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SAMHSA222s Weekly Financing News Pulse: National Edition July 2, 2010 7/2/10 1 SAMHSA222s Weekly Financing News Pulse: National Edition National News High- Risk Insurance Pools Begin Enrollment; Judge Hears First Oral Arguments in Virginia AG222s Lawsuit; HHS Begins Accepting Applications for Early Retiree Reinsurance Program KFF Poll Finds Increase in Support for National Health Care Reform Law Senators Introduce Bill to Extend COBRA Subsidy Program Update: President Obama Signs Six- Month Medicare Physician Reimbursement Rate Adjustment, CMS Opens Special Enrollment Period for Non -Participating Physicians DOD Final Rule Governs Employer Incentives for Military Retirees Using TRICARE CMS Issues Proposed Rule on Medicare Payment Policies Studies Released RWJF and Urban Institute Project Savings for States Under Hea lth Care Reform Urban Institute Report Finds Legal Basis For Individual Insurance Mandate, Highlights Vulnerabilities RWJF Report Examines Payment Reform Under the Health Care Reform Law Commonwealth Fund Report Examines Health Care Systems Worldwide 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_subscribe.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 July 2, 2010 7/2/10 2 National News High- Risk Insurance Pools Begin Enrollment; Judge Hears First Oral Arguments in Virginia AG222s Lawsuit; HHS Begins Accepting Applications for Early Retiree Rei nsurance Program: On July 1, the U.S. Department of Health and Human Services (HHS) launched its consumer portal at www.healthcare.gov and began enrolling patients in high -risk insurance pools in 21 states. Coverage in the HHS-operated pools will begin as early as August. In addition, HHS expects that states operating their own pools will begin enrollment by the end of the summer. The national health care reform law allocates $5 billion to operate the pools until 2014 and HHS officials estimate that 350,000 individuals will utilize the pools. However, the Congressional Budget Office (CBO) estimates that 700,000 individuals will seek enrollment in the pools and projects that an additional $5 to $10 billion will be necessary to meet the demand for the program. To be eligible, an individual must be a U.S. citizen or legal resident, been denied coverage because of a preexisting condition, and been uninsured for at least six months prior to enrollment ( Kaiser Health News, 7/1 ; Kaiser Health News, 6/30 ; AP, 6/30 ; The Wall Street Journal, 7/1 ; CNN, 7/1 ). Also on July 1, District Court Judge Henry E. Hudson heard the first oral arguments in Virginia Attorney General Ken Cuccinelli222s (R) lawsuit over the national health care reform law222s individual insurance mandate. Arguments focused on the constitutionality of the individual mandate and whether Attorney General Cuccinelli has the legal standing required to file the suit. Judge Hudson will decide whether to dismiss the case within 30 days. If the judge allows the case to proceed, oral arguments for summary judgment will begin October 18 ( Kaiser Health News, 7/1 ; The Washington Post, 7/1 ). In other health care reform news, on June 29 HHS made applications available for the health care reform law222s Early Retiree Reinsurance Program. The law allocates $5 billion for businesses, unions, and state and local governments t o cover health care costs of early retirees who are over 55 but ineligible for Medicare. The program will cover 80 percent of the costs of the retirees222 claims between $15,000 and $90,000 and offer coverage for early retirees222 spouses and dependents . Emp loyers that receive the federal funds must use the money to lower early retirees 222 health care costs and must continue their current contributions to retiree health benefits ( Kaiser Health News, 6/30 ; The Hill, 6/29 ). KFF Poll Finds Increase in Support for National Health Care Reform Law: On June 30, the Kaiser Family Foundation (KFF) released the June Kaiser Health Tracking Poll . The poll found that 48 percent of America ns view the national health care reform law favorably, 41 percent view it unfavorably, and 10 percent are undecided. The figures demonstrate increases support for the law since May, when 44 percent reported an unfavorable view of the law and 41 percent re ported a favorable view of it. In addition, KFF found that support for individual components of the law remains high. At least 50 percent of respondents indicated support for all but one of the individual measures included in the poll. The only measure which a majority of respondents viewed unfavorably was the individual insurance mandate, which only 34 percent of respondents view favorably ( KFF, 6/30 ; The Washington Post, 6/30 ). Senators Introduce Bill to Extend COBRA Subsidy Program: On June 29, Senator Bob Casey (D - PA) and Senator Sherrod Brown (D -OH) introduced S. 3548 that would extend the deadline for enrollment in the 65 percent COBRA subsidy program established under the American Recovery and Reinvestment Act (ARRA). The original deadline for enrollment in the program was June 1. The bill would extend the enrollment deadline through November, retroactive to June 1, and those who enroll would be eligible for the subsidy for six months. The bill222s sponsors project the measure will cost $4.1 billion, which they say would be offset by $5.3 billion in savings from the elimination of a tax credit for a type of asset transfer. The bill was referred to the Senate Finance Committee ( The Hill, 6/30 ; Kaiser Health News, 7/1 ). SAMHSA222s Weekly Financing News Pulse: National Edition July 2, 2010 7/2/10 3 Update: President Obama Signs Six- Month Medicare Physician Reimbursement Rate Adjustment, CMS Opens Special Enrollment Period for Non - Participating Physicians: On June 25, President Barack Obama signed the six -month Medicare physician reimbursement rate adjustment approved by the U.S. House on June 24. The measure will increase physician reimbursement rates 2.2 percent through November; however, without further Congressional action, lawmakers project that physicians will face a 23 percent cut in Medicare reimbursement rates in December. Legislators estimate that the rate increase will cost $6.5 billion but note that the cost is fully offset by reductions in other spending. In addition, the current reimbursement adjustment is retroactive to June 1. In related news, on June 28, officials from the Centers for Medicare & Medicaid Services (CMS) announced that CMS will offer a special enrollment period for non-participating physicians to participate in Medicare. Under normal CMS rules, physicians may elect to participate in Medicare only once annually, typically at the beginning or end of the year. However, because of the altered rates, CMS will allow non- participating physicians to join the program until July 16 ( Kaiser Health News, 6/25 ; California Healthline, 6/28 ; DOT Med, 6/29 ). DOD Final Rule Governs Employer Incentives for Military Retirees Using TRICARE: A U.S. Department of Defense (DOD) final rule took effect June 18, clarifying previous regulations governing employer incentives encouraging military retirees to utilize TRICARE rather than employer -sponsored health care coverage. The 2007 John Warner National Defense Authorization Act ( P.L. 109- 364) included a prohibition on employer -provided incentives encoura ging TRICARE utilization as DOD officials argued that such increasingly common incentives shifted the burden of employers222 health care costs onto the taxpayers. The interim regulation made no exceptions to the ban; however, under the final rule, employers may offer a TRICARE insurance supplement through a cafeteria -style health plan if employees coves the full cost of the supplement. Premiums paid for cafeteria - style health plans are exempt from federal and state taxes. Advocates for the change project that allowing military retirees to purchase TRICARE supplements through their employers will lower retirees222 out -of -pocket supplement costs by 27 percent. The Congressional Budget Office (CBO) estimates that the law222s restrictions on employer incentives for TRICARE utilization will save the federal government $64 million annually ( Colorado Springs Gazette, 6/27 ; Kaiser Health News, 6/28 ). CMS Issues Proposed Rule on Medicare Payment Policies: On June 25, CMS issued a proposed rule that would update Medicare payment policies and rates for services provided by physicians and non-physician practitioners (NPPs) under the Medicare Physician Fee Schedule (MPFS). Additionally, the proposed rule includes several provisions of the national health care reform law affect ing other aspects of the MPFS. Those provisions include measures to improve payment accuracy, increase the utilization and quality of primary and preventive care, and expand access to care. Comments on the proposed rule are due by August 24 and CMS will issue a final rule by November 1 ( CMS, 6/25 ; Health Leaders Media, 6/28 ). Studies Released RWJF and Urban Institute Project Savings for States Under Hea lth Care Reform: On June 21, the Robert Wood Johnson Foundation (RWJF) and the Urban Institute released a report projecting the impact of the national health care reform law on states. The report concludes that, on average, the law will lower state health care costs, citing increased federal Medicaid funding, changes to the Children222s Health Insurance Program (CHIP ), and the creation of health insurance exchanges. However, the SAMHSA222s Weekly Financing News Pulse: National Edition July 2, 2010 7/2/10 4 authors acknowledge that there will be regional variance in the impact of the law. The report estimates that Southern and Western states will benefit the most from the law, while the Northea stern and Midwestern states are will bear greater revenue contributions to fund the law222s provisions ( Robert Wood Johnson Foundation, 6/21 ; Kaiser Health News, 6/25 ). Urban Institute Report Finds Legal Basis For Individual Insurance Mandate, Highlights Vulnerabilities : On June 22, the Urban Institute released a report examining state challenges to the national health care reform law222s individual insurance mandate. The authors assert that the individual mandate has a legitimate legal basis; however, they highlight two vulnerabil ities of the mandate. The authors note that the U.S. Supreme Court could establish a new legal precedent by ruling against the mandate and further caution that the mandate222s enforcement provisions are too weak to guarantee the government222s ability to ensure coverage ( Urban Institute, 6/22 ; Kaiser Health News, 6/25 ). RWJF Report Examines Payment Reform Under the Health Care Reform Law: On June 17, the RWJF released a report examining the work of an RWJF panel convened to discuss health care payment reform under the national health care reform law. The report highlights the recommendations of the panelists, which include focusing on community-based payment reform, improving the ability to measure process efficiency and quality, and incorporating Medicaid into all payment reform models and strategies. The report concludes that payment reform is essential for improving quality and reducing costs but faces significant implementation challenges ( Robert Wood Johnson Foundation, 6/ 17 ; Kaiser Health News, 6/25 ). Commonwealth Fund Report Examines Health Care Systems Worldwide: The Commonwealth Fund released a report examining health care systems in Australia, Canada, Denmark, England, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. The report examines each system individually, highlighting eligible participants, covered services, average out - of -pocket contributions, and the systems222 overall financing mechanisms. Each country222s section also examines that nation222s efforts to improve efficiency and quality as well as any recently introduced reforms and innovations. The authors found that, though the U.S. did not have the highest o ut -of -pocket costs, its coverage system is the most fragmented and leaves the most residents uninsured ( Kaiser Health News, 6/ 25). Around the Hill: Hearings on Health Financing Congress is out of session for the July 4th recess. The Senate will reconvene Monday, July 12 and the House will reconvene Tuesday, July 13. Senate Veterans222 Affairs Committee : Veterans222 Claims Processing July 1, 9:30 a.m., 418 Russell House Veterans222 Affairs Subcommittee on Oversight and Investigations : Veterans222 Suicide Prevention Outreach Efforts July 14, 10:00 a.m., 334 Cannon House Veterans222 Affairs Committee : Treatments for TBI and PTSD J uly 14, 10:00 a.m., 334 Cannon SAMHSA222s Weekly Financing News Pulse: National Edition July 2, 2010 7/2/10 5 House Veterans222 Affairs Subcommittee on Oversight and Investigations : Gulf War Illness July 27, 10:00 a.m., 334 Cannon
