POLICY BRIEFINGS


Health Reform Law Given Positive Marks by Administration


U.S. Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell used a news conference to extol what she said is the expanded coverage (reducing the percentage of uninsured by 26%) and the lowering of health-care costs resulting from the passage of the Patient Protection and Affordable Care Act (PPACA). In this regard, the Centers for Medicare and Medicaid Services (CMS) also reported that almost eight million individuals enrolled in Medicaid or CHIP from October 1, 2013 through this July, thus bringing the total enrollment up to 67 million persons. The Secretary reported that hospital uncompensated care costs are expected to decrease by about $5.7 billion this year because of the expansion in health coverage. Also on the positive side, HHS reported that there will be a 25% increase in the number of health insurers who will participate in PPACA health insurance exchanges in 2015. Nonetheless, Secretary Burwell admitted that only 7.3 million individuals enrolled under HeatlhCare.gov actually paid their premiums, a reduction from the 8 million coverage figure often touted by the President as an indication of the law’s success. She said that HHS is prioritizing its implementation strategy moving forward by making the necessary corrections to HealthCare.gov, cleaning up the back-end functionality of the system with insurers and adding functionality for renewing and enrolling in coverage. However, she remained noncommittal on the level of improvement that will be completed when open enrollment begins October 1st as well as the number of individuals who will be successfully enrolled in the coming fiscal year.


Health Reform Law Failings Cited


The HHS Office of Inspector General (OIG) issued the first of several coming reports on the extent to which information security controls have been implemented under HealthCare.gov and several state exchanges in order for them to meet relevant federal requirements and guidelines. The report found that the websites and databases in the federal exchange and some state health insurance exchanges are still vulnerable to attack, putting personally identifiable information at risk. The OIG said CMS must improve security by, among other things: implementing an effective enterprise scanning tool to test for website vulnerabilities; and detecting and defending against website vulnerability scanning and simulated cyber-attacks directed at HealthCare.gov. In another report released by the Government Accountability Office (GAO), Patient Protection and Affordable Care Act: Procedures for Reporting Certain Financial Management Information Should Be Improved, the agency was unable to consistently verify the reliability of most of the data it received from CMS regarding the financial resources used to implement the private health insurance and marketplace provisions of the PPACA. The report was issued in response to a request by House Ways and Means Committee Chairman Dave Camp (R-MI) and Subcommittee on Oversight Chairman Charles Boustany (R-LA).


Administration Receives Win from Court in Challenges to PPACA


The U.S. Court of Appeals for the Seventh Circuit issued a ruling that upheld a lower court’s decision that dismissed a lawsuit challenging the Internal Revenue Service’s (IRS) regulation that delayed enforcement of the PPACA’s employer mandate (see Ass’n of Am. Physicians & Surgeons, Inc. v. Koskinen). The court held that the plaintiffs, Dr. Robert McQueeney and the Association of American Physicians and Surgeons Inc., did not have standing to assert claims that the agency had violated the separation of powers doctrine or the 10th Amendment by delaying the enforcement of the provision.


HHS/CDC Grants to Prevent Chronic Disease/Treat Mental Disorders


HHS announced that the CDC will make 193 grants awards totaling almost $212 million to the states and DC to help reduce rates of death and disability due to tobacco use, obesity, diabetes, heart disease and stroke. The agencies said that these causes account for seven out of 10 deaths among Americans each year and for over 80% of the $2.7 trillion national medical care tab. HHS also said that $48 million in “Now is the Time” grants will be made to fund Project AWARE (Advancing Wellness and Resilience in Education) efforts to support teachers, schools and communities in responding to mental health issues among youth, creating safe and secure schools and promoting the mental health of students. Another $34 million will be awarded for use in training over 4,000 new mental health providers who treat children, adolescents and young adults.



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