Weekly Health Care Wrap-Up.
Supreme Court Dominates Week in Washington, DC
The Supreme Court’s consideration of the Affordable Care Act dominated the policy dialogue and media airwaves this week in Washington, DC. With hearings Monday, Tuesday and Wednesday the health care and legal communities were abuzz with the potential implications of various decisions. General consensus among commentators and legal scholars is that, while tempting, it is important not to read too much into the oral arguments. Nonetheless, to help decipher the chatter, MLA Partner Bruce Brown, former clerk to Chief Justice Warren Burger, and Senior Managing Director Cindy Gillespie break things down in a 30 minute “Quick Take” session – the Supreme Court’s Consideration of the ACA: Legal Arguments, Policy Implications and Political Repercussions, which can be foundhere.
CMS Officially Delays Innovation Challenge Grants
Not surprisingly, the Centers for Medicare and Medicaid Services (CMS) officially announced this week that it would delay the release of Center for Medicare and Medicaid Innovation (CMMI) “Innovation Challenge” grant awards. CMMI received approximately 3,000 applications for $1 billion in funding for payment and delivery reforms under the program. More information on the delay is available here.
House Approves Ryan Budget
On Thursday, the House of Representatives approved Budget Chair Paul Ryan’s FY13 budget by a vote of 228-191. The budget plan is not expected to gain traction in the Senate. Meanwhile, Representatives Jim Cooper (D-TN), Steven LaTourette (R-OH), Charlie Bass (R-NH), Tom Reed (R-NY), Kurt Schrader (D-OR), and Mike Quigley (D-IL) released an alternative budget plan modeled on the Simpson-Bowles Fiscal Commission’s recommendations. While this budget is unlikely to gain significant momentum, it demonstrates that past deficit reduction proposals will likely remain “at the table” throughout future tax and entitlement reform debates. More information on the Simpson-Bowles alternative budget is available here.
From the States
For full coverage of this week’s exchange activities, check out this week’s State of the States – Health Insurance Exchanges here.
New York. At a press conference earlier this week, Governor Andrew Cuomo (D) was quoted saying that since “the Legislature has declined to include a health exchange in the budget, we will set it up by executive order.” He expects to issue the order this week.
Maryland. On Monday, Maryland’s House and Senate approved their respective versions of the Maryland Health Benefits Exchange Act of 2012, which sets the standards that will govern the operation of Maryland’s Exchange. The Senate passed its version of the bill, Senate Bill 238, by a 35-12 vote, while the House passed House Bill 443 by a 94-44 vote. Differences between the House and Senate versions of the legislation will need to be reconciled in conference committee.
Texas. A new interactive tool using data from the Texas Department of State Health Services tracks the number of primary care physicians per 100,000 Texas residents. In addition, the Texas Tribune calculates the number of Medicaid providers per 1,000 people in Texas cities. The primary care physician date is available here; the Medicaid data here.
A new report from the Urban Institute examines how many Americans would be impacted by the individual mandate if it is upheld by the Supreme Court. The report can be found here.
New polling data from the Kaiser Family Foundation examines public opinion of the individual mandate. The full Data Note is available here.
Booz and Co released a whitepaper this week on private exchanges and large employers. In particular, the paper focuses on defined contribution, employers’ attitudes toward exchanges, the potential impact on the payer industry as well as possible strategies for interested companies. The report can be found here.
A new blog post from NAISCO follows up with remaining ”Early Innovator” states’ efforts to develop IT for exchanges, checking in with New York, Oregon, New England and Maryland. The blog post can be found here.
Deloitte released a new report on mobile devices and the health care industry. In particular, the report presents selected findings from a highly targeted survey of senior executives on the challenges and opportunities the mobile industry will face in the coming three to five years. The report can be found here.
Health Insurance Exchanges: State of the States update.
Even with all eyes focused on the Supreme Court’s consideration of the Affordable Care Act, there was plenty of activity in the states this week on the exchange front. In particular, Democratic governors had a rough week moving exchange legislation forward, and in some cases, are now threatening to use Executive Orders to create exchanges.
In Minnesota, Governor Mark Dayton (D) sent a harshly worded letter to Republican legislators, accusing them of obstructing the legislative progress in favor of scoring political points. In his letter, Governor Dayton wrote that, “unfortunately, there are some who would rather play politics with this exchange in an election year, than work sincerely and cooperatively to advance it in Minnesota.” According to the Grand Forks Herald, Governor Dayton also informed Republican lawmakers that if the legislature did not pass exchange legislation he would “utilize the legal executive actions necessary to satisfy the federal law, as has already been done in other states.”
Governor Andrew Cuomo (D) in New York had a similarly difficult week after reaching a tentative State budget deal. With Senate Republicans unwilling to include language authorizing the creation of an exchange in the State’s budget, Governor Cuomo announced on Wednesday afternoon his intention to create a health care exchange by Executive Order. He planned to issue the order by the end of the week, but as of 4PM Friday 3/30, it has not been issued publicly.
Bucking the trend by making progress, Maryland’s House and Senate were able to approve their respective versions of the Maryland Health Benefits Exchange Act of 2012, which sets the standards that will govern the operation of Maryland’s Exchange. However, even though the bills were passed by strong margins, votes were cast largely along party lines with Democrats benefiting from their strong majorities in both the House and the Senate. Differences between the House and Senate versions of the legislation will need to be reconciled in conference committee before heading to Governor Martin O’Malley (D).
As for RFPs/RFIs, next week Oregon will stop accepting responses to an RFI it released to gauge the necessary technological issues for the implementation of its SHOP exchange. Also, Nevada is scheduled to release an RFP on April 2 to procure a “Software as a Service Business Operations Solution” to support the business functions of the Individual and SHOP exchanges. Interested parties should check the Silver State Health Insurance Exchange website next week.
On the private exchange front, Booz & Co released a White Paper this week discussing issues that employers providing health insurance, insurance companies and brokers will face if they embrace private exchanges. The paper also includes highlights from a Booze & Co survey of employers and consumers to gauge their interest in using private exchanges. Interestingly, the survey finds that 80 percent of employers would prefer to purchase insurance from a private exchange than from a public exchange and while employers generally favor a defined contribution approach, less than 20 percent plan to move to a pure defined contribution arrangement in which they would have little to no involvement in benefits selection and management.