society will host a panel of law and bioethics experts to discuss constitutional protections for a competent, terminally individual to choose assistance in dying. http://bit.ly/gRrnID

Around the Web:

Incoming oversight chairman shows interest in medical devices: Rep. Darrell Issa (R-Calif.), the incoming chairman of the Committee on Oversight and Government Reform, will target the use of costly medical devices, The Wall Street Journal reports. http://on.wsj.com/hC2UUy

Reform deals may be revisited: Deals that the White House cut with major industries to gain support for healthcare reform may be scrutinized in a Republican House, the Huffington Post reports. http://huff.to/f9Q8sS

Unintended consequence of healthcare reform: Companies have started notifying children’s hospitals that they no longer qualify for hefty discounts on drugs that treat rare medical conditions, The New York Times reports. http://nyti.ms/gdx1m5

MA too costly: Medicare Advantage plans have not provided the same services at a lower cost than traditional Medicare, a Health and Human Serivces regional director said, according to The Albany Times Union. http://bit.ly/eMF2Rh

Medicaid smoking program shows success: Massachusetts hospital stays for heart attacks and blocked arteries dipped by almost half after the state began paying its poorest residents to enroll in smoking cessation programs through Medicaid, The Boston Globe reports. http://bit.ly/gBNp5P

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Rep. Fred Upton (R-Mich.) is in position to become the next chairman of the powerful House Committee on Energy and Commerce after receiving the endorsement of the Republican steering committee Tuesday night.

The endorsement brings an end to the most contentious committee race since Republicans won back the House of Representatives in November. The chairmanship puts Upton in an enviable position for any House Republican, as he will lead efforts to investigate, repeal and replace the new healthcare reform law. 

His short-term agenda is clear: Upton called for the House to quickly repeal and replace the healthcare reform law in a Dec. 1 blog for The Hill. In the post co-authored with Rep. Joe Pitts (R-Pa.), who will lead the health subcomitte, Upton said the committee will provide comprehensive oversight to uncover problems with the new law and to find a new approach to reduce healthcare costs, reduce government’s role in healthcare and “protect the sanctity of life.”

“The Democrats have been derelict in their constitutional duty to oversee the implementation of this law and expose its problems; expect all of that to change in January,” Upton and Pitts wrote. “Real oversight is needed, and the Energy and Commerce Committee will work closely with other committees of jurisdiction to reveal, repeal and replace this law.”

Specifically, Upton said the committee plans to “pepper” the Congressional Budget Office and the Obama administration on taxes and mandates included in the reform law and how they affect care.

Despite his opposition to the healthcare reform law, Upton has been a strong supporter of the State Children’s Health Insurance Program. He voted for its reauthorization in 2009 and voted to override President George W. Bush’s vetoes of SCHIP in 2007 and 2008.

According to his website, Upton has coauthored bipartisan legislation to make investments in research and support services for those suffering from arthritis. He also supported establishing a nationwide alert system to locate missing senior citizens.

In the end, Upton’s campaign was not derailed by the opposition of anti-abortion groups, including the National Right to Life Committee, Americans United for Life Action (AULA) and the Susan B. Anthony List. According to AULA, Upton “voted against such common-sense policies as parents being notified if their minor child seeks an abortion at a federally funded facility, voted in favor of obstructing the partial-birth abortion ban and voted to allow the federal funding of embryo-destructive research.”

Upton’s primary mission to dismantle the healthcare reform law is clear, but with a Democratic Senate still in power, the effectiveness of his efforts are not.

Health and Human Services secretary says the law provides a "serious platform" for improving the quality of care.

The successful implementation of the new healthcare reform law will hinge on physicians and hospitals working out trust issues with one another, according to a new survey.

The reform law requires increased collaboration and information sharing between physicians and hospitals, including through new accountable care organization (ACO) arrangements, to reduce costs and increase quality.

However, one in five physicians don’t trust hospitals, and 60 percent of hospitals believe it will be difficult to obtain information from community physicians to improve patient care, according to a new PricewaterhouseCoopers (PwC) survey. Physicians said they were less inclined to trust hospitals because of competing goals, not enough physician leadership on hospital boards and lack of transparency, communication and similar incentives.

The relationship between physicians and hospitals soured during the 1990s, as hospitals bought and sold physician practices and physicians opened outpatient surgery centers and special hospitals to compete, the report said. However, the trend is reverting back toward consolidation, the PwC survey said. Almost three-fourths of physicians surveyed said they have financially aligned with hospitals through employment, joint ventures or directorships, and 58 percent said they want a closer financial relationship.

More than half (54 percent) believe hospitals and physicians will become more aligned over the next five years through ACOs, which were incentivized in the reform law. The Department of Health and Human Services is expected to release regulations on ACOs by early next year.