During a typical session of Congress, elected officials in both chambers work strenuously to pass legislation that can be sent to the President where it is signed into law. The really heavy lifting often takes place, however, in the executive branch agencies that are responsible for developing the rules and regulations that furnish specific guidance on how a law is to be administered. Whatever finally emerges may be challenged by parties that objected to portions of the legislation when it originally was being considered in Congress. Such disputes then make their way into the judicial sphere.
Although the Affordable Care Act of 2010 (ACA) already is almost a decade old, certain features are as lively and combustible in policy circles as when they initially were proposed. As previously reported in past issues of this newsletter, a prominent example is the case of Texas v. United States wherein that state and 17 other states claim that the ACA’s individual mandate is unconstitutional, which in essence also renders the entire law invalid as well. California and 20 other states are in opposition, along with the U.S. House of Representatives. A federal judge ruled for the plaintiffs and the case subsequently proceeded to the Fifth Circuit Court of Appeals. Assuming the decision is upheld, the next step may involve consideration by the U.S. Supreme Court.
Similar ongoing actions represent additional efforts by Republicans to reverse other components of the ACA. New York is one of 12 states contesting a decision by the Trump Administration to extend access to insurance plans that do not comply with the law. That case currently is poised for oral argument at the D.C. Circuit Court of Appeals. Meanwhile on the campaign trail for the 2020 election, several Democrat candidates for the White House advocate enactment of Medicare for All legislation. It is safe to assume that if such a law ever becomes a reality, many law firms and courthouses will be kept busy in efforts to influence its various provisions to their satisfaction.
Enhancement of Quality Care In Hospitals
The Centers for Medicare & Medicaid Services (CMS) is an example of an executive branch agency that on a regular basis develops guiding principles for implementing various health laws. In August 2019, CMS announced plans to update the quality measurement methodology of the Overall Hospital Quality Star Ratings in 2021. As an interim step, the agency will refresh the Star Ratings using the current methodology in early 2020, ensuring patients have timely access to the most up-to-date hospital quality information while a new methodology is being finalized. The effort represents a major step forward in delivering on President Trump’s recent Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First, which seeks to enhance the ability of patients to choose the health care that is best for them.
Potential Impact Of Reimbursing At Medicare Rates On The Health Insurance Exchanges
As the 2020 U.S. election season unfolds, various options for expanding the Medicare program as a way of addressing gaps in health insurance coverage will be discussed. Medicare for All legislation suggests that present commercial insurance and Medicaid could be replaced by having Medicare pay providers using current Medicare rates. According to an analysis released in August 2019 by Navigant Consulting Inc., doing so could place as many as 55% of rural hospitals, or 1,037 hospitals across 46 states, at high risk of closure. It is estimated that 28% of rural hospitals would be at high risk of closure if only uninsured and current individual market participants shifted to the public option, and that more than half of rural hospitals would face high risk of closure if employers shifted 25% to 55% of their covered workers from commercial coverage to the public option.
If nothing else, this analysis reflects the seriousness of the next election and the importance of paying close attention to what is being proposed. The ACA became law in 2010 without a single Republican in the House or Senate voting in favor of it. Important pieces of social legislation demand bipartisan support. Otherwise, to move forward with new health laws that will affect millions of individuals without the incorporation of the best possible thoughts and ideas by members on both sides of the political aisle is destined to result in increased needless litigation and frustration for all concerned parties.
CHALLENGES INVOLVED IN DOING THE RIGHT THING
Indicates the importance of providing appropriate health care based on accurate diagnoses. Read More
PRESIDENT’S CORNER—ASAHP MEMBER FOCUS
Susan Hanrahan offers her thoughts on the upcoming ASAHP Annual Conference, the Institutional Profile Survey, and other relevant activities of the Association. Read More
ACCELERATED PACE ON CAPITOL HILL
Describes legislation involving the budget, appropriations, the health workforce, along with telehealth and rural health proposed initiatives. Read More
HEALTH REFORM DEVELOPMENTS
Discusses efforts to enhance quality care in hospitals and the potential impact of reimbursing at Medicare rates on the health insurance exchanges. Read More
DEVELOPMENTS IN HIGHER EDUCATION
Summarizes recent activity by the National Advisory Committee on Institutional Quality and Integrity, and repeal of the “Gainful Employment” regulation. Read More
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
Aerobic Activity And Time Spent On Sedentary Behavior Among U.S. Adults
Unintentional Injury And Death Rates In U.S. Rural And Urban Areas
Achieving Better Health Care Integration Of Radiology
Manufacture Of Thread-Based Transistors For A Wide Range Of Health Applications Read More
AVAILABLE RESOURCES ACCESSIBLE ELECTRONICALLY
Investing In Interventions That Address Non-Medical, Health-Related Social Needs
Joint Commission Educational Campaign On Preventing Falls
A New Proposed Fix On Long-Term Care Read More
GAP BETWEEN WHAT IS SAID BY PROVIDERS AND HEARD BY PATIENTS
Mentions how health professionals and patients may not always have the same amount of understanding of statements involving treatability. Read More
ASSESSMENT OF ADULT COMPETENCIES
Refers to data from the National Center for Education Statistics on the topic of adult literacy. Read More