WeeklyFinancingNewsPulseNationalEditionfinal20100326.pdf (PDF | 153.43 kb)
SAMHSA222s Weekly Financing News Pulse: National Edition March 26, 2010 3/26/10 1 SAMHSA222s Weekly Financing News Pulse: National Edition National News President Signs Senate Health Care Reform Bill, Congress Passes Reconciliation Bill, States Pursue Legal Challenges Senate Considers House-Passed 223Extenders224 Bill to Delay Medic are Physician Payment Cuts, Extend ARRA COBRA Subsidies Senate Special Aging Committee Hears Testimony on DEA Prescription Drug Enforcement Polls Show Americans Remain Divided on Health Care Reform Studies Released AHP Issues Revised Report on MHPAEA IFR NDIC NDTA Estimates Drug Abuse Costs U.S. $215 Billion Annually Thomson Reuters Finds Employer Health Care Costs Rose 7.3 Percent in 2009 Health Affairs Article Indicates that High Private -Payer Profits May Lead to Low Medicare Margins Brief Examines the Impact of ARRA Medicaid Funding on Children and Families , Argues for Continued FMAP Increases KFF Finds One Third of Individuals Leaving Employer - Sponsored Coverage Sustained Prolonged Periods of Uninsurance KFF Publishes Summaries and Briefs Outlining the Effects of Democratic Health Care Reform 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 March 26, 2010 3/26/10 2 National News President Signs Senate Health Care Reform Bill, Congress Passes Reconciliation Bill, States Pursue Legal Challenges : After President Barack Obama signed the Patient Protection and Affordable Care Act ( HR 3590) on March 23, Congress passed the Health Care and Education Affordability Reconciliation Act ( HR 4872), making changes to the original health reform bill ( CQ Politics, 3/23 ; New York Times, 3/25 ). The House initially passed HR 4872 March 21 and the Senate took up the bill under reconciliation, requiring only 51 votes for final passage and avoiding a potential GOP filibuster. Despite rejecting approximately 40 GOP amend ments designed to force Democrats into politically unpopular votes, Republicans successfully removed two education provisions from the bill because they were ineligible for consideration under the budget reconciliation process ( Kaiser Health News, 3/25 ; Kaiser Health News, 3/25 ) . On March 25, the Senate approved the modified bill on a 56-43 vote, sending it back to the House, which approved the measure on a 220-207 the same night. In both votes, Republicans unanimously opposed the bill ( CQ Politics, 3/25 ; Kaiser Health News, 3/25 ). The House Ways and Means Committee published an official implementation timeline for the bill , as did the Kaiser Family Foundation (KFF) . Behavioral health organizations, including the National Association of State Alcohol and Drug Abuse Directors (NASADAD) and the National Association of Psychiatric Health Systems , have praised the laws as major steps forward in behavioral health coverage. The organizations note that health plans provi ded through the new exchanges must offer behavioral health coverage at parity and that the new laws fund a three-year $75 million demonstration project designed to increase access to emergency psychiatric care ( PRNewswire, 3/23 ; Crime R eport, 3/24 ). In addition, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius plans to issue regulations clarifying a provision in the bill designed to guarantee immediate coverage for children with pre-existing conditions. Democrats intended the language to require all insures to accept such children; however, some advocates contend that the measure222s language would only apply to children a lready enrolled in insurance plans. Furthermore, some legal experts note that the regulation may prompt a legal challenge, allowing the courts final say on interpreting the measure ( Kaiser Health News, 3/25 ). Finally, Republicans have mounted opposition to the bill at both the national and state level. Senator Jim DeMint (R -SC) proposed legislation ( S 3152) to repeal Democratic health care reform on March 23 and attorneys general in 14 states have filed lawsuits challenging the constitutionality of the bills222 individual mandate ( USA Today, 3/23 ; Kaiser Health News, 3/23 ; Kaiser Health News, 3/25 ). Attorneys general in 13 states (AL, CO, FL, ID, LA, MI, NE, PA, SC, SD, TX, UT, and WA) filed a joint lawsuit in federal court in Pensacola , Florida naming the U .S. Departments of Health and Human Services , Treasury , and Labor as defendants and claiming that the bill222s individual mandate violates the U.S. Constitution ( Kaiser Health News, 3/24 ; Boston Globe, 3/24 ) . In addition, Virginia Attorney General Ken Cuccinelli (R) filed a separate suit, arguing it conflicts with a recently-passed state law exempting Virginians from federal penalties for failure to obtain health coverage ( Reuters, 3/23 ). Senate Considers House - Passed 223Extenders224 Bill to Delay Medic are Physician Payment Cuts, Extend ARRA COBRA Subsidies : On March 17, the House approved the Continuing Extension Act of 2010 ( HR 4 85 1 ) to extend American Recovery and Reinvestment Act (ARRA) unemployment benefits and COBRA subsidies and delay a scheduled 21 percent Medicare physician reimbursement reduction. All of those provisions are set to expire during Congress222 upcoming two -week recess and the bill seeks to extend them through at least April 30. The Senate took up the measure March 25 and planned to continue debate March 26; however, Senate Majority Leader Harry Reid (D -NV) may extend the session into the chamber222s scheduled recess to pass the measure in time to avoid service disruptions and reimbursement reductions (CQ Today, 3/25; CQ Politics, 3/25 ). SAMHSA222s Weekly Financing News Pulse: National Edition March 26, 2010 3/26/10 3 Senate Special Aging Committee Hears Testimony on DEA Prescription Drug Enforcement: On March 24, the Sen ate Special Committee on Aging heard testimony on a recent Drug Enforcement Agency (DEA) action that has increased barriers to pain killers for seriously ill nursing home residents . The DEA recently began enforcing a law that requires pharmacies to obtain physician-signed prescriptions prior to dispensing painkillers for such residents . N ursing home advocates contend that the previous practice allowed nurses to take doctors 222 orders orally or from patient charts and pass them to pharmacists, as nurses are allowed to do in hospitals. DEA officials note that the agency is simply enforcing existing policies ( New York Times, 3/23 ; Kaiser Health News, 3/24 ). P olls Show Americans Remain Divided on Health Care Reform: The March Kaiser Health Tracking poll , conducted before Congress approved health care reform, found that 46 percent of Americans supported the Democrats222 health reform proposals while 42 percent opposed them. In addition, a March 22 CNN poll found that 59 percent of respondents opposed the bill ( HR 3590) passed by the House earlier this week while only 39 percent support ed it ( Kaiser Health News, 3/19 ; Politico, 3/22 ). Studies Released AHP Issues Revised Report on MHPAEA IFR : On March 20, Advocates for Human Potential Inc. (AHP) issued a revised analysis of the Mental Health Parity and Addiction Equity Act (MHPAEA) Interim Final Rule (IFR) . The report provides a detailed summary of the main provisions of the IFR and the timeline for implementation. In addition, AHP222s analysis highlights the operational considerations and implications of each provision of the IFR for plans and payers as well as providers. AHP plans to update the document routinely until the IFR open comment period ends May 3 ( Behavioral Health Central, 3/23 ). NDIC NDTA Estimates Drug Abus e Costs U.S. $215 Billion Annually: The U.S. Department of Justice222s (DOJ) National Drug Intelligence Center (NDIC) released the 2010 National Drug Threat Assessment (NDTA ), highlighting trends in production, transportation, distribution, and abuse of drugs. In addition, the NDTA estimates the economic cost of drug abuse at $215 billion annually ( DOJ via PRNewswire, 3/25 ). T homson Reuters Finds Employer Health Care Costs Rose 7.3 Percent in 2009: Analyzing data from the National Health Expenditures and the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary , a Thomson Reuters report found that employer health care spending rose 7.3 percent in 2009. The same year, overall U.S. health care spending grew 4.8 percent. According the Thomson Reuters, small employer health care costs rose 9.8 percent, medium -sized employers222 costs increased 10 percent, and large employers222 costs increased 5 percent ( Reuters, 3/22 ; Thomson Reuters, 3/22 ). Hea lth Affairs Article Indicates that High Private- Payer Profits May Lead to Low Medicare Margins: A study published in Health Affairs and authored by members of the Medicare Payment Advisory Commission (MedPAC) refutes the assumption that hospitals have little control over costs, forcing them to increase private insurers 222 rates to compensate for lower Medicare reimbursements. The article argues that hospitals with stro ng market power and higher private-payer revenue have less pressure to contain costs and high per - unit costs cause them to l ose money on Medicare patients. However, hospitals under greater financial pressures have more incentive to control costs and often generate profit on Medicare patients ( Kaiser Health News, 3/19 ). SAMHSA222s Weekly Financing News Pulse: National Edition March 26, 2010 3/26/10 4 Br ief Examines the Impact of ARRA Medicaid Funding on Children and Families , Argues for Continued FMAP Increases: A Georgetown University Health Policy Institute brief examines the impact of t he ARRA Medicaid Federal Medical Assistance Percentage ( FMAP ) increases on children and families. The brief notes that Medicaid enrollment has increased 3.3 million in the past year, with children accounting for 60 percent of that increase. The brief also argues that Congress should extend the ARRA FMAP increase to avoid reversing recent coverage expansions ( Georgetown University, 3/12 ; Kaiser Health News, 3/19 ). KFF Finds One Third of Individuals Leaving Employer - Sponsored Coverage Sustained Prolonged Periods of Uninsurance: A K FF analysis examined data from 2004 to 2007, finding that more than one-third of individuals who left a job that provided employer -sponsored health insurance were uninsured for at least six - months after lea ving their employer. In contras t, KFF found that only 5 percent of those remaining at their employers experienced similar periods of uninsurance. KFF found that workers leaving small businesses and those with in comes below 200 percent of the federal poverty level ( FPL) were more likely to be uninsured ( KFF, 3/17 ; Kaiser Health News, 3 /19 ). KFF Publishes Summaries and Briefs Outlining the Effects of Democratic Health Care Reform: The KFF published a brief outlining the combined effects of the Senate bill ( HR 3590) and the Reconciliation Bill ( HR 4872). In addition, KFF published a brief examining the health care reform bills222 effect on the Medicare Prescription Drug Benefit Program (Part D) and updated an inter active health care subsidy calculation tool to reflect changes made by HR 4872 ( KFF, 3/24 ; KFF, 3/25 ). Around the Hill: Hearings on Health Financing Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies: Fiscal 2011 Appropriations: Labor, HHS, Education March 23, 9:00 a.m., 138 Dirk sen House Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies : Fiscal 2011 Appropriations: Military Construction, VA March 23, 10:00 a.m., H -143 Capitol Building March 23, 1:30 p.m., H -143 Capitol Building March 24, 10:00 a.m., H -143 Capitol Building March 24, 2:30 p.m., H -143 Capitol Building Senate Armed Services Subcommittee on Personnel : FY2011 Budget: Military Health Programs March 24, 10:00 a.m., 232 -A Russell Senate Special Aging Committee: Medicine and Prescription Drugs for Nursing Home Patients March 24, 2:00 p.m., 106 Dirksen House Veterans222 Affairs Subcommittee on Health : Veterans222 Health Bills March 25, 10:00 a.m., 334 Cannon
