WeeklyFinancingNewsPulseNationalEditionfinal20100205.pdf (PDF | 309.94 kb)
SAMHSA222s Weekly Financing News Pulse: National Edition February 5, 2010 2/5/10 1 SAMHSA222s Weekly Financing News Pulse: National Edition National News President Obama Proposes FY2011 Budget Boosting SAMHSA, Other HHS Funding, Increasing Funding for Substance Abuse Treatment and Prevention Democrats File Legislation to Repeal Health Insurers222 Antitrust Exemption, Seek Plan for Broader Health Care Reform Senate Pay Go Legislation Exempts $82 Billion for Medicare Doc Fix Rep. Sestak Announces Bill to Mandate Health Coverage for Autistic Children Some States Seek Expanded Health Care Coverage, Others Reduce Benefits or Resist Elements of National Health Reform Studies Released Study Finds Increased Community Health Center Funding Expands Access to Behavioral Health Services, Treats More Uninsured Patients CMS Report Finds Public Spending Will Finance Over Half of Health Care Spending by 2012 ARRA Funding Helps Some Community Health Safety Net Providers KFF Brief Outlines Key ELE Policy Decisions for States KFF Updates State Budget, Medicaid and CHIP Data Study Finds Value Based Insurance Can Be Effective Around the Hill: Hearings on Health Financing 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 February 5, 2010 2/5/10 2 National News President Obama Proposes FY2011 Budget Boosting SAMHSA, Other HHS Funding, Increasing Funding for Substance Abuse Treatment and Prevention: President Barack Obama presented Congress his $3.8 trillion FY2011 budget on February 1, proposing $1.16 trillion in discretionary spending excluding funds for military operations in Iraq and Afghanistan. President Obama222s budget also freezes non security discretionary spending at $446.3 billion over three years, beginning in 2011, and assumes a $150 billion 10year deficit reduction due to national health care reform ( CQ Politics, 2/1 ; Washington Post, 2/1 ). The president requested a $911 billion U.S. Department of Health and Human Services (HHS) budget , $818 billion of which constitutes funding for mandatory spending programs including Medicare and Medicaid, including an additional $25 billion to continue American Recovery and Reinvestment Act (ARRA) Federal Medical Assistance Percentage (FMAP) increases. The remaining $81.2 billion will provide funding increases to numerous agencies and programs, including a $1 billion increase for the National Institutes of Health (NIH) and a $397 million increase for the Agency for Healthcare Research and Quality (AHRQ). President Obama222s budget also provides a $109 million increase for the Substance Abuse and Mental Health Services Administration (SAMHSA), bringing the agency222s 2011 budget to $3.54 billion ( Kaiser Health News, 2/2 ; Kaiser Health News, 2/1 ; Kaiser Health News, 2/1 ). President Obama222s budget requests $15.5 billion to reduce drug use and its consequences, a $521.1 million (3.5 percent) increase over FY2010 funding levels. The drug control budget would increase prevention funding 13.4 percent to $1.7 billion and treatment funding by 3.7 percent to $3.9 billion ( ONDCP, 2/1 ). Finally, the president222s budget proposal would also extend the 15month 65 percent ARRA COBRA subsidy to employees laid off between March 1 and December 31 ( Kaiser Health News, 2/2 ). Democrats File Legislation to Repeal Health Insurers222 Antitrust Exemption, Seek Plan for Broader Health Care Reform: On February 5, Reps. Tom Perriello (D VA) and Betsy Markey (D CA) filed legislation to repeal health insurers222 exemption from federal antitrust laws under the 1945 McCarran Ferguson Act . House Speaker Nancy Pelosi (D CA) says the bill will be the first in a series of smaller health care bills introduced in the House while Democrats determine their strategy for broader national health care reform ( Kaiser Health News, 2/4 ). Meanwhile, though Democratic leadership has not announced a formal plan for its broader bills ( HR 3590 , HR 3962 ), Senate Health, Education, Labor and Pensions (HELP) Committee Chair Tom Harkin (DIA) says his staff is developing a reconciliation package. News outlets report that Rep. Pelosi and Senate Majority Leader Harry Reid (D NV) hope to persuade Senate Democrats to pass a series of changes to HR 3590 through reconciliation. The changes would modify the Senate approved bill to reflect the informal agreement reached between House, Senate, and White House negotiators prior to Senator Scott Brown (R MA)222s election in January ( Kaiser Health News, 2/1 ; Kaiser Health News, 2/3 ; Kaiser Health News, 2/4 ). Senate Pay Go Legislation Exempts $82 Billion for Medicare Doc Fix: On January 28, the Senate passed paygo legislation ( S.Amdt 3305 to H.J.Res. 45 ) requiring Congress to identify revenue for much of its future spending to avoid increasing the deficit. However, the legislation exempts $82 billion to prevent a scheduled 21 percent reduction in physician Medicare reimbursements because of the Sustainable Growth Rate (SGR) formula. The funding is sufficient to prevent five years of reimbursement reductions, the longest reprieve Congress has approved since 2002. However, because the rate reductions compound, physician reimbursements cuts would be scheduled to increase 25 to 30 percent in 2015. Without legislative action, the 21 percent rate cut will take effect March 1 ( Kaiser Health News, 2/2 ). SAMHSA222s Weekly Financing News Pulse: National Edition February 5, 2010 2/5/10 3 Rep. Sestak Announces Bill to Mandate Health Coverage for Autistic Children: U.S. Rep. Joseph Sestak (D PA) announced new legislation mandating that employer sponsored health plans cover treatment for autistic children. Rep. Sestak222s bill would amend the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act (PHSA) to require coverage for the diagnosis and treatment of Autism Spectrum Disorders (ASD), including applied behavioral analysis therapy ( Delaware County Daily Times, 1/31 ). Some Stat es Seek Expanded Health Care Coverage, Others Reduce Benefits or Resist Elements of National Health Reform: The National Conference of State Legislators (NCSL) reports that lawmakersin 11 states have proposed bills designed to improve access to care ( Kaiser Health News, 2/2 ; Wall Street Journal, 2/2 ). However, Kaiser Health News (KHN) reports that five out of six states are considering cuts to programs that provide health care to adults not covered by Medicaid, noting that Connecticut, Minnesota, Pennsylvania, Tennessee, and Washington are considering serious reductions ( Kaiser Health News/USA Today, 2/2 ). Finally, the American Legislative Exchange Council reports that lawmakers in 34 states are pursuing constitutional modifications to block the individual mandate included in Democratic national health care reform bills ( HR 3590 , HR 3962 ) ( Kaiser Health News, 2/1 ; AP, 2/1 ). Studies Released Study Finds Increased Community Health Center Funding Expands Access to Behavioral Health Services, Treats More Uninsured Patients: A study published in Health Affairs found that increased federal funding for community health centers between 1996 and 2006 yielded increased service availability, particularly for mental health and substance abuse treatment. The study also found that every $500,000 in additional federal grant funding treated 540 more uninsured patients. The authors also note that community health centers will retain their vital role in the health care system even if more Americans receive health insurance under federal health care reform ( Reuters, 2/2 ). CMS Report Finds Public Spending Will Finance Over Half of Health Care Spending by 2012: A Centers for Medicare & Medicaid Services (CMS) Office of the Actuary study published February 4 projected U.S. health care spending through 2019, finding that public spending will account for more than half of all national health care spending by 2012. In addition, CMS projects that all health care spending will grow at an average annual rate of 6.1 percent from 2009 through 2019, faster than the anticipated growth in Gross Domestic Product (GDP). The report also estimates that national health spending already grew 5.7 percent to reach $2.5 trillion in 2009 despite a projected 1.1 percent decline in GDP ( Kaiser Health News, 2/4 ; Kaiser Health News, 2/4 ). ARRA Funding Helps Some Community Health Safety Net Providers: A Center for Studying Health System Change (CSHSC) case study of five communities in Arizona, New Jersey, Ohio, South Carolina, and Washington found that ARRA funding helped health care safety net providers cope with reduced state, local, and private funding as a result of the recession. CSHSC based the study on interviews with representatives from hospitals, community health centers, and free clinics ( Kaiser Health News, 1/29 ). KFF Brief Outlines Key ELE Policy Decisions for States: The Kaiser Family Foundation (KFF) published a brief outlining key policy issues for states concerning the implementation of Express Lane Eligibility (ELE) under the Children222s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). SAMHSA222s Weekly Financing News Pulse: National Edition February 5, 2010 2/5/10 4 ELE allows state Medicaid and Children222s Health Insurance Programs (CHIPs) to utilize eligibility findings from other need based programs to determine and/or renew children222s Medicaid and CHIP eligibility. However, CHIPRA gives states significant flexibility to design ELE initiatives and this brief considers the implications of state level implementation decisions ( KFF, 1/22 ; Kaiser Health News, 1/29 ). KFF Updates State Budget, Medicaid and CHIP Data: The KFF has published updated data on states222 projected shortfalls for FY2011 ; state spending for FY2008 , including Medicaid expenditures; and states222 Medicaid and CHIP enrollment practices and premiums . Some of the KFF data comes from the Center on Budget and Policy Priorities (CBPP) and the National Association of State Budget Officers (NASBO) as well as the Kaiser Commission on Medicaid and the Uninsured . Study Finds Value Based I nsurance Can Be Effective: A study published in Health Affairs examined one value based insurance program that reduced copayments to encourage drug utilization. The authors found that the program led to reduced utilization of non drug health services, offsetting the costs associated with the increased drug utilization. The study concludes that value base insurance, which incentivizes the use of high value clinical care through reduced out of pocket costs, does not increase total medical spending ( Kaiser Health News, 1/29 ). Around the Hill: Hearings on Health FinancingSenate Finance Committee : Budget: Overview February 2, 10:00 a.m., 215 Dirksen February 4, 10:00 a.m., 215 Dirksen Senate Budget Committee : Budget Overview February 2, 10:00 a.m., 608 Dirksen February 4, 10:00 a.m. 608 Dirksen House Budget Committee : Fiscal 2011 Budget February 2, 2:00 p.m., 210 Cannon House Ways and Means Committee : Fiscal 2011 Budget February 3, 10:00 a.m., 1100 Longworth February 3, 2:00 p.m., 1100 Longworth House Veterans222 Affairs Subcommittee on Health: Project Hero February 3, 10:00 a.m., 334 Cannon House Veterans222 Affairs Subcommittee on Disability Assistance and Memorial Affairs: Veterans222 Benefits Improvement Act February 3, 2:00 p.m., 334 Cannon Senate Finance Committee : Health Care Proposals February 3, 3:30 p.m. 215 Dirksen House Veterans222 Affairs Committee : Fiscal 2011 and 2012 Budget: VA February 4, 10:00 a.m., 334 Cannon SAMHSA222s Weekly Financing News Pulse: National Edition February 5, 2010 2/5/10 5 House Energy and Commerce Committee: Fiscal 2011 Budget: Health and Human Services February 4, 2:00 p.m., 2123 Rayburn
