Policy and Medicine

November 13, 2012

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Last week, in another historic Presidential election, Americans reelected President Barack Obama in a decisive victory that will lead to the continued full implementation of the landmark Patient Protection and Affordable Care Act (PPACA or ACA).  The Senate will remain in the control of Democrats, adding several more seats.  The House, however, will remain in Republican control—making it very difficult to overturn or change any piece of the ACA in the upcoming Congressional session.   

Shares in hospitals and other healthcare companies that will benefit from the health reform law jumped last week, but health insurers fell as the law sets limits on their profits and sets mandates on coverage. 

Big pieces of the ACA will be moving forward—including the Medical Loss Ratio (MLR) for insurance companies; coverage of pre-existing conditions; insurance for 26-year-olds; and bans on lifetime limits for insurance coverage.  It also means that the Patient Centered Outcomes and Research Institute (PCORI), which will carry out and offer grants for comparative effectiveness research will continue.   

Importantly for the Senate, there will be four (4) openings on the Senate Finance Committee, which oversees all of the federal dollars spent on health care; one opening on the Senate Health Education Labor and Pensions (HELP) Committee; and the Special Committee on Aging will be losing its Chairman Herb Kohl (D-WI)—who was co-author of the Physician Payment Sunshine Act—which we are watching closely for the final regulations.   

In addition to these policies and changes, Congress and the Obama administration must also face the Physician Payment Fix, or Sustainable Growth Rate (SGR)—which is scheduled to shrink by 29.5 percent on January 1, 2013—and another debt ceiling fight.   

Many health agencies will be affected by the President’s re-election.  Below is a summary of some of the major shifts in personnel, as well as some analysis and projections for how the ACA will continue to be implemented, including dates and important deadlines.  Analysis comes from several news stories, appropriately references, as well as DC based healthcare lobbying firm Thorn Run Partners and law firm SNR Denton’s 34-page report on what’s ahead for the 113th Congress and the Obama Administration over the next four years…

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