Health reform implementation

The Congressional Budget Office estimates that repeal of the provision would bring in $202 billion from 2014 to 2019.

A trade association challenging the healthcare reform law’s individual mandate thinks reform opponents have some momentum heading into oral arguments Thursday after a federal judge in Virginia struck the provision down as unconstitutional.

“I think it’s a positive that we got this ruling yesterday prior to oral arguments,” said Karen Harned, executive director of the National Federation of Independent Business’s (NFIB) legal foundation. “Any time a judge feels that he isn’t out on his own if he’s to rule in our favor, the better.”

The NFIB is involved in a 20-state lawsuit that also challenges the constitutionality of requiring individuals to purchase health insurance. Oral arguments in the lawsuit, filed by Florida’s attorney general in federal court, are scheduled for Thursday.

Baby boomers, who have some of the highest unemployment rates and have difficulty affording healthcare, will especially benefit from the new healthcare reform law, according to a new report from a pro-reform group.

The Commonwealth Fund report released Tuesday morning depicts a baby-boomer generation faced with financial challenges that often prevent it from seeking and receiving much-needed medical care. Nearly 75 percent of uninsured older adults said they skipped needed healthcare and medications because of costs, and nearly half reported they did not pursue recommended preventive care.

About 95 percent of 8.6 million uninsured adults ages 50-64 will benefit either from expanded Medicaid coverage, the ability to buy subsidized private insurance through new insurance exchanges or new consumer protections, the report said. Further, about 9.7 million older adults who have health insurance but cannot afford out-of-pocket costs will gain improved coverage through benefit standards, limits on out-of-pocket spending and the elimination of lifetime benefit limits.

“This report paints a picture of a baby boomer generation whose health and financial security are in jeopardy because of rising healthcare costs and declining health insurance coverage,” said Commonwealth Fund President Karen Davis. “The good news is that the Affordable Care Act is already making a difference for them, as lifetime and annual limits are phased out and pre-existing condition insurance plans get up and running. Things will only continue to improve as states and the federal government move toward fully implementing the law and we enter a new era in American healthcare, in which everyone has access to affordable, comprehensive health insurance.”

According to the report, baby boomers will also benefit from new plans for people with pre-existing conditions, improved access to mammograms and colorectal cancer screenings, new limits on how much premiums can rise by age and a new long-term care insurance program.

Holder and Sebelius argue it would be impossible to control costs without the new healthcare law's individual mandate.

A federal judge in Virginia ruled Monday that the healthcare law's insurance mandate is unconstitutional.

The Internal Revenue Service on Monday released guidance on the healthcare reform law's tax on drugmakers. The tax, which should raise about $2.3 billion a year, will target branded prescription drug sales of more than $5 million to Medicare and other government programs.

The pharmaceutical industry agreed to the tax during the healthcare reform debate because those costs are more than offset by the extra business from the 32 million additional Americans the law aims to cover by 2019.

The guidance proposes a methodology for calculating the fee. It also uses the proposed methodology to provide the companies with a preliminary 2011 fee calculation.

The guidance gives interested parties until June 2 to comment.

A Virginia federal judge is expected to issue a decision on the constitutionality of the new healthcare reform law on Monday.

U.S. District Judge Henry Hudson will decide whether the federal government can require individuals to purchase health insurance, in accordance with the Constitution's commerce clause. Whatever Hudson rules Monday, he said in October the case will wind up in the Supreme Court.

A federal court in Florida will hear oral arguments Thursday on a healthcare reform lawsuit filed by 20 states. In October, U.S. District Judge Roger Vinson allowed the lawsuit to challenge two constitutional provisions: whether the law’s individual mandate violates the commerce clause, and whether the federal government can require states to expand their Medicaid programs. 

The Senate will consider the food-safety bill this week after House leaders tucked it into a continuing resolution to keep the government funded through Sept. 30. The $1.1 trillion CR narrowly passed the House, 212-206, after House Republicans objected to the legislative maneuver.  Senate Appropriations Committee Chairman Daniel Inouye (D-Hawaii) is expected to include the CR into an earmark-loaded omnibus bill.

Senate Democrats will try again to pass $7.4 billion in health benefits and compensation to Ground Zero workers after failing a vital cloture vote on Thursday. Senate Republicans held up the bill partially because they want to finalize the budget and Bush tax cuts before dealing with other business. About 60 members on Thursday backed a proposal to include the health benefits bill into the Bush tax cuts extension.

On Friday, the Food and Drug Administration is expected to rule if it will rescind approval of Avastin for advanced breast cancer treatment. Just last week, Britain’s healthcare agency rejected the drug for the same purpose.

Another FDA panel this week will review whether mercury-based dental fillings exceed Environmental Protection Agency-approved levels. 

On Monday, the Centers for Medicare and Medicaid Services will host a conference call to gather stakeholder input on the design and development of the Independence at Home Demonstration included in healthcare reform. The project will enable Medicare beneficiaries with multiple chronic conditions to receive primary care in their homes.

Also on Monday, the liberal Center for American Progress will host a discussion panel on the future of financing and caring for Medicare and Medicaid dual eligibles. Edo Banach, senior adviser for CMS’s Federal Coordinated Health Care Office, will serve as a panelist.

The libertarian Cato Institute will be in the Rayburn House Office Building on Thursday to discuss the GOP budget agenda and how the next Congress should address entitlement spending.

A Virginia federal judge is expected to issue a decision on the constitutionality of the healthcare reform law Monday, a court employee confirmed to The Hill late Friday afternoon.

U.S. District Court Judge Henry E. Hudson will decide whether the Constitution's commerce clause prevents the federal government from requiring individuals to purchase health insurance.

Hudson will issue his decision in the same week that a Florida federal court will hear oral arguments for a lawsuit backed by 20 states that also challenges the commerce clause.

However Hudson rules on Monday, he acknowledged in October that it will not mark the end for the legal challenge.

"As you well know, this is only one brief stop on the way to the United States Supreme Court," Hudson said during oral arguments.

The Obama administration argues that healthcare is different from other commercial markets, because — illness being both inevitable and involuntary — everyone ultimately requires some form of care.

Healthcare reform law supporters are pointing to a new letter from the California Public Employees' Retirement System (CalPERS) detailing how the new law is already benefiting its members.

CalPERS said that by next year, 27,000 young adults will be covered under a reform law provision allowing them to stay on their parents' health insurance until they turn 26.

"That's not only good news for those young people, but imagine what a relief it is to their parents and other family members who worried that their sons, daughters, brothers and sisters were going to be uninsured," Health and Human Services Secretary Kathleen Sebelius said in a statement Friday afternoon.

CalPERS also said that it reduced premium increases by more than 3 percent for its non-Medicare plans, estimating it will save almost $200 million for more than 115,000 early retirees and their spouses.

"This letter is good news for California families, and we’re seeing similar signs of progress across the country," Sebelius said. "Just nine months after it was signed into law, the Affordable Care Act is already fulfilling its promise to help working Americans get and keep insurance, and to slow rising costs for those who have coverage, while ending some of the worst practices of the insurance industry with a new Patient’s Bill of Rights."

A number of California Democrats issued statements Friday afternoon touting the CalPERS letter.

“I commend CalPERS for working to implement the key benefits of the new healthcare reform law," said House Energy and Commerce Committee Chairman Henry Waxman. "Their efforts show that the law is containing costs for employers and already extending coverage to tens of thousands of people.”

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.)