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WASHINGTON (Reuters) - A key recommendation for medical coverage standards under President Barack Obama's healthcare overhaul will be released on October 7, according to the organization preparing the report.
The Department of Health and Human Services has asked the influential Institute of Medicine, an independent agency in Washington, to recommend how HHS should determine the basic health benefits for millions of Americans who will qualify for coverage sold through insurance exchanges beginning in 2014.
IOM spokeswoman Christine Stencel on Thursday said the agency will release the report on October 7, just a week later than the self-imposed deadline of the end of September.
Stencel has previously told Reuters that IOM will not produce specific benefits standards for the exchanges. Instead, the group is working toward recommendations on criteria and methods that would allow HHS to determine and update the essential health benefits package.
The findings will inform the final HHS decision expected by the end of the year. HHS has been subject to intense lobbying over which health services should be mandated by the government.
To view the entire article click here.
Thursday, September 29, 2011
White House, health reform opponents ask Supreme Court to review law
WASHINGTON (Reuters)—Twenty-six states and a small business group appealed Wednesday to the Supreme Court seeking to strike down all of President Obama's signature health care law, while the administration defended it.
The states and National Federation of Independent Business argued the entire law should be invalidated because Congress exceeded its powers requiring that Americans buy health insurance or face a penalty.
They urged the high court to quickly decide the issue in its upcoming term, which begins next week and lasts through June 2012.
The Obama administration filed its own appeal in which the Justice Department argued the so-called individual mandate was constitutional and said the issue was appropriate for Supreme Court review.
“Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act, and the Voting Rights Act, and all of those challenges failed,” the Justice Department said.
“We believe the challenges to Affordable Care Act…will also ultimately fail and that the Supreme Court will uphold the law,” the department said in a statement.
White House adviser Stephanie Cutter said the administration asked the Supreme Court to hear the case “so that we can put these challenges to rest and continue moving forward implementing the law to lower the cost of health care and make it more secure for all Americans.”
At issue was a ruling by a U.S. appeals court in Atlanta in August that declared unconstitutional the individual insurance requirement but refused to strike down the entire law.
The ruling by the appeals court in Atlanta conflicted with rulings by other appeals courts that have upheld the law or have rejected legal challenges, including a lawsuit by the state of Virginia that was dismissed earlier this month on procedural grounds.
The law, passed by Congress and signed by President Obama in 2010 after a bruising political battle, is expected to be a major issue in the 2012 elections as Obama seeks another four-year term. Republican presidential candidates oppose it.
The Supreme Court long has been expected to have the final word on the law's constitutionality. The dispute has important legal, political and financial implications for companies in the health care field.
Florida Attorney General Pam Bondi said the states sought Supreme Court review of their lawsuit.
“This health care law is an affront on Americans' individual liberty, and we will not allow the federal government to violate our constitutional rights,” she said.
Legal experts have said the nine member Supreme Court, with a conservative majority and four liberals, most likely will be closely divided on whether the individual mandate requiring insurance purchases exceeded the power of Congress.
The Obama administration earlier this week said it decided against asking the full U.S. Appeals Court for the 11th Circuit to review the August ruling by a three-judge panel of the court that found the insurance requirement unconstitutional.
That decision cleared the way for the administration to go to the Supreme Court.
The states in their appeal also argued the law's expansion of Medicaid, a federal-state partnership that provides health care to low-income Americans, was unconstitutionally coercive, forced upon the states.
The states and National Federation of Independent Business argued the entire law should be invalidated because Congress exceeded its powers requiring that Americans buy health insurance or face a penalty.
They urged the high court to quickly decide the issue in its upcoming term, which begins next week and lasts through June 2012.
The Obama administration filed its own appeal in which the Justice Department argued the so-called individual mandate was constitutional and said the issue was appropriate for Supreme Court review.
“Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act, and the Voting Rights Act, and all of those challenges failed,” the Justice Department said.
“We believe the challenges to Affordable Care Act…will also ultimately fail and that the Supreme Court will uphold the law,” the department said in a statement.
White House adviser Stephanie Cutter said the administration asked the Supreme Court to hear the case “so that we can put these challenges to rest and continue moving forward implementing the law to lower the cost of health care and make it more secure for all Americans.”
At issue was a ruling by a U.S. appeals court in Atlanta in August that declared unconstitutional the individual insurance requirement but refused to strike down the entire law.
The ruling by the appeals court in Atlanta conflicted with rulings by other appeals courts that have upheld the law or have rejected legal challenges, including a lawsuit by the state of Virginia that was dismissed earlier this month on procedural grounds.
The law, passed by Congress and signed by President Obama in 2010 after a bruising political battle, is expected to be a major issue in the 2012 elections as Obama seeks another four-year term. Republican presidential candidates oppose it.
The Supreme Court long has been expected to have the final word on the law's constitutionality. The dispute has important legal, political and financial implications for companies in the health care field.
Florida Attorney General Pam Bondi said the states sought Supreme Court review of their lawsuit.
“This health care law is an affront on Americans' individual liberty, and we will not allow the federal government to violate our constitutional rights,” she said.
Legal experts have said the nine member Supreme Court, with a conservative majority and four liberals, most likely will be closely divided on whether the individual mandate requiring insurance purchases exceeded the power of Congress.
The Obama administration earlier this week said it decided against asking the full U.S. Appeals Court for the 11th Circuit to review the August ruling by a three-judge panel of the court that found the insurance requirement unconstitutional.
That decision cleared the way for the administration to go to the Supreme Court.
The states in their appeal also argued the law's expansion of Medicaid, a federal-state partnership that provides health care to low-income Americans, was unconstitutionally coercive, forced upon the states.
Thursday, September 22, 2011
Obama Administration Downsizes CLASS Act Office
WASHINGTON BUREAU -- The Obama administration is reassigning the workers in the office that was developing the Community Living Assistance Services and Supports (CLASS) Act long term care benefits plan – a program that is part of the Patient Protection and Affordable Care Act (PPACA).
Erin Shields, director of communications for health issues at the U.S. Department of Health and Human Services (HHS), would say only that the office was being “reduced.”
Shields made the comment after Bob Yee, the actuary for the CLASS Act office, told friends in an e-mail he had lost his job effective Friday.
Yee said in an interview that the 9 members of the CLASS Act unit were told last Thursday that they were being reassigned effective Friday. Yee said he is leaving because he is an actuary and there is no comparable position for him to go to.
Shields said that the office is not closing and that HHS is continuing its analysis of the CLASS Act program.
“As we have said in the past, it is an open question whether the program will be implemented,” Shields said. “A CLASS program will only be implemented if it is fiscally solvent, self-sustaining, and consistent with the statute.”
The CLASS Act provision in PPACA -- a provision strongly supported by the late Sen. Edward Kennedy, D-Mass. -- is supposed to create a national, voluntary insurance program that workers would use to buy LTC protection at the worksite.
The office responsible for implementing the CLASS Act provision was created in January and has been headed by Kathy Greenlee, assistant HHS secretary for aging.
PPACA calls for HHS Secretary Kathleen Sebelius to define the CLASS benefit by October 2012.
To view the article in its entirety click here.
Erin Shields, director of communications for health issues at the U.S. Department of Health and Human Services (HHS), would say only that the office was being “reduced.”
Shields made the comment after Bob Yee, the actuary for the CLASS Act office, told friends in an e-mail he had lost his job effective Friday.
Yee said in an interview that the 9 members of the CLASS Act unit were told last Thursday that they were being reassigned effective Friday. Yee said he is leaving because he is an actuary and there is no comparable position for him to go to.
Shields said that the office is not closing and that HHS is continuing its analysis of the CLASS Act program.
“As we have said in the past, it is an open question whether the program will be implemented,” Shields said. “A CLASS program will only be implemented if it is fiscally solvent, self-sustaining, and consistent with the statute.”
The CLASS Act provision in PPACA -- a provision strongly supported by the late Sen. Edward Kennedy, D-Mass. -- is supposed to create a national, voluntary insurance program that workers would use to buy LTC protection at the worksite.
The office responsible for implementing the CLASS Act provision was created in January and has been headed by Kathy Greenlee, assistant HHS secretary for aging.
PPACA calls for HHS Secretary Kathleen Sebelius to define the CLASS benefit by October 2012.
To view the article in its entirety click here.
Wednesday, September 14, 2011
Judge Invalidates Health-Care Act’s Insurance-Buying Mandate
Sept. 13 (Bloomberg) -- The requirement in the 2010 health- care law that most Americans buy insurance or pay a fine is unconstitutional, a federal judge in Pennsylvania ruled.
U.S. District Judge Christopher C. Conner in Harrisburg today said Congress exceeded its powers under the federal Constitution when it included in the act President Barack Obama signed last year the provision requiring almost all Americans to have medical insurance starting in 2014.
“The federal government,” Conner said, “is one of limited enumerated powers, and Congress’s efforts to remedy the ailing health-care and health-insurance markets must fit squarely within the boundaries of those powers.”
Three federal appeals courts have weighed in on the issue since June 29. A Cincinnati three-judge panel backed the provision 2-1, while one in Atlanta rejected it by the same vote. The U.S. appeals court in Richmond on Sept. 8 declined to rule on two separate challenges, citing jurisdictional grounds.
The Harrisburg ruling, if appealed, would be heard by the U.S. Court of Appeals in Philadelphia, which hasn’t yet ruled on the merits of the Patient Protection and Affordable Care Act.
To view the entire article click here.
U.S. District Judge Christopher C. Conner in Harrisburg today said Congress exceeded its powers under the federal Constitution when it included in the act President Barack Obama signed last year the provision requiring almost all Americans to have medical insurance starting in 2014.
“The federal government,” Conner said, “is one of limited enumerated powers, and Congress’s efforts to remedy the ailing health-care and health-insurance markets must fit squarely within the boundaries of those powers.”
Three federal appeals courts have weighed in on the issue since June 29. A Cincinnati three-judge panel backed the provision 2-1, while one in Atlanta rejected it by the same vote. The U.S. appeals court in Richmond on Sept. 8 declined to rule on two separate challenges, citing jurisdictional grounds.
The Harrisburg ruling, if appealed, would be heard by the U.S. Court of Appeals in Philadelphia, which hasn’t yet ruled on the merits of the Patient Protection and Affordable Care Act.
To view the entire article click here.
IRS proposes safe harbor for health care plan affordability test
WASHINGTON—A new Internal Revenue Service proposal would make it easier for employers to determine if their health care plans are “affordable” and exempt from a stiff financial penalty mandated by the health care reform law.
Under the law, starting in 2014, employers are liable for an annual $3,000-per-employee penalty for employees whose required health insurance premium contribution for single coverage exceeds 9.5% of family income and the employees are eligible for federal premium subsidies to buy coverage through state insurance exchanges.
Following up on a promise made in August, the IRS on Tuesday asked for public comment on a proposed safe harbor in which coverage would be considered affordable as long as the premium contribution for single coverage did not exceed 9.5% of an employee's W-2 wages.
‘More workable, practical'
“By allowing employers to base their affordability calculations on each employee's W-2 wages (which employers know) instead of each employee's household income (which employers generally would not know), the safe harbor could provide a more workable and practical method for measuring the affordability of an employer's coverage,” the IRS said in Notice 2011-73.
“This will work very well for employers. It is a real positive for employers,” said Rich Stover, a principal with Buck Consultants L.L.C. in Secaucus, N.J.
To qualify for the safe harbor, an employer would have to meet certain requirements, including offering full-time employees the opportunity to enroll in a qualified employer-sponsored plan and that the required employee premium contribution for individual coverage in an employer's lowest-cost plan available to the employee not exceed 9.5% of the employee's W-2 wages.
Determined by employer
Application of the safe harbor would be determined at the end of a calendar year and on an employee-by-employee basis.
“The employer would determine whether it met the proposed affordability safe harbor for 2014 for an employee by looking at that employee’s W-2 wages for 2014 and comparing 9.5% of that amount to the employee’s 2014 premium contribution,” the IRS said.
To view the entire artcile click here.
Under the law, starting in 2014, employers are liable for an annual $3,000-per-employee penalty for employees whose required health insurance premium contribution for single coverage exceeds 9.5% of family income and the employees are eligible for federal premium subsidies to buy coverage through state insurance exchanges.
Following up on a promise made in August, the IRS on Tuesday asked for public comment on a proposed safe harbor in which coverage would be considered affordable as long as the premium contribution for single coverage did not exceed 9.5% of an employee's W-2 wages.
‘More workable, practical'
“By allowing employers to base their affordability calculations on each employee's W-2 wages (which employers know) instead of each employee's household income (which employers generally would not know), the safe harbor could provide a more workable and practical method for measuring the affordability of an employer's coverage,” the IRS said in Notice 2011-73.
“This will work very well for employers. It is a real positive for employers,” said Rich Stover, a principal with Buck Consultants L.L.C. in Secaucus, N.J.
To qualify for the safe harbor, an employer would have to meet certain requirements, including offering full-time employees the opportunity to enroll in a qualified employer-sponsored plan and that the required employee premium contribution for individual coverage in an employer's lowest-cost plan available to the employee not exceed 9.5% of the employee's W-2 wages.
Determined by employer
Application of the safe harbor would be determined at the end of a calendar year and on an employee-by-employee basis.
“The employer would determine whether it met the proposed affordability safe harbor for 2014 for an employee by looking at that employee’s W-2 wages for 2014 and comparing 9.5% of that amount to the employee’s 2014 premium contribution,” the IRS said.
To view the entire artcile click here.
Thursday, September 8, 2011
Court tosses Virginia challenge to health care law
RICHMOND, Va. (Reuters)—A U.S. appeals court handed President Barack Obama a victory Thursday, ruling against challenges by the state of Virginia and others seeking to invalidate the health care reform law as unconstitutional.
The 4th U.S. Court of Appeals in Richmond, Va., overturned a lower court judge who had ruled the federal government could not compel people to buy health insurance or face paying a penalty. This is known as the individual mandate and takes effect in 2014.
Virginia had contended this provision conflicted with a state statute, giving it standing to challenge the federal law. But the appeals court found that Virginia did not have the right to challenge it and overturned the decision.
One day after Congress passed the federal health care overhaul in March 2010, Virginia signed into law a measure aimed at protecting its residents from the federal law. But the appeals court said that was merely a declaration and did not trump the federal government's authority.
The appeals court did not address Virginia's challenge to whether the mandate, due to take effect in 2014, was constitutional.
In a separate ruling, the appeals court ordered another lawsuit against the health care law, which targeted the penalty imposed for those who do not purchase insurance, be dismissed because the penalty has yet to be imposed.
It was the second major victory at the appellate level for the White House in a case that will likely be heard by the U.S. Supreme Court during the 2011-12 term that begins next month.
President Obama, a Democrat, pressed for the legislation to be passed to help stem the soaring costs of health care services, but rival Republicans have pushed to undo it in the courts, in state legislatures and in the U.S. Congress.
The issue is expected to dominate the November 2012 elections for president and Congress.
The decision follows a similar one in late June by the U.S. Court of Appeals for the 6th Circuit in Cincinnati that upheld the so-called individual mandate by ruling that Congress had the power to require Americans to buy health insurance.
But it contrasts with one by the 11th Circuit in August that ruled against the individual mandate requirement in a challenge brought by 26 states.
Those conflicting decisions likely ensure that the Supreme Court, the country's highest court, will have to step in to resolve the differences
The 4th U.S. Court of Appeals in Richmond, Va., overturned a lower court judge who had ruled the federal government could not compel people to buy health insurance or face paying a penalty. This is known as the individual mandate and takes effect in 2014.
Virginia had contended this provision conflicted with a state statute, giving it standing to challenge the federal law. But the appeals court found that Virginia did not have the right to challenge it and overturned the decision.
One day after Congress passed the federal health care overhaul in March 2010, Virginia signed into law a measure aimed at protecting its residents from the federal law. But the appeals court said that was merely a declaration and did not trump the federal government's authority.
The appeals court did not address Virginia's challenge to whether the mandate, due to take effect in 2014, was constitutional.
In a separate ruling, the appeals court ordered another lawsuit against the health care law, which targeted the penalty imposed for those who do not purchase insurance, be dismissed because the penalty has yet to be imposed.
It was the second major victory at the appellate level for the White House in a case that will likely be heard by the U.S. Supreme Court during the 2011-12 term that begins next month.
President Obama, a Democrat, pressed for the legislation to be passed to help stem the soaring costs of health care services, but rival Republicans have pushed to undo it in the courts, in state legislatures and in the U.S. Congress.
The issue is expected to dominate the November 2012 elections for president and Congress.
The decision follows a similar one in late June by the U.S. Court of Appeals for the 6th Circuit in Cincinnati that upheld the so-called individual mandate by ruling that Congress had the power to require Americans to buy health insurance.
But it contrasts with one by the 11th Circuit in August that ruled against the individual mandate requirement in a challenge brought by 26 states.
Those conflicting decisions likely ensure that the Supreme Court, the country's highest court, will have to step in to resolve the differences
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