WeeklyFinancingNewsPulseNationalEditionfinal20091218.pdf (PDF | 351.39 kb)
SAMHSA222s Weekly Financing News Pulse: National Edition December 18, 2009 12/18/09 1 SAMHSA222s Weekly Financing News Pulse: National Edition National News Senate Democrats Unlikely to Include Medicare BuyIn in Health Care Reform Bill, Vote Could Come by December 24 President Obama Signs FY2010 Spending Bill, Increases Funding for HHS and SAMHSA Programs House Passes Bill to Extend COBRA Subsidies, Temporarily Blocks Medicare Physician Reimbursement Cuts Secretary Sebelius Announces Award to 9 States for Increasing Children222s Health Coverage Polls Find More Opposition to Health Care Reform Studies Released White House CEA Finds Health Care Reform Would Slow Health Care Cost Growth, Strengthen Economy CMS Report Finds Health Care Spending Would Increase More Rapidly Under Senate222s Reform Bill MTF Study Finds More Teens Using Marijuana While Other Drug Use Declines Study Finds Over 25 Percent of Adult Health Spending Associated with Disability Families USA Report Estimates the State Level Effects of the Senate Health Reform Bill on the Uninsured Urban Institute Explores Eligibility and Enrollment Procedures for Health Care Reform KFF Report Examines Health Coverage for Adults Ages 55 to 64 KFF Releases Medicaid and CHIP Data CWA Report Argues that the Senate222s Proposed 223Cadillac224 Health Plan Tax Would Hurt the Middle Class Study Questions Merit of Health Care Reform222s 223Cadillac224 Health Plan Tax Around the Hill: Hearings on Health Financing SAMHSA222s Weekly Financing News Pulse will be on hiatus over holidays. The next issue of the National Edition will be published on January 11, 2010. Happy Holidays from the SAMHSA Financing Center of Excellence! To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Financing224: https://service.govdelivery.com/service/multi_subscr ibe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx For questions or comments, please contact Kevin Hennessy ( kevin.hennessy@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: National Edition December 18, 2009 12/18/09 2 National News Senate Democrats Unlikely to Include Medicare Buy In in Health Care Reform Bill, Vote Could Come by December 24: Senate Majority Leader Harry Reid (D NV) continues to await official scores from the Congressional Budget Office (CBO) for numerous provisions that he may include in a 223manager222s amendment224 to the Patient Protection and Affordable Care Act of 2009 ( HR 3590 ). Last week, Sen. Reid announced a tentative plan that would replace the public plan option with a Medicare buy in provision for Americans ages 55 to 64 and a network of private non profit health plans managed by the Office of Personnel Management (OPM). However, after Senate Democrats met with President Barack Obama on December 15, senators indicated that the Medicare buy in provision will likely not be included in Sen. Reid222s amendment ( Kaiser Health News, 12/15 ; Kaiser Health News, 12/15 ). Senator Joe Lieberman (I CT), who caucuses with the Democrats and is considered crucial to obtaining the 60 vote majority, said he would only vote for the health care bill if it excluded the Medicare buy in provision and the public option ( CQ Today, 12/15 ; Kaiser Health News, 12/15 ). After a series of procedural votes, Sen. Reid plans to hold a final vote on HR 3590 by the evening of December 24; however, GOP Senators are attempting to delay that vote using procedural maneuvers ( Kaiser Health News, 12/11 ; CQ Today, 12/16 ; CQ Today, 12/17 ; Kaiser Health News, 12/17 ). Meanwhile, Sen. Reid continues to struggle to garner the necessary 60 votes, facing opposition from Senator Ben Nelson (D NE) who wants stronger restrictions on abortion funding and Senator John Rockefeller (D WV) who wants the Children222s Health Insurance Program (CHIP) continued ( CQ Today, 12/17 ). In other Senate news, Senator Byron Dorgan222s (D ND) amendment to allow the re importation of American pharmaceuticals from other countries failed on a 51 48 vote and Sen. Reid said that the final bill to emerge from conference committee will fully close the Medicare prescription drug coverage 223doughnut hole224 ( Kaiser Health News, 12/16 ; Kaiser Health News, 12/16 ). Finally, the White House announced that it will close a loop hole in HR 3590 that would allow annual and lifetime care limits while House Majority Leader Steny Hoyer (D MD) and House Speaker Nancy Pelosi (D CA) both indicated that the House could pass a health reform bill without a public option ( Kaiser Health News, 12/17 ; Kaiser Health News, 12/15 ; Kaiser Health News, 12/14 ). President Obama Signs FY2010 Spending Bill, Increases Funding for HHS and SAMHSA Programs: On December 16, President Obama signed the Consolidated Appropriations Act, 2010 ( HR 3288 ), increasing U.S. Department of Health and Human Services (HHS) funding to $603.7 billion for FY2010, which is $34.3 billion more than FY2009, including American Recovery and Reinvestment Act (ARRA) funding. The bill includes the following funding increases for the Substance Abuse and Mental Health Services Administration (SAMHSA): $20 million for the Center for Substance Abuse Treatment (CSAT) block grant funding $40.3 million for CSAT222s Programs of Regional and National Significance (PRNS) $1 million for the Center for Substance Abuse Prevention222s PRNS $7 million for the Center for Mental Health Services (CMHS) Primary and Behavioral Health Care Integration $17.1 million for CMHS222 PRNS $13 million for CMHS222 Children222s Mental Health $5 million for CMHS222 Projects for Assistance in Transition from Homelessness (PATH) ( CQ Bill Analysis , National Council, 12/17 ; AP, 12/13 ). Additional funding tables are available through the National Council for Community Behavioral Healthcare and Mental Health America . The bill also increases the Centers for Medicare & Medicaid Services222 (CMS) funding by $56 billion to $518.9 billion. SAMHSA222s Weekly Financing News Pulse: National Edition December 18, 2009 12/18/09 3 House Passes Bill to Extend COBRA Subsidies, Temporarily Blocks Medicare Physician Reimbursement Cuts: On December 16, the House passed a Department of Defense (DOD) appropriations bill ( HR 3326 ) that included a provision to expand the 65 percent COBRA subsidy originally passed as part of the ARRA and temporarily delay scheduled Medicare physician reimbursement reductions. The ARRA COBRA provision provides a nine month 65 percent COBRA subsidy to employees laid off before December 31, 2009. With eligibility for some early enrollees expiring this month, HR 3326 would expand the subsidy period from nine to 15 months, applying retroactively to those whose eligibility has already expired. The bill would also extend the enrollment cutoff point for COBRA subsidies through February 28, 2010. In addition, HR 3326 would delay a 21 percent cut in Medicare physician reimbursements currently scheduled to take effect January 1, pushing the cuts back until March 1 while Congress considers numerous 223Doc Fix224 proposals that would permanently alter the sustainable growth rate (SGR) formula used to calculate the payments. The Senate is expected to take up the bill December 18 ( Kaiser Health News, 12/17 ; Kaiser Health News, 12/17 ; Bloomberg, 12/16 ). Secretary Sebelius Announces Award to 9 States for Increasing Children222s Health Coverage: On December 17, HHS Secretary Kathleen Sebelius announced the award of $72 million in performances bonuses allocated under the Children222s Health Insurance Program Reauthorization Act (CHIPRA) for nine states that made significant progress enrolling children in Medicaid and improving access to children222s health care through Medicaid and CHIP. To receive the award funding, states had to adopt at least five of eight listed program features and demonstrate significant increases in Medicaid enrollment among children. Funding went to the following states: Alabama ($39.1 million), Alaska ($789,00), Illinois ($9.1 million), Louisiana ($1.5 million), Michigan ($3.7 million), New Jersey ($4.2 million), New Mexico ($5.1 million), Oregon ($1.6 million), Washington ($7.5 million) ( HHS via Business Wire, 12/17 ; Birmingham Business Journal, 12/17 ). Polls Find More Opposition to Health Care Reform: A Washington Post ABC News poll , conducted December 10 to 13, found that 51 percent of respondents oppose congressional health care reform while only 44 percent favor it. Similarly, the poll found that 53 percent of respondents disapprove of President Obama222s handling of health care while 44 percent approve. In addition, 53 percent of respondents believe that heath care reform will increase their health care costs and 50 percent believe that the quality of their care would deteriorate under the reform. However, the poll found that 63 percent of respondents favor the congressional proposal to allow individuals between 55 and 64 to enroll in Medicare ( Kaiser Health News, 12/16 ; ABC, 12/15 ). An NBC News/Wall Street Journal poll, conducted December 11 to 14, found similar results, with 47 percent of respondents calling the president222s health care reform 223a bad idea224 and only 33 percent characterizing it as 223a good idea.224 The NBC poll also found that 44 percent of Americans believe that it would be better to keep the current health care reform system than impose the president222s reforms ( Kaiser Health News, 12/16 ; MSNBC, 12/16 ). Studies Released White House CEA Finds Health Care Reform Would Slow Health Care Cost Growth, Strengthen Economy: On December 14, the White House Council of Economic Advisors (CEA) released a report on Congress222 current health care reform legislation ( HR 3590 and HR 3962 ), finding that both bills would slow health care cost growth over the long term. The report found that, after initial health care SAMHSA222s Weekly Financing News Pulse: National Edition December 18, 2009 12/18/09 4 spending increases associated with the bill222s222 expanded coverage, the Senate222s bill ( HR 3590 ) would slow the rate of health care cost growth by 1 percent annually and lower health care spending by 0.5 percent. The report also notes that, under the Senate bill, GDP will increase 4 percent by 2030 as health care spending falls and average family income will rise by roughly $6,800 ( Kaiser Health News, 12/15 ; Kaiser Health News, 12/14 ). CMS Report Finds Health Care Spending Would Increase More Rapidly Under Senate222s Reform Bill: A report by the CMS Office of the Actuary found that, under the Senate222s health care reform bill ( HR 3590 ) as proposed on November 18, total national health care expenditures will increase $234 billion (0.7 percent) between 2010 and 2019 while expanding coverage to 93 percent of Americans. The report also found that plans to cut Medicare spending by $493 million over 10 years through reduced provider payments and increased efficiency may cause service reductions for Medicare beneficiaries and loss of profitability for 20 percent of health care providers that predominately treat Medicare patients.Unlike the CBO222s cost estimates, which focus exclusively on the impact legislation on federal spending, the CMS report assesses the legislation222s effect on all health care spending ( Kaiser Health News, 12/14 ; AP, 12/12 ). MTF Study Finds More Teens Using Marijuana While Other Drug Use Declines: The 2009 Monitoring the Future (MTF) study, funded by the National Institute on Drug Abuse (NIDA) and conducted by University of Michigan , found that more teens are using marijuana though other drug use continues to decline. The survey found that past month marijuana use among 12th graders increased from 18.3 percent in 2006 to 20.6 percent this year while use among 10th graders rose from 13.8 percent to 15.9 percent. The survey also found OxyContin abuse increased slightly among 10th graders but found that the proportion of students reporting non marijuana drug use continues to fall, currently at 7, 12, and 18 percent respectively in eighth, tenth and twelfth grades ( MTF, 12/14 ; AP, 12/14 ; Join Together, 12/15 ). Study Finds Over 25 Percent of Adult Health Spending Associated with Disability: A study conducted by RTI International , funded by CMS , and published in Public Health Reports , found that over 25 percent of adult health care spending was associated with disability in 2006. The study found that disability associated health care spending in 2006, which includes spending on physical and mental disabilities, totaled $397.8 billion. The report found that the costs were largely borne by the public sector, especially Medicaid. The report also provides state level data on disability spending ( Kaiser Health News, 12/11 ; Insurance Journal, 12/11 ). Families USA Report Estimates the State Level Effects of the Senate Health Reform Bill on the Uninsured: Using data and estimates from the CBO, a Families USA report estimated the state level effects of Senate222s health care reform bill ( HR 3590 ) on the uninsured, finding that every state will see a significant increase in health insurance coverage under reform and a substantial loss of coverage without reform. The report found that, by 2019, Arizona, New Jersey, Ohio, North Carolina, Illinois, Georgia, New York, Florida, Texas, and California would have the largest gains in coverage under reform and the most substantial losses of coverage without reform ( Kaiser Health News, 12/17 ). Urban Institute Explores Eligibility and Enrollment Procedures for Health Care Reform: A report published by the Urban Institute examines lessons learned from previous health care coverage expansions, noting that many expansions fail to enroll eligible uninsured individuals. The authors SAMHSA222s Weekly Financing News Pulse: National Edition December 18, 2009 12/18/09 5 recommend using existing government data, including federal income tax data, to verify eligibility for national health care reform programs. In addition, the authors recommend funding community based organizations to help uninsured individuals learn about and apply to new health care programs ( Urban Institute, 12/1 ; Kaiser Health News, 12/11 ). KFF Report Examines Health Coverage for Adults Ages 55 to 64: The Kaiser Family Foundation (KFF) released a report documenting the current state of coverage for the 4 million uninsured Americans between the ages of 55 and 64 in anticipationof a potential Medicare buy in program in the Senate222s health care reform bill ( HR 3590 ). Because Senate Democrats have yet to release details of the proposal, which is not expected to be included in the final bill, the report does not present the potential effects of the program on the uninsured population ( Kaiser Health News, 12/11 ). KFF Releases Medicaid and CHIP Data: The KFF has released updated national and state level data on Medicaid and CHIP, including monthly enrollment data, eligibility information, enrollment and renewal practices, and updated information on Home and Community Based Services (HCBS) waivers. CWA Report Argu es that the Senate222s Proposed 223Cadillac224 Health Plan Tax Would Hurt the Middle Class: A report released December 17 by the Communications Workers of America (CWA) argues that the 40 percent excise tax on 223Cadillac224 health insurance plans that the Senate Democrats222 health reform bill ( HR 3590) would impose on health insurers, would adversely affect middle class Americans. The CWA report says that, though the law applies to insurers, it would affect nearly 25 million households by 2019, costing those households an average of $7,500 more over seven years. The CWA report also estimates that, by 2019, the tax would affect 20 percent of middle class Americans earning between $50,000 and $75,000 annually ( CWA, 12/17 ; Kaiser Health News, 12/17 ). Study Qu estions Merit of Health Care Reform222s 223Cadillac224 Health Plan Tax: A study published in Health Affairs argues that the 40 percent excise tax on 223Cadillac224 health insurance plans included in the Senate222s health care reform bill ( HR 3590 ) may not have the desired results. The authors note that only 3.7 percent of the variation in cost of coverage can be explained by benefit design while only 6.1 percent is attributable to benefit design and plan type (e.g. HMO, PPO). The authors argue that, because most variation in health insurance premiums remains largely unexplained, the proposed tax may not achieve its goal ( Kaiser Health News, 12/11 ). Around the Hill: Hearings on Health FinancingNone held or scheduled.
