Health Care Updates

House GOP Report Says ACA Gives Employers Inventive To End Coverage.

The “Healthwatch” blog of The Hill  (5/2, Baker) reports House Republicans on the Ways and Means Committee said that the healthcare reform law “gives the country’s biggest businesses a strong incentive to quit offering healthcare benefits” because they “would save billions of dollars.” However, “the Congressional Budget Office has said it does not expect an exodus from employer-based insurance.”

The Washington Times  (5/2, Cunningham) reports the Republican’s study said that “companies could save $4,821 per worker if they chose to end coverage and instead pay” the $2,000 fine per worker. However, the report is based on data that 71 companies Fortune 100 companies volunteered. The report said that if companies paid the fine and didn’t offer coverage, “they would pay $9.9 billion and save $28.6 billion.” Meanwhile, “Democrats said the GOP was being ‘cynical’ in its dire predictions.”

CQ Healthbeat  (5/2, Subscription Publication) reports, “Democratic staff on the Ways and Means Committee said the report did not ask whether the companies would continue offering coverage, adding that the largest companies have chosen to voluntarily provide coverage for years.” They said, “According to the logic of this so-called report, businesses could have ‘saved’ even more money if they dropped employee health coverage years ago, which is perfectly legal and carries no penalty.”

Widespread Self-Insuring Of Small Companies Seen As Possible Threat To ACA. Bloomberg BusinessWeek  (5/2, Tozzi) reports that under the Affordable Care Act, “federal regulators are now scrutinizing whether small companies with relatively healthy employees will pull out of the group health insurance market by self-insuring,” if so, “that could make premiums for traditional health insurance plans, where an insurance company bears the risk, unaffordable for the businesses that remain.” Small companies that self insure would purchase stop-loss policies, and now “regulators from the departments of Labor, Treasury, and Health and Human Services want to know where stop-loss policies are setting” the “‘attachment point’ and analogous to an individual’s deductible. If it’s low enough, the employer isn’t taking on much risk but does enjoy exemptions from state insurance requirements and taxes that don’t apply to self-insured plans.”

House Bill Would Limit Medicaid Payments, End Healthcare Exchange Grants.

The “Floor Action Blog” of The Hill  (5/2, Kasperowicz) reports, “House Budget Committee Chairman Paul Ryan (R-Wis.) has introduced legislation to replace a mandatory across-the-board discretionary spending cut in fiscal year 2013 that is required by last summer’s deal to raise the debt ceiling.” Additionally, the Sequester Replacement Reconciliation Act, “outlines the various cuts and savings to mandatory programs that will make up for ending the sequester,” based on recommendations from House committees. Amongst the reforms the “House Judiciary proposed medical liability reforms.” Meanwhile, “Energy & Commerce proposed the elimination of grants to help establish health insurance exchanges under the 2010 healthcare law, put limits on Medicaid payments, and also called for medical liability reform.”

Bella Defends Plan For Dual Eligibles.

CQ  (5/2, Adams, Subscription Publication) reports that Melanie Bella, director of the federal Medicare-Medicaid Coordination Office, appearing in a panel discussion at the American Enterprise Institute “faced tough questions…about an Obama administration plan to allow states to move up to 2 million patients into managed care.” Federation of American Hospitals president and CEO Chip Kahn said that “beneficiaries have paid payroll taxes into Medicare…and should be able to choose how to get their care just as other Medicare seniors do.” Georgetown Public Policy Institute professor Judy Feder also said, “This low-income population is being treated differently because it is a low-income population.” Bella said that “all of the beneficiaries will have a chance to opt out of the program if they wish.” She defended the program, pointing out that “the current system isn’t working well for the group that receives both Medicare and Medicaid.”

Kaiser Health News  (5/2, Barr) reports, “Bella said that questions about how fast to move are legitimate, but that it’s important for officials to act with urgency to get new models off the ground.”

GOP: End Bonuses For CHIP Enrollment.

Politico  (5/2, Dobias) reports, “House Republicans want to stop rewarding states for finding and enrolling low-income children in Medicaid and the Children’s Health Insurance Program,” arguing “it’s a smart fiscal move that will better protect the program against fraud.” Energy and Commerce Committee Republicans voted “to strip about $400 million earmarked for a bonus program created by the 2009 law to extend the Children’s Health Insurance Program.” However, “public health advocates are livid,” saying “it’s undermining years of progress states have made in identifying and enrolling a hard to serve population.”

Appellate Judge Okays Texas Excluding Planned Parenthood From Medicaid Program.

The New York Times  (5/2, A18, Fernandez, Subscription Publication) reports that in “the latest twist in a dispute between Texas officials and Planned Parenthood,” Judge Jerry E. Smith of the United States Court of Appeals for the Fifth Circuit “allowed Texas to ban Planned Parenthood clinics from participating in a health care program for low-income women late Monday night, hours after a lower court prohibited the state from doing so.” Nine Planned Parenthood clinics that do not perform abortions sued Texas over a “rule requiring all providers in the Medicaid Women’s Health Program to certify that they do not affiliate with entities that perform or promote abortions.”

The Wall Street Journal  (5/2, A4, Koppel, Subscription Publication) report that after the judge’s ruling Texas barred Planned Parenthood clinics from the program. The Obama Administration said that it would no longer fund Texas’ program due to the new rules, but Texas Gov. Rick Perry says the state can pay for the program.

The Houston Chronicle  (5/2, Fikac, Ackerman) reports, “The attorney general’s office pressed the argument that Texas would have to shut down the program if forced to give taxpayer money to ‘entities that affiliate with abortion-promoting entities,’ because to do otherwise would violate state law.” However, Planned Parenthood “said there is no reason for the state to shut down the program if the group participates.”

The Huffington Post  (5/2, Bassett) reports, “In the appeal for the emergency stay, a team of attorneys led by Texas Attorney General Greg Abbott compared Planned Parenthood to a terrorist organization,” saying “that giving Medicaid money to Planned Parenthood for breast cancer screenings, pap smears, STD testing and birth control is akin to giving a terrorist organization money for humanitarian activities.” However, Texas attorney general’s office spokesman Jerry Strickland said, “Texas did not state -– and does not believe –- that Planned Parenthood is a terrorist organization or comparable to one.” According to Stricklans, state attorneys “were citing a Supreme Court case in the brief that happened to be about a terrorist organization.”

The San Antonio Express-News  (5/2, Likac, Stoeltje) reports, “Planned Parenthood is fighting the appellate judge’s action and said its affiliates will keep serving low-income clients” who are in the program, “even though Texas Health and Human Services Commission spokeswoman Stephanie Goodman said they can no longer bill the state for program services.”

The Austin (TX) American Statesman  (5/2, Lindell) calls the ruling “an abrupt shift in fortunes for Planned Parenthood.” Also covering this story are the AP  (5/2, Tomlinson), Reuters  (5/2), the “Healthwatch” blog of The Hill  (5/2, Viebeck), and the Austin (TX) Chronicle  (5/2, Smith).

AHA Executive VP Says “Digital Divide” Among Hospitals Widening.

Modern Healthcare  (5/2, Conn, Subscription Publication) reports, “American Hospital Association Executive Vice President Richard Pollack says the ‘digital divide’ is widening between technologically advanced large and urban hospitals and their smaller and rural counterparts.” Additionally, while almost “3,500 hospitals have registered  (pdf) for federal incentive payment programs for the use of electronic health-records systems, more than 80% of hospitals have not yet achieved the first stage of meaningful use of their EHRs to qualify them for incentive payments — a result, Pollack said, of ‘both the high bar set and market factors such as accelerating costs and limited vendor capacity.'” He “made his remarks in a letter  (pdf) to CMS acting Administrator Marilyn Tavenner that accompanied the AHA’s formal comments on the proposed Stage 2 rules for the EHR incentive programs under Medicare and Medicaid created by the American Recovery and Reinvestment Act of 2009.”

Plan Would Freeze Payment Rates To Maryland Hospitals.