• House GOP lawmakers vote to repeal health care reform law
• Senate Labor Committee to hold hearings on beneficial effects of health care law
• Three million Medicare enrollees in 2010 received drug rebates under reform
• HHS announces grants for states to implement health insurance exchanges

House GOP lawmakers vote to repeal health care reform law

House Republicans met their 2010 campaign promise of winning passage of a largely symbolic bill to repeal the Patient Protection and Affordable Care Act of 2010, P. L. 111-148 on January 19, 2011. GOP lawmakers dubbed the new law the “job-killing Obamacare” and a “government takeover of health care” that would destroy state budgets, raise premiums for small businesses, and cut Medicare benefits for seniors. The measure is not expected to pass the Senate nor survive a veto by President Obama.

Following two days of debate, the Repealing the Job-Killing Health Care Law Act (HR 2) passed the House by a vote of 245-189. Democrats accused GOP lawmakers of making partisan political points with their health care reform vote, rather than actually work to improve the law. Republicans said that several House committees would begin drafting replacement legislation to ensure that popular patient benefits in the new law would still be available to Americans.

Despite House approval, repealing health care reform is likely to stall in the Senate where Democrats maintain a slim majority. Prior to the House vote Senate Majority Leader Harry Reid (D-Nev.) released a statement which called the House action “partisan grandstanding.”

Senate Republicans have given no indication that they will push to hold a vote. Instead, they will likely they will stick to the House Republican plan to dismantle health care reform legislation piece by piece. One piece of reform that is considered likely to be repealed in the near future is the new form 1099 reporting rules which go into effect in 2012 and require businesses that spend more than $600 with a specific vendor to report the expenditure to the IRS. Lawmakers from both parties and the White House agree the paperwork burden is too onerous.

Past efforts to repeal the provision failed over disagreements on how to make-up the $17 billion the measure was expected to raise to help pay for health care reform. Once both chambers reach accord on a suitable revenue offset, it is likely to pass quickly and smoothly. House Republicans have already renumbered the bill repealing the tax requirement as H.R. 4, indicating that it will be one of their first pieces of business. Senators Mike Johanns (R-Neb.) and Joe Manchin (D-W.Va.) have said they would introduce 1099 repeal legislation on January 25, the first available day for offering new bills in the Senate.

President Obama, in a written statement, said he is willing to work on a bipartisan basis to “improve” the health care law but made clear he wants to preserve the patient protections that have taken effect. “We can’t go backward,” Obama said. “Americans deserve the freedom and security of knowing that insurance companies can’t deny, cap, or drop their coverage when they need it the most, while taking meaningful steps to curb runaway health care costs.” He also noted that the health care reform law includes a tax credit to make it more affordable for small businesses to offer coverage to their employees.

Senate Labor Committee to hold hearings on beneficial effects of health care law

The Senate Health, Education, Labor and Pensions (HELP) Committee will hold a series of hearings on the beneficial effects of the Patient Protection and Affordable Care Act (PPACA), the landmark health care reform legislation signed into law last March. According to a statement last week by HELP Chairman Tom Harkin (D-IA), the hearings will delve into the implementation of PPACA provisions. The first of these hearings, “The Affordable Care Act: Freeing Americans from Insurance Company Abuses,” will be held on January 27, 2011 and will examine the protections offered by the law to individuals against abuses by the insurance industry, including the denial of coverage over preexisting conditions.

The goal of the hearings is clearly to combat the push by House Republicans and their business allies to repeal the bill. “Millions of Americans are already benefiting from protections in the health reform law, and millions more will see benefits in the coming months and years – both in terms of their health and their economic well-being,” said Harkin.

“While the Congressional Republicans seem dead-set on reopening old arguments,” said Harkin, “Democrats are focused on swiftly and efficiently implementing health reform so that its advantages will be enjoyed by all Americans.”

Later hearings will focus on how the PPACA is intended to force greater accountability in how insurers set rates, how the PPACA can benefit small businesses and employees, who will be able to change jobs without losing their insurance.

Three million Medicare enrollees in 2010 received drug rebates under reform

Three million Medicare beneficiaries nationwide received prescription drug rebates for 2010 under the Patient Protection and Affordable Care Act (ACA), the Department of Health and Human Services (HHS) has announced. For these beneficiaries, whose drug expenses in 2010 reached the Medicare Part D prescription drug coverage gap known as the donut hole, HHS automatically issued a one-time, tax-free $250 rebate check. Eligible beneficiaries who fell into the coverage gap during 2010 will continue automatically to receive rebate checks.

“For too long, many seniors and people with disabilities have been forced to make impossible choices between paying for needed prescription medication and necessities like food and rent,” said HHS Secretary Kathleen Sebelius. “The Affordable Care Act offers long overdue relief by lowering prescription drug costs each year until the donut hole is closed.”

The rebate checks are a first step in the implementation of the ACA’s provisions to reduce incrementally prescription drug costs for beneficiaries in the donut hole until it is eliminated in 2020. Starting this year, eligible beneficiaries in the coverage gap will receive a 50% discount on covered brand name medications while in the donut hole. In addition, in 2011 Medicare will begin paying 7% of the price for generic drugs during the coverage gap.

In addition to savings on prescription drugs, starting this year the ACA provides new benefits to Medicare beneficiaries when they visit their doctor:

• As of Jan. 1, 2011, traditional Medicare no longer imposes out-of-pocket costs for the “Welcome to Medicare” physical exam and, for the first time since the Medicare program was created in 1965, traditional Medicare now covers an annual wellness visit with a participating doctor, also at no cost.
• In addition to the annual wellness visits, most people with Medicare can now receive recommended preventive services, including cancer screenings such as mammograms and colonoscopies, for free.
• Also this year, the ACA will provide qualifying doctors and other health care professionals providing primary care to people on Medicare a 10% bonus for primary care services. This will help ensure that those primary care providers can continue to be there for Medicare patients, HHS said.

An HHS analysis (http://www.healthcare.gov/center/reports/affordablecareact.html) estimates that under the ACA, average savings for those enrolled in traditional Medicare will amount to more than $3,500 over the next ten years. Savings will be even higher – as much as $12,300 over the next ten years – for seniors and people with disabilities who have high prescription drug costs. Total savings per beneficiary enrolled in traditional Medicare are estimated to be $86 in 2011, rising to $649 in 2020. For a beneficiary in the donut hole, estimated total savings increase from $553 in 2011 to $2,217 in 2020.

HHS announces grants for states to implement health insurance exchanges

The Department of Health and Human Services (HHS) has announced the availability of new grant funds to help states continue to implement health insurance exchanges established under the Patient Protection and Affordable Care Act (ACA). When the ACA is fully implemented in 2014, health insurance exchanges will provide individuals and small businesses with a “one-stop shop” to find and compare affordable, high-quality health insurance options.

“States are moving forward, implementing the ACA and making reform a reality,” said Kathleen Sebelius, HHS Secretary. “These grants will help ensure states have the resources they need to establish exchanges and ensure Americans are no longer on their own when shopping for insurance.”

The exchanges are expected to make the health insurance market more transparent and enable consumers to compare plans based on price and quality. In addition, the exchanges are to offer all Americans the same insurance choices members of Congress will have. By increasing competition among insurance companies and allowing individuals and small businesses to band together to purchase insurance, the exchanges also are expected to lower costs.

The new grants recognize states’ different paces at progress toward establishing the exchanges. Applications for funding are available for a multiple year block for states progressing at a fast pace, and annually for states progressing at a slower, step-by-step approach, the HHS said. Moving forward, states will have multiple opportunities to apply for funding as they progress through the exchange establishment process. This gives states maximum flexibility and ensures that they can work to build their exchange on their own timetables.

The grants may be used for different activities including conducting background research, consulting with stakeholders, making legislative and regulatory changes, governing the exchange, establishing information technology systems, conducting financial management, performing oversight, and ensuring program integrity.

On Sept. 30, 2010, California became the first state to sign legislation to implement a health insurance exchange. The Maryland Health Reform Coordinating Council has conducted research to understand the state’s health insurance marketplace and health expenditures, as well as how to make health care costs and quality more transparent. Colorado is holding regular community forums on issues around developing an exchange, as well as conducting extensive research and economic analyses on the state’s health insurance market.

Many of those states’ activities have been funded by the $49 million in exchange planning grants HHS awarded in September 2010. States applied to use those grants for a number of important planning activities including research to understand their insurance markets, efforts to obtain the legislative authority to create exchanges, and steps to establish the governing structures of exchanges.

For more information, visit http://www.healthcare.gov/news/factsheets/exchestannc.html