WEEKLY E-BULLETIN


Supreme Court to Hear Repeal Arguments This Week

The big Washington news this week:  the oral arguments before the Supreme Court on the constitutionality of certain provisions in the Affordable Care Act. This led one major publication to headline, “The Health Care Circus Is in Town.”  More on this below.

House Likely to Pass Budget with Big Medicare Cuts

The big news last week in D.C. was the introduction and Ways and Means Committee passage of the House GOP budget for 2013. It passed 19 to 18, with all Democrats and two Republicans voting against.  Among the more significant health care provisions:

  • Cut $51 billion in Medicare over 10 years; this could include provider cuts.
  • Eliminate for one year the 2% sequester cuts for everything but Medicare; these cuts are scheduled to take effect under current law on January 1, 2013.
  • Starting in 2023, Medicare transitions to a premium support program. A federal bidding process would determine the level of federal premium support.
  • Much of the Affordable Care Act would be repealed, except for the $500 billion in provider cuts.

Click here to read the 17-page Congressional Budget Office summary. Should the House pass this budget (and it is likely to do so) the Senate will not. The Senate hasn’t passed a federal budget plan in three years. Democrats are launching an effort against the Republican Medicare plan – no surprise here. Click here for details.

House Repeals IPAB; Gets Tort Reform

The House did pass last week legislation to repeal the Independent Payment Advisory Board with mostly GOP and little Democratic support. It also included significant medical malpractice reform. The Senate is not likely to pass the bill and the Obama Administration announced its opposition. Click here for the Washington Post article. Democrats tried to turn the tables on the GOP effort to repeal IPAB. Click here for the story.

Successful Hospital Bundled Payment Initiative Detailed

Health care reform is front and center in D.C. this week with the Supreme Court review. One of the most interesting stories was about the bundled payments initiative at the Baptist Health System in San Antonio, which was started about three years ago. It details the implementation struggle – bonus payments to physicians – and its eventual success. Click here to read the Washington Post article.

Supreme Court Center of Health Reform Debate This Week

(Click here for a NY Times summary of Court preparations and here for its far reaching implications.)

Insurers Getting Ready – Just In Case

What if the court overturns the law (a decision isn’t expected until July)? The insurance industry is getting ready. Click here to read their story from the Associated Press.

Public Says Dump the Mandate: Poll

What does the public want the court to do? Toss the individual mandate. The latest polling is here.

GOP Governors Announce Reform Efforts

So if the reform law is thrown out, what does the GOP want as a replacement? GOP governors last week announced their 7 principles on which they will build their reform plan and release this summer.  Click here for details.

White House Defends Reform Law

The White House released a 6-page report on why the Affordable Care Act is good and should not be discarded. Click here.

Key Democrat Defends Working with GOP on Medicare Reform

The one key Democrat – Sen. Ron Wyden (OR) – who is working with Rep. Paul Ryan (R-WI) on Medicare reform was vigorously defending his work last week, as Democrats were publicly chastising him for his efforts. Click here for his retort.

New Study: 49 States and D.C. Moving Ahead with Health Reform

All but one state is moving ahead with reform initiatives, according to a Commonwealth Fund study out last week. The analysis finds that 49 states and the District of Columbia have passed new legislation, issued a new regulation, issued new sub-regulatory guidance, or are actively reviewing insurer policy forms for compliance with these protections. These findings suggest that states have required or encouraged compliance with the early market reforms, and that efforts to understand how states are responding cannot focus on legislative action alone. Click here for the study.

Utah Hoping Its Health Insurance Exchange Survives

In addition to Massachusetts, only one state – Utah – has an active insurance exchange up and running.  The GOP governor their hopes their “bare-bones” approach passes muster with HHS. Click here for the report.

Fifth State Joins Health Compact to Try to Avoid Feds

Indiana became the fifth state last week to sign a multi-state compact designed to remove states from federal health care controls. The conservative, GOP-led states of Texas, Georgia, Oklahoma and Missouri had previously signed on. Click here to learn more about the compact.

Higher Ed Nursing Enrollment Up; 75,000 Turned Away

According to a report released last week by the American Association of Colleges of Nursing, enrollment in baccalaureate, master’s, and doctoral nursing programs increased last year. Though nursing schools have been able to expand student capacity despite faculty and resource shortfalls, the latest data show that 75,587 qualified applications to professional nursing programs were turned away last year, including more than 14,354 applications to graduate programs. Click here for the survey.

CMS Announces $200 Million for APRN Training

CMS last week announced a call for applications for a new initiative designed to strengthen primary care in the United States. (Click here for details.) Under the Graduate Nurse Education Demonstration, CMS will provide hospitals working with nursing schools to train advanced practice registered nurses with payments of up to $200 million over four years to cover the costs of APRNs’ clinical training. Email Gwen Mathews and her CMS Applications Team at Strategic Health Care (gwen.mathews@shcare.net) for help in preparing your application. Applications are due May 21.

Two Insurers Accused of Unreasonable Insurance Increases in 9 States

HHS announced last week that two insurance companies have proposed unreasonable health insurance premium increases in nine states — Arizona, Idaho, Louisiana, Missouri, Montana, Nebraska, Virginia, Wisconsin, and Wyoming. The excessive rate hikes would affect over 42,000 residents across these nine states. Click here for details.