Health Care Reform Update (6-14-2012)
HCR Redux: As the waiting game for the Supreme Court’s final ruling on the Affordable Care Act draws to a close, scenario-planning based on possible outcomes continues in earnest. Whether the Court strikes down the entirety of the law or just parts of it, what will be immediately clear in the aftermath of the decision is that we may be in for Round 2. And, with so many stakeholders involved this time around, it could make us wistful for 2009’s legislative knockdown, drag-out.
Opposition Planning: Not ones to be sitting idly by, Republicans, for their part, are continuing to piece together their own way forward on the other side of this month’s ruling. And, despite the uncertainty surrounding the Court’s final decision, that health care reform will once again take center stage in the national conversation is all but guaranteed, leaving little room for an unprepared response…especially in an election year.
Tangled Web: Meanwhile, an investigation into the behind-the-scenes maneuvers leading up to the Affordable Care Act’s eventual passage continues to call into question the propriety of some of the backdoor deal-making that went into getting the bill signed into law. And, while some see this as nothing more than business-as-usual, others are outraged.
Still Out There: Not to be lost amidst all the political hand-wringing, the on-the-ground reality faced by the states as they continue to implement sweeping provisions of the health care law, chiefly, the expansion of Medicaid mandated under the Affordable Care Act. As detailed in the National Governors Association’s 2012 Fiscal Survey of States, the rise in demand for state services over the past two years leaves states with a combined $146 billion budget gap to reconcile.
Bureaucracy to the Rescue: A report released this week by the Center for American Progress (CAP) calls for, amongst other things, the creation of a new federal office to help streamline the logistics of health care delivery and ease the estimated $361 billion burden ascribed to administrative costs. CAP believes that $40 billion worth of savings could be achieved through better integration, careful coordination, and federal leadership.
Going Up: With the Tuesday release of national health expenditure projections published in Health Affairs, the debate coalesces around whether the forecast indicates a reliable trend in lowered expenditures going forward or portends accelerated increases in spending beginning in 2014, when major provisions of the Affordable Care Act go online. Between 2011 and 2013, health spending in the US is projected to grow at an average rate of 4.0 percent. However, after 2014, that growth is expected to accelerate to 7.4 percent. Regardless, Congressional Budget Office (CBO) projections peg that spending to reach one-fifth of the overall US economy by 2021, $478 billion of which being attributed to the sweeping law.
Whither Price Transparency?: A new study by Consumer Reports draws attention to the general lack of price transparency in health care and the confusion that results for patients when seeking care. However, in what could be seen as a checkbook palliative, a recent survey by NPR found that more Americans have latched onto the idea of shopping around before making health care decisions. This introduction of market-based thinking into an inherently transactional relationship seems to be a growing trend towards practicable solutions.
Troika Plowing Ahead: Irrespective of how the Supreme Court rules this month, a trio of insurers announced their respective intentions to keep in place some of the health care reform law’s sweeping provisions that have already been implemented (like allowing young adults to remain on their parents’ plans). While the announcement provided a rare opportunity for celebratory comity, not to mention political cover, not everyone was convinced.