Health Affairs

Wisconsin Republican Paul Ryan is frequently hailed for his fiscal responsibility and political courage.   After all, the Congressman has now put forward not one but two budget plans that offer “a blueprint for safeguarding America from the perils of debt, doubt and decline” and take on sensitive issues like Medicare.   Ryan seems to have emerged... Read the rest of this entry »

For the second year in a row, Rep. Paul Ryan (R-Wis.) has advanced a comprehensive budget plan that would restructure Medicare and Medicaid, repeal the big-spending portions of the Affordable Care Act (ACA), and ultimately resolve the fiscal crisis facing this country.  Critics react that the Ryan plan would dismantle health care as we know... Read the rest of this entry »

In the design of health insurance exchanges, one key issue is whether exchanges will offer improved value to people buying insurance in the individual and small group markets.  A lot depends on whether the exchanges act as prudent purchasers – making design decisions that keep quality high and costs low.  It appears that many states,... Read the rest of this entry »

On March 16, 2012, the Center on Medicare and Medicaid Services of the Department of Health and Human Services released its final rule on eligibility changes for Medicaid that will take effect under the Affordable Care Act (ACA) on January 1, 2014.  A notice of proposed rulemaking (NPRM)  had been published on August 17, 2011,... Read the rest of this entry »

On March 16, 2012, the Department of Health and Human Services published a final rule on the implementation of the reinsurance, risk adjustment, and risk corridor programs which are to be put in place under the Affordable Care Act (ACA), effective January 1, 2014. HHS also published final (and interim final) rules on Medicaid eligibility... Read the rest of this entry »

On March 12, 2012, the Department of Health and Human Services promulgated final regulations governing the establishment of the American Health Benefit Exchanges.  The exchanges are at the heart of the Affordable Care Act strategy for making health insurance available and affordable to millions of Americans in the individual (nongroup) and small group markets. The... Read the rest of this entry »

How much health spending is sustainable? Charles Roehrig’s post addressing this question heads the list of most-read Health Affairs Blog posts for February. Next on the list is a post contrasting Medicare and commercial insurance by Diane Archer and Theodore Marmor. Also in the top ten are posts by Larry Wolf and Ashish Jha examining... Read the rest of this entry »

On February 22, 2012, the Department of Health and Human Services (HHS) issued two final regulations implementing sections of the Affordable Care Act (ACA). The two regulations effectuate 1) an ACA provision that will offer the states flexibility in implementing key ACA requirements beginning in 2017, and 2) an ACA amendment to a section of... Read the rest of this entry »

Although public and media attention has been focused on the Affordable Care Act litigation pending in the Supreme Court, the Court’s February 22 decision in Douglas v. Independent Living Center is also of great importance.  The decision involved lawsuits brought by Medicaid providers and recipients claiming that California Medicaid payment cuts violated federal law. Medicaid... Read the rest of this entry »

On December 16, 2011, the Department of Health and Human Services issued a bulletin describing the approach that it intended to take to defining the essential health benefits (EHB) that individual (nongroup) and small group plans must cover under the Affordable Care Act.  In that bulletin, HHS indicated that each state will select a benchmark... Read the rest of this entry »

The Affordable Care Act’s state health insurance exchanges for small businesses present a host of opportunities for states now creating them, but they also present design and regulatory challenges that could make or break the success of the program, according to a cluster of articles in the February issue of Health Affairs, released yesterday. The... Read the rest of this entry »

Briefs continue to be filed at a furious pace in the Affordable Care Act Supreme Court litigation.  On January 6, the federal government led off with its brief challenging the decision of the Eleventh Circuit federal court of appeals that the ACA’s minimum coverage requirement (individual mandate) is unconstitutional.  The states and the National Federation... Read the rest of this entry »

At the Colorado Health Care Insider, Louise Norris hosts the latest edition of the Health Wonk Review. Louise includes Sharon Long’s Health Affairs Blog post clarifying the facts about health reform in Massachusetts. Check out Sharon’s post and all the great posts in Louise’s Wonk Review.

Last Thursday’s Republican Presidential Debate in Florida included a lively, but not always accurate, exchange on health reform in Massachusetts.  In particular, Senator Santorum reported that one in four Massachusetts residents were going without needed care because of high costs; he also implied that the share of residents choosing to pay the fine for failing... Read the rest of this entry »

Medicaid, the nation’s largest public health insurance program, provides health coverage for low-income people, or about one in five Americans. The program will also play a central role in expanding insurance coverage under the Affordable Care Act. However, recent concerns about federal budget deficits and the fiscal pressures on states have generated new proposals to... Read the rest of this entry »

Massachusetts’s health reform bill, which provided the template for the federal Affordable Care Act, went into effect in 2006. In a statewide survey taken in 2010, 94.2 percent of the state’s nonelderly (19–64) residents reported being covered, a significant increase over the 86.6 percent estimate of 2006. The survey is reported in a Health Affairs... Read the rest of this entry »

On January 10th, the states filed their latest arguments in their bid to have the ACA’s Medicaid expansion declared an unconstitutional coercion.  Following an effort to piece together a coercion doctrine from dicta found in a handful of Supreme Court cases, the states assert that the “[t]he ACA is Premised on the Understanding that It... Read the rest of this entry »

One of the priorities established in the Affordable Care Act is providing better, more efficient care to the “dual eligibles,” low-income seniors enrolled in both Medicare and Medicaid. AcademyHealth’s 2012 National Health Policy Conference (NHPC) will feature a panel on this topic, which is crucial to the nation’s goal of restraining health care cost growth... Read the rest of this entry »

As every reader knows, the Supreme Court has agreed to consider challenges that have been brought to the constitutionality of two provisions of the Affordable Care Act (ACA) by twenty-six states, the National Federation of Independent Businesses, and individual plaintiffs.  The Court has scheduled the case for five and a half hours of oral arguments... Read the rest of this entry »

What will the Obama Administration’s health policy priorities be in 2012? What ideas will be highest on the agendas of the two parties in Congress? You can hear the answers to these questions February 13-14 in Washington D.C. at the 2012 National Health Policy Conference. The NHPC will include presentations from Health and Human Services... Read the rest of this entry »