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.

The Department of Health and Human Services on Tuesday unveiled a new plan calling for increased collaboration between government agencies and the private sector to tackle the growing challenge of people with multiple chronic conditions.

More than a quarter of all Americans suffer from several chronic conditions, according to HHS, such as arthritis, asthma, chronic respiratory conditions, diabetes, heart disease, human immunodeficiency virus infection and hypertension. Treating those patients takes up 66 percent of the nation's healthcare budget, adds HHS.

But the nation's healthcare system is largely set up to deal with one disease or condition at a time, says HHS. That increases the risk of complications such as adverse drug reactions, unnecessary hospitalizations and overall confusion caused by conflicting medical advice.

"Given the number of Medicare and Medicaid beneficiaries with multiple chronic conditions," said Medicare and Medicaid administrator Donald Berwick, "focusing on the integration and coordination of care for this population is critical to achieve better care and health for beneficiaries, and lower costs through greater efficiency and quality."

The new Strategic Framework on Multiple Chronic Conditions seeks to resolve those issues by "fostering change within the system; providing more information and better tools to help health professionals ― as well as patients ― learn how to better coordinate and manage care; and by facilitating research to improve oversight and care."

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.

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

Monday's health news: 

As was widely predicted, a federal judge in Virginia ruled Monday that the healthcare reform law's individual mandate is unconstitutional. Judge Henry Hudson of the U.S. District Court for the Eastern District of Virginia stopped shy, however, of overturning the whole law, and restricted his ruling to the mandate that people buy insurance starting in 2014 "and directly-dependent provisions."

Next stop: Supreme Court. The case is widely expected to end up before the Supreme Court, as are several other lawsuits against the Democrats' reform law — including a 21-state lawsuit in Florida whose oral arguments will be heard Thursday. Incoming Majority Leader Eric Cantor (R-Va.) in a statement Monday called on the Obama administration to request that the courts skip the appeals process and send the issue straight to the high court.

Republicans ecstatic: Notable among the Republican victory declarations was Sen. Orrin Hatch's immediate response. The Utah Republican, who supported an individual mandate when Republicans proposed the idea in 1994, fears a Tea Party challenge in the 2012 primary. http://bit.ly/g3c29Q

White House unimpressed: The Obama administration quickly responded with a blog post calling the decision a "narrow ruling" that was "just one of many recent rulings on similar cases that have come down in recent months." http://bit.ly/dY9nTZ

Judge has ties to pro-repeal firm: Hudson, a George W. Bush appointee, is a passive investor in a conservative law firm whose clients include reform opponents, The Huffington Post has pointed out. http://huff.to/aTWlpL

IRS issues drug tax guidance: The Internal Revenue Service on Monday released guidance on the healthcare reform law's tax on drug makers. 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. http://bit.ly/dKm3OP

Doctors seeking $200M owed by Medicare: Doctors are asking the Medicare agency to quickly explain how it will dole out $200 million in overdue reimbursements following "a highly disruptive year" for physician payments. Healthcare reform enacted this year called on the Centers for Medicare and Medicaid Services (CMS) to reimburse doctors retroactively to Jan. 1, 2010, on several provisions, including extending the floor for a Medicare payment scale used to determine relative costs of practicing medicine in specific locations. http://bit.ly/e8LB5F

Top Democrat vows to defend reform's health savings: House Majority Leader Steny Hoyer (D-Md.) said Monday that Democrats' strategy to reform entitlement programs includes "sticking to the cost-control provisions we passed in the health care bill." Republicans vow to repeal the law, but Democrats say that would add to the federal deficit. http://bit.ly/gZBnXT

IPAB defined: Hoyer's remarks about the Democratic agenda for the next Congress comes as the Congressional Research Service released a 37-page analysis of the reform law's Independent Payment Advisory Board. The controversial provision would propose cuts to Medicare payments if the federal government's healthcare costs grow too fast.

Obama breathes easy with passage of childhood nutrition bill: Failing to pass his wife's priority would have had him "sleeping on the couch," the president said Monday as he signed the Healthy, Hunger-Free Kids Act. The $4.5 billion bill expands free lunches and makes school lunches more nutritious. http://bit.ly/eqJnhf

CMS seeks input on Independence at Home: CMS held a listening session with stakeholders on Monday to seek input on a provision of the healthcare reform law that creates an "Independence at Home Demonstration." The demo will test a payment incentive and service delivery model that relies on home-based primary care teams designed to provide better and cheaper care.

Report issues recommendations on "dual eligibles": Two liberal groups on Monday released a plan to deal with the soaring healthcare costs of poor older Americans who qualify for both Medicare and Medicaid. The plan's five principles: start with a well-designed healthcare delivery system; ensure strong beneficiary protections; engage dual eligibles and their families in program design; ensure combined Medicare/Medicaid funds to enhance healthcare delivery; and establish a culture of quality improvement. http://bit.ly/f7scCS  

On the agenda for Tuesday: 

Baby boomers and the reform law: The pro-healthcare-reform Commonwealth Fund will release a report in the morning outlining how 18.3 million people ages 50 to 64 will benefit from the new law. The biggest help to this population will come in 2014, when they will be able to access comprehensive insurance through expanded Medicaid and subsidized private insurance through insurance exchanges, the organization said.

Health IT year in review: The Office of the National Coordinator (ONC) for Health Information Technology will kick off a two-day review of the agency's progress in 2010. Health and Human Services Secretary Kathleen Sebelius, CMS Administrator Donald Berwick and ONC head David Blumenthal are scheduled to speak Tuesday.

Around the Web: 

Rep. Steve King (R-Iowa) outlines GOP repeal strategy on Fox News: "We know that the president would veto that when it gets to his desk but we need a test vote so we know where people stand and we can start marching down through the appropriations bills, every one of them, putting language in them that prohibits any of the funds that are appropriated from being used to either implement or enforce Obamacare." http://bit.ly/eNmTWG

Maine doctors will urge the newly elected governor and attorney general not to join efforts to repeal healthcare reform, the Portland Press Herald reports. http://bit.ly/dQ9IfW

Comments / complaints / suggestions? 

Please let us know:

Julian Pecquet : This e-mail address is being protected from spambots. You need JavaScript enabled to view it / 202-628-8527

Jason Millman : This e-mail address is being protected from spambots. You need JavaScript enabled to view it / 202-628-8351

Doctors are asking the Medicare agency to quickly explain how it will dole out $200 million in overdue reimbursements following “a highly disruptive year" for physician payments.

Healthcare reform enacted this year called on the Centers for Medicare and Medicaid Services (CMS) to reimburse doctors retroactively to Jan. 1, 2010, on several provisions, including extending the floor for a Medicare payment scale used to determine relative costs of practicing medicine in specific locations. Some states were set to receive significant increases due to changes in the scale, according to the Friday letter signed by more than 100 physicians groups.

The Medicare and Medicaid Extenders Act of 2010, which provided a one-year delay in a scheduled cut to Medicare physician rates, included $200 million to process the payment increases, the letter said.

The letter said uncertainty surrounding Medicare physician payments was disruptive to doctor practices. Congress enacted stopgap measures to delay scheduled cuts to Medicare payments several times this year, and on three occasions, temporary cuts went into effect.

“The payment uncertainties and delays were highly disruptive,” the letter said. “Many practices were forced to seek loans to meet payroll expenses, lay off staff or cancel capital improvements and investments in electronic health records and other technology.”

Further, the final 2010 fee schedule undervalued some cardiology codes due to a CMS calculation error, the letter said. Most of the claims have not been adjusted, and some were 40 percent lower than they should have been, the letter said.

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

Sen. Orrin Hatch (R-Utah) was quick to praise the Virginia district court's ruling that parts of the healthcare law are unconstitutional.

Hatch, who could face a tough primary challenge in 2012, pointed out he was the first senator to argue publicly that the individual mandate is unconstitutional.

That was one of the sections the Virginia judge struck down. U.S. District Court Judge Henry E. Hudson also struck down “directly dependent provisions” while upholding the rest of the law. The decision marks the first major step in a lawsuit destined for the Supreme Court.

“Today is a great day for liberty,” Hatch said in his statement. “Congress must obey the Constitution rather than make it up as we go along. Liberty requires limits on government, and today those limits have been upheld.”

In the 1990s, Hatch actually supported a bill that would have required the individual mandate as part of an effort to kill the Clinton healthcare reform. His office has said since that time, Hatch has examined the constitutionality of the issue and now sees it as unconstitutional.

Hatch also signed a friend-of-the-court brief in regards to another lawsuit against the healthcare law. This suit will be heard Dec. 16 in Florida. 

The six-term Utah senator might not be the only one looking to 2012.

The Virginia lawsuit was brought by Republican state Attorney General Ken Cuccinelli, who is a rising GOP star in the state and mentioned as a 2012 Senate candidate. 

— Jason Millman and Mike Lillis contributed to this post.