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While roughly 83% of adults in the United States will visit a health care provider in the next year, an estimated
News
7-28-11 Affordable Care Act Update
August 4, 2011
Federal Update
As the country approaches the deadline for a deal to raise the debt limit, negotiations in Congress seem to be coming to a head. The House and Senate currently have competing plans for increasing the debt limit while still cutting spending. It is worth noting that even with the steep cuts being proposed in both plans, the FY 2012 discretionary budget would still be more than $23 billion higher than the budget passed by the House in May. There are, however, significant differences in the spending cuts in each proposal.
The House plan, authored by Speaker John Boehner (R-OH), would cut spending by $915 billion over the next ten years while increasing the debt limit by $900 billion. This increase in the debt limit would likely require another increase in the debt limit by early next year. The Speaker’s plan would also require cuts to entitlement programs, such as Medicare, Medicaid, and Social Security, in order to secure the next increase in the debt limit.
The House is expected to vote on the Speaker’s plan this evening. Assuming the plan passes the House, the Senate will immediately take it up for a vote but it is not expected that the Senate will pass it.
Assuming the Senate votes down the Speaker’s plan, attention would then turn to the plan proposed by Senate Majority Leader Harry Reid (D-NV). Senator Reid’s plan would cut the budget deficit by $2.2 trillion over the next ten years, while increasing the debt limit by $2.7 trillion. This plan would not require cuts to Medicare, Medicaid, and other entitlement programs. It is unclear whether Senator Reid will be able to secure the 60 votes required in order to advance this plan.
Assuming that neither of the two plans advances, it is unclear at this time what the next step will be to achieving a resolution to this stalemate.
State Update
The number of states that have passed exchange legislation signed by their governor this session remains at 11. Another eight states have passed legislation that keeps the process of creating an exchange moving forward.
In the past week, several states were contacted by the Department of Health and Human Services requesting a medical loss ratio (MLR) waiver. North Dakota’s request for exemption from the provision was rejected, making that state the first to receive a complete denial. The states of Iowa and Kentucky were recently informed that their waiver requests were partially approved. They join Maine, Nevada and New Hampshire as states that have received a waiver or a partial waiver. Waivers do not allow a state to permanently sidestep MLR requirements. However, a waiver does allow a state more time to comply with the MLR provisions in the law.
Litigation Update
As expected, the plaintiffs in the case challenging the constitutionality of ACA's requirement that individuals purchase health insurance by 2014 (the so-called "individual mandate") in the Sixth Circuit U.S. Court of Appeals case has been appealed to the U.S. Supreme Court. There are numerous cases challenging the law, but the Sixth Circuit was the first appeals court to announce its decision in the case of Thomas More Law Center v. Obama. Late last month, the Sixth Circuit upheld the constitutionality of the law, saying that the individual mandate is a permissible exercise of congressional authority under the U.S. constitution. Other appeals courts have also heard arguments in similar lawsuits, but to date none of them have announced decisions. They are expected to do so during July or August, with the expectation that the U.S. Supreme Court would hear either one of the cases or consolidate all of them during its fall 2011 term. If the Supreme Court does accept the case in October, it would likely announce a decision in spring of 2012.
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families
Christopher W. Hansen
President
American Cancer Society Cancer Action Network (ACS CAN)