By Sam Baker and Julian Pecquet - 11/17/11 12:13 AM EST
Signals for SCOTUS: Yes, Congress passed the Affordable Care Act. But if Rep. Phil Roe (R-Tenn.) has his way, Congress will also pass a resolution stating that the law is unconstitutional. Roe introduced a resolution Wednesday that “clearly articulates” that the individual mandate is unconstitutional and cannot be severed from the rest of the law.
Breakfast of champions: Be sure to join The Hill on Thursday morning for a breakfast briefing on genetic testing and its role in the future of healthcare. Reps. Michael Burgess (R-Texas) and Charles Gonzales (D-Texas) will join a panel of health industry leaders to discuss innovations in the use of genetics to treat several forms of cancer.
The fun starts at 8 a.m. in 1539 Longworth.
Supercommittee and SGR: Prospects for the supercommittee might be
fading, but there’s still a major effort under way to get a Medicare
“doc fix” included in any deal the panel might reach. Rep. Allyson
Schwartz (D-Pa.) sent the supercommittee her proposal to fix the
“sustainable growth rate” formula through 2016, with the goal of using
that time to figure out a permanent replacement. Healthwatch’s Julian
Pecquet has more on Schwartz’s plan.
Not so fast: Schwartz said her SGR proposal has gotten positive feedback from supercommittee members, but she’s missing one key endorsement: the American Medical Association. The AMA has spent near-record amounts lobbying the supercommittee to tackle the SGR, but it’s not on board with Schwartz’s plan.
“While we applaud Rep. Schwartz’s general framework, we cannot support the proposal’s outline for future updates and penalties given the workflow changes and investments we expect will be required from physicians,” the group said in a statement. “There is also uncertainty about the broad availability and applicability of new payment models across the full range of medical specialties and practice settings.”
All drug plans are not created equal: There’s a huge variance in how many drugs the leading Medicare Part D plans cover, according to a new analysis from Avalere Health. That means seniors who simply pick a plan with a low premium run a high risk of paying for their prescriptions out of pocket. One popular plan covers 79 percent of all eligible Part D drugs, while another only covers 47 percent of drugs, according to Avalere.
Fascist healthcare: GOP presidential candidate Ron Paul said the Democrats' healthcare reform law isn't "socialized medicine" — it's "corporate medicine leading toward fascism." The Texas congressman made the comments during his appearance at the Congressional Health Care Caucus, hosted by Rep. Michael Burgess (R-Texas).
Paul stayed true to his anti-government views. He took shots at advocates of government-guaranteed universal healthcare, saying "the market is the only compassionate system" because it roots out inefficiencies and rationing. He blamed the Food and Drug Administration for the high cost of medicines, saying the agency should be abolished because it "does a lot more harm than good" and "keep(s) the good stuff off the market as well."
And he pined for a pre-Medicare era when patients paid their doctors out of pocket and community hospitals charged decent prices instead of fighting for every last penny they can extract from the government and third-party private insurers. You can watch it here.
Tell us how you really feel: Jonathan Gruber, the MIT economist who helped craft both Mitt Romney and Barack Obama’s healthcare laws, has apparently had enough of Romney’s claim that the two measures are not much alike. “They’re the same f---ing bill,” Gruber said in an interview with Capital New York. Read the Healthwatch post on Gruber’s comments.
Broker backlash: After more than a year of false starts, the
National Association of Insurance Commissioners is set to vote next week
on a measure that tries to help out insurance agents and brokers. The
proposal would urge HHS to find a way for insurance companies to exclude
agents’ commissions when they calculate their medical loss ratios. But
the NAIC’s consumer advocates are very much opposed.
“Over the years, the NAIC has rightfully earned the respect of Congress and many others for its thoughtful, transparent, evidence-based, and consumer-oriented approach to issues,” the consumer advocates wrote in a detailed letter to NAIC members. “We respectfully urge the NAIC to uphold its reputation by opposing this resolution that is based, at best, on mixed and inconclusive evidence.
More pressure on SCOTUS: Lawmakers are getting behind C-SPAN’s
request to broadcast the oral arguments in the Supreme Court’s
healthcare case. Sen. Chuck Grassley (R-Iowa) was the first to throw his
support behind a televised hearing, and House Minority Leader Nancy
Pelosi (D-Calif.) joined in Wednesday. She was followed by Rep. Joe
Courtney (D-Conn.). Healthwatch has more on the push for an
unprecedented level of public access to the Supreme Court.
The American Bar Association is holding a discussion of administrative law issues and the Affordable Care Act. Panelists will touch on the constitutional questions as well as issues related to insurance exchanges.
Sen. Bernie Sanders (I-Vt.) leads a press conference opposing Medicare, Medicaid and Social Security cuts in the supercommittee’s deficit-reduction package. Sen. Ben Cardin (D-Md.) and a host of healthcare advocacy groups are also scheduled to attend.
State by state
Canada caught and extradited a fugitive indicted for defrauding Medicare of more than $71 million through three Brooklyn clinics that billed the government for services that were never provided.
A North Carolina doctor agreed to pay $950,000 to settle allegations she billed Medicaid for more extensive services than she actually provided.
Healthcare providers are preparing to take cuts from the supercommittee, CNBC reports.
The New York Times writes up a new study that says employers are trying more aggressively to control their healthcare costs.
What you might have missed on Healthwatch
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Don't miss The Hill's Innovation Revolution: Genetic Testing in Today's Cancer Care Briefing! Watch it live Thursday at 8:30 a.m., at http://thehill.com/video/in-the-news/193083-livestreaming-genetic-testing-briefing. Sponsored by ACLA and Results for Life.