Year 2 of Obama's health reform promises more political fights

Bruising battles loom on Capitol Hill over the next 12 months as the nation enters Year 2 of healthcare reform.

The law calls for an overhaul of the insurance system in 2014, but the myriad changes that are scheduled to take place between now and then promise to offer plenty of controversy, especially if the past year is any indication

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Chief among the decisions taking shape over the next year is how much flexibility states will have to structure health insurance exchanges where individual and small-group plans will be offered and how generous those plans will have to be.

But federal regulators have plenty of other decisions to make, and they can expect stakeholders — and Congress — to weigh in at almost every step of the way.

Here, with help from the Kaiser Family Foundation, are some of the regulations and changes in law coming down the pike before March 23, 2012:

  • Health insurance exchanges: States become eligible for grants to help set up their insurance exchanges, which become operational in 2014 (effective March 23).
  • Food labeling: Restaurant chains and vending machines required to disclose nutritional content (effective March 23).
  • Hospital payments: Medicaid stops paying for conditions acquired at the hospital (effective July 1).
  • Home care: Medicaid incentivizes home- and community-based care (effective Oct. 1).
  • Medicare payments: The controversial Independent Payment Advisory Board tasked with recommending payment cuts to keep Medicare solvent becomes eligible for funding (Oct. 1; first recommendations due Jan. 15, 2014).
  • Care coordination: Medicare pays groups of providers more if they improve patient care and save the program money by banding together as Accountable Care Organizations (effective Jan. 1, 2012).
  • Medicare Advantage: Cuts in rebates and bonuses to high-quality plans start Jan. 1, 2012.
  • Drug tax: Pharmaceuticals get hit with a $2.3 billion a year fee, negotiated as part of healthcare reform negotiations (effective Jan. 1, 2012).