Top 5 Headlines in Health Reform

BY Sarah Clune  May 6, 2011 at 5:56 PM EDT

Chairman of the House Ways and Means Committee, Rep. Dave Camp (R-Mich.) speaks to reporters on Thursday at an event hosted by Health Affairs

Here’s a roundup of what’s been happening in health reform this week:

MEDICARE OVERHAUL: OUT OF BUDGET TALKS?

Republican lawmakers signaled this week they may back away from overhauling Medicare – a centerpiece of their budget plan.

On Thursday, the chairman of the House Ways and Means Committee, Rep. Dave Camp, R-Mich., said the opposition from Democrats made it pointless to proceed. “I’m not interested in talking about whether the House is going to pass a bill that the Senate shows no interest in,” he told reporters at the National Press Club, adding “I’m not interested in laying down more markers. I am interested in solutions.”

The Washington Post reported Democrats were encouraged by the news, and Rep. Chris Van Hollen, D-Md., seized upon the opportunity for “common ground.”

Both parties still face the task of reigning in the national debt – but big policy changes are likely to remain off the table, according to the The New York Times:

But given the parties’ differences and the short time frame for negotiations before Congress must increase the debt limit, both sides have indicated that any compromise is likely to be based less on specific policy changes than on proposals setting deficit-reduction targets for coming years. Those targets would be combined with triggers to make automatic cuts in spending — and tax increases, in Democrats’ view — if the targets are exceeded.

Another round of debt reduction talks is scheduled for Tuesday.

RULE TO DISCOURAGE CUTS TO MEDICAID PROVIDERS

Roughly half of the 32 million Americans who’ll get health insurance in 2014 will be joining the Medicaid rolls, at a time when states are faced with crippling budget deficits. (See our graphic of Medicaid State spending vs deficits here.)

This week, the Obama administration proposed a new rule that would make it much more difficult for states to cut Medicaid payments to doctors and hospitals.

According to the New York Times,

“The proposed rule generally prevents states from cutting Medicaid payments to providers unless they can show that Medicaid recipients will have “sufficient access” to care after the cuts.

“Regardless of whether they want to cut payment rates, states must continually monitor Medicaid recipients’ access to care and develop plans to fix any problems they discover, the rule says.”

Medicaid reimbursements are typically lower than what Medicare and private insurance pays, and recipients around the country find it difficult to find doctors who will take them.

HOUSE VOTES TO REPEAL FUNDING FOR EXCHANGES

As the NewsHour reported, the House voted to repeal funding aimed at helping states build their health exchanges.

The exchanges are critical to the new law’s plan to expand coverage to 32 million Americans. Each state is responsible for designing its own exchange, where individuals and small businesses can compare insurance plans and purchase them directly from the insurer. If a state does not set up an exchange, the federal government is required to do so.

It also signaled a new Republican strategy, according to Politico:

“Republicans insist the health care repeal effort hasn’t jumped the shark — but even they admit the bills they’re pushing through the House Tuesday aren’t exactly the biggest repeal votes they’ve taken.

“The bills are getting smaller and narrower — going after shrinking slices of President Barack Obama’s health care law, rather than the whole thing. The main one on Tuesday’s agenda, which passed the House 238-183, repeals the mandatory funding for the state-based health insurance exchanges. The other, which is expected to pass Wednesday, would get rid of the mandatory funds for building school-based health centers.”

YOUNG ADULTS FLOCK TO PARENTS’ INSURANCE

Hundreds of thousands of young adults are taking advantage of the new health law provision that allows them to stay on their parents insurance until age 26.
According to Kaiser Health News:

WellPoint, the nation’s largest publicly traded health insurer with 34 million customers, said the dependent provision was responsible for adding 280,000 new members. That was about one third its total enrollment growth in the first three months of 2011.

Others large insurers said they have added tens of thousands of young adults. Aetna, for example, added fewer than 100,000; Kaiser Permanente, about 90,000; Highmark Inc., about 72,000; Health Care Service Corp., about 82,000; Blue Shield of California, about 22,000, and United Healthcare, about 13,000.

The provision became law in September, and mandates health insurers offer coverage to enrollee’s children, until the age of 26.

The U.S. Health and Human Services Department estimated that about 1.2 million young adults would sign up for coverage in 2011. But initial estimates show that number could be higher.

ALL EYES ON VIRGINIA

The legal battle over the constitutionality of the new healthcare reform law shifts back to Virginia on Tuesday. Oral arguments are scheduled to begin at the The US Court of Appeals for the Fourth Circuit in Richmond.

USA Today’s Joan Biskupic previews the day:

“The U.S. Court of Appeals for the 4th Circuit will consider two cases testing the sweeping law that requires people to buy health insurance by 2014 or face a tax penalty. In one of those two cases, a trial judge declared that mandate, the linchpin provision of the 2010 health-care law, unconstitutional. In the other case, a judge upheld it.

“Competing arguments from the Obama administration and its challengers, which have come into focus as lower courts nationwide have reviewed the law extending insurance to 32 million Americans, will now play out before the highest court to date — one that brings the case closer to its likely destination, the U.S. Supreme Court.”

Find more coverage on our health reform page.