Health Legislation in the Senate and the House

The Senate passed and sent to the President for his signature the bill S. 1545 (PEPFAR Stewardship and Oversight Act of 2013), legislation that extends for five years the President’s emergency plan for AIDS relief (PEPFAR). After Senate passage, the House passed and sent to the President for his signature the bill H.R. 3204 (the Drug Quality and Security Act), legislation designed to give the FDA authority to improve the safety of drug compounding and the drug supply chain (by means of federal track-and-trace provisions that preempt state laws). The House Energy and Commerce Subcommittee on Health also held hearings on the following bills: H.R. 610, legislation which establishes a tick-borne disease advisory committee; H.R. 2703, legislation that gives community health center health professionals federal liability protection; H.R. 669, legislation authorizing the Centers for Disease Control and Prevention (CDC) to provide grants to states to improve Sudden Unexpected Infant Death (SUID) and Sudden Unexplained Death in Childhood (SUDC) investigations; H.R. 1281, legislation reauthorizing grants related to newborn screening for genetic disorders; H.R. 1098, legislation reauthorizing CDC grants related to reducing traumatic brain injuries; H.R. 3527, legislation reauthorizing the national poison control hotline and related grants; and H.R. 3528, legislation reauthorizing the National All Schedules Prescription Electronic Reporting (NASPER) program that encourages states to adopt controlled drug monitoring systems.

Punch and Counterpunch on PPACA

In addition to this week’s oversight hearings, House Republicans are ramping up their anti-Obamacare playbook to highlight the problems individuals are experiencing with the health law. Democrats have responded with their own message which cites Patient Protection and Affordable Care Act (PPACA) success stories. Republican members of the House Ways and Means Committee also sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius requesting information on whether the Secretary has “certified” under the PPACA that the subsidy verification process is working properly. They said they doubt this is the case and want to know when the Secretary will inform Congress either way. They said that eligible individuals need to know whether they will actually get their subsidies beginning on January 1, 2014. Also, ten Senate Republicans, including Senate Minority Leader Mitch McConnell (R-KY), introduced legislation to protect self-insured employers and plans from being kept from buying “stop-loss” insurance as a result of federal regulations. Senator John Thune (R-SD) also introduced legislation, S. 1724, which would prevent HHS from exempting Taft-Hartley union-negotiated multiemployer health plans from having to pay the PPACA’s reinsurance fees (regulations indicated that such an exemption would be soon promulgated for self-insured, self-administered plans). Touting the positive effects of the PPACA, the White House Council of Economic Advisers released a report stating that the lower than average 1.3% increase in real per capital health spending over the last three years may be partially attributable to the provisions of the health law.

HHS Announces Relief from PPACA Deadlines

Because of the problems individuals are having in accessing the HealthCare.gov website to enroll for health coverage, HHS announced that persons enrolling by December 23 (previously December 15) will have their coverage begin on January 1, 2014. The White House press spokesman also confirmed that the 2015 open enrollment period will be pushed back to November 15, 2014 from October 15, 2014 to give insurers more time to set their 2015 rates based on the claims experience of those enrolling as late as March 2014. Republicans were quick to point out that the new enrollment period will begin after the 2014 mid-term elections, thus delaying the disclosure of possible rate increases before the election. The move will also shorten open enrollment to two months. The HealthCare.gov consultant, Jeffrey Zients, also announced that the website’s capacity should increase from 25,000 users to 50,000 by November 30th. CMS also said that HealthCare.gov has been improved to allow insurers to process their “834” eligibility verification forms faster. To better address potential enrollee needs to obtain health insurance coverage, CMS said that efforts are underway to allow health insurers to directly enroll participants through their own health plan websites. CMS also issued guidance that includes standard notice requirements for insurers who elect to continue offering non-PPACA compliant health plans pursuant to the President’s transitional relief for individuals and small businesses receiving cancellation notices from their insurers. Insurers must tell policyholders what PPACA-mandated benefits are not included in their old plans and what other options are available through online marketplaces, including potential tax credits.

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