Health Care Rundown

March 9, 2011

The 2010 health care law continues to be a focal point for Congress and the administration. With the one year anniversary of its passage approaching, there are several health care reform happenings to highlight.

Defunding Reform

House and Senate Democrats are busy planning and promoting the law’s anniversary later this month by highlighting its benefits and implications for defunding or repealing it. On the other hand, notwithstanding the brief cessation of debate over how to cut the health law’s implementation funding in the recent continuing resolution, Republican members of Congress are pushing ahead with efforts to cut funding in the next continuing resolution and pending budget proposal.

With or without implementation defunding attached, passing another continuing resolution could be problematic in the Senate. Senate Democrats would object to a House passed defunding measure and Senate Republicans would object to any measure without defunding attached. This conundrum could make getting to 60 votes to overcome a filibuster difficult.

The House Energy and Commerce Committee have scheduled what is expected to be a series of hearings that examine the law’s funding in order to identify wasteful spending. Also, the House Education and Workforce Committee’s Subcommittee on Health, Education, Labor, and Pensions is scheduled to hold a hearing March 10 titled, “The Pressures of Rising Costs on Employer Provided Health Care.” Click here to read comments NSBA circulated to subcommittee members and staff.

Essential Health Benefits Package

Meanwhile, the Institute of Medicine (IOM) held their second public meeting the week of Feb. 28 in California to determine the process of establishing the essential health benefits package. In addition to discussing state flexibility, cost-sharing concerns, and the package’s interaction with Medicaid, the panel heard from insurers, state agencies, academics, and others on how to write its methodology. The final IOM report is due September 2011.

Broker/Producer Commissions

The National Association of Insurance Commissioners (NAIC) recently proposed legislative language to address broker/producer commissions under the medical-loss ratio (MLR) regulations, which define the percentage of health insurance premiums insurers must use for medical claims versus administrative expenses. While the MLR regulations classify broker/producer commissions as administrative, the NAIC proposal would classify them in an “other” category, which would put them with taxes and not administrative or medical expenses.

Stay in Lawsuit Against Reform Law

Finally, as has been widely reported, U.S. District Court Judge Roger Vinson March 3 issued a stay of his Jan. 31 ruling that the federal health reform law’s individual mandate is unconstitutional and said the other 26 states involved in the lawsuit should proceed with implementing the overhaul while the Obama administration pursues an appeal in the 11th Circuit. According to the ruling, the United States Department of Justice (DOJ) has until March 10 to file its appeal and must request an expedited appellate review.

NSBA will continue to monitor health care reform initiatives in Congress and elsewhere to ensure progress is made to benefit small-business owners, their employees, and their families. Stay tuned to NSBA’s Health Reform Today and Tomorrow Web site for more news and information as it is made available.