MHA Federalist

Health-care case brings fight over which Supreme Court justices should decide it

Just a little more than an hour after some House Democrats recently demanded an inquiry into Supreme Court Justice Clarence Thomas’s ethics, Senate Republicans stepped up the pressure on Justice Elena Kagan to take herself out of the court’s decision on the health-care reform act.

The process repeated itself a few days later. House Judiciary Committee Chairman Lamar Smith (R-Tex.) called for the release of more documents about Kagan’s role as President Obama’s solicitor general; the liberal group People for the American Way came out with another broadside against Thomas.

Read the full story from Robert Barnes in the Washington Post here.

House approves change to ACA income definition

The U.S. House of Representatives on Nov. 16 passed legislation (H.R. 674) tightening the definition of modified adjusted gross income used to determine eligibility for subsidies, Medicaid and the Children's Health Insurance Program under the Patient Protection and Affordable Care Act. The bill adds the non-taxable portion of Social Security benefits to the current definition to prevent middle-income Americans from qualifying for the low-income program.

Other federal assistance programs also include the entire Social Security benefit as income. The president is expected to sign the bill, which passed the Senate last week.

It returned to the House for a final vote because the Senate added provisions to promote the hiring of veterans.

[ via AHA News Now ]

Senate holds hearing on health care delivery reform

The Senate Committee on Health, Education, Labor & Pensions on Nov. 10 held a hearing on the role of health care delivery reform in improving quality and lowering costs. Witnesses included Gary Kaplan, M.D., chairman and CEO of Virginia Mason Health System in Seattle, WA; and Greg Poulsen, senior vice president and chief strategy officer for Intermountain Healthcare in Salt Lake City.

Kaplan described his organization’s efforts to adapt the Toyota Production System to improve health care quality and lower costs, while Poulsen shared his organization’s recommendations for improving quality and avoiding waste. Other witnesses at the hearing included Centers for Medicare & Medicaid Services Deputy Administrator Jonathan Blum; Mark Fendrick, M.D., co-director of the Center for Value-Based Insurance Design; and Rhode Island Health Insurance Commissioner Chris Koller.

Senate approves change to ACA income definition

The Senate on Nov. 10 voted 95-0 to pass legislation (H.R. 674) tightening the definition of modified adjusted gross income used to determine eligibility for subsidies, Medicaid and the Children's Health Insurance Program under the Patient Protection and Affordable Care Act. The bill adds the non-taxable portion of Social Security benefits to the current definition to prevent middle-income Americans from qualifying for the low-income program.

Other federal assistance programs also include the entire Social Security benefit as income. The bill also amends the Internal Revenue Code to repeal the imposition of 3% withholding on certain payments made to government contractors.

The president is expected to sign the bill, which passed the House last month.

[ via AHA News Now ]

Health Law Survives Test in Court of Appeal

Of four appellate court rulings on the Affordable Care Act so far, a federal appeals court in Washington is the third to deal with the law on the merits, and the second that upholds it. Read more from the New York Times here.

AHA recommends changes to proposed rule for state-based exchanges

The American Hospital Association generally supports the proposed flexibility given state-level health insurance exchanges under the Centers for Medicare & Medicaid Services’ proposed rule, but recommends CMS improve the proposed standards for qualified health plans’ provider networks and hold the plans more publicly accountable. In a comment letter, AHA said CMS should expand the rule’s health plan network adequacy requirements, and clarify that states and exchanges can expand the eligibility criteria for essential community providers.

In addition, AHA recommends potential enrollees have access to a qualified health plan’s provider directory, and exchanges notify health care providers when plans do not renew their certification or are decertified. AHA also calls for federal standards to prevent “red-lining” or exclusionary practices by qualified health plans, and recommends state-level exchanges have flexibility to develop criteria regarding the inclusion of essential community providers in qualified health plan provider networks.