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2-24-11 Affordable Care Act Update
February 28, 2011
Amendments to Defund Affordable Care Act in House-Passed Continuing Resolution
The U.S. House of Representatives spent four days last week debating HR1, a continuing resolution (CR) to fund the government through September 30 of this year. The bill cuts federal funding by almost $100 billion, and includes a five percent cut of $1.6 billion to the National Institutes of Health budget. More than 500 amendments were offered to the bill to make even deeper cuts to numerous federal programs. The bill was also used to attempt to block funding to pay federal employees implementing the Affordable Care Act (ACA). Nine amendments to the CR passed that would greatly complicate the law’s implementation, including the development of regulations that will govern the health benefit exchanges and determining the essential benefits package. Amendments also passed that would deny funding to enforce the new medical loss ratio rules.
The House-passed bill was sent to the Senate, where Majority Leader Harry Reid (D-NV) stated that he will not bring the bill to the Senate floor. Senate Democrats do not support the bill’s deep budget cuts, and they strongly oppose the ACA-related amendments. Senator Reid will likely bring a bill to the Senate floor early next week that would fund the government for another two weeks at 2010 fiscal year spending levels. At this time it is unclear how House and Senate leaders will negotiate a final bill that can be passed in both chambers. Read the ACS CAN statement on the HR 1 and coverage from The Washington Post, and NPR’s health blog.
Arizona Medicaid Waiver Decision
The state of Arizona in January requested that the Department of Health and Human Services (HHS) waive the ACA’s maintenance of effort (MOE) requirement for Medicaid that requires the state to sustain current eligibility levels for Medicaid coverage. Last week, HHS Secretary Kathleen Sebelius clarified Arizona’s unusual situation. Arizona’s Medicaid program covers approximately 280,000 people, including approximately 250,000 childless adults, through a Medicaid managed-care demonstration program that expires on September 30. The people covered are not otherwise eligible for Medicaid. HHS does not permit states to terminate coverage for ongoing demonstration programs or terminate programs prior to the date they are already set to expire, but in response to Arizona’s request HHS clarified that the state has the authority to decline to renew the program when it expires and determined that such a move would not violate the MOE provision. The Arizona case appears to be unusual, as there is no information indicating that any other state has significant demonstration programs scheduled to expire this year. Read the Bloomberg story.
Legal Challenges
It's been an eventful week in litigation surrounding the ACA. In Washington, D.C., Judge Gladys Kessler became the third federal district judge to uphold the law, with two others having struck it down. In the decision upholding the law, Judge Kessler called the individual mandate a “critical element in Congress’s comprehensive plan to reduce the spiraling health care costs that this country has experienced and is expected to experience in the future.”
Meanwhile, the recent federal court decision in Florida that invalidated the entire law has caused tremendous confusion about whether the judgment would be suspended while appealed, or whether the 26 states suing in that lawsuit should stop implementation of the law. Late last week, lawyers for the federal government filed motions asking Judge Roger Vinson to clarify his ruling to allow for implementation to continue in all states. Read the Dow Jones story about the government filing and coverage of the states’ response in The Hill.
Once Judge Vinson's decision is clarified, we plan on issuing materials to Society and ACS CAN staff to help explain in greater detail the implications of this ruling and its effect – if any – on state legislation.
New Poll: Americans Confused About Status of Health Care Law
Nearly half of all Americans think the Affordable Care Act has already been repealed or aren’t sure one way or the other, according to a new Kaiser Family Foundation poll out today. The poll shows that 22 percent of Americans think the law has already been repealed and 26 percent are not sure, while 52 percent of Americans correctly believe the law remains in effect.
The monthly tracking poll also measured general sentiments of the law. Overall, 48 percent of respondents disapprove of the law, down from 50 percent last month. Forty-three percent of people polled have favorable opinions of the law, up from 41 percent in January.
To learn more about the poll, read coverage in Politico or read commentary from Drew Altman, the Kaiser Family Foundation’s President and CEO. And remember the Society’s consumer-friendly booklet jointly produced by ACS CAN, the Health Promotions department and Corporate Communications, is a great resource to help staff and volunteers better understand the law. The guide can be viewed online and is also available through Ariba (Item/Catalogue Number 5600.00).
As always, thank you for all you do every day to support laws and policies that help cancer patients and their families