On Monday, the Supreme Court agreed to hear a joint filing by 26 states, led by Florida, that challenges Obamacare. Five and a half hours of oral arguments are scheduled, and they will broach the subject of the constitutionality of the law’s key provision, the “individual mandate”, and whether the entire law with its 450 sections must be scrapped if it is proved to be unconstitutional. The justices also announced that they will also consider a challenge to what many consider an even more central provision of the statute, the extension of Medicaid to cover a greater number of the poor. Individual states provide part of Medicaid’s funding, and they say the expansion amounts to an unconstitutional coercion of state governments. Joining Florida in the challenge are Alabama, Alaska, Arizona, Colorado, Georgia, Idaho, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming. Virginia and Oklahoma have filed separate challenges, along with other groups and individuals opposed to the law. Friday, the Supreme Court announced two veteran Washington, D.C., attorneys, H. Bartow Farr III and Robert Long will be arguing the health care case. Long, a partner at Covington & Burling, will argue that lawsuits challenging the insurance purchase requirement, a provision known as the individual mandate, are barred because the penalty has yet to be imposed. … Farr, a partner at Farr & Taranto, will argue that if government cannot require people to buy health insurance, all other provisions of the law can go into effect (Vicini, 11/18).
Last Wednesday, health care reform took a step in the right direction when the House unanimously voted 422-0 to undo the health care reform provision allowing some individuals of middle class status to qualify for Medicaid. This is the most substantial change to Obamacare since the repeal of 1099 reporting requirements, and it is fully supported by the Obama Administration.
The subject of Medicare’s physician payment system was also approach Wednesday when Rep. Allyson Schwartz (D-Pa.) sent the deficit-cutting supercommittee a detailed proposal to overhaul the current system. The proposal outlined a 2.5 percent annual bump in pay for generalists in hopes to attract more medical students to primary care, and for specialists, a flat payments in 2012 with an annual increase of 0.5 percent from 2013 through 2016. This bill was proposed to replace the currently scheduled 27.4% cut in Medicare reimbursements to be implemented on Jan 1st. This cut has been postponed by temporary patched for years, and Schwartz’s plan would save money in comparison to implementing another patch. Her plan also calls for reimbursement based on coordination and quality of care rather than the standard fee for service, and a gradual decrease in payments start with 2% in 2018, 3% in 2019, 4% in 2020 5% in 2021.
An exemption for medical plans sold to Americans overseas was requested Wednesday by four health insurers led by Cigna Corp. (CI). If the request is denied, the insurers threaten to move the management of the plans to offshore locations, which would lead to the loss of about 1,100 U.S. jobs. Fifteen members of Congress signed a letter detailing this threat to Health and Human Services Secretary Kathleen Sebelius, and they ask for quick action to save the jobs, almost half of which would be at Cigna’s international unit in Claymont, Delaware.
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