Supreme Court to Consider Constitutionality of PPACA

The U.S. Supreme Court announced that it will hear oral arguments on the U.S. Court of Appeals for the Eleventh Circuit’s decision that ruled the PPACA individual mandate is unconstitutional and that the Medicaid provisions did not violate the constitution.  Opening briefs are due by December 29 and opposing briefs by January 30, 2012.  The five and one-half hours of argument are likely to be heard during the last two weeks in March next year.  The constitutionality of the individual mandate will be considered in two hours of debate; the issue of whether the Anti-Injunction Act bars consideration of this former matter until penalties are collected in 2014 will take another hour; the issue of whether the entire statute should be held null and void, because the PPACA lacks a “severance” clause will take 1.5 hours; and the issue of whether the Act’s Medicaid provisions are coercive and unconstitutional will take up another hour of the court’s time.  Because the AIA and the severability provisions were not addressed by the plaintiffs in the Eleventh Circuit case--the NFIB, Florida and 25 other states, and two individuals--the court will appoint special lawyers to address these questions.  The court is expected to release its decision by the end of next June.  If the court determines that the AIA bars court jurisdiction until a penalty is assessed, the PPACA would proceed as intended until 2014 when the issue is ripe for court consideration.

Another PPACA Provision Repealed

On a unanimous vote, the House passed the Senate-modified bill, H.R. 674, legislation which repeals the PPACA provision which requires federal, state, and local governments to withhold 3% from payments for goods and services to vendors.  The $11 billion cost is offset by modifying the PPACA provision that defines income for determining eligibility for subsidies made available to participants under health insurance exchanges, Medicaid and the SCHIP program.  The bill, which the President is expected to sign into law, also provides tax incentives for hiring short-term and long-term unemployed veterans.

Grants under Health Care Innovation Challenge

HHS announced that the Center for Medicare and Medicaid Innovation (CMMI) will award up to $1 billion in PPACA grants to applicants who can rapidly implement the most compelling new ideas to deliver better health, improved care, and lower costs to beneficiaries enrolled in Medicare, Medicaid and SCHIP, particularly those with the highest health care needs.  Awards of $1 million to $30 million will be granted over three years.  Senator Orrin Hatch and other Senate Finance Committee members have expressed concern about the costs of the program and have requested more information and analysis from HHS and the GAO.

MACPAC Sets Sight on Managed Care

The Medicaid and CHIP Payment and Access Commission (MACPAC) announced that a priority for the commission will be to focus on new directions for providing access to Medicaid for the disabled and evolving models for providing Medicaid services through managed care.  The commission will also look at access to primary care physicians under Medicaid as the program expands to cover more individuals under the PPACA.

Antibiotic Tracking System

The CDC announced that it will launch a new antibiotic monitoring system as part of its “National Healthcare Safety Network.”  Hospitals that already submit information to the NHSN can use the new system by electronically sending pharmacy data from their drug administration records.

CLASS Act Repeal on the Move in House

The House Energy and Commerce Subcommittee on Health voice voted H.R. 1173 to send the bill to full committee in an effort to have the House vote this year to repeal of the PPACA long-term care CLASS Act.

December 31, 1969: | Page 1 Page 2 Page 3



 -  2018