Health Reform Watch: In Courts and Congress, Health Reform Faces Challengers

The health reform law faced major challenges this week in the courts and in Congress. The big news of came Monday in Florida, when U.S. District Judge Roger Vinson became the second judge to declare the law’s individual mandate unconstitutional. The issue will almost certainly be decided by the Supreme Court, but in the wake of the ruling, we examined the increasing chatter about whether policymakers need to work on a “backup plan” to the mandate.

Meanwhile, on Wednesday, Senate Republicans failed to pass a bill that would have repealed the entire law. The bill failed, as expected, along partisan lines in the Democratically-controlled Senate.

1099 Repeal Passes in Senate

Even as the repeal amendment failed along partisan lines in the Senate, one smaller repeal measure passed with bipartisan support. Senators voted 81-17 to overturn an provision of the law that would have increased tax reporting requirements for small businesses. The move wasn’t a surprise: President Obama and Democratic leaders had said the measure needed “tweaking,” and in his State of the Union address last week, the president had called it a “flaw in the legislation that has placed an unnecessary bookkeeping burden on small businesses.”

In Other Legislative News…

Meanwhile, Republican Senators continued to offer bills that aim to chip away at the underpinnings of the law and force Senate votes on some of the law’s most controversial provisions. On Tuesday, Sen. Lindsey Graham, R-S.C., and Sen. John Barrasso, R-Wyo., introduced a bill that would let states opt out of enforcing the bill’s individual mandate and the employer mandate.

And on Friday, Sen. Kay Bailey Hutchison, R-Tex., introduced a bill that would stop further implementation of the health reform law until a final judicial ruling decides the law’s constitutionality.

As Medicaid Crisis Deepens, HHS Offers Advice, But No Waivers

States facing severe budget crunches next year are considering slashing Medicaid services, and 29 Republican governors have asked Health and Human Services Secretary Kathleen Sebelius to waive a requirement in the health reform law that prevents them from placing new restrictions on Medicaid eligibility. On Thursday, Sebelius sent a letter offering advice to states — including increasing copayments, limiting some non-required benefits, and reducing Medicaid fraud. She did not, however, give an answer to the waiver request, saying her office was still reviewing the issues involved.

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